IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE最新文献_第5页

On call in psychiatry: moments, meaning, and the limits of crisis care. 精神病学的随叫随到：危机护理的时刻、意义和局限。

IF 2.5

IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE Pub Date : 2026-07-27 DOI: 10.1017/ipm.2026.10199

Karen O'Connor, Kevin Lally, Rebecca Conlan-Trant, Christopher Mohan, Harriet K Ryan, Gearoid Moynihan, Kellie Myers, Michael John Norton, John Sheehan, Yolande Ferguson, David Cotter, Aoibhinn Lynch

{"title":"On call in psychiatry: moments, meaning, and the limits of crisis care.","authors":"Karen O'Connor, Kevin Lally, Rebecca Conlan-Trant, Christopher Mohan, Harriet K Ryan, Gearoid Moynihan, Kellie Myers, Michael John Norton, John Sheehan, Yolande Ferguson, David Cotter, Aoibhinn Lynch","doi":"10.1017/ipm.2026.10199","DOIUrl":"https://doi.org/10.1017/ipm.2026.10199","url":null,"abstract":"Psychiatry on call occupies a distinct and formative space within mental health services, shaped by moments of uncertainty, responsibility, and relational decision-making. In Ireland, non-consultant hospital doctors continue to deliver the majority of out-of-hours emergency psychiatric care, often as the sole on-site psychiatric clinician, working across multiple settings and managing high levels of clinical and organisational risk. This paper situates contemporary psychiatry on call within its wider clinical, societal, and service context, drawing on the College of Psychiatrists of Ireland's 2025 position paper and emerging evidence on emergency mental health care. We argue that emergency psychiatry differs from other acute specialties, being characterised by distress rather than disease, uncertainty rather than diagnosis, and time-intensive relational work rather than protocol-driven intervention. Rising demand reflects broader systemic pressures, including unmet social need, reduced inpatient capacity, uneven crisis alternatives, and increasing regulatory burden. We examine the service-user experience of out-of-hours care, highlighting issues of environment, equity, trust, and safety, particularly for marginalised groups. While high-quality supervision and training remain essential, we contend that sustainable improvement requires system-level reform, including strengthened multidisciplinary crisis responses, clearer role delineation, and coordinated investment in and also beyond mental health services. Attending to psychiatry on call offers a critical lens through which to understand and improve emergency mental health care for both clinicians and service users.","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-4"},"PeriodicalIF":2.5,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The global landscape of Balint groups in medical training and accreditation pathways for Balint leaders: a comparative review across the UK, the USA, Ireland, Canada, and Germany. 巴林集团在医疗培训和巴林领导人认证途径方面的全球格局：英国、美国、爱尔兰、加拿大和德国的比较回顾。

IF 2.5

IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE Pub Date : 2026-07-24 DOI: 10.1017/ipm.2026.10206

Babak Dehestani, Ashley Liew, Catherine Diskin, Patsy Brady, Elizabeth Barrett

{"title":"The global landscape of Balint groups in medical training and accreditation pathways for Balint leaders: a comparative review across the UK, the USA, Ireland, Canada, and Germany.","authors":"Babak Dehestani, Ashley Liew, Catherine Diskin, Patsy Brady, Elizabeth Barrett","doi":"10.1017/ipm.2026.10206","DOIUrl":"https://doi.org/10.1017/ipm.2026.10206","url":null,"abstract":"The primary purpose of this review is to compare the implementation of Balint groups (mandatory versus voluntary participation) in medical training, particularly for medical students and psychiatry trainees, and the accreditation pathways for Balint leaders across the United Kingdom (UK), the United States (USA), Ireland, Canada, and Germany. The review aims to highlight the rationales and implications of each model. A comparative literature review was conducted to evaluate existing approaches in the specified countries, drawing on national guidelines, society requirements, and relevant studies. The methods focused on identifying specific requirements set by governing bodies such as the Royal College of Psychiatrists (UK), the American Balint Society (ABS), the College of Psychiatrists of Ireland, and the German Medical Association. Data were handled by summarizing the variations in implementation and accreditation. Implementation varies significantly; the UK, Ireland, Canada, and Germany typically mandate some form of reflective group work for psychiatry trainees, linking it to progression or certification. Ireland and Germany have explicit session requirements, while the USA largely maintains a voluntary model. Accreditation pathways share core philosophies but differ in specific hour requirements, with European pathways being more rigorous than the portfolio-based models in the USA and Canada. The global trend recognizes a clinician's emotional awareness as crucial for effective patient care, pushing toward mandatory exposure to reflective group work in psychiatry training. To ensure consistency across diverse national Balint societies, the International Balint Federation could develop global minimum standards for participation and co-leadership to eliminate ambiguity.","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-5"},"PeriodicalIF":2.5,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A gender perspective of dual diagnosis: a narrative review. 双重诊断的性别视角：叙事回顾。

IF 2.5

IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE Pub Date : 2026-07-24 DOI: 10.1017/ipm.2026.10202

