Objective: To describe the clinical characteristics and demographic details of a sample of patients with a principal diagnosis of obsessive compulsive disorder (OCD). Method: A retrospective review of fifty patients with DSM-III-R OCD referred to the Department of Behaviour Therapy at St. Patrick's Hospital, Dublin, Ireland between 1990 and 1991. Standard clinical ratings were made before and after treatment. Ratings used included the Maudsley Obsessive Compulsive Inventory (MOCI), the Fear Questionnaire (FQ), and the Yale-Brown obsessive compulsive score (YBOCS). Results: The male to female ratio was almost equal and the mean duration of illness was 6.1 (SD 11 years). OCD presented in isolation in a minority of cases (14%). A life time history of at least one other DSM-III-R axis I diagnosis, especially depression, was found in 72% of patients. Co-morbid Gilles de la Tourettes syndrome or epilepsy was rare. The majority of patients were on medication prior to presentation (78%). Levels of symptomatology were reduced in 91% of patients who completed treatment. Conclusions: Epidemiological research into the mass aspects of this disorder is required.

There has been relatively limited research focus on autism in the context of the criminal justice system. The relationship between autism spectrum disorder (ASD) and criminal responsibility is complex. Furthermore, the features inherent to ASD can have a significant bearing on a wide array of other issues in this context including police interviewing, fitness to be tried, culpability and the appropriateness of custodial disposal. This review explores the background to our understanding of ASD, patterns of offending behaviour and the nature of the relationship between this and characteristic ASD deficits. The clinical and legal challenges posed by ASD defendants in terms of identification, assessment and on a broader service level as they negotiate the criminal justice system are highlighted to illustrate the varied difficulties they may encounter and to draw attention to this field as a worthy area of research and training for the medical, legal and law enforcement professions.

Approaching 2 years into a global pandemic, it is timely to reflect on how COVID-19 has impacted the mental health of the global population. With research continuing apace, a clearer picture should crystallise in time. COVID-19 has undoubtedly had some impact on population mental health, although the severity and duration of this impact remain less clear. The exceptional period of COVID-19 has provided a unique prism through which we can observe and consider societal mental health. This is a momentous time to be involved in mental health research as we strive to understand the mental health needs of the population and advocate for adequate resourcing to deliver quality mental healthcare in the post-pandemic period.

Alan Turing was born in Paddington, London on June 23, 1912 . His family were middle-class and well-off. He was fascinated with science from an early age and showed precocious talent, especially in the areas of chemistry and mathematics. He attended Sherbourne Public School and then King's College, Cambridge where he studied mathematics. His areas of interest at Cambridge were probability theory and mathematical logic. It was at Cambridge that he first conceptualised the Universal Turing Machine, an idea that was to evolve into the modern theory of computing. He has been referred to as the father of the computer.

He worked on a cipher machine at Princeton University between 1936 and 1938. He worked for the British Government during World War II with the Government Code and Cipher School at Bletchley Park. He was ultimately the key player in deciphering the German 'Enigma' code used by its submarines during the war. After the war he took up a post in Manchester University where he continued to work on ideas of artificial intelligence. He was arrested and charged for homosexual activity in 1952 and underwent a course of oestrogen therapy. He committed suicide in 1954.

He was regarded as being socially aloof and eccentric by colleagues and friends. He was interested in mathematics, chemistry and logic from an early age, to the exclusion of other activities. This paper attempts to establish whether he fulfilled the criteria for Asperger's syndrome.

An account is given of an approach to group therapy for stuttering using Kelly's personal construct theory as a basis for exploring the understanding of stuttering and the process of change. All five clients who participated showed considerable improvement in fluency on the Riley Stuttering Severity Instrument. Although the improvement may be due to concurrent individual fluency therapy, feedback on the group sessions suggested that group therapy had a positive effect on personal behaviour and facilitated transfer and maintenance of speech fluency.

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.

Objective: To explore the relationship between social skills and depressive symptoms in a normal young adolescent population.

Method: An all male group of 85 schoolchildren, in the first year of secondary school, completed self-report instruments to measure the constructs of depression and of social skills. The Depression Self-Rating Scale (DSRS) and the Matson Evaluation of Social Skills with Youngsters (MESSY) were the instruments used.

Result. Regression analysis of the factor scores on the MESSY and the total score on the DSRS revealed a significant, negative relationship. This was particularly so for the jealousy/withdrawal factor (Factor V) on the MESSY (f = 27.323; p < 0.001)

Conclusion: The data provide support for the social skills deficit model of depression and indicate the possible role of fostering pro-social behaviours and promoting social skills enhancement in the vulnerable young adolescent.

Objectives: To examine the associations of self-reported alcohol consumption in a community based sample of elderly subjects.

