bluuebunny/crossref_metadata_2025_split huggingface dataset:
Motivational Change in an Inpatient Anorexia Nervosa Population and Implications for Treatment
Authors: Wade Tracey D. , Frayne Anna , Edwards Sally-Anne , Robertson Therese , Gilchrist Peter 
Published: December 2009

Objective: The relationship between motivation and recovery in anorexia nervosa has received increased attention in the research literature although few controlled investigations of increasing motivation in this population exist. Three questions were therefore examined in an inpatient anorexia nervosa population: (i) does baseline motivation predict change in eating pathology; (ii) does change in motivation predict change in eating pathology; and (iii) can we increase motivation to recover in this group? Method: Inpatients (n=47) in a specialist weight disorder unit with a mean age of 21.85 years (SD=5.37) were randomly allocated to receive four sessions of motivational interviewing with a novice therapist in addition to treatment as usual (n=22) or treatment as usual alone (n=25). Assessment of eating pathology and motivation to recover was conducted on three occasions: at admission (baseline), and at 2- and 6 week follow up. Eating pathology was assessed using the Eating Disorder Examination and self-reported motivation was assessed using the Anorexia Nervosa Stages of Change Questionnaire and six Likert scales. Results: Higher baseline motivation across five of the seven measures predicted significant decreases in eating pathology, and increased Anorexia Nervosa Stages of Change Questionnaire scores between baseline and 2 week follow up predicted significant improvement in eating pathology between baseline and 6 week follow up. Significantly more patients were lost to follow up from the treatment as usual compared to the motivational interviewing group. More patients in the motivational interviewing condition moved from low readiness to change at baseline to high readiness to change at 2 and 6 week follow up. Conclusions: Motivation is an important predictor of change in anorexia nervosa and preliminary evidence is provided that motivation can be improved in this population. Further investigations, however, of ways of improving motivation in this population need to be conducted, along with the impact of motivational changes on treatment outcome.
Climate Schools: Alcohol Module: Cross-Validation of a School-Based Prevention Programme for Alcohol Misuse
Authors: Newton Nicola C. , Vogl Laura E. , Teesson Maree , Andrews Gavin 
Published: December 2009

Objective: The aim of the present study was to conduct a cross-validation trial of the efficacy of a computerized school-based intervention for alcohol misuse in adolescents. Method: A cluster randomized control trial was carried out. Intervention and control groups were assessed at baseline, immediately after and 6 months after the intervention. A total of 764 Year 8 students from 10 independent secondary schools in Sydney, Australia participated in the study. Half of the schools were randomly allocated to the computerized prevention programme (n=397), and half to their usual classes (n=367). The six-lesson computerized intervention was evidence and curriculum based while having a focus on harm-minimization. Knowledge, expectancies, alcohol consumption (frequency, quantity and binging), patterns of use, and harms associated with one's own use of alcohol were assessed. Results: There were significant improvements in knowledge regarding alcohol use at immediate and 6 month follow up. Average weekly alcohol consumption was reduced immediately after the intervention. No differences between groups were found on alcohol expectancies, frequency of drinking to excess and harms related to alcohol use over time. Conclusions: The present results support the Climate Management and Treatment Education (CLIMATE) Schools: alcohol module as an effective intervention in increasing alcohol knowledge and reducing alcohol use in the short term.
Confirmatory Factor Analysis of the Parental Bonding Instrument in a Brazilian Female Population
Authors: Terra Luciana , Hauck Simone , Fillipon Ana Paula , Sanchez Patricia , Hirakata Vania , Schestatsky Sidnei , Ceitlin Lucia H. 
Published: December 2009

