IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE最新文献

{"title":"A two-year longitudinal evaluation of the impact of the COVID-19 pandemic on pre-existing mental health service attenders.","authors":"E O'Gorman, A Rainford, E Devaney, B O'Mahony, J McLoughlin, B Hallahan","doi":"10.1017/ipm.2024.8","DOIUrl":"https://doi.org/10.1017/ipm.2024.8","url":null,"abstract":"<p><strong>Background: </strong>To examine if the COVID-19 pandemic was associated with a differential effect longitudinally in relation to its psychological and functional impact on patients with bipolar disorder and Emotionally Unstable Personality Disorder (EUPD).</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 29 individuals attending the Galway-Roscommon Mental Health Services with an ICD-10 diagnosis of either bipolar disorder (<i>n</i> = 18) or EUPD (<i>n</i> = 11). The impact of the COVID-19 pandemic was assessed in relation to anxiety and mood symptoms, social and occupational functioning, and quality of life utilising psychometric instruments and Likert scale data, with qualitative data assessing participants' subjective experiences.</p><p><strong>Results: </strong>Individuals with EUPD exhibited significant anxiety and depressive symptoms and increased hopelessness compared to individuals with bipolar disorder. Repeated measures data demonstrated no significant change in symptomatology for either the EUPD or bipolar disorder group over time, but demonstrated an improvement in social (<i>t</i> = 4.40, <i>p</i> < 0.001) and occupational functioning (<i>t</i> = 3.65, <i>p</i> = 0.03), and in quality of life (<i>t</i> = 4.03, <i>p</i> < 0.001) for both participant groups. Themes attained from qualitative data included the positive impact of the discontinuation of COVID-19 mandated restrictions (<i>n</i> = 19), and difficulties experienced secondary to reductions in the provision of mental health services during the COVID-19 pandemic (<i>n</i> = 17).</p><p><strong>Conclusion: </strong>Individuals with EUPD demonstrated increased symptomatology over a two-year period compared to those with bipolar disorder. The importance of face-to-face mental health supports for this cohort are indicated, particularly if future pandemics impact the delivery of mental health services.</p>","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-7"},"PeriodicalIF":5.1,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179905","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 use of personal therapy by psychiatrists and psychiatry trainees: a systematic review.","authors":"R E Aubry, M Morgan, G Donohue","doi":"10.1017/ipm.2024.14","DOIUrl":"https://doi.org/10.1017/ipm.2024.14","url":null,"abstract":"<p><strong>Background: </strong>It is widely acknowledged that personal therapy positively contributes to the continued personal well-being and ongoing professional development of mental health professionals, including psychiatrists. As a result, most training bodies continue to recommend personal therapy to their trainees. Given its reported value and benefits, one might hypothesize that a high proportion of psychiatrists avail of personal therapy. This systematic review seeks to investigate whether this is the case.</p><p><strong>Aim: </strong>To identify and evaluate the findings derived from all available survey-based studies reporting quantitative data regarding psychiatrists' and psychiatry trainees' engagement in personal therapy.</p><p><strong>Method: </strong>A systematic search for survey-based studies about the use of personal therapy by psychiatric practitioners was conducted in four databases and platforms (PubMed, Scopus, Embase and EbscoHost) from inception to May 2022 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were assessed for quality using the quality assessment checklist for survey studies in psychology (Q-SSP) and findings summarized using narrative synthesis.</p><p><strong>Results: </strong>The proportion of trainees who engaged in personal therapy ranged from a low of 13.4% in a recent UK based study to a high of 65.3% among Israeli residents. The proportion of fully qualified psychiatrists who engaged in personal therapy varied from 32.1% in South Korea to 89% in New Zealand.</p><p><strong>Conclusion: </strong>This review represents the first known attempt to collect and synthesize data aimed at providing insights into the past and current trends in psychiatrists' use of personal therapy across different geographic regions and career stages.</p>","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-14"},"PeriodicalIF":5.1,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076417","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":"Attachment theory: survival, trauma, and war through the eyes of Bowlby.","authors":"Aoife Twohig, John Lyne, Fiona McNicholas","doi":"10.1017/ipm.2024.12","DOIUrl":"https://doi.org/10.1017/ipm.2024.12","url":null,"abstract":"<p><p>Children are no strangers to war and conflict, and for as long as history has been documented, so too has the negative impact of war on children. Attachment theory, which has shone a light upon the ways in which early life experiences can impact individuals across the lifespan, is a helpful lens through which we can view the consequences of war. Similar to the aftermath of war leading to lifelong and transgenerational suffering due to deaths and physical health issues, attachment difficulties created during war further compound long-term damage. Yet, despite our theoretical understanding of the detrimental impact of war on children and on humankind, humanity has failed to find ways to avert, or at least minimise, this unfortunate risk. Instead in this century, we see a growing number of conflicts globally with increasing asylum seekers. In this editorial, we argue that the large-scale disruption to attachment relationships caused by conflict and war is an important consideration for global policy, and that the healthcare community must show leadership in highlighting this serious impact of war.