bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recent advances in the biological treatment of mood disorders
Authors: McDonald Gary , Hallahan Brian 
Published: March 2016

AbstractWelcome to the first module in our Continuing Professional Development Section (CPD). CPD is now a key element in the clinical activity of all health professionals and a cornerstone of good clinical governance throughout mental health services. This section of the Irish Journal of Psychological Medicine will provide CPD modules dedicated to key topics in mental health care. In order to assist learning and self-assessment, multiple choice questions will be provided at the end of each module.This module and its multiple choice questions are available online on the website of the Irish Journal of Psychological Medicine (www.ijpm.org). The CPD policy of the College of Psychiatry of Ireland indicates that psychiatrists who participate in suitable online learning which fits the criteria for CPD may claim CPD points under the Personal CPD category (up to a maximum of 5 points per year).We are confident that this CPD Section of the Irish Journal of Psychological Medicine will prove to be a valuable resource for consultant psychiatrists, psychiatric trainees and all journal readers. We welcome feedback from readers and, especially, any suggestions for topics to be covered in future CPD modules. Suggestions should be emailed to:psychological@medmedia.ie
Clozapine induced myocarditis: a case report and literature review
Authors: Okereke Sunday O , Mohd Abdoh Wan MY , Murphy Bernadette M 
Published: March 2016

AbstractClozapine, the drug of choice for treatment resistant schizophrenia, has a range of serious cardiac side-effects. This paper describes a fatal case of myocarditis in a 48 year old man four weeks after starting clozapine. In particular, this case illustrates how incipient the disorder can be and the need for a high level of suspicion. Difficulties in diagnosing clozapine induced myocarditis and ways to minimise its risk are also discussed.
Psychiatric morbidity in male remanded and sentenced committals to Irish prisons
Authors: Curtin Katharine , Monks Stephen , Wright Brenda , Duffy Dearbhia , Linehan Sally , Kennedy Harry G 
Published: March 2016

AbstractObjectives: To describe the prevalence of psychiatric morbidity and the treatment needs of new committals to Irish prisons.Methods: A population survey of 615 prisoners representing 7.9% of male committals to Irish prisons in the year of survey, 313 remands (9.6% of total remand committals) and 302 sentenced committals (6.4% of total sentenced committals). The main outcome measures were ICD-10 diagnoses of mental disorder based on interviews using SADS-L and prison medical records.Results: Current prevalence rates of any psychotic illness were 3.8% (remand) and 0.3% (sentenced), six month prevalence rate 5.1% (remand) and 2.6% (sentenced) and lifetime rate 9.3% (remand) and 6.6% (sentenced). Schizophrenia and drug/organic psychoses were the most common psychoses. Major depressive disorder had a current prevalence of 4.5% (remand) and 4.6% (sentenced), a six month prevalence of 4.8% (remand) and 6.0% (sentenced), and a lifetime prevalence of 8.6% (remand) and 15.9% (sentenced). Sixty-point-six per cent of the sample had a current substance misuse problem.Conclusions: There is significant psychiatric morbidity in committal prisoners.
Has the Mental Health Act 2001 altered the clinical profile of involuntary admissions?
Authors: Murray Ivan , Hallahan Brian , McDonald Colm 
Published: March 2016

AbstractObjectives: To assess whether transition from the Mental Treatment Act (MTA), 1945 to the Mental Health Act (MHA), 2001 has had any impact on the clinical profile of patients in the West Galway Mental Health Services who are admitted on an involuntary basis.Methods: Data were collected from clinical records in relation to all those individuals residing in the West Galway Mental Health Services who were admitted involuntarily in the 12 months prior to and subsequent to the introduction of the MHA 2001.Results: A total of 175 individuals were included in this study (n = 91 - MTA 1945; and n = 84 - MHA 2001). No significant differences were found between the two groups in relation to demographic data, rates of involuntary detention or duration of involuntary detention. The applicant was less likely to be a family member under the MHA 2001 (54%) than the MTA 1945 (85%).Conclusions: Transition from the MTA 1945 to the MHA 2001 has had minimal impact on the admission rates, clinical profile or duration of detention of patients admitted involuntarily in the West Galway Mental Health Services.
Current psychotherapy training for psychiatry trainees in Northern Ireland
Authors: McNeill Owen , Ingram Richard 
Published: March 2016

