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

Recent Submissions

  • 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.
  • 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)
  • 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)
  • Individualized prediction of illness course at the first psychotic episode: a support vector machine MRI study.

    Mourao-Miranda, J; Reinders, A A T S; Rocha-Rego, V; Lappin, J; Rondina, J; Morgan, C; Morgan, K D; Fearon, P; Jones, P B; Doody, G A; Murray, R M; Kapur, S; Dazzan, P; Centre for Neuroimaging Sciences, Institute of Psychiatry, King's College London, UK. (2012-05)
    To date, magnetic resonance imaging (MRI) has made little impact on the diagnosis and monitoring of psychoses in individual patients. In this study, we used a support vector machine (SVM) whole-brain classification approach to predict future illness course at the individual level from MRI data obtained at the first psychotic episode.
  • 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; King's College London, King's Health Partners, Institute of Psychiatry, Department of Psychosis Studies and NIHR Biomedical Research Centre, London, SE5 8AF, UK. muriel.walshe@kcl.ac.uk (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.
  • 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.
  • Residential mobility among patients admitted to acute psychiatric wards

    Tulloch, Alex D.; Fearon, Paul; David, Anthony S. (2011)
  • 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; Zanelli, Jolanta; Reichenberg, Abraham; Jones, Peter; Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, London, UK. s.hodgins@kcl.ac.uk (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.
  • 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; Pariante, Carmine M; Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK. (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.
  • 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.
  • 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.
  • Promoter characterization and genomic organization of the human X11β gene APBA2.

    Hao, Yan; Chai, Ka-Ho; McLoughlin, Declan M; Chan, Ho Yin Edwin; Lau, Kwok-Fai; Biochemistry Program, School of Life Sciences, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR. (2012-02-15)
    Overexpression of neuronal adaptor protein X11β has been shown to decrease the production of amyloid-β, a toxic peptide deposited in Alzheimer's disease brains. Therefore, manipulation of the X11β level may represent a potential therapeutic strategy for Alzheimer's disease. As X11β expression can be regulated at the transcription level, we determined the genomic organization and the promoter of the human X11β gene, amyloid β A4 precursor protein-binding family A member 2 (APBA2). By RNA ligase-mediated rapid amplification of cDNA ends, a single APBA2 transcription start site and the complete sequence of exon 1 were identified. The APBA2 promoter was located upstream of exon 1 and was more active in neurons. The core promoter contains several CpG dinucleotides, and was strongly suppressed by DNA methylation. In addition, mutagenesis analysis revealed a putative Pax5-binding site within the promoter. Together, APBA2 contains a potent neuronal promoter whose activity may be regulated by DNA methylation and Pax5.
  • Genomic organization and promoter cloning of the human X11α gene APBA1.

    Chai, Ka-Ho; McLoughlin, Declan M; Chan, Ting Fung; Chan, Ho Yin Edwin; Lau, Kwok-Fai; Biochemistry Program, School Life Sciences, The Chinese University of Hong Kong , Shatin, New Territories, Hong Kong SAR. (2012-05)
    X11α is a brain specific multi-modular protein that interacts with the Alzheimer's disease amyloid precursor protein (APP). Aggregation of amyloid-β peptide (Aβ), an APP cleavage product, is believed to be central to the pathogenesis of Alzheimer's disease. Recently, overexpression of X11α has been shown to reduce Aβ generation and to ameliorate memory deficit in a transgenic mouse model of Alzheimer's disease. Therefore, manipulating the expression level of X11α may provide a novel route for the treatment of Alzheimer's disease. Human X11α is encoded by the gene APBA1. As evidence suggests that X11α expression can be regulated at transcription level, we have determined the gene structure and cloned the promoter of APBA1. APBA1 spans over 244 kb on chromosome 9 and is composed of 13 exons and has multiple transcription start sites. A putative APBA1 promoter has been identified upstream of exon 1 and functional analysis revealed that this is highly active in neurons. By deletion analysis, the minimal promoter was found to be located between -224 and +14, a GC-rich region that contains a functional Sp3 binding site. In neurons, overexpression of Sp3 stimulates the APBA1 promoter while an Sp3 inhibitor suppresses the promoter activity. Moreover, inhibition of Sp3 reduces endogenous X11α expression and promotes the generation of Aβ. Our findings reveal that Sp3 play an essential role in APBA1 transcription.
  • 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.
  • 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; Fisher, Helen L; Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany. ischaefe@uke.uni-hamburg.de (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.
  • 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.
  • 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; Department of Psychosis Studies, Institute of Psychiatry, Kings College London, UK. Margaret.Heslin@kcl.ac.uk (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.

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