bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychiatric problems of children exposed to opiates in utero – a descriptive study
Authors: Clarke Ciaran , Fitzpatrick Carol 
Published: March 2016

AbstractObjectives: To describe the psychosocial and clinical characteristics of children referred to a community-based child and adolescent mental health service, whose mothers reported that they took opiates during the pregnancy.Methods: In a retrospective study, the case notes of all children whose mothers reported that they had been exposed to opiates in utero, and who were referred to the Department of Child and Family Psychiatry, Mater Hospital, between 2001–2003, were identified by maternal reports. Information was obtained on age, gender, referral source, socio-economic group, family type, number of siblings, involvement of community care services, nature of presenting problems, diagnosis, interventions offered, and treatment difficulties. Information was recorded anonymously.Results: 15 children were identified, of whom nine were male. Most were found to be living with their mother alone or with their mother and a partner, and to be socially and financially disadvantaged. Their presenting complaints usually involved combinations of aggressive, hyperactive, and oppositional behaviour. Diagnoses included ADHD, a speech and language disorder, and an axis II disorder. Interventions were frequently unsuccessful because of parents' difficulties with attending appointments, and because of instability in the families' living arrangements.Conclusions: These children, due to a complex interplay of biological and psychosocial adversity, are at serious risk of ongoing psychiatric disorders in childhood and adolescence, and for adverse outcomes in adult life. A prospective cohort study of all children born to opiatedependent mothers is necessary to quantify the level of risk and identify resilience factors.
Myocarditis and cardiomyopathy linked with clozapine treatment
Authors: Prasad Sarah , Bell Douglas R 
Published: March 2016

AbstractClozapine is associated with a risk of myocarditis and cardiomyopathy. The exact mechanisms still remains unclear although there have been a range of proposals ranging from hypersensitivity reactions, toxic effects of the drug to vitamin deficiency. We present three cases where there were minor deviations of heart function or structure prior to the onset of clozapine treatment. One case developed a mild rise in troponin-1 levels within one month of clozapine treatment. We also review the current literature on the link between clozapine, myocarditis and cardiomyopathy and suggest clinical guidelines for monitoring patients for cardiac symptoms prior to commencing and while on clozapine treatment.
The Victorian genius of Earlswood – a review of the case of James Henry Pullen
Authors: Breathnach Caoimhghin S , Ward Conor 
Published: March 2016

SummaryLondon born James Henry Pullen (1836–1915) was admitted to Essex Hall in Colchester, an institution catering for learning disability, at the age of 13. Here his artistic talent was spotted before he moved two years later to Earlswood Asylum for Idiots, where he was apprenticed to woodworking. Such was his manual skill he was eventually employed making furniture for the asylum. His artistic propensity was similarly encouraged and although he never mastered coherent speech he has left a pictorial autobiography of some distinction. At observation he underwent detailed examination by Frederich Sano (1871–1946), particular attention being paid to tokens of arrested development. The clinical and pathological evidence of a pervasive developmental disorder points to a retrospective diagnosis of autism.
Temporal trends in rates of dual diagnoses at a Canadian addictions hospital over a five-year period
Authors: Kolla Nathan J , Marsh David C , Erickson Patricia G 
Published: March 2016

AbstractObjectives:Dual diagnosis refers to co-occurring substance use and psychiatric disorders. The principal aims of this investigation were two-fold: 1) to identify aspects of patients' drug use and prior treatment histories associated with their receiving a dual diagnosis upon admission to the Donwood Institute, a residential drug treatment facility located in Toronto, Canada; 2) to track temporal trends in the rates of diagnosed comorbidities over a five-year period at this same institution.Methods:We conducted an analysis of the intake assessment forms and hospital records of 159 patients who had been admitted to a drug treatment facility during the month of September for each of the years between 1998 and 2002 inclusive. Comparisons were made between patients who had received a psychiatric diagnosis on admission and patients who had received no such diagnosis. We then employed logistic regression analyses to explore the relationship of the variable psychiatric diagnosis on admission to other patient variables.Results:Among the patients studied in our sample, those receiving psychotherapy or taking prescription psychotropic medication at the time of their admission as well as patients whose primary problem substance was cannabis or who had been previously admitted to the treatment facility were significantly more likely to have received a psychiatric diagnosis on admission, in spite of our finding that several patients receiving psychotherapy or taking at least one psychotropic medication did not receive a psychiatric diagnosis on admission.Conclusions:Whilst our data indicate that psychiatric comorbidity is common among individuals in treatment for substance use disorders at the Donwood Institute, it is possible that some individuals with psychiatric illness in our sample were not diagnosed as such when presenting for treatment of their substance use difficulties. Moreover, temporal tracking of rates of dual diagnoses did not reveal a consistent increase during the period studied.
The point-prevalence of alcohol use disorders and binge drinking in an Irish general hospital
Authors: Molyneux Guy J , Cryan Elizabeth , Dooley Elisa 
Published: March 2016

