IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE最新文献

{"title":"Health Impact Assessment of proposed suicide prevention measures at Bridge A: A model for other high-risk locations.","authors":"Maria Deery, Christopher Carroll, Gregory Martin","doi":"10.1017/ipm.2026.10209","DOIUrl":"https://doi.org/10.1017/ipm.2026.10209","url":null,"abstract":"<p><strong>Objectives: </strong>Suicide in public places remains a public health challenge. In Ireland, 512 suicides were recorded in 2021, almost one third in public places. Bridge A was identified as a high-risk site for suicide by jumping. This study aimed to apply Health Impact Assessment (HIA) methods to evaluate proposed structural suicide-prevention interventions and examine the utility of HIA in informing suicide prevention decision-making.</p><p><strong>Methods: </strong>A project-level HIA was conducted by the Health Service Executive National Health Improvement team, with multi-agency input, following Institute of Public Health guidance. The four stages - screening, scoping, analysis and reporting - were informed by a literature review, a site visit, population health profiling, and analysis of incident data from An Garda Síochána.</p><p><strong>Results: </strong>Between January 2020 and April 2025, there were 20 suicide attempts and one death at Bridge A, most involving women under 35, contrasting with national and international trends. Parts of the surrounding area showed higher levels of disadvantage, contributing to population 'sensitivity'. The 'magnitude' of the health impact was assessed as high, and the intervention was judged to reduce 'Injury risk' and improve 'Road or Route Safety' in a way that is 'significant'. The proposed structural modifications, alongside non-structural measures including suicide prevention training and crisis support signage, were recommended.</p><p><strong>Conclusions: </strong>This study demonstrates the utility of HIA in informing multi-agency suicide prevention decision-making in public places. The findings support implementation of the proposed measures and highlight the potential for HIA to be applied to other high-risk locations.</p>","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-10"},"PeriodicalIF":2.5,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391944","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}

{"title":"Preserving borderline personality disorder within dimensionalized personality disorder assessment: a clinical sequencing model.","authors":"Valentin Radoi, Mark L Ruffalo","doi":"10.1017/ipm.2026.10210","DOIUrl":"https://doi.org/10.1017/ipm.2026.10210","url":null,"abstract":"<p><p>Borderline personality disorder (BPD) is a clinically significant and extensively studied personality disorder (PD), associated with substantial impairment, risk, treatment needs, and health-system burden. Contemporary debates about its classification now occur within diagnostic systems that already move beyond purely categorical models, including ICD-11 and the DSM-5 Alternative Model for Personality Disorders. The central question is therefore not simply whether dimensional assessment should be incorporated into PD diagnosis, but how general personality disorder diagnosis, named categorical patterns, dimensional characterization, and outcome/risk assessment should be clinically coordinated. This article examines BPD as a focal case for this broader categorical-dimensional problem. We review the clinical contributions and limitations of categorical and dimensional approaches, consider evidence supporting the reliability, validity, clinical utility, and treatment relevance of BPD, and propose a clinical sequencing model for PD assessment. The model is not intended as a new diagnostic architecture or diagnostic algorithm. Rather, it begins with establishing the presence of general personality disorder, then asks whether a named PD pattern is clinically meaningful, before proceeding to dimensional characterization and outcome/risk assessment. We argue that dimensional progress does not require the abandonment of named personality disorder diagnoses when they remain clinically and empirically meaningful. Within this framework, BPD can remain an organizing construct while categorical diagnosis is prevented from becoming the endpoint of clinical formulation.</p>","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-9"},"PeriodicalIF":2.5,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346846","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}

{"title":"HHC-induced psychosis in adolescents: a case series.","authors":"Piril Cevikel, Joana Ferreira, Eamon Raji, Catherine O'Brien, Brian Hallahan","doi":"10.1017/ipm.2026.10201","DOIUrl":"https://doi.org/10.1017/ipm.2026.10201","url":null,"abstract":"<p><p>Hexahydrocannabinol (HHC) is a semi-synthetic cannabinoid that recently emerged as a legal alternative to Δ9-tetrahydrocannabinol. Due to emerging concerns regarding its neuropsychiatric safety profile, including psychosis, it was banned in July 2025. We report two cases of HHC-induced psychosis in adolescents requiring inpatient psychiatric admission, both with no prior psychiatric history. Both individuals required about six weeks of inpatient treatment, with their symptoms resolving following abstinence from HHC and antipsychotic medications. These cases support recent regulatory measures banning HHC and highlight the need for ongoing clinician awareness of this agent and its associated risk of psychosis.</p>","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-5"},"PeriodicalIF":2.5,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148278829","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}

