bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hyperactivity of Associations in Psychosis
Authors: Miller Robert 
Published: November 2007

Disordered associative processes have long been regarded as central to the psychological description of psychotic states such as acute schizophrenia. Previous work is briefly summarised concerning the idea that hyperactive associative processes of thought underlie many of the symptoms of psychosis. The idea is developed further, with respect to several features of the psychotic state. Schneiderian symptoms are seenas a consequence of hyperactive associations of thought, combined with perceptual hypersensitivity characteristic of many psychotic individuals. Anxiety in psychotic states is seen as arising from the great ambiguity of mental images when associations are loosened. A vicious circle between high anxiety and hyperactive associations is postulated. The slow and variable response to neuroleptic treatment is seen as being determined in part by the dynamics of change of the memories acquired during a period of hyperactive associations. This essay has dealt exclusively with the positive (productive) symptoms of psychosis, and their treatment. It has briefly traced the origin of the idea that hyperactive associations of thought (i.e. of inductive inference) play an important part in the psychology of acute psychosis. Further it has attempted to show that this idea can be extended to give an account of Schneiderian symptoms, the high anxiety levels commonly found in acute psychosis, as well as the great variability in the rate and extent of response to drug treatment. The negative symptoms of schizophrenia are not included in the discussion. Some of these symptoms are not responsive to neuroleptic drugs. This leads one to suspect that other pathological processes in addition to those discussed above may be involved in the genesis of the negative symptoms.
Biologism in Psychiatry
Authors: Silove Derrick 
Published: November 2007

A recent study visit to North America impressed on me the seriousness with which Australian psychiatry should consider the recent ideological shift in the USA to an extreme biological model of mental disorders [1]. There is increasing evidence that proponents of this model are not simply promoting the value of biological research (with which few psychiatrists would quibble), but that the field is at risk of being overwhelmed by a reductionistic “biologism” which assumes an organic causation for all abnormal human behaviour. Australian and New Zealand Journal of Psychiatry 1190; 24: 461–463
An International Perspective on Bereavement Related Concepts
Authors: Middleton Warwick , Moylan Ann , Raphael Beverley , Burnett Paul , Martinek Nada 
Published: November 2007

This paper reports on part of a study which was aimed at assessing the views of leading researchers, theorists or clinicians working in the field of bereavement on key issues including, as reported here, concepts of different forms of grief as well as favoured theoretical orientations. Of a range of conceptual models the most favoured, by a large margin, were attachment theory and the psychodynamic model. The views of the “experts’ were canvassed with respect to the use of seven selected terms used to denote some variant of the grieving process. There was, on the part of the respondents, reasonable support for the syndromes of “delayed’, “chronic’, “anticipatory’ and “absent’ grief. “Inhibited’ and “unresolved’ grief tended to be described using one of the four terms already supported, while the use of the term “distorted grief’ attracted little support.
Workforce Deployment: Reconciling Demands and Resources
Authors: Andrews Gavin 
Published: November 2007

Objective: The purpose of the study was to review the information in a Consultancy prepared for the National Mental Health Policy which suggested that half of the people with serious mental illnesses were untreated, while persons with “mental problems” were being overserviced by the specialist mental health services. The fate of the large group of persons with mental disorders of mid-range severity was not addressed. Method: Epidemiological data was reconciled with the service patterns of the clinical workforce and the extent of the unmet need estimated. Results: It was estimated that 25–30% of the Australian population meet criteria for a mental disorder in any year, yet less than one third will receive treatment. Of those that are treated, three quarters will receive their treatment from general practitioners and the remaining quarter will be treated by either the public mental health services, the addiction services, or private psychiatrists. The problem is that less than one half of those with serious mental disorders and only two thirds of those with chronic and disabling disorders appear to be being treated by anyone. Even if there were no slippage of services away from these serious and chronic groups of patients, there would still be a workforce shortfall, especially in rural and remote areas. Conclusions: Strategies to remedy this shortfall that involve psychiatrists, clinical psychologists and general practitioners are noted, and the need for a National Mental Health Survey to provide accurate data is stressed.
The Relationship between Social Factors and Frequent Use of Psychiatric Services
Authors: Kent Suzanne , Yellowlees Peter 
Published: November 2007

