The prevalence of schizophrenia in Ireland: readdressing the enigma.
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Female↗
Biomedical subjects
A Kinsella
Publications and source records attributed to A Kinsella.
Sequential cross-sectional and 10-year prospective study of severe negative symptoms in relation to duration of initially untreated psychosis in chronic schizophrenia.
Current clinical correlates of duration of initially untreated psychotic symptoms were investigated in a cross-sectional analysis followed by a 10-year prospective study among 88 in-patients with a long-standing schizophrenic illness, many of whom had experienced prolonged periods of untreated psychosis due to illness onset and hospital admission in the pre-neuroleptic era. After controlling for the effects of age, and duration and continuity of subsequent neuroleptic treatment, the primary clinical correlate of duration of initially untreated psychosis was muteness. Over the subsequent 10-year-period, no new cases of muteness emerged and some existing cases of muteness partially resolved, though the speech that emerged remained very sparse and revealed generally gross cognitive debility. The pathophysiology underlying active, unchecked psychosis may also constitute an active morbid process that is associated with the further progression of severe negative symptoms and cognitive dysfunction in the long-term.
Adult↗
Reproductive behaviour in schizophrenia relative to other mental disorders: evidence for increased fertility in men despite decreased marital rate.
Using case register data, the overall marital rate among 5158 patients with mental illness was found to be comparable to the general population. The proportion of those ever married was markedly reduced in the schizophrenic group relative to those with a manic or neurotic illness. Men with schizophrenia had a particularly low rate of marriage. The overall marital fertility of the 3 groups was comparable to each other and appeared to be higher than that in the general population. In the schizophrenic group only, married men, particularly those with a family history of mental disorder, produced more children than married women. Men might represent a more fertile group of schizophrenic patients with some biological advantage of increased fecundity, which may help to compensate for negative selection pressures.
Analysis of Variance↗
Tardive dyskinesia in schizophrenia. Relationship to minor physical anomalies, frontal lobe dysfunction and cerebral structure on magnetic resonance imaging.
BACKGROUND: It was hypothesised that schizophrenic patients with tardive dyskinesia show an excess of neurodevelopmental disturbance, particularly minor physical anomalies, in association with cognitive dysfunction and abnormalities of cerebral structure. METHOD: Forty-seven out-patients with a DSM-III diagnosis of schizophrenia were examined for tardive dyskinesia using the Abnormal Involuntary Movement Scale; they were examined also for minor physical anomalies and neuropsychological test performance. Cortical atrophy, signal hyperintensities and lateral ventricular volume were determined on magnetic resonance imaging. RESULTS: Patients with and without tardive dyskinesia could not be distinguished by age, gender distribution or a number of clinical measures; however, patients with tardive dyskinesia sorted fewer categories on the Wisconsin Card Sorting Test (P = 0.04). Cerebral structure in patients with and without tardive dyskinesia could not be distinguished on magnetic resonance imaging but those with dyskinesia, all of whom showed involvement of the orofacial region, showed more evident minor physical anomalies of the head relative to those of the periphery (P = 0.02). CONCLUSIONS: Tardive orofacial dyskinesia in schizophrenia appears to be associated particularly with poorer frontal lobe function, while predominance of craniofacial dysmorphogenesis may constitute a vulnerability factor that is related to the early origins of the disease process.
Adult↗
Fluid replacements after squash: an analysis of the effects of several fluid regimens on exercise-related metabolic changes.
We studied the effects of several fluid replacements taken after squash on exercise-related metabolic responses. 12 subjects played 5 games and after each game were assigned one of the following, receiving a different one each time: (1) no fluid replacement, or 500 ml of (2) water, (3) electrolyte solution, (4) glucose solution or (5) a glucose/electrolyte 'sports' drink. Circulating levels of lactate, free fatty acids, glucose, potassium, sodium and plasma osmolality were measured at rest and at 5, 15, 30 and 60 min after games. There were significant changes over time for all measured variables (p < 0.001). The only effect of these drinks was by the glucose-containing drinks, which resulted in significant elevation of blood glucose levels (p < 0.001); no effects on circulating electrolyte levels were demonstrated. In conclusion, while fluid replacements may increase glucose levels, electrolyte levels are not affected by drinks which are commonly used after squash.
Adult↗
Cognitive dysfunction in schizophrenia: organic vulnerability factor or state marker for tardive dyskinesia?
