Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 27
Filtrar
Mais filtros

Base de dados
Tipo de documento
Intervalo de ano de publicação
1.
Nanotechnology ; 33(27)2022 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-35344940

RESUMO

With an increasing demand for large-scale energy storage systems, there is a need for novel electrode materials to store energy in batteries efficiently. 2D materials are promising as electrode materials for battery applications. Despite their excellent properties, none of the available single-phase 2D materials offers a combination of properties required for maximizing energy density, power density, and cycle life. This article discusses how stacking distinct 2D materials into a 2D heterostructure may open up new possibilities for battery electrodes, combining favourable characteristics and overcoming the drawbacks of constituent 2D layers. Computational studies are crucial to advancing this field rapidly with first-principles simulations of various 2D heterostructures forming the basis for such investigations that offer insights into processes that are hard to determine otherwise. We present a perspective on the current methodology, along with a review of the known 2D heterostructures as anodes and their potential for Li and Na-ion battery applications. 2D heterostructures showcase excellent tunability with different compositions. However, each of them has distinct properties, with its own set of challenges and opportunities for application in batteries. We highlight the current status and prospects to stimulate research into designing new 2D heterostructures for battery applications.

2.
Environ Health ; 13: 104, 2014 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-25480672

RESUMO

BACKGROUND: This study aimed to assess the relationship between cold temperature and daily mortality in the Republic of Ireland (ROI) and Northern Ireland (NI), and to explore any differences in the population responses between the two jurisdictions. METHODS: A time-stratified case-crossover approach was used to examine this relationship in two adult national populations, between 1984 and 2007. Daily mortality risk was examined in association with exposure to daily maximum temperatures on the same day and up to 6 weeks preceding death, during the winter (December-February) and an extended cold period (October-March), using distributed lag models. Model stratification by age and gender assessed for modification of the cold weather-mortality relationship. RESULTS: In the ROI, the impact of cold weather in winter persisted up to 35 days, with a cumulative mortality increase for all-causes of 6.4% (95% CI = 4.8%-7.9%) in relation to every 1°C drop in daily maximum temperature, similar increases for cardiovascular disease (CVD) and stroke, and twice as much for respiratory causes. In NI, these associations were less pronounced for CVD causes, and overall extended up to 28 days. Effects of cold weather on mortality increased with age in both jurisdictions, and some suggestive gender differences were observed. CONCLUSIONS: The study findings indicated strong cold weather-mortality associations in the island of Ireland; these effects were less persistent, and for CVD mortality, smaller in NI than in the ROI. Together with suggestive differences in associations by age and gender between the two Irish jurisdictions, the findings suggest potential contribution of underlying societal differences, and require further exploration. The evidence provided here will hope to contribute to the current efforts to modify fuel policy and reduce winter mortality in Ireland.


Assuntos
Doenças Cardiovasculares/mortalidade , Temperatura Baixa/efeitos adversos , Mortalidade/tendências , Doenças Respiratórias/mortalidade , Adolescente , Adulto , Idoso , Feminino , Humanos , Irlanda/epidemiologia , Masculino , Pessoa de Meia-Idade , Irlanda do Norte/epidemiologia , Estações do Ano , Adulto Jovem
3.
Animals (Basel) ; 13(18)2023 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-37760285

RESUMO

The feral donkey (Equus asinus L.) is an invasive species in Saudi Arabia and can cause severe damage to natural and cultural heritage. Over the last 30 years, feral donkeys have become a serious problem, as their abundance and geographic distribution has increased drastically. The impacts of feral donkeys are not well documented, and information about their abundance and distribution is lacking, certainly in Saudi Arabia, which hampers the implementation of effective management plans. Accordingly, we used the minimum population number approach (MPN) to determine the number of feral donkeys in this part of northwest Saudi Arabia. A total of 1135 feral donkeys were encountered in the region. The area around Khaybar harbors ~25% (n = 338) of the feral donkey population, whereas Tayma and AlGhrameel nature reserves were the least-inhabited sites (almost absent). The average population density of feral donkeys was estimated as 1.03 (0.19 SE) donkey/km2. We documented the negative ecological impact of feral donkeys on natural resources, which constituted overgrazing that resulted in habitat fragmentation and competition for resources with native species. We propose urgent actions to control the presence of feral donkeys in the region and suggest humane eradication as the most efficient and applicable to significantly reduce the negative impacts of feral donkeys.

