bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case of Koro in a 20 year old Irish male
Authors: Tobin John 
Published: March 2016

AbstractA case of classical Koro is described, in a non-Chinese patient having all three symptoms of the syndrome. Of significance is that the patient has a very marked family history for psychotic and affective illness. Also prior to the illness the patient had been under considerable stress, due to his perceived lack of manliness in not providing for his child. The syndrome was associated with impotence, which has been noted as a frequent finding. Also the patient took active physical precautions to prevent further perceived penile retraction, as has been noted in Chinese affected patients.
In search of black bile
Authors: Leonard Brian E 
Published: March 2016

Historically Western medicine has been divided into two main schools that were based on the ancient Greek tradition. These are the Hygeian school, based on the views of Hippocrates (born 460 BC), and the Asclepian school which is named after the Greek god of medicine but probably based on the physician Asclepius who was said to have performed miracles!In brief, the Hygeian school of medicine views health as a natural state of the body. The body is believed to be endowed with inherent healing powers which, if one lives in harmony with these powers, maintains health and helps to restore it should it become impaired. Disease is seen as a manifestation of a weakness of the inherent healing powers of the body and the function of the physician is to help the patients to live within the natural law (vis medicatrix naturae) and to remove impediments to those mechanisms that maintain and restore health.The second school that has profoundly influenced the development of modern medicine is the Asclepian school which arose in about 1200 BC around the teaching of Asclepius. This school focuses on diseases, their causes and cures. Each disease is considered to be the effect of, or response to, a specific cause that primarily affects a specific organ system. For every disease it is postulated that there is a specific drug or procedure which can alleviate the symptoms or cure the disease. Thus, the successful physician is the one who can make the correct diagnosis and prescribe the correct therapy.
Factitious post-traumatic stress disorder revisited
Authors: Fear Christopher F 
Published: March 2016

AbstractFactitious post-traumatic stress disorder, a variant of the psychological Munchausen syndrome, was first recognised in Vietnam war veterans but has not been described since. The case is described of a young man who claimed to have been involved in a fishingdisaster, feigning the symptoms to post-traumatic stress disorder to gain admission to hospital This appears to be a novel presentation of a Munchausen variant which has not been describedin connection with peace time disasters. It would appear that the psychopathology of factitious disorder, like that of other phenomena, such as delusions, is keeping pace with the views ofsocietyand current media concerns. This issue is discussed in the context of a review of recently reported variants of this interesting clinical syndrome.
Acute inpatient admissions in a community oriented old age psychiatry service
Authors: Freyne Aideen , Wrigley Margo 
Published: March 2016

AbstractObjective: This study reviewed all inpatient admissions in a community oriented old age psychiatry service with the aim of assessing the appropriateness of admission criteria, obtaining a profile of those admitted, and providing information about service utilisation.Method: A retrospective chart review of all first inpatient admissions from 1989-1993 was carried out. Information concerning sociodemographic and clinical variables, and outcome measures in terms of discharge destination, was obtained.Results: There were 205 first admissions in the study period. There were 37 patients (18%) admitted on an involuntary basis. One per cent of admissions were not assessed at home prior to admission. Six patients had no formal psychiatric disorder, of the remainder 53% had an organic, and 47% a functional psychiatric disorder. Of those admitted 68% were discharged to their original destination. Patients with dementia were more likely to be discharged to nursing homes. Other discharge destinations were also used.Conclusions: The policy of initial domiciliary assessment of all referrals prior to admission is feasible in the majority of cases. Defined admission criteria clarify reasons for admission, and ensures appropriate use of beds. The range of discharge destinations highlights the need for maintaining close ongoing links with other service providers.
Rapid cycling mood disorder: A review
Authors: Healy Elaine , McKeon Patrick 
Published: March 2016

