Older adults are more likely to develop delirium with COVID-19 infection. This cross-sectional cohort study was designed to explore the risk factors of delirium in hospitalized older adults with COVID-19 and to evaluate whether delirium is an independent predictor of mortality in this cohort of patients.

Data were collected through a retrospective clinical chart review of patients aged 65 years or older who were admitted to St. James’s Hospital between March 2020 and 2021 who tested positive for SARS-CoV-2 infection.

A total of 261 patients (2.8 % of total admissions 65 years or older) were included in this study. Patients who developed delirium were older (80.8 v. 75.8 years, p < 0.001), more likely to have pre-existing cognitive impairment (OR = 3.97 [95% CI 2.11–7.46], p < 0.001), and were more likely to be nursing home residents (OR = 12.32 [95% CI 2.54–59.62], p = 0.0018). Patients who developed delirium had a higher Clinical Frailty score (mean 5.31 v. 3.67, p < 0.001) and higher Charlson Co-morbidity index (mean 2.38 v. 1.82, p = .046). There was no significant association between in-hospital mortality and delirium in the patient cohort (p = 0.13). Delirium was associated with longer hospital stay (40.5 days v. 21 days, P = 0.001) and patients with delirium were more likely to be discharged to nursing homes or convalescence instead of home (OR = 8.46 [95% CI 3.60–19.88], p < 0.001).

Delirium is more likely to occur in COVID-19 patients with pre-existing risk factors for delirium, resulting in prolonged admission and functional decline requiring increased support for discharge.

Many consultations in primary care involve patients with mental health problems, and primary care is typically the place where many such patients initially seek help. While considerable research has examined the prevalence of mental health disorders in primary care, relatively few papers have examined this issue in recent years. This study aims to address this gap by reviewing contemporary literature from 2014 to 2024 on the prevalence of mental health disorders among general practice patients.

A comprehensive search across PubMed, PsycINFO, and Google Scholar was conducted, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for article selection and assessment, examining the prevalence of mental health disorders in general practice.

Studies varied in methodologies and healthcare settings, with reported prevalence rates of mental health disorders ranging from 2.4% to 56.3%. Demographic characteristics (female gender, older age) were associated with a higher prevalence of mental health disorders in the studies identified. Studies based on patient interviews reported broader prevalence (2.4–56.3%) compared to studies using electronic medical record reviews (12–38%). Prevalence also varied between countries. Notably, there has been a lack of post-COVID-19 studies, especially within Europe, examining the prevalence of mental health prevalence in primary care.

Mental health problems are still common among patients attending general practice; the approach to data collection (i.e., prospective interviews with patients), female gender and older age appear to be correlates of higher estimates. Further research involving a large-scale study with multiple sites is a priority.

Co-production is a relatively new concept with a history spanning back just four decades. However, it is only in the past ten years that it has been applied to mental health. It is now observed as a recovery principle whose presence is necessary for recovery-orientated services to become a reality. Despite this, today, there is still much confusion as per the philosophical, empirical and practical basis within mental health service provision, with key areas lacking theoretical clarity, for example, its definition within the mental health domain along with its ontological and epistemological stance on how the social world should be viewed and, more importantly, interpreted. As such, this paper will examine the concept of co-production within mental health service provision.

A scoping review that was compliant with the PRISMA amendments for scoping reviews and followed Arksey and O’Malley’s methodological framework was conducted. The databases CINAHL, Cochrane Online Library, Jstor, Ovid SP, PsycINFO, PsycTESTS, PubMed, RCNi, Science Direct, Web of Science and Wiley Online Library were used to search the peer-reviewed literature. This was supported by a comprehensive search of repositories for grey literature on co-production.

Ten articles were eligible for inclusion in the study. Through the use of a summative content analysis approach, the results were constructed in order to form a narrative. This narrative would reflect the key aspects of each study as they pertained to one or more of the five headings created as part of phase four of Arksey and O’Malley’s methodological framework. These headings include Co-Production Definition Used, Stated Advantages of Co-Production, Stated Disadvantages of Co-Production, Co-Production Types/Models and Implementing Co-Production.

