bluuebunny/crossref_metadata_2025_split huggingface dataset:
Down's syndrome, dementia and macrocytosis
Authors: Prasher Vee , Viswanathan Jay , Holder Roger 
Published: March 2016

AbstractObjective: No definitive peripheral biological marker has yet been found to correlate with Alzheimer's disease (AD). This study investigated the role of macrocytosis as a marker which could significantly improve our understanding of AD in the Down's syndrome (DS) population.Methods: This study investigated the possible association between raised mean corpuscular volume (MCV) and AD in 150 adults with DS over a five year study period.Results: A raised MCV is common in the DS population. A statistically significant association between a further elevated MCV and clinically diagnosed AD in adults with DS was found.Conclusions: The findings suggest that further research into the association between macrocytosis and DS could improve our understanding of the underlying biological mechanisms of AD. The measurement of MCV should be undertaken in all DS individuals with a diagnosis of possible or definite dementia. A significant raised MCV (above 97fl for males and 99fl for females) may further improve the clinical diagnosis. A single MCV measurement, however, cannot be recommended as a diagnostic test for AD in adults with DS.
Self-poisoning patients in the general hospital: the frequency and nature of their consultations with the general practitioner
Authors: Hasan S Masood-ul , Owens David 
Published: March 2016

AbstractObjectives: To update the 20 year-old maxim that the majority of patients who undertake self-poisoning have recently seen their general practitioner, and to determine the patients' expressed reasons for consulting the doctor.Methods: Two-stage cross-sectional survey: first, to find out from all self-poisoning patients whether they had recently attended their general practitioner; second, to determine, in a sub-sample of those who had attended, why they made their most recent consultation. The subjects were consecutive adult patients who were admitted to the general hospital in the City of Bradford as a consequence of self-poisoning.Results: Overall 125/237 (53%) patients reported a consultation with their general practitioner in the previous month, and 61 of the 237 (26%) were within the last week. Patients recounted that their main expectations when consulting were to do with prescriptions, sick-notes and physical check-ups.Conclusions: Although many of those who undertake self-poisoning consult their general practitioner shortly beforehand, a preponderance of physical complaints may render anticipation of the self-poisoning a difficult task.
Catastrophic reaction following the separation of adult twins
Authors: Dunlop Caroline , Williams Kelwyn , Holloway Amy 
Published: March 2016

AbstractWe describe a case of adult twins presenting simultaneously with profound psychological disturbance following sudden separation. Formulation is made of a catastrophic adjustment reaction manifesting as depression in one sibling and anxiety in the other. An alternative possibility of acute onset psychosis in one or both of the twins is discussed.
The use of HoNOSCA in a child and adolescent mental health service
Authors: Manderson Julie , McCune Noel 
Published: March 2016

AbstractObjectives: To assess the health and social functioning of patients attending a Child and Adolescent Mental Health Service (CAMHS) and to measure the impact of attendance using the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA).Method: HoNOSCA was completed on 73 consecutive patients attending for initial assessment with a review assessment being completed after six months or at discharge from the clinic if this occurred sooner on 53 of these. The impact of attendance at the clinics was determined by comparing initial and review mean HoNOSCA Scores.Results: Of the 53, 66% were male and 34% female. Boys were more highly rated with regard to aggressive behaviour, performance in peer relationships and family life relationships whilst girls were rated as having more nonorganic and emotional symptoms. Older children showed the highest rates of poor school attendance, non accidental (self) injury and emotional problems while younger children showed the greatest aggressive behaviour and language skill problems. An improvement in the total HoNOSCA score from initial assessment to review was seen in 92%. There was an improvement in the HoNOSCA mean score from initial assessment to review.Conclusions: Age, sex and symptom profiles of patients attending the service were similar to other CAMHS. Attendance at CAMHS produces improvements in patient outcomes over a six month period as measured using HoNOSCA, which proved to be a useful if somewhat time consuming tool.
ECT and etomidate-induced seizure-like activity
Authors: McCauley MacDara , Russell Vincent 
Published: March 2016

