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#31
06.10.2006, 21:08
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American Psychiatric Association
Practice Guideline for the Treatment of Patients With Eating Disorders, Third Edition [2006] [Ссылки доступны только зарегистрированным пользователям ] 
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#32
07.11.2006, 18:24
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[Ссылки доступны только зарегистрированным пользователям ]
Practice parameter: evaluation and treatment of depression, psychosis, and dementia in Parkinson disease (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. [Ссылки доступны только зарегистрированным пользователям ] Depression clinical practice guidelines.
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#33
27.11.2006, 15:57
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[Ссылки доступны только зарегистрированным пользователям ]
Management of adults with major depression. 2006 Jan
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#35
09.02.2007, 21:39
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[Ссылки доступны только зарегистрированным пользователям ]
The efficacy of antidepressants and various psychotherapies as adjunctive treatments for irritable bowel syndrome (IBS).
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#36
28.02.2007, 09:54
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Журнал "Оценка медицинских технологий"
Health Technol Assess. 2007 Mar;11(9):1-190. Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation. Connock M, Juarez-Garcia A, Jowett S, Frew E, Liu Z, Taylor RJ, Fry-Smith A, Day E, Lintzeris N, Roberts T, Burls A, Taylor RS. Department of Public Health and Epidemiology, University of Birmingham, UK. OBJECTIVES: To assess the clinical effectiveness and cost-effectiveness of buprenorphine maintenance therapy (BMT) and methadone maintenance therapy (MMT) for the management of opioid-dependent individuals. DATA SOURCES: Major electronic databases were searched from inception to August 2005. Industry submissions to the National Institute for Health and Clinical Excellence were accessed. REVIEW METHODS: The assessment of clinical effectiveness was based on a review of existing reviews plus an updated search for randomised controlled trials (RCTs). A decision tree with Monte Carlo simulation model was developed to assess the cost-effectiveness of BMT and MMT. Retention in treatment and opiate abuse parameters were sourced from the meta-analysis of RCTs directly comparing flexible MMT with flexible dose BMT. Utilities were derived from a panel representing a societal perspective. RESULTS: Most of the included systematic reviews and RCTs were of moderate to good quality, and focused on short-term (up to 1-year follow-up) outcomes of retention in treatment and the level of opiate use (self-report or urinalysis). Most studies employed a trial design that compared a fixed-dose strategy (i.e. all individuals received a standard dose) of MMT or BMT and were conducted in predominantly young men who fulfilled criteria as opiate-dependent or heroin-dependent users, without significant co-morbidities. RCT meta-analyses have shown that a fixed dose of MMT or BMT has superior levels of retention in treatment and opiate use than placebo or no treatment, with higher fixed doses being more effective than lower fixed doses. There was evidence, primarily from non-randomised observational studies, that fixed-dose MMT reduces mortality, HIV risk behaviour and levels of crime compared with no therapy and one small RCT has shown the level of mortality with fixed-dose BMT to be significantly less than with placebo. Flexible dosing (i.e. individualised doses) of MMT and BMT is more reflective of real-world practice. Retention in treatment was superior for flexible MMT than flexible BMT dosing but there was no significant difference in opiate use. Indirect comparison of data from population cross-sectional studies suggests that mortality with BMT may be lower than that with MMT. A pooled RCT analysis showed no significant difference in serious adverse events with MMT compared with BMT. Although treatment modifier evidence was limited, adjunct psychosocial and contingency interventions (e.g. financial incentives for opiate-free urine samples) appeared to enhance the effects of both MMT and BMT. Also, MMT and BMT appear to be similarly effective whether delivered in a primary care or outpatient clinic setting. Although most of the included economic evaluations were considered to be of high quality, none used all of the appropriate parameters, effectiveness data, perspective and comparators required to make their results generalisable to the NHS context. One company (Schering-Plough) submitted cost-effectiveness evidence based on an economic model that had a 1-year time horizon and sourced data from a single RCT of flexible-dose MMT compared with flexible-dose BMT and utility values obtained from the literature; the results showed that for MMT vs no drug therapy, the incremental cost-effectiveness ratio (ICER) was pound12,584/quality-adjusted life-year (QALY), for BMT versus no drug therapy, the ICER was pound30,048/QALY and in a direct comparison, MMT was found to be slightly more effective and less costly than BMT. The assessment group model found for MMT versus no drug therapy that the ICER was pound13,697/QALY, for BMT versus no drug therapy that the ICER was pound26,429/QALY and, as with the industry model, in direct comparison, MMT was slightly more effective and less costly than BMT. When considering social costs, both MMT and BMT gave more health gain and were less costly than no drug treatment. These findings were robust to deterministic and probabilistic sensitivity analyses. CONCLUSIONS: Both flexible-dose MMT and BMT are more clinically effective and more cost-effective than no drug therapy in dependent opiate users. In direct comparison, a flexible dosing strategy with MMT was found be somewhat more effective in maintaining individuals in treatment than flexible-dose BMT and therefore associated with a slightly higher health gain and lower costs. However, this needs to be balanced by the more recent experience of clinicians in the use of buprenorphine, the possible risk of higher mortality of MMT and individual opiate-dependent users' preferences. Future research should be directed towards the safety and effectiveness of MMT and BMT; potential safety concerns regarding methadone and buprenorphine, specifically mortality and key drug interactions; efficacy of substitution medications (in particular patient subgroups, such as within the criminal justice system, or within young people); and uncertainties in cost-effectiveness identified by current economic models. полный текст pdf [Ссылки доступны только зарегистрированным пользователям ]
