bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychiatric Disorder in Women with Early Stage and Advanced Breast Cancer: a Comparative Analysis
Authors: Kissane David W. , Grabsch Brenda , Love Anthony , Clarke David M. , Bloch Sidney , Smith Graeme C. 
Published: December 2009

Objective: To assess psychosocial morbidity in women with breast cancer and to compare the differential rates between women with early stage and advanced disease. Method: In this report, 303 women with early stage breast cancer, psychiatrically assessed at baseline (as part of a study of cognitive-existential group therapy during adjuvant chemotherapy), are compared with 200 women with advanced breast cancer (similarly assessed in a trial of supportive-expressive group therapy). A structured psychiatric interview plus self-report measures were used to assess psychiatric morbidity, quality of life and cognitive attitude to cancer. Results: The early stage patients, whose mean age was 46 years, were on average 3 months post-surgery and had an overall prevalence of DSM-IV psychiatric diagnosis of 45%. The metastatic patients, whose mean age was 51 years, were on average 63 months post-primary diagnosis and had an overall prevalence of DSM-IV diagnosis of 42%; the difference between the two rates was not statistically significant. Of women with early stage breast cancer, 36.7% had mood disorders, 9.6% suffering from major depression and 27.1% from minor depression. In the metastatic sample 31% had mood disorders, 6.5% having major depression and 24.5% with minor depression. Anxiety disorders were present in 8.6% of the early stage group and 6% of women with advanced disease. Fatigue, a past history of depression, and cognitive attitudes of helplessness, hopelessness or resignation were significantly associated with depression in both groups. The women from the metastatic sample were significantly less distressed by hair loss but more dissatisfied with body image, and had higher rates of lymphoedema and hot flushes than the early stage women. Conclusions: The rates of psychosocial distress are high, and similar, across patients with both early and advanced stage breast cancer, although the illness related causes of distress are different. These data present a challenge to clinical services to provide a comprehensive range of support services to ameliorate this distress.
Self-Esteem in Patients who have Recovered from Psychosis: Profile and Relationship to Quality of Life
Authors: Gureje Oye , Harvey Carol , Herrman Helen 
Published: December 2009

Background: New developments in pharmacotherapy are likely to improve substantially the symptomatic recovery from psychosis but low self-esteem may compromise quality of life. Aims: To investigate the profile and correlates of self-esteem in individuals who have achieved symptomatic recovery from psychosis and determine its relationship with quality of life. Method: Sixty-one individuals who had been free of psychotic symptoms for 6 months were selected during a community-based epidemiological survey of psychoses. Participants were evaluated for subjective assessment of self-esteem using a self-report questionnaire, for clinical and antecedent features of illness, and for quality of life. Results: Forty-three percent had scores in the range indicative of low self-esteem on the questionnaire. Level of self-esteem was unrelated to gender, employment status, the type of psychotic disorder, course of disorder or premorbid social adjustment. Depression was associated with reduced levels of self-esteem. However, independent of depression and other confounding variables, a low level of self-esteem was a risk factor for impaired quality of life. Conclusions: Self-esteem is often low among persons who have achieved symptomatic recovery from psychosis, is associated with depression and is a predictor of quality of life.
Duration of Untreated Psychosis and Treatment Outcome in Schizophrenia Patients Untreated for Many Years
Authors: Srinivasan Tirupati N. , Rangaswamy Thara , Raman Padmavati 
Published: December 2009

Objective: The duration of untreated psychosis (DUP) influences treatment outcome in schizophrenia but its relevance in untreated patients, ill for a very long duration, is not known. This study examined outcome and factors related to it after one year of treatment of schizophrenia patients who were ill for many years and not previously treated. Method: Among 75 never-treated patients with schizophrenia detected in a community survey in Chennai, India, 49 took treatment and were followed up prospectively for one year. Evaluation at intake and outcome was carried out using standardized methods. Results: A good clinical outcome in 29%, social outcome in 35%, occupational outcome in 51% and global outcome in 31% was observed at the end of one year. Patients with poor global outcome did not significantly differ from those with good outcome on demographic and clinical variables at intake but for the presence of delusions and formal thought disorder. The proportion with good outcome in clinical, work and global measures fell steadily with increasing DUP. This difference was significant for clinical and global outcomes after a DUP of 5 years. Conclusions: The relationship between DUP and response to treatment held good even in chronic stages of schizophrenia with longer DUP associated with poorer outcome.
Psychological Trauma: Psychiatry and the Law in Conflict
Authors: Tennant Chris 
Published: December 2009