</p>","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-3"},"PeriodicalIF":5.1,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141075869","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":"Impact of a national audit on child and adolescent psychiatrists' prescribing practices.","authors":"L Bond, J Z Ong, F McNicholas","doi":"10.1017/ipm.2024.11","DOIUrl":"https://doi.org/10.1017/ipm.2024.11","url":null,"abstract":"<p><strong>Background: </strong>A look back review of South Kerry Child and Adolescent Mental Health Services (CAMHS) in Ireland, known as the 'Maskey report' (MR), highlighted substandard prescribing practices. The aim of this 'Maskey Impact Study' (MIS) was to explore changes to child and adolescent psychiatrists' prescribing practices following the MR.</p><p><strong>Method: </strong>The study was cross-sectional and mixed method. A study specific questionnaire was distributed electronically to psychiatrists working in CAMHS (<i>n</i> = 160).</p><p><strong>Results: </strong>102 psychiatrists participated in the study (response rate 63.8%). Perceived improvement in prescribing practices included improved medical record keeping (63.7%), consent documentation (53.9%), medication information provision (41.2%) and physical health monitoring (60.8%). However, 43.1% of psychiatrists reported a reluctance to prescribe medication even when clinically indicated and 50% were more likely to avoid off-label use. Most respondents reported increased stress levels (80.4%) with higher stress being significantly associated with reticence in prescribing (<i>χ</i>² = 11.746, <i>p</i> < .001) and avoiding off-label use (<i>χ</i>² = 15.392, <i>p</i> < 0.001). Thematic analysis highlighted increased medication hesitancy, enforced 'meaningless' bureaucracy and medication mistrust among families.</p><p><strong>Discussion: </strong>Although improvements reported are welcomed, the increased hesitancy of medication use, avoidance of prescribing more than one medication, and avoidance of off-label use, is of concern with potential unintended adverse consequences. Reluctance in prescribing may deprive youth of access to evidence-based treatments and limit exposure of NCHDs to the safe practice of consultant-initiated psychopharmacology. Further research will be important to determine if this impacts clinical care. Continued education in psychopharmacology is essential along with increased public awareness of the evidence for medication, to help restore public confidence and trust in psychopharmacology.</p>","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-6"},"PeriodicalIF":5.1,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912952","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":"A network analysis of depressive symptoms in adults with and without diabetes: findings from the Irish longitudinal study on ageing.","authors":"Brendan Byrne, Amy M McInerney, Sonya S Deschênes","doi":"10.1017/ipm.2024.10","DOIUrl":"https://doi.org/10.1017/ipm.2024.10","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to estimate networks of depressive symptoms among Irish adults with and without diabetes at two time points and compare between the two groups at each time point using data from the Irish Longitudinal Study on Ageing (TILDA).</p><p><strong>Methods: </strong>Participants were from Wave 1 (2009-2011) and Wave 4 (2016) of TILDA, with <i>n</i> = 639 participants with diabetes and <i>n</i> = 7,837 without diabetes at Wave 1, and <i>n</i> = 1,151 with diabetes and <i>n</i> = 4,531 without diabetes at Wave 4. Depressive symptoms were measured using the 8 items of the Center for Epidemiologic Studies Depression Scale. Network psychometric analysis was used to examine symptom centrality, symptom-level associations, and network comparisons at each time point.</p><p><strong>Results: </strong>Stable, strongly connected networks emerged for people with and without diabetes at both time points. The symptoms of feeling depressed, feeling like everything's an effort, not enjoying life, feeling sad, and couldn't get going were the most central nodes in all networks, which did not differ between people with and without diabetes. However, for people with diabetes, the network was more densely connected at Wave 4, when the sample was predominately people with newly diagnosed diabetes. Furthermore, the relationship between 'felt lonely' and 'couldn't get going' and between 'not enjoying life' and 'sad' was significantly stronger for people with diabetes than for those without.</p><p><strong>Conclusions: </strong>This study provides a more detailed understanding of the structure of depressive symptoms at two time points in older Irish adults with and without type 1 or type 2 diabetes.</p>","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-10"},"PeriodicalIF":5.1,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862653","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":"Impact of the COVID-19 pandemic on persons experiencing an eating disorder in the Republic of Ireland.","authors":"Jahan Zeb Khan, Roisin McManus, Declan M Mcloughlin, Clare O'Toole","doi":"10.1017/ipm.2024.9","DOIUrl":"https://doi.org/10.1017/ipm.2024.9","url":null,"abstract":"","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-2"},"PeriodicalIF":5.1,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874919","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":"Turning 18 in mental health services: a multicountry qualitative study of service user experiences and views.","authors":"Anouk Boonstra, Sophie Leijdesdorff, Cathy Street, Ingrid Holme, Larissa van Bodegom, Tomislav Franić, Rebecca Appleton, Priya Tah, Helena Tuomainen, Helena Tomljenovic, Fiona McNicholas, Thérèse van Amelsvoort","doi":"10.1017/ipm.2024.5","DOIUrl":"https://doi.org/10.1017/ipm.2024.5","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, the division between Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) has frequently resulted in fragmented care with an unprepared, non-gradual transition. To improve continuity of care and other service transition experiences, service user input is essential. However, such previous qualitative studies are from a decade ago or focused on one mental disorder or country. The aim of the present study was to learn from service users' transition experiences and suggested improvements.