• 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)
    • 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.
    • 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.
    • Measuring consistency of autobiographical memory recall in depression.

      Semkovska, Maria; Noone, Martha; Carton, Mary; McLoughlin, Declan M; Department of Psychiatry, Trinity College, Dublin, Ireland. semkovsm@tcd.ie (2012-05-15)
      Autobiographical amnesia assessments in depression need to account for normal changes in consistency over time, contribution of mood and type of memories measured. We report herein validation studies of the Columbia Autobiographical Memory Interview - Short Form (CAMI-SF), exclusively used in depressed patients receiving electroconvulsive therapy (ECT) but without previous published report of normative data. The CAMI-SF was administered twice with a 6-month interval to 44 healthy volunteers to obtain normative data for retrieval consistency of its Semantic, Episodic-Extended and Episodic-Specific components and assess their reliability and validity. Healthy volunteers showed significant large decreases in retrieval consistency on all components. The Semantic and Episodic-Specific components demonstrated substantial construct validity. We then assessed CAMI-SF retrieval consistencies over a 2-month interval in 30 severely depressed patients never treated with ECT compared with healthy controls (n=19). On initial assessment, depressed patients produced less episodic-specific memories than controls. Both groups showed equivalent amounts of consistency loss over a 2-month interval on all components. At reassessment, only patients with persisting depressive symptoms were distinguishable from controls on episodic-specific memories retrieved. Research quantifying retrograde amnesia following ECT for depression needs to control for normal loss in consistency over time and contribution of persisting depressive symptoms.
    • 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.
    • 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.
    • 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; et al. (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.
    • A comparison of brief pulse and ultrabrief pulse electroconvulsive stimulation on rodent brain and behaviour.

      O'Donovan, Sinead; Kennedy, Mark; Guinan, Blaithin; O'Mara, Shane; McLoughlin, Declan M; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland. (2012-04-27)
      Brief pulse electroconvulsive therapy (BP ECT; pulse width 0.5-1.5ms) is a very effective treatment for severe depression but is associated with cognitive side-effects. It has been proposed that ultrabrief pulse (UBP; pulse width 0.25-0.30ms) ECT may be as effective as BP ECT but have less cognitive effects because it is a more physiological form of neuronal stimulation. To investigate this further, we treated normal rats with a 10 session course of either BP (0.5ms), UBP (0.3ms), or sham electroconvulsive stimulation (ECS) and measured antidepressant-related changes in dentate gyrus cell proliferation and hippocampal BDNF protein levels as well as hippocampal-dependant spatial reference memory using the water plus maze and immobility time on the forced swim test. Both BP and UBP ECS induced very similar types of motor seizures. However, BP ECS but not UBP ECS treatment led to a significant, near 3-fold, increase in cell proliferation (p=0.026) and BDNF levels (p=0.01). In the forced swim test, only BP ECS treated animals had a significantly lower immobility time (p=0.046). There was a trend for similarly reduced hippocampal-dependent memory function in both BP and UBP groups but overall there was not a significant difference between treatment and control animals when tested 10 days after completing allocated treatment. These findings show that, even though both forms of ECS elicited similar motor seizures, UBP ECS was less efficient than BP ECS in inducing antidepressant-related molecular, cellular and behavioural changes.
    • 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.
    • 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.
    • 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.
    • Annual report & financial statements 2010

      St Patrick's University Hospital (St Patrick's University Hospital, 2011-11-09)
    • 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.
    • The spectrum of worry in the community-dwelling elderly.

      Golden, Jeannette; Conroy, Ronán M; Bruce, Irene; Denihan, Aisling; Greene, Elaine; Kirby, Michael; Lawlor, Brian A; Department of Psychiatry for the Elderly, St Patrick's Hospital, Dublin, Ireland. Jeannette.golden@gmail.com (2011-11)
      In this study, we examine the prevalence and distribution of worry, its content, and its associations with quality of life and depression, based on a large sample of community-dwelling elderly. We will attempt to distinguish between pathological and non-pathological worry based on these associations.
    • 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.
    • CPR in the nursing home: fool's errand or looming dilemma?

      Lyons, D; Gormley, N; Zulfiquar, W; Silverman, M; Philpot, M; St. Patrick's Hospital, James's Street, Dublin 8, Ireland. dlyons@stpatsmail.com (2011-09)
      The indications for CPR (cardiopulmonary resuscitation) have expanded greatly since the technique was introduced and theoretically it can be attempted on all prior to death. Policy initiatives (such as the British Medical Association/Royal College of Nursing guidelines) have attempted to provide a clinical rationale for the withholding of inappropriate CPR. Traditionally a care home was felt to be an inappropriate environment to attempt CPR but increased use of advance directives may bring the issue to the fore in this setting.