Browsing by Author "Emsley, Robin"

Now showing 1 - 8 of 8
  • Thumbnail Image
    Item
    10Kin1day : a bottom-up neuroimaging initiative
    (Frontiers Media, 2019) Van den Heuvel, Martijn P.; Scholtens, Lianne H.; Van der Burgh, Hannelore K.; Agosta, Federica; Alloza, Clara; Arango, Celso; Auyeung, Bonnie; Baron-Cohen, Simon; Basaia, Silvia; Benders, Manon J. N. L.; Beyer, Frauke; Booij, Linda; Braun, Kees P. J.; Filho, Geraldo Busatto; Cahn, Wiepke; Cannon, Dara M.; Chaim-Avancini, Tiffany M.; Chan, Sandra S. M.; Chen, Eric Y. H.; Crespo-Facorro, Benedicto; Crone, Eveline A.; Dannlowski, Udo; De Zwarte, Sonja M. C.; Dietsche, Bruno; Donohoe, Gary; Du Plessis, Stefan; Durston, Sarah; Diaz-Caneja, Covadonga M.; Díaz-Zuluaga, Ana M.; Emsley, Robin; Filippi, Massimo; Frodl, Thomas; Gorges, Martin; Graff, Beata; Grotegerd, Dominik; Gąsecki, Dariusz; Hall, Julie M.; Holleran, Laurena; Holt, Rosemary; Hopman, Helene J.; Jansen, Andreas; Janssen, Joost; Jodzio, Krzysztof; Jancke, Lutz; Kaleda, Vasiliy G.; Kassubek, Jan; Masouleh, Shahrzad Kharabian; Kircher, Tilo; Koevoets, Martijn G. J. C.; Kostic, Vladimir S.; Krug, Axel; Lawrie, Stephen M.; Lebedeva, Irina S.; Lee, Edwin H. M.; Lett, Tristram A.; Lewis, Simon J. G.; Liem, Franziskus; Lombardo, Michael V.; Lopez-Jaramillo, Carlos; Margulies, Daniel S.; Markett, Sebastian; Marques, Paulo; Martinez-Zalacaín, Ignacio; McDonald, Colm; McIntosh, Andrew M.; McPhilemy, Genevieve; Meinert, Susanne L.; Menchon, Jose M.; Montag, Christian; Moreira, Pedro S.; Morgado, Pedro; Mothersill, David O.; Merillat, Susan; Muller, Hans-Peter; Nabulsi, Leila; Najt, Pablo; Narkiewicz, Krzysztof; Naumczyk, Patrycja; Oranje, Bob; De la Foz, Victor Ortiz-Garcia; Peper, Jiska S.; Pineda, Julian A.; Rasser, Paul E.; Redlich, Ronny; Repple, Jonathan; Reuter, Martin; Rosa, Pedro G. P.; Ruigrok, Amber N. V.; Sabisz, Agnieszka; Schall, Ulrich; Seedat, Soraya, 1966-; Serpa, Mauricio H.; Skouras, Stavros; Soriano-Mas, Carles; Sousa, Nuno; Szurowska, Edyta; Tomyshev, Alexander S.; Tordesillas-Gutierrez, Diana; Valk, Sofie L.; Van den Berg, Leonard H.; Van Erp, Theo G. M.; Van Haren, Neeltje E. M.; Van Leeuwen, Judith M. C.; Villringer, Arno; Vinkers, Christiaan H.; Vollmar, Christian; Waller, Lea; Walter, Henrik; Villringer, Arno; Vinkers, Christiaan H.; Vollmar, Christian; Waller, Lea; Walter, Henrik; Whalley, Heather C.; Witkowska, Marta; Witte, A. Veronica; Zanetti, Marcus V.; Zhang, Rui; De Lange, Siemon C.
    Parkinson’s disease (PD) is a well-known neurodegenerative disease with a strong association established with systemic inflammation. Recently, the role of the gingipain protease group from Porphyromonas gingivalis was implicated in Alzheimer’s disease and here we present evidence, using a fluorescent antibody to detect gingipain R1 (RgpA), of its presence in a PD population. To further elucidate the action of this gingipain, as well as the action of the lipopolysaccharide (LPS) from P. gingivalis, low concentrations of recombinant RgpA and LPS were added to purified fluorescent fibrinogen. We also substantiate previous findings regarding PD by emphasizing the presence of systemic inflammation via multiplex cytokine analysis, and demonstrate hypercoagulation using thromboelastography (TEG), confocal and electron microscopy. Biomarker analysis confirmed significantly increased levels of circulating proinflammatory cytokines. In our PD and control blood analysis, our results show increased hypercoagulation, the presence of amyloid formation in plasma, and profound ultrastructural changes to platelets. Our laboratory analysis of purified fibrinogen with added RgpA, and/or LPS, showed preliminary data with regards to the actions of the protease and the bacterial membrane inflammagen on plasma proteins, to better understand the nature of established PD.
