bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contemporary psychosurgery: indications, outcome and the Irish experience
Authors: O'Doherty Miriam , Bridges Paul K 
Published: March 2016

AbstractObjectives: To review recent use of psychosurgery in Britain and Ireland; to outline the indications and contraindications; and to summarise the Irish experience of psychosurgery.Method: The Geoffrey Knight National Unit for Affective Disorders (GKU), now based at the Maudsley Hospital has performed the largest number of psychosurgical operations in the last 30 years. This paper reviews criteria for referral and outcome of stereotactic subcaudate tractotomy at the GKU. The twenty-one referrals from Ireland to the Unit, resulting in eight operations over the fifteen year period 1981-1995, are considered separately.Results: The efficacy of stereotactic subcaudate tractotomy is of the order of 30-60% and there is a low incidence of long-term adverse effects. The outcome of the eight Irish patients who underwent psychosurgery compare favourably with the overall outcome figures for the Unit.Conclusions: Stereotactic subcaudate tractotomy remains a treatment of last resort in the rare cases of severely treatment-resistant affective disorders and obsessive compulsive disorders.
Dr Michael Kelleher (1938-1998)
Authors: Webb Marcus 
Published: March 2016

Psychiatrists throughout Ireland lost a valued and respected colleague when Michael Kelleher died on the 9th August 1998. It is unusual for a doctor and certainly for a psychiatrist to receive widespread tributes in the national as well as the professional press, and these have borne eloquent witness to Michael's qualities as a man and to his achievements as a psychiatrist.Dr Kelleher's major achievements have been well recorded: they particularly concern his research in Cork on suicide in the latter decades of the 20th century. This interest arose from his work with a post-graduate student, Dr Maura Daly, in the early 1980s. They identified the rising suicide rate, especially amongst the young, and set about understanding the phenomena they carefully observed. Having provided evidence that improved official reporting of suicide was not a sufficient cause of the rising rate, Dr Kelleher moved on to focus on unemployment, the availability of medicines, substance abuse and the rapid changes in Irish society in seeking to explain these disturbing trends. His writing was careful and considered and he maintained a consistently high standard of scholarship. This is clearly evident in his editorial “Youth suicide trends in the Republic of Ireland” for the British Journal of Psychiatry, published posthumously in September 1998. In latter years his voice became familiar in the media when he was always lucid and cautionary, while strongly advocating measures to improve Ireland's mental health.
Empirical investigation into placebo effectiveness
Authors: Dolinska Barbara 
Published: March 2016

AbstractObjectives: To investigate whether placebo effects may vary in strength, depending on appearance of the medication.Method: Polish subjects were randomly given different kinds of pills and told that the medicine was produced abroad or in Poland and that it was cheap or very expensive. Measures of different forms of well-being were taken directly after the ‘therapy’.Results: Subjective ratings were higher for subjects who received big white or small red medicine compared to subjects who received small white or big red pills. The results are discussed in the light of the subject's previous experience with drugs of different kinds.Conclusion: It was shown that placebo effects do vary in strength, depending on the appearance of the pill.
Management advice for children with chronic fatigue syndrome: a systematic study of information from the internet
Authors: Wright Barry , Williams Christine , Partridge Ian 
Published: March 2016

AbstractObjectives:Parents often present practising clinicians who see children with chronic fatigue syndrome with printouts from the internet. These are then brought into the discussion about the management and aetiology of this debilitating condition. We set out to systematically study the information on the internet on this subject and to explore the diversity of advice in relation to current research knowledge.Method:Systematic search by means of the internet browser Netscape Navigator and search engines AltaVista and Yahoo! Advice about levels of rest, exercise, medication, psychological interventions and suggestions about return to school is critically compared with current research evidence.Results:Thirteen websites were accessed. All have some treatment advice. Six offer conflicting advice about levels of rest, with two suggesting large amounts of rest, two suggesting some rest and two suggesting graded exercise. Nine suggest medications (with a wide variety of pharmacological activities) despite the lack of research evidence showing a significant contribution from medication. Four suggest psychological treatments but some advise that it is unnecessary despite the established evidence in chronic fatigue (and other chronic illnesses) that appropriate psychological treatments are helpful. There are a wide variety of differing diets recommended.Conclusions:Few websites provide useful management advice. Advice offered is often in conflict. Some of the advice is either contrary to current research evidence or not supported by it. This raises concerns about inaccurate information reaching families who have a child with chronic fatigue syndrome, with potentially damaging consequences. This suggests a need for a debate about the availability and validation of health related information on the internet.
The views of professional on the role of self-help groups in the mental health area
Authors: Dunn Elizabeth A , Fitzpatric Aine C 
Published: March 2016

