bluuebunny/crossref_metadata_2025_split huggingface dataset:
Signal Transmission, Rather Than Reception, is the Underlying Neurochemical Abnormality in Schizophrenia
Authors: Dean Brian 
Published: December 2009

Objective: This review aims to summarise the outcome of studies on changes in the molecular architecture of the brain of subjects with schizophrenia and formulate a hypothesis on mechanisms involved in the pathology of the illness. Method: The outcomes from key studies using neuroimaging techniques and tissue obtained post-mortem that have been directed toward identifying abnormalities in the molecular architecture of the brain in subjects with schizophrenia were summarised. Using the results from these studies hypotheses were formulated on the underlying pathological process that precipitate schizophrenia. Results: Studies using neuroimaging techniques or tissue obtained post-mortem have revealed changes in the dopaminergic, serotoninergic, glutamatergic, GABAergic and cholinergic systems of the brain in schizophrenia. Some of these studies have identified abnormalities in presynaptic proteins or functioning that may be central to the pathology of schizophrenia. Conclusions: There appears to be diverse changes in the molecular cytoarchitecture of the brains from subjects with schizophrenia. It could be that it is by affecting these multiple systems that the atypical antipsychotic drugs produce their improved clinical outcomes. Abnormal functioning of presynaptic processes could be central to the pathology of schizophrenia. If the ‘presynaptic’ hypothesis is proven, future antipsychotic drug design should be directed away from post-synaptic receptor antagonism toward the modulating the functions of presynaptic neurones.
Reactive Psychoses Revisited
Authors: Ungvari Gabor Sandor , Mullen Paul Edward 
Published: December 2009

Objective and Method: This paper describes the overlap between reactive (psychogenic) psychosis and other brief psychotic episodes, and explores the gradual disappearance of reactive psychoses as a distinct nosological entity from international classifications. Clinical and conceptual issues concerning reactive psychosis are examined on the basis of a critical review of major classical and modern papers. A brief illustrative case history is also provided. Results: Reactive psychoses are conceptualised as severe disturbances of mental state, on occasion chameleon-like in their shifting form and content, arising in response to a stressful event or life situation. Reactive psychoses have an abrupt onset and usually run their course to complete resolution in a matter of days or weeks. Precipitants include overwhelming fear, threat of imminent destruction, social isolation (as can occur with imprisonment, immigration or deafness), bereavement and intense sexual or interpersonal conflicts. The emergence of a reactive psychosis usually occurs against the background of a predisposing vulnerability in terms of personality disorder, organic impairment, or a history of sensitising experiences, occasionally operating in combination. Conclusions: The increasing failure to recognise reactive psychoses diminishes clinical psychiatry because it removes an important opportunity for understanding mental disorder in terms of an integration, and totalisation, of developmental history, psychological makeup, social context and current realities, and in so doing lessens our awareness of the links between psychosis and our common humanity.
Diurnal Variation in Cotard's Syndrome (Copresent with Capgras Delusion) Following Traumatic Brain Injury
Authors: Butler Peter V. 
Published: December 2009

Objective: The aim of this paper is to document regular nocturnal intensification of delusional nihilistic and persecutory ideas (Cotard delusion) linked with extreme depersonalisation and hypervivid dreaming. Clinical Picture: A 17-year-old man presented with Cotard and Capgras delusions after sustaining multiple cognitive impairments secondary to traumatic brain injury. Treatment and outcome: Delusional ideation fully resolved within 14 days of commencement of olanzapine 5 mg daily. Conclusion: This patient's experience of perceptual abnormalities and impairments in meta-abilities related to self-monitoring and critical inferencing lends support to multicomponent sensory processing accounts of brain injury related, content-specific delusional syndromes.
Public Beliefs About the Helpfulness of Interventions for Depression: Effects on Actions Taken When Experiencing Anxiety and Depression Symptoms
Authors: Jorm Anthony F. , Medway Jo , Christensen Helen , Korten Ailsa E. , Jacomb Patricia A. , Rodgers Bryan 
Published: December 2009

