Search PubMed⌕ Search

Biomedical subjects

E O'Callaghan

Publications and source records attributed to E O'Callaghan.

89 records · Page 5Linked to original sources
PubMed1991

Fetal brain development and later schizophrenia.

Computed tomography and magnetic resonance imaging studies have shown cerebral ventricular enlargement and a decreased volume of temporal lobe structures in a proportion of schizophrenic patients. Neuropathological investigations confirm these findings and also show diminished volume of the hippocampus and abnormal pre-alpha cell clusters in the parahippocampal gyrus. Compared with controls, schizophrenic patients are more likely to have minor physical anomalies, to have a history of obstetric complications, and to have been born in the late winter. Together the evidence regarding structural brain abnormalities and epidemiology suggests that a significant proportion of cases of schizophrenia have their origins in fetal or neonatal life. The mechanisms involved in the aberrant neurodevelopment remain obscure but some impairment of neuronal migration is an appealing hypothesis.

Brain↗
PubMed1991

Familial, obstetric, and other clinical correlates of minor physical anomalies in schizophrenia.

OBJECTIVE: This study investigated possible antecedents of minor physical anomalies in schizophrenia, particularly in terms of obstetric and genetic factors, and demographic, clinical and cognitive correlates of such anomalies in schizophrenia. METHOD: Forty-one outpatients satisfying the DSM-III criteria for schizophrenia were examined for minor physical anomalies by using the Waldrop scale. These subjects were drawn from a group of 45 such patients whose cognitive function had been previously evaluated with Trail Making Tests A and B and whose biological mothers had been interviewed for any history of obstetric complications or family history of schizophrenia. RESULTS: Linear multiple regression analysis showed that higher scores for minor physical anomalies were associated with impaired cognitive flexibility on Trail Making Test B, family history of schizophrenia in a first-degree relative, maternal history of obstetric complications, smaller number of siblings, later position in the birth order, and male sex. A family history of schizophrenia was particularly associated with abnormalities of the mouth. The association between minor physical anomalies in the patients and obstetric complications in their mothers appeared to be confined to instances in which the mother had a history of bleeding in early pregnancy. CONCLUSIONS: Minor physical anomalies indicate early dysmorphogenesis in schizophrenia, particularly in males, which appears to be associated more reliably with genetic rather than obstetric factors and with cognitive impairment.

Adult↗
PubMed1991

Season of birth in schizophrenia. Evidence for confinement of an excess of winter births to patients without a family history of mental disorder.

Although it is well recognised that schizophrenic patients are more often born in winter, the significance of this finding remains obscure. Data relating to season of birth and family history were analysed for 561 patients with an ICD-9 diagnosis of schizophrenia. Patients with no family history of any psychiatric disorder group were significantly more likely to be born in winter than patients with a first-degree relative affected by schizophrenia. In comparison with normal population controls, only those without a family history exhibited a significant excess of winter births, suggesting an environmental factor of greater aetiological significance in these patients.

Cross-Sectional Studies↗
PubMed1990

Obstetric complications in schizophrenia and the validity of maternal recall.

The significance of the excess of obstetric complications which appears to characterize the histories of schizophrenic patients is critically dependent on the validity of the source of obstetric information, especially when this is obtained by maternal recall. Twenty-one biological mothers of 17 schizophrenic and four other patients were interviewed for their recollections of individual events characterizing the pregnancy and delivery relating to each patient. These were then compared with those events documented in maternity hospital records. Only in two of the 21 instances (9.5%) were inconsistencies of detail apparent which would have affected the designation of the relevant patient as having, or as not having, experienced major obstetric complication(s). It is concluded that maternal recall can be a surprisingly accurate source of obstetric information in relation to research on schizophrenia.

Adult↗
PubMed1990

Obstetric complications, the putative familial-sporadic distinction, and tardive dyskinesia in schizophrenia.