Objective: The Parental Bonding Instrument (PBI) is a widely used measure of parenting. Recent studies have proposed different factor structures. There is a disagreement in the literature about whether the PBI is best used as a two-factor or a three-factor measure. Method: Two hundred and fifty-seven female adults were recruited from a clinical population (139 psychiatric patients and 118 controls) and were requested to complete the PBI. Maximum likelihood confirmatory factor analyses were performed to compare the five different factor structures in terms of model fit. Results: The poorest fit to the data was obtained by the Parker et al. model. The Kendler model was the only model that had an adjusted goodness-of-fit index >0.8 regarding both paternal and maternal PBI. When considering invariance of factor structure across age subgroups, the Kendler model was also the only acceptable model. Conclusion: Three-factor structures are preferable to two-factor structures. The Kendler model was the only one to provide an acceptable fit, but it must be considered that it was a female sample, and when considering gender subgroups other studies have found the same results. Despite the gender limitation, the present study contributes to a better understanding and use of the PBI in Brazilian samples.
Post-Traumatic Stress Disorder and Health Problems Among Medically Ill Canadian Peacekeeping Veterans
Authors: Richardson J. Don , Pekevski Jordan , Elhai Jon D. 
Published: December 2009

Objective: The aim of the present study was to examine the relationship between post-traumatic stress disorder (PTSD) symptom severity and four significant health conditions (gastrointestinal disorders, musculoskeletal problems, headaches, and cardiovascular problems). Method: Participants included 707 Canadian peacekeeping veterans with service-related disabilities, from a random, national Canadian survey, who had been deployed overseas. Results: PTSD severity was significantly related to gastrointestinal disorders, musculoskeletal problems, and headaches, but not to cardiovascular problems. Controlling for demographic factors did not affect PTSD's relationships with the three significant health conditions. Conclusions: The present study supports previous work in finding consistent relations between PTSD severity and specific types of medical problems.
Changing Utilization of Pro Re Nata (‘As Needed’) Sedation in a Child and Adolescent Psychiatric Inpatient Unit
Authors: Dean Angela J. , McDermott Brett M. , Scott James 
Published: December 2009

Objective: The primary purpose of the present study was to examine changes in utilization of pro re nata (PRN; ‘as required’) sedation over time within a child and adolescent psychiatric inpatient unit. The secondary purpose was to assess whether changes in PRN sedation were related to changing patient characteristics. Methods: A retrospective chart review examined 257 medical charts from a child and youth mental health inpatient service over two time periods (wave I, n = 122; wave II, n = 135) and collected data on PRN sedation, patient characteristics and routine medications. Results: Over time a significant reduction was observed in the proportion of patients prescribed PRN sedation from 70% to 54% (p < 0.01), and a reduction in the proportion of patients given PRN sedation from 46% to 26% (p < 0.01). The most commonly administered drug was chlorpromazine in wave I, and diazepam in wave II. Multivariate analysis indicated that reductions in PRN sedation occurred independently of changes in patient characteristics. Conclusions: High utilization rates of PRN sedation are not inevitable in a child and adolescent psychiatric inpatient unit and may be reduced over time. Changing utilization of PRN sedation occurred independently from changing patient characteristics. More treatment outcome studies are required to optimize use of PRN sedation in young people.
Anterior Hippocampus in Schizophrenia Pathogenesis: Molecular Evidence from a Proteome Study
Authors: Nesvaderani Maryam , Matsumoto Izuru , Sivagnanasundaram Sinthuja 
Published: December 2009

Objective: The purpose of the present study was to identify differentially expressed proteins in the anterior and posterior hippocampus of brains of schizophrenia patients compared to neurologically healthy controls. Method: Proteins extracted from fresh frozen post-mortem posterior and anterior hippocampus for nine schizophrenia and nine control individuals, and seven schizophrenia and seven control individuals, respectively, were screened for differential expression using 2-D gel electrophoresis and mass spectrometry. Results: A significantly larger number of protein spots were differentially expressed in the anterior (n = 43) compared to the posterior (n = 16) hippocampus, representing 34 and 14 unique proteins, respectively. These proteins are involved in cytoskeleton structure and function, neurotransmission and mitochondrial function. Conclusion: Based on the aberrant protein expression profiles, the anterior hippocampus appears to be more involved in schizophrenia pathogenesis than the posterior hippocampus. Furthermore, consistent with previous findings, we found molecular evidence to support abnormal neuronal cytoarchitecture and function, neurotransmission and mitochondrial function in the schizophrenia hippocampus.
Validation of an Australian Sign Language Instrument of Outcome Measurement for Adults in Mental Health Settings
Authors: Munro Louise , Rodwell John 
Published: December 2009

