bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and clinical correlates of depression in the acute phase of first episode schizophrenia
Authors: Roche Eric , Clarke Mary , Browne Stephen , Turner Niall , McTuige Orflaith , Kamali Moaayad , Kinsellla Anthony , Larkin Conall , Waddington John L , O'Callaghan Eadbhard 
Published: March 2016

AbstractBackground: Reported rates of depression in schizophrenia vary considerably.Objective: To measure the prevalence of depression in a first episode sample of people with schizophrenia.Methods: All referrals with a first episode of schizophrenia diagnosed using SCID interviews were assessed pre-discharge and again six months later. We used the Calgary Depression Scale for Schizophrenia (CDSS) and Positive and Negative Syndrome Scale (PANSS) to assess the severity of symptoms.Results: Pre-discharge, 10.4% of the sample met CDSS criteria for depression. According to the PANSS depression (PANSS -D) subscale, 3% of patients were depressed, with a mean score of 7.48 (SD = 2.97). Only 3% of patients pre-discharge were found to be depressed on both the CDSS and the PANSS-D. Six months later 6.5% were depressed according to the CDSS. However none reached depression criteria according to the PANSS-D. The CDSS correlated with PANSS-D both pre-discharge and at follow-up. Feelings of depression and self-deprecation were the most common symptoms at baseline and follow-up. The CDSS was unrelated to negative symptoms at both stages. A lifetime history of alcohol abuse increased the risk for depression.Conclusion: Rates of depression in this sample were low. The CDSS appears to discriminate between depression and negative symptoms. Like the general population, alcohol misuse is a risk factor for depression in first episode schizophrenia.
The Myth of Mental Illness: 50 years after publication: What does it mean today?
Authors: Kelly Brendan D , Bracken Pat , Cavendish Harry , Crumlish Niall , MacSuibhne Seamus , Szasz Thomas , Thornton Tim 
Published: March 2016

AbstractIn 1960, Thomas Szasz publishedThe Myth of Mental Illness, arguing that mental illness was a harmful myth without a demonstrated basis in biological pathology and with the potential to damage current conceptions of human responsibility. Szasz's arguments have provoked considerable controversy over the past five decades. This paper marks the 50th anniversary ofThe Myth of Mental Illnessby providing commentaries on its contemporary relevance from the perspectives of a range of stakeholders, including a consultant psychiatrist, psychiatric patient, professor of philosophy and mental health, a specialist registrar in psychiatry, and a lecturer in psychiatry. This paper also includes responses by Professor Thomas Szasz.Szasz's arguments contain echoes of positivism, Cartesian dualism, and Enlightenment philosophy, and point to a genuine complexity at the heart of contemporary psychiatric taxonomy: how is ‘mental illness’ to be defined? And by whom? The basis of Szasz's doubts about the similarities between mental and physical illnesses remain apparent today, but it remains equally apparent that a failure to describe a biological basis for mental illness does not mean there is none (eg. consider the position of epilepsy, prior to the electroencephalogram). Psychiatry would probably be different today ifThe Myth of Mental Illnesshad not been written, but possibly not in the ways that Szasz might imagine: does the relentless incarceration of individuals with ‘mental illness’ in the world's prisons represent the logical culmination of Szaszian thought?In response, Professor Szasz emphasises his views that “mental illness” differs fundamentally from physical illness, and that the principal habits the term ‘mental illness’ involves are stigmatisation, deprivation of liberty (civil commitment) and deprivation of the right to trial for alleged criminal conduct (the insanity defence). He links the incarceration of the mentally ill with the policy of de-institutionalisation (which he opposes) and states that, in his view, the only limitation his work imposes on human activities are limitations on practices which are conventionally and conveniently labelled ‘psychiatric abuses’.Clearly, there remains a diversity of views about the merits of Szasz's arguments, but there is little diminution in his ability to provoke an argument.
Absinthe and suicidality
Authors: Rizvi Naveed , Whitty Marie , Daly Robert 
Published: March 2016

