Research Library

Conference presentations:

1. Austin Payne, SEDIG conference, 2011. Outcome measures, Ravello profile and research at Huntercombe Hospital Edinburgh, short paper.

Peer reviewed papers:

1. Gowers, Claxton, Rowlands, Inbasagaran, Wood, Yi, Hugo, Clark-Stone, Bryant-Waugh, Nicholls & Ayton (2010). Drug Prescribing in Child and Adolescent Eating Disorder Services. Child and Adolescent Mental Health. 15 (1) 18-22.

Abstract:Psychotrophic drugs are not recommended for child and adolescent eating disorders, though they are used empirically for symptomatic treatment and co-morbid conditions. Little is known about rates of prescribing or the beneficial and adverse effects. Objective: To ascertain rates and outcomes of psychotrophic drug prescribing in child and adolescent eating disorder services. Results: Drugs were prescribed for 27% (mainly anorexia nervosa), 12% before referral to specialist services. The most commonly prescribed drugs were fluoxetine and olanzapine but 26 different drugs were used. The most common indications were depression, anxiety and ‘pseudo-psychotic’ concerns about weight. Drugs were generally well tolerated, but their effectiveness was uncertain. Conclusions: non-specialists commonly prescribe psychotrophic medication to this vulnerable group without reference to specialist services. Specialists prescribe regularly on empirical grounds, without apparent undue consequences, though these may be under-reported. A prospective clinical trial would further clarify risks and benefits.

http://onlinelibrary.wiley.com/doi/10.1111/j.1475-3588.2009.00535.x/pdf

2. Ayton, Keen & Lask (2009). Pros and cons of using the mental health act for severe Eating Disorders in Adolescents. European Eating Disorders Review. 17 (1) 14-23.

Abstract:In England and Wales the compulsory treatment of young people with severe eating disorders is controversial. There is a concern that such treatment may impair patient autonomy and negatively influence the outcome. In this study, based in a specialist hospital, we compared patients treated under parental consent with those detained under the Mental Health Act: their characteristics and outcome up to 12 months after discharge. Comments: In contrast with previous findings in adults, the outcome for detained patients was similar to that for informal patients, despite the former having more severe presentation on admission. There was no evidence of higher mortality in the detained group.

http://onlinelibrary.wiley.com/doi/10.1002/erv.887/abstract

3. Ayton, Azaz & Horrobin (2004). A pilot open case series of Ethyl-EPA supplementation in the treatment of anorexia nervosa. Prostaglandins, Leukotrienes and Essential Fatty Acids. 71 (4) 205-209.

Abstract: Anorexia nervosa carries the highest risk of morbidity and mortality amongst psychiatric disorders. The efficacy of current treatment approaches is limited. Despite the fat-phobic nature of the disease, poly-unsaturated fatty acids (PUFAs) have not received much research attention. Patients who consume western diet, which is rich in n-6 PUFAs and trans-fatty acids, are likely to develop severe n-3 PUFA deficiency during self-induced starvation. Re-feeding programmes do not take into consideration n-3 EFA intake, possibly leading to further n-3 PUFA deficiency during weight restoration, and this might contribute to the maintenance of the disorder. To test this hypothesis, we carried out a systematic case series of E-EPA supplementation in the treatment of AN. Seven young patients received 1g/day E-EPA in addition to standard treatment, and were followed up for three months. Three of them recovered and four improved. Randomised controlled trials are warranted to examine the effectiveness of E-EPA in AN further.

http://www.sciencedirect.com/science/article/pii/S0952327804000584

4. Ayton (2004). Dietary polyunsaturated fatty acids and anorexia nervosa; is there a link? Nutritional Neuroscience. 7 (1) 1-12.

Abstract: There has been little research examining the link between dietary fat intake and the symptoms and consequences of anorexia nervosa. In this selective literature review, the potential significance of poly-unsaturated fatty acids is discussed. It is hypothesised that dietary restriction causes essential fatty acid deficiencies and poly-unsaturated fatty acid abnormalities, which might contribute to the physical and mental symptoms and the maintenance of the disorder. The examination of epidemiology, symptoms, co-morbidity and consequences suggest that poly-unsaturated fatty acid and phospholipid abnormalities are significant in anorexia nervosa. This will be an important area for future research and may lead to the development of new interventions.

http://www.ingentaconnect.com/content/maney/nns/2004/00000007/00000001/art00001?token=005b1d6c983f3df5426917e442f20672176762a4445494a2f2d4042687627502b333e3568263c2b648d638125bb

5. Ayton (2003). Selective Resolution of Bulimic symptoms and increased suicidal behaviour in an adolescent during fluoxetine treatment. International Journal of Psychiatry in Clinical Practice. 7 (3) 213-216.

