About
248
Publications
78,711
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
7,259
Citations
Publications
Publications (248)
Objectives
Family members of people experiencing a first-episode psychosis (FEP) can experience high levels of carer burden, stigma, emotional challenges, and uncertainty. This indicates the need for support and psychoeducation. To address these needs during the COVID-19 pandemic, we developed a multidisciplinary, blended, telehealth intervention,...
Background
Trauma plays an important role in the development and maintenance of psychosis. However, it is still under‐examined in daily clinical practice. The current study investigated the rates of recording of trauma‐exposure in the clinical histories of a first‐episode psychosis (FEP) cohort attending an early intervention psychosis service.
Me...
The detection of psychosis and its prodrome have unique considerations in a child and adolescent population. Young people attending CAMHS are already a high‐risk group, which confers significant limitations in applying the current clinical high‐risk (CHR) model. This has catalysed calls for a transdiagnostic approach to psychosis risk prediction, b...
Background
The ‘at-risk mental state’ (ARMS) for psychosis has been critiqued for its limited prognostic ability and identification of a limited proportion of those who will develop a first episode of psychosis (FEP). Broadening the search for high-risk groups is key to improving population-level ascertainment of psychosis risk.
Aims
To explore ri...
Background Individuals with first-episode psychosis (FEP) face an increased risk of physical comorbidities, notably cardiovascular diseases, metabolic disorders, respiratory disorders, and certain types of cancer. Previous reviews report pooled physical health prevalence from chronic psychosis and FEP groups. By contrast, this review will focus on...
Attitudes to mental illness are an important factor in the willingness of professionals to engage in mental health care.
The aim of this study was to understand attitudes of undergraduate pharmacy students in Ireland to severe mental illness and the provision of medicines optimisation services as well as the variation in these attitudes throughout...
Objectives:
There are high levels of nutritional and metabolic, cardiovascular, and respiratory tract diseases among people diagnosed with serious mental illness (SMI). Consequently, we developed a pragmatic, affordable nutritional and exercise intervention: Choices4Health. Due to the COVID-19 pandemic, we modified this intervention so it could be...
Background:
Migration is a robust risk factor for developing a psychotic disorder, yet there is a paucity of research on the outcomes of migrants who develop a psychotic disorder. Identifying sub-groups within FEP cohorts who have a poorer outcome, could assist in the development and delivery of more targeted interventions.
Aims: There is a pauci...
Background
Attitudes to mental illness are an important factor in the willingness of professionals to engage in mental health care.
Aim
We sought to understand the attitudes of undergraduate pharmacy students in Ireland to severe mental illness and the provision of medicines optimisation services. Further, we aimed to understand if these attitudes...
The transition from higher training to consultanthood is a crucial point in the medical training pathway. Despite comprehensive higher training programs, studies of new consultants have reported a disparity in their sense of preparation for non-clinical and clinical duties. Post- “Certificate of Satisfactory Completion of Specialist Training” (CSCS...
Objective:
Determining the extent to which relationships between duration of untreated psychosis (DUP) and outcome endure longitudinally across the lifetime course of psychotic illness requires prospective, systematic studies of epidemiologically representative incidence cohorts across decades. Transience, persistence, or heterogeneity in associati...
Purpose
Long-term data on recovery conceptualisation in psychotic illness are needed to support mental health services to organise themselves according to recovery-oriented frameworks. To our knowledge, no previous research has investigated how first-episode psychosis (FEP) service users (sampled across psychotic illness type) perceive recovery bey...
The COVID-19 pandemic presents unique challenges to high quality, safe Early Intervention in Psychosis (EIP) service provision. Due to the necessity to ensure EIP continues despite this, we developed a multidisciplinary, blended, telehealth intervention, incorporating psychoeducation and peer support, for family members of first episode psychosis s...
