bluuebunny/crossref_metadata_2025_split huggingface dataset:
The work of Balint revisited
Authors: McDonald Paul S , O'Dowd Tom C , Standen Penny 
Published: March 2016

This paper summarises the work of Michael Balint, offers a revisionist view of his work, and argues that the new term heartsink is an indication that the problems Balint addressed need to be re-examined.The richness of Michael Balint's life was documented by Hopkins. The variety of his professional experiences meant that he was able to create a fertile atmosphere in which GPs felt free to express feelings about themselves and their patients. The Balint movement was based upon the talents of an exceptional man.
Memory impairment in Alzheimer's disease: replication and extension of the delayed word recall (DWR) test
Authors: Coen Robert F , Swanwick Gregory RJ , Maguire Conor , Kirby Michael , Lawlor Brian A , Walsh J Bernard , Coakley D 
Published: March 2016

AbstractObjective: The original DWR test, which measured delayed free recall, was reported to have high predictiveaccuracy in discriminating Alzheimer's disease (AD) patients from control subjects (overall accuracy of 95%).Comparison of differential performance in free recall and recognition of the same material may be of clinical interest. In the present study a delayed recognition component was added to the DWR test and the utility of both measures in discriminating AD patients from control subjects was evaluated.Procedure: This extended version of the DWR test was administered to 66 patients meeting NINCDS/ADRDA criteria for probable AD and 42 control subjects.Results: In a comparison between 42 of these patients (MMSE range 18–29), and 42 age matched healthy controls, both the delayed free recall and recognition measures were highly accurate in distinguishing patients from controls. The free recall measure achieved 98% sensitivity, specificity and overall accuracy, while the recognition measure yielded 98% sensitivity, 95% specificity, and 96% overall accuracy. The recognition performance of all 66 patients, ranging in severity from very mild to severe (MMSE range 11–29), was also evaluated to determine its relationship, if any, to measures of global cognitive impairment. While therecognition measure correlated poorly with MMSE and CAMCOG there was a modest but significant correlation with the CAMCOG memory subscale.Conclusions: In this study of highly selected AD patients both the free recall and recognition measures were sensitive and specific indicators of AD compared to control subjects. Recognition performance appears to be more closely related to degree of amnesia than to degree of global cognitive impairment.
Benzodiazepine misuse and dependence among opiate addicts in treatment
Authors: Williams Hugh , Oyefeso A , Ghodse AH 
Published: March 2016

AbstractObjective: Benzodiazepine misuse among opiate addicts is well described but few studies have reported on the occurrence and management of benzodiazepine dependence within this group. This study reports on the nature and extent of benzodiazepine dependence among a group of opiate addicts and describes the patients' treatment progress and requirement for substitute medication.Method: Over a 12 month period routinely collected data on all admissions of opiate addicts to our inpatient treatment and research unit were searched. Specific details were then extracted for those 61 admissions who were opiate dependent and also currently misusing benzodiazepines.Results: 26 (43%) of the 61 admissions were found to bephysically dependent on benzodiazepines. Temazepam and diazepam (respectively) were the most commonly misused preparations and 22% of those using temazepam were injecting it. Patients requiring detoxification were stabilised on doses of diazepam ranging from 20mg to 80mg daily (mean; 40mg). No correlation was found between reported use of benzodiazepines and the dose of diazepam required for stabilisation. Users found to be physically dependent on benzodiazepines more commonly reported daily use and use of two or more benzodiazepines concurrently.Conclusions: Our findings suggest: 1) that benzodiazepine dependence occurs in opiate addicts with a frequency similar to that reported previously for other groups of benzodiazepine users; 2) that individuals using benzodiazepines on a daily basis may be more at risk of developing physical dependence; and 3) that clinically it is difficult to accurately predict requirements for substitute medication solely from patient's reported daily use prior to admission.
Effects of co-existent cerebrovascular disease on rate of progression in Alzheimer's disease
Authors: Swanwick Gregory RJ , Kirby Michael , Coen Robert F , Maguire Conor P , O'Neill Desmond , Walsh Bernard J , Coakley Davis , Lawlor Brian A 
Published: March 2016

