The British journal of psychiatry : the journal of mental science
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A debate has ensued about the long-term consequences of mild traumatic brain injury, the 'signature injury' of the Iraq and Afghanistan Wars. Most epidemiological studies have found that mild traumatic brain injury is unrelated to unspecific post-concussion symptoms based on self-reported symptoms. A longitudinal study, in this issue of the Journal, using objective tests has demonstrated that mild traumatic brain injury has limited lasting neuropsychological consequences.
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The UK has seen a dramatic increase in alcohol consumption and alcohol-related harm over the past 30 years. Alcohol taxation has long been considered a key method of controlling alcohol-related harm but a combination of factors has recently led to consideration of methods which affect the price of the cheapest alcohol as a means of improved targeting of alcohol control measures to curb the consumption of the heaviest drinkers. Although much of the evidence in favour of setting a minimum price of a unit of alcohol is based on complex econometric models rather than empirical data, all jurisdictions within the UK now intend to make selling alcohol below a set price illegal, which will provide a naturalistic experiment allowing assessment of the impact of minimum pricing.
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Editorial Comment
Does cannabidiol protect against the negative effects of THC?
A recent study by Morgan and colleagues found that cannabidiol attenuates the acute cognitive effects of delta-9-tetrahydrocannabinol (THC). This is of interest as THC has been associated with the detrimental effects of cannabis on mental health in at-risk users, and the potency of cannabis is increasing across Europe.
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Editorial Comment
Psychotherapy research: do we know what works for whom?
Clinical decision-making about suitability for psychological therapies is hampered by limitations of psychotherapy research and our lack of understanding of therapeutic mechanisms. Watzke et al's important randomised controlled study offers apparent validation for clinical judgement in relation to suitability for psychodynamic psychotherapy but also highlights the negative effects of unselected assignment to this type of treatment. Here, I consider why systematic selection for this form of treatment may be important and suggest how the limited effectiveness of psychodynamic therapy for an unselected group of patients may be addressed by more systematic treatment delivery and the ongoing monitoring of intermediate treatment outcomes.
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During the period of austerity that we now face, the National Health Service (NHS), including mental health services, will have to make efficiency savings at a time when demand for services is likely to rise. It is critical to highlight that investment in evidence-based prevention, early intervention and treatment for mental disorders can have economic benefits that go far beyond the health sector. Many potential areas for efficiency savings, such as resources invested in management and administration, are relevant across the whole of the health system. The economic downturn may, however, also present a specific opportunity for radical innovation within the mental health system.