bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two-year study of the use of neuroimaging in a psychiatric inpatients unit
Authors: Alugo Tolulope , Badejo Johnson , Whitty Peter 
Published: March 2016

AbstractObjectives: Neuroimaging is being used increasingly in the investigation of psychiatric disorders. Previous studies have found abnormalities in about two-thirds of all scans done in psychiatry. The aim of our study was to investigate the use of CT and MRI in the management of inpatients in psychiatry department Adelaide & Meath hospital, Tallaght and to examine the relationship between diagnosis and abnormalities seen on scans.Method: We did a two-year retrospective study of all inpatient referrals for CT scans/MRI scans. A case note review of bio-demographic data, diagnosis, relevant medical history, substance misuse history, indication for tests and results of scans was done. We found that 66 CTs and MRI scans were done over the study period.Results: Fourteen (21%) of the scans had abnormal results which were mostly atrophic changes. Of the 14 abnormal scans, seven had abnormal findings on neurological examination. We found a lower number of abnormal scans compared to previous studies.Conclusions: Radiological abnormalities were not disease specific. We wish to propose guidelines on the indications for using neuroimaging in psychiatric patients.
Epilepsy at a large psychiatric hospital: survey and audit of its management
Authors: Haw Camilla 
Published: March 2016

AbstractObjectives:Although epilepsy and psychiatric disorder are known to be associated, little is known about the nature of epilepsy in psychiatric inpatients and how well psychiatrists manage psychiatric patients with epilepsy. The aim of this study was to describe the nature of epilepsy in patients at a large specialist independent psychiatric hospital and to audit the management of epilepsy using patients' records.Method:Cross-sectional survey of inpatients and audit of clinical documents. Audit standards were derived from good clinical practice and UK guidelines.Results:In total, 83/488 (17%) patients had a life-time history of epileptic seizures and 67 (14%) were receiving anti-epileptic drugs. The prevalence of epilepsy was 37% among brain injury patients, compared with 10-11% in adult male and female forensic patients and in the elderly and 2% in adolescents. Generalised tonic-clonic seizures predominated. Common aetiological factors were: traumatic brain injury, antipsychotics, cerebral hypoxia, cerebrovascular disease and learning disability. In 53/67 (79%) cases the care plan stated the patient had epilepsy but in only 20 (30%) was the seizure type recorded. For 30 (45%) there was no history of how epilepsy had been diagnosed. Of those patients with a history of status epilepticus, 5/15 (33%) had a readily accessible emergency treatment plan. The patient's last seizure was incompletely documented in 29/44 (66%) cases, while for only 7/67 (10%) patients was there documented evidence of a review of epilepsy management within the past year.Conclusions:Epilepsy was common in this group of psychiatric inpatients. Documentation and management needed improvement and to be in line with national guidelines.
Relapse of postictal psychosis following 14-year symptom-free period
Authors: Uhoegbu Chimdi , Lannon Rosaleen , Cooney Colm , Freyne Aideen , O'Shea Diarmuid 
Published: March 2016

AbstractNeuropsychiatric sequelae in patients with epilepsy have been vastly studied and documented. These may be affective, cognitive or psychotic. Certain risk factors may predispose some epileptics more to these sequelae. In general, good epileptic control may minimize these outcomes. We present in this report, a case of postictal psychosis (PIP), superimposed on delirium, in a 68-year-old woman, with history of a single previous psychotic illness following a cluster of seizures. This report shows a collaborative management of the neuropsychiatric complications of temporal lobe epilepsy (TLE), by the neurology, geriatric medicine and psychiatry teams.
The prevalence of alcohol dependence syndrome in a rural general hospital in Northern Ireland
Authors: Mangan Brian G , Patterson Diana G 
Published: March 2016

