bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparison of Australian Men with Psychotic Disorders Remanded for Criminal Offences and a Community Group of Psychotic Men who have not Offended
Authors: White Paul , Chant David , Whiteford Harvey 
Published: December 2009

Background: People remanded into custody by the courts have a substantially higher rate of severe mental disorder than other prisoners and the general population. Knowledge of their prevalence, needs and characteristics and an analysis of pathways to care may be necessary to provide mental health care effectively and efficiently. Previous prison studies focusing on psychotic offenders have suffered from the use of instruments not validated in a forensic setting and lack of a relevant comparison group. Method: The Diagnostic Interview for Psychosis (DP) is a composite semi-structured standardized interview schedule. It combines social and demographic descriptors with measures of functioning adapted from the World Health Organisation Disability Assessment Schedule (DAS). The remand centre surveyed had 466 cells and is the main remand and reception centre for males for the southern region of the state of Queensland, Australia. Of the 621 men screened, 65 answered yes to at least one question in the DP and were interviewed. Results: Six hundred and twenty-one remandees were screened and of these 61 were interviewed as screened positive for psychotic disorder. Thirty-five per cent had been homeless for an average of 32 weeks during the previous year. Most had had little contact with families or close friends. Eighty-one per cent were receiving no treatment at the time of offence. Seventy-eight per cent were unemployed and in receipt of a pension. Eighty per cent were dependent on alcohol, cannabis or amphetamines. Statistical issues of power are detailed in the text. Conclusions: The simplistic ‘prison, hospital or community treatment’ debate is misleading. Instead, the development of flexible preventative, management and accommodation services for people with severe mental disorder who have committed offences is a priority.
Mental Disorders in Australian Prisoners: a Comparison with a Community Sample
Authors: Butler Tony , Andrews Gavin , Allnutt Stephen , Sakashita Chika , Smith Nadine E. , Basson John 
Published: December 2009

Background: The plight of those with mental health problems and the possible role of prisons in “warehousing” these individuals has received considerable media and political attention. Prisoners are generally excluded from community-based surveys and to date no studies have compared prisoners to the community. Objective: The objective was to examine whether excess psychiatric morbidity exists in prisoners compared to the general community after adjusting for demographics. Method: Prison data were obtained from a consecutive sample of reception prisoners admitted into the state's correctional system in 2001 (n=916). Community data were obtained from the 1997 Australian National Survey of Mental Health and Wellbeing (n=8168). Mental health diagnoses were obtained using the Composite International Diagnostic Interview and a number of other screening measures. Weighting was used in calculating the 12-month prevalence estimates to control for demographic differences between the two samples. Logistic regression adjusting for age, sex and education was used to compare the prison and community samples. Results: The 12-month prevalence of any psychiatric illness in the last year was 80% in prisoners and 31% in the community. Substantially more psychiatric morbidity was detected among prisoners than in the community group after accounting for demographic differences, particularly symptoms of psychosis (OR=11.8, 95% CI 7.5–18.7), substance use disorders (OR=11.4, 95% CI 9.7–13.6) and personality disorders (OR=8.6, 95% CI 7.2–10.3). Mental functioning and disability score were worse for prisoners than the community except for physical health. Conclusions: This study found an overrepresentation of psychiatric morbidity in the prisoner population. Identifying the causes of this excess requires further investigation.
Mindfulness-Based Psychotherapies: A Review of Conceptual Foundations, Empirical Evidence and Practical Considerations
Authors: Academic Mindfulness Interest Group Melbourne , Academic Mindfulness Interest Group Melbourne 
Published: December 2009

Objective: This paper, composed by an interest group of clinicians and researchers based in Melbourne, presents some background to the practice of mindfulness-based therapies as relevant to the general professional reader. We address the empirical evidence for these therapies, the principles through which they might operate, some practical questions facing those wishing to commence practice in this area or to refer patients into mindfulness-based therapies, and some considerations relevant to the conduct and interpretation of research into the therapeutic application of mindfulness. Method: Databases (e.g. PsycINFO, MEDLINE) were searched for literature on the impact of mindfulness interventions, and the psychological and biological mechanisms that underpin the effects of mindfulness practice. This paper also draws upon the clinical experience of the author group. Results: Mindfulness practice and principles have their origins in many contemplative and philosophical traditions but individuals can effectively adopt the training and practice of mindfulness in the absence of such traditions or vocabulary. A recent surge of interest regarding mindfulness in therapeutic techniques can be attributed to the publication of some well-designed empirical evaluations of mindfulness-based cognitive therapy. Arising from this as well as a broader history of clinical integration of mindfulness and Western psychotherapies, a growing number of clinicians have interest and enthusiasm to learn the techniques of mindfulness and to integrate them into their therapeutic work. This review highlights the importance of accurate professional awareness and understanding of mindfulness and its therapeutic applications. Conclusions: The theoretical and empirical literatures on therapeutic applications of mindfulness are in states of significant growth and development. This group suggests, based on this review, that the combination of some well-developed conceptual models for the therapeutic action of mindfulness and a developing empirical base, justifies a degree of optimism that mindfulness-based approaches will become helpful strategies to offer in the care of patients with a wide range of mental and physical health problems.
Psychotherapy in the Medically Ill: A Commentary
Authors: Vamos Marina 
Published: December 2009

