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O'Donoghue B, Sexton S, Lyne JP, Roche E, Mifsud N, Brown E, Renwick L, Behan C, Clarke M. Socio-demographic and clinical characteristics of migrants to Ireland presenting with a first episode of psychosis. Ir J Psychol Med 2023; 40:336-342. [PMID: 33632349 DOI: 10.1017/ipm.2020.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES When presenting with a first episode of psychosis (FEP), migrants can have different demographic and clinical characteristics to the native-born population and this was examined in an Irish Early Intervention for Psychosis service. METHODS All cases of treated FEP from three local mental health services within a defined catchment area were included. Psychotic disorder diagnoses were determined using the SCID and symptom and functioning domains were measured using validated and reliable measures. RESULTS From a cohort of 612 people, 21.1% were first-generation migrants and there was no difference in the demographic characteristics, diagnoses, symptoms or functioning between migrants and those born in the Republic of Ireland, except that migrants from Africa presented with less insight. Of those admitted, 48.6% of admissions for migrants were involuntary compared to 37.7% for the native-born population (p = 0.09). CONCLUSIONS First-generation migrants now make up a significant proportion of people presenting with a FEP to an Irish EI for psychosis service. Broadly the demographic and clinical characteristics of migrants and those born in the Republic of Ireland are similar, except for less insight in migrants from Africa and a trend for a higher proportion of involuntary admissions in the total migrant group.
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Affiliation(s)
- B O'Donoghue
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - S Sexton
- Linndara, Child and Adolescent Mental Health Services, Health Service Executive, Kildare, Ireland
| | - J P Lyne
- Wicklow Mental Health Services, Newcastle Hospital, Greystones, Co. Wicklow, Ireland
- Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland
| | - E Roche
- Cluain Mhuire Mental Health Services, Newtownpark Avenue, Blackrock, Co Dublin, Ireland
| | - N Mifsud
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - E Brown
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - L Renwick
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, England, UK
| | - C Behan
- DETECT Early Intervention for Psychosis Service, Blackrock, Co Dublin, Ireland
| | - M Clarke
- DETECT Early Intervention for Psychosis Service, Blackrock, Co Dublin, Ireland
- Department of Psychiatry, University College Dublin, Dublin, Ireland
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Behan C, Davis R, Vasseghi M, Moloney P, Amin S, Delanty N, Doherty CP. Tuberous Sclerosis: A Rare Disease with an Orphan Complex. Ir Med J 2022; 115:635. [PMID: 36300768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Introduction
In the Republic of Ireland, there are no tuberous sclerosis complex (TSC) specialist clinics.
Methods
A clinical audit was carried out to assess the care received by patients attending two specialist adult epilepsy specialist centres, measuring their care against the UK guidelines.
Results
Although many baseline investigations are carried out, only one-third of patients had diagnostic genetic testing results available. Neuropsychiatry is largely neglected, and the completion of neuropsychiatric assessments checklists is inadequate. Discussions concerning SUDEP are not happening and access to treatment is limited. Reporting of radiological findings in TSC is inconsistent and the number of adults with TSC accessing specialist epilepsy services appear to be low.
Discussion
TSC care in the Republic of Ireland is fragmented, difficult to navigate and wasteful of resources due to the complex nature of the disease and no formal clinical setting to manage it. The service gaps echo the demand for an improved care system including consistent radiological reporting of TSC pathology. The absence of a specialist TSC clinic compounds the complexity of navigating care for individuals with TSC, families and healthcare professionals. Extending this audit nationally will give a more complete picture and highlight the resources required to bring care of these patients in line with recommended guidelines.
