The Nottingham Psychiatric Archive

ITEMS OF SPECIAL INTEREST.

Annotations by J.E Cooper and S.Leask.

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These items, present in the Archive, have been selected as of special interest. Some are are unique to Nottingham and some of them have not been published elsewhere.

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All of these items can be accessed directly from this list without going into the Master list of the full Archive. The first five can be downloaded directly from the "Background" section of this website, and the rest  have all been published elsewhere (references are given).

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1). 361 D Gruenberg E. (1983) Mission to Britain. International Journal of Mental Health.

This is a quite long paper describing the background to visits by Macmillan to the USA and reciprocal visits by Gruenberg and others to the UK. These culminated in Gruenberg’s visit to Mapperley hospital to see if what Duncan Macmillan said he had done about running a mental hospital with no locked doors was really true ( it was true, as described in detail in the next item 395) .

 

2). 360 D Gruenberg E. (1983) Memories of Duncan Macmillan . This was written at my request and has not been published elsewhere. It describes in detail Gruenberg’s experiences when visiting Macmillan. He stayed in Mapperley hospital, , having free access to all wards and departments, and had daily discussions with Duncan Macmillan.

 

3). 374 Kennedy C. and Bennet (2011) Ernest Gruenberg ; a biographical sketch.

This was written at my request after his death, and has not been published elsewhere. Cille Kennedy worked closely with Ernest Gruenberg for many years, and they were eventually married. Latterly she worked in the NIMH administration dealing with disability legislation.

 

4). 371 Davis N. (2003) Memories of Duncan Macmillan.(written at my request, and not previously published).

Nora had a unique view of Duncan Macmillan, first from the local government services, and then as medical records officer at Mapperley Hospital. In this post she also worked with Eileen Brooke ( of the Register Office) on the early stages of the manual version of the Mapperly Case register. She then transferred to the team that computerised the case register , playing a vital role in the collection and checking of the data for entry.

 

5). 244 Cooper J.E. Mapperly and Duncan Macmillan. Talk given by JEC to the Institute of Mental Health, Nottingham (2011). This was 10 years after my retirement. It was designed to be a non-technical account suitable for an audience of non-psychiatrists (mainly young trainee mental heath workers who had never worked in a mental hospital and knew very little about the work of Duncan Macmillan.)

 

6). 348 2s Chisholm, D., Conroy, S., Oates, M.R. et al. 2004 Health services research into postnatal depression :  results from a preliminary - cross cultural study.    British Journal of Psychiatry 184 [ suppl 46 ]; 45-52, and:
351 2s Oates, M.R. 2015 Perinatal Mental Health Health Services. Recommendations for the provision of services for childbearing women.    Royal College of Psychiatrists Council report 197

Dr Margaret Oates, Lecturer and Senior Lecturer, became an expert in all matters to do with infants and mothers and perinatal mental disorders, and set up a unique Mothers and Babies unit in the QMC. Latterly she also became an expert in maternal mortality . For all this she was honoured with the Royal College of Psychiatrists Lifetime Achievement award in 2013, and appointed OBE in 2017. The unit was named after her, but some years after her retirement it was moved out of the QMC in the totally misguided re-arrangements of all the psychiatric services of Nottingham around 2015-2018.

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7). 25 Giggs J.A. and Cooper J.E. (1987) Ecological Structure and the distribution of schizophrenia and affective psychoses in Nottingham. British Journal of Psychiatry 151 627-633.

John Giggs of the University Department of Geography had done a similar study before the advent of the Medical School, but was able to repeat it using the computerised Case Register and the better quality diagnostic data from the Nottingham data of the WHO DOSMED study (Determination of the Outcome of severe Mental Disorders). The study showed that almost all the patients with schizophrenia were clustered in the central areas of the town having indices of social deprivation, in contrast to the patients with affective disorders who lived mostly in the more peripheral areas with more favourable social indices.

