bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nalbuphine dependence: a brief report from the UK
Authors: Williams Hugh , Remedios Andrew , Rooney Jan , Hanstock Rick 
Published: March 2016

AbstractObjectives: Nalbuphine (Nubain) is a synthetic opioid analgesic with agonist-antagonist properties. This study describes a characteristic patient profile, pattern of use and treatment outcome for a series of nalbuphine dependent subjects.Method: Retrospective systematic case-note review of uniformly collected clinical data on 11 cases of nalbuphine dependence presenting to a substance misuse service.Results: There were nine males and two females with a mean age of 31 years of whom nine were currently employed. At presentation the mean duration of nalbuphine use was three years, the average daily dosage was 60mg (range lOmg-lOOmg) and all subjects reported injecting between two and eight times daily (mean five times daily). All subjects met opioid dependence criteria (ICD-10). Drug-related problems were multiple and varied while forensic history was uncommon. Exposure to nalbuphine occurred exclusively within the gymnasium environment and was used by bodybuilders to enhance weight training and bodybuilding. Eight subjects admitted previous anabolic steroid use, and seven current cocaine use. Eleven subjects represented 14 separate treatment episodes of which 11 treatment episodes involved the use of methadone substitution therapy. The mean stabilisation dose of methadone was 29mg (range 15mg-40mg) and in eight episodes (73%) patients were successfully retained in treatment to completion of detoxification.Conclusions: Dependence on nalbuphine, an agonist-antagonist opioid previously believed to have low abuse potential, does occur and may be particularly associated with bodybuilders who use its analgesic properties to facilitate pain free training. Its use appears linked not only with other performance enhancing drugs (viz. anabolic steroids) but may also be associated with other psychoactive drugs such as cocaine. Methadone substitution therapy appears to be a viable treatment option.
A comparison of voluntary and involuntary patients admitted to hospital
Authors: Rooney Siobhan , Murphy Kieran C , Mulvaney Fiona , O'Callaghan Eadbhard , Larkin Conall 
Published: March 2016

AbstractObjectives: In view of the apparent public discontent that has been expressed by individuals towards temporary certification and involuntary treatment, this study was set up to assess patients' reactions to their involuntary admission. The study compared the demographic characteristics of voluntary and involuntary patients and assessed their attitudes towards and knowledge of the certification process that presently exists in Ireland.Method: A total of 68 patients, 38 involuntary patients consecutively admitted over a six month period and 30 voluntary patients selected over the same period, were interviewed with a standard questionnaire, on average six months after discharge.Results: Involuntary patients were more likely to be single, live with their families and showed no demonstrable gender bias. Involuntary patients had limited knowledge of specific aspects of their individual certifications, particularly with regard to knowledge of their rights, admission status and knowledge of the identity of the applicant of the certificate. Of these, 10% were aware of their rights on admission and only 14% could recall that their rights had been explained to them on admission.Conclusion: Although patients initially expressed strong feelings of anger on admission towards committal, these feelings were found to reduce over time. Recommendations for improving the present Mental Health Act were suggested by those interviewed and these included a need for an initial assessment period before certification is completed and a need for improved communication by medical staff regarding information on the admission status, the identity of the applicant and on the person's rights.
Schizophrenia, lung cancer and glutathione-S-transferase-μ
Authors: Murphy Kieran C , Graham M , Mantle T , Shelley RK 
Published: March 2016

