The development of the child and adolescent versions of the Verona Service Satisfaction Scale (CAMHSSS)

BACKGROUND

There is a shortage of comprehensive and validated instruments to measure satisfaction with Child and Adolescent Mental Health Services (CAMHS). This study chose the Verona Service Satisfaction Scale (VSSS as a template for the development of a new CAMHS Satisfaction Scale (CAMHSSS).

METHOD

The new questionnaires were developed by involving service users and members of the multidisciplinary team in several stages. The psychometric qualities of the 39-item draft were tested on a random sample.

RESULTS

A total of 56 adolescents and 104 parents participated in the study. The acceptability of the questionnaires was excellent, and internal consistency was high. Test-retest reliability was between substantial to moderate for individual items, and high for the seven dimension and the final versions of the scale. The questionnaires differentiated well between satisfied and dissatisfied service users.

CONCLUSIONS

Two versions were generated to measure service satisfaction among outpatients (CAMHSSS-39 and 20) and one for inpatients and day-patients (CAMHSSS-Unit). All have good psychometric properties and can be recommended for future studies.

A pilot open case series of ethyl-EPA supplementation in the treatment of anorexia nervosa

Anorexia nervosa (AN) carries the highest risk of morbidity and mortality amongst psychiatric disorders. The efficacy of current treatment approaches is limited. Despite the fat-phobic nature of the disease, poly-unsaturated fatty acids (PUFAs) have not received much research attention. Patients who consume western diet, which is rich in n-6 PUFAs and trans-fatty acids, are likely to develop severe n-3 PUFA deficiency during self-induced starvation. Re-feeding programmes do not take into consideration n-3 EFA intake, possibly leading to further n-3 PUFA deficiency during weight restoration, and this might contribute to the maintenance of the disorder. To test this hypothesis, we carried out a systematic case series of E-EPA supplementation in the treatment of AN. Seven young patients received 1g/day E-EPA in addition to standard treatment, and were followed up for 3 months. Three of them recovered and four improved. Randomised controlled trials are warranted to examine the effectiveness of E-EPA in AN further.

Dietary polyunsaturated fatty acids and anorexia nervosa: is there a link?

There has been little research examining the link between dietary fat intake and the symptoms and consequences of anorexia nervosa. In this selective literature review, the potential significance of poly-unsaturated fatty acids is discussed. It is hypothesised that dietary restriction causes essential fatty acid deficiencies and poly-unsaturated fatty acid abnormalities, which might contribute to the physical and mental symptoms and the maintenance of the disorder. The examination of epidemiology, symptoms, co-morbidity, and consequences suggest that poly-unsaturated fatty acid and phospholipid abnormalities are significant in anorexia nervosa. This will be an important area for future research, and may lead to the development of new interventions.