bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can We Track the Impact of Australian Mental Health Research?
Authors: Hickie Ian B. , Hickie Ian B. , Christensen Helen , Davenport Tracey A. , Luscombe Georgina M. 
Published: December 2009

Objective: Arguments are being made to increase research and development funding for mental health research in Australia. Consequently, the methods used to measure the results of increased investment require review. This study aimed to describe the status of Australian mental health research and to propose potential methods for tracking changes in research output. Specifically, we describe the research output of nations, Australian states, Australian and New Zealand institutions and Australian and New Zealand researchers using citation rates. Method: Information on research output was sourced from two international databases (Institute for scientific information [ISI] Essential Science Indicators and ISI Web of Science) and the ISI list of Highly Cited Researchers. Results: In an international setting, Australia does not perform as well as other comparable countries such as New Zealand or Canada in terms of research output. Within Australia, the scientific performance of institutions apparently relates to the strength of some individual researchers or consolidated research groups. Highly cited papers are evident in the fields of syndrome definition, epidemiology and epidemiological methods, cognitive science and prognostic or longitudinal studies. Conclusions: Australian researchers need to consider the success of New Zealand and Canadian researchers, particularly given the relatively low investment in health and medical research in New Zealand. Although citation analyses are fraught with difficulties, they can be effectively complemented by other measures of responsiveness to clinical or population needs and community expectations and should be conducted regularly and independently to monitor the status of Australian mental health research.
Low Hospital Inpatient Readmission Rate in Patients with Borderline Personality Disorder: A Naturalistic Study at Southern Health, Victoria, Australia
Authors: Wong Michael T.H. , Wong Michael T.H. , Tye Christine 
Published: December 2009

Objective: To study how the standard management protocol and the special management contract relate to the clinical profile of patients with borderline personality disorder and their hospital admission pattern. Method: A retrospective review was undertaken using naturalistic data from the Client Management Interface over a 2-year period. The standard management protocol patient group and the special treatment contract patient group were compared with respect to variables which included basic demographic data, number of admissions, length of stay and comorbidity. Results: Eighty patients received a diagnosis of borderline personality disorder. The majority (81.2%) were managed with the standard management protocol and only 41.5% had more than one admission. For those who received a special treatment contract (18.8%), 93.3% of them had more than one admission. The special treatment contract group had a significantly higher total number of admissions (p<0.001), a higher number of admissions when they received (p<0.001) and did not receive (p=0.001) a diagnosis of borderline personality disorder, a higher number of comorbidities (p=0.004) but not more presentations to the emergency department. Conclusions: Most patients with borderline personality disorder treated with the standard management protocol had a low readmission rate. The small group of patients with comorbidities managed with a special treatment contract had multiple readmissions but not more crisis presentations to the emergency department. Further studies are required to elucidate the therapeutic mechanism of the standard management protocol and special treatment contract and how that impacts on presentations and admissions to a hospital.
Adverse Mental Health Effects of Cannabis Use in Two Indigenous Communities in Arnhem Land, Northern Territory, Australia: Exploratory Study
Authors: Clough Alan R. , D'abbs Peter , Cairney Sheree , Gray Dennis , Maruff Paul , Parker Robert , O'reilly Bridie 
Published: December 2009

Objective: We investigated adverse mental health effects and their associations with levels of cannabis use among indigenous Australian cannabis users in remote communities in the Northern Territory. Method: Local indigenous health workers and key informants assisted in developing 28 criteria describing mental health symptoms. Five symptom clusters were identified using cluster analysis of data compiled from interviews with 103 cannabis users. Agreement was assessed (method comparison approach, κ-statistic) with a clinician's classification of the 28 criteria into five groups labelled: ‘anxiety’, ‘dependency’, ‘mood’, ‘vegetative’ and ‘psychosis’. Participants were described as showing ‘anxiety’, ‘dependency’ etc., if they reported half or more of the symptoms comprising the cluster. Associations between participants' self-reported cannabis use and each symptom cluster were assessed (logistic regression adjusting for age, sex, other substance use). Results: Agreement between two classifications of 28 criteria into five groups was ‘moderate’ (64%, κ=0.55, p<0.001). When five clusters were combined into three, ‘anxietydependency’, ‘mood-vegetative’ and ‘psychosis’, agreement rose to 71% ( κ=0.56, p<0.001). ‘Anxiety-dependency’ was positively associated with number of ‘cones’ usually smoked per week and this remained significant when adjusted for confounders (p=0.020) and tended to remain significant in those who had never sniffed petrol (p=0.052). Users of more than five cones per week were more likely to display ‘anxiety-dependency’ symptoms than those who used one cone per week (OR=15.8, 1.8–141.2, p=0.013). A crude association between the ‘mood-vegetative’ symptom cluster and number of cones usually smoked per week (p=0.014) also remained statistically significant when adjusted for confounders (p=0.012) but was modified by interactions with petrol sniffing (p=0.116) and alcohol use (p=0.276). There were no associations between cannabis use and ‘psychosis’. Conclusions: Risks for ‘anxiety-dependency’ symptoms in cannabis users increased as their level of use increased. Other plausible mental health effects of cannabis in this population of comparatively new users were probably masked by alcohol use and a history of petrol sniffing.
Samoan and Psychiatrists' Perspectives on the Self: Qualitative Comparison
Authors: Bush Allister , Collings Sunny , Tamasese Kiwi , Waldegrave Charles 
Published: December 2009