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#37
28.02.2007, 10:10
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полный текст пдф
[Ссылки доступны только зарегистрированным пользователям ] Health Technol Assess. 2007 Feb;11(6):1-104. Oral naltrexone as a treatment for relapse prevention in formerly opioid-dependent drug users: a systematic review and economic evaluation. Adi Y, Juarez-Garcia A, Wang D, Jowett S, Frew E, Day E, Bayliss S, Roberts T, Burls A. Department of Public Health and Epidemiology, University of Birmingham, UK. OBJECTIVES: To investigate the clinical effectiveness and cost-effectiveness of naltrexone for relapse prevention in detoxified formerly opioid-dependent individuals compared with any strategy that does not use naltrexone, including treatment with placebo, other pharmacological treatments, psychosocial interventions or no treatment. DATA SOURCES: Major electronic databases were searched from inception to September 2005. REVIEW METHODS: Selected studies were screened and quality assessed. Meta-analyses were carried out as appropriate. A decision-analytic model using Monte Carlo simulation was developed that compared naltrexone as an adjunctive therapy to no naltrexone. It assumed compliance rates that were not enhanced by contingent management rewards (because this is current UK practice). Utility values could not be identified from the literature and so were obtained by research specially commissioned from the Value of Health Panel. RESULTS: The methodological quality of the 26 randomised controlled trials (RCTs) that met the inclusion criteria was poor to moderate. The results suggest that naltrexone as maintenance therapy may be better than placebo in terms of retention in treatment, but this was not statistically significant. A meta-analysis of seven included RCTs gave the relative risk (RR) of loss of retention in treatment in the naltrexone arm as 0.94. The pooled hazard ratio (HR) reported in five of the RCTs for retention in treatment data followed up to 35 weeks was calculated as 0.90 in favour of naltrexone and also did not reach statistical significance. The risk of drug abuse in naltrexone versus placebo, with or without psychological support given in both arms, gave a pooled RR of 0.72, which was a statistically significant difference in favour of naltrexone. The pooled HR from three RCTs for opioid relapse-free rates was significantly different from placebo in favour of naltrexone 0.53; however, this fell off over time and may be of limited clinical significance. The RR of reimprisonment while on naltrexone therapy showed results in favour of naltrexone in the combined two studies of parolees or people on probation, but the number of participants was small. One study of 52 participants found that the difference in improvement score for risky sexual behaviour in the naltrexone group compared with the placebo group was not statistically significant. The adverse events data reported showed no significant difference between the naltrexone and placebo arms. The quality of the nine RCTs of interventions designed to increase retention with naltrexone was poor to moderate; however, all three different modalities of enhanced care showed some evidence of effectiveness. All of the contingency management programmes used incentive vouchers; the mean duration of treatment retention was 7.4 weeks for the contingency management intervention compared with 2.3-5.6 weeks for the naltrexone treatment alone. The mean length of time for which patients stayed on naltrexone was 84-103 days with additional psychosocial therapy compared with 43-64 days for the control group. In trials with added pharmacological agents the RRs of stopping treatment were 1.63 at 6 months and 1.31 at 12 months (in favour of naltrexone plus fluoxetine). It became statistically significant at 6 months, but not at 12 months. A meta-analysis of the RR of stopping treatment at week 12 (the minimum follow-up period) was carried out using six of the nine studies. The pooled RR of stopping treatment was 0.81. The results indicated that overall the intervention groups had 19% fewer patients who stopped treatment compared with the control group, but there was only a small number of studies and their quality was relatively poor. No existing economic evaluations were identified. The point estimate for the cost-effectiveness of naltrexone was pound42,500 per quality-adjusted life-year (QALY). Sensitivity analysis was carried out and the incremental cost-effectiveness ratio varied between pound34,600 and pound42,500 per QALY gained. CONCLUSIONS: Following successful withdrawal from opioids, naltrexone may be administered on a chronic basis to block any future effects of opioids. Naltrexone appears to have some limited benefit in helping formerly opioid-dependent individuals to remain abstinent, although the quality of the evidence is relatively poor and heterogeneous. The limited quality and extent of the studies precluded an analysis of subgroups likely to benefit from naltrexone prescribing. Oral naltrexone is used infrequently in current UK practice, and this review suggests that this is appropriate as there is little evidence to support its wider implementation. There is an important deficit in information about the quality of life of people who use illicit opioids and this would perhaps be a worthwhile area of research in informing policy questions about the cost-effectiveness of different programmes and interventions.