AbstractAbsinthe is an alcoholic drink which is becoming more widely consumed after being banned for many decades. An association between absinthe use and psychiatric symptoms, ranging from impairment of concentration to marked hallucinations and seizures, has been suggested, but evidence remains unclear. Thujone, identified as a possible psychoactive ingredient, has recently been implicated in absinthe's putative neuropsychiatric effects. This report presents a case where acute suicidality emerged during absinthe consumption; possible neurobiological aetiological mechanisms and the history of absinthe use and associated adverse effects are reviewed.
Are you looking at me? Paranoid psychosis in pre-existing social phobia
Authors: O'Connor Karen , Scully Paul 
Published: March 2016

AbstractObjectives: Three patients presenting with a first episode of psychosis each had a past history of social phobia. We sought to explore the literature on the co-occurrence of these disorders and investigate three hypotheses to explain this: (1) the chance co-occurrence of two illnesses with distinct aetiologies; (2) two clinical presentations reflecting different points on the same spectrum of illness; and (3) two distinct disorders representing different end points resulting from the same aetiology.Method: A literature review of Embase, PubMed and Psych Lit was performed.Results: We found no reports on social phobia preexisting an episode of psychosis, and prevalence studies indicate that their chance co-occurrence is extremely unlikely. Psychological explanations for co-occurrence include attributional theories, and theories related to cognitive biases and loss of self-esteem.Conclusion: There is a phenomenological overlap between social phobia and paranoia but the two concepts should and can be distinguished. Epidemiological studies indicate that their chance occurrence as two unrelated disorders is unlikely. Most people with one of these disorders do not develop the other and hypothesis (2) is also unlikely. There is increasing speculation that anxiety, and in particular social phobic symptoms have a central role in the development of psychotic symptoms. The greatest evidence was found to support hypothesis (3).However, it seems more likely that social phobia and psychosis, rather than representing manifestations of the same illness, instead are implicated in a complex interaction where symptoms which characterise social phobia and psychosis, have the capacity to affect, alter and possibly provoke each other. The recognition and treatment of co-occurring anxiety disorders, especially social phobia with psychosis, may have an important impact on prognosis and quality of life.
Expenditure of compensation from legal claims in an opiate dependent population
Authors: Cohen Dermot P , Barry Helen , Unoh Emma , O'Connor John J 
Published: March 2016

AbstractThis study examined the expenditure of compensation received from legal claims by service users attending an outpatient methadone programme in Dublin. Most claims (n = 62) were as a result of road traffic accidents (74%) or personal injury (15%). There were 28 reports of claims resulting in payment of compensation totalling €912,871. Of the compensation not placed in trust (€477,871), almost 40% was spent on drugs and 8% on alcohol. Of those who reported no drug misuse at the time of the compensation being paid, seven out of 11 (64%) reported subsequently spending a significant amount on substance misuse.The risks of receiving large amounts of money in this population are substantial and include initiation and exacerbation of substance misuse, and risk of overdose. Alternative ways of managing the payment of compensation should be considered for this vulnerable population.
Irish adolescents with ADHD and comorbid substance use disorder
Authors: Edokpolo Osamede , Nkire Nnamdi , Smyth Bobby P 
Published: March 2016