Aim
Early intervention for people experiencing first episode psychosis is a priority, and keyworkers are vital to such services. However, keyworkers' roles in addressing first episode psychosis patients' physical health are under researched. This study addresses this knowledge gap by evaluating a keyworker-mediated intervention promoting physical h...
Background
Migration is an established risk factor for developing a psychotic disorder in countries with a long history of migration. Less is known for countries with only a recent history of migration. This study aimed to determine the risk for developing a psychotic disorder in migrants to the Republic of Ireland.
Methods
We included all present...
Introduction
Of those with schizophrenia, one third develop treatment-resistant illness. Nearly 60% of these benefit from clozapine- the only antipsychotic medication licensed in this group.
Objectives
As treatment-resistant illness developed in the follow-up of a first-episode psychosis (FEP) cohort, clozapine was prescribed. This study retrospec...
Objectives
When presenting with a first episode of psychosis (FEP), migrants can have different demographic and clinical characteristics to the native-born population and this was examined in an Irish Early Intervention for Psychosis service.
Methods
All cases of treated FEP from three local mental health services within a defined catchment area w...
Objective
Guidelines for antipsychotic use in first-episode psychosis (FEP) recommend that medication be chosen initially on the basis of side effect profile with doses at the lower end of the range. Our objective was to describe the pattern of antipsychotic use in FEP over a period of 21 years in the context of changing clinical guidelines and the...
Background:
While research indicates that people with serious mental health conditions want to work, few studies have examined motivation and concerns associated with employment.
Objectives:
This study examined the work attitudes among two samples of Irish people with psychotic conditions, primarily schizophrenia.
Methods:
Data gathered throug...
Objectives
Often referred to as psychotic experiences, unusual perceptual experiences, thoughts and beliefs (UPTBs) are not uncommon in youth populations. Phenomenological studies of these experiences are lacking. This study aimed to (1) describe the phenomenological characteristics of UPTBs in a sample of young adolescents and (2) explore how youn...
Background
Those with serious mental illness (SMI) including both psychotic and affective disorders are recognized to have a premature mortality compared to the general population, at least in part due to elevated cardiovascular risk profile.
Aim
To examine the effect of a 12‐week, pragmatic, sustainable, low‐cost intervention involving community...
Background
One-third of individuals with schizophrenia have treatment-resistant illness. Of these, up to 60% will respond to clozapine treatment.
Aims
This study retrospectively examined clozapine prescribing patterns against National Institute for Health and Care Excellence (NICE) guidelines as treatment-resistant illness emerged in a first-episo...
Aim:
Studies have demonstrated that a majority of the decline in health status and functioning emerges during the first few years following the onset of psychosis. This knowledge led to the development of specialized early intervention services (EIS) targeting patients experiencing their first episode of psychosis (FEP). The central component of E...
Introduction
Mental disorders are increasingly common among adults in both the developed and developing world and are predicted by the WHO to be the leading cause of disease burden by 2030. Many common physical conditions are more common among people who also have a common mental disorder. This scoping review aims to examine the current literature...
Sleep has been shown to impact on both physical and mental health, and sleep problems present a considerable burden for individuals and society. There appears to be a complex bidirectional relationship between sleep disturbance and psychiatric symptoms, each potentially influencing the other. In particular, sleep disorders have been associated with...
Purpose
Increased mortality rates have been found in those with a diagnosis of psychosis; studies suggest a shortened life expectancy of up to 20 years less than that of the general population. This study aimed to investigate the mortality of a first episode psychosis cohort at 20-year follow-up, compare it to that of the general Irish population,...
Objective. To develop a model system for involving patients and caregivers in curriculum development of mental health education in an undergraduate pharmacy program. Methods. Purposive recruitment was used to convene a focus group of nine people with experience in using mental health services from either the patient or caregiver perspective. Group...
Background
Psychotic experiences (PEs) are reported by a significant minority of adolescents and are associated with the development of schizophrenia and other psychiatric disorders in adulthood. Few modifiable protective factors have been identified to date. The aims of this study were to examine associations between a range of psychopathological,...
