bluuebunny/crossref_metadata_2025_split huggingface dataset:
Withdrawal delirium with dance drug ‘liquid ecstasy’ (GHB)
Authors: Garvey Ruth , Fitzmaurice Brian 
Published: March 2016

AbstractWe wish to describe a case of gamma hydroxyl butyrate (GHB) withdrawal, including seizure activity in a 34 year old male, who had been taking the substance over a two year period. The syndrome has many aspects in common with alcohol withdrawal (delirium tremens) and benzodiazepine withdrawal (long duration of symptoms), however detoxification presents many challenges for clinicians.
A brief adherence therapy: training issues and patients' satisfaction
Authors: Boilson Marie , Murdoch Jane M , Hull Alastair M , Hamilton Ross J , Scott Jan 
Published: March 2016

Abstract:Objectives: Medication non-adherence in affective disorder is an area of concern. Abbreviated cognitive therapy for adherence (ACTA) is an intervention specifically designed to address this. Our objectives were to explore psychiatric trainees' experiences of delivering this therapy, and to examine patient satisfaction using the Client Satisfaction Questionnaire (CSQ).Method: This preliminary study took place in two centres in Scotland. The experiences of five higher psychiatric trainees who underwent training in this novel approach were gathered at a ‘brain storming’ meeting after completing training, which included clinical application of the intervention. Also included is the preliminary feedback from a small number of participants involved in a randomised controlled pilot study of ACTA provided by these same trainees. In this pilot, 15 participants with bipolar affective disorder were allocated to receive ACTA (n = 7) or treatment as usual (TAU) (n = 8) and both groups completed a CSQ (client satisfaction questionnaire) at the end of the study.Results: It was possible to learn and use this approach with limited previous experience of cognitive behavioural techniques. Longer structured sessions with the patients fostered the development of a collaborative relationship and facilitated negotiation of a treatment plan. There was 100% attendance rate for those receiving ACTA. Satisfaction scores for both the ACTA group and TAU group were high with median scores greater than 55 from a maximum of 60 in both groups. The ACTA group made additional positive comments.Conclusions: Training in a brief therapy, such as ACTA, appears possible during psychiatric training and may represent a useful set of cognitive and behavioural techniques for busy clinicians. Preliminary findings suggest that patients like it.
Doctor Foster ‘went’ to Gloucester: the origin and aims of The Royal College of Psychiatrists
Authors: Foster Tom 
Published: March 2016

AbstractIn 1841 Dr Samuel Hitch organised a meeting at Gloucester Lunatic Asylum during which a decision was taken to establish the Association of Medical Officers of Asylums and Hospitals for the Insane with a view to “improvement in the management of such institutions and the treatment of the insane, and the acquirement of a more extensive and more correct knowledge of insanity”. From the six medical officers present at this historic meeting the membership of The Royal College of Psychiatrists has grown to more than 11,000, of whom over 1,500 practise overseas. Dr Mike Shooter (President) believes that the College's most important, and painful, transformation has been from a largely educational to a political organisation.
Learning disability among referrals to a community child psychiatric service
Authors: Clarke Ciaran S , Houlihan Brian 
Published: March 2016

AbstractObjectives:We sought to determine the frequency of learning disability (IQ > 70) among referrals over a period of six years to a community child psychiatric service in a socially disadvantaged area of Dublin.Methods:We investigated the gender and age characteristics, as well as the frequency of speech and language, emotional, and behavioural problems in this group. We tried to determine what educational help each child was receiving at the time of referral.Results:Sixty-five of 942 patients referred to the clinic had a mild (60) or moderate (five) learning disability. Forty-eight patients were male and 17 were female. The mean age at referral was 10.5 years, and there was no gender difference. All were referred because of educational problems. Behavioural disorders were present in 31, emotional disorders in 13 and speech and language disorders in 37. Six had suffered some form of abuse, mostly emotional. Five had problems with concentration or markedly impulsive behaviour. At the time of referral, 10 were in special schools, seven were in special classes in normal schools, and nine had a special resource teacher. Adequate educational support was not being adequately provided for 33 at the time of psychiatric referral.Conclusions:Learning disability occurs in 7% of children referred to the child psychiatry clinic of a disadvantaged urban community and, while this may reflect the late onset of psycho-social and educational problems in such children, these findings give cause for concern that delayed referral may exacerbate their and their families' problems. The educational needs of most of the children were not being addressed. Reasons for these findings are discussed.
Neuropsychiatric complications of corticosteroids in older people
Authors: Freyne Aideen 
Published: March 2016

