bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multidisciplinary review to identify patients who could be managed in primary care
Authors: Agyapong Vincent IO , Ahmodu Olorunfemi , Guerandel Allys 
Published: March 2016

AbstractObjectives: Primary care teams have the potential to deliver much of the care currently provided by specialist services. The aim of this review was to determine from patients' clinical records and multidisciplinary team discussions, those that may be suitable for discharge back into primary care.Methods: A retrospective review of the clinical notes of all patients attending a psychiatric outpatient clinic was carried out by all members of the multidisciplinary team to determine the appropriateness of continuing to provide psychiatric services in a specialised psychiatric clinic rather than in a primary care setting, taking into account the patients demographic and clinical variables.Results: It was recommended that 60% of all the patients needed to continue attending the local mental health service, 35.2% could be discharged back into primary care for continuing management whilst the remaining 4.8% could be managed jointly between primary care and the community mental health service. The bulk of the patients recommended for discharge into primary care had a diagnosis of anxiety disorder or depression and all of them had been stable on their treatment for more than six months.Conclusion: Regular multidisciplinary team review has a potential to identify patients who could be discharged back into primary care.
Psychiatric aspects of abortion
Authors: Clare Anthony W , Tyrrell Janette 
Published: March 2016

AbstractObjective: To examine the evidence concerning the psychological consequences of abortion, the risk of suicide in pregnancy and the psychological consequences for the mother and the child in cases of refused abortion. Method: An extensive literature search was undertaken and key relevant papers were examined and analysed. Results: Legal abortion has become more widely available throughout the western world and the actual reported incidence of cases of refused abortion is low. The majority of studies indicate that the psychological consequences of abortion itself are in the main mild and transient but there is evidence that women who have strong religious or cultural attitudes negative to abortion do experience high levels of psychological stress following abortion. The risk of suicide is low in pregnancy and suicide is a rare outcome of refused abortion. There is evidence of psychological and social difficulties experienced by mothers of unwanted pregnancies forced to proceed to term and by many offspring of such unwanted pregnancies. Conclusions: Definitive conclusions are difficult to draw from the published studies of refused abortion and many studies are over thirty years old.
Acquired immune deficiency syndrome: a comparison of psychiatric and general nursing staff beliefs
Authors: Kelly Cornelius A 
Published: March 2016

AbstractObjective: To assess the preparedness of psychiatric nurses to care for patients with Acquired Immune Deficiency Syndrome (AIDS). Method: Voluntary anonymous questionnaires were sent to psychiatric and general nurses in a district general teaching hospital. The behaviour, knowledge and attitudes towards AIDS of both groups were then compared with those of three experts specialising in the care of AIDS patients. Results: No inter group differences were found but a majority of nurses differed from the experts on two statements. Contrary to expert opinion nurses believed AIDS could be spread by needle stick injury and if given a choice they stated they would not volunteer to work on an AIDS ward. On controversial issues such as testing and where best to treat psychiatrically disturbed AIDS patients there was wide variation. Conclusion: While this study shows an improvement in health professionals knowledge, behaviour and attitudes towards AIDS, there remain underlying anxieties that need to be addressed with continuing education and training.
Attitudes towards the mentally ill in Ireland
Authors: Black Patrick , Duffy Martin , Kieran John , Mallon James , Murphy Bernadette M 
Published: March 2016

AbstractObjective: This survey attempts to ascertain the attitude of the general public towards the mentally ill and former psychiatric patients in Ireland. Method: A random selection of 155 adults were interviewed using Likert-type scales (29 items). Results: Factor analysis revealed four main attitude dimensions: fear, lack of sympathy, personal rejection and perceived community rejection. Overall, respondents express a low level of fear and a high level of sympathy towards the mentally ill. Lack of sympathy correlated highly with older age group, lower educational level and lower socio-economic class of respondent. Respondents with higher self-reported knowledge about mental illness were less fearful and more sympathetic towards the mentally ill. Conclusions: The findings are encouraging to the development of community psychiatric services and support the usefulness of public education in the area of mental health.
An analysis of a new longstay population: the need for mental hospitals
Authors: Carey Teresa G , Owens John M , Horne Patricia 
Published: March 2016

