bluuebunny/crossref_metadata_2025 huggingface dataset:
Traumatic Memories: Bridging the Gap Between Functional Neuroimaging and Psychotherapy
Authors: Peres Julio F. P. , McFarlane Alexander , Nasello Antonia G. , Moores Kathryn A.
Published: December 2009

Objective: Neuroimaging studies have highlighted important issues related to structural and functional brain changes found in sufferers of psychological trauma that may influence their ability to synthesize, categorize, and integrate traumatic memories.

Methods: Literature review and critical analysis and synthesis.

Results: Traumatic memories are diagnostic symptoms of post-traumatic stress disorder (PTSD), and the dual representation theory posits separate memory systems subserving vivid re-experiencing (non-hippocampally dependent) versus declarative autobiographical memories of trauma (hippocampally dependent). But the psychopathological signs of trauma are not static over time, nor is the expression of traumatic memories. Multiple memory systems are activated simultaneously and in parallel on various occasions. Neural circuitry interaction is a crucial aspect in the development of a psychotherapeutic approach that may favour an integrative translation of the sensory fragments of the traumatic memory into a declarative memory system.

Conclusion: The relationship between neuroimaging findings and psychological approaches is discussed for greater efficacy in the treatment of psychologically traumatized patients.
‘Stealing Me from Myself’: Identity and Recovery in Personal Accounts of Mental Illness
Authors: Wisdom Jennifer P. , Bruce Kevin , Auzeen Saedi Goal , Weis Teresa , Green Carla A.
Published: December 2009

Objectives: To understand and promote recovery from serious mental illnesses, it is important to study the perspectives of individuals who are coping with mental health problems. The aim of the present study was to examine identity-related themes in published self-narratives of family members and individuals with serious mental illness. It adds to the body of research addressing how identity affects the process of recovery and identifies potential opportunities for using published narratives to support individuals as they move toward positive identities that facilitate recovery.

Method: Forty-five personal accounts from individuals with severe mental illness, which were published in two prominent research journals between 1998 and 2003, were qualitatively analysed.

Results: Individuals with mental illness and their family members described a loss of self and identity that had to be overcome, or at least managed, for recovery to become possible. Writers described (i) a loss of self, (ii) the duality of (ill/well) selves, (iii) perceptions of normality, (iv) specific concerns about parenting and identity, and (v) hope and reconciliation.

Conclusions: Individuals’ stories of their experiences of severe mental illness describe severe challenges managing identity. Efforts to publish personal accounts that focus on strengths-based patient-centred stories, rather than on deficits, could be helpful to provide hope for patients. These published narratives highlight the importance of moving recovery and hope to the forefront among patient, family, and clinician groups. Increasing such information and role models can provide important resources to individuals working to redefine themselves and create a sense of self-worth and stable identity that will support productive, happy lives.
Correlates of Delusion-Like Experiences in a Non-Psychotic Community Sample
Authors: Varghese Daniel , Scott James , McGrath John
Published: December 2009

Objective: Several large population-based studies have reported that otherwise-well individuals endorse items related to delusion-like experiences. The aim of the present study was to examine selected correlates of delusion-like experiences in a sample of non-psychotic individuals.

Method: Subjects (n=310) were screened with the Diagnostic Interview for Psychosis in order to exclude psychotic disorders. Delusion-like experiences were assessed with the Peters Delusional Inventory (PDI). Non-parametric statistics were used to assess the relationship between total PDI score and a range of demographic (age, sex, migrant status, paternal age), physical (minor physical anomalies) symptom-related variables (hallucinations, awareness of thought disorder) and family history of mental illness.

Results: The median (range) PDI score was 4 (0–26), while one-third of the subjects endorsed seven or more items. The presence of a family history of any psychiatric condition was significantly correlated with a higher PDI score. PDI score was significantly positively correlated with endorsement of hallucinations and awareness of thought disorder. PDI was not significantly associated with sex, family history of schizophrenia, paternal age, migrant status nor scores related to minor physical anomalies. There was a trend level association between younger age and higher PDI score.

Conclusion: Delusion-like experiences are relatively common in non-psychotic individuals. The association with a family history of mental disorders provides clues to the mechanisms underlying the profile of delusion-like experience.
Suicide, Misappropriation and Impulsivity
Authors: Cheah Danny , Schmitt Gerhard , Pridmore Saxby
Published: December 2009

Objective: To describe a patient who survived a suicidal act in which lethal means were used and who subsequently cooperated with psychiatric examination.

Method: Case report.

Results: A 22-year-old man jumped from a bridge into the water 49m below and survived. He was admitted to hospital for assessment. No psychiatric diagnosis could be made on either Axis I or II. He had misappropriated money and lost it gambling, and detection was imminent. He described his jumping as being the result of a sudden impulse. While he was falling he changed his mind and assumed an appropriate diving posture with the intention of preventing his death.