Abstract: The case of a 15 year old girl is reported, who suffered from depression and comorbid bulimia nervosa. Her suicidal behaviour worsened with parallel improvement of bulimic symptoms during fluoxetine treatment. These symptoms reversed after the medication was changed to mirtazapine and quetiapine. The small dose of quetiapine was used as an adjunct to the antidepressant treatment, and it resulted in dramatic improvement of mood, cessation of suicidal ideation and return of normal psychosocial functioning. It is suggested that the anti-bulimic effect of fluoxetine is independent of the antidepressant effect. Worsening of suicidal symptoms during fluoxetine treatment warrants a change of antidepressant. Quetiapine may be useful as an adjunct to antidepressants in the management of treatment resistant depression.

http://www.ingentaconnect.com/content/apl/pcp/2003/00000007/00000003/art00008

6. Ayton, Rasool & Cottrell (2003). Deliberate self-harm in children and adolescents: association with social deprivation. European Child Adolescent Psychiatry. 12, 303-307

Abstract: It has been demonstrated that adult suicidal behaviour is associated with unemployment and social deprivation. The association between self-harm and social deprivation in young people is less clear. Aims: To examine the relationship between social deprivation and deliberate self-harm in children and adolescents in an UK district. Results: 730 young people in Hull and East Yorkshire presented with self-harm during a period of two years. Socio-economic deprivation was associated with overdose, self-injury and poisoning by illicit substances. After controlling for the proportion of single parent households, moving households with children, and adult long-term sickness in each ward, partial correlations remained significant between overdose, self-injury and Townsend scores. The results highlighted the importance of socio-economic deprivation in the aetiology of deliberate self-harm in young people. Primary and secondary prevention programs cannot be successful without taking this into consideration.

http://www.springerlink.com/content/mb740ntxq8edtjug/

7. Ayton, Mooney, Sillifant, Powls & Rasool (2007). The development of the child and adolescent versions of the Verona Service Satisfaction Scale (CAMHSSS). Social Psychiatry and Psychiatric Epidemiology (42), 892-901

Abstract: Background: There is a shortage of comprehensive and validated instruments to measure satisfaction with Child and Adolescent Mental Health Services (CAMHS). This study chose the Verona Service Satisfaction Scale (VSSS as a template for the development of a new CAMHS Satisfaction Scale (CAMHSSS).

Method: The new questionnaires were developed by involving service users and members of the multidisciplinary team in several stages. The psychometric qualities of the 39-item draft were tested on a random sample.

Results: A total of 56 adolescents and 104 parents participated in the study. The acceptability of the questionnaires was excellent, and internal consistency was high. Test-retest reliability was between substantial to moderate for individual items, and high for the seven dimension and the final versions of the scale. The questionnaires differentiated well between satisfied and dissatisfied service users.

Conclusions: Two versions were generated to measure service satisfaction among outpatients (CAMHSSS-39 and 20) and one for inpatients and day-patients (CAMHSSS-Unit). All have good psychometric properties and can be recommended for future studies.

http://www.springerlink.com/content/1vq7j7h6h62qlk52/

8. Ayton, Azaz, & Horrobin (2004). Rapid improvement of severe anorexia nervosa during treatment with Ethyl-Eicosapentaenoate and micronutrients. European Psychiatry 19 (5) 317-319

No abstract available

http://www.sciencedirect.com/science/article/pii/S0924933804001336

Book:

1. Dr Agnes Ayton (2011) Anorexia Nervosa: Hope for Recovery: A Nutritional Way to Understand and Treat Anorexia Nervosa,Hammersmith Press Limited

Conference presentations:

1. XXXIInd International Congress on Law and Mental Health Humboldt University Faculty of Law , Berlin, 2011, The Pros and Cons of Using Compulsory Treatment for Severe Eating Disorders in Adolescents, short paper