AbstractObjective:To estimate the prevalence of alcohol dependence syndrome in a rural General Hospital.Method:The entire inpatient population of 107 patients was administered the CAGE questionnaire to detect alcohol dependency. Patients scoring two or more (maximum score 4) were diagnosed alcohol dependent.Results:Sixteen patients were unable to complete the questionnaire due to severity of illness or dementia. Of the 91 patients who completed the CAGE questionnaire, 20 scored one or more, and 12 scored two or more, giving a prevalence of probable alcohol dependency in this population of 13%. There were significantly more male alcohol dependent patients than female, 30% vs 2% (p<0.001). Fifty percent of the patients who scored on the CAGE as alcohol dependent were not recognised by medical staff as being problem drinkers. All of the alcohol dependent patients came from the medical and surgical units including Ear, Nose and Throat surgical unit (ENT).Conclusion:Administration of the CAGE questionnaire to all medical and surgical admissions seems to be one of the most economical way of detecting alcohol dependency and engaging patients in treatment as early as possible.
Clozapine for the treatment of levodopa-induced psychosis and dyskinesia in Parkinson's disease
Authors: Jalenques Isabelle , Coudert André-Julien 
Published: March 2016

AbstractThe treatment of psychosis in patients with Parkinson's disease (PD) is one of the most difficult problems in clinical psychiatry. Clozapine's low propensity to induce extrapyramidal side effects makes it an attractive treatment for psychotic patients with PD. A number of published uncontrolled studies suggest that low-dose clozapine is effective in these patients. However, the dose range, side effect profiles and length of treatment have varied in these reports. In this article, the authors review the literature and report on the effects of clozapine in a patient with Parkinson's disease and psychosis. Clozapine (50mg per day) resulted in a complete resolution of psychosis, improvement of motor function, reduction of “off” time and a major improvement in levodopa-induced dystonic dyskinesias. The only adverse effect was mild sedation during the first two weeks of clozapine treatment. The lack of acute blockade of striatal D2 receptors by clozapine and the failure of chronic clozapine treatment to suppress striatal dopamine release may account for its beneficial effect in Parkinson's disease. Additionally, an ameliorating effect of clozapine on parkinsonism might be due to its action on serotonergic systems leading to release of striatal dopamine.
Involuntary admissions to a district mental health service – implications for a new mental treatment act
Authors: Carey Teresa G , Owens John M 
Published: March 2016

AbstractObjective: The aim of this study was to examine the working of the 1945 Irish Mental Treatment Act in relation to compulsory admission and detention and to establish issues that will need to be addressed in imminent new legislation. Method: A 3 year retrospective study was carried out on all compulsory admissions to the Cavan/Monaghan Psychiatric Service using case note material. The circumstances surrounding application for compulsory admission in one year of the study period were further investigated by delivery of a schedule to Relative-Applicants. Results: The study revealed rates of compulsory admission equivalent to other Irish regions but much higher than neighbouring jurisdictions. There was no evidence of deliberate abuse of the act. Indications emerged of excessive and inappropriate recourse to certification by some relatives and General Practitioners. Excessive length of detained stay and lack of specific procedures for informing patients of their rights were evident. Conclusions: A new Mental Treatment Act will need to place much greater emphasis on patients' civil rights while facilitating access to treatment.
Adolf Hitler: a re-assessment of his personality status
Authors: Henry Desmond , Geary Dick , Tyrer Peter 
Published: March 2016

AbstractObjective: The assessment of the personality status of Adolf Hitler using a structured interview schedule, the Personality Assessment Schedule, with two informants, one a psychiatrist with an interest in psychohistory and the other a historian with special knowledge of the Third Reich and Weimar Republic. Method: The Personality Assessment Schedule was given in two forms to the two informants at different times; on each occasion Hitler was assessed as he was in 1937. Results: There was considerable discrepancy between the ratings of the two informants, the historian recording less-personality disturbance in all areas of function, although correlations between the two sets of ratings were relatively high (R1 0.5-0.6), with rater bias accounting for the differences in severity. Both informants regarded Hitler as having a dissocial personality disorder (using the new ICD-10 criteria), but the psychiatrist's rating also scored the diagnosis of paranoid and histrionic personality disorders. Conclusions: Interview schedules which use informants to assess personality disorder can be of value in examining the personality status of historical figures.
Nintendo hallucinations: a new phenomenological entity
Authors: Spence Sean A 
Published: March 2016