Conclusions: This is an example of a person performing a highly lethal suicide act, in the absence of Axis I or II disorder. Threat of disgrace and possible prosecution; and impulsivity were significant factors.
Attitudes of Staff Towards Patients With Personality Disorder in Community Mental Health Teams
Authors: Newton-Howes Giles , Weaver Tim , Tyrer Peter
Published: December 2009

Objective: The purpose of the present paper was to assess the attitudes of clinicians working with personality disordered patients.

Methods: Secondary analysis of the Comorbidity of Substance Misuse and Mental Illness Collaborative (COSMIC) data set was undertaken using a priori hypothesis testing. The null hypothesis was that there would be no measurable difference between the attitudes of mental health professionals toward patients with a clinical diagnosis of personality disorder and those with an instrument-rated diagnosis of personality disorder. The potential confounders of global psychopathology, need, social functioning and documented aggression were assessed as possible reasons explaining a rejection of the null hypothesis.

Results: Clinicians believed those with the clinical diagnostic label of personality disorder to be more difficult to manage than personality-disordered patients identified by a research tool who did not carry this label. These attitudes were not explained by the potential confounders of psychopathology, social morbidity or acts of aggression.

Conclusions: An awareness of a personality disorder diagnosis is associated with a clinician belief that patients will be harder to manage. Objective measures of potential confounders do not explain why this group should be harder to manage. One explanation of this finding is that the label ‘personality disorder’ is stigmatizing. This may also explain the disparity between clinical and research assessments of personality disorder.
Depression Prevalence: Is it Really Increasing?
Authors: Hawthorne Graeme , Goldney Robert , Taylor Anne W.
Published: December 2009

Objective: There is conflicting evidence as to whether depression prevalence is increasing or is stable. Although birth cohort analysis studies show increasing prevalence, longitudinal studies do not. To date there are no published Australian studies providing long-term estimates of depression prevalence. The aim of the present study was to examine the increasing depression prevalence hypothesis in an Australian context.

Method: Data from the 1998 and 2004 South Australian Health Omnibus Surveys were re-analysed. In each survey there were >3000 participants who were interviewed. The data were weighted to achieve representativeness prior to analysis. Depression status was classified by the Primary Care Evaluation of Mental Disorders scale (the PRIME – MD) into major, other and no depressions. Both univariate and multivariable analyses were used to examine depression trends over time and to adjust the data for significant background variables.

Results: There was no significant increase in the cases of patients classified with major depression between 1998 and 2004; there was, however, a significant decrease in other depression. The overall unadjusted prevalence of major depression was 7.4% (6.8% in 1998 and 8.0% in 2004) and for other depression it was 9.5% (10.6% in 1998 and 8.4% in 2004). The highest levels of depression, both major and other, were observed among females aged 15–29 years, and the lowest levels among those aged ≥50 years. The strongest predictor of depression was poor overall health status.

Conclusion: It is time for the conventional wisdom that depression is increasing to be reconsidered, and for a more realistic perspective, developed from evidence-based analyses, to be accepted.
Professional Attitudes Towards Deliberate Self-Harm in Patients With Borderline Personality Disorder
Authors: Commons Treloar Amanda J. , Lewis Andrew J.
Published: December 2009

Objective: The aim of the present study was to assess the attitudes of mental health and emergency medicine clinicians towards patients diagnosed with borderline personality disorder. The clinician gender, primary occupation and service setting, level of university training and years of experience, frequency of clinical contact, and completion of specific training in borderline personality disorder were expected to influence the attitudes of health professionals towards working with borderline patients that engage in self-harm.

Method: A purpose-designed questionnaire and an assessment tool to quantify attitudinal levels were used to collect demographic information and assess the attitudes of 140 mental health and emergency medicine practitioners across two Australian health services and a New Zealand health service.

Results: Statistically and clinically significant differences were found between emergency medical staff and mental health clinicians in their attitudes towards working with borderline personality disorder. The strongest predictor of attitudes was whether the clinician worked in emergency medicine or mental health. This was followed by years of experience and specific training in personality disorders as significant predictors of attitudes to self-harm.

Conclusions: The implications of these findings for the professional training of clinicians in the management and treatment of borderline personality disorder patients are discussed.
Alert: Inaccurate Lithium Assay Results
Authors: Parker Gordon
Published: December 2009

Objectives: A patient who had experienced bipolar disorder for over 20 years and who had been euthymic for most of that period while highly compliant with lithium, had falsely low lithium levels reported over two periods, 6 years apart, and was actually lithium toxic on the most recent occasion. At that latter time the spuriously low lithium levels reported on the assay risked dispelling any clinical suspicion of lithium toxicity, although toxicity was later confirmed.

Method: Case report.

Results: The latter incident identified a serious problem, whereby it is likely that the particular assay risks generating spuriously low values when high serum levels of lithium are present – a so-called ‘hook phenomenon’ that has been described for some quantitative immunoassays.

