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Recent research: two papers on mindfulness, two on insomnia & two on antidepressants in pregnancy

Here are six recently published research papers.  Barnhofer and colleagues report on encouraging results using mindfulness-based cognitive therapy (MBCT) for sufferers from chronic-recurrent depression while they are still depressed.  The three major studies published already have used MBCT for recurrent depression while the sufferers are reasonably well.  The next step will clearly be a fuller randomized controlled trial.  Heeren and colleagues report on the how MBCT acts to reduce overgeneral autobiographical memoriy in formerly depressed patients. 

Archer and colleagues describe the successful development and assessment of a group-based cognitive behavioural intervention for sleep problems.  Participants' satisfaction ratings with the training were very high and there were very encouraging reductions in their sleep problems and depressive symptoms.  Morin and coworkers also report on CBT for sleep problems, this time singly or combined with sleep medication.  They concluded that "In patients with persistent insomnia, the addition of medication to CBT produced added benefits during acute therapy, but long-term outcome was optimized when medication is discontinued during maintenance CBT."

NICE guidelines: January guidance including antisocial personality disorder

Yesterday NICE - the National Institute for Health and Clinical Excellence in England & Wales - published guidance on a diverse range of fifteen clinical, technology, interventional and public health subjects.  Their clinical guidance on Medicines Adherence  interested me, as too did their public health guidance on Promoting Physical Activity for Children and Young People.  The subject of this post is the clinical guidance on Antisocial Personality Disorder and in my next post, I'll talk about their guidance on Borderline Personality Disorder.  As Dr Tim Kendall, Joint Director, National Collaborating Centre for Mental Health, states: "Approximately 2 million people in the UK have personality disorders, with antisocial and borderline disorders being the most common.

Excellent free information & advice on over 180 common medical conditions

Good stuff!  The British Medical Journal Group have just launched their Evidence Centre.  It's a fine evidence-based resource providing excellent information for doctors, patients and organizations.  Most of the services however seem to cost money to access.  The Best Health resource for patients, for example, costs £9.99 plus VAT for a 30 day subscription (or £3.00 plus VAT to look at information on a single condition).  The good news for searches to the Best Health resource from the UK and Republic of Ireland is that Boots have linked with the BMJ Group to give access to this service free of charge.  Visit Ask Boots to see how helpful this can be.  Key features include:

  • In-depth information on more than 180 common conditions
  • Evaluation of over 1500 treatments
  • Assessment of 23 common operations and tests
  • Decision-support guidelines to help patients assess their options
  • Search tips to help them navigate to the right information
  • Regular updates to include new evidence and drug guidelines

 

Organization of teratology information specialists (OTIS)

Teratology is the study of the effects that drugs, medications, chemicals and other exposures may have on the unborn child during pregnancy.  Particulary when a mother is taking a medication that is helping her stay well, it can be a difficult decision whether or not to stop taking the medication because of a possible risk to the fetus.  This decision is made harder because we know that if a pregnant woman becomes unwell, for example with depression, this too risks damaging the fetus, so it's not necessarily the case that stopping medication is going to be in the unborn baby's best interest.

In this situation, having access to up to date, expert information can be crucially important.  I came across a helpful website today - OTIS (Organization of Teratology Information Specialists) - that provides exactly this.  Although the organization is based in the US and Canada, there is much that is useful on the website. 

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