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Intellectual disabilities: improving access to therapeutic communities
Access to specialised therapeutic communities (TCs) for people with intellectual disabilities (IDs) such as ‘Camphill communities’ and ‘TCs plus’ is limited and patchy in the UK. Nonetheless, the emphasis for some time now has been to enable people with IDs to access mainstream services, which have a legal duty to make reasonable adjustments to facilitate this. Here, the authors propose a set of recommendations in order to improve the access of people with ID to mainstream therapeutic communities and enhance the services they receive. (Source: Progress in Neurology and Psychiatry)
Source: Progress in Neurology and Psychiatry - December 21, 2016 Category: Neurology Authors: Farshad Shaddel, Marjan Ghazirad, Subimal Banerjee, Christopher Newrith Tags: Original research Source Type: research

Anorexia nervosa: diagnosis, risk factors and evidence ‐based treatments
As part of the series on managing neurological and psychiatric conditions in children and adolescents, Dr Sara Kakhi and Dr Jacinta McCann cover recent updates in epidemiology, risk factors, common comorbidities and treatment options for anorexia nervosa. (Source: Progress in Neurology and Psychiatry)
Source: Progress in Neurology and Psychiatry - December 21, 2016 Category: Neurology Authors: Sara Kakhi, Jacinta McCann Tags: Review Source Type: research

Treatment for cancer and depression in a female with intellectual disability
Identifying depression in those with an intellectual disability can be difficult as symptoms may differ from those usually observed in the general population. The anti‐oestrogen medication tamoxifen is widely used for the treatment of breast cancer and clinically relevant depression may be a common side‐effect. Here, the authors discuss a case that highlights the importance for mental health professionals managing individuals with an intellectual disability and cancer to consider all possible causes of a change in mood or behaviour, so that the diagnosis and treatment of depression in this vulnerable group is not negle...
Source: Progress in Neurology and Psychiatry - December 21, 2016 Category: Neurology Authors: Pamela Kaushal, Elizabeth Naomi, Sarah Maddock Tags: Case notes Source Type: research

ECT in a patient with a meningioma and Takotsubo cardiomyopathy
There are few studies that look at the use of electroconvulsive therapy (ECT) in elderly patients with a comorbid meningioma or other intracranial tumour, with the dilemma being whether or not to do ECT. This case notes article examines the ECT management of an elderly lady with severe depression, coexisting Takotsubo cardiomyopathy, and an incidental finding of a frontal meningioma. The authors detail the multidisciplinary approach necessary for managing a patient with coincident psychiatric, cardiac and neurological diagnoses and the implications for practice. (Source: Progress in Neurology and Psychiatry)
Source: Progress in Neurology and Psychiatry - December 21, 2016 Category: Neurology Authors: Margaret Gani, Faisal Parvez Tags: Case notes Source Type: research

Obsessive ‐compulsive symptoms: a side‐effect of antipsychotic treatment
Obsessive‐compulsive symptoms (OCS) secondary to antiserotonergic antipsychotic treatment of schizophrenia appear to have a significant prevalence from previous studies but can be very difficult to detect as they are overshadowed by the diagnosis of schizophrenia. Here, the authors describe three cases where patients have developed OCS after starting risperidone in one case, and clozapine in two other cases and how significant improvements can be achieved with SSRIs and, if necessary, cognitive behavioural therapy (CBT). (Source: Progress in Neurology and Psychiatry)
Source: Progress in Neurology and Psychiatry - December 21, 2016 Category: Neurology Authors: Obioha Ukaegbu, Francis J Dunne, Henok Getachew Tags: Case notes Source Type: research

Digest
Ending summer time increases depression Putting the clocks back at the end of summer increases the incidence of depressive episodes by 11%, say Danish investigators (Epidemiology 2016; doi: 10.1097/EDE.0000000000000580). Their analysis of the national Psychiatric Central Research Register from 1995 to 2012 included a total of 185 419 hospital contacts for episodes of unipolar depression. The incidence rate increased by 11% during the period of transition from summer time to winter time, then diminished over the following 10 weeks. There was no corresponding increase in spring when clocks moved forward. The authors suggest ...
Source: Progress in Neurology and Psychiatry - December 21, 2016 Category: Neurology Tags: Digest Source Type: research

Personalised care in severe mental illness – there's no need to wait
(Source: Progress in Neurology and Psychiatry)
Source: Progress in Neurology and Psychiatry - October 31, 2016 Category: Neurology Authors: Andrew Molodynski, Rob Bale Tags: Opinion Source Type: research

