bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shyness Programme: Longer Term Benefits, Cost-Effectiveness, and Acceptability
Authors: Titov Nickolai , Andrews Gavin , Johnston Luke , Schwencke Genevieve , Choi Isabella 
Published: December 2009

Objective: In two randomized controlled trials Titov et al. demonstrated significant benefit from an Internet- and email-based treatment programme for social phobia: the Shyness programme. Data are presented about the longer term outcomes (6 months after treatment), cost-effectiveness relative to face-to-face treatment, and the acceptability of the programme to participants. Method: Participants completed outcome and acceptability questionnaires at 6 months after treatment. Repeated measures analyses of variance were calculated using an intention-to-treat design. Cost-effectiveness in years lived with disability averted were calculated based on between-group effect sizes. Results: A total of 59% of treatment group participants completed the 6 month follow-up questionnaires. Between post-treatment and 6 month follow up participants continued to make improvements in symptoms of social phobia, while maintaining improvements in mood, psychological distress, and disability. At 6 month follow up the mean within-group effect size (Cohen's d) for the two social phobia measures increased from 1.2 to 1.4. Cost-effectiveness in years lived with disability (YLD) averted was calculated as one-quarter that of face-to-face group treatment, or $AUD1495 for one YLD gained, compared to $AUD5686/YLD gained. Participants rated the Internet treatment to be as effective and helpful as face-to-face treatment. Conclusions: The present results confirm the reliability of the short-term findings reported in the first two Shyness programmes. The procedure appears to be very cost-effective, and acceptable to participants. These data provide further support for the development of Internet-based virtual clinics for common mental disorders.
Psychotic-Like Experiences in a Community Sample of Adolescents: Implications for the Continuum Model of Psychosis and Prediction of Schizophrenia
Authors: Yung Alison R. , Nelson Barnaby , Baker Kathryn , Buckby Joe A. , Baksheev Gennady , Cosgrave Elizabeth M. 
Published: December 2009

Objective: Studies conducted in community samples suggest that psychotic-like experiences are common in the general population, leading to suggestions that they are either variations of normal personality or are different expressions of underlying vulnerability to psychotic disorder. Different types of psychotic symptoms may exist, some being normal variants and some having implications for mental health and functioning. The aim of the present study was to determine if different subtypes of psychotic-like experiences could be identified in a community sample of adolescents and to investigate if particular subtypes were more likely to be associated with psychosocial difficulties, that is, distress, depression and poor functioning, than other subtypes. Method: Eight hundred and seventy-five Year 10 students from 34 schools participated in a cross-sectional survey that measured psychotic-like experiences using the Community Assessment of Psychic Experiences; depression using the Centre for Epidemiologic Studies Depression Scale; and psychosocial functioning using the Revised Multidimensional Assessment of Functioning Scale. Factor analysis was conducted to identify any subtypes of psychotic experiences. Results: Four subtypes of psychotic-like experiences were identified: Bizarre Experiences, Perceptual Abnormalities, Persecutory Ideas, and Magical Thinking. Intermittent, infrequent psychotic experiences were common, but frequent experiences were not. Bizarre Experiences, Perceptual Abnormalities and Persecutory Ideas were strongly associated with distress, depression and poor functioning. Magical Thinking was only weakly associated with these variables. Overall these findings may suggest that infrequent psychotic-like experiences are unlikely to be a specific risk factor for onset of a psychotic disorder in community samples. Conclusions: Given that the different subtypes had varying associations with current difficulties it is suggested that not all subtypes confer the same risk for onset of psychotic disorder and poor outcome. Bizarre Experiences, Perceptual Abnormalities and Persecutory Ideas may represent expressions of underlying vulnerability to psychotic disorder, but Magical Thinking may be a normal personality variant.
Differences in Neuropsychological Performance Between Subtypes of Obsessive–Compulsive Disorder
Authors: Nedeljkovic Maja , Kyrios Michael , Moulding Richard , Doron Guy , Wainwright Kylie , Pantelis Chris , Purcell Rosemary , Maruff Paul 
Published: December 2009

