bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nutrition and Obesity in the Chronic Mentally ILL
Authors: Wallace Bridget , Tennant Chris 
Published: January 2008

Objective: The aim of this study was to determine the need for nutrition intervention in a group of people living in mental health residential houses in the Northern Sydney Area. Method: A nutrition assessment was conducted by the researcher using a face-to-face interview with mental health residents and a survey on medical background completed by case managers. Results: The prevalence of overweight and obesity was significantly greater than that reported for the general population. Respondents also had a significantly higher prevalence of abdominal obesity than the general population. No respondent met the minimum core food group requirements as outlined in the 12345+ Food and Nutrition Plan. Conclusions: The needs assessment has shown that nutrition promotion is required in this group. The task ahead is to motivate the group to change their food and nutrition behaviours, where many barriers to a healthy lifestyle exist.
A Critical Review of the Biopsychosocial Model
Authors: McLaren N. 
Published: January 2008

Objective: The aim of this review is to provide an analysis of the epistemic status of the biopsychosocial model. Method: A critical comparison of the biopsychosocial model with the general concept of models. Results: In its present form, the biopsychosocial model is so seriously flawed that its continued use in psychiatry is not justified. Conclusion: Further development of theory-based models in psychiatry is urgently needed.
Staff Response to Abuse Histories of Psychiatric Inpatients
Authors: Read John , Fraser Allen 
Published: January 2008

Objective: In the context of numerous studies demonstrating that a significant proportion of psychiatric inpatients have been sexually or physically abused at some point in their lives this study ascertained the responses of staff in a psychiatric inpatient unit to knowledge that patients had been subjected to sexual or physical abuse, in childhood or adulthood.Method: The medical records of 100 consecutive admissions were examined. Staff response was measured in terms of: (i) acquiring information about previous treatment for, or disclosure of, abuse; (ii) providing information, support or counselling during hospitalisation; (iii) reporting to legal authorities; and (iv) referring for ongoing abuse counselling.Results: Of the 32 patients who were documented as having disclosed abuse 11 files included documentation of previous treatment or disclosure; none were reported to have received support, counselling or information while in hospital; and three referrals were made for ongoing counselling. None of the 52 separate instances of abuse were reported to the authorities. Demographic, diagnostic, clinical and treatment variables, as well as the four abuse categories, were analysed for possible linkage to probability of staff response in each of the four response categories.Conclusions: It was hypothesised that the low staff response rate is not unique to the particular unit evaluated here. Recommendations are offered regarding the need for unit policies ensuring routine abuse inquiry and for staff training about how to respond to abuse disclosures.
The Implications of Legislative Change on the Future of Psychiatric Nursing in Victoria
Authors: Happell Brenda 
Published: January 2008

Objective: The aim of this paper is to explore the potential implications of the Nurses Act introduced in 1993 upon psychiatric nursing in Victoria. Essentially this Act abolished the existing separate undergraduate education for psychiatric nursing. The focus of this paper is to explore the potential implications of this legislative change to the psychiatric nursing profession, particularly in light of relevant research findings. Method: In order to ascertain the impact of legislative change, a survey of psychiatric nursing content was conducted in Schools of Nursing throughout Victoria. Results: A 100% response rate was achieved. The responses indicated that little alteration had been made to existing general nursing courses to incorporate the change in legislation. The compulsory psychiatric nursing content varies from nil to 17.4% of the total curriculum. Conclusions: The theory and practice of psychiatric nursing constitute only a small proportion of undergraduate curricula. In view of the comparative unpopularity of psychiatric nursing as a career option for undergraduate students, the implications of this situation for the future psychiatric nursing workforce are serious.
Paedophilia: A Review of the Evidence
Authors: McConaghy Nathaniel 
Published: January 2008