AbstractObjective: The aim of this study was to determine whether patients with possible Alzheimer's disease (AD) who do not meet criteria for vascular dementia but who nonetheless have clinical or radiographic evidence of cerebrovascular disease (CVD), differ in presentation or rate of progression from patients with probable AD.Method: Baseline cognitive and functional scores were obtained from 154 patients who had either possible or probable AD. Repeat data after a 12 month interval were obtained on 73 of these patients. Baseline data and rates of progression were compared for probable AD patients and possible AD patients with evidence of co-existent CVD.Results: The diagnostic groups did not differ at baseline with a mean mini-mental state examination (MMSE) score of 18.1. Comparison of the longitudinal data showed a mean annual drop of 4.1 points on the MMSE in both groups.Conclusions: The patients with and without evidence of co-existent CVD did not differ either at baseline or prognostically suggesting that evidence of CVD does not affect the rate of progression in AD. However, further longitudinal studies using neuropathological criteria are warranted to determine whether such data can be interpreted in favour of including possible AD cases in clinical trials of probable AD.
Depressive episodes in adults with learning disabilities
Authors: Cooper Sally-Ann , Collacott Richard A 
Published: March 2016

AbstractObjective:In view of the Royal College of Psychiatrists Defeat Depression campaign, to review the existing literature on depressive episodes in people with learning disabilities.Methods:Review of all papers identified to cover this area. Papers were identified by Medline search and also by direct checking of the contents in the preceding five years of eight key learning disabilities journals, the British Journal of Psychiatry, Psychiatric Bulletin and bibliography in Current Opinions in Psychiatry. Papers about children or odd ‘depressive’ symptoms (rather than the syndrome of depression) were excluded.Findings:For over a century it has been recognised that depression can occur in people with learning disabilities. However, the number of studies in this area is very limited. There remain many unanswered questions, such as those of prevalence, clinical presentation and diagnostic criteria, associated social factors, and the evaluation of treatments. Suitable rating scales have yet to be evaluated or devised. The authors propose diagnostic criteria for future use.Conclusions:Research in this important area is very limited. Advances are yet to be made in the clinical assessment and management of the illness.
Psychosis among the Mayan people of Mexico
Authors: Gibbons Pat 
Published: March 2016

AbstractThe Mayan people of Mexico have a radically different concept of illness than that of western countries. In the absence of any formal psychiatric service in their area, the people continue to rely on the interventions of the traditional healers, which include the use of herbal medicines, prayers and magico-religious rituals. A case history of a Mayan patient with a chronic psychotic illness is described, which illustrates the gulf in concepts of mental illness that exists between Western and folk cultures. These cultural differences may have a profound impact on the application of modern psychiatric interventions in developing countries.
Current research issues in cross-cultural psychiatry
Authors: Gibbons Pat 
Published: March 2016

AbstractThe international pilot study of schizophrenia (IPSS) was the first major study to show that the use of standardised assessment and classification instruments allows the reliable comparison of data on the prevalence, psychopathology and prognosis of major psychiatric illness between different cultures. Important questions about the methodology used in cross-cultural research remain to be answered, however These include the inherently ‘Eurocentric’ nature of much of western psychiatric terminology and the absence of directly comparable concepts and language to describe emotional and psychological distress between western and non-western cultures. These difficulties especially arise in relation to illness where organic factors appear to contribute little to aetiology, such as the neurotic and Axis II disorders, and need to be overcome before useful crosscultural research into these disorders can be accomplished.
Attitudes of general practitioners to child psychiatry services
Authors: McNicholas Fiona 
Published: March 2016

AbstractObjective: To ascertain the views of Irish GPs with regard to local child psychiatry provision.Method: 180 randomly selected general practitioners were sent a questionnaire designed to ascertain their views on child psychiatry services. They were asked to rate service provisions, professional staff and therapies offered in terms of priority.Results: 74 (41%) returned completed questionnaires. Written reports, short waiting list times and emergency inpatient provisions were accorded the highest priority by the largest number of GPs (77%, 64.9%, and 63.5% respectively). Expertise in child sexual abuse, mental handicap and alcohol/drug addiction were also prioritised (77%, 66.2%, & 58.1% respectively). The core staffing required included child psychiatrists, community psychiatry nurses, psychologists and social workers. Family therapy followed by counselling were the most popular treatment modalities. However, more than two thirds (68.6%) of the sample rated their current service as unsatisfactory.Conclusion: In planning service provision it is important to take into account the needs of the community, referrers' views and accessibility in order to provide optimum services for both users and referrers.
The relationship between menstruation and psychiatric admissions
Authors: O'Dwyer Jane , Friedman Trevor , Clifford Elizabeth 
Published: March 2016

