Brian Hallahan

• Ollscoil na Gaillimhe – University of Galway

Objectives 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. Methods 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 = v...

Objectives:To examine the criteria utilised for detaining individuals under the Irish Mental Health Act 2001 (MHA 2001) and their association with clinical features. Methods:Demographic and clinical data of 505 involuntary admissions under the MHA 2001 between 2013 and 2023 were attained. Data included criteria utilised for detention and renewal, s...

Objectives To examine if the COVID-19 pandemic had a differential impact longitudinally over four years on psychological and functional impact in individuals with a pre-existing anxiety, bipolar or emotionally unstable personality Disorder (EUPD). Methods Semi-structured interviews were conducted with 52 patients attending the Galway-Roscommon Men...

Objectives To examine the psychosocial impact of the COVID-19 pandemic on patients with a diagnosis of diabetes mellitus (DM). Methods Semi-structured interviews were conducted with 31 individuals with DM attending a diabetes clinic to determine the impact of the COVID-19 restrictions on anxiety and depressive symptoms, social and occupational fun...

Background To examine if the COVID-19 pandemic was associated with a differential effect longitudinally in relation to its psychological and functional impact on patients with bipolar disorder and Emotionally Unstable Personality Disorder (EUPD). Methods Semi-structured interviews were conducted with 29 individuals attending the Galway-Roscommon M...

Introduction: Schizophrenia (SCZ) is a complex neurodevelopmental disorder characterised by functional and structural brain dysconnectivity and disturbances in perception, cognition, emotion, and social functioning. In the present study, we investigated whether the microstructural organisation of the uncinate fasciculus (UF) was associated with emo...

Background Fluphenazine decanoate licenced as a long-acting injectable (LAI) first-generation antipsychotic (FGA) was withdrawn from sale in 2018. This study evaluates if its withdrawal resulted in increased relapse rates of psychosis in an Irish patient cohort and examines which prescribed alternative antipsychotic medications were associated with...

Objectives:This study aimed to evaluate the proportion of Irish medical students exposed to ‘badmouthing’ of different specialities and to ascertain: the degree of criticism of specialities based on the seniority of clinical or academic members of staff; if ‘badmouthing’ influenced student career choice in psychiatry; and attitudes of medical stude...

Objectives To examine and compare rates and methods of probable suicide in a Western region of Ireland during a 24 month period since the onset of the COVID-19 pandemic compared with a similar period immediately prior to the pandemic onset. Methods Post-mortem reports between March 1 st 2018 and February 29 th 2020 were reviewed and compared with...

Myocyte Enhancer Factor 2C ( MEF2C ) is a transcription factor that plays a crucial role in neurogenesis and synapse development. Genetic studies have identified MEF2C as a gene that influences cognition and risk for neuropsychiatric disorders, including autism spectrum disorder (ASD) and schizophrenia (SCZ). Here, we investigated the involvement o...

Cannabis abuse is prevalent among young people in Pakistan, despite its association with significant psychopathology. Current treatment models to reduce cannabis use have been purported to have variable effectiveness and lack cultural adaptability. Consequently, this study assessed if an indigenously adapted community reinforcement approach (IA-CRA...

Objective The Corona Radiata (CR) is a large white matter tract in the brain comprising of the anterior CR (aCR), superior CR (sCR), and posterior CR (pCR), which have associations with cognition, self-regulation, and, in schizophrenia, positive symptom severity. This study tested the hypothesis that the microstructural organisation of the aCR, as...

This case describes delusions of vampirism among several other psychotic symptoms in a 15-year-old who has a diagnosis of schizophrenia, with these delusions first presenting when he was 13 years of age. Delusions of vampirism can be associated with a strong desire to suck human blood but these delusional beliefs were not acted upon here. This is t...

Impact factor (IF) is a concept dating back over half a century, created to evaluate the impact of a journal within a particular scientific field. In spite of limitations, IF remains a widely used metric for journals to establish the average number of citations for articles published in a journal. The Irish Journal of Psychological Medicine (IJPM)...

Investigating alterations in brain circuitry associated with bipolar disorder (BD) may offer a valuable approach to discover brain biomarkers for genetic and interventional studies of the disorder and related mental illnesses. Some diffusion MRI studies report evidence of microstructural abnormalities in white matter regions of interest, but we lac...

Objectives: Escherichia coli ST 127 is a pandemic clone that belongs to the extraintestial pathogenic (ExPEC) family, associated with urinary tract infections and bloodstream infections. Here, we report the complete genome of an E. coli ST127 isolate which was identified in the saliva of a patient with Treatment Resistant Schizophrenia (TRS) exhib...