AbstractObjectives:Several reports have suggested that, despite the high prevalence of cigarette smoking, the incidence of lung cancer is lower than would be expected in patients with schizophrenia. In addition, patients with lung cancer have been shown to have a lower expression of glutathione-Stransferase-μ (GST-μ) compared to healthy controls. In this study, we tested the hypothesis that GST-μ was a trait marker that protected patients with schizophrenia from developing lung cancer.Methods:One hundred patients who fulfilled DSMIIIR criteria for schizophrenia were examined for the presence or absence of GST-μ.Results:Significantly more male (86%) and female patients (64%) were smokers compared to general population rates of 30% and 30% respectively (p < 0.0001). There were no significant differences in the expression of GST-μ in patients (48%) compared to controls (46%).Conclusions:We found no difference in the expression of GST-μ in patients with schizophrenia compared to normal controls. It is therefore unlikely that GST-μ acts as a trait marker protecting patients with schizophrenia from lung cancer. However, a significantly large smoking prevalence rate was ascertained in the patient population.
Controlled assessment of alcoholics admitted involuntarily to a general psychiatric hospital
Authors: O'Loughlin Fionnula , Webb Marcus 
Published: March 2016

AbstractObjective:As the provision for the involuntary admission to hospital of alcoholics is likely to be discarded in a new Irish Mental Health Act, the characteristics of patients committed under the 1945 Irish Mental Treatment Act were explored and compared with those alcoholics admitted voluntarily.Method:All alcoholics admitted compulsorily from 1989-1992 to a general psychiatrichospital in Dublin were compared retrospectively with voluntarily admitted alcoholics. Data was taken from case notes.Results:Results showed that patients admitted compulsorily were older (t = 3.74, df = 62, p < 0.001) and had more physical complications (X2= 8.4, df = 1, p < 0.004) than those admitted voluntarily. Although results did not reach a statistically significant level, there were proportionately more females in the compulsorily admitted group compared with the voluntary group. The outcome of admission overall was better in those admitted voluntarily, although this was influenced both by length of stay and previous admissions for treatment of alcohol dependence. One particularly interesting finding, regardless of admission category, was that duration of admission was statistically significantly longer for women when compared with men.Conclusions:Compulsory admission of alcoholics to a psychiatric hospital for very brief periods was not shown to be strikingly helpful, but this study cannot decide whether or not longer periods of compulsory admission would be valuable.
Suicide in Kerry: a comparison of the official and a clinically based rate
Authors: Naughton Mary , Doyle Anne , Melia Patrick , Barry Don 
Published: March 2016

AbstractThe suicide rate for county Kerry in 1988 was determined by clinical means using postmortem records as a starting point. Sixteen deaths due to suicide were thus identified (eight males and eight females). The official figure for the year is 19 (13 males and six females). Four of the clinically determined suicides did not appear in the official figures. Combining information from both sources gives a figure of 23 suicide deaths, a rate of 18.58 per 100,000. The authors conclude that there are continuing deficiencies in suicide recording practices.
Hyponatraemia in elderly and adult psychiatric inpatients
Authors: Critchlow Stephen 
Published: March 2016

AbstractObjectives: The objectives of this paper are to review the presentation of hyponatraemia and diagnose its cause in psychiatric inpatients.Method: Episodes of significant hyponatraemia (sodium <130mmol/L) were identified from computerised biochemical data and a retrospective review of patients' notes was carried out.Result. The diagnoses of hyponatraemia reached were different for the two groups of patients studied, adults of over 65 years and under 65 years. Carbamazepine, polydipsia and medical conditions were found as causes in the below 65 age group. Diuretics, medical conditions and lofepramine were identified as causes in the over 65 age group. Inpatients with polydipsia below the age of 65 had lower sodium (p = 0.013) and urea levels (p = 0.00059) than other groups and patients with carbamazepine induced hyponatraemia tended to have episodic hypocalcaemia (p = 0.056). These groups were compared using Fisher's exact test. This study also showed the overall frequency of serum sodium of less than 135mmol/L to be 9.5% in psychiatric inpatients.Conclusion: Hyponatraemia is a not uncommon finding in psychiatric inpatients. Attention to drug therapy and biochemical findings are helpful in its diagnosis. Accurate diagnosis is usually possible and may vary according to age-group.
Behaviour disorders in adults with learning disabilities: Effect of age and differentiation from other psychiatric disorders
Authors: Cooper Sally-Ann 
Published: March 2016