Objective: The aim of this study was to critically review the literature concerning the nature and prevalence of paedophilia. Method: The literature of the past 30 years was examined in relation to the author's clinical experience and with emphasis on methodologically appropriate empirical studies. Results: Concern and reporting of child-adult sexual activity has increased markedly in the last decade, although its prevalence has not increased at least since the 1960s. The prevalence in women can be as high as 60%, depending on the definition and method of enquiry used, and female compared to male victims report more negative effects, although a percentage of both men and women report the experience as positive. Validation of effects requires multivariate statistical analysis. Current pro-active procedures to identify paedophiles detect those who victimise boys but do not detect the much greater number of paedophiles who victimise girls. Perpetrators are known to the majority of their female and male victims, and those reported are almost all male; most boys do not consider their prepubertal experiences with older women abusive. Relapse prevention, the current most popular treatment, has been shown to be ineffective for incarcerated child molesters. Conclusions: Child-adult sexual activity should be opposed as an infringement of children's rights rather than requiring a false belief that it is invariably harmful; whether it should be mandatory for therapists to report it requires examination. Scientifically appropriate evaluation should be an essential component of current treatment programs.
A Pilot Study of Computer-Aided Vicarious Exposure for Obsessive-Compulsive Disorder
Authors: Clark Augustino , Kirkby Kenneth C. , Daniels Brett A. , Marks Isaac M. 
Published: January 2008

Objective: This study reports the use of an interactive computer program to instruct vicarious exposure and ritual prevention for obsessive-compulsive disorder (OCD). Method: Thirteen OCD volunteers and 10 non-OCD volunteers completed three 45-minute sessions at weekly intervals. Subjects with OCD completed the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Padua Inventory (PI) and the Beck Depression Inventory (BDI) 1 week prior to and 1 week after the three computer treatment sessions. Non-OCD subjects only completed these measures at baseline, allowing confirmation that they had no significant level of OCD symptomatology. Results: In the OCD subjects, scores fell significantly on the PI and BDI, and Y-BOCS scores fell non-significantly. Engagement in vicarious exposure with ritual prevention improved from sessions 1–3. Compared to the non-OCD participants, OCD subjects did less vicarious exposure in session 1 but not sessions 2 and 3. Performance of vicarious exposure by OCD subjects in session 1 correlated with pre-post improvement in PI and BDI scores. Conclusions: The vicarious exposure program may have a role to play as an adjunct in behaviour therapy.
Puerperal Psychosis: Associated Clinical Features in a Psychiatric Hospital Mother-Baby Unit
Authors: Mowry Bryan J. , Lennon David P. 
Published: January 2008

Objective: Current psychiatric diagnostic systems do not regard puerperal psychosis as a separate entity. However, there is continuing debate about the validity and clinical utility of this concept. This paper aims to investigate the prognostic importance of a number of clinical features in a sample of patients with puerperal psychosis. Method: A retrospective case note study was conducted on 42 consecutive admissions to a mother-baby unit in a psychiatric hospital. Data were collected on a range of variables, and diagnoses made according to DSM-III-R and RDC criteria for puerperal psychosis. Results: Maternal hostility toward the baby was the only studied variable to increase the likelihood of the baby being cared for by someone other than the mother, indicating the mother's inability to safely care for the baby. Conclusions: These findings tentatively suggest that it is maternal hostility toward the baby, not puerperal psychosis per se that is associated with foster care.
Hyponatraemia Associated with the Use of Selective Serotonin Re-Uptake Inhibitors
Authors: Strachan John , Shepherd John 
Published: January 2008

