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references

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does anyone know whether we can get away without quoting references /evidence,i can never remember any

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I have had differing answers form people. One (examiner) said he would fail an essay without at least some references. Other people have said that most important is structure and legibility, and that people have passed without references.

I think its best to try to squeeze in a couple of generic ones at least if at all possible. I am rubbish at remembering them too.

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It might be useful to post some references on this board, ive come across some that were thought to be important, i'll dig them up

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that would be great even ,ive heard that there are a few classic references we should know ,the only one im really sure about is the Kane et al,archives of general pysch ? 1988 clozapine vs chlorpromazine in rx resistant schizophenia -tobe used in any essay related to atypicals

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I dont think we need to give the detail of the paper ,the journal and the page nos. if we can just quote some imp people and the years it should be fine.

i was planning of writing few for myself

so here you go

COMMUNITY PSYCHIATRY

goffman 1961 total institutions

Barton 1959 institutional neurosis

Lunatics act 1845

mental trt act 1930

MHA 1959,1983

community care act 1990 (care programme approach)

Health of the nations 1992 suicide reduction by 15% by 2000

NSF 1999

Stein and test 1980 assertive community treatment RCT in US

PRISM (psychiatric research in service management) study 1998 gains made for community care was maintained in clinical practice

bjpsych editorials

Mcnaughten rules plea for insanity

Diminished responsibility (homicide act 1957) if successful conviction for manslaughter

Farrington and west year ?? Cambridge study of delinquent development

risk of violence-- The ECA survey 1990

McArthur Foundation research network

Link/Stueve 1996 'threat/control override'

National confidential inquiry &nbsp:lol:OH 1999

(Risk assessment method)psychopathy check list,

HCR 20

Monahan/Steadman iterative classification tree

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I dont think we need to give the detail of the paper ,the journal and the page nos. if we can just quote some imp people and the years it should be fine.

i was planning of writing few for myself

so here you go

COMMUNITY PSYCHIATRY

goffman 1961 total institutions

Barton 1959 institutional neurosis

Lunatics act 1845

mental trt act 1930

MHA 1959,1983

community care act 1990 (care programme approach)

Health of the nations 1992 suicide reduction by 15% by 2000

NSF 1999

Stein and test 1980 assertive community treatment RCT in US

PRISM (psychiatric research in service management) study 1998 gains made for community care was maintained in clinical practice

bjpsych editorials

Forensic psychiatry

Mcnaughten rules plea for insanity

Diminished responsibility (homicide act 1957) if successful conviction for manslaughter

Farrington and west year ?? Cambridge study of delinquent development

risk of violence-- The ECA survey 1990

McArthur Foundation research network

Link/Stueve 1996 'threat/control override'

National confidential inquiry &nbsp:lol:OH 1999

(Risk assessment method)psychopathy check list,

HCR 20

Monahan/Steadman iterative classification tree

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Child Psychiatry

NICE recommendation on use of ritalin

The famous IOW (Isle Of White) study by Rutter

Mary Robertson lot of work on Tourett's

Mary Ainsworth Strange situation test

Harlow

Bowlby

Thomas and chess New york longitudinal study for Temprament

piaget cognitive development

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Thx asr,

This is very useful. Its a pretty tricky problem to solve - a lot of important reserarch is done in related disciplines which have very important implications for psychiatry e.g. piaget's research on cognitive development. I have three ideas - the first one is to list important (purely) psychiatric research and the second is to give a brief outline of the research if possible. The third idea is for people to add their comments e.g. stating if the research is not important or other important studies have been missed out.

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Starting with personality disorders

Lack of validity implies much research is descriptive

Pinel (Manie sans delire) 1801; Prichard, moral insanity, 1835; Koch, psychopathic inferiority 1891 - later psychopathic personality; Henderson, Psychopathic states, 1939; Paranoid PD Schneider, 1950, Kretschmer, 1927 - sensitive type; Schizoid - Kretschmer, 1936; Borderline - Kernberg, 1975, psychodynamic formulation; Spitzer et al 1979 - objective criteria now included ICD-10/DSM IV; Overlap with other dramatic PD Pope et al, 1983, Oldham 1992; Kahn, 1928, anankastic;

Prevalence of ASPD - USA (St Louis, Baltimore, Newhaven) Robins et al 1984, Regier et al, 1988 - 3000 people DSMIII - lifetime prevalence 1.5-3.2 %

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Kretschmer, 1936 - pyknic boidy build, asthenic, athletic; Sheldon et al, 1940,42 - endo/ecto/mesomorph.

