bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deliberate self-harm: how feasible are the current guidelines?
Authors: Currie Alan , Blennerhassett Richard 
Published: March 2016

AbstractObjectives: To examine the operation of a deliberate self-harm service at a large general hospital with reference to standards outlined by the Royal College of Psychiatrists. To examine the characteristics of referrals and to make recommendations for improvements to the service.Method: Data on referral and assessment characteristics were collected for 96 consecutive referrals over a three month period.Results: The services achieved the college standards in relation to the time period for assessments. Most referrals were made routinely at a predictable time but assessments were conducted on an ad hoc basis. Only a minority of those referred had a mental illness or complex problems. A significant number of patients were discharged from the A&E department without a psychiatric assessment. Assessors underemphasised the role of previous deliberate self-harm and/or the presence of mental illness in forming a judgment on the risk of suicide. After-care arrangements were predominantly medical (general practitioners or psychiatrists) with little multidisciplinary input.Conclusions: The deliberate self-harm service at the hospital could be improved by the establishment of a self-harm services planning group to oversee the delivery of the service throughout the hospital and address the deficits identified. Given the number of referrals seen within the service and the fact that deliberate self-harm is only one element of a comprehensive liaison service, consideration should be given to the establishment of a separate multi-disciplinary liaison team. Once again importance is drawn to the need for all assessors to be aware of the risk factors in relation to the future risk of suicide rather than placing undue emphasis on whether the most recent attempt was planned or impulsive in nature.
Doctor Maurice O'Connor Drury, Wittgenstein's pupil
Authors: Wallace John 
Published: March 2016

Doctor Maurice O'Connor Drury worked for most of his life in Saint Patrick's Hospital, Dublin. While going about his routine clinical work at that hospital, Doctor Drury quietly maintained a close, lifelong friendship with the man regarded as perhaps the greatest philosopher of the 20th century, Ludwig Wittgenstein.Few realised that before studying medicine at Trinity College, Dublin, ‘Con’ Drury had read philosophy at Cambridge, where he came into close contact with some of the great minds of philosophy this century; Bertrand Russell, George Moore and Gilbert Ryle.Con Drury is importan t not just because of his own philosophical work but because, through his enduring friendship with the deeply troubled philosopher, he challenged the portraye d image of Wittgenstein as a ‘cantankerous, arrogant and tormented genius’.
The relationship between karyotype and cognitive functioning in Turner syndrome
Authors: O'Connor John , Fitzgerald Michael , Hoey Hilary 
Published: March 2016

AbstractObjectives: To examine the underlying cognitive abilities of girls with Turner syndrome, as well as to examine the nature, direction and extent of discrepancies between verbal and performance functioning.Method: Standard tests of intellectual functions (WISC-R and WAIS-R) were administered to 28 girls with Turner syndrome. Subjects varied in age between one year and nine years.Results: The findings indicate that there is strong, though not entirely consistent, tendency among Turner subjects to show depressed performance scores in comparison with their verbal scores. There was also a tendency toward lower levels of overall cognitive functioning among girls with the classic karyotype over those with mosaic karyotypes.Conclusions: These findings are in keeping with international findings concerning the intellectual functioning, of girls with Turner syndrome. The findings support the view that the X chromosome is important in regulating the overall balance within the intellectual functioning between verbal and performance domains.
The biological basis of schizotypal personality disorder
Authors: Kirrane Richelle M , Siever Larry J 
Published: March 2016

AbstractSchizotypal personality disorder is the DSM equivalent of the ICD category schizotypal disorder. It may be seen as part of the schizophrenia spectrum of disorders. Patients with schizotypal personality disorder (SPD) share many features with schizophrenic patients. These include symptoms of social isolation and cognitive impairment. They also share imaging and biochemical evidence of brain dysfunction, and genetic similarities. SPD patients, however, for some reason do not become chronically psychotic. The study of schizotypal patients is of great importance in attempting to clarify the genetic and biological basis of the schizophrenia spectrum. It is also important in helping to delineate the differences between schizophrenic and schizotypal patients, and to distinguish those factors that protect the schizotypal patient from becoming floridly psychotic. In this article we present recent findings regarding the biological basis of schizotypal personality disorder. We illustrate the contribution of these findings to our understanding of risk and protective factors in the schizophrenia spectrum.
Spiritual well-being in psychiatric patients
Authors: Mountain Deborah Ann , Muir Walter J 
Published: March 2016

