Research by staff affiliated to St. Patrick's University Hospital

Recent Submissions

  • Adult mental health social work and housing: a position paper

    Curran, Linda; Irish Association of Social Workers; Social Workers in Adult Mental Health Special Interest Group; Cowman, John; Egan, M.; Lane, J.; Nagwadia, N.; Guckian, P. (Irish Association of Social Workers (IASW), 2022-12)
    This position paper offers a viewpoint on the current housing crisis in Ireland from the perspective of adult mental health social workers. A key part of the social work role is to assist individuals and families with accessing housing and accommodation, so that they might have an opportunity to build their recovery upon a secure base. The paper begins with a brief review of literature related to the role of the social worker in this area. The methodology is outlined and followed by the study findings. The paper concludes with discussion and key recommendations for social workers, government, housing departments, council services, educators and others involved in this important field.
  • Retrograde autobiographical amnesia after electroconvulsive therapy: on the difficulty of finding the baby and clearing murky bathwater.

    Semkovska, Maria; McLoughlin, Declan M; From the *Department of Psychology, University of Limerick, Castletroy, Co. Limerick, Ireland and †Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland. (2014-09)
  • Dialectical behaviour therapy-informed skills training for deliberate self-harm: a controlled trial with 3-month follow-up data.

    Gibson, Jennifer; Booth, Richard; Davenport, John; Keogh, Karen; Owens, Tara; Department of Psychology, St Patrick's University Hospital, James's Street, Dublin 8, Ireland. Electronic address: jgibson@stpatsmail.com. (2014-09)
    Dialectical Behaviour Therapy (DBT) has been shown to be an effective treatment for deliberate self-harm (DSH) and emerging evidence suggests DBT skills training alone may be a useful adaptation of the treatment. DBT skills are presumed to reduce maladaptive efforts to regulate emotional distress, such as DSH, by teaching adaptive methods of emotion regulation. However, the impact of DBT skills training on DSH and emotion regulation remains unclear. This study examined the Living Through Distress (LTD) programme, a DBT-informed skills group provided in an inpatient setting. Eighty-two adults presenting with DSH or Borderline Personality Disorder (BPD) were offered places in LTD, in addition to their usual care. A further 21 clients on the waiting list for LTD were recruited as a treatment-as-usual (TAU) group. DSH, anxiety, depression, and emotion regulation were assessed at baseline and either post-intervention or 6 week follow-up. Greater reductions in the frequency of DSH and improvements in some aspects of emotion regulation were associated with completion of LTD, as compared with TAU. Improvements in DSH were maintained at 3 month follow-up. This suggests providing a brief intensive DBT-informed skills group may be a useful intervention for DSH.
  • Sing, dance, play and be mindful [presentation]

    Lucey, Jim; St Patrick's University Hospital (Trinity College Dublin, 2014-04-09)
    Increasingly good evidence emerges of the positive benefits of sport, exercise, music, dance and mindfulness-based stress reduction in the building of the mental strength necessary to overcome these troubled times. The integrity of our mental health is challenged as each of us is threatened by calamity. Groups and teams, community’s and clubs are effective means of collective support. And positive mental health skills and attitudes are associated with greater individual wellbeing and with longer and happier life. Mental health is the resource which will empower recovery in us and in our economy. Modern neuroscience is proving the centrality of the brain in positive wellbeing. The evidence shows that human recovery is enhanced by music and dance and by song and by exercise, and by mindfulness. That is why we mustn’t wait any longer to lead mentally healthy lives. In Ireland we must not wait any longer to be happy. Biography Prof. Jim Lucey is Medical Director of St. Patricks University Hospital since 2008. He has more than 25 years’ experience in psychiatry. In addition to medical management he maintains his clinical practice at St. Patrick`s where he works on the assessment, diagnosis and management of obsessive compulsive (OCD) and other anxiety disorders. Dr. Lucey's research includes studies into the biology of OCD which were completed while a JNP Moore Research Fellow at St. Patricks. Later while a Wellcome Trust Junior Fellow at the Institute of Psychiatry, University of London, he studied the use of functional brain-imaging to examine the biology of OCD, Panic disorder and Post-traumatic Disorder. In October 2006 he attended Harvard School of Public Health for "Leadership Development for Physicians in Academic Medical Centres" and again in 2008 for "Forces for Change" in health services.
  • Mental health services: the way forward: the perspectives of young people and parents