Conclusions: It is in situations of high potential gravity – when lithium toxicity is present – that lithium quantification is most likely to be compromised and low values generated. Also of grave concern is the fact that there are no regulatory processes in place to communicate this problem to lithium prescribers.
Cognitive and Health-Related Outcomes of Group Cognitive Behavioural Treatment for People With Depressive Symptoms in Hong Kong: Randomized Wait-List Control Study
Authors: Fu Keung Wong Daniel
Published: December 2009

Objectives: This study examined the efficacy of a territory-wide cognitive behavioural group treatment programme for Chinese people with depression launched in Hong Kong.

Method: Three hundred and forty-seven subjects with depressive symptoms (i.e. Beck Depression Inventory–Chinese version >9) were randomly assigned to CBT and waitlist control groups.

Results: After 10 weeks of treatment, participants in the group CBT programme had significantly fewer symptoms of depression, fewer dysfunctional and perfectionist attitudes, and better quality of life when compared to the participants in the control group. Effect size statistics showed small to medium differences in symptoms of depression, dysfunctional and perfectionist attitudes and quality of life between the two groups (Cohen's d, 0.22–0.74). Statistical analysis of the clinical significance indicated that approximately 27% of the participants in the experimental group could be considered as clinically remitted or recovered, respectively (RCI >1.28). Last, multiple regression provided some evidence of a linkage between cognition and depression among the participants in the experimental group.

Conclusions: The design and content of the group CBT programme, which aimed at facilitating the understanding and modification of automatic thoughts and dysfunctional attitudes among the participants, might have contributed to the initial positive results.
Social Dysfunction in Bipolar Disorder: Pilot Study
Authors: Castanho de Almeida Rocca Cristiana , Britto de Macedo-Soares Márcia , Gorenstein Clarice , Sayuri Tamada Renata , Kluger Issler Cilly , Silva Dias Rodrigo , Maria Schwartzmann Angela , Lafer Beny
Published: December 2009

Objective: The purpose of the present study was to assess the social skills of euthymic patients with bipolar disorder.

Methods: A group of 25 outpatients with bipolar disorder type I were evaluated in comparison with a group of 31 healthy volunteers who were matched in terms of level of education, age, sex and intelligence. Both groups were assessed using a self-report questionnaire, the Brazilian Inventário de Habilidades Sociais (IHS, Social Skills Inventory). Two Wechsler Adult Intelligence Scale subtests (Picture Arrangement and Comprehension) were also used in order to assess subject ability to analyse social situations and to make judgements, respectively.

Results: Patients with bipolar disorder had lower IHS scores for the domains that assessed conversational skills/social self-confidence and social openness to new people/situations. Patients with anxiety disorders had high scores for the domain that assessed self-confidence in the expression of positive emotions. No differences were found between patients and controls in performance on the Wechsler Adult Intelligence Scale Picture Arrangement and Comprehension subtests.

Conclusions: Euthymic patients with bipolar disorder present inhibited and overattentive behaviour in relation to other people and their environment. This behaviour might have a negative impact on their level of social functioning and quality of life.
Reducing Symptoms of Trauma Among Carers of People With Psychosis: Pilot Study Examining the Impact of Writing About Caregiving Experiences
Authors: Barton Karen , Jackson Chris
Published: December 2009

Objectives: To establish whether writing about experiences of the first episode of psychosis may alleviate trauma-like symptoms among carers of people with psychosis.

Method: A total of 37 people caring for someone with early psychosis were randomized to two conditions: either writing about the first psychotic episode, or writing about time management. Data were collected before and after intervention, and 8 weeks later.

Results: Those in the writing group were significantly less likely to avoid reminders and feelings associated with their relative's episode at follow up. Furthermore, carers in this group who exhibited trauma-like symptoms had significantly greater reductions in trauma severity.

Conclusions: Written emotional disclosure can help carers who are experiencing trauma symptoms following a relative's first episode of psychosis. If writing about emotional events is beneficial through mechanisms of exposure then screening participants for trauma symptoms may eliminate previous research inconsistencies. These results, however, need to be replicated in a larger study.
Symptom Subtypes of Obsessive–Compulsive Disorder: Are they Relevant for Treatment?
Authors: Starcevic Vladan , Brakoulias Vlasios
Published: December 2009

