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O'Callaghan E, Sánchez JM, Rabaglino MB, McDonald M, Liu H, Spencer TE, Fair S, Kenny DA, Lonergan P. 118 Influence of sire fertility status on conceptus-induced transcriptomic response of the bovine endometrium. Reprod Fertil Dev 2021; 34:296. [PMID: 35231255 DOI: 10.1071/rdv34n2ab118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- E O'Callaghan
- University College Dublin, Belfield, Dublin, Ireland
| | - J M Sánchez
- Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria, Madrid, Spain
| | - M B Rabaglino
- University College Dublin, Belfield, Dublin, Ireland
| | - M McDonald
- University College Dublin, Belfield, Dublin, Ireland
| | - H Liu
- University of Missouri, Division of Animal Sciences, Columbia, MO, USA
| | - T E Spencer
- University of Missouri, Division of Animal Sciences, Columbia, MO, USA
| | - S Fair
- University of Limerick, Laboratory of Animal Reproduction, School of Natural Sciences, Biomaterials Research Cluster, Bernal Institute, Faculty of Science and Engineering, Limerick, Ireland
| | - D A Kenny
- Teagasc, Animal and Grassland Research and Innovation Centre, Grange, Dunsany, Meath, Ireland
| | - P Lonergan
- University College Dublin, Belfield, Dublin, Ireland
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2
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Nkire N, Scully PJ, Browne DJ, Baldwin PA, Kingston T, Owoeye O, Kinsella A, O'Callaghan E, Russell V, Waddington JL. Systematic comparison of duration of untreated illness versus duration of untreated psychosis in relation to psychopathology and dysfunction in the Cavan-Monaghan first episode psychosis study (CAMFEPS). Eur Neuropsychopharmacol 2021; 47:20-30. [PMID: 33823369 DOI: 10.1016/j.euroneuro.2021.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 02/25/2021] [Accepted: 03/01/2021] [Indexed: 01/22/2023]
Abstract
This study systematically compared duration of untreated illness (DUI) with duration of untreated psychosis (DUP) in prediction of impairment at first-episode psychosis and investigated the extent to which these relationships are influenced by premorbid features. The Cavan-Monaghan First Episode Psychosis Study ascertained cases of first-episode psychosis in rural Ireland via all routes to care with limited variations in socioeconomic milieu. Cases were evaluated for DUI and DUP and assessed clinically for psychopathology, neuropsychology, neurology, insight and quality of life, together with premorbid features. Analyses then determined prediction of clinical assessments by DUI versus DUP. The study population consisted of 163 cases of first episode psychosis, among which 74 had a schizophrenia spectrum disorder. Shorter DUI but not DUP predicted less severe positive and general symptoms, while shorter DUP and particularly DUI predicted less severe negative symptoms; neither shorter DUP nor shorter DUI predicted less severe cognitive impairment or fewer neurological soft signs; shorter DUP and DUI predicted increased quality of life; shorter DUI but not DUP predicted greater insight. Only prediction of quality of life was weakened by consideration of premorbid features. Results were generally similar across the two diagnostic groupings. The present findings systematically delineate associations with DUI versus DUP across domains of impairment in first episode psychosis. They suggest that DUI may reflect a more insidious process than DUP and that reduction in DUI may be associated with more consistent and broader diminutions in impairment than for DUP.
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Affiliation(s)
- Nnamdi Nkire
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, and Cavan General Hospital, Cavan, Ireland; School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Paul J Scully
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, and Cavan General Hospital, Cavan, Ireland; School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - David J Browne
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, and Cavan General Hospital, Cavan, Ireland; School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Patrizia A Baldwin
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, and Cavan General Hospital, Cavan, Ireland; School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Tara Kingston
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, and Cavan General Hospital, Cavan, Ireland; School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Olabisi Owoeye
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, and Cavan General Hospital, Cavan, Ireland; School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Anthony Kinsella
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Vincent Russell
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, and Cavan General Hospital, Cavan, Ireland; Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - John L Waddington
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, and Cavan General Hospital, Cavan, Ireland; School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland; Jiangsu Key Laboratory of Translational Research & Therapy for Neuro-Psychiatric-Disorders and Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, China.
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3
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O'Callaghan E, Sánchez JM, McDonald M, Kelly AK, Hamdi M, Maicas C, Fair S, Kenny DA, Lonergan P. Sire contribution to fertilization failure and early embryo survival in cattle. J Dairy Sci 2021; 104:7262-7271. [PMID: 33714587 DOI: 10.3168/jds.2020-19900] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/28/2021] [Indexed: 12/21/2022]
Abstract
Despite passing routine laboratory tests of semen quality, bulls used in artificial insemination (AI) exhibit a significant range in field fertility. The objective of this study was to determine whether subfertility in AI bulls is due to issues of sperm transport to the site of fertilization, fertilization failure, or failure of early embryo or conceptus development. In experiment 1, Holstein-Friesian bulls (3 high fertility, HF, and 3 low fertility, LF) were selected from the national population of AI bulls based on adjusted fertility scores from a minimum of 500 inseminations (HF: +4.37% and LF: -12.7%; mean = 0%). Superovulated beef heifers were blocked based on estimated number of follicles at the time of AI and inseminated with semen from HF or LF bulls (n = 3-4 heifers per bull; total 19 heifers). Following slaughter 7 d later, the number of corpora lutea was counted and the uteri were flushed. Recovered structures (oocytes/embryos) were classified according to developmental stage and stained with 4',6-diamidino-2-phenylindole to assess number of cells and accessory sperm. Overall recovery rate (total structures recovered/total corpora lutea) was 52.6% and was not different between groups. Mean (± standard error of the mean) number of embryos recovered per recipient was 8.7 ± 5.2 and 9.4 ± 5.5 for HF and LF, respectively. Overall fertilization rate of recovered structures was not different between groups. However, more embryos were at advanced stages of development (all blastocyst stages combined), reflected in a greater mean embryo cell number on d 7 for HF versus LF bulls. Number of accessory sperm was greater for embryos derived from HF than for LF bulls. The aim of experiment 2 was to evaluate the effect of sire fertility on survival of bovine embryos to d 15. Day 7 blastocysts were produced in vitro using semen from the same HF (n = 3) and LF (n = 3) bulls and transferred in groups of 5-10 to synchronized heifers (n = 7 heifers per bull; total 42 heifers). Conceptus recovery rate on d 15 was higher in HF (59.4%,) versus LF (45.0%). Mean length of recovered conceptuses for HF bulls was not affected by fertility status. In conclusion, while differences in field fertility among AI sires used in this study were not reflected in fertilization rate, differences in embryo quality were apparent as early as d 7. These differences likely contributed to the higher proportion of conceptuses surviving to d 15 in HF bulls.
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Affiliation(s)
- E O'Callaghan
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland D04 N2E5
| | - J M Sánchez
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland D04 N2E5
| | - M McDonald
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland D04 N2E5
| | - A K Kelly
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland D04 N2E5
| | - M Hamdi
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland D04 N2E5
| | - C Maicas
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland D04 N2E5
| | - S Fair
- Laboratory of Animal Reproduction, Department of Biological Sciences, Biomaterials Research Cluster, Bernal Institute, Faculty of Science and Engineering, University of Limerick, Limerick, Ireland V94 PT85
| | - D A Kenny
- Animal and Bioscience Research Department, Animal and Grassland Research and Innovation Centre, Teagasc, Meath, Ireland C15 PW93
| | - P Lonergan
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland D04 N2E5.
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Nkire N, Scully PJ, Browne DJ, Baldwin PA, Kingston T, Owoeye O, Kinsella A, O'Callaghan E, Russell V, Waddington JL. Systematic epidemiological and clinical comparisons across all 12 DSM-IV psychotic diagnoses in the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS). Psychol Med 2021; 51:607-616. [PMID: 31858926 DOI: 10.1017/s0033291719003520] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 11/06/2022]
Abstract
BACKGROUND Research on psychotic illness is loosening emphasis on diagnostic stringency in favour of including a more dimensionally based conceptualization of psychopathology and pathobiology. However, to clarify these notions requires investigation of the full scope of psychotic diagnoses. METHODS The Cavan-Monaghan First Episode Psychosis Study ascertained cases of first episode psychosis across all 12 DSM-IV psychotic diagnoses via all routes to care: public, private or forensic; home-based, outpatient or inpatient. There was no arbitrary upper age cut-off and minimal impact of factors associated with variations in social milieu, ethnicity or urbanicity. Cases were evaluated epidemiologically and assessed for psychopathology, neuropsychology, neurology, antecedent factors, insight and quality of life. RESULTS Among 432 cases, the annual incidence of any DSM-IV psychotic diagnosis was 34.1/100 000 of population and encompassed functional psychotic diagnoses, substance-induced psychopathology and psychopathology due to general medical conditions, through to psychotic illness that defied contemporary diagnostic algorithms. These 12 DSM-IV diagnostic categories, including psychotic disorder not otherwise specified, showed clinical profiles that were consistently more similar than distinct. CONCLUSIONS There are considerable similarities and overlaps across a broad range of diagnostic categories in the absence of robust discontinuities between them. Thus, psychotic illness may be of such continuity that it cannot be fully captured by operational diagnostic algorithms that, at least in part, assume discontinuities. This may reflect the impact of diverse factors each of which acts on one or more overlapping components of a common, dysfunctional neuronal network implicated in the pathobiology of psychotic illness.
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Affiliation(s)
- Nnamdi Nkire
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, and Cavan General Hospital, Cavan, Ireland
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Paul J Scully
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, and Cavan General Hospital, Cavan, Ireland
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - David J Browne
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, and Cavan General Hospital, Cavan, Ireland
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Patrizia A Baldwin
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, and Cavan General Hospital, Cavan, Ireland
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Tara Kingston
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, and Cavan General Hospital, Cavan, Ireland
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Olabisi Owoeye
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, and Cavan General Hospital, Cavan, Ireland
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Anthony Kinsella
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Vincent Russell
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, and Cavan General Hospital, Cavan, Ireland
- Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - John L Waddington
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, and Cavan General Hospital, Cavan, Ireland
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
- Jiangsu Key Laboratory of Translational Research & Therapy for Neuro-Psychiatric-Disorders and Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, China
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5
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O'Callaghan E, Keogh K, Staub C, Cirot M, Heslin J, Fair S, Kelly AK, McDonald M, Kenny DA, Lonergan P. 101 Heifer plane of nutrition during the prepubertal phase modifies reproductive development in male fetuses. Reprod Fertil Dev 2021. [DOI: 10.1071/rdv33n2ab101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Maternal nutritional perturbation during gestation influences fetal development which, in turn, can affect postnatal growth, gonad development, gamete quality, and health of the offspring. The objective of this study was to determine whether maternal diet during the pre-pubertal phase would induce modifications in future male fetal reproductive development. Angus×Holstein-Friesian heifers (n=80) with a mean (±s.d.) age of 141±8d and bodyweight (BW) of 119±23kg had unrestricted access to a perennial ryegrass dominated sward supplemented with either 0.5kg of concentrate daily to achieve an average daily gain (ADG) of 0.50kg (moderate, MOD) or concentrate ad libitum to achieve an ADG of >1.0kg (high, HI). Heifers were offered these divergent dietary regimens from 4.5 to 8.5 months of age, after which they were all offered a moderate plane of nutrition. Heifers were bred to a synchronised oestrus at a mean age of 502±8.2d and mean BW of 360±46.7kg using semen from a single proven sire. Transrectal uterine ultrasonography was carried out 63 days post-AI to determine pregnancy and fetal sex; a cohort of heifers reflective of group average BW and age and carrying male fetuses were slaughtered on Day 100 of gestation (HI: n=10; MOD: n=12). Fetal crown–rump length and weight were recorded. One testis was snap frozen for RNA sequencing and the other was processed for stereology. Mean (±s.d.) fetal crown–rump length and weight were 19.5±0.69cm and 314.6±33.6g, respectively, and did not differ between groups. RNA sequencing revealed 45 differentially expressed genes (DEGs) between groups, 44 of which were upregulated in the HI group. A total of 29 biochemical pathways were identified as significantly enriched (P<0.05), six of which were predicted to be involved in the development of the reproductive tract based on several DEGs. Histological analysis revealed greater (P<0.05) fetal testicular interstitial tissue density in the MOD group and a strong tendency towards increased seminiferous tubule density (P=0.06) in the HI group. In conclusion, offering a high plane of nutrition during the prepubertal period not only increases the rate of sexual development in the heifer but also induces latent in utero modifications to the testicular development of their subsequent male progeny. The consequences for postnatal development of male progeny remain to be elucidated.
This research was supported by Science Foundation Ireland (16/IA/4474).
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Turner N, Ferguson L, Hill M, Nesbitt T, O'Callaghan E, O'Mahony P, Clarke M. Perspectives on paid work among men and women with schizophrenia: The results of a two study comparison in Ireland. Work 2020; 67:507-515. [PMID: 33074214 DOI: 10.3233/wor-203300] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND While research indicates that people with serious mental health conditions want to work, few studies have examined motivation and concerns associated with employment. OBJECTIVES This study examined the work attitudes among two samples of Irish people with psychotic conditions, primarily schizophrenia. METHODS Data gathered through two work related research projects was used. A self-report instrument, the work motivation scale (WMS), gathered data in two separate studies. It was possible to examine participants' motives and concerns due to the two factor structure, positive and negative, of this scale. Descriptive statistical analysis was conducted for each of the two samples individually. A sub-analysis by gender was also conducted. RESULTS Across the two samples, analysis showed the consistent motivators were increased coping ability, improved self-identity, and enhanced self-worth. Men particularly wanted others to see them as good workers. On the other hand, women regarded a job as a means to forget about having a mental illness. A sizeable minority in both samples expressed apprehensions such as work being boring and an expectation from others that they should work rather than them being personally motivated to do so. CONCLUSIONS While caution must be exercised in interpreting the results due to the small sample size, this study has extended our understanding in this under-researched but important topic.