AbstractObjective: The Objective of this study was to analyse the characteristics and disabilities of patients becoming new longstay in a Mental Health District, to describe their needs and define the implications for service development. Method: All patients entering into the new longstay category between January 1st 1981 and December 31st 1991 were analysed. New longstay patients were defined as those remaining continuously in hospital for one year or longer. An accumulated inpatient group, still resident in the hospital, was examined using the Community Placement Questionnaire (CPQ), a standardised questionnaire useful for estimating needs for care and accommodation. Results: The analysis revealed a globally disabled patient group, largely intractable to treatment, the majority of whom required care and supervision in the longterm. An estimate of new longstay bed requirements, based on a stay of 1-5 years, was 11.3 per 100,000 for those under 65. The assessment team categorised current inpatients into four groups with regard to placement recommendations. An analysis of the CPQ results supported these recommendations which were: Specialist Unit for chronically disturbed Geriatrics, Geriatric Unit, High Support Staffed Hostel and Medium Support Staffed Hostel. Conclusions: Despite current service practice and community provision new longstay patients continue to accumulate. Given further specialist alternative community structures, it is suggested that these patient's requirements can be met without the need for continued longstay mental hospital beds.
A case of monosymptomatic musical hallucinations
Authors: Feehan Catherine J , Birchwood Max 
Published: March 2016

AbstractA 61 year old man presented to the psychiatric services with an eight month history of musical hallucinations, unresponsive to neuroleptic medication. Investigation revealed hypertension with brain infarcts in the left temporal and left parietal lobes. Following reassurance that his hallucinations were organic rather than psychiatric in origin, they faded in significance.
An association between functional psychosis and urinary incontinence
Authors: Williams Christopher , Yeomans David , Curran Stephen , Blackwood Gilbert 
Published: March 2016

AbstractUrinary incontinence commonly occurs in the setting of organic brain damage. However a literature search found no previous reports of an association between urinary incontinence and functional psychosis. Three cases are described in which patients with organic predisposing factors for the development of urinary incontinence showed an association between the degree of incontinence and the severity of their mental illness. It is suggested that the underlying psychosis may have contributed to the worsening of urinary incontinence, perhaps through non-specific factors such as poor attention, memory and psychotic symptoms. An association between functional psychosis and urinary incontinence has not been previously reported, and thus merits further investigation.
The relationship between behaviour disturbance and psychiatric diagnosis in male mentally handicapped adults resident in a long-stay unit
Authors: Walshe David , O'Kelly Mary , Ramsay Louis , Gibson Tessa , Mulvanney Fiona , Kara Ahmed , Corcoran Edan 
Published: March 2016

AbstractObjective: To investigate the relationship between behavioural disturbance and psychiatric diagnosis in male mentally handicapped adults resident in a long stay unit. Method: The case notes of all 144 residents of St. Raphaels were reviewed. Diagnoses were classified according to the International Classification of Diseases Ninth Revision (ICD-9) and grouped into one of four categories Infantile Autism, Functional Psychoses, Personality/Behavioural Disorder and Emotional Disorders. Carers (Senior Nursing Staff) were interviewed using the Adaptive Behaviour Scale Part 2 (ABS Part 2) as a measure of behavioural disturbance in the preceding year for the 144 residents. Results: 56% of residents had significant psychiatric disorder. Those with a psychiatric diagnosis showed increased behavioural disturbance across a wide range of measures (p<0.001) with Hyperactivity, Self Abuse and Violence showing greatest discriminative power. However there was not a relationship between diagnostic category and pattern of scoring on the ABS Part 2. There was a significant relationship between Degree of Mental Handicap and Psychiatric Diagnostic Category (p<0.001). Neither psychiatric morbidity nor behavioural disturbance was associated with epilepsy, age or duration of stay. Conclusions: Mentally handicapped adults in residential care show high rates of psychiatric disturbance. Those with psychiatric diagnoses exhibit a wide range of disturbed behaviours but similar patterns of maladaptive behaviour occur across the spectrum of psychiatric disorders. These findings refer to a male residential population and cannot be generalised to all mentally handicapped.
Side effects of moclobemide in depressed patients refractory to other treatments
Authors: Fahy T J 
Published: March 2016