AbstractObjectives:There is a paucity of data concerning the prevalence of alcohol use disorders and binge drinking in the general hospital adult population in Ireland. We therefore examined the point-prevalence of alcohol use disorders and of binge drinking in the adult inpatient population of the acute wards of an Irish university teaching hospital. The secondary aim was to examine gender, age, and patient group (medical/surgical) as risk factors.Method:We administered the Alcohol Use Disorders Identification Test (AUDIT) to all consenting patients (n = 126) on the acute adult medical and surgical wards over one day.Results:76% of all inpatients on the acute medical and surgical wards were interviewed (n = 126) using the AUDIT.Of the subjects 28% screened positive for an alcohol use disorder. Of these 91% were identified as binge drinkers.A further 8% of the subjects screened positive for binge drinking but were not identified as having an alcohol use disorder.Overall, 36% of the subjects screened positive for either an alcohol use disorder and/or for binge drinking using the AUDIT.Male gender and under 65s were risk factors for both alcohol use disorders and binge drinking.Conclusions:The high point-prevalences of alcohol use disorders and binge drinking in hospital inpatients in particular are a cause for concern as they may have illness complicated by or secondary to undiagnosed alcohol excess. As this population is an easily accessible group for screening, and clinical and economic evidence supports intervention, we recommend screening all acute hospital admissions for alcohol use disorders and binge drinking, followed by appropriate management.
Bipolar affective disorder: advances in genetics and mood-stabilising medication
Authors: White Daniel C. , Kelly Brendan D. 
Published: March 2016

AbstractThe lifetime prevalence of bipolar affective disorder is between 1 % and 2%. This educational review paper focuses on two areas of interest and relevance to trainees preparing for the membership examination of the Royal College of Psychiatrists: (a) advances in the genetics of bipolar affective disorder; and (b) mood-stabilising medication in bipolar affective disorder.
Psychiatric morbidity in the male sentenced Irish prisons population
Authors: Duffy Dearbhla , Linehan Sally , Kennedy Harry G 
Published: March 2016

AbstractBackground:This is the first epidemiologically representative cross-sectional study of psychiatric morbidity using research diagnostic instruments in sentenced prisoners in Ireland.Objective:To estimate the prevalence of psychiatric morbidity and psychiatric service requirements.Method:We interviewed 340 men serving a fixed sentence (14.6% of total) and 98 men serving a life sentence (82% of total). Prisoners were drawn from 15 different prisons using a random stratified sampling method. Mental illness and substance misuse was measured using the SADS-L, SODQ and a structured interview to generate ICD-10-DCR diagnoses.Results:We found a high prevalence of mental illness. Our six month prevalence for psychosis (2.7%) was similar to an international meta-analysis. We found a significantly higher prevalence of psychosis in life sentenced prisoners (6.1%) compared to fixed sentenced prisoners (1.8%). Drugs and alcohol problems were very prevalent.Conclusions:Using the six month prevalence figures found for psychosis, we estimate that there are approximately 79 sentenced male prisoners with a severe mental illness who would require treatment in hospital additional to current provision. We discuss the relationship between drug availability and the prevalence of severe mental illnesses in prisons.
Variations in residential accommodation for adults with intellectual disabilities: the example of Northern Ireland
Authors: McConkey Roy 
Published: March 2016

AbstractObjectives: Over the past three decades, major changes have taken place internationally in the type of residential accommodation provided for people with intellectual disabilities but these appear to be less evident in Northern Ireland.Method: A census was undertaken of all persons in any form of residential placement using a range of existing databases to identify the population, with a short questionnaire completed for each resident.Results: Around 440 persons lived in hospitals and 1,970 in some other form of provision but mostly in large congregated settings such as residential care homes and nursing homes. This was more marked in certain Health and Social Service Boards than in others. Most places are provided by the private sector although voluntary organisations and housing associations now manage around one-third of places. People living in hospitals reportedly had different characteristics to those in all other settings while those in nursing homes tended to require greater personal care. However the characteristics of people living in residential homes, supported living arrangements and village communities were broadly comparable. Around one in 10 persons were deemed to benefit from a move; mostly from residential homes to more independent living arrangements.Conclusions: Compared to Britain and the Republic of Ireland there is an under-provision of residential placements in Northern Ireland. To date, funding from outside of health and social services has been the main driver for the type of accommodation provided. The implications for future policy and provision are discussed.
Atypical antipsychotic monitoring: A survey of patient knowledge and experience
Authors: Feeney Larkin , Mooney Mary 
Published: March 2016