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Affiliation(s)
- Niall Turner
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland
| | - Lisa Ferguson
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland
| | - Michele Hill
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland
| | - Tara Nesbitt
- St John of Gods Community Mental Health Services, Blackrock, Co. Dublin, Ireland
| | - Eadbhard O'Callaghan
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Paul O'Mahony
- School of Occupational Therapy, Trinity College Dublin, Dublin, Ireland
| | - Mary Clarke
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
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Jackson D, Lawoyin R, Gaynor K, Clarke M, Browne S, Renwick L, Sutton M, Turner N, Kinsella A, Waddington JL, Larkin C, O'Callaghan E. Is the duration of untreated psychosis temporally stable? Eur Psychiatry 2020; 23:97-9. [DOI: 10.1016/j.eurpsy.2007.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2007] [Revised: 08/17/2007] [Accepted: 08/22/2007] [Indexed: 10/22/2022] Open
Abstract
AbstractAlthough there is some evidence that duration of untreated psychosis (DUP) is geographically stable, few have examined whether the phenomenon is temporally stable. We examined DUP in two cohorts within two discrete time periods (1995–1999 and 2003–2005) spanning a decade in the same geographically defined community psychiatric service with no early intervention programme. Patients were diagnosed by Structured Clinical Interview for DSM (SCID) and we determined the DUP using the Beiser Scale. The DUP of the 240 participants did not differ significantly between study periods.
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Sutton M, O'Keeffe D, Frawley T, Madigan K, Fanning F, Lawlor E, Roche E, Kelly A, Turner N, Horenstein A, O'Callaghan E, Clarke M. Feasibility of a psychosis information intervention to improve mental health literacy for professional groups in contact with young people. Early Interv Psychiatry 2018; 12:234-239. [PMID: 28102617 DOI: 10.1111/eip.12410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 09/20/2016] [Indexed: 11/28/2022]
Abstract
The aim of this study was to assess the feasibility of a psychosis information intervention for professionals in contact with young people in Ireland. A quasi-experimental pre- and post-intervention design was used. One thousand and thirty-two professionals received an information intervention designed to improve mental health literacy (MHL) and confidence in providing help to people with psychosis. Seven hundred and fifty-five participants completed the Psychosis Information and Confidence Questionnaire pre- and post-intervention. The information intervention significantly improved participants': (1) knowledge of psychosis; (2) ability to recognize signs and symptoms of psychosis; (3) awareness of how to access services; and (4) confidence in providing help to people experiencing psychosis. Findings provide promising support for the intervention's feasibility and acceptability. The intervention enhanced MHL regarding psychosis among professionals in contact with young people. Further research assessing if such improvements translate to the facilitation of appropriate help seeking, the enhanced early detection of psychosis and a reduction of the duration of untreated psychosis is required.
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Affiliation(s)
- Marie Sutton
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland
| | - Donal O'Keeffe
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland.,School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Timothy Frawley
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland.,School of Nursing, Midwifery, and Health Systems, University College Dublin, Dublin, Ireland
| | - Kevin Madigan
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland.,Royal College of Surgeons in Ireland, Institute of Leadership, Dublin, Ireland
| | | | | | - Eric Roche
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Aine Kelly
- Saint John of God Hospitaller Services, Research Department, Dublin, Ireland
| | - Niall Turner
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland
| | - Arielle Horenstein
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland.,Department of Psychology, Boston University, Boston, Massachusetts
| | - Eadbhard O'Callaghan
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Mary Clarke
- DETECT Early Intervention in Psychosis Service, Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
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9
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Kingston T, Scully PJ, Browne DJ, Baldwin PA, Kinsella A, O'Callaghan E, Russell V, Waddington JL. Functional outcome and service engagement in major depressive disorder with psychotic features: comparisons with schizophrenia, schizoaffective disorder and bipolar disorder in a 6-year follow-up of the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS). CNS Neurosci Ther 2018; 24:633-640. [PMID: 29575682 DOI: 10.1111/cns.12836] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 02/06/2018] [Accepted: 02/08/2018] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE While long-term outcome following a first psychotic episode is well studied in schizophrenia (SZ), schizoaffective disorder (SA), and bipolar disorder (BD), major depressive disorder with psychotic features (MDDP) has received less investigation. This study compares MDDP with SZ, SA, and BD at 6-year follow-up. METHODS At 6 years after a first psychotic episode, follow-up data on psychopathology, functioning, quality of life, and service engagement were obtained for 27 cases of MDDP in comparison to 60 SZ, 27 SA, and 35 BD. RESULTS Positive psychotic symptoms were less prominent in MDDP and BD than in SZ and SA. Negative symptoms, impaired functioning, and reduction in objectively determined quality of life were less prominent in MDDP and BD, intermediate in SA and most prominent in SZ. However, subjectively determined quality of life was indistinguishable across diagnoses. Service engagement was highest for MDDP, intermediate for SA and BD, and lowest for SZ. CONCLUSIONS At 6-year follow-up, these diagnoses are characterized by quantitative rather than qualitative differences in psychopathology, functionality, quality of life, and service engagement, with considerable overlap between them. These findings suggest that MDDP should join SZ, SA, and BD in a milieu of psychosis that transcends arbitrary boundaries.
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Affiliation(s)
- Tara Kingston
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, Ireland.,Cavan General Hospital, Cavan, Ireland.,Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Paul J Scully
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, Ireland.,Cavan General Hospital, Cavan, Ireland
| | - David J Browne
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, Ireland.,Cavan General Hospital, Cavan, Ireland
| | - Patrizia A Baldwin
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, Ireland.,Cavan General Hospital, Cavan, Ireland
| | - Anthony Kinsella
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Vincent Russell
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, Ireland.,Cavan General Hospital, Cavan, Ireland.,Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - John L Waddington
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, Ireland.,Cavan General Hospital, Cavan, Ireland.,Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland.,Jiangsu Key Laboratory of Translational Research & Therapy for Neuro-Psychiatric Disorders, Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, China
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10
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Cohen DP, Akhtar MS, Siddiqui A, Shelley C, Larkin C, Kinsella A, O'Callaghan E, Lane A. Aggressive incidents on a psychiatric intensive care unit. Psychiatr bull 2018. [DOI: 10.1192/pb.bp.107.015412] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aims and MethodThis study looked at patient aggressive behaviour on an Irish psychiatric intensive care unit, and whether it was related to diagnosis, patient's insight and symptomatology. Each aggressive incident was recorded throughout the patient's stay using the Staff-Observed Aggression Scale.ResultsNinety-nine individuals were admitted to the unit during the study. We recorded 82 aggressive incidents, with most occurring during the daytime and on weekdays. There was no statistical difference in BPRS scores between the aggressive and non-aggressive groups. the aggressive patient group had a lower insight score than the non-aggressive group (P < 0.05) as measured on the Schedule of the Assessment of Insight. However, when gender and verbal aggression only were included in the analysis, the difference in insight was less significant (P=0.07).Clinical ImplicationsAggression is common on a psychiatric intensive care unit. Low levels of insight in patients may increase the risk of aggression.
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Scully PJ, Quinn JF, Morgan MG, Kinsella A, O'Callaghan E, Owens JM, Waddington JL. First-episode schizophrenia, bipolar disorder and other psychoses in a rural Irish catchment area: Incidence and gender in the Cavan–Monaghan study at 5 years. Br J Psychiatry 2018; 43:s3-9. [PMID: 12271797 DOI: 10.1192/bjp.181.43.s3] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BackgroundThe potential of first-episode studies in schizophrenia is maximised through systematic epidemiological, clinical and biological comparisons between homogeneous populations of the psychoses.AimsTo conduct prolonged accrual of ‘all’ cases of non-affective and affective psychotic illness on an epidemiologically complete basis.MethodWithin the region covered by Cavan–Monaghan psychiatric service (population 102 810), all putative cases of first-episode psychosis were diagnosed using DSM–IV.ResultsFrom 1995 to 2000, 69 cases of psychosis were ascertained, the incidence being 2.3-fold lower in females than in males. On resolving the ‘core’ diagnoses of schizophrenia and bipolar disorder, incidence of schizophrenia among women was 7.5-fold lower than among men whereas incidence of bipolar disorder among women was 6.6-fold lower than among men.ConclusionsThis homogeneous population, which eliminates factors associated with urbanicity and minimises confounding factors such as socioeconomic, ethnic and geographical diversity, shows a markedly reduced incidence among females both of schizophrenia and of bipolar disorder.
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Affiliation(s)
- Paul J Scully
- Stanley Research Unit, St Davnet's Hospital, Monaghan, Ireland
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12
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Walsh E, Rooney S, Sloan D, McCauley P, Mulvaney F, O'Callaghan E, Larkin C. Irish psychiatric absconders: characteristics and outcome. Psychiatr bull 2018. [DOI: 10.1192/pb.22.6.351] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Absconding constitutes a significant clinical problem, leading to high levels of anxiety among staff. Ninety-five psychiatric in-patients who absconded from an Irish hospital over a period of 12 months were reviewed retrospectively. Absconders were significantly more likely to be single and compulsorily detained with a diagnosis of schizophrenia or personality disorder when compared to the remaining hospital population for that year. Common destinations included the public house and home, with most returning of their own volition within 24 hours. The rates of self-harm and violence against others are recorded.
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13
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Renwick L, Drennan J, Sheridan A, Owens L, Lyne J, O'Donoghue B, Kinsella A, Turner N, O'Callaghan E, Clarke M. Subjective and objective quality of life at first presentation with psychosis. Early Interv Psychiatry 2017; 11:401-410. [PMID: 26176934 DOI: 10.1111/eip.12255] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 06/08/2015] [Indexed: 11/30/2022]
Abstract
AIM Quality of life (QOL) in first-episode psychosis (FEP) is impaired when compared to non-clinical controls and several clinical factors including symptoms and untreated psychosis have been linked with poorer QOL. Measurement methods are varied, however, resulting in inconsistent findings and there is a need to simultaneously combine subjective and objective measures of QOL. METHODS We examined both subjective (n = 128) and objective QOL (n = 178) in a catchment area cohort of individuals with FEP (n = 222) to determine correspondence between patient satisfaction and clinician-rated functional domains. We also examined the contribution of sociodemographic and clinical characteristics to both subjective and objective QOL. RESULTS There were complex relationships between subjective and objective QOL domains in that patient's assessments of health status (psychological well-being, symptoms/outlook, physical health) were not correlated with clinicians but there were strong correlations between social functioning domains (occupation, social relations, financial status and activities of daily living) assessed by patients and clinicians. Longer duration of untreated psychosis, being treated as an inpatient, higher positive symptoms and poorer social functioning in client-rated QOL domains predicted poorer objective QOL. CONCLUSION We found that both subjective and objective assessments of QOL displayed a degree of clinical utility demonstrated by relationships between clinical factors and both QOL perspectives. Moreover, the lack of association between patient characteristics and QOL shows some potential malleability of QOL outcomes through intervention as there were several clinical factors linked with both subjective and objective QOL.
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Affiliation(s)
- Laoise Renwick
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.,DETECT Early Psychosis Service, Dublin, Ireland.,School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - Jonathan Drennan
- Centre for Innovation and Leadership in Health Sciences, University of Southampton, Southampton, UK.,School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - Ann Sheridan
- School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - Liz Owens
- DETECT Early Psychosis Service, Dublin, Ireland
| | - John Lyne
- DETECT Early Psychosis Service, Dublin, Ireland
| | - Brian O'Donoghue
- Early Psychosis Prevention and Intervention Centre (EPPIC), Orygen, National Centre for Excellence in Youth Mental Health, Melbourne, Victoria, Australia
| | | | | | | | - Mary Clarke
- DETECT Early Psychosis Service, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
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14
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Renwick L, Owens L, Lyne J, O'Donoghue B, Roche E, Drennan J, Sheridan A, Pilling M, O'Callaghan E, Clarke M. Predictors of change in social networks, support and satisfaction following a first episode psychosis: A cohort study. Int J Nurs Stud 2017; 76:28-35. [PMID: 28910597 DOI: 10.1016/j.ijnurstu.2017.08.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 07/04/2017] [Accepted: 08/24/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Diminished social networks are common in psychosis but few studies have measured these comprehensively and prospectively to determine how networks and support evolve during the early phase. There is little information regarding perceived support in the early phase of illness. The aim of this study was to describe social support, networks and perceived satisfaction, explore the clinical correlates of these outcomes and examine whether phases of untreated psychosis are linked with social network variables to determine potential opportunities for intervention. METHODS During the study period, we assessed 222 people with first-episode psychosis at entry into treatment using valid and reliable measures of diagnosis, positive and negative symptoms, periods of untreated psychosis and prodrome and premorbid adjustment. For follow-up we contacted participants to conduct a second assessment (n=158). There were 97 people who participated which represented 61% of those eligible. Social network and support information obtained at both time points included the number of friends, self-reported satisfaction with support and social network size and clinician's evaluation of the degree of support received through networks. Mixed effects modelling determined the contribution of potential explanatory variables to social support measured. RESULTS A number of clinical variables were linked with social networks, support and perceived support and satisfaction. The size of networks did not change over time but those with no friends and duration of untreated psychosis was significantly longer for those with no friends at entry into treatment (n=129, Median=24.5mths, IQR=7.25-69.25; Mann-Whitney U=11.78, p=0.008). Social support at baseline and at one year was predicted by homelessness (t=-2.98, p=0.001, CI -4.74 to -1.21), duration of untreated psychosis (t=-0.86, p=0.031, CI -1.65 to -0.08) and premorbid adjustment (t=-2.26, p=0.017, CI -4.11 to -0.42). Social support improved over time but the duration of untreated psychosis was not linked with the rate of improvement in this outcome. CONCLUSIONS Improved social support could indicate greater reliance on social support or becoming more adept at mobilising resources to meet social needs. Particularly vulnerable groups with very long duration of untreated psychosis confirm the need for earlier intervention or targeted social network interventions to preserve social connectedness.