AbstractObjectives: Rapid cycling mood disorder is an important clinical phenomenon. The concept of rapid cycling has evolved since it was first described in 1974. The purpose of this review is to summarise current diagnostic criteria, postulated risk factors and suggested management strategies.Method: A Medline and Psych-Lit computerised literature search was supplemented by tracing back through the references from existing review work.Results: Over 80 papers were identified which discussed diagnosis and management of rapid cycling.Conclusions: DSM-IV provides a useful but narrow definition of rapid cycling. Standard treatment of affective disorder may exacerbate rapid cycling. If a rapid cycling course develops, discontinuation of antidepressants and use of mood stabilisers is recommended.
Homozygous mutation at cytochrome P4502D6 in an individual with schizophrenia: Implications for antipsychotic drugs, side effects and compliance
Authors: Gill Michael , Hawi Ziarih , Webb Marcus 
Published: March 2016

AbstractWe report the case of a patient with schizophrenia who has suffered severe side effects with many different antipsychotics. She is poorly compliant with treatment probably because of her experiences with medication. We determined her genotype at the CYP2D6 gene that codes for an enzyme principally involved in the metabolism of many antipsychotics. She was homozygous for the ‘B’ mutation, the most frequent of several known mutations. She therefore has no functioning CYP2D6 enzyme in common with 5%-10% of the population. This may explain why she is sensitive to quite moderate doses of antipsychotic medication, and more rational prescribing may lead to fewer side effects and increased compliance.
Brain blood flow abnormalities associated with oral cocaine use
Authors: Johnson Bankole , Lamki Lamk , Barron Bruce , Spiga Ralph , Chen Richard , Meisch Richard , Khilnani Neera 
Published: March 2016

AbstractSingle photon emission tomography (SPECT) is the prototypical tool for measuring cerebral blood flow (CBF) in discrete areas of the brain. Compared with when a male ‘crack’ cocaine user received placebo, oral cocaine (1mg/kg) ingestion was associated with non-uniformity of overall CBF with hypoperfusion of discrete brain regions, particularly of the frontal, temporo-parietal, basal ganglia, and thalamic areas. While these results should be viewed as preliminary, they do suggest that oral cocaine use may be associated with CBF abnormalities in ‘crack’ users.
Salbutamol inhaler abuse and psychosis
Authors: Cotter Paul A 
Published: March 2016

AbstractA case is described in which a man with asthma and a history of alcohol dependence presented with a paranoid psychosis refractory to standard neuroleptic treatment. Symptomatic improvement was achieved when abuse of salbutamol (Ventolin®) metered dose inhaler was discovered and an alternative β2-agonist delivery system prescribed. A contribution by salbutamol to the psychosis is proposed. It is suggested that increased awareness regarding psychiatric morbidity is needed when metered dose salbutamol inhalers are prescribed.
Clozapine plasma levels and dosing strategies in patients with treatment-refractory schizophrenia
Authors: Buckley Peter F , Cola Philip , Hasegawa Mitsuru , Lys Christine , Thompson Paul 
Published: March 2016

AbstractObjective: To determine the effect on clinical response to clozapine of increasing the plasma levels of clozapine and its major metabolite N-desmethylclozapine in 19 patients with schizophrenia who had plasma clozapine levels ≤ 370ng/ml, a level previously determined to identify patients who were unlikely to have an adequate response to clozapine.Method: The dosage of clozapine was increased by 20% in 11 patients and left unaltered in the other eight patients. Clozapine and N-desmethylclozapine plasma levels were measured after six weeks at the higher dose.Results: Nine of the 11 patients in whom clozapine dosage was increased subsequently achieved plasma clozapine levels ≥ 370ng/ml. However, in this group of patients who already had partially responded to clozapine, increasing the dosage of clozapine did not produce additional clinical improvement.Conclusion: Clozapine plasma levels are useful in clinical practice to guide dosage strategies. However, these results suggest that increasing the dosage of clozapine to achieve plasma levels ≥ 370ng/ml is unlikely to produce further improvement in patients who have already achieved a partial response to clozapine at plasma levels ≤ 370ng/ml.
Where to? A survey of the residual population of a district mental hospital and their predicted placement needs
Authors: Smyth Ciaran , Mohan Angela , Buckley Con , Clarke Anna 
Published: March 2016