AbstractFifteen consecutive cases of moderate and severe depression were treated with moclobemide in recommended dosage and followed for six months. Eleven developed excitatory side effects including agitation, insomnia, restlessness and aggressivity; five patients reported unreality experiences. Subject to confirmation, these findings, together with indications of similar side effects in published studies and in non fatal overdose, raise the possibility that the potential of moclobemide to cause excitation in depressed patients refractory to other treatments may have been hitherto underestimated.
Clozapine: the Holywell experience with the first 24 patients
Authors: King David J , Mills Philip J 
Published: March 2016

AbstractClozapine was substituted for standard antipsychotic drugs in the treatment of 24 chronic schizophrenic inpatients and the response assessed after a mean of ten months. The majority (71%) improved (33.3% markedly), on their previous level of functioning. The response was better in those under 40 years of age, but neither duration of illness nor previous neuroleptic dose appeared to predict response to clozapine. The drug was ultimately discontinued in five (21%) patients – in three because of non-response and intolerance of sedation and in two because of neutropenia.
Who gives the most reliable account of a psychiatric patient's personality?
Authors: Brothwell Judith , Casey Patricia R , Tyrer Peter 
Published: March 2016

AbstractObjective: To compare the perceived accuracy of diagnostic information derived from psychiatric patients and a range of other informants using a schedule for assessing personality disorders (Personality Assessment Schedule). Method: The Personality Assessment Schedule includes a rating of reliability of the information obtained from whatever source. A record was made of these reliability scores in 405 patients with psychiatric disorder; 146 with both subjects and other informants and 259 with the informant only, and analysed using non-parametric statistics. Results: There was significant variation in the distribution of scores among the four psychiatrists who rated 232 of the interviews with informants, suggesting that inter-individual differences are paramount in deciding who is a reliable informant. Nevertheless, the views of other informants when they were spouses or cohabitees were judged to be more accurate than those of other relatives or acquaintances. No differences were found in the perceived reliability of data from subjects and informants when both were interviewed separately. Conclusions: Subjects and informants are judged to be equally reliable in giving assessments of personality status but the informants who have the closest relationship to subjects, spouses and cohabitees, are judged superior to informants of more distant immediate relationship in the accuracy of their information about personality status.
Emergency psychiatry: a neglected area of a Cinderella service?
Authors: Kehoe Robert F , Pullen Ian M 
Published: March 2016

AbstractObjectives: To describe existing Scottish psychiatric emergency services, particularly the staffing levels and supervision of junior staff, to assess the level of recording of the urgency of referrals to such services and to determine the approximate rates of emergency presentations. Method: A postal questionnaire was sent to all 29 Scottish psychiatric hospitals, addressed to the physician superintendent or the consultant in charge of emergency services. Twenty-six were returned and further details on these and the other three services were clarified by telephone contact with medical records and medical staff. Description of services, number of presentations, staffing levels and degree of supervision were recorded. Rates of referral were estimated for Health Board populations. Results: Services varied from hospital based walk-in clinics through to community orientated domicillary assessment services. Emergency presentations are usually seen by junior staff in a psychiatric hospital outpatient department, a psychiatric ward or at an accident and emergency department. Out of hours supervision is typically by telephone advice from a consultant. Rates of emergency presentations based on collected and estimated figures were highest in urban areas. Conclusions: Scottish psychiatric emergency services are disparate in nature but all provide a 24 hour service. There is a lack of reliably collected data on the urgency of referrals but estimates suggest that there is a greater need for emergency psychiatric care in the large urban areas. Working definitions are proposed to assist in the classification of the urgency of referrals.
Outpatient detoxification of alcoholics using alprazolam – a two-year pilot project
Authors: McCollam Catherine , O'Shea Brian , Browne Larry , Lynch Mary 
Published: March 2016