4.
Mol Phylogenet Evol ; 50(3): 526-33, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19111936

RESUMO

Data from eight microsatellite loci were used to infer the evolutionary and past demographic processes in 97 Tibetan snowcocks sampled from eight different geographical locations on the Qinghai-Tibetan Plateau. Analysis of the microsatellite DNA markers indicated that Tibetan snowcock on the plateau were geographically structured, and that phylogenetic analyses identified three phylogroups, namely those from Xunhua, the Qilian Mountains and all others. The use of Bayesian Clustering and Population Assignment analyses of the microsatellite genotypes revealed clear differentiation among the eight sampled groups of Tibetan snowcock, indicating strong isolation of these sub-populations. Therefore, we suggested that the distribution pattern of Tibetan snowcock observed today resulted from adaptation to the climatic conditions and glacial cycles on the Qinghai-Tibetan Plateau. In addition, BOTTLENECK analysis indicated that Tibetan snowcock had recently passed through evolutionary bottlenecks. These results suggested that effective conservation measures should be undertaken to protect Tibetan snowcock from an increased probability of extinction.


Assuntos
Evolução Molecular , Galliformes/genética , Genética Populacional , Filogenia , Animais , Teorema de Bayes , China , Clima , Ecossistema , Variação Genética , Genótipo , Geografia , Desequilíbrio de Ligação , Repetições de Microssatélites , Análise de Sequência de DNA
5.
Br J Psychiatry ; 194(1): 18-24, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19118320

RESUMO

BACKGROUND: The critical period hypothesis proposes that deterioration occurs aggressively during the early years of psychosis, with relative stability subsequently. Thus, interventions that shorten the duration of untreated psychosis (DUP) and arrest early deterioration may have long-term benefits. AIMS: To test the critical period hypothesis by determining whether outcome in non-affective psychosis stabilises beyond the critical period and whether DUP correlates with 8-year outcome; to determine whether duration of untreated illness (DUI) has any independent effect on outcome. METHOD: We recruited 118 people consecutively referred with first-episode psychosis to a prospective, naturalistic cohort study. RESULTS: Negative and disorganised symptoms improved between 4 and 8 years. Duration of untreated psychosis predicted remission, positive symptoms and social functioning at 8 years. Continuing functional recovery between 4 and 8 years was predicted by DUI. CONCLUSIONS: These results provide qualified support for the critical period hypothesis. The critical period could be extended to include the prodrome as well as early psychosis.


Assuntos
Transtornos Psicóticos Afetivos/terapia , Período Crítico Psicológico , Transtornos Psicóticos/terapia , Adolescente , Adulto , Transtornos Psicóticos Afetivos/diagnóstico , Transtornos Psicóticos Afetivos/psicologia , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Seguimentos , Humanos , Irlanda/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/psicologia , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
6.
Soc Psychiatry Psychiatr Epidemiol ; 44(10): 863-9, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19255700

RESUMO

INTRODUCTION: Employment is generally beneficial to health and quality of life. Despite many advances in the treatment of psychosis there are continuing reports of high levels of unemployment. In most studies of first episode psychosis (FEP) only rudimentary rates of employment are provided. We sought to establish the prevalence of employment amongst those with FEP from a geographically defined area, to compare employment categories for differences in demographical and clinical characteristics and finally, to examine factors associated with employment. METHODS: All cases of FEP were assessed from a defined suburban area with a structured clinical interview for DSM-III-R diagnosis and a standardised assessment protocol. Employment status was divided into employed, non-labour force work and unemployed. RESULTS: Of 162 cases of psychosis, those employed (46%) were indistinguishable from those in non-labour force work (21%). Those unemployed (33%) had significantly longer DUP, more negative symptoms and lower quality of life than those engaged in non-labour force work or those employed. Having a non-affective psychosis (chi(2) = 0.05, OR = 1.2; 95% CI 1.0, 1.4) was associated with being unemployed at presentation. Better (beta = -0.2, P = 0.00) academic premorbid adjustment was associated with being employed at presentation. CONCLUSIONS: Although 67% of those with FEP from a geographically defined area are engaged in purposeful work, the rate of unemployment is nine times the local rate. Longer DUP and negative symptoms are associated with unemployment at presentation. Standardised reporting of employment status would greatly assist research in this area.


Assuntos
Emprego/estatística & dados numéricos , Transtornos Psicóticos/diagnóstico , Adulto , Manual Diagnóstico e Estatístico de Transtornos Mentais , Escolaridade , Feminino , Humanos , Irlanda/epidemiologia , Modelos Logísticos , Masculino , Valor Preditivo dos Testes , Prevalência , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/psicologia , Qualidade de Vida , Ajustamento Social , Desemprego/estatística & dados numéricos
7.
Eur Psychiatry ; 23(2): 97-9, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17945469

RESUMO

Although 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.