AbstractFollowing the withdrawal of methohexitone from the market place psychiatrists and anaesthetists have been forced to seek out alternative anaesthetic agents for ECT. We report a case of etomidate-induced seizure-like activity. We review the literature on ECT and anaesthetic agents and discuss the alternatives available in accordance with a statement by The Royal College of Psychiatrists.
Telepsychiatry in a Child and Adolescent Psychiatric Service
Authors: Browne David , Reilly Michael , Bradley Oonagh 
Published: March 2016

AbstractObjectives: To carry out a survey on the use of video conferencing equipment by a rural child psychiatric multidisciplinary team and to determine what impact the introduction of this equipment had on service provision.Method: Several aspects were studied including user satisfaction and estimations of cost saving, on the basis of avoidance of travel to and from the regional base in Galway. A questionnaire was also developed to determine whether alternative contact would have been made if if this new technology were not in place.Results: The results of the initial six months following commencement were investigated. Use of the equipment was attempted 17 times during this period. Most members of the child psychiatry team participated in its use. Visual problems accounted for 66.7% of reported technical difficulty and 88.9% of users rated their level of satisfaction with the equipment as ‘Satisfied’ or ‘Very Satisfied’.Conclusions: Apart from the start-up cost implications of installing this equipment, it satisfied its aim of increasing contact between the rural service and St Anne's Children Centre in Galway. The equipment was easy to use and for the most part reliable.
Oedipism: Auto-enucleation in a schizophrenic patient
Authors: Murphy Mary , Nathan Malavika , Lee Edward , Parsons Brian , Gunasekera Lal 
Published: March 2016

AbstractWe report the rare occurrence of subarachnoid haemorrhage secondary to probable auto-enucleation of the orbit (oedipism) and we document management of these co-incident pathologies in a schizophrenic patient.A 67 year old schizophrenic woman suffered a subarachnoid haemorrhage and presented with seizures following enucleation of her right eye. Initial efforts should focus on investigation and management of the subarachnoid haemorrhage. Management of Oedipism must include collaboration between psychiatrists, neurosurgeons and opthalmologists, focusing on management of the subarachnoid haemorrhage with precautions to prevent further self-injurious behaviour.
Borderline personality disorder and clozapine
Authors: Rutledge Emer , O'Regan Mary , Mohan Damian 
Published: March 2016

AbstractClozapine is an atypical anti-psychotic medication that has proved useful in the management of both psychotic and mood disorders and that has been shown to decrease aggression and the risk of suicide, which suggests that clozapine may be useful in the management of severe borderline personality disorder. Here we present the case of a 36 year old female with severe borderline personality disorder with symptoms of psychosis, aggression and violence. We discuss how treatment with clozapine resulted in a marked clinical improvement in this patient.
Dermatitis artefacta: an unusual diagnosis in psychodermatology
Authors: Motherway Lee , Gallagher Damien , Guerandel Allys , Kirby Brian , Malone Kevin 
Published: March 2016

AbstractWe report the case of a 22 year old female diagnosed with dermatitis artefacta. This is an uncommon diagnosis and provides a unique therapeutic challenge for psychiatrists and dermatologists alike. We describe how early intervention and a close collaborative approach is central to securing a favourable outcome for patients.
An exploration of the relationship between social support and depressive symptoms in schizophrenia
Authors: Simms Jane , Mulholland Ciaran 
Published: March 2016

AbstractObjective:Depressive symptoms in schizophrenia have previously been associated with a perceived lack of social support. The aim of this study was to explore the relationship between perceived social support and depressive symptoms in schizophrenia; to assess the psychological wellbeing of their carers; and to examine the quality of the relationship between the patients and their carers.Method:Individuals with schizophrenia (n = 17) were assessed on the Beck Depression Inventory (BDI), the Beck Hopelessness Scale (BHS), a measure of perceived social support, the Significant Others Scale (SOS) and the Quality of Relationship Inventory (QRI).Results:The mean score on the BDI for patients fell within the moderate-severe range and the mean range on the BHS fell within the moderate range. Family and friends were perceived as supportive resources by patients. There was no significant relationship between patient depressive symptoms or hopelessness and perceived social support. Carers of patients did not report high rates of depressive symptoms or hopelessness.Conclusions:These findings do not support the previous finding of an association between depressive symptoms and a perceived lack of social support in schizophrenia.
Meeting standards set for non self-harm presentations to emergency departments
Authors: Mullins Diane , MacHale Siobhan , Cotter David 
Published: March 2016

