bluuebunny/crossref_metadata_2025 huggingface dataset:
Suicide in Australia—A Comparison with Suicide in England and Wales
Authors: Snowdon John
Published: October 2008

This study reports changes of suicide rate in Australia and in England and Wales in the twenty years up to 1976. Rates in both places reached a peak in 1963, related to increases in poisoning as a means of suicide. Decreases since then can be attributed partly to reduced likelihood of death after inhalation of domestic gas or after ingestion of poisons. There has been an increase in suicide deaths among younger people, but a decrease among older age groups. The two countries have patterns of suicide which are similar in many respects, the most striking difference being the frequency with which firearms are used by male suicides in Australia. There is good reason to believe that variation in availability of a means of suicide is the factor which has most effect on rates of suicide, though cultural attitude towards each method also is an important determinant of how much it will be used for suicide.
Repertoires of Response to Potential Precipstants of Depression
Authors: Parker Gordon , Brown L. B.
Published: October 2008

A study that would appear to overcome two weaknesses in previous investigations of what have been termed ‘antidepressive behaviours’ is reported, from patients routinely attending two general practices. Questionnaires were designed to measure such behaviours and their reported effectiveness in response to potential precipitants of depression. While the subjects revealed no sex differences on a trait depression measure, in previous recourse to professional help for expression, or in their appraisal of two given situations, a number of sex differences in their reported antidepressive responses were found. Females scored as less reckless, and they scored higher on help-seeking and self-consolation dimensions; they were also less likely to regard reckless behaviours as being effective. Higher social class was associated with higher scores on the self-consolation behavioural dimension and in higher scores on socializing. Younger subjects scored higher on socializing and found reckless behaviours more effective than did the older subjects.
Social Support and the Social Environment of Depressed and Normal Women
Authors: Winefield H. R.
Published: October 2008

A brief self-report measure of social support was administered initially to a student population, and then to a sample of hospitalized depressed women. Comparison of the responses of the 32 patients with 35 student women of similar age showed no differences between the groups in number of cohabitants or of casual friends, or in faith in the value of talking over one's problems. Patients were more likely than controls to report having no or few confidants, nobody confiding in them, and little confidence in being liked by others. Training in social skills specific to fostering intimacy is suggested as a therapeutic step, and modifications to the social support measure for future use discussed.
The Psychiatrist's Family—A Comparative Study
Authors: Goldney Robert , Czechowicz Maryla , Dibden Shirley , Govan Jill , Miller Michael , Tottman Jan
Published: October 2008

The results of a questionnaire survey of the partners of psychiatrists and general practitioners are presented. The questionnaire was designed to elicit feelings about the respective professions. Methodological issues are discussed, and the wisdom of comparing different medical groups is questioned.

Although significantly fewer psychiatrists' partners initially had positive feelings towards their spouse's career, the majority of both groups reported currently positive feelings. Only a minority, and in equal proportions in the two groups, reported that their spouse's profession had interfered with their relationships with friends or had influenced their marital relationship. A significantly greater number of general practitioners' partners reported that their spouse's profession was more stressful than that of other professionals. The results also indicated that a significantly greater number of psychiatrists than general practitioners as perceived by their partners as using psychiatric interpretation and jargon in the family setting. Furthermore, the comments provided, although representative of only a minority of respondents, demonstrated that this could provide a unique stress for the families of some psychiatrists.
A Psychologist's Perspective on Psychiatry in China
Authors: Brown L. B.
Published: October 2008

Social and political procedures, which have an important role in Chinese psychiatry are examined with reference to observations made during visits to hospitals in Shanghai and Tianjin, the available Western literature, and to two recent Chinese documents.
Mental Illness and Road Traffic Accidents
Authors: Armstrong J. L. , Whitlock F. A.
Published: October 2008

One hundred psychiatric patients were carefully matched with 100 physically ill patients and their driving records compared. The psychiatric patients were consuming far greater quantities of psychotropic drugs and included a larger number of alcoholics and heavy drinkers. During the six months before admission there were no significant differences between the two groups of patients with respect to accident and traffic code infringements. Apart from individual patients, drugs did not appear to be influencing the outcome in statistical terms. Alcoholics and heavy drinkers showed an increased lifetime accident liability. No specific psychiatric diagnosis was otherwise associated with increased accident rates. The majority of accidents reported were relatively trivial.
An Observation on the Genesis of Münchausen Syndrome: A Case Report
Authors: Sale Ian , Kalucy Ross
Published: October 2008

A case of Münchausen Syndrome diagnosed in an antenatal ward is reported. This patient, while pregnant, presented a variety of factitious obstetric complications to her medical attendants.

