bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Ethnicity Affect Need for Mental Health Service Among New Zealand Prisoners?
Authors: Simpson Alexander I. F. , Brinded Philip M. , Fairley Nigel , Laidlaw Tannis M. , Malcolm Fiona 
Published: December 2009

Objective: The National Study on Psychiatric Morbidity in New Zealand Prisons identified undiagnosed mental illness and unmet treatment needs for mentally disordered offenders. As approximately 50% of prisoners are of Maori and 8.3% Pacific Island ethnicity, we analyzed the data to determine if there were any differences in the rates of major mental disorders between ethnic groups. Method: A census of all female prisoners, all remand male prisoners and an 18% random sample of the sentenced male prisoners were interviewed employing the diagnostic interview for mental illness (CIDI-A), screening diagnostic interview for relevant personality disorders (PDQ) and suicide screening questions. Self-identified ethnicity was recorded. Ethnic groups were compared for sociodemographic variables, morbidity for mental disorder, treatment experience and suicidality. Results: The ethnic groups were largely similar in age and current prevalence for mental disorders, although there was some evidence of differing sociodemographic factors, especially younger age among the Maori prisoners. Maori report fewer suicidal thoughts, but acted suicidally at the same rate as non-Maori. Treatment for mental disorder was less common among Maori and Pacific Island prisoners than others, both in prison and in the community. Conclusion: Criminogenic factors present in the developmental histories of prisoners might also increase the risk of mental disorders. Ethnic groups were not different in the rate at which they manifest mental disorders in the face of such factors. Younger prisoners were disproportionately more likely to be of Maori or Pacific Island ethnicity. Both prior to and after entry to prison, services must improve responsiveness to Maori and Pacific Island people.
Can Recovery-Focused Multimodal Psychotherapy Facilitate Symptom and Function Improvement in People With Treatment-Resistant Psychotic Illness? A Comparison Study
Authors: Randal Patte , Simpson Alexander I. F. , Laidlaw Tannis 
Published: December 2009

Objective: To assess whether recovery-focused multimodal psychotherapy can facilitate symptom and function improvement in people with treatment-resistant psychotic illness. Method: Nine people with treatment-resistant schizophrenia or schizoaffective disorder whose symptoms and level of functioning necessitated inpatient care were engaged in individual multimodal psychotherapy for up to 21 months. In addition to the multimodal therapy they also received standard inpatient care. Twelve people retrospectively matched for diagnosis, age, sex, and chronicity of illness, formed a comparison group. They also received standard inpatient care. The standard inpatient care for both experimental and comparative groups consisted of custodial care, predominantly atypical antipsychotic drug therapy, and ongoing care from a key worker. Results: The treatment group showed clinically significant improvements in the overall Positive and Negative Symptom Scale (PANSS) scores which was significantly better than the changes found in the comparison group (p = 0.037). There was a 43% reduction in positive symptoms, a 30% reduction in negative symptoms, a 27.5% reduction in general psychopathology symptoms and a 30% reduction in overall scores on the PANSS. General behaviour scores on the Rehabilitation Evaluation of Hall and Baker were clinically improved, with a 32% reduction, as were deviant scores, with a 93.3% reduction. The change in the deviant scores was significantly better in the treatment group (p = 0.025). Conclusion: Recovery-focused multimodal psychotherapy may facilitate symptom and function improvement in people with treatment-resistant psychotic illness.
Temperament, childhood environment and psychopathology as risk factors for avoidant and borderline personality disorders
Authors: Joyce Peter R. , Mckenzie Janice M. , Luty Suzanne E. , Mulder Roger T. , Carter Janet D. , Sullivan Patrick F. , Robert Cloninger C. 
Published: December 2009

Objective: To evaluate childhood experiences (neglect and abuse), temperament and childhood and adolescent psychopathology as risk factors for avoidant and borderline personality disorders in depressed outpatients. Method: One hundred and eighty depressed outpatients were evaluated for personality disorders. Risk factors of childhood abuse, parental care, temperament, conduct disorder symptoms, childhood and adolescent anxiety disorders, depressive episodes, hypomania and alcohol and drug dependence were obtained by questionnaires and interviews. Results: Avoidant personality disorder can be conceptualized as arising from a combination of high harm avoidance (shy, anxious), childhood and adolescent anxiety disorders and parental neglect. Borderline personality disorder can be formulated as arising from a combination of childhood abuse and/or neglect, a borderline temperament (high novelty seeking and high harm avoidance), and childhood and adolescent depression, hypomania, conduct disorder and alcohol and drug dependence. Conclusions: Combinations of risk factors from the three domains of temperament, childhood experiences and childhood and adolescent psychopathology make major contributions to the development of avoidant and borderline personality disorders.
Case Managers' Attitudes to the Physical Health of Their Patients
Authors: Hyland Brendan , Judd Fiona , Davidson Sandra , Jolley Damien , Hocking Barbara 
Published: December 2009

