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By Hole Ousia Posted on August 11, 2019February 21, 2023

National Suicide Prevention Strategy

Last month I wrote to the Lead for the National Suicide Prevention Strategy for England. The current lead, Professor Louis Appleby, has a prominent social media presence and naturally many … Continue reading National Suicide Prevention Strategy

Categories: Antidepressant prescribing, Depression, Medical Education, Medical humanities, Pharmaceutical industry and Medical Education, Psychiatry, Stigma, suicideTags: #pillshaming, 100 words, 2002, 2019, 2020, A disorder for everyone, A message from Professor Louis Appleby, a timeline from 2002 to 2019 in relation to England's National Suicide Prevention Strategy, A timeline of missed opportunities, A word to the coroner, Academics and social media hostility, AD4E, advisor, akathisia, antidepressant, antidepressant aware, antidepressants, April Charity, Beverley Thorpe, Birthe L. Knizek, BJPsych, BMJ, British Journal of Psychiatry, Care Quality Commission, Carmine Pariante, Centre for Mental Health and Safety, CEP, Chasing Time, chronicle of a death foretold, Clare Gerada, Council for Evidence Based Psychiatry, death, Dexter Britain, Do Antidepressants Save Lives? A Comment On The 2016 Interim Report On Suicide Prevention By The House Of Commons Health Select Committee, Dr Michael Hengartner, Dr Peter J Gordon, duty of candour, elusive, England's National Suicide Prevention Strategy, Executive Director, Freedom to speak up, From Truth, Gabriel García Márquez, Gilbert Farie, Gilbert Farie Revisited, Government, Heidi Hjelmeland, Helen McArdle, Herald, Hole Ousia, House of Commons, Huffpost, Ian Marsh, impulsivity, JAMA 2004, Katrina Jaworski, Last month I wrote to the Lead for the National Suicide Prevention Strategy for England, Louis Appleby, Manchester, Marion Brown, medication-induced akathisia, medication-induced suicide, mental health, Mental health drug epidemic for children in Scotland, Michael Hengartner, Michael P Hengartner, Michael Pascal Hengartner, Millie and the Tsar, Millie Kieve, MISSD, missd.co/, Narrative Controllers, National Clinical Director for Health and Criminal Justice, National Confidential Inquiry into Suicide and Homicide, National Director for Mental Health, National Lead, National lead for suicide prevention, National Suicide Prevention Strategy, Newer-Generation Antidepressants and Suicide Risk in Randomized Controlled Trials: A Re-Analysis of the FDA Database., Omphalos, Omphalos films, Paroxetine, PE1493, PE1651, Perfect I am not, Peter Gordon, Plöderl, powerful embrace, Prescribed drug dependence and withdrawal, Prescribed harm, Problematic advice from suicide prevention experts, Prof Carmine Pariante, Prof Louis Appleby, Professor Carmine Pariante, Professor Clare Gerada, Professor Louis Appleby, Professor Sir Louis Appleby, Professor Sir Simon Wessely, rebel antiquary, Rob Kerwin, Robert Francis, SAER, Selective Serotonin Reuptake Inhibitor, Seroxat, Significant Adverse Events, Simon Says, Simon Wessely, Social maverick, Soft Power, SSRI, SSRIs, SSRIs double the risk of suicide and violence in healthy adults., suicidality, suicide, suicide risk and the SSRIs, The Narrative Controllers, the National Suicide Prevention Strategy for England does not seem to engage on social media with those who have experienced less than positive experiences of psychotropic medications, The Rebel Antiquary, The University of Manchester, thical Human Psychology and Psychiatry, Treatment emergent violence to self and others, University of Manchester, Wilful Blindness, Willful blindness, withdrawal, working with the Government, www.simonwessely.com, Zero Suicide Alliance

By Hole Ousia Posted on March 22, 2015January 19, 2023

Do we care enough about consent?

This leaflet is widely available to patients in NHS Scotland including in the waiting room outside my consulting room: Its first page defines consent as follows: This is the front … Continue reading Do we care enough about consent?

