<p>Publications by staff affiliated to Saint John of God Hospitaller Services</></p>

Recent Submissions

  • Obsessive compulsive symptoms in patients with schizophrenia on clozapine and with obsessive compulsive disorder: a comparison study.

    Doyle, Mairead; Chorcorain, Aoife Ni; Griffith, Eleanor; Trimble, Tim; O'Callaghan, Eadbard; Cluain Mhuire Mental Health Service, Blackrock, Co. Dublin, Ireland. Electronic address: mairead.doyle@sjog.ie. (2014-01)
    Obsessive compulsive symptoms are commonly reported in those with schizophrenia. Clozapine has previously been reported to induce, aggravate and alleviate these symptoms. It is unclear if these are similar to the symptoms experienced by those with obsessive compulsive disorder. This study describes the obsessive compulsive symptom profile of a population of patients with schizophrenia treated with clozapine (n = 62) and compares this with patients with Obsessive Compulsive Disorder (n = 35). All participants were attending an outpatient community mental health service. The Obsessive Compulsive Inventory (which measures the frequency and associated distress of a range of "behavioural" and "cognitive" symptoms), the Hospital Anxiety and Depression Scale and a demographic questionnaire were completed. In addition the schizophrenia group treated with clozapine completed the Brief Psychiatric Rating Scale. The OCD group reported significantly more symptoms for all OCI subscales compared to the clozapine group. Overall fourteen (22%) of the schizophrenia treated with clozapine group had clinically significant total OCI scores. Two (3%) had documented OCS pre clozapine. De novo OCS was reported in twelve (19%) cases. Nine (11%) had documented OC symptoms pre-clozapine while only two (3%) had symptoms after clozapine was initiated. In terms of OC symptom profile, the clozapine group scored highest on the Doubting scale, a cognitive symptom whereas the OCD group scored highest on Washing, a behavioural symptom. Both groups reported greater distress with cognitive rather than behavioural symptoms. Medication including clozapine dose was not correlated with symptom severity. Anxiety correlated highly with obsessive compulsive symptoms in the Clozapine group but not the OCD group. Within the Clozapine group, Obsessing correlated highly with Unusual Thought Content. Findings suggest that obsessive compulsive symptoms in the Clozapine group may reflect a subtype of 'schizo-obsessive' disorder.
  • Payment of research participants: current practice and policies of Irish research ethics committees.

    Roche, Eric; King, Romaine; Mohan, Helen M; Gavin, Blanaid; McNicholas, Fiona; Cluain Mhuire Community Mental Health Service, Dublin, Ireland. dr.roche.eric@gmail.com (2013-09)
    There is considerable variability among RECs on the payment of research participants and a lack of clear consensus guidelines on the subject. The development of standardised guidelines on the payment of research subjects may enhance recruitment of research participants.
  • Service users' perceptions about their hospital admission elicited by service user-researchers or by clinicians.

    O'Donoghue, Brian; Roche, Eric; Ranieri, Veronica F; Shannon, Stephen; Crummey, Ciaran; Murray, Johanna; Smith, Damian G; O'Loughlin, Kieran; Lyne, John P; Madigan, Kevin; Feeney, Larkin; Cluain Mhuire Mental Health Service, Newtownpark Ave., Blackrock, Co. Dublin, Ireland. briannoelodonoghue@gmail.com (2013-05-01)
    OBJECTIVE Service users may express positive, ambivalent, or negative views of their hospital admission. The objective of this study was to determine whether the background of the interviewer-service user-researcher or clinician-influences the information elicited. The primary outcome was the level of perceived coercion on admission, and secondary outcomes were perceived pressures on admission, procedural justice, perceived necessity for admission, satisfaction with services, and willingness to consent to participate in the study. METHODS Participants voluntarily and involuntarily admitted to three hospitals in Ireland were randomly allocated to be interviewed at hospital discharge by either a service user-researcher or a clinician. Interviewers used the MacArthur Admission Experience Survey and the Client Satisfaction Questionnaire. RESULTS A total of 161 participants were interviewed. No differences by interviewer status or by admission status (involuntary or voluntary) were found in levels of perceived coercion, perceived pressures, procedural justice, perceived necessity, or satisfaction with services. Service users were more likely to decline to participate if their consent was sought by a service user-researcher (24% versus 8%, p=.003). CONCLUSIONS Most interviewees gave positive accounts of their admission regardless of interviewer status. The findings indicate that clinicians and researchers can be more confident that service users' positive accounts of admissions are not attributable to a response bias. Researchers can also feel more confident in directly comparing the results of studies undertaken by clinicians and by service user-researchers.
  • The therapeutic relationship after psychiatric admission.

