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A pragmatic evaluation of the practicality of diabetes screening for users of serotonin specific reuptake inhibitors (SSRI’s). The paper aims to discuss this issue.

This study audited the response of SSRI-users to personal invitation for diabetes screening. One-third of such patients had been screened during the past year. The remaining 217 patients were invited for fasting blood glucose tests and the improvement in screening rates measured. The rate of positive results was compared to a cohort who received fasting blood glucose screening due to physical risk factors for diabetes.

Specific invitation increased the take-up of screening from 34 to 52 per cent of SSRI-users. Engagement was significantly better when patients could be contacted by telephone rather than letter. The SSRI-using cohort had a greater rate of identified diabetes than a cohort with physical risk factors for diabetes.

SSRI-users are a difficult group to engage in medical screening and an assertive approach is of value. It is likely that the physical care of these patients would be enhanced by the active maintenance of contact by a practice healthcare professional. Screening of SSRI-users for diabetes is justified by both detection rate and the importance of establishing co-morbidity in terms of treatment decisions.

Co-morbidity of diabetes and depression has been observed to result in a poor prognosis for the patient which can be tempered if successful engagement leads to early treatment of both conditions with a more tailored choice of medication and care.

The purpose of this paper is to explore the qualitative relationship between cannabis and the most commonly used antidepressant drugs known as selective serotonin reuptake inhibitor (SSRIs) through the narratives of depressed individuals who have used both drugs at one point during their lifetime. Despite their prevalence, depression, cannabis use, and SSRI use have not been previously studied together through the perspective of those who have experienced them. Using a exploratory approach, this paper investigates and compares the user experiences of these drugs.

Semi-structured interviews were conducted involving participants who were between the ages of 16–59 in the UK and have used both SSRIs and cannabis either simultaneously or at any point in their lives. Five interviews were conducted either via telephone or in person, and the method of analysis was an inductive approach which was inspired by grounded-theory.

While the two drugs were used by participants in order to relieve symptoms of depression, they were used for very different reasons and typically at different stages of their lives. Though participants did not state that the drugs were interchangeable for improving mood, their responses indicated that these drugs were viewed as two alternatives to alleviate symptoms of depression. Participants’ relationships with their doctors also played a crucial role and affected interviewees’ decisions to use either SSRIs or cannabis, as well as perceptions of the medical industry.

This research shows the importance of doctor and patient interactions as they were crucial influences on patients’ decisions related to drugs. Participants’ experiences with SSRI and cannabis were subjective and varied, therefore, the value of personalised treatment (which may or may not include psychotropic drugs) is highlighted. These findings can help health practitioners gain a better understanding of the rationale of depressed patients in choosing treatments and thereby improve healthcare outcomes.

Given that depression is stigmatised, and cannabis use is both illegal and stigmatised, this paper examines the opinions of a difficult to reach population. Previous work involving cannabis, antidepressants and mood-elevating effects is primarily written with a biochemical or medical perspective which paid more focus on the efficacy of these drugs and had less emphasis on the beliefs of the users. This paper highlights the opinions of cannabis and SSRI users regarding these two drugs specifically, which had not been previously explored.

This paper aims to compare the students enrolled to a three-year undergraduate, bachelor degree on Security of Computer Systems and Networks, offered in traditional, classroom fashion as well as online at the University of Milan (Italy). Its main purposes are to estimate the main characteristics of the two different student populations addressed (i.e. online vs classroom students) to understand if an online version of an already existing traditional university degree allows to extend the enrollment of students; and to evaluate the effectiveness of the e-learning approach adopted, comparing performance of the two student populations. The study aims to supply a significant case study, based on a real experience more than 10 years long.

The paper is based on the statistical interpretation of a huge amount of data, collected during the overall life of Sicurezza dei Sistemi e delle Reti Informatiche (SSRI) online, regarding student age, income, grades obtained in exams and after final dissertation and graduation time.

The paper allows to conclude that the online student population has very limited overlap with the classroom one, which means that the online version of an already existing degree can definitely enlarge the student enrollment and reach older students; and a carefully designed e-learning environment allows committed online students to obtain results comparable when not better than the ones of classroom students.