Objective: Neuropsychological studies have suggested that frontal–striatal dysfunction plays a role in obsessive–compulsive disorder (OCD), although findings have been inconsistent, possibly due to heterogeneity within the disorder and methodological issues. The purpose of the present study was therefore to compare the neuropsychological performance of different subtypes of OCD and matched non-clinical controls (NCs) on the Cambridge Automated Neuropsychological Test Battery (CANTAB). Methods: Fifty-nine OCD patients and 59 non-clinical controls completed selected tests from CANTAB examining executive function, visual memory and attentional-set shifting. Depression, anxiety and OCD symptoms were also assessed. Results: From 59 OCD patients, four subtypes were identified: (i) washers; (ii) checkers; (iii) obsessionals; and (iv) mixed symptom profile. Comparisons between washers, checkers, obsessionals and NCs indicated few differences, although checkers were generally found to exhibit poorer performance on spatial working memory, while obsessionals performed poorly on the spatial recognition task. Both checkers and the mixed subgroups showed slowed initial movement on the Stockings of Cambridge planning task and poorer pattern recognition relative to NCs. Conclusion: Overall the results suggested greater impairments in performance on neuropsychological tasks in checkers relative to other subtypes, although the observed effects were small and the conclusions limited by the small subtype samples. Future research will need to account for factors that influence neuropsychological performance in OCD subtypes.
Psychiatric Symptoms and Dissociation in Conversion, Somatization and Dissociative Disorders
Authors: Espirito-Santo Helena , Pio-Abreu José Luís 
Published: December 2009

Objective: Conversion, dissociation and somatization are historically related in the long established concept of hysteria. Somewhere along the way they were separated due to the Cartesian dualistic view. The aim of the present study was to compare these pathologies and investigate whether symptoms of these pathologies overlap in their clinical appearance in a Portuguese sample. Method: Twenty-six patients with conversion disorder, 38 with dissociative disorders, 40 with somatization disorder, and a comparison group of 46 patients having other psychiatric disorders answered questions about dissociation (Dissociative Experiences Scale), somatoform dissociation (Somatoform Dissociation Questionnaire), and psychopathological symptoms (Brief Symptom Inventory). Results: Dissociative and somatoform symptoms were significantly more frequent in dissociative and conversion disorder than in somatization disorder and controls. There were no significant differences between dissociative and conversion patients. Conclusions: Conversion disorder is closely related to dissociative disorders. These results support the ICD-10 categorization of conversion disorder among dissociative disorders and the hypothesis of analogous psychopathological processes in conversion and dissociative disorders versus somatization disorder.
Excessive Exercise in Eating Disorder Patients and in Healthy Women
Authors: Mond Jonathan M. , Calogero Rachel M. 
Published: December 2009

Objective: In order to elucidate the nature of excessive exercise among individuals with eating disorders, exercise behaviours were compared between eating disorder patients receiving specialist treatment and healthy women, and between subgroups of patients.Methods: Self-report measures of obligatory exercise, motivation for exercise and frequency of hard exercise for weight or shape reasons were completed by eating disorder patients (n=102) and healthy women (n=184).Results: The experience of intense guilt when exercise is missed and exercising solely or primarily for reasons of weight, shape or physical attractiveness, were the exercise behaviours that most clearly differentiated between women with eating disorders and healthy women. Patients with the purging form of anorexia nervosa (n=13) and those with bulimia nervosa (n=41) tended to have higher scores on measures of these behaviours than those with the restricting form of anorexia nervosa (n=15).Conclusions: Research addressing the prevalence and correlates of excessive exercise in eating disorder patients would benefit from a broader assessment of exercise behaviour than has typically been used in previous studies. In addition, the findings may indicate specific targets for the clinical management of excessive exercise as well as for community-based health promotion initiatives.
Randomized Controlled Trial of an Early Intervention Programme for Adolescent Anxiety Disorders
Authors: Hunt Caroline , Andrews Gavin , Sakashita Chika , Crino Rocco , Erskine Alicia 
Published: December 2009

Objective: To assess the effectiveness of an indicated early intervention and prevention programme for anxiety disorders when conducted by school staff. Method: A total of 260 students in their first year of high school with self-reported anxiety symptoms >1 SD above the mean score of a normative sample were randomly allocated on the basis of their school to an intervention condition led by school staff or to a monitoring condition. Results: There was little difference between conditions at the 2 year and 4 year follow up on self-reported symptoms, and no difference on diagnosis or health-care use. Conclusions: Outcomes associated with indicated prevention programmes led by school staff may not be as strong as those produced by specialist mental health staff. More work is needed to delineate models by which evidence-based treatments can be effectively used in schools.
Emotion Categorization Perception in Schizophrenia in Conversations with Different Social Contexts
Authors: Huang Jia , Chan Raymond C. K. , Lu Xiaobin , Tong Zishun 
Published: December 2009