AbstractObjective: To determine whether the previously reported relationship between menstruation and emergency psychiatric admissions still pertains.Method: All females admitted on an emergency basis to a general psychiatric unit of a DGH, were interviewed and data regarding menstrual function was collected on those fitting the inclusion criteria who consented to inclusion in the study.Results: Ninety three people were included in the study, of whom significantly more were admitted in the late luteal and menstrual phases of the cycle. Symptoms suggestive of premenstrual syndrome were significantly commoner in those admitted in the late luteal and menstrual phases.Conclusions: The findings suggest that the premenstrual syndrome is either a risk factor for psychiatric admission or is important in determining the time of admission. Adequate detection and treatment of premenstrual syndrome, could in theory, reduce some psychiatric admissions. The methodology and limitations of the study are discussed.
Effects of waiting time on appointment attendance with clinical psychologists and length of treatment
Authors: Loumidis Konstantinos S , Shropshire Julia M 
Published: March 2016

AbstractObjective:With the increasing demand for clinical psychology services and the existing shortage of clinical psychologists, it is theoretically and clinically important to identify variables associated with non-attendance for clinical psychology appointments. The study reported here attempted to: (a) examine the effect of waiting time for an appointment on non-attendance to clinical psychology services; (b) investigate variables associated with prolonged waiting time; (c) explore the nature of the relationship between waiting time and length of psychological treatment.Method:The records of 49 3 patients offered an appointment to attend a clinical psychology service over a period of 24 months were analysed. Subsequently information on sex, age, type of referring problem, previous treatment history, treatment venue and waiting time for appointment, was collected and statistically analysed.Results:Non-attendance was significantly related to prolonged waiting time and young age. Controlling for the effects of waiting time and age, patients with complex problems and new patients wh o had never sought psychological treatment in the past were less likely to attend. Length of waiting time was higher in groups with previous treatment history, patients seen at a hospital based department, and patients with complex problems and anxiety disorders. Finally, length of psychological treatment (total number of sessions required) was not affected by prolonged waiting time.Conclusion:Non-attendance for clinical psychology appointments was associated with (a) young age, (b) prolonged waiting time (over six months), (c) complex psychological problems, and (d) new patients. The limitations and clinical implications of these findings are critically discussed.
An evaluation of Threshold therapeutic communities in Northern Ireland
Authors: Kapur R , Weir MB , McKevitt C , Devine M , Collins L , Maxwell H , Heaney C 
Published: March 2016

AbstractObjective: To measure the effects of providing a therapeutic community environment for patients suffering from severe mental illness.Method: 35 patients who remained in a therapeutic community environment for a minimum of 18 months were administered three instruments which measured psychiatric symptomatology (Brief Psychiatric Rating Scale), intrapsychic and interpersonal functioning (Therapeutic Community Questionnaire) and overall psychiatric and psychological functioning (Global Assessment Scale). Assessments were carried out at zero and 18 months.Results: The Brief Psychiatric Rating Scale revealed significant positive changes on the two items of blunted affect and un-cooperativeness while the global assessment scale revealed that patients significantly improved after 18 months.Conclusion: Patients who remained in a therapeutic community environment for 18 months demonstrated benefits on three particular variables. While no causative link can be proposed in this study, it does seem that this environment does improve the functioning of severely mentally ill patients.
Risperidone therapy in the control of behavioural disturbances in patients with learning disability
Authors: Natarajan Dhanapal , Martin Alberto Jarabo , Tesh Dorothy 
Published: March 2016

AbstractObjective: The objective of this audit to examine the effect of risperidone therapy in controlling some behavioural disturbances in people with learning disability.Method: Retrospective analysis of various behavioural disturbances before and after beginning risperidone therapy (during the month before risperidone was started in each case, and during September 1994 in all cases).Results: Risperidone was found to be effective in controlling various behaviour problems in 12 of 17 patients.Conclusion: Risperidone may selectively influence behaviour problems secondary to possible underlying mental illness but not others. There was also some evidence that it was more effective in an average dose of 6-8mg/day, but was not beneficial in doses smaller or larger than this dose range.
Parkinson's disease exacerbated by paroxetine
Authors: Mannion Laura , O'Sullivan Sheila , Carney PA , Moran John 
Published: March 2016

AbstractPatients with Parkinson's disease are frequently treated by psychiatrists. We report on the exacerbation of parkinsonian symptoms in tw o patients prescribed paroxetine, an SSRI antidepressant. We discuss the possible mechanism for such an interaction.
Hopelessness and suicidal feelings among the community dwelling elderly in Dublin
Authors: Kirby Michael , Bruce Irene , Coakley Davis , Radic Alicja , Lawlor Brian A 
Published: March 2016