Objective: The aim of this study is to examine the frequency and severity of hyponatraemia in a psychogeriatric inpatient population taking selective serotonin re-uptake inhibitors (SSRls). Method: Casenotes for 1 year were reviewed and 53 patients with 55 admissions were identified. Eighteen were treated with fluoxetine and 37 with paroxetine. Five (28%) of the patients on fluoxetine and eight (22%) on paroxetine were, or became, hyponatraemic. Results: The SSRl was discontinued in two symptomatic patients. Serum sodium returned to normal in nine patients maintained on the SSRI. Two patients maintained on an SSRl remained hyponatraemic but asymptomatic. Conclusions: Hyponatraemia may be a relatively common early asymptomatic side effect of SSRls, especially in older women. Serum sodium should be measured before commencing an SSRl and monitored during the first month. Any patient who exhibits symptoms of hyponatraemia, or whose depression apparently worsens, while on an SSRl must have their serum sodium measured. Discontinuation of the SSRl may be avoidable if serum sodium levels can be closely monitored.
Issues in the Assessment of Outcome in Mental Health
Authors: Trauer Tom 
Published: January 2008

Objective: The purpose of this paper is to examine a number of issues in the assessment of outcome in mental health. Method: Issues are considered in terms of a number of dichotomies or choices. These include: intervention-dependent versus intervention-independent definitions of outcome, focussing on inputs or processes versus outcomes; individual versus organisational outcomes; outcomes for patients versus outcomes for significant others; pure versus mixed outcomes; care versus cure; direct versus indirect measures; objective versus subjective measures; descriptive versus prescriptive measures; global versus specific assessment; and assessing at significant times points versus assessing at fixed intervals. Conclusions: Guiding principles are formulated in terms of the foregoing issues.
Medicine and the Manic Defence
Authors: Schimmel Paul 
Published: January 2008

Objective: The aim of this paper is to explore the relevance of the concept of the manic defence to understanding the treatment behaviours of doctors, and psychiatrists in particular. Method: The manic defence and manic reparation are defined. Treatment approaches by doctors in physical and psychiatric medicine are examined within the perspective offered by these concepts. Results: Evidence for the operation of a manic defence can often be discerned in treatment approaches to psychological and psychosomatic disorders. Widespread reliance on the prescribing of antidepressant medication for depression provides an example. Conclusions: In the face of psychological and psychosomatic presentations, doctors may resort to reductionist aetiological formulations which promote active but reductionist treatments. Such approaches represent the enactment of a manic defence against depressive anxieties that might otherwise be experienced by patient and/or practitioner.
Correlates of Aggressive Behaviour in Schizophrenia: An Overview
Authors: Cheung Peter , Schweitzer Isaac 
Published: January 2008

Objective: This review aims to critically evaluate the reported biological, psychological and social correlates of aggression in schizophrenia and to delineate those correlates which could be of use clinically and those which require further research. Method: The literature from 1974–1996 was searched using Psychlit and supplemented by suggestions from senior members of the authors' Department. Results: Past history of aggression, psychopathology, extrapyramidal side effects of neuroleptic medications, substance abuse, reduced serotonin function, antisocial and impulsive personality traits, neurological/neuropsychological deficits, electroen-cephalography, neuroimaging abnormalities and environmental factors were all found to be correlated with aggressive behaviour in schizophrenia. However, there are many methodological limitations of previous studies in this field, often leading to inconsistent and inconclusive findings. Conclusions: Some tentative conclusions regarding clinically useful predictors of aggression in schizophrenia can be drawn at this stage. There is a need for methodological limitations of previous studies to be overcome before more firm conclusions can be reached.
Comparison between Register and Structured Interview Diagnoses of Schizophrenia: A Case for Longitudinal Diagnostic Profiles
Authors: Kirkby Kenneth C. , Hay David A. , Daniels Brett A. , Jones Ivor H. , Mowry Bryan J. 
Published: January 2008