The study refers to a single, specific degree in computer science and technology; thus, it may lack generalizability. Similar experiences in other areas could be useful.

This paper fulfills an identified need to study how e-learning can be successfully applied to already existing traditional university degrees.

Explains how, with the Internet increasingly being used for the conduct of electronic commerce, organizations are now cognizant of the need to control their employees’ usage of the Internet. Little research has been conducted to date into this important concern. Suggests that an Internet acceptable usage policy is one vehicle for providing this control, containing guidelines for employees indicating both acceptable and unacceptable Internet usages. The policy aims to control those employee behaviours and actions which contribute to the incidence and severity of internal and external Internet risks, while enabling employees and the organization to gain maximum business value from the Internet connection. Explores the issues to be considered in the development of an organization’s Internet acceptable usage policy. Uses a case study of a large Australian organization to illustrate the issues. Proposes a set of criteria for an effective Internet acceptable usage policy as a result of this research.

Depressive disorder has been defined by increasingly specific neurophysiological mechanisms and features during the past two decades. At the same time, depression has grown into an epidemic proportion and become a major public health problem. Consequently, the scope of depressive experience and conduct has also widened and the meaning of depression has multiplied and become equivocal. This chapter analyses how this tension is handled in current Western mental health care. The focus of the study is the role of neuroscientific views in mental health reasoning and practice. The empirical case is the mental health discussion in Finland from the late 1980s to the present day. The analysis of the historical change in understandings of depression in Finnish psychiatry and mental health care provides a view of the relevance of neuroscientific models in defining depressive illness and outlining diagnostic and treatment practices. Moreover, the analysis brings forth the relationship of neuroscientific concepts to other ways of defining depression – epidemiology, diagnostic classification, psychodynamic and other psychological theories – within clinical reasoning. A conclusion to be drawn from the analysis of the Finnish case is that neurobiological concepts of depression have only limited influence on the ways in which the disorder is conceived within the practical context of mental health care. It seems that the idea of depression as a multi-factorial disorder remains a good enough conceptual framework for clinical practice. Even the influence of neurosciences on treatment is still somewhat marginal. Within current practices of depression management, it is not the brain that is treated but risks, symptoms, and persons.

The management of individuals with autism spectrum disorders (ASDs) requires a multimodal approach of behavioural, educational and pharmacological treatments. At present, there are no available drugs to treat the core symptoms of ASDs and therefore a wide range of psychotropic medications are used in the management of problems behaviours, co-occurring psychiatric disorders and other associated features. The purpose of this paper is to map the literature on pharmacological treatment in persons with ASD in order to identify those most commonly used, choice criteria, and safety.

A systematic mapping of the recent literature was undertaken on the basis of the following questions: What are the most frequently used psychoactive compounds in ASD? What are the criteria guiding the choice of a specific compound? How effective and safe is every psychoactive drug used in ASD? The literature search was conducted through search engines available on Medline, Medmatrix, NHS Evidence, Web of Science and the Cochrane Library.

Many psychotropic medications have been studied in ASDs, but few have strong evidence to support their use. Most commonly prescribed medications, in order of frequency, are antipsychotics, antidepressants, anticonvulsants and stimulants, many of them without definitive studies guiding their usage. Recent animal studies can be useful models for understanding the common pathogenic pathways leading to ASDs, and have the potential to offer new biologically focused treatment options.

This is a practice review paper applying recent evidence from the literature.

This article provides a review and conceptual comparison between self‐report and performance‐based measures of emotional intelligence. Analyses of reliability, psychometric properties, and various forms of validity lead to the conclusion that self‐report techniques measure a dispositional construct, that may have some predictive validity, but which is highly correlated with personality and independent of intelligence. Although seemingly more valid, performance‐based measures have certain limitations, especially when scored with reference to consensual norms, which leads to problems of skew and restriction of range. Scaling procedures may partially ameliorate these scoring weaknesses. Alternative approaches to scoring, such as expert judgement, also suffer problems since the nature of the requisite expertise is unclear. Use of experimental paradigms for studying individual differences in information‐processing may, however, inform expertise. Other difficulties for performance‐based measures include limited predictive and operational validity, restricting practical utility in organizational settings. Further research appears necessary before tests of E1 are suitable for making real‐life decisions about individuals.