Objective: To contrast the psychiatric and legal construct of psychological trauma, with posttraumatic stress disorder (PTSD) as the reference disorder. Method: Literature relevant to DSM-IV PTSD definition of a traumatic event (Criterion A) was assessed. This construct was compared with the current legal status for psychological trauma arising from recent judgements of the Australian High Court. Conclusions: The current legal construct of psychological trauma is not only practical and sensible, but is far more evidence-based than the DSM-IV construct of trauma.
‘Kindling Theory’ in Arson: How Dangerous are Firesetters?
Authors: Brett Adam 
Published: December 2009

Objective: This article aims to review the literature on firesetters particularly looking at recidivism rates. The early literature described firesetters as dangerous individuals. This article reviews the more recent empirical data to examine if it supports the early literature. Method: A literature review was performed examining papers which described firesetters with any reference to recidivism. These were divided into three broad categories based on where studies have been performed, namely in forensic psychiatric settings, the criminal justice system and general and psychiatric hospitals. Results: The literature has been poorly focused and provides little help when assessing an individual firesetter. Risk factors associated with general criminology have been cited. Conclusions: The empirical literature cannot support the hypothesis that firesetters are inherently dangerous. More research should target different groups of firesetters and examining individual risk within that group with an aim of researching treatment for the different groups.
Bipolar II Disorder: Personality and Outcome in two Clinical Samples
Authors: Joyce Peter R. , Joyce Peter R. , Luty Suzanne E. , McKenzie Janice M. , Mulder Roger T. , McIntosh Virginia V. , Carter Frances A. , Bulik Cynthia M. , Sullivan Patrick F. 
Published: December 2009

Objective: To compare the personality traits and disorders of patients with bipolar II disorder and major depression and to examine the impact on treatment outcome of a bipolar II diagnosis. Method: Patients from two clinical trials, a depressive sample (n = 195, 10% bipolar II) and a bulimic sample (n = 135, 16% bipolar II), were assessed for personality traits using DSM-IV criteria. Patients were randomised to treatments (fluoxetine or nortriptyline for depressive sample; cognitive behaviour therapy for bulimic sample) and followed for 3 years (depressive sample) or 5 years (bulimic sample) to assess the impact on outcome of a bipolar II diagnosis. Results: Bipolar II patients were assessed as having more borderline, histrionic and schizotypal personality traits than patients with major depression. A baseline bipolar II diagnosis did not impact negatively on treatment outcome, and less than 5% of bipolar II patients developed bipolar I disorder during follow up. Conclusions: The low rate of conversion of bipolar II to bipolar I disorder and the lack of adverse impact of the diagnosis on outcome, questions the need for antimanic or mood stabliser medication in most bipolar II patients.
Length of Therapy with Selective Serotonin Reuptake Inhibitors and Tricyclic Antidepressants in Australia
Authors: Mcmanus Peter , Mcmanus Peter , Mant Andrea , Mitchell Philip , Dudley John 
Published: December 2009

Objective: To investigate the proportion of patients starting on either selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs) who continued treatment for a period consistent with recommended guidelines for major depression, that is at least 6 months. Method: Cohort study using a national dispensing claims database involving patients eligible for social security entitlements in Australia. Two ‘new user’ cohorts were established of patients who were supplied a prescription for either an SSRI (6026) or a TCA (4158) in the first week of April 2000 and who had not received a prescription for any antidepressant in the preceding three months. The main outcome measure was the proportion of patients who were still having any SSRI or TCA prescription, respectively, dispensed between 6 and 8 months after initiation. Additionally, for patients starting on either a leading SSRI (sertraline) or TCA (dothiepin), the proportions of those that remained on these drugs or had changed to other antidepressants were determined. The dispensing data are not linked to reason for prescribing in the national dataset. Results: 2267 SSRI ‘new users’ (38%) were still receiving SSRIs 6–8 months later, compared with 1269 (31%) of the 4158 TCA ‘new users’ (p < 0.001). The difference between the groups occurred early, by the 2–4 month time interval. 1038 (41%) of patients starting on the individual SSRI and 385 (38%) of patients starting on the individual TCA were receiving some type of antidepressant therapy at 6–8 months, with no significant difference (p = 0.6) in the proportions that had changed to another antidepressant. Conclusions: In 2000, only 40% of patients started on an antidepressant continued to be prescribed some antidepressant therapy 6–8 months later. Patients were more likely to continue on SSRIs as a class than on TCAs and the difference in continuation between these two classes occurred within the first 2 months of therapy. However, patients starting on an individual SSRI or TCA were equally likely to change to another antidepressant.
Screening for Depression in Women with Metastatic Breast Cancer: A Comparison of the Beck Depression Inventory Short form and the Hospital Anxiety and Depression Scale
Authors: Love Anthony W. , Grabsch Brenda , Clarke David M. , Bloch Sidney , Kissane David W. 
Published: December 2009

