CIAP Newsletter

Celebrate World Mental Health Day on 10 October to raise awareness of mental health issues around the world and mobilise efforts in support of mental health. Visit the World Health Organisation for more information.

The NSW Government is undertaking a decade-long whole-of-government enhancement of mental health care. The reforms come in response to the Mental Health Commission of NSW’s Living Well report, a framework for reform which puts people at the centre of the NSW mental health care system. More information can be found at NSW Health-Mental Health Reform, along with fact sheets on Suicide Prevention, Pathways to Community Living Initiative, Assisting long-term patients to live in the community, and other strategies toward strengthening mental health care in NSW.

CIAP provides access to a diverse range of resources to support the delivery of high-quality, evidence-based mental health care staff across NSW Health.

Guidelines for mental health care may be viewed by selecting Guidelines from CIAP’s left menu, which will display a list of links that will direct you to current guidelines. The first link is to Therapeutic Guidelines (eTG). Choose Psychotropic from the list of guidelines on eTG’s home page to view the full range of psychotropic topics, disorders, treatment options and guidelines. A helpful feature of eTG is its collection of summarised information in tables, boxes, and appendices, for example:

  • Appendix 8.1: Resources, and links to support organisations
  • Appendix 8.3: Dietary guidelines for patients taking irreversible non-selective monoamine oxidase inhibitors
  • Appendix 8.4: Management of common adverse effects of psychotropic drugs
  • Table 8.15: Antidepressant-free intervals recommended when changing from one antidepressant to another
  • Box 8.16: Assessing Suicide Risk
  • Table of drugs and their categories of use in pregnancy and breastfeeding

CIAP’s Guidelines section also contains a link to Emergency Guidelines. Selecting this opens the Emergency Specialty Guide, which provides access to a list of NSW Health Guidelines including Mental Health for Emergency Departments – A Reference Guide. A link to this resource is also available under Emergency Care on CIAP’s left menu. Other helpful links are also listed in this Specialty Guide.

For information on Diseases and Conditions, select Diseases and Conditions from CIAP’s left menu. Each of the resources may be browsed and/or searched for evidence-based and comprehensive information on a broad range of mental health conditions. If you work in Forensic Mental Health, for example, explore UpToDate by entering ‘Forensic’ in the search field. This search will yield topics such as: Clinical care for incarcerated adults; Evaluation and management of adult sexual assault victims; Sexual abuse in children and adolescents; Physical abuse; Antisocial personality disorder, and more. As you review each topic, expanded menus will display to the right to provide detailed and referenced information including graphics (images).

UpToDate also features a ‘What’s New’ section, which provides summaries of recent updates within selected clinical specialties. The example below is from the current ‘What’s New in Psychiatry’:

Treatment of binge eating disorder (July 2016)

Several psychotherapies and medications have been studied for treating binge eating disorder. In a recent systematic review and meta-analysis of trials evaluating the efficacy of different treatment options compared with no treatment or placebo, there was strong evidence supporting the use of therapist-led cognitive-behavior therapy (CBT), lisdexamfetamine, or second-generation antidepressants (eg, selective serotonin reuptake inhibitors) [4]. In addition, less compelling evidence indicated that patients can achieve abstinence with self-help CBT or topiramate. We regard CBT as first-line treatment; however, no head-to-head trials have compared the efficacy of different active treatments. (See "Binge eating disorder in adults: Overview of treatment", section on 'Cognitive-behavior therapy'.)”

CIAP’s extensive collection of eBooks and texts includes DSM-5 and ICD-10 (International Statistical Classification of Diseases and Related Health Problems 10th Revision). Both of these texts are accessible by selecting Specialty Guides and Links at the bottom of the Quick Links panel on CIAP’s home page and then Mental Health. DSM-5 is also accessible by selecting Books and Dictionaries from CIAP’s left menu, where it appears on the Most Popular books list.

Many other texts of direct relevance and/or significance may be discovered by browsing Books and Dictionaries. One way to search for books is to ‘Browse by Publisher.’ Select Access Medicine to view many diverse and relevant eBooks. Of particular interest may be:

  • Medical Management of Vulnerable and Underserved Patients – this book explores policies, issues and diseases relating to vulnerable groups such as the homeless, immigrant populations, adolescents and the elderly (the ‘hidden poor’), and discusses the impact of mental health comorbidities on health outcomes for vulnerable population groups.

Learn more about CIAP’s resources by visiting the Knowledge Centre where you can find a range of helpful materials including video tutorials, user guides and live online training sessions.

Find out more about Mental Health Month events through Way Ahead Mental Health Association NSW and the Australian BPD Foundation Limited (Borderline Personality Disorder).

Therapeutic Guidelines

CIAP Update

eTG has released its update of Palliative Care.

The new update of eTG complete includes a comprehensive revision of the Palliative Care guidelines. A number of new topics are included to provide holistic advice on the principles of palliative care as well as management of symptoms. There is new advice on optimising pain management, and more detail on care in the last days of life. The guidelines highlight that a palliative approach to care can be adopted by any healthcare provider and applied to any patient with life-limiting illness, including those with malignant or nonmalignant conditions. See What’s new for more information on Palliative Care 4.

Triple Indexing in Ovid Medline

Ovid has recently released a new triple indexing feature to Embase, which is the three level indexing of full text articles. The update will enable users to view or select grouped subheadings that can assist in understanding the relevance of search results/articles.

For a detailed description of the new triple indexing feature on Embase, please watch this short tutorial video released by Ovid.

iMIMS App Update

MIMS have now released an update for the iMIMS app, which will fix the image and table display on IOS 10 devices. The update can be downloaded from the App Store and does not require users to uninstall the app or re-download any data.

psychiatry

Article in Focus

Efficacy and Safety of Antidepressants Added to Antipsychotics for Schizophrenia: A Systematic Review and Meta-Analysis

The American Journal of Psychiatry Volume 173 (9) 2016: 876-86

Abstract

This Meta-Analysis examined the safety and efficacy of antidepressants added to antipsychotic drugs in the treatment of schizophrenia.

Eighty-two RCTs with a total of 3608 participants were included. Add-on antidepressants appeared more efficacious than controls for depressive symptoms, negative symptoms, overall symptoms, positive symptoms, quality of life, and responder rate. There were no significant differences between antidepressants and controls in terms of exacerbation of psychosis, premature discontinuation, and the number of participants with at least one adverse event.

Analysis of primary outcomes (depressive and negative symptoms) suggests small, beneficial effects of adjunctive antidepressants.

To read the full article, or navigate to the ‘Full Journal List’ from the 'Journals' panel on the CIAP home page and search for the journal.

Ovid Today for Tablet Devices

Gems on CIAP

OvidToday for Tablet Devices

Ovid has now released the OvidToday app and offers free access to all CIAP users.

OvidToday provides on-the-go access to the last 6 months' worth of journals content as well as publish-ahead-of-print from the CIAP collection of Ovid journals. It also enables you to read or save articles in pdf format which can be accessed offline at any time. The app offers an intuitive, easy to navigate interface, which could change the way that you read journals and conduct and store your research.

OvidToday is available from the App Store, Google Play or Amazon Store.

For more information, visit the ‘Mobile’ section of CIAP.

Contact the CIAP Helpdesk 24 hours, 7 days a week.

or visit Support & Contact.

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