This study describes the attitudes, knowledge and prescribing of psychotropic medication in children.

A study-specific questionnaire was mailed to all child psychiatrists, paediatricians and a group of registered general practitioners (GPs) from a selected Child and Adolescent Mental Health Services catchment area.

In the 116 respondents who replied (39% response rate), psychotropic medication was generally valued and used by all groups (70.1%). Respondents believed that the majority (61.9%) of their non-medical colleagues would also value/support the use of medication and this endorsement influenced the respondents’ prescribing rates. Initiating medication was viewed as the province of child psychiatry (78.6%). Medication is felt to be justified in a wide variety of mental health disorders, their use being reserved for severe presentations, with psychostimulants and selective serotonin reuptake inhibitors being most used. A significant number of GPs (60.9%) and paediatricians (63.4%) were felt to be lacking in competence in psychotropic prescribing, with a general request for more seminars in this area (61.5%) with almost half (45%) of them believing that they would prescribe more often.

The use of psychotropic medication in children remains a valued and common practice in Ireland. Attitudinal and practice differences across professional groups exist, and although the experience is one of relative safety there was a strong desire for further education leading to a perceived increase in utilisation. The impact of perceived public opinion regarding psychotropic prescribing along with a lack of competence may represent a major barrier to effective prescribing, thus highlighting the importance of ongoing professional development and increased public health initiatives to increase knowledge and understanding in this increasingly important area.

Newspaper media are an important source of information regarding mental health and have a significant influence on people’s awareness of, and decision making around, mental health issues. Depression in young people has seen increasing media attention in recent years, but few studies have examined media representation of mental health, specifically in young people. The current study used a quantitative approach to examine the words used in reports concerning depression in young people, in Irish broadsheets, published between 2007 and 2011.

A sample of 269 texts, containing 176 223 words, was collected from three Irish broadsheet newspapers, using the search terms ‘depression’ or ‘depressed’ or ‘mental health’ and ‘youth’ or ‘young people’. A corpus-based approach was used to examine word frequencies, clusters and keywords.

The analysis identified textual patterns, suggesting recurring associations between youth depression and suicide, and, to a lesser extent, alcohol use and bullying. Keywords relating to emotional distress and symptoms of depression were less frequent and sometimes associated with constructions inferring lack of agency (such as ‘suffering from’). A focus on the role of the parents was also evident. Of the professions mentioned, psychiatrists were referred to most often.

The analysis suggests that media coverage of depression in young people accurately reflects concerns reported in surveys by young people, but provides less information that might help in recognising depression in a young person.

To examine attitudes and practices in the management of attention-deficit/hyperactivity disorder (ADHD) among health professionals across seven European countries.

The web-based survey was developed by an international steering committee of ADHD experts and consisted of 64 multiple-choice questions relating to ADHD, covering the following topics: attitudes, diagnosis, referral, treatment and improving care. Health professionals working with ADHD were identified using a medical marketing database (Medical Marketing Service Inc., IL, USA) and invited via email to participate in the survey. No incentive was offered for participation and the survey was only available in English.

Over 22 000 emails and postal invitations were sent. One hundred and thirty-four (0.6%) health professionals completed the survey. Results highlighted significant differences by profession and country. In general, ADHD is considered a clinically important and valid disorder (n = 111, 84%), with biological underpinnings (n = 82, 62%), continuing into adulthood (n = 123, 93%) and responsive to treatment. Respondents from France were less likely to be convinced about biological validity (n = 4, 27%) and those from Italy and France were more likely to be concerned about the risk of underdiagnosis (n = 9, 64% and n = 9, 60%, respectively). Psychologists were the specialty who most frequently reported not believing in the diagnostic validity of ADHD (n = 4, 19%). One-third (n = 25, 35%) of respondents recommended medical tests before prescribing medication, with differences emerging by country despite the lack of support for such routine assessments in the guidelines.

Despite the very low response rate, intriguing country- and profession-specific differences emerged in this study and warrant further exploration.

The purpose of this paper is to trace the origins and decline of the diagnostic entity monomania, which became prevalent in the early 19th century and to investigate its use in Irish psychiatry.

The French psychiatric scientific writings of the early 19th century have been surveyed to identify and describe the clinical entity of monomania. The clinical description of monomania has been investigated and its cultural diffusion through literature and the arts has been reviewed. The increase in its use as a diagnosis and its ultimate decline has been documented in France, Britain and Ireland. The clinical characteristics leading to the diagnosis in Ireland have been investigated through the clinical symptoms recorded in patients accorded this diagnosis in the 19th century case books and committal documentation of the Richmond District Asylum and case books of the Central Mental Hospital.

The diagnostic entity of monomania first emerged in France in the 1820s and had disappeared from use in the hospitals of Paris by 1870. It first appeared in Ireland in the patients’ admission register of the Richmond District Asylum in 1833 and increased substantially before decreasing just as markedly with the last patient, given the diagnosis on admission being in 1878. However, the diagnosis of monomania was applied to admissions to the Central Mental Hospital as late as 1891. The Irish asylum case books have been of limited value in elucidating the clinical and symptomatological presentations leading to its use by 19th century Irish psychiatrists.

Monomania, although enjoying a scientific and cultural success in France, both within and without psychiatric circles, was a tenuous clinical entity with an ill-defined and uncertain core and fragile boundaries, both in France and more particularly in Ireland. In pure form, rarely described, its closest modern equivalent would have been delusional disorder, but case descriptions only occasionally correspond to this concept as it is understood today. Its popularity dating from around 1830 declined and by the 1870s it was in terminal decline. The factors delineating its rise and fall are unclear.

This paper aims to show how effective teamworking can be achieved in Community Mental Health Teams (CMHTs), in the context of recovery-focused care.

A narrative review of various governmental policy documents and selected papers relevant to teamworking and recovery-focused care within mental health services, in an Irish context.

Effective teamworking within CMHTs is a prerequisite to the provision of quality, recovery-focused care. It requires the management of various environmental (e.g. adopting a ‘recovery’ model of mental health), structural (e.g. sharing of responsibilities and capabilities) and process (e.g. utilising a clear referral pathway) factors that influence teamworking, as CMHTs develop over time.

Completion by CMHT members of teamworking and other evaluative measures can assist teams in highlighting potential interventions that may improve recovery-focused team functioning and effectiveness.