Now showing 1 - 10 of 33
  • Publication
    Media and the Coverage of Psychiatry
    (Doctors Academy Group of Educational Establishments, 2014-12) ; ; ;
    Background and aim: Psychiatric issues have often been a focus for the media. Studies have differed in their findings about how the subject matter is portrayed in newspapers.We compared tone and content of Irish print with the British, broadsheets and tabloids, and the coverage of physical and mental illness. Methods: A selection of Irish and British broadsheet and tabloid newspapers were examined page by page by researchers for period of 6 months. Various parameters investigated including who the authors were, commenting on the tone, focus and topic of the articles. A comparison of the parameters between the two countries was made. Results: The total numbers of newspapers studied in six months were 579. In comparison the tone of heading and article was neutral for both Irish and English articles. The tone was more negative (and sensationlist) on tabloids compared to dailies and Sunday newpapers. Predominantly for articles related to mental and physical illnesses tone of headline and article itself was neutral in daily and Sunday broadsheets and dramatic in daily tabloids. Conclusions: To ensure accuracy of information and a more balanced article, we feel more articles should be written by health care professionals themselves, especially for tabloids. Databases now exist where journalists can contact the health care professionals for various illnesses.
  • Publication
    I'm spiritual but not religious : Implications for research and practice
    (SCM Press, 2013-05)
    There is an assumption, amongst some mental health service users, clinicians, researchers and others, that religiousness and spirituality are the same construct. A consideration of the history of these concepts shows that, over time, each has become separated from the other. Both require careful definition. The definitions of spirituality are heterogeneous and, with important implications for research and practice, some encompass mood states. The failure to separate spirituality and religiousness, and the confounding of spirituality with mood states in some research in psychiatry, makes interpretation of the findings difficult. Greater clarity and precision will be required in future research including, if possible, attempts to provide distinctive operational definitions of spirituality and religiousness.                          
  • Publication
    Mental health professionals and information sharing: carer perspectives
    (Springer for Royal Academy of Medicine in Ireland, 2015) ; ; ;
    Background: The important role played by carers of those with mental health problems is frequently undervalued among healthcare professionals. Aims: To identify the difficulties encountered by carers in relation to obtaining information from mental health teams. Methods: Participants in the study included carers or family members of persons with mental illness who were affiliated with a support group in Ireland. Information was gathered using an 18-item self-report questionnaire. This is an amended version of the Carer Well-Being and Support Questionnaire for carers of people with a mental health problem or dementia. Results: One-hundred and fifty-nine carers complete the questionnaire. On average respondents stated that they have been in the role of a carer for someone with a mental health problem for 14.4 years, spending a median of 20-h caring each week. Despite most carers maintaining that they are generally satisfied with the support offered to them from medical and/or care staff, the majority (56.3 %) of respondents stated that they have specifically encountered difficulties accessing information from the treating mental health team. The main reasons given to them by the mental health team for withholding information include: lack of patient consent (46.2 %) and unavailability of a team member (46.2 %). From a carer perspective, respondents stated that the main reason they feel there is difficulty in accessing information is a lack of concern for their role as a carer in the patient's management (60.5 %). More than 75 % of all respondents are afraid of negative consequences for them or for the person in their care as a result of information being withheld by the treating team. Conclusions: Carer involvement is essential for the complete and effective management of individuals with mental illness. Confidentiality should not be used as a reason for completely excluding carers.
      1152Scopus© Citations 9
  • Publication
    Adjustment disorder considered
    (The Royal College of Psychiatrists, 2013) ;
    Adjustment disorder has been included in psychiatric classifications for over 40 years but has received little attention from the research community. It is particularly common in consultation liaison psychiatry. Evaluation is problematic since it may be mistaken for major depression, generalised anxiety or non-pathological reactions to stress. Its measurement by structured interview is difficult since it is not included in many instruments and, in others, cannot be diagnosed once the threshold for another disorder is reached. There are few evidence-based treatments and it is possible that these transient reactions may not require any formal intervention. Adjustment disorder generally carries an excellent prognosis but in some individuals is associated with self-harm and suicide.                         
      637Scopus© Citations 8
  • Publication
    Health service use by adults with depression: community survey in five European countries - Evidence from the ODIN study
    Background: Little is known about patterns of healthcare use by people with depression in Europe. Aims: To examine the use and cost of services by adults with depressive or adjustment disorders in five European countries, and predictive factors. Method: People aged 18-65 years with depressive or adjustment disorders (n=427) in Ireland, Finland, Norway, Spain and the UK provided information on predisposition (demographics, social support), enablement (country, urban/rural, social function) and need (symptom severity, perceived health status) for services. Outcome measures were self-reported use Client Services Receipt Interview and costs of general practice, generic, psychiatric or social services in the past 6 months. Results: Less frequent use was made of generic services in Norway and psychiatric services in the UK. Severity of depression, perceived health status, social functioning and level of social support were significant predictors of use; the number of people able to provide support was positively associated with greater health service use. Conclusions: Individual participant factors provided greater explanatory power than national differences in healthcare delivery. The association between social support and service use suggests that interventions may be needed for those who lack social support.