Objective: Previous research has shown that the public have different beliefs to mental health professionals about the helpfulness of interventions for mental disorders. However, it is not known whether the public's beliefs actually influence their behaviour when they develop psychiatric symptoms. Method: A postal survey of 3109 Australian adults was used to assess beliefs about the helpfulness of a broad range of interventions for depression, as well as respondents' current level of anxiety and depression symptoms and any history of treated depression. A follow-up survey of 422 persons who had a high level of symptoms at baseline was conducted 6 months later. These people were asked which interventions they had used to reduce their symptoms. An analysis was carried out to see whether beliefs and other factors at baseline predicted subsequent use of interventions. Results: There were some major discrepancies between the ranking of interventions as likely to be helpful and the ranking of how frequently they were actually used. Interventions involving mental health professionals were often rated as likely to be helpful, but were rarely used in practice. Other simple, cheap and readily available interventions were used the most frequently, but were not the most likely to be rated as helpful. The most consistent predictors across all interventions used were gender, history of treatment, current symptoms and belief in a particular intervention. Of particular interest was the finding that beliefs in the helpfulness of antidepressants predicted their use. However, beliefs were not predictors of use for all interventions. Conclusions: Beliefs about the helpfulness of an intervention did not always predict actual use of that intervention, although beliefs did predict use of antidepressants. Therefore, campaigns that change public beliefs about effective treatments may also influence actual use of treatments. Interventions preferred by professionals are not frequently used at present. Most people with anxiety and depression symptoms rely primarily on simple self-help interventions, the effectiveness of which has been little researched.
The Cost of Being Perfect: Perfectionism and Suicide Ideation in University Students
Authors: Hamilton Teresa K. , Schweitzer Robert D. 
Published: December 2009

Objective: The aim of the study was to assess the relationship between dimensions of perfectionism and suicide ideation in a tertiary student population in Australia. Method: The methodology involved 405 students completing the General Health Questionnaire (GHQ-28) which includes a subset of questions which can be used to assess suicide ideation, and the Multidimensional Perfectionism Scale. Results: The presence of suicide ideation was associated with higher scores on total perfectionism and two perfectionism dimensions, and total GHQ scores. There were significant differences between participants with high levels of perfectionism and participants with moderate to low levels of perfectionism on a measure of suicide ideation. Neither gender nor age were associated with differences in the scores, with results indicating high levels of perfectionism may indicate a vulnerability to suicide ideation. Conclusions: Perfectionism is a valued attribute in high-achieving populations. The question needs to be asked, however, at what cost? The findings indicate that high levels of perfectionism may be associated with an increased vulnerability to suicide ideation. Future research is needed to gain a better understanding of the complex interrelationship between personality and temperament, environmental factors and self-destructive behaviour.
Transsexualism in Female Monozygotic Twins: A Case Report
Authors: Sadeghi Majid , Fakhrai Ali 
Published: December 2009

Objective: A case report is presented of a gender identity disorder involving a pair of female monozygotic twins who requested sex reassignment. As far as we know, this case is the first in psychiatric literature and supports a genetic aetiology of this disorder. Clinical picture: The patients were two 18-year-old female monozygotic twins who had showed symptoms of transsexualism since early childhood. They had no other physical or psychiatric disorder except borderline mental functioning. Treatment: The patients were referred for sex reassignment. Outcome: They were lost to follow up after initial evaluation. Conclusion: In addition to other possible (yet not confirmed) causes of trans-sexualism, a genetic basis for this disorder is suggested by this case.
Effect of Somatic Comorbidity on Alleviation of Depressive Symptoms
Authors: Viinamäki Heimo , Tanskanen Antti , Hintikka Jukka , Haatainen Juha , Antikainen Risto , Honkalampi Kirsi , Haatainen Kaisa , Koivumaa-Honkanen Heli , Saarinen Pirjo , Lehtonen Johannes 
Published: December 2009

Objective: The aim of this study was to investigate whether somatic comorbidity (SC) impedes recovery from depression. Method: The study design was naturalistic. Diagnosis of depression was confirmed by means of the Structured Clinical Interview for DSM-III-R (SCID). Changes in the symptom scales for those patients with somatic comorbidity (n = 75) were compared with corresponding changes in depressive patients without somatic comorbidity (n = 41) in a 6-month follow up. Results: Measured on the Hamilton and Beck scales, recovery rates of those with SC was only slightly lower to that of the others. The difference was statistically significant only in relation to the Hamilton scale. Forty-four per cent of those with SC and 42% of the other patients recovered from their depression (BDI score < 10 on follow up). Logistic regression analysis showed no independent association between recovery and somatic comorbidity. Conclusions: Moderate somatic comorbidity has only a minor effect on recovery from depression.
Issues Associated with the Identification of Cognitive Change Following Coronary Artery Bypass Grafting
Authors: Symes Emma , Maruff Paul , Ajani Andrew , Currie Jon 
Published: December 2009