Objectives: To compare psychiatrists' perspectives on the meaning of self, in general adult public practice psychiatry in the Wellington region of New Zealand, with a Samoan view of self and to discuss the implications for the practice of psychiatry with Samoan people in New Zealand. Method: A focus group of psychiatrists was convened for three sessions. A Samoan view of self was presented to the participants. Transcripts of the focus groups were analysed using inductive content analysis and a process of cultural accountability was included in the research design. Results: Individual and secular notions of self dominated the psychiatrists' perspectives and contrasted with the primacy of relational and spiritual notions of self in Samoan culture. Psychiatrists experienced a sense of cultural ‘dissonance’ on first exposure to the Samoan views. The Samoan notion of self was considered to challenge the universalist assumptions of Western psychiatric theories as understood by the participants. The Samoan relational notion of self had implications for clinical interviewing, understanding of phenomenology, formulation and treatment planning with Samoan patients and their families. Conclusions: Dedicated Samoan or Pacific Island mental health services would allow culture-specific concepts central to an understanding of mental health to be embedded in service delivery. The process used in this study and the notion of dialectical tension could be used in the cultural education of mental health clinicians. The cultural accountability process models an important aspect of such training.
Adverse Childhood Experiences, Stressful Life Events or Demographic Factors: Which are Important in Women's Depression? A 2-Year Follow-Up Population Study
Authors: Honkalampi Kirsi , Honkalampi Kirsi , Hintikka Jukka , Haatainen Kaisa , Koivumaa-Honkanen Heli , Tanskanen Antti , Viinamäki Heimo 
Published: December 2009

Objective: The aim of this study was to simultaneously test adverse background factors, namely adverse childhood experiences (ACEs), stressful life events and prior depressive symptoms, for their ability to predict recovery and non-recovery from depression in women among the general population. Method: A stratified random sample of women (n=835) from the general population was collected at baseline in 1999. Depression (Beck Depression Inventory, BDI-21), ACEs and background factors were assessed by postal questionnaire at baseline. Two years later, stressful life events during the study phase, social support, use of health services and current depression (BDI≥13) were similarly assessed. Results: Adverse childhood experiences were common among depressed women and these past experiences together with the use of health services were associated with recovery from depression. Financial difficulties and a poor subjective health status associated with non-recovery and current stressful life events increased the likelihood of depression on follow-up. Furthermore, the important variables explaining depression on follow-up were the quality of social support and the existence of prior depressive symptoms at baseline. Conclusions: Our results suggest that women's current depression especially associates with stressful life events, insufficient social support, poor subjective health and financial difficulties. It seems possible that past adverse experiences predispose women to depression, but current stressful events actualize these symptoms. In addition, use of health services are associated with recovery in women who had ACEs.
Considerations in the Management of Bipolar Disorder in Women
Authors: Barnes Caryl , Barnes Caryl , Mitchell Philip 
Published: December 2009

Objective: Recent research has emphasized important gender differences in the epidemiology, course, comorbidity and treatment of bipolar disorder. This article aims to provide an overview of these important findings in order to assist the clinician in treating women with bipolar disorder. Complex issues regarding the treatment of bipolar disorder during pregnancy and the post-partum period are discussed. Method: A literature review was undertaken using Medline (1966–current), PsychInfo and PubMed databases. Search terms used were gender, sex, women, bipolar disorder, suicide, epidemiology, rapid cycling, mixed episode, treatment, mood stabilizers, antidepressants, antipsychotics, pregnancy, post-partum, menopause, lactation and breast-feeding. Results: The lifetime prevalence of bipolar I disorder is equal in men and women; however, bipolar II appears to be more common in women. Gender differences have been reported in the phenomenology, course and outcome of this condition. Some comorbid disorders, such as thyroid disease and anxiety disorders have more relevance to women. Increasingly, sex differences in the pharmacokinetics and pharmacodynamics of medications used in bipolar disorder are being reported. Conclusions: There is increasing evidence for gender differences in a number of clinical features of bipolar disorder that have relevance to management. Although more studies are needed, it is important for clinicians to be aware of these issues to optimize treatment of women with this condition.
Bipolar I and II Disorders in a Random and Representative Australian Population
Authors: Goldney Robert D. , Fisher Laura J. , Dal Grande Eleonora , Taylor Anne W. , Hawthorne Graeme 
Published: December 2009