{"title":"The Mind and Movement clinic: developing a new integrated cognitive-neuropsychiatric service for Lewy body dementia.","authors":"Panagiotis Alexopoulos, Loredana Frau, Ella Carroll, Orla Keane, Ashay Panse, Heather Dignam, David Bradley, Anna Mullen, Iracema Leroi","doi":"10.1017/ipm.2026.10194","DOIUrl":"https://doi.org/10.1017/ipm.2026.10194","url":null,"abstract":"<p><strong>Background: </strong>Lewy body dementia (LBD), including Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB), is common but under-recognised and poorly supported in the Irish healthcare system. This study evaluates the 'Mind and Movement Clinic' at St James's Hospital, Dublin, developed to address the needs of this population.</p><p><strong>Objectives: </strong>To analyse the demographic, cognitive, and neuropsychiatric profiles of 99 consecutive referrals and to map the care pathway for individuals with Parkinson's disease (PD), PD with mild cognitive impairment (PD-MCI), PDD, and DLB.</p><p><strong>Methods: </strong>A cohort study of the first 99 referrals to the clinic was conducted, including clinical, demographic, cognitive, motor, and neuropsychiatric data.</p><p><strong>Results: </strong>The sample included 36 individuals with PD-MCI, 9 with PD, and 48 with LBD (11 PDD, 37 DLB). Main referral reasons were cognitive impairment (64.65%), psychotic symptoms (30.30%), and affective symptoms (44.44%). LBD patients had significantly higher rates of hallucinations (75% vs. 26.7%) and delusions (31.25% vs. 4.44%) compared to those without dementia (<i>p</i> < 0.001). Medication interventions included cholinesterase inhibitors, antidepressants, and adjustments to dopaminergic therapy. Significant service needs were reflected in referrals to 16 different services.</p><p><strong>Conclusions: </strong>Patients with LBD have complex care requirements, supporting the need for a specialised service integrating memory and movement disorder care. Development of a core outcome set for LBD and an integrated care pathway, including post-diagnostic support, is recommended in the Irish context.</p>","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-11"},"PeriodicalIF":2.1,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145043","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}

{"title":"Adolescent polysubstance use and psychopathology: a population-based survey in schools.","authors":"Ronan Fleury, Niamh Dooley, Lorna Staines, John Hoey, Colm Healy, Diane Gillan, Fiachra O'Higgens, Teresa O'Dowd, Bobby Smyth, Mary Cannon","doi":"10.1017/ipm.2026.10197","DOIUrl":"https://doi.org/10.1017/ipm.2026.10197","url":null,"abstract":"<p><strong>Background: </strong>Substances, such as cannabis, alcohol, and nicotine, have each been associated with an increased risk of mental health concerns in adolescence. These substances are often taken concurrently and less is known about the effects of polysubstance use. We investigated the relationship between polysubstance use and psychopathology in adolescence including internalising, externalising behaviours, and psychotic experiences (PE). As a secondary analysis, we examined gender differences.</p><p><strong>Methods: </strong>A sample of 4,404 15-16-year-old adolescents in 40 schools in Ireland was examined. Our exposure was single substance use (cannabis, alcohol, and nicotine) and polysubstance use within the past month. The outcome of interest was psychopathology, measured using the Strengths & Difficulties Questionnaire, and the Adolescent Psychotic Symptoms Scale. Associations were explored using mixed-effects logistic models.</p><p><strong>Results: </strong>Adjusted odds ratios were calculated to examine the associations between polysubstance use and each outcome, compared to substance-naive participants. A significant dose response relationship was observed, with increasing substance use associated with higher odds of general psychopathology (aOR range: 1.65-5.09), internalising behaviours (aOR range: 1.18-2.06), externalising behaviours (aOR range: 1.68-5.79), and PE (aOR range: 1.60-3.13). Females engaging in polysubstance use exhibited the poorest mental health outcomes.</p><p><strong>Conclusion: </strong>This study highlights the strong associations between adolescent polysubstance use and emerging mental health problems. The findings reinforce the need for mental health services to take polysubstance use into consideration during intervention. Tailored public health messaging is required, acknowledging polysubstance use as a marker for poor mental health among adolescents and young adults.</p>","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-10"},"PeriodicalIF":2.1,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036295","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}

