A gilded cage is still a cage: Cheshire West widens 'deprivation of liberty'.

The Supreme Court's recent judgment in Cheshire West has clarified, and broadened, the legal definition of deprivation of liberty, with the new definition reflecting the fact that human rights apply to everyone in the same way. The widely criticised Deprivation of Liberty Safeguards need to be replaced: recommendations for reform are set out.

Psychiatrists' experiences of being stalked: a qualitative analysis.

Stalking is a well-recognized social phenomenon, one that particularly affects health care professionals, especially psychiatrists and other mental health workers; however, the nature and effects of stalking of psychiatrists have not been examined in detail. This study is a qualitative thematic analysis of the free-text responses of 2,585 psychiatrists in the United Kingdom (approximately 25% of all U.K. psychiatrists), almost 11 percent of whom described being stalked according to a strict research definition, and 21 percent of whom perceived themselves as having been stalked. It demonstrates that threat minimization, negative psychological impact, awareness of vulnerability, and difficulty obtaining help were major themes in how psychiatrists viewed their experiences of being stalked. It shows how some psychiatrists coped better than others and makes suggestions for appropriate professional support.

Effects of severe mental illness on survival of people with diabetes.

BACKGROUND: People with mental health problems are more likely to die prematurely than the general population but no study has examined this in individuals with diabetes. AIMS: To compare survival rates in people with diabetes with and without schizophrenia or bipolar disorder. METHOD: A total of 43,992 people with diabetes were drawn from the QRESEARCH database population of over 9 million patients. Survival rates during the study period, between 1 April 2000 and 1 April 2005, and hazard ratios for deaths associated with schizophrenia and bipolar disorder were adjusted by age and gender and additionally for socioeconomic status, obesity, smoking and use of statins. RESULTS: Among the participants, we identified 257 people diagnosed with schizophrenia, 159 with bipolar disorder and 14 with both conditions. Although crude survival rates did not show significant differences between the groups during the study period, people with schizophrenia or bipolar disorder and diabetes, compared with those with diabetes alone, had a significantly increased risk of death after adjusting for age and gender, with hazard ratios for schizophrenia of 1.84 (95% CI 1.42-2.40) and for bipolar disorder of 1.51 (95% CI 1.10-2.07). After adjusting for the other factors, hazard ratios were 1.52 (95 CI 1.17-1.97) for schizophrenia and 1.47 (95% CI 1.07-2.02) for bipolar disorder. CONCLUSIONS: People with schizophrenia or bipolar disorder in addition to diabetes have a relatively higher mortality rate. This suggests that diabetes either progresses more rapidly or is more poorly controlled in these individuals, or that they have higher levels of comorbidity and so are more likely to die of other causes.

Who stalks? A description of patients at a high security hospital with a history of stalking behaviour.

BACKGROUND: Knowledge about stalking, and in particular the people who do it, is limited in the UK. AIM: This study aims to describe a sample of stalkers drawn from the resident population of Broadmoor high security hospital in the UK. METHODS: Case notes and research database information for 362 consecutive admissions were used to identify stalkers retrospectively. Data were extracted using a stalking behaviour screening checklist. RESULTS: A total of 33 patients (9.1%) were classified as stalkers. They were mostly male (28), young (median age 29), unmarried (30), minimally educated and unemployed. Most had psychosis and personality disorder. They had inflicted a wide range of unwanted intrusions and communications on their victims, and both threats (55%) and assaults (45%) were common. The types of stalkers were more or less equally split between intimacy seeking, rejected suitors, resentful and predatory, with only a tiny group being incompetent suitors. CONCLUSIONS: Although this small group of stalkers had been intrusive and attacking, few had been referred for treatment because of the stalking. The screening questionnaire is easy to use and can be done from records. It may be that such screening should become routine in specialist secure hospitals.

Effects of medial prefrontal cortex cytotoxic lesions in mice.

Mice (C57BL/6J strain, females) with cytotoxic lesions of the medial wall of the prefrontal cortex were given a battery of tests to assess emotional, species-typical, cognitive, motor and other behaviours. Lesioned mice showed a profile of reduced anxiety, both on a plus-maze, and a similar, novel test, the successive alleys. There was no evidence, however, for attenuation of anxiety in tests of hyponeophagia, and lesioned mice, like controls, preferred the black to the white area of an enclosed alley. Their locomotor activity tended to be higher than that of the controls, particularly when the test surroundings were novel or relatively so. Species-typical behaviours were similar to those of control mice, except lesioned mice displaced ('burrowed') less food pellets from a tube in their home cage. They were not impaired at learning a spatial Y-maze reference memory task, which is profoundly affected by cytotoxic hippocampal lesions in the same strain, or at learning a multi-trial passive avoidance test. Their strength and co-ordination in motor performance tests was also normal. The results show that cytotoxic medial prefrontal cortex lesions in mice produce a clear but restricted anxiolytic action. The marked reduction in burrowing, in the absence of any detectable impairment of motor ability, demonstrates the sensitivity of this behavioural index.