Several symptom subtypes of obsessive–compulsive disorder (OCD) have been identified on the basis of the predominant obsessions and compulsions. The objectives of the present article were to review the literature on the relationship between OCD symptom subtypes and treatment response and to suggest strategies that might assist with the choice of treatment and improve treatment outcome in patients with various subtypes. An extensive literature search was performed, relevant studies were identified, and their results reported. Overt compulsions were generally associated with a relatively good response to the behaviour therapy technique of exposure and response prevention (ERP) and with poorer response to serotonin re-uptake inhibitors (SRIs). Washing/cleaning and checking compulsions tend to respond well to ERP, whereas the majority of studies show that washing/cleaning compulsions are associated with a poorer response to SRIs. Most studies suggest that patients with the symmetry, ordering and arranging subtype do not fare worse with ERP and SRIs than patients with other symptom subtypes. Some studies suggested that obsessions might respond to SRIs somewhat better than to ERP. In the majority of the studies, hoarding and the subtype characterized by sexual or religious obsessions and absence of overt compulsions (‘pure obsessions’) have been associated with poor response to ERP and SRIs. It was concluded that treatment strategies cannot be precisely tailored to OCD symptom subtypes. Many other factors influence the outcome of treatment and need to be considered along with the symptom subtypes when making decisions about treatment. While ERP and SRIs remain the mainstay of treatment regardless of the symptom subtype, the addition of cognitive therapy techniques and/or antipsychotic medications may enhance treatment response in the presence of certain features discussed in the article.
Social Functioning Deficits in Young People at Risk for Schizophrenia
Authors: Shim Geumsook , Kang Do-Hyung , Sun Chung Yu , Young Yoo So , Young Shin Na , Soo Kwon Jun
Published: December 2009

Objective: Impairment in social functioning is a central feature of schizophrenia and is known to be evident before the onset of psychosis, acting as a potential vulnerability marker. The aim of the present study was to test the hypothesis that social impairment is simultaneously a state and trait marker of risk for schizophrenia and schizophrenia-related disorder.

Method: Social functioning was examined in three groups: ultra-high-risk subjects (UHR, n =32), genetic high-risk subjects (GHR, n =32), and age- and IQ-matched healthy controls (HC, n =30). Social functioning was assessed using the Social Functioning Scale (SFS), and prodromal symptoms were assessed in high-risk subjects using the Comprehensive Assessment of At-Risk Mental States (CAARMS).

Results: Both the UHR and GHR groups exhibited significantly impaired social functioning compared with the HC group, and the UHR group was more impaired than the GHR group. In the UHR group, duration of prodromal symptoms was related to impaired ‘interpersonal behaviour’. Positive and negative symptoms were not significantly associated with social functioning, whereas disorganized and general symptoms were significantly correlated with poor ‘independence–competence’ in UHR individuals.

Conclusion: The findings support the hypothesis that impairment in social functioning is both a trait and state marker of risk for schizophrenia and other psychotic disorders, implying that social impairment constitutes a mediating vulnerability indicator of psychotic disorders including schizophrenia.
Use of Community Treatment Orders to Prevent Psychiatric Hospitalization
Authors: Segal Steven P. , Burgess Philip M.
Published: December 2009

Objective: The purpose of the present study was to analyse how, for whom, under what circumstances, and with what consequences for a patient's treatment career the community treatment orders (CTOs) were used to prevent psychiatric hospitalization during the course of a decade in Victoria, Australia.

Method: Records were obtained from the Victorian Psychiatric Case Register for 8579 patients who were exposed to CTOs. Descriptive statistics and logistic regression were used to determine the characteristics of patients solely selected for placement on orders directly from the community, in lieu of hospitalization, versus patients selected for placement on orders only from the hospital or for those who experienced both hospital- and community-initiated orders. Ordinary least squares regression was used to evaluate the relationship of sole reliance on community-initiated orders and experienced changes in future hospital utilization.

Results: CTOs were infrequently issued directly from the community by comparison with outpatient orders issued at termination of inpatient episodes. Patients whose placements on orders were carried out only through direct community placement differed from those whose placement was primarily initiated from hospital or from both hospital and community. The former group, although largely consisting of people with schizophrenia, was less likely to include such patients than the comparison samples. It also included fewer male subjects and ‘never married’ individuals as well as more individuals with major affective disorders. Those served solely with community-initiated orders had significantly less use of subsequent inpatient care than individuals in the comparison samples, all other diagnostic and pre-morbid adjustment characteristics taken into account.

Conclusion: For patients at risk of beginning a career of long-term psychiatric hospitalization, sole reliance on community-initiated orders appeared to prevent additional hospital involvement. The issuance of orders from hospital and the combined-order strategy were associated with protective oversight throughout extended inpatient careers. Sole reliance on community-initiated outpatient orders provided a ‘least restrictive’ alternative to hospitalization.
Pilot Evaluation of Parent–Child Interaction Therapy Delivered in an Australian Community Early Childhood Clinic Setting
Authors: Phillips Jane , Morgan Susan , Cawthorne Karen , Barnett Bryanne
Published: December 2009

Objective: Parent–child interaction therapy (PCIT) is a short-term, evidence-based parent training intervention used widely in the treatment of behaviourally disordered preschool-aged children. Outcome studies have shown PCIT to be associated with lasting improvements in child and sibling behaviours and in the interactional styles, stress levels, confidence, and psychological functioning of parents. To date, however, all outcome studies have been conducted in university research clinic settings, and therefore understanding about the effectiveness of PCIT applied in a real-world setting has been limited. The present study evaluated the effectiveness of PCIT delivered to families in an Australian community-based early childhood clinic.

