bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adverse Psychological Impact of Operative Obstetric Interventions: A Prospective Longitudinal Study
Authors: Fisher Jane , Astbury Jill , Smith Anthony 
Published: January 2008

Objective: This paper reports the findings of a prospective longitudinal study of 272 nulliparous pregnant women, which investigated as one of its objectives the psychological sequelae of obstetric procedures. Method: Participants completed structured interviews and standardised, published psychometric questionnaires, including the Rosenberg Self-Esteem Scale and the Profile of Mood States late in pregnancy and again early in the postpartum period. Results: Little evidence was found to support the notion that the total number of obstetric interventions was linked to a deterioration in postpartum mood. Significant adverse psychological effects were associated with the mode of delivery. Those women who had spontaneous vaginal deliveries were most likely to experience a marked improvement in mood and an elevation in self-esteem across the late pregnancy to early postpartum interval. In contrast, women who had Caesarean deliveries were significantly more likely to experience a deterioration in mood and a diminution in self-esteem. The group who experienced instrumental intervention in vaginal deliveries fell midway between the other two groups, reporting neither an improvement nor a deterioration in mood and self-esteem. Conclusions: The findings of this study suggest that operative intervention in first childbirth carries significant psychological risks rendering those who experience these procedures vulnerable to a grief reaction or to posttraumatic distress and depression.
Using Action Research to Facilitate Organisational Change in Mental Health Service Delivery
Authors: Tobin Margaret , Dakos Tash , Urbane Amanda 
Published: January 2008

Objective: To report how well a particular mental health service was responding to National and State mental health policies by emphasising community-based clinical care for patients. Method: The method involved analysis and action in response to information obtained from a consecutive sample of 100 people admitted to a psychiatric hospital ward from a geographical catchment area. Results: It was found that community mental health staff were working without adequate support and were not able to effectively implement early intervention and relapse prevention strategies. Concern about these findings led to organisational change using action research methodology and some of these changes are discussed. Conclusions: Such methodology was a useful tool to identlfy and achieve organisational change in psychiatric services.
The Case-Conferencing Project: A First Step towards Shared Care between General Practitioners and a Mental Health Service
Authors: Davies John W. , Ward Warren K. , Groom Grace L. , Wild Amanda J. , Wild Stephen 
Published: January 2008

Objectives: The objectives of this study were: (i) to improve general practitioners' knowledge of the mental disorders they commonly treat, and to increase their confidence in managing people with these disorders; and (ii) to increase general practitioners' familiarity with the Logan-Beaudesert Mental Health Service. Method: Eleven general practitioners met with psychiatrists from the Logan-Beaudesert Mental Health Service in six 2-hour sessions held at monthly intervals. Each session comprised a teaching component, a consumer interview and a case-conference. Outcomes were measured using an objective test of general practitioners' knowledge, a subjective test of their confidence in dealing with mental health problems, and satisfaction surveys for participating consumers, general practitioners and psychiatrists. Results: On the objective test, the scores of 10 out of the 11 general practitioners improved (p < 0.05). On the subjective test, the ranked scores improved in nine out of the 11 cases (p < 0.05). Consumers, general practitioners and psychiatrists expressed their satisfaction with the format and content of the course. Conclusions: Having improved the knowledge of a group of general practitioners who are familiar with the functioning of the Logan-Beaudeserl Mental Health Service, the stage is now set to proceed to the next step: the shared-care project.
Intensive Nutritional Counselling in Bulimia Nervosa: A Role for Supplementation with Fluoxetine?
Authors: Beumont Pierre J.V. , Russell Janice D. , Touyz Stephen W. , Buckley Cathy , Lowinger Kitty , Talbot Peter , Johnson Gordon F.S. 
Published: January 2008