Categories: Ageing, British Medical Journal, Delirium, Dementia, History of medicine, Medical humanities, Medical writings, NHS Scotland, ScreeningTags: "screening for dementia and delirium is a practice to be recommended", Alzheimer Scotland, Alzheimer's Society, antipsychotics, Antiquary, APPG, BMJ, Care Standards, Change Page: “Don’t use antipsychotics routinely to treat agitation and aggression in people with dementia, Chief Executive of the Mental Welfare Commission for Scotland, Cognitive screening, comprehensive delirium pathway, comprehensive delirium pathway as developed by SDA and HIS includes use of prescribed Haloperidol, Concerns about the over-prescribing of antipsychotic drugs in the elderly, Consent, Cumberlege, Daniel Sokol, Delirium, Delirium Screening, Dementia, dementia screening, Do we care enough about consent?, Doing damage in delirium, Doing damage in delirium the hazards of antipsychotic treatment in elderly people, Dr Peter Gordon, Ethics Committee of the Royal College of Psychiatrists, ethics man, Fiona Godlee, fully informed consent, Fully informed consent: NHS Scotland, Glasgow Declaration, Gunnar Jungner, Gunnar Jungner and the Principles and Practice of Screening for Disease, he principle of patient consent should be a fundamental right for all ages, Healthcare Improvement Scotland, HEAT target 4, HIs mandatory screening recommendation, Hole Ousia, House of Commons, How to improve dementia diagnosis rates in the UK, how you should be involved in decisions about your healthcare and treatment, incentivised target, incentivised target for the early diagnosis of dementia, Independent Medicines and Medical Devices Safety Review, informed consent, it's your decision, James Maxwell Glover Wilson, Legal update on consent: what doctors must know, mandatory delirium screening, mental Welfare Commission, MSP, National Clinical Lead for dementia, New rules of consent: the patient decides, NHS Scotland, Peter Gordon, Peter's Declaration, Peter's Lost Marbles, Prescribed drug dependence and withdrawal, Prescribed harm, Principles and Practice of Screening for Disease. World Health Organisation, Realistic Medicine, rebel antiquary, rights-based, Royal College of Psychiatrists, Scottish Government, Scottish Parliament, Social maverick, target-driven, target-driven medicine, The Antiquary, The faltering unfaltering steps, The Glasgow Declaration, The Rebel Antiquary, timely diagnosis, timely diagnosis of dementia, UK National Screening Committee, VOX, we have applied a bit of HEAT to the system, why ethics matters to us all, Wilson and Jungner

By Hole Ousia Posted on January 17, 2015January 15, 2023

Evidence to back dementia screening is still lacking, committee says

This report has just been published in the BMJ: It has attracted this response from a “free spirit” and “old man”: The article begins: “GPs have again raised the question … Continue reading Evidence to back dementia screening is still lacking, committee says

Categories: Alzheimer's disease, British Medical Journal, Dementia, Medical humanities, NHS Hospitality Registers, NHS Scotland, Pharmaceutical industry and Medical Education, Screening, Sunshine Act for ScotlandTags: Alzheimer Society, Alzheimer's, Alzheimerisation, Antiquary, APPG, ’ to circumvent [National Screening Committee] guidance, BMJ, case-finding, case-finding and screening, Classic Pharma shill stuff, Dementia, Dementia case-finding: language and ethics, dementia screening, Dementia Tsar, DGHSC, Dr Peter Gordon, early diagnosis is everywhere, early diagnosis of demenia, Edinburgh Consensus, Evidence to back dementia screening is still lacking, Evidence to back dementia screening is still lacking committee says, focusing on what is measured rather than the outcomes intended, Geoff Huggins, Glasgow Declarartion, HEAT target 4, high rate of false-positives, Hole Ousia, House of Commons, How to improve dementia diagnosis rates in the UK, incentivised target, incentivised target based approach, incentivised target for the early diagnosis of dementia, Industry's interest in diagnosing dementia, Intelligent Kindness: Reforming the Culture of Healthcare, Issues not considered in the 'Edinburgh Consensus', J K Anand, National Clinical Director for Dementia, national clinical leads and disease champions argue that early detection policies are exercises in ethical case-finding, NHS England policy has been to introduce screening programmes in primary and secondary care by using the term ‘case finding, NHS Scotland, NHS Scotland DGHSC, Nicola Sturgeon, Omphalos, Omphalos films, one and the same, Open letter to the prime minister and chief medical officer for England: There is no evidence base for proposed dementia screening., paid opinion leaders, paid opinion leaders are a blot on medicine’s integrity and we should make them a thing of the past, parabolic pattern, Paul Gray, Peter Gordon, Peter's Lost Marbles, Professor Alistair Burns, rebel antiquary, retired doctor, Scotland's approach to dementia diagnosis, Scottish Government, Scottish Government DGHSC, screening, Screening and case-finding are one and the same thing, snakes ladders and Monopoly, Social maverick, target-driven, target-driven activities, target-driven medicine, The Antiquary, The Glasgow Declaration, the glasgow declaration was based on Peter's work, The Rebel Antiquary, there has never been a recommendation to screen for dementia, UK Screening Committee