Objective: To compare two self-report questionnaires for identifying possible depression in women with metastatic breast cancer. Method: We conducted structured psychiatric interviews and administered the Beck Depression Inventory Short Form (BDI-SF) and Hospital Anxiety and Depression Scale (HADS) to 227 women with stage IV breast cancer. The accuracy for identifying DSM-IVdefined major and minor depression was examined. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated and receiver operating characteristic curves plotted. Results: Seventy-four (32.6%) patients satisfied DSM-IV criteria for a depressive disorder. With a cut-off of 4, the BDI-SF had a sensitivity of 0.84, specificity of 0.63, and PPV of 0.52. A cut-off of 11 on the HADS-Depression scale (HADS-D) resulted in sensitivity, specificity, and PPV of 0.16, 0.97, and 0.75, respectively. For major depression alone, the BDI-SF with a cut-off of 5 had excellent sensitivity but poor PPV; the HADS, with a cut-off of 7, had weak sensitivity and PPV. Conclusions: Overall, the two scales perform similarly in identifying major depression, while the BDI-SF is the more useful in screening for DSM-IV major or minor depression categories in this clinical group.
Women Psychiatrists and Research: So Far, no Further? An Australasian Perspective on Factors that Encourage and Hinder Women Psychiatrists' Involvement in Research
Authors: Favilla Amanda , Bloch Sidney 
Published: December 2009

Objective: Relatively few women psychiatrists conduct research during their careers. Little is known as to what accounts for this consistent finding. We sought to ascertain factors that might be pertinent among women Fellows of the Royal Australian and New Zealand College of Psychiatrists (RANZCP). Our long-term goal is to identify measures that could boost the proportion of women who become involved in research. Method: We submitted a questionnaire to the 670 women Fellows of the RANZCP in which we asked them whether they participated in research and what factors they considered helpful or detrimental to the pursuit of an interest in research. Results: Of the 375 (56%) respondents, 116 (31%) could be assigned to a researcher group (RG). Members of the RG more often identified features in their professional environment and access to mentors as facilitating research involvement compared to the non-researcher group (NRG). The RG had dedicated more time to research as well as to teaching, and less to clinical practice, compared to the NRG. Although family obligations affected both groups, the RG cited these as exerting less of an impact on their career than their non-researching colleagues. Conclusions: Given the factors that distinguish researching from non-researching Fellows, attention needs to be paid to the ethos of the professional environment, mentoring, and training opportunities in research in order to increase the recruitment of women investigators.
Cognitive Functioning in Young People with First Episode Psychosis: Relationship to Diagnosis and Clinical Characteristics
Authors: Fitzgerald Dianne , Fitzgerald Dianne , Lucas Sara , Redoblado Marie Antoinette , Winter Virginia , Brennan John , Anderson Josephine , Harris Anthony 
Published: December 2009

Objective: To examine the extent and nature of neuropsychological deficits in adolescents and young people with first episode psychosis (FEP), and to determine whether the pattern and extent of neuropsychological deficits varied according to diagnosis. Method: A total of 83 FEP subjects aged 13–25 years, and 31 healthy controls completed a comprehensive battery of neuropsychological tests, grouped into 10 cognitive domains. First episode psychosis subjects were stratified into three diagnostic groups (schizophrenia, affective disorders, substance-induced psychosis) and differences in cognitive profiles were examined. The contribution of demographic and clinical characteristics to cognitive performance was also explored. Results: The schizophrenia group demonstrated significantly worse performance on tasks of verbal learning and memory than the affective disorders group. Compared to healthy controls, the schizophrenia group also demonstrated global impairment across the majority of cognitive domains. The substance-induced group's performance lay between that of the schizophrenia and affective disorders groups. Analyses of differential deficits revealed that verbal learning, verbal memory and current intellectual functioning were selectively impaired in the schizophrenia group, whereas the affective disorders group demonstrated a selective deficit in speeded processing. Premorbid intellectual functioning, negative symptomatology and medication levels were the strongest predictors of cognitive performance in FEP subjects. Conclusions: Verbal memory deficits differentiate individuals with schizophrenia from those with psychotic affective disorders. Although significant cognitive deficits are evident across all diagnostic FEP groups, individuals with schizophrenia appear to have more generalized impairment across a broad array of cognitive functions than other psychotic diagnoses. Lower premorbid intellectual functioning does not appear to contribute to greater cognitive deterioration following onset of psychosis, but severity of illness may be a more important factor than levels of mood disturbance.
Normative Verbal and Non-Verbal Memory Test Scores for Australian Women Aged 56–67
Authors: Clark Margaret S. , Dennerstein Lorraine , Elkadi Shaymaa , Guthrie Janet R. , Bowden Stephen C. , Henderson Victor W. 
Published: December 2009

