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In recent years, concerns have been highlighted in several jurisdictions, including Ireland, regarding abuse of over-the-counter codeine-containing medicines. On the 1st of August 2010, national regulatory guidelines aimed at limiting the supply of these medicines in Ireland came into force.
To study the effects of the new regulations on the use of non-prescribed codeine-containing medicines by psychiatric patients admitted to an Irish university teaching hospital before (n = 117) the regulations came into effect and 6 months afterwards (n = 126).
Participants completed a brief self-administered survey questionnaire about their use of over-the-counter codeine-containing medicines in the preceding 3 months.
Compared with before the introduction of the new regulations, there was a large decline in the reported ‘often’ or ‘regular’ use of codeine-containing medicines in the 3 months before admission (33.3% v. 17.4%, χ2 = 6.354, p = 0.01) and there was a reduction in the proportion of patients for whom others had expressed concerns about their frequency of use of such medications (15.5% v. 4.8%, χ2 = 7.29, p = 0.03). There was also a decline in the proportion of patients who stated that they would use codeine-containing medicines for either a ‘feel-good’ effect or to curb cravings (15.9% v. 1.9%, p < 0.01, two-tailed Fisher's exact test).
We conclude that tight regulations on the supply of non-prescription codeine-containing medicines have the potential to reduce the use and abuse of such medicines in patient populations availing of admission to psychiatry hospitals.
The paper provides new estimates of dementia prevalence at a national and local level in Ireland and new projections of future numbers of people with dementia.
The prevalence of dementia at a national and local level has been calculated by applying European Collaboration on Dementia (EuroCoDe) prevalence rates to data from the Census of Population 2006. The National Disability Survey has been used to estimate the number of people with Down syndrome and dementia. Projections of future numbers of people with dementia have been calculated by applying EuroCoDe prevalence rates to the most recently available population projections from the Central Statistics Office (CSO).
It is estimated that there were 41 740 people with dementia in Ireland in 2006. Estimates show that there are clear regional differences in prevalence of dementia across Ireland, with the largest proportion of people with dementia in the West of Ireland, and the Dublin North Eastern region having the lowest share of dementia. Our best estimate is that there are 700 people with Down syndrome and dementia in Ireland. Applying EuroCoDe prevalence rates to the most recent CSO population projections shows that the prevalence of dementia in Ireland will increase to between 67 493 and 70 000 in 2021 and to between 140 580 and 147 000 in 2041.
Although there are several limitations to these estimates, the data provide timely and useful information for planning effective health and social care services, as well as raising public and professional awareness about dementia at a national level.
This study assessed self-reported and objective prospective memory (PM) processes in smokers and a never-smoked comparison group. If persistent smoking does impair PM, then one would expect smokers recall being lower on a study that requires them to remember everyday activities when compared with a never-smoked group.
An existing-groups design was used to compare a group of smokers with a never-smoked group on the self-report Prospective Memory Questionnaire (PMQ) and the Prospective Remembering Video Procedure (PRVP) measuring objective PM. An example of the location–action combination from the PRVP is ‘At Thornton's shop’ (location), ‘Buy a bag of sweets’ (action). Participants who reported using an illegal substance (e.g. ecstasy, cannabis), who drank excessively or were ‘binge drinkers’, or who reported suffering from a clinical condition, such as depression, were excluded from the study. Age, weekly ‘safe levels’ alcohol use, and strategy use were also measured and controlled for in the study. Each person was tested individually in a quiet laboratory setting on a university campus.
After controlling for variations in age, weekly alcohol use, and strategy use, smokers recalled significantly fewer location–action combinations on the PRVP when compared with a never-smoked group, with no between-group differences on self-reported PM as measured by the PMQ.
The findings suggest objective PM deficits are associated with persistent smoking – a relatively unexplored area of research. This cannot be attributed to other drug use, mood, or strategy use. The findings also suggest smokers lack self-awareness of such PM deficits. This study extends the area by utilising a more naturalistic object measure of PM and incorporating strict controls into the study.
The aim of this article is to review and highlight evidence-based computerised cognitive behavioural therapy (cCBT) programmes that can potentially be used in Ireland for the treatment of mild-to-moderate mental health difficulties.
The authors undertook a literature search using three databases, and consulted a recognised, university-developed web portal. For a programme to be included in this review, it had to (a) have at least one randomised controlled trial demonstrating its efficacy; (b) be available on the internet; and (c) be delivered in English.