AbstractObjective: In line with Irish government and health board policy, existing district psychiatric hospitals are scheduled for rundown and closure, with ongoing care being transferred to general hospitals and community based resources. However it is unclear as to what resources will be required if this policy is to proceed. The objective of this study is to obtain the current needs profile of the inpatient population of one such hospital and to predict what facilities would be needed in the event of closure.Method: Using a staff completed questionnaire, specially constructed by the hospital rehabilitation team, and which has been used to help predict needs for past successful relocations, information was obtained on all inpatients on a designated day. Each patient was rated as requiring independent, low-support, or high-support accommodation, the nature of which depending on the perceived needs.Results: This survey shows that the residual population is predominantly middle-aged and elderly with many disabilities and persisting challenging behaviours. The majority have high dependency needs which limits the placements options to high support facilities, which as yet are under provided for in the community.Conclusion: Further planning and resources will be required if the above policy is to be realised.
A survey of psychotropic drug use in elderly psychiatric inpatients
Authors: Loane Ruth , McGauran Sheila , Buckley Con , Howell Fenton , Johnson Zachary , Mohan Angela 
Published: March 2016

AbstractObjective: The objective of the present study was to examine the use of medication in an elderly psychiatric inpatient population.Method: This was a retrospective survey of medication prescribed to the total elderly inpatient population of a single psychiatric hospital. Data collected included basic sociodemographic information, length of stay, number of admissions, frequency of psychiatric disturbance, diagnosis and medication prescribed.Results: A total of 340 cases were studied, 229 (67%) were female, 324 (95%) had been inpatients for more than one year, 111 (33%) suffered from dementia, while the remainder were in the functional category. In 57% more than one psychotropic drug was used. Over half (56%) of those with dementia were on neuroleptic medication.Conclusion: Psychotropic polypharmacy was found in this population of elderly patients. Management issues emphasised include the risk of polypharmacy in this age group, the need for staff education, an active pharmacy committee and alternative methods of managing behavioural disturbance in elderly patients in particular those with dementia.
Object relations theory applied to early emotional deprivation, resulting in autistic spectrum disorder
Authors: Rooney Siobhan , Byrne Gerard 
Published: March 2016

AbstractObjective: The following case report describes a child with autistic symptoms who experienced early emotional deprivation and institutionalisation. The paper discusses her symptoms in relation to Melanie Klein's theories on object relationships.Method: LM was a four year old Rumanian adoptee, when she was first assessed by a child service in Dublin. On presentation, she exhibited a spectrum of autistic symptoms including an impairment in social interaction, absence of separation anxiety, poor attachment formation with others and restricted, repetitive, stereotyped patterns of behaviour. While attending the pre-school, she was involved in an individualised programme which focused on her specific needs.Result: After attending the pre-school programme, L exhibited a greater ability to express various emotions and her social interaction with others had improved, but she continued to have marked deficits in her personality. This child's symptoms are discussed with reference to the paranoid schizoid and depressive positions associated with ego development.Conclusion: By applying Melanie Klein's theories on object relations, one can gain a further understanding of a child's pathological symptoms, ego development and the necessary treatments required to improve these symptoms.
Reintroduction of antipsychotics in a patient with clozapine induced neuroleptic malignant syndrome
Authors: Williams Kelwyn , MacPherson Rob 
Published: March 2016

AbstractWe report a case of neuroleptic malignant syndrome (NMS) secondary to clozapine treatment in which re-introduction of two different antipsychotics led to elevation of creatinine kinase (CK) levels without associated symptoms of NMS. The significance of CK levels as a marker for NM S is discussed in the light of previous findings in this area. We suggest clinical guidelines for antipsychotic rechallenge after the occurrence of NMS.
Hypertension and increased serum clozapine associated with clozapine and fluoxetine in combination
Authors: Sloan Darina , O'Boyle James 
Published: March 2016