Assuntos
Antipsicóticos/uso terapêutico , Transtornos Psicóticos/tratamento farmacológico , Transtornos Psicóticos/epidemiologia , Esquizofrenia/tratamento farmacológico , Esquizofrenia/epidemiologia , População Urbana , Adolescente , Adulto , Idade de Início , Estudos de Coortes , Estudos Transversais , Diagnóstico Precoce , Feminino , Humanos , Irlanda , Masculino , Pessoa de Meia-Idade , Prognóstico , Transtornos Psicóticos/diagnóstico , Esquizofrenia/diagnóstico
8.
Schizophr Res ; 86(1-3): 221-5, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16846719

RESUMO

Many studies have confirmed that the risk of suicide is high in the period after first presentation. There is relatively little information about the risk of suicide using illness onset as the starting point. We assessed suicidality in a cohort of 166 individuals from an urban catchment area during the period of untreated psychosis and at 4 year follow up. Nearly 10% of individuals attempted suicide prior to presentation. Four years later 18% had made a suicide attempt and 3% completed suicide. Suicide attempts prior to presentation were associated with a longer duration of untreated psychosis.


Assuntos
Transtornos Psicóticos/diagnóstico , Tentativa de Suicídio , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Fatores de Risco
9.
Schizophr Res ; 86(1-3): 110-7, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16765029

RESUMO

BACKGROUND: Neurological soft signs (NSS) are well described among patients with schizophrenia, the neurology of other psychoses is relatively unexplored and few comparative studies have prospectively examined these signs in first-episode patients. METHODS: We assessed neurological functioning in 242 patients presenting with a first episode of psychosis (in accordance with DSM-IV diagnosis) using the Condensed Neurological Examination (CNE). We sought to determine whether NSS were specific to patients with schizophrenia, bipolar affective disorder and other forms of psychosis. We also examined the factors associated with and predictive of neurodysfunction at first presentation and at 4 year follow-up. RESULTS: NSS were not specific to any diagnostic group. Neurological functioning was closely associated with psychopathology and mixed-handedness at first presentation. At follow-up there was a statistically significant improvement in neurological functioning. Persistent neurodysfunction at this stage was related to enduring negative symptoms and associated with poorer outcome. DISCUSSION: Schizophrenia and bipolar disorder are indistinguishable in terms of neurodysfunction at presentation. At presentation and 4 years NSS closely parallel psychopathology and mixed-handedness indicating that NSS may be a function of these factors or possibly an independent factor operates equally upon both symptoms and neurological function.


Assuntos
Transtorno Bipolar/diagnóstico , Transtorno Bipolar/fisiopatologia , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/fisiopatologia , Esquizofrenia/diagnóstico , Esquizofrenia/fisiopatologia , Psicologia do Esquizofrênico , Adolescente , Adulto , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Entrevistas como Assunto , Estudos Longitudinais , Masculino , Exame Neurológico , Testes Neuropsicológicos , Valor Preditivo dos Testes , Escalas de Graduação Psiquiátrica , Sensibilidade e Especificidade
10.
Schizophr Res ; 72(2-3): 161-8, 2005 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-15560961

RESUMO

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.


Assuntos
Agressão/psicologia , Internação Compulsória de Doente Mental/estatística & dados numéricos , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/psicologia , Violência/psicologia , Violência/estatística & dados numéricos , Conscientização , Feminino , Hospitalização , Humanos , Incidência , Masculino , Estudos Prospectivos , Transtornos Psicóticos/reabilitação
11.
Psychiatr Serv ; 56(9): 1084-8, 2005 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16148321

RESUMO

OBJECTIVE: The objective of this study was to determine the stability of a diagnosis of psychosis four years after the first-episode diagnosis. METHODS: The study was a prospective four-year follow-up study (1995 to 1999) of 147 patients with schizophrenia, affective disorder, and other psychoses who presented with a first episode of psychosis in an epidemiologic catchment area in Ireland. All diagnoses were made on the basis of the Structured Clinical Interview for DSM-IV. RESULTS: One quarter of the patients evidenced a change in diagnosis at follow-up. The most common change was to a diagnosis of schizophrenia. The positive predictive values of schizophrenia and bipolar affective disorder were 97 percent and 80 percent, respectively. Fewer years spent in education, lower levels of initial psychopathology, and presence of comorbid alcohol or substance abuse were associated with change in diagnosis at follow-up. CONCLUSIONS: Among the diagnoses studied, schizophrenia was the most stable diagnosis after four years. The greatest instability occurred in the categories of drug-induced psychosis and psychosis not otherwise specified.