    Roche, Eric; Madigan, Kevin; Lyne, John P; Feeney, Larkin; O'Donoghue, Brian; Cluain Mhuire Community Mental Health Service, Dublin, Ireland; †St Vincent's University Hospital, Dublin, Ireland; and ‡Royal College of Surgeons of Ireland, Dublin, Ireland. (2014-03)
    The therapeutic relationship is one of the most central and important factors in the treatment of mental health disorders. A better therapeutic relationship is associated with service engagement, medication adherence, and satisfaction with services. This study aimed to compare the demographic and clinical factors associated with the therapeutic relationship in voluntarily and involuntarily admitted psychiatric service users. We found that individuals who had been admitted involuntarily, who had a diagnosis of a psychotic disorder, and who reported higher levels of perceived pressures on admission were more likely to have a poorer therapeutic relationship with their consultant psychiatrist. Greater levels of insight and treatment satisfaction, together with higher levels of procedural justice experienced on admission, were associated with a better therapeutic relationship. We found that the level of perceived coercion on admission was not related to the therapeutic relationship. Targeted interventions to improve the therapeutic relationship, particularly for involuntarily admitted service users, are discussed.
  • Depression, anxiety and cardiovascular disease: which symptoms are associated with increased risk in community dwelling older adults?

    Gallagher, Damien; O'Regan, Claire; Savva, George M; Cronin, Hillary; Lawlor, Brian A; Kenny, Rose A; Cluain Mhuire Mental Health Services, Blackrock, Co. Dublin, Ireland. gallagherdamien@hotmail.com (2012-12-15)
    Core symptoms of depression, which are both cognitive and somatic in nature, are associated with increased risk of CVD while co-morbid anxiety did not confer additive risk. It is important that clinicians give due regard both to both cognitive and somatic symptoms of depression when determining cardiovascular risk. Future longitudinal investigation should confirm these findings and explore potential pathological mechanisms.
  • Teaching recovery to medical students.

    Feeney, Larkin; Jordan, Iain; McCarron, Peter; Cluain Mhuire Community Mental Health Service, Dublin, Ireland. larkin.feeney@sjog.ie (2013-03)
    The recovery teaching program was associated with increased knowledge of recovery principles and more positive attitudes toward mental illness. Psychiatric clinical placements for medical students should include an explicit recovery focus.
  • A multi-center, randomized controlled trial of a group psychological intervention for psychosis with comorbid cannabis dependence over the early course of illness.

    Madigan, Kevin; Brennan, Daria; Lawlor, Elizabeth; Turner, Niall; Kinsella, Anthony; O'Connor, John J; Russell, Vincent; Waddington, John L; O'Callaghan, Eadbhard; St. John of God Adult Mental Health Services, Cluain Mhuire Family Centre, Blackrock, Co. Dublin, Ireland; DETECT Early Intervention in Psychosis Service, Blackrock, Co. Dublin, Ireland. kevin.madigan@sjog.ie (2013-01)
    Over the early phase of psychotic illness, group psychological interventions for those with comorbid cannabis dependence improved subjective quality of life. However, this was not associated with reduction in use of cannabis or improvement in clinical outcomes.
  • Prospective relationship of duration of untreated psychosis to psychopathology and functional outcome over 12 years.