Examination of the patient's hospital records threw light on the natural history of Münchausen Syndrome, and suggested the possibility that the nature of her interactions with hospitals were of aetiological significance. The implications of this hypothesis are considered.
The Prevalence of Symptoms of Depression in An Australian General Population
Authors: Byrne D. G.
Published: October 2008

The prevalence of depressive symptoms was estimated in a random sample of an Australian general population by administration of the Zung Self-Rating Depression Scale (S.D.S.). Rates, calculated according to criteria derived from a previously studied clinical sample, were somewhat higher in this population than had been reported in similar studies elsewhere. It was reasoned that this finding related to the relative laxity of criteria employed in the present study.

Socio-demographic influences on the reporting of depressive symptoms were evident, the most prominent of these being the sex of the subject. It was suggested that these influences may underlie socio-demographic differences in rates of recognized depressive states occurring within clinical samples.
Review Notions of Neurosis: A Comparison of Community Cases with Declared Patients
Authors: Jones Robert Finlay
Published: October 2008

Seven ways are discussed in which the concept of neurosis, as measured in community surveys, differs from the concept of neurosis among declared patients. These are different ratio of neurotic symptoms to dysthymic states (using Foulds' terms), the different ratio of mixed anxiety/depression to anxiety or depression alone, the duration, seriousness, and intensity of symptoms, and the two states of social dysfunction without symptoms, and symptoms without dysfunction. Attention is drawn to the need for epidemiologists and clinicians to describe neurosis on axes other than the presence or absence of symptoms alone.
Stimulus Intensity Control in Depression: A Study of the Comparative Effect of Doxepin and Amitriptyline on Cortical Evoked Potentials
Authors: Friedman Jeannette , McCallum Peter , Meares Russell
Published: October 2008

The perceived intensity of a stimulus may be magnified during depression. Stimulus intensity control can be studied by means of cortical evoked potentials. In a study of 33 depressives, cortical evoked potentials were greater during depression than on recovery. The effect of doxepin on the amplitudes of evoked potentials of depressives was compared with that of amitriptyline. Doxepin reduced amplitudes. Amitriptyline had a similar, but non-significant effect.
At the Research Front: Cognition and Behaviour Change
Authors: Cameron Roy , Meichenbaum Donald
Published: October 2008

For the past decade we have been attempting to understand the role of cognition in psychopathology and behaviour modification. The purpose of the present paper is to highlight and discuss what we consider to be some of the most important findings and issues that have emerged. While many other investigators are conducting related research, we have limited our review and discussion to work conducted by Meichenbaum and his colleagues. The research program and the field in general have been reviewed in more detail by Meichenbaum (1977). See an annual newsletter on cognitive-behaviour modification for further detailed reviews (Meichenbaum, 1975–1979). Initially, we were interested in developing and evaluating treatment procedures that blended cognitive and behavioural components. While this work continued, we have become interested in attempting to formulate an integrative model of behaviour change (Meichenbaum, 1977). The following review and discussion will describe the research program that led us to highlight the role of cognition in behaviour change.
Female Transsexualism in Singapore: A Report on 20 Cases
Authors: Tsoi Wing Foo , Kok Lee Peng
Published: October 2008

Twenty female transsexuals were assessed for sexual reassignment surgery in Singapore. This gives a prevalence of 1 in 36,000 for females aged 15 and above. The age ranged from 18 to 31 with the mean at 24.9 years. Fifteen had received secondary education and 19 were employed. There was no history of serious anti-social behaviour. They were closer to their mothers, some of whom encouraged their cross dressing behaviour during childhood. Eighteen started to develop the transsexual syndrome during childhood. Their behaviour became more masculine as they grew older. All were unmarried. Eighteen had girl friends and 10 indulged in sexual activities with their girl friends. They sought the sex change operation because they wanted to live as males so that they could marry their girl friends. Eight are at present under-going the multi-stage operation.
Querulous Paranoia: Diagnosis and Dissent
Authors: Stålström Olli W.
Published: October 2008

The possible misuse of psychiatric diagnosis for political and social purposes not originally intended as coming within the domain of diagnostic categories is reviewed. One such example, the category of querulous paranoia, is described in terms of both diagnostic criteria and actual applications. Possible applications and potential for abuse of this classification are noted also, particularly with regard to the classification including reactions to actual, as well as imagined, persecution. The relationship between the use of the concept of querulous paranoia and psychiatric abuse, as well as points of difference are discussed.
Which Science for Psychiatry??: The Challenge of the Behavioural Therapies
Authors: Pilowsky I.
Published: October 2008

The advent of behavioural medicine has presented psychiatry with the need to re-examine its relationships to the human sciences on the one hand, and the natural sciences on the other. This paper discusses the essential differences between these two approaches as they are applied in the clinical situation. It is suggested that a need exists to marry these two ways of approaching patient problems and, in particular, for psychiatrists to improve their understanding of the hermeneutic mode of achieving understanding.
Assessment of Tardive Dyskinesia in Psychiatric Outpatients Using a Standardized Rating Scale
Authors: Rey J. M. , Hunt G. E. , Johnson G. F. S.
Published: October 2008