AbstractObjectives: Some patients with mental illness have said that religion (whether institutional or private) provides them with resources to cope with their illness. The aim of the study was to examine the spiritual well-being and religious practices, beliefs and psychological morbidity of psychiatric patients (n = 41) compared to control groups of patients with chronic medical conditions (n = 40) and community controls attending their GP (n = 39).Method: The study was a cross sectional survey. The study group were identified in psychiatric rehabilitation and day unit settings, the medical controls from a physical rehabilitation hospital and rheumatology outpatient department and the community controls from a GPs surgery. General Health Questionnaire-28 (GHQ-28), the Spiritual Well-Being Scale (consisting of religious and existential well-being subscales) and an open-ended Religious Survey Questionnaire were personally administered to the groups and information supplemented by casenote data.Results: Although there were no differences between the groups on the measure of overall Spiritual Weil-Being or on the subscale of Religious Well-Being, the psychiatric group scored lower on the Existential Well-Being subscale (p < 0.001) and had higher scores on the GHQ-28 (p < 0.001). The psychiatric group had increased frequency of private religious behaviour (p < 0.05) (praying and reading the Bible) which were thought to be coping strategies. Existential Well-Being of the whole sample was positively correlated to religious beliefs (feeling close to God (F = 6,337, p < 0.001); believing everything is according to God's plan (F = 2,709, p < 0.05) and having a mission in life (F = 3,563, p < 0.05)) and to religious practice (attending church) (F = 3,489, p < 0.05). Regression analysis of the whole sample showed that 49.5% of the variance in Existential Well-Being could be predicted by the severe depression subscale of the GHQ, but an additional 9.6% of the variance in Existential Well-Being could be predicted by religious beliefs.Conclusions: The psychiatric group expressed lower life satisfaction and purpose, and were more likely to be single and unemployed. Religious belief does impact on life satisfaction and could be considered as an adjunct in the management of some psychiatric patients.
Rape and sexual assault of the elderly – an exploratory study of 10 cases referred to the Irish Forensic Psychiatry Service
Authors: Collins Philip G , Connor Art O' 
Published: March 2016

AbstractObjectives: This small exploratory study aims to investigate the characteristics of those convicted of rape or serious sexual assault against an elderly person (aged 65 years or over) who were referred to the Irish Forensic Psychiatry Service for assessment.Method: A retrospective examination of the case histories of such individuals both at the Central Mental Hospital, Dundrum, Dublin and at Arbour Hill Prison, Dublin between 1989 and 1995.Results: Ten such cases were found. The most frequent diagnoses were those of schizophrenia and alcohol dependence syndrome. A dual diagnosis of both schizophrenia and alcohol dependence was common. A high percentage of the schizophrenia cases had been previously charged with sexual offences and most were non-compliant with prescribed psychotropic medication at the time of the offence.Conclusions: A very small number of people with mental illness may be at increased risk of committing a sexual offence against an elderly person. Further study of such offenders is merited.
A rose by any other name: psychiatric outpatients' views on dress and address
Authors: Swift Geraldine , Zachariah Mazly , Casey Patricia R 
Published: March 2016

AbstractObjectives: The manner in which psychiatrists dress and how they address their patients and in turn are addressed, may impact upon the therapeutic relationship. We undertook a survey to assess patients' preferences regarding doctors' dress and forms of address.Method: Patients attending four psychiatric clinics were asked to complete a questionnaire asking them to rate photographs of doctors dressed in varying levels of formality, presented in random order.Results: One hundred and forty-five patients agreed to take part. Patients had a strong preference for their consultants to wear suits but were more ambivalent about NCHDs' attire. When asked to rate the photographs in terms of competence and ease in forming a trusting relationship, suits scored the highest ratings. When asked to rate for friendliness, smart attire scored slightly higher than suits. Of the patients 50% said that they wished to be called by their first name and 50% said that they did not have a preference. Very few patients preferred to be addressed by title but 95% said that they tended to call their doctor by title. Of the respondents 70% preferred to be called patients rather than clients or service users.Conclusions: The patients in this survey preferred their doctors to dress formally and were comfortable with an asymmetrical form of address.
Medically unexplained symptoms, illness perception and childhood experience in neurology outpatients
Authors: Targosz Sarah A , Kapur Navneet , Creed Francis 
Published: March 2016

