bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Greysteel massacre: the local effect on the prevalence of admissions with overdose
Authors: Sharkey John 
Published: March 2016

AbstractObjective: To explore the nature of the relationship between the Greysteel massacre and the low number of admissions with overdose to the area general hospital in the following week.Method: Ward records over a ten year period were examined for seasonal and yearly trends for admission with overdose.Results: In the two year period surrounding the week following the Greysteel massacre there were no similar periods of low admission with overdose.Conclusion: A direct relationship between the Greysteel massacre and the ensuing dearth of admissions with overdose seems likely.
Community organisations' expectations of mental health statutory services
Authors: Bhugra Dinesh , La Grenade Janet 
Published: March 2016

AbstractObjective: Community organisations provide care for psychiatric patients at multiple levels. With increasing emphasis on joint planning and purchasing of care it is important to ascertain the views of such organisations towards statutory organisations and services the latter provide.Method: All community organisations working within one inner city catchment area in London were approached in order to obtain their views and experiences on the mental health services provided by the secondary care services. This was a postal survey and non-responders were contacted by personal calls.Results: Sixty organisations out of a total of 100 in the database responded. More than half had experiences of statutory services and these were generally negative. The services provided were perceived as being rigid and inflexible. A large majority of the organisations wished services to be more flexible as well as provide more training for voluntary organisations.Conclusion: The survey suggests that the perceptions of the statutory services and co-working with voluntary organisations can succeed only if the two groups work together closely to make good quality community care possible.
Evidence-based medicine and psychiatry
Authors: Geddes John 
Published: March 2016

Over the last five years the adjective ‘evidence-based’ has become difficult to avoid. Indeed, a MEDLINE search for articles containing the phrase ‘evidence-based medicine’ in their titles or abstracts reveals one mention in 1992, rapidly increasing to 53 in 1996. So great has been the increase that the National Library of Medicine now includes ‘evidence-based medicine’ as a MeSH heading for indexing papers.But what is evidence-based medicine (EBM)? First and foremost, EBM is a set of strategies designed to help the clinician keep up-to-date and to base his clinical decision making on the best available external evidence. EBM has been espoused by policymakers, purchasers and others — and, although the approach is open to misuse by these groups as a cost-cutting exercise, there are refreshing signs that they will be able to use the approach to help produce real improvements in patient care. However, the essential focus of EBM is on assisting doctors and other clinicians make decisions about individual patients. The steps involved in EBM include: a precise definition of the clinical problem (a crucial first step — in medical practice it will usually include making a diagnosis), an efficient search for the best available evidence, critical appraisal of the evidence and integration of the research findings with clinical expertise. Finally, the clinician assesses the outcome of the process and continues to improve his EBM skills.
Acute psychiatric services: an appraisal of a major change in service delivery within one catchment area
Authors: O'Doherty Miriam 
Published: March 2016

AbstractObjectives: To investigate effects on one psychiatric inpatient service of a 40% reduction in the number of acute beds and the establishment of an acute day hospital.Method: A retrospective review of all public admissions to the acute inpatient unit during two three-month study periods; before and almost three years after the changes. Review of attendance at the acute day hospital during the second study period.Results: The number of admissions actually increased by 3% from 169-174; the mean duration of stay fell from 27-17 days; and the number of brief admissions of three days duration or less almost tripled from 15-43. Although fewer patients suffering from schizophrenia were admitted in the second study period than in the first, their mean duration of stay and the frequency of re-admission within 28 days of discharge changed little, while patients with diagnoses of mild/moderate depression and substance misuse experienced significantly shorter admissions and higher readmission rates. The use of temporary orders under the Mental Treatment Act (1945) doubled, and the readmission rates within 28 days increased by over 60%.The acute day hospital treated 98 patients who had a diagnostic profile similar to that of the inpatients; 53% of them required admission before and/or after attendance at the day hospital.Conclusions: The major reduction in the number of acute inpatient beds and the opening of an acute day hospital resulted in greater concentration of inpatient resources on the more severely ill patients. The increase in re-admissions and the failure to effect a reduction in admissions and may have a complex aetiology and merits further investigation.
Bilateral autoenucleation in a man with a severe personality disorder
Authors: Meagher David J , Fahy Tom J , Nolan John 
Published: March 2016

AbstractA case of self-inflicted eye injury is described in a setting of alcohol intoxication and severe personality disturbance. The case is believed to be the only one of its type described this century. The relevant classical and contemporary literature is reviewed and psychopathological explanations discussed. Possible indicators of impending self-violence are reviewed.
The Tukes of York
Authors: Breathnach Caomhghin S 
Published: March 2016