AbstractObjectives: To investigate psychotherapy training for psychiatry trainees in N.Ireland.Method: A detailed survey of both trainee's current experience and completion of Royal College requirements.Results: While trainees rated experience highly in terms of enjoyment and relevance to psychiatry, we found a large proportion (94%) were failing to meet requirements for psychotherapy training, despite awareness being high (91%). Both cognitive-behavioural and psychodynamic therapy were the predominant models of therapy trainees had experience in and although most supervision was rated highly, a number of trainees had irregular or no case supervision.Conclusions: At a time when it is becoming increasingly recognised that psychological therapies play a central role in the treatment of many psychiatric disorders, current training fails to provide a substantial experience. With such a high proportion of trainees not meeting the mandatory requirements and similar findings being replicated in other parts of the UK, serious consideration must be given to both the nature of the guidelines and the opportunities for psychotherapy training if future psychiatrists are going to be equipped to deliver a truly biopsychosocial model of care.
Association between antipsychotic medication and venous thromboembolism
Authors: Gunasekaran Santhana 
Published: March 2016

AbstractObjective: This study aims to identify and review available evidence in the literature to determine the strength of association between antipsychotic medications and thromboembolism as an adverse effect.Method: Electronic databases were searched for evidence.Results: A total of 15 case reports, 14 case series, two observational studies and three case-control studies were found in the literature. Two case control studies found significantly increased risk of venous thromboembolism (OR 13.3 and 7.1 respectively). The risk was high for low potency antipsychotics. Studies were critically appraised to determine the strength of evidence.Conclusion: The studies reviewed indicate a significant association between antipsychotics and venous thromboembolism. Patients using the antipsychotics and those who prescribe them should be aware of this association.
Patient attitudes towards compulsory community treatment orders and advance directives
Authors: O'Donoghue Brian , Lyne John , Hill Michele , O'Rourke Linda , Daly Sally , Feeney Larkin 
Published: March 2016

AbstractObjectives: The Mental Health Act 2001 was implemented in Ireland in 2006, however, within this new legislation there is no provision for compulsory community treatment or advance directives, which are now established practice in other countries. We aimed to determine the proportion of patients who believe that compulsory treatment may be justified, the preference for where the treatment should be delivered and factors which may influence this preference. We also sought to determine the proportion of people who would be interested in the option of having an advance directive in their future care plan.Methods: Patients who had been admitted involuntarily in a 183 bedded psychiatric hospital in Dublin (St John of God Hospital) over a 15 month period were interviewed one year following discharge. A structured interview was used and included the Birchwood Insight Scale and Drug Attitude Inventory (DAI).Results: Sixty-seven patients were interviewed, which resulted in a follow-up rate of 68%. A total of 56% of participants believe that there are situations in which involuntary treatment with medication may be justified. Of the participants 59% think that the person should be admitted to hospital if they are going to be administered medication without consent. A total of 41 % of participants stated they would have preferred to have been treated at home rather than hospital and this was associated with having a diagnosis of an affective disorder or it being their first involuntary admission. Of the participants 84% expressed interest in having the option of an advance directive in their treatment care plan.Conclusions: With the increasing community based provision of mental health services in Ireland a debate on compulsory community treatment orders and advance directives needs to take place amongst all stakeholders.
Do we need community treatment orders in Ireland?
Authors: Walsh Dermot 
Published: March 2016