The purpose of the study was to develop a comprehensive demographic, diagnostic and social profile of patients who are heavy service users of hospital and community based services within the South Australian Mental Health Services (SAMHS). This paper concentrates on the relationship of social issues to heavy service use. The 50 heaviest users of public adult acute psychiatric services in a defined catchment area of Adelaide were identified. Data were obtained retrospectively from the case notes over a 3 year study period. All patients' primary therapists were interviewed, as were 35 of the patients. These structured interviews included a variety of psychosocial rating scales investigating disability and social networks. The 50 patients studied were found to be seriously disabled by chronic psychiatric illness, with substance abuse often complicating their management and their ability to live successfully in the community. The study confirms the emergence in the literature of a valid global profile of the heavy service user patient, and indicates that social factors are strongly related to heavy service use.
A Community Study of Preschool Behaviour Disorder in New Zealand
Authors: Pavuluri Mani N. , Luk Siu-Luen , Clarkson John , McGee Rob 
Published: November 2007

A two stage epidemiological study of 320 children aged between 2.5 and 5 years of age, from eight randomly selected preschool centres, was performed in order (1) to test the psychometrics of the Behaviour Check List (BCL), a parent report instrument for preschool children, (2) to estimate the prevalence, and (3) to describe the correlates of preschool behaviour disorder. After the initial screening using the BCL, the Hyperactivity Scale (HAS) and the Internalising Disorder Scale (IDS), parents were interviewed using the Behaviour Screening Questionnaire (BSQ); the children were examined using the Rutter and Graham's interview. Data was also collected on family functioning, maternal mental health, social adversity, development, physical health and perinatal history. The BCL was found to be a reliable and valid screening measure. A cut off point of 8+ was established for New Zealand preschoolers; this is lower than that in the UK sample, illustrating the importance of retesting the instruments in a different culture. The prevalence rate of behaviour problems based on clinical diagnosis was 22.5%. Results of logistic regression analysis showed that poor family functioning, poor maternal mental health and parental separation were associated significantly with behaviour disorder. This study emphasises the need to identify preschool behaviour disorder and associated risk factors to enable an early intervention.
Ethnic Differences in the Utilisation of Public Psychiatric Services in An Area of Suburban Melbourne
Authors: Trauer Tom 
Published: November 2007

Objective: The main aim of this study was to compare levels of service use by English and non-English speaking background people. Method: A comparison of service use in 1991/1992 between clients of English speaking (ESB) and non English-speaking (NESB) background was undertaken using hospital inpatient statistics, community mental health centre contact data, interpreter usage figures, and the 1991 Australian census. Results: The main findings indicated: (a) longer median lengths of stay of NESB than ESB inpatients; (b) roughly equal involuntary hospitalisation rates between ESB and NESB residents, but significantly lower rates of voluntary hospitalisation for NESB residents; (c) NESB face-to-face clinic contacts significantly shorter (by between five to ten minutes) than ESB; and (d) variable and generally low use of interpreters. No significant associations between ethnicity, legal status and gender were found. There were limitations in the available data and conclusions could be drawn only with caution. Conclusions: Recommendations include better routine collection of ethnically relevant information, and measures designed to improve the acceptability and accessibility of inpatient services.
Victims of Violence in Fiji
Authors: Pridmore Saxby , Ryan Kim , Blizzard Leigh 
Published: November 2007

Objective: The aim of the paper is to examine the statistics for violence performed by self or others in Fiji during the period 1969–1989 in the following sub-classifications: (1) fatal vs non-fatal; (2) Fijian vs Indian; and (3) male vs female. Method: Crude rates per 100,000 were determined and the data sets were statistically examined. Results: (1) Violence by self, which includes suicide and non-fatal injury by self, has significantly increased; (2) Indian violence by self has increased in both males and females; (3) suicide is 4 times more common than homicide, whereas non-fatal injury by others is 4 times more common than non-fatal injury by self; (4) non-fatal injury by self is 8 times more common than suicide, whereas non-fatal injury by others is over 100 times more common than homicide; (5) Indian violence by self is 6 times more common than Fijian violence by self, whereas Fijians experience violence by others 2.5 times more commonly than Indians; (6) female violence by self is 1.5 times more common than male violence by self, whereas male violence by others is 3 times more common than female violence by others; (7) the rates of suicide and homicide are low by international standards; and (8) Fijian violence by self is particularly low, but consistent with the low suicide rate of the indigenous populations in surrounding geographical regions. Conclusion: Our findings suggest that racial differences in violence are likely to be due to cultural factors.
Arguments for and against Teaching Suicide Prevention in Schools
Authors: Hazell Philip , King Ray 
Published: November 2007