Objective: To examine the attitudes and practices of case managers working in Area Mental Health Services (AMHS) towards the physical health of people with chronic mental illness. Method: Case managers at four AMHS in Melbourne participated in focus groups and completed a survey questionnaire. Results: Case managers generally believed that mental illness, psychotropic medication and lifestyle factors contributed to the poor physical health status of their patients. Although many case managers attempted interventions aimed at improving physical health, there was inconsistency regarding the areas targeted. Preventive health measures were often neglected. Overall, there was a sense of pessimism around whether improved physical health was possible for people with chronic mental illness. Conclusions: Lack of coordination among health professionals and the health system may contribute to the poor general health of people with mental illness. Patients often have difficulty accessing general practitioners and the culture within the AMHS can exclude considerations of physical health. Case management should include aspects addressing the physical health issues of AMHS clients.
Chronic Posttraumatic Stress Disorder and Family Functioning of Vietnam Veterans and Their Partners
Authors: Evans Lynette , Mchugh Tony , Hopwood Malcolm , Watt Carol 
Published: December 2009

Objective: This study examines the association between posttraumatic stress disorder (PTSD), in terms of the three main symptom clusters (intrusion, avoidance and arousal), and the self-report of family functioning of Vietnam veterans and the self-report of family functioning of their partners. A second objective was to determine if depression, anger and alcohol abuse mediated between PTSD symptoms and family functioning. Method: Vietnam veterans and their partners completed a series of questionnaires as part of their participation in the inpatient and outpatient PTSD treatment program, in the Veterans Psychiatry Unit, at the Austin and Repatriation Hospital. Results: Data from 270 veterans and partners were used in the final analyses. The PTSD subscales were initially correlated with family functioning for veterans and family functioning for partners. Then two path diagrams were constructed and analyzed using the statistical program AMOS to test for mediating effects between PTSD symptoms and family functioning. For veterans there were significant initial correlations with all three subscales of the PTSD measure. In the path analysis when the mediating variables were included only the avoidance subscale of the PTSD measure remained directly associated with family functioning. The arousal PTSD subscale was mediated by anger. The measures of depression and anger were significantly associated with poor family functioning and the anger and the avoidance subscales were significantly associated with depression. In the second set of analyses conducted on data from partners, the PTSD symptoms of avoidance and arousal were initially correlated with family functioning. When the test for mediation was conducted none of the PTSD subscales remained associated with partners' self-report of family functioning. Posttraumatic stress disorder arousal and alcohol abuse were mediated by anger for partners' self-report of family functioning. Conclusions: Posttraumatic stress disorder symptoms of avoidance for veterans, and comorbid symptoms of anger and depression for veterans, and anger on its own for partners appear to be important in the self-report of family functioning. These findings suggest that veterans and their partners have similar difficulties as couples with distressed relationships in the community.
A Mother's Attitude Towards her Infant and Child Behaviour Five Years Later
Authors: Bor William , Brennan Patricia A. , Williams Gail M. , Najman Jake M. , O'callaghan Michael 
Published: December 2009

Objective: The relationship between maternal attitude to the infant at 6 months of age and behavioural outcomes at 5 years is explored, controlling for numerous demographic, child and psychosocial family factors. Method: Data was used from the Mater-University Study of Pregnancy, an Australian longitudinal study of over 7000 mothers and children followed from pregnancy to when the children were 5 years. Measures ranging from the key variables of maternal attitude and child behaviour as well as numerous confounders were dichotomised. Logistic regression analyses were performed to examine the relationship between maternal negative attitude toward the infant and clinically significant levels of child behaviour problems and other infant risks, early social risks, and concurrent social risks. Results: The results suggest that maternal negative attitude towards the infant at 6 months is an independent predictor of child behaviour problems at 5 years. This association remained significant for boys’ externalizing behaviours and girls’ internalizing behaviours. Conclusions: The findings lend support to the concept of a sensitive period in early infancy; the need for a broad perspective in the assessment of the mother-infant relationship and the need for early intervention with dysfunctional mother-infant dyads.
Researching Psychiatry in Western Australia
Authors: Jablensky Assen 
Published: December 2009