AbstractObjectives: Re-admissions to inpatient psychiatric care are now so frequent as to be designated the ‘revolving door’ phenomenon and constitute 72% of admissions to Irish inpatient psychiatric units and hospitals. It is commonly believed that treatment non-adherence with aftercare following inpatient discharge contributes to readmission. Attempts to improve adherence and reduce or shorten readmission through compulsory community treatment orders have been made in several countries including Scotland in 2005 and, from November 2008, England and Wales. Provision for conditional discharge in Ireland has already been furnished by the Criminal Law (Insanity) Act 2006 but has been compromised by the inability to impose enforcement of conditions. The paper aims to determine whether compulsory community treatment orders are effective in improving adherence and reducing re-admission and whether, in consequence, their introduction in Ireland should be considered.Method: The legislative measures adopted to improve treatment adherence and thereby reduce re-admissions are presented. The evidence of their effectiveness is examined.Results: Evaluation of the effectiveness of community treatment orders is limited and hindered by confounding factors. What evidence there is does not provide convincing evidence of their utility.Conclusions: It is concluded that there is insufficient evidence to advocate their early introduction in Ireland in civil mental health legislation. Instead a wait and see policy is suggested with critical assessment of the outcome of such developments in Scotland and England and Wales. In addition further research on the characteristics of revolving door patients in Ireland and the circumstances determining their readmission is advocated. There is an anomaly in the Criminal Law (Insanity) Act 2006 which allows of conditional discharge but does not provide for its enforcement.
Bipolar affective disorder as the initial manifestation of multiple sclerosis
Authors: Vohra Adarsh , Leeming Caroline 
Published: March 2016

AbstractThe association between bipolar affective disorder and multiple sclerosis continues to be poorly understood in view of the limited knowledge and research in this field. Here we present the case of a 43 year old female with bipolar affective disorder who later developed multiple sclerosis. The relationship between the two disorders is discussed in the light of relevant and pertinent literature. It is hypothesised that bipolar affective disorder may be the presenting manifestation of multiple sclerosis and should be considered as a differential diagnosis in patients of bipolar affective disorder with neurological symptoms.
Combined antipsychotic use in a community rehabilitation psychiatric service
Authors: Apantaku-Olajide Tunde , Khattak Abid , Whitty Peter 
Published: March 2016

AbstractObjectives:Despite the clinical guidelines regarding the use of combined antipsychotics and the limited evidence for its benefits, use remains high in psychiatric practice. The aim of this study was to examine prescribing practices and investigate reasons for initiating and continuing combined antipsychotics in stable psychiatric illnesses.Method:A cross-sectional case record survey of antipsychotic prescribing practices in a community psychiatric rehabilitation service. A total sample (n = 75) of patients with chronic and enduring psychiatric illnesses was studied. The age, gender, diagnosis and prescribed antipsychotics were examined. The proportional prevalence and documented reasons for combined antipsychotic prescribing were analysed.Results:Seventy-three of the 75 patients were prescribed antipsychotic mediations. Of these, 44 (60%) received a combination of two or more antipsychotics. The most common reason for combined prescribing was a switch of antipsychotic (n = 18; 41%). No reason was documented in 19 cases (43%).Conclusions:In this study, slow cross-tapering or incomplete switch process of antipsychotics contributed to the prolonged period of combined antipsychotics treatment. Adequate documentation regarding indication and review of medications cannot be overemphasized.
Depressive psychosis associated with a cyclo oxygenase 2 inhibitor (meloxicam)
Authors: White Daniel , McCauley MacDara 
Published: March 2016

AbstractWe describe a 60 year old man who developed a fluctuating depressive psychosis associated with meloxicam, a non-steroidal anti-inflammatory drug (NSAID). The psychological symptoms observed were temporally related to the administration of meloxicam and occurred in the presence of signs of meloxicam intolerance, such as skin rash and raised blood pressure. The depressive reaction resolved quickly following cessation of meloxicam, recurring on re-exposure. The psychiatric manifestations of NSAID intolerance are rare, however 40% of cases have a history of mental illness. Data from adverse event reporting systems suggest that the newer NSAIDs (COX-2 inhibitors) may have a higher propensity to cause psychiatric adverse effects and should be used with caution in individuals with a history of mental illness. This data may be provocative given current research in to the use of COX-2 inhibitors in augmenting neuroleptic treatment in schizophrenia.
The use of inpatient services in patients with borderline personality disorder
Authors: O'Neill Sinead , Curran Ruth , Canning Catherine , Daly Oscar 
Published: March 2016