      475Scopus© Citations 35
  • Publication
    Distinguishing between adjustment disorder and depressive episode in clinical practice: The role of personality disorder
    Background: There is significant symptomatic overlap between diagnostic criteria for adjustment disorder and depressive episode, commonly leading to diagnostic difficulty. Our aim was to clarify the role of personality in making this distinction. Methods: We performed detailed assessments of features of personality disorder, depressive symptoms, social function, social support, life-threatening experiences and diagnosis in individuals with clinical diagnoses of adjustment disorder (n=173) or depressive episode (n=175) presenting at consultation-liaison psychiatry services across 3 sites in Dublin, Ireland. Results: Fifty six per cent of participants with adjustment disorder had likely personality disorder compared with 65% of participants with depressive episode. Compared to participants with depressive episode, those with adjustment disorder had fewer depressive symptoms; fewer problems with social contacts or stress with spare time; and more life events. On multi-variable testing, a clinical diagnosis of adjustment disorder (as opposed to depressive episode) was associated with lower scores for personality disorder and depressive symptoms, and higher scores for life-threatening experiences. Limitations: We used clinical diagnosis as the main diagnostic classification and generalisability may be limited to consultation-liaison psychiatry settings. Conclusions: Despite a substantial rate of likely personality disorder in adjustment disorder, the rate was even higher in depressive episode. Moreover, features of likely personality disorder are more strongly associated with depressive episode than adjustment disorder, even when other distinguishing features (severity of depressive symptoms, life-threatening experiences) are taken into account.
      1411Scopus© Citations 17
  • Publication
    The Role of a Neuropsychiatry Clinic in a Tertiary Referral Teaching Hospital: A Two-Year Study
    Objectives: Mental disorder is common among individuals with neurological illness. We aimed to characterise the patient population referred for psychiatry assessment at a tertiary neurology service in terms of neurological and psychiatric diagnoses and interventions provided. Methods: We studied all individuals referred for psychiatry assessment at a tertiary neurology service over a 2-year period (n= 82). Results: The most common neurological diagnoses among those referred were epilepsy (16%), Parkinson’s disease (15%) and multiple sclerosis (8%). The most common reasons for psychiatric assessment were low mood or anxiety (48%) and medically unexplained symptoms or apparent functional or psychogenic disease (21%). The most common diagnoses among those with mental disorder were mood disorders (62%), and neurotic, stress-related and somatoform disorders, including dissociative (conversion) disorders (28%). Psychiatric diagnosis was not related to gender, neurological diagnosis or psychiatric history. Conclusion: Individuals with neurological illness demonstrate significant symptoms of a range of mental disorders. There is a need for further research into the characteristics and distribution of mental disorder in individuals with neurological illness, and for the enhancement of integrated psychiatric and neurological services to address the comorbidities demonstrated in this population.
  • Publication
    The prevalence of suicidal ideation in the general population: results from the Outcome of Depression International Network (ODIN) study
    (D. Steinkopff-Verlag (Springer), 2008-04) ; ; ;
    Background: Suicidal ideation is believed to be part of a constellation of suicidal behaviours that culminates in suicide. There is little information on the cross-national prevalence of all suicidal ideation or of serious suicidal ideation in spite of its likely public health importance. Methods: A two-stage screening approach of over 12,000 adults from the general population were evaluated by face to face interview to identify those meeting ICD-10 criteria for depressive disorders at eight sites in five European countries. This study is a cross-sectional analysis of item 9 (suicidal ideation) of the Beck depression inventory from the total screened sample. Results: The standardised period prevalence for all suicidal ideation varied from 1.1 to 19.8% while for serious suicidal ideation there was much less variation. Examining the inter-relationships between all suicide ideation, serious suicide ideation, depressive disorders and suicide failed to support a seamless transition from suicide ideation through depression and serious ideation to suicide. Conclusions: Strategies to prevent suicide should be tailored to take account of site specific differences in its aetiology and understanding the path from suicidal ideation through depression to suicide is crucial to this.
      1025Scopus© Citations 78
  • Publication
    Abortion among young women and subsequent life outcomes
    (Elsevier, 2010-08)
    This article will discuss the nature of the association between abortion and mental health problems. Studies arguing about both sides of the debate as to whether abortion per se is responsible will be presented. The prevalence of various psychiatric disorders will be outlined and where there is dispute between studies, these will be highlighted. The impact of abortion on other areas such as education, partner relationships and sexual function will also be considered. The absence of specific interventions will be highlighted. Suggestions for early identification of illness will be made.
      1354Scopus© Citations 15
  • Publication
    Impact of severity and type of depression on quality of life in cases identified in the community
    (Cambridge University Press, 2010) ; ; ; ;
    Background: The impact of different levels of depression severity on quality of life (QoL) is not well studied, particularly regarding ICD-10 criteria. The ICD classification of depressive episodes in three levels of severity is also controversial and the less severe category, mild, has been considered as unnecessary and not clearly distinguishable from non-clinical states. The present work aimed to test the relationship between depression severity according to ICD-10 criteria and several dimensions of functioning as assessed by Medical Outcome Study (MOS) 36-item Short Form general health survey (SF-36) at the population level. Method: A sample of 551 participants from the second phase of the Outcome of Depression International Network (ODIN) study (228 controls without depression and 313 persons fulfilling ICD criteria for depressive episode) was selected for a further assessment of several variables, including QoL related to physical and mental health as measured with the SF-36. Results: Statistically significant differences between controls and the depression group were found in both physical and mental markers of health, regardless of the level of depression severity; however, there were very few differences in QoL between levels of depression as defined by ICD-10. Regardless of the presence of depression, disability, widowed status, being a woman and older age were associated with worse QoL in a structural equation analysis with covariates. Likewise, there were no differences according to the type of depression (single-episode versus recurrent). Conclusions: These results cast doubt on the adequacy of the current ICD classification of depression in three levels of severity.
      708Scopus© Citations 11