bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clozapine: A Mimicry of Phaeochromocytoma
Authors: Li June K.Y. , Yeung Vincent T.F. , Leung C. M. , Chow C. C. , Ko Gary T.C. , So W. Y. , Cockram C. S. 
Published: January 2008

Objective: To report a case of clozapine-induced hypertension with raised urinary catecholamines. Clinical picture: A 27–year-old man fulfilling DSM-Ill-R criteria for catatonic schizophrenia was treated with clozapine. He later developed both hypertension and raised urinary catecholamines which mimicked phaeochromocytoma. Treatment: Clozapine was withdrawn. Outcome: Both blood pressure and urinary catecholamines normalised. Conclusions: Clozapine may induce sympathetic hyperactivity.
Media Depictions of Mental Illness: An Analysis of the Use of Dangerousness
Authors: Allen Ruth , Nairn Raymond G. 
Published: January 2008

Objective: To explore how the commonsense understanding, that those with a mental illness are dangerous, is deployed in a small sample of print media. Method: The print media sample was subjected to a discourse analysis informed by knowledge of media practices. Materials were read closely and references to mental illness were identified, classified and analysed. Results: This non-sensational material was shown to provide repeated confirmations of the commonsense understanding that mental illnesses make people unpredictable and dangerous. Close study of the lead article suggested that it was written so that readers had to draw on such understandings to make sense of the account it presented. Conclusion: The study challenges the notion that media present negative depictions of mental illnesses either because journalists are poorly informed or because ‘sensation sells’. It is concluded that media practices directed at engaging readers require the use of cases and a style of writing that forces readers to draw upon commonsense knowledge of mental illness to understand the text. It is argued that this is a deliberate effort to enlist readers as co-creators of the text and thereby increase their interest.
Liaison Psychiatry in an HIV/AIDS Unit
Authors: Judd Fiona K. , Cockram Alexandra , Mijch Anne , McKenzie Dean 
Published: January 2008

Objective: To provide an overview of the work of a liaison psychiatry service to an HIV/AIDS inpatient unit, and particularly to examine the identification of mood and related disorders by referring doctors. Method: The micro-cares prospective clinical database system was used to obtain data on all patients referred to the HIV/AIDS consultation–liaison psychiatry service in an infectious diseases hospital in Melbourne. Results: Three hundred and ninety-two inpatient referrals were made in the 2 years from 1993–1995: a referral rate of 16.7%. The most frequent reasons for referral were evaluation of coping problems (42%), assessment of possible depression (31%), and assessment of psychotropic medication (24.5%). The most common psychiatric diagnoses were mood disorders (36.5%), psychoactive substance use disorders (22.7%) and organic mental disorders (18.1%). Overall concordance of recognition of depression by the referring doctor and diagnosis of depression by the consultant psychiatrist was 79%; 20% false positive rate, 23% false negative rate. Conclusions: Psychiatric comorbidity is common in patients with HIV/AIDS. Reasons for referral vary from those seen in other inpatient settings. Previously noted problems such as the misdiagnosis of psychiatric disorder and the mislabelling of the syndrome recognised by psychiatrists as depression were noted here.
Bilateral Ulnar Nerve Paralysis: An Unreported Complication of Drug-Induced Extrapyramidal Rigidity
Authors: Sampath Govindarajan , Pandurangi Ananda K. 
Published: January 2008

Objective: This case report describes a very unusual consequence of drug-induced extrapyramidal side effects. Clinical picture: The patient developed bilateral ulnar nerve paralysis. Treatment: The treatment consisted of anticholinergic medication and physiotherapy. Outcome: The patient made a complete recovery over a period of 8 months. Conclusions: There is a need to ensure compliance with anticholinergic medication when using depot neuroleptic medication.
Risk Factors for Posttraumatic Stress Disorder in Australian Vietnam Veterans
Authors: O'toole Brian I. , Marshall Richard P. , Schureck Ralph J. , Dobson Matthew 
Published: January 2008

