• Regional variation in electroconvulsive therapy use

      Dunne, R; McLoughlin, DM (Irish Medical Journal, 2011-03)
    • Regional variation in electroconvulsive therapy use.

      Dunne, R; McLoughlin, D M; Department of Psychiatry, Trinity College, St. Patrick's University Hospital, Dublin. ross.dunne@tcd.ie (2011-03)
      Although electroconvulsive therapy (ECT) is the most powerful treatment for depression, substantial variability in use has been described in Ireland. The Mental Health Commission collects usage data from approved centres but does not include home addresses or independent sector patients. Therefore, estimates of regional variation cannot be accurate, e.g. 145 (35% of total) independent sector patients were omitted from their 2008 analysis. When public and independent sector patients are combined inter-regional variation for 2008 is more than halved (chi-squared decreased from 83 to 30), with Western region contributing most to variation (chi-squared = 43). Ratio of ECT programmes to depressed admissions correlated negatively with rate for depressed admissions (r = -0.53, p = 0.01), while depressed admission numbers correlated with acute beds per area (r = 0.68, p = 0.001). Regional variation in ECT is less than previously reported; service factors probably account for much of this with smaller centres admitting severely ill patients more likely to require ECT.
    • Reliability and Comparability of Psychosis Patients' Retrospective Reports of Childhood Abuse

      Fisher, H. L.; Craig, T. K.; Fearon, P.; Morgan, K.; Dazzan, P.; Lappin, J.; Hutchinson, G.; Doody, G. A.; Jones, P. B.; McGuffin, P.; et al. (2009-09-23)
    • Residential mobility among individuals with severe mental illness: cohort study of UK700 participants.

      Tulloch, Alex D; Fearon, Paul; Fahy, Tom; David, Anthony; Department of Psychiatry, Institute of Psychiatry, Kings College London, De Crespigny Park, London, SE5 8AF, UK. a.tulloch@iop.kcl.ac.uk (2010-08)
      There is limited research concerning residential mobility among people with severe mental illness.
    • Residential mobility among patients admitted to acute psychiatric wards

      Tulloch, Alex D.; Fearon, Paul; David, Anthony S. (2011)
    • 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)
    • Review of communication with primary care and appropriateness of providing on-going care to patients in a psychiatric clinic

      Agyapong, V I O; Olorunfemi, A; Nwachukwu, I; Guerandel, A; St. Patrick's University Hospital, Dublin (2010)
    • Review: high frequency repetitive transcranial magnetic stimulation improves symptoms of major depression.

      McLoughlin, Declan M; Department of Psychiatry, Trinity College Dublin, St Patrick's Hospital, Dublin, Ireland. (2009-08)
    • Riluzole protects against glutamate-induced slowing of neurofilament axonal transport.

      Stevenson, Alison; Yates, Darran M; Manser, Catherine; De Vos, Kurt J; Vagnoni, Alessio; Leigh, P Nigel; McLoughlin, Declan M; Miller, Christopher C J; MRC Centre for Neurodegeneration Research, Institute of Psychiatry, King's College, London, UK. (2009-04-24)
      Riluzole is the only drug approved for the treatment of amyotrophic lateral sclerosis (ALS) but its precise mode of action is not properly understood. Damage to axonal transport of neurofilaments is believed to be part of the pathogenic mechanism in ALS and this has been linked to defective glutamate handling and increased phosphorylation of neurofilament side-arm domains. Here, we show that riluzole protects against glutamate-induced slowing of neurofilament transport. Protection is associated with decreased neurofilament side-arm phosphorylation and inhibition of the activities of two neurofilament kinases, ERK and p38 that are activated in ALS. Thus, the anti-glutamatergic properties of riluzole include protection against glutamate-induced changes to neurofilament phosphorylation and transport.
    • The role of ethnicity in clinical psychopathology and care pathways of adults with intellectual disabilities.

      Tsakanikos, Elias; McCarthy, Jane; Kravariti, Eugenia; Fearon, Paul; Bouras, Nick; Estia Centre, Institute of Psychiatry, King's College London, 66 Snowsfields, London SE1 3SS, UK. elias.tsakanikos@kcl.ac.uk (2011-04-27)
      The objective of this study was to explore whether people with intellectual disability from ethnic minority groups have higher rates of mental health problems and access different care pathways than their White counterparts. Clinical and socio-demographic data were collected for 806 consecutive new referrals to a specialist mental health service for people with intellectual disabilities in South London. Referrals were grouped according to their ethnic origin. The analyses showed that there was an over-representation of referrals from ethnic minority groups with diagnoses of schizophrenia spectrum disorder. In addition, Black participants were more likely to have an autistic spectrum disorder. Referrals of ethnic minority groups were considerably younger than White referrals, and less likely to be in supported residences. The results are discussed in the context of cultural and familial factors in particular ethnic groups that may play an important role in accessing and using mental health services.
    • Satisfaction with inpatient treatment for first-episode psychosis among different ethnic groups: A report from the UK AeSOP study.

