Publications by authors named "Paul Mackin"

In the original submission two of the authors declared a filing of a pharmaceutical patent. This does not comply with Cochrane's Commercial Sponsorship Policy. The remaining authors are unable to update the review at this time and have therefore withdrawn it from the Cochrane library.

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Studies investigating the relationship between cigarette smoking and prolactin secretion in the general population have yielded inconsistent results. Many antipsychotic drugs increase prolactin secretion, but there are no published studies that have investigated the relationship between smoking and prolactinaemia in antipsychotic-treated patients. We obtained prolactin levels from 228 antipsychotic-treated patients in secondary care mental health services and investigated the relationship between prolactinaemia and cigarette smoking.

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The recent drive within the UK National Health Service to improve psychosocial care for people with mental illness is both understandable and welcome: evidence-based psychological and social interventions are extremely important in managing psychiatric illness. Nevertheless, the accompanying downgrading of medical aspects of care has resulted in services that often are better suited to offering non-specific psychosocial support, rather than thorough, broad-based diagnostic assessment leading to specific treatments to optimise well-being and functioning. In part, these changes have been politically driven, but they could not have occurred without the collusion, or at least the acquiescence, of psychiatrists.

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Frontotemporal dementia (FTD) is the most common form of primary degenerative dementia after Alzheimer's disease that affects people in middle age. The average delay in reaching an accurate diagnosis has been reported to be around 3 years. We report a case of FTD in a 35-year-old female who presented with complex symptoms and no clear physical signs.

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This review describes the common effects of psychotropic drugs on the cardiovascular system and offers guidance for practical management. Selected reports from the literature describing common side effects associated with psychotropic drugs are reviewed, and suggestions for further reading are given throughout the text. Orthostatic hypotension is the most common adverse autonomic side effect of antipsychotic drugs.

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Background: Prevalence of physical comorbidity in severe mental illness is a significant public health concern, but comparative data in people with diagnoses other than schizophrenia are sparse.

Aims: To investigate the prevalence of metabolic disease and cardiovascular risk in people with severe mental illness treated with antipsychotics in the community.

Methods: Case-control study of 90 people treated with antipsychotics in the community and 92 age- and gender-matched controls.

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Background: Patients with severe mental illness are at increased risk for metabolic and cardiovascular disease. A number of recent guidelines and consensus statements recommend stringent monitoring of metabolic function in individuals receiving antipsychotic drugs.

Methods: We conducted a prospective cohort study of 106 community-treated psychiatric patients from across the diagnostic spectrum from the Northeast of England to investigate changes in metabolic status and monitoring practices for metabolic and cardiovascular disease.

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Objective: Brain-derived neurotrophic factor (BDNF) is stress-responsive and has been implicated in a number of disparate neuropsychiatric disorders. Glucocorticoid antagonists have been shown to have beneficial effects on mood and cognitive function in bipolar disorder but not in schizophrenia. The aim of the present study was to investigate BDNF levels in patients with bipolar disorder and schizophrenia before and after treatment with the glucocorticoid receptor antagonist mifepristone.

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Cultural background may influence the perception of psychiatric symptoms. We examined the effects of cultural biases on the identification of manic symptoms using the Young Mania Rating Scale. Two video interviews, each with an American person with mania, were shown to psychiatrists from three countries (US, UK and India).

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Visuospatial working memory theory is used to interpret the cognitive impairment in euthymic bipolar disorder. Such patients show deficits in the Corsi Blocks Test (CBT) and executive control. To understand these deficits, 20 euthymic bipolar patients and controls were administered the CBT, Visual Patterns Test (VPT), and a new visual memory task designed to make minimal demands on executive resources.

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Background: Antipsychotic drugs have been associated with prolongation of the QTc interval on the electrocardiogram, and QTc prolongation is, in turn, associated with an increased risk of cardiac arrhythmias and sudden death. Antipsychotic polypharmacy has been implicated in reduced survival, possibly secondary to cardiotoxic effects of antipsychotic medication. Abnormalities of glucose homeostasis, which may be more common in individuals with major mood disorders and schizophrenia, also affect the QTc interval.

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Objective: Rapid cycling bipolar disorder presents a significant challenge with respect to treatment. The cyclical nature of bipolar disorder has been well recognised for over a century, and following Dunner and Fieve's landmark paper in 1974, investigators have increasingly turned their attention to issues such as the definition of rapid cycling, demographic characterisation, treatment response and pharmacologic intervention.

Methods: A literature search using Medline was performed, and selected articles which consider important developments in the definition, demographics and course of rapid cycling are reviewed.

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Objective: The value of microalbuminuria (MA) in predicting renal disease and premature mortality in longer duration type 1 diabetes is unclear.

Research Design And Methods: We followed 135 patients with long-standing type 1 diabetes (>30 years' duration) over a 7-year period, recording albuminuria and other clinical variables. Vital status was ascertained and cause of death was recorded.

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