AbstractObjectives: To examine why five patients with borderline personality disorder were contributing to a high bed occupancy and high staff turnover on a general adult psychiatry inpatient unit.Method: A retrospective audit looking at these individuals' service pattern use for the two-year period between 2001–2003 was undertaken. A new admission policy was then introduced. The policy was that admissions were agreed, where possible, at consultant level and, if deemed unavoidable, were time limited. The audit cycle was repeated for the next two year period, 2003–2005 and a third audit cycle was then performed for the period 2005–2007.Results: Following the new admission policy, there was a 95% reduction in bed days for this group. Untoward incidents by these individuals reduced by 93% and attendance at Accident and Emergency was also significantly reduced.Conclusions: By limiting the frequency and length of admissions there was, unsurprisingly, a reduction in adverse incidents which lead to significant problems for patients and staff alike.
Catatonia – case report and review
Authors: O'Brien Finian M , Moroney Joan , Lyons Declan , Murphy Kieran C 
Published: March 2016

AbstractCatatonia is a neuro-psychiatric disorder that can occur in medical, psychiatric and drug-induced conditions but is often unrecognised. A 64 year-old woman was admitted to hospital for assessment of a significant deterioration in her ability to communicate and function normally so that she had become completely dependent on others for all activities of daily living for nearly three years. Outpatient medical and psychiatric assessments failed to clarify diagnosis. On admission to a general hospital, the neurology team initially believed she had a Parkinson's-like syndrome but after further investigation and comprehensive multidisciplinary assessment, including neuro-psychiatric review, she was diagnosed with catatonia. She was subsequently admitted to a psychiatric hospital where she received electro-convulsive therapy and changes to her psychotropic medication regimen. She responded well to treatment and within a short period of time was able to function independently again.
Cardiac rehabilitation: the role of psychological intervention
Authors: McGee Hannah 
Published: March 2016

A coronary event has major psychological, as well as physical, consequences. The recent British Cardiac Society's Working Party Report on Cardiac Rehabilitation acknowledges the importance of comprehensive rehabilitation programmes incorporating a psychological input. Psychological intervention as part of cardiac rehabilitation serves two purposes: to maximise psychosocial recovery, including return to customary activities such as work and sexual relationships, and to facilitate the secondary prevention of coronary heart disease. The latter involves providing behavioural change strategies for a range of lifestyle factors from stress identification and management, through dietary, smoking and physical activity change, to increasing adherence to medication regimes.Psychological interventions have proven successful in decreasing general morbidity in the year after coronary events and in reducing reinfarction-related mortality. Little is understood about the mechanisms by which psychological interventions may operate. However, a recent seminal study of intensive lifestyle modification in cardiac patients has demonstrated that it is possible to achieve regression of atherosclerosis (although the authors themselves caution that their intensive methods are unlikely to be applicable in most patient settings). More general discussion of the relationship between psychological factors and coronary disease is available. With regard to enhancement of psychosocial recovery, early work documented positive effects of exercise-only programmes on psychosocial functioning.
An analysis of general practice referral behaviour to psychiatric out-patient clinics
Authors: Carey Teresa , Owens John , Mulligan Pauline , Moran Damien 
Published: March 2016

AbstractObjective: The objective of this study was to analyse general practice referrals to psychiatric out-patient clinics and their relation to practice and patient variables.Method: Retrospective analysis of new episode attendances at out-patient services over a three year period was undertaken. Referring practices were examined for referral rates, single or group practice and the presence of Vocational/Psychiatric training within the practice.Results: Referral rates were similar to national rates, but were lower than other jurisdictions. There was a tendency for group practices to have lower referral rates.Conclusions: There was considerable difference between practices in referral rates. These differences were significantly related to GP vocational training.
Attendance at a psychiatric day centre
Authors: Lynch Gerry , McKee Margaret , Brennan Daniel M 
Published: March 2016

