Biomedical subjects

Ian Brockington

Publications and source records attributed to Ian Brockington.

5 recordsLinked to original sources

PubMed2006

Obstetric variables associated with bipolar affective puerperal psychosis.

BACKGROUND: Previous cross-sectional studies have highlighted a number of obstetric variables that may be associated with the development of broadly defined puerperal (post-partum) psychosis. These include: (a) primiparity, (b) pregnancy complications, (c) delivery complications, (d) Caesarean section, (e) female baby and (f) shorter gestation period. AIMS: To examine these risk factors in women with well-characterised bipolar affective puerperal psychosis. METHOD: A sample of 129 women with bipolar affective puerperal psychosis were investigated using a design that takes advantage of within-subject comparisons of affected and unaffected deliveries. RESULTS: Two of the variables studied were independently associated with an episode of puerperal psychosis: primiparity (odds ratio=3.76, P < 0.001) and delivery complications (odds ratio=2.68, P=0.022). CONCLUSIONS: This study provides further evidence of the association between primiparity and puerperal psychosis and suggests that complications during delivery may be associated with a severe post-partum episode.

Adolescent↗

PubMed2005

Menstrual psychosis.

This paper reviews the literature on menstrual psychosis and proposes a new classification, adapting that of v. Krafft-Ebing (1902) and Jolly (1914). The world literature consists mainly of case reports; they include a few with data good enough for a statistical demonstration of the link between onset and menses. These well-documented cases include examples of pre-menstrual, catamenial, paramenstrual and mid-cycle onsets, and continuous illnesses with phasic shifts rhythmic with the menstrual cycle. In sufferers, episodes seem to be concentrated around the menarche and after childbirth. The clinical picture resembles that of puerperal psychosis, and there are at least 20 women who have suffered both psychoses at different epochs in their lives. Both seem to fall within the manic depressive rubric, so that menstruation can be another trigger of a bipolar episode. Some work suggests an association with anovulatory cycles. Cases starting before the menarche suggest a diencephalic origin.

Journal Article↗

PubMed2004

Postpartum psychiatric disorders.

This review summarises the psychiatry of the puerperium, in the light of publications during the past 5 years. A wide variety of disorders are seen. Recognition of disorders of the mother-infant relationship is important, because these have pernicious long-term effects but generally respond to treatment. Psychoses complicate about one in 1000 deliveries. The most common is related to manic depression, in which neuroleptic drugs should be used with caution. Post-traumatic stress disorder, obsessions of child harm, and a range of anxiety disorders all require specific psychological treatments. Postpartum depression necessitates thorough exploration. Cessation of breastfeeding is not necessary, because most antidepressant drugs seem not to affect the infant. Controlled trials have shown the benefit of involving the child's father in therapy and of interventions promoting interaction between mother and infant. Owing to its complexity, multidisciplinary specialist teams have an important place in postpartum psychiatry.

Antidepressive Agents↗

PubMed2004

Diagnosis and management of post-partum disorders: a review.

This paper reviews the psychiatry of the puerperium, in the light of work published during the last eight years. Many distinct disorders are seen. In addition to various psychoses and a heterogeneous group of depressions, there are specific anxiety, obsessional and stress-related disorders. It is important to identify severe disorders of the mother-infant relationship, which usually respond to treatment, but have pernicious effects if untreated. The complexity of post-partum psychiatry requires the deployment of multidisciplinary specialist teams, which can handle the challenges of therapy, prevention, training, research and service development.

Journal Article↗

PubMed2002

Recruitment into psychiatry.

BACKGROUND: Despite improvements in psychiatric teaching, British medical schools have never produced enough graduands aiming for psychiatry. AIMS: To inform the strategy for improving recruitment. METHOD: A literature review. RESULTS: The number of psychiatrists required depends on the role of psychiatry, which is constantly changing. The present requirement is about 250-300 per year, including replacements and new posts. The number of psychiatric trainees has always been higher than expected from the career plans of newly qualified doctors, but the number of British graduates passing the Royal College of Psychiatrists' Membership examination has still fallen short, requiring a supplement of foreign medical graduates. The recent 50% expansion in medical students may make this country self-sufficient. CONCLUSIONS: To improve recruitment, the College should focus on influences before and after undergraduate training - the kind of student entering medical school and the factors favouring sustained psychiatric practice after graduation.

Adult↗