Publications (61)204.79 Total impact
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Article: A multi-center, randomized controlled trial of a group psychological intervention for psychosis with comorbid cannabis dependence over the early course of illness.
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ABSTRACT: BACKGROUND: Patients who experience the onset of psychotic illness with a comorbid diagnosis of cannabis dependence experience poor clinical outcomes. Few studies have identified interventions that reduce cannabis use and improve clinical outcome in this population. AIMS: We undertook a multi-center, randomized controlled trial of a group psychological intervention for psychosis with comorbid cannabis dependence to determine whether there was any impact on cannabis use symptoms, global functioning, insight, attitudes to treatment and subjective quality of life. METHOD: Across three centers, we compared a group psychological intervention, based on cognitive behavioral therapy and motivational interviewing, with treatment as usual among patients experiencing their first psychotic episode or early in the course of psychotic illness. Substance misuse and indices of clinical outcome were assessed at baseline, 3months and 1year. RESULTS: At 3month and 1year follow-ups, there was no evidence for an intervention effect on cannabis use, symptoms, global functioning insight or attitude to treatment. However, the intervention improved subjective quality of life at 3months and this effect was sustained at 1year. CONCLUSIONS: Over the early phase of psychotic illness, group psychological interventions for those with comorbid cannabis dependence improved subjective quality of life. However, this was not associated with reduction in use of cannabis or improvement in clinical outcomes.Biological Psychiatry 11/2012; · 8.28 Impact Factor -
Article: The effects of daily weather variables on psychosis admissions to psychiatric hospitals.
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ABSTRACT: Several studies have noted seasonal variations in admission rates of patients with psychotic illnesses. However, the changeable daily meteorological patterns within seasons have never been examined in any great depth in the context of admission rates. A handful of small studies have posed interesting questions regarding a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (especially heat waves) and sunshine. In this study, we used simple non-parametric testing and more complex ARIMA and time-series regression analysis to examine whether daily meteorological patterns (wind speed and direction, barometric pressure, rainfall, sunshine, sunlight and temperature) exert an influence on admission rates for psychotic disorders across 12 regions in Ireland. Although there were some weak but interesting trends for temperature, barometric pressure and sunshine, the meteorological patterns ultimately did not exert a clinically significant influence over admissions for psychosis. Further analysis is needed.International Journal of Bioclimatology Biometeorology 08/2012; · 2.25 Impact Factor -
Article: Prevalence of item level negative symptoms in first episode psychosis diagnoses.
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ABSTRACT: The relevance of negative symptoms across the diagnostic spectrum of the psychoses remains uncertain. The purpose of this study was to report on prevalence of item and subscale level negative symptoms across the first episode psychosis (FEP) diagnostic spectrum in an epidemiological sample, and to ascertain whether items and subscales were more prevalent in a schizophrenia spectrum diagnoses group compared to an 'all other psychotic diagnoses' group. We measured negative symptoms in 330 patients presenting with FEP using the Scale for Assessment of Negative Symptoms (SANS), and ascertained diagnosis using the Structured Clinical Interview for DSM IV. Prevalence of SANS items and subscales were tabulated across all psychotic diagnoses, and logistic regression analysis determined which items and subscales were predictive of schizophrenia spectrum diagnoses. SANS items were most prevalent in schizophrenia spectrum conditions but frequently presented in other FEP diagnoses, particularly substance induced psychotic disorder and Major Depressive Disorder. Brief psychotic disorder and bipolar disorders had low levels of negative symptoms. SANS items and subscales which significantly predicted schizophrenia spectrum diagnoses, were also frequently present in some of the other psychotic diagnoses. Conclusions: SANS items have high prevalence in FEP, and while commonest in schizophrenia spectrum conditions are not restricted to this diagnostic subgroup.Biological Psychiatry 03/2012; 135(1-3):128-33. · 8.28 Impact Factor -