A paper based on a workshop presented to the Suicide Prevention Australia conference, ‘Suicide. Who Cares?’, on 15 March 1995 in Sydney Objective: To present arguments for and against the provision of curriculum-based suicide prevention programs in schools. Method: The authors developed their arguments independently, based on the available literature on school-based programs, prior to debating the topic at a national conference on suicide prevention. Results: The rationale for school-based programs is that the school has the responsibility: to resolve problems that interfere with education; to teach health education; and to acknowledge a duty of care to parents and to the community as well as to youth. Primary prevention programs in schools are not aimed at so-called ‘at-risk’ students, but potential ‘helpers’, based on the knowledge that peers are a primary support for troubled adolescents. One measure of the efficacy of school-based prevention programs must be the extent to which there is an increase in the tendency for adolescents to turn to adults for help. There is ample evidence that increasing the tendency for adolescents to approach adults for help is achievable. The argument against such programs is that evidence from evaluation research suggests that they are ineffective, inefficient, not universally acceptable, and of questionable safety. Conclusions: Those persuaded by the positive argument will wish to see these programs adopted in all Australian secondary schools. Those persuaded by the negative argument will recommend that suicide prevention resources be allocated to activities other than school-based suicide education programs.
Group Peer Review: A Questionnaire-Based Survey
Authors: Beatson Josephine , Rushford Nola , Halasz George , Lancaster Jeanette , Prager Shirley 
Published: November 2007

Objective: This paper presents the findings from a questionnaire-based survey of psychiatrists designed to elucidate the positive and negative aspects of group peer review and its perceived place in accountability procedures, and to provide information about how accountability through group peer review might be improved. Method: Three hundred and eighty-eight psychiatrists were surveyed via mail-out questionnaire. Demographic data, details of groups, and perceptions of beneficial and detrimental effects of group peer review were sought from group participants and non-participants. Attitudes of participants were compared with those of non-participants. Features of groups related to satisfaction in participants were examined. Results: The majority of the 170 respondents participating in groups regarded peer review as a means of maintaining and improving skills, sharing ideas and methods, receiving constructive criticism and feedback, of educational benefit and an important source of professional accountability. Non-participants, while less positive overall, responded equally that participation in peer review groups would be an effective response to accountability procedures. Potential detrimental effects and problems with the functioning of peer review groups were elucidated. Conclusions: Group peer review contributes significantly to professional accountability and education in well-functioning groups. Further strategies for the facilitation of group functioning and for the processing of problems arising in group peer review need to be developed to optimise its contribution to the maintenance and improvement of professional standards.
Recruitment and Retention of Psychiatrists in Non-Metropolitan Public Positions in Queensland: Research on ‘Queensland Health's Response’
Authors: Emmerson Brett , Brown Peggy , Whiteford Harvey , McVie Ness , Kuipers Willem 
Published: November 2007

Objective: To evaluate Queensland Health's recruitment campaign of 15 full-time psychiatrists to non-metropolitan areas between July 1992 and December 1993. Method: A detailed 170-item Likert-type questionnaire was designed and mailed to all 15 psychiatrists. Thirteen questionnaires were completed and followed-up by a face to face interview. Results: Findings indicate that most of those recruited were experienced senior specialists who came to the positions as result of personal contact and were attracted to non-metropolitan positions because of ‘lifestyle’ and ‘professional challenge’ variables. ‘Lifestyle’ and ‘professional’ variables were identified as major contributors to their retention. They reported that ‘bureaucracy’ and ‘social and family’ reasons would be the most likely cause of them considering leaving their current positions. Conclusions: While the recruitment campaign was evaluated as successful, some aspects were clearly more influential than others. It was noted that factors which were likely to influence psychiatrists to leave non-metropolitan public sector positions were more ‘public’ than ‘non-metropolitan’ in nature.
Bipolar Disorder following a Stroke Involving the Left Hemisphere
Authors: Liu Chia-Yih , Wang Shuu-Jiun , Fuh Jong-Ling , Yang Yong-Yi , Liu Hsiu-Chih 
Published: November 2007

Objective: Post-stroke mania has rarely been noted and researched, and reported cases have mostly involved the non-dominant hemisphere. In this paper, we report a case of bipolar disorder secondary to a stroke over the dominant hemisphere. Clinical picture: A 48-year-old, right-handed man had a cerebral infarct over the left temporal region. He became depressed after the stroke, and 4 months later developed a manic episode. Treatment: The patient was treated with haloperidol and lorazepam. Outcome: The symptoms subsided within 2 months after treatment. Conclusions: It is premature to consider mania to be a syndrome of the right, or non-dominant, hemisphere. We suggest that further study focusing on specific anatomical regions, rather than laterality, will help to elucidate the interrelationship between mood and brain function.
The Mental Health Status of Adolescents Released from Custody: A Preliminary Study
Authors: Kosky Robert John , Sawyer Michael Gifford , Fotheringham Michael 
Published: November 2007