Sara P Vilas, Laura Prieto-Arenas, Antonio Vidal-Infer, Judit Tirado-Muñoz

{"title":"A gender perspective of dual diagnosis: a narrative review.","authors":"Sara P Vilas, Laura Prieto-Arenas, Antonio Vidal-Infer, Judit Tirado-Muñoz","doi":"10.1017/ipm.2026.10202","DOIUrl":"https://doi.org/10.1017/ipm.2026.10202","url":null,"abstract":"Dual diagnosis (DD) refers to the coexistence in the same individual of a substance use disorder and other mental disorder. The increase in substance use among women over the past two decades, along with related health issues and mortality rates, has underscored the importance of integrating a gender-based approach in addiction research and treatment. This transition has led to an increased focus on substance use among women and individuals of other gender identities. This narrative review aims to examine the evidence on gender differences in DD to enhance knowledge that supports the development of innovative, evidence-based policies and practices. These efforts seek to improve access to and the adequate treatment of drug use disorders and comorbid conditions among women and LGBTQIA+ individuals. Additionally, advancements in the literature on epidemiology, clinical characteristics, environmental factors, treatment needs, and final recommendations are discussed. This manuscript supports a progression from gender integration towards gender transformation - a paradigm shift extending beyond the simple incorporation of gender perspectives into existing systems towards a deeper transformation that challenges and changes current gender norms and structures, aiming for a more equitable system.","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-10"},"PeriodicalIF":2.5,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evolutionary psychiatry in clinical training: findings from a workshop-based educational evaluation. 临床训练中的进化精神病学：基于工作坊的教育评估结果。

IF 2.5

IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE Pub Date : 2026-07-23 DOI: 10.1017/ipm.2026.10207

Gurjot Brar, Benjamin Griffin, John McFarland, Henry O'Connell

引用次数: 0

When screen engagement becomes a social substitute: evidence from children with ADHD. 当屏幕接触成为社交替代品：来自多动症儿童的证据。

IF 2.5

IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE Pub Date : 2026-07-21 DOI: 10.1017/ipm.2026.10216

Lisbeth Strandberg, Thiago P Fernandes, Daniele Fatima Paiva Abreu, Natanael A Santos

引用次数: 0

Extended-release naltrexone (Vivitrol) augmentation for compulsive sexual behavior disorder: a case report. 延长释放纳曲酮（Vivitrol）增强治疗强迫性性行为障碍1例。

IF 2.5

IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE Pub Date : 2026-07-16 DOI: 10.1017/ipm.2026.10204

Connor Welz

{"title":"Extended-release naltrexone (Vivitrol) augmentation for compulsive sexual behavior disorder: a case report.","authors":"Connor Welz","doi":"10.1017/ipm.2026.10204","DOIUrl":"https://doi.org/10.1017/ipm.2026.10204","url":null,"abstract":"Background: Compulsive sexual behavior disorder (CSBD) was included in the ICD-11 as an impulse control disorder, yet pharmacological treatment options remain limited. Naltrexone, an opioid receptor antagonist approved for alcohol and opioid use disorders, has shown promise for compulsive sexual behaviors, though the extended-release injectable formulation has not been evaluated for this indication.Case presentation: A 54-year-old married man with longstanding compulsive sexual behavior presented with acute symptom escalation following job loss, including compulsive pornography use, financial concealment, occupational impairment, and secondary depressive symptoms. Despite desvenlafaxine 50 mg and weekly psychotherapy incorporating motivational interviewing, cognitive-behavioral, and mindfulness-based techniques, he achieved inadequate symptomatic benefit. Extended-release naltrexone (Vivitrol) 380 mg intramuscular injection monthly was initiated as augmentation, chosen for more consistent receptor occupancy than oral formulations. Symptom severity was assessed using the Compulsive Sexual Behavior Inventory-13 (CSBI-13) and Hypersexual Behavior Inventory-19 (HBI-19) at baseline and monthly over three months. Hepatic function was monitored throughout.Outcomes: The patient demonstrated substantial improvement on both measures. CSBI-13 scores decreased from 65/65 at baseline to 25/65 at one month (61.5% reduction), stabilizing at 35/65 by month three (46.2% total reduction). HBI-19 scores decreased from 91/95 to 49/95 at one month (46.2% reduction), remaining stable at 47/95 through month three (48.4% total reduction). Liver enzymes remained within normal limits and no adverse events were reported.Conclusions: This case suggests extended-release naltrexone may be an effective augmentation strategy for CSBD unresponsive to antidepressant pharmacotherapy and psychotherapy. Controlled trials are needed to establish efficacy.","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-5"},"PeriodicalIF":2.5,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Autism and autism features in a young adult ADHD population, gender differences and use of the RAADS-14. 自闭症和自闭症特征的年轻成人ADHD人群，性别差异和使用的RAADS-14。

IF 2.5

IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE Pub Date : 2026-07-15 DOI: 10.1017/ipm.2026.10213

Marie Boilson, Aidan Roarty, Andrew Stanfield, Tom Berney, Diarmuid Lenihan, Mary Doherty, Sophie O Dea