Method: Participants included 43 families with children aged 19–52 months who were referred for treatment of disruptive child behaviours and who completed PCIT treatment at the Karitane Toddler Clinic, in Sydney, Australia. Parents provided pre- and post-treatment ratings of child behaviours, parental stress, parental psychopathology and parental attitudes to therapy.

Results: At the end of the programme, clinically and statistically significant improvements were seen in child behaviours and parental well-being, and parents reported high levels of satisfaction with treatment.

Conclusions: Implications for the implementation of PCIT programmes in community-based settings are discussed and areas of further research are identified.
Treatment-Resistant Depression: Critique of Current Approaches
Authors: Wijeratne Chanaka , Sachdev Perminder
Published: December 2009

The aim of the present study was to critically appraise current conceptual approaches; demographic, neurobiological and clinical correlates; and management strategies of treatment-resistant depression (TRD), especially in light of recent research findings. To this end, a review of the relevant English-language literature was undertaken using Medline, Embase and Psychinfo. TRD has been defined in conceptually restrictive terms as symptomatic non-response to physical therapies alone, with little systematic study of aetiology made. It is likely that a range of sociodemographic (such as higher socioeconomic status), genetic (such as variation in functional monoamine polymorphisms) and clinical variables (such as signal hyperintensities seen on structural neuroimaging scans) are responsible for non-response in individuals. There is insufficient evidence to suggest that TRD is associated with specific subtypes of depression, physical comorbidity, personality or chronicity. The large-scale Sequenced Treatment Alternatives to Relieve Depression (STAR∗D) and other studies have suggested that a structured psychotherapy such as cognitive behaviour therapy may be as effective as medication in initial drug non-responders. Also conventional alternatives such as the use of older antidepressant classes, pharmacological augmentation or electroconvulsive therapy in established cases of TRD are not as effective as traditionally thought. There is insufficient preliminary evidence to make formal recommendations about the use of novel brain stimulation techniques in TRD. TRD should be re-defined as the failure to reach symptomatic and functional remission after adequate treatment with physical and psychological therapies. Treatment resistance may be more usefully conceived within the context of well-defined cohorts such as patients with specific subtypes of depression. Although neurobiological markers such as gene polymorphisms, which are potentially predictive of medication tolerance and efficacy, may be used in the future, it is likely that sociocultural variables such as beliefs about depression, and evidence-based treatments for it, will also determine treatment resistance.
Randomized Double-Blind Multicentre Placebo-Controlled Clinical Trial of the Clonidine Adhesive Patch for the Treatment of Tic Disorders
Authors: Du Ya-song , Li Hua-fang , Vance Alasdair , Zhong You-quan , Jiao Fu-yong , Wang Hui-mei , Wang Min-jie , Su Lin-yan , Yu De-li , Ma Shi-wei , Wu Jie-bao
Published: December 2009

Objective: The aim of the present study was to evaluate the therapeutic effectiveness and safety of the clonidine adhesive patch in treating tic disorders.

Method: A total of 437 patients, who met Chinese Classification of Mental Disorders–third edition diagnostic criteria for transient tic disorder (5%), chronic motor or vocal tic disorder (40%) or Tourette disorder (55%), aged 6–18years, were divided randomly into an active treatment group and a clinical control group. Participants in the active treatment group were treated with a clonidine adhesive patch and participants in the clinical control group with a placebo adhesive patch for 4weeks. The dosage of the clonidine adhesive patch was 1.0mg, 1.5mg or 2.0mg per week, depending on each participant's bodyweight. Participants whose Yale Global Tic Severity Scale (YGTSS) score decreased <30% and Clinical Global Impression score was ≥4 by the end of week 3 were withdrawn from the trial.

Results: After 4 weeks of treatment the active treatment group participants’ YGTSS score was significantly lower than that of the clinical control group (F=4.63, p=0.03). Further, the active treatment group had a significantly better therapeutic response than the clinical control group (χ2=9.15, p=0.003). The response rate in the active treatment group was 68.85% compared to 46.85% in the clinical control group (χ2=16.98, p=0.0001). The rate of adverse events was low (active treatment group, 3.08%; clinical control group, 7.21%) and did not differ between the two groups.