Objective: To establish normative data for tests of verbal and non-verbal memory for midlife Australian-born women, and in so doing investigate factors which contribute to variation in test performance. Method: Two hundred and fifty-seven healthy women aged 56–67 years (mean age 60), who are participating in the Melbourne Women's Midlife Longitudinal Health Project, were administered two word list learning tasks, a story recall task (the East Boston Memory Test) and the Faces subtest from the Wechsler Memory Scale III as part of a larger neuropsychological battery. Word list learning tasks consisted of either 16 semantically related words, derived from the California Verbal Learning Test II, or a list of 10 unrelated words. Mood was assessed by the Center for Epidemiological Studies Depression questionnaire. Results: Education was significantly related to memory performance and there was a nonsignificant trend for test scores to decline with age. Mood was unrelated to test performance. A confirmatory factor analysis indicated a clear distinction between verbal and non-verbal memory performances. Mean scores were stratified by education (less than 12 years vs. 12 or more years) and age (56–59 vs. 60–67 years), and scaled normative data were constructed for all the tests. Conclusion: This study provides education-based normative data for tests of verbal and non-verbal memory for midlife Australian women. The establishment of population-based normative data will facilitate future investigations of ageing and dementia in Australian women.
The Portrayal of Mental Health and Illness in Australian Non-Fiction Media
Authors: Francis Catherine , Pirkis Jane , Francis Catherine , Pirkis Jane , Blood R. Warwick , Dunt David , Burgess Philip , Morley Belinda , Stewart Andrew , Putnis Peter 
Published: December 2009

Objective: To provide a detailed picture of the extent, nature and quality of portrayal of mental health/illness in Australian non-fiction media. Method: Media items were retrieved from Australian newspaper, television and radio sources over a 1-year period, and identifying/descriptive data extracted from all items. Quality ratings were made on a randomly selected 10% of items, using an instrument based on criteria in Achieving the Balance (a resource designed to promote responsible reporting of mental health/illness). Results: Reporting of mental health/illness was common, with 4351 newspaper, 1237 television and 7801 radio items collected during the study period. Media items most frequently focused on policy/program initiatives in mental health (29.0%), or on causes/ symptoms/treatment of mental illnesses (23.9%). Stories about mental health issues in the context of crime were relatively uncommon, accounting for only 5.6% of items. Most media items were of good quality on eight of the nine dimensions; the exception was that details of appropriate help services were only included in 6.4% of items. Conclusions: In contrast to previous research, the current study found that media reporting of mental health/illness was extensive, generally of good quality and focused less on themes of crime and violence than may have been expected. This is encouraging, since there is evidence that negative media portrayal of mental health/illness can detrimentally affect community attitudes. However, there are still opportunities for improving media reporting of mental health/illness, which should be taken up in future media strategies.
Assessing Cost-Effectiveness – Mental Health: Introduction to the Study and Methods
Authors: Haby Michelle M. , Haby Michelle M. , Carter Rob , Mihalopoulos Cathrine , Magnus Anne , Sanderson Kristy , Andrews Gavin , Vos Theo 
Published: December 2009

Objective: The Assessing Cost-Effectiveness – Mental Health (ACE–MH) study aims to assess from a health sector perspective, whether there are options for change that could improve the effectiveness and efficiency of Australia's current mental health services by directing available resources toward ‘best practice’ cost-effective services. Method: The use of standardized evaluation methods addresses the reservations expressed by many economists about the simplistic use of League Tables based on economic studies confounded by differences in methods, context and setting. The costeffectiveness ratio for each intervention is calculated using economic and epidemiological data. This includes systematic reviews and randomised controlled trials for efficacy, the Australian Surveys of Mental Health and Wellbeing for current practice and a combination of trials and longitudinal studies for adherence. The cost-effectiveness ratios are presented as cost (A$) per disability-adjusted life year (DALY) saved with a 95% uncertainty interval based on Monte Carlo simulation modelling. An assessment of interventions on ‘second filter’ criteria (‘equity’, ‘strength of evidence’, ‘feasibility’ and ‘acceptability to stakeholders’) allows broader concepts of ‘benefit’ to be taken into account, as well as factors that might influence policy judgements in addition to cost-effectiveness ratios. Conclusions: The main limitation of the study is in the translation of the effect size from trials into a change in the DALY disability weight, which required the use of newly developed methods. While comparisons within disorders are valid, comparisons across disorders should be made with caution. A series of articles is planned to present the results.