2. Royal College of Psychiatrists CAP Faculty, Cambridge, 2011, title to be confirmed, short paper presentation

Involvement in preparing national/international policy guidelines (e.g. NICE committees)

1. Junior MARSIPAN guidelines (to be published this year - by the Royal College of Psychiatrists and Institute of Child Health)

http://sites.google.com/site/marsipannini/

2. Tulloch, Lelliott, Bannister, Andiappan, O'Herlihy, Beecham & Ayton (2008). The Costs, Outcomes and Satisfaction for Inpatient Child and Adolescent Psychiatric Services (COSI-CAPS) study. Royal College of Psychiatrists Research and Training Unit, London.

http://www.rcpsych.ac.uk/pdf/COSI%20CAPS.pdf

Peer reviewed papers:

1. Hvidsten S, Bates G (2008). Pseudonarcolepsy in an 11-year-old boy. Clinical Child Psychology and Psychiatry 13 (4): 585-591

Abstract: Narcolepsy is a common disorder with a prevalence of 0.56/1000. Patients present with a classic tetrad of excessive daytime sleepiness, cataplexy, sleep paralysis and hypnagogic hallucinations, which is seen only rarely in children. The term ‘narcolepsy' is taken from Greek and means ‘seized by somnolence'; it was first described in 1880 by Gelineau. This article is a case study of an 11-year-old male with pseudonarcolepsy. He presented to accident and emergency with episodes of falling asleep at inappropriate and unexpected times, often falling to the floor. Pseudonarcolepsy is a term coined to describe the phenomenon in which a patient presents with the symptoms and signs of narcolepsy, but the origin is psychogenic. Differential diagnosis, investigation and possible aetiology are discussed, along with treatment and outcome.

http://ccp.sagepub.com/content/13/4/585.long

2. Agadagba T, Bates GDL (2011). Treatment of Schizophrenia Complicated by Catatonia with Clozapine in a 16 year Old Asylum Seeker. Journal of Psychiatric Intensive Care: DOI: 10.1017/S1742646411000082

Abstract: In this case report, we describe the clinical course of a 16 yr old asylum seeker from Afghanistan who developed paranoid schizophrenia complicated by catatonia and was successfully treated with diazepam and clozapine. To our knowledge, this is the first case report of its kind in this age group. Our patient became psychotic and presented to A&E after cutting off the tip of his nose in response to command hallucinations telling him to kill himself, his mother and his siblings. His catatonic features, which emerged after hospitalization, were those of mutism, akinesia, posturing including the psychological pillow. He did not respond to risperidone or haloperidol; showed a partial response to lorazepam and diazepam. His catatonic features and psychosis only resolved upon the introduction of clozapine. We go on to review the literature about catatonia in children and adolescents. We discuss the nosological dilemma with classification, the evolution of treatments and the role of anti-psychotic medication in the treatment of catatonia. Specifically, we advocate the usefulness of clozapine as an adjunct and as monotherapy.

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8193007

3. Bates G (2009). Drug Treatments for Attention-Deficit Hyperactivity Disorder in Young People. Advances in Psychiatric Treatment 15, 162-171

Abstract: The central role of medication in the treatment of attention-deficithyperactivity disorder (ADHD) in children and adolescents isthe focus of controversy once more. Questions about the safetyand appropriateness of medication have arisen both within andwithout the medical community. This coincides with the disappointingresults for long-term ADHD treatment, illustrated recently bythe first major outcome study to be published. Clinicians havehad to contend with a number of public health scares followingon from the actions of drug regulatory bodies, in addition tomisinformation and misunderstanding from the media. Ironically,this comes at a time when we have an ever-widening range ofmedications and formulations available to us, and better-qualitystudies to inform treatment decisions. The recently publishedNational Institute for Health and Clinical Excellence guidelinesaddress some of these issues and provide a welcome summary andreference point for beleaguered clinicians.