Article: Prevalence of item level negative symptoms in first episode psychosis diagnoses
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ABSTRACT: The relevance of negative symptoms across the diagnostic spectrum of the psychoses remains uncertain. The purpose of this study was to report on prevalence of item and subscale level negative symptoms across the first episode psychosis (FEP) diagnostic spectrum in an epidemiological sample, and to ascertain whether items and subscales were more prevalent in a schizophrenia spectrum diagnoses group compared to an 'all other psychotic diagnoses' group. We measured negative symptoms in 330 patients presenting with FEP using the Scale for Assessment of Negative Symptoms (SANS), and ascertained diagnosis using the Structured Clinical Interview for DSM IV. Prevalence of SANS items and subscales were tabulated across all psychotic diagnoses, and logistic regression analysis determined which items and subscales were predictive of schizophrenia spectrum diagnoses. SANS items were most prevalent in schizophrenia spectrum conditions but frequently presented in other FEP diagnoses, particularly substance induced psychotic disorder and Major Depressive Disorder. Brief psychotic disorder and bipolar disorders had low levels of negative symptoms. SANS items and subscales which significantly predicted schizophrenia spectrum diagnoses, were also frequently present in some of the other psychotic diagnoses. Conclusions: SANS items have high prevalence in FEP, and while commonest in schizophrenia spectrum conditions are not restricted to this diagnostic subgroup.Schizophrenia Research 03/2012; 135(1):128. · 4.75 Impact Factor -
Article: Group cognitive behavioural therapy for first episode psychosis: who's referred, who attends and who completes it?
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ABSTRACT: Aim: Most national guidelines recommend psychological therapy for people with first-episode psychosis (FEP) but interventions proven effective in randomized control trials (RCTs) conducted in research settings do not always translate effectively to real-world clinical environments. In a limited health system, it is important to understand the system and patient barriers to participation in effective treatment. We sought to determine what patient characteristics influenced clinicians' decision to refer or not to refer to group cognitive behavioural therapy for FEP and what characteristics were associated with those referred attending/not attending and adhering/not adhering to the programme. Methods: Between 2006 and 2008, all cases of confirmed FEP from a defined geographical region were examined using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnoses, the Scale for Assessment of Positive Symptoms, Scale for Assessment of Negative Symptoms, Calgary Depression Scale for Schizophrenia and Birchwood Insight Scale. Duration of untreated psychosis was established using the Beiser Scale. Results: Of the 124 (77 males, 47 females) people in the final sample, 88 (72%) were referred for cognitive behavioural therapy (CBT), 52 (59%) attended and 12 (23%) did not complete CBT. Those with higher levels of insight into the need for treatment (U = 740.00, z = -2.63, P = 0.008) and higher levels of positive symptoms (t (120) = -3.064, P = 0.003) were more likely to be referred to CBT. Those with higher educational attainment (χ(2) = 9.48, P = 0.03) and fewer negative symptoms, particularly in relation to global attention (t (85) = 2.32, P = 0.03), were more likely to attend and complete CBT. Conclusion: Within an early intervention service for FEP, it appears that individuals with less education, more negative symptoms and less insight experienced significant barriers to successfully completing group CBT. More information for referring clinicians about the benefits of CBT for FEP could help increase referral rates. Assertive outreach for people at risk of disengaging or non-adherence should also be considered.Early Intervention in Psychiatry 01/2012; · 0.92 Impact Factor -
Article: A descriptive study of 'non-cases' and referral rates to an early intervention for psychosis service.
