Cognitive behavioural therapy (CBT) has been used in the treatment of alcohol use disorder (AUD), generally in individual or group therapy, but not via computer.

This study examined the effectiveness of an interactive, personalised, computer-based CBT therapy in a randomised control trial.

We studied a group of 55 patients with AUD, randomised to either 5-hour-long computerised CBT sessions or a placebo cognitive-stimulating session, together with a 4-week inpatient rehabilitation treatment, and followed them for 3 months.

There was a high degree of patient adherence to the protocol. Both groups did well, with a significant fall in alcohol outcome measures including number of drinks per drinking day, and number of drinking days, and an increase in abstinence rates in both groups to an equivalent level. The CBT group attended alcoholics anonymous groups more frequently, and had significant alterations in their alcohol self-efficacy outcomes, which correlated with their drinking outcomes. We concluded that computerised CBT is a potentially useful clinical tool that warrants further investigation in different treatment settings for AUD.

The aim of the current study was to gain insight into the process of initiation and progression to problematic use among young people who reach clinically significant levels of substance use requiring treatment.

Twenty young people, aged between 15 and 19 years from two different drug treatment centres in Ireland were interviewed regarding their views on their pathway into substance use, their progress to more problematic use, their perception of their parents’ role, if any, in their trajectory and their typical coping style before treatment. Content analysis was conducted on the resulting narratives.

The use of substances to cope with life stressors emerged as a prominent theme at initial and problematic stages of use. Multiple maladaptive coping approaches were reported. Both direct and indirect influences from parents in their substance use problem were cited. However, some participants reported that parents had no causal role in their substance use trajectory, in particular regarding mothers.

The current findings suggest that substance misuse is a multi-determined problem and a number of intervention strategies are suggested to delay onset and related harms associated with adolescent substance use.

There is a strong and growing body of evidence supporting the mental health benefits of music. With regard to Child and Adolescent Mental Health Services (CAMHS) there is a need for creative, child friendly approaches to improve rapport and promote engagement. This study was established as an exploratory pilot project to assess the feasibility of a running a music group within a CAMHS setting as well as any potential benefit to the mental health of a group of diagnostically heterogeneous young people attending the service.

Five young people attending the out-patient clinic participated in a weekly music group over the course of 2 months. Feedback was obtained using a study specific questionnaire as well as baseline and follow-up Strengths and Difficulties Questionnaires.

The music group was described as an enjoyable experience in the clinic setting and young people identified benefits with regard to mood, self-confidence and social skills. Attendance at appointments within the clinic was good for the duration of the group, suggesting a benefit in encouraging engagement.

A music group is a welcome intervention in a CAMHS setting with potential positive benefits for both the service and service users. Further work is needed to establish specific mental health benefits of music-based interventions in young people with mental health difficulties.

Mindfulness-based cognitive therapy (MBCT) is a group-based intervention similar to mindfulness-based stress reduction, but which includes cognitive therapy techniques. This study investigates its usefulness in the treatment of depressive, anxiety and stress/distress symptoms in cancer patients referred to a psycho-oncology service. It also examines whether effect on depression is mediated by self-compassion.

In phase 1 of this study, 16 cancer patients with mild/moderate psychological distress were randomised to MBCT (n=8) or treatment as usual (TAU; n=8), and assessed pre- and post-treatment. Analysis of variance was performed to examine the effect of treatment on anxiety and depression. In phase 2, the TAU group received the intervention, and results of pre- and post-MBCT assessments were combined with those receiving MBCT in phase 1. Finally, both groups were followed up at 3 months.

In phase 1, the MBCT group had a significant improvement in mindfulness and a decrease in anxiety. Statistically significant improvements in both depression and anxiety were found at 3 month follow-up. Self-compassion appeared to mediate the effect on anxiety/depression.

This small pilot study suggests that MBCT may have a beneficial effect on psychological variables often adversely affected in cancer in a heterogeneous cancer population.

Ireland’s rates of psychiatric institutionalisation increased rapidly throughout the 1800s and early 1900s. This paper provides a systematic analysis of individuals with mental illness who were not resident in psychiatric hospitals, workhouses or other institutions in 1901.

We examined the online census records of all individuals described as ‘lunatics’ on the island of Ireland, not resident in psychiatric hospitals, workhouses or other institutions on census night, 1901.

There were 482 individuals described as ‘lunatics’ and not resident in psychiatric hospitals, workhouses or other institutions on 31 March 1901, yielding a point prevalence of 10.6 per 100 000 population. The lowest prevalence (7.8) was in Leinster (possibly owing to provision of workhouses and asylums); the highest prevalence was in Connaught (17.5) (p=0.013). A majority of them (60.4%) were women. Mean age was 45.7 years. In addition, a majority were single (never married) (63.7%); 33.3% of women were married, compared with 14.1% of men (p<0.001). The most common relationship to the head of the household was child (32.8%), although some were boarders or lodgers. The majority were Roman Catholic (82.0%) and could ‘read and write’ (64.5%). Among those for whom ability to speak Irish was recorded, 74.4% spoke both Irish and English.

There were significant geographical and gender differences within the population recorded in the 1901 census as mentally ill and outside institutions. This group merits further study, especially with regard to their distribution in relation to asylum locations, and the extent to which they were cared for in communities, possibly prefiguring later models of community care.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with international prevalence rates estimated to be 5%. It is currently the most common disorder treated in Child and Adolescent Mental Health Services in Ireland. There have been a number of guidelines worldwide produced to aid clinicians in the diagnosis and treatment of ADHD; however, there are no guidelines available specifically for the Irish population and healthcare system.

The aim of this paper is to review the available clinical guidelines for the diagnosis and management of ADHD in children adolescents across North America, Canada, Europe and the United Kingdom and to apply these to an Irish context.

A number of international guidelines were reviewed. A proposed pathway for the assessment and treatment of children and adolescents with ADHD has been devised with the recommendation that a formalised consensus guideline should be implemented.

This review paper has highlighted that there is consensus between the guidelines for the diagnosis of ADHD with a thorough clinical history remaining the gold standard. They further agree on the importance of identifying co-morbid disorders. When it comes to the treatment, the guidelines are less unified. This current paper has devised a proposed care pathway for ADHD in Ireland to ensure high quality cost effective care within its healthcare system.