    Hill, Michele; Crumlish, Niall; Clarke, Mary; Whitty, Peter; Owens, Elizabeth; Renwick, Laoise; Browne, Stephen; Macklin, Eric A; Kinsella, Anthony; Larkin, Conall; Waddington, John L; O'Callaghan, Eadbhard; Cluain Mhuire Family Centre, St John of God Adult Psychiatric Service, Co., Dublin, Ireland. michelehill1@gmail.com (2012-11)
    These results provide qualified support for the potential long-term benefit of reduction in the duration of untreated psychosis in terms of improvement in symptoms and functional outcome. Its failure to predict real-life outcomes such as independent living and gainful employment could reflect the importance of pre-existing socio-cultural factors such as individual opportunity. The relationship between duration of untreated psychosis and negative symptoms was largely responsible for its effect on function, suggesting a possible long-term protective mechanism against disability.
  • Can we combine symptom scales for collaborative research projects?

    Lyne, John P; Kinsella, Anthony; O'Donoghue, Brian; DETECT Services, Avila House, Block 5 Blackrock Business Park, Co. Dublin, Ireland. johnlyne@mail.com (2012-02)
    Collaborative research projects have the potential to answer important research questions, which may otherwise require huge resources, funding, and time to complete. There are several scales for measuring psychotic symptoms in schizophrenia and other psychotic disorders, with the Scale for Assessment of Positive Symptoms (SAPS), Scale for Assessment of Negative Symptoms (SANS), Positive and Negative Symptom Scale (PANSS), and the Brief Psychiatric Rating Scale (BPRS) being among the most commonly used. High quality research efforts have used these three scales in different projects, and in order to merge study efforts, some means of combining data from these scales may be necessary. We reviewed correlations in published studies for these three scales, finding them to be highly correlated, however on comparison of the three scales there were considerable clinical differences between them. The paper discusses potential methods for combining the scales in collaborative research, including use of the recently developed standardised remission criteria for schizophrenia.
  • Comorbid psychiatric diagnoses among individuals presenting to an addiction treatment program for alcohol dependence.

    Lyne, John Paul; O'Donoghue, Brian; Clancy, Maurice; O'Gara, Colin; Addictions Department, St. John of God Hospital, Stillorgan, Co. Dublin, Ireland. johnlyne@mail.com (2011)
    A retrospective patient record review was conducted to examine comorbid psychiatric diagnoses, and comorbid substance use, among 465 patients below 45 years of age, presenting to a national alcohol addiction treatment unit in Dublin, between 1995 and 2006. Rates were high for depressive disorder (25.3%) particularly among females (35.4%). Lifetime reported use of substances other than alcohol was 39.2%, and further analysis showed significantly higher rates of deliberate self-harm among this group. Lifetime reported use of ecstasy was also significantly associated with depression in this alcohol-dependent population using logistic regression analysis. Implications and limitations of the findings are discussed.
  • Guidelines reduce time to consultation for a liaison psychiatry service in an Irish teaching hospital.

    Lyne, J; O'Donoghue, B; Bonnar, M; Golden, D; Burke, P; Hill, M; Kinsella, A; McInerney, C; Callanan, I; Ryan, M; Department of Psychiatry, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. johnlyne@mail.com (2012-06)
    Introduction of guidelines for time to consultation, may improve response times, leading to improved quality of service for inpatient consultation services.
  • Prevalence of item level negative symptoms in first episode psychosis diagnoses.

    Lyne, John; O'Donoghue, Brian; Owens, Elizabeth; Renwick, Laoise; Madigan, Kevin; Kinsella, Anthony; Clarke, Mary; Turner, Niall; O'Callaghan, Eadbhard; DETECT Services, Avila House, Block 5 Blackrock Business Park, Blackrock, Co Dublin, Ireland. johnlyne@mail.com (2012-03)
    The relevance of negative symptoms across the diagnostic spectrum of the psychoses remains uncertain. The purpose of this study was to report on prevalence of item and subscale level negative symptoms across the first episode psychosis (FEP) diagnostic spectrum in an epidemiological sample, and to ascertain whether items and subscales were more prevalent in a schizophrenia spectrum diagnoses group compared to an 'all other psychotic diagnoses' group. We measured negative symptoms in 330 patients presenting with FEP using the Scale for Assessment of Negative Symptoms (SANS), and ascertained diagnosis using the Structured Clinical Interview for DSM IV. Prevalence of SANS items and subscales were tabulated across all psychotic diagnoses, and logistic regression analysis determined which items and subscales were predictive of schizophrenia spectrum diagnoses. SANS items were most prevalent in schizophrenia spectrum conditions but frequently presented in other FEP diagnoses, particularly substance induced psychotic disorder and Major Depressive Disorder. Brief psychotic disorder and bipolar disorders had low levels of negative symptoms. SANS items and subscales which significantly predicted schizophrenia spectrum diagnoses, were also frequently present in some of the other psychotic diagnoses. Conclusions: SANS items have high prevalence in FEP, and while commonest in schizophrenia spectrum conditions are not restricted to this diagnostic subgroup.
  • Depression and quality of life in first-episode psychosis.