By Hole Ousia Posted on September 29, 2014January 14, 2023

Early detection of dementia: RCPsych result

“This House supports the early detection of dementia” Following on from my previous post which outlined my opposing argument, I can now share the result of this RCPsych debate: The … Continue reading Early detection of dementia: RCPsych result

Categories: Alzheimer's disease, Dementia, Neuro-imaging, NHS Hospitality Registers, Pharmaceutical industry and Medical Education, Sunshine Act for ScotlandTags: "Toxic certainty" - Alzheimer's Society, 'King of Lewy Body research', 'The Edinburgh Consensus: Preparing for the advent of disease-modifying therapies for Alzheimer's disease' Alzheimer's research & therapy, 2014, A 24-week, a blot a stain or perhaps something worse, A rallying call for an evidence based approach to dementia ‎and related policy, A rallying call for an evidence based approach to dementia ‎and related policy development, A Sunshine Act for Scotland, A timely arrival, acetyl-cholinesterase inhibitors are not disease modifying, acetylcholinesterase inhibitors, advocated the pre-diagnosis of dementia, ageing brain, ageism, Alistair Burns, All-Party Parliamentary Group on Dementia, All-Party Parliamentary Group on Dementia. How to improve dementia diagnosis rates in the UK, ALZ1906, ALZ1907, Alzheimer, Alzheimer Scotland, Alzheimer Society, Alzheimer Society film: Dementia Ambassador, Alzheimer's, Alzheimer's disease, Alzheimer's from the inside out, Alzheimer's Society, Alzheimer’s drugs ‘overprescribed’ suggest NHS figure, Alzheimerisation, Alzheimerisation of society, amyloid, Amyloid imaging to prevent Alzheimer's disease, AMYPAD, AMYVID, an underestimation by analysts of the number of people with Alzheimer’s disease, and Cost of Physicians' Prescribing: A Systematic Review, anti-amyloid drugs, anti-dementia, anti-dementia drugs, Antiquary, at risk, ‘Evidence Based Medicine’ or ‘Industry Biased Medicine’, “Anti-dementia” drugs improve the outcome, Back in the driving seat, Bad Medicine, Bad Medicine: dementia, Baroness Cumberlege, barriers to evidence-based prescribing in Alzheimer’s disease, BBC news, Big Pharma, Bioscience's Promethean Promises of the new biology, BMJ, BMJ 2013;347:f5597, BMJ 2014;348:g2607, branding, branding firm, British Journal of General Practice, by putting clinicians in the driving seat of any clinical ‎assessment will protect individuals against any inappropriate intervention, Cambridge Cognition, CANTAB mobile, CANTABmobile and its misleading promotion, Cart or Horse, case-finding, case-finding and screening, Chan M. WHO director-general addresses G8 dementia summit., Chief Executive of the Mental Welfare Commission for Scotland, Chief Executive Officer of IXICO, Classic Pharma shill stuff, Clive Ballard, Cognitive Impairment: Do you have the evidence you need to reach a diagnosis?, competing interests, Complete Clarity, Complexity and dementia, Conditions and Diseases, Conference, Confusion is everywhere, Consent, Continuing Medical Education and its entanglement with the Pharmaceutical Industry, Cumberlege Review, current treatments only help with symptoms for a short while, David Cameron, Delphi figures, Dementia, dementia ambassador, Dementia case-finding: language and ethics, dementia challenge, Dementia DES, Dementia DES will result in widespread misdiagnosis, dementia guidelines, Dementia Guidelines: research and clinical criteria are not simply “interchangeable”, Dementia Policy, dementia prevalence calculator, Dementia Tsar, Dementia: the “epidemic” of metaphors, Dementia: who is in the “driving seat, Derek Hill, Des Spence, disease mongering, do prescribe the “anti-dementia” drugs, Do we care enough about consent?, Does early diagnosis really save lives?, double-blind, double-blind study of donepezil in moderate to severe Alzheimer’s disease, Dr Iona Heath, Dr Jill Rasmussen, Dr Peter Gordon, Driving Sea, Driving Seat, Drug Discovery Programme - Alzheimer's Society Dementia Research, DSM5 Minor Neurocognitive Disorder, Durham, Early detection of dementia: RCPsych result, early diagnosis, early diagnosis is crucial to end “toxic uncertainty” for both patient and family, early diagnosis is everywhere, Early diagnosis