Carers experience a significant amount of guilt and distress once they have found out about their loved one's eating disorder. Across the studies, there were many themes of unmet need for carers. Siblings have often been overlooked by both clinicians and researchers. Interventions for people with eating disorders should also acknowledge carers and close family members.

DTC is more effective than TAU in improving outcomes in personality disorder. Further studies are required to confirm this conclusion.

ObjectivesTo examine the clinical and cost-effectiveness of brief advice for excessive alcohol consumption among people who attend sexual health clinics.MethodsTwo-arm, parallel group, assessor blind, pragmatic, randomised controlled trial. 802 people aged 19 years or over who attended one of three sexual health clinics and were drinking excessively were randomised to either brief advice or control treatment. Brief advice consisted of feedback on alcohol and health, written information and an offer of an appointment with an Alcohol Health Worker. Control participants received a leaflet on health and lifestyle. The primary outcome was mean weekly alcohol consumption during the previous 90 days measured 6 months after randomisation. The main secondary outcome was unprotected sex during this period.ResultsAmong the 402 randomised to brief advice, 397 (99%) received it. The adjusted mean difference in alcohol consumption at 6 months was −2.33 units per week (95% CI −4.69 to 0.03, p=0.053) among those in the active compared to the control arm of the trial. Unprotected sex was reported by 154 (53%) of those who received brief advice, and 178 (59%) controls (adjusted OR=0.89, 95% CI 0.63 to 1.25, p=0.496). There were no significant differences in costs between study groups at 6 months.ConclusionsIntroduction of universal screening and brief advice for excessive alcohol use among people attending sexual health clinics does not result in clinically important reductions in alcohol consumption or provide a cost-effective use of resources.Trial registration numberCurrent Controlled Trials ISRCTN 99963322.

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