AbstractObjectives: The commonest psychiatric presentation in most emergency departments (EDs) is deliberate self-harm. However, there are other significant categories of psychiatric presentation which include alcohol and substance misuse, acute psychosis and mood disorder. In addition to the NICE Guidelines for deliberate self-harm, there are good practice guidelines available for the management of other psychiatric attendances to the ED. The aim of this study was to identify the psychiatric attendances other than deliberate self-harm to Beaumont Hospital ED over a 12-month period with the objective of studying the rates and characteristics of attendances and to investigate whether good practice guidelines were met.Method: From a total of 657 psychiatric attendances other than deliberate self-harm which were recorded, data was collected on demographics, provision of a psychosocial assessment and adherence to good practice guidelines.Results: Alcohol (38%) was the most common reason for presentation. Of the total number of attendees, only 44% received a psychosocial assessment compared to 59% of attendees who had presented following deliberate self-harm during the same 12-month period.Conclusions: The attendees who did not receive a psychosocial assessment represent a vulnerable group in which the levels of psychosocial assessment need to be improved in order to meet good practice guidelines standards of care.
First episode psychosis and an underlying cerebellar tumour
Authors: Nkire Nnamdi , Barry Helen , Russell Vincent 
Published: March 2016

AbstractWe report on the case of a middle aged lady who was referred by her GP with what appeared to be a case of first episode psychosis. Following assessment and investigation an underlying cerebellar tumour was identified. Our aim is to draw attention to the ongoing debates regarding the possible role of the cerebellum in psychosis and cognition and on neuroimaging as a diagnostic modality in cases of first episode psychosis.
Two psychiatric presentations linked with ‘head shop’ products
Authors: Uhoegbu Chimdi , Kolshus Eric , Nwachukwu Izu , Guerandel Allys , Maher Caroline 
Published: March 2016

AbstractWe report two cases of acute onset and rapid resolution of psychotic symptoms, the first following oral ingestion and the second following intravenous injection of some head shop products (HSPs). Both were associated with autonomic instability and negative results on urine toxicology screening using standard techniques. They highlight the potential dangers of managing such cases in acute stand-alone psychiatric units. Recent advance in characterising some HSPs by toxicology screening is also discussed.
Benzylpiperazine-induced acute delirium in a patient with schizophrenia and an incidental temporal meningioma
Authors: Tully John , Hallahan Brian , McDonald Colm 
Published: March 2016

AbstractBenzylpiperazine is a psychotropic compound that has been widely available until recently from licensed premises such as ‘head shops’. This report describes a case of a 48 year old man with schizophrenia who developed an acute delirium secondary to benzylpiperazine use, although he initially presented as a diagnostic conundrum. Investigation of his delirium unearthed a temporal meningioma which appears to be an incidental finding. This is the first documented case of delirium due to benzylpiperazine use. Benzylpiperazine has significant abuse potential and psychiatric complications. Its sale and possession have recently been made illegal in Ireland, which may limit its abuse in the future.
Reducing the costs of chronic somatisation
Authors: Williams Christopher , House Allan 
Published: March 2016

