To explore the lived experience of informal dementia caregivers during the COVID-19 pandemic.

Interpretative Phenomenological Analysis (IPA) was employed. Eight primary informal caregivers were recruited from a community mental health service for older people when attending in their role as caregiver of a service-user. Semi-structured interviews were conducted at home or in the clinic based on the participants’ convenience and preference. IPA was completed following Smith and colleagues framework for analysis.

Six group experiential themes, each with a number of subthemes, emerged from the cross-case interpretative analysis: the ambivalent experience of caregiving (subtheme: those complex emotional experiences); navigating lockdown: lived challenges and opportunities (subthemes: the pervasive fear, intensification of existing struggles, being prevented from caring for a loved one, and lockdown as a time for opportunity); transitioning out of lockdown (subthemes: regaining freedom, but restricted freedom after all and being in a lockdown of one’s own); the present with COVID-19, but mostly with dementia (subthemes: dementia, a disease that does not pause, and ‘takeaways’ from the journey); looking into the future (subthemes: embracing COVID-19 and the true needs); and a word on coping (subtheme: managing it all as best one can).

Findings demonstrate the significance of the meaning caregivers ascribed to their experiences on their wellbeing and ability to cope in times of COVID-19 and thereafter. Gaining an understanding of the caregivers’ unique experiences is crucial to appreciate how to best support them.

This study provides data on the prevalence of mental health problems among adolescents in Ireland in 2021, toward the end of the COVID-19 pandemic. The importance of having recent, large-scale, mental health data for adolescents has been heightened by COVID-19, the increased demand for child and adolescent mental health services, and the rapidly changing adolescent environment.

As part of the Planet Youth study, a cross-sectional survey of adolescents (N = 4,404), mostly aged 15–16, was conducted between September and December 2021. Participants were recruited from 40 schools and non-traditional educational centres across 3 regions in Ireland, one predominantly urban (North Dublin) and two predominantly rural (Cavan, Monaghan). A range of mental health outcomes were self-reported: a single-item question on mental health; the Strengths & Difficulties Questionnaire (SDQ); depressive and anxiety symptoms from the Symptom Check List 90; the Adolescent Psychotic-like Symptom Screener; and lifetime self-harm, suicidal ideation, and attempt.

Over a quarter of adolescents described their mental health as ‘bad’ or ‘very bad’ (29%), and had SDQ total problem scores over 20 (26%). Over a third (39%) reported self-harming, 42% reported suicidal ideation, and 11% reported attempting suicide, in their lifetime. Gender-diverse youth (non-binary, trans, and undisclosed) had higher rates of poor mental health outcomes compared to cis-gendered youth (male/female), and females had higher rates of most mental health outcomes compared to males.

Many of these estimates suggest a deterioration from previous epidemiological studies. While our findings do not definitively prove youth mental health has worsened over time, these findings are highly concerning. We propose a close monitoring of mental health in future surveys of this population and encourage initiatives to improve the capacity and quality of youth mental health services.

Anxiety related school avoidance can affect up to 5% of a country’s students each year. VRET (Virtual Reality Exposure Therapy) is a novel therapy proven to be as effective as conventional approaches for treating many anxiety disorders. The aim of this research is to co-design and evaluate a VRET intervention for students experiencing school related anxiety.

Eighteen adolescents participated in design thinking workshops where they developed a script and storyboard for the VRET. Using an iterative approach, a VRET prototype was developed based on this work. Eighteen teenagers were subsequently recruited to engage with the VRET for one session each and provide feedback on their experience via a structured questionnaire (supervised by a study coordinator) particularly focusing on the ability of the VR experience to reduce school related anxiety.

Exposure therapy needs to produce an anxiety response to be effective. The VRET was effective in producing an anxiety response in 89% of participants. Results demonstrated that 93% of participants found the simulations immersive, 94% found the scenarios believable, and 83% could relate to ‘Dala’, the avatar in the videos. 100% of participants believed that VRET would help with school anxiety.

This proof-of-concept study demonstrates favourable face validity indicating promise for this mode of intervention for delivering targeted support to anxious students. VRET could be used as a scalable, cost effective early intervention to reduce the severity of anxiety associated with school avoidance.

To examine the psychosocial impact of the COVID-19 pandemic on patients with a diagnosis of diabetes mellitus (DM).

Semi-structured interviews were conducted with 31 individuals with DM attending a diabetes clinic to determine the impact of the COVID-19 restrictions on anxiety and depressive symptoms, social and occupational functioning and quality of life. Anxiety symptoms were correlated with functioning, quality of life and diabetes self-management.

Likert data demonstrated that social functioning (mean = 5.5, SD = 3.7) and quality of life (mean = 4.1, SD = 3.1) were most impacted by the COVID-19 pandemic. Anxiety symptoms were prevalent with 13 individuals (41.9%) scoring above cut-off scores for the presence of anxiety symptoms based on the Beck Anxiety Inventory. Diabetes self-management was significantly correlated with functioning (r = 0.51, p = 0.006) and inversely correlated with anxiety symptoms (r = −0.51, p = 0.007). A prior history of a depressive or anxiety disorder was associated with significantly increased anxiety symptoms, as well as impaired global functioning (p < 0.01), poorer self-care of diabetes (p = 0.014) and satisfaction with diabetes treatment (p = 0.03).