Obstetric complications were more common in the histories of those schizophrenic outpatients without a family history of psychiatric disorder, and were associated with an earlier onset of their illness. Those patients with tardive dyskinesia were more likely to have a family history of psychiatric disorder, less likely to have experienced obstetric complications, and showed greater cognitive deficit. Obstetric complications should be considered in juxtaposition with genetic factors in evaluating the putative familial-sporadic distinction in schizophrenia. Additionally, familial/genetic factors appears to contribute to vulnerability to tardive dyskinesia.

Adult↗
PubMed1990

Psychosis following use of proprietary antidiarrhoeal medicines.

Anticholinergic psychosis was observed to follow ingestion of proprietary antidiarrhoeal preparations by a 63-year-old woman. Possible abuse or accidental overuse of such medicines in the acutely psychotic patient should always be considered.

Belladonna Alkaloids↗
PubMed1989

An evaluation of cranial CT scanning in clinical psychiatry.

From 6,300 psychiatric admissions over a 37 month period, all 54 patient referrals for CT were identified and their charts reviewed. CT influenced diagnosis, management or prognosis in 11.7 percent of patients scanned. There was poor correlation between organicity on CT scan and findings on physical examination, laboratory testing, EEG and psychological testing. The mental state examination was the single significant correlate of CT abnormality. We suggest that the use of a formalised mental state examination such as the Mini Mental State, in addition to the usual clinical assessment of mental state, may improve the accuracy of prediction of abnormality on CT scan. The introduction of X-ray computed tomography (CT) is recognised to be one of the most important innovations in the recent history of clinical medicine. In neurology the value of a non-invasive technique for examining the intracranial contents was quickly realised in the areas of diagnosis, particularly in the detection of vascular accidents and tumours. CT has also attained a significant place in psychiatry. In research studies, it has provided important information on schizophrenia, alcoholism and chronic organic reactions. The place of CT in clinical psychiatry is less clear. As its availability has increased, such scans are being requested with increasing frequency in psychiatric patients. Cranial CT is a highly sensitive diagnostic procedure which, when used unselectively, may result in the discovery of incidental findings. Until recently, a function of the psychiatrist in relation to diagnosis was to first seek to distinguish symptoms produced by organic pathology from those produced by functional illness.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

'Early-onset schizophrenia' after teenage head injury. A case report with magnetic resonance imaging.

A 14-year-old youth sustained an injury to the left frontoparietal area, which was followed by evident change in personality and subsequently by an early-onset schizophrenia-like psychosis. Magnetic resonance imaging revealed ventricular dilatation, slightly more marked in the left hemisphere, and cortical atrophy. Some implications of this case for research on schizophrenia itself are discussed.

Adolescent↗
PubMedDate not supplied

Schizophrenia: solving the puzzle.

BACKGROUND: Schizophrenia is a common mental illness with an incidence of 15 new cases per 100,000 population per year. AIM: To review evidence for current neurodevelopmental models of the aetiology of schizophrenia. METHODS: We performed a literature search using Medline and PsychINFO. We evaluated the relevance of each article and tracked other relevant articles through references. RESULTS: There is considerable evidence to support neurodevelopmental models of the aetiology of schizophrenia. One or more aetiological events occur between conception and birth that disturb central nervous system (CNS) development, leading to persisting alterations in brain structure and function. These early events, acting in concert with genetic loading and later influences or insults, predispose to the development of schizophrenia in early adulthood. CONCLUSIONS: There have been considerable advances in schizophrenia research over the past 20 years. Future study of Indices of neural development will help advance our understanding of this common, disabling mental illness.

Central Nervous System↗
PubMedDate not supplied

Schizophrenia in general practice: a national survey of general practitioners in Ireland.

BACKGROUND: Chronic schizophrenia is challenging to manage in primary care. AIMS: We sought to establish the views of General Practitioners about managing patients with chronic schizophrenia in primary care. METHODS: A cross-sectional, postal survey questionnaire of a randomly selected sample of 20% of GPs was carried out. RESULTS: Most GPs (97.2%) have at least one person with schizophrenia attending their practice. A substantial number of GPs (22.2%) treat cases of schizophrenia without specialist input following an initial referral to psychiatric services. Almost all (88.7%) advised patients who had experienced multiple relapses to remain on medication indefinitely. One third of GPs reported that they always experience difficulties managing patients with schizophrenia in their practice. Non-adherence with prescribed medication and loss to follow-up were the commonest impediments to treatment encountered. CONCLUSION: GPs require appropriate back up from specialist services to enable their management of chronic schizophrenia.

