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Kathirvel N.,Institute of Mental Health Woodbridge Hospital | Mortimer A.,NAViGO Health and Social Care CIC North East Lincolnshire Mental Health Services
Progress in Neurology and Psychiatry | Year: 2013

Visceral hallucinations are unpleasant sensations that appear to arise from internal organs, and can occur in both psychiatric and neurological disorders. Here, Dr Kathirvel and Professor Mortimer discuss the differential diagnosis, pathophysiology and treatment of visceral hallucinations. © 2013 John Wiley & Sons, Ltd.


Wang Z.M.,Nanyang Technological University | Song Q.,Nanyang Technological University | Soh Y.C.,Nanyang Technological University | Sim K.,Institute of Mental Health Woodbridge Hospital
IEEE Transactions on Neural Networks | Year: 2010

This brief presents a curve clustering technique based on a new multivariate model. Instead of the usual Gaussian random effect model, our method uses the multivariate $t$-distribution model which has better robustness to outliers and noise. In our method, we use the B-spline curve to model curve data and apply the mixed-effects model to capture the randomness and covariance of all curves within the same cluster. After fitting the B-spline-based mixed-effects model to the proposed multivariate $t$ -distribution, we derive an expectation-maximization algorithm for estimating the parameters of the model, and apply the proposed approach to the simulated data and the real dataset. The experimental results show that our model yields better clustering results when compared to the conventional Gaussian random effect model. © 2010 IEEE.


Yogaratnam J.,Institute of Mental Health Woodbridge Hospital
East Asian archives of psychiatry : official journal of the Hong Kong College of Psychiatrists = Dong Ya jing shen ke xue zhi : Xianggang jing shen ke yi xue yuan qi kan | Year: 2013

Metabolic syndrome is a cluster of risk factors comprising obesity, dyslipidaemias, glucose intolerance, insulin resistance (or hyperinsulinaemia), and hypertension, and is highly predictive of type 2 diabetes mellitus and cardiovascular disease. The life expectancy of people with schizophrenia is reduced by 20%, with 60% of the excess mortality due to physical illness. Schizophrenia itself may be a risk factor for metabolic syndrome and there is also increasing concern that antipsychotic drugs, particularly second-generation antipsychotics, have metabolic consequences that contribute to the risk. Various diagnostic guidelines, updated facts with regard to epidemiology, pathophysiology, risk factors, and complications of metabolic syndrome are discussed in this review. Moreover, the impact of various antipsychotics on metabolic syndrome and their possible mechanisms are comprehensively reviewed. The authors emphasise that, while many adults with schizophrenia receive little or no medical care, such care is important given the risk of metabolic abnormalities associated not only with antipsychotic medications, but also with schizophrenia in general.


Rekhi G.,Institute of Mental Health Woodbridge Hospital
Journal of law and medicine | Year: 2012

Singapore is legally restrictive when it comes to research involving minors. The age of majority is 21 and parental consent is required for participation in medical research. This article explores the age of majority and the issues related to obtaining consent for research in Singapore, focusing on "young adults" (17-21 years), using an example of a translational and clinical research project called the Longitudinal Youth at Risk Study (LYRIKS). It describes the unique legal and social conditions pertaining to the age of majority in Singapore, before presenting an argument for consideration as to whether the age of consent to participate in research should be reviewed. It concludes that rather than a set of doctrinaire rules for the age of participation in research, there should be an assessment of the kind of tasks that minors can assume themselves in respect to a specific project, and the degree of parental involvement.


Mahendran R.,National University of Singapore | Hendricks M.M.,Institute of Mental Health Woodbridge Hospital
Clinica Terapeutica | Year: 2013

Aim: The association of second generation antipsychotic medications and hyperglycaemia has been reported for Caucasian populations but is unknown for asian patients who unfortunately are predisposed to diabetes. We report the findings from a health quality improvement project which tracked patients with schizophrenia and schizoaffective disorder newly started on second generation antipsychotics. Materials and Methods: 266 patients were newly started on second generation antipsychotics in a 2 year period. Amongst the baseline parameters monitored was the fasting plasma glucose levels. Repeat testing was done at 4 weeks, 12 weeks and 12 months. Results: 14 patients were excluded form the analysis as they had diabetes at the start of treatment with second generation antipsychotics. Hyperglycaemia was found in 88 patients (34.9%). 68 (77.3%) of these patients experienced the Hyperglycaemia at 12 weeks, 3 patients (3.4%) at 4 weeks and 17 patients (19.3%) at 12 months. Fasting plasma glucose levels were highest at 4 weeks. Conclusions: Despite the limitations of the project, the one third prevalence of hyperglycaemia amongst patients newly started on second generation antipsychotics is a cause for concern and suggests the need for further extensive follow-up and assessment of the problem. © Società Editrice Universo (SEU).

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