AbstractObjective -To examine the safety and efficacy of alprazolam as an outpatient detoxification agent. Mehtod - Two-year, prospective, uncontrolled study of detoxification from alcohol employing alprazolam in a North Wicklow day centre. The HAD scale was used to measure emotional change. Results -Detoxification was completed in 26 cases. Adverse effects were mild or absent. Significant changes were recorded in both HAD scale scores. Client and staff satisfaction ratings were both high. Conclusions - Alprazolam is a safe and effective detoxification agent in outpatients. The HAD scale provided an objective measure of changes in anxiety and depression in this group of alcoholics. The treated population were older and more often employed than were alcoholics treated in the parent psychiatric hospital.
Psychiatric units in general hospitals — the Irish experience
Authors: McGennis Aidan 
Published: March 2016

AbstractObjective: Psychiatric units in general hospitals are becoming a key feature of Irish psychiatric practice. This is in accordance with national policy as laid down in “Planning for the Future” in 1984. To date these units have not been the subject of much research. This paper presents baseline data, gives some clinical impressions of how these units are operating, and discusses the implications of these findings. Method: Questionnaires were sent to the medical directors of all 12 psychiatric units in general hospitals in Ireland. In addition, statistical data was collected from the Health Research Board and from the Mental Health Services Section of the Department of Health. Results: All the questionnaires were returned and the results showed that these units were operating in a largely self sufficient way with little usage of local psychiatric hospitals. Outside Dublin 35% of all Health Board admissions are now going to such units, a figure comparable to England and Wales. There was little evidence of patient selectivity as units seemed to be treating the full range of psychiatric disorders. Conclusion: The picture given of general hospital units in Ireland is, in the main, very encouraging. The main problems encountered were the management of disturbed patients and the heavy demands of liaison psychiatry and these two areas would need to be further researched.
Manic-depressive illness — I: clinical characteristics of bipolar disorder subtypes
Authors: McKeon Patrick , Manley Patrick , Swanwick Gregory 
Published: March 2016

AbstractThe clinical and demographic features of 100 bipolar disorder patients, who were categorised into bipolar I, bipolar II, unipolar mania and rapid cycling groups, and who were further classified on the basis of the sequence of occurrence of the manic and depressive episodes within each cycle, are compared. Bipolar I (including unipolar manic) patients, 77% of whom had a sequence of moods where mania preceded depression (Mania-Depression – normothymic Interval: M.D.I.) constituted 69% of the total sample. Six per cent were classified as bipolar II and 25% has a rapid cycling disorder. Patients who had an M.D.I. sequence of moods, whether rapid or non-rapid cycling, had a younger age of onset, a higher male:female ratio and a stronger family history of bipolar disorder than patients whose depression preceded mania (D.M.I.). Unipolar manic patients, 12% of the sample, had a comparable age of onset, a greater family history of bipolarity and more frequent hospitalisations than the bipolar I-M.D.I. group. Rapid cycling patients had a lower mean serum thyroxine concentration than the non-rapid cycling bipolar disorder patients. This study supports the rationale for distinguishing bipolar patients with an M.D.I, sequence from those with a D.M.I, pattern and rapid cyclers from non-rapid cyclers.
“War neurosis” and associated physical conditions: an exploratory statistical analysis
Authors: Watson Ian P Burges , Wilson George V , Hornsby Helen 
Published: March 2016