Objective: The aim of the present study was to investigate whether the boundaries between the happy and angry emotions of schizophrenia would be influenced by social context and the difference in emotion categorization boundaries between schizophrenia patients and healthy controls. Method: Eighteen patients with schizophrenia and 16 healthy controls were given a forced-choice emotion identification task in which they were required to listen to a series of conversations with different social contexts. The stimuli were linear morphed facial expressions between ‘happy’ and ‘angry’ emotions. For each type of social context, the shift point was used as the parameter to estimate when the subjects began to perceive the morphed facial expression as angry. The response slope was used to estimate how abruptly this change in perception occurred. Results: There was no significant difference in the schizophrenia group in the shift point of emotion categorization perception for four categories of conversations occurring in different social contexts. Compared with the healthy controls, the schizophrenia group demonstrated a steeper response slope at the shift point regardless of the conversation type. Conclusion: The patients with schizophrenia were less discriminative in their categorization of emotion perception in conversations with different social contexts. The schizophrenia patients, however, were more alert to angry facial expressions in the process of facial expressions morphing from happy to angry, independent of the social context.
Caseload Management, Work-Related Stress and Case Manager Self-Efficacy Among Victorian Mental Health Case Managers
Authors: King Robert 
Published: December 2009

Objective: In Australia and comparable countries, case management has become the dominant process by which public mental health services provide outpatient clinical services to people with severe mental illness. There is recognition that caseload size impacts on service provision and that management of caseloads is an important dimension of overall service management. There has been little empirical investigation, however, of caseload and its management. The present study was undertaken in the context of an industrial agreement in Victoria, Australia that required services to introduce standardized approaches to caseload management. The aims of the present study were therefore to (i) investigate caseload size and approaches to caseload management in Victoria's mental health services; and (ii) determine whether caseload size and/or approach to caseload management is associated with work-related stress or case manager self-efficacy among community mental health professionals employed in Victoria's mental health services. Method: A total of 188 case managers responded to an online cross-sectional survey with both purpose-developed items investigating methods of case allocation and caseload monitoring, and standard measures of work-related stress and case manager personal efficacy. Results: The mean caseload size was 20 per full-time case manager. Both work-related stress scores and case manager personal efficacy scores were broadly comparable with those reported in previous studies. Higher caseloads were associated with higher levels of work-related stress and lower levels of case manager personal efficacy. Active monitoring of caseload was associated with lower scores for work-related stress and higher scores for case manager personal efficacy, regardless of size of caseload. Although caseloads were most frequently monitored by the case manager, there was evidence that monitoring by a supervisor was more beneficial than self-monitoring. Conclusion: Routine monitoring of caseload, especially by a workplace supervisor, may be effective in reducing work-related stress and enhancing case manager personal efficacy.
Factors Associated with Dropout and Diagnosis in Child and Adolescent Mental Health Services
Authors: Johnson Emily , Mellor David , Brann Peter 
Published: December 2009

Objective: Dropout from child and adolescent mental health services has ramifications for children, families and the services themselves. Understanding the factors that are associated with dropout for different diagnoses has the potential to assist with tailoring of services to reduce dropout. The aim of the current study was to identify such factors. Method: A file audit was conducted for all referrals to a child and adolescent mental health service over a 12 month period, yielding 520 subjects for analysis (264 male, 256 female, mean age = 12.6 years). Parent, child and service variables of interest were recorded as were diagnoses, which were categorized into 25 superordinate categories. Results: Almost 50% of subjects dropped out of treatment. Factors associated with dropout varied across diagnosis, and no factor was associated with dropout for all diagnoses. Conclusion: There are differences in the factors that were associated with dropout for different disorders. This is a useful finding in terms of understanding and preventing dropout in child and adolescent mental health settings, but more research is needed.
Ethnomethodological Study of the Values of Australian Psychiatrists: Towards an Empirically Derived RANZCP Code of Ethics
Authors: Robertson Michael , Kerridge Ian , Walter Garry 
Published: December 2009

Objective: The aim of the present study was to identify the core values of Australian psychiatrists to ascertain how these are reflected in the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Code of Ethics. Method: An ethnomethodological study was conducted on a non-purposive sample of Australian psychiatrists using a non-probabilistic theoretical sampling method. Data obtained at interview were analysed using a qualitative computer-assisted thematic analysis paradigm. The themes generated using this coding strategy were refined into a rich description of the core values held by Australian psychiatrists. Results: Four main values emerged from the data: the value of the patient, the value of sophisticated understanding, the value of reflexivity, and the value of advocacy. Conclusions: The four main values identified in the present study were well reflected in the main principles of the RANZCP Code of Ethics. In the light of the data, some additional annotations to the document are suggested, to better reflect this value system.
Removing Bridge Barriers Stimulates Suicides: An Unfortunate Natural Experiment
Authors: Beautrais Annette L. , Gibb Sheree J. , Fergusson David M. , Horwood L. John , Larkin Gregory Luke 
Published: December 2009