Background
Early intervention in psychosis is a complex intervention, usually delivered in a specialist stand-alone setting, which aims to improve outcomes for people with psychosis. Previous studies have been criticised because the control used did not accurately reflect actual practice.
Aims
To evaluate the cost-effectiveness of early interventi...
Background:
Studies have demonstrated that, for patients with psychosis, a majority of the decline in health status and functioning emerges during the first few years after the onset of illness. This knowledge led to the development of specialized early intervention services (EISs) targeting patients experiencing their first episode of psychosis....
This paper aims to investigate the feasibility of conducting research on a two-pronged vocational intervention for people with first episode psychosis. The paper also aims to empirically examine the impact of a two-pronged vocational intervention for people with first episode psychosis by determining what effect, if any, introducing a two-pronged v...
Aim
New psychoactive substance (NPS) use can negatively impact mental health and may result in drug‐related psychiatric admissions (DRPA). Irish youth reported very high rates of NPS use by international standards, the most common being synthetic cannabinoids and cathinones. This occurred in the context of a rapid expansion in specialist high stree...
Objectives
Migrant youths endure many challenges. Such challenges can be stressful and lead to psychological difficulties. We investigated the relationship between migration, psychopathology and stressful events in children and adolescents. We hypothesised that migrant youths would show higher levels of psychopathology and more stressful life event...
Objective:
Knowledge of outcome in psychotic illness is limited by the paucity of very long-term epidemiologically representative studies of incidence first episode psychosis (FEP) cohorts that measure and compare outcomes reflecting modern clinical practice, mental health policy and research agendas. Our study aimed to address this gap.
Method:...
Early intervention for psychosis (EIP) programmes have attracted significant interest over the last three decades. It is generally agreed these initiatives are important, with demonstrated improvements in recovery rates and cost effectiveness. EIP programmes were originally designed with a youth focus, however it is known that psychosis presents ac...
Objective. To create a brief, experiential educational intervention for undergraduate pharmacy students aimed at developing appropriate attitudes, knowledge, and skills for the delivery of recovery-focused pharmacy services to people with mental illness, and to elicit student perceptions of the value and impact of the intervention. Methods. A brief...
Little is known about how recovery oriented policy and legislative changes influence service users’ perceptions of mental health care over time. Although the recovery approach is endorsed in many countries, qualitative research examining its impact on service use experiences has been lacking. This study aimed to explore this impact as well as exper...
A vocational intervention for people attending an Irish Early Intervention for Psychosis Service. A two pronged intervention was designed and tested. It included a job retention programme for people who had not lost their vocational role and used IPS with this those who had.
Aim
The aim of this study is to assess the prevalence and clinical correlates of aggression and violence in individuals presenting with first‐episode psychosis (FEP) and to evaluate whether this prevalence has changed in recent years when compared to a similar previous study.
Methods
Retrospective cross‐sectional study of clinical case notes and d...
Background
Psychotic experiences (PEs) are common in childhood and have been associated with concurrent mental disorder and poorer global functioning. Little is known about the effects of childhood PEs on future functioning. We investigated the effects of childhood PEs on global functioning from childhood into early adulthood.
Method
Fifty‐six par...
There is increasing supportive evidence for the paradigm of early intervention in psychosis. International data have confirmed the superior cost effectiveness of specialised early psychosis programmes in comparison to standard public mental health services. The role of Duration of Untreated Psychosis (DUP) in outcome in psychotic illness is now est...
Background Venous thromboembolism (VTE) is an important and potentially preventable cause of morbidity and mortality in hospitalised patients. It is a significant, international patient safety issue affecting medical, surgical and mental health in-patients. There is a paucity of published evidence on the incidence of VTE, and the role of VTE risk-a...