The results of this review has added empirically to the literature base on co-production. The study highlights the lack of renumeration for those working in co-production activity that needs to be addressed. Most striking is the formal recognition, for the first time, of a philosophical war between co-production and that of evidence-based practice itself. This is an interesting but important development that requires further study in order to ensure that co-production as a recovery principle can be further enhanced and sustained into the future.

The aim of this rapid scoping review was to provide a summary of the available evidence on the development and implementation of peer support work in mental health services. The specific objectives were: to undertake a comprehensive review of the literature on peer support work; and identify how such work may be best implemented.

A rapid scoping review was identified as the most appropriate approach to reviewing the literature mainly because the objectives of this review were relatively broad and there was a short timeframe. In a rapid scoping review the data extraction and reporting are focused and limited to provide an overview of existing evidence.

From the initial database results of 7406 records, 663 were identified as meeting the inclusion criteria. The most relevant of these were then selected (n = 26) to be reported in this review with existing reviews of the research evidence (n = 7) being prioritised. The findings were organised into a number of sections: definitions, values and the role; development and implementation of peer support work; experiences of peer support workers; perceptions of others about peer support work; recruitment of peer support workers; training; supervision and support; and research on effectiveness.

There are excellent sources of guidance, considerable qualitative research about experiences and some encouraging, but limited, findings about the impact of peer support work specifically on recovery-oriented outcomes. There is a need for further rigorous research on the key aspects and effectiveness of peer support work.

Personality disorders, characterised by pervasive emotional and interpersonal dysfunction, are integral to psychiatric practice. This service review estimated the prevalence of personality disorders in a psychiatric inpatient setting and looked at various clinical and demographic factors of interest.

Data were retrospectively collected from 526 patients discharged from St Patrick’s University Hospital in 2019–2020 under the care of two consultant-led teams. Demographic and clinical data such as age of first mental health contact, number of previous admissions, and risk history were recorded as well as the use of the Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD).

37% of the sample had at least one personality disorder, with borderline (24.9%), avoidant (13.3%) and obsessive-compulsive (7.6%) being the most common subtypes. Notably, in 72.1% of cases the diagnosis was new. High comorbidity was observed, particularly with affective (47.7%) and anxiety disorders (28.4%). Patients with personality disorders exhibited high rates of self-harm (45%) and suicide attempts (40%).

The review highlighted potential delays in diagnosis, with an average of 15 years of mental health service contact prior to diagnosis. The findings underscore the need for specialised services and further research to better understand and manage personality disorders in the Irish psychiatric setting. Limitations include the specific sample from a private mental health facility and the high use of structured interviews, which may affect the generalisability of the results to other settings. This review contributes valuable data to the limited research on personality disorder prevalence in Irish psychiatric services.

Autistic people have high levels of mental ill-health and an increased risk of suicide across the lifespan. Yet autistic people report difficulties communicating with healthcare professionals and accessing a range of healthcare services. At the same time, mental healthcare workers in other countries are reporting links between confidence when working with autistic patients and the degree of autism knowledge and training they can access.

We sought to examine what factors helped or hindered Irish mental healthcare colleagues when working with autistic healthcare service users. An online survey using quantitative and qualitative metrics was circulated among psychiatrists who are members of the College of Psychiatrists of Ireland, both in training and at consultant level, from April 2021 to April 2022.

Knowledge of autism was high among psychiatrists (n = 140), but self-efficacy scores were variable, particularly in relation to care pathways. Self-efficacy was better among psychiatrists with caseloads of children and youth or individuals with co-occurring intellectual disabilities. Three key qualitative themes emerged relating to capacity and training of mental health professionals, ways to improve mental health services provision for autistic individuals and also the critical need for co-creation and neurodiversity affirmative care.

The study highlighted critical systemic and professional challenges in providing mental health care to autistic people in Ireland. We provide recommendations for reducing these challenges and for enabling the development of inclusive, evidenced-based care to autistic individuals.