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ABSTRACT: Despite there being approximately 200 early intervention services for psychosis worldwide, little is known about the referral rates to these services, the diagnoses and needs of individuals found not to have a first episode of psychosis (FEP). Firstly, we aimed to describe the diagnoses for individuals who were found not to have a FEP (non-cases) following an assessment using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders IV (SCID). We then aimed to examine the referral rates of cases and non-cases to an early intervention service. All individuals referred to the early intervention service underwent a clinical assessment using the SCID. In a 4-year period, there were 632 referrals to the early intervention service for psychosis, and of these, 53% (n = 338) were found to have a FEP, 5% (n = 34) were found to have an at-risk mental state for psychosis and 41% (n = 260) were found to be 'non-cases'. This represents a ratio of 1.9:1 of referrals to cases, or approximately 2:1. Of the non-cases, 27% (n = 62) satisfied criteria for a mood disorder, with major depressive disorder the commonest diagnosis. A further 18% (n = 42) of non-cases satisfied criteria for an anxiety disorder and nearly half of these were diagnosed with social phobia. The ratio of referrals to cases was not consistent over time and rose from 1.3:1 in the first year to 2:1 in the fourth year. A large proportion of individuals referred to an early intervention for psychosis service were found not to have psychotic disorder, however they still have significant needs regarding their mental health.Early Intervention in Psychiatry 01/2012; 6(3):276-82. · 0.92 Impact Factor -
Article: Prospective relationship of duration of untreated psychosis to psychopathology and functional outcome over 12 years
Schizophrenia Research 01/2012; 141(2–3):215-221. · 4.75 Impact Factor -
Article: Perceptions of involuntary admission and risk of subsequent readmission at one-year follow-up: the influence of insight and recovery style.
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ABSTRACT: Involuntary admission is one of the most ethically challenging practices in medicine, yet we are only beginning to learn more about the patient's perspective. To investigate (i) peoples' perception of the necessity of their involuntary admission at one year after discharge (ii) readmission rates to hospital and the influence of insight and recovery style. We interviewed individuals admitted involuntarily at one year following discharge using the Mac Arthur Admission Experience Interview, Birchwood Insight Scale, the Drug Attitude Inventory, Global Assessment of Functioning and the Recovery Style Questionnaire. Sixty-eight people (84%) were re-interviewed at one year and fewer (60%) reported that their involuntary admission had been necessary when compared to inception (72%). Of the 33% that changed their views, most reflected negatively on their involuntary admission. We found that insight was moderately associated with the acknowledgement that the involuntary admission was necessary. Within a year, 43% were readmitted to hospital and half of these admissions were involuntary. Individuals with a sealing over recovery style were at four times the risk of involuntary readmission. Peoples' perception of the necessity of their involuntary admissions is not stable over time and risk of involuntary readmission is associated with recovery style.Journal of Mental Health 06/2011; 20(3):249-59. · 1.01 Impact Factor -
Article: Group cognitive behavioural therapy as a treatment for negative symptoms in first-episode psychosis.
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ABSTRACT: We aimed to test the idea that there is an early critical time period during a psychotic illness when patients may be more responsive to psychological treatment attention. We tested this hypothesis by comparing the treatment responsiveness to group cognitive behavioural therapy (CBT) of 25 first-episode psychosis participants (FEP) and 15 patients with currently stable psychosis (n = 40). Following 12 sessions of outpatient-based group CBT, there were significant decreases in positive, depressive and anxiety symptoms, and an improvement in quality of life for both groups. However, negative symptoms only improved in the FEP group. Considering the pernicious nature of negative symptoms as well as the difficulties in treating them, this study provides some support for the concept of early intervention with CBT.Early Intervention in Psychiatry 05/2011; 5(2):168-73. · 0.92 Impact Factor -
Article: First rank symptoms in first episode psychosis and their relationship to the duration of untreated illness.
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ABSTRACT: Most studies of First Rank Symptoms (FRS) are based on cross-sectional inpatient samples of people with schizophrenia at various stages of illness. We sought to examine the prevalence of FRS in a representative sample of first episode psychosis patients and compare those with and without FRS clinically and in terms of duration of untreated illness. Information was gathered from 158 consecutive cases of first episode psychosis presenting in a defined geographical region through semi-structured interview tools. Of this sample, 40.5% of cases received a diagnosis of schizophrenia. The prevalence of FRS among the entire group was 52.5%. After controlling for multiple testing, no FRS contributed significantly to predicting a diagnosis of schizophrenia. There was no significant relationship between the duration of untreated illness and FRS.The Journal of nervous and mental disease 11/2010; 198(11):820-3. · 1.77 Impact Factor -
Article: Nonadherence to medication four years after a first episode of psychosis and associated risk factors.