Psychiatric outpatients were assessed for dyskinetic movements using the abnormal involuntary movement scale (AIMS). The prevalance of tardive dyskinesia in an Australian sample of 66 patients was 44% which is similar to reported prevalence in other countries. Although the prevalence was significantly higher in patients over 45 years of age and with more than a 5 year history of neuroleptic medication, there were no significant correlations between presence of dyskinesias and age, sex or duration of neuroleptic treatment. Organic factors such as neurological disorders, ECT or alcoholism were not related to dyskinetic movements, nor was the use of anticholinergic or tricyclic antidepressant medication. The AIMS is a reliable rating scale for dyskinetic movements and could be used more widely as a screening instrument for early detection of tardive dyskinesia.
Outcome of Sex Reassignment Surgery for Transsexuals
Authors: Pauly Ira B.
Published: October 2008

Fifteen years ago the author reviewed the world literature on male transsexualism (Pauly, 1965). Subsequently he summarized the results of sex reassignment surgery for male and female transsexuals (Pauly, 1968), and reviewed the literature on female transsexualism (Pauly, 1974). Very recently, Meyer and Reter (1979) concluded that ‘sex reassignment surgery confers no objective advantage in terms of social rehabilitation’ as compared with a group of individuals who sought sex reassignment but remained unoperated upon at follow-up. Both groups improved over time and led the Johns Hopkins Gender Identity Clinic to conclude that sex reassignment surgery would no longer be offered there. This report, and other non-surgical, psychotherapeutic approaches to gender dysphoric patients (Barlow et al. 1973; Barlow et al. 1979; Lothstein and Levine, 1980) call into question the justification for sex reassignment surgery. Therefore, it becomes important to update the results of sex reassignment surgery for transsexuals. Data on 283 male to female transsexuals and 83 female to male transsexuals are presented.
Assessment and Accommodation of Demented Patients in the Community
Authors: Harrison Arthur W.
Published: October 2008

Many moderately to severely demented, ambulant patients whose behaviour is not grossly disturbed can be managed satisfactorily and economically in small units in the community by non-professional staff. Unsuitable candidates can be excluded by making a thorough preliminary assessment which may also lead to the diagnosis of potentially treatable dementias and other disorders. Senile dementia progresses relatively slowly in physically fit, eighty year old female patients and the majority may require more than two years of institutional care.
An Exploration of Homesickness among Student Nurses
Authors: Porritt D. , Taylor D.
Published: October 2008

Clinical experience of the author and literature reports suggest that homesickness can be an important factor in adjustment difficulties among student nurses. Following previous studies of residential relocation, homesickness is conceptualised as a grief reaction. It is suggested that attempts to maintain attachment to home and family will also be involved. A scale of ‘homesickness symptoms’ based on this conceptualisation was developed and administered to 185 student nurses, 85 after 4 months of training and 100 after 10 months. Results supported the view that homesickness is a state involving both grief behaviour and attachment behaviour. Recency of separation increased the likelihood of reporting many symptoms. The numbers reporting large numbers of symptoms declined after the first 6 weeks but remained steady at 40–50% thereafter. Students with easier access to their homes were not less likely to report many symptoms initially, but were more likely to report fewer symptoms after the first 6 weeks.

Some findings of a more intensive interview study of studnets, some of whom appeared never to have been homesick, some to have recovered, and some to have continued being homesick, are described. Finally, the therapeutic implications of the results are discussed and the potential of further research for elucidation of attachment behaviour in young adults and of maturation to self-reliance is suggested.
Heavy Drinkers — Their Prevalence, Attitudes and Characteristics
Authors: Reynolds Ingrid , Rizzo Concetta , Gallagher Hugh , Speedy Brian
Published: October 2008

Heavy drinkers were defined as those admitting to drinking six or more drinks every day or most days. This pattern of alcohol consumption which is equivalent to 80 or more grams of ethanol per day, puts them at ‘high risk’ of physical and / or psychosocial complications. Eleven percent of 23,673 males and 1% of 19,803 females who had a Medicheck screening were heavy drinkers. The most frequent reasons given for heavy drinking were relaxation, social contact and enjoyment of the taste. Most heavy drinkers felt that they drank more than was good for them but did not consider themselves to be ‘sick’ people in need of treatment. Heavy drinkers had a higher prevalence of psychosocial problems than moderate or light drinkers.
Showing that Life Events are a Cause of Depression—A Review
Authors: Finlay-Jones Robert
Published: October 2008

Some necessary conditions are set out for showing that some quality of life events is a cause of depression. Recent advances in method which help to fulfil these conditions are reviewed in the fields of life events, depression and survey design. Studies which may have been regarded as refuting a causal link between life events and depression are analysed in detail and their conclusions are challenged. Studies which have claimed a causal link have used methods which in general fulfil the conditions for showing a cause. It was concluded that the hypothesis that severely unpleasant life events, particularly events involving loss, are a cause of depression has not been refuted. Furthermore, a number of studies have accumulated evidence for such a causal link. The weaknesses of these studies are discussed. Improved methods are suggested for use in future research.
Neighbours and Strangers — on Losing the Track
Authors: Cawte John
Published: October 2008

