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Jamieson-Craig R.,University College London | Scior K.,University College London | Chan T.,Child and Adolescent Mental Health Learning Disability Service | Fenton C.,Highgate Mental Health Center | Strydom A.,University College London
Journal of Policy and Practice in Intellectual Disabilities | Year: 2010

As clinicians often rely on carer reports to identify adults with intellectual disabilities (ID) with early signs of dementia, this study focused on carer-reported symptoms to ascertain whether carer reports of decline in everyday function would be a more effective screening method to detect possible cases of dementia than reports of memory decline in older adults with ID. Subjects were 154 participants who were reassessed along with their carers two to three years after baseline. A questionnaire for carer-reported change in everyday function and the Dementia Questionnaire for Persons with Mental Retardation (DMR) were used to assess carer views of everyday function and memory. The diagnosis of dementia was confirmed by two psychiatrists working independently. Participants who developed dementia displayed both everyday function and memory decline. Overall, decline in everyday function appeared to be the best indicator of new dementia cases. Retrospective carer report of change in everyday function was as good as, if not better than, prospective ratings to identify dementia; however, in those with mild ID, memory change was a better indicator of dementia, while in those with more severe ID, decline in everyday function was a better indicator. Decline in everyday function (whether prospective change from baseline or reported retrospectively by carers) appears to be a better screening method for dementia than memory decline, particularly for participants with moderate/severe ID. © 2010 International Association for the Scientific Study of Intellectual Disabilities and Wiley Periodicals, Inc. Source

Butler C.,University of Oxford | van Erp W.,Nijmegen Medical Center | Bhaduri A.,Highgate Mental Health Center | Hammers A.,The Neurodis Foundation Fondation Neurodis | And 4 more authors.
Epilepsy and Behavior | Year: 2013

Transient epileptic amnesia (TEA) is a recently described epilepsy syndrome characterized by recurrent episodes of isolated memory loss. It is associated with two unusual forms of interictal memory impairment: accelerated long-term forgetting (ALF) and autobiographical amnesia. We investigated the neural basis of TEA using manual volumetry and automated multi-atlas-based segmentation of whole-brain magnetic resonance imaging data from 40 patients with TEA and 20 healthy controls. Both methods confirmed the presence of subtle, bilateral hippocampal atrophy. Additional atrophy was revealed in perirhinal and orbitofrontal cortices. The volumes of these regions correlated with anterograde memory performance. No structural correlates were found for ALF or autobiographical amnesia. The results support the hypothesis that TEA is a focal medial temporal lobe epilepsy syndrome but reveal additional pathology in connected brain regions. The unusual interictal memory deficits of TEA remain unexplained by structural pathology and may reflect physiological disruption of memory networks by subclinical epileptiform activity. © 2013 Elsevier Inc. Source

McMullen I.,South London and Maudsley NHS Foundation Trust | Checinski K.,Highland House | Halliwell S.,Center for Quality Improvement | Raji O.,South West London and St Georges Mental Health NHS Trust | And 4 more authors.
Psychiatrist | Year: 2013

Aims and method Passing the MRCPsych Clinical Assessment of Skills and Competencies (CASC) is a significant challenge for trainee psychiatrists.We describe the process of setting up a new educational intervention of a simulated CASC examination incorporating peer observation, and report the findings from these events. Results The training events involved a series of simulated scenarios followed by personalised feedback from examiners. Peer observation was a fundamental part of the events and was viewed positively by the trainees with perceived improvements in knowledge and skills. Differences in self-rated and examiner-rated competence were observed more often in those who subsequently failed the CASC. Clinical implications Simulated CASC examination as a training event with a strong focus on observing and learning from peers provides a useful learning experience and supports trainees who are preparing for the CASC examination. Declaration of interest None. Source

Shah N.,Highgate Mental Health Center | Donaldson L.,Camden and Islington NHS Foundation Trust | Giridhar R.,Highgate Mental Health Center
Obstetric Medicine | Year: 2013

Background: A published audit demonstrated that a pilot psychiatric clinic failed to capture predicted numbers of women with severe and enduring mental illness. Methods: On the basis of recommendations from this audit, along with those from the Royal College of Psychiatrists and NICE guidelines, a more comprehensive psychiatric service was developed to meet this demand and therefore manage risk more effectively. Results: Over the course of a year, the new service attracted a higher rate of referrals of pregnant women with severe and enduring mental illness. The majority referral source continued to be midwifery-led. Conclusions: Audit is a useful tool for evaluating and informing service development and helped us identify further improvements needed to deliver an effective mental health service. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav. Source

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