Objective: The aims of the paper are to determine whether nutritional counselling is associated with an improvement in bulimic symptomatology, whether this improvement is maintained during post-treatment follow-up, and whether the addition of fluoxetine 3 × 20 mg/day confers additional benefit. Method: Psychological, pharmacological and combined psychopharmacological treatments of bulimia nervosa were reviewed briefly. Sixty-seven patients referred to specialist eating disorder services who fulfilled strict diagnostic criteria were treated with intensive nutritional counselling and randomly assigned to either fluoxetine 3×20 mg/day or placebo. After a 1-week ‘wash-out’, active treatment was given over 8 weeks, followed by post-treatment interviews at 12 and 20 weeks. Results: Both groups of patients improved significantly during treatment. In some respects, the fluoxetine group did slightly better as demonstrated by the items ‘restraint’, ‘weight concern’ and ‘shape concern’ (p<0.05 vs p<0.0001) on the Eating Disorder Examination (EDE). Fluoxetine patients decreased their energy intake and lost a modest amount of weight. They went on to regain weight during the follow-up period, returning to levels higher than they were initially. These patients also appeared more likely to have a recurrence of symptoms, as shown by the fall in percentage of binge-free patients and by changes in the EDE. Conclusion: Nutritional counselling is an effective means of treating bulimia nervosa, with improvement maintained up to 3 months follow-up. The addition of fluoxetine may confer some benefit during active treatment, but its discontinuation may contribute to a higher rate of recurrence of symptoms post treatment. Of course, this study cannot be extrapolated to the efficacy of fluoxetine when used as the only form of treatment in patients for whom intensive nutritional counselling or other structured psychological programs are not available.
A Prospective Study of Psychological Distress Related to Refugee Camp Experience
Authors: McKelvey Robert S. , Webb John A. 
Published: January 2008

Objective: Previous reports have suggested a direct relationship between refugee camp experience and levels of psychological distress among refugees. Specifically, it has been postulated that refugee camps with harsh conditions and low levels of social support foster high levels of psychological distress. The present study was designed to assess the relationship between camp conditions and social support within a refugee camp and refugees' levels of psychological distress. Unlike previous reports, which were based on retrospective data, the present study evaluated psychological distress among a group of Vietnamese refugees both prior to departure from Vietnam and during their refugee camp experience. Method: A group of 101 Vietnamese Amerasians was assessed at a transit centre in Vietnam and subsequently at a refugee camp in the Philippines. Assessment instruments were the Hopkins Symptom Checklist-25 and a Camp Comparison Questionnaire. Results: There were significant decreases in symptom levels of anxiety and depression between the transit centre in Vietnam and the refugee camp in the Philippines. However, these changes were not related to changes in refugee camp conditions or social support within the camp. Conclusions: Contrary to previous reports, levels of psychological distress among this group of Vietnamese refugees were not related to either refugee camp conditions or levels of social support within the camp.
Patterns of Symptomatology and Patterns of Torture and Trauma Experiences in Resettled Refugees
Authors: Cunningham Margaret , Cunningham John D. 
Published: January 2008

Objectives: The purpose of this study was: (i) to examine the incidence of psychological and medical symptomatology, torture and related trauma in a sample of 191 refugee clients of the Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS) in New South Wales (NSW), Australia; and (ii) to identify patterns of current symptoms, patterns of torture and trauma experiences and the relationships between symptoms and experiences. Method: Analysis of STARTTS client records permitted the coding of the presence/absence of 41 medical and psychological symptoms and of 33 torture and trauma experiences. Principal components analyses were used to identify patterns of current symptoms and patterns of torture and trauma experiences. Multiple regression analysis was used to identify relationships between current symptoms and traumatic events in the country of origin or en route to Australia. Results: Six factors were extracted for both the symptoms and trauma experiences; the first symptom factor was labelled ‘core posttraumatic stress disorder (PTSD)’. Regression analysis showed that threats and humiliation, and being forced to watch others being tortured best predicted scores on this factor. Conclusions: Although core PTSD is the dominant factor in symptomatology, comorbidity is high, with another three symptom factors emerging as meaningful. However, client reports of threats and humiliation or forced viewing of others being tortured should alert clinicians to the likely development of core PTSD, if it has not already occurred. Other implications of these findings for treatment and service development are discussed.
HIV Risk Behaviour and HIV Testing of Psychiatric Patients in Melbourne
Authors: Thompson Sandra C. , Checkley Gill E. , Hocking Jane S. , Crofts Nick , Mijch Anne M. , Judd Fiona K. 
Published: January 2008

Objectives: Patients with chronic mental illnesses constitute an important risk group for HIV infection overseas. This study aimed to determine the prevalence of risk behaviours associated with HIV transmission and factors associated with HIV testing in psychiatric patients in Melbourne. Methods: Inpatients and outpatients completed an interviewer-administered questionnaire which covered demographics, psychiatric diagnosis, risk behaviour, and HIV education and testing. Results: Of 145 participants, 60% were male and 55.2% had schizophrenia. Injecting drug use (IDU) was reported by 15.9%, a figure approximately 10 times that found in other population surveys. Most patients reported sex in the last decade and over 20% had multiple sexual partners in the last year. Of males, 12.6% reported sex with another male (9.2% anal sex); 19.0% of females reported sex with a bisexual male. Nearly half of the males reported sex with a prostitute, 2.5 times that in a population sample. Only 15.9% reported ever having someone talk to them specifically about HIV and its transmission, although one-third had been tested for HIV. In multivariate analysis, male-male sex, paying for sex, and IDU were associated with HIV testing, but those whose primary language was not English were less likely to be tested. Those who had received HIV education were more likely to have used a condom last time they had sex (OR 4.52, 95%C11.49–14.0). Conclusions: This study provides evidence that those with serious mental illness in Victoria have higher rates of participation in risk behaviour for HIV infection than those in the general community. Attention to HIV education and prevention in this group has been inappropriately scant; strategies to encourage safer behaviour are urgently needed.
Smooth Pursuit Eye Movements in Schizophrenia in New Zealand
Authors: Allen John S. 
Published: January 2008

Objective: The objective of this study was to answer the following questions: what is the frequency of smooth pursuit dysfunction in schizophrenia in New Zealand; is it comparable to that observed in other populations; is it specific to schizophrenia; and is it represented in major ethnic groups present in New Zealand? Method: Patients with schizophrenia (n = 26) were recruited at five clinical facilities in the Auckland region. Diagnoses were taken from clinical records. Patients'smooth pursuit eye movements while following sinusoidal and triangular wave targets were recorded and their performance compared to a control population (n = 34). Eye movements were scored using the ln(s/n), pursuit gain, and saccadic frequency measures. Results: Patients with schizophrenia scored significantly worse than controls using the ln(s/n) measure and had significantly higher saccadic frequencies for both targets. Percentile equivalents allow the estimation that about 50% of patients with schizophrenia have smooth pursuit dysfunction (SPD). There was no difference between groups for pursuit gain score, although low gain pursuit was significantly correlated with higher medication in the schizophrenia patient group. There were no differences associated with age, sex or ethnicity. The SPD marker was found in European- and Polynesian-derived New Zealanders. Conclusions: The results of the present study are consistent with results of previous studies performed elsewhere. Differences are at least partly ascribable to variations in methods. Smooth pursuit dysfunction is a robust marker for schizophrenia. Its application would be particularly useful in the New Zealand context as part of a first admission study looking at the effects of ethnicity on schizophrenia prognosis and on the stability of psychiatric diagnoses.
The Bowerbird Symptom': A Case of Severe Hoarding of Possessions
Authors: Fitzgerald Paul B. 
Published: January 2008