AbstractObjective: To clarify the effect of age on behaviour disorders in adults with learning disabilities, and the differentiation of behaviour disorders from other psychiatric disorders.Method: Detailed assessments, measuring maladaptive behaviours, psychiatric disorders and demographic factors were completed on 93.7% of all people with learning disabilities aged 65 years and over, living in Leicestershire, UK (n = 134), and also a random sample of adults with learning disabilities aged 20-64 years (n = 73). Behaviour disorders were distinguished from other psychiatric disorders. Descriptive and inferential statistics were calculated.Result: Equal rates (15%) and types of behaviour disorder were found in the two groups. The presence of behaviour disorder was associated with the severity of learning disabilities, but age was not associated, and nor was presence of epilepsy or gender. In many cases, positive scores on the behavioural assessment, which carers attributed to challenging behaviour/ behaviour disorder, were actually symptoms of psychiatric illness.Conclusion: Behaviour disorders persist into old age, and therefore require management from the appropriate services. This need will increase, due to increasing lifespan. The accurate interpretation of behaviour scales requires that a comprehensive psychiatric assessment is also undertaken, particularly in elderly people where rates of psychiatric disorders are higher than for younger adults.
Normal ageing and the brain
Authors: Breathnach CS 
Published: March 2016

AbstractInterest in the psychiatric aspects of old age predated the institution of geriatrics as a clinical discipline, but the systematic study of the ageing brain only began in the second half of this century when an ageing population presented a global numerical challenge to society. In the senescent cerebral cortex, though the number of neurons is not reduced, cell shrinkage results in synaptic impoverishment with consequent cognitive impairment. Recent advances in imaging techniques, combined with burgeoning knowledge of neurobiological structure and function, have increased our understanding of the ageing processes in the human brain and permit an optimistic approach in the application of the newer insights into neuropsychology and geriatric psychiatry.
Behavioural management of Prader-Willi syndrome
Authors: Gibbons Pat , O'Donoghue Kathryn 
Published: March 2016

AbstractPrader-Willi syndrome is a genetic illness associated with a defect on chromosome 15. It presents with hypotonicity in infancy followed by voracious appetite and gross obesity from early childhood and with a range of other clinical and behavioural sequelae. This case report is of an adolescent boy who was admitted to a psychiatric unit for an intensive behavioural programme to control his weight gain and deal with associated behavioural problems, and demonstrates that an inpatient programme can lead to sustainable improvements in weight control and other indicators of well-being in PWS patients.
Sexual abuse in childhood and subsequent illicit drug abuse in adolescence and early adulthood
Authors: Browne Roy , Keating Shay , O'Connor John J 
Published: March 2016

AbstractObjectives: This study examines the frequency of childhood sexual abuse and physical abuse in a cohort of opiate addicted patients and looks at clinical correlates in those abused.Method: Fifty-two consecutive patients attending an out patient drug treatment programme were interviewed using a semi-structured technique. Demographic details, details of schooling, marital status and number of children were recorded. The duration of drug abuse, age of onset of opiate abuse, early life experiences of both child sex abuse and childhood violence and a family history of alcohol abuse were also investigated.Results: 21.2% of patients gave a history of sex abuse, with 23.1% of patients having a history of exposure to violence as a child. Those exposed to sex abuse had an earlier age of onset of opiate injection. A correlation between parental alcohol abuse and sex abuse and violence was noted.Conclusions: A history of child sex abuse was associated with earlier onset of opiate abuse in this group of patients. The relatively frequent incidence of abuse and violence in those with opiate abuse must be born in mind when providing treatment. The addressing of issues relating only to addiction leaves earlier traumas continuing to exert an influence on the patient.
Mental illness in an elderly rural population in Ireland: a prevalence study
Authors: Kelleher Margaret , O'Sullivan Mary , McMahon Nuala 
Published: March 2016

