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Aberdeen, United Kingdom

Simonsen H.,Royal Cornhill Hospital | Shand A.J.,Royal Cornhill Hospital | Scott N.W.,University of Aberdeen | Eagles J.M.,Royal Cornhill Hospital
Journal of Affective Disorders | Year: 2011

Background: There is evidence of seasonality in bipolar affective disorder (BAD) and the preponderance of atypical symptoms in bipolar depressive episodes is also seen in winter type Seasonal Affective Disorder. Differences in seasonal symptoms between BAD and appropriate comparison populations have been scrutinised only in small studies. Methods: Symptoms described on the Seasonal Pattern Assessment Questionnaire (SPAQ) were compared between 183 patients with BAD and 468 patients consulting their general practitioners. Statistical analyses were adjusted for differing age and gender distributions between the two groups. Results: Compared with the general practice patients, subjects with BAD reported greater seasonal fluctuations in mood (p = 0.003). On one measure BAD subjects reported increased seasonal changes in social activity (p < 0.001) and greater weight fluctuation over the year (p = 0.001). The most striking differences were in sleep patterns; BAD subjects slept significantly more throughout the year, and slept for a mean of 1.8 h more in winter than in summer (versus a 1.0 h difference in the general practice group, p < 0.001). Against 20% of the general practice group, 46% of BAD patients rated seasonal changes in well-being to be at least a moderate problem. Limitations: The SPAQ was designed as a screening instrument for Seasonal Affective Disorder, not for studies of this nature. Some of the reported differences, notably in social activity and weight changes, may reflect secondary psychosocial effects of BAD. Conclusions: Seasonal changes, most notably winter hypersomnia, should be identified in patients with BAD. These symptoms may respond to treatments such as light therapy that are used in recurrent winter depression. © 2011 Elsevier B.V. All rights reserved.

Shand A.J.,Royal Cornhill Hospital | Scott N.W.,University of Aberdeen | Anderson S.M.,Royal Cornhill Hospital | Eagles J.M.,Royal Cornhill Hospital
Journal of Affective Disorders | Year: 2011

Background: In contrast with recurrent unipolar depression, relatively little is known about the seasonality of depressive episodes in bipolar affective disorder (BAD). Method: We compared responses on the Seasonal Pattern Assessment Questionnaire (SPAQ) between a cohort of 183 patients with BAD and a large sample of patients in primary care (N = 4746). Comparisons were adjusted for age and gender. Results: 27% of the BAD patients fulfilled SPAQ criteria for Seasonal Affective Disorder (SAD. This gave an adjusted odds ratio of 3.73 (95% confidence intervals 2.64 to 5.27) in comparison with the rate among the primary care samples. Global seasonality scores were significantly higher among BAD patients (adjusted mean difference 1.73, 95% CI 0.97 to 2.49, p < 0.001). Limitations: The SPAQ was originally designed as a screening instrument rather than as a case-finding instrument. Conclusions: Vigilance for seasonal symptom recurrence in BAD may be important with regard to management and relapse prevention. © 2011 Elsevier B.V. All rights reserved.

Curtis-Barton M.T.,University of Aberdeen | Eagles J.M.,Royal Cornhill Hospital
Psychiatrist | Year: 2011

Aims and method: This cross-sectional study investigated the evolution of intentions among medical students to pursue a career in psychiatry and the factors that might discourage them from becoming a psychiatrist. A questionnaire survey was sent to medical students in years 1-5 at Aberdeen University. Results: From 918 students, 467 (51%) returned useable responses. Proportions of students across the 5-year groups who definitely or probably intended to become psychiatrists remained fairly stable at 4-7%. In their final year, psychiatry remained a possible career option for a further 17% of students. The most potent discouraging factor was the perception of poor prognoses among psychiatric patients. Perceptions of a lack of scientific/evidence base reduced enthusiasm for becoming a psychiatrist. Issues relating to the prestige of the specialty were also important. Implications If recruitment to the specialty is to improve, these negative perceptions among students should be addressed by their teachers and more widely within psychiatry.

Vaitheswaran S.,NHS Grampian | Crockett P.,Royal Cornhill Hospital | Millar H.,NHS Grampian
Advances in Psychiatric Treatment | Year: 2012

Video technology was first used in psychiatric services in the 1950s but came into general use in the 1990s, particularly in North America and Australia. Video has utility across all ages and in a wide range of clinical situations. These include case conferencing for patients with complex problems (e.g. when planning discharge from specialist in-patient units), psychological assessment and treatment, Mental Health Act assessments, suicide risk assessment and work in forensic settings. Potential for benefit may be most obvious in remote locations, but video use is also relevant in urban settings. Lack of training and experience, inadequate access to equipment and insufficient technical support have all limited the take-up of this technology in the UK. This article briefly reviews the literature and outlines technical and cost considerations when using video technology. Three services in Scotland are described to illustrate ways in which videoconferencing can enhance services.

Milders M.,University of Aberdeen | Bell S.,Royal Cornhill Hospital | Platt J.,Royal Cornhill Hospital | Serrano R.,Royal Cornhill Hospital | Runcie O.,Royal Cornhill Hospital
Psychiatry Research | Year: 2010

Although abnormalities in emotion recognition during a depressed episode have frequently been reported in patients with depression, less is known about the stability of these abnormalities. To examine the stability of emotion recognition abnormalities, this longitudinal study assessed patients with unipolar depression on three separate occasions at 3-monthly intervals. Recognition of sad, angry, fearful, disgusted, happy and neutral facial expressions was assessed in a matching task and a labelling task. Patients performed as well as matched healthy controls on the matching task. On the labelling task, patients showed higher accuracy and higher response bias than controls for sad expressions only, which remained stable over a 6-month interval. Over the same period, symptom severity, as measured with the Beck Depression Inventory and the Hamilton Depression Rating Scale, decreased significantly in the patient group. Furthermore, labelling performance for sad expressions was not associated with symptom severity or with changes in severity over time. This stable bias for sad expressions might signal a vulnerability factor for depression, as proposed by cognitive theories of depression. © 2009 Elsevier Ltd.

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