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Biomedical subjects

Brendan D Kelly

Publications and source records attributed to Brendan D Kelly.

18 recordsLinked to original sources
PubMed2006

Can adjustment disorder and depressive episode be distinguished? Results from ODIN.

BACKGROUND: No large-scale epidemiological study has included adjustment disorders (AD) for consideration yet it is considered to be a common psychiatric diagnosis. METHODS: Using a two stage screening method, those above a threshold score for possible caseness on the Beck Depression Inventory (BDI), were interviewed using SCAN to identify those with depressive episode and AD. Variables that might distinguish AD from depressive episode were examined. RESULTS: The prevalence of AD was extremely low with one centre having no cases. Finland, the country with the highest prevalence, only achieved a frequency of 0.8% and 1%, respectively, for urban and rural sites. Logistic regression failed to identify any variables that independently differentiated AD from depressive episode. Findings relating to severity of symptoms using BDI were robust. LIMITATIONS: The small sample size might have contributed to a failure to identify distinguishing features between AD and other disorders. CONCLUSIONS: Reasons for the failure of even robust results, such as BDI severity, to distinguish AD from depressive episode are considered of which problems in conceptualising AD are the most likely. Further studies are required.

Adjustment Disorders↗
PubMed2005

Is craniofacial dysmorpholgy correlated with structural brain anomalies in schizophrenia?

This study aimed to examine the relationship between craniofacial dysmorphology and anomalies of brain morphology in schizophrenia. Assessments of craniofacial dysmorphology and magnetic resonance imaging of brain were performed independently of each other and blind to each other in 24 males with schizophrenia and 16 male controls. Ventricular cerebrospinal fluid volume was negatively correlated with total dysmorphology score in males with schizophrenia (i.e., the larger the ventricular cerebrospinal fluid volume, the lower the total dysmorphology score) but not in male controls. These findings suggest that craniofacial dysmorphology and anomalies of brain morphology may be associated with independent processes in the etiology of schizophrenia.

Adult↗
PubMed2005

Incidence and clinical correlates of aggression and violence at presentation in patients with first episode psychosis.

This study aimed to identify the incidence and clinical correlates of aggression and violence in first episode psychosis. We prospectively recruited subjects with a first episode of DSM-psychosis presenting from a geographically defined catchment area to a secondary referral psychiatric service over a four-year period (n = 157). We used the Modified Overt Aggression Scale to retrospectively assess aggression (a hostile or destructive mental attitude, including verbal aggression, physical aggression and/or violence) and violence (the exercise of physical force), blind to diagnosis. One in three patients with psychosis was aggressive at the time of presentation. One patient in 14 engaged in violence that caused, or was likely to cause, injury to other people. Aggression was independently associated with drug misuse (odds ratio (OR) 2.80, 95% confidence interval 1.12-6.99) and involuntary admission status (OR = 3.62, 95% CI 1.45-9.01). Violence in the week prior to presentation was associated with drug misuse (OR = 2.75, CI 1.04-7.24) and involuntary admission status (OR = 3.21, CI 1.21-8.50). Violence in the week following presentation was associated with poor insight (OR 2.97, CI 1.03-8.56) and pre-contact violence (OR 3,82, CI 1.34-10.88). In patients with schizophrenia, violence in the week following presentation was associated with drug misuse (OR = 7.81, CI 1.33-45.95) and high psychopathology scores (OR = 20.59, CI 1.66-254.96). Overall, despite a high rate of verbal aggression, physical violence towards other people is uncommon in individuals presenting with first episode psychosis.

Aggression↗
PubMed2005

Structural violence and schizophrenia.

Despite clear evidence of a substantial biological basis to schizophrenia, there is also evidence that social, economic and political factors have considerable relevance to the clinical features, treatment and outcome of the illness. Individuals from lower socio-economic groups have an earlier age at first presentation and longer durations of untreated illness, both of which are associated with poor outcome. Individuals with schizophrenia are over-represented in the homeless population. Migration is associated with increased rates of mental illness, including schizophrenia, and this relationship appears to be mediated by psycho-social factors, including difficulties establishing social capital in smaller migrant groups. Individuals with schizophrenia are substantially over-represented amongst prison populations, and imprisonment increases the disability and stigma associated with mental illness, and impedes long-term recovery. The adverse effects of these social, economic and societal factors, along with the social stigma of mental illness, constitute a form of 'structural violence' which impairs access to psychiatric and social services and amplifies the effects of schizophrenia in the lives of sufferers. As a result of these over-arching social and economic factors, many individuals with schizophrenia are systematically excluded from full participation in civic and social life, and are constrained to live lives that are shaped by stigma, isolation, homelessness and denial of rights. There are urgent needs for (1) the development of enhanced aetiological models of schizophrenia, which elucidate the interactions between genetic risk and social environment, and can better inform bio-psycho-social approaches to treatment; (2) a renewal of emphasis on the United Nations' "Principles for the Protection of Persons with Mental Illness" and related legislative measures in individual countries; and (3) continued study and examination of the impact of social, economic and political structures on the clinical features and outcome of mental illnesses.