The cultural gap between the colonists and their indigenous neighbours was an insurmountable tracking difficulty for the young nations of Australia and New Zealand. Scattered across the island continent lived Aborigines, unappreciated; and to the north, Papua New Guinea and Indonesia. The cultural distance, one of colour, of custom, of creed, of consciousness and of cash, was too wide to cross. But cultural distances between neighbours inevitably lead to tracking failures, characterized by misconceptions, fears, and ultimately, conflict.

Psychiatry has some capacity to define these tracking failures, and to assess their danger. In this paper, Australia's psychiatric approach to its neighbours is examined. Two challenges are specified. In the developing countries: it is subsistence versus surplus psychiatry — do we comprehend the distinction?? In Aboriginal Australia: it is the Aboriginal mental health system — do we appreciate its existence? An Aboriginal scripture (bark painting) provides the text.
Crimes, Follies and Misfortunes in the History of Australasian Psychiatry
Authors: Dax E. Cunningham
Published: October 2008

The value of the study of Australian psychiatric history is discussed. The administration of the lunatic asylums during the first 120 years of settlement and some of the prevailing conditions are reviewed. A number of famous persons, both doctors and patients, are mentioned and the progress of the practice of psychiatry is followed. Some important psychiatric aspects of Australian history which might have been more thoroughly studied are described. In particular these are crime and punishment, alcoholism, and the crises associated with transportation, malnutrition and the gold rush. Lastly, it is suggested that a number of historical researches associated with psychiatry need to be undertaken before the important existing connections with the past are lost.
Psychiatric Disorder among the Young Unemployed
Authors: Finlay-Jones Robert , Eckhardt Bob
Published: October 2008

A sample of 19% (n401) of people aged 16–24 years registered as seeking full-time employment in Canberra, completed a psychiatric screening instrument. A weighted subsample (n72) was examined by a psychiatrist. The screening instrument showed that 56% were probable cases. By harnessing the results of the psychiatrist's examination to the scores on the screening instrument, the proportion with severe psychiatric disorder was estimated to be 49%. Three-quarters were cases of depression. They had been ill for 10 months on average. In 70% of cases, the onset of their disorder followed unemployment. In more than half of these there was no evidence of any other recent stress apart from unemployment itself. The median time between unemployment and the onset of disorder was five months.
Behaviour Therapy for the Neuroses: Some Conceptual and Practical Problems
Authors: Hafner R. Julian
Published: October 2008

Some problems in reconciling behaviourism as pure science with clinical behaviour therapy for complex neurotic and personality disorders are examined. A major problem is the inability of scientific behaviourism to permit motivation, will and choice to be considered from an intrapsychic perspective. Cognitive behaviour therapy and its derivatives have been developed in an attempt to overcome this problem. Although such therapies have retained a paradigmatic attachment to behaviourism, they have more in common with psychodynamic psychotherapy. Conflict among contemporary behaviourists about the relevance of cognitive theory to behaviourism has obscured more fundamental issues such as the role of the patient-therapist relationship. Both classical and cognitive behaviour therapists view a direct examination of the patient-therapist relationship as therapeutically irrelevant, although there is evidence that such a viewpoint may be anti-therapeutic in some severe neurotic disorders. Behaviourists must acknowledge the central importance of examining the patient-therapist relationship in such disorders if they are to continue their successful dialectic with psychodynamic therapists.
Life Event Scaling and Psychiatric Impairment
Authors: Frydman Michael I.
Published: October 2008

The relationships between psychiatric symptoms and life events scaled for the aetiological relevance of Chance, Self and Others were explored in a sample of 220 parents of chronically ill children. Psychiatrically impaired subjects reported a significant excess of life events in each of the three categories, and not just the Self-caused scale. Similar findings occurred when the aetiological contingency scalings were combined with scalings of Distress and Life Change. Impaired subjects reported an excess of Distress and Life Change attributable to Chance and Others, as well as to Self. The correlation between psychiatric symptoms and self-caused events was weaker than the correlation between a) symptoms and Others-caused events, and b) symptoms and the raw number of events.