Objective: To provide an overview of the development, approaches and main research projects of the Centre for Clinical Research in Neuropsychiatry (CCRN) in Perth, Western Australia. Method: Discursive. Results: Underlying concepts, methods and selected findings of recent research into the neurobiology and epidemiology of schizophrenia, autism and other psychotic disorders are presented. Conclusion: CCRN, one of Australia's youngest centres of psychiatric research, has invested fruitfully in research areas such as molecular genetics, neuropsychology, neurophysiology, behavioural pharmacology, diagnostic assessment procedures and record linkage epidemiology.
Australian Psychiatrists Today: Proud of their Profession but Stressed and Apprehensive about the Future
Authors: Rey Joseph M , Walter Garry , Giuffrida Michael 
Published: December 2009

Objective: To examine the levels of satisfaction and stress of Australian psychiatrists. Method: A survey was mailed in December 2002 to all Fellows of the Royal Australian and New Zealand College of Psychiatrists residing in Australia; 1039 out of 2059 (50%) returned the questionnaire. Results: The large majority of respondents (79%) were proud of being a psychiatrist. Most (88%) reported being satisfied with their work. Reasons for dissatisfaction varied between public and private psychiatrists. Private psychiatrists nominated litigation/indemnity issues as the most frequent (69%) while the most common for public psychiatrists was lack of beds (47%). The main reason for satisfaction was helping patients get better (72%). Sixty-two percent found their work in the previous 12 months to be stressful. Dissatisfied psychiatrists were 11 times as likely to report being stressed as those satisfied. In the previous 12 months, 34% reported having had a threat of legal action, 39% had to answer a formal complaint, 67% had been verbally or physically abused by patients or relatives and 29% had patients who had suicided. Overall, psychiatrists were more pessimistic about the future than optimistic and 15% said they would not do psychiatry again. There were few differences according to state of origin or type of practice. However, females differed from males in several areas. Conclusion: Helping patients was reported as the main source of satisfaction for Australian psychiatrists while not being able to provide the best care for patients was described as one of the main reasons for dissatisfaction. Although most Australian psychiatrists are satisfied and proud of their profession, they are stressed and often experience verbal or physical abuse and threats of legal action and complaints. They are apprehensive about the future. The increasing number of females in the profession, their higher levels of stress and dissatisfaction, and other differences from males must be taken into account as the profession reshapes its future. There is a need for regular surveys of this kind.
Some Recommendations to Assess Depression in Chinese People in Australasia
Authors: Chan Bibiana , Parker Gordon , Chan Bibiana , Parker Gordon 
Published: December 2009

Objective: To provide some general recommendations for psychiatric assessment of depression among Chinese patients within a predominately Western society. Method: A literature review is provided with interpretive comments. Results: The prevalence of depression reported in community studies undertaken in Chinese communities is very low. To what extent Chinese people experience and seek help for depression, and how they report depressive symptoms have long been topics of some importance. The impact of acculturation as well as concepts and interpretations of illness in traditional Chinese medicine are discussed. Awareness of sensitive issues and practices within the Chinese culture will facilitate communication between medical professionals and patients, resulting in more accurate identification and diagnosis of depressive disorders. Conclusion: Direct but culturally sensitive and empathic questioning of psychological symptoms is needed to unveil patients' explanatory models, as most Chinese initially nominate only somatic symptoms to health practitioners. Successfully treated patients can promote earlier and wider utilization of mental health services to other Chinese people.
Knowledge and Attitudes about Suicide in 25-Year-Olds
Authors: Beautrais Annette L. , John Horwood L. , Fergusson David M. 
Published: December 2009

Objective: To examine knowledge and attitudes about suicide in a New Zealand sample of young people aged 25 years. Method: The sample was a birth cohort of 1265 young people born in New Zealand in 1977 who have been followed in a longitudinal study for 25 years. At age 25, participants were asked a series of questions designed to assess their knowledge and attitudes about suicide. Results: Young people had poor knowledge about youth suicide. They overestimated the number of youth suicide deaths, with a quarter believing that the number of deaths was at least 10× higher than the actual number. They overestimated the fraction of all suicides accounted for by youth suicides with two-thirds believing that 50% or more of all suicides occurred among young people. The most common source of information about suicide was the media. Young people tended to hold mixed attitudes toward suicide, having both liberal and conservative views. Those with lifetime histories of suicidal ideation or suicide attempt and those with family histories of suicide or suicide attempt tended to hold more liberal attitudes. Attitudes toward suicide were unrelated to gender and to knowledge about suicide. Conclusions: Young people over-estimate the prevalence of youth suicide and the fraction of suicides accounted for by youth deaths, and hold both conservative and liberal attitudes toward suicide. Their primary source of information about suicide is the media. These findings raise concerns about the potential for media coverage of youth suicide issues to normalize suicide as a common, and thereby acceptable, response among young people, and suggest the need for careful dissemination of accurate information about suicide by knowledgeable, respected and reputable sources.
Single and Combined Psychotropic Medication Use in a Child and Adolescent Mental Health Service
Authors: Reed Elizabeth , Vance Alasdair , Luk Ernest , Nunn Kenneth 
Published: December 2009