Conclusions: The clonidine adhesive patch is effective and safe for tic disorders.
Suicide on Railway Networks: Epidemiology, Risk Factors and Prevention
Authors: Krysinska Karolina , De Leo Diego
Published: December 2009

The aim of the present study was to review international literature on the incidence of suicide on railway networks, describe risk factors associated with it, and examine existing prevention practices. Searches on Medline and PsycINFO for the period 1966–2007 were performed. Thirty original studies published in English on epidemiology of rail suicide were included in the review along with peer-reviewed articles on risk factors and prevention of rail suicide. Internationally, suicide by collision with a train accounted for 1–12% of all suicides, with up to 94% of all attempts resulting in death. Suicide by train seriously affects not only survivors, but also train drivers and bystanders. Correlations between density of rail network, number of passengers and number of suicides by train have been found. Conflicting data exist on gender ratio of this type of suicide, but studies are homogenous in identifying young adults (20–40year of age) as those most exposed to train suicide. Documented psychiatric diagnoses were found in up to 83% of cases. Mid-seasonal peaks were also identified, with events occurring mostly during late morning and early afternoon. Limited evidence exists for effective suicide prevention practices. Successful examples are represented by pits and sliding door systems (Singapore Mass Rapid Transit System) and responsible media reporting (Viennese Subway). Suicide by train involves emotional and financial costs to individuals and society as a whole. A combination of different strategies might significantly reduce its effect.
Suicidal Behaviour by Train Collision in Queensland, 1990–2004
Authors: De Leo Diego , Krysinska Karolina
Published: December 2009

Objective: A study on the incidence of suicide in the train system and a description of main characteristics of victims and attempters was commissioned by Queensland Rail in response to an apparent increase of suicide phenomena and their consequences.

Methods: Two sources of data were used for the analyses: the Queensland Suicide Register (QSR) and the Queensland Rail Incident Surveillance Information System (ISIS). Data on suicide were cross-checked on the two systems for the years 1990–2004. ISIS provided information on cases of attempted suicide for the period 1993–2206.

Results: One hundred and sixty-one train suicide victims were identified. Globally, they represented 2% of all cases of suicide in Queensland. During the examined period no significant changes in trends of suicide through that method were found. Of all suicide cases, 59 (36.6%) included victims aged 15–24years. The ratio of male:female was 4:1, equal to the sex distribution of suicide with all methods in Queensland. Positive blood alcohol content was found in nearly 50% of young people and in 29.8% of the total sample. A psychiatric diagnosis was documented in 40.4% of all train suicide victims. Only 18 suicide attempters were identified through the ISIS database; of them, 15 were male and three were female, with a gender ratio similar to that of suicide victims.

Conclusions: This study involved the largest dataset ever published in Australia on this topic. In Queensland, train suicides presented a stable trend during 1990–2004. Subjects of very young age (15–24) seem to be particularly exposed to this method; in this age group one in two individuals had positive blood alcohol content.
Parenting Gifted and Talented Children: What are the Key Child Behaviour and Parenting Issues?
Authors: Morawska Alina , Sanders Matthew R.
Published: December 2009

Objective: The literature on gifted and talented children is limited. Little is known about the types and nature of difficulties experienced by gifted and talented children, and even less known about parenting issues related to parenting a gifted and talented child. The aim of the present study was to describe children's behavioural and emotional adjustment, and the factors that contribute to children's difficulties, as well as to examine the styles of discipline used by parents of gifted and talented children and their level of confidence in managing specific parenting tasks.

Method: A survey of parents of gifted and talented children was conducted, with 211 parents meeting criteria for the study.

Results: For a community sample, in general gifted and talented children exhibit no more behavioural difficulties than do other children. But children in this sample seemed to show higher levels of emotional symptoms and peer problems. Children's behavioural and emotional difficulties were best predicted by parenting factors, particularly parental confidence. Parents reported that they were less likely to be permissive with their child, but they tended to use a more authoritarian style of parenting characterized by lecturing and a strong reaction to any problems.

Conclusions: There are a number of implications for future research, clinical practice, and the development of parenting interventions for this group of parents.
Burden of Alzheimer's Disease: Population-Based Estimates and Projections for New Zealand, 2006–2031
Authors: Tobias Martin , Yeh Li-Chia , Johnson Elizabeth
Published: December 2009

Objective: To estimate the burden of Alzheimer's disease (AD, including ‘mixed’ dementia) in New Zealand in 2006, and project this burden out to 2031.

Method: An incidence to prevalence methodology was utilized, the foundation of which is a discrete time Markov model allowing for multiple stages of disease (early vs late). Population estimates and projections, and all-cause mortality rates, were obtained from Statistics New Zealand. In the absence of usable New Zealand data, data on disease incidence and progression were obtained from systematic reviews of the international (mainly European, Australian and North American) literature. Projection scenarios included a demographic scenario in which change resulted only from increases in population size and ageing; a prevention scenario in which incidence rates were reduced by 25% from 2011; a treatment scenario in which disease progression rates were likewise reduced by 25% from 2011; and a combined scenario capturing both interventions.

