This month the National Institute for Health and Clinical Excellence (NICE) published their new evidence-based clinical guideline on "Physical advice: brief advice for adults in primary care".  NICE state "The guidance is for ... anyone ... whose remit includes offering lifestyle advice. Examples include: exercise professionals, GPs, health trainers, health visitors, mental health professionals, midwives, pharmacists, practice nurses, physiotherapists.  It may also be of interest to others with a role in encouraging physical activity and members of the public." 

I wrote an initial post yesterday on the very interesting recent Lancet paper "Cognitive behavioural therapy as an adjunct to pharmacotherapy for primary care based patients with treatment resistant depression: Results of the CoBalT randomised controlled trial".  In today's post I want to give a little more context to this trial and a bit more detail about the patients treated and the treatment used.

In January, the National Institute for Health and Clinical Excellence (NICE) published their new evidence-based clinical guideline on the care and treatment of adults with generalised anxiety disorder (GAD) or panic disorder (with or without agoraphobia).  This guideline updates and replaces their 2004 one (which was itself amended in 2007).  The full 56 page guideline is available as a PDF and in Word format.  It also comes as a 24 page "Quick reference guide" for health professionals, and as a 16 page "Treating generalised anxiety disorder and pan

Here are half a dozen recent research papers on depression (all details & abstracts to these studies are listed further down this blog post).  The first two are about the well-known Treatment for Adolescents with Depression Study (TADS).  There have been a whole series of research papers published on this large multisite US National Institute of Mental Health funded study.  For more information click on the TADS home page.  The study compared CBT, fluoxetine, or their combination in treating moderate to severe depression in teenagers.  As March & Vitiello state in their overview "Findings revealed that 6 to 9 months of combined fluoxetine plus CBT should be the modal treatment from a public health perspective as well as to maximize benefits and minimize harms for individual patients ...

Here are five papers on lifestyle and the benefits of making healthy choices.  The first by Cohen et al on sleep habits and susceptibility to the common cold, showed increased risk of developing a cold after infection for those with shorter sleep duration.  Interestingly the increased risk was even greater for those with poor sleep efficiency.  Sleep efficiency is calculated by dividing the time spent asleep by the time spent in bed trying to sleep.  The Good Knowledge section of this website contains useful information on assessing and treating sleep difficulties.

Here are half a dozen papers relevant to psychotherapy.   The first two throw some light on the question of whether it matters which form of established psychotherapy one uses to treat a particular depression sufferer - bearing in mind Cuijpers et al's recent meta-analysis suggesting that " ...

Blogging about my mum's illness and my reactions to it led me to think again about self disclosure by health professionals.  Our job is to be helpful for our clients - it's what we're about.  Self disclosure by health professionals is a mixed bag.  It can sometimes be helpful and sometimes damaging.  Different schools of therapy and different styles of doctor have strong opinions about what's right and wrong in this area.  Strong opinions without research back-up tend to generate more heat than light.  As has been so delightfully stated "The plural of anecdote is not data".  This post is not at all intended to be exhaustive about research on health professional self disclosure.  It is intended to shine a light on some interesting facts and to raise some questions.