These findings are interpreted as support for the proposition that the relationship between events and symptoms in the present study is not found because of contamination of the former (independent) variable by the measure of the latter (dependent) variables.
A Review of Compulsory Admissions to a Psychiatric Unit in Sydney
Authors: Snowdon John
Published: October 2008

This study is concerned with compulsory admissions of patients from a defined catchment area of Sydney in 1979. The rate of such detentions under the present Mental Health Act in New South Wales was found to be about one per 1000 of the total population in one year. A much smaller proportion of psychotic than of non-psychotic patients was considered dangerous by doctors who signed the schedules, yet those (40%) requiring to be on compulsory orders after magisterial hearings were all diagnosed as psychotic. If dangerousness were to be the main criterion for compulsory detention under the Mental Health Act (as recently proposed), many psychotic patients could not legally be detained. Yet follow-up, as in this study, demonstrates the benefits of such admissions. Revision of proposed amendments is recommended.
The Castle Hill Lunatic Asylum (1811–1826) and the Origins of Eclectic Pragmatism in Australian Psychiatry
Authors: Parkinson J. P.
Published: October 2008

Australia's first lunatic asylum was improvised in a disused convict barracks. The first doctors were themselves convicts, who were in conflict with a sternly moral lay superintendent. Disturbances, including a murder, occurred among the patients. The Governor restored peace by dismissing the superintendent and abolishing the post of resident doctor but deprivation and dirt prevailed until the asylum was transferred to further makeshift quarters. Primitive colonial times demanded improvisation and flexibility, i.e. eclectic pragmatism. Moreover, Government control of psychiatry over many years tended to curb the growth of any one ideology and so fostered the eclecticism which seems characteristic of Australian psychiatry. A colonial resourcefulness is an asset in work where patients' individual differences can defy any one theoretical framework and remedies must be pragmatic.
Spouse-Aided Therapy in Psychiatry: An Introduction
Authors: Hafner R. Julian
Published: October 2008

This paper underlines the failure of contemporary individual and marital psychotherapies to help many married people with persisting psychological disorders. It examines the spouse's contribution to the maintenance of psychological disability, and discusses the problems of constructively involving such spouses in conjoint therapy. Spouse-aided therapy addresses this problem by inviting the patient's spouse to become a co-therapist. It is explicitly not a marriage therapy, and is conducted on a goal-orientated time-limited out-patient basis. During discussion of problems with achieving treatment goals, the focus of therapy shifts from the patient's symptoms to marital interaction. Confrontation of the spouse's contribution to the patient's continuing disability then becomes possible, and is followed by changes in marital interaction which generally facilitate the patient's improvement. Many couples choose to proceed with marital therapy after spouse-aided therapy has allowed them to reconstrue the patient's symptoms in interactional terms.
Pseudodementia or Ganser Syndrome in a Ten Year Old Boy
Authors: Adler Robert
Published: October 2008

A case of pseudodementia, occurring in a 10 year old boy following a minor head injury and associated with a claim for compensation, is presented. The case is unusual in the age of the patient and the failure to respond to treatment including prolonged hospitalization. The case is discussed in the light of the available literature and an attempt is made to clarify the confusion surrounding the terms pseudodementia and Ganser Syndrome.
Training of Psychiatrists for Developing Countries
Authors: Deva M. Parameshvara
Published: October 2008

There are significant differences in approaches to the training of psychiatrists in developed and developing countries. In the latter, with acute shortages of manpower in psychiatry and gross deficiencies in psychiatric services, there is a need for training programs to emphasise the practical needs of the country. The aim should be to produce a well-rounded generalist who is capable of coping with most psychiatric problems with little access to a clinical psychologist or social worker, both of whom are usually not readily available in developing countries. The trainee should have a good grounding in the briefer psychotherapies and behaviour modification. There is a need to pool resources in developing countries to initiate local training programs. Cooperation between developed and developing countries can also play a useful role in the starting of regional training programs to benefit several countries.
Affective Disorders, Diabetes Mellitus and Lithium
Authors: Russell J. D. , Johnson G. F. S.
Published: October 2008

There appears to be an association between affective disorders and diabetes mellitus independent of the use of lithium in treatment. Prior studies have suggested that lithium treatment may impair glucose tolerance or produce frank diabetes in certain patients.

Metabolic complications of the diabetic state, such as hypersosmolality and salt depletion increase lithium absorption and the risk of toxicity even at generally acceptable serum levels. The management of patients with diabetes and affective disorders on prophylactic lithium is discussed.
How Do Psychiatrists Think?? Clinical Reasoning in the Psychiatric Interview: A Research and Education Project
Authors: Nurcombe Barry , Fitzhenry-Coor Ina
Published: October 2008

This paper describes a model of the clinical process in psychiatry. Research into the clinical reasoning of physicians is reviewed. Experimental work at the University of Vermont has demonstrated systematic differences between medical students and psychiatrists of different levels of experience, in regard to the logical order and complexity of clinical reasoning. A psychiatric educational program which objectifies cue recognition, clinical inference, hypothesis generation and systematic enquiry has been associated with changes in reasoning. This suggests that the acquisition of efficient diagnostic reasoning strategies could be accelerated by appropriately designed educational programs.
A Treatment Outline for Agoraphobia: The Quality Assurance Project
Authors: Andrews Gavin
Published: October 2008

