Max Birchwood

Bio: Max Birchwood is an academic researcher from University of Warwick. The author has contributed to research in topics: Mental health & Psychological intervention. The author has an hindex of 65, co-authored 259 publications receiving 18491 citations. Previous affiliations of Max Birchwood include University of Birmingham & Royal College of Psychiatrists.

Staff attitude towards cocaine/crack-cocaine use amongst individuals with severe mental health problems in an inner city area of the UK (Staff attitude towards cocaine)

Abstract: Background: Cocaine/crack-cocaine use is associated with a number of negative outcomes in people with mental health problems. Aims: To explore the extent of use in individuals with severe mental health problems and impact of client use on mental health service staff. Method: Following Graham et al. (2001), care coordinators within community mental health teams in Birmingham, UK completed a prevalence survey of cocaine/crack-cocaine use in clients on their current caseload to determine the extent of use. Findings were compared to those of Graham et al. Interviews with staff explored the impact of cocaine/crack-cocaine on client outcome and effects on staff within the teams under study. Results: An increase in cocaine/crack-cocaine use is reported (from 5.6% to 11.5% over 8 years). Interview data indicate that despite this increase, staff declare themselves more competent and confident in dealing with cocaine/crack-cocaine use. Conclusions: We propose that the integration of substance use treatment within m...

Status of primary and secondary mental healthcare of people with severe mental illness: an epidemiological study from the UK PARTNERS2 programme.

Abstract: Background There is global interest in the reconfiguration of community mental health services, including primary care, to improve clinical and cost effectiveness. Aims This study seeks to describe patterns of service use, continuity of care, health risks, physical healthcare monitoring and the balance between primary and secondary mental healthcare for people with severe mental illness in receipt of secondary mental healthcare in the UK. Method We conducted an epidemiological medical records review in three UK sites. We identified 297 cases randomly selected from the three participating mental health services. Data were manually extracted from electronic patient medical records from both secondary and primary care, for a 2-year period (2012-2014). Continuous data were summarised by mean and s.d. or median and interquartile range (IQR). Categorical data were summarised as percentages. Results The majority of care was from secondary care practitioners: of the 18 210 direct contacts recorded, 76% were from secondary care (median, 36.5; IQR, 14-68) and 24% were from primary care (median, 10; IQR, 5-20). There was evidence of poor longitudinal continuity: in primary care, 31% of people had poor longitudinal continuity (Modified Modified Continuity Index ≤0.5), and 43% had a single named care coordinator in secondary care services over the 2 years. Conclusions The study indicates scope for improvement in supporting mental health service delivery in primary care. Greater knowledge of how care is organised presents an opportunity to ensure some rebalancing of the care that all people with severe mental illness receive, when they need it. A future publication will examine differences between the three sites that participated in this study.

Preventing the Traumatic Sequelae of First Episode Psychosis: A Randomised Controlled Trial

Abstract: Objective: To evaluate a cognitive therapy based intervention designed to reduce the traumatic symptoms and emotional dysfunction, which can follow a first episode of psychosis. Materials and methods: 66 first episode patients were randomized to receive either a cognitive therapy intervention or treatment as usual and assessed at baseline, post intervention (6 months) and follow-up (12 months) on a variety of measures including Impact of Events Scale, Calgary Depression Scale and PANSS. Results: Interim analysis revealed significant benefit for those receiving the cognitive therapy intervention in terms of reduced trauma symptoms and other outcome measures. Conclusions: The findings are discussed in the context of current models of trauma and psychosis and their implications for clinical practice.

Disagio mentale in un campione comunitario di giovani adulti: l'help-seeking in un modello generalista di salute mentale Emerging mental disorders in a community sample of young adults in Italy: help-seeking in a Generalist Community Mental Health setting

Abstract: RIASSUNTO. Scopo. Il ritardo nell’accesso alle cure rappresenta uno dei principali ostacoli alla presa in carico dei giovani adulti con disturbi mentali all’esordio. Questo ritardo, troppo spesso osservato nella pratica clinica, ha diverse cause. Una di queste e la richiesta di aiuto inespressa (unexpressed help-seeking), che e influenzata da fattori di ordine storico-culturale, dalle caratteristiche della patologia stessa, ma anche dalle modalita con le quali sono organizzati i servizi di salute mentale. Gli obiettivi dello studio sono quelli di individuare: il livello di stress e di disagio mentale, le determinanti principali dell’unexpressed help-seeking all’interno di un campione comunitario di giovani adulti in un contesto nazionale in cui vige un modello generalista di salute mentale. Metodi. Il campione e costituito da 3446 studenti universitari. Sono stati somministrati contestualmente: un questionario esplorativo, la scala SVS per la valutazione dello stress percepito e il GHQ-12 per la valutazione del disagio mentale. E stata condotta un’analisi descrittiva seguita dalle correlazioni tra l’unexpressed help-seeking e le altre variabili. E stata effettuata una regressione logistica sul sottocampione con punteggi GHQ-12 ≥4 utilizzando la richiesta d’aiuto inespressa come variabile dipendente. Risultati. Il 46,8% del campione ha avuto un punteggio GHQ-12 ≥4. L’unexpressed help-seeking e pari al 63,6% e risulta significativamente correlata a: sesso maschile, status di fuorisede, elevato punteggio SVS, assenza di servizi di salute mentale specificamente dedicati ai giovani adulti, sfiducia nei confronti dei servizi esistenti. Conclusioni. Una riorganizzazione dei servizi di salute mentale, nel senso della creazione di contesti piu appropriati per utenti giovani, potrebbe portare a una riduzione della richiesta di aiuto inespressa.

Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide

Abstract: Without a complete published description of interventions, clinicians and patients cannot reliably implement interventions that are shown to be useful, and other researchers cannot replicate or build on research findings. The quality of description of interventions in publications, however, is remarkably poor. To improve the completeness of reporting, and ultimately the replicability, of interventions, an international group of experts and stakeholders developed the Template for Intervention Description and Replication (TIDieR) checklist and guide. The process involved a literature review for relevant checklists and research, a Delphi survey of an international panel of experts to guide item selection, and a face to face panel meeting. The resultant 12 item TIDieR checklist (brief name, why, what (materials), what (procedure), who provided, how, where, when and how much, tailoring, modifications, how well (planned), how well (actual)) is an extension of the CONSORT 2010 statement (item 5) and the SPIRIT 2013 statement (item 11). While the emphasis of the checklist is on trials, the guidance is intended to apply across all evaluative study designs. This paper presents the TIDieR checklist and guide, with an explanation and elaboration for each item, and examples of good reporting. The TIDieR checklist and guide should improve the reporting of interventions and make it easier for authors to structure accounts of their interventions, reviewers and editors to assess the descriptions, and readers to use the information.

Constructing Grounded Theory: A Practical Guide through Qualitative Analysis

Abstract: การวจยเชงคณภาพ เปนเครองมอสำคญอยางหนงสำหรบทำความเขาใจสงคมและพฤตกรรมมนษย การวจยแบบการสรางทฤษฎจากขอมล กเปนหนงในหลายระเบยบวธการวจยเชงคณภาพทกำลงไดรบความสนใจ และเปนทนยมเพมสงขนเรอยๆ จากนกวชาการ และนกวจยในสาขาสงคมศาสตร และศาสตรอนๆ เชน พฤตกรรมศาสตร สงคมวทยา สาธารณสขศาสตร พยาบาลศาสตร จตวทยาสงคม ศกษาศาสตร รฐศาสตร และสารสนเทศศกษา ดงนน หนงสอเรอง “ConstructingGrounded Theory: A Practical Guide through Qualitative Analysis” หรอ “การสรางทฤษฎจากขอมล:แนวทางการปฏบตผานการวเคราะหเชงคณภาพ” จะชวยใหผอานมความรความเขาใจถงพฒนาการของปฏบตการวจยแบบสรางทฤษฎจากขอมล ตลอดจนแนวทาง และกระบวนการปฏบตการวจยอยางเปนระบบ จงเปนหนงสอทควรคาแกการอานโดยเฉพาะนกวจยรนใหม เพอเปนแนวทางในการนำความรความเขาใจไประยกตในงานวจยของตน อกทงนกวจยผเชยวชาญสามารถอานเพอขยายมโนทศนดานวจยใหกวางขวางขน

Psychosis as a state of aberrant salience: A framework linking biology, phenomenology, and pharmacology in schizophrenia.

Abstract: OBJECTIVE: The clinical hallmark of schizophrenia is psychosis. The objective of this overview is to link the neurobiology (brain), the phenomenological experience (mind), and pharmacological aspects of psychosis-in-schizophrenia into a unitary framework. METHOD: Current ideas regarding the neurobiology and phenomenology of psychosis and schizophrenia, the role of dopamine, and the mechanism of action of antipsychotic medication were integrated to develop this framework. RESULTS: A central role of dopamine is to mediate the “salience” of environmental events and internal representations. It is proposed that a dysregulated, hyperdopaminergic state, at a “brain” level of description and analysis, leads to an aberrant assignment of salience to the elements of one’s experience, at a “mind” level. Delusions are a cognitive effort by the patient to make sense of these aberrantly salient experiences, whereas hallucinations reflect a direct experience of the aberrant salience of internal representations. Antipsyc...