AbstractAt the instigation of William Tuke the York Retreat was built in 1794 by the Society of Friends. From its opening in 1796 until 1845 its management was in the hands of lay administrators, and the moral treatment of insanity which was the creation of George Jepson between 1797 and 1823 became a model of its kind. The great tradition thus established was continued by William's grandson, Samuel Tuke, and Samuel's son Daniel Hack Tuke. Daniel's older brother James is better known to Irish history for his philanthropy during Black '47 which is still warmly embedded in folk memory in the West of Ireland.
Admissions to a day hospital and to a general hospital psychiatric unit in a new community psychiatric service
Authors: Joseph Anil P , Loane Ruth , Sheehan John 
Published: March 2016

AbstractObjective: To conduct an audit of the patients treated at a day hospital or in an inpatient unit of a district general hospital from the South Kildare sector of the Kildare Mental Health Service, a new community based psychiatric service.Method: Retrospective case note review of all admissions over a six month period. ICD-9 diagnosis used.Results: There were 39 and 29 admissions to the inpatient unit and day hospital respectively. The average duration of stay in the inpatient unit was 14 days, 66% were discharged home and 33% discharged to the day hospital. The average duration of stay was 30 days in the day hospital, 62% were discharged home and 17% discharged to the inpatient unit.Conclusions: The trend was to treat more neurotic patients in the day hospital; psychotic patients were treated in both settings; the proportion of patients discharged home was similar. The duration of stay was longer in the day hospital.
The molecular genetics of affective disorders: An overview
Authors: Mynett-Johnson Lesley A , McKeon Patrick 
Published: March 2016

AbstractObjective: Genetic mapping, the method of comparing an inheritance pattern of a disease to that of a chromosomal region, has brought about a revolution in the field of human inherited diseases. Diseases which exhibit a more complex pattern of inheritance now afford the next challange in the application of genetic mapping to the field of human disease. This article aims to review the application of genetic mapping to affective disorders.Method: Review of literature concerning the molecular genetics of affective disorders.Findings: This article describes the evidence for a genetic role in affective disorders, reviews the research to date and describes the difficulties arising out of the complex nature of these disorders.Conclusions: Although progress to date in psychiatric genetics has been somewhat disappointing, the combined approach of using all the genetic tools currently available on large collections of affected individuals and families should enable the genetic basis of affective disorders to be identified.
Schizophrenia in a patient with established Gilles de la Tourette Syndrome
Authors: Cassidy Elizabeth C , Miller Steven John , Chalmers Julie F 
Published: March 2016

AbstractA 24 year old man with established Gilles de la Tourette Syndrome (GTS)and schizophrenia of recent onset is described. Other comorbid reports of schizophrenia and GTS are reviewed showing this association to be rare, with only nine previous reported cases. GTS and schizophrenia have many phenomenological similarities and a link has been considered between the two disorders but never clearly established. Reasons for the lack of an association where one might be expected are considered. Possibilities include under reporting or misdiagnosis of GTS or the possible masking of psychotic symptoms by treatment of the GTS.
Primary and secondary erotomania: Is the distinction worthwhile?
Authors: Garland Malcolm , McGennis Aidan 
Published: March 2016

AbstractObjective: To examine the phenomenology of erotomania and to discuss the relevance of its classification into primary and secondary forms.Method: Two case reports are presented. Both were female, non-Irish nationals who travelled to Ireland expressly to pursue their objects, who were both members of an internationally famous rock band. Case 1 and Case 2 are presented as primary and secondary erotomania, respectfully.Result: The difficulty in distinguishing primary from secondary erotomania is discussed; the modern literature is referred to, which appears to be divided about the status of the primary form of this disorder as a distinct entity.Conclusion: Until further advances are made in elucidating mental disorders, diagnosis will remain symptom-based, leaving diagnostic formulations somewhat over-crowded with syndromes of undetermined aetiology. Such is the case with erotomania.
Unilateral auditory hallucinations in association with ear infection
Authors: Carroll Andrew , Milnes David 
Published: March 2016

AbstractWe report the case of a patient with unilateral left-sided auditory hallucinations in association with a left middle ear infection, who in addition demonstrated a symptom of passivity, attributing the infection to the actions of a voice. The case demonstrates the potential for complex interplay between physical and mental pathology.
Characteristics of epilepsy in a population based cohort of adults with learning disability
Authors: Deb Shoumitro , Joyce Joseph 
Published: March 2016

AbstractObjectives: The purpose of the study was to define various aspects of epilepsy in a population based sample of adults with a learning disability.Method: A purpose-designed questionnaire was used to collect information on various aspects of epilepsy on 143 adults with a learning disability and epilepsy. Names of these subjects were collected from a hospital for learning disabled adults, specialist epilepsy clinics and social services department. Data was gathered from case notes and direct patient examination.Results: Generalised tonic clonic seizure was the most common seizure type. Seventy-three per cent sustained a seizure within the previous 12 months of the study. Abnormal EEG findings including excessive slow background activities and epileptiform waves were documented in a high proportion of subjects with a learning disability and epilepsy.Conclusions: Both resistant epilepsy and generalised tonic clonic seizures seem to be more frequent among the learning disabled population compared with the general population.
Consultant psychotherapists: who needs them?
Authors: Adams Clare , O'Kane Maria 
Published: March 2016

