Introduction
The final issue of the Irish Journal of Psychological Medicine (hereafter, the Journal) in 2025 includes research on a wide variety of topics, with subthemes that provide fresh insights into suicidal behaviours and their impacts, neurodiversity, the psychiatry of older people, and the neuroscience of compassion. We will highlight some of the key papers featured in this issue.
Suicide and suicidal behaviours are an area of significant public health concern among Irish Travellers. The mental health of Travellers is a critical area of focus, and one that, despite the acknowledged high levels of need, has not been researched to a degree matching the scale of the problem. Travellers experience significant adversity and associated unmet healthcare needs and, like other underserved populations, frequently rely on unscheduled care. This population experiences disproportionately elevated risk for suicide and suicidal crisis. Kavalidou et al.’s mixed-methods study exploring the experiences of Traveller women presenting to emergency departments used robust data and patient experiences to highlight the vulnerability of this patient group. It calls for culturally informed models within emergency departments to address the significant social and systemic factors contributing to this disparity.
The second paper on the topic of suicide, by O’Brien et al addresses the profound impact which patient suicide can have on psychiatrists and psychiatrists in training. The National Suicide Research Foundation conducted this study in collaboration with the National Office for Suicide Prevention and the College of Psychiatrists of Ireland. Given that psychiatrists are the professionals with clinical responsibility for crisis and suicide assessment, they are the medical professionals most impacted by the experience of patient suicide. Similarly, by virtue of their roles as both clinical leads and the medical members of the team, psychiatrists usually have greater involvement with people who die by suicide than other members of multidisciplinary mental health teams. This study examined the experiences of over 200 psychiatrists, including trainees and consultants. The vast majority (88.5%) had experienced the death of a patient by suicide and reported that patient suicide had a profound effect on their lives: both in terms of how they approached their work and professional identity, and the even greater impact on their personal lives, especially where the psychiatrists were women. This study offered strategies that might help mitigate the impact of death and the coronial process. The authors suggest that there is a greater need for guidance and both clinical leadership and occupational support for clinicians who experience the death of a patient by suicide.
This issue presents two pieces of original research surrounding diagnoses and services in the area of neurodiversity. Rudden et al.’s timely observational cohort study evaluated the referral pathway from general practice to Irish specialist adult attention deficit hyperactivity disorder (ADHD) services. Concerningly, the study found that specialist adult ADHD teams received three to four times as many referrals as they could assess during the timeframe studied. The article discussed the implications of increased awareness of neurodiversity for the provision of clinical services. Adamis et al.’s prospective longitudinal study evaluated the prevalence of the coexistence of autism spectrum disorder (ASD) traits in adults already diagnosed with ADHD. The study found that almost half of the participants had traits of ASD. Longitudinal analyses demonstrated that people with ADHD and ASD traits have worse clinical outcomes, quality of life, social skills, and family functioning, compared to those with ADHD only.
Munawar et al.’s cross-sectional cohort study examines delirium among elderly people hospitalised with COVID-19. It concludes that certain pre-existing risk factors are associated with a higher incidence of delirium, and delirium often results in prolonged hospital admissions and greater subsequent functional decline for patients. Taqvi et al.’s cross-sectional study evaluated the perspectives of nursing staff regarding the use of antipsychotic medication to manage behavioural and psychological symptoms of dementia (BPSD) in nursing homes. The authors reported that nurses reported confidence in their knowledge of pharmacological treatment for BPSD. However, concerns were expressed regarding the limited availability of non-pharmacological interventions.
Kamal et al.’s scoping review of literature on the neuroscience of compassion and compassion focused therapies highlights the possible benefits of compassion-based training for healthcare professionals. Their results showed various neurological changes in regions of the brain following compassion-based training. The authors concluded that compassion-based training could lead to neuroplastic changes, which interconnect to enhance overall well-being, resilience, and compassionate care among healthcare professionals.
Finally, on the topic of compassion, this issue includes “Psychiatry and Songs: An Appreciation of Dr Niall Crumlish,” which offers a moving tribute to the psychiatrist and writer, written by fellow psychiatrists, including a previous Editor-in-Chief of this Journal, Professor Kelly. It is an example of how one person, who makes compassion their focus, can make a real and lasting difference across personal, clinical, and academic domains. The late Dr Crumlish contributed several scientific papers to this Journal during his too-short career, and well as being a valued member of the Editorial Board.