Adult↗
PubMedDate not supplied

Compliance with neuroleptic medication in outpatients with schizophrenia; relationship to subjective response to neuroleptics; attitudes to medication and insight.

The relationship between compliance, subjective response to neuroleptics, attitudes to medication, and insight was assessed in a selected group of individuals with schizophrenia who were attending a catchment area outpatient psychiatric service. Regular compliers with medication reported a significantly better subjective response to neuroleptics and were more frequently prescribed depot medication compared with individuals who were irregularly compliant. There was no difference between regular and irregular compliers in terms of attitudes to medication or level of insight. There was a significant correlation between the measures of insight obtained using a self-report questionnaire (the Insight Scale [IS]) and a semistructured interview (the Scale for Assessment of Insight [SAI]).

Adult↗
PubMedDate not supplied

Course of psychopathology, cognition and neurobiological abnormality in schizophrenia: developmental origins and amelioration by antipsychotics?

It is argued that schizophrenia has origins in events occurring during the first or early second trimester that are reflected in minor physical anomalies and which may at least in part predispose to later obstetric complications. This neurodevelopmental basis underlies certain neuromotor and psychosocial abnormalities of infancy and childhood, which are the early manifestations of what will be reconceptualised later as negative symptoms and (particularly frontal) cognitive dysfunction, but gives rise to positive symptoms only on the maturation of other systems necessary for their expression. This later emergence of psychosis may reflect an active morbid process that is associated with increased accrual of negative symptoms and of general (but not frontal) cognitive impairment that may be ameliorated by effective antipsychotic treatment. The psychological or biological basis of this heuristic process is poorly understood. Contemporary re-appraisal of any impact of antipsychotics on the long-term course of schizophrenia must take into account what is known of the origins of the disease process with which such drugs might interact. Much recent work continues to indicate that very early events, during the embryonic/fetal period, are important in, if not fundamental to, the genesis of schizophrenia; i.e. that there is a neurodevelopmental basis to the disorder. The present article seeks to establish a time-line relating early intrauterine adversity and dysmorphogenesis, through the onset of psychosis, to the chronic phase of the illness over adulthood; from this time-line, a schema is elaborated for a beneficial impact of antipsychotics on the course of psychopathology, cognition and, less clearly, neurobiological abnormality.

Antipsychotic Agents↗
PubMedDate not supplied

Early cerebro-craniofacial dysmorphogenesis in schizophrenia: a lifetime trajectory model from neurodevelopmental basis to 'neuroprogressive' process.

Understanding the temporal origin(s) of schizophrenia, through specifying the earliest identifiable pathology, might indicate when to look for etiological factor(s), what their nature might be, and how course of illness might evolve from these origins. From this premise, earlier formulations are elaborated to offer a rigorously data-driven model that roots schizophrenia in cerebro-craniofacial dysmorphogenesis, particularly along the mid-line but involving other structures, over weeks 9/10 through 14/15 of gestation. However, a brain that has been compromised very early in fetal life is still subject to the normal endogenous programme of developmental, maturational and involutional processes on which a variety of exogenous biological insults and psychosocial stressors can impact adversely over later pregnancy, through infancy and childhood, to maturation and into old age, to sculpt brain structure and function; it should be emphasised that the effects of such endogenous programmes and exogenous insults on such an already developmentally-compromised brain may be different from their effects on a brain whose early fetal origins were unremarkable. From these early origins, a lifetime trajectory model for schizophrenia from developmental basis to 'neuroprogressive' process is constructed. Thereafter, consideration is given to what the model can explain, including cerebral asymmetry and homogeneity, what it cannot explain, what empirical findings would challenge or disprove the model, what cellular and molecular mechanisms might underpin the model, and what are its implications.

Brain↗