Objective: There are currently no adult mental health outcome measures that have been translated into Australian sign language (Auslan). Without a valid and reliable Auslan outcome measure, empirical research into the efficacy of mental health interventions for sign language users is unattainable. To address this research problem the Outcome Rating Scale (ORS), a measure of general functioning, was translated into Auslan and recorded on to digital video disk for use in clinical settings. The purpose of the present study was therefore to examine the reliability, validity and acceptability of an Auslan version of the ORS (ORS-Auslan). Method: The ORS-Auslan was administered to 44 deaf people who use Auslan as their first language and who identify as members of a deaf community (termed ‘Deaf’ people) on their first presentation to a mental health or counselling facility and to 55 Deaf people in the general community. The community sample also completed an Auslan version of the Depression Anxiety Stress Scale-21 (DASS-21). Results: t-Tests indicated significant differences between the mean scores for the clinical and community sample. Internal consistency was acceptable given the low number of items in the ORS-Auslan. Construct validity was established by significant correlations between total scores on the DASS-21-Auslan and ORS-Auslan. Acceptability of ORS-Auslan was evident in the completion rate of 93% compared with 63% for DASS-21-Auslan. Conclusions: This is the only Auslan outcome measure available that can be used across a wide variety of mental health and clinical settings. The ORS-Auslan provides mental health clinicians with a reliable and valid, brief measure of general functioning that can significantly distinguish between clinical and non-clinical presentations for members of the Deaf community.
Management of Depression by General Practitioners: Impact of Physician Gender
Authors: Parker Gordon B. , Hyett Matthew P. 
Published: December 2009

Objective: The aim of the present study was to determine whether anecdotal claims of gender differences in the treatment of depression by general practitioners (GPs) existed in practice. Method: Referral letters from 100 GPs to a specialized psychiatric depression clinic were analysed by word count and gender of referrer. Second, a Web-based survey of 517 participants examined the impact of GP gender in terms of levels of management nuances. Results: The first study established that female GPs wrote distinctly longer referral letters. The second study identified that female GPs were seen as distinctly more caring over a range of parameters and identified the impact of some GP–patient gender differences. Conclusions: Reasons why female GPs are viewed as more caring – and any impact on the management of those with a depressive disorder – would benefit from refined investigation.
2004 Tsunami: Long-Term Psychological Consequences for Swiss Tourists in the Area at the Time of the Disaster
Authors: Kraemer Bernd , Wittmann Lutz , Jenewein Josef , Schnyder Ulrich 
Published: December 2009

Objective: Most of the data on psychological outcome and the mental health treatment available following natural disasters originate from the indigenous population of the region destroyed. Examining tourists returning from the area affected by the 2004 tsunami presents an opportunity of studying the impact of natural disasters on psychological outcome and mental health treatment in their countries of origin. The aim of the present study was to extend the current knowledge on psychiatric morbidity and potential positive outcomes, as well as subsequent mental health treatment following a natural disaster, based on the results from a sample of home-coming Swiss tourists. Method: Tourists who had been potentially affected by the 2004 tsunami were assessed using the Post-traumatic Diagnostic Scale, the Hospital Anxiety and Depression Scale, and the Post-traumatic Growth Inventory. Outcome variables were related to the degree of tsunami exposure. In addition, mental health treatment before and after the tsunami was assessed. Results: Of the 342 respondents, 55 (16.8%) fulfilled the criteria of post-traumatic stress disorder (PTSD). Evidence of anxiety or depressive disorder was found in 17.8% and 8.0%, respectively. The tsunami victims who had been directly affected showed significantly more symptoms of anxiety, depression and PTSD, as well as post-traumatic personal growth, than tourists who were indirectly affected or unaffected. A total of 12.3% of untreated respondents fulfilled the criteria for PTSD and 38% of respondents who had received psychiatric treatment were still fulfilling PTSD criteria 2½ years after the tsunami. Conclusion: A marked percentage of respondents reported symptoms of PTSD but they remained untreated or were treated insufficiently. We recommend that tourists returning from regions affected by natural disasters be informed about PTSD and that careful screening be given to those found to be at risk of PTSD. An open-door policy of mental health services is particularly needed for tourists returning home who have been affected by large-scale disasters.
Effectiveness of Psychoanalytic Psychotherapy for Adolescents with Serious Mental Illness: 12 Month Naturalistic Follow-Up Study
Authors: Tonge Bruce John , Pullen Jill Marie , Hughes Georgina Catherine , Beaufoy Jeanette 
Published: December 2009