Background
There has been a surge of interest into the relationship between psychotic experiences (PEs) and bullying. However, the methods of bullying and impact of bullying varies across individuals and the prevalence may also vary by respondent (parent or children). For this reason, a thorough investigation into this relationship is warranted.
M...
Background
Individuals with schizophrenia show significant brain morphological abnormalities. The ENIGMA consortium identified that patients with schizophrenia had smaller hippocampus, amygdala, thalamus, accumbens and intracranial volumes.1 Reduced hippocampal volume is one of the most consistent findings in schizophrenia research.2–4 Also, Previo...
Background
Existing literature suggests that prenatal stress may be a risk factor for offspring psychiatric disorders. For example, large ecological studies have found that those exposed to stressors during gestation, such as war and famine, have a twofold increase risk of schizophrenia, as well as an increased risk for other affective disorders. S...
Background:
Distinguishing between a primary psychotic disorder with concurrent substance abuse (PPD+SA) and a substance-induced psychotic disorder (SIPD) can be diagnostically challenging. We aimed to determine if these two diagnoses are clinically distinct, particularly in relation to psychopathology. In addition, we aimed to examine the specifi...
Aim:
Negative symptoms are a cause of enduring disability in serious mental illness. In spite of this, the development of effective treatments for negative symptoms has remained slow. The challenge of improving negative symptom outcomes is compounded by our limited understanding of their aetiology and longitudinal development.
Methods:
A literat...
Introduction
The aim of this review was to conduct a meta-synthesis of qualitative studies examining the meaning of recovery and influences on recovery from the perspective of people diagnosed with ‘psychotic illness’. Due to the substantive difference between the experience of ‘psychotic illness’ and other types of ‘mental illness’ and the absence...
Objectives The findings of increased risk of physical health problems in those with schizophrenia and other psychoses, has deemed the systematic physical health monitoring an essential component of treatment in this vulnerable population. Physical health problems include weight gain, hypertension and metabolic syndrome. Genetic risk factors along w...
Background
Diminished social networks are common in psychosis but few studies have measured these comprehensively and prospectively to determine how networks and support evolve during the early phase. There is little information regarding perceived support in the early phase of illness. The aim of this study was to describe social support, networks...
Purpose/background:
For approximately one third of individuals treated for psychosis or schizophrenia, antipsychotic medications will have little or no therapeutic benefit. Clozapine remains the sole medication approved for treatment-resistant schizophrenia, and studies have demonstrated its superior efficacy in reducing psychotic symptoms.
Metho...
Aim:
Although the relationships between duration of untreated psychosis (DUP) and outcomes are often assumed to be linear, few studies have explored the functional form of these relationships. The aim of this study is to demonstrate the potential of recent advances in curve fitting approaches (splines) to explore the form of the relationship betwe...
Background:
Understanding social inclusion among at-risk populations will deepen our understanding of their specific needs.
Aim:
This study explored the level of social inclusion among people with psychotic-related conditions using a standardised interview.
Method:
The Social Inclusion Interview Schedule was used in two research projects. Peop...
Background
Previous magnetic resonance imaging (MRI) research suggests that, prior to the onset of psychosis, high risk youths already exhibit brain abnormalities similar to those present in patients with schizophrenia.
Objectives
The goal of the present study was to describe the functional organization of endogenous activation in young adolescent...
The aim of this study was to assess the feasibility of a psychosis information intervention for professionals in contact with young people in Ireland. A quasi-experimental pre-and post-intervention design was used. One thousand and thirty-two professionals received an information intervention designed to improve mental health literacy (MHL) and con...
Objectives
Clinical practice guidelines (CPGs) support the translation of research evidence into clinical practice. Key health questions in CPGs ensure that recommendations will be applicable to the clinical context in which the guideline is used. The objectives of this study were to identify CPGs for the pharmacological treatment of first-episode...