Methods: A total of 518 non-institutionalised community dwelling elderly identified from general practice registers were interviewed in their own homes using the Geriatric Mental State (GMS-AGECAT), the Mini-Mental State Examination and the sociodemographic questionnaire. Physical health was rated on a six-point scale. Self reported alcohol consumption was recorded in units per week. The group was then divided according to the presence or absence of excessive alcohol consumption (ie. consumption of over 14 units per week for females and 21 units per week for males). Results were analysed using multivariate regression analysis with excessive alcohol consumption as the dependent variable.

Results: The mean age of the sample was 73 (range 65-95), 63% (n = 329) were female. Thirty-six per cent of the population were abstinent and 7% reported excessive alcohol consumption. Analysis of the data revealed no association between excessive alcohol consumption and diagnosis, age, cognitive function or poor physical health. Excess consumption was found to be significantly associated with gender (male) and widowed status (p < 0.001, p = 0.013 respectively).

Conclusions: As alcohol misuse is commonly missed in the elderly identifying high risk groups is important for the development of intervention strategies. Our results suggest that elderly widowers may be more at risk than their peers of alcohol misuse.

Over the recent past, reports have argued that there has been a decline in the mental health of children and young people in Western societies. This is said to have occurred gradually over the second half of the last century and possibly longer. This view is based on evidence of a progressively declining peak age for adult type depressive disorders, and an apparent increase in adolescent disturbance such as substance abuse, attempted and completed suicide, perhaps eating disorders, and behaviour disorders. These phenomena have been attributed to the major changes in social values and behaviour, with their impact on child rearing and family life that gathered pace over the course of the last century.

Objectives: To assess social and educational status, trauma experienced, diagnosis and treatment of asylum seekers, who presented to psychiatrists in St James's hospital Dublin over a two-year period.

Method: All files of asylum seekers assessed by psychiatrists in St James's hospital over a two-year period were scrutinised. Using a pro-forma, data was obtained about social and educational status, language skills, trauma suffered, diagnosis, treatment and follow-up. Demographic data was obtained from the Department of Justice, the Irish refugee centre and various social welfare offices.

Results: Over a two-year period 31 asylum seekers were in contact with this service. Most originated from Africa. Overall subjects were well educated but socially isolated with poor language skills. Many had been imprisoned or tortured, or had relatives or friends tortured or killed prior to migration. Almost one third met criteria for PTSD and greater than a third met criteria for major depression. The majority of subjects received pharmacological treatment, but few were offered psychological treatments. Most had no prior psychiatric diagnosis and dropped out of treatment at an early stage.

Conclusions: Large numbers of asylum seekers are currently residing in Dublin and may need specialised psychological support and treatment. They have been exposed to significant levels of pre-migratory trauma, often have poor language skills and drop out of treatment quickly which may indicate dissatisfaction with existing treatment approaches. There is an urgent need for increased funding for the psychological needs of this vulnerable group, for the provision of trained interpreters, specialised psychotherapy and assessment of their needs.

The association between intellectual disability and offending is complex. Recent evidence would suggest that the received wisdom of intellectually disabled persons being more prone to offending is either incorrect or only tells part of the story. Those within the ‘borderline’ intellectual disability range may be more prone to committing sexual and criminal damage offences but those with an IQ less than 50 rarely offend.

The offender with intellectual disability shares characteristics with his counterpart from the general population. As with the general population as a whole, offending in this group is often unreported and its recognition is complicated by issues of competence. The lack of validated forensic assessment schedules for this population poses a further challenge. Some general approaches to assessment in this population are discussed. This case report illustrates the difficulties of assessing and managing offending behaviour in an individual with moderate intellectual disability. The challenge of treating offenders with an intellectual disability is immense and requires specialist expertise. Managing such cases in a generic setting is inappropriate and the need for a forensic learning disability service in Ireland is highlighted.

Clozapine was substituted for standard antipsychotic drugs in the treatment of 24 chronic schizophrenic inpatients and the response assessed after a mean of ten months. The majority (71%) improved (33.3% markedly), on their previous level of functioning. The response was better in those under 40 years of age, but neither duration of illness nor previous neuroleptic dose appeared to predict response to clozapine. The drug was ultimately discontinued in five (21%) patients – in three because of non-response and intolerance of sedation and in two because of neutropenia.

We present a rare case of Acute Interstitial Nephritis (AIN) that occurred following a re-trial of clozapine in a 56-year-old lady with schizoaffective disorder. On initial trial of clozapine, this patient felt generally unwell with respiratory symptoms. Her inflammatory markers were raised and her renal function showed a mild, transient deterioration which normalised on the day of cessation of clozapine. Two years later, clozapine was re-trialled due the refractory nature of her psychiatric symptoms. She subsequently developed renal failure and AIN was confirmed by renal biopsy. Renal function improved after cessation of clozapine; however, she never fully regained normal renal function.