Objective: The aims of this paper are to determine the risk factors for combat-related posttraumatic stress disorder (PTSD) and to examine the relative contribution of pre-military factors, pre-trauma psychiatric diagnoses, military factors such as combat posting, and combat and casualty stress exposure. Method: An epidemiological cohort study using standardised psychiatric, social and health interviews was undertaken with a national random sample of male Australian Army Vietnam veterans. Multivariate logistic regression was used to examine the relative contribution of factors derived from interview and from military records in four categories: pre-enlistment circumstances including home life, education, major life stress; pre-Vietnam psychiatric diagnoses; military experiences before and during Vietnam; and combat and stress experiences. Results: Of the 128 data items examined, significant associations were found for 39, in addition to combat stress. Pre-enlistment items accounted for about 3% of the deviance towards PTSD diagnosis, pre-enlistment psychiatric diagnosis about 13%, military variables about 7% and combat stress about 18%; all factors together accounted for 42%. Conclusions: The results confirm that pre-military and military variables make only a small but significant contribution to PTSD either alone or after controlling for combat stress; that psychiatric diagnoses of depression, dysthymia and agoraphobia make strong contributions to PTSD; but that combat stress makes the largest contribution even after controlling for the effects of other variables. Psychiatric diagnoses and combat stress appear to be independent in their effects on PTSD.
Optimal Treatment Strategies to Enhance Recovery from Schizophrenia
Authors: Falloon Ian R.H. , Held Tilo , Roncone Rita , Coverdale John H. , Laidlaw Tannis M. 
Published: January 2008

Objective: The aim of this paper is to examine the base for integrating biomedical, psychological and social strategies in the management of schizophrenia. Method: A review of the literature on schizophrenia with particular emphasis in management considerations. Results: Effective treatment components include psychoeducation, medication strategies, carer-based stress management training, community-based intensive treatment, living skills training, and specific drug and cognitive-behavioural strategies for residual symptoms. Conclusions: Treatment for schizophrenia is best provided by integrating the various and specific psychosocial intervention strategies in addition to the optimal use of medication. Methods for implementing these strategies in outpatient settings include the use of a comprehensive assessment and treatment plan, the training of mental health professionals, and periodic review with assessment packages.
Neuroleptic Management of Schizophrenia: A Survey and Commentary on Australian Psychiatric Practice
Authors: Parker Gordon , Lambert Tim , McGrath John , McGorry Patrick , Tiller John 
Published: January 2008

Objective: We seek to assess Australian psychiatrists' views and practices concerning provision of neuroleptic medication to patients with schizophrenia, and to determine whether such management strategies are likely to have changed over time and the extent to which they correspond to published treatment guidelines. Method: A sample of 139 psychiatrists based in three Australian capital cities was derived, with respondents completing a brief questionnaire by choosing from a limited-option answer set. Co-authors of this paper comment on the extent to which responses are in line with contemporary recommendations driven by experts or empirical studies. Results: Overall, survey findings indicate that there has been considerable change in clinical practice over the last decade and provide some estimate of the extent to which Australian management practices are congruent with contemporary recommendations. We identify a number of issues of concern (more in relation to dose levels of neuroleptic medication rather than treatment duration) revealed by survey data and make recommendations for addressing a number of practical clinical issues. Conclusions: As this report focuses on central issues involved in managing schizophrenia, and integrates a number of treatment guidelines, we suggest that it should be of assistance for practice review by clinicians.
An Aetiological Model of Non-Melancholic Depression: Study Design and Validity of the Measures
Authors: Parker Gordon , Gladstone Gemma , Wilhelm Kay , Hickie Ian , Mitchell Philip , Hadzi-Pavlovic Dusan , Austin Marie-Paule , Eyers Kerrie 
Published: January 2008

