Post-SSRI sexual dysfunction: Patient experiences of engagement with healthcare professionals.

Objective: A petition to the European Medicines Agency provided an opportunity to collect reports of a specific adverse event from patients and healthcare professionals, along with details of clinicians' attitudes when asked to endorse patient reports.

Methods: We approached a cohort of patients reporting post-SSRI sexual dysfunction (PSSD) to an adverse event reporting website, RxISK.org.

Paediatric antidepressants: Benefits and risks.

The data supporting the use of "antidepressants" in children and adolescents is largely unavailable. Academic publications give a different picture as regards benefits and harms to publications from regulatory other sources. Despite disagreements about the data driving use of these medicines, in practice "antidepressants" may now be the most commonly used drugs by adolescent girls, and children's mental health services are attracting increasing attention.

Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases.

Objective: To investigate clinical reports of post-SSRI sexual dysfunction (PSSD), post-finasteride syndrome (PFS) and enduring sexual dysfunction following isotretinoin.

Methods: Data from RxISK.org, a global adverse event reporting website, have been used to establish the clinical features, demographic details and clinical trajectories of syndromes of persistent sexual difficulties following three superficially different treatment modalities.

Study 329 continuation phase: Safety and efficacy of paroxetine and imipramine in extended treatment of adolescent major depression.

Objective: This is an analysis of the unpublished continuation phase of Study 329, the primary objective of which was to compare the efficacy and safety of paroxetine and imipramine with placebo in the treatment of adolescents with unipolar major depression. The objectives of the continuation phase were to assess safety and relapse rates in the longer term. The objective of this publication, under the Restoring Invisible and Abandoned Trials (RIAT) initiative, was to see whether access to and analysis of the previously unpublished dataset from the continuation phase of this randomized controlled trial would have clinically relevant implications for evidence-based medicine.

Bipolar disorder and its outcomes: two cohorts, 1875-1924 and 1994-2007, compared.

We compared admission rates and outcomes for bipolar disorder patients using the medical records of patients with a first hospital admission in 1875-1924 retrospectively diagnosed based on International Classification of Diseases (ICD)-10 criteria, and patients with a first admission in 1994-2007. The incidences of first admissions in the historical and contemporary periods are comparable: 1.2 and 1.

Restoring Study 329: efficacy and harms of paroxetine and imipramine in treatment of major depression in adolescence.

Objectives: To reanalyse SmithKline Beecham's Study 329 (published by Keller and colleagues in 2001), the primary objective of which was to compare the efficacy and safety of paroxetine and imipramine with placebo in the treatment of adolescents with unipolar major depression. The reanalysis under the restoring invisible and abandoned trials (RIAT) initiative was done to see whether access to and reanalysis of a full dataset from a randomised controlled trial would have clinically relevant implications for evidence based medicine.

Design: Double blind randomised placebo controlled trial.

One hundred and twenty cases of enduring sexual dysfunction following treatment.

Background: There have been reports for over a decade linking serotonin reuptake inhibitors, finasteride and isotretinoin with enduring sexual dysfunction after treatment stops.

Objective: To explore the clinical pictures linked to all 3 drugs.

Methods: We have selected 120 reports to RxISK.

Sudden cardiac death & the Reverse Dodo Verdict.

Adverse effects of treatment on cardiac QT intervals were first reported 50 years ago. A clear link to sudden death was established, but the problem remained relatively unknown. The issue of treatment related effects on the heart, and the contribution this might make to sudden cardiac deaths in general, came more clearly into focus 20 years ago, linked to regulatory actions.

Mental health admissions in paediatric populations in North Wales: two cohorts compared 1875-1924 and 1994-2008.

Objectives: To investigate frequency of under-18s admitted to mental health services (MHS) in North West Wales (NWW) between 1875 and 2008. There are claims that 1 in 10 children have a mental illness, but there are little data on their inpatient MHS utilisation.

Setting: Looking at admissions at the secondary care level, three data samples were included; the first comprises historical asylum admissions, the second comprises contemporary admissions to acute psychiatric beds, and the third comprises admissions to district general hospital (DGH) beds that resulted in a mental health coding.

The morbidity and mortality linked to melancholia: two cohorts compared, 1875-1924 and 1995-2005.

For over a century, melancholia has been linked to increased rates of morbidity and mortality. Data from two epidemiologically complete cohorts of patients presenting to mental health services in North Wales (1874-1924 and 1995-2005) have been used to look at links between diagnoses of melancholia in the first period and severe hospitalized depressive disorders today and other illnesses, and to calculate mortality rates. This is a study of the hospitalized illness rather than the natural illness, and the relationship between illness and hospitalization remains poorly understood.

Mortality in schizophrenia and related psychoses: data from two cohorts, 1875-1924 and 1994-2010.

Objective: To investigate death rates in schizophrenia and related psychoses.

Design: Data from two epidemiologically complete cohorts of patients presenting for the first time to mental health services in North Wales for whom there are at least 1, and up to 10-year follow-up data have been used to calculate survival rates and standardised death rates for schizophrenia and related psychoses.

Setting: The North Wales Asylum Denbigh (archived patient case notes) and the North West Wales District General Hospital psychiatric unit.

The incidence of admissions for schizophrenia and related psychoses in two cohorts: 1875-1924 and 1994-2010.

Objective To investigate changes in incidence of admissions for schizophrenia and related non-affective psychoses in North Wales. Design Data from two epidemiologically complete cohorts of patients presenting for the first time to mental health services in North Wales between 1875-1924 and 1994-2010 are used in this study to map the incidence of hospital admissions for schizophrenia and non-affective psychoses. Setting The North Wales Asylum Denbigh (archived patient case notes) and the North West Wales District General Hospital psychiatric unit.

The incidence and prevalence of admissions for melancholia in two cohorts (1875-1924 and 1995-2005).

Background And Method: There have been recent proposals to have melancholia reinstated in classification systems as a disorder distinct from major depressive disorder. Data from two epidemiologically complete cohorts of patients presenting to mental health services in North Wales between 1875-1924 and 1995-2005 have been used to map the features of melancholia.

Results: The data point to a decline in the contemporary incidence of hospital admissions for depressive psychosis, and greater heterogeneity among hospitalized severe non-psychotic depressions today.

The incidence and prevalence of diabetes in patients with serious mental illness in North West Wales: two cohorts, 1875-1924 & 1994-2006 compared.

Background: Against a background of interest in rates of diabetes in schizophrenia and related psychoses and claims that data from historical periods demonstrate a link that antedates modern antipsychotics, we sought to establish the rate of diabetes in first onset psychosis and subsequent prevalence in historical and contemporary cohorts.

Methods: Analysis of two epidemiologically complete databases of individuals admitted for mental illness. 3170 individuals admitted to the North Wales Asylum between 1875-1924 and tracked over 18,486 patient years and 394 North West Wales first admissions for schizophrenia and related psychoses between 1994 and 2006 and tracked after treatment.

Historical overview: Kraepelin's impact on psychiatry.

This paper reviews the importance Emil Kraepelin put on disease course as a classificatory principle. It then outlines the academic reception of Kraepelin's disease entities outside Germany, charts the uptake of his diagnostic concepts within clinical practice in Britain, and compares data on admissions for bipolar disorders, involutional melancholia and postpartum psychoses to the North Wales asylum during the period Kraepelin was working to data on contemporary admissions in an effort to shed further light on the validity of his diagnostic concepts.