AbstractObjective:The aim of this study was to determine the one-month frequency of hopelessness and suicidal feelings in a community dwelling elderly sample in Dublin.Method:A total of 891 individuals of 65 years and over, without a dementia, were interviewed using the Geriatric Mental State (GMS)-AGECAT system. Items from the GMS relating to reports of hopelessness and suicidal feelings over the previous month were identified and the relationship of these items to gender and age was studied.Result:Serious suicidal feelings were rare with 0.2% of the sample expressing a pervasive wish to die, but less intense feelings were more common with 15.5% reporting that life was not worth living. Hopelessness and suicidal feelings were present with similar gender frequencies unlike other studies which have demonstrated a higher frequency among females. Any feeling of hopelessness or suicidality was present in 18.4% of those aged 65-74 years (‘young elderly’) compared with 14.8% of those over 75 years (‘old elderly’). Depressed elderly who reported hopelessness or suicidal feelings were not more likely to be taking antidepressants than the depressives without such feelings.Conclusion:Cultural factors may explain the pattern of suicidal feelings reported in our sample, with the more intense feelings being rare, and may influence the gender distribution. Hopelessness and suicidality is not more common in the ‘old elderly’ than in the ‘young elderly’ and should not be regarded as an integral part of ageing. The small number of elderly depressives with feelings of hopelessness or suicidality wh o are being treated with antidepressants is a cause for concern.
Platelet studies in panic disorder: A review
Authors: Mannion Laura , Nugent Desmond , Leonard Brian 
Published: March 2016

AbstractObjective: The blood platelet has been proposed as a model of central neurons and may therefore be used as a peripheral marker of psychiatric illness. One method of investigating serotonin function in panic disorder has relied on the use of the platelet as a model of serotonergic neurons. This article reviews the studies of platelet function in panic disorder.Method: A literature search and review of relevant papers was undertaken.Result: Studies examining platelet serotonin uptake and concentration in panic disorder patients have to date yielded conflicting results, with some investigators reporting increased serotonin uptake, others reduced uptake. Similarly studies of platelet 3H-imipramine binding have also yielded conflicting results. Two studies of platelet 3H-paroxetine binding have shown a reduction in the density of binding sites (Bmax) in patients with panic disorder. Platelet monoamine oxidase activity in anxiety disorders has been reported to be increased by some investigators but decreased by others. Methodological considerations may have been responsible for these differences. Finally, studies of α2 adrenoceptor density have also produced contrasting findings.Conclusion: The findings of these studies indicate that platelet function is altered in panic disorder. Such changes may allow an insight into the biochemical aetiology of the illness. Further studies are required to delineate the role of serotonin and non-adrenaline in panic disorder.
Assaults on psychiatrists – a three year retrospective study
Authors: O'Sullivan Martin , Meagher David 
Published: March 2016

AbstractObjectives: This study investigates the problem of assaults on psychiatrists by their patients.Method: A postal questionnaire was circulated to 178 psychiatrists and trainees working in the Dublin area enquiring about assaults experienced in the previous three years.Results: Of those 147 (82%) who responded 57 (39%) had been assaulted. There were few discriminating factors between those assaulted and those not but those in child psychiatry were less likely and those in general adult psychiatry were more likely to have been the victim of an assault. Only 10% of respondents had received any formal training in violence management. Assailants tended to be male (63%) and known to the doctor involved (71%). Personality disorder (37%), schizophrenia (29%) and substance abuse (26%) were common assailant diagnoses. Management responses to the assaults were generally internal with administrative staff involvement in only four cases.Conclusions: Factors which potentially protect or expose clinicians to a greater risk of assault are not well defined and need to be further explored. Simple clinician or patient variables are not especially predictive of violence risk. Clinicians need to acquaint themselves better with the basic practices of violence prevention and management. External measures (such as involving administration) could be used more frequently to combat this common problem.
An audit of the care of 266 patients with schizophrenia in 16 general practices
Authors: Holden John 
Published: March 2016

AbstractSixteen general practices completed an audit of the care of their patients with schizophrenia. This resulted in improved levels of recording of six different aspects of patient care; family care, Mental State Examination, quality of life, preventive physical care, co-ordinated care and details of medication.
Pharmacogenetics of the hepatic cytochrome P450 enzyme system: its relevance for prescribing in psychiatry
Authors: O'Donohoe Alan , Gill Michael 
Published: March 2016

AbstractThis article reviews the current knowledge regarding the hepatic cytochrome P450 system, with particular reference to its effect on psychotherapeutic medication. The metabolic processes – by which drugs are broken down in the liver by cytochrome P450 enzymes – are affected by genetic variation between individuals, inhibition and induction of these enzymes by other drugs, disease and age. Genetic influences and enzyme inhibition/induction are discussed in particular detail in this article.