Harder Crawford (bullchard3)

Objective To explore how the implementation of a motivational physical activity (PA) intervention for inpatients with severe mental illness was experienced by patients, staff, and leaders at a psychiatric institution. Method After the intervention individual semi-structured interviews were conducted with patients (n = 6) and staff (n = 6), and a focus group interview was conducted with the leaders (n = 4). Results All had a positive view on PA as part of psychiatric treatment, thinking it would benefit the patients' health. There were some differences among the groups as to the importance of PA relative to traditional treatments. Positive outcomes were reported from all three groups, but with different foci. The patients and the staff underscored the importance of PA professionals in order to achieve high quality activities, whereas the leaders, due to restraints in resources, could not prioritize to hire PA professionals. Conclusion PA was considered a positive part of treatment. Ideas about what it takes to obtain the potential physical, mental, and social benefits of PA differed between patients, the staff involved, and the leaders. Having staff with PA as a primary responsibility and with sufficient competence as PA instructors seems to be important. Copyright © 2020 Sørensen, Bentzen and Farholm.Family-based treatment (FBT) has become well established as the first-line evidence-based treatment for adolescents with anorexia nervosa. However, fidelity to the FBT model can be poor, and treatment is often augmented or modified in various untested forms in the hope of increasing its effectiveness and acceptability. The New Zealand Eating Disorders Clinic, a private specialist outpatient clinic in New Zealand, has been seeing increasing numbers of families presenting for treatment reporting an experience of "failed FBT". All of the families who presented with a child under the age 19 living at home agreed to restart FBT with the author when re-engaging in treatment. This essay summarizes the experience of the author in repeating FBT with previously "failed" FBT cases over 20 months between 2017 and 2019. Common themes of the first course of FBT were identified that raised questions for the author as to whether FBT had been implemented with sufficient fidelity and proficiency the first time around. This clinical perspective essay describes how these identified issues were addressed when FBT was administered again. It does not intend to make broad claims, but instead is intended to be helpful to clinicians who are implementing FBT, to assist them in carefully examining and assessing whether key FBT principles and procedures have been exhausted before evaluating the need for modification or augmentation. Furthermore, this perspective provides suggestions as to how the identified common themes can be addressed if families re-present for FBT treatment after having had a course of "failed FBT". Copyright © 2020 Lavender.Schizophrenia is a life-long mental disorder, affecting young adolescents to elderly patients. Antipsychotic treatment is indicated for all patients with schizophrenia, including the very young and old as well. Developmental issues in the young and decline in organ functioning in the elderly could influence reactions to the drug, and require different dosing regimens. The aim of the present article was to examine the safety profile and dosing requirements in adolescent (13 to less than 18) and elderly (65 and above) patients treated with cariprazine. Data from two clinical studies (one pharmacokinetic pediatric study and one phase III clinical trial) on 49 adolescent patients and 17 elderly patients (65 years of age or above) treated with cariprazine was examined. Safety measures included assessment of adverse events (AEs), clinical laboratory values, physical examinations, extrapyramidal symptom (EPS)-, depression-, and suicidality rating scales. Safety param