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Affiliation(s)
- Laoise Renwick
- School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK.
| | - Liz Owens
- DETECT Early Psychosis Service, Dublin, Ireland
| | - John Lyne
- DETECT Early Psychosis Service, Dublin, Ireland; North Dublin Mental Health Services, Dublin, Ireland
| | - Brian O'Donoghue
- DETECT Early Psychosis Service, Dublin, Ireland; Orygen, the National Centre for Excellence in Youth Mental Health, Melbourne, Australia
| | - Eric Roche
- DETECT Early Psychosis Service, Dublin, Ireland
| | - Jonathan Drennan
- School of Nursing and Midwifery, University College Cork, Ireland
| | - Ann Sheridan
- School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland
| | - Mark Pilling
- School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK
| | - Eadbhard O'Callaghan
- DETECT Early Psychosis Service, Dublin, Ireland; St. John of God Hospital, Dublin, Ireland; Department of Psychiatry, University College Dublin, Dublin, Ireland
| | - Mary Clarke
- DETECT Early Psychosis Service, Dublin, Ireland; St. John of God Hospital, Dublin, Ireland; Department of Psychiatry, University College Dublin, Dublin, Ireland
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15
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Turner N, Ferguson L, Hill M, Nesbitt T, O'Callaghan E, O'Mahony P, Clarke M. An exploratory study of the extent of social inclusion among people with psychosis and psychotic-related conditions. Int J Soc Psychiatry 2017; 63:195-202. [PMID: 28466747 DOI: 10.1177/0020764017691551] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Understanding social inclusion among at-risk populations will deepen our understanding of their specific needs. AIM This study explored the level of social inclusion among people with psychotic-related conditions using a standardised interview. METHOD The Social Inclusion Interview Schedule was used in two research projects. People with psychosis participated in both studies and had been recruited as part of an Irish programme of research on psychotic conditions. Descriptive statistics were used to quantify participants' level of social exclusion. RESULTS Data from 71 participants were available, 38 in one cohort and 33 in the other. The smaller cohort had a shorter mean duration of illness. Participants' mean age was 40. The majority lived in the community and were satisfied with their living arrangements. In each cohort, the same two areas of community integration emerged as problematic - having something productive to do and being close to someone in the community. There was a higher level of perceived stigma among the cohort with the longer duration of illness. DISCUSSION/CONCLUSION While evidence of social inclusion was found among participants, there were areas of concern particularly with regard to integration into work and social connectedness.
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Affiliation(s)
- Niall Turner
- 1 St John of Gods Community Mental Health Services, Co. Dublin, Ireland
| | - Lisa Ferguson
- 2 DETECT Early Intervention in Psychosis Service, Co. Dublin, Ireland
| | | | - Tara Nesbitt
- 1 St John of Gods Community Mental Health Services, Co. Dublin, Ireland
| | - Eadbhard O'Callaghan
- 2 DETECT Early Intervention in Psychosis Service, Co. Dublin, Ireland.,4 School of Medicine and Medical Science, University College Dublin, Dublin 4, Ireland
| | - Paul O'Mahony
- 5 Occupational Therapy, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | - Mary Clarke
- 2 DETECT Early Intervention in Psychosis Service, Co. Dublin, Ireland.,4 School of Medicine and Medical Science, University College Dublin, Dublin 4, Ireland
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16
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Turner N, Jackson D, Renwick L, Sutton M, Foley S, McWilliams S, Kinsella A, O'Callaghan E. What Influences Purpose in Life in First-Episode Psychosis? Br J Occup Ther 2016. [DOI: 10.1177/030802260707000906] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although purpose in life (PIL) is significant to psychological wellbeing, there is little published research on PIL among those with a mental illness. This prospective study of first-episode psychosis (n = 54) included assessment of symptomatology, PIL and duration of untreated psychosis. The results showed that the baseline PIL scores of those with first-episode psychosis were lower than those of other populations. This was worsened by a long duration of untreated psychosis and was linked to depression. The study concludes that psychosis results in many losses for the individual, including PIL. Meaningful occupation can address this lost sense of purpose and the occupational difficulties associated with psychosis.
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17
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O'Donoghue B, Lyne JP, Renwick L, Lane A, Madigan K, Staines A, O'Callaghan E, Clarke M. Neighbourhood characteristics and the incidence of first-episode psychosis and duration of untreated psychosis. Psychol Med 2016; 46:1367-1378. [PMID: 27032697 DOI: 10.1017/s003329171500286x] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [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
BACKGROUND The incidence of psychotic disorders varies between geographical areas and it has been hypothesized that neighbourhood-level factors may influence this variation. It is also plausible that the duration of untreated psychosis (DUP) is associated with neighbourhood characteristics. The aims of this study were to determine whether the incidence of first-episode psychosis (FEP) and the DUP are associated with the level of social deprivation, fragmentation, social capital and population density. METHOD All individuals with a FEP from a geographical defined catchment area over a 5-year period were included. Age-standardized incidence rates were calculated for each neighbourhood factor. RESULTS A total of 292 cases of FEP were included in the study and 45% had a diagnosis of a schizophrenia-spectrum disorder. The age standardized incidence rate of FEP in the most deprived area was 72.4 [95% confidence interval (CI) 26.4-162.7] per 100 000 person-years compared with 21.5 (95% CI 17.6-26.0) per 100 000 person-years in the most affluent areas. This represents a 3.4-fold increase in FEP incidence in the most deprived areas. The incidence of FEP was also increased in neighbourhoods that were more socially fragmented [incidence rate ratio (IRR) = 2.40, 95% CI 1.05-5.51, p = 0.04] and there was a trend for the incidence to be increased in neighbourhoods with lower social capital (IRR = 1.43, 95% CI 0.99-2.06, p = 0.05). The median DUP was 4 months and was higher in more socially fragmented neighbourhoods. CONCLUSIONS The incidence of psychotic disorders is related to neighbourhood factors and it may be useful to consider neighbourhood factors when allocating resources for early intervention services.
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Affiliation(s)
- B O'Donoghue
- The Centre for Youth Mental Health,University of Melbourne,Melbourne,VIC,Australia
| | - J P Lyne
- Department of Psychiatry,Royal College of Surgeons in Ireland,Dublin,Republic of Ireland
| | - L Renwick
- School of Nursing, Midwifery and Social Work,University of Manchester,Manchester,UK
| | - A Lane
- Department of Psychiatry,School of Medicine,University College Dublin,Belfield,Dublin 4,Republic of Ireland
| | - K Madigan
- DETECT,Early Intervention for Psychosis Service,Blackrock,Dublin,Republic of Ireland
| | - A Staines
- School of Nursing and Human Services,Dublin City University,Dublin,Republic of Ireland
| | - E O'Callaghan
- Department of Psychiatry,School of Medicine,University College Dublin,Belfield,Dublin 4,Republic of Ireland
| | - M Clarke
- Department of Psychiatry,School of Medicine,University College Dublin,Belfield,Dublin 4,Republic of Ireland
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18
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Virgo-Milton M, Boak R, Hoare A, Gold L, Waters E, Gussy M, Calache H, O'Callaghan E, de Silva AM. An exploration of the views of Australian mothers on promoting child oral health. Aust Dent J 2016; 61:84-92. [PMID: 25892487 DOI: 10.1111/adj.12332] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND An important role for parents and caregivers in the prevention of dental caries in children is the early establishment of health promoting behaviours. This study aimed to examine mothers' views on barriers and facilitators to promoting child and family oral health. METHODS Semi-structured interviews were undertaken with a purposive sample of mothers (n = 32) of young children. Inductive thematic analysis was conducted. RESULTS Parental knowledge and beliefs, past experiences and child behaviour emerged as major influences on children's oral health. Child temperament and parental time pressures were identified as barriers to good oral health with various strategies reported for dealing with uncooperative children at toothbrushing time. Parental oral health knowledge and beliefs emerged as positive influences on child oral health; however, while most mothers were aware of the common causes of dental caries, very few knew of other risk factors such as bedtime feeding. Parents' own oral health experiences were also seen to positively influence child oral health, regardless of whether these were positive or negative experiences. CONCLUSIONS Understanding parental oral health beliefs is essential to overcoming barriers and promoting enablers for good child oral health. Improving child oral health also requires consideration of child behaviour, family influences, and increasing awareness of lesser-known influencing factors.
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Affiliation(s)
- M Virgo-Milton
- Jack Brockhoff Child Health and Wellbeing Program, Academic Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - R Boak
- Jack Brockhoff Child Health and Wellbeing Program, Academic Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - A Hoare
- Jack Brockhoff Child Health and Wellbeing Program, Academic Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - L Gold
- Deakin Health Economics, Deakin Population Health Social Research Centre, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - E Waters
- Jack Brockhoff Child Health and Wellbeing Program, Academic Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - M Gussy
- Department of Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - H Calache
- Dental Health Services Victoria, Carlton, Victoria, Australia.,Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
| | - E O'Callaghan
- Jack Brockhoff Child Health and Wellbeing Program, Academic Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - A M de Silva
- Dental Health Services Victoria, Carlton, Victoria, Australia.,Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
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19
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O'Donoghue B, Fanning F, Lyne J, Renwick L, Madigan K, Kinsella A, Lane A, Turner N, O'Callaghan E, Clarke M. Social class at birth and risk of psychosis. Int J Soc Psychiatry 2015; 61:768-76. [PMID: 25897057 DOI: 10.1177/0020764015581434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Individuals with psychotic disorders are represented more in the lower social classes, yet there is conflicting evidence to whether these individuals drift into the lower social classes or whether lower social class is a risk factor for developing psychosis. The aim of this study was to examine whether the social class at birth is a risk factor for developing psychosis. METHODS We included individuals with a first episode of psychosis (FEP) whose social class at birth was determined from birth records. We employed a case-control study design and also compared the distribution of the social classes at birth of the cases to that of the general population. RESULTS A total of 380 individuals with an FEP and 760 controls were included in the case-control study. The odds ratio for developing an FEP associated with social class (low vs high) was .62 (95% confidence interval (CI): .46-.85, p < .001), indicating that individuals from a lower social class at birth have a reduced risk of psychosis. Individuals born between 1961 and 1980 with an FEP were more likely to be from a higher social class at birth compared to the general population (60.8% vs 36.7%, χ(2) = 60.85, df = 1, p < .001). However, this association was not observed for those born between 1981 and 1990. CONCLUSION A higher social class at birth is associated with a greater risk for developing a psychotic disorder; however, this effect may show temporal variation.
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Affiliation(s)
- Brian O'Donoghue
- University College Dublin, Dublin, Ireland DETECT Early Intervention for Psychosis Service, Dublin, Ireland Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - Felicity Fanning
- DETECT Early Intervention for Psychosis Service, Dublin, Ireland
| | - John Lyne
- University College Dublin, Dublin, Ireland DETECT Early Intervention for Psychosis Service, Dublin, Ireland
| | - Laoise Renwick
- University College Dublin, Dublin, Ireland DETECT Early Intervention for Psychosis Service, Dublin, Ireland
| | - Kevin Madigan
- DETECT Early Intervention for Psychosis Service, Dublin, Ireland
| | - Anthony Kinsella
- DETECT Early Intervention for Psychosis Service, Dublin, Ireland Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Abbie Lane
- University College Dublin, Dublin, Ireland
| | - Niall Turner
- DETECT Early Intervention for Psychosis Service, Dublin, Ireland
| | - Eadbhard O'Callaghan
- University College Dublin, Dublin, Ireland DETECT Early Intervention for Psychosis Service, Dublin, Ireland
| | - Mary Clarke
- University College Dublin, Dublin, Ireland DETECT Early Intervention for Psychosis Service, Dublin, Ireland
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20
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O’Keeffe D, Turner N, Foley S, Lawlor E, Kinsella A, O'Callaghan E, Clarke M. The relationship between mental health literacy regarding schizophrenia and psychiatric stigma in the Republic of Ireland. J Ment Health 2015; 25:100-8. [DOI: 10.3109/09638237.2015.1057327] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Renwick L, Lyne J, Donoghue BO, Owens L, Doyle R, Hill M, McCarthy E, Pilling M, O'Callaghan E, Clarke M. Prodromal symptoms and remission following first episode psychosis. Schizophr Res 2015; 168:30-6. [PMID: 26187148 DOI: 10.1016/j.schres.2015.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 06/06/2015] [Accepted: 07/01/2015] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Describing the trajectory of prodromal symptoms has obvious appeal in supporting advances towards sub-clinical intervention. Identifying clinical phenomena associated with unfavourable illness outcomes could have greater significance in explaining some heterogeneity within and between psychotic disorders and advancing understanding of pre-psychotic typologies. Few studies have assessed the continuity, if any, between prodromal phases and illness outcome one year after treatment. METHODS We assessed 375 people with first-episode psychosis (FEP) and 215 (57.4%) were seen approximately one year later. We performed factor analysis on prodromal symptom items obtained by interview with families and participants and identified a five-factor solution. We determined whether these factors predicted non-remission from psychosis in the presence of other factors that may predict outcome including premorbid adjustment, duration of prodrome and untreated psychosis (DUP), baseline symptoms and DSM-IV diagnoses. We used random forest classification to predict the most important variables and logistic regression to identify specific predictors. RESULTS We identified five prodromal symptom factors comprising Negative Symptoms, General Psychopathology, Reality Distortion, Strange Ideas and Irritability. Prodromal symptoms did not predict a greater risk of non-remission with the exception of Irritability and this factor was also associated with earlier age at onset, being male and a diagnosis of substance-induced psychosis. Being male, DUP and baseline positive symptoms predicted non-remission at one year. CONCLUSION Prodromal symptoms were not linked with outcome after a year of treatment which could be explained by greater heterogeneity in illness psychopathology which may be more pronounced in broad FEP diagnoses at different stages. It could also be explained by prodromal symptoms exerting greater influence earlier in the course illness.