Twenty-five cCBT programmes that met the inclusion criteria were profiled. Taken together, these programmes target various anxiety difficulties (i.e. generalised anxiety, panic/phobia, social anxiety and post-traumatic stress), depression (or low mood), eating problems, stress, insomnia, pain and alcohol misuse.
cCBT programmes, preferably administered as part of a stepped-care model, offer effective, low-cost and low-intensity interventions for a wide range of psychological problems. Their use could be beneficial given how underdeveloped primary care mental health services are in Ireland.
The aim of this study was to examine the perceived impact of a community mobilisation intervention programme to reduce alcohol consumption among amateur sportsmen aged 16–34 years.
A qualitative focus group format was used to identify potentially important themes or concepts relating to players’ and coaches’ experiences of the intervention. Six focus groups were conducted (five with four to seven players per focus group and one with six coaches) to elicit participants’ experiences of the intervention.
Three major themes emerged from the analyses: patterns of alcohol consumption and associated factors; perceived impact of the intervention; and suggested changes to the community mobilisation intervention. Excessive binge drinking (i.e. the consumption of six or more standard drinks on any one occasion) was common among players. The perceived impact of the intervention programme among players was low; players and coaches believed that if future programmes were to succeed, a ‘bottom-up’ rather than a ‘top-down’ approach should be adopted.
The findings suggest that players perceived the community mobilisation programme to have had only limited success in changing attitudes or behaviour towards alcohol consumption in this amateur sports setting.
Stigma towards mental health disorders remains a significant problem in society. Numerous public awareness campaigns and, to a lesser extent, educational interventions have been carried out to date to help address this issue.
A brief questionnaire was formulated and administered to two small groups of transition year students from schools throughout Ireland who participated in a week-long placement in a Psychiatric Hospital in Dublin in 2012. The input was from psychiatry and allied health professionals covering a wide range of mental health topics. It was administered before the first session and immediately after the last session. The input for each group in terms of topics was almost identical.
In all, 24 students participated, and the majority had either gone to school with, had observed in passing, or had a friend of the family or a relative with a mental illness, although only 21% had had knowledge on mental illness up to the intervention. The post-intervention scores demonstrated that the week had an impact on most of these views. Their attitudes to individuals with mental illness as regards employment, treatment, assistance, and recovery were encouraging, even at baseline, and all their responses improved following the sessions. There was a view that those with mental illness were somewhat reluctant to seek professional help.
Although the results of this study are very encouraging as regards attitudes towards mental health and their response to education, far more research and interventions are needed to explore and address stigma in more detail.
We present the case of a 23-year-old man with a first episode of severe mania, which was refractory to pharmacotherapy. The case demonstrates a rapid response and full recovery after the use of electroconvulsive therapy (ECT). The ECT was administered involuntarily under Section 59(1) (b) of the Irish Mental Health Act 2001 as the patient was unable to consent to the treatment. The case highlights the benefits of ECT for this serious condition and emphasises the importance of retaining the legislative capacity to provide such an effective treatment for patients unable to consent because of severe psychotic illness.
The past 15 years have seen a growing interest in early intervention and detection of psychosis before the onset of the first episode. Recent proposals to include a psychosis risk syndrome (PRS) in DSM 5 have focused attention on the evidence base achieved to date in this field.
This article aims to (1) review the underlying principles of early identification and intervention during the pre-psychotic phase, (2) summarise the naturalistic follow-up studies conducted to date in this ‘at-risk’ population, (3) discuss the identified clinical risk factors for transition to psychosis, (4) summarise the interventional studies both psychological and pharmacological completed to date and (5) briefly discuss the controversy around the proposed inclusion of the PRS in DSM 5.
Electronic databases EmBase, MedLine and PsychInfo were searched using the keywords ultra-high risk/at-risk mental state/risk syndrome/pre-psychotic/prodrome/prodromal and psychosis/schizophrenia.
The evidence suggests that it is possible to identify individuals who may be at risk of developing psychosis. Results from intervention studies, mostly involving second-generation antipsychotics and cognitive behavioural therapy, are currently insufficient to make treatment recommendations for this group. The emerging research with regard to possible neuroprotective factors such as omega fatty acids is promising, but will require replication in larger cohorts before it can be recommended.