http://apt.rcpsych.org/cgi/content/abstract/15/3/162

4. Bates G (2010). Autism in Fiction and Autobiography. Advances in Psychiatric Treatment 16, 47- 52

Abstract: Many memorable characters in Western culture could be viewedas having features of autism or Asperger syndrome. In spiteof the familiarity of autistic stereotypes such as Star Trek’sMr Spock, more completely described characters with autism arestill unusual. In recent years there has been a growing interestin autism, mirrored by an increase in depictions of autism inpopular works of fiction and autobiography. In this articleI will outline the issues that have preoccupied writers andthe techniques they have used to demonstrate autistic difference.Some writers have illuminated aspects of the autistic triadof social impairment, abnormalities of language and need forsameness. Other writers have opened our eyes to the autisticworld view in its strangeness and richness. Still more have started to examine prejudice, disability rights and the implications of an international autism community. As in other areas of mentalhealth, literature can help inform, entertain and question ourattitudes and values.

http://apt.rcpsych.org/cgi/content/abstract/16/1/47

5. Martin K, Bates G, Whitehouse W (2010). Transient loss of consciousness and syncope in children and young people: What you need to know.Archives of Diseases in Childhood: Education and Practice Edition 95:66-72

http://ep.bmj.com/content/95/3/66.short

6. Bates G, Sanchar S, Harpin V (2011). Choice of treatment for ADHD: are we doing enough? Progress in Neurology and Psychiatry 15: 2, 27-30

Abstract: While patient choice is key when deciding on medication for patients with attention deficithyperactivity disorder (ADHD), doctors can sometimes unwittingly impose their views if the patient is unsure or unclear. Here, three specialists in the field discuss whether enough time is spent with patients examining and explaining the options, and if drugs are properly tailored to the needs of the patient. This discussion covers areas including approach to diagnosis and what factors should be considered when deciding on a particular drug treatment. Copyright © 2011 Wiley Interface Ltd

http://onlinelibrary.wiley.com/doi/10.1002/pnp.194/abstract

Involvement in preparing national/international policy guidelines:

1. Ongoing contributor to Children’s British National Formulary (2005-present), British Medical Association and Royal Pharmaceutical Society of Great Britain Publishing

Books:

1. Bates GDL (2009). Autism in Fiction and Autobiography. Chapter 11 In Mind readings: Literature and Psychiatry (Ed Oyebode F) Gaskell Press, London

2. Bates GDL (2011). Physical aspects of Child and Adolescent Psychiatry. In Essentials of Medicine in Psychiatry (Eds Cormac I, Gray D) Gaskell Press, London [In Press]

Conference presentations:

1. MacNicholas, Bates, & Fink. American Academy of Child and Adolescent Psychiatrists Annual Meeting, Chicago, 2008. Pervasive Refusal syndrome v. Catatonia, short paper

2. MacNicholas, Bates, Kristensen, & Sharkey, Royal College of Psychiatrists Child and Adolescent Faculty, Annual Residential Meeting, Dublin, 2009. Presentations of Mutism, clinical workshop.

Conference presentations:

1. Bray, J. Royal College of General Practitioners 16^th National Conference: working with drug and alcohol users in primary care. Harrogate, 2011. “Inpatient drug and alcohol treatment- the inside story”. (Special Interest Session).

2. Bray, J. Royal College of General Practitioners 16^th National Conference: working with drug and alcohol users in primary care. Harrogate, 2011. “A new gold standard for inpatient alcohol detoxification” (Presentation of Paper)

Letters:

1. Bray, J. Mcloughlin, J. A new gold standard for inpatient alcohol detoxification. British Medical Journal E-letter

http://www.bmj.com/content/340/bmj.c2942.short/reply

Involvement in preparing national/international policy guidelines (e.g. NICE committees)

1. NICE Guideline CG100 - "Alcohol-use disorders: physical complications" (2010) Bray, J. Member of the Guideline Development Group

http://guidance.nice.org.uk/CG100/Guidance/pdf/English

Peer reviewed papers:

1. Hvidsten (2010). Facilitating Young People’s Development: International Perspectives on Person-Centred Theory and Practice. Child and Adolescent Mental Health, 15 (1) 64-64

No abstract available.

http://onlinelibrary.wiley.com/doi/10.1111/j.1475-3588.2009.00554_3.x/abstract

2. Hvidsten & Bates (2008). Pseudonarcolepsy in an 11-year-old boy. Clinical Child Psychology and Psychiatry, 13 (4) 585-591