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Affiliation(s)
- Laoise Renwick
- School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK.
| | - John Lyne
- DETECT Early Psychosis Service, Dublin, Ireland
| | - Brian O Donoghue
- DETECT Early Psychosis Service, Dublin, Ireland; Orygen, The National Centre for Excellence in Youth Mental Health, Melbourne, Australia
| | - Liz Owens
- DETECT Early Psychosis Service, Dublin, Ireland
| | | | | | - Emma McCarthy
- St. John of God Hospital, Dublin, Ireland; School of Nursing, Midwifery & Health Systems, University College Dublin, Ireland
| | - Mark Pilling
- School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK
| | - Eadbhard O'Callaghan
- School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK
| | - Mary Clarke
- DETECT Early Psychosis Service, Dublin, Ireland; St. John of God Hospital, Dublin, Ireland; Department of Psychiatry, University College Dublin, Dublin, Ireland
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22
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O'Donoghue B, Lyne J, Madigan K, Lane A, Turner N, O'Callaghan E, Clarke M. Environmental factors and the age at onset in first episode psychosis. Schizophr Res 2015; 168:106-12. [PMID: 26232243 DOI: 10.1016/j.schres.2015.07.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [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] [Received: 02/26/2015] [Revised: 06/09/2015] [Accepted: 07/04/2015] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Factors that influence the age at onset in psychotic disorders could provide valuable insights into precipitating or causative factors of the disorder. Despite being established risk factors, it is not yet known whether migration status, place of birth, social class at birth and season of birth influence the age at onset of psychotic disorders. This study aimed to determine whether these environmental factors, in addition to cannabis abuse and obstetric complications, influence the age at onset. Additionally, we investigated whether environmental factors could have a cumulative effect on the age at onset. METHOD Data was obtained from two first episode of psychosis (FEP) cohort studies. Diagnosis was established using the Structured Clinical Interview for DSM IV diagnoses. RESULTS The age at onset was determined for 555 individuals with a FEP and the median age at onset was 27.3years. Individuals with a history of cannabis abuse had an earlier age at onset by nearly six years. There was a trend for a history of obstetric complications to be associated with a younger age at onset by 2.7years and this was significant in the subgroup with a family history of psychosis. Social class at birth, migration status, place of birth and season of birth were not associated with the age at onset. Exposure to a higher number of environmental factors was associated with an earlier age at onset. CONCLUSIONS Cannabis and obstetric complications are associated with an earlier age at onset and there appears to be a cumulative effect of exposure to multiple environmental factors.
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Affiliation(s)
- Brian O'Donoghue
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.
| | - John Lyne
- DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland; University College Dublin, Belfield, Dublin 4, Ireland.
| | - Kevin Madigan
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Institute of Leadership, Royal College of Surgeons, Ireland.
| | - Abbie Lane
- University College Dublin, Belfield, Dublin 4, Ireland.
| | - Niall Turner
- DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland.
| | - Eadbhard O'Callaghan
- DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland; University College Dublin, Belfield, Dublin 4, Ireland
| | - Mary Clarke
- DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland; University College Dublin, Belfield, Dublin 4, Ireland.
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23
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Lyne J, Renwick L, O'Donoghue B, Kinsella A, Malone K, Turner N, O'Callaghan E, Clarke M. Negative symptom domain prevalence across diagnostic boundaries: The relevance of diagnostic shifts. Psychiatry Res 2015; 228:347-54. [PMID: 26162655 DOI: 10.1016/j.psychres.2015.05.086] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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] [Received: 09/27/2014] [Revised: 04/26/2015] [Accepted: 05/20/2015] [Indexed: 11/20/2022]
Abstract
Negative symptoms are included in diagnostic manuals as part of criteria for schizophrenia spectrum psychoses only, however some studies have found their presence in other diagnoses. This study sought to clarify negative symptom domain prevalence across diagnostic categories, while investigating whether negative symptoms predicted diagnostic shift over time. Scale for the Assessment of Negative Symptoms (SANS) data were collected at first presentation in 197 individuals presenting with first episode psychosis and again at one year follow-up assessment. Negative symptoms were highest among individuals with schizophrenia and among those whose diagnosis shifted from non-schizophrenia spectrum at baseline to schizophrenia spectrum at follow-up. In a non-schizophrenia spectrum group negative symptoms at baseline were not a significant predictor of diagnostic shift to schizophrenia spectrum diagnoses. The study suggests negative symptoms can present among individuals with non-schizophrenia spectrum diagnoses, although this is most relevant for individuals following diagnostic shift from non-schizophrenia spectrum to schizophrenia spectrum diagnoses. The findings support introduction of a negative symptom dimension when describing a range of psychotic illnesses, and indicate that further research investigating the evolution of negative symptoms in non-schizophrenia diagnoses is needed.
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Affiliation(s)
- John Lyne
- Dublin and East Treatment and Early Care Team (DETECT) Services, Blackrock, Co. Dublin, Ireland; College of Life Sciences, University College Dublin, Belfield, Dublin 4, Ireland; Centre for Support and Training in Analysis and Research (CSTAR), University College Dublin, Belfield, Dublin 4, Ireland; The School of Psychotherapy, St. Vincent's University Hospital/School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Laoise Renwick
- Dublin and East Treatment and Early Care Team (DETECT) Services, Blackrock, Co. Dublin, Ireland; College of Life Sciences, University College Dublin, Belfield, Dublin 4, Ireland; Centre for Support and Training in Analysis and Research (CSTAR), University College Dublin, Belfield, Dublin 4, Ireland; The School of Psychotherapy, St. Vincent's University Hospital/School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Brian O'Donoghue
- Dublin and East Treatment and Early Care Team (DETECT) Services, Blackrock, Co. Dublin, Ireland; College of Life Sciences, University College Dublin, Belfield, Dublin 4, Ireland; Centre for Support and Training in Analysis and Research (CSTAR), University College Dublin, Belfield, Dublin 4, Ireland; The School of Psychotherapy, St. Vincent's University Hospital/School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Anthony Kinsella
- Dublin and East Treatment and Early Care Team (DETECT) Services, Blackrock, Co. Dublin, Ireland; Centre for Support and Training in Analysis and Research (CSTAR), University College Dublin, Belfield, Dublin 4, Ireland; The School of Psychotherapy, St. Vincent's University Hospital/School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Kevin Malone
- Centre for Support and Training in Analysis and Research (CSTAR), University College Dublin, Belfield, Dublin 4, Ireland; The School of Psychotherapy, St. Vincent's University Hospital/School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; Department of Psychiatry, Psychotherapy and Mental Health Research, St. Vincent's University Hospital/School of Medicine and Medical Science, University College Dublin, Elm Park, Dublin 4, Ireland
| | - Niall Turner
- Dublin and East Treatment and Early Care Team (DETECT) Services, Blackrock, Co. Dublin, Ireland; Centre for Support and Training in Analysis and Research (CSTAR), University College Dublin, Belfield, Dublin 4, Ireland; The School of Psychotherapy, St. Vincent's University Hospital/School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Eadbhard O'Callaghan
- Dublin and East Treatment and Early Care Team (DETECT) Services, Blackrock, Co. Dublin, Ireland; Centre for Support and Training in Analysis and Research (CSTAR), University College Dublin, Belfield, Dublin 4, Ireland; The School of Psychotherapy, St. Vincent's University Hospital/School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; St. John of God Community Services Ltd., Blackrock, Co. Dublin, Ireland
| | - Mary Clarke
- Dublin and East Treatment and Early Care Team (DETECT) Services, Blackrock, Co. Dublin, Ireland; Centre for Support and Training in Analysis and Research (CSTAR), University College Dublin, Belfield, Dublin 4, Ireland; The School of Psychotherapy, St. Vincent's University Hospital/School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; St. John of God Community Services Ltd., Blackrock, Co. Dublin, Ireland
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Turner N, O'Mahony P, Hill M, Fanning F, Larkin C, Waddington J, O'Callaghan E, Clarke M. Work life after psychosis: A detailed examination. Work 2015; 51:143-52. [DOI: 10.3233/wor-141865] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Niall Turner
- DETECT Early Intervention for Psychosis Service, Dublin, Ireland
- Department of Occupational Therapy, Trinity College Dublin, Dublin, Ireland
| | - Paul O'Mahony
- Department of Occupational Therapy, Trinity College Dublin, Dublin, Ireland
| | - Michelle Hill
- DETECT Early Intervention for Psychosis Service, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Felicity Fanning
- DETECT Early Intervention for Psychosis Service, Dublin, Ireland
| | - Conall Larkin
- DETECT Early Intervention for Psychosis Service, Dublin, Ireland
| | | | - Eadbhard O'Callaghan
- DETECT Early Intervention for Psychosis Service, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Mary Clarke
- DETECT Early Intervention for Psychosis Service, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
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Sheridan AJ, Drennan J, Coughlan B, O'Keeffe D, Frazer K, Kemple M, Alexander D, Howlin F, Fahy A, Kow V, O'Callaghan E. Improving social functioning and reducing social isolation and loneliness among people with enduring mental illness: Report of a randomised controlled trial of supported socialisation. Int J Soc Psychiatry 2015; 61:241-50. [PMID: 25001267 DOI: 10.1177/0020764014540150] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND This randomised controlled trial examined if for people with enduring mental illness, being supported to socialise leads to improved social functioning, increased self-esteem and extended social networks; a reduction in social isolation, social, emotional and family loneliness and a reduction in illness symptoms, namely depression. METHODS A prospective randomised controlled trial was undertaken from November 2007 to September 2011. Service users with a diagnosis of enduring mental illness (>18 years) were invited to participate. Participants were randomly allocated to intervention or control group conditions in a 1:1 ratio. Intervention group participants were matched with a volunteer partner, asked to engage in social/leisure activities for 2 hours weekly over a 9-month period, and received a €20 stipend monthly. Control group participants received a €20 monthly stipend and were asked to engage in a weekly social/leisure activity. Social functioning, the primary outcome, was measured using the Social Functioning Scale (SFS) at three time points (baseline, midpoint and endpoint). FINDINGS In all, 107 people completed this study. There were no significant differences between control and intervention groups at the commencement of the intervention on demographic characteristics or the main outcome measures of interest. Overall social functioning positively changed throughout the three time points from a mean of 99·7 (standard deviation (SD) = 15.1) at baseline, to a mean of 106.0 (SD = 27.0) at the endpoint for the control group, and from a mean of 100·4 (SD = 15.0) at Time 1 for the intervention group, to a mean of 104.1 (SD = 23.4) at the endpoint for the intervention group. CONCLUSIONS The intervention showed no statistical differences between the control and intervention groups on primary or secondary outcome measures. The stipend and the stipend plus volunteer partner led to an increase in recreational social functioning; a decrease in levels of social loneliness, in depression and in the proportion living within a vulnerable social network.
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Affiliation(s)
- Ann J Sheridan
- UCD School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - Jonathan Drennan
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Barbara Coughlan
- UCD School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | | | - Kate Frazer
- UCD School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - Mary Kemple
- UCD School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | | | - Frances Howlin
- UCD School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - Anne Fahy
- UCD School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - Veronica Kow
- UCD School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - Eadbhard O'Callaghan
- DETECT Early Intervention Services, Dublin, Ireland UCD School of Medicine and Medical Science, Health Sciences Centre, University College Dublin, Dublin, Ireland
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Amezdroz E, Carpenter L, O'Callaghan E, Johnson S, Waters E. Transition from milks to the introduction of solid foods across the first 2 years of life: findings from an Australian birth cohort study. J Hum Nutr Diet 2015; 28:375-83. [PMID: 25891532 PMCID: PMC5054912 DOI: 10.1111/jhn.12313] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The current literature regarding the transition from milks to solid foods across the first 2 years of life is limited despite the important influence of early dietary intake on children's growth and development. The present study describes dietary intake from birth to 2 years across four developmental relevant time-points within an Australian birth cohort. METHODS Dietary data from 466 infants was collected at four time-points in the first 2 years of life via parent-reported questionnaire, including a 45-item food and beverage frequency questionnaire. Subsample analyses of children who were aged 1-3, 6-8, 12-14 and 18-20 months at the time of data collection were conducted. RESULTS Infant formula remained consistently consumed by over 75% of children from the 6-8- to 18-20 months old age groups. Mean (SD) age of introduction to solid foods was 5.2 (1.3) months. Almost 20% and 10% of children were introduced before 16 and after 32 weeks, respectively. The highest consumption of core foods, recommended for a healthy diet, daily was seen in the 12-14 months old age group with lower proportions in the 18-20 months old age group coinciding with an increased proportion of children eating discretionary choice foods, not recommended for a healthy diet. Discretionary choice foods/beverages presented in children's diets as early as in the 6-8 months old age group. By 18-20 months, at least 20% of children were consuming savoury biscuits, sweet biscuits, muesli bars and luncheon meats at least twice a week. CONCLUSIONS The present study identified a number of findings outside the recommendations of the Australian Dietary and Infant Feeding Guidelines. Further work is warranted to explore these outcomes.
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Affiliation(s)
- E Amezdroz
- Jack Brockhoff Child Health & Wellbeing Program, Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - L Carpenter
- Jack Brockhoff Child Health & Wellbeing Program, Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - E O'Callaghan
- Jack Brockhoff Child Health & Wellbeing Program, Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - S Johnson
- Jack Brockhoff Child Health & Wellbeing Program, Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - E Waters
- Jack Brockhoff Child Health & Wellbeing Program, Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, VIC, Australia
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Young E, Pugh R, Hanlon R, O'Callaghan E, Wright C, Jeanrenaud P, Jones TM. Tracheal stenosis following percutaneous dilatational tracheostomy using the single tapered dilator: an MRI study. Anaesth Intensive Care 2014; 42:745-51. [PMID: 25342407 DOI: 10.1177/0310057x1404200610] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite widespread adoption of percutaneous dilatational tracheostomy within the critical care setting, there is still uncertainty regarding long-term complications, particularly in relation to missed or subclinical tracheal stenosis. In this study, all patients underwent tracheostomy using a single tapered dilator ≥ three months prior to enrollment and were evaluated using magnetic resonance imaging, spirometry and questionnaire. Tracheal area was recorded and deemed to be stenotic if a reduction of ≥10% was found. Fifty patients underwent magnetic resonance imaging and 49 attended for interview. Five patients were diagnosed with tracheal stenosis-none were symptomatic. Six of the 50 tracheostomies were technically difficult. Spirometry was not predictive of stenosis. A post critical care exercise tolerance of less than 100 metres was found in four tracheal stenosis patients. The prevalence of subclinical tracheal stenosis following percutaneous tracheostomy is low, with limited clinical significance. No patients required corrective surgery for tracheal stenosis. Routine airway follow-up in asymptomatic patients appears to be unwarranted.