Zooanthropy (delusional beliefs of turning into an animal) is a rare but well recognised psychiatric phenomenon. This case describes the presence of kynanthropic delusions (delusional beliefs of turning into a dog). Multiple other psychotic symptoms were also evident including unusually the additional presence of delusions of vampirism. Delusional...

Childhood trauma (CT) is associated with lower cognitive and social cognitive function in schizophrenia. Recent evidence suggests that the relationship between CT and cognition is mediated by both low-grade systemic inflammation and reduced connectivity of the default mode network (DMN) during resting state. This study sought to test whether the sa...

Introduction and aims: Symptomatology of epilepsy and its' associated alteration in brain processes, stigma of experiencing seizures, and adverse sequelae of anti-epileptics have been demonstrated to impact behaviour and exacerbate psychopathology. This study examines the role of dysfunctional schema modes in People with Epilepsy (PWE) and their a...

Amblyopia is a common developmental disability resulting in reduced visual acuity and gaze stability; it occurs in approximately 5% of the general population. Here, we present the case of an 18-year-old girl diagnosed with amblyopia. Subsequent to her diagnosis of amblyopia, she developed a depressive episode with co-morbid anxiety symptoms. She wa...

Objectives: To examine if the COVID-19 pandemic is associated with a differential effect over a 2-year time period in relation to its psychological and social impact on patients with established anxiety disorders. Methods: Semi-structured interviews were conducted with 21 individuals attending the Galway-Roscommon Mental Health Services in Irela...

Background Impulsivity is associated with suicidal acts and ideation, whereas higher religious commitment has been identified as a potential protective factor linked to lower suicidal ideation. Objectives We examined the extent to which higher religious commitment is associated with lower suicidal ideation and whether religious commitment modifies...

Investigating brain circuitry involved in bipolar disorder (BD) is key to discovering brain biomarkers for genetic and interventional studies of the disorder. Even so, prior research has not provided a fine-scale spatial mapping of brain microstructural differences in BD. In this pilot diffusion MRI dataset, we used BUndle ANalytics (BUAN), a recen...

Objectives: To examine and compare rates and methods of self-harm presenting to a tertiary referral hospital during an 18-month period since the onset of the COVID-19 pandemic with a similar period immediately prior to the pandemic onset. Methods: Data from an anonymized database compared rates of self-harm presentations and methods employed bet...

It has been reported that childhood trauma (CT) is associated with reductions in fractional anisotropy (FA) in individuals with schizophrenia (SZ). Here, we hypothesized that SZ with high levels of CT will show the greatest reductions in FA in frontolimbic and frontoparietal regions compared to healthy controls (HC) with high trauma levels and part...

Background Poor insight is associated with negative attitudes to involuntary admission and care in qualitative studies. Aims The current paper aims to examine and compare retrospective qualitative perceptions of service-users in relation to their involuntary admission with their levels of clinical insight, using a mixed methods approach. Methods...

Objectives : Kalamiella piersonii is a newly identified bacterial species, firstly isolated from surfaces of the International Space Station (ISS). It also appears as a novel human pathogen reported to be implicated in bacteremia and kidney stone disease. Here, we report the first complete genome of a multidrug resistant (MDR) strain of K.piersonii...

Introduction: Alcohol use in bipolar disorder (BD) is associated with mood lability and negative illness trajectory, while also impacting functional networks related to emotion, cognition, and introspection. The adverse impact of alcohol use in BD may be explained by its additive effects on these networks, thereby contributing to a poorer clinical...

Teaser “Dark tourism’ refers to travel by individuals to destinations and sites linked to death, tragedy, and the macabre; with vampire tourism increasingly popular over the last 20 years. The capacity of travellers, especially those with mental disorder, to cope psychologically with travel to associated emotionally challenging destinations require...

Background: Both low-grade systemic inflammation and functional connectivity of the default mode network (DMN) during rest have recently been observed to mediate the association between childhood trauma (CT) and behavioural performance on an emotion recognition task. Whether inflammation also mediates the association between CT and functional conne...

Objective: Schizophrenia is a complex functionally debilitating neurodevelopmental disorder, with associated social cognitive impairment. Corpus Callosum (CC) white matter tracts deficits are reported for people with schizophrenia; however, few studies focus on interhemispheric processing relative to social cognition tasks. This study aimed to dete...