AbstractObjectives:To examine the literature for drug treatment of attention deficit hyperactivity disorder (ADHD) in adolescents with co-occurring substance use disorder (SUD), the challenges posed by this, and make recommendations taking into account current trend in Ireland.Methods:Articles published from 1992-2008 were identified using OVID-MEDLINE search using the search terms attention deficit hyperactivity disorder and substance use disorder. Studies cited include review articles, epidemiological studies, experimental researches, open and controlled trials of drugs in ADHD with comorbid SUD and clinical guidelines. No non-English language papers were included.Results:Thirty-six studies were examined. A number of the papers reported on the link between ADHD and SUD, that they frequently co-occur, and there is evidence that treating ADHD can reduce the risk of future SUD. Some of the studies reviewed demonstrated the safety and effectiveness of ADHD medication on the ADHD symptoms but less so on the SUD. Concerns around stimulant abuse and diversion are valid. Although there is no current evidence of frequent diversion of ADHD medications in Ireland, this practice is prevalent in the US. Consequently psychiatrists should remain vigilant to the possibility of such diversions and take measures to address them if identified.Conclusions:The available evidence suggests that medication is not hazardous in ADHD comorbid with SUD. Pharmacological treatment of ADHD, following consideration of potential risks and benefits, is justified in the presence of SUD. Both methylphenidate and atomoxetine can be used. Stabilisation of serious SUD before pharmacotherapy is preferable, and it is advisable to provide psychological treatment to address SUD in these patients.
Post-traumatic stress disorder: present and future
Authors: Crumlish Niall 
Published: March 2016

Post-traumatic stress disorder (PTSD) and acute stress disorder (ASD) differ from almost every other psychiatric diagnosis in that they may only be diagnosed with reference to an aetiological event – an external traumatic stressor. ASD occurs immediately after the stressor and is comparatively short-lived, while PTSD is a prolonged abnormal response that may take months to develop. The types of stressor leading to ASD and PTSD are identical and were intended to be tightly defined, involving a perceived threat of death, serious injury or loss of physical integrity.It is useful initially to distinguish ASD and PTSD from adjustment disorders, which are also diagnosed only after an observable life event. An adjustment disorder may be thought of as a gradual and prolonged response to stressful changes in a person's life. The range of stressors precipitating an adjustment disorder is potentially much broader than that precipitating ASD or PTSD, as a threat of death or injury is not needed.Indeed, a ‘threat’ as such is not needed, as the event may be a loss. Events such as job loss or the breakup of a relationship may lead to an adjustment disorder, as well as threats such as accidents or assaults. The diagnostic criteria for adjustment disorder do not specify what the immediate response, if any, to the precipitating stressor must be.
Use of seclusion in a general hospital acute psychiatric unit
Authors: Prinsloo Bernice , Noonan Angela 
Published: March 2016

AbstractObjective: To examine the frequency of use of seclusion and the factors associated with its use in Lakeview Unit, a 29-bedded acute psychiatric unit in Naas General Hospital.Methods: A survey was carried out involving a retrospective chart review of all patients secluded over a 12-month period, as well as a review of the seclusion register for this period. Secluded and non-secluded patients were compared for gender, nationality, age, diagnosis, duration of admission and admission status by reviewing discharge summaries of all patients admitted during the 12-month period.Results: Most (75%) of the secluded patients were secluded only once. Half of seclusion events were initiated in the first week of admission. Length of time spent in seclusion ranged from 50 minutes to 96 hours, with a mean duration of 25 hours 20 minutes. Seclusion was most often associated with risk to others and risk to self. Alternatives to seclusion considered included verbal de-escalation, medication, special nursing, single room accommodation and time out Male and non-Irish patients were more likely to be secluded. There was no significant difference between secluded and non-secluded patients in terms of age. Patients with psychotic disorders tended to be secluded more frequently than others, followed by patients with bipolar affective disorder and substance use disorders. Longer duration of admission and involuntary admission status were strongly associated with seclusion.Conclusion: Seclusion remains an important part of psychiatric practice on Lakeview Unit, and reflects indirect measures of illness severity. In order to reduce the duration of seclusion episodes, the development of alternative containment strategies needs to be addressed. Seclusion audits should be carried out regularly to ensure that best practice is adhered to.
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL): a familial cause of depression and headache
Authors: O'Rourke Killian , Crumlish Niall , Murphy Darra , Stack John , Murray Brian 
Published: March 2016

AbstractA 31 year-old man with a history of a depressive episode presented with acute severe ‘thunderclap’ headache. Magnetic resonance imaging (MRI) revealed abnormalities typical of cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL), which was subsequently confirmed by genetic analysis. The psychiatric features of this genetic cause of depression and headache are discussed.
Self-injurious behaviour and the serotonin link: two case illustrations and theoretical overview
Authors: Jawed Syed Hasan , HR Krishnan Vallepur , Cassidy Géraldine 
Published: March 2016

