13 e-Letters

  • Simulation training to teach medical students skills in a psychosocial intervention for alcohol related harm.

    We applaud the article by Dr Neale (1) which highlights the importance of simulation training to teach communication skills in psychiatry. However, there was no reference to the role of simulation training in teaching medical students skills in addictive medicine.
    As a result of an increase in alcohol related harm in Israel over the last 20 years (2) and recommendations (3) for controlled and replicable studies in undergraduate medical education in alcohol and substance abuse, we studied the impact of a short term intervention on the knowledge of psychiatric aspects of alcohol amongst 4th and 5th year medical students (4). The intervention consisted of a powerpoint lecture on alcohol related harm to small groups of students, followed immediately by an active member of an alcoholics anonymous group wherever possible relating his story to the material in the lecture. After 2 weeks the same group of students participated in a structured simulation of a family doctor interviewing a female adolescent because of a concern that she suffered from alcohol related harm.
    The students who did not participate directly in the simulation were asked to provide constructive feedback to the student who simulated the primary care physician along the lines of motivational interviewing (Engaging the patient, Focussing on the goals of the meeting, Evoking "change talk" by the patient as a way of introducing behavioural change and Closure of the meeting while maintaining...

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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.

  • Response to commentary
    Seena Fazel

    Dear Editor,

    Peters discusses some limitations in relation to our systematic review of the prevelance of substance abuse and dependence in prisoners. Peters states that we have not disaggregated findings obtained from sentenced and unsentenced prisoners. In fact, in Table 3, we do present the findings of sentenced and remand prisoners separately by gender, and by type of substance (alcohol and drug).


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  • Statement link missing
    Thorsten Schumann

    Dear Editor,

    It would have been utterly helpful if you had included a citation for the APA-NAMI-NMHA-statement in your article - or the following hypertext- link: http://www.nmha.org/newsroom/system/news.vw.cfm?do=vw&rid=662.

    Kind regards,

    Th. Schumann

  • Protection at home or risks away
    Andrew Al-Adwani

    Dear Editor,

    Is it not just as plausible to postulate a relative protection from schizophrenia in less developed countries that is inversely proportional to their degree of development. In this scenario the schizophrenia genotypes would be more prevalent in these countries and only become more liable to expression upon migration. This of course would be particularly so for those in the high risk years which a numbe...

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  • Risperidone improves tardive dyskinesia- are the benefits maintained in the longer term?
    C Feroz-Nainar

    Dear Editor,

    It would be interesting to know what proportion of the sample that had the initial positive response maintain the improvement in the longer term. This is important as tardive dyskinesia characteristically occurs after prolonged neuroleptic therapy. There are several case reports of long-term risperidone therapy causing tardive dyskinesia [1-5]. Recently a child in my clinic developed tardive dyskines...

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  • Buprenorphine is not a "symptomatic" treatment
    Andrew Al-Adwani

    Dear Editor

    The title and content of this article give the impression that buprenorphine is akin to symptomatic treatments like clonidine, lofexidine and the various cocktails of drugs added to these drugs during detoxification.

    We have been using buprenorphine detoxification for over a year with good results. However, it should be recognized that buprenorphine is a drug of abuse and more like methadone or...

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  • Whether social phobia or social anxiety disorder,other studied show different results?
    A.K Al-Sheikhli

    Dear Editor

    It was interesting to read the paper of Haug et al.[1] I have a number of comments:

    1.The SSRI group of anti-depressant medications are the best-established drug treatment for social anxiety disorder.[2] However, Veale in his review article shows that CBT is the initial of choice of treatment for social phobia.[3]

    2.I think the authors should have included other treatment o...

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  • Not Proven
    D B Drysdale

    Dear Editor

    I just loved the commentator, Karl-Heinz Schultz's use of the Scottish "Not Proven"! It is a much too little used verdict, especially in psychiatry where both sample and effect sizes are small and the science usually poor.

    Douglas Drysdale
    Consultant Psychiatrist