The HOME study - Michael Sharpe s CBT for the elderly

Note it's called the 'HOME' study. They seem to select study names that will appeal to participants.... I find it rather disingenuous & cynical. This 'home' study - for people who are miserable & just want to go home. The PACE trial - for people who know that pacing works & would be much better off if thats all they did. The 'FINE' trial - for people who want to feel fine, but actually all is a very long way from fine because the head nurse thinks that ''the bastards dont want to get better''.
'SMILE' because thats what sick children would love to be able to do.....

I can only say EEEEWWWW.
 
Amw66 said:
Does this sound like SMILE - usual care v usual care plus intervention? Where is the control group?
( or have i not had enough coffee?)
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Don't be silly... having a proper control group might lead to a null result.

It would be so easy to have a control group (instead of 'seeing a doctor or nurse who specialises in psychological problems in the medically ill', the control group would have a cup of tea and a natter with just a regular visitor). There is so much social isolation that the elderly face, such that the fact of an extra visit itself is likely to have a positive effect, regardless of any psychological intervention delivered on said visit. The fact that no such control group is included tells you all you need to know about the poor trial design in psychological intervention studies. We'll get a 'positive' result that doesn't tell you either way whether the actual intervention, as opposed to increased social contact, is useful. But it'll guarantee jobs for the BPS industry.
 
Londinium said:
Don't be silly... having a proper control group might lead to a null result.

It would be so easy to have a control group (instead of 'seeing a doctor or nurse who specialises in psychological problems in the medically ill', the control group would have a cup of tea and a natter with just a regular visitor). There is so much social isolation that the elderly face, such that the fact of an extra visit itself is likely to have a positive effect, regardless of any psychological intervention delivered on said visit. The fact that no such control group is included tells you all you need to know about the poor trial design in psychological intervention studies. We'll get a 'positive' result that doesn't tell you either way whether the actual intervention, as opposed to increased social contact, is useful. But it'll guarantee jobs for the BPS industry.
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precisely
 
https://www.psych.ox.ac.uk/research/psychological-medicine-research-pmr
"
The Psychological Medicine Research group moved to Oxford from Edinburgh in 2011.

The work we have done to date includes the development and evaluation of treatments for patients with depression and cancer, medically unexplained neurological symptoms and chronic fatigue syndrome. "

https://www.psych.ox.ac.uk/team/michael-sharpe
Michael Sharpe
MA, MB BChir, MD, FRCP, FRCPEdin, FRCPsych
Professor of Psychological Medicine

  • Fellow of Saint Cross College, Oxford.
  • Honorary Consultant in Psychological Medicine and Trust Lead in Psychological Medicine at Oxford University Hospitals NHS Foundation Trust and advisor to Oxford Health NHS Foundation Trust.
  • Honorary Professor, University of Edinburgh.
  • NIHR Senior Investigator


    https://www.kcl.ac.uk/study/postgra...s/psychological-medicine-mdres-mphil-phd.aspx

    "The Department of Psychological Medicine focuses on the interface between psychiatry and medicine, psychiatry and occupation, psychiatry and the military, and psychiatry in different settings. The disorders of interest are those of the common mental disorders, such as depression, anxiety, perinatal psychiatry, eating disorders and stress related disorders. The principal research methodologies used within the department are epidemiological, clinical and psychological research, including cross sectional studies, cohort studies and randomised controlled trials. The Head of the Department is Professor Simon Wessely, Chair of Psychological Medicine, who is also Vice Dean for Academic Psychiatry.

    Psychological Medicine as a Department and as part of the Clinical Academic Group (CAG) with the same name has a unique position within King’s Health Partners as crossing the divide between psychiatry and medicine. Professors Matthew Hotopf and Simon Wessely provide the academic leadership for the CAG. Several members of the Mood, Anxiety and Personality Disorders CAG at King’s Health Partners are also part of the Department of Psychological Medicine."

