"Better together: Scotland's patient experience programme" works to use the public's experience of NHS Scotland to improve health services.  At the end of April they published provisional results for GP Practices throughout Scotland, and pilot results for a few initial hospitals are beginning to come through as well.  I find this fascinating, sobering, helpful stuff. 

I read a lot of research.  When I find an article of particular interest I download it to my bibliographic database - EndNote - which currently contains over 14,300 abstracts. 

The overlap between money and the health professions seems to involve a complex, multi-faceted set of issues.  I was triggered into thinking about this by the coincidence of three events.  One was a conversation at the recent annual BABCP psychotherapy conference, a second was reading Lewis Hyde's book "The gift", and the third was struggling to pay my most recent tax bill.

"Quis custodiet ipsos custodes?"    Juvenal

Blogging about my mum's illness and my reactions to it led me to think again about self disclosure by health professionals.  Our job is to be helpful for our clients - it's what we're about.  Self disclosure by health professionals is a mixed bag.  It can sometimes be helpful and sometimes damaging.  Different schools of therapy and different styles of doctor have strong opinions about what's right and wrong in this area.  Strong opinions without research back-up tend to generate more heat than light.  As has been so delightfully stated "The plural of anecdote is not data".  This post is not at all intended to be exhaustive about research on health professional self disclosure.  It is intended to shine a light on some interesting facts and to raise some questions.

Five of these six studies are from last month's American Journal of Psychiatry.  Kendler et al discuss the many similarities and only occasional differences between bereavement-related and other life event-related depression - an issue explored further in Maj's editorial.  Li et al show that depression in pregnancy (exacerbated further by stressful life events and obesity) increases the risk of preterm delivery.  Miklowitz reviews research on the value of adjunctive psychotherapy for bipolar disorder sufferers (already taking medication) and discusses the various ways it can be helpful.  Oquendo et al (in a freely viewable editorial) argue that suicidal behaviour should be placed on a "separate axis" in the next version of the DSM diagnostic system.  Finally Vertanen et al, in an interesting study, demonstrate that increased hospital overcrowding - measured by bed occupancy rates - is associated with increased use of antidepressants by hospital staff.

Kendler, K. S., J. Myers, et al. (2008). "Does Bereavement-Related Major Depression Differ From Major Depression Associated With Other Stressful Life Events?" Am J Psychiatry 165(11): 1449-1455.  [Abstract/Full Text]  

This week's recent research post is a mixed bag of six studies covering the physiological & psychological changes triggered by being separated from one's partner, why similar levels of anxiety & interpersonal sensitivity can lead to social anxiety in some individuals and paranoia in others, how difficulty identifying feelings is associated with increased somatization, the frequency of burnout in family doctors around Europe, personality factors that predict a longer life, and how wrong the old saying is that "Sticks & stones may break my bones, but words will never hurt me"!  

Bryant, R. A., J. Mastrodomenico, et al. (2008).