Assuntos
Transtornos Psicóticos/diagnóstico , Adulto , Transtornos Psicóticos Afetivos/diagnóstico , Transtornos Psicóticos Afetivos/epidemiologia , Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , Comorbidade , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Diagnóstico Diferencial , Manual Diagnóstico e Estatístico de Transtornos Mentais , Escolaridade , Feminino , Seguimentos , Humanos , Masculino , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Psicometria/estatística & dados numéricos , Transtornos Psicóticos/epidemiologia , Reprodutibilidade dos Testes , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
12.
Biochem Pharmacol ; 98(4): 587-601, 2015 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-26519552

RESUMO

We recently reported that CMPD1, originally developed as an inhibitor of MK2 activation, primarily inhibits tubulin polymerisation and induces apoptosis in glioblastoma cells. In the present study we provide detailed pharmacological investigation of CMPD1 analogues with improved molecular properties. We determined their anti-cancer efficacy in glioblastoma cells with enhanced EGFR signalling, as deregulated EGFR often leads to chemoresistance. Eight analogues of CMPD1 with varying lipophilicity and basicity were synthesised and tested for efficacy in the cell viability assay using established glioblastoma cell lines and patient-derived primary glioblastoma cells. The mechanism of action for the most potent analogue 15 was determined using MK2 activation and tubulin polymerisation assays, together with the immunofluorescence analysis of the mitotic spindle formation. Apoptosis was analysed by Annexin V staining, immunoblotting analysis of bcl-2 proteins and PARP cleavage. The apoptotic activity of CMPD1 and analogue 15 was comparable across glioblastoma cell lines regardless of the EGFR status. Primary glioblastoma cells of the classical subtype that are characterized by enhanced EGFR activity were most sensitive to the treatment with CMPD1 and 15. In summary, we present mechanism of action for a novel small molecule tubulin inhibitor, compound 15 that inhibits tubulin polymerisation and mitotic spindle formation, induces degradation of anti-apoptotic bcl-2 proteins and leads to apoptosis of glioblastoma cells. We also demonstrate that the enhanced EGFR activity does not decrease the efficacy of tubulin inhibitors developed in this study.


Assuntos
Receptores ErbB/metabolismo , Glioblastoma/metabolismo , Transdução de Sinais/fisiologia , Moduladores de Tubulina/farmacologia , Tubulina (Proteína)/metabolismo , Linhagem Celular Tumoral , Glioblastoma/tratamento farmacológico , Glioblastoma/patologia , Humanos , Transdução de Sinais/efeitos dos fármacos , Moduladores de Tubulina/química
13.
Child Abuse Negl ; 45: 101-7, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26026360

RESUMO

One-hundred-ninety-nine adult mental health service users were interviewed with a protocol that included the Childhood Trauma Questionnaire, the Structured Clinical Interviews for Axis I and II DSM-IV disorders, the Global Assessment of Functioning scale, the SCORE family assessment measure, the Camberwell Assessment of Need Short Appraisal Schedule, and the Readiness for Psychotherapy Index. Compared to a U.S. normative sample, Irish clinical cases had higher levels of maltreatment. Cases with comorbid axis I and II disorders reported more child maltreatment than those with axis I disorders only. There was no association between types of CM and types of psychopathology. Current family adjustment and service needs (but not global functioning and motivation for psychotherapy) were correlated with a CM history. It was concluded that child maltreatment may contribute to the development of adult psychopathology, and higher levels of trauma are associated with co-morbid personality disorder, greater service needs and poorer family adjustment. A history of child maltreatment should routinely be determined when assessing adult mental health service users, especially those with personality disorders and where appropriate evidence-based psychotherapy which addresses childhood trauma should be offered.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Adolescente , Adulto , Idoso , Análise de Variância , Estudos de Casos e Controles , Serviços Comunitários de Saúde Mental/estatística & dados numéricos , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Entrevista Psicológica , Irlanda/epidemiologia , Masculino , Pessoa de Meia-Idade , Psicopatologia , Estados Unidos , Adulto Jovem
14.
Opt Express ; 10(25): 1508-19, 2002 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-19461686

RESUMO

We present here results using two novel adaptive optic elements, an electro-static membrane mirror, and a dual frequency nematic liquid crystal. These devices have the advantage of low cost, low power consumption, and compact size. Possible applications of the devices are astronomical adaptive optics, laser beam control, laser cavity mode control, and real time holography. Field experiments were performed on the Air Force Research Laboratory, Directed Energy Directorate's 3.67 meter AMOS telescope on Maui, Hawaii.

