Mark Toynbee

Background To inform the future development of Consultation-Liaison (C-L) Psychiatry services we need accurate information on the prevalence of psychiatric disorders in the general hospital inpatient setting. Systematic reviews have summarized the literature on specific aspects of this broad topic, but there has been no high-level overview that agg...

Objective To determine the prevalence of anxiety in general hospital inpatients by conducting a systematic review and meta-analysis of all relevant published studies. Method We searched Ovid Medline, Ovid Embase and Ovid PsycINFO from inception to December 2020. We included studies of the prevalence of anxiety symptoms of clinically significant se...

Background Violence perpetrated by psychiatric inpatients is associated with modifiable factors. Current structured approaches to assess inpatient violence risk lack predictive validity and linkage to interventions. Methods Adult psychiatric inpatients on forensic and general wards in three psychiatric hospitals were recruited and followed up pros...

Objective: The question of whether depression is associated with worse survival in people with cancer remains unanswered because of methodological criticism of the published research on the topic. We aimed to study the association in a large methodologically robust study. Methods: We analysed data on 20,582 patients with breast, colorectal, gyna...

Objective To systematically review randomized trials of the effectiveness of inpatient Consultation-Liaison (C-L) Psychiatry service models in improving patient outcomes, reducing length of hospital stay and decreasing healthcare costs. Method We searched databases including Ovid Medline, Ovid Embase, Ovid PsycINFO and EBSCO CINAHL for relevant tr...

Objectives Our primary objective was to better discern features that can differentiate people with ‘mixed’ symptomatology from those who experience epileptic seizures (ES) or functional/psychogenic nonepileptic seizures (PNES) alone, in a population of patients referred for video-telemetry. We wished to see if we could establish the prevalence of P...

Objective: Depression and anxiety have both been reported to predict worse subsequent survival in people with cancer. However, depression and anxiety are mutually associated and we lack understanding of their independent associations with survival. We therefore aimed to investigate these in a large sample of patients with common cancers. Methods: W...

Objective To describe a new service model for the psychiatric care of general hospital inpatients, called Proactive Integrated Consultation-Liaison Psychiatry (‘Proactive Integrated Psychological Medicine’ in the UK). Method The new service model was developed especially for general hospital inpatient populations with multimorbidity, such as older...

Background: Prolonged acute hospital stays are a problem for older people and for health services. Failure to effectively manage the psychological and social aspects of illness is an important cause of prolonged hospital stay. Proactive Psychological Medicine (PPM) is a new way of providing psychiatry services to medical wards which is proactive,...

This chapter provides an overview of the links between mental health disorders and crime, particularly violent crime. The chapter summarizes the increasing evidence that mental illnesses, such as psychosis, bipolar disorder, and depression, are associated with an increased risk for violent offending, even after accounting for sociodemographic and f...

Background: Prolonged acute hospital stays are a major problem for older people and for health services. Failure to effectively manage the psychological and social aspects of illness is an important cause of prolonged hospital stays. Proactive Psychological Medicine (PPM) is a new way of providing psychiatry services to medical wards. PPM is proac...

This chapter explores the impact of physical health comorbidities on morbidity and mortality in individuals with psychiatric illnesses. There is a significant and enduring disparity in the life expectancy of the general population and people with severe mental illness (SMI). The majority of this inequality is due to preventable physical illness, pa...

Acute inpatient mental health care remains an irreplaceable part of some people’s mental health recovery pathway, either through the severity of their difficulties or the associated risks. It can often be a traumatic experience associated with distress and vulnerability both for patients and their relatives. Modern acute inpatient psychiatric care...

Background Little is known about the interventions required to build the capacity of mental health policy-makers and planners in low- and middle-income countries (LMICs). We conducted a systematic review with the primary aim of identifying and synthesizing the evidence base for building the capacity of policy-makers and planners to strengthen menta...

An impasse in negotiations between the Department of Health (DoH) and the British Medical Association in November this year led to an overwhelming vote for industrial action (IA) by junior doctors. At the time of writing, a last minute concession by DoH led to a deferment of IA to allow further negotiations mediated by the Advisory, Conciliation an...

FROM: Mundt AP, Chow WS, Arduino M, et al . Psychiatric hospital beds and prison populations in South America since 1990: does the Penrose hypothesis apply? JAMA Psychiatry 2015;72:112–18. About 80 years ago, Penrose proposed an inverse relationship between the relative number of psychiatric beds available to a population and its total number of p...

Research on mitochondrial replacement therapy (MRT) holds the promise of helping women who have, or are at risk of transmitting, mitochondrial disease, but has recently been blocked by the Food and Drug Administration (FDA). Thus, several critical ethical and policy questions arise. Mitochondrial disease can be devastating for those who have it. Ye...

We performed genetic and immunohistochemical studies in a sister and brother with autosomal recessive neonatal inflammatory skin and bowel lesions. The girl died suddenly at 12 years of age from parvovirus B19-associated myocarditis; her brother had mild cardiomyopathy. We identified a loss-of-function mutation in ADAM17, which encodes a disintegri...