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A battery of psychological tests was administered on three occasions over a three-month period to 75 patients admitted to a geriatric hospital and 75 patients admitted to psychiatric hospitals serving the same catchment area. The test results, used as an independent criterion, provided evidence that the criteria of psychiatric diagnosis were applied with constancy and accuracy in the two types of hospital, and supported the psychiatrists' findings that there were no strong grounds to believe that elderly patients were being ‘misplaced’ in one or other type of hospital facility. [ABSTRACT FROM AUTHOR]

In a cross-national comparison of the frequency of occurrence of various diagnoses among elderly psychiatric patients admitted to public mental hospitals in London and New York, a short battery of psychological tests was administered to all patients independently of psychiatric examination. The psychological assessment was focused on the differentiation between dementing and affective disorders. The test performance showed a highly significant difference between the two groups as diagnosed, and when patients were allocated to groups on the basis of tests alone these allocations showed a high rate of agreement with initial psychiatric diagnosis. There was a similar high rate of agreement between test allocation and hospital diagnosis in the U.K., but this was not so in the U.S. No significant differences were found between the test performance of U.K. and U.S. patients, except on the WAIS Vocabulary and the Angles Error measurement of the Bender-Gestalt test. When the effects of age and Vocabulary score were eliminated these differences disappeared. The hypothesis that the diagnosis of affective disorder would be confirmed by a relatively greater improvement in test performance over time in this group of patients was not upheld by the non-parametric analysis of change scores. However, an analysis of covariance utilizing age and initial score did indicate the expected differential improvement. [ABSTRACT FROM AUTHOR]

Psychiatric diagnosis in the elderly has been examined in order to extract the information which leads to later modification of the diagnosis. Initial diagnoses of neuroses and toxic states were least stable, 14 out of 29 changing to a different category. Information from relatives and further interviews contributed most to the modification of the initial diagnosis, though affective and neurotic syndromes were particularly susceptible to change resulting from conceptual differences, and dementia to change consequent on physical examination. It is concluded that an adequate initial interview of a patient and his next of kin will achieve a diagnosis which is correct in its major category on 95 per cent of occasions. [ABSTRACT FROM AUTHOR]

The article presents a study that explores the influence of post-graduate training in psychiatry on the new registrars' rating of mental abnormality at the Bethlem-Maudsley Hospitals in Great Britain. All new registrars who started training at the institution were asked to rate a timed videotaped unstructured clinical interview of a psychiatric patient and after two years of post-graduate training, they rated the same instrument. Comparison between the initial and post-findings revealed that the registrars rated less mental abnormality after two years of training.

The article presents a study which tries to establish the distinction between psychogeriatric and geriatric patients. The study examines a series of elderly admissions to a psychiatric and a geriatric hospital serving the same catchment area in order to evaluate the success of the two hospital services in separating their patients into two groups. A distinction between the patients can be made satisfactorily in clinical practice provioded that both the quality and quantity of the services supplied are adequate.

The article presents a study which compares the diagnoses of elderly psychiatric patients admitted to mental hospitals in Queens County, New York and Camberwell in London, England. The authors stressed the importance for the patient of making the distinction between an organic and a functional diagnosis. Results showed that while the diagnosis in Camberwell and Queens on the patients examined differed as expected, there were no significant differences in the diagnostic proportions found by the Project on either side.

A computerized diagnosis, AGECAT, is applied to data from random community samples of elderly people in New York and London in order to examine the distribution of mental illness between males and females. The greater proportion of dementia in females is confirmed for all AGECAT's levels of diagnostic confidence, and for depression at all levels except one. Age- and sex- specific prevalence rates are quoted for each half decade between 65 and 90 years. Differences between the sexes on syndrome case and subcase levels of neurotic disorder do not reach statistical significance. [ABSTRACT FROM AUTHOR]

The official suicide rate in Ireland increased markedly between 1970 and 1985. This is genuine increase in suicide and not an apparent one due to previous deficiencies in recording practices. Possible reasons for this change include an increase in 'anomie' shown by a rise in the rates of crime, illegitimacy and admissions to hospital for alcoholism, a decline in social cohesion revealed by a fall in the marriage rate and a rise in the number of separated couples, and an increase in unemployment. [ABSTRACT FROM AUTHOR]

A survey of 54 firesetters who had been in hospital or prison was conducted. The results confirmed earlier findings on several aspects, such as male predominance, unstable childhood and proclivity to self-injurious behaviour. Revenge emerged as the commonest motive overall and an association with alcohol was found. Only 11% of the fire-raising episodes, whether among hospital or prison groups, were truly trivial. Arsonists in prison and hospital had many features in common and generally were quite psychologically disturbed, which contrasted with those who set fires for profit. A poor outcome was found, with continuing self-harm and a high suicide rate. Our findings suggest that arson recidivism arises in at least 35% of arsonists. [ABSTRACT FROM AUTHOR]