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ABSTRACT: This study examined concurrent associations and predictors at first indication of nonadherence to antipsychotic medication four years after a first episode of psychosis. 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). 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). 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.Psychiatric services (Washington, D.C.) 02/2010; 61(2):189-92. · 2.81 Impact Factor -
Article: Attitudes towards compulsory community treatment orders and advance directives among patients previously admitted involuntarily under the Mental Health Act 2001
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ABSTRACT: Objectives: The Mental Health Act 2001 was implemented in Ireland in 2006, however, within this new legislation there is no provision for compulsory community treatment or advance directives, which are now established practice in other countries. We aimed to determine the proportion of patients who believe that compulsory treatment may be justified, the preference for where the treatment should be delivered and factors which may influence this preference. We also sought to determine the proportion of people who would be interested in the option of having an advance directive in their future care plan. Methods: Patients who had been admitted involuntarily in a 183 bedded psychiatric hospital in Dublin (St John of God Hospital) over a 15 month period were interviewed one year following discharge. A structured interview was used and included the Birchwood Insight Scale and Drug Attitude .Inventory (DAI). Results: Sixty-seven patients were interviewed, which resulted in a follow-up rate of 68%. A total of 56% of participants believe that there are situations in which involuntary treatment with medication may be justified. Of the participants 59% think that the person should be admitted to hospital if they are going to be administered medication without consent. A total of 41 % of participants stated they would have preferred to have been treated at home rather than hospital and this was associated with having a diagnosis of an affective disorder or it being their first involuntary admission. Of the participants 84% expressed interest in having the option of an advance directive in their treatment care plan. Conclusions: With the increasing community based provision of mental health services in Ireland a debate on compulsory community treatment orders and advance directives needs to take place amongst all stakeholders.Irish journal of psychological medicine 01/2010; 27(2):66. -
Article: Caregiver psychoeducation for first-episode psychosis.
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ABSTRACT: International best-practice guidelines for the management of first-episode psychosis have recommended the provision of psychoeducation for multifamily groups. While there is ample evidence of their efficacy in multiepisode psychosis, there is a paucity of evidence supporting this approach specifically for first-episode psychosis. We sought to determine whether a six-week caregiver psychoeducation programme geared specifically at first-episode psychosis improves caregiver knowledge and attitudes. Caregivers of people with first-episode psychosis completed a 23-item adapted version of the self-report Family Questionnaire (KQ) and a 17-item adapted version of the self-report Drug Attitudes Inventory (DAI) before and after the six-week DETECT Information and Support Course (DISC). Using a Generalised Linear Repeated Measures Model, we analyzed the differences in proportions of correct answers before and after the programme. Over a 24-month study period, 31 caregivers (13 higher socioeconomic; 13 lower socioeconomic; five unspecified socioeconomic; 19 female; 12 male) participated in the DISC programme and completed inventories before and after the course. Knowledge of psychosis and specific knowledge of medication treatment improved among caregivers overall (p<.01; effect sizes 0.78 and 0.94 respectively). There were no significant gender or socioeconomic differences in any improvement. This study confirms that caregiver psychoeducation specifically for first-episode psychosis directly improves knowledge of the illness overall and, in particular, knowledge of medication. Gender is not a factor in this, while the lack of any socioeconomic differences dispels the myth that patients in lower socioeconomic groups are disadvantaged because their caregivers know less.European Psychiatry 11/2009; 25(1):33-8. · 2.77 Impact Factor -
Article: Schizophrenia and the city: A review of literature and prospective study of psychosis and urbanicity in Ireland.