    Renwick, Laoise; Jackson, Deirdre; Foley, Sharon; Owens, Elizabeth; Ramperti, Nicolas; Behan, Caragh; Anwar, Mansoor; Kinsella, Anthony; Turner, Niall; Clarke, Mary; O'Callaghan, Eadbhard; DETECT Early Psychosis Service, Dublin, Ireland. laoise.renwick@detect.ie (2012-07)
    These findings suggest that QOL is heavily influenced by depressive symptoms at initial presentation; however, as QOL domains are also influenced by admission status with in-patients being more symptomatic in terms of positive symptoms, subjective QOL assessment may be compromised during the acute phase of illness by both positive and depressive symptom severity.
  • Concurrent cocaine and alcohol use in individuals presenting to an addiction treatment program

    Lyne, J.; O’Donoghue, B.; Clancy, M.; Kinsella, A.; O’Gara, C. (2010-06)
  • Treat negative symptoms of schizophrenia early on.

    Lyne, John P; Turner, Niall; Clarke, Mary (2012-03)
  • Audit of thrice- versus twice-weekly ECT.

    Roche, Eric; Lope, Jasmin; Hughes, Helen; McCullagh, Niamh; Larkin, Terence; Feeney, Larkin; Cluain Mhuire Community Mental Health Service, Blackrock, County Dublin, Ireland. ectoroche@gmail.com (2012-09)
    Our results support the current international trend toward giving ECT twice weekly.
  • The relationship between insight and neurological dysfunction in first-episode psychosis.

    Hill, M; Crumlish, N; Whitty, P; Clarke, M; Browne, S; Gervin, M; Kinsella, A; Waddington, J L; Larkin, C; O'Callaghan, E; Stanley Research Unit, Cluain Mhuire Family Centre, St John of God Adult Psychiatric Service, Dublin, Ireland. (2012-04)
    This study does not support a direct link between neurological dysfunction and insight in psychosis. Our understanding of insight as a concept remains in its infancy.
  • Schizophrenia: a five-year follow-up of patient outcome following psycho-education for caregivers.

    McWilliams, S; Hill, S; Mannion, N; Fetherston, A; Kinsella, A; O'Callaghan, E; DETECT Early Intervention in Psychosis Service, Avila House, Block 5, Blackrock Business Park, Carysfort Avenue, Co. Dublin, Ireland. stephen.mcwilliams@sjog.ie (2012-01)
    This study, which is among the first to examine outcome over five years, supports the efficacy of psycho-education for caregivers in improving outcome for patients. Caregivers should be encouraged to take up psycho-education where it is available.
  • Caregiver psychoeducation for first-episode psychosis.

    McWilliams, Stephen; Egan, Patrick; Jackson, Deirdre; Renwick, Laoise; Foley, Sharon; Behan, Caragh; Fitzgerald, Emma; Fetherston, Alastair; Turner, Niall; Kinsella, Anthony; O'Callaghan, Eadbhard; DETECT Early Intervention in Psychosis Service, DETECT, Avila House, Block 5, Blackrock Business Park, Carysfort Avenue, Co. Dublin, Ireland. drstevemb@gmail.com (2010-01)
    This study confirms that caregiver psychoeducation specifically for first-episode psychosis directly improves knowledge of the illness overall and, in particular, knowledge of medication. Gender is not a factor in this, while the lack of any socioeconomic differences dispels the myth that patients in lower socioeconomic groups are disadvantaged because their caregivers know less.

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