Richard Bowskill

The effects of expressive writing on lung function, quality of life, medication use, and symptoms in adults with asthma: a randomized controlled trial

Objectives Asthma is a chronic condition affecting 300 million people worldwide. Management involves adherence to pharmacological treatments such as corticosteroids and &bgr;-agonists, but residual symptoms persist. As asthma symptoms are exacerbated by stress, one possible adjunct to pharmacological treatment is expressive writing (EW). EW involves the disclosure of traumatic experiences which is thought to facilitate cognitive and emotional processing, helping to reduce physiological stress associated with inhibiting emotions. A previous trial reported short-term improvements in lung function. This study aimed to assess whether EW can improve lung function, quality of life, symptoms, and medication use in patients with asthma. Methods Adults (18–45 years) diagnosed as having asthma requiring regular inhaled corticosteroids were recruited from 28 general practices in South East England (n = 146). In this double-blind randomized controlled trial, participants were allocated either EW or nonemotional writing instructions and asked to write for 20 minutes for 3 consecutive days. Lung function (forced expired volume in 1 second [FEV1]% predicted), quality of life (Marks Asthma Quality of Life Questionnaire), asthma symptoms (Wasserfallen Symptom Score Questionnaire), and medication use (inhaled corticosteroids and &bgr;-agonist) were recorded at baseline, 1, 3, 6, and 12 months. Results Hierarchical linear modeling indicated no significant main effects between time and condition on any outcomes. Post hoc analyses revealed that EW improved lung function by 14% for 12 months for participants with less than 80% FEV1% predicted at baseline (&bgr; = 0.93, p = .002) whereas no improvement was observed in the control condition (&bgr; = 0.10, p = .667). Conclusions EW seems to be beneficial for patients with moderate asthma (<80% FEV1% predicted). Future studies of EW require stratification of patients by asthma severity. Trial Registration: ISRCTN82986307

Health professionals' beliefs about medication for bipolar disorder

Purpose – The purpose of this paper is to compare beliefs about medication prescribed for bipolar disorder across professional groups within Community Mental Health Teams (CMHTs) – psychiatric nurses, psychiatrists, support workers, social workers, and occupational therapists – who each receive different training.Design/methodology/approach – Participants (n=138) completed an adapted version of the Beliefs about Medicines Questionnaire. ANOVAs with Tukeys post hoc tests were used to compare beliefs across professional groups.Findings – Beliefs about medication differed across professional groups, with psychiatrists believing most strongly that medication is necessary in the treatment of bipolar disorder (p<0.05) and reporting the lowest concern about its adverse effects (p<0.05). Psychiatrists and social workers were significantly more likely to believe that patients take less than instructed than occupational therapists, nurses and support workers (p<0.05).Practical implications – The differences in per...