</p><p><strong>Methods: </strong>Semi-structured interviews were held with young people aged 18-24 and/or parents/caregivers in the United Kingdom, Ireland, the Netherlands and Croatia. Inclusion was based on the experience of specialist mental health care before and after turning 18. Thematic analysis of transcribed and translated interview transcripts was performed using ATLAS.ti 9.</p><p><strong>Results: </strong>Main themes of service user experiences included abrupt changes in responsibilities, various barriers and a lack of preparation, communication and ongoing care. Young people expressed a great need for continuity of care. Their suggestions to improve transitional care included early and adequate preparation, joint working, improved communication from and between services, overlapping services, staying at CAMHS for longer and designated youth mental health teams.</p><p><strong>Conclusions: </strong>Young people who experienced care before and after turning 18 suggested either altering the age limits of services or ensuring early preparation and communication regarding the transition and finding AHMS. This communication should include general changes when turning 18. Further considerations include increasing collaboration and overlap between CAMHS and AMHS.</p>","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-9"},"PeriodicalIF":5.1,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337174","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":"Using learned tools for experiential gain: the application of experiential knowledge to traditional service processes.","authors":"Michael John Norton","doi":"10.1017/ipm.2024.4","DOIUrl":"https://doi.org/10.1017/ipm.2024.4","url":null,"abstract":"","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-2"},"PeriodicalIF":5.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337175","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 impact of fluphenazine withdrawal: a mirror-image study.","authors":"S Meehan, S Moran, A Rainford, C McDonald, B Hallahan","doi":"10.1017/ipm.2024.2","DOIUrl":"https://doi.org/10.1017/ipm.2024.2","url":null,"abstract":"<p><strong>Background: </strong>Fluphenazine decanoate licenced as a long-acting injectable (LAI) first-generation antipsychotic (FGA) was withdrawn from sale in 2018. This study evaluates if its withdrawal resulted in increased relapse rates of psychosis in an Irish patient cohort and examines which prescribed alternative antipsychotic medications were associated with more optimal outcomes.</p><p><strong>Methods: </strong>Fifteen participants diagnosed with a psychotic disorder were included. A mirror-image study over 24-months' pre-and post-withdrawal of fluphenazine was conducted. Kaplan-Meier survival and proportional hazards analyses were conducted. The impact of alternate antipsychotic agents (LAI flupenthixol compared to other antipsychotic medications) was evaluated. Semi-structured interviews with participants examined subjective opinions regarding the change in their treatment.</p><p><strong>Results: </strong>Seven participants (46.7%) relapsed in the 24-month period subsequent to fluphenazine discontinuation compared to one individual (6.7%) in the previous identical time-period (<i>p</i> = 0.035). Flupenthixol treatment was associated with reduced relapse rates compared to other antipsychotics (<i>χ</i>² = 5.402, <i>p</i> = 0.02). Thematic analysis revealed that participants believed that the discontinuation of fluphenazine deleteriously impacted the stability of their mental disorder.</p><p><strong>Conclusion: </strong>The withdrawal of fluphenazine was associated with increased relapse rate in individuals previously demonstrating stability of their psychotic disorder. While acknowledging the limitation of small sample size, preliminary evidence from this study suggests that treatment with the first-generation antipsychotic (FGA) flupenthixol was associated with a lower risk of relapse compared to SGAs. Reasons for this lower risk of relapse are not fully clear but could be related to dopamine hypersensitivity with this treatment change.</p>","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"1-5"},"PeriodicalIF":5.1,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144277","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":"Social media and ADHD: implications for clinical assessment and treatment.","authors":"Y Hartnett, E Cummings","doi":"10.1017/ipm.2023.40","DOIUrl":"10.1017/ipm.2023.40","url":null,"abstract":"<p><p>The interaction between social media use and mental health is complicated. The mental health information shared on these platforms is frequently of poor quality but has the potential to exert powerful influence on users. Social media trend peaks in some mental disorders have led to increases in illness behaviour through social contagion. There has been a marked upsurge in online interest in attention deficit hyperactivity disorder (ADHD) over the last number of years, which has been particularly noticeable since the onset of the COVID-19 pandemic. The exponential increase in online ADHD interest has the potential to contribute to overloading mental health services with referrals. Mental health professionals and organisations need to consider strategies to ensure that quality health information is disseminated to younger audiences.</p>","PeriodicalId":46220,"journal":{"name":"IRISH JOURNAL OF PSYCHOLOGICAL MEDICINE","volume":" ","pages":"132-136"},"PeriodicalIF":5.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10113034","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}