Aims and method In up to a quarter of patients, schizophrenia is resistant to standard treatments. We undertook a naturalistic study of 153 patients treated in the tertiary referral in-patient unit of the National Psychosis Service based at the Maudsley Hospital in London. A retrospective analysis of symptoms on admission and discharge was undertaken using the OPCRIT tool, along with preliminary economic modelling of potential costs related to changes in accommodation.Results In-patient treatment demonstrated statistically significant improvements in all symptom categories in patients already identified as having schizophrenia refractory to standard secondary care. The preliminary cost analysis showed net savings to referring authorities due to changes from pre- to post-discharge accommodation.Clinical implications Despite the enormous clinical, personal and societal burden of refractory psychotic illnesses, there is insufficient information on the outcomes of specialised tertiary-level care. Our pilot data support its utility in all domains measured.
This work is, to the best of our knowledge, the first to neuroimage the effects of a "hallucinatory rTMS protocol" on basic auditory processing in healthy controls. Our data demonstrated that a so-called "inhibitory paradigm" can also produce distal neuronal activation and that effects can vary with neural loading. These results highlight the insufficient knowledge of the effects of rTMS on normal physiology, and this, combined with a lack of consensus on clinical trial parameters, may be contributing to the ambivalent data in therapeutic trials.
Word reading and short-term memory performance of forty two developmental dyslexics (mean age 10.1 years, SD = .7) and thirty three unimpaired reading age matched (mean age of 8.5, SD = .5) and thirty six unimpaired chronological age matched children (mean age of 10.6, SD = .7) was investigated in transparent Polish orthography. Fifty of the children were instructed that they were expected to recall the list of (12 high frequency mainly concrete) words after reading them aloud (Condition A), whilst others had no such instructions (Condition B). Word reading was tested by recording the time taken to read aloud the list of words in seconds and by taking into account errors in pronunciation. Overall, word reading was significantly slower for developmental dyslexics compared to reading age (RA) and chronological age (CA) controls. However, developmental dyslexics' recall of words was comparable to CA and significantly superior to RA both in conditions A and B of the experiment. The implications of these results in relation to the impact of spelling transparency on memory performance of impaired and unimpaired readers are discussed.
Word reading and short-term memory performance of forty two developmental dyslexics (mean age 10.1 years, SD = .7) and thirty three unimpaired reading age matched (mean age of 8.5, SD = .5) and thirty six unimpaired chronological age matched children (mean age of 10.6, SD = .7) was investigated in transparent Polish orthography. Fifty of the children were instructed that they were expected to recall the list of (12 high frequency mainly concrete) words after reading them aloud (Condition A), whilst others had no such instructions (Condition B). Word reading was tested by recording the time taken to read aloud the list of words in seconds and by taking into account errors in pronunciation. Overall, word reading was significantly slower for developmental dyslexics compared to reading age (RA) and chronological age (CA) controls. However, developmental dyslexics' recall of words was comparable to CA and significantly superior to RA both in conditions A and B of the experiment. The implications of these results in relation to the impact of spelling transparency on memory performance of impaired and unimpaired readers are discussed.
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