{"title":"Overcoming barriers: co-design of digital therapeutics for substance use disorders by people with lived experience.","authors":"Jenna L Butner, Olivia Campbell, Jolene Bressi, Joseph Tay Wee Teck","doi":"10.1017/ipm.2026.10196","DOIUrl":"https://doi.org/10.1017/ipm.2026.10196","url":null,"abstract":"<p><p>This commentary examines the imperative of including people with lived and living experience (PWLE) in the development of digital innovations for substance use disorders (SUD). Centering PWLE in design processes improves usability, equity, and effectiveness, particularly for individuals with multimorbidity and those facing socioeconomic marginalization. Participatory approaches - such as co-design workshops and community-led monitoring - alongside ethical and regulatory considerations, are critical to both the prevention and treatment of SUD. However, meaningful involvement is often hindered by limited funding, disparities in digital access and literacy, and complex data privacy laws. The commentary underscores the need for supportive policy frameworks and sustained investment that prioritize culturally sensitive, person-centered design. Ensuring digital health tools for SUD are informed by the insights and needs of PWLE is essential for creating inclusive, effective, and ethically grounded responses to the ongoing challenges of substance use and recovery.</p>","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-3"},"PeriodicalIF":2.1,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875996","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}

{"title":"From the editor's desk: June 2026.","authors":"Niamh Dhondt, Anne M Doherty","doi":"10.1017/ipm.2026.10198","DOIUrl":"10.1017/ipm.2026.10198","url":null,"abstract":"","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-2"},"PeriodicalIF":2.5,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869972","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}

{"title":"Considerations about the proliferation of large language model chatbots and youth mental health.","authors":"Evan Matthews, Frances Cleary, Joseph Firth","doi":"10.1017/ipm.2026.10195","DOIUrl":"https://doi.org/10.1017/ipm.2026.10195","url":null,"abstract":"<p><p>Young people are experiencing worsening mental health and a growing reliance on online tools and services to address mental health difficulties. At the same time, next-generation large language models (LLMs) that are deployed through 'chatbot style interfaces', using deep learning artificial intelligence akin to interacting with a human appear to mark an opportunity for mental health therapeutics when designed specifically for clinical intervention. However, emergent evidence suggests the use of more generic LLM chatbots may pose a risk of providing misinformation, bias, or over reliance for some individuals when used outside of clinical contexts for mental health. This perspective paper examines the intersection of youth mental health and the rapid adoption of LLM chatbots. It first contextualises rising mental health challenges among young people alongside their increasing reliance on digital solutions. The paper then explores the potential benefits of LLM chatbot style interfaces in clinical mental health interventions. Following this, we discuss the evidence surrounding adverse mental health outcomes from the use of generic LLMs to support mental health at population level, describing complex system-level and human-level factors noted from the evidence. Finally, we outline considerations for public health and youth mental health discourse, purpose built LLM platform design, and a supporting research agenda. While current evidence on benefits and risks from generic LLMs is emergent and not youth-specific, this perspective highlights a need for research focused on young people to ensure safe and effective use of widely available LLMs for mental health support.</p>","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-4"},"PeriodicalIF":2.1,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785054","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}

