A small controlled trial of cognitive behaviour therapy for drug-resistant psychosis is reported. The study was designed as a pilot study for a future larger and longer randomized controlled trial. The therapy was offered to patients with a diagnosis of schizophrenia or schizo-affective psychosis who presented unremitting positive symptoms. An average of 16 sessions were delivered over a six-month period. The results of this pilot study are promising. Rates of engagement in therapy were high. The treatment group also improved significantly on a number of key symptom measures when compared with the controls. These were reductions in delusional conviction, general symptomatology and depression scores. Future studies should offer therapy over a longer period, targeting social as well as symptom change, and considering factors which will enhance maintenance of improvement.

Contributors WJB and DHM were involved in the conception and design of the study. JKS recruited and obtained consent from participants and conducted the MRI analysis. DRA conducted the statistical analysis. All authors contributed to preparation of the manuscript. Competing interests OC receives grant support from the Multiple Sclerosis Society of Great Britain and Northern Ireland, UCLH-UCL Biomedical Research Centre and honoraria from Novartis, Bayer Schering and GE. She is a member of the editorial board of Neurology. DHM has received honoraria through payments to his employer, UCL Institute of Neurology, for Advisory Committee and/or Consultancy advice in multiple sclerosis studies from Biogen Idec, GlaxoSmithKline, Novartis, Merck, Chugai, Mitsubishi Pharma Europe and Bayer Schering Pharma. He has also received compensation through payments to my employer for performing central MRI analysis of multiple sclerosis trials from GlaxoSmithKline, Biogen Idec, Novartis and Merck. Ethics approval Ethics committees at Queen Square and Moorfields Eye Hospital. Provenance and peer review Not commissioned; externally peer reviewed. Data sharing statement Clinical and MRI data are available for collaborative studies and can be requested by non-profit researchers.

Background: Low-grade fibromyxoid sarcoma (LGFMS) is a rare sarcoma subtype with a generally indolent pattern of clinical behaviour, but treatments for advanced disease are limited. Patients and Methods: A retrospective search of a prospectively maintained institutional database identified 102 patients treated from December 1994 to August 2018. We evaluated the outcome of patients and the efficacy and safety of non-surgical therapies in LGFMS. Results: Ninety-four out of 102 (92.2%) underwent primary resection, seven (6.9%) were treated with systemic therapy and one (1.0%) is currently being treated with pre-operative radiotherapy. The RECIST 1.1 response rate to first-line chemotherapy was 0%, and median progression-free survival was 1.84 months (95% confidence intervaI=0.10-3.6 months). Conclusion: Conventional systemic therapy has limited efficacy in advanced LGFMS.

A prospective randomized controlled trial was conducted to examine the relative effects of the provision of information and of cognitive-behavioural counselling on the psychological adjustment of women who had previously been informed of an abnormal cervical smear result and subsequently required a further diagnostic procedure (colposcopy examination) and treatment. Altogether, 219 women were randomized to one of two groups: (a) counselling plus the provision of an information leaflet, and (b) information leaflet only. Patients in both groups received an information leaflet with their first colposcopy appointment. Patients in the counselling group also attended a counselling interview prior to their colposcopy examination. The Abnormal Smears Questionnaire (a measure of specific concerns relating to the smear result and subsequent diagnostic and treatment procedures), together with the Spielberger State Anxiety Inventory (STAI-Yl), the General Health Questionnaire (GHQ-30), and the Profile of Mood States (POMS-36) were administered pre-colposcopy, post-colposcopy, pre-treatment, post-treatment and at three-and six-month follow-ups. Additionally a counselling evaluation questionnaire was completed by women in the counselling group after their colposcopy examination.High levels of distress were reported by both groups of patients on all measures prior to the colposcopy examination, with a subsequent highly significant postcolposcopy reduction, again in both groups. There were no significant differences in psychological functioning between the two groups at post-colposcopy assessment. Some minor differences emerged between the two groups at treatment and