The Royal Australian and New Zealand College of Psychiatrists has initiated a project to develop treatment outlines for various psychiatric disorders. It is envisaged that the present outline, which was developed by a project team and an expert committee may be modified by the College before being used in post graduate and continuing education and in peer review. In its present form it should be of use to practising psychiatrists. Comments and criticisms on this outline are welcome. A loose-leaf insert is included so that interested readers may respond, either directly to the project team or indirectly via the Editor. This is the first of a series of treatment outlines and concerns the diagnosis and treatment of agoraphobia. The next outline will be on the treatment of depressive illness.
ECT: Misconceptions and Attitudes
Authors: Kerr R. A. , McGrath J. J. , O'kearney R. T. , Price John
Published: October 2008

One hundred and seventy-eight subjects completed a questionnaire regarding ECT. The sample comprised three groups of approximately equal size: a group of patients who had received ECT, a group of visitors to ECT-treated psychiatric patients, and a group of visitors to non-ECT-treated psychiatric patients. Misconceptions about ECT were common throughout, particularly in the young, those giving films and television as a source of information and those visiting patients not receiving ECT. Fewer misconceptions occurred among those who were more highly educated or had experience of ECT either personally or via a visited friend or relative. Less fear of the procedure was expressed by those given the treatment and those who had the treatment explained to them by a doctor. Over half of the patient group denied having had ECT explained to them.
Causation of Insanity in Nineteenth Century Australia
Authors: Edwards Graham A.
Published: October 2008

In this article an endeavour has been made to explore the writings of Frederick Norton Manning as they pertain to understanding nineteenth century medical viewpoints in Australia as to the causation of mental disease. Of particular note are the concept of hereditary weakness and issues related to the harsh Australian environment and the developing colonial society. These writings reveal, in large part, the use of a scientific approach and some concepts of causality which, for the times, were highly sophisticated. Nevertheless, some highly speculative theorising does occur.
Pharmacokinetics of Standard (Lithicarb) and Sustained-Release (Priadel) Lithium Carbonate Preparations in Patients
Authors: Johnson G. F. S. , Hunt G. E. , Lewis J. , George B. St.
Published: October 2008

Equivalent oral dosages (800 mg, 21-6 mmol) of a standard (Lithicarb) and a sustained-release (Priadel) lithium carbonate preparation were administered to six patients receiving lithium maintenance treatment using a randomized cross-over design. There were no significant differences in the two preparations for 24 hour plasma level curves, 24 hour bioavailability, peak plasma concentrations (Cmax), time to peak plasma concentrations (Tmax) or urinary excretion rates. These results are in agreement with a previous study using Priadel in healthy volunteers, and indicate that Priadel is a delayed-release, rather than a true sustained-release preparation. In order to maintain therapeutic plasma levels and to minimise adverse effects that may occur with high plasma lithium levels, Priadel needs to be administered in divided dosages rather than as a single daily dose.
An Attempt to Predict who Will Benefit from Brief Psychotherapy in a General Practice Setting
Authors: Brodaty Henry , Andrews Gavin , Grant W. Brodie
Published: October 2008

The possibility of predicting success in patients receiving brief problem orientated psychotherapy was tested in 18 adult patients selected from 10 Sydney general practices. Ratings were made of six clinical prediction criteria at the beginning of therapy and outcome was assessed directly after therapy and 12 months later. There were modest but significant correlations, particularly among the women, between the sum of the prediction ratings and the outcome 12 months after therapy.
Monitoring and Interpretation of Antidepressant Plasma Concentrations
Authors: Norman Trevor R. , Maguire Kay P. , Scoggins Bruce A. , Burrows Graham D.
Published: October 2008

A brief review of the factors influencing plasma tricyclic concentrations and the relationship between clinical response and plasma concentration is presented. It is concluded that routine monitoring of tricyclics is unwarranted. In some specific instances monitoring tricyclic antidepressant plasma concentrations may be indicated: in cases of therapeutic failure a low level may indicate poor compliance or rapid metabolism and the need to increase the dose; for the management of side effects, especially when cardiac abnormalities exist prior to therapy; in cases of polypharmacy when drug interactions can occur; the management of overdoses and in patients with physical illnesses especially renal and hepatic disease. The elderly also constitute a group of patients in whom drug monitoring may be advisable. This group of patients tends to develop higher plasma levels than younger patients on equivalent doses. Some guidelines for the interpretation of laboratory results are presented and discussed.
The Need for Adolescent Units: General Issues
Authors: Wells Peter
Published: October 2008

There is a growing demand for psychiatric services for adolescents in Australia. The provision of residential treatment units as part of such a service raises a number of issues. This paper examines the questions whether such units are effective, whether justified, and what the optimal numbers of beds and staff are. A facilitative treatment model for the majority of disturbed adolescents is briefly described. The case for providing residential treatment units for adolescents is reaffirmed.
A Social and Psychiatric Survey of Unemployment among Young People
Authors: Finlay-Jones Robert , Eckhardt Bob
Published: October 2008