Objective: To overview the field of psychotherapy in the medically ill. Rather than attempting a systematic review of this very extensive area, the article seeks to capture some of the main threads and issues of importance. Method: The subject is looked at under four headings: (i) which illnesses have attracted research interest in psychotherapy; (ii) which outcome measures have been chosen; (iii) which modes of intervention have been used; and (iv) finally a review of the methodology and the results obtained. Results: Some illnesses have attracted much more psychotherapeutic interest than others; the differences are haphazard. Outcome measures on the whole have focused on coping with illness and psychological distress, with a smaller number looking at disease outcome. Only short-term changes have been sought in the main. The most commonly used modalities of therapy have been cognitive-behavioural; additionally, supportive information-giving and group therapy have been trialled. Benefit in terms of all these have been reported, but the majority of studies are weakened by major methodological shortcomings. Conclusion: There is an overall paucity of well-designed studies that clearly demonstrate psychotherapy as an efficacious treatment in the medically ill. The field is hampered by the lack of a clear conceptual thread recognizing the long-term and diverse experience of patients with medical illness and relating this to the question of the part psychotherapy should play. Future work needs to concentrate on appropriate selection of patients who might benefit, as well as including a wider range of more clinically relevant outcome measures and more stringent methodology.
Symbolism of Community I: The Boundary between Hospital and Community
Authors: Barrett Robert J. , Parker Damon B. 
Published: December 2009

Objective: To study the symbolism of community as understood and practised in a mental health Crisis and Assessment Service in an Australian city. Theoretical approaches: The paper draws on anthropological theories of symbolism and boundary work. Method: Ethnographic fieldwork techniques were employed for data collection. Ethnographic analysis was then applied to these data. Results: In mental health practice, community is primarily defined in contradistinction to hospital. Narratives about community, including an orthodox version and a sceptical counter-narrative, revolve around this community–hospital boundary. Conclusions: This analysis identifies a key symbol, which we have designated community, and enumerates the social values that comprise it.
Symbolism of Community II: The Boundary between Community Mental Health Professional and Community
Authors: Parker Damon B. , Barrett Robert J. 
Published: December 2009

Objective: To study the symbolism of community as understood and practised within a mental health Crisis and Assessment Service in an Australian city. Theoretical approaches: The paper draws on anthropological theories of symbolism, boundary work and social networks. Method: Ethnographic fieldwork techniques were employed for data collection. Ethnographic analysis was then applied to these data. Results: In mental health practice, rules of professional behaviour established a boundary that prohibited mental health professionals from social engagement with members of the community they served. Ethical imperatives prevented them from forming interpersonal bonds with their clients. Rules of privacy and confidentiality meant that they could not relate to the client's social network as a whole. Conclusions: The companion to this paper identified a summarizing symbol, which we designated community, and it specified the social values it represented when appropriated to the task of drawing a boundary between hospital and community. This paper specifies additional social values represented by community when it is appropriated to the task of drawing a boundary between community mental health professionals and the community.
Effect of Post-Migration Detention on Mental Health Among Afghan Asylum Seekers in Japan
Authors: Ichikawa Masao , Nakahara Shinji , Wakai Susumu 
Published: December 2009

Objectives: Afghan asylum seekers in Japan were increasingly subject to detention following the terrorist attack in New York in September 2001, yet little is reported about the net impact of the detention on their mental health. We examined this by comparing asylum seekers who had once been detained in post-migration and their non-detained counterparts. Method: We conducted a cross-sectional survey in 2002/03 among asylum seekers from Afghanistan who were in the process of refugee application in Japan. We contacted them through their lawyers or non-governmental organizations. Of 73 contacted, 55 agreed to participate. Anxiety and depression were measured using the Hopkins Symptom Checklist 25, and posttraumatic stress disorders (PTSD) and past traumatic experiences were studied with the Harvard Trauma Questionnaire. These mental disorders were scored on a 4-point scale; the average symptom score of 4 indicates the worst mental health status. Results: Respondents reported a mean (SD) of 10 (4.0) pre-migration traumas. Since their arrival in Japan, 18 (33%) had once been detained. Trauma exposures and other characteristics of those detained were not significantly different from those not detained, whereas the symptom scores of anxiety (2.91), depression (2.75) and PTSD (2.90) among those detained were higher than among those not detained (2.30, 2.41, 2.34 respectively). Multiple regression analyses revealed independent adverse effects of post-migration detention, alongside exposure to greater trauma and living alone, and the effects were comparable between these variables. Conclusion: The post-migration detention of Afghan asylum seekers in Japan was independently related to their worsened mental health.
Antiglucocoticoid Treatments for Depression
Authors: Young Allan H. 
Published: December 2009