AbstractObjectives:Changes in healthcare policy over the last decade emphasise care in the community over residential care. Self-help organisations may play a useful role in these circumstances. Against this background, the objective of this study was to obtain the views of members of the main mental health professions on the place of self-help groups in mental health care.Method:A postal survey of 255 mental health professionals from two health boards was carried out, using a semi-structured questionnaire that contained both open and closed questions. The responses obtained were analysed using descriptive statistics and content analysis as appropriate.Results:The response rate was 35% so results must be interpreted cautiously. Self-help groups are used particularly in the management of addictive behaviours, and are also considered useful in cases of mood disorder. In general, self-help organisations are seen as providing support to patients and their families; information on mental illness/health to the general public; and lobbying for services relevant to the needs of their members. Respondents were concerned that the philosophy and programme of a group should not conflict with established models of mental health. The impact of the organisational structure of the multi-disciplinary team on the referral pattern of the different mental health professions, and the role of group availability and accessibility on the decision to refer a patient to a self-help group is commented upon.Conclusions:While some professionals see a role for self-help organisations in the mental health care system, reservations expressed about a possible clash between selfhelp groups' approach and professional mental healthcare practice need to be addressed so that the potential of both positions can be realised.
Towards mental hospital closure – a study of a residual long-stay population
Authors: Farragher Barbara , Fahy Sabina , Carey Teresa , Owens John 
Published: March 2016

AbstractObjectives: To describe an entire long-stay hospita population and examine the differences between the old and new long-stay groups. It outlines the communitybased facilities required for hospital closure to occur.Method: One hundred and twenty-four patients were assessed using the Community Placement Questionnaire (CPQ), a standardised instrument used in service planning.Results: The CPQ revealed a globally disabled group with multiple handicaps. The mean age was 68.7 years and the predominant diagnosis was schizophrenia. Though the old long-stay (74) were more disabled than the new long-stay (50), similar sheltered accommodation was required for both groups. The new long-stay required a more active day-care program.Conclusions: Reprovision for long-stay patients must not only include sheltered accommodation but also appropriate day-care facilities. Assessment of the placement needs of all categories of long-stay patients necessary before hospital closure can take place.
A 15 month follow-up study of children admitted to a child psychiatric inpatient unit
Authors: Sheerin Declan , Maguire Roseann , Robinson Jean 
Published: March 2016

AbstractObjectives: This study focused on measuring symptomatology and self-esteem in children admitted to an inpatient child psychiatric unit.Method: Twenty-six children consecutively admitted to a child psychiatric unit were assessed using the Rutter Parent Interview, the Birleson Depression Scale and the Harter Self Perception Profile for Children. Children were followed up at three and 15 months post-discharge and the same measures administered.Results: A stay in the unit was linked with a significant reduction in overall symptomatology and this was particularly so for emotional-type symptoms at both follow-up points and for hyperactive-inattentive symptoms at 15-month follow-up. The unit did not appear to be successful at reducing conduct symptoms at either followup. Nor did self-esteem change significantly following an inpatient episode. Children with depressive symptoms especially appeared to benefit both in the short- and longterm and this benefit extended to self-esteem.Conclusions: When analysing the benefits of an inpatient admission it is crucial to consider outcome and therefore efficacy on a long-term basis. Efficacy needs to take into account longer-term outcomes. The impact of an inpatient episode on a child's psychosocial adjustment will for some children take time. These ‘sleeper effects’ need further study.
Ganser syndrome – 100 years on
Authors: Williams Kelwyn 
Published: March 2016

AbstractA patient presenting with psychogenic paralysis then Ganser syndrome is described. Formulation is made in terms of unresolved grief manifesting as shifting dissociative symptoms. Treatment and the patient's resistance to it are discussed. The nosological status of Ganser syndrome 100 years on is reviewed and the role hysteria as a causative mechanism endorsed.
Gender differences in characteristics of drug users presenting to a Dublin syringe exchange
Authors: Geoghegan Tony , O'Shea Mary , Cox Gemma 
Published: March 2016