“The idea of a psychotherapeutically informed psychiatry seems such a simple and obvious one and yet the divide between psychotherapy and general psychiatry – between ‘brainlessness’ and ‘mindlessness’ has, until recently, seemed unbridgeable”.The Psychotherapy section of the Royal College of Psychiatrists has the largest membership in the college. Since psychotherapy became recognised as a discipline within psychiatry in 1975 the Royal College of Psychiatrists has recommended one consultant psychotherapist for each 200,000 of the population. In Northern Ireland there are only 1.9 whole time equivalents rather than the eight expected and in the Republic of Ireland there is none. According to the recent document produced by the Royal College of Psychiatrists' Psychotherapy Faculty Executive Committee in December 1998, The development of psychological therapy services: Role of the consultant psychotherapist, there has been no net growth in the last five years in the numbers of psychotherapists in England and Wales. The future looks equally gloomy in Ireland.This is rather surprising given that recent government documents have highlighted both the importance and the effectiveness of psychological therapies. There is a growing evidence base underpinning the use of psychotherapy in the management of a wide variety of conditions including psychoses, eating disorders and severe personality disorders.Psychotherapy has high public acceptability and finds itself in the unusual position of having both government and public demanding the provision of extra psychological therapies, but not receiving the full support of psychiatry and the purchasers of healthcare.
An assessment of the psychoeducational needs of long-term psychiatric patients
Authors: Gibbons Pat , Hogan Grace , McGauran Sheila 
Published: March 2016

AbstractObjectives: We aimed to identify which illness related topics were of most interest to chronic psychiatric patients in our catchment area service, and to obtain a baseline measure of the amount of knowledge which patients with schizophrenia had about their illness.Method: Patients attending for a minimum of one year were recruited from the outpatient clinic and day centre. Participants completed three instruments: a brief questionnaire which asked about the details of their diagnosis and drug treatment regimen, the ‘Educational Needs Questionnaire’ (ENQ), and a modified form of the ‘Understanding Schizophrenia Scale’ (USS).Results: Forty-seven patients with a chronic psychotic illness participated in the study. Despite having attended the service for an average of 14 years, the majority of patients were unable to correctly identify their diagnosis. Most patients were able to name the drugs which they had been prescribed; but were not able to describe the dosage of these drugs. According to the ENQ results, patients expressed most interest in learning about general aspects of their illness, such as ‘how to cope with stress’, and less in how to manage specific illness related symptoms. Similarly, schizophrenia patients were found to know more about general aspects of their illness, such as rehabilitation and non-medical aspects of treatment, than about medication.Conclusion: Chronic psychiatric patients, especially those with schizophrenia, have very limited knowledge of their illness and its treatment. The focus of psychoeducation should be extended from insight and compliance to include broader ‘quality of life’ issues which appear to be of more concern to patients themselves. Patient participation in psychoeducation can thus be improved by including topics identified by such instruments as the ENQ. It is encouraging that cognitive deficits and negative symptomatology do not seem to prevent long-term psychiatric patients from benefiting from such inputs.
Vampirism and schizophrenia
Authors: Kelly Brendan D , Abood Zainab , Shanley David 
Published: March 2016

AbstractA case of schizophrenia with vampiric delusions is described. The relevant classical and contemporary literature is reviewed, both in relation to clinical vampirism and the relationship between vampirism and schizophrenia. In patients with vampiric delusions, the possibility of future vampiric behaviour should be considered, and appropriate treatment initiated.
Good practice in attention deficit hyperactivity disorder
Authors: McNicholas Fiona 
Published: March 2016

AbstractMajor advances have been made in ADHD over the years, both in terms of diagnostic validity, different subtypes, comorbidities and treatment options. A comprehensive assessment needs to include medical, developmental and educational history using multiple sources of information and across different settings. In certain cases, additional investigations and neuropsychological testing may need to complement basic physical and neurological examination. The focus of treatment must include not only the core ADHD symptoms but also additional comorbid problems, family and peer relationships, and academic achievement. Treatment should therefore be multi-modal with simultaneous medication, behavioural and educational management. Both diagnosis and treatment response needs to be reviewed regularly to ensure optimal response with minimal adverse side effects.The increased awareness of ADHD by both clinicians and other professionals has resulted in a huge increase of referrals for assessment, diagnosis and treatment. In particular, families are becoming increasingly knowledgeable about the disorder and are rightly requesting adequate assessment and treatment of their children. It is therefore essential that all clinicians are equally knowledgeable about the advances in this area and offer a service to families which represents good clinical practice. This article reviews what constitutes good clinical practice in ADHD.
Depression among postnatal women in an urban Irish community
Authors: Cryan Elizabeth , Keogh Fiona , Connolly Eibhlin , Cody Stasia , Quinlan Ailis , Daly Ian 
Published: March 2016

