bluuebunny/crossref_metadata_2025_split huggingface dataset:
Suicide in Australian Farming, 1988–1997
Authors: Page Andrew N. , Fragar Lyn J. 
Published: March 2003

Objectives: To identify and describe suicide data for occupational classifications relating to farm managers and agricultural labourers for Australia for the period 1988 to 1997, and to relate resultant suicide rates to farmers’ terms of trade. Method: Descriptive and linear regression analysis of aggregated mortality data. Results: In the period 1988 to 1997, 921 suicides were identified. The majority of these suicides were farm managers (67.4%). Farm manager suicides occurred predominantly in older age groups (55 + years). In comparison agricultural labourer suicides were younger, with the majority of suicides occurring in the 15–39 years age group. The most common methods for both groups were firearms (particularly hunting rifles and shot guns), hanging and motor vehicle exhaust gas. These methods accounted for approximately 81% of all male farm suicides. Firearms accounted for 51% of male farm suicide, in comparison to 23% for the wider Australian male population for the same period. Estimated age standardized rates per 100 000 for male farm managers for the 10-year period ranged from 24.8 to 51.4. For male agricultural labourers these rates ranged from 23.5 to 41.9. Analyses also revealed a negative correlation (r = −0.75, p < 0.01) between farm manager suicide rates and farmers’ terms of trade. Conclusion: Male farm manager and agricultural labourer suicide rates are higher than male national rates and rates in the wider rural population, particularly in the later years of the period investigated. Firearms prefigure as the most common method of suicide, despite decreases in this method in the wider rural population. Establishing more accurate denominator data for the farming community is a priority, as is preventative action that accounts for unique aspects of farm life.
Factors Associated With Dysmorphic Concern and Psychiatric Morbidity in Plastic Surgery Outpatients
Authors: Kisely Stephen , Morkell Daniel , Allbrook Bruce , Briggs Patrick , Jovanovic Jasmina 
Published: March 2003

Objectives: To compare new referrals to a plastic surgery clinic for cosmetic (non-medically explained) reasons with a control group of equal size with medically explained symptoms. Method: Patients attending for cosmetic (non-medically explained) reasons were compared with the controls using the general health questionnaire (GHQ), and dysmorphic concern questionnaire (DCQ). Patients were divided into high and low DCQ scores on the basis of their median scores. Results: Ninety subjects were approached of whom 84 (93%) participated giving 42 patients each in the cosmetic (non-medically explained) and control groups. Forty-four per cent were referred for mammoplasty (n = 37) and 8% for rhinoplasty (n = 7). The other 40 cases (48%) were for other procedures including excision, abdominoplasty and blepharoplasty. Thirty-two per cent of the sample were GHQ cases (n = 27). Patients presenting for cosmetic (non-medically explained) reasons were 13 times more likely to be female (95% CI = 4.3–41), nine times more likely to have high DCQ scores (95% CI = 3.3–24), six times more likely to be GHQ cases (95% CI = 2.1–17), and seven times more likely to present for mammoplasty. The same factors were associated with high DCQ scores. Patients with high DCQ scores were 32 times as likely to be GHQ cases (95% CI = 6.8–151). On multivariate analysis, dysmorphic concern emerged as the only independent predictor of GHQ caseness rather than sex, surgical diagnosis or procedure (adjusted OR = 32.0, 95 % CI = 6.5–156). Similarly, only GHQ caseness and presentation for cosmetic (non-medically explained) surgery independently predicted DCQ score. Conclusions: Patients presenting for cosmetic (non-medically explained) surgery have high rates of dysmorphic concern and psychiatric morbidity
Deinstitutionalization for Long-Term Mental Illness: A 6-Year Evaluation
Authors: Hobbs Coletta , Newton Lesley , Tennant Christopher , Rosen Alan , Tribe Kate 
Published: March 2003