AbstractRecords of the war service disability claims for Australian Vietnam veterans in Tasmania (n = 751) were analysed to establish patterns of interrelationships between categories of disability. The predicted relationship between psychiatric disability and stress related skin disabilities was strongly supported and relationships between psychiatric and other medical disabilities were found. An exploratory principal components analysis produced three independent components which accounted for 21.2 percent of total variance. Component 1 was interpreted as a general military service component and components 2 and 3 were labelled as stress components. The most likely interpretation of the two stress components was that they reflect differences in profiles of records for disability claims depending on the time when the disability presented. The relevance of the findings is discussed.
A survey of manual preference, skill and strength in undergraduates
Authors: Moynihan John B , Breathnach Caomhghin S 
Published: March 2016

AbstractObjective: To examine hand preference, hand skill and hand strength in university undergraduates in order to determine the most reliable index of handedness.Method: The Edinburgh Inventory, a group test of handedness by marking dots in circles, and a standard dynamometer were used with 248 (148 female, 100 male) subjects.Results: No statistically significant correlations were found between hand skill and strength, or between hand preference and strength. A significant correlation between skill and preference was found in the male right-handed group of 93 students.Conclusion: It is not possible to demonstrate whether preference or skill is the better index of handedness; a standardised method for assessment of hemispheric dominance for handedness is required; in the meantime the criterion used in a specific study should be explicitly stated in any citation of that study.
Cognitive therapy of agoraphobia in reaction to physical illness: an uncontrolled study
Authors: Bishay Nagy R , Tarrier Nicholas , Roberts Anthony P 
Published: March 2016

AbstractThis study describes the uncontrolled treatment of six patients who developed an agoraphobia-like syndrome following physical illness. They all revealed danger-related cognitions associated with possible sequelae of their physical illness. Cognitive therapy based on realistic assessment of risks and a strategy to minimise them was associated with improvements that were maintained at six-month follow up. The study identifies the specificity of the danger-related cognitions and points to the need for further studies to assess the size of the problem, and the need for controlled trials to assess the outcome of the treatment.
The anonymous patient: clinical characteristics of patients unidentified at presentation
Authors: Meagher David J , Collins Aidan G 
Published: March 2016

AbstractObjective: The aim of this study was to investigate the characteristics of patients whose identities are unknown at presentation to psychiatric services.Method: We retrospectively reviewed 12 years of presentations to an emergency psychiatric unit and identified 37 anonymous presentations in that period. Cases were assessed with regard to demographic data, legal status, reasons for presentation, putative diagnosis at presentation, eventual documented (ICD-9) diagnosis, previous history, duration of anonymity, method of identification and re-occurrence.Results: 0.6% of all patients who presented during the study period were unidentified for at least 24 hours. Patients were young (mean age 33.6 years). Over half were of foreign nationality (53%). The majority were suffering from major psychotic illnesses (86%). When compared with all admissions during the study period, schizophrenia and drug-induced psychoses were significantly more common in the group unidentified at presentation. Malingering, organic psychiatric disorders and dissociative states were not commonly encountered underlying diagnoses. All of our patients were subsequently identified. Successful identification methods included self admission, careful examination of personal belongings, careful history taking, liaison with police and recognition by staff. Patients frequently had a previous psychiatric history (91%). Recurrence was uncommon.Conclusion: The anonymous presentation represents a unique challenge to the investigative skills of the psychiatrist. The application of basic strategies enables the successful identification of the majority of cases.
A fatal complication of clozapine - induced agranulocytosis
Authors: Mangan Brian , Toal Martin J 
Published: March 2016

AbstractClozapine (Clozaril-Sandoz) is an atypical anti-psychotic drug used for the treatment of resistant schizophrenia. We describe the first fatal outcome as a consequence of neutropenia in the British Isles attributed to the use of clozapine. This death occurred despite proper monitoring by the Clozaril Patient Monitoring Service (CPMS) and full clinical vigilance.