Objective: To selectively review the literature germane to antiglucocoticoid treatments for depression. Method: Selective review of the relevant literature. Results: Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis has been welldescribed in both bipolar and unipolar depression. Hypercortisolaemia, possibly secondary to breakdown in glucocorticoid-receptor-mediated negative feedback mechanisms within the HPA axis, may be central to the pathogenesis of both depressive symptoms and the neurocognitive deficits which characterize these disorders. Strategies to counteract the effects of elevated cortisol, which may potentially restore HPA axis integrity, have been the focus of recent research. Conclusions: Both preclinical and clinical studies report encouraging results which suggest that lowering circulating cortisol levels or blocking the effects of elevated cortisol with antagonists, which may up-regulate glucocorticoid receptors, has therapeutic benefits in terms of improvements in depressive symptoms and some domains of neurocognitive function.
Anticonvulsants in Bipolar Disorder
Authors: Bowden Charles L. , Karren Nancy U. 
Published: December 2009

Objective: To review the literature on the effectiveness of anticonvulsant drugs in the management of bipolar disorder. Methods: A selective review of the literature. Results: Valproate is an effective drug, alone or in combination, for mania, but has limited benefit in bipolar depression. Although valproate is widely used in maintenance therapy of bipolar disorder, and secondary analyses suggest benefit, in the largest randomised maintenance trial there was only a trend favouring valproate. Lamotrigine has benefit in bipolar depression and maintenance, but not in mania. Carbamazepine is effective in mania. Other anticonvulsant drugs have been tried in mania, but with mixed results. Conclusions: Valproate, lamotrigine and carbamazepine have a valuable place in the management of bipolar disorder.
Transcranial Magnetic Stimulation for Depression
Authors: Mitchell Philip B. , Loo Colleen K. 
Published: December 2009

Objective: To review the accumulated literature on the efficacy, safety and predictors of response for repetitive transcranial magnetic stimulation (rTMS) in the treatment of depression. Methods: A descriptive review of the more than 25 published sham-controlled rTMS studies in depression was undertaken, focusing on reported meta-analyses as well as individual trial reports. Potential determinants of efficacy were examined, including the form of shams employed, stimulation parameters and clinical features. Results: There is now clear evidence for the statistical superiority of left-prefrontal high frequency rTMS compared with sham therapy. However, the clinical benefits are marginal in the majority of reports. There is also still considerable uncertainty concerning the optimal stimulation parameters. Those clinical features which appear to be associated with greater response include younger age, lack of refractoriness to antidepressants and no psychotic features. Conclusions: Current studies confirm statistical efficacy, but insubstantive clinical benefit. Large multicentre studies currently underway should clarify if rTMS should be approved by regulatory agencies for widespread clinical availability. Furthermore, there is a need to clarify the preferred parameters for administering this treatment.
Pathways to Care in a New Zealand Firstepisode of Psychosis Cohort
Authors: Turner Mark , Turner Mark , Smith-Hamel Cecilia , Mulder Roger 
Published: December 2009

Objectives: To present the clinical and sociodemographic characteristics of patients referred to a New Zealand early intervention for psychosis service and to describe the pathways to care for these patients. Method: Clinical and sociodemographic characteristics were examined in 200 patients consecutively admitted to an early psychosis service over a 5-year period. Assessment measures included DSM-IV diagnosis, the Quality of Life Scale, Positive and Negative Syndrome Scale and information on pathways to care. Results: The majority of patients were young (mean age = 22.35), single (90.1%), male (72.5%), of New Zealand European descent (63.7%), living in the parental home (60.2%) and on a government benefit (60.2%). Overall, 40.8% of patients were initially diagnosed with a schizophrenia spectrum disorder, 36.4% with a mood disorder and 22.8% were classified as ‘other psychoses’ (substance-induced psychosis, brief psychotic disorder, etc.). Those with a schizophrenia spectrum disorder had a median duration of untreated psychosis of 120 days compared with 29 days for other diagnoses. Overall, 64.1% of referrals came from the Inpatient Service, 36.3% of patients had a compulsory admission under the Mental Health Act, and 41.8% had contact with police in 6 months prior to referral to the service. No differences in inpatient admission rates, police involvement or compulsory admission were evident for ethnicity or diagnosis. Conclusions: The pathways to care, clinical and sociodemographic descriptors of the present sample are somewhat different to those previously reported in international cohorts. This reflects the inclusion of patients with affective psychoses, the age range of 18–30 years and New Zealand's distinctive healthcare system. Examination of the sociodemographic characteristics and pathways to care in the present cohort suggests that service reconfigurations are required to optimize the experience of inpatient admission, given the substantial proportion of clients with non-schizophrenia spectrum disorders that present acutely for treatment.
Pattern and Correlates of Inpatient Admission During the Initial Acute Phase of First-Episode Psychosis
Authors: Wade Darryl , Harrigan Susy , Harris Meredith G. , Wade Darryl , Harrigan Susy , Harris Meredith G. , Edwards Jane , Mcgorry Patrick D. , Wade Darryl , Harrigan Susy , Harris Meredith G. , Edwards Jane , Mcgorry Patrick D. 
Published: December 2009