Abstract: Narcolepsy is a common disorder with a prevalence of 0.56/1000. Patients present with a classic tetrad of excessive daytime sleepiness, cataplexy, sleep paralysis and hypnagogic hallucinations, which is seen only rarely in children. The term `narcolepsy' is taken from Greek and means `seized by somnolence'; it was first described in 1880 by Gelineau. This article is a case study of an 11-year-old male with pseudonarcolepsy. He presented to accident and emergency with episodes of falling asleep at inappropriate and unexpected times, often falling to the floor. Pseudonarcolepsy is a term coined to describe the phenomenon in which a patient presents with the symptoms and signs of narcolepsy, but the origin is psychogenic. Differential diagnosis, investigation and possible aetiology are discussed, along with treatment and outcome.

http://ccp.sagepub.com/content/13/4/585.abstract

3. Grahnquist, Chapman, Hvidsten, & Murphy (2003). Evaluation of 99m Tc-HMPAO leukocyte scintigraphy in the investigation of pediatric inflammatory bowel disease. The Journal of Pediatrics, 143, 48-53

Abstract: OBJECTIVE: To evaluate (99m)Tc-HMPAO leukocyte scintigraphy as an investigation for inflammatory bowel disease (IBD). STUDY DESIGN: Scintigraphy was performed in 95 children undergoing investigation for IBD in a tertiary Gastroenterology Department. Diagnosis was based on conventional investigations including small bowel barium contrast radiology (BCR), upper gastrointestinal endoscopy (UGIE), colonoscopy, and endoscopic biopsy (the "gold standards"). IBD was confirmed in 73 (57 Crohn's disease; 10 ulcerative colitis; 6 indeterminate colitis) and excluded in 22 (controls). Scintigraphy was (1) evaluated as a screening test, (2) compared with individual conventional tests, (3) assessed for each gut segment. RESULTS: Screening test: sensitivity 0.75 (95% CI, 0.63-0.85), specificity 0.82 (95% CI, 0.59-0.94), PPV 0.93, NPV 0.5. Comparison with BCR: sensitivity 0.87 (95% CI, 0.72-0.96), specificity 0.57 (95% CI, 0.39-0.73), PPV 0.69, NPV 0.2. Comparison with UGIE: specificity 0.9 (95% CI, 0.79-0.96), NPV 0.13 (sensitivity and PPV unavailable). Comparison with colonoscopy: sensitivity 0.57 (95% CI, 0.41-0.73), specificity 0.71 (95% CI, 0.54-0.85), PPV 0.71, NPV 0.42. Comparison with biopsies paralleled that with endoscopy. False negatives were especially common (NPV< or =0.2) in the proximal gut. CONCLUSIONS: (99m)Tc-HMPAO leukocyte scintigraphy should not be relied on as a screening test for IBD because false negative results are common. This method is especially unreliable at detecting disease in the proximal gut.

http://www.jpeds.com/article/S0022-3476(03)00280-4/abstract

Book chapter:

1. Hvidsten (2003).Electrical Injuries and Burns. Reflex Anoxic Seizures. In A Paediatric Vade Mecum, 14th edition. Edited by V.Diwaker, T Barrett, A. Lander. Arnold publications, London

Conference presentations:

1. Hvidsten, Atkinson, & Pemmaraju. Royal College of Psychiatrists Annual Meeting - Dublin 2009. An audit of emergency department presentations of older children to 3 Birmingham hospitals - regional audit of substance misuse presentations. (poster)

2. Hvidsten & Pemmaraju. IACAPAP, Istanbul, 2008 and Royal College of Psychiatrists Annual Meeting, 2008. An international cross sectional survey of child and adolescent mental health services. (poster)

3. Hvidsten & Handy. Royal College of Psychiatrists Annual Meeting, 2008. Educational supervision in child psychiatry - a survey of trainees and trainers views. (poster)

4. Hvidtsen, Rickards, & Cavanna. British Neuropsychiatry Association. 2008. Phenylketonuria and gilles de la tourette's syndrome - case report and management. (poster)

5. Royal College Psychiatrists Annual Meeting 2008. Increased prescribing is the norm - or is it? (poster)

6. Lobban, Hvidsten, Bates, & Whitehouse. British Neuropsychiatry Association, Institute of Child Health London 2001. Reflex anoxic seizures - epidemiology and impact on the family - results of a pilot parental questionnaire. (poster)

Peer reviewed paper:

1. Pall (2009). Complex Trauma, Impact on Development and Possible Solutions on an Adolescent Intensive Care Unit. Clinical Child Psychology and Psychiatry 14, (3): 437-454.