AbstractIncreasing exposure to video technology has provoked descriptions of psychopathology related to playing video games. However, there exists no description of hallucinatory phenomena occuring in psychotic illness deriving from such material. The subject of this report is one such patient suffering from a persistent auditory hallucination of computer music and other non-verbal information.
The controlled drinking controversy
Authors: Tobin John , Delaney William , Doyle Harry 
Published: March 2016

AbstractObjective:of the review was to explore the three major controversies over the controlled drinking debate, and to assess for whom controlled drinking may be a viable form of treatment of alcohol dependence.Method:was to survey the literature of the last twenty years, using the Medline data base, the Index Medicus, and the Excerpta Medica.Findings:were that controversies involving the work of the Sobells and the Rand reports were influenced by the social attitudes of the time, and that D.L. Davies work despite being methodologically unsound, made the consideration of having a controlled drinking goal a viable treatment option. We also found that comparing studies using different definitions of controlled/normal drinking is difficult, but it would appear that the young, married, less severely dependent, and possibly female drinker may benefit from this form of treatment. The return of a patient to controlled drinking is not always dependent on the treatment model they have undergone.Conclusions:are that controlled drinking should be considered as a serious option, and that the recommended safe alcohol intake, will differ between patients, and that flexibility will be required. Also that a source of ongoing collateral information about the patient is essential.
Audit of psychiatric emergencies in the A & E department of an urban general hospital
Authors: Webb Marcus , Webb Douglas , Webb Glenn 
Published: March 2016

AbstractObjectives: To ascertain the frequency and nature of emergencies referred to psychiatrists at the A & E Department of an urban teaching general hospital. Deliberate self-harm and other forms of violence were to be special foci of the study, as was substance abuse, particularly alcohol abuse. Clinical management strategies used by psychiatric emergency staff were also to be assessed. Method: A retrospective audit was made of all of the reports of emergencies written by psychiatric trainees (who were first on call to the A & E) during a six-month period (January-June, 1991). The reports were analysed according to demographic characteristics, main clinical problem, presence or absence of each special focus problem, and also clinical management strategies. Main outcome measures were recorded as percentages of relevant groupings. Mean and median ages were reported as indicated. Results: The 550 emergency psychiatric reports represented 2.2% of A & E attendances. Fifty-two percent were male and 70% were between 15 and 44 years of age. Forty-eight percent resided outside the psychiatric catchment area of St. James's Hospital. Forty-six percent of all psychiatric emergencies required careful assessment of suicidal potential; twenty percent were admitted to inpatient care, 53% were referred to out-patient or day-patient care, 7% to their general practitioner and just 3% to social services. Conclusions: 1. Emergency assessment at the A & E provides a considerable workload for the psychiatric service of an urban general hospital. 2. Careful assessment of suicidal potential still represents an important part of this emergency work. 3. Only 1 in 5 patients were referred on to in-patient care. Undue pressure should not be placed on psychiatric trainees to manage potentially suicidal patients outside hospital. 4. Few referrals were made by psychiatric trainees to general practitioners or to the social services, suggesting that more formal consultant supervision of trainees in this emergency work is warranted.
Cognitive dysfunction in recently detoxified female alcoholics
Authors: Blennerhassett Richard , Schneider Antonie , Tubridy Patrick , O'Loideáin Domhnall S , Shelley Rory K 
Published: March 2016