15.
Schizophr Res ; 141(2-3): 215-21, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23006501

RESUMO

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.


Assuntos
Psicopatologia , Transtornos Psicóticos , Adolescente , Adulto , Distribuição de Qui-Quadrado , Estudos de Coortes , Feminino , Humanos , Masculino , Prognóstico , Escalas de Graduação Psiquiátrica , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/fisiopatologia , Transtornos Psicóticos/psicologia , Qualidade de Vida , Estudos Retrospectivos , Ajustamento Social , Adulto Jovem
16.
Ir J Psychol Med ; 27(1): 15-18, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30282289

RESUMO

BACKGROUND: Reported rates of depression in schizophrenia vary considerably. OBJECTIVE: To measure the prevalence of depression in a first episode sample of people with schizophrenia. METHODS: All referrals with a first episode of schizophrenia diagnosed using SCID interviews were assessed pre-discharge and again six months later. We used the Calgary Depression Scale for Schizophrenia (CDSS) and Positive and Negative Syndrome Scale (PANSS) to assess the severity of symptoms. RESULTS: Pre-discharge, 10.4% of the sample met CDSS criteria for depression. According to the PANSS depression (PANSS -D) subscale, 3% of patients were depressed, with a mean score of 7.48 (SD = 2.97). Only 3% of patients pre-discharge were found to be depressed on both the CDSS and the PANSS-D. Six months later 6.5% were depressed according to the CDSS. However none reached depression criteria according to the PANSS-D. The CDSS correlated with PANSS-D both pre-discharge and at follow-up. Feelings of depression and self-deprecation were the most common symptoms at baseline and follow-up. The CDSS was unrelated to negative symptoms at both stages. A lifetime history of alcohol abuse increased the risk for depression. CONCLUSION: Rates of depression in this sample were low. The CDSS appears to discriminate between depression and negative symptoms. Like the general population, alcohol misuse is a risk factor for depression in first episode schizophrenia.

17.
Psychiatr Serv ; 61(2): 189-92, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20123826

RESUMO

OBJECTIVES: This study examined concurrent associations and predictors at first indication of nonadherence to antipsychotic medication four years after a first episode of psychosis. METHODS: A prospective cohort of 171 patients in urban Ireland with a first episode of psychosis was followed up four years after inception (follow-up primary analysis, N=84; secondary analysis, N=104). RESULTS: At the four-year follow-up 76% were adherent and 24% were not. Nonadherence was concurrently associated with substance misuse (p<.01), increased symptomatology (p<.01), less insight (p=.01), lower global functioning (p<.01), and negative attitudes toward medication (p<.01). Compared with other patients, those who were nonadherent had more readmissions (p=.01). Predictors of future nonadherence were substance misuse (p=.02) and duration of untreated psychosis (p=.04). CONCLUSIONS: This prospective investigation confirms previous cross-sectional studies. The association between longer duration of untreated psychosis and nonadherence warrants further research because it could be interpreted as further evidence of the importance of early intervention.


Assuntos
Antipsicóticos/uso terapêutico , Adesão à Medicação , Transtornos Psicóticos/tratamento farmacológico , População Urbana , Adulto , Estudos de Coortes , Comorbidade , Feminino , Seguimentos , Humanos , Irlanda , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Readmissão do Paciente , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Transtornos Psicóticos/epidemiologia , Ajustamento Social , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
18.
Schizophr Res ; 116(1): 75-89, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19897342