AbstractSelf-injurious behaviour (SIB) is one of the challenging behaviours that is exhibited by people with severe learning disabilities. Various current aetiological theories of SIB have failed to provide a feasible model of care for this complex clinical problem. Recent advances in the understanding of serotonin neurotransmitter function may provide a way forward in the management of SIB. Case histories of two people whose SIB responded to antidepressant medication are described. Possible implication of serotonin neurotransmitter function in the causation of SIB is explored and relevant recent literature is reviewed.
The ‘whiplash’ enigma: undetected psychological factors? A pilot study
Authors: Sheehan John D , Maguire Ann , Ryan John P , Vella Leo 
Published: March 2016

AbstractStudies in general medicine and general practice have shown that psychological disorder is frequently undetected and that it may exacerbate the morbidity of physical conditions. The aim of this study was to detect possible psychological disorder in patients with soft tissue neck injury (STNI) attending a 660 bed teaching hospital in Dublin. Using the General Health Questionnaire-30, 100 STNI patients were compared with 100 consecutive other attenders at the Accident and Emergency Department. There was a significantly greater prevalence in the frequency and severity of psychological disorder in the STNI group, who also were more likely to have a history of depression.
Groupwork with HIV positive drug misusers in prison
Authors: Pugh Julian 
Published: March 2016

AbstractObjective: The groupwork programme in this study sought to engage HIV positive drug misusers within a prison setting in order to introduce ideas and information, and by so doing promote desired behavioural changes in terms of risk behaviour and drug addiction. Such an effort was also seen as a strategy to help prisoners cope with imprisonment and to prepare them for the demands that they might face following release.Method: Various methods of giving information and discussion were employed in order to influence members' views and behaviour. The interactions between group members were recorded using a modified version of Bale's Interaction Process Analysis Instrument during each session. In this way it was possible to analyse individual member's functioning as well as that of the whole group over the duration of the programme.Results: While significant changes in members' views and behaviour could not be proven, an analysis of the group's communication, control, evaluation and decision making profiles reflected effort and engagement in tackling the subject inputs. Analysis of individual member's contributions was, however, open to more speculative interpretation.Conclusion: The positive response from group members, combined with an analysis of the results suggests that the approach adopted in the programme was an encouraging step in devising an acceptable and relevant educational and treatment strategy in dealing with this usually reluctant client group, many of whom are unresponsive to traditional treatment methods.
Barriers to the diagnosis and treatment of depression in the community dwelling elderly
Authors: Lawlor Brian A 
Published: March 2016

AbstractThere is broad agreement in the literature that depression in the community dwelling elderly is under-diagnosed and under-treated by general practitioners. Somatisation, overlap with medical illness, bereavement and atypical presentations of depression in this age-group may contribute to the difficulties in diagnosis in primary car settings. Furthermore, the apparent reluctance of primary care physicians to treat depression in the elderly may reflect the mistaken notion that depression in this population is a benign condition, an understandable reaction to physical illness and as such untreatable. Fundamental changes in the patterns of collaboration between psychiatry and general practice will be necessary to overcome these barriers to the detection and treatment of depression in the community dwelling elderly.
Prader-Willi syndrome and psychotic symptoms: report of a further case
Authors: Clarke David J , Webb Tessa , Bachmann-Clarke Joyce P 
Published: March 2016

AbstractA 21 year-old woman with Prader-Willi syndrome (PWS) and a delusional disorder (paranoid psychosis) is described. Other reports of psychoses associated with PWS are reviewed. Reasons for the co-existence of the two disorders are considered, with discussion of the possible role of auditory information processing deficits in the genesis of psychotic symptoms. Such symptoms must be differentiated from maladaptive behaviours not arising from psychosis, the latter being relatively common in PWS. Treatment with a small dose of flupenthixol greatly reduced the impact of the patient's psychotic symptoms, with a corresponding improvement in her quality of life.
Schizophrenia and Down's syndrome
Authors: Duggirala Chandrudu , Cooper Sally-Ann , Collacott Richard Anthony 
Published: March 2016