AbstractWe report the case of a patient with schizophrenia who demonstrated increased serum clozapine and norclozapine levels in association with hypertension, when treated with fluoxetine and clozapine in combination.
Driving, mental illness and the role of the psychiatrist
Authors: Elwood Peter 
Published: March 2016

AbstractObjectives: Drivers with certain mental illnesses are obliged by the Driver & Vehicle Licensing Authority (DVLA) to stop driving and to report their condition. This study aims to quantify the number of psychiatric patients failing to meet the DVLA standards of ‘fitness to drive’ and to record how frequently psychiatrists failed to advise patients of these standards.Method: In this prospective descriptive study, 10 psychiatrists reported by questionnaire the diagnosis and driving status of all patients encountered over a four week period. They recorded their advice given to patients failing to meet the DVLA criteria of ‘fitness to drive’ and advice given when prescribing psychotropic medication.Results: Of 297 patients, 123 (41%) were drivers. 19/123 (13%) of drivers failed to meet the DVLA standards of ‘fitness to drive’. In 9/19 of these cases the psychiatrist did not advise the patient in line with the DVLA guidelines. This was especially the case for alcohol related disorders. Of drivers 49% were prescribed psychotropic medication with potential adverse effects on driving.Conclusions: Driving amongst mentally ill patients appears commonplace. In this study, 13% of drivers were considered by the authorities to be unfit to drive. Psychiatrists frequently used their own judgement when advising patients regarding driving. This arguably contravenes doctors' responsibilities to patients and has potential legal implications for both the patient and psychiatrist.
Coprophagia in association with depression and hypothyroidism
Authors: Nicholls KR , Ananthanarayanan TS 
Published: March 2016

AbstractCoprophagia is a disturbing behaviour sometimes associated with mental disorder in humans which is poorly described and understood. We describe a case of hypothyroidism and depressive psychosis, associated with coprophagia which resolved with treatment. Further examination of this phenomenon and its relationship with underlying endocrine and psychotic disorder is required.
Neuroleptic induced polydipsia and hyperphagia in an adult with learning disability
Authors: Graham Candida , Jawed Syed Hasan 
Published: March 2016

AbstractThis case report is of a young male with learning disability, who presented with long-term polydipsia and hyperphagia. The patient's polydipsia and hyperphagia showed a correlation with long-term use of neuroleptics for behavioural problems. Withdrawal of all neuroleptic medication resulted in an immediate improvement in both the polydipsia and hyperphagia leading to a complete resolution of both symptoms. While neuroleptics are a recognised cause of polydipsia, hyperphagia is less frequently described and we believe this to be the first report in which a patient is observed to have polydipsia and hyperphagia induced by neuroleptics. We discuss the possible aetiological mechanisms for both polydipsia and hyperphagia and conclude that the basic pathophysiology in our case appears to be a neuroleptic induced malfunction of the satiety centre due to blockage of dopamine receptors in the ventromedial hypothalamus.
Recent developments in the genetics of schizophrenia
Authors: Murphy Kieran C , Gill Michael 
Published: March 2016

AbstractObjectives:To examine the evidence concerning the recent developments in the genetics of schizophrenia.Methods:An extensive literature search was performed and relevant papers were examined and analysed.Findings:There is overwhelming evidence that schizophrenia shows familial aggregation. Recent molecular genetic studies support the presence of susceptibility genes on chromosomes 6 and 22. In addition, an association between schizophrenia, the dopamine D3 receptor gene and the 5-HT2areceptor gene has also been demonstrated.Conclusions:Recent advances in DNA technology have paved the way for the detection of genes of major and minor effects in the aetiology of schizophrenia. If the presence of the recently identified susceptibility genes is confirmed, it is likely that these genes will be recognised in the near future.
Suicide: Some ethical implications
Authors: Kelleher Michael J 
Published: March 2016