AbstractWe report the case of a 48 year old woman who presents with a 25 year history of somatisation disorder. She has ten volumes of notes from four hospitals in one city which together weigh almost 10kg. She has been under the care of ten hospital specialities, had eleven operations, with 77 admissions and a total of 856 days in hospital over a period of twenty-five years. No physical diagnoses can satisfactorily explain her presentations which have been accurately costed to a total of over £250,000 as a conservative estimate.Somatisation disorder is a chronic illness with financial, medical and personal costs. We report in detail recurrent dangers and pitfalls which arose during her hospital contact. By undertaking a case note review, contacting all the physicians involved and writing a “Key” summary letter outlining the contribution of psychological factors to her problems, her annual health care costs were reduced from a total of over £10,000 a year to a little over £2,000 after psychiatric intervention and the appointment of one physician to take overall charge of her case. Implications for service provision are discussed.
Student
Authors: Breathnach Caoimhghin S 
Published: March 2016

AbstractWilliam Sealy Gosset [1876-1937] was a brewer in Arthur Guinness and Co. Dublin from 1899 to 1935 when he moved to London. In 1907, writing under the nom de plumeStudenthe published his paper on “the probable error of a mean” which was later developed by R A Fisher intoStudent's test of significancenow in everyday use in biology and industry.
Blood groups in dementia (SDAT) — a pilot study
Authors: Mathew V M 
Published: March 2016

AbstractObjective:Various studies have shown an association between ABO blood groups and both physical and mental illness. This pilot study was conducted to find out whether there is any association between ABO blood groups and senile dementia of Alzheimer's type.Methods:The sample was selected from 107 patients admitted to the psychogeriatric assessment unit of the district psychiatric hospital over a period of one year. All Caucasian patients of United Kingdom origin above the age of 70 with confirmed diagnosis of Alzheimer's dementia according to DSM-III criteria who had developed dementia after the age of 65 were included (N = 33); 74 patients were excluded for various reasons.Results:Out of the 33 patients there were 21 (64%) with group A, 3 (9%) with group B, 9 (27%) with group O and none with group AB blood. Among the United Kingdom population there were 79,334 (42%) with group A, 16,280 (9%) with group B, 88,782 (47%) with group O and 5,781 (3%) with group AB blood (p = 0.038).Conclusions:Although the number of cases were not large, the results of this study suggest that the prevalence of type A blood group was greater and O was less for Caucasian Alzheimer's subjects than for the general population.
Psychosis following lorazepam withdrawal
Authors: Sheehan John D , Shelley Rory K 
Published: March 2016

AbstractA sixty three year old woman developed an organic psychosis after stopping lorazepam. She had taken a high dosage of the drug for 4 years but had discontinued it gradually in reducing doses over six months. It suggests that serious withdrawal reactions may still occur despite gradual cessation and highlights the importance of total dose ingested as a predictor of withdrawal phenomena.
Ictal aggression in severely mentally handicapped people
Authors: Creaby Mary , Warner Mary , Jamil Nahla , Jawad Sudad 
Published: March 2016

AbstractObjective: To study the relationship between epilepsy and aggression in a population of severely mentally handicapped people. Methods: Comparing epilepsy and aggression variables in people with epilepsy without aggression, people with aggression without epilepsy, and people with both. The epilepsy variables were: seizure frequency, classification, anticonvulsant drugs, therapeutic drug monitoring, and neuroleptic drugs. Aggression variables were: frequency, direction, type, and neuroleptic drugs. Results: Prevalence of aggressive behaviour was similar in people with and without epilepsy (36%). Partial seizures were less prevalent in people with epilepsy and aggression. People with epilepsy were more likely to manifest unprovoked aggression directed against property. Conclusion: Some episodes of aggressive behaviour in people with epilepsy may be ictal in origin.
Macha's curse: an Ulster pedigree
Authors: Montgomery Robert C , Nevin Norman C , King David J 
Published: March 2016