The literature on the putative association between cognitive dysfunction in schizophrenia and the presence of tardive dyskinesia is critically reviewed, focusing on potential artifacts and specific relationships to a particular topography of involuntary movements. These issues are exemplified via a study of cognitive function in 64 schizophrenic patients, in which impaired cognitive flexibility was identified as the primary measure distinguishing those with tardive orofacial dyskinesia. The significance of such an association with cognitive dysfunction is considered in relation to competing hypotheses of organic vulnerability to vs. state marker for this movement disorder.
Adult↗
Neck sprains after road traffic accidents: a modern epidemic.
This study was carried out to determine the incidence of soft tissue injuries of the cervical spine after road traffic accidents and to assess whether the incidence had changed with time. The results show that there has been a progressive increase since 1982 in the number of patients seen in accident and emergency departments with a neck sprain after road traffic accidents. The results suggest that the increase is not necessarily due to the introduction of seat belts, but that the relentless increasing epidemic may be due to other factors.
Accidents, Traffic↗
Gender specificity of geographical variation in morbid risk for schizophrenia in rural Ireland.
The morbid risk for schizophrenia was determined separately for men and women within each of 36 contiguous district electoral divisions of a rural Irish county in which all cases of schizophrenia satisfying DSM-III-R criteria had been sought. The distribution of morbid risk values for men (0.0-19.2 per 1000) was in accordance with a statistical model for random occurrences in space, while for women (0.0-38.3 per 1000) it deviated markedly from such a model; thus, morbid risk for schizophrenia showed very prominent geographical variations in women, but not in men. These findings may have a basis in factors that can show both spatial inhomogeneity and gender specificity in their consequences for schizophrenia.
Adult↗
Clinical correlates of distinct topographies of tardive dyskinesia in schizophrenia.
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Antipsychotic Agents↗
Exercise-related potassium and free fatty acid level changes in coronary artery disease. Responses after moderate intensity training.
Exercise produces changes in circulating levels of potassium and free fatty acids which may provoke arrhythmias in patients with coronary artery disease. Twenty patients participating in 6 weeks of training were studied; 9 of these patients took part in 4 more weeks of training and a third exercise test. After 6 weeks, potassium levels were higher at submaximal levels of exercise, free fatty acid levels were reduced at rest, and at 5, 15, and at 30 min post-exercise. Norepinephrine levels were reduced at submaximal work loads after 6 weeks and increased at maximal work loads. The extra 4 weeks had no additive effect on these metabolic changes. Participation by coronary artery disease patients in a short-term, moderate intensity, exercise training program increases potassium levels at submaximal work loads and reduces levels of free fatty acids at rest and after exercise. The arrhythmogenic relevance of these findings deserves further consideration.
Aged↗
Lipids and fatty acids and their relationship to restenosis.
One hundred consecutive patients had fasting lipids and percutaneous fat biopsy performed at the time of percutaneous transluminal coronary angioplasty to determine if there was an association between restenosis and lipids or fatty acids. Angiographic follow-up and complete lipid and fatty acid results were available in 82 patients. Restenosis occurred in 37/82 (45%). Total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, and apolipoproteins A1 and B were not associated with restenosis. There was a significantly lower level of the monounsaturated fat palmitoleic acid (p less than 0.02), a trend towards a lower level of the monounsaturated fat oleic acid (p less than 0.09), and a trend towards a higher level of the saturated fat palmitic acid (p less than 0.08) in the restenosis group. The polyunsaturated fatty acids were not associated with restenosis. We conclude that lipids are not significantly associated with restenosis, and that lower levels of monounsaturated fatty acids may increase the risk of restenosis.
Angina Pectoris↗
Initial investigation of the left temporoparietal region in schizophrenia by 31P magnetic resonance spectroscopy.
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Adult↗
Evidence for geographical variations in the prevalence of schizophrenia in rural Ireland.