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Affiliation(s)
- E Young
- Department of Critical Care, Aintree University Hospital, NHS Foundation Trust, Liverpool, United Kingdom
| | - R Pugh
- Department of Critical Care, Aintree University Hospital, NHS Foundation Trust, Liverpool, United Kingdom
| | - R Hanlon
- Department of Radiology, Aintree University Hospital, NHS Foundation Trust, Liverpool, United Kingdom
| | - E O'Callaghan
- Department of Critical Care, Aintree University Hospital, NHS Foundation Trust, Liverpool, United Kingdom
| | - C Wright
- Department of Critical Care, Aintree University Hospital, NHS Foundation Trust, Liverpool, United Kingdom
| | - P Jeanrenaud
- Department of Critical Care, Aintree University Hospital, NHS Foundation Trust, Liverpool, United Kingdom
| | - T M Jones
- Department of Critical Care, Aintree University Hospital, NHS Foundation Trust, Liverpool, United Kingdom
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McWilliams S, Kinsella A, O'Callaghan E. Daily weather variables and affective disorder admissions to psychiatric hospitals. Int J Biometeorol 2014; 58:2045-2057. [PMID: 24599495 DOI: 10.1007/s00484-014-0805-9] [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] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Revised: 12/17/2013] [Accepted: 02/12/2014] [Indexed: 06/03/2023]
Abstract
Numerous studies have reported that admission rates in patients with affective disorders are subject to seasonal variation. Notwithstanding, there has been limited evaluation of the degree to which changeable daily meteorological patterns influence affective disorder admission rates. A handful of small studies have alluded to a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (heat waves in particular), wind direction and sunshine. We used the Kruskal-Wallis test, ARIMA and time-series regression analyses to examine whether daily meteorological variables--namely wind speed and direction, barometric pressure, rainfall, hours of sunshine, sunlight radiation and temperature--influence admission rates for mania and depression across 12 regions in Ireland over a 31-year period. Although we found some very weak but interesting trends for barometric pressure in relation to mania admissions, daily meteorological patterns did not appear to affect hospital admissions overall for mania or depression. Our results do not support the small number of papers to date that suggest a link between daily meteorological variables and affective disorder admissions. Further study is needed.
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Turner N, Foley SR, Kinsella A, O'Callaghan E, Clarke M. Putting television's portrayal of schizophrenia into reverse: an evaluation of the impact on public opinion. Early Interv Psychiatry 2014; 8:366-74. [PMID: 23773257 DOI: 10.1111/eip.12056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Accepted: 05/04/2013] [Indexed: 11/28/2022]
Abstract
AIM We examined whether it is possible to use a television programme to improve mental health literacy about schizophrenia by investigating the impact of the introduction of a realistic portrayal of schizophrenia into a popular television soap opera. METHOD A population level omnibus survey method was used. A market research company conducted face-to-face interviews with a representative sample of the Irish population (n = 993). A specifically developed questionnaire was used which included a question on the extent to which the relevant television programme was watched. A grouping variable 'viewers/non-viewers' was then created. Groups were subsequently compared for differences in demographic characteristics, mental health literacy and attitudes towards schizophrenia. RESULTS Of the sample, 370 were regarded as viewers. When compared, viewers and non-viewers did not differ on demographic characteristics but there were significant differences between the groups in both knowledge and attitudes regarding schizophrenia. Viewers were better informed on where to go for help and were more optimistic regarding the likelihood of recovery. However, on a question regarding willingness to have an intimate relationship with someone with a previous history of mental illness, viewers had greater concerns than non-viewers. CONCLUSION It is possible to use television dramas to educate the public about mental illnesses. Piloting of the educational material may offer an opportunity to refine the storyline so that the relevant messages are clearly communicated.
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O'Donoghue B, Lyne J, Kinsella A, Turner N, O'Callaghan E, Clarke M. Detection and characteristics of individuals with a very long duration of untreated psychosis in an early intervention for psychosis service. Early Interv Psychiatry 2014; 8:332-9. [PMID: 23786447 DOI: 10.1111/eip.12063] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 05/04/2013] [Indexed: 12/01/2022]
Abstract
AIM Early intervention (EI) services for psychosis aim to reduce the duration of untreated psychosis (DUP) with intensive large-scale multi-focus initiatives, including public awareness campaigns. As a consequence of this approach, individuals with a very long DUP who might have otherwise remained undiagnosed may come to medical attention. The aim of this study was to investigate if an EI service detected additional cases of individuals with a first-episode psychosis (FEP) with a very long DUP and identify demographic and clinical characteristics associated with a very long DUP. METHODS We compared the distribution of the DUP in cases with FEP in a cohort from an EI service in a geographically defined catchment area with a historical control group. Participants were interviewed using the Structured Clinical Interview for DSM IV (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) diagnoses and the Beiser scale to determine the DUP. RESULTS A total of 172 individuals were included in the EI service and 151 were included from the historical control. There was no difference in the distribution of the DUP in the EI service compared with the historical control group (χ(2) = 3.77, degrees of freedom (d.f.) = 3, P = 0.29). In the EI service, 7.6% of cases had a DUP between 24 and 35.9 months compared to 3.3% in the historical control, and 13.4% of cases in the EI service had a DUP of greater than three years compared to 10.6% in the historical control. A very long DUP was associated with unemployment, less insight and involuntary treatment. CONCLUSION Further examination of the pathways to care in cases with a long DUP may clarify the contribution of help-seeking and health system delays for these individuals.
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Affiliation(s)
- Brian O'Donoghue
- DETECT, Early Intervention in Psychosis Service, Dublin, Ireland
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31
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O'Donoghue B, Lyne JP, Fanning F, Kinsella A, Lane A, Turner N, O'Callaghan E, Clarke M. Social class mobility in first episode psychosis and the association with depression, hopelessness and suicidality. Schizophr Res 2014; 157:8-11. [PMID: 24924403 DOI: 10.1016/j.schres.2014.05.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 05/01/2014] [Accepted: 05/18/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Psychotic disorders are associated with a significant impairment in occupational functioning that can begin in the prodromal phase of the disorder. As a result, individuals with a psychotic disorder may not maintain their social class at birth. The aim of this study was to examine the distribution of the social classes of individuals presenting with a first episode of psychosis (FEP) compared to the general population and to their family of origin. We evaluated whether social drift was associated with depression, hopelessness and suicidality at first presentation. METHODS All individuals with a FEP presenting to a community mental health service between 1995 and 1999 and to an early intervention service between 2005 and 2011were included. Diagnosis was established using the Structured Clinical Interview for DSM IV diagnoses and clinical evaluations included the Calgary Depression Scale for Schizophrenia, Beck Hopelessness Scale and the Suicidal Intent Scale. RESULTS 330 individuals were included in the study and by the time of presentation, individuals with a FEP were more likely to be represented in the lower social classes compared to the general population. 43% experienced a social drift and this was associated with a diagnosis of a non-affective disorder, co-morbid cannabis abuse and a longer DUP. Individuals who did not experience a social drift had a higher risk of hopelessness. CONCLUSIONS Social drift is common in psychotic disorders; however, individuals who either maintain their social class or experience upward social class mobility are more susceptible to hopelessness.
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Affiliation(s)
- Brian O'Donoghue
- University College Dublin, Belfield, Dublin 4, Ireland; DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland.
| | - John P Lyne
- University College Dublin, Belfield, Dublin 4, Ireland; DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland.
| | - Felicity Fanning
- DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland.
| | - Anthony Kinsella
- DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland; Department of Psychiatry, Royal College of Surgeons, 123 St Stephen's Green, Dublin 2, Ireland.
| | - Abbie Lane
- University College Dublin, Belfield, Dublin 4, Ireland.
| | - Niall Turner
- DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland.
| | - Eadbhard O'Callaghan
- University College Dublin, Belfield, Dublin 4, Ireland; DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland
| | - Mary Clarke
- University College Dublin, Belfield, Dublin 4, Ireland; DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland; St John of God Hospitaller Services, Stillorgan, Co Dublin, Ireland.
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32
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Morris DW, Pearson RD, Cormican P, Kenny EM, O'Dushlaine CT, Perreault LPL, Giannoulatou E, Tropea D, Maher BS, Wormley B, Kelleher E, Fahey C, Molinos I, Bellini S, Pirinen M, Strange A, Freeman C, Thiselton DL, Elves RL, Regan R, Ennis S, Dinan TG, McDonald C, Murphy KC, O'Callaghan E, Waddington JL, Walsh D, O'Donovan M, Grozeva D, Craddock N, Stone J, Scolnick E, Purcell S, Sklar P, Coe B, Eichler EE, Ophoff R, Buizer J, Szatkiewicz J, Hultman C, Sullivan P, Gurling H, Mcquillin A, St Clair D, Rees E, Kirov G, Walters J, Blackwood D, Johnstone M, Donohoe G, O'Neill FA, Kendler KS, Gill M, Riley BP, Spencer CCA, Corvin A. An inherited duplication at the gene p21 Protein-Activated Kinase 7 (PAK7) is a risk factor for psychosis. Hum Mol Genet 2014; 23:3316-26. [PMID: 24474471 PMCID: PMC4030770 DOI: 10.1093/hmg/ddu025] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 12/24/2013] [Accepted: 01/20/2014] [Indexed: 12/14/2022] Open
Abstract
Identifying rare, highly penetrant risk mutations may be an important step in dissecting the molecular etiology of schizophrenia. We conducted a gene-based analysis of large (>100 kb), rare copy-number variants (CNVs) in the Wellcome Trust Case Control Consortium 2 (WTCCC2) schizophrenia sample of 1564 cases and 1748 controls all from Ireland, and further extended the analysis to include an additional 5196 UK controls. We found association with duplications at chr20p12.2 (P = 0.007) and evidence of replication in large independent European schizophrenia (P = 0.052) and UK bipolar disorder case-control cohorts (P = 0.047). A combined analysis of Irish/UK subjects including additional psychosis cases (schizophrenia and bipolar disorder) identified 22 carriers in 11 707 cases and 10 carriers in 21 204 controls [meta-analysis Cochran-Mantel-Haenszel P-value = 2 × 10(-4); odds ratio (OR) = 11.3, 95% CI = 3.7, ∞]. Nineteen of the 22 cases and 8 of the 10 controls carried duplications starting at 9.68 Mb with similar breakpoints across samples. By haplotype analysis and sequencing, we identified a tandem ~149 kb duplication overlapping the gene p21 Protein-Activated Kinase 7 (PAK7, also called PAK5) which was in linkage disequilibrium with local haplotypes (P = 2.5 × 10(-21)), indicative of a single ancestral duplication event. We confirmed the breakpoints in 8/8 carriers tested and found co-segregation of the duplication with illness in two additional family members of one of the affected probands. We demonstrate that PAK7 is developmentally co-expressed with another known psychosis risk gene (DISC1) suggesting a potential molecular mechanism involving aberrant synapse development and plasticity.
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Affiliation(s)
- Derek W Morris
- Department of Psychiatry and Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Richard D Pearson
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Paul Cormican
- Department of Psychiatry and Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Elaine M Kenny
- Department of Psychiatry and Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Colm T O'Dushlaine
- Broad Institute and Center for Human Genetics Research of Massachusetts General Hospital, Boston, MA 02142, USA
| | - Louis-Philippe Lemieux Perreault
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK Montreal Heart Institute, Université de Montréal, Montréal, Québec H1T 1C8, Canada
| | - Eleni Giannoulatou
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Daniela Tropea
- Department of Psychiatry and Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Brion S Maher
- Departments of Psychiatry and Human Genetics, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Brandon Wormley
- Departments of Psychiatry and Human Genetics, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Eric Kelleher
- Department of Psychiatry and Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Ciara Fahey
- Department of Psychiatry and Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Ines Molinos
- Department of Psychiatry and Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Stefania Bellini
- Department of Psychiatry and Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Matti Pirinen
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Amy Strange
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Colin Freeman
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Dawn L Thiselton
- Departments of Psychiatry and Human Genetics, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Rachel L Elves
- Departments of Psychiatry and Human Genetics, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Regina Regan
- School of Medicine and Medical Science, University College Dublin, Ireland
| | - Sean Ennis
- School of Medicine and Medical Science, University College Dublin, Ireland
| | - Timothy G Dinan
- Department of Psychiatry, University College Cork, Cork, Ireland
| | - Colm McDonald
- Department of Psychiatry, National University of Ireland, Galway, University Road, Galway, Ireland
| | - Kieran C Murphy
- Department of Psychiatry, RCSI Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Eadbhard O'Callaghan
- DETECT Early Intervention in Psychosis Services, Dun Laoghaire, Co. Dublin, Ireland
| | - John L Waddington
- Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Dermot Walsh
- Health Research Board, 73 Lower Baggot St, Dublin 2, Ireland
| | - Michael O'Donovan
- MRC Centre for Neuropsychiatric Genetics and Genomics, and Neuroscience and Mental Health Research Institute, Cardiff University, Heath Park, Cardiff CF4 4XN, UK
| | - Detelina Grozeva
- MRC Centre for Neuropsychiatric Genetics and Genomics, and Neuroscience and Mental Health Research Institute, Cardiff University, Heath Park, Cardiff CF4 4XN, UK
| | - Nick Craddock
- MRC Centre for Neuropsychiatric Genetics and Genomics, and Neuroscience and Mental Health Research Institute, Cardiff University, Heath Park, Cardiff CF4 4XN, UK
| | - Jennifer Stone
- Broad Institute and Center for Human Genetics Research of Massachusetts General Hospital, Boston, MA 02142, USA
| | - Ed Scolnick
- Broad Institute and Center for Human Genetics Research of Massachusetts General Hospital, Boston, MA 02142, USA
| | - Shaun Purcell
- Broad Institute and Center for Human Genetics Research of Massachusetts General Hospital, Boston, MA 02142, USA The Mount Sinai Hospital, New York, NY 10029, USA
| | - Pamela Sklar
- Broad Institute and Center for Human Genetics Research of Massachusetts General Hospital, Boston, MA 02142, USA The Mount Sinai Hospital, New York, NY 10029, USA
| | - Bradley Coe
- University of Washington School of Medicine, Howard Hughes Medical Institute, Seattle, WA 98195, USA
| | - Evan E Eichler
- University of Washington School of Medicine, Howard Hughes Medical Institute, Seattle, WA 98195, USA
| | - Roel Ophoff
- Department of Human Genetics, UCLA School of Medicine, Los Angeles, CA 90095, USA
| | - Jacobine Buizer
- Rudolf Magnus Institute, University of Utrecht, 3584 CG Utrecht, Netherlands
| | - Jin Szatkiewicz
- University of North Carolina, Chapel Hill, NC 27599-7264, USA
| | - Christina Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | | | - Hugh Gurling
- Molecular Psychiatry Laboratory, Mental Health Sciences Unit, University College London, London WC1E 6BT, UK
| | - Andrew Mcquillin
- Molecular Psychiatry Laboratory, Mental Health Sciences Unit, University College London, London WC1E 6BT, UK
| | - David St Clair
- Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK
| | - Elliott Rees
- MRC Centre for Neuropsychiatric Genetics and Genomics, and Neuroscience and Mental Health Research Institute, Cardiff University, Heath Park, Cardiff CF4 4XN, UK
| | - George Kirov
- MRC Centre for Neuropsychiatric Genetics and Genomics, and Neuroscience and Mental Health Research Institute, Cardiff University, Heath Park, Cardiff CF4 4XN, UK
| | - James Walters
- MRC Centre for Neuropsychiatric Genetics and Genomics, and Neuroscience and Mental Health Research Institute, Cardiff University, Heath Park, Cardiff CF4 4XN, UK
| | - Douglas Blackwood
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh EH10 5HF, UK and
| | - Mandy Johnstone
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh EH10 5HF, UK and
| | - Gary Donohoe
- Department of Psychiatry and Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Francis A O'Neill
- Department of Psychiatry, Queen's University, Belfast BT7 1NN, Northern Ireland
| | - Kenneth S Kendler
- Departments of Psychiatry and Human Genetics, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Michael Gill
- Department of Psychiatry and Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Brien P Riley
- Departments of Psychiatry and Human Genetics, Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Chris C A Spencer
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Aiden Corvin
- Department of Psychiatry and Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin 2, Ireland
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Omer S, Kirkbride JB, Pringle DG, Russell V, O'Callaghan E, Waddington JL. Neighbourhood-level socio-environmental factors and incidence of first episode psychosis by place at onset in rural Ireland: the Cavan-Monaghan First Episode Psychosis Study [CAMFEPS]. Schizophr Res 2014; 152:152-7. [PMID: 24342585 PMCID: PMC3906531 DOI: 10.1016/j.schres.2013.11.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Revised: 10/31/2013] [Accepted: 11/12/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Little is known about associations between the social environment and risk for psychosis within rural settings. This study sought to investigate whether such associations exist within a rural context using a prospective dataset of unusual epidemiological completeness. METHOD Using the Cavan-Monaghan First Episode Psychosis Study database of people aged 16 years and older, both ecological analyses and multilevel modelling were applied to investigate associations between incidence of psychosis by place at onset and socio-environmental risk factors of material deprivation, social fragmentation and urban-rural classification across electoral divisions. RESULTS The primary finding was an association between more deprived social contexts and higher rates of psychotic disorder, after adjustment for age and sex [all psychoses: incidence rate ratio (IRR)=1.12, 95% CI (1.03-1.23)]. CONCLUSIONS These findings support an association between adverse socio-environmental factors and increase in risk for psychosis by place at onset within a predominantly rural environment. This study suggests that social environmental characteristics may have an impact on risk across the urban-rural gradient.