Objective: The aim of this paper is to describe an approach to sub-typing non-melancholic depression and to determine which raters from a variety of backgrounds provided the most valid information on study variables. Method: A sample of non-melancholic depressed patients is described. Multiple raters (i.e. patients, psychiatrists, referrers and corroborative witnesses) completed measures of the patient's trait anxiety levels, severity of recent life event stressors and personality functioning. Results: The study and representative data are reported. Congruence between several measures employed indicated that psychiatrist rating of disordered personality was superior to corroborative witness report. Assessment of anxiety traits indicated reasonable agreement between referrers and corroborative witnesses but poor agreement between those ratings and interview-elicited ratings. There were also discrepancies in quantifying “severity” of life event stress, with patients and their corroborative witnesses rating such events as more severe than either the interviewing psychiatrist or psychiatrists involved in consensus rating sessions. Importantly, the psychiatrists' capacity to quantify the relative contribution of disordered personality, anxiety and life-event stress to the particular depressive episode was supported. Conclusions: Results indicate some of the difficulties in operationalising determinants that may contribute to and sub-type the non-melancholic depressions, and demonstrate the advantages of using a range of rating strategies and raters. In this study, psychiatrist-generated judgements are clearly favoured, although the advantages of also assessing trait anxiety and life-event stress impact by self-report strategies are conceded. Some techniques for estimating the contribution of disordered personality function, anxiety and life-event stress are offered for both their research and their clinical utility.
Psychiatry and Paedophilia: A Major Public Health Issue
Authors: Glaser Bill 
Published: January 2008

Objective: The aim of this study was to provide a brief review of current perspectives on paedophilia as well as some suggestions regarding the place of psychiatry in dealing with the problem. Method: A literature survey was conducted. Results: Child sexual abuse has unfortunately been ignored and minimised by psychiatry until recently. The current evidence strongly indicates that it is a common event which is highly likely to cause both short-and long-term harm to its victims. The perpetrators generally are psychiatrically otherwise “normal” men who are skilled at both planning their offending behaviours and denying their existence. Conclusions: Psychiatrists have an important role to play in assessment and treatment of both offenders and victims, although they may have to learn new clinical skills. Their preventative role is also important, particularly in the field of public education.
The Relationship between Fatigue, Psychological and Immunological Variables in Acute Infectious Illness
Authors: Bennett Barbara K. , Hickie Ian B. , Quigley Bronwyn , Brennan Catherine M. , Vollmer-Conna Ute S. , Wakefield Denis , Douglas Michael P. , Hansen Geoffrey R. , Tahmindjis Alex J. , Lloyd Andrew R. 
Published: January 2008

Objective: The aim of this paper is to explore the longitudinal relationships between physical and psychological symptoms and immunological factors following acute infective illnesses. Method: Preliminary data from a prospective investigation of patients with serologically proven acute infectious illnesses due to Epstein-Barr virus (EBV), Ross River virus (RRV) or Q fever are reported. Patients were assessed within 4 weeks of onset of symptoms and then reviewed 2 and 4 weeks later. Physical illness data were collected at interview. Psychological and somatic symptom profiles were assessed by standardised self-report questionnaires. Cell-mediated immune (CMI) function was assessed by measurement of delayed-type hypersensitivity (DTH) skin responses. Results: Thirty patients who had been assessed and followed over the 4–week period (including 17 patients with EBV, five with RRV and eight with Q fever) were included in this analysis. During the acute phase, profound fatigue and malaise were the most common symptoms. Classical depressive and anxiety symptoms were not prominent. Initially, 46% of cases had no DTH skin response (i.e. cutaneous anergy) indicative of impaired cellular immunity. Over the 4–week period, there was a marked improvement in both somatic and psychological symptoms, although fatigue remained a prominent feature in 63% of subjects. The reduction in reported fatigue was correlated with improvement in the DTH skin response (p = 0.001) and with improvement in General Health Questionnaire (GHQ) scores (p < 0.01). Conclusions: Acute infectious illnesses are accompanied by a range of nonspecific somatic and psychological symptoms, particularly fatigue and malaise rather than anxiety and depression. Although improvement in several symptoms occurs rapidly, fatigue commonly remains a prominent complaint at 4 weeks. Resolution of fatigue is associated with improvement in cell-mediated immunity.
The Health of the Nation Outcome Scales in Psychiatric Hospitalisation: A Multicentre Study Examining Outcome and Prediction of Length of Stay
Authors: Goldney Robert D. , Fisher Laura J. , Walmsley Sonja H. 
Published: January 2008

