bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.
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.
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.