Objective: The aim of this naturalistic longitudinal study was to examine the effectiveness of individual psychoanalytic psychotherapy in reducing symptoms and improving overall functioning for adolescents with severe mental illness beyond the changes observed with treatment as usual. Changes to family functioning were also examined. Method: Participants at 12 month follow up were 55 of an initial group of 80 Child and Adolescent Mental Health Services patients with complex, severe mental illness (32 female, mean age = 15.11 years). At initial assessment 40 participants were offered psychoanalytic psychotherapy when a psychotherapist became available; 23 accepted and received once- or twice-weekly psychoanalytic psychotherapy for 4–12 months. Out of the initial 57 participants who received Child and Adolescent Mental Health Services treatment as usual, 33 were reassessed at 12 months. Self-reported depressive symptoms, parent-reported social and attention problems and researcher-evaluated overall functioning and family functioning were measured at initial assessment and 12 months later. Results: At 12 months, psychotherapy was associated with a greater reduction in depressive, social and attention problems than treatment as usual, alone, if these problems were initially in the clinical range. There was no effect on participant overall functioning or family functioning. Conclusions: This naturally occurring sample of seriously ill adolescents referred to Child and Adolescent Mental Health Services for assessment were suffering complex mental illness and poor mental health. Empirical evidence is presented that psychoanalytic psychotherapy is an effective addition to Child and Adolescent Mental Health Services treatment as usual for mental illness in adolescence, particularly for more severe and complex cases. The naturalistic study design and participant attrition are possible study limitations.
Sleepwalking in Psychiatric Patients: Comparison of Childhood and Adult Onset
Authors: Lam Siu-Ping , Fong Samson Yat-Yuk , Yu Mandy Wai-Man , Li Shirley Xin , Wing Yun-Kwok 
Published: December 2009

Objectives: In contrast to the ‘benign and self-limiting nature’ of childhood sleepwalking, some population and case studies have suggested that adult sleepwalking is more likely to be associated with psychopathology and psychotropic medications. There is a paucity, however, of systematic study in adult psychiatric populations, and the aim of the present study was therefore to compare the impact of psychopathology and medication usage on sleepwalking with reference to age of onset. Methods: Clinical characteristics, sleep symptoms, psychiatric diagnosis and psychotropic usage in 66 childhood- and adult-onset sleepwalkers as identified from a psychiatric clinic, were studied. Results: There was a higher proportion of adult-onset sleepwalking in the psychiatric population. In comparison with childhood-onset sleepwalkers, adult-onset sleepwalkers had higher peak frequency of attacks and a high comorbidity with sleep-related eating features. Factors including frequent insomnia (odds ratio (OR) = 5.39, 95% confidence interval (CI) = 1.58–18.40, p = 0.007) and lifetime usage of regular zolpidem (OR = 5.58, 95%CI = 1.65–18.84, p < 0.006) were associated with a higher risk of adult-onset sleepwalking. Conclusions: Adult-onset sleepwalking in a psychiatric sample has unique clinical characteristics and specific risk factors. These patients were more likely to present with sleep-related eating features, comorbid insomnia, had and lifetime usage of non-benzodiazepine hypnotics, especially zolpidem. A heightened awareness of the presence of sleepwalking and their associated risk factors among the adult psychiatric population is needed.
Reliability of Psychiatric Evidence in Serious Criminal Matters: Fitness to Stand Trial and the Defence of Mental Illness
Authors: Large Matthew , Nielssen Olav , Elliott Gordon 
Published: December 2009