AbstractThere are few reports in the literature of schizophrenia in individuals with Down's syndrome, but a suggestion that such individuals may be protected from schizophrenia. We report six cases of schizophrenia fulfilling ICD-10 guidelines, occurring in people with Down's syndrome. In one case, hypothyroidism was associated. Response to neuroleptic treatment was good. Reasons for the paucity of previous reports on this association are discussed.
Clozapine in treatment-resistant schizophrenic patients: preliminary results from an open prospective study
Authors: Jalenques Isabelle , Albuisson Eliane , Tauveron Igor 
Published: March 2016

AbstractObjective:This report describes an open prospective study of the effects of clozapine on positive and negative symptomatology in treatment resistant schizophrenic patients.Method:In this prospective study, 15 DSM-III-R schizophrenic patients, who had failed to respond to various neuroleptics were followed up for a period of 21 months (median: 9; 25th and 75th percentiles: 4-10). When clozapine treatment was initiated, the mean duration of the illness was 16 +/-9 years. Brief Psychiatric Rating Scale (BPRS) scores, BPRS ‘positive symptoms’ and BPRS ‘anergia factor’ scores were all rated at days 0 and 15, months one, two and three and every three months thereafter.Results:Significant improvements in total BPRS scores, BPRS positive symptoms and anergia factor were recorded and resulted in two distinct patterns of outcome. The improvements in BPRS scores translated into marked changes in health care utilisation and in sheltered employment. Of the side effects noted, dry mouth was more common in the first month after wash-out (three patients), while hypersalivation was more frequent after this period (eight patients). There was no agranulocytosis in this cohort. Two cases of eosinophilla occurred during the first month. Weight gain affected six patients.Conclusions:We found that clozapine offers particular benefits for some treatment-resistant schizophrenic patients despite the increased hematologic risk. Our study also indicates that the beneficial effects of clozapine are delayed in relation to negative symptoms as compared with positive symptoms.
Absent without leave – can we predict those who go AWOL?
Authors: Farragher Barbara , Gannon Miriam , Ahmad Ishtag 
Published: March 2016

AbstractObjective: To quantify the number of patients absent without leave (AWOL) from an Irish psychiatric hospital in one year and to examine the clinical and demographic data of this group of patients.Method: This was a retrospective study of all patients reported as AWOL from St Brendan's Hospital in 1991. The following information was obtained from the patients' case notes: age, sex, legal status, marital status, psychiatric diagnosis, number of previous admissions, past history of absconding, length and outcome of absence. Their clinical and demographic variables were compared with a control group of 214 patients (non-absconders) randomly selected from the hospital admissions over a 12 month period.Results: A total of 48 patients absconded. The majority were male, single, compulsorily detained, with a past history of absconding. The most common psychiatric diagnoses were schizophrenia (32%), personality disorder (23%) and alcohol dependence syndrome (17%). While absent, three patients had a history of suicidal behaviour and four became involved in criminal activity. Compulsory status was statistically significant when compared to the control group.Conclusion: The characteristics of our group of absconders are similar to those in previous studies apart from the increased prevalence of personality disorder and alcohol dependence syndrome. We discuss the risks associated with absconding and recommend close follow-up of this group of patients.
Eating psychopathology and its effect on pregnancy, infant growth and development
Authors: McNicholas Fiona 
Published: March 2016

AbstractPreoccupation with weight and shape is very prevalent in the female population and is generally well researched. However, the effects of eating psychopathology on infant growth and child development have not been adequately covered and they merit the attention and interest of clinicians. This present submission, using Medline search, critically reviews the available literature and highlights the importance of clinically addressing these issues. It also makes reference to other areas requiring further research. Fifteen articles are discussed which relate specifically to eating psychopathology and the possible effect on mother-child interactions.