The psychological and social impact of COVID-19 restrictions on individuals with DM was significant, with poorer management of diabetes correlated with anxiety symptom severity.

The difficulties in accessing Child and Adolescent Mental Health Services (CAMHS) and the lack of out-of-hours and crises services have resulted in Ireland’s national police force, An Garda Síochána (GS), becoming increasingly involved as first responders to children and young people (CYP) who are experiencing potential mental health crises.

To outline challenges faced by members of GS and emergency department (ED) professionals in such cases.

Qualitative study design with semi-structured interviews conducted with a convenience sample of medical and mental health professionals (n = 11) from a paediatric ED who are frequently involved with the interface between GS and CYP experiencing potential mental health crises. Thematic analysis was conducted on transcribed interviews using the software package MaxQDA to systematically organise and code transcriptions.

Participants highlighted a lack of appropriate clinical settings within the ED for CYP who attend with a mental health crisis through GS. Whilst participants described positive rapport between GS and ED staff, interactions between GS and patients were identified as challenging. Knowledge gaps amongst members of GS in Mental Health Act (MHA) legislation and restraint were also identified as contributory stressors for GS and emergency department professionals.

The increased prevalence of CYP mental health issues and psychosocial stressors in conjunction with difficulty in accessing CAMHS means that challenges faced by GS as first responders are likely to continue. Research is needed to quantify the adverse personal impacts on GS along with the potential negative impact on youth. Access to emergency mental health review for youth is essential to optimise the experience of both groups.

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).

Semi-structured interviews were conducted with 29 individuals attending the Galway-Roscommon Mental Health Services with an ICD-10 diagnosis of either bipolar disorder (n = 18) or EUPD (n = 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.

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 (t = 4.40, p < 0.001) and occupational functioning (t = 3.65, p = 0.03), and in quality of life (t = 4.03, p < 0.001) for both participant groups. Themes attained from qualitative data included the positive impact of the discontinuation of COVID-19 mandated restrictions (n = 19), and difficulties experienced secondary to reductions in the provision of mental health services during the COVID-19 pandemic (n = 17).

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.

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.

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.

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.

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.

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.

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.

The study was cross-sectional and mixed method. A study specific questionnaire was distributed electronically to psychiatrists working in CAMHS (n = 160).

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 (χ2 = 11.746, p < .001) and avoiding off-label use (χ2 = 15.392, p < 0.001). Thematic analysis highlighted increased medication hesitancy, enforced ‘meaningless’ bureaucracy and medication mistrust among families.

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.

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).

Participants were from Wave 1 (2009–2011) and Wave 4 (2016) of TILDA, with n = 639 participants with diabetes and n = 7,837 without diabetes at Wave 1, and n = 1,151 with diabetes and n = 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.

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.

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.

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.

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.

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.

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.

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.

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.

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 (p = 0.035). Flupenthixol treatment was associated with reduced relapse rates compared to other antipsychotics (χ2 = 5.402, p = 0.02). Thematic analysis revealed that participants believed that the discontinuation of fluphenazine deleteriously impacted the stability of their mental disorder.

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.

To assess the prevalence of neuropsychiatric symptoms 2 years after the COVID-19 acute phase and to identify biobehavioral risk factors.

This 2-year prospective study assessed adult individuals with COVID-19 via face-to-face interview and laboratory testing at onset, and via telephone interview at 2-year follow-up. Data collected included COVID-19 severity and management at onset, as well as depression, anxiety, insomnia, cognitive failure, and fatigue at follow-up using standardized assessment tools.

Out of 1,067 screened COVID-19 patients, 230 completed the 2-year follow-up (female, 53.5%; aged>40, 80.9%; native Italian, 94.9%; medical comorbidity, 53.5%; chronic medication, 46.3%; moderate to severe COVID-19, 24.9%; hospital admission, 28.7%; ICU, 5.2%). At follow-up, 9.1% had anxiety, 11.3% depression, 9.1% insomnia, 18.3% cognitive failure, and 39.1% fatigue, of clinical relevance. Headache (OR = 2.49, 95% CI = 1.01–6.16, p = 0.048), dyspnea (OR = 2.55, 95% CI = 1.03–6.31, p = 0.043), and number of symptoms (OR = 1.23, 95% CI = 1.01–1.51, p = 0.047) at onset were associated with anxiety at follow-up; dyspnea at onset was associated with depression at follow-up (OR = 2.80, 95% CI = 1.22–6.41, p = 0.015); number of comorbidities at onset was associated with insomnia at follow-up (OR = 1.48, 95% CI = 1.06–2.08, p = 0.022); female gender (OR = 2.39, 95% CI = 1.14–5.00, p = 0.020) and number of symptoms (OR = 1.20, 95% CI = 1.02–1.42, p = 0.026) at onset was associated with cognitive failure at follow-up; number of comorbidities (OR = 1.33, 95% CI = 1.03–1.73, p = 0.029) and symptoms (OR = 1.19, 95% CI = 1.04-1.37, p = 0.013) and raised interleukin 6 levels (OR = 4.02, 95% CI = 1.42–11.36, p = 0.009) at onset was associated with fatigue at follow-up.

COVID-19 survivors, especially if female, with preexisting health problems, and with a more severe acute phase, may present with long-lasting neuropsychiatric sequalae, urging interventions to sustain recovery particularly in these higher risk individuals.