Objectives: To determine the frequency of reported suicidal thoughts and acts in (a) a school-based sample of Irish adolescents, (b) adolescents attending a community child and family mental health service.

Method: The study population consisted of: (a) 195 adolescents aged 13-15 years attending ten secondary schools throughout Ireland. The schools were selected to represent a wide social and cultural spread: and (b) 66 adolescents aged 13-15 years attending a community child mental health service. The measures used were the Child Behaviour Checklist completed by the parents of the adolescents and the Youth Self Report completed by the adolescents.

Results: Within the school sample, the parents of 3% of adolescents reported that their child had talked of harming him/herself, but none reported acts of self-harm. Fifteen percent of the adolescents themselves reported that they had thoughts of harming or killing themselves, and 8% reported that they had tried to harm or kill themselves.

Within the mental health clinic attenders sample, the parents of 33% of the adolescents reported that their child had talked of harming him/herself, and the parents of 27% reported that their child had tried to harm or kill themselves. Twenty-one percent of the adolescents themselves reported that they had thoughts of harming or killing themselves, and 21% percent reported that they had tried to do so. In both groups, adolescents with higher total problem, internalising and externalising scores on the questionnaires, indicating greater disturbance, were more likely to report thoughts and acts of self harm.

Conclusions: Thoughts of suicide and acts of self harm are common in Irish adolescents and are not limited to those attending mental health services. Parents are frequently unaware of these thoughts. Further studies involving interviews with adolescents at risk are indicated to determine the significance of these thoughts and how adolescents deal with them.

Objectives: This exploratory study was designed to explore the social correlates of suicides rates of Irish counties.

Method: Suicide rates were calculated for Irish counties and subdivisions for the period 1988-1994 and correlated with social data for these regions obtained from the 1991 Census.

Results: The suicide rates showed a low level of reliability for the periods 1978-1984 and 1988-1994, and the social correlates of suicide rates changed between the two periods. Whereas age structure was associated with suicide rates in 1978-1984, urbanisation was associated with suicide rates in 1988-1994.

Conclusions: It is important to check the reliability of results of ecological studies of Irish suicide rates. Furthermore, the impact on suicide rates of the changing role of women in Ireland needs to be explored in time-series studies of the Irish suicide rate.

Objectives: This report describes an epidemic outbreak of mass hysteria in secondary school girls in a North Indian village following tetanus toxoid injection. It also attempts to identify the aetiological roles of the immunisation programme and the adverse media reports.

Method: The socio-demographic, clinical, and school environment variables of the 58 symptomatic students were evaluated. Interviews with health staff, parents and school teachers were conducted.

Results: Fifty-eight out of 200 immunised students reported giddiness, headache, vomiting and restlessness. This initiated an exaggerated socio-political response. The majority of the students responded to counselling and reassurance.

Conclusions: This outbreak fulfils the criteria of epidemic or communicable hysteria with mass presentations of unusual behaviour and spread of somatic symptoms without any organic basis. The episode exposed flaws in the immunisation programme and suggests the need to formulate clear guidelines for vaccination, including pre-vaccination counselling.

Adult ADHD is becoming a rather ‘firm’ diagnosis in adult psychiatry practice. Nevertheless it is a diagnosis that is often missed which leads to unnecessary distress to patients. This paper sets out the treatment possibilities.

More than a century ago Freud provoked a bitter controversy concerning alleged recollections of childhood sexual abuse: Were they fact or fiction? This debate is still ongoing, with some professionals stubbornly holding on to deeply entrenched and polarised positions. On the one side there are those who continue to deny the veracity of all ‘recovered memories’, and thus also of the implicated psychological defenses of repression and dissociation. At the other extreme are those therapists who simplistically assume that particular symptoms invariably imply sexual abuse. Over the decades there is a growing corpus of anecdotal, clinical and, more recently, research evidence supporting the contention that childhood sexual abuse, like all other trauma, can be forgotten for days, and even for many years, before being recalled. However, the reconstruction of these memories is a complex and, at times, a rather fallible process.

Priapism is a rare urological emergency, which can be associated with the use of psychotropic medication. The authors were able to find only one brief report of this condition in people with an intellectual disability. A case is reported in a man with moderate intellectual disability, who was receiving antipsychotic medication to manage extreme challenging behaviour. We discuss the condition and its implications for pharmacological treatments of behavioural disturbance in susceptible individuals.

A case of affective psychosis and cognitive impairment is described. The patient had a history of cerebrovascular disease and had been ingesting large quantities of a complex herbal tonic prior to presentation. Diagnostic issues are discussed. Relevant literature on cerebrovascular disease and herbal remedies is reviewed. We propose a stress-diathesis model to account for this patient's illness and we advise caution in the use of complementary therapies in patients with compromised cerebrovascular status. Appropriate practice guidelines are outlined.