AbstractObjectives: Up to one third of patients presenting to neurology outpatients clinics have medically unexplained symptoms, but the aetiology of such symptoms is not well understood. In the current study we sought to investigate the role of anxiety, depression, cognitive factors and early experience in the development of medically unexplained symptoms.Method: Fifty-seven new patients presenting to a neurology outpatients clinic were studied. Demographic details were recorded and a Hospital Anxiety and Depression Scale, an Illness Perception Questionnaire, and a Childhood Development Questionnaire were administered. An assessment was made by trained medical investigators as to whether the patients symptoms were medically unexplained or accounted for by organic pathology.Results: We found that 17 out of 56 patients (30%) had medically unexplained symptoms. Such patients complained of a greater number of symptoms, were more anxious, were more likely to have a past history of depression, and were more likely to attribute their illness to stress than patients with a presumed organic basis for their disease. They were also more likely to have been in foster care as children. High levels of depression and anxiety were strongly associated with the number of physical symptoms and the perceived negative consequences of the illness.Conclusions: The recognition and treatment of anxiety and depressive disorders may contribute to the management of patients with medically unexplained symptoms. Open discussion of beliefs regarding aetiology are also likely to be of benefit regardless of the presence or absence of organic pathology.
Junior doctors' experience and knowledge of procedures in compulsory psychiatric admissions in Ireland
Authors: Swift Geraldine , Nasir M , Sheehan John D , Casey Patricia R 
Published: March 2016

AbstractObjectives: Prompted by the current debate in Ireland regarding involuntary detention, we undertook a survey of psychiatric trainees to examine their level of knowledge of the legislation governing such admissions.Method: Eighty psychiatric trainees working in centres affiliated to a particular training scheme were invited to complete a purpose-designed instrument.Results: Response rate was 52/80. Trainees were well informed concerning the procedures necessary to initiate detention. Their knowledge of the legal indications for involuntary detention and restrictions on its duration was patchy.Conclusions: We suggest that training in the area of mental health legislation needs to be increased and to focus on satisfying legal requirements in real-life scenarios.
Post traumatic stress disorder and the adrenal gland
Authors: Tobin John P 
Published: March 2016

AbstractLow serum and urinary Cortisol has been a consistent finding in post traumatic stress disorder (PTSD). Glucocorticoid receptor numbers are increased. PTSD patients have a significantly lower adrenocorticotropic hormone (ACTH) in response to corticotrophin releasing hormone (CRH) when compared to a control group of normal volunteers. The dexamethasone suppression test exhibits an exaggerated suppression response of Cortisol to dexamethasone, when the dose utilised is lower than that utilised to test patients with depression. Increased urine levels of noradrenaline and dopamine has been noted in patients with PTSD. This is believed to be related to the hyperarousal state of PTSD.
The place and purpose of research training for specialist registrars: a view from the Collegiate Trainees' Committee (CTC) of the Royal College of Psychiatrists
Authors: Ramchandani Pau , Corby Catherine , Guest Louise , Cole-King Alys 
Published: March 2016

AbstractResearch is currently recognised as an integral part of higher training in psychiatry, but can become a poorly structured training experience. The Collegiate Trainees' Committee (CTC) suggests that clear objectives should be set for the use of a trainee's research time, allowing far greater flexibility over the methods by which those training objectives are met. The process of setting and meeting these objectives requires a fundamental review with the possibility of teaching and supervision being increasingly solicited from other professional groups. Without adequate supervision and support many trainees will continue to struggle unnecessarily with research, and lack confidence in using research findings (for their patients benefit) throughout their consultant careers.
What it says in the papers: an audit
Authors: O'Connor Alison , Casey Patricia 
Published: March 2016

AbstractObjectives: There have been concerns in the international literature that the manner in which psychiatry and psychiatric patients is portrayed in the print media is negative and sensational. If correct this has serious implications for the stigma and prejudice that our patients will suffer. This study was designed to evaluate the content and tone of articles relating to psychiatry. It was compared with a broadly similar study published in 1995 and will form the base from which to measure changes in psychiatric coverage over time.Method: All the daily broadsheets, one daily tabloid and three Sunday broadsheets were examined for a six month period in 1999 and all articles, letters or headlines incorporating psychiatry-related material were examined. Using specific definitions, articles and headlines were examined for tone and content as well as for the contribution of mental health professionals.Results: Overall 0.65 articles per newspaper per day were found. News items and feature predominated, with forensic issues receiving the greatest attention. The tone of the articles was either neutral or positive and the improvement in the tone of articles in the tabloids was particularly noticeable when compared with an earlier study. This is very different from the findings of international studies. However, the headlines were more sensational in tone than the contents of the articles themselves. Increasingly the opinion of health professionals was sought but contributions from psychiatrists remained low, writing just two articles and constituting 15% of health professionals whose opinions were sought. Nine per cent of items constituted misuse of terms.Conclusions: The Irish print media are not hostile to psychiatry and there has been an improvement in tone and type of article in the past five years. Greater involvement of psychiatrists in the media and particularly more direct engagement with editors is required if there is to be a shift from coverage of forensic matters in favour of informative articles as well as improvement in the headline tone.
Childhood ‘risk characteristics’ and the schizophrenia spectrum prodrome
Authors: Morris Mark , Macpherson Robert 
Published: March 2016