  • Thumbnail Image
    Item
    Cognitive insight is associated with perceived body weight in overweight and obese adults
    (BMC (part of Springer Nature), 2021-03-19) Suliman, Sharain; L. Van Den Heuvel, Leigh; Kilian, Sanja; Brocker, Erine; Asmal, Laila; Emsley, Robin; Seedat, Soraya
    Background: Accurate perception of body weight is necessary for individuals with a high body mass index (BMI) to initiate strategies to improve their health status. Furthermore, identifying factors that influence accurate body weight perception can assist in designing appropriate educational and weight management programs. We therefore aimed to investigate whether levels of cognitive functioning and insight influence the ability to correctly judge body weight. Methods: One hundred and eighty four overweight and obese adults who participated in a cross- sectional casecontrol study and were controls in the aforementioned study were included. The study was conducted in Cape Town, South Africa. Demographic, weight-related, neuropsychiatric, neurocognitive and cognitive insight measures were administered. Regression analysis was conducted to determine the factors associated with correct weight perception. Results: The final regression model explained 52.3% of variation in accurate perception of body weight and was significant (p ≤ 0. 001). The model correctly classified 79.3% of individuals who were able to correctly and incorrectly judge their weight. Adults with higher BMI, and lower self-certainty, those who reported that they had gained weight in the previous year and those who were told by a healthcare professional to lose or maintain a healthy weight were more likely to correctly judge their weight. Conclusion: Some aspects of cognitive insight (self-certainty) but not cognitive functioning were associated with perception of body weight in this sample. Awareness of recent weight changes, higher BMI and advice from of health care professionals were also significantly associated with perception of body weight, while demographic variables were not. Understanding the factors that contribute to the correct perception of weight is important in identifying appropriate health interventions that may address the burden of associated non-communicable diseases in overweight and obese individuals.
  • Thumbnail Image
    Item
    Forensic mental health services: Current service provision and planning for a prison mental health service in the Eastern Cape
    (AOSIS Publishing, 2016) Sukeri, Kiran; Betancourt, Orlando A.; Emsley, Robin; Nagdee, Mohammed; Erlacher, Helmut
    Objectives: No research data exists on forensic psychiatric service provision in the Eastern Cape, Republic of South Africa. The objective of this research was to assess current forensic psychiatric service provision and utilisation rates at Fort England Hospital. This is important in improving and strengthening the service. A related objective was to develop a model for a provincial prison mental health service. Methodology: This study is a situational analysis of an existing forensic psychiatric service in the Eastern Cape. The design of the study was cross sectional. An audit questionnaire was utilised to collate quantitative data, which was submitted to Fort England Hospital, Grahamstown. A proposed prison mental health service was developed utilising prevalence rates of mental illness among prisoners to calculate bed and staff requirements for an ambulatory and in-patient service. Results: During the study period a total of 403 remand detainees were admitted to the forensic psychiatry division of Fort England Hospital. The average length of stay was 494 days and the bed utilisation rate was determined at 203.54%. We estimate that to provide a provincial prison mental health service to treat psychotic illnesses and major depression the province requires a 52 bedded facility and a total staff complement of approximately 31. Conclusions: Forensic psychiatric services include the assessment, management and treatment of mentally disordered persons in conflict with the law and prisoners requiring psychiatric assessments. The Eastern Cape Province does not have plans or policies to assess and manage mentally ill offenders, resulting in an increased load on available services. We recommend that an inter-departmental task team, which includes Health, Justice and Constitutional Development and Correctional Services, should be established in the province, to develop a strategy to assist in the development of an effective and efficient forensic psychiatric service. This should be driven by the provincial Department of Health.
  • Thumbnail Image
    Item
    Lessons from the past : historical perspectives of mental health in the Eastern Cape
    (AOSIS Publishing, 2014-07-30) Sukeri, Kiran; Alonso-Betancourt, Orlando; Emsley, Robin
    The development of mental health services in the Eastern Cape Province is inextricably entwined in South Africa’s colonial history and the racist policy of apartheid. Prior to the development of mental hospitals, mental health services were provided through a network of public and mission hospitals. This paper explores the development of early hospital and mental health services in the Eastern Cape from the time of the Cape Colony to the dissolution of apartheid in 1994, and highlights the influence of colonialism, race and legislation in the development of mental health services in this province. The objective is to provide a background of mental health services in order to identify the historical factors that have had an impact on the current shortcomings in the provision of public sector mental health services in the province. This information will assist in the future planning and development of a new service for the province without the stigma of the past. This research indicates that one lesson from the past should be the equitable distribution of resources for the provision of care for all that inhabit this province, as enshrined in South Africa’s constitution.