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ABSTRACT: 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).Biological Psychiatry 11/2009; 116(1):75-89. · 8.28 Impact Factor -
Article: Involuntary admission from the patients' perspective.
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ABSTRACT: Involuntary admission legislation and rates differ greatly throughout the European Union Member States. In Ireland, the Mental Health Act 2001 has introduced significant changes in the care for patients admitted involuntarily, including mental health tribunals that review the involuntary admission orders. To investigate (1) people's perception of the involuntary admission, (2) awareness of legal rights and perception of tribunal, (3) the impact of being admitted involuntarily on the relationship with their family, consultant psychiatrist and prospects for future employment. Over a 15-month period patients admitted involuntarily to a Dublin Hospital were interviewed using a semi structured interview. Eighty-one people participated in the study. Seventy-two percent of patients believed that their involuntary admission was necessary at the time and this was associated with greater insight into illness. A total of 77.8% of patients felt that the treatment they received had been beneficial. A total of 86.4% of patients were aware that they had been admitted involuntarily and 45.5% of patients found it easier to accept that they had been admitted involuntarily as their case was reviewed by a tribunal. A total of 27.5% experienced a negative impact upon the relationship with their family as a result of the involuntary admission, while for 15% there was a positive impact. For 26.6% of patients the doctor-patient relationship was negatively impacted upon and a third felt their prospects for employment could be affected. The majority of patients reflect positively on their involuntary admission and this opportunity should be used to engage patients in follow-up treatment.Social Psychiatry 09/2009; 45(6):631-8. · 2.05 Impact Factor -
Article: First episode psychosis and the trail to secondary care: help-seeking and health-system delays.
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ABSTRACT: People experience delays in receiving effective treatment for many illnesses including psychosis. These delays have adverse consequences in heart disease and cancer, and their causes have been the subject of much research but only in recent years have pathways to care in psychosis received such attention. We sought to establish if, when and where people seek help in the early phase of psychosis in a representative sample. One hundred and sixty-five people with first episode psychosis, referred from community-based psychiatric services and a private psychiatric facility to an early intervention service over 18 months, were interviewed with the Structured Clinical Interview for DSM-IV diagnoses. Symptoms were measured using the Schedule for the Assessment of Positive Symptoms, Schedule for the Assessment of Negative Symptoms and the Calgary Scale. Duration of untreated illness (DUI) and duration of untreated psychosis (DUP) were established using the Beiser Scale. Pathways to mental health services were systematically detailed through interviews with patients and their families. The final sample consisted of 142 (88M, 54F) cases after those with psychosis due to a general medical condition and those without pathway and DUP data were excluded. Less than half of participants initiated help seeking themselves. Of those who did seek help (n = 57) 25% did so during the DUI. Those who had a positive family history of mental illness and poorer premorbid adjustment were significantly less likely to seek help for themselves and those who did not seek help were more likely to require hospitalisation. Families were involved in help seeking for 50% of cases and in 1/3 of cases did so without the affected individual participating in the contact. Being younger and having more negative symptoms were associated with having one's family involved in help seeking. Delays to effective treatment from the onset of psychosis were evenly split between "help-seeking delays" and "health-system delays". Having a family member involved in help seeking and better premorbid adjustment were independently associated with shorter help-seeking delays when measured from the onset of psychosis. Being female, having better premorbid adjustment and fewer negative symptoms were associated with shorter help-seeking delays from the onset of illness. Those with a non-affective psychosis had significantly longer system delays. Many people with first episode psychosis do not initiate help-seeking for themselves particularly those with a relative affected by mental illness. Those with poor premorbid adjustment are at particular risk of longer delays. Poor premorbid adjustment compounded by long delays to effective treatment reduces the likelihood of a good outcome. Families play a vital role in hastening receipt of effective treatment.Social Psychiatry 08/2009; 45(3):381-91. · 2.05 Impact Factor -
Article: Lifetime history of substance misuse in first-episode psychosis: prevalence and its influence on psychopathology and onset of psychotic symptoms.