Objective: To describe a severe case of hoarding of possessions in a patient with obsessive-compulsive disorder. Clinical picture: A 22-year-old male presented with a history from early childhood of persistent collecting of valueless objects and the inability to give up possessions. He had significant insight but ambivalent feelings about changing his behaviour, despite the degree of disruption it produced in his environment. Treatment and outcome: Attempts to engage the patient in treatment were unsuccessful because of the patient's ambivalence towards change. Conclusions: The symptom of hoarding behaviour may be a severe and disruptive expression of psychiatric distress, and in obsessive-compulsive disorder it is likely to indicate a poor prognosis due to the difficulties of engaging the patient in treatment.
Double Talk: Changing and Conflicting Constructions of Indigenous Mental Health
Authors: Hunter Ernest 
Published: January 2008

Objective: The method by which psychiatric professionals and the profession itself have addressed the mental health needs of Indigenous Australians is explored. Method: A sociohistorical frame is utilised to explore the changing nature of psychiatric engagement in this field since the Second World War. Results: A series of distinct phases are definable, each of which demonstrates particular characteristics that relate to the social and political circumstances of indigenous Australia and changing investment on the part of mental health professionals. Significant difficulties have emerged at various stages and there exist quite different interpretations and uses of language relating to indigenous mental health. Conclusions: Current relations between mental health professionals and members of indigenous communities in Australia are informed by a history of which we should be aware. It has had and continues to have consequences that include significant differences in the ways in which mental health needs are conceived and articulated. These, in turn, are consequential in terms of policy and practice.
Mental Health Status of Iranian Migrants in Sydney
Authors: Khavarpour Freidoon , Rissel Chris 
Published: January 2008

Objective: The aim of this study was to determine the levels and predictors of psychological distress within the Iranian community in Sydney, Australia. Method: Participants (n = 161) were identified using snowball sampling, and a questionnaire incorporating the General Health Questionnaire (GHQ-20) and other migration-related factors was mailed to their preferred address. Results: A relatively high proportion of respondents (37%) had GHQ-20 scores above the recommended threshold (4+). Students were significantly more likely to report psychological distress compared with respondents who worked full-time. A feeling that migration had contributed to their distress was also found to be significantly associated with above-threshold GHQ-20 scores. Conclusions: Iranian migrants in Sydney may need mental health programs to address migration-related distress.
Beliefs about the Helpfulness of Interventions for Mental Disorders: A Comparison of General Practitioners, Psychiatrists and Clinical Psychologists
Authors: Jorm Anthony F. , Korten Ailsa E. , Jacomb Patricia A. , Rodgers Bryan , Pollitt Penelope 
Published: January 2008

Objective: The aim of this study was to assess health professionals' beliefs about the helpfulness of a broad range of possible interventions for mental disorders. Method: The study involved a postal survey of 872 general practitioners (GPs), 1128 psychiatrists and 454 clinical psychologists. These health practitioners were presented with a vignette describing either a person with schizophrenia or one with depression. The vignettes were taken from an earlier survey of the general public. Respondents were asked to rate the likely helpfulness of various types of professional and non-professional help and of pharmacological and non-pharmacological interventions. Results: Two-thirds or more of each profession agreed that the person with schizophrenia would be helped by GPs, psychiatrists, clinical psychologists, antipsychotic agents and admission to a psychiatric ward. Similarly, two-thirds agreed that the person with depression would be helped by GPs, psychiatrists, clinical psychologists, antidepressants, counselling and cognitive-behavioural therapy. However, there were also areas of disagreement. Psychiatrists were less likely than GPs and clinical psychologists to rate psychological and lifestyle interventions as helpful, while clinical psychologists were less likely to rate specifically medical interventions as helpful. Younger members of the professional groups and female members (who also tended to be younger) tended to rate a wider range of interventions for each disorder as likely to be helpful. Conclusions: Despite areas of broad agreement about treatment, health practitioners were more likely to endorse the interventions associated with their own profession. However, younger members of each profession tended take a broader view. If these age differences represent a cohort effect, health professionals may in the future show greater acceptance of the helpfulness of interventions offered outside their profession. These conclusions are limited by the methodology of the survey, which involved a questionnaire designed for the public rather than professionals.
Hunting Guns in Homes and Suicides in 15–24–Year-Old Males in Eastern Finland
Authors: Hintikka Jukka , Lehtonen Johannes , Viinamäki Heimo 
Published: January 2008