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Affiliation(s)
- Sami Omer
- Department of Psychiatry, College of Medicine, University of Dammam, Saudi Arabia; Cavan-Monaghan Mental Health Service, Cavan Hospital, Cavan, Ireland; Molecular & Cellular Therapeutics and 3U Partnership, Royal College of Surgeons in Ireland, Dublin, Ireland.
| | | | - Dennis G. Pringle
- Department of Geography and 3U Partnership, National University of Ireland Maynooth, Maynooth, Ireland
| | - Vincent Russell
- Cavan–Monaghan Mental Health Service, Cavan Hospital, Cavan, Ireland,Department of Psychiatry and 3U Partnership, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | | | - John L. Waddington
- Cavan–Monaghan Mental Health Service, Cavan Hospital, Cavan, Ireland,Molecular & Cellular Therapeutics and 3U Partnership, Royal College of Surgeons in Ireland, Dublin, Ireland
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Lyne J, Renwick L, Grant T, Kinsella A, McCarthy P, Malone K, Turner N, O'Callaghan E, Clarke M. Scale for the Assessment of Negative Symptoms structure in first episode psychosis. Psychiatry Res 2013; 210:1191-7. [PMID: 24094608 DOI: 10.1016/j.psychres.2013.09.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 09/06/2013] [Accepted: 09/10/2013] [Indexed: 11/29/2022]
Abstract
Previous studies in schizophrenia samples suggest negative symptoms can be categorized as expressivity or experiential. This study examines the structure of the Scale for the Assessment of Negative Symptoms (SANS) at two separate interviews in a first episode psychosis (FEP) sample. SANS structure was determined with principal components analysis in a schizophrenia spectrum (SSD, N=191) and non-schizophrenia spectrum (NSSD, N=246) sample at first presentation. Confirmatory factor analysis (CFA) was conducted in the entire FEP sample (N=197) at a follow-up assessment. A three factor model solution was extracted in both SSD and NSSD at first presentation. The three components, consisting of expressivity, experiential and alogia/inattention components, explained 26.1%, 16.6% and 13.6% of the variance respectively in SSD. In NSSD the same three components explained 24.2%, 17.9% and 13.1% of the variance respectively. CFA at follow-up showed similar model fit for both the original SANS five factor and for a three factor model solution. The results indicate that either a three or five factor SANS model solution may be appropriate in a psychosis sample inclusive of both SSD and NSSD. The findings also provide initial support for expressivity and experiential domain research in NSSD.
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Affiliation(s)
- John Lyne
- Dublin and East Treatment and Early Care Team (DETECT) Services, Blackrock, Co. Dublin, Ireland; College of Life Sciences, University College Dublin, Belfield, Dublin 4, Ireland.
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35
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Kingston T, Scully PJ, Browne DJ, Baldwin PA, Kinsella A, Russell V, O'Callaghan E, Waddington JL. Diagnostic trajectory, interplay and convergence/divergence across all 12 DSM-IV psychotic diagnoses: 6-year follow-up of the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS). Psychol Med 2013; 43:2523-2533. [PMID: 23480983 DOI: 10.1017/s003329171300041x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The boundaries of psychotic illness and the extent to which operational diagnostic categories are distinct in the long term remain poorly understood. Clarification of these issues requires prospective evaluation of diagnostic trajectory, interplay and convergence/divergence across psychotic illness, without a priori diagnostic or other restrictions. METHOD The Cavan-Monaghan First Episode Psychosis Study (CAMFEPS), conducted using methods to attain the closest approximation to epidemiological completeness, incepts all 12 DSM-IV psychotic diagnoses. In this study we applied methodologies to achieve diagnostic reassessments on follow-up, at a mean of 6.4 years after first presentation, for 196 (97%) of the first 202 cases, with quantification of prospective and retrospective consistency. RESULTS Over 6 years, the 12 initial psychotic diagnoses were characterized by numerous transitions but only limited convergence towards a smaller number of more stable diagnostic nodes. In particular, for initial brief psychotic disorder (BrP), in 85% of cases this was the harbinger of long-term evolution to serious psychotic illness of diagnostic diversity; for initial major depressive disorder with psychotic features (MDDP), in 18% of cases this was associated with mortality of diverse causality; and for initial psychotic disorder not otherwise specified (PNOS), 31% of cases continued to defy DSM-IV criteria. CONCLUSIONS CAMFEPS methodology revealed, on an individual case basis, a diversity of stabilities in, and transitions between, all 12 DSM-IV psychotic diagnoses over 6 years; thus, psychotic illness showed longitudinal disrespect to current nosology and may be better accommodated by a dimensional model. In particular, a first episode of BrP or MDDP may benefit from more vigorous, sustained interventions.
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Affiliation(s)
- T Kingston
- Cavan-Monaghan Mental Health Service, St Davnet's Hospital, Monaghan, and Cavan General Hospital, Cavan, Ireland
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36
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McWilliams S, Kinsella A, O'Callaghan E. The effects of daily weather variables on psychosis admissions to psychiatric hospitals. Int J Biometeorol 2013; 57:497-508. [PMID: 22855350 DOI: 10.1007/s00484-012-0575-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 07/01/2012] [Accepted: 07/03/2012] [Indexed: 06/01/2023]
Abstract
Several studies have noted seasonal variations in admission rates of patients with psychotic illnesses. However, the changeable daily meteorological patterns within seasons have never been examined in any great depth in the context of admission rates. A handful of small studies have posed interesting questions regarding a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (especially heat waves) and sunshine. In this study, we used simple non-parametric testing and more complex ARIMA and time-series regression analysis to examine whether daily meteorological patterns (wind speed and direction, barometric pressure, rainfall, sunshine, sunlight and temperature) exert an influence on admission rates for psychotic disorders across 12 regions in Ireland. Although there were some weak but interesting trends for temperature, barometric pressure and sunshine, the meteorological patterns ultimately did not exert a clinically significant influence over admissions for psychosis. Further analysis is needed.
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Madigan K, Brennan D, Lawlor E, Turner N, Kinsella A, O'Connor JJ, Russell V, Waddington JL, O'Callaghan E. A multi-center, randomized controlled trial of a group psychological intervention for psychosis with comorbid cannabis dependence over the early course of illness. Schizophr Res 2013. [PMID: 23187069 DOI: 10.1016/j.schres.2012.10.018] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND 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. AIMS We undertook a multi-center, randomized controlled trial of a group psychological intervention for psychosis with comorbid cannabis dependence to determine whether there was any impact on cannabis use symptoms, global functioning, insight, attitudes to treatment and subjective quality of life. METHOD Across three centers, we compared a group psychological intervention, based on cognitive behavioral therapy and motivational interviewing, with treatment as usual among patients experiencing their first psychotic episode or early in the course of psychotic illness. Substance misuse and indices of clinical outcome were assessed at baseline, 3months and 1year. RESULTS At 3month and 1year follow-ups, there was no evidence for an intervention effect on cannabis use, symptoms, global functioning insight or attitude to treatment. However, the intervention improved subjective quality of life at 3months and this effect was sustained at 1year. CONCLUSIONS 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.
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Affiliation(s)
- Kevin Madigan
- 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.
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Fanning F, Foley S, Lawlor E, McWilliams S, Jackson D, Renwick L, Sutton M, Turner N, Kinsella A, Trimble T, O'Callaghan E. Group cognitive behavioural therapy for first episode psychosis: who's referred, who attends and who completes it? Early Interv Psychiatry 2012; 6:432-41. [PMID: 22240156 DOI: 10.1111/j.1751-7893.2011.00333.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM Most national guidelines recommend psychological therapy for people with first-episode psychosis (FEP) but interventions proven effective in randomized control trials (RCTs) conducted in research settings do not always translate effectively to real-world clinical environments. In a limited health system, it is important to understand the system and patient barriers to participation in effective treatment. We sought to determine what patient characteristics influenced clinicians' decision to refer or not to refer to group cognitive behavioural therapy for FEP and what characteristics were associated with those referred attending/not attending and adhering/not adhering to the programme. METHODS Between 2006 and 2008, all cases of confirmed FEP from a defined geographical region were examined using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnoses, the Scale for Assessment of Positive Symptoms, Scale for Assessment of Negative Symptoms, Calgary Depression Scale for Schizophrenia and Birchwood Insight Scale. Duration of untreated psychosis was established using the Beiser Scale. RESULTS Of the 124 (77 males, 47 females) people in the final sample, 88 (72%) were referred for cognitive behavioural therapy (CBT), 52 (59%) attended and 12 (23%) did not complete CBT. Those with higher levels of insight into the need for treatment (U = 740.00, z = -2.63, P = 0.008) and higher levels of positive symptoms (t (120) = -3.064, P = 0.003) were more likely to be referred to CBT. Those with higher educational attainment (χ(2) = 9.48, P = 0.03) and fewer negative symptoms, particularly in relation to global attention (t (85) = 2.32, P = 0.03), were more likely to attend and complete CBT. CONCLUSION Within an early intervention service for FEP, it appears that individuals with less education, more negative symptoms and less insight experienced significant barriers to successfully completing group CBT. More information for referring clinicians about the benefits of CBT for FEP could help increase referral rates. Assertive outreach for people at risk of disengaging or non-adherence should also be considered.
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Affiliation(s)
- Felicity Fanning
- DETECT, Early Intervention in Psychosis Service, Dublin, Ireland.
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Hill M, Crumlish N, Clarke M, Whitty P, Owens E, Renwick L, Browne S, Macklin EA, Kinsella A, Larkin C, Waddington JL, O'Callaghan E. Prospective relationship of duration of untreated psychosis to psychopathology and functional outcome over 12 years. Schizophr Res 2012; 141:215-21. [PMID: 23006501 DOI: 10.1016/j.schres.2012.08.013] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 08/16/2012] [Accepted: 08/17/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND 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. METHODS The authors examined the relationship between duration of untreated psychosis and outcome 12years after a first episode of psychosis and assessed whether its relationship with function is affected by symptoms in a prospective, 12-year follow-up of an epidemiologically-based inception cohort. RESULTS Longer duration of untreated psychosis predicted poorer remission status, more severe positive and negative symptoms, and greater impairment in general functioning, social functioning and quality of life at 12years on standardised measures, independent of other factors at baseline. It was not associated with gainful employment, for which education was the only predictor, or independent living, for which age was the only predictor. The relationship between duration of untreated psychosis and functional outcome was mediated by concurrent psychopathology, particularly negative symptoms. CONCLUSIONS 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.
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Affiliation(s)
- Michele Hill
- Cluain Mhuire Family Centre, St John of God Adult Psychiatric Service, Co., Dublin, Ireland.
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Sloan D, Browne S, Meagher D, Lane A, Larkin C, Casey P, Walsh N, O'Callaghan E. Attitudes toward psychiatry among Irish final year medical students. Eur Psychiatry 2012; 11:407-11. [PMID: 19698492 DOI: 10.1016/s0924-9338(97)82579-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/1996] [Accepted: 04/22/1996] [Indexed: 10/18/2022] Open
Abstract
This study investigated the attitudes of medical students towards psychiatry, both as a subject on the medical curriculum and as a career choice. Three separate questionnaires previously validated on medical student populations were administered prior to and immediately following an 8-week clinical training programme. The results indicate that the perception of psychiatry was positive prior to clerkship and became even more so on completion of training. On completion of the clerkship, there was a rise in the proportion of students who indicated that they might choose a career in psychiatry. Attitudes toward psychiatry correlated positively with the psychiatry examination results. Those that intended to specialise in psychiatry achieved significantly higher examination scores in the psychiatry examination.