Schizophrenia is a chronic condition that requires long-term management. Quality of life is an important outcome measure for individuals diagnosed with schizophrenia; it can be tracked over time allowing evaluation of whether interventions lead to sustainable improvements. Nutrition and dietary interventions are an underutilized treatment for tackling the metabolic consequences of mental illness, which is now recognized as having increased importance in the management of schizophrenia. This study examines the impact of nutrition and dietary interventions on quality of life outcomes for those with schizophrenia.

A systematic review of the literature was conducted, assessing the impact of nutritional interventions on quality of life outcomes in individuals with a diagnosis of schizophrenia.

A total of 982 articles were screened, of which nine articles met the inclusion criteria. Quality of life measures varied across studies, which made comparison across studies challenging. Previous studies had relatively small sample sizes and did not have long follow-up durations. Some of the studies found that dietary interventions such as counselling, weight management programs, food diaries and nutritional education improved quality of life, whereas others did not detect any effect.

The review provides preliminary evidence that nutrition and dietary interventions may benefit quality of life among individuals with schizophrenia. There were however substantial limitations in studies highlighting the need for further research. The paper also highlights the need to standardize assessment tools for future quality-of-life research.

Compassion is the emotion that motivates people to relieve the physical, emotional, or mental pains of others. Engaging in compassionate behaviour has been found to enhance psychological wellness and resilience. However, constant displays of compassionate behaviour can lead to burnout particularly for healthcare workers who inherently practise compassion day to day. This burnout can be relieved by Compassion focused meditation. The aim of this review is to identify neuroplastic changes in the brain associated with meditation, with a focus on compassion and compassion related meditation.

Based on PRISMA guidelines, we conducted a scoping review of studies which described neuroplastic effects of meditation, focusing on compassion-based training. Studies were excluded if they (i) included multiple meditation practices or (ii) included participant populations with psychiatric/neuropsychiatric history (except anxiety or depression) or (iii) included exclusively ageing populations.

The results of the reviewed studies showed various neurological changes in regions of the brain as a result of compassion based training. These regions include amygdala, the anterior insula, medial prefrontal cortex, medial orbitofrontal cortex and structures within the dopamine system.

This review highlights that compassion-based training could lead to neuroplastic changes which interconnect to enhance overall well-being, resilience and compassionate care among health-care professionals. However, further work is required to establish conclusive evidence of its sustained benefit and cost-effectiveness, as well as its utility in a healthcare setting.

Advance Choice Documents (ACDs) have been recommended for inclusion in new mental health legislation for England and Wales based on evidence they reduce compulsory psychiatric admission, with particular benefit for Black people. As Black people disproportionately experience compulsory psychiatric admission in the UK, our aim was to explore potential barriers and enablers to effective ACD implementation for Black people with previous experience of compulsory admission.

Six stakeholder workshops and one consensus workshop were held with: Black service users who had previously been involuntarily admitted, carers/supporters of Black service users, and mental health staff. Thematic analysis was conducted on workshop transcripts.

Participants were service users (n = 13), carers/supporters (n = 7), service users and carers/supporters (n = 3), and staff (n = 18). Thematic analysis identified themes of ‘training’, ‘completion’, ‘access’, and ‘use’ concerning ACD implementation. Stakeholders highlighted the importance of understanding the racialised experience of Black service users for effective ACD implementation. Strong communication between and amongst stakeholders and helpful systems for access were also emphasised. Stakeholders also recommended joint training and independent facilitation of ACDs to address Black service user-staff power imbalances.

Known enablers and barriers to ACD implementation are important when considering ACDs for Black people, as is explicitly engaging with their experiences holistically, including racialised historical and individual experiences that underline some treatment preferences. Independent facilitation and shifts in service user-staff power dynamics present as key to realising the potential of ACDs to empower Black service users in relation to their care, and in turn to potentially reduce coercive care.

To examine if the current taught undergraduate psychiatry syllabus at an Irish University relates to what doctors in psychiatry consider to be clinically relevant and important.