    Buckley, Sarah; Gavin, Blainid; Noctor, Colman; Devitt, Catherine; Guerin, Suzanne; The Way Forward Project Team (St Patrick's University Hospital, 2012-09)
  • Early interventions for people with psychotic disorders

    Power, P; McGorry, PD; St. Patrick's University Hospital, Dublin (Oxford University Press, 2011)
  • Lemur tyrosine kinase-2 signalling regulates kinesin-1 light chain-2 phosphorylation and binding of Smad2 cargo.

    Manser, C; Guillot, F; Vagnoni, A; Davies, J; Lau, K-F; McLoughlin, D M; De Vos, K J; Miller, C C J; Department of Neuroscience P037, MRC Centre for Neurodegeneration Research, Institute of Psychiatry, King's College London, London, UK. (2012-05-31)
    A recent genome-wide association study identified the gene encoding lemur tyrosine kinase-2 (LMTK2) as a susceptibility gene for prostate cancer. The identified genetic alteration is within intron 9, but the mechanisms by which LMTK2 may impact upon prostate cancer are not clear because the functions of LMTK2 are poorly understood. Here, we show that LMTK2 regulates a known pathway that controls phosphorylation of kinesin-1 light chain-2 (KLC2) by glycogen synthase kinase-3β (GSK3β). KLC2 phosphorylation by GSK3β induces the release of cargo from KLC2. LMTK2 signals via protein phosphatase-1C (PP1C) to increase inhibitory phosphorylation of GSK3β on serine-9 that reduces KLC2 phosphorylation and promotes binding of the known KLC2 cargo Smad2. Smad2 signals to the nucleus in response to transforming growth factor-β (TGFβ) receptor stimulation and transport of Smad2 by kinesin-1 is required for this signalling. We show that small interfering RNA loss of LMTK2 not only reduces binding of Smad2 to KLC2, but also inhibits TGFβ-induced Smad2 signalling. Thus, LMTK2 may regulate the activity of kinesin-1 motor function and Smad2 signalling.
  • Steroid metabolism and excretion in severe anorexia nervosa: effects of refeeding.

    Wassif, Wassif S; McLoughlin, Declan M; Vincent, Royce P; Conroy, Simon; Russell, Gerald F M; Taylor, Norman F; Department of Clinical Biochemistry, King's College Hospital National Health Service Foundation Trust, London, United Kingdom. ws.wassif@bedfordhospital.nhs.uk (2011-05)
    To our knowledge, changes in steroid metabolism in subjects with anorexia nervosa (AN) after weight gain have not been elucidated.
  • Systematic review and meta-analysis of bifrontal electroconvulsive therapy versus bilateral and unilateral electroconvulsive therapy in depression.

    Dunne, Ross A; McLoughlin, Declan M; Department of Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, Dublin, Ireland. ross.dunne@tcd.ie (2012-04)
    Our aim was to perform a meta-analysis of randomized controlled trials comparing efficacy and side effects of bifrontal (BF) ECT to bitemporal (BT) or unilateral (RUL) ECT in depression.
  • Long-term maternal recall of obstetric complications in schizophrenia research.