Results: The model estimated that approximately 28000 people are currently living with AD (whether formally diagnosed or not), approximately 55% in the early and 45% in the late stage of the disease; approximately 6600 people newly develop AD each year; and approximately 2300 people die from (as opposed to with) this condition. The model projected that the prevalence of AD will increase approximately 2.5-fold (to approx. 70000 people) by 2031, if demographic drivers are unopposed. Plausible improvements in prevention and treatment, however, acting together, could reduce this growth by up to 50%, so that the prevalence of AD only doubles.

Conclusion: Even this more optimistic projection has profound implications for the funding and provision of dementia care services, as well as for patients, their families, informal carers and the psychogeriatric workforce. New service configurations and models of care will be necessary. Access, quality and coordination standards for home care, day care, respite care, residential care and specialist services (including memory clinics) will need to respond accordingly.
How Should Mood Disorders be Modelled?
Authors: Parker Gordon
Published: December 2009

Classification of any mental disorder is likely to have clinical utility only if it is based on a valid underlying model. The depressive disorders have long provoked debates as to whether a categorical or a dimensional model is all explanatory. This paper will argue that no single (categorical or dimensional) model is likely to be valid, and that a mix of models is required to classify, diagnose and shape management decisions for the mood disorders. After reviewing limitations to the dimensionally based official classificatory systems (DSM-IV and ICD-10), and noting some of the consequences, a set of alternative strategies is outlined. In essence, identifying syndromal ‘fuzzy sets’ from phenotypic and aetiological clustering, a model that occurs in the rest of medicine.
Psychiatric Care of Adults with Intellectual Disabilities: Changing Perceptions Over a Decade
Authors: Torr Jennifer , Lennox Nicholas , Cooper Sally-Ann , Rey-Conde Therese , Ware Robert S. , Galea Jennifer , Taylor Miriam
Published: December 2009

Objective: In light of developments in training and service provision, the aim of the present study was to compare two state-wide surveys, undertaken in 1994 and in 2004, of psychiatrists about their perceptions of their training and psychiatric treatment of adults with intellectual disabilities who also have mental health needs.

Methods: A 50-item self-administered questionnaire was developed for the 2004 survey, based on the 1994 study. This was sent to all 624 Fellows of the Royal Australian and New Zealand College of Psychiatry registered in Victoria at the time. A series of questions was asked based on workload, training, the role of psychiatry in intellectual disabilities, opinions on assessment and management, improving services, and the demographics of participant psychiatrists. Results of the 2004 survey are compared with the 1994 study.

Results: There has been some change in psychiatrists’ opinions about acute admission wards, believing strongly that they do not meet the needs of the adults with severe intellectual disabilities, leaving them vulnerable to exploitation. There has been some improvement in their ability to adequately manage adults with intellectual disabilities who have mental health needs and/or problem behaviours.

Conclusions: Mainstream mental health services fail to meet the needs of adults with intellectual disabilities. Improved specialist clinical services and more clinical training opportunities are required.
Prevalence of Transsexualism Among New Zealand Passport Holders
Authors: Veale Jaimie F.
Published: December 2009

Objective: Most previous studies of the prevalence of transsexualism have used data from individuals seeking sex reassignment surgery. New Zealand is unique in that transsexual people can apply to have an ‘X’ for the sex on their passport if they have a name on their birth certificate that is congruent with the sex opposite to their birth assigned sex, and provide a statutory declaration stating they have lived as a member of that sex.

Method: From information provided by the New Zealand Passports Office, it was ascertained that the prevalence of transsexualism among New Zealand passport holders was at least 1:6364.

Results: The prevalence of male-to-female transsexualism was estimated at 1:3639, and the corresponding figure for female-to-male transsexualism was 1:22 714.

Conclusions: These estimates were higher than most previous estimates of transsexualism prevalence. There was also a larger than expected ratio of male-to-female transsexual people to female-to-male transsexual people (6:1), which could in part be due to female-to-male transsexual people being relatively overrepresented among those transsexual people for whom we did not have data on the direction of sex change, or this may be indicative of the demography of transsexualism in Australasia.
Classification of Mood Disorders in DSM-V and DSM-VI
Authors: Joyce Peter R.
Published: December 2009

For any diagnostic system to be clinically useful, and go beyond description, it must provide an understanding that informs about aetiology and/or outcome. DSM-III and DSM-IV have provided reliability; the challenge for DSM-V and DSM-VI will be to provide validity. For DSM-V this will not be achieved. Believers in DSM-III and DSM-IV have impeded progress towards a valid classification system, so DSM-V needs to retain continuity with its predecessors to retain reliability and enhance research, but position itself to inform a valid diagnostic system by DSM-VI. This review examines the features of a diagnostic system and summarizes what is really known about mood disorders. The review also questions whether what are called mood disorders are primarily disorders of mood. Finally, it provides suggestions for DSM-VI.
Confabulation: A Spontaneous and Fantastic Review
Authors: Glowinski Remy , Payman Vahid , Frencham Kate
Published: December 2009