AbstractObjectives: To examine the knowledge and experiences of side-effects and their monitoring in patients prescribed atypical antipsychotic medications.Methods: A tick box survey was designed to ask questions of patients prescribed atypical antipsychotic medications about side-effects and monitoring for them. This survey was distributed anonymously to all suitable outpatient attendees over a three month period who had been prescribed atypical antipsychotic medication for at least one year.Results: Seventy-four of the 90 surveys (82%) distributed were returned complete. Fifty-six (76%) of those surveyed said they were currently experiencing side-effects. Twenty-two (39%) said they had not told their psychiatrist about the side-effects. Weight gain was most commonly complained of (49%). Forty-five (61%) said that they had had no monitoring blood tests in the past year. Fifty-one (69%) did not know that certain monitoring blood tests were recommended.Conclusions: Patients prescribed atypical antipsychotic medications are not currently being monitored as best practice dictates. It cannot be assumed that GPs will pursue this monitoring. More resources are needed for mental health services so that adequate monitoring services can be provided.
Survey of a second opinion clinic in child and adolescent psychiatry
Authors: Ahuja Alka S 
Published: March 2016

AbstractObjectives: Second opinion is a medical opinion provided by a second physician/ medical expert after first receiving an opinion by another physician/ medical expert. Little is known about the provision of second opinion in Child and Adolescent Mental Health Services (CAMHS). This study describes the second opinion service provided by the Child and Adolescent Mental Health Services (CAMHS) in the South Wales region.Methods: We undertook a survey of a second opinion service in Child and Adolescent Mental Health Services (CAMHS). We also assessed whether the recommendations made by the second opinion clinic were implemented by the referrers.Results: The diagnoses were not changed in 68% of the cases but alternative treatments were suggested. In 90% of the cases the treatment recommended by the clinic was implemented and nearly 70% of the patients showed improvement with the recommended treatment.Conclusion: A second opinion service can provide valuable support and expertise to CAMHS and the referred families.
Read all about it: guided bibliotherapy for depression in adults
Authors: Foster Tom 
Published: March 2016

AbstractEarly intervention in depression is important for many reasons including expeditious alleviation of suffering, assisting parenthood, suicide prevention and helping the economy. The fact that people with depression frequently employ maladaptive coping strategies, notably alcohol misuse, suggests the need for evidence-based self-help for sufferers. Self-help can be viewed as a philosophy of patient empowerment and as “a health technology solution to volume and demand”. Bibliotherapy (self-help using written materials) provides information and encourages the reader to make changes leading to improved self-management. Enthusiasm for the use of bibliotherapy in depression should be tempered by pursuit of a sound evidence base.
Attitudinal change toward psychiatry during undergraduate medical training in Ireland
Authors: Glynn Shauna , Reilly Michael , Avalos Gloria , Mannion Laura , Carney PA 
Published: March 2016

AbstractObjectives: This study examined the impact of psychiatric teaching on attitudes toward psychiatry of a cohort of medical students by means of a questionnaire survey. The impact of social desirability bias on questionnaire responses was also explored. Gender and nationality subgroups in the cohort were examined in more detail to determine whether these variables had any bearing on attitude change.Methods: Fifth year medical students at NUI Galway completed the Attitudes to Psychiatry-30 questionnaire at the beginning and end of the psychiatric curriculum.This was coupled to the Marlowe-Crowne Social Desirability Scale (13 items) to determine the effect of this potential bias on responses to the attitudinal scale.Anonymity was ensured by using unique identification codes on the questionnaires, which facilitated individual comparisons of pre- and post-teaching responses.Results: Attitudes toward psychiatry were positive prior to training but significantly improved following the teaching programme.There was no difference in attitudinal change between male and female subgroups.While students from outside the EU did show an improvement in mean scores on the ATP-30 this increase failed to reach significance. This finding was in contrast to the results for students from EU states whose mean increase on the ATP-30 was highly significant.Social desirability questionnaire scores fell significantly between the first and second administration, lending support to the findings being a true reflection of the students' attitudes toward psychiatry.Conclusions: These findings suggest that a teaching programme has the ability to influence students' attitudes. This is encouraging for recruitment into psychiatry and overall patient care.
The Gloucester assertive community treatment team: A description and comparison with other services
Authors: Gregory Nathan , Macpherson Rob 
Published: March 2016