      Boydell, Jane; Morgan, Craig; Dutta, Rina; Jones, Barry; Alemseged, Fana; Dazzan, Paola; Morgan, Kevin; Doody, Gillian; Harrison, Glynn; Leff, Julian; et al. (2010-09-17)
      BACKGROUND: There is concern about the level of satisfaction with mental healthcare among minority ethnic patients in the UK, particularly as black patients have more compulsory admissions to hospital. AIMS: To determine and compare levels of satisfaction with mental healthcare between patients from different ethnic groups in a three-centre study of first-onset psychosis. METHOD: Data were collected from 216 patients with first-episode psychosis and 101 caregivers from South London, Nottingham and Bristol, using the Acute Services Study Questionnaire (Patient and Relative Version) and measures of sociodemographic variables and insight. RESULTS: No differences were found between ethnic groups in most domains of satisfaction tested individually, including items relating to treatment by ward staff and number of domains rated as satisfactory. However, logistic regression modelling (adjusting for age, gender, social class, diagnostic category and compulsion) showed that black Caribbean patients did not believe that they were receiving the right treatment and were less satisfied with medication than white patients. Black African patients were less satisfied with non-pharmacological treatments than white patients. These findings were not explained by lack of insight or compulsory treatment. CONCLUSIONS: The study found that black patients were less satisfied with specific aspects of treatment, particularly medication, but were equally satisfied with nursing and social care. Understanding the reasons behind this may improve the acceptability of psychiatric care to black minority ethnic groups.
    • Selective deficits in semantic verbal fluency in patients with a first affective episode with psychotic symptoms and a positive history of mania.

      Kravariti, Eugenia; Reichenberg, Abraham; Morgan, Kevin; Dazzan, Paola; Morgan, Craig; Zanelli, Jolanta W; Lappin, Julia M; Doody, Gillian A; Harrison, Glynn; Jones, Peter B; et al. (2009-05)
      Neurocognitive dysfunction is likely to represent a trait characteristic of bipolar disorder, but the extent to which it comprises 'core' deficits as opposed to those secondary to longstanding illness or intellectual decline is unclear. We investigated neuropsychological performance in an epidemiologically derived sample of patients with a first affective episode with psychotic symptoms and a positive history of mania, compared to community controls.
    • 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.
    • Shared care between specialized psychiatric services and primary care: the experiences and expectations of consultant psychiatrists in Ireland.

      Agyapong, Vincent I O; Conway, Catherine; Guerandel, Allys; University of Dublin Trinity College and St. Patrick's University Hospital, Dublin, Ireland. israelhans@hotmail.com (2011)
      Internationally, there has been a growing interest in the pursuit of collaborative forms of care for patients with enduring mental health difficulties.
    • 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.
    • Sources of patients' knowledge of the adverse effects of psychotropic medication and the perceived influence of adverse effects on compliance among service users attending community mental health services.

      Agyapong, Vincent I O; Nwankwo, Vincent; Bangaru, Raju; Kirrane, Rachelle; Department of Psychiatry, University of Dublin and St Patrick's University Hospital, Dublin, Ireland. israelhans@hotmail.com (2009-12)
      Noncompliance with medication has been a complex issue with patients with severe mental illness during the last few decades, and adverse effects of medication have been identified as a major contributor to noncompliance.
    • Specific and generalized neuropsychological deficits: a comparison of patients with various first-episode psychosis presentations.

      Zanelli, Jolanta; Reichenberg, Abraham; Morgan, Kevin; Fearon, Paul; Kravariti, Eugenia; Dazzan, Paola; Morgan, Craig; Zanelli, Caroline; Demjaha, Arsime; Jones, Peter B; et al. (2010-01)
      Overwhelming evidence suggests that compromised neuropsychological function is frequently observed in schizophrenia. Neurocognitive dysfunction has often been reported in other psychotic disorders, although there are inconsistencies in the literature. In the context of four distinct diagnostic groups, the authors compared neuropsychological performance among patients experiencing their first psychotic episode.
    • 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.
    • Stendhal syndrome: a case of cultural overload

      Nicholson, TRJ; Pariante, C; McLoughlin, D; St. Patrick's University Hospital, Dublin (BMJ, 2009-02-20)
    • 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.