bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Stigma of Mental Illness in Asian Cultures
Authors: Ng Chee Hong 
Published: January 2008

Objective: This article reviews the attitudes towards mental illness and psychiatric stigma in Asian cultures. Method: Relevant literature published in English was reviewed. Results: Psychiatric stigmas in Asian cultures share some common features. However, response to mental illness has many variations across cultures. Psychiatric stigma is prevalent and severe in some but not all Asian cultures. Conclusions: The stigma of mental illness needs to be studied within its sociocultural context in order to understand its origins, meanings and consequences. It may be relevant to examine the indigenous concepts, experience and implications of psychological problems to address problems in mental health care relating to stigma.
Pivotal Issues in Forensic Psychiatry
Authors: O'brien Kenneth P. 
Published: January 2008

Objective and Method: This review examines the scope of forensic psychiatry with particular emphasis on its ethical and social implications. Some comparisons are made between the development of the subspecialty in Australasia and similar developments in the United Kingdom and North America, and the reasons for differences. Results: There has been inadequate debate in Australasia about some of the ethical issues relating to the practice of forensic psychiatry. Furthermore, Australian forensic psychiatry in particular has been slow to develop comprehensive and integrated services compared to other jurisdictions, and remains predominantly an assessment-based activity with primacy of the expert witness. Conclusions: Australasian psychiatry faces significant problems with respect to maldistribution of services. Governments are becoming more radical in their attempts to address this maldistribution and this has ethical implications for the profession itself and the practice of forensic psychiatry. Greater emphasis on the development of integrated and community-based forensic services, with leadership being provided by the profession itself, may deflect some of the present criticism, thereby allowing the subspecialty to more fully mature and develop with the approach of the new millennium.
Access to Methods of Suicide: What Impact?
Authors: Cantor Christopher H. , Baume Pierre J.M. 
Published: January 2008

Objective: The aim of this paper is to explore the conceptual basis of limiting access to potential methods of suicide as a public health measure. Method: A review of the literature was conducted. Results: Both physical availability and sociocultural acceptability are important determinants of choice. There is considerable evidence of an association between method availability and method specific suicide rates. There is also evidence that restriction of method availability is often associated with a reduction in method specific suicide rates. There is some evidence that restrictions on method availability under certain conditions may reduce overall suicide rates. Conclusions: Suicide methods employed by young Australians are changing, with a disturbing rise in frequency of hanging and car exhaust suicides slightly offset by a decline in firearm suicides. Opportunities exist for further reducing firearm suicides and addressing exhaust suicides by practical measures. There are also obvious options for changing prescribing practices with respect to more lethal medications (e.g. tricyclic antidepressants). However, the rise in hanging seems problematic from this perspective and in need of ecological study.
Posttraumatic Stress Disorder and Comorbidity in Australian Vietnam Veterans: Risk Factors, Chronicity and Combat
Authors: O'toole Brian I. , Marshall Richard P. , Schureck Ralph J. , Dobson Matthew 
Published: January 2008

Objective: The objective of this study was to examine the relationship between combat-related posttraumatic stress disorder (PTSD) and comorbid DSM-III-R psychiatric diagnoses to determine commonalities in risk factors, relative onsets and the role of combat 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. Interviews and searches of military records yielded risk factors for PTSD, which were examined for association with each psychiatric diagnosis. Relative onsets of PTSD and each Diagnostic Interview Schedule diagnosis were compared. Comorbidity odds ratios were adjusted for combat exposure effects using logistic regression, and the relation between each diagnosis and combat was assessed after controlling for PTSD. Results: Commonality of risk factor profile was evident for several diagnoses, and for many their onset preceded PTSD onset. Combat was independently related to only a few diagnoses after controlling for PTSD, and PTSD remained strongly associated with several conditions after controlling for combat exposure. Conclusions: The analysis suggests that the disorders that may constitute risk factors or vulnerabilities for PTSD comprise depression and dysthymia, antisocial personality disorder, agoraphobia and simple phobia, while those that may be consequent on PTSD are panic and generalised anxiety disorder, drug use disorders and somatoform pain disorder. Alcohol and drug use disorders and social phobia may have a mixed aetiology, while obsessive-compulsive disorder may be serendip-itously related to PTSD through an association with risk of combat. Gambling disorder is unrelated.
How Effective is Lithium in the Prevention of Relapse in Bipolar Disorder? A Prospective Naturalistic Follow-Up Study
Authors: Silverstone Trevor , McPherson Heather , Romans Sarah , Hunt Neil 
Published: January 2008