AbstractThis review identifies similarities between behavioural indicators of children with future schizophrenia-spectrum disorders and prodromal symptoms in the first episode of schizophrenia. An alternative concept of prodrome is described with implications for early recognition, monitoring and intervention of individuals at risk of future schizophrenia spectrum disorders.
Screening for dementia in primary care - a viable proposition?
Authors: Freyne Aideen 
Published: March 2016

AbstractHealth policy documents recommend screening for cognitive impairment, although in practice this is not implemented. This article looks at the issues which require consideration in implementing a screening programme. These include factors pertinent to the disease under consideration, resources, both personnel and time, lack of experience of cognitive screening at a primary care level, use of screening instruments and uncertainty about management of positive cases. Only by identifying the practical difficulties involved in screening, can steps can be taken to overcome them and to implement screening programmes which are acceptable to the population under consideration and their primary care physicians.
Mass hysteria among high school girls following tetanus toxoid immunisation
Authors: Gupta Rajiv , Vohra Adarsh K , Madaan Vishal , Gaur Devinder R 
Published: March 2016

AbstractObjectives: This report describes an epidemic outbreak of mass hysteria in secondary school girls in a North Indian village following tetanus toxoid injection. It also attempts to identify the aetiological roles of the immunisation programme and the adverse media reports.Method: The socio-demographic, clinical, and school environment variables of the 58 symptomatic students were evaluated. Interviews with health staff, parents and school teachers were conducted.Results: Fifty-eight out of 200 immunised students reported giddiness, headache, vomiting and restlessness. This initiated an exaggerated socio-political response. The majority of the students responded to counselling and reassurance.Conclusions: This outbreak fulfils the criteria of epidemic or communicable hysteria with mass presentations of unusual behaviour and spread of somatic symptoms without any organic basis. The episode exposed flaws in the immunisation programme and suggests the need to formulate clear guidelines for vaccination, including pre-vaccination counselling.
Screening for excessive drinkers in a Hampshire general practice
Authors: James Alistair , Edwards Guy 
Published: March 2016

AbstractObjectives:To identify excessive drinking in a Hampshire general practice and evaluate the usefulness of the screening tools employed. Although excessive alcohol consumption is common, only one in 10 heavy drinkers is known to their general practitioner. Early identification of such patients increases the likelihood that successful intervention will decrease their alcohol intake. Screening helps recognise excessive drinkers.Method:Three hundred and one patients consulting their general practitioner for any reason were interviewed using a questionnaire comprising a drinking history, CAGE, and brief MAST (Michigan Alcohol Screening Test). The medical records of patients identified as drinking excessively were reviewed.Results:Forty-eight (15.9%) patients were identified as drinking to excess. Only nine of them were known to the general practitioner. The most useful tests were the drinking history and CAGE, detecting 21 and 20 of the excessive drinkers respectively. No single test used in isolation performed adequately, but the combination of a drinking history, including enquiry about binge drinking, and the CAGE was the most productive.Conclusion:Screening for excessive drinking by taking a simple drinking history and using the CAGE is cheap and easy to administer. Only about one in five of the patients identified in this study had information concerning excessive alcohol intake in their GP records.
Interaction of forensic and general psychiatric services in Ireland: learning the lessons or repeating the mistakes?
Authors: O'Neill Conor , Sinclair Hamish , Kelly Alan , Kennedy Harry 
Published: March 2016

AbstractObjective:General psychiatric bed numbers in Ireland have reduced markedly in recent decades. In other jurisdictions such reductions have been accompanied by increases in the prevalence rates of severe mental illness among prisoners. We examined variations in per capita provision of local psychiatric beds and community residential places in Ireland for associations with forensic psychiatric service utilisation.Method:All admissions via the courts and prisons to the national forensic psychiatry service during the years 1997-1999 were assigned to the appropriate health board. Forensic admission and bed utilisation rates were compared with measures of general psychiatric service provision.Results:There were 476 admissions via the criminal justice system during the study period (0.74% of all psychiatric admissions in Ireland). A disproportionate number came from the most urbanised area. There were fivefold differences in overall bed and hostel place allocation between Irish health boards. Combined general psychiatric beds were inversely correlated with forensic bed utilisation (Spearman r = -0.75, p = 0.013). These differences showed a strong inverse correlation with forensic service utilisation.Conclusions:General psychiatric services are relatively under-resourced in areas of greatest predicted need in Ireland. This is associated with increased use of forensic psychiatric services and may reflect accumulation of the mentally ill in Irish prisons.