Objective: The Health of the Nation Outcome Scales (HoNOS) is a reliable instrument, useful in detecting change in symptoms and functioning during psychiatric hospitalisation. The present study examines its utility in predicting length of stay of patients in six private psychiatric hospitals in four Australian States. Method: The HoNOS was administered on admission and discharge in six private psychiatric hospitals in Australia. Results: There were significant differences in total score and in all sub-scales between admission and discharge. There were no significant associations between total HoNOS scores and length of stay, either for individual hospitals or for specific diagnosis-related groups. There were only very weak associations, of doubtful practical clinical significance, between length of stay of all patients and individual HoNOS sub-scales. Conclusion: While the HoNOS is of some value in providing a readily administered and understood measure for clinicians, on the basis of these findings it is unlikely to be of utility in predicting length of stay or in offering a “gate-keeping” service in decision-making in regard to the allocation of resources for individual patients.
A Longitudinal Study Comparing Bereavement Phenomena in Recently Bereaved Spouses, Adult Children and Parents
Authors: Middleton Warwick , Raphael Beverley , Martinek Nada , Burnett Paul 
Published: January 2008

Objective: The study investigated previous research findings and clinical impressions which indicated that the intensity of grief for parents who had lost a child was likely to be higher than that for widows/widowers, who in turn were likely to have more intense reactions than adult children losing a parent. Method: In order to compare the intensities of the bereavement reactions among representative community samples of bereaved spouses (n = 44), adult children (n = 40) and parents (n = 36), and to follow the course of such phenomena, a detailed Bereavement Questionnaire was administered at four time points over a 13–month period following the loss. Results: Measures based on items central to the construct of bereavement showed significant time and group differences in accordance with the proposed hypothesis. More global items associated with the construct of resolution showed a significant time effect, but without significant group differences. Conclusions: Evidence from this study supports the hypothesis that in non-clinical, community-based populations the frequency with which core bereavement phenomena are experienced is in the order: bereaved parents bereaved spouses bereaved adult children.
Comorbidity of Bipolar and Personality Disorder
Authors: Barbato Nazareno , Hafner R. Julian 
Published: January 2008

Objective: The aims of this study were to determine the prevalence of personality disorder in a sample of patients with well-documented bipolar disorder, and to assess the effects of cormorbidity. Method: The sample (n = 42) was drawn from patients currently case-managed within a community treatment program who fully met DSM-IV criteria for bipolar I disorder. The International Personality Disorder Examination, a structured interview, was used to diagnose personality disorder. The Brief Symptom Inventory assessed overall levels of psychological symptoms. Results: Seven of the 13 men (55%) in the sample had 10 personality disorder diagnoses and 12 of the 29 women (41%) had 28 diagnoses, an overall prevalence of 45%. Hospital admission rates and all measures of psychological symptoms and impairment were significantly elevated in the comorbid group, who found medication significantly less helpful. Conclusions: Comorbid personality disorder was common in the sample studied, which was representative of Australian patients treated in public community psychiatry programs. However, only three (7%) had a personality disorder diagnosis recorded in their case notes, reflecting clinicians' reluctance to apply what is widely viewed as a pejorative and therapeutically nihilistic label. New treatments for personality disorder have proven effective within both public and private psychiatric settings, so that underdiagnosis represents undertreatment. The findings suggest that clinicians should be more vigilant for comorbid personality and bipolar disorder, and less reluctant to diagnose it.
Predictability of Rehospitalisation over 5 Years for Schizophrenia, Bipolar Disorder and Depression
Authors: Daniels Brett A. , Kirkby Kenneth C. , Hay David A. , Mowry Bryan J. , Jones Ivor H. 
Published: January 2008