Objectives: Safety barriers to prevent suicide by jumping were removed from Grafton Bridge in Auckland, New Zealand, in 1996 after having been in place for 60 years. This study compared the number of suicides due to jumping from the bridge after the reinstallation of safety barriers in 2003. Methods: National mortality data for suicide deaths were compared for three time periods: 1991–1995 (old barrier in place); 1997–2002 (no barriers in place); 2003–2006 (after barriers were reinstated). Results: Removal of barriers was followed by a fivefold increase in the number and rate of suicides from the bridge. These increases led to a decision to reinstall safety barriers. Since the reinstallation of barriers, of an improved design, in 2003, there have been no suicides from the bridge. Conclusions: This natural experiment, using a powerful a-b-a (reversal) design, shows that safety barriers are effective in preventing suicide: their removal increases suicides; their reinstatement prevents suicides.
Illness Aetiology Constructs, Health Status and Use of Health Services among Cambodians in New Zealand
Authors: Cheung Peter , Spears George 
Published: December 2009

Objective: The objectives of this study were to determine, among all adult Cambodians living in Dunedin: prevalence of illness aetiology beliefs; psychiatric and physical health status; pattern of use of health services; relationships between use of health services and demographic factors, illness aetiology constructs and health status; and problems encountered and improvements desired in the local health services. Method: 223 (i.e. 93.3% of all) adult Cambodians living in Dunedin were assessed, using a structured interview, in relation to their sociodemographic status, illness aetiology beliefs, physical health status and use of health services. The 28-item version of the General Health Questionnaire was used to assess psychiatric status. Results: Subjects held multiple indigenous and Western illness aetiology constructs. Psychiatric morbidity using the 28item of the General Health Questionnaire (GHQ28) cutoff of 3/4 was 15.7% despite this only six subjects had ever used specialist psychiatric services. Malaria, intestinal parasitic infestations and heart conditions were the three most frequently reported physical problems. Most subjects had used traditional services in Cambodia but very few had used them in New Zealand. Health service was related to duration of stay in New Zealand. Socio-economic status, both physical and psychiatric health status and some illness aetiology constructs. One hundred and forty-two (63.7%) subjects reported problems with use of health services in Dunedin. Conclusion: Despite methodological limitations, some useful preliminary data on factors pertaining to use of and satisfaction with health services among Cambodians were collected. Future research should examine family characteristics and the decision-making processes that determine service use.
Evaluation of a Rural Telepsychiatry Service
Authors: Greenwood James , Chamberlain Christie , Parker Gordon 
Published: December 2009

Objective: To evaluate a telepsychiatry clinical service to Wagga Wagga in rural New South Wales, comprising a face-to-face interview with a psychiatrist followed by a telepsychiatry interview with a Sydney-based psychiatrist. Methods: Thirty-one patients were referred to a specialist mood disorder clinic in a rural setting for consultation and assessment. A retrospective evaluation was made to determine the acceptance of the teleconferenced psychiatry and face-to-face psychiatry, as well as the overall patient response. Results: Twenty participants completed all evaluation components. Their results indicated a satisfaction level of 95% with the consultation process as a whole, with 80% happy to use telepsychiatry again and 60% preferring telepsychiatry over travelling to a larger centre for face-to-face consultation. The face-to-face component was satisfactory for 85% of patients while the telepsychiatry component was satisfactory for 72%. Conclusions: Although face-to-face psychiatry was preferred by this sample, the telepsychiatry component was highly rated and preferred over travel to larger centres for face-to-face consultation, by residents of rural and remote locations. Certain issues are of more concern in telepsychiatry than face-to-face psychiatry, including confidentiality, rapport, explanation and education.
Repetitive Transcranial Magnetic Stimulation and Electroconvulsive Therapy: Complementary or Competitive Therapeutic Options in Depression?
Authors: Fitzgerald Paul 
Published: December 2009

Objective: To examine issues pertaining to the potential clinical roles of repetitive transcranial magnetic stimulation (rTMS) and the relationship of these to the use of electroconvulsive therapy (ECT). Methods: A review of studies was carried out comparing the use of rTMS and ECT, with consideration of issues relating to the populations in which rTMS may be applied. Results: There have been a number of randomized comparisons of rTMS and ECT. There are limitations with these studies, but in general they indicate that in non-psychotic patients rTMS appears to have a similar rate of response to ECT and certainly seems to have meaningful clinical effects. There are a number of clinical subpopulations in whom rTMS, but not ECT, is suitable, and assessment of the effectiveness of TMS in these populations is required. Conclusions: Repetitive TMS and ECT are likely to prove to be complementary clinical tools and the introduction of clinical programmes with rTMS will enhance patient options rather than replace the use of ECT.