Studies seeking predictors of outcomes after involuntary admission, including quality of life (QoL), are limited and results inconsistent. We aimed to describe QoL 3 months after involuntary psychiatric admission and to investigate associated factors. One hundred and fifty-three involuntarily admitted inpatients were assessed for a range of sociode...

Background Psychosis, even in its early stages, is associated with significant disability, causing it to be ranked ahead of paraplegia and blindness in those aged 18–35 in terms of years lived with disability. Current pharmacological and psychological interventions intervention have focused primarily on the reduction of positive symptoms (hallucina...

Introduction and aims Objective structured clinical examinations (OSCEs) play a pivotal role in medical education assessment. The Advanced Clinical Skills (ACS) OSCE examines clinical skills in psychiatry, general practice, obstetrics and gynaecology and paediatrics. This study examined if the 2020 ACS OSCE for fourth year medical students attendin...

Background: Current treatment options for the management of depressive episodes in bipolar disorder are often sub-optimal, with some treatments either noted to be only partially effective or to require long durations of treatment prior to a therapeutic response. Therefore, pharmaco-therapeutic options that reduce depressive symptoms in a more rapi...

Introduction: Structural alterations in cortical thickness and the microstructural organisation of white matter are independently associated with non-dependent alcohol consumption and bipolar disorder(BD). Identifying their interactive and network level effects on brain topology may identify the impact of alcohol on reward and emotion circuitry, a...

Objectives We previously demonstrated that three months into the COVID-19 pandemic, the impact on individuals with treatment-resistant psychotic disorders was modest. Here, we examined and compared the psychological and social impact of the COVID-19 pandemic on the same patient cohort 12 months after their initial study engagement. Methods Semi-st...

Objective: To explore individuals" knowledge and perception of the COVID-19 virus pandemic, views on imposed governmental restrictions and engagement rates in mandatory behavioural restrictions in a cohort of Pakistan under or postgraduate students. Methodology: A web-based cross-sectional survey was conducted and 358 participants completed the onl...

Background and Objectives Long-acting injectable (LAI) antipsychotics increase patient adherence, reduce relapse rates and facilitate regular interaction with community mental health teams. Antipsychotics are however associated with adverse effects including metabolic syndrome. This review outlines the rates of monitoring for and rates of metabolic...

Background: Current treatment options for the management of depressive episodes in bipolar disorder are often sub-optimal, with some treatments either noted to be only partially effective or to require long durations of treatment prior to a therapeutic response. Therefore, pharmaco-therapeutic options that reduce depressive symptoms in a more rapid...

Currently, there are limited data comparing demographic and clinical characteristics of individuals who died by probable suicide and who did and did not previously attend mental health services (MHSs). This study compared demographic and clinical factors for both groups, in a Western region of Ireland over a 13-year period. Postmortem reports betwe...

The muscarinic-cholinergic system is involved in the pathophysiology of bipolar disorder (BD), and contributes to attention and the top-down and bottom-up cognitive and affective mechanisms of emotional processing, functionally altered in BD. Emotion processing can be assessed by the ability to inhibit a response when the content of the image is em...

A 35-year-old primigravida presented with significant anxiety symptoms at 26 weeks’ gestation. Symptoms were preceded by a nightmare about her upcoming labour. She developed repetitive intrusive thoughts of being trapped emotionally and physically in her pregnancy. Her symptoms were suggestive of new-onset claustrophobia associated with pregnancy,...

Background Cognitive difficulties are experienced frequently in schizophrenia (SZ) and are strongly predictive of functional outcome. Although severity of cognitive difficulties has been robustly associated with early life adversity, whether and how they are affected by current stress is unknown. The present study investigated whether acute stress...

Background: Deficits in facial emotion recognition are a core feature of schizophrenia and predictive of functional outcome. Higher plasma levels of the cytokine interleukin 6 (IL-6) have recently been associated with poorer facial emotion recognition in individuals with schizophrenia and healthy participants, but the neural mechanisms affected re...

Background: Increasing evidence has implicated the cholinergic system as a modulator of mood episodes, with possible involvement of nicotinic and/or muscarinic receptors. A number of randomized controlled trials (RCTs) have demonstrated a putative rapid antidepressant effect of the muscarinic antagonist scopolamine. Here, we review the clinical evi...

Objective Exposure to childhood trauma (CT) is associated with cognitive impairment in schizophrenia, and deficits in social cognition in particular. Here, we sought to test whether IL-6 mediated the association between CT and social cognition both directly, and sequentially via altered default mode network (DMN) connectivity. Methods Three-hundre...