AbstractObjectives: The aim of this study was to provide the first Irish prevalence data on mental illness in an elderly, rural, community dwelling population.Method: Subjects were identified from four general practitioners' lists. This included GMS patients, private patients and nursing home residents. Six hundred and fifty people aged 65 years or over were interviewed in their own homes using GMS-AGECAT, a standardised diagnostic instrument.Results: The overall prevalence of mental illness was 14.6%. The prevalence of depression was 9.4%. There was a significantly higher rate among women (13.2%) than men (4.3%). Depression in women was not age related. Of the total sample, 3.7% were classified as organic cases. Of the remaining cases, anxiety disorders occurred most frequently and represented 0.9% of all cases.Conclusions: Elderly people in rural areas experience similar levels of psychiatric morbidity as those in urban centres.
Adolescent parasuicide in the Foyle area
Authors: Davies Mark , Cunningham Gerry 
Published: March 2016

AbstractObjectives: Renewed scientific and media interest in suicidal behaviour has resulted in a number of initiatives examining and defining this complex and tragic phenomenon. However, in comparison to the study of adult suicidal behaviour, that of adolescents is still under researched. This study aimed to identify the extent and nature of parasuicide in young people under 17 years of age in the Foyle area in the 28 month period up to and including April 1997.Method: The psychiatric assessments of all those admitted to hospital as the result of parasuicide during this period were examined. A psychosocial and clinical profile of this group of young people was then constructed. Any reported stressors recorded in the assessments were noted, and an attempt was made to ‘track’ contact with helping agencies in each case during the months immediately before and after admission.Results: One hundred and twenty four young people were admitted during the period under review, the vast majority following an overdose.Conclusions: Family conflict, family illness and bullying were the three most frequently recorded stressors. Twothirds had no apparent contact with services in the three months prior to admission, and of these, half were not referred on to specialist services after they had been discharged from hospital.
Does psychosis predict response to ECT in depressed elderly patients?
Authors: Gormley Niall , Cullen Con , Watters Liam , Philpot Michael , Lawlor Brian A 
Published: March 2016

AbstractObjectives:To compare the electroconvulsive therapy response of a sample of depressed elderly patients as a function of the presence or absence of psychosis.Method:Retrospective study of patients over age 65 treated with ECT at three psychiatric hospitals over a three year period.Results:One hundred and eighty-nine ECT courses were administered to 135 patients. Almost 8 5% of patients made a marked or moderately good response to treatment. There was no difference in ECT response between psychotic and non-psychotic depressed patients.Conclusions:ECT should be considered as a treatment option for severe depressive illness, regardless of depressive subtype.
Circadian system and sleep anomaly in depression
Authors: Emilien Gérard , Maloteaux Jean-Marie 
Published: March 2016

AbstractAbnormalities of circadian rhythms in depressed patients have been noted, including decreased amplitude, distorted waveform, day-to-day instability, and unusual 48 hour periods. Consistent electroencephalographic sleep recording in these patients show a shortened rapid eye movement latency and slow-wave sleep (stages 3 and 4), resulting in an increase in rapid eye movement sleep. This phenomenon appears to be a dependable, measurable marker for diagnosing primary depression. Total sleep deprivation appears to significantly improve mood in a high percentage of depressed patients. Current pharmacological research suggests that drug treatment such as lithium would not affect the intra sleep cycles of the REM stagebut would shift the phase backward and lithium would also shift the phase of circadian rhythm of the daytime sleepiness backward. This paper highlights some of the new approaches for investigating the molecular substrate for the control of circadian rhythmicity and sleep in man and critically examines the hypothesis of the alteration of this mechanism in psychopathology, particularly depression. What is known of the endogenous clock mechanism is discussed with known molecular circadian mechanisms with a view towards understanding how circadian information is transmitted to the rest of the central nervous system and how it is affected in depression.
Louis Wain: his life, his art and his mental illness
Authors: McGennis Aidan 
Published: March 2016