Attitude to Health↗
PubMed2005

Erotomania : epidemiology and management.

Erotomania is generally classified as a delusional disorder in contemporary classification systems (DSM-IV and ICD-10). The incidence of erotomania is not known, but that of delusional disorder in general has been reported as approximately 15 cases per 100,000 of the population per year, with a female : male ratio of 3 : 1. Both primary and secondary types of erotomania have been identified, the latter being associated with evidence of an aetiologically significant organic or psychiatric condition. The aetiology of primary erotomania is not yet fully understood, but neuroimaging, genetic studies and findings from evolutionary psychopathology hold considerable promise for a deeper and broader understanding of this condition. The initial management of secondary erotomania focuses on treating the underlying organic or psychiatric illness. The management of primary and secondary erotomania involves a combination of pharmacological treatments, psychosocial interventions and risk management strategies. In the past, the antipsychotic medication pimozide was commonly used, at least in certain countries (such as the US and Canada), despite a paucity of systematic studies of its use in this disorder. In recent years, there have been reports of positive therapeutic outcomes with atypical antipsychotics (risperidone, clozapine), which, as a result of their improved tolerability over older agents such as pimozide, will hopefully enhance patient acceptability and, thereby, improve clinical outcome. Despite this advance, there is still a strong need for controlled clinical trials of therapeutic strategies for primary erotomania and related syndromes.

Antipsychotic Agents↗
PubMed2004

Neurological soft signs and dermatoglyphic anomalies in twins with schizophrenia.

Schizophrenia is associated with altered neural development. We assessed neurological soft signs (NSS) and dermatoglyphic anomalies (total a-b ridge count (TABRC) and total finger ridge count) in 15 pairs of twins concordant and discordant for schizophrenia. Within-pair differences in both NSS and TABRC scores were significantly greater in discordant compared to concordant monozygotic pairs. There was no significant difference in NSS and TABRC scores between subjects with schizophrenia and their co-twins without the illness. However, monozygotic discordant twins with schizophrenia had higher ABRCs on their right hands compared to their co-twins without the illness. These findings suggest that an unidentified environmental event acting between weeks 6 and 15 of gestation affects the development of monozygotic twins who go on to develop schizophrenia but does not have a corresponding effect on their co-twins who do not develop the illness. The effect of such an event on dermatoglyphic profiles appears lateralised to the right hand in affected twins.

Adult↗
PubMed2004

Obstetric adversity and age at first presentation with schizophrenia: evidence of a dose-response relationship.

OBJECTIVE: The purpose of the study was to determine if a dose-response relationship exists between obstetric adversity and age at first presentation with schizophrenia. METHOD: The Dublin Psychiatric Case Register was used to identify subjects with schizophrenia. Data on obstetric complications, social class of origin, and family history of psychiatric illness were obtained for those subjects. RESULTS: A total of 409 patients with ICD-9 schizophrenia were identified. Patients with a history of obstetric complications presented earlier to psychiatric services. As the number of complications increased, the mean age at first presentation decreased. This effect was independent of social class of origin and family history of psychiatric illness. CONCLUSIONS: Obstetric adversity exerts an independent influence on the age at first presentation with schizophrenia, in a dose-response manner. This finding supports the existence of a causal relationship between obstetric adversity and age at first presentation with schizophrenia.

Adult↗
PubMed2002

Dysmorphic features and learning disability in an adult male with pure partial trisomy 17q24-q25 due to a terminal duplication.

We describe an adult male with severe learning disability, epilepsy, and dysmorphic features. Cytogenetic studies demonstrated a terminal duplication of the long arm of chromosome 17, resulting in partial trisomy 17q24-q25. Our patient shows some of the characteristic features of the distal 17q phenotype, but in addition has more unusual features such as epilepsy, sensorineural hearing loss, and long fingers and overlapping toes. We suggest that these features occur with terminal duplications of 17q.

Abnormalities, Multiple↗
PubMedDate not supplied

Schizophrenia.

Explore the source record for details and available documents.

Causality↗