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ABSTRACT: 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. 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. 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. 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.Early Intervention in Psychiatry 08/2009; 3(3):198-203. · 0.92 Impact Factor -
Article: Are symptoms associated with increased levels of perceived stress in first-episode psychosis?
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ABSTRACT: Several studies report on the presence of external stress and life events prior to the onset and exacerbation of psychotic illness. However, the relationship between the subjective appraisal of stress at first presentation with psychosis is less well understood. This paper reports on the relationship between the individual perception of stress and symptomatology in individuals with first-episode psychosis at presentation to community mental health services. We assessed 123 individuals using standardized measures of symptoms, quality of life, perceived stress, global functioning, and duration of untreated psychosis. At first presentation, people with more depressive symptoms and reduced overall functioning were more likely to report increased levels of perceived stress. In addition, people with less positive symptoms of psychosis were experiencing higher levels of subjective stress. In terms of stress vulnerability models, it is important to consider how functioning and symptoms can influence individual appraisal of stress. Acknowledging this interaction can provide opportunities for nursing interventions directed at enhancing adaptive coping and provide benchmarks for assessing the effectiveness of nursing interventions provided in the acute phase of psychosis. Further research should focus on the interaction between symptoms and individually-appraised stress over time.International journal of mental health nursing 07/2009; 18(3):186-94. · 1.07 Impact Factor -
Article: Is "clinical" insight the same as "cognitive" insight in schizophrenia?
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ABSTRACT: Poor insight is associated with impaired cognitive function in psychosis. Whether poor clinical insight overlaps with other aspects of self-awareness in schizophrenia, such as cognitive self-awareness, is unclear. We investigated whether awareness of clinical state ("clinical insight") and awareness of cognitive deficits ("cognitive insight") overlap in schizophrenia in a sample of 51 stabilized patients with chronic schizophrenia. Cognitive insight was assessed in terms of the agreement between subjective self-report and neuropsychological assessment. Patients who show good cognitive insight did not necessarily show good clinical insight. By contrast, self-report and objective neuropsychological assessment only correlated for patients in the intact clinical insight group and not for those in the impairment clinical insight group. We conclude that while good cognitive insight may not be necessary for good clinical insight, good cognitive awareness is at least partly reliant on the processes involved in clinical insight.Journal of the International Neuropsychological Society 06/2009; 15(3):471-5. · 2.76 Impact Factor -
Article: Cognitive deterioration and duration of untreated psychosis.
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ABSTRACT: To examine the relationship between cognitive deterioration and the duration of untreated psychosis (DUP) in a first-episode psychosis sample. We assessed a consecutive sample of first-episode psychosis participants (N = 50) with measures of cognitive deterioration and DUP. Using correlations and stepwise linear regressions, we found strong relationships between DUP and measures of cognitive deterioration. The length of DUP predicted cognitive deterioration. These results highlight a potential DUP grace period (>6 months) in which significant cognitive deterioration may be averted.Early Intervention in Psychiatry 05/2009; 3(2):157-60. · 0.92 Impact Factor
Top co-authors
Top Journals
Institutions
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2012
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Trinity College Dublin
Dublin, L, Ireland (Republic of Ireland)
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2004–2012
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Saint John of God Hospitaller Services
Dublin, L, Ireland (Republic of Ireland) -
Royal College of Surgeons in Ireland
- Department of Clinical Pharmacology
Dublin, L, Ireland (Republic of Ireland)
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2003–2012
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St John of God Hospital
Dublin, L, Ireland (Republic of Ireland)
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2011
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St. Vincents University Hospital
Dublin, L, Ireland (Republic of Ireland)
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2001–2009
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University College Dublin
Dublin, L, Ireland (Republic of Ireland)
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2002
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Cavan Monaghan Hospital
Monaghan, U, Ireland (Republic of Ireland)
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