Unemployment raised the odds of having a psychiatric disorder by a factor of six in this sample of 401 young single people. The effect of unemployment was borne by men and women equally, since the difference between the sexes was preserved in the proportion who had a psychiatric disorder. Those particularly at risk for psychiatric disorder were men who were dismissed, who could not borrow money readily, and who had large debts. Women at high risk were those who resigned, and who could not borrow money readily.
Families of Agoraphobic Women
Authors: Quadrio Carolyn
Published: October 2008

Marital systems of agoraphobic women may reinforce or support the phobic condition and in some cases entire families are affected. Four case histories are presented in which agoraphobia and related disturbances and alcoholism are traced through three generations. Other studies are reviewed relating agoraphobia to alcoholism, examining the characteristics of parents and siblings and the marital adjustments of agoraphobic patients. A relationship with sex role stereotyping is suggested, particularly as relevant to the differing adjustments of males and females in these families. It is concluded that conflicts relating to separation/individuation and autonomy versus dependency and fear are crucial in these families and they are defended against by mechanisms of phobic avoidance, counterphobia and alcoholism.
Emic Accounts of a Mystery Illness: The Groote Eylandt Syndrome
Authors: Cawte John
Published: October 2008

The Aboriginal people of Groote Eylandt, in the Northern Territory of Australia, are suffering from an unusual disease complex having neurological, psychiatric and teratological features, which admits no ready explanation. The island people at various times blame it on the spirits, or accuse enemies, or take some responsibility upon themselves. In this paper, ‘emic’ accounts of the illness (those current among the members of the society) are described in order to compare them with ‘etic’ accounts of those who study the society from the outside. Since emic views regulate people's behaviours toward illness, it is suggested these views should complement and inform etic views of researchers and therapists. This principle might apply to all mysterious or poorly understood illness.
Neurotransmitter Markers of Depression
Authors: Leonard B. E.
Published: October 2008

The role of antidepressants in bringing about adaptive changes in peripheral and central neurotransmitter receptors is briefly reviewed and extended to show how changes in platelet and lymphocyte adrenoceptor and serotonin receptor activity may correlate with the depressed state and normalise following effective treatment. By contrast, the 3H-imipramine binding sites on the platelet membrane do not change following successful treatment and may therefore reflect a trait-dependent (genetic) change. The neuroendocrine markers, such as the dexamethasone suppression test (DST), have the advantage over the receptor markers in that they require less sophisticated laboratory facilities. It is concluded that a better insight into the aetiology and progress of depression may be gained by combining receptor markers with such neuroendocrine markers as the DST.
Psychopathology and Development: II. Childhood Experiences and Personality Development
Authors: Rutter Michael
Published: October 2008

Concepts and empirical findings are reviewed with regard to personality development and to the role of childhood experiences in that process. It is concluded that personality development cannot be reduced to the stabilisation of behavioural traits, to the production of a fixed personality structure or to the acquisition of social-cognitive skills, although there is some form of personality organisation in terms of habits, attitudes, concepts and styles of behaviour. Personality development takes place in a social context, with both continuities and discontinuities stemming from maturational and experiential factors and interactions between them. Chains of indirect linkages result from complex patterns of circular processes involving reciprocal interactions between children and their environments. No single mechanism is responsible and no one theory provides an explanation.
Considerations in Determining Cost Effectiveness in Psychiatric Rehabilitation
Authors: Walker Freda A.
Published: October 2008

Over the past decade there has been an increasing tendency by mental health professionals and economists to evaluate programs in terms of costs and benefits. The current paper deals with some of the more important issues which should be accounted for when contemplating undertaking a cost benefit analysis or a cost effectiveness exercise in the area of psychiatric rehabilitation.
Secondary Premature Ejaculation
Authors: Williams Warwick
Published: October 2008

Secondary premature ejaculation is a definite entity which can be due to a variety of causes — physical, pharmacological and psychological. The sparse literature on this subject is reviewed and a series of 25 cases of diverse and sometimes unusual aetiology reported. The fact that ejaculatory control can be adversely affected by a variety of physical and psychological conditions has implications for theories as to the cause of the much commoner entity of primary premature ejaculation, for which there is still no generally agreed-upon aetiological formulation.
Ash Wednesday: The Effects of a Fire
Authors: McFarlane A. C. , Raphael B.
Published: October 2008

The psychological effects of bushfires that devastated areas of South Australia on Ash Wednesday 1983 are described. We emphasise the need to assess the various components of a disaster to understand its immediate and long-term impact. In the inventory phase, much of the symptomatic disturbance is different from that seen in psychiatric clinic populations and is best dealt with in the early stages using a consultation model. Providing information about the nature of these reactions is helpful for those affected and for service personnel managing disaster relief. In the reconstruction phase, it is important for relief agencies to be aware of the ways in which grief and psychological morbidity can interfere with people's ability to make decisions and carry out practical tasks.
The Experience of a Mental Health Team Involved in the Early Phase of a Disaster
Authors: Berah E. F. , Jones H. J. , Valent P.
Published: October 2008

