Gambling legislation in Ireland has not been amended for the last several decades. The proposed Gambling Control Bill 2013 provides the opportunity to enact a bill in accordance with the current trends in gambling. The classification of Gambling Disorder in DSM 5 under Substance Use Disorders in 2013 highlights the addiction potential of gambling and the perils associated with the same. This editorial discusses the prevalence of gambling disorders, its societal implications, mental health conditions co-morbid with gambling disorders, screening tools available for gambling disorders, and the treatment options available for gambling disorders at present. Furthermore, factors to be considered before enacting the proposed Gambling Control Bill 2013 into legislation have also been discussed.

This study assessed both executive function (EF) and prospective memory (PM) in a group of current smokers (CS) to observe whether deficits in both sets of memory processes co-existed in smokers, comparing this group with a group who had never smoked (NS).

An existing-groups design was used to compare smokers with the NS group on a Reserve Digit Span Task (RDST) that measured EF and the Cambridge Prospective Memory Test (CAMPROMPT) measuring PM. Age, mood, other drug use and IQ were also measured and controlled for in the study.

After omitting anyone using an illegal substance and observing no between-group differences in age, gender, anxiety, depression, alcohol use and IQ, the CS group performed significantly worse on the RDST and recalled significantly fewer time-based and event-based tasks on CAMPROMPT, compared with the NS group.

Both EF and PM deficits were evident in the same cohort of CS when compared with a NS group, a finding which is novel in the current literature. Since both EF and PM are interrelated in that they share common resources in the brain, the finding that both sets of deficits co-existed in smokers suggests that persistent cigarette smoking impedes these underlying resources.

To examine the impact of a change in local prescribing policy on the adherence to evidence-based prescribing guidelines for antipsychotic medication in a general adult psychiatric hospital.

All adult in-patients had their clinical record and medication sheet reviewed. Antipsychotic prescribed, dose prescribed and documented indications for prescribing were recorded. This was done before and after the implementation of the change in hospital antipsychotic prescribing policy.

There were no significant differences in age, sex, Mental Health Act status, psychiatric diagnosis or documented indications for prescribing multiple or high dose antipsychotics between the two groups. There was an increase in the preferential prescribing of multiple second-generation antipsychotics (p=0.01) in the context of a significant reduction in the prescribing of multiple antipsychotics overall (p=0.02). There were no significant reductions in prescribing of mixed generations of antipsychotics (p=0.12), high dose antipsychotics (p=1.00) or as required (PRN) antipsychotics (p=0.74).

Changes in local prescribing policy can improve adherence to quality prescribing guidelines and cause clinically significant improvements in patterns of prescribing in a general adult psychiatric hospital.

Alcohol consumption during pregnancy potentially has significant effects on both mother and baby. The aim of the study was to determine the effectiveness of a brief intervention to reduce alcohol consumption during pregnancy.

This study was performed at the outpatient antenatal clinics of a large academic maternity teaching hospital in Dublin city centre. Six hundred and fifty-six women who drank alcohol before pregnancy were recruited at their first antenatal clinic visit. Drinking patterns before pregnancy, since becoming pregnant, and in later pregnancy (at ~32 weeks of gestation) were assessed using the Alcohol Use Disorders Identification Test (AUDIT). A controlled study was conducted – participants were allocated to either the brief intervention group (screening and 5 minutes of non-directive discussion of their drinking pattern) or a control group (screening and treatment as usual).

Before pregnancy, 57% of women consumed five or more units of alcohol per drinking occasion (i.e. binge drinking); during pregnancy, the rate of binge drinking fell to 4.8%. Sixty per cent of women who drank before pregnancy ceased drinking when pregnant, and a further 9% reduced their intake substantially. Four hundred and ninety-nine women were followed up in later pregnancy. The brief intervention did not produce any significant reduction in alcohol consumption above that attributable to pregnancy and comprehensive screening in antenatal care. Larger reductions in alcohol intake during pregnancy were associated with younger age, non-Irish nationality and greater intake of alcohol before first antenatal clinic visit.

Pregnancy itself produces abstinence and large reductions in alcohol consumption, even among women who drink relatively heavily. Consequently, a universal screening and brief intervention programme is not warranted but screening and targeted interventions could be appropriate such as repeated interventions for those who continue to binge drink. Future research could include evaluating interventions for those women who continue to binge drink during pregnancy and exploring ways of maintaining reductions in alcohol consumption among women who decreased consumption during pregnancy.

Co-prescription of linezolid and serotonergic agents (SSRIs, SNRIs, NaSSA, TCAs) can lead to serotonin syndrome, this study seeks to identify prescribing practise of these agents.

Study of all general hospital inpatients prescribed intravenous linezolid in a 3-month period, using drug charts and clinical notes.

Co-prescription occurred in 20% with SSRIs most frequently concurrently used. There were no cases of serotonin syndrome. There was no evidence in clinical notes of vigilance for potential interaction.

Co-prescription is common; awareness of potentially serious interaction is not evident in current practice.

This paper will bring you on a polemical journey to understand the issues related in conceptualizing bereavement-related depression.

A critical narrative review was carried out to evaluate arguments and controversies surrounding DSM-IV classifications of bereavement exclusion for the diagnosis of major depressive disorder (MDD).

Available studies that are associated with bereavement exclusion criteria, the open trials and treatments with the implications of such conceptualizations and the current removal of the bereavement exclusion from MDD in DSM-5 were addressed.

The review highlights the never-ending polemical journey of conceptualizing any mental disorders, bereavement-related depression included.

Deaths by suicide have been increasing in recent years in Ireland, many of whom have co-morbid mental health difficulties and/or have attended primary care services 1 month before death.

To profile how ‘Access to Psychological Services Ireland’ (APSI) provides stepped-care therapies for mild-to-moderate adult mental health presentations and the potential effectiveness of this model based on comparison to a review of evidence-based strategies in suicide prevention. A secondary aim is to highlight how APSI has the potential to target those at risk of suicide and provide an integrative after-care service to complement secondary care mental health services.

In a context of inter-agency working, APSI provides an integrated continuum of suicide prevention interventions that map onto or intervene across the continuum of suicide behaviour. Hence, APSI appears to implement what the literature suggests will work in preventing suicide. However, outcome research is needed to establish APSI’s impact in preventing suicide.

It is recommended that Irish-based research is conducted to establish APSI’s impact in preventing suicide with a view to rolling out APSI as a national mental health clinical care programme.