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Affiliation(s)
- D Sloan
- Department of Psychiatry, University College Dublin, and St Vincent 's Hospital, Elm Park, Dublin 4, Ireland
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Cummings E, Donohoe G, Hargreaves A, Moore S, Fahey C, Dinan TG, McDonald C, O'Callaghan E, O'Neill FA, Waddington JL, Murphy KC, Morris DW, Gill M, Corvin A. Mood congruent psychotic symptoms and specific cognitive deficits in carriers of the novel schizophrenia risk variant at MIR-137. Neurosci Lett 2012; 532:33-8. [PMID: 22982201 DOI: 10.1016/j.neulet.2012.08.065] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [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: 06/19/2012] [Revised: 08/03/2012] [Accepted: 08/09/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The Schizophrenia Psychiatric Genome-wide Association (GWAS) Consortium recently reported on five novel schizophrenia susceptibility loci. The most significant finding mapped to a micro-RNA, MIR-137, which may be involved in regulating the function of other schizophrenia and bipolar disorder susceptibility genes. METHOD We genotyped 821 patients with confirmed DSM-IV diagnoses of schizophrenia, bipolar affective disorder I and schizoaffective disorder for the risk SNP (rs1625579) and investigated the clinical profiles of risk allele carriers using a within-case design. We also assessed neurocognitive performance in a subset of cases (n=399) and controls (n=171). RESULTS Carriers of the risk allele had lower scores for an OPCRIT-derived positive symptom factor (p=0.04) and lower scores on a lifetime measure of psychosis incongruity (p=0.017). Risk allele carriers also had more cognitive deficits involving episodic memory and attentional control. CONCLUSION This is the first evidence that the MIR-137 risk variant may be associated with a specific subgroup of psychosis patients. Although the effect of this single SNP was not clinically relevant, investigation of the impact of carrying multiple risk SNPs in the MIR-137 regulatory network on diagnosis and illness profile may be warranted.
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Affiliation(s)
- E Cummings
- Dept of Psychiatry & Neuropsychiatric Genetics Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin 2, Ireland
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Fayolle G, Levick W, Lajiness-O'Neill R, Fastenau P, Briskin S, Bass N, Silva M, Critchfield E, Nakase-Richardson R, Hertza J, Loughan A, Perna R, Northington S, Boyd S, Anderson A, Peery S, Chafetz M, Maris M, Ramezani A, Sylvester C, Goldberg K, Constantinou M, Karekla M, Hall J, Edwards M, Balldin V, Strutt A, Pavlik V, Marquez de la Plata C, Cullum M, lacritz L, Reisch J, Massman P, Royall D, Barber R, Younes S, Wiechmann A, O'Bryant S, Patel K, Suhr J, Patel K, Suhr J, Chari S, Yokoyama J, Bettcher B, Karydas A, Miller B, Kramer J, Zec R, Fritz S, Kohlrus S, Robbs R, Ala T, Gifford K, Cantwell N, Romano R, Jefferson A, Holland A, Newton S, Bunting J, Coe M, Carmona J, Harrison D, Puente A, Terry D, Faraco C, Brown C, Patel A, Watts A, Kent A, Siegel J, Miller S, Ernst W, Chelune G, Holdnack J, Sheehan J, Duff K, Pedraza O, Crawford J, Terry D, Puente A, Brown C, Faraco C, Watts A, Patel A, Kent A, Siegel J, Miller L, Younes S, Hobson Balldin V, Benavides H, Johnson L, Hall J, Tshuma L, O'Bryant S, Dezhkam N, Hayes L, Love C, Stephens B, Webbe F, Allen C, Lemann E, Davis A, Pierson E, Lutz J, Piehl J, Holler K, Kavanaugh B, Tayim F, Llanes S, Mulligan K, Poston K, Riccio C, Beathard J, Cohen M, Stolberg P, Hart J, Jones W, Mayfield J, Allen D, Weller J, Dunham K, Demireva P, McInerney K, Suhr J, Dykstra J, Riddle T, Suhr J, Primus M, Riccio C, Highsmith J, Everhart D, Shadi S, Lehockey K, Sullivan S, Lucas M, Mandava S, Murphy B, Donovick P, Lalwani L, Rosselli M, Coad S, Carrasco R, Sofko C, Scarisbrick D, Golden C, Coad S, Zuckerman S, Golden C, Perna R, Loughan A, Hertza J, Brand J, Rivera Mindt M, Denney R, Schaffer S, Alper K, Devinsky O, Barr W, Langer K, Fraiman J, Scagliola J, Roman E, Martinez A, Cohen M, Dunham K, Riccio C, Martin P, Robbins J, Golden C, Axelrod B, Etherton J, Konopacki K, Moses J, Juliano A, Whiteside D, Rolin S, Widmann G, Franzwa M, Sokal B, Mark V, Doyle K, Morgan E, Weber E, Bondi M, Delano-Wood L, Grant I, Sibson J, Woods S, Andrews P, McGregor S, Golden C, Etherton J, Allen C, Cormier R, Cumley N, Elek M, Green M, Ogbeide S, Kruger A, Pacheco L, Robinson G, Welch H, Etherton J, Allen C, Cormier R, Cumley N, Kruger A, Pacheco L, Glover M, Parriott D, Jones W, Loe S, Hughes L, Natta L, Moses J, Vincent A, Roebuck-Spencer T, Bryan C, Padua M, Denney R, Moses J, Quenicka W, McGoldirck K, Bennett T, Soper H, Collier S, Connolly M, Hanratty A, Di Pinto M, Magnuson S, Dunham K, Handel E, Davidson K, Livers E, Frantz S, Allen J, Jerard T, Moses J, Pierce S, Sakhai S, Newton S, Warchol A, Holland A, Bunting J, Coe M, Carmona J, Harrison D, Barney S, Thaler N, Sutton G, Strauss G, Allen D, Hunter B, Bennett T, Quenicka W, McGoldrick K, Soper H, Sordahl J, Torrence N, John S, Gavett B, O'Bryant S, Shadi S, Denney R, Nichols C, Riccio C, Cohen M, Dennison A, Wasserman T, Schleicher-Dilks S, Adler M, Golden C, Olivier T, Schleicher-Dilks S, Golden C, LeMonda B, McGinley J, Pritchett A, Chang L, Cloak C, Cunningham E, Lohaugen G, Skranes J, Ernst T, Parke E, Thaler N, Etcoff L, Allen D, Andrews P, McGregor S, Golden C, Northington S, Daniels R, Loughan A, Perna R, Hertza J, Hochsztein N, Miles-Mason E, Granader Y, Vasserman M, MacAllister W, Casto B, Peery S, Patrick K, Hurewitz F, Chute D, Booth A, Koch C, Roid G, Balkema N, Kiefel J, Bell L, Maerlender A, Belkin T, Katzenstein J, Semerjian C, Culotta V, Band E, Yosick R, Burns T, Arenivas A, Bearden D, Olson K, Jacobson K, Ubogy S, Sterling C, Taub E, Griffin A, Rickards T, Uswatte G, Davis D, Sweeney K, Llorente A, Boettcher A, Hill B, Ploetz D, Kline J, Rohling M, O'Jile J, Holler K, Petrauskas V, Long J, Casey J, Long J, Petrauskas V, Duda T, Hodsman S, Casey J, Stricker S, Martner S, Hansen R, Ferraro F, Tangen R, Hanratty A, Tanabe M, O'Callaghan E, Houskamp B, McDonald L, Pick L, Guardino D, Pick L, Pietz T, Kayser K, Gray R, Letteri A, Crisologo A, Witkin G, Sanders J, Mrazik M, Harley A, Phoong M, Melville T, La D, Gomez R, Berthelson L, Robbins J, Lane E, Golden C, Rahman P, Konopka L, Fasfous A, Zink D, Peralta-Ramirez N, Perez-Garcia M, Puente A, Su S, Lin G, Kiely T, Gomez R, Schatzberg A, Keller J, Dykstra J, Suhr J, Feigon M, Renteria L, Fong M, Piper L, Lee E, Vordenberg J, Contardo C, Magnuson S, Doninger N, Luton L, Balkema N, Drane D, Phelan A, Stricker W, Poreh A, Wolkenberg F, Spira J, Lin G, Su S, Kiely T, Gomez R, Schatzberg A, Keller J, DeRight J, Jorgensen R, Fitzpatrick L, Crowe S, Woods S, Doyle K, Weber E, Cameron M, Cattie J, Cushman C, Grant I, Blackstone K, Woods S, Weber E, Grant I, Moore D, Roberg B, Somogie M, Thelen J, Lovelace C, Bruce J, Gerstenecker A, Mast B, Litvan I, Hargrave D, Schroeder R, Buddin W, Baade L, Heinrichs R, Thelen J, Roberg B, Somogie M, Lovelace C, Bruce J, Boseck J, Berry K, Koehn E, Davis A, Meyer B, Gelder B, Sussman Z, Espe-Pfeifer P, Musso M, Barker A, Jones G, Gouvier W, Weber E, Woods S, Grant I, Johnson V, Zaytsev L, Freier-Randall M, Sutton G, Thaler N, Ringdahl E, Allen D, Olsen J, Byrd D, Rivera-Mindt M, Fellows R, Morgello S, Wheaton V, Jaehnert S, Ellis C, Olavarria H, Loftis J, Huckans M, Pimental P, Frawley J, Welch M, Jennette K, Rinehardt E, Schoenberg M, Strober L, Genova H, Wylie G, DeLuca J, Chiaravalloti N, Hertza J, Loughan A, Perna R, Northington S, Boyd S, Hertza J, Loughan A, Perna R, Northington S, Boyd S, Ibrahim E, Seiam A, Ibrahim E, Bohlega S, Rinehardt E, Lloyd H, Goldberg M, Marceaux J, Fallows R, McCoy K, Yehyawi N, Luther E, Hilsabeck R, Fulton R, Stevens P, Erickson S, Dodzik P, Williams R, Dsurney J, Najafizadeh L, McGovern J, Chowdhry F, Acevedo A, Bakhtiar A, Karamzadeh N, Amyot F, Gandjbakhche A, Haddad M, Taub E, Johnson M, Wade J, Harper L, Rickards T, Sterling C, Barghi A, Uswatte G, Mark V, Balkema N, Christopher G, Marcus D, Spady M, Bloom J, Wiechmann A, Hall J, Loughan A, Perna R, Hertza J, Northington S, Zimmer A, Webbe F, Miller M, Schuster D, Ebner H, Mortimer B, Webbe F, Palmer G, Happe M, Paxson J, Jurek B, Graca J, Meyers J, Lange R, Brickell T, French L, Lange R, Iverson G, Shewchuk J, Madler B, Heran M, Brubacher J, Brickell T, Lange R, Ivins B, French L, Baldassarre M, Paper T, Herrold A, Chin A, Zgaljardic D, Oden K, Lambert M, Dickson S, Miller R, Plenger P, Jacobson K, Olson K, Sutherland E, Glatts C, Schatz P, Walker K, Philip N, McClaughlin S, Mooney S, Seats E, Carnell V, Raintree J, Brown D, Hodges C, Amerson E, Kennedy C, Moore J, Schatz P, Ferris C, Roebuck-Spencer T, Vincent A, Bryan C, Catalano D, Warren A, Monden K, Driver S, Chau P, Seegmiller R, Baker M, Malach S, Mintz J, Villarreal R, Peterson A, Leininger S, Strong C, Donders J, Merritt V, Vargas G, Rabinowitz A, Arnett P, Whipple E, Schultheis M, Robinson K, Iacovone D, Biester R, Alfano D, Nicholls M, Vargas G, Rabinowitz A, Arnett P, Rabinowitz A, Vargas G, Arnett P, Klas P, Jeffay E, Zakzanis K, Vandermeer M, Jeffay E, Zakzanis K, Womble M, Rohling M, Hill B, Corley E, Considine C, Fichtenberg N, Harrison J, Pollock M, Mouanoutoua A, Brimager A, Lebby P, Sullivan K, Edmed S, Silva M, Nakase-Richardson R, Critchfield E, Kieffer K, McCarthy M, Wiegand L, Lindsey H, Hernandez M, Puente A, Noniyeva Y, Lapis Y, Padua M, Poole J, Brooks B, McKay C, Mrazik M, Meeuwisse W, Emery C, Brooks B, Mazur-Mosiewicz A, Sherman E, Brooks B, Mazur-Mosiewicz A, Kirkwood M, Sherman E, Gunner J, Miele A, Silk-Eglit G, Lynch J, McCaffrey R, Stewart J, Tsou J, Scarisbrick D, Chan R, Bure-Reyes A, Cortes L, Gindy S, Golden C, Hunter B, Biddle C, Shah D, Jaberg P, Moss R, Horner M, VanKirk K, Dismuke C, Turner T, Muzzy W, Dunnam M, Miele A, Warner G, Donnelly K, Donnelly J, Kittleson J, Bradshaw C, Alt M, Margolis S, Ostroy E, Rolin S, Higgins K, Denney R, Rolin S, Eng K, Biddle C, Akeson S, Wall J, Davis J, Hansel J, Hill B, Rohling M, Wang B, Womble M, Gervais R, Greiffenstein M, Denning J, Denning J, Schroeder R, Buddin W, Hargrave D, VonDran E, Campbell E, Brockman C, Heinrichs R, Baade L, Buddin W, Hargrave D, Schroeder R, Teichner G, Waid R, Buddin W, Schroeder R, Teichner G, Waid R, Buican B, Armistead-Jehle P, Bailie J, Dilay A, Cottingham M, Boyd C, Asmussen S, Neff J, Schalk S, Jensen L, DenBoer J, Hall S, DenBoer J, Schalk S, Jensen L, Hall S, Miele A, Lynch J, McCaffrey R, Holcomb E, Axelrod B, Demakis G, Rimland C, Ward J, Ross M, Bailey M, Stubblefield A, Smigielski J, Geske J, Karpyak V, Reese C, Larrabee G, Suhr J, Silk-Eglit G, Gunner J, Miele A, Lynch J, McCaffrey R, Allen L, Celinski M, Gilman J, Davis J, Wall J, LaDuke C, DeMatteo D, Heilbrun K, Swirsky-Sacchetti T, Lindsey H, Puente A, Dedman A, Withers K, Chafetz M, Deneen T, Denney R, Fisher J, Spray B, Savage R, Wiener H, Tyer J, Ningaonkar V, Devlin B, Go R, Sharma V, Tsou J, Golden C, Fontanetta R, Calderon C, Coad S, Golden C, Calderon C, Fontaneta R, Coad S, Golden C, Ringdahl E, Thaler N, Sutton G, Vertinski M, Allen D, Verbiest R, Thaler N, Snyder J, Kinney J, Allen D, Rach A, Young J, Crouse E, Schretlen D, Weaver J, Buchholz A, Gordon B, Macciocchi S, Seel R, Godsall R, Brotsky J, DiRocco A, Houghton-Faryna E, Bolinger E, Hollenbeck C, Hart J, Thaler N, Vertinski M, Ringdahl E, Allen D, Lee B, Strauss G, Adams J, Martins D, Catalano L, Waltz J, Gold J, Haas G, Brown L, Luther J, Goldstein G, Kiely T, Kelley E, Lin G, Su S, Raba C, Gomez R, Trettin L, Solvason H, Schatzberg A, Keller J, Vertinski M, Thaler N, Allen D, Gold J, Buchanan R, Strauss G, Baldock D, Ringdahl E, Sutton G, Thaler N, Allen D, Fallows R, Marceaux J, McCoy K, Yehyawi N, Luther E, Hilsabeck R, Etherton J, Phelps T, Richmond S, Tapscott B, Thomlinson S, Cordeiro L, Wilkening G, Parikh M, Graham L, Grosch M, Hynan L, Weiner M, Cullum C, Hobson Balldin V, Menon C, Younes S, Hall J, Strutt A, Pavlik V, Marquez de la Plata C, Cullum M, Lacritz L, Reisch J, Massman P, Royall D, Barber R, O'Bryant S, Castro-Couch M, Irani F, Houshyarnejad A, Norman M, Peery S, Fonseca F, Bure-Reyes A, Browne B, Alvarez J, Jiminez Y, Baez V, Cortes L, Golden C, Fonseca F, Bure-Reyes A, Coad S, Alvarez J, Browne B, Baez V, Golden C, Resendiz C, Scott B, Farias G, York M, Lozano V, Mahoney M, Strutt A, Hernandez Mejia M, Puente A, Bure-Reyes A, Fonseca F, Baez V, Alvarez J, Browne B, Coad S, Jiminez Y, Cortes L, Golden C, Bure-Reyes A, Pacheco E, Homs A, Acevedo A, Ownby R, Nici J, Hom J, Lutz J, Dean R, Finch H, Pierce S, Moses J, Mann S, Feinberg J, Choi A, Kaminetskaya M, Pierce C, Zacharewicz M, Axelrod B, Gavett B, Horwitz J, Edwards M, O'Bryant S, Ory J, Gouvier W, Carbuccia K, Ory J, Carbuccia K, Gouvier W, Morra L, Garcon S, Lucas M, Donovick P, Whearty K, Campbell K, Camlic S, Donovick P, Edwards M, Balldin V, Hall J, Strutt A, Pavlik V, Marquez de la Plata C, Cullum C, Lacritz L, Reisch J, Massman P, Barber R, Royall D, Younes S, O'Bryant S, Brinckman D, Schultheis M, Ehrhart L, Weisser V, Medaglia J, Merzagora A, Reckess G, Ho T, Testa S, Gordon B, Schretlen D, Woolery H, Farcello C, Klimas N, Thaler N, Allen D, Meyer J, Vargas G, Rabinowitz A, Barwick F, Arnett P, Womble M, Rohling M, Hill B, Corley E, Drayer K, Rohling M, Ploetz D, Womble M, Hill B, Baldock D, Ringdahl E, Sutton G, Thaler N, Allen D, Galusha J, Schmitt A, Livingston R, Stewart R, Quarles L, Pagitt M, Barke C, Baker A, Baker N, Cook N, Ahern D, Correia S, Resnik L, Barnabe K, Gnepp D, Benjamin M, Zlatar Z, Garcia A, Harnish S, Crosson B, Rickards T, Mark V, Taub E, Sterling C, Vaughan L, Uswatte G, Fedio A, Sexton J, Cummings S, Logemann A, Lassiter N, Fedio P, Gremillion A, Nemeth D, Whittington T, Hansen R, Reckow J, Ferraro F, Lewandowski C, Cole J, Lewandowski A, Spector J, Ford-Johnson L, Lengenfelder J, Genova H, Sumowski J, DeLuca J, Chiaravalloti N, Loughan A, Perna R, Hertza J, Morse C, McKeever J, Zhao L, Leist T, Schultheis M, Marcinak J, Piecora K, Al-Khalil K, Webbe F, Mulligan K, Robbins J, Berthelson L, Martin P, Golden C, Piecora K, Marcinak J, Al-Khalil K, Webbe F, Mulligan K, Stewart J, Acevedo A, Ownby R, Thompson L, Kowalczyk W, Golub S, Davis A, Lemann E, Piehl J, Rita N, Moss L, Davis A, Boseck J, Berry K, Koehn E, Meyer B, Gelder B, Davis A, Nogin R, Moss L, Drapeau C, Malm S, Davis A, Lemann E, Koehn E, Drapeau C, Malm S, Boseck J, Armstrong L, Glidewell R, Orr W, Mears G. Grand Rounds. Arch Clin Neuropsychol 2012. [DOI: 10.1093/arclin/acs070] [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: 11/15/2022] Open