Objective: Forty-seven patients with long-term mental illness were transferred to the community following the closure of a psychiatric hospital in Sydney. This 6-year evaluation is an extension of a detailed clinical, ethnographic and economic study of the initial 2-years of community transition. Method: Quantitative evaluation was conducted using the Brief Psychiatric Rating Scale, Life Skills Profile, Social Behaviour Scale, Montgomery Asberg Depression Rating Scale and Quality Of Life measures. Assessments were completed prior to discharge and at two- and 6-year intervals following community transfer. Repeated measures analysis was utilized to determine changes in outcome variables over time. The residents' perception of 6-years of community living was explored in qualitative semistructured interviews. Details of accommodation, level of care, readmissions, incidents and medication were also documented. Results: During the 6 years following community relocation a total of seven residents returned to hospital for long-term care, three residents died from medical causes and one resident required detention in a corrective services facility. The 36 residents who remained in the community at the 6-year follow-up no longer required intensive 24-h supervision. Living semi-independently, 23 residents resided in two to three person accommodation with either daily or weekly case manager visits. Clinically, community residents remained stable over the 6 years without significant changes in psychiatric symptoms, depression, living skills or social behaviour problems. Clinical stability was achieved with significant reduction in medication levels over the 6 years. Community-based residents continued to experience improved quality of life and reported their marked preference for living in the community. Conclusion: The residents maintained community tenure with significant improvement in quality of life and a reduction in medication, supported by a mental health system with adequate community resources. Issues regarding continuing rehabilitation and social integration need to be addressed. Further deinstitutionalization will require 24-h supervision for most initially and for some on a continuing basis. An ageing population will require specific age related medical and psychiatric services.
The Prevalence and Nature of Stalking in the Australian Community
Authors: Purcell Rosemary , Pathé Michele , Mullen Paul E. 
Published: March 2003

Objective: This study examines the extent and nature of stalking victimisation in a random community sample. Method: A postal survey was distributed to 3700 adult men and women selected from the electoral roll in the State of Victoria. Outcome measures included the lifetime and annual cumulative incidence of stalking, the duration and methods of harassment, rates of associated violence and responses to victimisation. Results: Almost one in four respondents (23.4%;432) had been stalked, the unwanted behaviour they were subjected to being both repeated and fear-provoking. One in 10 (197) had experienced a protracted course of stalking involving multiple intrusions spanning a period of at least one month. Women were twice as likely as men to report having been stalked at some time in their lives, though the rates of victimisation in the 12 months prior to the study did not differ significantly according to gender. Younger people were significantly more likely than older respondents to report having been stalked. Victims were pursued by strangers in 42% of cases. The most common methods of harassment involved unwanted telephone calls, intrusive approaches and following. Associated threats (29%) and physical assaults (18%) frequently arose out of the stalking. Significant social and economic disruption was created by the stalking for 63% of victims. Most sought assistance to manage their predicament (69%). Conclusions: The experience of being stalked is common and appears to be increasing. Ten percent of people have been subjected at some time to an episode of protracted harassment. Assaults by stalkers are disturblingly frequent. Most victims report significant disruption to their daily functioning irrespective of exposure to associated violence.
Life Events, Stress and Depression: A Review of Recent Findings
Authors: Tennant Christopher 
Published: March 2003

Objective: To review recent empirical prospective studies on the relation between life event stressors and depression. Method: A systematic literature search focusing on predictive studies was carried out from 1980 to early 2001 using Medline, Embase and PsychInfo. Results: The empirical findings for the most part support clinical impressions of the relation of stressors to depression but at the same time provide some clearer understanding in relation to differences of stressor impact on depression type and on index episode, relapse or recurrence. Twin studies now provide the strongest evidence of the relative magnitude of effect of environmental stressors and genetic factors: the former explains at least as much of the variance in depression as our genes. Conclusions: Continuing research into life events and depression have been fruitful especially those studies assessing the effect of stressors in combination with other aetiological variables such as genetic factors.
Treatments for Chronic Fatigue Syndrome and the Internet: A Systematic Survey of what Your Patients are Reading
Authors: Kisely Stephen R 
Published: March 2003

Objective: To evaluate the type, quality, and focus of patient information on the treatment of chronic fatigue syndrome on the Internet using simple search techniques. Design: The search phrase ‘chronic fatigue syndrome’ was entered into nine common Internet search engines. The 25 most highly ranked pages identified by each of the nine search engines were analysed using a standardized pro forma. The following outcome measures were used: balance of content, consistency of content with evidence-based practice, declared authorship with credentials, information sources including the presence of references, the declaration of any potential conflict of interest, and the need to clarify information with an appropriate health professional. Results: Two hundred and twenty-five websites were reviewed during a 2-week period in September 2000. A further 15 sites (6.3%) were inaccessible. Agreement between websites and systematic reviews of treatment for chronic fatigue syndrome ranged from 4 to 68%, the greatest agreement being for recommendations for graded exercise and the avoidance of prolonged rest. Most sites (64%) had a named author. Only a quarter to a third contained a declaration of interest, advised readers to clarify information with an appropriate health professional, or avoided inaccurate statements. Conclusions: The Internet contains a great deal of information on chronic fatigue syndrome that is neither balanced nor consistent with evidence-based practice. Doctors individually, and as a profession, should provide guidance on which Internet sites to trust.
Cardiotoxicity and Prescription of Thioridazine in New Zealand
Authors: Menkes David B , Knight James C 
Published: March 2003