Abstract: In order for us to begin to understand the effect of abusiveexperiences in childhood on young people's personality developmentand symptomatology, we have to draw upon a number of theories.The most important of these relate to attachment, mentalization,dissociation, trauma, and how abusive experiences affect thedevelopment of the individual and their developing brain. Inthis article I will share with you my attempts to understandthe young people that come to stay on our intensive care unitand consider how these theories inform our understanding ofthem and the treatment approach that we try to provide.

http://ccp.sagepub.com/content/14/3/437.abstract

Conferences:

1. The Centre for Child Mental Health Conference “Bad things happen: enabling children and teenagers to recover well from painful life events”, London, 2011.Complex Trauma, Impact on Development and Possible solutions, short paper.

2. The Centre for Child Mental Health Conference “Bad things happen: enabling children and teenagers to recover well from painful life events”, London, 2011. EMDR for Complex trauma, workshop.

Letters:

1. Bray, J. Mcloughlin, J. A new gold standard for inpatient alcohol detoxification. British Medical Journal E-letter

Conferences:

1. Huntercombe Conference – Quantifying the Unquantifiable, London (2010). Considering change in brain injury rehabilitation: lessons from in-patients and out-patients, short paper

Peer reviewed papers:

1. Rose, Davis, Frampton & Lask (2011). The Ravello Profile: Development of a global standard neuropsychological assessment for young people with anorexia nervosa. Clinical Child Psychology and Psychiatry 16 (2): 195-202. DOI:10.1177/1359104511401191

Abstract: Recent research suggests that neuropsychological factors may play an important role in the development and maintenance of anorexia nervosa. However, it has been difficult to draw firm conclusions because of the wide range of assessments and norms that have been used. The aim of the Ravello Profile is to define a common shared neuropsychological assessment battery that can be adopted by researchers and clinicians working with young people. We describe the background to the Ravello Profile and the process of developing it, before specifying the recommended tests. We present an illustrative case example and consider some of the potential clinical and research applications of the profile with young people suffering from anorexia nervosa.

http://ccp.sagepub.com/content/16/2/195.abstract

2. Rose, Frampton & Lask (2011). A case series investigating distinct neuropsychological profiles in children and adolescents with anorexia nervosa. European Eating Disorders Review. Published online in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/erv.1095.

Abstract: A number of specific deficits in neuropsychological functioning in anorexia nervosa (AN) have been identified. However, it is not known whether these specific deficits cluster together to form one or more clear neuropsychological profiles. We present a case series of nine participants who were recruited as part of a wider, ongoing investigation of the neuropsychological profile of eating disorders (the Ravello Profile). Results show that there was a wide range of different neuropsychological profiles at initial assessment. This suggests a spectrum of neuropsychological strengths and weaknesses that would otherwise be masked in a cohort analysis. It is anticipated that factor and cluster analytic studies will establish one or more common profiles of neuropsychological deficits in AN. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.

http://onlinelibrary.wiley.com/doi/10.1002/erv.1095/abstract;jsessionid=C65411C67DCDE8F70857D27AB74847BE.d02t03

Books:

1. Rose and Frampton (in press) Neuroscience models in Anorexia Nervosa. In Eating Disorders and the Brain, edited by Bryan Lask and Ian Frampton. Wiley-Blackwell.

Conferences:

1. London Eating Disorders Conference 2009:A Global Neuropsychological Assessment in Anorexia Nervosa- The first findings from the Ravello Profile collaboration, short paper.