Objective: The effectiveness of lithium in preventing recurrences of bipolar disorder was examined prospectively for 2 years in two representative samples of bipolar I patients being treated in a comprehensive program following recommended guidelines. Method: One hundred and twenty patients were recruited from consecutive admissions to two catchment area psychiatric services (one in the United Kingdom, the other in New Zealand). They were seen at 3–monthly intervals by a member of the research team. Treatment was adjusted according to clinical needs. Results: Overall, two-thirds of the patients had a recurrence. Of the 57 on lithium as sole treatment, 39 (68%) had a further episode; 17 after stopping lithium. The 42 on other mood stabilisers and/or an antipsychotic, with or without lithium, did no better. By contrast, only eight (38%) of the 21 who were taking no prophylactic medication had a recurrence. Conclusions: Lithium is much less effective in clinical practice than would be expected from clinical trial results. A major reason for this is poor compliance. Alternative treatment strategies are needed to improve the outcome for bipolar disorder patients
Anthropometry and Adiposity in a Group of People with Chronic Mental Illness
Authors: Sharpe Jenny-Kay , Hills Andrew P. 
Published: January 2008

Objective: The prevalence of excess body weight has been reported as two to four times greater in the chronic mentally ill than in the general population. However, there has been a paucity of body composition research with this population. The purpose of this study was to compare with population data the prevalence and distribution of body fat in a group of chronic mentally ill individuals. Method: An anthropometric profile consisting of height, weight, waist and hip girths was completed on 29 males and 23 females. Results: Consistent with other groups with excess adiposity, measures of skinfold thickness were generally unreliable. The biceps was the only site where a reliable skinfold measure was possible in all subjects. More than half of the males and three-quarters of the females had a waist circumference in excess of 100 cm. Conclusions: There were significantly higher levels of relative body weight and excess abdominal adiposity in the study group compared with the wider population. A brief anthropometric protocol of waist and hip girths and biceps skinfold in addition to height and weight, rather than the use of weight alone as an indicator of adiposity, is recommended.
Neuroplasticity and Psychiatry
Authors: Gynther Bruce D. , Calford Mike B. , Sah Pankaj 
Published: January 2008

Objective: There is increasing concern that the course of psychiatric disorders may be affected by parameters such as the duration and intensity of symptoms of initial episodes of illness. As this indicates that abnormal function produces long-term changes within the brain, a review of the neuroscience literature regarding neuroplasticity is warranted. Method: This article is a selective review, focusing in particular on results obtained from physiological experiments assessing plasticity within the mammalian neocortex. The possible relevance of results to psychiatry is discussed. Results: While the most dramatic examples of neuroplasticity occur during a critical period of neural development, neuroplasticity can also occur in adult neocortex. Neuroplasticity appears to be activity-dependent: synaptic pathways that are intensively used may become strengthened, and conversely, there may be depression of transmission in infrequently used pathways. Conclusions: Results from neurophysiological experiments lend support to the clinical observation that the intensity and duration of a psychiatric disorder may adversely alter its long-term course. Rapid aggressive treatment may prevent this from occurring. While pharmacotherapy may reduce the duration and severity of symptoms, it may also have an independent, as yet unknown, effect on neuroplasticity.
Coroners' Records of Rural and Non-Rural Cases of Youth Suicide in New South Wales
Authors: Dudley Michael , Kelk Norman , Florio Tony , Waters Brent , Howard John , Taylor Darryl 
Published: January 2008

Objective: The aim of this study is to compare the frequency of certain putative risk factors for youth suicide in New South Wales (especially use of alcohol, social class, unemployment, and internal migration) in metropolitan and rural settings. Method: A review of 137 files for 10–19-year-old subjects judged by the Coroner to have committed suicide in 1988–1990 was carried out. Results: One hundred and fifteen males and 21 females were identified (one subject's sex was unavailable). The male-female ratio was higher in rural (13.0) areas than non-rural (4.9; χ2 = 12.14, p<0.01). Of 27 subjects migrating within Australia, most migrated in a rural direction, and most to rural shires. Unemployment was somewhat more common among rural (38.5%) than non-rural (28.9%) subjects (χ2 = 0.75, p = 0.39). Eleven of 50 non-rural parents of the deceased, but none of the 11 rural parents, were ranked as being in social classes 2 or 3. Alcohol consumption appeared more common in rural shires (44%) than metropolitan areas (32.9%), but this was not statistically significant. Medical services were less utilised prior to death in rural (15%) than non-rural (25%) areas (χ2 = 1.69, p = 0.19), and a psychiatric diagnosis was recorded more commonly in non-rural areas. Conclusions: Incomplete coronial file data and relatively small numbers limit this study's conclusions. Male suicides, principally by firearms, predominated in rural areas. Youth firearm access remains highly relevant to rural communities. Possible trends among rural subjects toward rural migration, higher unemployment, lower social class and lower medical attendance may point to resource deprivation among this group; these matters require further investigation.
Comparison of Treatments of Persistent Conduct Problems in Primary School Children: A Preliminary Evaluation of a Modified Cognitive-Behavioural Approach
Authors: Luk Ernest S.L. , Staiger Petra , Mathai John , Field David , Adler Robert 
Published: January 2008