    The Chronic Fatigue Research and Treatment Unit is jointly run with King’s College Hospital: this national specialist service undertakes assessment, treatment and research. Researchers are involved, for example, in the MRC PACE Trial, the largest trial of treatments for Chronic Fatigue Syndrome/ME to date, which is testing the effectiveness of different therapies. Research into the contribution of neuroendocrinological and other neurobiological factors in CFS/ME is conducted with the Chronic Fatigue Research and Treatment Unit, a national specialist service run jointly by King’s College Hospital NHS Foundation Trust and the Section of General Hospital Psychiatry."

    https://www.bps.org.uk/policy-research-guidelines
    https://www.bps.org.uk/sites/default/files/documents/code_of_human_research_ethics.pdf


Am posting this here because, I thought that, whilst they might overlap, Psychiatry and Psychology were supposedly different. But it appears that they both fall under Psychological Medicine (or at least they do now).
Psychiatrists are Profs of Psychological Medicine. So are they both (ie psychiatrists and psychologists) bound by the same guidelines and research ethics?
Sorry am just trying to figure out how this works. (might delete this post later)
 
Barry said:
@Sly Saint not sure if this might help:

https://www.mind.org.uk/information...sychologist-and-psychotherapist/#.WpK9q2rFLZY
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thanks. No I get that, and have read a few of those, but psychiatrists seem to be involved in a lot/most of the psychological 'research' (whereas most of the definitions say that they are the ones who prescribe medication as opposed to psychological treatment.......usually done by psychologists). Then as I said, their (the psychiatrists) departments and their titles say 'psychological medicine'..........
:confused:

I was reading thro the research ethics (see link above) of the BPS and just wondered if it applied to the RCTs like PACE, MAGENTA,SMILE etc as they are psychological therapies................but then you have Esther Crawley who is a Paediatrician.......so which ethics guidelines apply to her?
 
Sly Saint said:
Psychiatrists are Profs of Psychological Medicine. So are they both (ie psychiatrists and psychologists) bound by the same guidelines and research ethics?
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I think what happened is that sometime around 1980 psychiatrists wanted their speciality to sound a bit more friendly, and they thought 'psychological medicine' sounded nice. The same happened with geriatrics which became old age medicine.

But is is not difficult to see that both changes are likely to backfire. Being over 65 I fall under the scope of a geriatrician, but I do not particularly want to sit in the waiting room of an old age medicine clinic. Sixty -seven might have seemed old in 1980 but I have just had a good day skiing off piste and I hope to carry on a bit longer.

Psychiatry was a perfectly respectable speciality that dealt with illnesses that affected brain functions more to do with thinking and memory than just moving arms and legs. The psych part was about as invisibles the geri- bit of geriatrics or the orthopaedic bit of orthopaedics (the speciality of 'straightening children'). But 'psychological medicine' brings in the word 'psychological' which has a quite different meaning to ordinary people - to do with things you can control yourself, like beliefs or fear of heights. And it is a bit like 'psychosomatic research' - which strictly speaking means research that is not actually physically real but imagined. 'Psychological medicine' sounds pretty much like medicine that is just dreamed up by the doctors. Ironically it is becoming clear just how true that is.

So whereas there used to be psychiatry, where the doctors were psychiatrists and the helpers were psychiatric nurses and clinical psychologists (in rather recent times) the same thing is now psychological medicine. The doctors are still psychiatrists but because they work in departments of psychological medicine they become professors of psychological medicine.

Psychiatrists are involved in psychological research of a clinical kind because they have always been in charge. The 'clinical psychologists' have always been the handmaidens, just as physios were for rheumatologists.
 
Barry said:
In principle I agree, but if fulfilled politicians as a species would be decimated.
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Thats ok, i would be happy to have non reality denying leaders. Someone once said alternative medicine does not exist, medication either works or it does not. In many ways politics does not exist either, reality either exists or it does not. Except for a few issues reality is reality, taking from the poor to give to the rich does not improve society, pollution does harm humans, alternative facts are lies and so forth. We can vote for lies and when the consequences hit us vote for the other side and keep going back and forth which is common in many countries today.

The only real difference is what do we want as a society to be good or evil. If we want to believe lies and employ discrimination or not (based on disability, gender, religion, location, ethnicity etc). Thats what politics is really about today.
 
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