of Alzheimer’s disease, early diagnosis of dementia, Edinburgh, Edinburgh Consensus, Effects of memantine on cognition in patients with moderate to severe Alzheimer’s disease: post-hoc analyses of ADAS-cog and SIB total and single-item scores from six randomized, Eli Lilly, Eli Lilly UK, EPAD, epidimiology, ethicists, ethics, European ALCOVE project, European Prevention of Alzheimer's Dementia Consortium, evidence, explaining to my patients that this is because they may produce mild symptomatic improvements in the short term, false positives, Fiona Phillips., first do no harm, FOI returns, From forgetfulness to dementia: clinical and commissioning implications of diagnostic experiences, fully informed consent, future-focussed market landscape, G8 dementia summit, G8 summit, Genes Cells Brains, Geoff Huggins, Glasgow Declaration, Good Medical Practice, Good news on dementia prevalence – we can make a difference., Government backs new high tech early dementia assessment service to reduce time to diagnosis from 18 months to 3 months, harm, he full spectrum of ethical issues in dementia care: systematic qualitative review, he paradigmatic brain pathology of Alzheimer’s Disease – plaques and tangles – is only a post-mortem finding of limited explanatory value in the expression of dementia in the population, Health & Social Care Information Centre, HEAT target 4, Hilary and Steven Rose, Hole Ousia, Hope over dementia summit boost to ailing industry, House of Commons, How much is too much medicine, How to improve dementia diagnosis rates in the UK, How we risk getting it wrong in cognitive screening too, Human Rights, imaging, Improvement in behavioural symptoms in patients with moderate to severe Alzheimer’s disease by memantine: a pooled data analysis, In Defence of Wonder (And other philosophical reflections), in terms of a cure, In the driving seat, In this published reply no declarations of interest were made., independent experts or drug representatives in disguise, industry, Industry's interest in diagnosing dementia, Information from Pharmaceutical Companies and the Quality, informed consent, interests, Inverse care, Issues around early diagnosis of Alzheimer’s disease, Issues not considered in the 'Edinburgh Consensus', IXICO has worked with seven of the top fifteen pharmaceutical companies, IXICO: we put patients at the heart of what we do, J Haynes, Jeremy Hunt, Jesse Ballenger, Key Opinion Leaders, Key opinion leaders: independent experts or drug representatives in disguise?, Kill the QOF, Lancet, LCOVE: a European Joint Action on Alzheimer’s disease, lived experience, Long-term Donepezil treatment in 565 patients with Alzheimer’s disease (AD2000): randomised double-blind trial, Lunbeck, Lundbeck, Many of these Key Opinion Leaders are today still being well paid for educating us all, Mapping the Future of Alzheimer’s Disease: The Business Problem, maps, Margaret Chan, Martin Brunet, Mary Midgley, MCI, Medical Diagnostics, Medical Sociology and Old Age: Towards a sociology of health in later life., medication, mental Welfare Commission, mild cognitive impairment, Mini–mental state examination, misdiagnosis, modifying, Motion defeated, My argument against the motion, My reply to Tripathi and Kumar, Narrative Controllers, National Clinical Director for Dementia, National Dementia 2014 Conference, Neurological Disorders, NHS Scotland, NICE, NICE guidance, NICE guideline 42 (updated), no competing declarations, No sunshine for Scotland, Northern and Yorkshire Autumn Conference of the Royal College of Psychiatrists, Nuffield Council on Bioethics, old age psychiatrist, On the Map, Only now, only when off-patent, Open letter to the prime minister and chief medical officer for England: There is no evidence base for proposed dementia screening., or even a treatment that can modify the disease we are empty-handed, outcome, Outcome of judicial review for NICE guidance on drugs for Alzheimer's disease., over-diagnosis, overdiagnosis, Overdiagnosis: when good intentions meet vested interests, paid opinion leaders, paid opinion leaders are a blot on medicine’s integrity and we should make them a thing of the past, parabolic distribution, paradigm shift, paradigmatic, PE1493, PE1517, Peter