Objective: The criminal justice system relies on the opinions of expert witness to assist in decisions about fitness to stand trial (FST) and verdicts of not guilty by reason of mental illness (NGMI). The aim of the present study was to assess the level of agreement between experts about these legal issues using a consecutive series of serious criminal matters in New South Wales. Methods: Pairs of reports from 110 consecutive criminal matters completed by the New South Wales Office of the Director of Public Prosecutions between 2005 and 2007 were examined. The opinions of experts about FST and NGMI were recorded. Results: Agreement about FST was fair–moderate (experts engaged by opposite sides, κ = 0.293; experts engaged by the same side, κ = 0.471), although there was a higher level of agreement in homicide matters. Agreement about NGMI was moderate–good (experts engaged by opposite sides, κ = 0.508; experts engaged by the same side, κ = 0.644) and there was a higher level of agreement when the experts also agreed about the diagnosis of schizophrenia. Further analysis using generalized estimating equations did not find a higher level of agreement about FST or NGMI in pairs of reports containing the opinion of experts from the same side. Conclusions: Little evidence was found for bias in expert opinions about either FST or NGMI, but the comparatively low level of agreement about FST suggests the need for reform in the way that FST is assessed.
More Us Than Them: Positive Depictions of Mental Illness on Australian Television News
Authors: Henson Connie , Chapman Simon , McLeod Lachlan , Johnson Natalie , McGeechan Kevin , Hickie Ian 
Published: December 2009

Objective: The aim of the present study was to review television news coverage of mental illness including self-depictions from people with mental illness, and views expressed by mental health experts and politicians in all 538 news and current affairs items related to mental illness broadcast on free-to-air Sydney television, May 2005–October 2007. Methods: Content and frame analysis was done of news actors (those with mental illnesses, experts and politicians) of whether depictions were positive ‘one of us’, or negative ‘one of them’. Results: Only 6% of all items with a main focus on a specific health condition, focused on mental health. Individuals with mental illness were present in 264 (49%) of 538 items, with most (174, 66%) of these self-depictions categorized as either neutral or positive. Experts and politicians overwhelmingly represented and described people with mental illnesses in neutral or positive ways (95% and 84%, respectively). Overall news angle included 299 items (55%), which were categorized as positive ‘recovery focused’ items. Another 156 items (29%) were neutral, and 62 items (12%) were classified as negative. Twenty-one (4%) had unclear or mixed themes. Conclusions: The present findings differ from previous descriptions of media depiction of mental illness, which have been largely negative. The present study provides support for the importance of involving those with histories of mental illness in news coverage.
Evaluation of Treatment in 35 Cases of Bipolar Suicide
Authors: Keks Nicholas A. , Hill Christine , Sundram Suresh , Graham Annette , Bellingham Kylee , Dean Brian , Opeskin Ken , Dorissa Arrigo , Copolov David L. 
Published: December 2009

Objective: The aim of the present study was to evaluate clinical factors relevant to suicide prevention (including treatment) in cases of bipolar suicide with available therapeutic histories. Method: Victorian Coroner's Office data enabled identification of suicides that occurred between March 1993 and December 2001. Cases involving sufficient clinical notes to enable diagnosis of DSM-IV bipolar disorder and review of treatment were de-identified and assessed by an expert clinical panel. Results: From 3752 suicides, 35 eligible bipolar subjects (22 men, 13 women) aged 40.3±1.8 years were identified. Duration of illness was 11.9±1.1 years. A total of 86% had made at least one previous suicide attempt, and 83% were in the depressed phase of illness. A total of 63% manifested psychosis at some time during lifetime illness. Fourteen per cent were inpatients, and 26% suicided within 6weeks of hospital discharge. The panel's retrospective risk assessment concluded that only 48% of cases could have been assessed as high risk. In the 4 weeks prior to suicide, treatment was rated as not reaching benchmark standards in 60% of cases. Electroconvulsive therapy had been given to 11%, lithium to 43% (but definitely therapeutic in only 11%), 31% had never been treated with lithium, and psychosocial interventions did not reach adequate standards in 57% during the previous year. Conclusions: In the majority of bipolar suicide cases in the present case series the subjects did not receive treatment at or above a benchmark standard, often due to illness and situational factors, but also possibly due to inadequate clinical interventions. Strategies to improve treatment may reduce suicide in bipolar disorder.