Objective: To assess the prevalence of bipolar I and II disorders in an Australian population. Method: The Mood Disorder Questionnaire (MDQ) was administered to 3015 respondents in a random and representative sample in South Australia. Health status, quality of life and demographic data were also collected. Results: There was a 2.5% lifetime prevalence of bipolar I and II disorders delineated by the MDQ. Those people had a significantly greater use of services and a poorer health status and quality of life than those who were MDQ-negative. Conclusions: These results in an Australian population are consistent with other international studies showing a greater prevalence of bipolar disorders than hitherto appreciated.
Evidence for a Possibly X-Linked Trait Related to Affective Illness
Authors: Vaillant George E. , Vaillant George E. , Batalden Maren , Orav John , Roston Diane , Barrett James E. 
Published: December 2009

Objective: The present report attempts to replicate on the probands' brothers, a previously reported (1992) negative relationship between maternal grandfather longevity (MGFL) and affective illness in grandsons. Hitherto this finding had not been replicated. To provide further evidence that the association may be recessive and X-linked, we also examined the association between MGFL and affective illness in the probands' mothers. Finally, in order to examine why MGFL might be a predictor of affective illness, the report examines the association of the probands' affective illness and their own mortality. Method: A 60-year prospective study of men selected in 1940 and followed until the present day provided good information on depressive illness in relatives and longevity of ancestors. To overcome the uncertainty of depressive diagnoses, we assessed affective illness in the probands categorically, dimensionally, operationally and with the Lazare Personality Inventory. Results: Presence of affective illness in brothers was negatively associated with MGFL (p=0.003) but maternal affective illness was independent of MGFL. Test items suggesting emotional lability in the probands were significantly and negatively associated with MGFL. Consistent with the association of increased MGFL with low affective distress in the probands, the 70 probands showing the least evidence of affective distress before age 50 had twofold (p<0.001) lower mortality at 80 than the rest of the sample. The 31 probands manifesting the greatest affective distress manifested twofold higher mortality before age 65 (p<0.001) than the rest of the sample. Conclusion: The strong negative association of proband affective distress – and equally important – the positive association of proband mental health with MGFL and the lack of association of maternal longevity and depression with MGFL points to the possibility of a recessive X-gene or genes playing a role in depressive illness.
Screening for Postnatal Depression in Routine Primary Care: Properties of the Edinburgh Postnatal Depression Scale in an Australian sample
Authors: Milgrom Jeannette , Ericksen Jennifer , Negri Lisa , Gemmill Alan W. 
Published: December 2009

Objectives: First, to explore the utility of the Edinburgh Postnatal Depression Scale (EPDS) in routine primary care through a large community screening program. Next, to compare administration of a second EPDS versus the Beck Depression Inventory (BDI) in identifying postnatal depression in the prescreened population. Method: Screening with the EPDS through Maternal and Child Health Centres at 4 months post-partum. Women scoring ≥12 were assessed against DSM-IV criteria and completed a BDI and a second EPDS. These data were subjected to receiver operating characteristic (ROC) analyses. Results: Of 4148 screened, 533 (12.8%) scored ≥12. Of these, 344 were assessed against DSM-IV criteria: 193 (56%) – major depressive disorder; 67 (20%) – other diagnoses that incorporated depression. Positive predictive value at screening was therefore 76%. Another 45 (13%) had non-depressive disorders and 39 (11%) were psychiatric non-cases. The BDI was the better diagnostic instrument in the prescreened population, having a significantly higher efficiency as quantified by ROC curve analysis, though the absolute difference in efficiency was small (approximately 6%). Conclusions: Screening with the EPDS integrated well into routine primary care. Twostep screening offers one way of achieving acceptable balances of operational simplicity and diagnostic accuracy.
Self-Harming in Depressed Patients: Pattern Analysis
Authors: Parker G , Parker G , Malhi Gin. , Mitchell Philip , Kotze Beth , Wilhelm Kay , Parker Kay 
Published: December 2009