Objective: Mental health registers contain diagnoses from serial contacts with mental health facilities over many years. This study examines the relationship between longitudinal diagnostic profiles and structured interview diagnoses. The aim is to improve the definition of diagnoses drawn from clinical case registers. Method: The Tasmanian Mental Health Case Register includes 1922 individuals, each with at least one diagnosis of schizophrenia between 1965 and 1990. A representative subsample of 29 individuals were assessed by the structured diagnostic interview for DSM-Ill-R (SCID). Diagnostic agreement between Register and SClD diagnoses was compared. Results: Twenty-four subjects (82.8%) received a lifetime diagnosis of schizophrenia on the SCID. For each subject, ‘schizophrenia diagnostic dominance’, the percentage of register entries with schizophrenia diagnoses over total entries, was calculated. Agreement between register and SClD correlated positively with schizophrenia diagnostic dominance and negatively with register mood diagnoses. Conclusions: Longitudinal diagnostic profiles on databases may be superior to cross-sectional clinical diagnoses in predicting structured interview diagnoses, and may be useful in defining caseness in epidemiological studies using register diagnoses.
Lowering the Language Barrier in an Acute Psychiatric Setting
Authors: Stolk Yvonne , Ziguras Stephen , Saunders Trish , Garlick Robyn , Stuart Geoffrey , Coffey Guy 
Published: January 2008

Objectives: The aim of this paper is to investigate the effectiveness of a training and policy strategy to improve communication opportunities in an acute inpatient unit for patients of non-English-speaking background (NESB) with low English proficiency. Method: A pre- and post-intervention design involved: (i) a survey of the multilingual skills of 80 clinical staff: (ii) recording of patients' ethnic background and proficiency; (iii) pre- and post-intervention data collection of the main outcome measure (communications with patients in a language other than English [LOTE]); and (iv) staff training, and active encouragement, in interpreter use. English proficiency was assessed using the population census proficiency question. Results: Of 257 admissions, 33% were of NESB and 19% preferred to speak a LOTE. The staff survey yielded a 49% return rate and showed that, of 11 LOTEs spoken by patients, seven were also spoken by 17 of the staff. Twenty-nine percent of staff were not clinically proficient in these languages. Compared to the NESB population, a higher proportion of NESB patients rated low on proficiency. Following the intervention, interpreter bookings and booking duration increased significantly. Conclusions: A standard training package and a policy promoting interpreter use improved communication opportunities in an acute setting where language needs are typically poorly met. Failure to ensure effective communicate raises risks of mis-diagnosis and inappropriate treatment. By measuring patients' proficiency directly, the present study identified a higher level of need for interpreter services than estimated by past reports.
Carbamazepine Treatment in a Case of Musical Hallucinations with Temporal Lobe Abnormalities
Authors: Terao Takeshi , Tani Yukio 
Published: January 2008

Objective: The aim of this paper is to describe a case of musical hallucinations with temporal lobe abnormalities responding to carbamazepine treatment. Clinical picture: A 63–year-old woman suffered from musical hallucinations accompanied by mild left temporal spike activity. Treatment: She received carbamazepine treatment. Outcome: Four weeks of carbamazepine treatment diminished her musical hallucinations in parallel with the normalisation of her mild left temporal spike activity. Conclusions: These findings suggest that carbamazepine can be an effective treatment for musical hallucinations with temporal lobe abnormalities.
Lithium Augmentation of Venlafaxine in Adolescent Major Depression
Authors: Walter Garry , Lyndon Bill , Kubb Rosie 
Published: January 2008

Objective: Studies on the pharmacotherapy of adolescent major depression are limited but suggest that the illness is often resistant to drug treatment. We aim to report the use of lithium augmentation of venlafaxine in two teenagers with major depression. Clinical picture: Two 16–year-olds with major depression are described. Treatment: In both patients, the treatment involved trials of a selective serotonin re-uptake inhibitor, venlafaxine, and psychotherapy preceded lithium augmentation of venlafaxine. The trial of venlafaxine alone had been short in one patient. Outcome: Combining lithium and venlafaxine was rapidly followed by marked improvement in mood and function. Conclusions: Augmentation of antidepressants should be considered in young depressed patients who fail to respond to adequate trials of new antidepressants alone.
The Nameless Father in the Poetry and Life of Francis Webb
Authors: Powell Craig 
Published: January 2008

