• 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.
    • 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.
    • 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.
    • Transcranial magnetic stimulation

      McLoughlin, D; Mogg, A; St. Patrick's University Hospital, Dublin (Oxford University Press, 2009)
    • Transcriptional regulation of human FE65, a ligand of Alzheimer's disease amyloid precursor protein, by Sp1.

      Yu, Hoi-Tin; Chan, William Wai-Lun; Chai, Ka-Ho; Lee, Chris Wing-Cheung; Chang, Raymond Chuen-Chung; Yu, Man-Shan; McLoughlin, Declan M; Miller, Christopher C J; Lau, Kwok-Fai; Department of Biochemistry (Science), The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR. (2010-03-01)
      FE65 is a neuronal-enriched adaptor protein that binds to the Alzheimer's disease amyloid precursor protein (APP). FE65 forms a transcriptionally active complex with the APP intracellular domain (AICD). The precise gene targets for this complex are unclear but several Alzheimer's disease-linked genes have been proposed. Additionally, evidence suggests that FE65 influences APP metabolism. The mechanism by which FE65 expression is regulated is as yet unknown. To gain insight into the regulatory mechanism, we cloned a 1.6 kb fragment upstream of the human FE65 gene and found that it possesses particularly strong promoter activity in neurones. To delineate essential regions in the human FE65 promoter, a series of deletion mutants were generated. The minimal FE65 promoter was located between -100 and +5, which contains a functional Sp1 site. Overexpression of the transcription factor Sp1 potentiates the FE65 promoter activity. Conversely, suppression of the FE65 promoter was observed in cells either treated with an Sp1 inhibitor or in which Sp1 was knocked down. Furthermore, reduced levels of Sp1 resulted in downregulation of endogenous FE65 mRNA and protein. These findings reveal that Sp1 plays a crucial role in transcriptional control of the human FE65 gene.
    • Unilateral brief-pulse electroconvulsive therapy and cognition: Effects of electrode placement, stimulus dosage and time.

      Semkovska, Maria; Keane, Deborah; Babalola, Oyemi; McLoughlin, Declan M; Department of Psychiatry, Trinity College Dublin, St Patrick's University Hospital, James's Street, Dublin 8, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, St Patrick's University Hospital, James's Street, Dublin 8, Ireland. (2010-11-23)
      To clarify advantages of unilateral electrode placement as an optimisation technique for electroconvulsive therapy (ECT) for depression, aims were to meta-analyse unilateral ECT effects on cognitive performance relative to: (1) bitemporal electrode placement, (2) electrical dosage, and (3) time interval between final treatment and cognitive reassessment. Relevant electronic databases were systematically searched through May 2009, using the terms: "electroconvulsive therapy" and ["cogniti∗", "neuropsycholog∗", "memory", "attention", "executive", "spatial", or "intellectual"]. Inclusion criteria were: independent study of depressed patients receiving unilateral or bitemporal brief-pulse ECT; within-subjects design; use of objective cognitive assessments; available mean electrical dosage for unilateral samples. Standardized pre-post ECT weighted effect sizes were computed and pooled within 16 cognitive domains by a mixed-effects model. Thirty-nine studies (1415 patients) were meta-analysed. Up to three days after final treatment, unilateral ECT was associated with significantly smaller decreases in global cognition, delayed verbal memory retrieval, and autobiographical memory, compared to bitemporal ECT. Significant publication bias was found for autobiographical memory, favouring reporting of larger percentage loss. Higher unilateral ECT electrical dosage predicted larger decreases in verbal learning, delayed verbal memory retrieval, visual recognition, and semantic memory retrieval. When retested more than three days after completing ECT, no significant differences remained between the two electrode placements; for unilateral ECT, electrical dosage no longer predicted cognitive performance whereas increasing interval between final treatment and retesting predicted growing improvement in some variables. This interval is a more useful long-term predictor of cognitive function than electrode placement or electrical dosage following unilateral ECT.
    • An update on the management of bipolar disorder

      Thekiso, T; Fearon, P (2011-05-19)
    • The varying impact of type, timing and frequency of exposure to childhood adversity on its association with adult psychotic disorder.

      Fisher, H L; Jones, P B; Fearon, P; Craig, T K; Dazzan, P; Morgan, K; Hutchinson, G; Doody, G A; McGuffin, P; Leff, J; et al. (2010-12)
      Childhood adversity has been associated with onset of psychosis in adulthood but these studies have used only general definitions of this environmental risk indicator. Therefore, we sought to explore the prevalence of more specific adverse childhood experiences amongst those with and without psychotic disorders using detailed assessments in a large epidemiological case-control sample (AESOP).
    • An X11alpha/FSBP complex represses transcription of the GSK3beta gene promoter.

      Lau, Kwok-Fai; Perkinton, Michael S; Rodriguez, Lilia; McLoughlin, Declan M; Miller, Christopher C J; Department of Biochemistry Science, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR. kflau@cuhk.edu.hk (2010-08-04)
      X11alpha is a neuronal adaptor protein that interacts with the amyloid precursor protein (APP) through a centrally located phosphotyrosine binding domain to inhibit the production of Abeta peptide that is deposited in Alzheimer's disease brains. X11alpha also contains two C-terminal postsynaptic density-95, large discs, zona occludens 1 (PDZ) domains, and we show here that through its PDZ domains, X11alpha interacts with a novel transcription factor, fibrinogen silencer binding protein. Moreover, we show that an X11alpha/fibrinogen silencer binding protein complex signals to the nucleus to repress glycogen synthase kinase-3beta promoter activity. Glycogen synthase kinase-3beta is a favoured candidate kinase for phosphorylating tau in Alzheimer's disease. Our findings show a new function for X11alpha that may impact on Alzheimer's disease pathogenesis.
    • X11beta rescues memory and long-term potentiation deficits in Alzheimer's disease APPswe Tg2576 mice.

      Mitchell, Jacqueline C; Ariff, Belall B; Yates, Darran M; Lau, Kwok-Fai; Perkinton, Michael S; Rogelj, Boris; Stephenson, John D; Miller, Christopher C J; McLoughlin, Declan M; MRC Centre for Neurodegeneration Research, King's College London, Institute of Psychiatry, London SE5 8AF, UK. (2009-12-01)
      Increased production and deposition of amyloid beta-protein (Abeta) are believed to be key pathogenic events in Alzheimer's disease. As such, routes for lowering cerebral Abeta levels represent potential therapeutic targets for Alzheimer's disease. X11beta is a neuronal adaptor protein that binds to the intracellular domain of the amyloid precursor protein (APP). Overexpression of X11beta inhibits Abeta production in a number of experimental systems. However, whether these changes to APP processing and Abeta production induced by X11beta overexpression also induce beneficial effects to memory and synaptic plasticity are not known. We report here that X11beta-mediated reduction in cerebral Abeta is associated with normalization of both cognition and in vivo long-term potentiation in aged APPswe Tg2576 transgenic mice that model the amyloid pathology of Alzheimer's disease. Overexpression of X11beta itself has no detectable adverse effects upon mouse behaviour. These findings support the notion that modulation of X11beta function represents a therapeutic target for Abeta-mediated neuronal dysfunction in Alzheimer's disease.