AbstractObjectives: This study explores the gender difference in patterns of drug use, risk behaviour, health and well-being among 934 new attenders at a Dublin syringe exchange.Method: Over the period May 1997 to April 1998 data was collected by means of structured interviews with all clients who presented for the first time at Merchant's Quay health promotion unit. All information collected was based on clients' self-reported behaviour.Results: Of the new clients, 24.3% were female and 75.7% were male. The female clients were significantly younger than their male counterparts (p < 0.0001). The women were significantly more likely to report having a sexual partner who was an injecting drug user (OR 9.04, 95% CI, 5.9-13.9) and to be living with an injecting drug user (OR 1.69, 95% CI, 1.2-2.3). They were also significantly more likely to share injecting equipment with their sexual partner (OR = 3.83, 95% CI, 2.7-5.5) and to report recently sharing injecting paraphernalia (OR = 1.79, 95% CI, 1.3-2.5). However, the interval between initiating intravenous drug use and first presenting at the Merchant's Quay health promotion unit was significantly shorter for female clients (p < 0.0001).Conclusions: One of the most important concerns with regard to illicit intravenous drug use is that of needle sharing, and the associated risks of infection with human immunodeficiency virus and hepatitis. This study highlights the greater personal involvement of women with other drug users, and its consequences in terms of healthrelated problems and risk behaviour. There is a need to address this issue, by taking advantage of the fact that women present for treatment at a younger age than their male counterparts and at a much earlier stage in their injecting career.
Differential diagnosis of adolescent and adult pervasive developmental disorders/autism spectrum disorders (PDD/ASD): a not uncommon diagnostic dilemma
Authors: Fitzgerald Michael 
Published: March 2016

The failure to recognise the pervasive developmental disorders/autism spectrum disorders is probably not uncommon in adult psychiatry. Indeed some of the treatment-resistant chronic mental illnesses are due to the failure to make this diagnosis and apply more appropriate treatment.Patients with PDD/ASD cause considerable diagnostic difficulties in both inpatient and outpatient adolescent and adult psychiatry. Clinical experience suggests that patients with PDD/ASD in adulthood have been misdiagnosed as having schizophrenia resulting in inappropriate treatment. Mesibov and Handlan state that the diagnostic situation is complicated because the characteristics of autism are less pronounced in older clients. It is critical that an accurate diagnosis is given because of the specific treatment implications. In the past decade there have been considerable developments in our understanding of autism. The importance of bringing the developmental viewpoint into adult psychiatry is now highly relevant. Unfamiliar diagnostic categories now have to be considered by adolescent and adult psychiatrists. Grounds for the deletion of adult psychiatric disorders, eg. simple schizophrenia from ICD102 may exist. Instead PDD/ASD disorder may need to be considered.As the purpose of diagnosis is to ensure appropriate client management, it is essential that diagnostic criteria are continually reviewed in view of clinical observation and research developments. In this paper, diagnostic categories causing confusion are outlined, and that these are variants of the core deficit of autism is suggested. The major PDD/ASD diagnoses in adolescence and adulthood are listed below.Two of the following are required for the diagnosis of autism:
Attitudes to doctors and medicine: a failure to replicate
Authors: Conroy Ronán M , Siriwardena Ruwani , Smyth Olive , McGee Hannah M , Fernandes Paula 
Published: March 2016

AbstractObjectives: Despite their potential importance in affecting interactions between doctors and patients, there have been few attempts to measure attitudes to doctors and medicine. One scale, developed by Marteau, had shown a promising factor structure in a UK antenatal setting. The present study assessed its characteristics in Dublin general practice attenders.Method: Patients aged over 16 waiting for a self-initiated consultation were recruited. The Attitudes to Doctors and Medicine Scale was administered by interview. Item analysis and factor analysis were used to examine its psychometric properties.Results: Of 200 respondents, with a median age of 31, 144 were women. Item analysis showed lower reliabilities for the subscales of Marteau's scale than the original UK study, especially the subscales measuring negative attitudes to doctors and to medicine. Factor analysis failed to confirm a clear-cut distinction between attitudes to doctors and attitudes to medicine, and between positive and negative attitudes. Furthermore, factors which loaded in opposite directions in the original UK study loaded in the same direction in the Irish sample.Conclusions: The differences found may reflect the differences either in culture or setting between the two studies. They strongly suggest that the Attitudes to Doctors and Medicine Scale does not have desirable psychometric properties. They also underline the need for a reliable and valid measure of attitudes to doctors and medicine, and for a more serious research interest in the area.
Suicide rates in Irish counties
Authors: Connolly John F , Lester David 
Published: March 2016