The reactions of a volunteer mental health team which convened in the aftermath of the 1983 Ash Wednesday bushfires are reported. A questionnaire designed to explore psychological and physical responses was completed by the 19 staff who made up the team. Using both open-ended and closed questions, the questionnaire tapped such areas as motivation, goals, expectations and observations, initial and later emotional and physical reactions, fantasies and evoked memories; an evaluation of the service and the experience was also included. Analysis of responses indicated that team members experienced considerable stress during their postdisaster work but also gained a great deal at both professional and personal levels. Sources of stress are discussed as are recommendations for their alleviation.
Mental Health, Absences from Work, Stress and Satisfaction in a Sample of New Zealand Primary School Teachers
Authors: Galloway David , Panckhurst Fay , Boswell Kathleen , Boswell Colin , Green Kathy
Published: October 2008

A study of 296 primary school teachers in New Zealand revealed a very low correlation between mental health, measured by the General Health Questionnaire, and absence from work. The correlations between mental health and feelings of stress at work and between mental health and job satisfaction were higher. The most highly rated sources of stress were ranked, as were the most highly rated sources of satisfaction. It is suggested that teachers' experiences of stress are associated with lack of satisfaction with intrinsic aspects of their job rather than with dissatisfaction at their conditions of employment.
Feasibility of Discharge of Chronic Psychiatric Patients
Authors: Krupinski Jerzy , Mackenzie Alan , Carson Norman
Published: October 2008

In a survey of all (2795) chronic psychiatric patients resident in Victorian Mental Health Division hospitals, charge nurses were asked to assess patients' levels of physical and psychological dependence on nursing care, aggressive and difficult behaviour and their preferred future placement. The vast majority were ‘old’ chronic patients and nurses considered the present placement as the most appropriate for two-thirds of the surveyed population. We adopted our own criteria of placement needs, such as level of physical and psychological dependence, behavioural problems and treatment received. Of the 2795 patients, one-quarter (682) would require continuing hospital care. The remainder could be transferred, depending on their characteristics, to intensive or general nursing care homes, hostels or special accommodation houses, provided that such facilities are available and the participation of patients in various therapeutic activities was ensured.
Agoraphobia and the Dexamethasone Suppression Test: Atypical Depression?
Authors: Whiteford H. A. , Evans Larry
Published: October 2008

The tricyclic antidepressants and the monoamine oxidase inhibitors have been shown to be effective in the treatment of some patients with phobic and panic disorders. To explain this action it has been suggested that a number of these patients may have an atypical biological depression. In an attempt to test this hypothesis we used the dexamethasone suppression test (DST), which has been proposed as a state dependent biological marker of depression. We compared the non-suppression rate of agoraphobic patients suffering panic attacks with controls and with patients suffering major depression. Twenty-nine per cent of the agoraphobics showed non-suppression compared with 12% of the control group and 64% of the depressives.
Who Treats In-Patients with a Primary Psychiatric Diagnosis?
Authors: Stampfer H. G. , Burvill P. W. , Reymond J. , Carlson J.
Published: October 2008

Data are presented concerning all patients with a primary psychiatric diagnosis who were admitted to various hospitals in Western Australia during 1976–1978. Data were analysed, first, to ascertain the relative proportion of these patients who were admitted under psychiatrists and non-psychiatrists respectively; second, to compare the diagnoses of patients admitted under psychiatrists with those admitted under non-psychiatrists, and, third, to ascertain if there were any differences in terms of the first two measures between city and country patients. A high proportion of patients were admitted under non-psychiatrists. The majority of patients with a diagnosis of alcoholism, and a high proportion of patients with a diagnosis of neurosis, were admitted under non-psychiatrists. The majority of patients with a diagnosis of functional psychosis were admitted, under psychiatrists, to Mental Health Services hospitals and to psychiatric units at general teaching hospitals. Psychiatrists in private practice admitted mainly patients with a diagnosis of neurosis and personality disorder. The results are discussed in terms of the population distribution, the availability of psychiatric services and other factors which might influence the type of hospital to which patients are admitted and the type of doctor care they receive.
Capgras' Syndrome: Outmoded Term for Changeling Delusions?
Authors: Cawte John , Tarrant Morison
Published: October 2008

A case of so-called Capgras' syndrome occurring in an elderly woman showing several degenerative conditions is presented as a basis for questioning the value of preserving this diagnostic term. It is pointed out that the concept of the changeling has ancient provenance in man's thought down the ages, and that its occurrence in psychosis does not justify its ascription as a syndrome. ‘Changeling’ or ‘imposture’ are terms which describe this kind of delusion usually occurring in underlying schizophrenic, affective and organic syndromes.