Search PubMed⌕ Search

Biomedical subjects

Peter Hayward

Publications and source records attributed to Peter Hayward.

32 records · Page 2Linked to original sources
PubMed2003

A randomized controlled study of cognitive therapy for relapse prevention for bipolar affective disorder: outcome of the first year.

BACKGROUND: Despite the use of mood stabilizers, a significant proportion of patients with bipolar affective disorder experience frequent relapses. A pilot study of cognitive therapy (CT) specifically designed to prevent relapses for bipolar affective disorder showed encouraging results when used in conjunction with mood stabilizers. This article reports the outcome of a randomized controlled study of CT to help prevent relapses and promote social functioning. METHODS: We randomized 103 patients with bipolar 1 disorder according to the DSM-IV, who experienced frequent relapses despite the prescription of commonly used mood stabilizers, into a CT group or control group. Both the control and CT groups received mood stabilizers and regular psychiatric follow-up. In addition, the CT group received an average of 14 sessions of CT during the first 6 months and 2 booster sessions in the second 6 months. RESULTS: During the 12-month period, the CT group had significantly fewer bipolar episodes, days in a bipolar episode, and number of admissions for this type of episode. The CT group also had significantly higher social functioning. During these 12 months, the CT group showed less mood symptoms on the monthly mood questionnaires. Furthermore, there was significantly less fluctuation in manic symptoms in the CT group. The CT group also coped better with manic prodromes at 12 months. CONCLUSION: Our findings support the conclusion that CT specifically designed for relapse prevention in bipolar affective disorder is a useful tool in conjunction with mood stabilizers.

Adaptation, Psychological↗
PubMed2002

Stigma and self-esteem in manic depression: an exploratory study.

BACKGROUND: As part of a larger study on coping styles in manic depressive patients, it was felt that self-esteem and stigmatisation, two areas that have received little attention in connection with this illness, warranted investigation. METHOD: A questionnaire on self-esteem and feelings of stigmatisation was piloted. The rationale of the questionnaire is explained and data on its reliability and validity are presented. RESULTS: This pilot study suggests a relationship between mood and self-esteem, while feelings of stigmatisation seem to be relatively independent of mood. However, some relationship between self-esteem and stigmatisation is suggested. LIMITATIONS: This study focused on an atypical group of patients, and the questionnaire had never been used before. For this reason, the results can be best seen as suggesting further research. CONCLUSIONS: We believe that issues of self-esteem and stigmatisation can have considerable clinical significance in this client group. For this reason, we hope this paper will stimulate interest in these areas.

Adult↗
PubMedDate not supplied

Prevalence of mental incapacity in medical inpatients and associated risk factors: cross-sectional study.

BACKGROUND: Although mental incapacity is becoming increasingly important in clinical practice, little information is available on its frequency in medical inpatients. We aimed to estimate the prevalence of mental incapacity in acutely admitted medical inpatients; to determine the frequency that medical teams recognised patients who did not have mental capacity; and to identify factors associated with mental incapacity. METHODS: Over an 18-month period, we recruited 302 consecutive acute medical inpatients. Participants were assessed with the MacArthur competence tool for treatment and by clinical interview. Cognitive impairment was measured by the mini-mental state examination. FINDINGS: 72 (24%) patients were severely cognitively impaired, unconscious, or unable to express a choice and were automatically assigned to the incapacity group. 71 (24%) refused to participate or could not speak English. Thus, 159 patients were interviewed. Of these, 31% (95% CI 24-38) were judged not to have mental capacity. For the total sample (n=302), we estimated that at least 40% did not have mental capacity. Clinical teams rarely identified patients who did not have mental capacity: of 50 patients interviewed, 12 (24%) were rated as lacking capacity. Factors associated with mental incapacity were increasing age and cognitive impairment. INTERPRETATION: Mental incapacity is common in acutely ill medical inpatients, and clinicians tend not to recognise it. Screening methods for cognitive impairment could be useful in detecting those with doubtful capacity to consent.

Acute Disease↗