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Biomedical subjects

Peter Tyrer

Publications and source records attributed to Peter Tyrer.

56 records · Page 4Linked to original sources

A comparison of statistical models in predicting violence in psychotic illness.

BACKGROUND: The application of statistical modeling techniques, including classification and regression trees, in the prediction of violence has increasingly received attention. METHODS: The predictive performance of logistic regression and classification tree methods in predicting violence was explored in a sample of patients with psychotic illness. RESULTS: Of 2 logistic regression models, the forward stepwise method produced a simpler model than the full model, but the latter performed better. The performance of the classification tree appeared to be high before cross-validation, but reduced when cross-validated. The standard logistic model was the most robust model. A simplified tree with extra weight given to violent cases was a reasonable competitor and was simple to apply. CONCLUSION: Although classification trees can be suitable for routine clinical practice, because of the simplicity of their decision-making processes, their robustness and therefore clinical utility was problematic in this sample. Further research is required to compare such models in large prospective epidemiologic studies of other psychiatric populations.

Adolescent↗

Principles of nidotherapy in the treatment of persistent mental and personality disorders.

BACKGROUND: The principles of a psychological intervention for psychiatric disorders, nidotherapy, are described following its use in the treatment of patients with severe mental illness, most of whom also have personality disorders. Nidotherapy is the collaborative systematic assessment and modification of the environment to minimise the impact of any form of mental disorder on the individual or on society. It is particularly appropriate to consider for chronic and recurring disorders in which there is no prospect of short-term improvement. METHODS: An analysis of the treatment suggests its main tenets are the development of a joint consensus (collateral collocation) of environmental change needed, formulation of targets, consequent monitoring and adjustments made to test the effectiveness of intervention, and a joint structure (arbitrage solving) to adjudicate when changes are considered feasible or impractical by one party and not the other. RESULTS: Case vignettes are used to describe the main features of the treatment. Although nidotherapy includes some of the elements of cognitive, occupational and family therapy, and even social work, it is different in that it focuses on changing the environment, not the person. It is therefore much more acceptable to those patients who have repeatedly challenged the justification of conventional therapy for their conditions. CONCLUSIONS: Nidotherapy deserves further enquiry as a useful addition to existing psychological treatments.

Adult↗