AbstractThe neuropsychiatric effects of corticosteroids are well described in the literature but relatively little is known specifically about their effects among older people. As the population ages, and increasing numbers of older people receive assertive medical treatment for physical conditions, more patients are likely to present to psychiatric services suffering from adverse neuropsychiatric effects associated with corticosteroid use. A review of the effects of corticosteroids among older people was carried out through Medline and PubMed searches and a review of article references. Very little has been specifically written about steroid use and the effects on older people. This paper briefly outlines the current level of knowledge of neuropsychiatric effects of steroids, and relates this to general treatment considerations for older subjects. Recommendations for further research and early identification of complications are made.
Of the Right and Left Hand (1646):Sir Thomas Browne's historical survey of ‘handedness”
Authors: Breathnach Caoimhghin S 
Published: March 2016

‘Handedness’ as an expression of cerebral lateralisation is valuable in analysis of hemispheric asymmetries, carrying implications for implementation (as well as interpretation) of complex cognitive functions. In recent decades it has become possible to categorise handedness in a reproducible manner and, independently, to estimate accurately the degree of language lateralisation of the brain. These advances have re-focussed attention on cerebral organisation and hemispheric asymmetries, and there is now considerable interest in the neuropsychology of left-handedness. Because of procedural and ethical constraints there are relatively few large scale studies on language dominance, whereas handedness has been studied extensively in recent decades. Language is represented in the left hemisphere in all but 1% of right-handers, and in 60% of left-handers; in 15% of right-handers speech representation was bilateral.Precise determination of handedness or lateralisation does not appear to have been assessed in major studies of electroconvulsive therapy (ECT). Results in 29 reports, when the electrodes were placed over either the non-dominant or both hemispheres, were tabulated and briefly discussed by d'Elia and Raotma, but the criterion of lateral dominance assignment was not clearly specified; the unilateral and bilateral placements were equally efficacious in their antidepressant effect. d'Elia, who introduced unilateral therapy in 1970, accepted the assumption that the left hemisphere was ‘dominant’, but later workers were more circumspect.
Physical sciences and psychological medicine: the legacy of Prof John Dunne
Authors: Kelly Brendan D 
Published: March 2016

AbstractFifty years ago, on July 13, 1955, Professor John Dunne delivered his presidential address to the annual meeting of the Royal Medico-Psychological Association in Dublin, focussing on the contributions of ‘the physical sciences to psychological medicine.’ In his address, Professor Dunne discussed (a) the principle of conditioning, and the work of Hans Selye, especially in relation to ‘General Adaptation Syndrome’ and the role of stress in producing psychosomatic symptoms; (b) cybernetics and the generation of partial models of cerebral functioning, such as Grey Walter's Conditioned Reflex Analogue and the Electronic Delayed Storage Automatic Computer of Cambridge and (c) the development of integrated, holistic models of cerebral functioning, that took account of advances in both physical medicine and psychoanalytic thought. Professor Dunne placed particular emphasis on the importance of basic scientific research and the development of broadly based models of psychiatric care, both of which were to play critical roles in the development of more scientifically-based, bio-psycho-social models of service provision in the decades to follow.
Mental health in general practice: assessment of current state and future needs
Authors: Copty Mimi , Whitford David L 
Published: March 2016

AbstractObjectives: To determine the extent of mental health services provided in the community in one Irish health board area. To examine the influence of postgraduate mental health training of GPs on provision of mental health services.Method: Questionnaire and focus group methods were employed to determine views on mental health service provision. Data analysis was with parametric and non-parametric tests of association including student's t and chi-squared tests. Thematic analysis of the focus groups was carried out.Results: Twenty-five per cent of patients attending general practice have mental health problems and over 95% of these problems are dealt with in primary care. Only 32% of GPs had received postgraduate training in psychological therapies. GPs with postgraduate training in psychological therapies were more likely to estimate a higher proportion of their patient population with mental health problems and less likely to refer to psychiatric services. A need for support from other health care professionals in primary care was also identified.Conclusion: The majority of patients with mental health problems are treated in primary care. Further training of GPs and increased resources would improve mental health care in primary care and lead to fewer referrals to psychiatric services.
Atypical antipsychotic monitoring in the Kilkenny Mental Health Services
Authors: Feeney Larkin , Mooney Mary 
Published: March 2016

