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2019

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From Mental Disorder To Shared Understanding: A Non-Categorical Approach To Support Individuals With Distress In Primary Care, Richard Byng, Nora Groos, Christopher Dowrick Jan 2019

From Mental Disorder To Shared Understanding: A Non-Categorical Approach To Support Individuals With Distress In Primary Care, Richard Byng, Nora Groos, Christopher Dowrick

Peninsula Medical School

This article argues that, rather than aiming for a psychiatric diagnosis, generalist professionals such as those working in primary care, as well as in other hospital and community settings, should use a non-diagnostic framework when encountering distress. The conceptual and empirical limitations of the psychiatric diagnostic system and evidence that psychological phenomena are dimensional suggest the need for an alternative approach; one that might also address problems of overdiagnosis and overmedication.1 There are three key problems with the current Diagnostic Statistical Manual (DSM) and International Classification of Diseases (ICD) systems of psychiatric classification. The process can be stigmatising; diagnoses are …

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Gender Incongruence In Children, Adolescents, And Adults: Response To Dr White, M Mccartney, S Bewley, D Clifford, R Byng Jan 2019

Gender Incongruence In Children, Adolescents, And Adults: Response To Dr White, M Mccartney, S Bewley, D Clifford, R Byng

Peninsula Medical School

No abstract provided.

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Teasing Apart The Impact Of Illness And Iq On Functional Neuroimaging Findings In Schizophrenia, S Graham, Tm Oh, V Manning, J Jiang, Ib Yeh, S Kang, Pj Mckenna Jan 2019

Teasing Apart The Impact Of Illness And Iq On Functional Neuroimaging Findings In Schizophrenia, S Graham, Tm Oh, V Manning, J Jiang, Ib Yeh, S Kang, Pj Mckenna

Peninsula Medical School

Schizophrenia is a major psychiatric disorder associated with cognitive impairment. Functional brain imaging (fMRI) studies of schizophrenia patients reveal a complex pattern of brain differences in the prefrontal cortex. Both decreased (hypofrontality) and increased (hyperfrontality) activity have been reported in patients – inconsistencies that this paper argues could be explained by differences in IQ between patients and healthy controls. This study demonstrates a novel method to tease apart IQ and schizophrenia effects on brain activity. Twelve schizophrenia patients were matched to twelve healthy controls matched to patients’ estimated (premorbid) IQ before their illness, and twelve healthy controls matched to patients’ …

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Going To Extremes: The Goldilocks/Lagom Principle And Data Distribution, Henry J. Leese, Thozhukat Sathyapalan, Victoria Allgar, Daniel R. Brison, Roger Sturmey Jan 2019

Going To Extremes: The Goldilocks/Lagom Principle And Data Distribution, Henry J. Leese, Thozhukat Sathyapalan, Victoria Allgar, Daniel R. Brison, Roger Sturmey

Peninsula Medical School

Numerical data in biology and medicine are commonly presented as mean or median with error or confidence limits, to the exclusion of individual values. Analysis of our own and others’ data indicates that this practice risks excluding ‘Goldilocks’ effects in which a biological variable falls within a range between ‘too much’ and ‘too little’ with a region between where its function is ‘just right’; a concept captured by the Swedish term ‘Lagom’. This was confirmed by a narrative search of the literature using the PubMed database, which revealed numerous relationships of biological and clinical phenomena of the Goldilocks/Lagom form including …

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Evaluation Of The Impact Of The Nice Head Injury Guidelines On Inpatient Mortality From Traumatic Brain Injury: An Interrupted Time Series Analysis, Carl Marincowitz, Fiona Lecky, Victoria Allgar, Trevor Sheldon Jan 2019

Evaluation Of The Impact Of The Nice Head Injury Guidelines On Inpatient Mortality From Traumatic Brain Injury: An Interrupted Time Series Analysis, Carl Marincowitz, Fiona Lecky, Victoria Allgar, Trevor Sheldon

Peninsula Medical School

ObjectiveTo evaluate the impact of National Institute for Health and Care Excellence (NICE) head injury guidelines on deaths and hospital admissions caused by traumatic brain injury (TBI).SettingAll hospitals in England between 1998 and 2017.ParticipantsPatients admitted to hospital or who died up to 30 days following hospital admission with International Classification of Diseases (ICD) coding indicating the reason for admission or death was TBI.InterventionAn interrupted time series analysis was conducted with intervention points when each of the three guidelines was introduced. Analysis was stratified by guideline recommendation specific age groups (0–15, 16–64 and 65+).Outcome measuresThe monthly population mortality and admission rates …

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How Data Science Can Advance Mental Health Research, Tc Russ, E Woelbert, Kas Davis, Jd Hafferty, Et Al Jan 2019

How Data Science Can Advance Mental Health Research, Tc Russ, E Woelbert, Kas Davis, Jd Hafferty, Et Al

Peninsula Medical School

Accessibility of powerful computers and availability of so-called big data from a variety of sources means that data science approaches are becoming pervasive. However, their application in mental health research is often considered to be at an earlier stage than in other areas despite the complexity of mental health and illness making such a sophisticated approach particularly suitable. In this Perspective, we discuss current and potential applications of data science in mental health research using the UK Clinical Research Collaboration classification: underpinning research; aetiology; detection and diagnosis; treatment development; treatment evaluation; disease management; and health services research. We demonstrate that …

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