eLetters

22 e-Letters

  • CBT for Psychosis: the devil is in the detail
    Keith R Laws

    Dear Editor,

    Dr Lecomte provides a strongly endorsing overview of Morrison et als (2014) recent trial of CBT for psychosis in patients who refuse medication. However, her synopsis and associated implications are not as unequivocal nor as supportive of CBT as Dr Lecomte suggests.

    1)First, no significant CBT vs control group differences emerged on any of Morrison et als primary symptom measures (overall, pos...

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  • The odd one out
    Keith R Laws

    Dear Editor,

    Professor Wykes discusses the effectiveness of CBT, contrasting the positive findings of her and co-workers' meta-analysis in 2007 (Wykes et al, 2007) with our recent finding, in a meta-analysis using similar inclusion criteria, of small effects on positive symptoms that became nonsignificant in blind studies (Jauhar et al, 2014). As well as these two 'comprehensive' meta-analyses, she considers three r...

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  • Both Section 17s and CTOs are clinical mechanisms testing treatment stability on hospital release
    Steven P Segal

    Dear Editor,

    Both Section 17s and Community Treatment Orders (CTOs) are forms of conditional release -- involuntary outpatient commitment orders issued upon release from psychiatric hospitalization as a least restrictive alternative to continuing such hospitalization. They are both terminated when it is determined that an individual no longer meets the criteria for involuntary psychiatric hospitalization (i.e. when...

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  • Conceptual clarity in clinical psychiatry
    David H Marjot

    Dear Editor,

    Psychiatry is that clinical speciality in which the primary symptoms are changes in our behaviours, the way we think, feel and act. Signs as opposed to symptoms are usually indefinite. In any case the mind is the brain in action and for science at present the brain still remains a black -box. Hence the difficulty of linking changes in behaviour to changes in brain anatomy, physiology and chemistry. Let...

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  • Towards a More Effective Therapeutic Model
    Ninu-Alexandri Quirk, MD

    Dear Editor,

    I was so pleased to read the editorial entitled "Drop the Language of Disorder" by Peter Kinderman, et al. The DSM has become something of a Bible in medicine, but I believe that this tendency towards bureaucratization is doing a disservice to patients as well as limiting the creative thinking of clinicians.

    While diagnostic categorization can be helpful to organize a medical student's think...

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  • Inappropriate anti-psychotic use in low income countries
    Rohit Verma

    Dear Editor,

    We read with interest the article on inappropriate antipsychotic use. The article brings forth an emerging problem. The increasing use off-label use of atypical antipsychotics has resulted in a growing number of safety alerts that were launched in the past few years by international regulatory agencies. Their usage in the elderly population further raises the possibility of harm. Illnesses like antipsy...

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  • Reply to Consedine
    John Brodersen

    Dear editor,

    We would like to thank Nathan Consedine for his interest in our recently published paper: Long-Term Psychosocial Consequences of False- Positive Screening Mammography.(1)

    Consedine writes in the Commentary section "A)...wonders whether the right balance between measurement comprehensiveness and redundancy has been obtained. B) The absence of reversed items makes psychological indices vulnerab...

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  • Response to Dr Goy's commentary
    Bridget Candy

    Dear Editor,

    We thank Dr Goy for her interpretation of our systematic review. She has touched on an important issue in the meta-analysis of complex interventions, which is to keep the right balance between enough power to detect any effect, and combining sometimes heterogeneous trials. We appreciate her comments on the combination of broad psychological outcomes and we would like to take the opportunity to clarify t...

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  • Brief advice good enough
    Sahoo Saddichha

    The review by Havard and colleagues [1] does not take into account the fact that brief advice, either oral or written, is good enough to bring about behavioral change. To have such a group as the control group is self-defeating. In fact, in an emergency department (ED) setting, where both emotions and tension run high, it would be futile to try and attempt other time-consuming interventions such as motivational interviewi...

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  • ADHD behaviour
    Billy Levin

    Dear Editor

    The only method of improving the behaviour of ADHD children is to make them teachable. To become teachable the medical treatment needs to be titrated to an optimal dose, given every day without exception and monitored with an effective rating scale on a monthly basis.

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