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Affiliation(s)
- C Behan
- Neurology Department, St. James's Hospital, Dublin
- SFI FutureNeuro Research Centre, Ireland
- Trinity College Dublin, College Green, Dublin 2
| | - R Davis
- Trinity College Dublin, College Green, Dublin 2
| | - M Vasseghi
- SFI FutureNeuro Research Centre, Ireland
- Trinity College Dublin, College Green, Dublin 2
| | - P Moloney
- Neurology Department, Beaumont Hospital, Dublin
- SFI FutureNeuro Research Centre, Ireland
| | - S Amin
- University Hospitals Bristol, Bristol, United Kingdom
| | - N Delanty
- Neurology Department, Beaumont Hospital, Dublin
- SFI FutureNeuro Research Centre, Ireland
| | - C P Doherty
- Neurology Department, St. James's Hospital, Dublin
- SFI FutureNeuro Research Centre, Ireland
- Trinity College Dublin, College Green, Dublin 2
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Salem A, Little R, Babur M, Featherstone A, Peset I, Cheung S, Watson Y, Tessyman V, Mistry H, Ashton G, Behan C, Matthews J, Asselin M, Bristow R, Jackson A, Williams K, Parker G, Faivre-Finn C, O’Connor J. P1.13-35 Hypoxia Mapping Using Oxygen-Enhanced MRI in Lung Cancer. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Behan C, Doyle R, Masterson S, Shiers D, Clarke M. A double-edged sword: review of the interplay between physical health and mental health. Ir J Med Sci 2014; 184:107-12. [PMID: 25342160 DOI: 10.1007/s11845-014-1205-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 09/27/2014] [Indexed: 01/22/2023]
Abstract
It is widely acknowledged that there is interplay between physical and mental health, with causality in both directions. A common theme across countries is the uncertainty surrounding who should act as gatekeeper for physical health matters in psychiatry. Much of the metabolic monitoring is carried out by psychiatrists who often feel ill equipped to treat medical problems such as abnormal cholesterol or disturbances of glucose metabolism. However many patients do not attend primary care on a regular basis and may not be likely to follow through on referral to primary care. This review aims to examine the interplay between co-morbid physical and mental health conditions, identify the physical health conditions particularly associated with severe affective and psychotic illness and briefly discuss interventions and recommendations in this area. As people with severe mental illness die 10-20 years younger than their peers, with much of this premature mortality due to cardiovascular disease, this topic is emerging as one of great importance amongst clinicians and policymakers internationally.
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Affiliation(s)
- C Behan
- DETECT Early Intervention Service in Psychosis, Dublin, Ireland,
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Neary P, Behan C, Powell T, Owens T, MacErlaine D, Mehigan D, Sheehan S, Keaveny T. Early outcomes following alternative treatment strategies in the management of the acutely ischemic limb. Int J Angiol 2011. [DOI: 10.1007/s00547-004-1029-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kamal F, Flavin S, Campbell F, Behan C, Fagan J, Smyth R. Factors affecting the outcome of methadone maintenance treatment in opiate dependence. Ir Med J 2007; 100:393-7. [PMID: 17491538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
This study aimed to measure the rates of ongoing heroin abuse among patients on methadone maintenance treatment (MMT) and sought to identify patient and treatment characteristics associated with poorer outcome. The study was carried out at an outpatient drug treatment clinic and included all patients who were on the MMT during a three month period in 2004. Treatment response was measured from analysis of opiate positive urine samples. Of the 440 patients, 63% were male and their mean age was 32 years (range 17 to 52 years). 163 patients (37%) had a comorbid psychiatric illness. The average methadone dose was 74 mg. On average, 71% of urine samples were opiate negative. Shorter time in treatment (less than 24 months), lower dose of methadone, cocaine abuse and intermittent benzodiazepine abuse were each found to be significantly associated with lower rates of opiate abstinence. Outcomes were not associated with gender, age and accessing counselling. Dual diagnosed patients tended to have higher rates of abstinence (p = 0.08). MMT clients who abuse cocaine and benzodiazepines are at increased risk of continuing opiate abuse. Higher doses of methadone might be necessary to prevent illicit opiate abuse.
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Affiliation(s)
- F Kamal
- Substance Misuse Services, St. James Hospital Portsmouth, UK.
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Hurson C, Neary P, Behan C, Kieran S, Richards S, Sheehan S, Mehigan D, Keaveny TV. Ischaemic colitis and abdominal aortic aneurysm repair. Ir J Med Sci 2002. [DOI: 10.1007/bf03170372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Behan C. Expanding the technology. Health Manag Technol 2000; 21:30, 32. [PMID: 11155630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Sorian R, Kohn D, Millenson M, Cohen A, Behan C, Firshein J, Jee M. America speaks. Was anyone listening? J Am Health Policy 1992; 2:25-30. [PMID: 10117909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Town meetings are a uniquely American political device intended to allow citizens to have a voice in the course of the local or even national policymaking process. On January 14, 1992, Democratic members of the U.S. House of Representatives conducted 140 such meetings to discuss health care reform. While the discussions ranged from the ridiculous to the sublime, Americans made it clear that they are fed up with a current system that they believe costs too much and provides too little. But a key question remains: Who, if anyone, was listening? House Democrats appear determined to avoid specifics and to pin President Bush with an "anti-health" label. The strategy is a risky one; a riled up populace could well turn against those who convinced them to be concerned in the first place.
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