Objective: The aim of this study was to investigate the associations between firearm ownership, the presence of guns in homes, the use of psychiatric services and suicides in 15–24–year-old males in Eastern Finland. Method: Police and medico legal records of all suicides (n = 68) performed by 15–24–year-old males in the Kuopio province, Eastern Finland, in 1988–1995 were studied. Information was sought about firearm ownership, legality and purposes of use. Information was also sought about recent contacts with psychiatric services. Firearm suicides were compared with suicides by other methods. Results: The annual suicide rate for 15–24–year-old males was 51/100 000. Sixty-two percent of suicides were committed by shooting. In 74% of these, licensed hunting guns were used. The proportion of suicides committed by legal hunting guns stored in the homes of victims was 60% of all firearm suicides. Sixty-two percent of firearm suicides were committed in homes of victims or in someone else's residence where guns were present. Only 2% of those who shot themselves were seen in psychiatric consultation during the 3 months prior to death. Conclusions: The presence of hunting guns in homes means easy access to a most lethal suicide method and is associated with a high suicide rate for 15–24–year-old males in Eastern Finland.
Folie à Deux in a Forensic Setting
Authors: Kraya Niazi A.F. , Patrick Colin 
Published: January 2008

Objective: This paper is written with the aim of presenting a series of cases of folie à deux, an unusual disorder, occurring in a forensic setting where all the victims suffered a fatal or near-fatal outcome. Similarities in the psychopathology in these cases are drawn and comments are made about their outcome in court. The paper is also written to draw attention to the potential risks involved in this type of case and to accent patterns in psychopathology and in legal outcomes. Clinical picture: Five folie à dew cases are described. All are well known to one of the authors (NK), who has treated them at some stage of their illness, provided medico legal reports for the trial of cases 3, 4 and 5, and provided expert witness testimony in the trial of case 3. All case notes and other relevant documents were studied in detail and a brief summary is provided for each case. Outcome: The cases appear to conform with the description of folie a deux given in the literature and consist of husband and wife (three cases), mother and daughter (one case) and twin brothers (one case). None of these cases had had any past psychiatric or criminal history, yet all the victims suffered a fatal or near fatal outcome. Additionally, all had shared religious delusions in one form or another. Conclusions: Folie a deux cases with shared religious delusions can be a very high risk and could be potentially fatal in a family setting. The authors also highlight the difficulties inherent in a forensic system restricted to McNaughton rules, particularly when a person is on trial having committed, or being alleged to have committed, a serious offence, and who is found to be suffering from a psychotic illness.
A Reassessment of the Link between Mental Disorder and Violent Behaviour, and its Implications for Clinical Practice
Authors: Mullen Paul E. 
Published: January 2008

Objective and Method: This review examines the central studies which, over the last decade, have investigated the association between mental illness and rates of violent behaviours. The clinical and public policy implications of such research is then examined. Results:Recent research appears to have established a modest association between having a mental illness and an increased propensity to violence. Conclusions:The increased risk of violence is mediated, in part at least, by the active symptoms of illness. The most effective response to the risks of dangerous behaviour in the mentally ill is not to return to policies of greater control and containment but to improve the care, support and treatment delivered to patients in the community. Those at high risk need to be targeted for priority follow-up and intensive support. We need, as a profession, to become as aware of the risks in our patients of violence towards others as we currently are of the risks of suicidal behaviour. We also need to develop responses which effectively manage such patients, to their benefit and ultimately to the benefit of potential victims.