AbstractObjectives:To estimate the prevalence of postnatal depression in a community sample of women in a disadvantaged urban area in West Dublin, and to examine the factors which may be associated with it.Method: All women who had a live birth in the area over a one year period were identified (944) and the self-rated Edinburgh Postnatal Depression Scale (EPDS) was distributed to those who could be contacted by the public health nurses. Those scoring in the depressed range (> 12) were compared to non-depressed for age, marital status, employment, parity, presence of a confidant, mode of delivery, previous miscarriage and previous psychiatric history.Results: Contact was made with 596 women and 377 responded. Responders were older and more likely to be first time mothers, but there was no significant difference between responders and eligible population for marital status. One hundred and eight women (28.6%) scored in the depressed range. Ten sociodemographic and clinical variables were entered into a logistic regression. Scores over the threshold (> 12), suggesting clinical depression, were significantly associated with four variables, lower age, absence of a confidant, previous miscarriage and previous treatment for depression by a GP.Conclusions: A high prevalence of postnatal depression of 28.6% was reported, which may be associated with overall high levels of social disadvantage in this sample. There were implications for the targeting of resources into such areas. The associated factors are discussed.
Rehabilitation psychiatry
Authors: Mountain Deborah A 
Published: March 2016

AbstractRehabilitation services are changing across Britain. The focus of service developments appears to be in relation to community teams and assertive outreach. This leaves the question of which direction rehabilitation services are heading. As patients move into the community from long stay wards as part of the process of bed closures and resource transfer, rehabilitation services are left with changing patient characteristics. In addition, patient characteristics in rehabilitation vary between Trusts. This article explores and expands on these themes.
Psychiatric and medical co-morbidity in mitral valve prolapse
Authors: Gonzalez Efrain A , Pimentel Claudia , Natale Ruby A , Toll Benjamin A , Soffer Ariel , Gralnik Leonard 
Published: March 2016

AbstractObjective: Significant controversy continues to exist in the empirical literature regarding the diagnosis and treatment of mitral valve prolapse (MVP). In addition, there is also inconsistency in the correlation of anxiety disorders as co-existing with MVP, as well as cause and effect issues in terms of the role of the autonomic nervous system, MVP and panic attacks. Recent studies suggest that the co-morbidity of an anxiety disorder and clinical depression appears to increase the likelihood of MVP in predisposed patients. The objective of this review was to examine, clarify, and further define the medical and psychiatric aspects of MVP.Methods: A literature review was conducted on empirical studies and reviews examining MVP.Results: It was found that although MVP is highly correlated with psychiatric disorders, the lack of adequate control groups and clear criteria for a diagnosis of MVP in most empirical studies examining these associations make it difficult to determine the relationship between MVP and psychiatric disorders.Conclusions: Suggestions for further research in the areas of depression and personality characteristics are offered. It is also suggested that the use of control groups from populations with cardiac disorders and a better definition of MVP will clarify many of the problems in empirical studies aiming to determine the relationship between MVP and psychiatric disorders.
Buprenorphine detoxification treatment for heroin dependence: a preliminary experience in an outpatient setting
Authors: Williams Hugh , Remedios Andrew , Oyefeso Adenekan , Bennett Jennifer 
Published: March 2016

AbstractObjectives: The aim of the study was to evaluate buprenorphine as a detoxification agent for heroin dependence in an outpatient setting. Specifically we sought to establish the rate of completion of detoxification and retention in treatment, the duration of successful detoxification and dose requirements.Methods: The study was an open prospective evaluation of routinely collected clinical data on the first 60 consecutive heroin dependent patients who underwent buprenorphine detoxification. A flexible dosing regime was adopted with the dose of buprenorphine being adjusted daily against the previous day's withdrawal symptoms.Results: The majority of patients (40 (67%)) completed detoxification. The median duration of treatment for completers was 17 days (range 9-30 days) with 90% of detoxification episodes completed within 21 days. Patients were commenced on initial median dose of 4mg buprenorphine (range 2mg-6mg) and the median stabilisation dose for the sample was 10mg daily (range 6mg-14mg). The median final dosage of buprenorphine required by patients retained in treatment was 1.2mg (range 0.4mg-2mg). We found older patient age to be a significant predictor of treatment completion.Conclusions: Buprenorphine was an acceptable and a feasible outpatient detoxification treatment option for heroin dependent patients. Based on the study findings we propose a standard 21-day fixed-dose detoxification schedule.