The purpose of this paper is to analyse how novel homicide defences predicated on contemporary neuroscience align with legal insanity.

Doctrinal analysis, systematic investigation of relevant statutes and cases, was used to elucidate how the law of insanity is evolving. Cases represent the first recorded instance of a particular neuroscientific defence. US appellate cases were categorised according to the mechanism of action of neurotransmitter relied upon in court. A case study approach was also used to provide a contextualised understanding of the case outcome in depth.

Findings broadly depict how the employment of expert testimony runs parallel with our contemporary understanding of key neurotransmitters and their function in human behaviour. Generally, medico-legal evidence concerning neuromodulating agents and violent behaviour was inconclusive. However, the outcome of defence strategy may depend on the underlying neurotransmitter involved.

This study shows that as more discoveries are made about the neurobiological underpinnings of human behaviour; this new knowledge will continue to seep into the US court system as innovative defence strategies with varying success. Medical and legal practitioners may gauge the success of a defence depending on the neuromodulating agent.

Many scholars have focused on the role of neuroimaging as neuroscientific evidence and how it is used is shaping US criminal jurisprudence. To the best of the author’s knowledge, no study has incorporated the true origin of neuroscientific evidence as being underpinned by the understanding of neurotransmitters.

Purpose – This chapter explores the changing definition of bipolar disorder, examining how debates within psychiatry actually construct the definition of mental illness, thereby creating the appearance of an emerging epidemic with increasing prevalence.

Method – I review the recent psychiatric and epidemiological research to reveal that the intellectual and scientific debates that occur in the psychological laboratory and in survey research are in fact falsely increasing the figures that show that an epidemic of bipolar is emerging.

Findings – For centuries, bipolar disorder was equated with severe psychosis and had a prevalence rate between 0.4% and 1.6%. As spectrum and subthreshold conceptions of bipolar disorder become established in official psychiatric diagnostic manuals, however, estimates of the prevalence of bipolar spectrum disorders have risen to almost 25%. I demonstrate that nearly all of this increase is a result of changes in the scientific and intellectual definition of bipolar disorders among psychiatric professionals, and that rates of symptoms are not in fact increasing.

Contribution to field – The arbitrariness of diagnostic thresholds naturally leads researchers to argue for lower thresholds. This allows more individuals who were previously considered psychiatrically normal to be reclassified as psychiatrically disordered. Lowering diagnostic thresholds increases the risk of confusing normal elation or sadness with disordered states, increasing the potential of false-positive diagnoses and the false impression of rising rates of disorder.

The purpose of this paper is: first, to consider the reported problems in sexual function caused by psychotropic medication. Second, the complex undertaking of completing an assessment of sexual functioning. Third, the role of the pharmaceutical industry is explored. Finally, implications for future research and practice are suggested.

As a commentary this paper draws on the available literature to synthesise what is already known about the relationship between psychoactive substances and sexual functioning.

The limited literature and lack of research attention given to psychotropic induced sexual dysfunction limits our collective understanding of how many people are affected and in what way.

A greater focus on psychotropic induced sexual dysfunction is needed for people with a dual diagnosis. There has been an over reliance on single case studies and self-reporting. Large scale epidemiological investigation would help understand the extent and nature of the problem more fully. The demographic shift particularly in relation to an ageing population should be considered as psychotropic substances effect individuals in different ways as they grow older.

There is scope for workers to engage more fully in a conversation with clients about their experience of using psychotropic substances and how this has impacted their sexual functioning. The literature suggests that clients want to talk about this issue but staff are unwilling or unable to discuss the topic.

To the authors’ knowledge this is the first paper that draws on the available literature to explore the known and likely implications of psychotropic induced sexual dysfunction for this client group.