Objective: Coronary artery bypass grafting (CABG) is a surgical procedure used to treat individuals with ischaemic heart disease and to relieve angina. Disruption to the central nervous system (CNS) has frequently been reported by patients who have undergone CABG. Method: The following paper is a review of the literature that has examined the effects of CABG on the CNS. Results and Conclusions: It becomes apparent that issues about the incidence and severity of post-CABG cognitive decline are still unresolved. First, the cause of post-CABG CNS change has not yet been established, although the presence of changes to brain microvasculature as a result of the presence of microemboli appears to be a likely factor. Second, while some studies have reported high rates of poor performance on neuropsychological tests postoperatively, these reports are often subject to confounds such as variability in postoperative testing intervals, the definition of decline and the neuropsychological test batteries used. Finally, improvements in surgical techniques and changes in patient characteristics may have changed the real nature and prevalence of post-CABG cognitive decline. The review finishes with a series of recommendations for the neuropsychologlical study of CABG.
Attention Deficit Hyperactivity Disorder: Current Progress and Controversies
Authors: Vance Alasdair L. A. , Luk Ernest S. L. 
Published: December 2009

Objective: Attention deficit hyperactivity disorder (ADHD) is a common chronic and disabling condition in children. This paper reviews the taxonomic issues and the major comorbid conditions, neurobiological correlates, treatment and public health issues associated with ADHD. Method: Pertinent recent papers are reviewed from the psychological and psychiatric literature. Results: The two major taxonomies now define a similar group of children with ADHD of a combined type/hyperkinetic disorder. Advances in the understanding and treatment of ADHD demonstrate the complex multidimensional links between neurobiology, psychology and behaviour. Careful assessment of individual factors in treatment planning and ongoing monitoring of psychostimulant medication treatment in the longer term are recommended. Conclusions: There is much still to learn about ADHD, and increased levels of clinical research and treatment resources are required.
Liveliness
Authors: Korner Anthony 
Published: December 2009

Objective: The objective of this study is to explore the significance of the experience of liveliness in psychotherapeutic interactions and its relevance to the practice of psychotherapy. Method: Stern's notion of ‘vitality affects’ and Emde's concept of a ‘primary affective core’ are employed in developing a concept of liveliness, or an enlivening-deadening axis of experience. A critique of Freud's ‘principles of mental functioning’ is made in the light of this concept. Clinical examples are provided as illustrations of the relevance of considering the ‘sense of liveliness’, and its sustainability, in psychotherapy. Results and Conclusions: A sense of liveliness relates closely to activity within a system of interpersonal resonance with non-linear characteristics. The experience of, and responses to, vitality affects may be an important basis of a sense of liveliness. Sudden shifts towards experiences of deadness are a matter for concern in psychotherapy. This sphere of experience, although occurring largely outside verbal awareness, may constitute a distinct type of mental process. Three types of mental activity or process are postulated: (i) emergent, pre-representational activity characterised by the sense of liveliness; (ii) Play-related thought or activity typically experienced as enlivening; and (iii) work-related or adaptational thought or activity.
Community Treatment Orders: Relationship to Clinical Care, Medication Compliance, Behavioural Disturbance and Readmission
Authors: Vaughan Kevin , McConaghy Neil , Wolf Cherry , Myhr Craig , Black Terry 
Published: December 2009

Objective: The objective of this study was to investigate the readmission rate, and the level of patient disturbance and community care associated with readmission following Community Treatment Orders (CTOs) in New South Wales, Australia. Method: The readmission rates of all patients given CTOs within a 4-year period and a matched comparison group were investigated. The following factors were compared before, during and following a CTO: medication non-compliance, number of clinical services and duration of disturbed behaviour preceding hospitalisations. Results: Of 123 patients on CTOs (mean length, 288 days; SD, 210 days), 38 were readmitted during the CTO, the majority in the first 3 months and a further 21 patients were readmitted following termination of the CTO. Evidence of lower severity of illness in the comparison patients prevented meaningful evaluation of the readmission rates of the two groups. While on CTOs, patients receiving depot medications showed high compliance and a significantly reduced readmission rate compared with that of patients receiving oral medications. In the 2 months prior to hospitalisations during CTOs, compared with those before or after CTOs, patients received more frequent consultations and showed a shorter duration of medication non-compliance and disturbed behaviour. The level of services in the 3 months following discharge were comparable for patients on CTOs and the comparison group. Conclusions: CTOs may reduce rehospitalisations by use of depot medication. Earlier and possibly more frequent readmissions in the CTO group shortened the disturbance associated with illness recurrence. It would appear that to establish a control group with equivalent severity of disorder necessary to evaluate the impact of CTOs requires a random allocation design.
Interrater Reliability of the Camberwell Assessment of Need Short Appraisal Schedule
Authors: Andresen Retta , Caputi Peter , Oades Lindsay G. 
Published: December 2009