{"title":"Autism and autism features in a young adult ADHD population, gender differences and use of the RAADS-14.","authors":"Marie Boilson, Aidan Roarty, Andrew Stanfield, Tom Berney, Diarmuid Lenihan, Mary Doherty, Sophie O Dea","doi":"10.1017/ipm.2026.10213","DOIUrl":"https://doi.org/10.1017/ipm.2026.10213","url":null,"abstract":"Objectives: Diagnostic criteria for attention deficit hyperactivity disorder (ADHD) and autism have broadened and are common at estimated adult prevalences of 3%. This paper explores the incidence of autism and overlap of features in ADHD young adults transitioning from Child and Adolescents Mental Health Services (CAMHS) into a specialist adult ADHD service, and the utility of the Ritvo Autism Asperger Diagnostic Scale 14 (RAADS-14) assisting assessment and support planning.Methods: This comparative cohort study included all young adult ADHD patients referred from CAMHS. A comprehensive assessment and diagnostic formulation, including RAADS-14 was completed. Those without a current autism diagnosis but clinical assessment suggested autism, underwent further assessment. Percentage of autistic and ADHD young adults was calculated. RAADS-14 total and subscale scores were compared between groups. Gender differences were assessed.Results: Co-occurrence of autism in a group of young adults diagnosed with ADHD was high (53%). High levels of autism features were evident in the ADHD only group. Significant differences in the RAADS-14 sub-scores (social anxiety, mentalizing and sensory sensitivities) were found between the autistic ADHD and non autistic ADHD groups. Autistic females scored higher on all domains of the RAADS-14 compared to males. Sensory sensitivities were significantly higher in females in both groups.Conclusions: The level of co-occurrence of autism, and overlap of features, suggests employment of neurodevelopmental rather than single condition approaches to avoid mis-diagnosis/missed diagnoses. Sensory sensitivities are suggestive of neurodevelopmental differences particularly in females regardless of diagnostic category. The RAADS-14 may be helpful as part of screening and support planning.","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-9"},"PeriodicalIF":2.5,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Electroconvulsive therapy training in Ireland: a self-reinforcing decline? 爱尔兰的电痉挛疗法培训：自我强化的衰退？

IF 2.5

IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE Pub Date : 2026-07-14 DOI: 10.1017/ipm.2026.10211

Stephen Eyu-Zhen Tan

引用次数: 0

Mental Health Care for Forcibly Displaced Migrants in Ireland: a Perspective Review for Health Professionals. 爱尔兰被迫流离失所移民的精神卫生保健：卫生专业人员的观点审查。

IF 2.5

IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE Pub Date : 2026-07-14 DOI: 10.1017/ipm.2026.10200

Zahra Legris, Ana Lucia R Moreira, Man Ching Wong

引用次数: 0

A turning point or a terminus - a qualitative survey exploring the subjective experiences of those receiving a diagnosis of personality disorder. 转折点或终点——一项定性调查，探索那些被诊断为人格障碍的人的主观经历。

IF 2.5

IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE Pub Date : 2026-07-14 DOI: 10.1017/ipm.2026.10208

Molly Bredin, Sorcha McManus, Gavin Rush

{"title":"A turning point or a terminus - a qualitative survey exploring the subjective experiences of those receiving a diagnosis of personality disorder.","authors":"Molly Bredin, Sorcha McManus, Gavin Rush","doi":"10.1017/ipm.2026.10208","DOIUrl":"https://doi.org/10.1017/ipm.2026.10208","url":null,"abstract":"Introduction: Despite being common and linked to significant morbidity and mortality, personality disorders (PD) are underdiagnosed. Stigma, professionals' therapeutic nihilism and lack of effective treatments are contributing factors. This survey aimed to explore the experiences of a service user group of being assessed for and receiving a diagnosis of personality disorder and to examine the impact of the diagnosis and the disorder on their life.Methods: Patients under the care of two consultant-led teams who had received a diagnosis of personality disorder using Structured Clinical Interview for DSM-5 PD (SCID-5-PD) in 2019 and 2020 were invited by email to complete a qualitative survey. Responses were analysed using thematic analysis.Results: Participants were predominantly aged 41-50 years, with most discharged over three years previously. Borderline personality disorder was most commonly reported. Thematic analysis identified three themes: Understanding and Being Understood - highlighting variable levels of comprehension and agreement with the diagnosis; A turning point - describing both abandonment and access to targeted treatment; and Restriction - capturing stigma, secrecy, and perceived negative impacts on care, relationships, and functioning.Discussion: Findings highlight the complexity of delivering diagnoses in a meaningful and therapeutic way. Participants reported limited understanding, underscoring the need for clear, repeated psychoeducation and collaborative formulation while others described positive experiences leading to self understanding and recovery. Many were relieved to get the diagnosis after significant delays and lack of appropriate treatment. Revisiting formulation over time and linking diagnosis to treatment pathways appear crucial for acceptance, empowerment, and positive outcomes.","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-8"},"PeriodicalIF":2.5,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0