Objectives In Ireland, regularly reviewed Individual Care Plans (ICPs) for inpatients at all acute psychiatric inpatient units are a requirement of the Mental Health Act 2001. In this study, we comprehensively evaluated and compared opinions of key stakeholders in relation to the ICP as a care delivery tool. Methods We employed a descriptive surve...

Objectives To examine the psychological and social impact of the COVID-19 pandemic and its associated restrictions on a cohort of patients with severe and enduring mental illness treated with clozapine. Methods Semi-structured interviews were conducted with 63 individuals attending a clozapine clinic within the Galway-Roscommon Mental Health Servi...

Objectives To examine if the Covid-19 pandemic is associated with a differential effect over time in relation to its’ psychological and social impact on patients with established anxiety disorders. Methods Semi-structured interviews were conducted with 24 individuals attending the Galway-Roscommon Mental Health Services with an ICD-10 diagnosis of...

Background: There is considerable evidence of dysconnectivity within the default-mode network (DMN) in schizophrenia, as measured during resting-state functional MRI (rs-fMRI). History of childhood trauma (CT) is observed at a higher frequency in schizophrenia than in the general population, but its relationship to DMN functional connectivity has...

This study investigates changes on white matter microstructure and neural networks after 6 months of switching to clozapine in schizophrenia patients compared to controls, and whether any changes are related to clinical variables. T1 and diffusion-weighted MRI images were acquired at baseline before commencing clozapine and after 6 months of treatm...

The present study explored awareness and opinions pertaining to mental health legislation in Pakistan in the context of the United Nation Convention on Rights of People with Disabilities (UNCRPD) through a mixed method research design. In the quantitative arm of the study, a structured questionnaire examined awareness and opinions of key stakeholde...

The present study explored awareness and opinions pertaining to mental health legislation in Pakistan in the context of the United Nation Convention on Rights of People with Disabilities (UNCRPD) through a mixed method research design. In the quantitative arm of the study, a structured questionnaire examined awareness and opinions of key stakeholde...

Objectives Previous work suggests supplementation with omega‐3 polyunsaturated fatty acids (PUFAs) may improve mood symptoms in bipolar disorder (BD) although findings remain unclear. In this study we assess the efficacy of omega‐3 PUFA administration for prophylaxis in BD using a clinical trial design over 52‐weeks (ClinicalTrials.gov Identifier:...

Childhood trauma, and in particular physical neglect, has been repeatedly associated with lower performance on measures of social cognition (e.g. emotion recognition tasks) in both psychiatric and non-clinical populations. The neural mechanisms underpinning this association have remained unclear. Here, we investigated whether volumetric changes in...

Childhood trauma, and in particular physical neglect, has been repeatedly associated with lower performance on measures of social cognition (e.g. emotion recognition tasks) in both psychiatric and non-clinical populations. The neural mechanisms underpinning this association have remained unclear. Here, we investigated whether volumetric changes in...

The hippocampus consists of anatomically and functionally distinct subfields that may be differentially involved in the pathophysiology of bipolar disorder (BD). Here we, the Enhancing NeuroImaging Genetics through Meta‐Analysis Bipolar Disorder workinggroup, study hippocampal subfield volumetry in BD. T1‐weighted magnetic resonance imaging scans f...

Objective This study investigated associations between childhood trauma, parental bonding, and social cognition (i.e., Theory of Mind and emotion recognition) in patients with schizophrenia and healthy adults. Methods Using cross‐sectional data, we examined the recollections of childhood trauma experiences and social cognitive abilities in 74 pati...

The location, extent and progression of longitudinal morphometric changes after first-episode of psychosis (FEP) remains unclear. We investigated ventricular and cortico-subcortical regions over a 3-year period in FEP patients compared with healthy controls. High resolution 1.5T T1-weighted MR images were obtained at baseline from 28 FEP patients a...

This study aims to assess whether 12 sessions of indigenously adapted cognitive–behavioral therapy for excessive smartphone use (IACBT-ESU) would reduce excessive smartphone use. A single-blind randomized controlled trial was conducted in students (12 to 19 years of age) to examine the potential beneficial effects of IACBT-ESU (n = 62) compared wit...

This study aims to assess whether 12 sessions of indigenously adapted cognitive-behavioral therapy for excessive smartphone use (IACBT-ESU) would reduce excessive smartphone use. A single-blind randomized controlled trial was conducted in students (12 to 19 years of age) to examine the potential beneficial effects of IACBT-ESU (n = 62) compared wit...