AbstractObjective: To examine the service utilisation of a newly opened psychiatric day centre. We wished to determine if different diagnostic groups had different perspectives of the day centre, and to see if the drop-out rate differed among clients with neurotic or psychotic disorders.Method: Demographic and diagnostic data was gathered for all clients referred in the first year of operation of the day centre. Those who defaulted from attendance were visited at home and asked to detail reasons for non-attendance. Those who continued to attend 16 months after the centre opened completed a satisfaction survey.Results: The drop-out rate was high for both clients with neurotic and psychotic disorders. Clients who continued to attend were very positive about the day centre. Both client groups saw the benefits of attendance in social rather than therapeutic terms.Conclusions: Consumer opinion may have a valuable part to play in overall measure,measurement of service quality, particularly if it includes the opinion of those who no longer use that service.
Prognosis of depression in the elderly
Authors: Freyne Aideen , Wrigley Margo 
Published: March 2016

AbstractObjective: To ascertain the outcome of depression and factors associated with outcome over a minimum followup period of 12 months in patients referred to an Old Age Psychiatry Service.Method: A retrospective study was performed. All depressed patients assessed by the service between January 1989 and December 1990 were followed up. This included patients seen on domiciliary and consultationliaison visits. Follow up data included information on physical, psychological, cognitive and social parameters using standardised scales where appropriate. Outcome of depression was assessed using a six point scale to enable comparison with other studies.Results: 86 patients with a primary diagnosis of depression were seen in 1989 and 1990. At follow up, 37% were dead. 50% of patients alive at follow up were well and 7% were demented. Patients seen on domiciliary visits had the best outcome, and those with physical illness or cognitive impairment at presentation the worst outcome.Conclusion: The association between physical status and outcome highlights the need for close monitoring of both physical and mental status of depressed elderly patients.
Platelet serotonin aggregation in depression
Authors: Keely Helen , Ring Mary , Dunne Anne MM , Kelleher Michael J , Corkery Finbarr 
Published: March 2016

AbstractSerotonin aggregation is a measure of function of platelet 5-HT2 receptors. The test has been proposed as a valid peripheral model of central 5-HT2 receptor function. Receptors of this subtype are implicated in theories of the aetiology of depressive states.This pilot study proposes a normal range for the test for both males and females. Untreated depressed subjects had results which grouped at the lower end of the range. The test proved reproducible with a correlation coefficient of r = 0.939 with an interval of at least six weeks between sampling. A small number of successfully treated patients were retested with no empirical difference in their results, which are included in the reproducibility studies.Our provisional results indicate the reliability of serotonin aggregation scores for an individual. The difference in scores noted in depressed subjects is more likely to be a trait rather than a state marker.
A study of psychiatric inpatient suicides
Authors: Coakley Gráinne M , Carey Teresa G , Owens John M 
Published: March 2016

AbstractObjective: The aim of this paper was to elucidate factors associated with inpatient suicide.Method: A retrospective review of inpatient suicides over a 20 year period in the Cavan/Monaghan mental health service was undertaken. Clinical files, statutory reports and Central Statistics Office returns were studied and information was obtained on demography, diagnosis and circumstances of the event.Results: Eight patients committed suicide, giving a rate of 0.55/1,000 discharges and 0.39/100,000 population per year. Depressive illness and Schizophrenia were the diagnoses found. Repeated admissions and long duration of illness were noted. Previous suicidal behaviour was common. Four of the patients were considered a suicide risk at some time during the index admission. Underreporting of the suicides and inaccurate registration of institutional location by the Central Statistics Office were found.Conclusion: More formal clinical procedures in registering suicide risk are recommended. New procedures for investigating inpatient suicides are suggested. Largescale studies at a national level are essential in defining more specific and sensitive risk factors. Procedural changes involving accurate central registration of data are required.