Doctors of different clinical grades were invited to rate their views on 216 items on a 10-point Likert scale ranging from ‘0 = not relevant’ to ‘10 = very relevant’. Participants were invited to comment on topics that should be excluded or included in a new syllabus. Thematic analysis was conducted on this free-text to identify particular themes.

The doctors surveyed rated that knowledge of diagnostic criteria was important for medical students. This knowledge attained high scores across all disorders with particularly high scores for a number of disorders including major depressive disorder (mean = 9.64 (SD = 0.86)), schizophrenia (mean = 9.55 (SD = 0.95)) and attention deficit hyperactivity disorder (Attention Deficit Hyperactivity Disorder (ADHD); mean = 9.26 (SD = 1.40)). Lower scores were noted for less frequently utilised management strategies (transcranial magnetic stimulation (mean = 4.97 (SD = 2.60)), an awareness of the difference in criteria for use disorder and dependence from psychoactive substances (mean = 5.56 (SD = 2.26)), and some theories pertaining to psychotherapy (i.e. Freud’s drive theory (mean = 4.59 (SD = 2.42)).

This study highlights the importance of an undergraduate programme that is broad based, practical and relevant to student’s future medical practice. An emphasis on diagnosis and management of major psychiatry disorders, and knowledge of the interface between mental health services, other medical specialities and support services was also deemed important.

To explore current and potential upcoming legal provisions concerning advance healthcare directives in psychiatry in Ireland, with particular focus on clinical challenges and ethical issues (e.g., self-harm, suicide).

Review and analysis of selected relevant sections of the Assisted Decision-Making (Capacity) Act 2015, Assisted Decision-Making (Capacity) (Amendment) Act 2022, Mental Health Act 2001, Mental Health Bill 2024, and Criminal Law (Suicide) Act 1993, and relevant publications from Ireland’s Medical Council and Decision Support Service.

The Assisted Decision-Making (Capacity) Act 2015 outlined new procedures for advance healthcare directives. The Assisted Decision-Making (Capacity) (Amendment) Act 2022 specified that advance healthcare directives relating to mental health are binding for involuntary patients unless involuntary status is based on Section 3(1)(a) of the Mental Health Act 2001 (i.e., the ‘risk’ criteria). The Mental Health Bill 2024 proposes making advance healthcare directives binding for all involuntary patients. In relation to suicide and self-harm, the Criminal Law (Suicide) Act 1993 states that ‘a person who aids, abets, counsels or procures the suicide of another, or an attempt by another to commit suicide, shall be guilty of an offence’, and the Decision Support Service advises that healthcare professionals are exempted from criminal liability if complying with a valid and applicable advance healthcare directive that refuses life-sustaining treatment, even where the directive-maker has attempted suicide.

Considerable public and professional education are needed if advance healthcare directives are to be widely used. The ethical dimensions of certain advance directives require additional thought and, ideally, professional ethical guidance.

To examine the clinical and demographic profile of inpatient psychosis admissions in Ireland.

Anonymised data was extracted from the Health Research Board (HRB) National Psychiatric Inpatient Reporting System (NPIRS) from 2013–2022. The NPIRS database is maintained by the HRB and records all admissions to inpatient units and hospitals on the register of approved centres under the Mental Health Act 2001. Data was reviewed and analysed using SPSS V26.

There were 43,963 psychosis admissions over the 10-year period corresponding to 26% of all psychiatric admissions. Males accounted for 58% of psychosis admissions. The median age at first admission was 36 years of age for males and 42 years of age for females. Median length of stay in days was longer for psychosis admissions (median = 20 days IQR = 8–43) than for other mental health disorders (median = 13 days IQR = 4.0–33).

Understanding the clinical and demographic profile of psychosis related inpatient psychiatric admissions in Ireland provides insights that can inform effective service planning and care delivery. The findings of this study have particular relevance for the implementation and evolution of the Health Service Executive Early Intervention in Psychosis Clinical Programme.