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8). 31 Jones S. and Turner R. (1987) Assessing patients in their homes; the first steps in community care . Bulletin of the Royal College of Psychiatrists 11(4) 117- 119.

Dr Richard Turner was the NHS consultant who led the way in a number of innovations during the development of the flexible sectorisation of the Nottingham psychicatric services. All patients referred to his sector team, whether urgent of not, were assessed within a few days in their homes by a psychiatrist and a psychiatric social worker from his sector team. He developed excellent relationships with the social services, and was the first to have a sector base.

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9). 32 Harrison G., Holton A. et al. ( 1989) Severe Mental Disorder in Afro-Caribbeans. Psychological Medicine vol 19 683 - 696 . This was the first of a number of studies headed by Glyn Harrison on this topic in Nottingham, using the same basic methods as in the WHO DOSMED study. The high incidence was confirmed by other studies elsewhere.

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10). 40 Arie T. (1990) Combined Geriatrics and Psychogeriatrics; a new model. Geriatric medicine, April , pp 24-27. This method of service provision was of great benefit to the patients, since it avoided the often problematic decision of whether the patient should be regarded as suitable for a psychiatric or a geriatric service.

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11). 27  Cooper J.E. , Goodhead et al. (1987) The incidence of Schizophrenia in Nottingham. British Journal of Psychiatry vol 151 pp619 – 626. After the IPSS, Nottingham replaced London as the UK Field Centre for the WHO. , and carried out the DOSMED study ( Determinants of Outcome of Severe Mental Disorders ), an incidence and two year follow-up study. The Nottingham rate was roughly in the middle of the range of the range of rates of all the other centres.

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12). 66 Mason P., Harrison G., Glazebrook C. et al. (1995) Characteristics of outcome in Schizophrenia at 13 years follow-up. British Journal of Psychiatry v 167 596 -603. This was an unusually complete (90%) follow-up, and found nobody in a long-stay hospital unit.

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13). 21 2c Kontny, E. , Jones S. et al. (1986) The design of a zoning system; an example from the Nottingham Psychiatric Case Register. In - Psychiatric Case registers and public health, eds S.Ten Horn, R.Giel, W.Gulbinat and J Henderson. Elsevier, Amsterdam.

Between 1975 and 1985, the general adult psychiatric services of Nottingham were developed into six zones of roughly equal size, each served by a multidisciplinary team led by two consultants. Each sector had an admission ward and a sector base, and the sector boundaries were chosen so that all sectors had a mixture of both high and low referral rate areas ( thus providing approximately equal workloads). All referrals were dealt with by the appropriate sector team in the first instance, but exceptions could be made if either the patient of the referring GP insisted. The change was gradual and took about ten years, but resulted in a service with very short waiting lists and high staff satisfaction.

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14). 114  Kirkbride J.B., Croudace T. et al. (2008 ) Is the incidence of psychotic disorder in decline?     International Journal of Epidemiology 38(5) 1255-64 .   The studies done in Nottingham over a 20 year period give the opportunity to examine whether the incidence of first episode psychosis has changed, and to test whether any change could be explained by demographic or clinical changes. Patients from the entire population of Nottingham at risk aged 16 to 54 over three time periods ( 1978-1980, 1993-1995 and 1997-1999) Were followed up. All participants presenting with ICD9 or ICD-10 diagnoses of first episode psychosis were included (347 participants). The findings suggest that psychotic disorders are not in decline, although there has been a change in syndromal presentation of non-affective disorders away from schizophrenia towards other nonaffective psychoses. The incidence of substance induced psychotic disorders increased.

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15). 146 Morgan, C., Lappin, J., et al. (2014)    Reappraising the long-term course and outcome of psychotic disorders: the AESOP-10 study. Psychological Medicine. 44(13), 2713-26.
This analysis from the 10-year follow-up of a multi-centre first episode cohort lacks a bias present in many long-term follow-up studies, which often feature prevalent cases who therefore have poorer prognosis. It observes that in the ten years after patients present with psychosis, sustained periods of remission are the norm, and almost half recover.