RESUMO

Urbanicity has been repeatedly associated with increased incidence of schizophrenia. This article (a) presents results of a prospective study of urbanicity and schizophrenia in Ireland and (b) reviews the literature relating to urbanicity and schizophrenia. We prospectively compared incidence of schizophrenia and other psychoses in urban and rural catchment areas (over 4years and 7years, respectively) using face-to-face, DSM-III-R diagnostic interviews. Incidence of schizophrenia in males was higher in urban compared to rural areas, with an age-adjusted incidence rate ratio (IRR) of 1.92 (1.52-2.44) for males and 1.34 (1.00-1.80) for females. Incidence of affective psychosis was lower in urban compared to rural areas for males (IRR 0.48; 0.34-0.67) and females (IRR 0.60; 0.43-0.83). These findings are consistent with the literature, which provides persuasive evidence that risk for schizophrenia increases with urban birth and/or upbringing, especially among males. Register-based studies support this conclusion more consistently than studies using face-to-face diagnostic interviews, the difference being related to power. The mechanism of association is unclear but may relate to biological or social/environmental factors or both, acting considerably before psychotic symptoms manifest. There is a diversity of potential candidates, including air pollution, cannabis and social exclusion. Urbanicity may have a synergistic effect with genetic vulnerability. Future research is likely to focus on the relationship between urbanicity and neural maldevelopment, the possibility of rural protective factors (e.g. social capital, low social fragmentation), urbanicity in developing countries, cultural variables and geographical location, and associations between urbanicity and other disorders (e.g. affective psychosis).


Assuntos
Cidades/epidemiologia , Esquizofrenia/epidemiologia , População Urbana/estatística & dados numéricos , Distribuição por Idade , Intervalos de Confiança , Bases de Dados Factuais/estatística & dados numéricos , Feminino , Humanos , Incidência , Irlanda/epidemiologia , Masculino , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Estudos Retrospectivos , População Rural , Fatores Sexuais , Meio Social
19.
Early Interv Psychiatry ; 3(3): 198-203, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22640383

RESUMO

INTRODUCTION: Substance misuse (SM) (drug/alcohol dependence or abuse) in psychotic illness is an increasingly recognized problem. We aimed to estimate the prevalence and examine the influence of SM on age at onset of psychosis and psychopathology among patients with first-episode psychosis. METHOD: One hundred seventy-one consecutive patients with first-episode psychosis were assessed. SM, age of onset of psychosis and psychopathology were determined using valid instruments. RESULTS: Seventy-seven (46%) patients had a lifetime history of SM and were predominately males, had more positive symptoms, and in the majority of cases (84%), started misusing substances before the onset of psychosis (SM-BP). There was no difference in age of onset between patients with SM-BP and the rest of the sample. CONCLUSION: Lifetime history of SM is common and may influence psychopathology, but does not appear to influence or bring forward the age at onset of psychotic symptoms.


Assuntos
Idade de Início , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Idoso , Diagnóstico Duplo (Psiquiatria)/psicologia , Diagnóstico Duplo (Psiquiatria)/estatística & dados numéricos , Feminino , Humanos , Irlanda/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Transtornos Psicóticos/complicações , Transtornos Relacionados ao Uso de Substâncias/complicações
20.
Ir J Psychol Med ; 25(3): 100-103, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30282217

RESUMO

OBJECTIVE: All patients who resided in state provided long-stay care in Ireland were required to pay the state for that care until 2006. In 2001 the Irish Ombudsman and Information Commissioner had highlighted the issue of the entitlement of people with medical cards to provision of free long-stay care. The Health Repayment scheme was subsequently set up in 2006 to facilitate the repayment of long-stay charges wrongly paid by patients. Issues of mental capacity arise particularly in the context of long-stay psychiatric patients applying for repayment of long-stay charges. Our aim was to devise a test suitable to assess the capacity of an individual to make an application for refund charges. METHOD: There was no specific test in existence to assess the capacity of an individual to make an application for refund of charges. A suitable test was devised based on the available literature which assessed whether the person understands the 'nature and effects' of making a refund application. Fifty-eight long-stay patients were deemed to be entitled to apply for a refund. RESULTS: Staff identified 47 (80%) patients as possibly lacking the capacity to make an application. Of these, 14 patients (29.8%) were found to have capacity to make an application (mean age 58.5 years) with 33 (70.2%) found to lack capacity (mean age 73 years). Of those with capacity 50% had a diagnosis of schizophrenia/schizoaffective disorder. None had cognitive impairment of degenerative origin. Of those who lacked capacity 45.5% had a diagnosis of dementia. All of the patients with dementia who were assessed were found to lack capacity whereas 59% of those with a diagnosis of schizophrenia/schizoaffective disorder lacked capacity. CONCLUSION: A substantial number of long-stay psychiatric patients may lack the capacity to make particular decisions. In this study the group who lacked capacity were an elderly group with dementia common. This process raised a dilemma about how a patient without capacity to make a refund application can then manage the money claimed on their behalf and whether guardianship safeguards are necessary.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA