• 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)
      There is a lack of knowledge regarding some basic differences between different electroconvulsive therapy (ECT) treatment schedules.
    • 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; et al. (2010-01)
      International best-practice guidelines for the management of first-episode psychosis have recommended the provision of psychoeducation for multifamily groups. While there is ample evidence of their efficacy in multiepisode psychosis, there is a paucity of evidence supporting this approach specifically for first-episode psychosis. We sought to determine whether a six-week caregiver psychoeducation programme geared specifically at first-episode psychosis improves caregiver knowledge and attitudes.
    • Cognitive deterioration and duration of untreated psychosis.

      Gaynor, Keith; Dooley, Barbara; Lawlor, Elizabeth; Lawoyin, L Richard; O'Callaghan, Eadbhard; School of Psychology, University College Dublin, Dublin, Ireland. keith.gaynor@gmail.com (2009-05)
      The length of DUP predicted cognitive deterioration. These results highlight a potential DUP grace period (>6 months) in which significant cognitive deterioration may be averted.
    • 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.
    • 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; et al. (2012-07)
      Quality of life (QOL) has gained recognition as a valid measure of outcome in first-episode psychosis (FEP). This study aimed to determine the influence of specific groups of depressive symptoms on separate domains of subjectively appraised QOL.
    • Expanding the test of counterfeit deviance: are sexual knowledge, experience and needs a factor in the sexualised challenging behaviour of adults with intellectual disability?

      Lockhart, Karen; Guerin, Suzanne; Shanahan, Sean; Coyle, Kevin; School of Psychology, University College Dublin, Belfield, Dublin, Ireland. karen.lockhart@sjog.ie (Elsevier, 2010-01)
      It is posited within the literature that the sexualised challenging behaviour of adults with intellectual disability may be influenced by low levels of sexual knowledge, lack of sexual experience and unmet sexual needs. In this study, individuals with sexualised challenging behaviour were identified and matched for gender, age and ability level with individuals recruited to the non-sexualised and no challenging behaviour groups. All (n=24) were interviewed using the Socio-Sexual Knowledge and Attitudes Tool - Revised (SSKAAT-R) and the Sexual Knowledge, Experience and Needs Scale for Intellectual Disability (Sex-Ken-ID) to assess their sexual knowledge, experience and needs. Adaptive behaviour was measured as a covariate. In the current study, contrary to expectations in the wider literature, the sexualised challenging behaviour group showed significantly higher levels of sexual knowledge in several areas when adaptive behaviour was controlled. Their needs in relation to Dating and Intimacy were also significantly higher but no differences were found between groups in relation to sexual experience. The implications of these findings for service provision are outlined along with the considerations of directions for future research.
    • 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; et al. (2012-06)
      Timeliness of response from referral to consultation is necessary to provide best standards of care to inpatients in the general hospital setting.
    • 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)
      Patients who experience the onset of psychotic illness with a comorbid diagnosis of cannabis dependence experience poor clinical outcomes. Few studies have identified interventions that reduce cannabis use and improve clinical outcome in this population.
    • Nonadherence to medication four years after a first episode of psychosis and associated risk factors.

      Hill, Michele; Crumlish, Niall; Whitty, Petter; Clarke, Mary; Browne, Stephen; Kamali, Moayyad; Kinsella, Anthony; Waddington, John L; Larkin, Conall; O'Callaghan, Eadbhard; et al. (2010-02)
      This study examined concurrent associations and predictors at first indication of nonadherence to antipsychotic medication four years after a first episode of psychosis.
    • 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.
    • 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.
    • 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; et al. (2012-11)
      The duration of untreated psychosis is well recognised as an independent predictor of symptomatic and functional outcome in the short term and has facilitated the development of worldwide early intervention programmes. However, the extent and mechanisms by which it might influence prognosis beyond a decade remain poorly understood.
    • 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; et al. (2012-04)
      Impaired insight is commonly seen in psychosis and some studies have proposed that is a biologically based deficit. Support for this view comes from the excess of neurological soft signs (NSS) observed in patients with psychoses and their neural correlates which demonstrate a degree of overlap with the regions of interest implicated in neuroimaging studies of insight. The aim was to examine the relationship between NSS and insight in a sample of 241 first-episode psychosis patients.
    • 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)
      There is evidence that psycho-education courses for caregivers of individuals with schizophrenia improve the short-term outcome of the condition. However, most of the outcome studies are limited to two-year follow-up.
    • 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; et al. (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.