{"title":"School-level differences in self-harm and psychosocial problems associated with self-harm in adolescents.","authors":"David McEvoy, Ross Brannigan, Colm Healy, Niamh Dooley, Ella Arensman, Mary Clarke","doi":"10.1017/ipm.2026.10192","DOIUrl":"https://doi.org/10.1017/ipm.2026.10192","url":null,"abstract":"<p><strong>Background: </strong>The school environment plays a key role in adolescents' emotional development and well-being, yet little research has compared self-harm and related psychosocial problems across different secondary school types.</p><p><strong>Methods: </strong>Using data from the Growing Up in Ireland (GUI) longitudinal cohort, this study examined differences in the prevalence of self-harm and psychosocial risk factors across different school types: single-sex versus coeducational, fee-paying versus non-fee-paying, disadvantaged versus non-disadvantaged, and schools with different religious ethos. Multilevel regression models distinguished school-level from individual-level effects.</p><p><strong>Results: </strong>Almost all variance in self-harm and most of the variance in psychosocial problems associated with self-harm occurred at the individual level. Higher self-harm prevalence in single-sex girls' schools was accounted for by the greater concentration of girls, who had over twice the odds of self-harm compared with boys (OR 2.1, 95% CI 1.71-2.69). No significant differences in self-harm were found by school socio-economic status or religious ethos. Disadvantaged schools showed higher prevalence in seven of nine psychosocial problems, although only internalising problems and truancy/absenteeism remained significantly associated with disadvantaged schools in the fully adjusted models. Adolescents whose parents reported having a religion were less likely to self-harm (OR 0.62, 95% CI 0.50-0.75).</p><p><strong>Discussion: </strong>Although schools are important settings for self-harm prevention, findings indicate that interventions should primarily target individuals and high-risk groups. Girls, in particular, may benefit from supports addressing self-harm. Disadvantaged schools, where well-established psychosocial risk factors for self-harm are more common, may benefit from well-being programmes targeting internalising problems and truancy/absenteeism.</p>","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-12"},"PeriodicalIF":2.1,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730409","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}

{"title":"Feasibility and tolerability of group cognitive behavioral therapy on improving functioning and managing craving and psychosocial factors among incarcerated women with methamphetamine use disorder.","authors":"Kristiana Siste, Janni Leung, Belinda Julivia Murtani, Lee Thung Sen, Kevin Surya Kusuma, Enjeline Hanafi, Fitri Dona Nainggolan, Astria Aryani, Christopher Tan, Adhayani Lubis, Astia Murni","doi":"10.1017/ipm.2026.10190","DOIUrl":"https://doi.org/10.1017/ipm.2026.10190","url":null,"abstract":"<p><strong>Introduction: </strong>Methamphetamine use disorder (MUD) has risen among women globally and is disproportionately higher in prisons. In Indonesia, correctional facilities still lack any structured and evidence-based psychological therapy. To address this gap, we developed the Indonesia Substance Use Reduction for Female Therapy (Indo-SURFT).</p><p><strong>Methods: </strong>A single-arm unblinded design with a 3-month follow-up was conducted among incarcerated women with MUD. Participants completed 12 sessions over six weeks. Assessments included user perception ratings, Addiction Severity Index (ASI), Visual Analog Scale for craving, University of Rhode Island Change Assessment Scale, Self-Reporting Questionnaire-20 (SRQ-20), and WHO Quality-of-Life Brief (WHOQOL-BREF).</p><p><strong>Results: </strong>A total of 33 incarcerated women with MUD participated and the median age was 35 (21-57). All of the participants had complete attendance during the 6-week program. By week 12, participants rated the Indo-SURFT module as useful (<i>M</i>_diff = 0.484, 95%CI [0.235, 0.732], <i>p</i> < 0.001, <i>d</i> = 0.482). Employment-related ASI scores improved post-intervention (<i>B</i> = -0.076, <i>p</i> = 0.002) and at follow-up (<i>B</i> = -0.106, <i>p</i> = 0.004). Psychiatric domain of ASI remained stable post-intervention but increased after follow-up (<i>B</i> = 0.200, <i>p</i> ≤ 0.001). Craving declined post-treatment but rose at follow-up (<i>B</i> = 1.247, <i>p</i> = 0.036). SRQ-20 increased over time, while WHOQOL-BREF declined.</p><p><strong>Conclusions: </strong>Indo-SURFT is tolerable and feasible for women with MUD in incarceration. Participants highly rated the module and delivery. The module demonstrates initial improvement in functional domain and curbs craving level during treatment. Maintenance sessions may be required to fully maintain and enhance improvements. These findings support Indo-SURFT's as a potential intervention but requires further multisite investigation to enhance generalizability.</p>","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-8"},"PeriodicalIF":2.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700245","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}