2. EDRS Pittsburgh 2009: The Ravello Profile- A global standard neuropsychological assessment in Anorexia Nervosa (AN): Step 1 of 5: Factor Analysis, poster

3. Child Health Symposium, Institute of Child Health, London 2009: The Ravello Profile- A global standard neuropsychological assessment in Anorexia Nervosa, poster

4. Aberdeen Eating Disorders Conference, 2009: The Ravello Profile- A global standard neuropsychological assessment in Anorexia Nervosa, poster

5. AED Salzburg, 2010: The Ravello Profile- A global standard neuropsychological assessment in Anorexia Nervosa: Steps 1 & 2 of 5: Preliminary Factor & Cluster Analysis, poster

6. EDRS Boston 2010: Factor and cluster analysis of a neuropsychological test battery in anorexia nervosa, short paper

7. Rio Eating Disorders Conference, 2010:Learning to love neuropsychological assessment in clinical practice and research. Workshop

8. London Eating Disorders Conference 2011: The Ravello Profile- case series, short paper

9. AED Miami 2011: Clinical validation of neuropsychological clusters from the Ravello Profile, short paper

Peer reviewed paper:

1. Freestone, Sanchez Espana, Kelly & Gale (2010). An achievable standard for in-house TC evaluation? Service, individual and group-level outcome data for CHT therapeutic communities. Therapeutic communities, 31, (4): 372-392.

Abstract: This paper presents the results of a naturalistic evaluation of the therapeutic community (TC) projects comprising Community Housing and Therapy (CHT), a network of TCs in the South East of the UK. A panel sample design was used and data were collected at set periods by in-house research assistants working at the TCs, which were then gathered and analysed centrally, with reference to previous studies performed by the Association of Therapeutic Communities and others. The project was conducted without significant external funding and was intended to demonstrate what could be achieved by a motivated in-house research team. The study had a high initial take-up from clients, and regular recruitment, but experienced a high dropout rate over its 12-month duration. The results suggested the heterogeneous nature of presenting difficulties residents experienced with mental health and social functioning when entering CHT, which were equivalent in many respects to those individuals admitted to NHS psychotherapy services and in some cases more severe than those in all but prison TCs. They also indicated that those admitted to CHT during the study showed statistically significant overall improvement on most psychometric measures, with 31% reporting reliable and clinically significant positive change and 11% a reliable deterioration.

http://www.therapeuticcommunities.org/index.php?option=com_content&view=article&id=131:volume-31-issue-4-winter-2010&catid=31:journal&Itemid=117

Peer reviewed paper:

1. Neiderman, Zarody, Tattersall, & Lask (2000). Enteric Feeding in Severe Adolescent Anorexia Nervosa: A report of four cases. International Journal of Eating Disorders 28 (4) 470-475.

Abstract: OBJECTIVE: Refeeding patients with anorexia nervosa can be one of the more challenging aspects of their treatment, and particularly if all food and fluids are adamantly and persistently refused. METHOD: If the decision is made to augment or replace oral feeds, the most common intervention is nasogastric feeding. RESULTS: Although this is often successful, a subset of patients manage to sabotage feeding via this route. Other means of delivering nutrition such as intravenous feeds are often impractical for long-term use. Another alternative in such life-threatening situations is the use of enteric feeds via gastrostomy or jejunostomy. This paper presents the successful use of such enteric feeding in four cases of severe adolescent anorexia nervosa. DISCUSSION: The psychological, legal, and ethical issues involved are discussed, concluding that gastrostomy and jejunostomy are valid lifesaving methods to feed highly resistant anorectic patients.

http://onlinelibrary.wiley.com/doi/10.1002/1098108X%28200012%2928:4%3C470::AID-EAT18%3E3.0.CO;2-1/abstract

Peer reviewed paper:

1. Wood, Al-Khairulla, Lask (2011). Group cognitive remediation therapy for adolescents with anorexia nervosa. Clinical Child Psychology and Psychiatry 16 (2): 225-31.

Abstract: Cognitive remediation therapy (CRT) for anorexia nervosa (AN) is a relatively new intervention and targets neuropsychological deficits, such as set shifting difficulties, weak central coherence and visuospatial deficits. To date there are no published descriptions of CRT for adolescents with AN. CRT has been traditionally delivered on an individual basis but other modalities are currently being explored. This paper describes the process of a 10-session course of group-based CRT for adolescents with AN. The nine participants, aged 13-19, were being treated on an inpatient service. Group-based CRT was well received by the participants, who reported it to be fun and useful. Clinical impressions suggest that this approach is a potentially useful addition to the treatment of this challenging population.

http://ccp.sagepub.com/content/16/2/225.abstract