Purpose: The literature has demonstrated the complexity of the concept of recovery in the context of ‘psychotic illness’. Much can be learned from qualitative explorations of recovery from the viewpoint of the service user. Materials and Methods: A systematic review and meta-synthesis were undertaken to synthesise the findings of qualitative studie...
Purpose: Internationally, the delivery of mental health services has changed dramatically over the last 20 years. In Ireland, this transformation is instantiated by the national policy document A Vision for Change (2006). This policy shift is underpinned by a recovery orientated approach which emphasises: service user and family/carer/supporter inv...
Background:
Formal thought disorder (FTD) is associated with poor outcome in established psychotic illnesses and it can be assessed as a categorical or dimensional variable. However, its influence on functional outcome and hospitalisation patterns in early psychosis has not been investigated. We evaluated the relationship between FTD and these out...
The negative symptoms of schizophrenia can be divided into two domains. Avolition/apathy includes the individual symptoms of avolition, asociality and anhedonia. Diminished expression includes blunted affect and alogia. Until now, causes and treatment of negative symptoms have remained a major challenge, which is partially related to the focus on n...
Aim:
Although early intervention in psychosis is an accepted policy internationally, the evidence base for this paradigm, originates mostly from the specialist model. In a real world setting, variations of this model are often implemented. The aim of this paper is to systematically evaluate the evidence for delivering early intervention outside th...
Background
The incidence of psychotic disorders varies between geographical areas and it has been hypothesized that neighbourhood level factors may influence this variation. It is also plausible that the DUP is associated with neighbourhood characteristics. The aims of this study are to determine whether the incidence of FEP and the DUP are associa...
A clinical trial of individual placement and support and a job retention programme at the DETECT Early Intervention for Psychosis Service. Conducted by Niall Turner Occupational Therapist.
Language disturbance has a central role in the presentation of psychotic disorders however its relationship with functioning requires further clarification, particularly in first episode psychosis (FEP). Both language disturbance and functioning can be evaluated with clinician-rated and performance-based measures. We aimed to investigate the concur...
Background:
There is an unclear relationship between mental health literacy (MHL) and psychiatric stigma. MHL is associated with both positive and negative attitudes to mental illness. To our knowledge, no published peer reviewed study has examined this relationship in the Republic of Ireland.
Aims:
This study was conducted to assess MHL regardi...
Describing the trajectory of prodromal symptoms has obvious appeal in supporting advances towards sub-clinical intervention. Identifying clinical phenomena associated with unfavourable illness outcomes could have greater significance in explaining some heterogeneity within and between psychotic disorders and advancing understanding of pre-psychotic...
The authors developed and validated a clozapine-specific side-effects scale capable of eliciting the subjectively unpleasant side-effects of clozapine.
Questions from the original Glasgow Antipsychotic Side-effects Scale (GASS) were compared to a list of the most commonly reported clozapine side-effects and those with a significant subjective burde...
Abstract
BACKGROUND:
Early intervention in psychosis is an accepted policy internationally. When 'A Vision for Change', the national blueprint for mental health policy in Ireland, was published in 2007 there was one Irish pilot service for early intervention in psychosis. The National Clinical Mental Health Programme Plan (2011) identified early in...
Objective
Wellness Recovery Action Planning (WRAP) is a cross-diagnostic, patient-centred, self-management intervention for psychiatric illness. WRAP utilises an individualised Wellness Toolbox, a six part structured monitoring and response system, and a crisis and post-crisis plan to promote recovery. The objective of this study was to evaluate th...
Individuals with psychotic disorders are represented more in the lower social classes, yet there is conflicting evidence to whether these individuals drift into the lower social classes or whether lower social class is a risk factor for developing psychosis. The aim of this study was to examine whether the social class at birth is a risk factor for...
Objectives. Study of illness characteristics and symptoms in a young population with psychosis can assist for under-standing of their needs, and can inform service planning strategies. The aims of the current study were to describe illness characteristics and symptoms of a first episode psychosis (FEP) sample aged 25 years and under, and compare wi...