Genetic basis for ASPD - Adoption studies increased in children of APSD - Crowe 1974, Cadoret et al 1975, 1978.

3 % patients in max security prison XYY, Jacobs et al, 1965 controversial; Hill 1952, abnormal EEG;

Bowlby, 1946, separation of children - APSD - Forty four juvenile thieves; Borderline Personality Disorder - Stone et al, 1987, 25% still met criteria in middle age;

Cognitive Therapy in OCD - Beck and Freeman, 1990

Quality Assurance Project, 1991 - Antisocial and BPD psychotherapy results; therapeutic community - Jones, 1952 work in Henderson hospital; Rapoport, 1960 factors bringing about change. Improvement rates 40-60% Taylor, 1966.; Antipsychotics small dose - benefit when pt disturbed - Cowdrey and Gardner, 1988; TCA worsen BPD Soloff, 1986; SSRI useful in BPD Marcovityz and schultz 1993; Carbamezapine effective in aggressive behaviour (Gardner and Cowdrey, 1986); Noe that names keep repeating in the literature

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Mood Disorders

Leonhard, 1957 - cycloid psychoses

Withdrawal of antidepressants after inducing rapid cycling resolves frequent mood swings (Wehr et al, 1988)

Carney et al in Newcastle, 1965 - found neurotic v psychotic depression; Kendell 1968 did not;

Leonhard et al, 1962 division into unipolar depression, unipolar mania and bipolar disorder;

Anxiety v depression - different courses - 66 patients - Kerr et al, 1972, Schapira et al, 1972

Depressive sx common - point prevalence 13-20% - increased in women, divorced/separated/ lower social class (Boyd and Weissman, 1982) [smith and Weissman, 1992 show cohort effects for BPD and UPD)

Epidemiological Catchment area (ECA) study (Reger et al, 1988) - life time risk of BPD 0.5-1.5%, prevalence 0.4%

lifetime prevalence 5% of depression; 1.6 cases per 100 males, 2.9 cases per 100 females;

National comorbidiity Survery in US however shows lifetime prevalence 17% (Kessler et al, 1994)

Holmes and Rahe, 1967 - Life events scale; Paykel 1978 - relationship of life events to onset of depression;

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Brown and Harris, 1978 - precipitating events, Camberwell, working class women

1. Long term difficulties 2. Vulnerability factors a. Lack of confiding relationship, b. Early events (loss of mother - death/separation) before age 11 c. Not working outside home d. Caring for young childrenPaykel and Cooper, 1992 - poor social support

Freud - Mourning and Melancholia, 1917; Seligman, 1975 - animal experiments - learned helplessness; Beck, 1967 - automatic thoughts - self/world/future - beck's triad

Delgado et al, 1992 - monamine hypothesis

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Schizophrenia

National Comorbidity survey Kendler 1996

ECA study 1991 (quoted no of times)

WHO 10 cohort study(quoted no of times)

Finnish adoption study 1997 interaction between genetic and environmental effects

British birth cohort (jones et al 1994) children who went on to develop schizophrenia

Andreason swedish military conscripts association of cannabis and schizophrenia

Expressed emotion leff

Liddle three clusters or dimensions of symptoms

Geddes et al BMJ 2000 metaanalysis of atypicals vs typicals

*** Henderson Am J psych 2000 clozapine and diabetes

london east anglia CBT trials for psychosis

course and outcome better in India ,Nigeria ,and Columbia WHO IPSS ten country study

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Many thx asr, I will just finish off mood disorders