Objective: Treatment for persistent conduct problems in primary school children was developed using a modification of cognitive-behavioural therapy (MCBT). Its effectiveness was evaluated by comparing it with conjoint family therapy (FT) and eclectic therapy (ET). Method: Children with persistent conduct problems were randomly assigned to one of three treatment groups. They were assessed prior to treatment and then 6 months after. Measures included symptoms of the child; parents' mental health; stress of parenting; family functioning; and parental relationship. In addition, parents' and children's perception of the therapy were assessed and a treatment record was developed to track the treatment process. Results: Thirty-two children were recruited for the study. No statistically significant differences were found in terms of effectiveness between the three groups. In terms of parents' perception of the therapy, there was no difference on the perception of the qualities of the therapists, but on the perception of therapy MCBT was considered to be higher in cognitive-behavioural orientation. Conclusion: Further research using a larger sample is required to evaluate MCBT. The study supports the idea that controlled treatment studies can be carried out within busy mental health services.
Management of Somatisers in Primary Care: Are Family Doctors Motivated?
Authors: Garcia-Campayo Javier , Sanz-Carrillo Concepcion , Yoldi-Elcid Amaya , Lopez-Aylon Rosa , Monton Carmen 
Published: January 2008

Objective: The aim of this paper is to assess the attitudes of Spanish general practitioners towards somatisers and the degree of involvement that family doctors are ready to adopt in the care of these patients. Method: A postal questionnaire on attitudes was sent to a representative sample (n = 135) of general practitioners from two health districts of the region of Aragon. Seventy (51.8%) of them returned usable questionnaires. Results: Most of the general practitioners were interested in the treatment of somatisers and considered that they should be treated at primary care level. However, when specific treatment tasks were proposed, they only accepted to act as a filter to specialised care and to care for patients with chronic functional syndromes. Additionally, they refuse to detect presenting somatisers, to prescribe psychotropic drugs or offer any psychological approach, and to avoid reinforcing abnormal illness behaviour in these patients and their families. These findings can be explained because the main emotions somatisers produce in doctors are frustration and anger. Conclusions: Family doctors need a lot more help, education and support in the management of somatisers, and psychiatrists need to provide it. Any management program for the treatment of somatisers in primary care should include methods to modify general practitioners' attitudes towards these patients.
Obsessive—Compulsive Disorder in Post-Streptococcal Infection
Authors: Monasterio Erik , Mulder Roger T. , Marshall Thomas D. 
Published: January 2008

Objective: We describe the sudden onset of obsessive—compulsive symptoms fol lowing a peritoneal infection with α-haemolytic streptococci. Clinical picture: A 35–year-old woman with no past history or family history of obsessions or compulsions developed these symptoms 2 weeks after a peritoneal infection. Treatment: The patient received 80 mg fluoxetine daily. Outcome: She responded to treatment with a progressive reduction in symptoms. Conclusions: It is suggested that these obsessions and compulsions may be related to an autoimmune response to the streptococcal infection.
Mania Associated with Codeine and Paracetamol
Authors: Orr Kenneth G.D. , Mostert Johann , Castle David J. 
Published: January 2008

Objective: We describe a patient in whom a manic episode was precipitated by use of panadeine forte, a preparation containing codeine and paracetamol. Clinical picture: The patient developed a discrete manic psychotic episode. Treatment: The treatment consisted of cessation of the Panadeine forte and antipsychotic medication. Outcome: The patient made a complete recovery after 1 week. Conclusions: Mania can be induced by large doses of Panadeine forte, particular ly if there is a biological predisposition.
From Consultation—Liaison Psychiatry to Psychosocial Advocacy: Maintaining Psychiatry's Scope
Authors: Smith Graeme C. 
Published: January 2008

Objective: To review the status of consultation-liaison (C-L) psychiatry and the forces shaping it, and to propose strategies for dealing with the crisis in which it finds itself. Method: A Medline search of C-L psychiatry and related terms, together with hand-searching of C-L psychiatry and psychosomatic journals and bibliographies of found articles, was used for the literature base. The experience of membership of the committees of national and international C-L psychiatry organisations and their interaction with health care administrators was used as the basis for the discussion of strategies. Results: It is argued that patients with physical/psychiatric comorbidity and somatisation have been marginalised by application of narrow definitions of what constitutes ‘serious mental disorder’ in the public sector. Evidence is presented to support the argument that physical/psychiatric comorbidity is the most common form of psychiatric presentation in the community, that such comorbidity has serious consequences in terms of morbidity, mortality and health-care costs, and that even subthreshold psychiatric symptoms have serious implications when physical comorbidity exists. Conclusion: It is concluded that a number of strategies, including pre-admission screening, integrated discharge planning, liaison, as well as shared care with general practitioners, advanced training in C-L psychiatry and more research to establish practice guidelines, are required if psychiatry is to remain a broad-based discipline rather than retreat to being a specialty for psychosis. Consultation-liaison psychiatrists must become the advocates for the psychosocial system.
Six-Month Outcome following a Relapse of Schizophrenia
Authors: Bergen Jenny , Hunt Glenn , Armitage Paul , Bashir Marie 
Published: January 2008