Objective: To describe the prevalence of mental health problems and the social circumstances of young offenders after their release from custody in a juvenile detention centre. Method: The subjects were 37 adolescents from an original sample of 101 adolescents who had been remanded in a juvenile detention centre in Adelaide, South Australia. The adolescents were evaluated at the time of their initial detention in custody and again 1 year later. Results: The adolescents reported having a large number of social and mental health problems after their release from custody. One year after their release, 32% of the adolescents scored above the recommended ‘cut off score on the Youth Self Report. This represents a rate of disorder three to four times higher than that reported by adolescents in the community and is comparable to the rate reported by adolescents attending mental health clinics. Conclusions: Adolescents remanded in juvenile detention centres experience continuing mental health problems after their release from custody. As well, they experience considerable social dysfunction. There is an urgent need for more active therapeutic follow-up of these young people.
The Inter-Rater and Test-Retest Reliabilities of Prodromal Symptoms in First-Episode Psychosis
Authors: Jackson Henry J. , McGorry Patrick D. , Harrigan Susan , Dakis Jenepher , Henry Lisa , Mihalopoulos Cathy 
Published: November 2007

Objective: As part of the DSM-IV field trial for psychotic disorders, the authors endeavoured to determine the reliability of the DSM-IV prodromal features for schizophrenia in a first-episode sample. Method: Fifty first-episode psychotic patients were assessed using a semi-structured instrument to determine the presence/absence of nine prodromal symptoms. Inter-rater reliability data were calculated for 25 of the patients, and test-retest data were calculated for the remaining 25 patients. Results: Levels of reliability were poor. Conclusions: The results lend some support to American Psychiatric Association and World Health Organization decisions to omit specific criteria for prodromal features from their respective nosologies.
Casemix and Affective Disorders: A Comparison of Private and Public Psychiatric Systems
Authors: Goldney Robert D. , Kent Penny , Elzinga Robert H. 
Published: November 2007

Objective: To determine whether there is a difference in length of stay for patients with affective disorders between private and public psychiatric hospitals. Method: The casemix Australian national diagnosis-related group (AN-DRG) diagnoses of all inpatient separations from private and public psychiatric hospitals in South Australia for 1 year were abstracted from records. The average length of stay for patients with affective disorders was calculated. Results: There was no significant difference in the average length of stay for patients with affective disorders treated in private and public psychiatric hospitals. Conclusions: These results should allay fears that the treatment of patients with affective disorders in any particular treatment setting will be compromised by the introduction of casemix.
Access to Firearms and the Risk of Suicide: A Case Control Study
Authors: Beautrais Annette L. , Joyce Peter R. , Mulder Roger T. 
Published: November 2007

Objective: This study examined the association between access to a firearm and risk of suicide in a consecutive sample of individuals who had made serious suicide attempts. Method: The study used a case control design in which a sample of 197 individuals who died by suicide and 302 individuals who made medically serious suicide attempts was contrasted with 1028 randomly selected community control subjects. Results: Suicide attempts by gunshot accounted for 1.3% of all serious suicide attempts (with non-fatal outcome) and 13.3% of suicides. However, among those making serious suicide attempts, gunshot had a high rate of fatality (83.3%). While access to a firearm was associated with increased risks that gunshot would be chosen as the method of suicide attempt (OR = 107.9; CI = 24.8-469.5), this access was not associated with significant increases in the risk of suicide (OR = 1.4; CI = 0.96-1.99). Conclusions: For this sample, access to a firearm was not associated with a significant increase in the risk of suicide, although such access was associated with an increased probability that gunshot would be chosen as the method of suicide attempt.
Competence and the Elderly Patient with Cognitive Impairments
Authors: Ryan Shane P. 
Published: November 2007

Objective: The purpose of this paper is to discuss the assessment of competence in the elderly, focusing particulary on individuals with cognitive impairments. Method: An analysis of autonomy forms the basis of an ethical discussion which attempts to modify the existing concept of competence. Results and conclusion: A discussion of the factors which influence competence is presented including variations in situation, task and degree of risk. A critical analysis of four standards of competence is presented, leading to a discussion of the standards which can most successfully promote self-determination in elderly patients. Finally, three classes of competence are suggested which extend the criteria of competence to patients with cognitive deficits.