AbstractObjective:To assess the extent of cognitive impairment in a group of female alcoholics and to examine if any relationship was present between the degree of cognitive impairment, and the duration of alcohol dependence, impairment of liver function or associated prescribed medication abuse.Method:The subjects were thirty consecutive women in a residential alcoholism treatment programme who were assessed two weeks after detoxification. The visual reproduction subtest of the Wechsler Memory Scale was used, together with four subtests of the Wechsler Adult Intelligence Scale: vocabulary, similarities, block design and object assembly. We examined the effect on these scales of prolonged alcohol abuse (>5 years), abnormal liver function tests and prescribed medication abuse.Results:The group showed a significant impairment on the subtests, similarities, block design and object assembly when compared with the general population mean for the WAIS-R. Analysis of sub-groups showed little statistically significantly greater impairment on cognitive testing then the remainder of the group.Conclusions:The pattern of cognitive dysfunction for the group indicated subjects had deficits in abstraction, visual spatial and visual motor reasoning similar to previous studies involving male alcoholics. The usefulness of the sub-group comparisons was limited by the small numbers involved and larger studies would help clarify the role of contributory factors in the development of cognitive dysfunction in alcoholic subjects.
Psychotropic drug regimes in compulsive water drinkers
Authors: Cooney John A 
Published: March 2016

AbstractObjective: To assess the importance of psychotropic medications in Compulsive Water Drinking (CWD) among psychiatric inpatients. Method: The psychotropic medication regimes of 21 CWD inpatients (16 of whom had a diagnosis of schizophrenia) and 21 age and sex matched control inpatients were compared. The CWD group was selected on the basis of urine specific gravity testing amongst the non-geriatric rehabilitation population of a Canadian psychiatric hospital. Regular and prn medications were compared by type and dose. Results: Both groups had generally similar regular medication regimes. No significant differences were found for any of the more commonly prescribed medications. There was a nonsignificant tendency for more CWD subjects to be given prn psychotropics, likely a consequence rather than a cause of the polydipsia. Conclusion: No significant differences were found between the two groups. However, because of the large number of medications used and the relatively small number of subjects, the study has relatively low power. A larger study, combining the CWD inpatients of several hospitals, would be required to definitely rule out a role for psychotropics in the aetiology of CWD.
Major depressive illness with secondary pathological gambling – case report and literature review
Authors: O'Dwyer Anne-Marie , Sheppard Noel P 
Published: March 2016

AbstractThe case of a lady who developed a major depressive illness with secondary pathological gambling is described. The gambling was manifest by uncontrolled purchasing of lottery tickets. The inter-relationship between affective disorder and pathological gambling and the effect, if any, of lotteries on pathological gambling is discussed.
Flashbacks and schizophrenia
Authors: Obaydi Hazim 
Published: March 2016

AbstractThree cases of schizophrenia (DSM-III-R) (l), whilst responding to treatment, exhibit a group of symptoms which had the essential features of “flashbacks”, as described in relation to psychedelic drugs, though there was no evidence of psychedelic drug misuse. Symptoms were characterised by memory flashes of the original psychotic experience, followed immediately by very brief re-experiencing of earlier symptoms, including visual perceptual changes in clear consciousness and full insight. Symptoms were less clear, less severe, but more distressing, than the original episodes. Symptoms were triggered by stress/anxiety, and relieved by an anxiolytic. The association of flashbacks with schizophrenia is discussed.
A study of the legal involvement of new patient attenders at a Dublin alcohol treatment unit
Authors: Doyle Harry , Tobin John , Delaney William 
Published: March 2016

AbstractObjective:To determine the influence of the legal system on new attenders at an alcohol treatment unit.Method:One hundred and forty seven new patient referrals to an alcohol unit were examined prospectively over a four month period. Data were obtained by standard psychiatric interview, drinking history inventory, Severity of Alcohol Dependence Questionnaire and a detailed questionnaire of present and past legal involvement. Subjects were then followed up and the numbers remaining in treatment after the first visit and after one month ascertained.Results:Both legally referred and non-legally referred groups had significant past legal involvement while those attending under legal pressure were found to be as severely addicted as other referral types and to have no greater drop out rate from treatment.Conclusion:It is suggested that legally pressured attenders should be accepted into treatment as readily as other referral types and that greater liaison between the criminal justice system and alcohol treatment units is required.
Procedures for involuntary admission to public and private psychiatric facilities
Authors: Farren Conor , McLoughlin Declan , Clare Anthony 
Published: March 2016

