Samuel Thomson’s research while affiliated with Nottinghamshire Healthcare NHS Trust and other places

Background: Adolescents with anorexia nervosa rarely present themselves as having a problem and are usually reliant on parents to recognise the problem and facilitate help-seeking. This study aimed to investigate parents' experiences of recognising that their child had an eating problem and deciding to seek help. Methods: A qualitative study with interpretative phenomenological analysis applied to semi-structured interviews with eight parents of adolescents with a diagnosis of anorexia nervosa. Results: Parents commonly attributed early signs of anorexia nervosa to normal adolescent development and they expected weight loss to be short-lived. As parents' suspicions grew, close monitoring exposing their child's secretive attempts to lose weight and the use of internet searches aided parental recognition of the problem. They avoided using the term anorexia as it made the problem seem 'real'. Following serial unsuccessful attempts to effect change, parental fear for their child's life triggered a desire for professional help. Conclusions: Parents require early advice and support to confirm their suspicions that their child might have anorexia nervosa. Since parents commonly approach the internet for guidance, improving awareness of useful and accurate websites could reduce delays in help-seeking.

In England, a large proportion of general adult psychiatric consultations are outpatient appointments. To assess whether patients and doctors agree on the key components of outpatient consultations. Separate patient and doctor focus groups were conducted to generate perceived key components of the outpatient consultation for each group. A self-report questionnaire was then constructed, to assess how important these key components were considered to be by both patients and doctors in the clinical setting. The key components were rated in relation to specific consultations the participants were about to have. Paired responses were collated and analysed for similarity indices between patients and their doctors. One-hundred-and-three patient-doctor pairs completed the pre-appointment questionnaire. There was no statistically significant agreement detected between pairs of patients and doctors on the importance of any of the six key components of a general adult outpatient consultation generated by the patient and doctor focus groups. Patients and their psychiatrists disagree on the key components of an outpatient consultation. However, patient priorities are central to service delivery. Therefore, listening to the patients' priorities highlighted in this article is important to achieve patient-centred services.