Objective: A brief biographical review of the poet Francis Webb was carried out, with reference to his mental illness and recurring themes in his poetry. Method: Material is drawn from a recent biography and the author's personal encounters with the poet. Reference is also made to Lacan's theory of psychosis and Winnicott's construct of the “transitional object”. Results: The poetry may be seen in part as a transitional object whereby the poet sought to repair deficits in the structure of the self and contain psychotic chaos. Conclusions: The poems have a beauty and power beyond any psychoanalytic theorising, but may also be read as a vital striving toward self-healing on the part of the poet.
A Comparison of Estimates of the Prevalence of Heavy Drinkers in Local Regions of Queensland
Authors: Crook Gabrielle M. , West Mark E. , Oei Tian P.S. 
Published: January 2008

Objective: This study developed and compared separate estimates of the number of heavy drinkers (the in-need population for alcohol treatment interventions) across eight local regions in Queensland. Method: Estimates were based on: (i) a self-report population survey of alcohol consumption; and (ii) an application of the Ledermann log-normal distribution of consumption model to liquor sale figures. Results: Estimates based on the 1989–1990 National Health Survey (NHS) data indicated that 10.98% (n = 83 880) of adult male drinkers and 1.25% (n = 6581) of adult female drinkers in Queensland (total = 90 461) were on average drinking the equivalent of six or more standard drinks a day in the week prior to the survey (4.74% of Queensland adult drinkers, n = 90,461). Estimates based on the Ledermann model indicated that 12.18% of adult Queensland drinkers (n = 232,283) were drinking six or more standard drinks a day. Estimates based on the Ledermann model were 157% larger than estimates based on NHS data (i.e. a difference of 141 821 heavy drinkers), with large variations in the two estimates across local regions. Conclusion: The NHS data appears to underestimate the population of heavy drinkers, whereas the Ledermann model overestimates it. In this situation, it seems preferable to use the more conservative self-report survey estimates.
Severe Morbid Onychophagia: The Classification as Self-Mutilation and a Proposed Model of Maintenance
Authors: Wells Jennifer H. , Haines Janet , Williams Christopher L. 
Published: January 2008

Objectives: The aim of this review is to make a distinction between a mild and a severe form of onychophagia (nailbiting) that has not been adequately recognised in clinical research. Furthermore, the aim is to emphasise the need for greater under standing of the motivation for such self-injury as occurs in the severe form. The purpose of making the distinction is to evaluate whether a label of self-mutilation can be applied to the severe form. If this is the case, the tension-reduction model of self-mutilation can be proposed as the mechanism which may maintain the behaviour in the face of serious social and physical consequences. Method: Examination was made of the literature relating to onychophagia and to self-mutilation. Treatment studies of onychophagia were examined to evaluate the mechanisms by which the behaviour may be maintained. Results: Considering the self-mutilative nature of the severe form and the common theme of tension reduction in the literature on onychophagia, application of the tension-reduction model of self-mutilation is warranted. Conclusion: There is a need for empirical research as to the tension-reducing nature of severe onychophagia.
(You Gotta Have) Faith
Authors: Korner Anthony 
Published: January 2008

Objective: The modern scientific tendency to disavow the relevance of faith is questioned, particularly in relation to psychiatric practice. An experience-near approach to psychiatric practice, inclusive of human values such as faith, is highlighted. Method: Drawing upon the philosophical work of Jaspers and the developmental psychology of Stern, a model is built up of the flow of lived experience that relies to a large extent on what can be “taken on faith” rather than “known about”. An argument is presented that from this standpoint of “lived reality”, the separation of fact and value inherent in modern scientific thought is not valid. Conclusions: It is found that lived experience is infused with faith in three senses: that of faith-in-oneself, that of faith-in-the-other; and that of transcendent faith. Each of these is shown to be relevant to praxis in psychiatry. Failure to include faith in psychiatric thinking may lead to a distancing of the discipline from the level of everyday experience. Key words: fact, faith, lived reality, transcendence, value.