Objective: The aim of this study was to examine the rate of rehospitalisation for schizophrenia, bipolar disorder and depression over a 5-year period in Tasmania, and to identify predictors of the number and duration of readmissions. Method: The Tasmanian Mental Health Register was used to study the 5-year pattern of rehospitalisation for all patients admitted to a Tasmanian public psychiatric inpatient facility with a primary diagnosis of schizophrenia, bipolar disorder or depression, in 1983 or 1984. Results: Seventy-one percent of patients receiving a diagnosis of schizophrenia were readmitted in the 5-year period, compared to 59% for bipolar disorder and 48% for depression. For all three diagnoses, the number of prior admissions was a predictor of the number of readmissions and the total number of days spent in hospital in the follow-up period. Age and sex also had significant effects, which varied across diagnostic groups. Conclusions: A substantial proportion of patients hospitalised for schizophrenia, bipolar disorder or schizophrenia were rehospitalised during the next 5 years. Patients with more previous admissions had more readmissions than those with fewer previous admissions.
Withdrawal Reactions Associated with Venlafaxine
Authors: Parker Gordon , Blennerhassett Jenny 
Published: January 2008

Objective: The aim of this paper is to describe discontinuation syndromes associated with abrupt and tapered withdrawal of venlafaxine, and to document that withdrawal symptoms may occur after missing a single dose. Clinical picture: We report on two patients prescribed venlafaxine. One developed a broad range of serious side effects after reaching a dose of 300 mg a day, and a severe withdrawal syndrome (including hallucinations) during a slow taper regime. The second had severe discontinuation symptoms during and aborting a slow taper regime, and described withdrawal responses after missing a single dose of venlafaxine. Conclusions: As for the short-acting selective serotonin re-uptake inhibitors, severe discontinuation reactions may occur with venlafaxine, seemingly marked most distinctly by headache, nausea, fatigue, dizziness and dysphoria, and may make cessation of the drug extremely difficult. Two strategies for addressing the concern are considered.
Outcomes Focused Service Delivery: Developing an Academic-Management Partnership
Authors: Tobin Margaret , Hickie Ian 
Published: January 2008

Objective: Current mental health policies emphasise the need for services to be integrated and to develop outcomes-based evaluation systems. An overview of the challenges faced by service managers and clinical academics who develop the appropriate financial, personnel and academic infrastructure for these tasks is presented. Method: By drawing on experiences within the St George Service and references to other services, we propose a model for a successful partnership between the academic and management components of a district service. Results: Major logistic impediments to the development of a partnership are identified, although the long-term scientific and service delivery benefits are highlighted. Key areas within both academic practice and managerial approaches requiring transformation are discussed. Conclusions: A successful long-term partnership between management and an academic department within a district service may provide the opportunity for rapid progress in population-based service evaluation and health outcomes research.
Childhood Abuse, Postpartum Depression and Parenting Difficulties: A Literature Review of Associations
Authors: Buist Anne 
Published: January 2008

Objective: The aim of this paper is to obtain an understanding of the links between maternal postpartum depression, poor parenting and childhood abuse, and the subsequent development of adult psychopathology in children from these families. Method: A literature review was undertaken of studies on postpartum depression looking at parental childhood abuse, parenting and child outcomes, as well as childhood abuse and its association with adult depression and parenting difficulties. Results: Considerable overlap is noted in predisposing factors for major depression, postpartum depression, inadequate parenting and childhood abuse. Links appear to begin in early infancy, suggesting postpartum depression as a possible mechanism for intergenerational transmission of psychopathology. Conclusions: Further research is required to look at the outcome of children of women who are at high risk of chronic or recurrent depression and of difficulties parenting; the postpartum period is the optimum time for identification and intervention.