AbstractObjectives:To examine baseline testing and ongoing monitoring of cardiovascular and other risk factors in individuals prescribed atypical antipsychotic medications.Methods:We derived a list of baseline and ongoing monitoring tests from the literature (Weight, BMI, blood pressure, U&E, LFTs, glucose, HbA1C, FBC, TFTs, prolactin, lipids & ECG) and then reviewed a random sample of 80 records of patients prescribed atypical antipsychotics and currently attending an Irish public catchment area service, for evidence of testing.Results:Levels of testing for baseline tests ranged from 45% for blood pressure to 0% for BMI. Levels of ongoing monitoring tests ranged from 42.5% for U&E to 0% for BMI. Patients admitted to hospital were much more likely to have had testing.Conclusions:The need for baseline and ongoing monitoring of certain tests in patients prescribed atypical antipsychotics is increasingly accepted. Levels of such testing are currently quite low and need to increase.
Psychiatric morbidity among women prisoners newly committed and amongst remanded and sentenced women in the Irish prison system
Authors: Wright Brenda , Duffy Dearbhia , Curtin Katherine , Linehan Sally , Monks Stephen , Kennedy Harry G 
Published: March 2016

AbstractObjectives: To estimate the prevalence of psychiatric morbidity, substance misuse problems and related health and social problems among women prisoners newly committed and a cross-section remanded and sentenced in the Irish prison population. In 2002 women represented 10.7% (1043) of all persons committed to the Irish Prison system, and 3.3% (104) of the daily average number of persons in custody. We surveyed psychiatric morbidity in these two groups to assess the need for psychiatric services for women prisoners, and to compare Irish morbidity with an international average.Method: We interviewed 94 newly committed women prisoners within 72 hours of committal, representing approximately 9% of female committals per year. We also interviewed a cross sectional sample of 92 women, representing approximately 90% of all women in custody. Mental illness and substance misuse was measured using the SADS-L, SODQ and a structured interview.Results: Five (5.4%) of the committal and 5 (5.4%) of the cross-sectional sample had a psychotic illness within the previous six months. 8 (8.5%) of the committals and 15 (16.3%) of the women in the cross-sectional sample had a major depressive disorder in the last six months. 8 (8.6%) committals and 14 (15.2%) in the cross-sectional sample had an anxiety disorder within the last six months. 61 (65.6%) of the women interviewed at committal and 61 (65.2%) of the cross-sectional sample had a substance misuse problem in the last six months.Conclusions: There is a high prevalence of mental illness and substance misuse problems amongst women newly committed to prison and in a cross section of those remanded or sentenced in prison in Ireland. We found evidence of a cycle of deprivation and institutionalisation. These findings highlight the need for the integration of community and forensic psychiatric services, and for ongoing collaboration with drug services.
Choreoathetosis, an unusual presentation of serotonin syndrome
Authors: Hodnett Phillip , Renganathan Radhakrishnan , Fitzgerald Patricia , Roderick Gaivin 
Published: March 2016

AbstractWe describe a 63 year old male with serotonin syndrome, presenting with choreoathetosis. Differentiating this syndrome from neuroleptic malignant syndrome remains a challenge. It is important to be aware of drugs that can potentially precipitate this syndrome.
The assessment of need in patients presenting to psychiatrists in the general hospital
Authors: Feeney Larkin , Kavanagh Annette , Mooney Mary , Browne Stephen 
Published: March 2016

AbstractObjective: The evaluation of psychosocial need is an important part of the assessment of any patient who presents to a psychiatrist. The Camberwell Assessment of Need (CAN) instrument was developed for the systematic assessment of need in people with severe and enduring mental illness. Variations of the CAN have been developed for forensic, elderly and learning disability populations. Patients presenting to psychiatrists in the general hospital may also have different needs to those presenting to psychiatrists in other settings. We set out to examine whether the CAN would be useful in identifying needs in patients referred to psychiatrists in the general hospital with self-harm or alcohol problems.Method: Over a four-month period from September 2004 we prospectively assessed all patients with self-harm or alcohol problems referred to a liaison psychiatry service. We used the short version of the Camberwell Assessment of Need instrument (CANSAS) to assess psychosocial needs. Urgent referrals to a local psychiatric service of patients with severe enduring mental illness (SEMI) were assessed using identical methodology over the same time period and used as a comparison group.Results: Over the study period 53 patients with self-harm, 42 with alcohol problems and 45 with SEMI were assessed. Patients presenting with self-harm and alcohol problems had significantly fewer needs than those with SEMI (4.40 vs 3.98 vs 7.96, p < 0.001). Looking after the home, self-care, daytime activity, psychotic symptoms, safety to others and sexual expression needs were significantly greater in the SEMI group than in either the DSH or alcohol groups. Only safety to self-needs in the DSH group and alcohol needs in the alcohol group were significantly higher than in the SEMI group. The proportion of needs that were unmet was similar in each group.Conclusions: The CANSAS instrument identified some needs in deliberate self-harm and alcohol problem patients that might not have been identified during the course of a standard psychosocial assessment. It was easy to administer and as such was a useful addition to the assessment process. However the development of a more specific instrument for the assessment of need in these populations would be useful.
Views of family carers to the future accommodation and support needs of their relatives with intellectual disabilities
Authors: McConkey Roy , McConaghie Jayne , Barr Owen , Roberts Paul 
Published: March 2016