Geographical variations in the rate of occurrence of schizophrenia have been the subject of much speculation and controversy, but it has proved extremely difficult to establish the existence of the phenomenon within a given study area. Using current inpatient and outpatient records and information from key informants active in the community, this study sought to identify all cases of schizophrenia in 36 District Electoral Divisions, constituting a clinical catchment area of 25,178 persons in a rural Irish county. Though the overall prevalence rate (3.3 per 1000) was unremarkable, this obscured a substantial and significant variation in prevalence rates (from 0.0 to 14.3 per 1000) between District Electoral Divisions. Prevalence rates in five District Electoral Divisions made particular contributions to the overall deviation from a statistical model for random occurrences in space. The results indicate spatial inhomogeneity in the prevalence of schizophrenia in rural Ireland and imply geographical variation in environmental or genetic factor(s) of etiologic relevance.
Adolescent↗
Familial, obstetric, and other clinical correlates of minor physical anomalies in schizophrenia.
OBJECTIVE: This study investigated possible antecedents of minor physical anomalies in schizophrenia, particularly in terms of obstetric and genetic factors, and demographic, clinical and cognitive correlates of such anomalies in schizophrenia. METHOD: Forty-one outpatients satisfying the DSM-III criteria for schizophrenia were examined for minor physical anomalies by using the Waldrop scale. These subjects were drawn from a group of 45 such patients whose cognitive function had been previously evaluated with Trail Making Tests A and B and whose biological mothers had been interviewed for any history of obstetric complications or family history of schizophrenia. RESULTS: Linear multiple regression analysis showed that higher scores for minor physical anomalies were associated with impaired cognitive flexibility on Trail Making Test B, family history of schizophrenia in a first-degree relative, maternal history of obstetric complications, smaller number of siblings, later position in the birth order, and male sex. A family history of schizophrenia was particularly associated with abnormalities of the mouth. The association between minor physical anomalies in the patients and obstetric complications in their mothers appeared to be confined to instances in which the mother had a history of bleeding in early pregnancy. CONCLUSIONS: Minor physical anomalies indicate early dysmorphogenesis in schizophrenia, particularly in males, which appears to be associated more reliably with genetic rather than obstetric factors and with cognitive impairment.
Adult↗
Risk behaviour for HIV transmission in attenders on methadone maintenance.
Sixty-nine opiate addicts on methadone maintenance programmes at the Drug Treatment Centre were interviewed, all meet DSM. 3 criteria for opioid dependency. Most were young, poorly educated, unemployed and had involvement with both police and prison. Drug abuse started at a young age, all had injected drugs, heroin being the most widely abused opiate. Forty-eight (70%) were HIV (Human Immunodeficiency Virus) positive. Since diagnosis these individuals had made significant changes in their injecting practices and sexual behaviour. However, despite this positive change, there remained a high level of at risk behaviour for further HIV transmission.
Adolescent↗
The measurement of adolescent adaptive processes in the clinical interview.
A study is described measuring the clinical usefulness of Adolescent Adaptive Process Scales. These processes are measured in three groups of adolescents in which psychopathology is also measured using a standardized psychiatric interview. Inter-rater reliability is calculated between two raters and mean score comparisons are made between the groups using the t-test method. In the study a higher inter-rater reliability and some preliminary evidence of construct validity are found for these scales. The findings indicate that these scales could constitute a useful clinical tool in psychotherapy, research and teaching. They also provide scope for future work in the field.
Adaptation, Psychological↗
Prevalence of psychological distress in Irish female adolescents.
Some female adolescents (N = 132) attending two inner city Dublin schools completed the Youth Self Report Questionnaire (YSRQ). Of this group 15.4 per cent obtained a Total Problem Score in the clinical range. A higher proportion, 23 per cent, obtained a score in the clinical range on one or more problem subscales of the YSRQ. No one scored abnormally on the Social or Competence Scales. A number of interesting and thought provoking responses to individual questions were obtained. The possible clinical relevance of these findings and implications for future planning in schools are discussed.
Adolescent↗
Cognitive dysfunction in schizophrenia followed up over 5 years, and its longitudinal relationship to the emergence of tardive dyskinesia.
In this study, 51 chronic schizophrenic in-patients were evaluated for a range of demographic, clinical and medication variables, and followed up over five years. There was no significant overall change in cognitive function in this patient group as a whole, suggesting the absence of active disease at this stage of the illness. The only correlate of individual instances of cognitive deterioration over the study period was the emergence of new cases of tardive buccal-lingual-masticatory but not of limb-truncal dyskinesia, and the greater severity of such movement disorder. A positive family history was also identified prospectively as a predictor of the emergence of tardive dyskinesia in chronic schizophrenia.
Adult↗