AbstractObjective: The aims of this study were to assess the procedures for involuntary admission to both public and private psychiatric hospitals as determined by the Mental Treatment Act, 1945 which is one of the oldest pieces of mental health legislation in the EC. Method: Over a prospective five month period all involuntary admissions to both a public and a private hospital in Dublin were studied. Social-demographic data and clinical features of 54 involuntary admissions were recorded and analysed. Results: 11.2% of public admissions were involuntary as were 3.4% of admissions to the private hospital. The most common diagnoses were schizophrenia and mania. 74.1% of the patients had been previously admitted. 81.5% of the patients were detained in hospital for less than three months although they were committed for a potential six months. There was no formal method of decertification. Conclusions: There appears to be little need nowadays for differentiating between legislation for public and private patients. The duration of the initial reception order should be reduced from six months to a period of forty-eight hours for initial assessment and treatment. If necessary this could be extended to three months. Formal methods for decertification are required. Mental health legislation in Ireland needs to be modernised.
Dexamethasone suppression test in mentally handicapped subjects
Authors: Keane Verena , Soni Saroj 
Published: March 2016

AbstractObjective:This study investigated the frequency of abnormal Dexamethasone Suppression Test (DST) in a randomly selected group of mentally handicapped subjects.Method:Forty three subjects living in the community were selected and assessed on a variety of clinical rating scales including Hamilton Rating Scale for Depression (HDS) and Wessex Case Register Form (WCRF). DST was conducted on all the patients and the findings correlated with demographic and clinical variables. Groups defined by DST status were also compared using t-test. In subjects who showed an abnormal response, clinical assessments and DST was repeated after 3 months.Results:Only 7 of 43 subjects showed an abnormal response which did not correlate with either the severity of affective symptoms or the presence or absence of behavioural difficulties. Six of the 7 DST positive subjects were either severely or profoundly impaired on DSM-III criteria indicating that the underlying brain pathology may be pathogenetically important. This was supported by the observation that abnormal DST response was enduring at follow up.Conclusions:The findings suggest that DST may be of little value as a diagnostic tool in the mentally handicapped.
An outcome study of a brief anxiety management programme: Anxiety Control Training
Authors: Snaith Philip , Owens David , Kennedy Eileen 
Published: March 2016

AbstractObjective: Anxiety management techniques may all be expected to produce immediate therapeutic effect; more information is required on long term outcome after contact with the therapist ceases. The study is an independently monitored enquiry into the outcome of a brief technique, Anxiety Control Training. Following eight ten-minute instructional sessions with the therapist, assessments were made by a person who had not been involved with the treatment. Medication was withheld throughout the whole period of the study and ‘booster’ sessions were not given in order that an estimate may be made of the degree of subsequent improvement which may be attributed to the patient's own resources and continued practice of the technique. Method: The study was conducted on a sample of patients referred to an anxiety management service suffering from a phobic disorder. Assessments of the severity of the phobia and of generalized anxiety were made at commencement of treatment, at the end of the eight sessions and thereafter at three month and nine month intervals. Follow up assessment of all patients included in the sample was achieved. Results: At inception into the treatment phase seven of the 22 patients suffered from a moderate to severe degree of generalized anxiety in addition to phobia. As expected a significant (p<0.001) degree of improvement in phobic severity occurred during the period of therapy. Following termination of therapy further significant (p<0.01) improvement occurred up to the final assessment. The number of patients suffering from generalized anxiety was too small to allow confident conclusion but the results suggest improvement in generalized as well as phobic anxiety. Conclusions: The instructional sessions of the ACT procedure provide skill in mastery over anxiety. The subject may continue to use this skill without further aid from the therapist; with regular practice of the technique progressive improvement is likely to occur.