This year we celebrate the 60th anniversary of the death of that famous cat artist, Louis Wain. It is therefore appropriate to reflect briefly on his life, his art, and in particular the rather controversial nature of his mental illness.Louis Wain was born in London in 1860, the eldest child of William, a textile traveller, and Felicia, a designer of carpets. Louis had five younger sisters. As a child he was regarded as physically weak, not starting school until the age of 10 where his academic performance was indifferent, and from which he played truant frequently. In 1877 he went to the West London School of Art, qualifying in 1880. His first job was that of an art teacher, but he needed to supplement his income from this job by doing freelance illustrations for magazines. Eventually he gave up art teaching and became a full-time illustrator, working initially with the Illustrated Sporting and Dramatic News.In 1884 he married Emily Richardson, a governess in the Wain household and 10 years his senior. Their happy marriage ended two years later when Emily died of breast cancer. During her illness a stray black and white kitten joined the Wain household. The kitten was named Peter and he was a great comfort to Emily in her terminal illness. While Louis sat frequently by his wife's sick bed he began drawing Peter from every possible angle. This was the first time he showed any interest in drawing cats, as prior to that he had been a general illustrator.
Making contact – bereavement and Asperger's syndrome
Authors: Marston Geoffrey M , Clarke David 
Published: March 2016

AbstractA case of abnormal bereavement is described in a man with borderline learning disability and Asperger's syndrome. Bereavement issues and concurrent assessment of psychiatric illness in people with pervasive developmental disorders are discussed. Particular reference is made to relevant psychopathology and possible underlying psychodynamic mechanisms.
The use of clozapine in an individual with moderate intellectual disability, aggressive behaviour and resistant psychosis
Authors: Kamal Manzar , Kelly Mary 
Published: March 2016

AbstractThe case of a 32 year old man with moderate intellectual disability, severe behavioural problems and psychotic symptoms is described. Having tried various traditional antipsychotics he was commenced on clozapine with a marked improvement in symptoms. Clozapine is a useful drug for the treatment of schizophrenia in the intellectually disabled who are refractory to the conventional antipsychotics. It improves aggressive and self-injurious behaviour which may be in addition to its antipsychotic effect.
The utility of naming tests in the diagnosis of Alzheimer's disease
Authors: Coen Robert F , Kidd Nicholas , Denihan Aisling , Cunningham Conal , Bruce Irene , Buggy Fiona , O'Neill Desmond , Walsh J Bernard , Coakley Davis , Lawlor Brian A 
Published: March 2016

AbstractObjectives: To evaluate the sensitivity of the CAMCOG naming subscale to anomia in Alzheimer's disease (AD) patients identified as anomic on the Boston Naming Test (BNT); and to compare the sensitivities of BNT, category (semantic) fluency (CF), and episodic memory (Delayed Word Recall, DWR) in detecting AD.Method: Data from 140 probable AD patients (NINCDS/ADRDA) were analysed. Anomic AD patients were identified (BNT) and the sensitivity to anomia of the CAMCOG naming subscale was calculated. Sensitivity (to AD) and specificity of the BNT, CF and DWR were compared in a subgroup of 60 patients age-matched to controls.Results: On BNT 81% of ADs were classified as anomic (87% specificity). Of these anomic ADs, 23 scored 6/6 on CAMCOG naming (sensitivity = 80%), and sensitivity fell to 30% using a 5/6 cut-off. Correlation between BNT and CAMCOG naming yielded Kendall's tau = 0.48 (p<0.0001). Compared to age-matched controls BNT correctly classified 70% of ADs and 87% of controls (overall accuracy = 77%). On CF 68% of ADs and 83% of controls were correctly classified (overall accuracy = 72%). BNT and CF were moderately correlated (r = 0.49, p<0.0001). DWR correctly classified 93% ADs and 98% controls (overall accuracy = 95%).Conclusions: Given its brevity, we recommend the inclusion of a split-half form of the BNT in screening test batteries for the detection of AD. The observed pattern of cognitive impairment is consistent with current models in which semantic memory deficits occur in AD only when the neuropathology extends beyond the entorhinal/hippocampal region to the temporal neocortex.