AbstractObjectives:The demand for places in supported accommodation is likely to rise due to the increasing longevity of people with intellectual disabilities and as their parents become unavailable or unable to care for them. However few attempts have been made to ascertain carer's views on alternative accommodation.Method:Four studies were undertaken in Northern Ireland to ascertain carer's views using three different methods. In all, 387 carers participated with the response being greatest for individual interviews conducted in the family home and least for self-completed questionnaires and attendance at group meetings.Results:The majority of carers envisaged the person continuing to be cared for within the family. The most commonly chosen out-of-home provision was in residential or nursing homes, living with support in a house of their own and in homes for small groups of people. Few carers chose living with another family. However only small numbers of carers envisaged alternative provision being needed in the next two years and few had made any plans for alternative living arrangements.Conclusions:The implications for service planning are noted, primarily the need for individual reviews of future needs through person-centred planning; improved information to carers about various residential options and their differential benefits, along with more services aimed at improving the quality of life of people living with family carers. These need to be underpinned by a commitment of statutory agencies to partnership working with family carers. The implications for mental health services are noted.
Older people with enduring or recurrent severe mental illness in the Eastern Region of Ireland
Authors: Wrigley Margo , Murphy Bernadette , Farrell Martin , Cassidy Brendan , Ryan Jim 
Published: March 2016

AbstractObjectives: There has been no specific planning for older people with enduring or recurrent severe mental illness in Ireland. This survey aims to identify the number of affected over 65 year olds (graduates) and 55-64 year olds (prospective graduates) in the Health Service Executive, Eastern Region, their diagnoses and their use of psychiatric services.Method: A comprehensive survey of the ten general adult psychiatry and four old age psychiatry services in the (HSE) Eastern Region was undertaken for the year 2003 to determine the number of patients, their diagnoses and service utilisation.Results: 649 people over 65 years old were identified within the general adult psychiatry services and a further 279 within the old age psychiatry services giving a total of 928. (This number rose to 1141 after correcting for missing outpatient data.) 1,397 people between the ages of 55-64 were identified. (This number rose to 1,916 after correcting for missing outpatient data.)Conclusions: There are substantial numbers of ‘graduates’ and ‘prospective graduates’ in the Eastern Region. It is essential that services for this population are specifically planned for and further qualitative research is required to inform this process.
Older people with enduring or recurrent severe mental illness (graduates): A literature review
Authors: Wrigley Margo , Murphy Bernadette , Farrell Martin , Cassidy Brendan , Ryan Jim 
Published: March 2016

AbstractObjectives: To review the literature on older people with enduring or recurrent severe mental illness with an onset earlier than 65 years (graduates) and, in particular, to look at the specific features and needs of this group.Method: A Medline literature search produced 41 relevant papers and reports on the subject.Results: There are a substantial number of older people with severe mental illness and the number will rise in line with increased longevity. As they age these patients' psychiatric disabilities are compounded by medical and social problems. The move to community based care has largely ignored the needs of graduates who were previously cared for in psychiatric institutions.Conclusion: There is an urgent need to plan and develop adequate services for this vulnerable group.
High prevalence of risk factors for physical illness in a long-stay psychiatric unit
Authors: O'Brien Sinead , Devitt Enda , Ahmed Mohamed , McDonald Colm 
Published: March 2016

AbstractObjective: The aim of this study was to determine the prevalence of risk factors for physical illness in a long stay psychiatric unit, where all care (both psychiatric and physical) is provided by the psychiatric team.Method: All patients in the long-stay ward had a full physical examination including calculation of BMI. All patients had blood sampling including FBC, U&E, LFTs, TFTs, lipid profile (total cholesterol, triglycerides, HDL and LDL), glucose, HbA1c, and prolactin. ATP111 criteria were used to determine the presence of the metabolic syndrome.Results: We found the mean number of comorbid medical diagnosis was 2.7. The prevalence of metabolic syndrome was 40.7% (44.4% of females and 24.1% of males). The prevalence of obesity was 51%, and 51% also had a total cholesterols in excess of 5.0mmol/l. Prolactin was elevated in two-thirds of female patients.Conclusion: We conclude that the annual physical examination is of limited value in long-stay psychiatric unit. The high prevalence of physical illness and physical risk factors warrants primary care involvement in screening and treatment of long-stay psychiatric patients.