First admissions for schizophrenia to inpatient psychiatric services in Ireland are declining. The reason for this decline has been debated and it has been proposed that it could be attributable to either a decline in incidence or to policy changes or to both.

Objectives: This study examines the trends in first admission numbers for schizophrenia in Ireland and the influence of gender and marital status on age at first admission over the time period 1971-2004.

Method: Data were derived from the National Psychiatric Inpatient Recording System (NPIRS) for the years 1971-2004 inclusive. All first admissions with a diagnosis of schizophrenia during these years were included in the analysis.

Results: The results showed a significant decline in the number of first admissions with the number of first admissions for males exceeding those for females. The average age of first admission was higher for females than males (p < 0.001). The average age of first admission showed a decline for males (p < 0.001), but not for females. Marital status was a stronger predictor of age of admission than gender (p < 0.001). Never married persons had a lower age of first admission than those married and the delaying effect of marriage on age at first admission was evident in males and females (p < 0.001).

Conclusions: An examination of first admission hospital data confirm male disadvantage in schizophrenia. The study highlighted a number of areas for future research which include examining gender differences in more refined diagnostic sub groups of schizophrenia and the monitoring of first contacts with community-based mental health services.

Objectives: The aim of this study was to examine and describe levels of psychological health and well-being in a group of young people living in Dublin.

Method: A sample of 97 young people (50 males, 47 females) were assessed for psychological status, suicidal ideation, substance misuse, contact with the law, self-esteem and locus of control as well as various social indicators such as educational attainment and social connectedness. A screening version of the Structured Clinical Interview for DSM-IV Axis Diagnosis (SCID) was used to assess psychological functioning and the Beck Scale for Suicide Ideation was employed to ascertain suicidal ideation. Self-esteem was measured using the Rosenberg Self-Esteem Scale and locus of control was measured using a scale devised by Pearlin, Menaghan, Lieberman and Mullan (1981).

Results: Symptom levels were high and approximately one fifth of respondents had a probable psychiatric condition (most commonly depression or anxiety). Yet, only a small percentage was receiving treatment for psychiatric difficulties. Over half of the participants had used nonprescription drugs at some time. Alcohol consumption was high, especially amongst male respondents. Over half of those interviewed were categorised as misusing alcohol and/or drugs and participants greatly underestimated their level of alcohol use. Approximately one-quarter had had some contact with the law which was related to deficits in educational attainment and the latter variable was associated with childhood economic disadvantage.

Conclusions: These findings suggest that among a sample of 97 young Irish people, a high level of psychiatric symptomatology and excessive use of alcohol is evident. This remains largely untreated as only a small percentage of the group had sought help for psychological difficulties which suggests a need to address the issues of mental health awareness, alcohol use and the accessibility of services. The paper also underlines the association between economic disadvantage and lack of educational attainment with associated linkages to offending.

Objectives: To examine the relationship between cognitive deficits, the duration of untreated psychosis (DUP) and positive and negative symptoms in a first episode psychosis sample.

Method: We assessed a consecutive sample of first episode psychosis participants from a catchment area service with a comprehensive neuropsychology battery, a family and service-user based measure of DUP and measures of symptomatology.

Results: Using correlations and stepwise linear regressions, we found strong relationships between measures of DUP and positive symptomatology. We found that positive and negative symptoms were associated with different time periods within DUP. However, we did not find evidence of a relationship between DUP and cognitive factors.

Conclusions: There was no evidence of a relationship between DUP and cognitive deterioration. However, there does appear to be evidence of a relationship between positive symptoms and aspects of DUP. These results highlight the importance of the heterogeneity of DUP and the potential to reduce positive symptoms through early intervention.

This paper investigates the characteristics of those under inpatient psychiatric care in 1901 in the context of a policy formulated to provide institutional care and treatment for mentally ill persons. It presents data on admissions, discharges and deaths, their demographic and clinical characteristics and reported outcomes.

Objective: The association between depression and cardiovascular disease has been well documented but the nature of this relationship continues to be defined. Given the accumulation of epidemiological evidence linking these diseases a number of interventional studies have been undertaken to assess the issue of whether antidepressant treatment in depressed patients with cardiovascular disease improves cardiac outcome. The objective of this paper is to review recent randomised controlled trials on this topic and to explore the implications that these may have for future research in this area.

Method: This review is derived from a MEDLINE search using the search terms ‘depressive disorder’ and ‘cardiovascular diseases’. Only randomised controlled trials published in English with clearly defined methods and interventions are included here. Reference sections from the articles were used to identify additional relevant studies.

Results: A small number of high quality trials were uncovered which indicated mixed results in terms of the treatment of depression in cardiovascular disease. None indicated a statistically significant difference in cardiac outcome.

Conclusions: It is not possible at this time to recommend treatment for depression to reduce cardiovascular risk. However depression remains prevalent in patients with cardiovascular disease and is a treatable cause of morbidity in its own right.

We report a 45 year old man with neuroleptic-induced dyskinesia for whom deep brain stimulators (DBS) were implanted in the globus pallidus internus (GPi). We describe a significant improvement in his symptoms. Lastly, we review briefly the success of deep brain stimulation to date, and discuss the clinical implications for individuals who develop movement disorders during neuroleptic use.