Press Releases Saturday 8 May 1999
No 7193 Volume 318
Please remember to credit the BMJ as source when publicising
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article and to tell your readers that they can read its full text on
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(1) MENTAL
HEALTH SERVICES SHOULD AIM TO IMPROVE
SAFETY TO PREVENT SUICIDE AND HOMICIDE - BUT
RETROSPECTIVE INQUIRIES SHOULD BE
DISCONTINUED
(2) FURTHER
EVIDENCE ON THE EFFECT OF THE NATIONAL
CERVICAL SCREENING PROGRAMME
(3) BETTER
EMERGENCY MEDICAL ASSISTANCE SHOULD
BE PROVIDED AT MARATHONS
(4) ARECA (BETEL) NUTS COULD DAMAGE YOUR HEALTH
(1) MENTAL HEALTH SERVICES
SHOULD AIM TO IMPROVE
SAFETY TO
PREVENT SUICIDE AND HOMICIDE - BUT
RETROSPECTIVE
INQUIRIES SHOULD BE
DISCONTINUED
(Suicide within 12 months of contact
with mental health services:
national clinical survey)
http://www.bmj.com/cgi/content/full/318/7193/1235
(Mental disorder and clinical care
in people convicted of homicide:
national clinical survey)
http://www.bmj.com/cgi/content/full/318/7193/1240
(Suicide and homicide by people with
mental illness)
http://www.bmj.com/cgi/content/full/318/7193/1225
About 1000 people who commit suicide each
year (nearly a quarter
of all suicides) and about 40 of those
who commit homicide (about
eight per cent of all UK homicides) have
had some contact with the
mental health services in the year before
death suggest researchers
in two papers in this week's BMJ. The
team from the National
Confidential Inquiry into Suicide and
Homicide by People with
Mental Illness, at the University of Manchester
base their finding on
detailed clinical data collected on a
sample of people in England and
Wales who committed suicide during a two
year period or who
committed homicide during 18 months.
The authors say that their amalgamated
findings highlight problems
of non-compliance with medication regimens,
loss of contact
between patients and mental health services
and drug and alcohol
misuse. They say that these problems emphasise
the need to
develop strategies for preventing such
tragic incidents.
In an accompanying editorial Dr John Geddes
from the Warneford
Hospital in Oxford says that the full
1999 inquiry report "Safer
Services" makes 31 recommendations for
changes in clinical
practice. These include recommendations
about training in risk
assessment, documentation (including the
introduction of "patient
passports"), the use of specific drug
and psychological treatments,
reducing access to means of suicide and
changes in the Mental
Health Act to allow compulsory community
treatment. He warns
that policymakers should be cautious about
implementing these
wide-ranging recommendations. He says
that there are substantial
uncertainties largely unacknowledged in
the report about the current
knowledge about suicide prevention and
he says that these
uncertainties present a need for further
research.
Geddes also suggests that individual local
inquiries into homicide
should be discontinued because they are
retrospective and foster a
simplistic notion of the preventability
of homicides and suicides.
Contact:
Professor Louis Appleby, Director, National
Confidential Inquiry
into Suicide and Homicide by People with
Mental Illness, School of
Psychiatry and Behavioural Sciences, University
of Manchester,
Withington Hospital, Manchester M20 8LR
Email: Louis.Appleby{at}man.ac.uk
Dr John Geddes, Honorary Consultant Psychiatrist,
Department of
Psychiatry, University of Oxford, Warneford
Hospital, Oxford
Email: john.geddes{at}psych.ox.ac.uk
(2) FURTHER EVIDENCE
ON THE EFFECT OF THE NATIONAL
CERVICAL SCREENING
PROGRAMME
(Effect of screening on cervical
cancer mortality in England and
Wales: analysis of trends with an
age period cohort model)
http://www.bmj.com/cgi/content/full/318/7193/1244
In this week's BMJ a paper written by Dr
Peter Sasieni and Joanna
Adams from the Imperial Cancer Research
Fund supports recent
findings of a beneficial effect of the
national cervical screening
programme. The authors say that before
the relaunch of the
programme in 1988 screening had a minimal
effect on mortality, but
since its relaunch screening appears to
have reduced cervical
cancer mortality by over 60 per cent in
those aged under 55 years
(up until 1997). They estimate that 1300
lives were saved in 1997 by
screening in previous years.
Contact:
Dr Peter Sasieni, Senior Scientist, Department
of Mathematics,
Statistics and Epidemiology, Imperial
Cancer Research Fund,
London Communications Department, Imperial
Cancer Research
Fund, London WC2A 3PX
Email: comms{at}icrf.icnet.uk
(3) BETTER EMERGENCY
MEDICAL ASSISTANCE SHOULD
BE PROVIDED
AT MARATHONS
(Medical rules are need in marathons
in the United Kingdom)
http://www.bmj.com/cgi/content/full/318/7193/1285
Legally binding medical rules should be
introduced for marathons
run in the UK, write Phillip and Pauline
Loyley in this week's BMJ.
The parents of Anna Loyley, who collapsed
and died as she crossed
the finishing line of a half marathon,
say that race organisers should
be compelled to provide advanced life
support at such events and
they call upon the sports minister to
take action. According to the
Loyleys, currently the UK Athletics 98
rules do not stipulate the
degree or quality of care that should
be provided, nor do they
specify the need for advanced life support
or advanced cardiac life
support, the role of medical staff or
what is meant by emergency.
They report that their daughter collapsed
on the finish line close to
first aid staff who were equipped with
a modern automatic external
defibrillator. Evidence presented at the
inquiry suggested that
although the staff reached her within
less than a minute they did not
diagnose cardiac arrest or follow the
correct defibrillator
procedures, claim Mr and Mrs Loyley.
In France, medical rules are comprehensive
and legally binding, say
the authors. The French rules call for
a high degree of mobility of a
doctor skilled in resuscitation, paramedical
ambulances and an
effective means of radio communication.
They conclude that 70 athletes have died
in the past ten years in the
UK at such sporting events and that the
"....current haphazard
system....should not be allowed to continue".
Contact:
Phillip and Pauline Loyley, Bath, UK
Email: loyley.int{at}dial.pipex.com
(4) ARECA (BETEL) NUTS COULD DAMAGE YOUR HEALTH
(Areca nuts can have deleterious
effects)
http://www.bmj.com/cgi/content/full/318/7193/1287
Not all nuts are good for your health,
write a team of researchers in
a letter in this week's BMJ. In particular
the areca nut (often
referred to as the betel nut), which is
chewed by over 200 million
people world wide is linked to several
damaging effects on oral and
general health report Chetan Trivedy and
colleagues from King's
College Hospital in London.
The authors report that consumption of
areca has been strongly
linked to the development of a potentially
malignant disorder of the
oral cavity and a high incidence of oral
cancer in the Indian
subcontinent and among Indian immigrants.
They say that the nut
has also been linked with cardiovascular
disease, diabetes and
asthma.
Trivedy et al conclude that recent research
which suggests that
eating nuts may be a safe and healthy
habit should have specified
safe nuts and considered the potentially
damaging effects of others,
such as areca.
Contact:
Saman Warnakulasuriya, Reader in Oral Medicine
& Pathology,
King's College Hospital London
Email: s.warne{at}kcl.ac.uk
FOR ACCREDITED JOURNALISTS
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London WC1H 9JR
(contact Jill Shepherd;pressoffice{at}bma.org.uk)
and from:
the EurekAlert website, run by the American Association for the
Advancement of Science
(http://www.eurekalert.org)
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