Objectives: The first aim of this study was to examine the rate, pattern and correlates of inpatient admission during the first 3 months of treatment for first-episode psychosis (FEP). The second aim was to determine whether the pattern of inpatient admission during this period was associated with remission of psychotic symptoms or inpatient service use at 15-month follow-up. Method: One hundred and four consecutive patients with FEP at a specialist treatment service were approached to participate in a follow-up study. Patients were grouped on the basis of the pattern of inpatient admission (none, one, or multiple) during the first 3 months of treatment. Clinical ratings at baseline and 3-month follow-up, and ratings of remission of psychotic symptoms at 3 and 15-month follow-up, were available for two-thirds of the patients. Inpatient data for the 15-month follow-up period were derived from an electronic database for most patients (n = 98). Results: Eighty (76.9%) of the 104 patients were admitted to an inpatient unit during the first 3 months of treatment. Fifty-nine (56.7%) patients had a single admission and 21 (20.2%) had multiple admissions. At baseline, inpatient admission was associated with a diagnosis of affective psychosis and more severe behavioural and functional disturbance but not positive psychotic symptoms. Multiple admissions were associated with risks to self or others at baseline and 3-month follow-up, and lack of remission of positive symptoms at 3 and 15-month follow-up. There was no association between the pattern of inpatient admission during the initial 3-month period and inpatient service use during the following 12-month period. Conclusions: The substantial proportion of young patients with FEP admitted to hospital emphasizes the need for youth-friendly treatment environments and practices. Although patients with multiple admissions during the initial treatment period are less likely to achieve remission, these patients are no more likely to establish a pattern of revolvingdoor hospitalizations compared with other patients.
Treatment with Olanzapine, Risperidone or Typical Antipsychotic Drugs in Asian Patients with Schizophrenia
Authors: Lee Chul , Wu Kuang-Hsien , Habil Hussain , Dyachkova Yulia , Lee Phil 
Published: December 2009

Objective: To examine clinical outcomes in Asian patients with schizophrenia receiving monotherapy with olanzapine, risperidone or typical antipsychotics in naturalistic settings. Method: In this report, data from the first 12 months of the prospective, observational, 3-year Intercontinental Schizophrenia Outpatient Health Outcomes study are presented for patients from participating Asian countries (Korea, Taiwan and Malaysia) who were started on, or switched to, monotherapy with olanzapine (n = 484), risperidone (n = 287) or a typical antipsychotic drug (n = 127) at baseline. Results: At 12 months, overall reduction in the score of Clinical Global Impressions-Severity of Illness rating scale was greatest with olanzapine (p < 0.001 vs typical agents), followed by risperidone (p = 0.007 vs typical agents) treatment. Olanzapine treatment was found to have significantly better effects than typical agents on negative and depressive symptom scores, and significantly greater improvements than risperidone on negative and cognitive symptoms. The occurrence of extrapyramidal symptoms was least likely with olanzapine (p < 0.001 vs typical agents, and p = 0.012 vs risperidone), while the estimated odds of tardive dyskinesia were greatest in the typical treatment group (p = 0.046 vs olanzapine, and p = 0.082 vs risperidone). Mean weight increase was greater for olanzapine-treated patients compared with the other agents (p = 0.030 vs typical agents and p < 0.001 vs risperidone). The risk of menstrual disturbance was relatively high with risperidone when compared with olanzapine treatment (p < 0.001). Conclusions: The results of this observational study indicate that, in Asian patients with schizophrenia, olanzapine may offer benefits when compared with typical agents or risperidone. However, the significantly greater odds of weight gain should be considered in the clinical management of olanzapine-treated patients.