AbstractAssertive Community Treatment (ACT) has developed globally as a model of community care for the severely mentally ill. However, in the United Kingdom there is mixed evidence regarding improvements in outcome and concerns about ACT teams having poor fidelity to the original ACT model.Objective:This study presents the fidelity characteristics of an established ACT team serving Gloucester City. It describes service user demographic and illness data and compares these findings to other important studies in the United Kingdom.Method:The Dartmouth Assertive Community Treatment Scale was applied to rate the Gloucester ACT team's fidelity characteristics. The Gloucester Caseload Project Demographic Pro-Forma was collected from all of the team's 79 service users.Results:The population of severely mentally ill ACT service users in Gloucester City were an older and more “disabled” group compared to the classic ACT studies. Furthermore, although findings indicate a high level of fidelity to the original ACT model, the team it is still associated with high levels of inpatient treatment.Conclusion:High fidelity ACT services appear to be associated with high admission rates. Therefore teams should not be viewed as alternatives to hospital admission but have goals of improving engagement and social functioning. Furthermore, findings have allowed the team to benchmark its service and target areas for further service development. More consistent reporting of fidelity data on ACT research would facilitate comparison across different services.
Group cognitive behavioural therapy for children with anxiety disorder – an evaluation of the ‘Friends for Youth’ programme
Authors: O'Brien Finian , Olden Nollaig , Migone Maria , Dooley Barbara , Atkins Louise , Ganter Kate , Bates Anthony 
Published: March 2016

AbstractObjectives: This study evaluated the effectiveness of group cognitive behavioural therapy (GCBT) for the treatment of anxiety disorders in children over an initial period of 12 weeks and to one-month follow-up. Parents of the children receiving GCBT participated in adjunctive psycho-education sessions and the effect of these sessions on parental anxiety was also evaluated.Methods: Participants were 12 children, six male and six female, aged between 11 and 15 years who were attending a child mental health service. Participants were interviewed with their parents and anxiety symptoms assessed, using the following measures: Anxiety Disorder Interview Schedule – revised, the Children's Depression Inventory, the Revised Children's Manifest Anxiety Scale, the Coopersmith Self-Esteem Inventory and the Child Behaviour Checklist. Parental anxiety levels were assessed using the Depression, Anxiety and Stress Scale. The 12 children were randomly assigned into two age- and sex-matched groups. While the first group received therapy, the second group acted as a treatment-as-usual control (TAU) group. The second group began group cognitive behavioural therapy after the 10-week waiting period. All participants and their parents provided structured feedback on the intervention.Results: Group cognitive behavioural therapy was significantly effective in reducing both child-reported depressive symptoms, and anxiety on the physiological, worry and total anxiety subscales of the Revised Children's Manifest Anxiety Scale. There were associated significant increases in the childrens' subjective levels of general and total self-esteem, that relating to their self-confidence with peers and when engaging in social and academic pursuits. Diagnosis of anxiety disorder reduced by an average of 67% immediately post-treatment, and by 72% by the onemonth follow-up period. Parents reported significant reductions in their children's levels of internalising symptoms, thought and attention problems. However, parents reported no significantly positive changes in their own levels of depression, anxiety and stress symptoms.Conclusions: Group cognitive-behavioural therapy is a useful and clinically effective intervention for the treatment of anxiety disorder in children.
Effectiveness of daily outpatient alcohol detoxification by an Irish public psychiatric hospital – A pilot study
Authors: Agyapong Vincent , Benbow Jackie , Browne Roy 
Published: March 2016

AbstractObjective: To assess the effectiveness of daily outpatient alcohol detoxification in an Irish public psychiatric hospital.Method: The outpatient records of patients presenting to the Assessment Unit of St Brendan's Hospital in one year (August 2004-July 2005) with symptoms of Alcohol Dependence Syndrome (ADS) and commencing daily outpatient detoxification were examined retrospectively for parameters relevant to the objectives of the study. The results were compiled and analysed using descriptive statistics.Results: Forty patients underwent outpatient alcohol detoxification in one year and complete records were available for 32 patients (80%). Twenty patients had fixed addresses in the hospital catchment areas, eight patients had no fixed addresses and the remaining four patients had addresses outside the catchment areas. Seven patients (22%) presented with a co-morbid psychiatric condition including depression (four patients), anxiety disorder (two patients) and personality disorder (one patient). All seven patients were known to psychiatric sector services. Of the 32 patients commencing detoxification, 28 patients (87.5%) attended on the second day whilst 22 patients (69%) attended their third day's appointment. Only 17 patients (53%) completed the outpatient detoxification. Thirteen patients (40.6%) received at least two outpatient detoxifications during the year; of whom seven patients (58%) received their second detoxification within two months of the first one. The record of 20 patients (62.5%) showed that they had received advice regarding selfreferral to counselling services.Conclusion: A high proportion of patients (47%) presenting with symptoms of ADS did not complete daily outpatient detoxifications. A high proportion of all patients (40.6%) also underwent multiple outpatient detoxifications during the year. It is possible that the separation between alcohol detoxification and alcohol counselling services in Ireland contributed to these disappointing results.