Gordon, Peter J Gordon, Peter's Lost Marbles, pharma, Pharmaceutical Industry, placebo controlled studies, plaques, plaques and tangles, Political drive to screen for pre-dementia: not evidence based and ignores the harms of diagnosis, Polypropylene Mesh Medical Devices, Post-diagnostic support, pre-diagnosis of dementia, preclinical, preclinical Alzheimers, preclinical dementia, prevention, Primum non forgetful, Principles and Practice of Screening for Disease. World Health Organisation, Probity, prodromal, prodromal dementia, Professor Alistair Burns, Professor Alistair Burns considers that I may have taken the wrong direction by expressing concerns about bias introduced by vested commercial interests, Professor Carol Brayne, Professor Clive Ballard, Professor Sube Banerjee, prognosis, Progressive Test, Promises of transparency? Hold the applause, Proposed dementia screening: Confusion is everywhere, public health, PULSE magazine, Putting dementia on the map, Quantity, randomized, Raymond Tallis, RCPsych, Realistic Medicine, rebel antiquary, rebranding psychiatry, Rees Jones, Reply by Tripathi and Kumar, research, research criteria, Reward doctors for early diagnosis of dementia, Richard Taylor, Ritchie Consultancies Ltd, Robert K Merton, room 101, Royal College of Psychiatry, says think tank, scientific pluralism, Scientists want G8 countries to quadruple funding for dementia research within 10 years, Scottish Government, screening, Screening and case-finding are one and the same thing, Senility, Shrink rethink: rebranding psychiatry, SIGN 86 Guideline, Simone de Beauvoir, snakes ladders and Monopoly, Social maverick, Social Structure and Anomie, stigma, Sunshine Act, Sunshine Act for Scotland, swayed by the determination of a "Paid Opinion Leader", tangles, Target Diagnosis Rates - a New Mechanism for Overdiagnosis?, target-driven, target-driven activities, target-driven medicine, targets, Tau Therapeutics, The Alzheimer’s Hockey Stick, The Antiquary, The BMJ’s stance on collaboration with industry, The Cognitive Function and Ageing Study (CFAS) I and II, the death of old age, the diseased other, The Edinburgh Consensus, The Evolving classification of dementia: placing the DSM-V in a meaningful historical and cultural context and pondering the future of “Alzheimers”, The featured image (above) is from the Alzheimer's Society and is their position statement on current anti-dementia medications, The forgetfulness of others, The Glasgow Declaration, The medical untouchables, The Myths we Live By, The Narrative Controllers, the paradigmatic brain pathology of Alzheimer’s Disease – plaques and tangles – is only a post-mortem finding of limited explanatory value in the expression of dementia in the population, The patient paradox, the Prime Minister's Challenge on Dementia, The Rebel Antiquary, The report of the Independent Medicines and Medical Devices Safety Review, the result of the debate, the summit is reached, The [generally hidden] place of big business, This House supports the early detection of dementia, This story seems to reveal that my profession was perhaps not following evidence but rather wishful thinking and indeed mythology, Through the amyloid gateway, Timely debate, timely diagnosis, timely diagnosis of dementia, to prevent Alzheimer's disease, Too much Medicine, Transparency, Tripathi, Truth telling and dementia, Unlocking Diagnosis, urrent treatments don’t stop dementia from progressing, Use of NICE appraised medicines in the NHS in England, waiting lists, wandering wondering and worrying, was not irrational in concluding that there is no cumulative benefit to patients after 6 months treatment with these drugs, we have had twelve different categories for mild cognitive change in the later years of our life, we will be making a prognosis not a diagnosis, What do we mean by Alzheimer's disease, Who were the biggest winners and losers of the G8 dementia summit?, why ethics matters to us all, Why I feel angry - not grateful - after David Cameron’s dementia summit, widespread misdiagnosis, Wilson and Junger, Wilson and Jungner, windfall of elders, World Alzheimer Report 2011, Wrong Direction

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