The non-fatal deliberate taking of overdoses in Cork city during 1982 was investigated from records in the general hospitals. In one of the hospitals, those attending after an overdose were personally interviewed. For both sexes, the greatest incidence of overdoses was in the younger groups; for females, there was a seasonal variation. Those taking overdoses were grouped by electoral wards, and the social characteristics of these wards determined. The frequency varied greatly throughout the city; some wards, particularly in corporation northern estates and part of the city centre, showed a rate of up to three times the average; these areas were the most likely to show social deprivation. [ABSTRACT FROM AUTHOR]

The author reflects on the impact of increasing suicidal rate on social and cultural conditions in Ireland. He discusses the social and cultural changes, including the public practice of religious worship and the proportionality of the demographic statistics of youth attending schools which are more visible in rural areas. He also mentions the increasing urbanization, distinguished internal migration and widespread industrialization as well as a great increase in the gross domestic product.

The article presents an abstract of the study "A Prospective Study of the Influence of Post-Graduate Training in Psychiatry on the Rating of Mental Abnormality." Comparisons between the initial and subsequent ratings of observed abnormalities on a scale of psychiatric patients through a timed videotaped clinical interview, and the ratings made on the same tape by American scientists. Findings show that the initial ratings were intermediate between the ratings of Maudsley and the psychiatrists.

Background: The coronavirus pandemic resulted in many changes which had the potential to impact mortality related to opioid agonist therapy (OAT; methadone, buprenorphine), including changes in the prescribing and dispensing of OAT and patterns of drug availability and use. We aimed to assess the impact of the first lockdown (initiated March 23rd 2020) on methadone- and buprenorphine-related deaths in England in people both prescribed and not prescribed OAT using data from the National Programme on Substance Abuse Deaths.Methods: This was a retrospective post-mortem toxicology study of OAT-related deaths which occurred in the 3-month period March 23rd to June 22nd in the years 2016-2020. Provisional data regarding numbers accessing treatment for opioid use disorder was provided by the National Drug Treatment Monitoring System.Results: We found a 64% increase in methadone-related deaths in March to June 2020 compared to March to June 2019 (2019 n = 96; 2020 projected n = 157). There were increases in the mortality rate of both in-treatment decedents (22% increase; 2019 n = 45; an exponential smoothing model of the 2016-19 trend [α=0.5] predicted 44 deaths in 2020, 55 were reported) and decedents not prescribed methadone (74% increase; 2019 n = 46; 2016-19 trend predicted 43 deaths in 2020, 80 were reported). There was no increase in buprenorphine-related deaths (2019 n = 9/529; 2020 n = 11/566). There were no changes in the numbers of deaths where other opioids or multiple substances were detected, or in methadone levels detected. Numbers of people accessing treatment for opioid use disorder in 2020 did not decrease relative to previous years (p >0.05).Conclusions: Methadone-related deaths in non-prescribed individuals, but not prescribed individuals, increased considerably above the annual trend forecast for 2020 during the first COVID-19 lockdown in England. Further studies are thus needed to understand this difference. [ABSTRACT FROM AUTHOR]

This study, based in Ireland in the Limerick centre of the WHO/EURO Multicentre Study of Parasuicide, tests the hypothesis that the uptake of hospital services increases significantly following an act of parasuicide. To investigate this, the costs of hospital attendance in the year before and in the year after an act of parasuicide are measured and compared. The sample is comprised of the first 100 individuals who attended an acute general hospital following an act of parasuicide after July 1, 1995. Using a computerized patient record system, every hospital attendance is identified, for each individual, in the 12 months before and after the parasuicide act. This includes every visit to the Emergency Room as well as both general and psychiatric inpatient admissions and outpatient attendances. There was a 50% increase in the uptake of hospital services--32% of the sample attended hospital in the year before compared with 48% in the year after. The total yearly costs for the 100 patients almost doubled from IR 53,652 Pounds (Euro 68,138) to IR 104,454 Pounds (Euro 132,657). Generalizing to the 539 individuals who engaged in parasuicide in the Limerick catchment area, total costs increased from IR 289,184 Pounds (Euro 367,264) to IR 563,007 Pounds (Euro 715,019). This study is an initial step toward the more complex task of estimating to what extent the increased uptake of hospital services is due to the consequences of parasuicide and how much is due to other aspects of the patient's health.

In the Western World self-immolation is an uncommon but dramatic method of attempting suicide. In-patients who attempt suicide by fire-setting tend to be female with severe psychopathology. In a previous study from the South of Ireland, seven cases from a psychiatric and prison population were identified in a five year period from 1984 to 1989. This would represent an annual rate of 1.07 per cent of burns treated in the burns unit at Cork University Hospital. In this study 12 cases were identified for the years 1994 and 1995. This represents an increase of 3.5 per cent from 1.07 to 4.6 per cent of all burns treated at the same institution. Ten of these patients had a previous psychiatric history and eight of them were resident on a psychiatric ward when they committed the act. Seven of the patients were found to have a high degree of suicide intent of whom four died of their injuries, which gives a mortality rate for this group of 33 per cent. Effective prevention policies are necessary if this increasing problem is to be curtailed.