Autobiographical memory in depression's pathology and treatment
(Source: Progress in Neurology and Psychiatry)
Source: Progress in Neurology and Psychiatry - October 24, 2016 Category: Neurology Authors: Mark Greener Tags: News review Source Type: research

Riluzole
stands out as one of the few drugs that made the transition from proof of concept in animal models to clinical use. The authors trace the drug's development and describe some of its key characteristics. (Source: Progress in Neurology and Psychiatry)
Source: Progress in Neurology and Psychiatry - October 24, 2016 Category: Neurology Authors: Tarek A-Z K Gaber, Zafar Mehmood, Hazel Siringwani Tags: Drug note Source Type: research

Evidence for neuroinflammation in Alzheimer's disease
New understanding in neuroscience has established that alongside the amyloid plaques, neurofibrillary tangles and atrophy, the neuroinflammation triggered by the CNS's innate immune response plays a central role in the pathogenesis of Alzheimer's disease (AD). In this review, the authors look at the roles that the cells of the immune response play in the pathogenesis of AD, the influence of genetics, the developing role for neuroimaging to detect inflammation and progress towards potential therapeutic strategies. (Source: Progress in Neurology and Psychiatry)
Source: Progress in Neurology and Psychiatry - October 24, 2016 Category: Neurology Authors: Anna Walters, Emma Phillips, Rui Zheng, Maya Biju, Tarun Kuruvilla Tags: Review Source Type: research

Evaluating outcomes in an adult inpatient psychiatric rehabilitation unit
Patients with severe and enduring mental illness often require recovery‐focused inpatient rehabilitation in order to improve functional impairment and successfully reintegrate into the community. Here, the authors describe a case note audit of patients admitted to a rehabilitation unit over a two‐year period to establish how many patients were successfully discharged back into the community and what the vocational reintegration outcomes were. The study highlights the crucial need for evaluating these outcomes in order to guide future practice and improve care quality. (Source: Progress in Neurology and Psychiatry)
Source: Progress in Neurology and Psychiatry - October 24, 2016 Category: Neurology Authors: Marlene Kelbrick, Suheib Abu ‐Kmeil, Marco Picchioni Tags: Original Research Source Type: research

Aggression in Down's syndrome
It has been speculated that there is a personality/behavioural phenotype among people with Down's syndrome, although research has been inconclusive. There is little evidence to support severe psychotic disturbance and aggressive behaviours being common in the Down's syndrome population. This case is that of a 24‐year‐old male with Down's syndrome who showed abnormally aggressive behaviours. He was kept in the community without psychiatric review, partly due to his behaviours being overlooked as he had a learning disability. (Source: Progress in Neurology and Psychiatry)
Source: Progress in Neurology and Psychiatry - October 24, 2016 Category: Neurology Authors: Racheal Johnson, Amir Jarvaid, Manoj Narayran, Dasari Michael Tags: Case notes Source Type: research

Corticosteroid ‐induced psychosis in rheumatoid arthritis
Reports of corticosteroid‐induced psychiatric effects began to appear in the literature soon after the introduction of these medications in the 1950s. Here, the authors present the case of a man who developed psychosis after receiving high‐dose corticosteroid for rheumatoid arthritis. The complex management of his long‐lasting and challenging symptoms is discussed. (Source: Progress in Neurology and Psychiatry)
Source: Progress in Neurology and Psychiatry - October 24, 2016 Category: Neurology Authors: Louisa Ward, Joji George Tags: Case notes Source Type: research

Epilepsy: when family history holds the key to diagnosis
There may be many causes of epileptic seizures, so thorough clinical history taking and examination to determine the seizure semiology is paramount. In this article, the authors describe a patient with new‐onset seizures whose family history proved pivotal to targeted genetic testing and appropriate antiepileptic drug therapy. (Source: Progress in Neurology and Psychiatry)
Source: Progress in Neurology and Psychiatry - October 24, 2016 Category: Neurology Authors: Baba M Aji, Philip Milburn ‐McNulty, Andrew J Larner Tags: Case notes Source Type: research

Hyperglycaemia and the brain
Evidence is accumulating that diabetes worsens cognition and can lead to dementia. The author discusses some of that evidence in this article: it highlights the importance of early diagnosis and adequate treatment to prevent cognitive decline. (Source: Progress in Neurology and Psychiatry)
Source: Progress in Neurology and Psychiatry - October 24, 2016 Category: Neurology Authors: Anand Beri Tags: Comment Source Type: research