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O'Donoghue B, Lyne J, Renwick L, Madigan K, Kinsella A, Clarke M, Turner N, O'Callaghan E. A descriptive study of 'non-cases' and referral rates to an early intervention for psychosis service. Early Interv Psychiatry 2012; 6:276-82. [PMID: 22240056 DOI: 10.1111/j.1751-7893.2011.00328.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM Despite there being approximately 200 early intervention services for psychosis worldwide, little is known about the referral rates to these services, the diagnoses and needs of individuals found not to have a first episode of psychosis (FEP). Firstly, we aimed to describe the diagnoses for individuals who were found not to have a FEP (non-cases) following an assessment using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders IV (SCID). We then aimed to examine the referral rates of cases and non-cases to an early intervention service. METHODS All individuals referred to the early intervention service underwent a clinical assessment using the SCID. RESULTS In a 4-year period, there were 632 referrals to the early intervention service for psychosis, and of these, 53% (n = 338) were found to have a FEP, 5% (n = 34) were found to have an at-risk mental state for psychosis and 41% (n = 260) were found to be 'non-cases'. This represents a ratio of 1.9:1 of referrals to cases, or approximately 2:1. Of the non-cases, 27% (n = 62) satisfied criteria for a mood disorder, with major depressive disorder the commonest diagnosis. A further 18% (n = 42) of non-cases satisfied criteria for an anxiety disorder and nearly half of these were diagnosed with social phobia. The ratio of referrals to cases was not consistent over time and rose from 1.3:1 in the first year to 2:1 in the fourth year. CONCLUSION A large proportion of individuals referred to an early intervention for psychosis service were found not to have psychotic disorder, however they still have significant needs regarding their mental health.
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Affiliation(s)
- Brian O'Donoghue
- DETECT, Early Intervention in Psychosis Service, Blackrock, County Dublin, Ireland.
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Renwick L, Jackson D, Foley S, Owens E, Ramperti N, Behan C, Anwar M, Kinsella A, Turner N, Clarke M, O'Callaghan E. Depression and quality of life in first-episode psychosis. Compr Psychiatry 2012; 53:451-5. [PMID: 21871616 DOI: 10.1016/j.comppsych.2011.07.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 06/22/2011] [Accepted: 07/06/2011] [Indexed: 10/17/2022] Open
Abstract
AIM 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. METHODS We assessed 208 individuals with first-episode non-affective psychosis using measures of diagnosis (Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), symptoms (Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, and Calgary Depression Scale for Schizophrenia), functioning (Global Assessment of Functioning), insight (Birchwood Scale), duration of untreated psychosis (Beiser Scale), and QOL World Health Organisation Quality of Life Instrument (WHOQOL-Bref). We used multiple regression to determine the contribution of depressive symptoms to QOL domains while controlling for socio-demographic and other clinical characteristics. RESULTS There were complete data for 146 individuals with FEP. Quality-of-life domains were consistently predicted by depressive symptoms including depressive mood and hopelessness rather than biological symptoms of depression with those experiencing more depressive symptoms reporting worse QOL. Those who were treated as in-patients reported improved QOL, and hospitalization was an independent predictor of most QOL domains. In-patients displayed greater levels of positive symptoms with those involuntarily detained displaying greater levels of bizarre behavior, thought disorder, and delusions. CONCLUSIONS 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.
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Lyne J, O'Donoghue B, Owens E, Renwick L, Madigan K, Kinsella A, Clarke M, Turner N, O'Callaghan E. Prevalence of item level negative symptoms in first episode psychosis diagnoses. Schizophr Res 2012; 135:128-33. [PMID: 22281102 DOI: 10.1016/j.schres.2012.01.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 12/14/2011] [Accepted: 01/04/2012] [Indexed: 11/27/2022]
Abstract
UNLABELLED 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.
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Affiliation(s)
- John Lyne
- DETECT Services, Avila House, Block 5 Blackrock Business Park, Blackrock, Co Dublin, Ireland.
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O'Donoghue B, Lyne J, Hill M, O'Rourke L, Daly S, Larkin C, Feeney L, O'Callaghan E. Perceptions of involuntary admission and risk of subsequent readmission at one-year follow-up: the influence of insight and recovery style. J Ment Health 2011; 20:249-59. [PMID: 21574790 DOI: 10.3109/09638237.2011.562263] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Involuntary admission is one of the most ethically challenging practices in medicine, yet we are only beginning to learn more about the patient's perspective. AIMS To investigate (i) peoples' perception of the necessity of their involuntary admission at one year after discharge (ii) readmission rates to hospital and the influence of insight and recovery style. METHODS We interviewed individuals admitted involuntarily at one year following discharge using the Mac Arthur Admission Experience Interview, Birchwood Insight Scale, the Drug Attitude Inventory, Global Assessment of Functioning and the Recovery Style Questionnaire. RESULTS Sixty-eight people (84%) were re-interviewed at one year and fewer (60%) reported that their involuntary admission had been necessary when compared to inception (72%). Of the 33% that changed their views, most reflected negatively on their involuntary admission. We found that insight was moderately associated with the acknowledgement that the involuntary admission was necessary. Within a year, 43% were readmitted to hospital and half of these admissions were involuntary. Individuals with a sealing over recovery style were at four times the risk of involuntary readmission. CONCLUSIONS Peoples' perception of the necessity of their involuntary admissions is not stable over time and risk of involuntary readmission is associated with recovery style.
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Affiliation(s)
- Brian O'Donoghue
- St John of God/ St Vincents University Hospital Postgraduate Training Scheme in Psychiatry, Dublin, Ireland.
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Gaynor K, Dooley B, Lawlor E, Lawoyin R, O'Callaghan E. Group cognitive behavioural therapy as a treatment for negative symptoms in first-episode psychosis. Early Interv Psychiatry 2011; 5:168-73. [PMID: 21535424 DOI: 10.1111/j.1751-7893.2011.00270.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM We aimed to test the idea that there is an early critical time period during a psychotic illness when patients may be more responsive to psychological treatment attention. METHODS We tested this hypothesis by comparing the treatment responsiveness to group cognitive behavioural therapy (CBT) of 25 first-episode psychosis participants (FEP) and 15 patients with currently stable psychosis (n = 40). RESULTS Following 12 sessions of outpatient-based group CBT, there were significant decreases in positive, depressive and anxiety symptoms, and an improvement in quality of life for both groups. However, negative symptoms only improved in the FEP group. CONCLUSION Considering the pernicious nature of negative symptoms as well as the difficulties in treating them, this study provides some support for the concept of early intervention with CBT.
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Affiliation(s)
- Keith Gaynor
- Schools of Psychology, University College Dublin Cluain Mhuire Service, Blackrock, Ireland.
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Madigan K, Egan P, Brennan D, Hill S, Maguire B, Horgan F, Flood C, Kinsella A, O'Callaghan E. A randomised controlled trial of carer-focussed multi-family group psychoeducation in bipolar disorder. Eur Psychiatry 2011; 27:281-4. [PMID: 21334858 DOI: 10.1016/j.eurpsy.2010.12.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Revised: 12/15/2010] [Accepted: 12/16/2010] [Indexed: 12/12/2022] Open
Abstract
In a RCT of family psychoeducation, 47 carers of 34 patients were allocated to one of three groups; Multifamily Group Psychoeducation, Solution Focussed Group Therapy or Treatment as Usual. Carers in both the MFGP intervention and the SFGP arm demonstrated greater knowledge and reduction in burden than those in the TAU arm.
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Affiliation(s)
- K Madigan
- Cluain Mhuire Family Centre, Newtownpark Avenue, Blackrock, Co. Dublin and Health Research Board, Dublin 2, Ireland
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Langrick H, Hammell C, O'Callaghan E, Dempsey G. UK practice in management of patients with poor-grade subarachnoid haemorrhage. Crit Care 2011. [PMCID: PMC3066998 DOI: 10.1186/cc9744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Haley C, O'Callaghan E, Hill S, Mannion N, Donnelly B, Kinsella A, Murtagh A, Turner N. Telepsychiatry and carer education for schizophrenia. Eur Psychiatry 2010; 26:302-4. [PMID: 20542666 DOI: 10.1016/j.eurpsy.2009.12.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Revised: 12/21/2009] [Accepted: 12/21/2009] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE Despite the scientific evidence, most families of people with schizophrenia in Europe never receive a carer education programme. We evaluated whether a carer education course delivered by telepsychiatry was as effective as a carer education course delivered in situ. METHOD We delivered the carer education course for schizophrenia simultaneously to a carers group in rural north west Ireland (remote) via three ISDN lines and live to a carers group in a city (host). We compared knowledge gains using the Knowledge Questionnaire before and after each course. RESULTS Fifty-six carers of people with schizophrenia participated in the trial. At baseline, participants at the remote and host centers did not differ in terms of knowledge about schizophrenia. After the course, carers at both centers improved significantly and the knowledge gains between groups were equivalent at 6 weeks. CONCLUSION Telepsychiatry can deliver effective carer education programmes about schizophrenia and may provide one solution to bridging the chasm between scientific evidence and clinical reality.
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Affiliation(s)
- C Haley
- Donegal Mental Health Services, Letterkenny, Co. Donegal, Ireland
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