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#38
28.02.2007, 11:44
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Бюллетень бесплатных информационных ресурсов, Февраль 2007 г.
Инфосеть «Здоровье Евразии» [Ссылки доступны только зарегистрированным пользователям ] Посттравматический стресс: диагностика и обследование (Posttraumatic stress disorder: diagnosis and assessment) (2006) (на англ.яз.) Автор: Совет по здоровью населения и практике общественного здоровья (Board on Population Health and Public Health Practice) Описание: “По просьбе департамента по делам ветеранов Институт медицины провел исследование по посттравматическому стрессу (ПТС). Комитет провел оценку и дал комментарии по диагностике и обследованию в случае посттравматического стресса и известных факторов риска его развития. Комитет выявил, что посттравматический стресс представляет собой четко характеризуемое медицинское состояние и что диагностические критерии, приведенные в справочнике по диагностике и статистическому учету психических заболеваний (DSM-IV), являются доказательными, принятыми в широких кругах и широко используемыми. В соответствии с отчетом комитета, постановка диагноза ПТС и обследование должны проводиться медицинским работником, имеющим опыт в диагностике психических нарушений (например, врачами первичного звена здравоохранения, сестрами, социальными работниками) с использованием критериев DSM-IV. В идеальном случае этот диагноз должен выставляться в приватных условиях, в результате интервью один на один, которое может длиться час и дольше. Кроме того, несмотря на то что скрининг и диагностические инструменты могут оказать помощь в диагностировании и обследовании в случаях ПТС, эти средства не могут заменить обследование опытным специалистом.” 74 с. Доступно через Интернет URL: [Ссылки доступны только зарегистрированным пользователям ]
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#39
27.04.2007, 20:00
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Mental Health Policy Implementation Guide
A Learning and Development Toolkit for the whole of the mental health workforce across both health and social care National Institute for Mental Health in England (NIMHE) National Workforce Programme – April 2007 Website: [Ссылки доступны только зарегистрированным пользователям ] The health and social care workforce is the crucial element in driving forward and improving the delivery of mental health services. While it is important to have robust, well-thought-out policies and a sufficient level of resources, coupled with effective service models to support implementation, these perhaps count for little if the workforce does not have the opportunity to learn and develop Content: Introduction Purpose of the Toolkit Background Who is the Toolkit aimed at? What are they expected to do with the Toolkit? How might this be achieved? Vision What the Toolkit does not cover Current learning and development issues and priorities Contemporary guidance and learning materials Supporting frameworks Forthcoming issues Forthcoming guidance and learning materials Child and Adolescent Mental Health Services (CAMHS) Older People’s Mental Health (OPMH) Making the links Commissioning Examples of innovative practice Summary and next steps Appendices
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#40
22.06.2007, 14:16
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Руководство по применению нормативно-правовой базы в области охраны психического здоровья: пакет разработанных методик обучения и развития всего кадрового потенциала в сфере охраны психического здоровья в аспекте не только медицинской, но и социальной помощи (Mental health policy implementation guide: A Learning and Development Toolkit for the whole of the mental health workforce across both health and social care) (2007) (на англ.яз)
Автор: Национальный институт психического здоровья в Англии [NIMHE], Национальная программа кадровой политики Описание:”Целью этого пакета разработанных методик является изложение текущих вопросов обучения и развития в области охраны психического здоровья; приоритетные местные лечебно-профилактические и социальные учреждения могут принять их во внимание при разработке собственных стратегий обучения и развития, учитывая, что вопросы обучения и будущего развития уже не за горами.” Как получить: Имеется в режиме online в виде файла в формате PDF [591 килобайт] URL: [Ссылки доступны только зарегистрированным пользователям ]
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#41
26.06.2007, 17:14
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Журнал
Child and Adolescent Psychiatry and Mental Health [Ссылки доступны только зарегистрированным пользователям ] This journal will provide an international platform for rapid and comprehensive scientific communication on child and adolescent mental health across different cultural backgrounds.
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#42
26.06.2007, 21:48
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[Ссылки доступны только зарегистрированным пользователям ]
[Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ] [Ссылки доступны только зарегистрированным пользователям ]
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#43
27.06.2007, 11:51
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[Ссылки доступны только зарегистрированным пользователям ]
Anxiety Disorders Patient Education Cente [Ссылки доступны только зарегистрированным пользователям ] Anxiety Disorders Association of America
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#44
28.06.2007, 08:41
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[Ссылки доступны только зарегистрированным пользователям ]
Expert physicians review journal articles that impact medical professionals in the field of psychiatry.
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#45
13.08.2007, 14:37
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new open access journal:
International Journal of Mental Health Systems Abbreviation: Int J Ment Health Syst [Ссылки доступны только зарегистрированным пользователям ] This journal considers articles on all aspects of mental health system development and reform.
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Линейный вид