Objective: As deliberate self-harm (DSH) is a common concomitant of depressive disorders, we undertook a study examining the relevance of possible determinants and correlates of DSH. Method: Three separate samples of depressed outpatients were studied to determine consistency of identified factors across samples, with principal analyses involving gender, age and diagnosis-matched DSH and non-DSH subjects. Results: Across the samples, some 20% of subjects admitted to episodes of DSH. Women reported higher rates and there was a consistent trend for higher rates in bipolar patients. Univariate analyses examined the relevance of several sociodemographic variables, illicit drug and alcohol use, past deprivational and abusive experiences, past suicidal attempts and disordered personality functioning. Multivariate analyses consistently identified previous suicide attempts and high ‘acting out’ behaviours across the three samples, suggesting the relevance of an externalizing response to stress and poor impulse control. Conclusions: Results assist the identification and management of depressed patients who are at greater risk of DSH behaviours.
Children of a Cohort of Depressed Patients 25 Years on: Identifying Those at Risk
Authors: Peisah Carmelle , Brodaty Henry , Luscombe Georgina , Anstey Kaarin J 
Published: December 2009

Objective: Factors associated with psychological outcome in children of patients with depression have been examined piecemeal, with emphasis on young rather than adult children. We hypothesized that psychological morbidity in adult children of patients with depression would be associated with characteristics of the children, their parents and their family relationships. Method: Factors predicting psychopathology in children (n = 94) of a cohort of patients with depression, admitted to a teaching hospital 25 years earlier, were examined using logistic regression. Results: Psychological morbidity in children was predicted by their being younger at parent's admission, their perception of the depressed parent as more controlling and chronicity of the parent's depression. Correlations between child characteristics, parent illness and family relationship variables showed systemic interactions between parental illness, child psychopathology and family relationships. Conclusion: Chronicity (though neither recurrence nor severity) of parent depression and younger children's age at the time of parental admission for depression were associated with psychological morbidity in the children in adulthood. The interaction between child psychopathology, parental illness and family relationships emphasizes the need for a systemic, family focus in the treatment of depression.
Classification of Somatization and Functional Somatic Symptoms in Primary Care
Authors: Fink Per , Rosendal Marianne , Olesen Frede 
Published: December 2009

Objective: A substantial proportion of patients found in primary care complain of physical symptoms not attributable to any known conventionally defined disorder, that is, medically unexplained or functional somatic symptoms. The objective of this paper is to outline the problems with the current classification and propose a classification more suitable for primary health care. Method: We refer to and discuss relevant literature including papers on our own research on the topic in the light of our experiences from major projects on somatizing patients in primary health care. Results: Functional somatic symptoms may impose severe suffering on the patient and are costly for society because of high health-care utilization, lost working years and social expenses. At present, studies on functional somatic symptoms and disorders and their treatment are hampered by lack of a valid and reliable diagnostic classification. The diagnostic categories of somatoform disorders are overlapping. Thus, the present situation is that patients with identical symptoms and clinical pictures may receive different diagnostic labels depending on the focus of interests of the assessing physician. A particular problem in primary care is that the somatoform diagnostic categories only include persistent cases and do not offer the opportunity for classification of the patients with short-symptom duration found in this setting. We present a framework for a new descriptive classification of functional somatic symptoms and unfounded illness worrying, and outline a new classification that covers the whole spectrum of severity seen in clinical practice. Conclusion: A precondition for an appropriate management of patients with functional somatic symptoms is a valid taxonomy common for all medical specialties facilitating cooperative care. Classification systems as outlined in this paper may be a candidate for such a system, but it should be subject to further evaluation in research.
Psychiatry and Psychosomatic Medicine in Germany: Lessons to be Learned?
Authors: Diefenbacher Albert 
Published: December 2009

Objective: To describe the reshaping of the German system of psychiatric services in the wake of the international social psychiatric movement and the beginnings of separate consultation–liaison (C-L) psychiatry and C-L psychosomatics services, to outline the differences and similarities of these two disciplines, and to see whether there are lessons to be learned from this unique development that may be relevant to other countries. Method: The author draws on material published in German and international publications, and on his experience as co-chair of the Section of Behavioral Medicine and Consultation Liaison Psychiatry of the German Society for Psychiatry, Psychotherapy and Neurology. Results: Consultation–liaison psychiatry services are provided in virtually all German general hospitals, mainly by the medical specialty of psychiatry and psychotherapy and to a lesser extent by the specialty of psychosomatics and psychotherapeutic medicine, exclusively so in 5%. The latter specialty includes non-psychiatric physicians. The unique history of combined neurology and psychiatry training until 1992, and of mandated psychotherapy training in both specialties shapes the service provided but also sets up tensions. Conclusions: Lack of empirical evidence prevents objective assessment of the advantages and/or shortcomings of this two-stranded system, but its existence may sharpen the ongoing debate about how C-L services should be structured in other countries.