Confabulation can be of two types: provoked or spontaneous. The former is the more common and can occur on challenge to an amnesic patient's memory. Spontaneous confabulation involves an unprovoked outpouring of unbelievable autobiographical claims. The purpose of the present paper is to synthesize the current literature on confabulation for the use of treating clinicians. There is a focus on the spontaneous form, which is less common, but more memorable when encountered. In this paper the history, phenomenology, incidence, anatomical underpinnings and theoretical mechanisms of spontaneous confabulations will be reviewed, and then the paper will conclude by addressing prognostic and treatment issues. A systematic literature review of electronic databases was conducted to identify the key articles, reviews and books that have shaped the understanding of spontaneous confabulation.
Evaluating the Short form of the Reynolds Adolescent Depression Scale in New Zealand Adolescents
Authors: Milfont Taciano L. , Merry Sally , Robinson Elizabeth , Denny Simon , Crengle Sue , Ameratunga Shanthi
Published: December 2009

Objective: The aim of the present study was to examine the reliability and validity of the short form of the Reynolds Adolescent Depression Scale (RADS-SF).

Method: A sample of 9567 randomly selected New Zealand secondary school students participated in the Youth2000 Health and Wellbeing Survey that included the full-length version of the RADS. The reliability and validity of the subset of items that make up the RADS-SF and its comparability to the original version were assessed using Cronbach's alpha, kappa statistics, correlations between the two versions of the instrument, confirmatory factor analysis and correlation to other questions in the survey considered likely to be associated with depression.

Results: The RADS-SF had Cronbach's alpha of 0.88, was strongly correlated (0.95) to the RADS, had acceptable fit for the data (χ2=2823.27, df=35, comparative fit index=0.96, root mean square error of approximation=0.092, 90% confidence interval=0.089–0.095, standardized root mean square residual=0.042), showed configural invariance across gender, age and ethnic groups, and was strongly correlated with other depression-related questions, such as suicidal ideation (r=0.48). While the overall agreement for classification of depression by the two scores was good (κ=0.75), a higher percentage of students were classified as having depressive symptoms using the recommended RADS-SF cut-off point of 26 compared with the RADS criteria.

Conclusions: The RADS-SF was found to have acceptable reliability and validity and to have psychometric properties comparable to the RADS in a large population of New Zealand adolescents.
Temperament, Substance Use and Psychopathology in a Prisoner Population: Implications for Treatment
Authors: Allnutt Stephen , Wedgwood Lucinda , Wilhelm Kay , Butler Tony
Published: December 2009

Objective: The association between temperament and drug use or temperament and psychopathology has previously been restricted to community clinical or non-clinical samples. The aim of the present study was therefore to examine these associations in a large cohort of Australian offenders using Cloninger's Temperament and Character Inventory (TCI).

Methods: A total of 1322 prisoners from New South Wales (NSW) who completed all dimensions of the TCI and were screened for mental illness using the Australian National Survey of Mental Health and Wellbeing were included in the study.

Results: A total of 15% of the sample fulfilled the criteria for a diagnosis for depression, 36% for anxiety disorders and 54% for a substance abuse disorder. Using logistic regression analysis, the TCI dimensions of harm-avoidance and low self-direction predicted depression. Being female, a poly-substance user and having high harm-avoidance, persistence, self-direction and self-transcendence predicted anxiety disorders. Significant stepped trends across age, gender, and type of drug use were found for all TCI dimensions.

Conclusions: The TCI is useful in identifying prisoners with a history of psychopathology and substance misuse. This tool also provides clinically relevant information about at-risk individuals and has the potential to guide the development of intervention programmes for inmates.
Consciousness and Hallucinations in Schizophrenia: The Role of Synapse Regression
Authors: Bennett Ao Maxwell R.
Published: December 2009

Consciousness takes two forms, transitive and intransitive. Transitive consciousness is a matter of being conscious of something or other whereas intransitive consciousness has no object, as being conscious or awake. Of the different forms of transitive consciousness, perceptual, somatic, kinaesthetic and so on, cognitive neuroscience has concentrated on determining the neural concomitants of perceptual consciousness. To be conscious of a percept is to be aware of it and this requires attending to it. This work sets out a hypothesis as to what brain areas are involved in a schizophrenia subject attending and becoming aware of hallucinations. First, the different areas of cortex that support different visual and auditory illusions of percepts are considered. Next it is argued that endogenous activity in these areas of cortex give rise to hallucinations of percepts that are similar to the percepts that these same areas support during illusions. The basis of such endogenous activity, it is suggested, is to be found in the paucity of afferent synapses to these cortical areas. This may occur as a consequence of loss and regression of synapses due to a degenerative disease or because of abnormal synapse formation and regression during childhood and adolescence, as is likely to be the case in schizophrenia. Finally the neural basis of attention and awareness of these hallucinations are considered for subjects suffering from schizophrenia, and a set of important questions posed that await elucidation through future experimental studies.