    Walshe, Muriel; McDonald, Colm; Boydell, Jane; Zhao, Jing Hua; Kravariti, Eugenia; Touloupoulou, Timothea; Fearon, Paul; Bramon, Elvira; Murray, Robin M; Allin, Matthew; et al. (2011-05-30)
    Obstetric complications (OCs) are consistently implicated in the aetiology of schizophrenia. Information about OCs is often gathered retrospectively, from maternal interview. It has been suggested that mothers of people with schizophrenia may not be accurate in their recollection of obstetric events. We assessed the validity of long term maternal recall by comparing maternal ratings of OCs with those obtained from medical records in a sample of mothers of offspring affected and unaffected with psychotic illness. Obstetric records were retrieved for 30 subjects affected with psychosis and 40 of their unaffected relatives. The Lewis-Murray scale of OCs was completed by maternal interview for each subject blind to the obstetric records. There was substantial agreement between maternal recall and birth records for the summary score of "definite" OCs, birth weight, and most of the individual items rated, with the exception of antepartum haemorrhage. There were no significant differences in the validity of recall or in errors of commission by mothers for affected and unaffected offspring. These findings indicate that several complications of pregnancy and delivery are accurately recalled by mother's decades after they occurred. Furthermore, there is no indication that mothers are less accurate in recalling OCs for their affected offspring than their unaffected offspring. When comparing women with and without recall errors, we found those with recall errors to have significantly worse verbal memory than women without such errors. Assessing the cognition of participants in retrospective studies may allow future studies to increase the reliability of their data.
  • The economic cost of pathways to care in first episode psychosis.

    Heslin, Margaret; McCrone, Paul; Flach, Clare; Fearon, Paul; Morgan, Kevin; Jones, Peter; Murray, Robin M; Dazzan, Paola; Doody, Gill; Morgan, Craig; et al. (2011)
    Few studies have examined the economic cost of psychoses other than schizophrenia and there have been no studies of the economic cost of pathways to care in patients with their first episode of psychosis. The aims of this study were to explore the economic cost of pathways to care in patients with a first episode of psychosis and to examine variation in costs. Data on pathways to care for first episode psychosis patients referred to specialist mental health services in south-east London and Nottingham between 1997-2000. Costs of pathway events were estimated and compared between diagnostic groups. The average costs for patients in south-east London were £54 (CI £33-£75) higher, compared to patients in Nottingham. Across both centres unemployed patients had £25 (CI £7-£43) higher average costs compared to employed patients. Higher costs were associated with being unemployed and living in south-east London and these differences could not be accounted for by any single factor. This should be considered when the National Health Service (NHS) is making decisions about funding.
  • Assessment of posttraumatic symptoms in patients with first-episode psychosis.

    Schäfer, Ingo; Morgan, Craig; Demjaha, Arsime; Morgan, Kevin; Dazzan, Paola; Fearon, Paul; Jones, Peter B; Doody, Gillian A; Leff, Julian; Murray, Robin M; et al. (2011-11)
    Posttraumatic stress disorder is common among patients with psychotic disorders. The present study examined the internal reliability and comparability of the Impact of Event Scale (IES) in a sample of 38 patients with first-episode psychosis and 47 controls exposed to severe physical and/or sexual abuse. The IES total score and both subscales showed high internal consistency in both groups (Cronbach's alpha coefficients of approximately 0.9 or higher). Given their equivalent trauma reporting, the lack of differences in IES scores between patients and controls seems to indicate that patients are likely to report accurately and neither exaggerate nor minimize their posttraumatic symptoms. Overall, the findings suggest that the IES can be used to assess symptoms of posttraumatic stress in patients with psychotic disorders as in other populations.
  • Timing, prevalence, determinants and outcomes of homelessness among patients admitted to acute psychiatric wards.

    Tulloch, Alex D; Fearon, Paul; David, Anthony S; Department of Psychosis Studies, Institute of Psychiatry, Kings College London, De Crespigny Park, London, SE5 8AF, UK. alex.tulloch@kcl.ac.uk (2012-07)
    To document the prevalence, timing, associations and short-term housing outcomes of homelessness among acute psychiatric inpatients.
  • Initial diagnosis and treatment in first-episode psychosis: can an operationalized diagnostic classification system enhance treating clinicians' diagnosis and the treatment chosen?