Kendler et al, 1993 - 680 female twins - four factors predicted likelihood of depressive disorder - past hx of depression, neuroticism [eysenck], recent stressful life events, genetic; Black et al, 1987 - 11-17% of pts who had severe depresion kill themselves at some point; Paykel, 1989, TCA's effective in depression (not so much in very severe depression) v placebo; GP, amitripytline, mild depression, significant benefits (Paykel, 1989); MAOI's placebo control trials equal to TCA's in depression Davidson, 1988, 1992; SSRI's effective metaanalysis - Song et al, 1993; Depression Guideline Panel, 1993, Psychotherapy in depression; NIMH multicentre psychotherapy study where 240 outpatients depression randomised to IPT, CT, Imipramine, Placebo; Imipramine > IPT > CT > Placebo (Elkin et al, 1989);

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Bilateral ECT effective in mania randomised prospective trial (Small et al, 1988); Carbamezapine effective in acute tx mania (Small et al, 1991); Antidepressants long term use, prophylaxis against recurrence depression MRC, 1981; (Vaughn and Leff, 1976) critical comments predict relapse of depression; 50% tx-resistant depressive respond if TCA replaced with fluoxetine  (Beasley et al, 1990); 50% respond if A.D replaced with Tranylcypromine in those who tried both SSRI and TCA (Nolen et al, 1988); THyroxine effective in non-TCA responders (Chalmers and Cowen, 1990); Goodwin, 1994 - stopping lithium in bpd - greater chance of relapse; Slow withdrawal - relapse less likely (Faeda et al, 1993);

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here is my suggestion re references

if the exam is at the next sitting go through a standard text such as companion to get the feel ot the narrative

make crib notes of each topic eg with references; also possibly bessant & puri rivision notes do references:

if the exam is in 6 months get the actual papers and read them this will help the authors names to stick in

your mind.

good luck :)

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Here are some on cross-cultural studies on schizophrenia.

WHO has been very interested, hence all studies were sponsored by them

IPSS 1972 - International Pilot Study of Schizophrenia - 26 centres, 13 countries.

Better outcome in developing than developed countries, probably due to more tolerance towards illness and patients in developing countries.

Leff et al 1980 - 5 year followup of IPSS

similar findings

Determinants of Outcome of Schizophrenia DOSMed study ( i dont remember the year)

included first episode patients

better outcome in developing countries not fully explained by presence of Acute Psychosis, rather than schizophrenia, only.

US-UK Diagnositic project

Comparison of rates of diagnosing schizophrenia in US and UK. In US, schizophrenia diagnosed more loosely than in UK

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Two corrections :

ECA study was done in 1987 and not 1991.

National Comorbidity Survey is in 1994.

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I wonder how much specific references matter.  I can see that if there is clearly a key paper that is essentially the basis of the question then you're probably stuck without it.  On the other hand if you just need a few names to get the 'used references' box ticked on the mark sheet then you can use the following in almost any essay :

Freud

Goffman

Eysenk

Gunn (anything about mental health and criminals)

Wing (3 Hospitals)

Kraeplin / Schneider / Jaspers / Bleuler

Department of Health / NICE

Royal College (!)

World Health Organization

Cochrane

(etc. etc.)

No. 6

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references are not as important as content , clarity of argument and presentation. Guildford use a similar mark sheet to royal college i guess, and only so many marks are given for them. Even in the royal college guidelines for writing the essay it says you don`t have to put references , it just looks better. ::)

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well i passed the exam finally!!!,

i took the written twice and passed the essay,with 1 reference for both attempts(the eca figures)so i guess that answered my intial question

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Re.references. I know for a fact that quoting references is not compulsary. There are some topics where references are hard to come by for eg, the question on gender differences and implication for psychiatry. On the other hand, in other instances adding refereces to your essay lifts its standard one notch up. One of the useful ways of studying for the eswsay question is to read all the editorials and the occasional article on psychiatric topics in the BMJ over the last 3-4 years and the references given in them are invaluable. Make photocopies of the editorials. The style of BMJ editorials is on worth emulating. Also remember that in quoting classic papers it pays to go into it in some detail just to show that you have read the paper. Examples would be, IOW stuedy by Rutter etal; a useful summary of this can be foun in the book CHILD PSYCHIATRY by Goodman & Scott; similarly the Kean study on Clozapine.

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