AbstractObjectives: This study was designed to explore the social correlates of the country suicide rate in Ireland.Method: Suicide rates for Irish counties were calculated for the period 1978-1984, a seven year period centred around the 1981 Census.Results: The county suicide rates were positively associated with death rates and the percentage of elderly population and negatively with change in population, the birth rate and the percentage of the population under the age of 15.Conclusions: There is good evidence to suggest that the official suicide rate in Ireland has been underestimated in the past. This underestimation may not have been uniform across all of the counties.
A survey of clozapine prescribing for inpatients in a tertiary psychiatric hospital
Authors: Haw Camilla , Stubbs Jean , Mountjoy Christopher 
Published: March 2016

AbstractObjectives: To audit the prescribing of clozapine for inpatients at a large, specialist psychiatric hospital.Method: The clinical standards used were agreed by the authors after reference to the clozapine data sheet and British National Formulary (BNF). Prescribing practices for forty-six patients were audited.Results: In this population of difficult to manage, treatment-resistant schizophrenic patients, prescribing and case note documentation needed improvement. Although almost all of these patients had had an adequate trial of clozapine monotherapy, over a quarter were currently receiving clozapine augmented with another antipsychotic. Plasma clozapine monitoring was used only once in a patient who had failed to respond adequately to clozapine.Conclusions: Clinicians should fully document the patient's consent to treatment, the clinical response to treatment and the reasons for any deviation in clinical practice from that recommended by the data sheet and national formulary. Plasma clozapine monitoring should be used to optimise therapy and clinical rating scales should be used to evaluate outcome. Until the clinical effectiveness of clozapine augmentation strategies is proven, their use should be restricted to cases where evidence-based therapies have failed.
Substance use history taking by trainee psychiatrists: “There is a tide in the affairs of men…”
Authors: Grandison Alistair , Williams Hugh , Oyefeso Adenekan , Dratcu Luiz 
Published: March 2016

AbstractObjectives: To investigate the extent and quality of substance use history taking by trainee psychiatrists.Method: A retrospective clinical casenote audit of admissions to an acute inner city psychiatric unit during three randomly selected months. Data on substance use history taking was recorded by means of a specially designed study checklist.Results: In almost three-quarters (45, 73%) of admission episodes trainee psychiatrists had made some mention of substance misuse. However, substance use history taking often occurred subsequent to the initial clinical assessment and varied greatly in quality.Conclusions: The need for a brief, standardised substance use screening questionnaire, easily incorporated into the existing psychiatric interview format is highlighted.
Psychiatric disorders amongst adults with learning disabilities - prevalence and relationship to ability level
Authors: Cooper Sally-Ann , Bailey Nicola M 
Published: March 2016

AbstractObjectives: To determine the prevalence of psychiatric disorders in adults with learning disabilities, and the relationship with severity of learning disabilities.Method: The study is population-based. Detailed psychiatric assessments on 207 adults with learning disabilities living in Leicestershire, UK. were conducted by a learning disabilities psychiatrist, using the Present Psychiatric State - Learning Disabilities; and Disability Assessment Schedule. Diagnostic criteria are clearly defined. Developmental assessments were undertaken using the Vineland Scale (survey form).Results: Psychiatric disorders were found in 49.2%, and rates for most individual disorders were higher than those found in the general population. Comparison with the two previous population-based studies shows the ascertained rates were broadly similar to those reported by Corbett but higher than those reported by Lund. Adults with more severe learning disabilities had higher rates of additional psychiatric disorders.Conclusions: The results may be explained by a combination of the genetic, physical, psychological and social factors associated with learning disabilities also being aetiological to psychiatric disorders. The high prevalence rates of psychiatric disorders demonstrate the importance of health service provision for adults with learning disabilities.
Psychological problems of early school leavers
Authors: James Deborah , Lawlor Maria 
Published: March 2016

AbstractObjectives: To establish the prevalence of psychological problems in early school leavers, who attend training schemes.Method: The Youth self report inventory was completed by teenagers as part of a group setting. Percentages of those scoring above clinical threshold were calculated and gender differences examined.Results: 78 teenagers participated in the study, 40 males and 38 females. 24% were classified as being in the clinical range of total problem score. Girls reported more total, internalising and externalising problems than boys. 13% of girls frequently thought of suicide and 7% had frequent thoughts of self harm, this contrasts with none of the boys admitting suicidal ideation and 2.5% reporting thoughts of self harm.Conclusions: 24% of this group experienced problems which placed them within the clinical range. Girls experienced greater problems than boys and appear to be at greater risk of self harm. This group appear to be representative of those who attend training programmes, however it is not possible to determine whether they are representative of all early school leavers. This highlights the vulnerability of older adolescents, and in particular those who leave school early. More detailed examination of issues facing this group are needed and should be a priority along with greater service provision from the educational and health sectors.