Objective: An audit of the extent and effectiveness of medication prescribing in a metropolitan child and adolescent mental health service (CAMHS) is presented, given the lack of data about medication effectiveness in CAMHS. Method: The audit involved: (i) determining the rates of prescription of different medications, the symptoms, syndromes and diagnoses for which they were used, and the profession of the medication prescriber; and (ii) a semistructured interview of clinicians using combination pharmacotherapy enquiring about the rationale for its use and the outcomes obtained. Results: Two hundred and thirty-five patients using medication were included in the study. A range of medications were prescribed, both alone and in combination. Indications for combination therapy were a single medication being ineffective or associated with adverse effects. They were targeted at symptoms and were associated with no increase in adverse effects. Trainees did relatively little prescribing. Conclusions: This study confirms earlier findings that medical practitioners are prescribing combination pharmacotherapy despite a lack of research to support this practice. Trainees working in CAMHS may be receiving inadequate experience in prescribing psychotropic medication.
A Comparative Evaluation of Community Treatments for Post-Partum Depression: Implications for Treatment and Management Practices
Authors: Highet Nicole , Drummond Peter 
Published: December 2009

Objective: To compare existing community treatments for post-partum depression (PPD), treatment efficacy was evaluated for 146 women seeking treatment for PPD in the local community. Method: Self-report questionnaires were designed to assess clinical depression and anxiety (psychological and physiological), risk factors, treatment satisfaction and the impact of social supports. Results: Comparison of treated subjects with those on a wait-list demonstrated that depression and the psychological component of anxiety decreased significantly after treatment. Psychological and pharmacological interventions produced similar clinical benefit in the treatment of psychological symptoms, and receiving both treatments in combination was of no added clinical benefit in the immediate or longer term. Individual treatment was associated with more rapid treatment gains initially than group treatment. However, the benefits of group treatment emerged during the 6 months following treatment, leading both interventions to be equally effective in the longer term. Cognitive behavioural therapy was not superior to the combination of non-specific counselling or behavioural strategies, either immediately following treatment or 6 months later. Conclusions: Clinical efficacy together with other clinical and financial benefits strongly advocate the application of psychological treatment for PPD. Clear parallels between PPD and general depression support the application of knowledge about general depression to extend understanding of PPD and refine clinical management practices.
Longitudinal Designs, Methods and Analysis in Psychiatric Research
Authors: Anstey Kaarin J. , Hofer Scott M. 
Published: December 2009

Objective: To outline the strengths and limitations of longitudinal research designs in psychiatry, and to describe different types of longitudinal designs and methods for analyzing longitudinal data. Method: Key references on longitudinal methods were reviewed and examples drawn from literature in psychiatry and psychology. Results: Longitudinal studies provide important information regarding the incidence and developmental trajectories of mental disorders. They allow for identification of risk factors and developmental concomitants. Recent developments in statistical methods for analyzing longitudinal data provide efficient estimates of change and predictors of change over time, identification and characteristics of distinct subgroups defined by change pattern, and improved methods for obtaining unbiased population estimates when data are incomplete. Conclusion: Longitudinal designs, methods and analysis can contribute to psychiatric studies on risk factors for common mental disorders, studies of early intervention and prevention and treatment outcomes.
Australian and New Zealand Clinical Practice Guidelines for the Treatment of Bipolar Disorder
Authors:   Royal Australian And New Zealand College Of Psychiatrists Clinical Practice Guidelines Team For Bipolar Disorder
Published: December 2009

Background: The Royal Australian and New Zealand College of Psychiatrists is coordinating the development of clinical practice guidelines (CPGs) in psychiatry, funded under the National Mental Health Strategy (Australia) and the New Zealand Health Funding Authority Method: For these guidelines, the CPG team reviewed the treatment outcome literature (including meta-analyses) and consulted with practitioners and consumers. Treatment recommendations: This guideline provides evidence-based recommendations for the management of bipolar disorder by phase of illness, that is acute mania, mixed episodes and bipolar depression, and the prophylaxis of such episodes. It specifies the roles of various mood-stabilizing medications and of psychological treatments such as cognitive therapy and psycho-education.