    Coentre, Ricardo; Blanco, Pablo; Fontes, Silvina; Power, Paddy; Lambeth Early Onset Service, SouthLondon and Maudsley NHS Trust, London, UK. ricardo.coentre@netc.pt (2011-05)
    Diagnosis during the initial stages of first-episode psychosis is particularly challenging but crucial in deciding on treatment. This is compounded by important differences in the two major classification systems, International Classification of Diseases, 10th revision (ICD-10) and Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). We aimed to compare the concordance between an operationalized diagnosis using Operational Criteria Checklist (OPCRIT) and treating clinician-generated diagnosis in first episode psychosis diagnosis and its correlation with treatment prescribed.
  • Gender differences in outcome at 2-year follow-up of treated bipolar and depressed alcoholics.

    Farren, Conor K; Snee, Laura; McElroy, Sharon; Department of Addiction Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, Dublin 8, Ireland. cfarren@stpatsmail.com (2011-09)
    Alcohol dependence and affective disorders are significant health problems, and their co-occurrence is mutually detrimental. There are few long-term studies on the impact of treatment on the prognosis of these comorbid disorders. We wished to study if the impact of effective inpatient integrated treatment for these co-occurring disorders was maintained 2 years after discharge from the hospital.
  • Promoting psychiatry as a career option for Ghanaian medical students through a public-speaking competition.

    Agyapong, Vincent Israel Opoku; McLoughlin, Declan; Department of Psychiatry, University of Dublin, St Patrick’s University Hospital, Dublin, Ireland. israelhans@hotmail.com (2012-05-01)
    Authors assessed the impact of a public-speaking competition on the level of interest in psychiatry of Ghanaian medical students.
  • Shared care between specialised psychiatric services and primary care: The experiences and expectations of General Practitioners in Ireland.

    Agyapong, Vincent Israel Opoku; Jabbar, Faiza; Conway, Catherine; Department of Psychiatry, University of Dublin Trinity College. (2012-04-17)
    Objective. The study aims to explore the views of General Practitioners in Ireland on shared care between specialised psychiatric services and primary care. Method. A self-administered questionnaire was designed and posted to 400 randomly selected General Practitioners working in Ireland. Results. Of the respondents, 189 (94%) reported that they would support a general policy on shared care between primary care and specialised psychiatric services for patients who are stable on their treatment. However, 124 (61.4%) reported that they foresaw difficulties for patients in implementing such a policy including: a concern that primary care is not adequately resourced with allied health professionals to support provision of psychiatric care (113, 53.2%); a concern this would result in increased financial burden on some patients (89, 48.8%); a lack of adequate cooperation between primary care and specialised mental health services (84, 41.8%); a concern that some patients may lack confidence in GP care (55, 27.4%); and that primary care providers are not adequately trained to provide psychiatric care (29, 14.4% ). Conclusion. The majority of GPs in Ireland would support a policy of shared care of psychiatric patients; however they raise significant concerns regarding practical implications of such a policy in Ireland.
  • Childhood trauma and cognitive function in first-episode affective and non-affective psychosis.

    Aas, Monica; Dazzan, Paola; Fisher, Helen L; Morgan, Craig; Morgan, Kevin; Reichenberg, Abraham; Zanelli, Jolanta; Fearon, Paul; Jones, Peter B; Murray, Robin M; et al. (2011-06)
    A history of childhood trauma is reportedly more prevalent in people suffering from psychosis than in the general population. Childhood trauma has also been linked to cognitive abnormalities in adulthood, and cognitive abnormalities, in turn, are one of the key clinical features of psychosis. Therefore, this study investigated whether there was a relationship between childhood trauma and cognitive function in patients with first-episode psychosis. The potential impact of diagnosis (schizophrenia or affective psychosis) and gender on this association was also examined.
  • Criminal offending and distinguishing features of offenders among persons experiencing a first episode of psychosis.

    Hodgins, Sheilagh; Calem, Maria; Shimel, Rhiannon; Williams, Andrew; Harleston, Dionne; Morgan, Craig; Dazzan, Paola; Fearon, Paul; Morgan, Kevin; Lappin, Julia; et al. (2011-02)
    Persons with severe mental illness (SMI) are at increased risk of criminal offending, particularly violent offending, as compared with the general population. Most offenders with SMI acquire convictions prior to contact with mental health services. This study examined offending among 301 individuals experiencing their first episode of psychosis.

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