Objectives:To examine the psychological and social impact of the Covid-19 pandemic on patients with established anxiety disorders during a period of stringent mandated social restrictions. Methods:Semi-structured interviews were conducted with 30 individuals attending the Galway-Roscommon Mental Health Services with an ICD-10 diagnosis of an anxiet...

Background: Synchronous and antisynchronous activity between neural elements at rest reflects the physiological processes underlying complex cognitive ability. Regional and pairwise-connectivity investigations suggest perturbations in these activity patterns may relate to widespread cognitive impairments seen in bipolar disorder (BD). Here we take...

Background While traumatic childhood experiences have been frequently associated with adverse effects on social cognitive abilities, specifically emotion recognition, in individuals with schizophrenia (SZ) and to some degree in healthy adults also (Rokita et al., 2018), the neural mechanisms for this association remain unclear. Therefore, the main...

Background The extent and location of longitudinal morphometric changes after first-episode of psychosis (FEP) remains unclear. We investigated the progressive profile of ventricular and cortico-subcortical regions over a 3-year period in FEP patients compared with healthy controls (HC), and whether any progressive neuroanatomical changes were rela...

Background The association of antipsychotic medication with abnormal brain morphometry in schizophrenia remains uncertain. Early studies investigating a switch from first generation antipsychotic to clozapine have steadily shown a decrease of caudate volume over time; however nowadays most patients are already on second generation antipsychotic med...

Background: It is known that childhood trauma (CT) is linkedto altered brain activation and functional connectivity during task-based studies in schizophrenia (SZ). However, despite its relevance in SZ, it remains unknown what the association is between CT and functional connectivity of the default-mode network (DMN). We hypothesized that CT is rel...

The association of neuroanatomical progression with cognitive and clinical deterioration after first-episode of psychosis remains uncertain. This longitudinal study aims to assess whether i)impaired executive functioning and emotional intelligence at first presentation are associated with progressive prefrontal and orbitofrontal cortical thinning i...

For a person with mental illness, travelling abroad can be challenging but it can be easier when the traveller and healthcare practitioner have a clear understanding of the likely impact of travel on the illness and of the illness on the travel experience. Travel may also precipitate first presentations of mental illness or unmask previously undiag...

The association of antipsychotic medication with abnormal brain morphometry in schizophrenia remains uncertain. This study investigated subcortical morphometric changes 6 months after switching treatment to clozapine in patients with treatment-resistant schizophrenia compared with healthy volunteers, and the relationships between longitudinal volum...

Objectives To examine the rate of monitoring of metabolic syndrome and actual rates of metabolic syndrome in two patient cohorts [clozapine treatment and long-acting injectable (LAI) antipsychotic] who are reviewed on an equally regular basis (1–4 weekly) for administration of treatment. Methods Clinical and laboratory data are examined on 119 pat...

Objectives To identify factors influencing successful international travel among patients with psychotic illness. Methods Eight individuals participated in a semi-structured interview of 15–20-minute duration with a clinician in relation to their recent experience of international travel. Clinical files were reviewed and a case series was compiled...

Background: Functional abnormalities, mostly involving functionally specialized subsystems have been associated with disorders of emotion regulation such as bipolar disorder (BD). Understanding how independent functional subsystems integrate globally and how they relate with anatomical cortico-subcortical networks is key to understanding how the hu...

Well-established structural abnormalities, mostly involving the limbic system, have been associated with disorders of emotion regulation. Understanding the arrangement and connections of these regions with other functionally specialized cortico-subcortical subnetworks is key to understanding how the human brain's architecture underpins abnormalitie...

Background: Graph theory applied to brain networks is an emerging approach to understanding the brain's topological associations with human cognitive ability. Despite well-documented cognitive impairments in bipolar disorder (BD) and recent reports of altered anatomical network organization, the association between connectivity and cognitive impai...

Background Alterations in functional networks during working memory (WM), including the salience network, frontoparietal network, dorsal attention network and default-mode network, have been repeatedly reported in schizophrenia. Changes in functional connectivity related to Early-Life Adversity (ELA) have yet to be characterized despite its relevan...

Background In the last two decades, there has been a substantial number of studies indicating a link between schizophrenia (SZ) and early life adversities, such as childhood trauma (CT), which is highly prevalent in psychiatric populations (Rokita et al., 2018). However, little is known about the association between CT and social cognition, defined...

This study aims to explore the role of conventional beliefs and social stigma on attitude towards access to mental health services. From 50 caregivers data were collected by Perceived Public Stigma Scale and an in-depth semi-structured interview. The majority (86%) of patients having significant symptoms of major mental illness visited traditional...