AbstractTwo individuals, a father and son with idiopathic intestinal pseudo-obstruction (IIPO), a familial visceral neuropathy, and major depressive illness are presented. In both the bowel symptoms preceded the onset of the depressive illness – the bowel symptoms presenting in mid-adolescence and the depressive illness presenting in middle age. Both patients required numerous laparotomies and both were treated with a series of ECTs. Both developed vitamin B12deficiency anaemia and other evidence of malabsorption. At post-mortem both patients showed evidence of distension of the small bowel with volvulus. An extensive pedigree of both conditions overlapping in two inter-related families now extending to the fourth generation with 28 children under the age of 30 is described. Pending further investigation and genetic studies we postulate a possible common neurotransmitter pathology and recommend further neurochemical and histopathological studies of the myenteric plexus in IIPO. Furthermore, the genetic locus of familial IIPO might provide a genetic marker for some forms of primary affective disorder.
Manic-depressive illness — II: treatment outcome in bipolar disorder subtypes
Authors: McKeon Patrick , Manley Patrick , Swanwick Gregory 
Published: March 2016

AbstractThe treatment outcome of 100 bipolar disorder patients (B.P.) was examined retrospectively to determine whether bipolar subtypes had a differential prophylactic response to lithium, carbamazepine, neuroleptics and antidepressant drugs when these treatments were given in a predetermined sequence. Sixty-eight per cent of 53 B.P.-I patients with a mania-depression-normothymic-interval (M.D.I.) sequence of mood changes had a good response to lithium, and all but one of the remainder responded with the addition of carbamazepine or an antidepressant. While only 17% of 12 unipolar manic patients achieved prophylaxis with lithium and a further 17% when carbamazepine was added, the other 66% remained normothymic when a neuroleptic was prescribed with lithium. Of the seven rapid cycling patients where depression preceded mania, 28% had a good prophylactic effect with lithium, a further 28% when a tricyclic antidepressant was added and 14% with lithium and carbamazepine. None of the 18 rapid cycling M.D.I. group had a good response to lithium, but 39% stabilised when carbamazepine was added to lithium. Twenty-eight per cent of this group failed completely to respond to any of the treatments used. Neuroleptics increased the severity and duration of depressive phases for all subtypes except the unipolar mania group.
The role of the child psychiatric ward in health care: experiences with different types of admissions over a period of twenty-one years
Authors: Gray Colin , Chisholm Douglas , Smith Patricia , Brown Madeline , McKay Christina 
Published: March 2016

AbstractThe concept of the child psychiatric unit is considered. The character, capacities and activities of one unit are described and some features of the admissions over its first 21 years are discussed in relation to the findings of other studies. Among the factors considered are the patients' presenting diagnoses, their sex, their physical health and their length of stay in the Unit. Some possible future directions for the Unit are discussed, and the pattern of work over the two decades covered by the study is related to current and future requirements. It is suggested that for several categories of disorder, a child psychiatric unit offers unique advantages in both assessment and treatment.
Emotionalism in Parkinson's disease
Authors: Madeley Peter , Biggins Colin Anthony , Boyd Jane L , Mindham Richard H S , Spokes Ernest G S 
Published: March 2016

AbstractForty seven patients with idiopathic Parkinson's disease (PD) were assessed to ascertain the presence or absence of emotionalism. Thirty eight per cent of the sample reported being more tearful since the onset of PD than previously. Five patients (10.6%) were found to exhibit emotionalism according to specified criteria. Emotionalism in PD is not solely associated with lowered mood or global cognitive impairment.
The manic readmissions explosion in Edinburgh
Authors: Mander Anthony J 
Published: March 2016

AbstractBetween 1975 and 1985 there was a significant increase in the total number of admissions for mania and schizophrenia and a significant decrease for personality disorder to the Royal Edinburgh Hospital. All admissions for 1975 and 1985 in these three groups were subsequently examined retrospectively. The number of first admissions for personality disorder dropped significantly and the number of readmissions for mania increased significantly. Patients with schizophrenia and personality disorder had shorter admissions and a shorter relapse-free interval in 1985 but the overall effect of these changes was to reduce the total number of bed days used by these groups. For mania there was no change in admission length but significant shortening of the relapse-free interval leading to a substantial increase in total bed days used. There was no evidence that a change of diagnostic practice had occurred or that patients admitted with mania in 1985 were less ill. Although there were changes in referral and after-care arrangements, these were not specific to mania. Further work should specifically address the issue of aftercare arrangements and their influence on prognosis in mania, and the resource implications of the continuing rise in admissions.