SELECTED ABSTRACTS

EFFECTIVENESS OF CONGNITIVE-BEHAVIOURAL FAMILY INTERVENTION IN REDUCING THE BURDEN OF CARE IN CARERS OF PATIENTS WITH ALZHEIMER'S DISEASE

alison marriot, caherine donaldson, nicholas tarrier and alistair burns
Background : The majority of patients with Alzheimer's disease live outside institutions and there his considerable serious psychological morbidity among their carers.
Aims : To evaluate whether family intervention reduces the subjective burden reduces the subjective burden of care in carers of patients with Alzheimer's disease and produces clinical benefits in the patients
Method : A prospective single-blind randomized conformed trail with three month follow-up in which the experimental group received family intervention and was compared with two control groups.
Results : there were significant reduction in distress and depression in the intervention group compared with control groups at post- treatment and follow up. There were significant reduction in behavioural disturbance at post-treatment and an increase in activities at three months in patients in the intervention group. Based on an improvement on the General Health Questionnaire resulting in a carer converting from a case to a non-case, the number to treat was three immediately post-treatment and two at follow-up
Conclusion : Family intervention can have significant benefits in carers of patients with Alzheimer's disease and has a positive impact on patient behaviour.
Declaration of interest: The study was funded through a fellowship from the Alzheimer's disease Society.
British Journal of psychiatry (2000,176,557-562)

COGNITIVE-BEHAVIOUR THERAPY AS A TREATMENT FOR IRRITABLE BOWEL SYNDROME : A PILOT STUDY

PHILIP BOYCE, JEMMA GIL CHRIST, NICHOLAS J., TALLEY, DONNA ROSE
Objective : The Irritable Bowel Syndrome (IBS) is a chronic and often disabling functional bowel disorder. Psychological treatments, in particular cognitive and behavioural interventions, have been shown to be effective for this disorder. The aim of this study was to test the efficacy of a cognitive behaviour program.

Method : Eight participants (seven female, on male) aged between 24 and 71 years, with a diagnosis of IBS according to the Rome criteria, were recruited from among the gastroenterology outpatients at Nepean Hospital, in psychological function and bowel symptom severity. Following a 2-week has baseline period, participants began a structured psychological treatment comprising eight sessions of cognitive-behaviour therapy. Through out treatment, participants maintained dairy records of symptom severity and completed homework assignments to ensure treatment compliance. The pretreatment assessment measures were repeated 1 week poet-treatment.
Results : After treatment, five of the eight patients no longer met the Rome diagnostic criteria for IBS. There was no significant reduction in bowel symptom frequency. There were, however, significant improvements in the distress and disability associated with bowel symptoms. Anxiety and depression were also significantly reduced.
Conclusions : Cognitive-behaviour therapy reduced the distress and disability associated with IBS, but not the frequency of bowel symptoms. This supports the proposed cognitive model for IBS, and cognitive-behaviour therapy appears to have its effect by altering the cognitive response to visceral hypersensitivity
Ke words : Cognitive-behaviour therapy, functional bowel disorders, irritable bowel syndrome, somatisation.
(Australian and New Zealand Journal of Psychiatry 2000; 34;300-309)

EFFECT OF DEATH OF DIANA, PRINCESS OF WALES ON SUICIDE AND DELIBERATE SELF-HARM
KEITH HAWTON, LOUIS HARRIS, LUIS APPLEBY, EDMUND JUSZCZAK, SUE SIMKIN, ROS
Background : The death of the Princes of Wales in 1997 was followed by widespread public mourning. Such major events may influence suicidal behaviour.
Aims : To assess the impact of the Princess's death on suicide and deliberate self-harm (DSH).
Method :Analysis, using Poisson regression, of the number of suicides and open verdicts ('suicides') in England and Wales following the Princess's death compared to the 3 months beforehand, and the equivalent periods in 1992-1996. Similar analysis on DSH presentations to a general hospital.
Results : Suicides increased during the month following the Princess's funeral(+17.4%). This was particularly marked in females (+33.7%), especially those aged 24-44 years(+45.1%). Suicides did not fall in the week between the death and the funeral. Presentations for DSH increased significantly during the week following the death (+44.3%), especially in females the death (+44.3%), especially in female (+65.1%). Examination of case notes suggested that the influence of the death was larger, though amplification of personal losses or exacerbation of existing distress.
Conclusion : The death of a major public figure can influence rates of suicidal behaviours. For DSH, the impact may be immediate, but for suicide it may be delayed.
Declaration of  interest:None British Journal of Psychiatry (2000,177,463-466).
PSYCHOTHERAPIES IN PSYCHO-ONCOLOGY AN EXCITING NEW CHALLENGE

SIDNEY BLOCH AND DAVID KISSANE
Background : There is ample scope to devise form of psychotherapy in conclusion-liaison psychiatry, including the newly evolving area of psycho-oncology.
Aims : To highlight the development of psychotherapy in psycho-oncology, providing two illustrations.
Method : We report on conceptual and clinical research in the context of oncology and palliative care, focusing on (a) an approach for families at risk of maladaptive bereavement; and (b) a group programme for women newly diagnosed with early stage breast cancer.
Conclusion : Psychotherapists should grasp the opportunity to bring their skills to the medical arena, but need to subject newly devised interventions to well designed and methodologically rigorous research.
Declaration of interest : This research has been supported by the Australian Rotary Health Fund, Bethlehem Griffiths Research Foundation and the Australian National Health and Medical Research Council.  British Journal of Psychiatry  (2000,177,112-116).
PSYCHIATRIC MORBIDITY OF A RURAL INDIAN COMMUNITY CHANGES OVER A 20 YEAR
D.N. NANDI, GAURANAGA BANERHEE, S.P. MUKHERJEE, ASIT GHOSE, P.S. NANDI AND S. NANDI

Background : Cross sectional studies give no indication of the changes that may occur in the mental health status of a community in course of time. Studies should be designed to assess these changes.

Aims: To assess the changes, if any, in the prevalence of mental disorders in a rural community after an interval of 20 years in the context its changing socio-economic conditions.
Method : A door-to-door survey of the prevalence of psychiatric morbidity in two village was conducted by a team of psychiatrists. The survey was repeated after 20 years by the same team and by the same method. Changes in the mental health status of the community were compared.

Results : Total morbidity per 1000 fell from 116.8 to 105.2. Morbidity in men fell from 86.9 to 73.5 per 1000 and in women from 146.8 to 138.3 per 1000. Rates of anxiety, hysteria and phobia had fallen dramatically and those of depression and mania had risen significantly.
Conclusion : The level psychiatric morbidity showed on statistically significant change. The morbidity pattern (relative propertion of type of morbidity). However, showed some interesting changes. Similar studies should be done on a larger sample.
Decleration of interest : None British Journal of Psychiatry (2000,176,351-356).