  • Thumbnail Image
    Item
    The nature of relapse in schizophrenia
    (BioMed Cenral, 2013-02) Emsley, Robin; Chiliza, Bonginkosi; Asmal, Laila; Harvey, Brian, H.
    Background Multiple relapses characterise the course of illness in most patients with schizophrenia, yet the nature of these episodes has not been extensively researched and clinicians may not always be aware of important implications. Methods We critically review selected literature regarding the nature and underlying neurobiology of relapse. Results Relapse rates are very high when treatment is discontinued, even after a single psychotic episode; a longer treatment period prior to discontinuation does not reduce the risk of relapse; many patients relapse soon after treatment reduction and discontinuation; transition from remission to relapse may be abrupt and with few or no early warning signs; once illness recurrence occurs symptoms rapidly return to levels similar to the initial psychotic episode; while most patients respond promptly to re-introduction of antipsychotic treatment after relapse, the response time is variable and notably, treatment failure appears to emerge in about 1 in 6 patients. These observations are consistent with contemporary thinking on the dopamine hypothesis, including the aberrant salience hypothesis. Conclusions Given the difficulties in identifying those at risk of relapse, the ineffectiveness of rescue medications in preventing full-blown psychotic recurrence and the potentially serious consequences, adherence and other factors predisposing to relapse should be a major focus of attention in managing schizophrenia. The place of antipsychotic treatment discontinuation in clinical practice and in placebo-controlled clinical trials needs to be carefully reconsidered.
  • Thumbnail Image
    Item
    Psychiatrists' awareness of adherence to antipsychotic medication in patients with schizophrenia : results from a survey conducted across Europe, the Middle East, and Africa
    (Dovepress, 2013) Olivares, Jose Manuel; Alptekin, Koksal; Azorin Jean-Michel; Canas, Fernando; Dubois, Vincent; Emsley, Robin; Gorwood, Philip; Haddad, Peter M.; Naber, Dieter; Papageorgiou, George; Roca, Miquel; Thomas, Pierre; Martinez, Guadalupe; Schreiner, Andreas
  • Thumbnail Image
    Item
    Safety of psychotropic medications in people with COVID-19 : evidence review and practical recommendations
    (BMC (part of Springer Nature), 2020-07-15) Ostuzzi, Giovanni; Papola, Davide; Gastaldon, Chiara; Schoretsanitis, Georgios; Bertolini, Federico; Amaddeo, Francesco; Cuomo, Alessandro; Emsley, Robin; Fagiolini, Andrea; Imperadore, Giuseppe; Kishimoto, Taishiro; Michencigh, Giulia; Nose, Michela; Purgato, Marianna; Dursun, Serdar; Stubbs, Brendon; Taylor, David; Thornicroft, Graham; Ward, Philip B.; Hiemke, Christoph; Correll, Christoph U.; Barbui, Corrado
    Background: The novel coronavirus pandemic calls for a rapid adaptation of conventional medical practices to meet the evolving needs of such vulnerable patients. People with coronavirus disease (COVID-19) may frequently require treatment with psychotropic medications, but are at the same time at higher risk for safety issues because of the complex underlying medical condition and the potential interaction with medical treatments. Methods: In order to produce evidence-based practical recommendations on the optimal management of psychotropic medications in people with COVID-19, an international, multi-disciplinary working group was established. The methodology of the WHO Rapid Advice Guidelines in the context of a public health emergency and the principles of the AGREE statement were followed. Available evidence informing on the risk of respiratory, cardiovascular, infective, hemostatic, and consciousness alterations related to the use of psychotropic medications, and drug–drug interactions between psychotropic and medical treatments used in people with COVID-19, was reviewed and discussed by the working group. Results: All classes of psychotropic medications showed potentially relevant safety risks for people with COVID-19. A set of practical recommendations was drawn in order to inform frontline clinicians on the assessment of the anticipated risk of psychotropic-related unfavorable events, and the possible actions to take in order to effectively manage this risk, such as when it is appropriate to avoid, withdraw, switch, or adjust the dose of the medication. Conclusions: The present evidence-based recommendations will improve the quality of psychiatric care in people with COVID-19, allowing an appropriate management of the medical condition without worsening the psychiatric condition and vice versa.
  • Thumbnail Image
    Item
    Second-generation antipsychotics - a panacea?
    (AOSIS, 2004) Carey, Paul D.; Stein, Dan; Emsley, Robin
    The introduction of the second-generation antipsychotics (SGAs) (atypical antipsychotics) for the treatment of psychotic disorders has changed the goals of modern therapeutic outcomes. No longer are positive symptoms of psychosis in schizophrenia the only outcomes measured, but dimensions including negative and cognitive symptoms are now crucial to determining efficacy. As a result outcomes in these areas are increasingly impacting on our choice of treatment.