Death faces us all. Preoccupation with it however is commonly regarded as morbid. As a way of dying, suicide is seen as being abnormal. This is certainly so in a statistical sense. In 1993, there were 31,896 deaths in the Republic of Ireland of which officially 357 were suicides. This means that approximately one in a hundred deaths today are self-inflicted. The proportion of suicide deaths to other deaths varies across age groups, however. Generally speaking among the young, suicide is a more common cause of death because other types of death are less common. In the past the official Irish suicide figures may have under-estimated the true picture. Recent research however has shown that the official Irish suicide statistics are likely not to underestimate the true rate and are also more likely to be reliable than are the equivalent statistics from England and Wales.The word ‘abnormal’, however, in medicine is also used in a nonstatistical sense to imply deviation from the ideal or desirable. If we say someone is abnormal, we imply that he is either mentally ill or suffering from a defect or blemish of personality. Most people assume that those who intentionally end their lives are abnormal in this latter medical sense, immediately prior to death. The opposite holds in murder. Society assumes the perpetrator is not mentally ill unless evidence is brought forward to the contrary. Not all believe this, however, and some actively canvass the viewpoint that suicide, in certain circumstances, is to be encouraged.
Asymptomatic tricyclic toxicity associated with diltiazem
Authors: Cotter Paul A , Raven Peter W , Hudson Marina 
Published: March 2016

AbstractTherapeutic drug monitoring of tricyclic antidepressants is a controversial issue. A case is reported in which a patient with recurrent depression developed asymptomatic tricyclic toxicity while on trimipramine, a tricyclic antidepressant, and diltiazem, a calcium channel blocker. A metabolic interaction involving cytochrome P450 3A (CYP3A) is postulated. It is suggested that routine therapeutic drug monitoring of tricyclic levels should be an essential part of the management of depression.
The relationship between maternal depression (antenatal and pre-school stage) and childhood behavioural problems
Authors: Mohan Damian , Fitzgerald Michael , Collins Claire 
Published: March 2016

AbstractObjective: This study aims to determine if there is a relationship between antenatal depression and maternal depression in the following three to four years. Secondly, to establish if there is a relationship between maternal depression and behavioural problems with the pre-school child. Thirdly, to investigate if social parameters are correlated with maternal health and childhood behaviour.Method: In a longitudinal study, a sample of women were screened for depression at the antenatal stage and followed up four years later. Mothers were screened for depressive illness on both occasions. Children's behaviour was assessed at four years. Social parameters were also measured at the pre-school stage.Result: Depression at the antenatal stage was not found to be significantly related to depression at the pre-school stage. The existence of a behaviour problem was not significantly related to the depressive state of the mother antenatally, however a currently depressed mother is approximately six times more likely to have a child with behaviour problems than a mother who is not depressed. Social factors were also assessed and found to correlate with maternal depression.Conclusion: In managing a child with behavioural problems the child psychiatrist should consider the mental state of the mother. The social world of the individual would appear to be important and should not be ignored when treating either a child with behavioural problems or an adult with depression.
Social skills correlates of depressed mood in normal young adolescents
Authors: Garland Malcolm , Fitzgerald Michael 
Published: March 2016

AbstractObjective: To explore the relationship between social skills and depressive symptoms in a normal young adolescent population.Method: An all male group of 85 schoolchildren, in the first year of secondary school, completed self-report instruments to measure the constructs of depression and of social skills. The Depression Self-Rating Scale (DSRS) and the Matson Evaluation of Social Skills with Youngsters (MESSY) were the instruments used.Result. Regression analysis of the factor scores on the MESSY and the total score on the DSRS revealed a significant, negative relationship. This was particularly so for the jealousy/withdrawal factor (Factor V) on the MESSY (f = 27.323; p < 0.001)Conclusion: The data provide support for the social skills deficit model of depression and indicate the possible role of fostering pro-social behaviours and promoting social skills enhancement in the vulnerable young adolescent.