Objective: Australian mental health policy aims to introduce evidence-based practice within a community care approach. This aim requires reliable measures that can be used by a wide variety of professionals. The interrater reliability of the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) was assessed under routine conditions. Method: Three interviewer-observer dyads assessed the needs of 14 inpatients and 18 day patients of a psychiatric rehabilitation unit in New South Wales, Australia. Results: Agreement on the identification of an area of need was high. However, agreement was higher on patient ratings than on staff ratings. Correlations on staff ratings of met needs were also moderate (r = 0.53), suggesting discrepancies in rating the level of need. Conclusion: Differences in staff ratings may be attributed to ambiguity in the definition of need and levels of need and/or the sources of information used by the rater making the assessment. An approach to establishing an operational definition of need is suggested, and an increase in the number of levels of need is recommended. Implications for Australian mental health policy are noted.
Measuring Disability, Need and Outcome in Australian Community Mental Health Services
Authors: Gallagher Jill , Teesson Maree 
Published: December 2009

Objective: This study trialled routine measurement of disability, need and outcome in mental health services within Sydney. Method: Fifteen community mental health clinicians with a combined caseload of 283 patients participated in the study. The Health of the Nation Outcome Scales (HoNOS) was used to assess disability and outcome and the patient and staff versions of the Camberwell Assessment of Need (CAN) were used to assess need. Results: The HoNOS and CAN appear to be promising contenders for routine use. Patients receiving assertive case management were rated as having higher levels of disability and need than patients receiving standard case management. Significant change in outcome was demonstrated with the HoNOS. Conclusions: To ensure the continued measurement of consumer outcome, issues such as staff education, training, and the development of computerised information systems should be addressed.
Capgras Syndrome: Possibly More Common Among the Maori of New Zealand
Authors: Mackirdy Catherine , Shepherd Debbie 
Published: December 2009

Objective: The report describes an apparently greater incidence of Capgras syndrome among the Maori population compared with the European population, in the most easterly catchment area served by Tauranga Hospital in New Zealand's Bay of Plenty. Method: Over the last year we have become aware of five cases of Capgras syndrome in our catchment area. This area (population nearly 21 000) consists of a rapidly expanding new suburb of the city of Tauranga and a rural area extending 55 km east of the city. These figures were compared with those of the westerly catchment area served by Tauranga Hospital, where the psychiatric team is not aware of any examples of Capgras syndrome among their population. The 1996 census figures were obtained in order to calculate a population ethnicity breakdown. Results: Five cases of Capgras syndrome were identified in the most easterly catchment area where 19% of the population identified as Maori, 75% as European and 6% as other or non-specified. All of the cases occurred in Maori patients. This compares with no identified cases of Capgras syndrome in the most westerly catchment area where 12% of the population identified as Maori, 87% as European and 1% as other or non-specified. Four out of five cases were female. Two cases had a history of cannabis use. Three cases had exhibited dangerous behaviour towards family members. Conclusions: There is an apparently greater incidence of Capgras syndrome among the New Zealand Maori population compared with the European population in the most easterly catchment area served by Tauranga Hospital. In our population Capgras syndrome is a common, not rare, feature of psychotic illness, and the cases support a previously reported association of this syndrome with dangerousness.
Australian and New Zealand Clinical Practice Guidelines for the Treatment of Panic Disorder and Agoraphobia
Authors:   Royal Australian and New Zealand College Of Psychiatrists Clinical Practice Guidelines Team For Panic Disorder And Agoraphobia
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, consulted with practitioners and patients and conducted a meta-analysis of recent outcome research. Treatment recommendations: Education for the patient and significant others covering: (i) the nature and course of panic disorder and agoraphobia; (ii) an explanation of the psychopathology of anxiety, panic and agoraphobia; (iii) rationale for the treatment, likelihood of a positive response, and expected time frame. Cognitive behaviour therapy (CBT) is more effective and more cost-effective than medication. Tricyclic antidepressants (TCAs) and serotonin selective reuptake inhibitors are equal in efficacy and both are to be preferred to benzodiazepines. Treatment choice depends on the skill of the clinician and the patient's circumstances. Drug treatment should be complemented by behaviour therapy. If the response to an adequate trial of a first-line treatment is poor, another evidence-based treatment should be used. A second opinion can be useful. The presence of severe agoraphobia is a negative prognostic indicator, whereas comorbid depression, if properly treated, has no consistent effect on outcome.