Improving patient return to general practice after specialist assessment.

OBJECTIVE: The aim of this study was to evaluate the impact of a two-pronged, letter intervention strategy to improve the follow-up after referral (FAR) rate to general practitioners of patients referred for a psychiatric assessment. METHODS: The FAR rate of patients referred to the Inner South East Primary Mental Health Team (PMHT) between June 2007 and June 2008 was examined via telephone call, before and after the implementation of a process sending letters to patients and practice managers advising them to make an appointment to discuss recommendations resulting from the psychiatric assessment. RESULTS: A statistically significant improvement (χ² (1, n = 44) = 5.81, p = 0.016) in FAR rate was observed for patients post-intervention, with 11/25 (44%) pre-intervention patients not returning to their referring general practitioner within 1 month of assessment, compared to 2/19 (10.5%) patients post-intervention. CONCLUSIONS: The implementation of two simple and inexpensive measures resulted in a fourfold improvement in the return rate of patients to their referring general practitioner post-psychiatric assessment.

Mailing GP reply letters after psychiatric assessment - a pilot randomised controlled trial.

BACKGROUND: Patients are not always fully aware of the details of their assessment and management plan detailed in the letter sent from the specialist to the general practitioner following referral. One approach to solving this problem is for the specialist to copy the GP reply letter to the patient. OBJECTIVE: To determine whether receiving a copy of the GP reply letter improves outcomes in patients referred by their GP for a psychiatric assessment. METHODS: A single blinded randomised control trial comparing outcomes following a one-off consultation for a depressive and/or anxiety disorder in patients who received the GP reply letter sent from a community mental health service, to patients who did not. RESULTS: Data was collected for 21 letter recipients and 18 control participants. A significant group by time interaction found total DASS-21 scores improved to a greater extent for the letter recipient group, no significant difference in adherence was found.

"Overeating is not about the food": women describe their experience of a yoga treatment program for binge eating.

As part of a larger mixed-methods study, data from 20 personal journals were analyzed to examine the experience of a 12-week yoga treatment program for binge eating among a sample of 25 women who were obese. Qualitative analysis revealed a positive shift experienced by the women during the program, summarized by a general structural description: disconnection versus connection. Women's comments suggested that the program appeared to encourage a healthy reconnection to food, as well as the development of physical self-empowerment, through cultivating present-moment awareness. Specifically, women perceived an overall reduction in the quantity of food they consumed, decreased eating speed, and an improvement in food choices throughout the program. The women also reported feeling more connected to and positive about their physical well-being. These evolving outcomes were summarized through two major themes: the way their physicality changed, and the way their food consumption changed over time. Findings provide insights relevant to therapeutic processes that might occur within eating disorder interventions that draw on meditation-based approaches.

What do GPs want from a psychiatrist's letter?

OBJECTIVE: The aim of this study was to investigate the preferences of general practitioners (GPs) in reply letters for patients referred for a one-off psychiatric assessment. METHOD: A sample of GPs referring to a primary mental health team service were mailed a questionnaire inquiring into the usefulness of 21 different letter items. RESULTS: The response rate was 51%. Many of the items in our routine reply letters were rated highly, but others such as developmental history, supplementary information and a comprehensive report were not. Sending a copy of the letter to the patient was rated as useful by only 42.5%. CONCLUSIONS: The Royal Australian and New Zealand College of Psychiatrists' guidelines for reply letters are endorsed. There are, however, some additional items that GPs may find useful.

Yoga as a treatment for binge eating disorder: a preliminary study.

OBJECTIVE: To examine the efficacy of a 12-week yoga program aimed at reducing binge eating severity. DESIGN: A randomised trial was undertaken assigning participants to yoga (n=45) or wait-list control (n=45) groups. Of these, 25 in each group were analysed. PARTICIPANTS: A community-based sample of women between 25 and 63 years of age who identified with diagnostic criteria for binge eating disorder (BED) and a BMI>25 were recruited for the study. MAIN OUTCOME MEASURES: Primary outcomes included the Binge Eating Scale (BES) and International Physical Activity Questionnaire (IPAQ). Secondary outcomes comprised measures for BMI, hips and waist. RESULTS: For the yoga group, self-reported reductions in binge eating and increases in physical activity were statistically significant. Small yet statistically significant reductions for BMI, hips and waist measurement were obtained. The wait-list control group did not improve significantly on any measures. CONCLUSION: In conjunction with formal weekly sessions, home-based yoga programs are potentially efficacious for the treatment of binge eating.