Objective: To analyse clinical data on patients with schizophrenia on admission to acute care and 6 months later in order to identify factors associated with frequent hospitalisations and poor outcome. Method: Information was collected from the medical records of 99 patients with schizophrenia consecutively admitted to acute care in hospital or by community based 24 h Crisis Teams and prospectively studied for 6 months. Results: One-quarter of patients were being admitted to acute care within 3 months of their last hospital discharge and only 34 patients were compliant with their neuroleptic medication 3 months prior to the index admission. Twenty-one patients were managed entirely by the Crisis Teams, 27 patients received inpatient care only and the remainder ( n = 51) had both types of acute care. Six months after admission, 42 patients had been discharged and did not require further acute care, 29 patients had been re-admitted at least once and three patients had been transferred to an inpatient rehabilitation unit and, therefore, remained in hospital over the entire period. Of the remaining 25 patients, one committed suicide 2 months after discharge and the other patients were not contactable by Community Mental Health Teams at the 2 and/or 6 month follow up. Conclusions: Some of the factors associated with relapse identified in the present study were non-compliance with medication, stress, inadequate social support and substance abuse. The poor outcome in patients with frequent relapses emphasises the need to reduce the occurrences of schizophrenic symptoms to provide a better quality of life. The 25% of patients dropping out of care soon after a relapse indicates that more should be done to engage these people in long-term treatment programs.
Familial Bipolar Disorder: Preliminary Results from the Otago Familial Bipolar Genetic Study
Authors: Edmonds Liza K. , Mosley Barbara J. , Admiraal Anita J. , Olds Robin J. , Romans Sarah E. , Silverstone Trevor , Walsh Anne E.S. 
Published: January 2008

Objective: This paper outlines the methodologies used, and preliminary descriptive data collected, on a cohort of familial bipolar disorder (BPD) probands and first-degree relatives taking part in a descriptive and genetic study into familial BPD in New Zealand. Method: Fifity-five bipolar probands and 67 first-degree relatives were interviewed using the modified Diagnostic Interview for Genetic Studies (DIGS) and Family Interview for Genetic Studies (FIGS). Data was also collated from other sources. Blood samples were taken for DNA genomic analysis. Results: New Zealand families in which BPD segregates proved willing participants in this familial based genetic research. The methodologies used were acceptable. High rates of comorbidity were found in probands (27.3% met DSM-IV criteria for panic disorder/sub-threshold panic disorder; 12.7% for phobic disorder; 1.8% for obsessive-compulsive disorder; 9.1% for alcohol-related disorders and 7.3% for an eating disorder) and relatives (major depression 34.3%; panic disorder/sub-threshold panic disorder 12.0%; phobias 11.9% and alcohol-related disorders 11.9%). The polarity of index BPD illness was related to age of onset and frequency of comorbidity. Suicidal behaviour was common. Conclusions: Psychiatric genetic research in New Zealand families is highly feasible. Emerging trends in the familial transmission of BPD include high rates of comorbidity, illness patterns based on polarity of index episode and frequent suicidal behaviour. Such trends will be delineated further as numbers accrue, perhaps enabling identification of more homogenous phenotypic subgroups than currently produced by diagnostic schemes.
Conceptual Foundations of Schizophrenia: I. Degeneration
Authors: Barrett Robert J. 
Published: January 2008

Objective: This is the first of two papers that aim to identify some of the institutional processes of 19th century European psychiatry, and some prevailing cultural themes of that era that played a role in shaping the development of schizophrenia as a disease concept. Method: Three areas of psychiatric history are examined: the first is concerned with the key figures who coined the concept of dementia praecox; the second with the rise of the asylum; and the third is to do with the ideology of 19th century psychiatric science and its relationship to a broader intellectual milieu. These three literatures are examined for common themes. Results: The theme of degeneration is evident in all three literatures, and denotes both a biological process (neuro-degeneration) and a moral state (degeneracy). Conclusions: The idea of degeneration, a pervasive cultural theme of the 19th century, dominated psychiatric thinking long before schizophrenia was developed as a diagnostic category. It contributed to the ideational form-work that gave foundation, structure and shape to the concept of schizophrenia.