Objective: To review the production of cardiac arrhythmia by thioridazine, and consider the role of government regulation in light of antipsychotic prescribing trends in New Zealand. Methods: We conducted a focused literature review on psychotropic-induced cardiotoxicity, including mechanisms and incidence. In addition, we considered trends in antipsychotic prescription in New Zealand and decisions made by regulatory bodies in Australia, North America and the United Kingdom regarding restrictions on the prescription of thioridazine. Results: In general, the cardiotoxicity of antipsychotics, including thioridazine, relates to the ability of these drugs to antagonize voltage-sensitive potassium channels, and thereby prolong the QT interval. This action can lead to malignant arrhythmias in a very small proportion (< < 1%) of patients; the risk may be increased by other drugs or factors which prolong QT or inhibit the metabolism of thioridazine. A review of prescription doses and volumes in New Zealand indicates that thioridazine is prescribed mainly in low doses by nonspecialists, and its use has been waning significantly over the past 2 years. These trends predate recent publicity regarding cardiotoxicity. Conclusions: Recommendations regarding thioridazine use are presented. Although new patients should not receive this drug, existing patients benefiting from modest doses should not be denied access unless clear-cut risk factors for cardiotoxicity are evident.
Project for a Scientific Psychiatry in the 21st Century
Authors: Levy Florence , Levy Florence 
Published: March 2003

Objective: To discuss potential advances in neuroscientific knowledge in the 21st century, enabling the realization of Freud's original vision of a basic biological science and an associated metapsychology. Results: The Australian Twin Study of Attention Deficit Hyperactivity Disorder (ADHD) has demonstrated the high heritability of the core symptoms of ADHD, as well as showing important genetic and environmental influences on comorbid conditions. Brain mapping techniques suggest that working memory, as measured by an A–X Continuous Performance Task, is important in ADHD. Methods: To outline the development of our own clinical research into ADHD, and the potential for future behaviour and molecular genetic approaches. Conclusions: The 21st century promises new and exciting developments in phenomenology, genetics, and neuroscientific understandings in Child Psychiatry.
Pro Re Nata Medication for Psychoses: An Audit of Practice in Two Metropolitan Hospitals
Authors: Geffen Josh , Sorensen Lene , Stokes Julie , Cameron Allison , Roberts Michael S. , Geffen Laurence 
Published: March 2003

Objective: To examine the use of pro re nata (PRN) (as needed) medication in hospitalized patients with psychotic disorders. Methods: Retrospective chart reviews were conducted at two large public psychiatry units situated in inner city general hospitals. Pro re nata medication prescription, administration and outcomes were examined during inpatient episodes of care for 184 consecutive admissions of patients diagnosed with a psychotic disorder. Patient demographics, diagnoses, and regularly prescribed medication were also recorded. All admissions were drawn from a threemonth period from December 1998–February 1999. Results: The most prevalent diagnoses were schizophrenia related disorders (n = 111) and mania (n = 34). Substance use disorders (n = 49) were the most common comorbid disorders. Pro re nata medication was administered during the acute phase of 82% of admissions. Drugs prescribed Pro re nata were mostly typical antipsychotics, benzodiazepines and/or anticholinergics. Coprescription of typical antipsychotics PRN with regularly scheduled atypical antipsychotics was common (64%). Pro re nata medications accounted for 31% of the total antipsychotic dose and 28% of the total anxiolytic dose administered during acute treatment. Higher daily doses of PRN medication were given to manic patients, males, younger patients and those with substance use disorders. Pro re nata prescriptions usually specified a maximum daily dose (87%) but rarely gave indications for use (6%). Administration records frequently lacked a specified reason for use (48%) or a notation of outcome (64%). Unit staff noted medication-related morbidity in 37% of patients receiving PRN medication, compared to 3% of patients receiving only regularly scheduled medication. Extrapyramidal symptoms (EPS) were most frequently associated with administration of PRN haloperidol (Relative Risk vs other PRN medications = 5.61, 95% CI = 2.36–13.73). Conclusions: Pro re nata medications comprised a significant part of the treatment which psychotic patients received. The common practice of coprescribing PRN typical antipsychotics with scheduled atypical antipsychotics is potentially problematical since administration of PRN medication is associated with significant medication related morbidity. Preferential use of benzodiazepines as PRN agents may minimize this morbidity and foster subsequent compliance with regularly prescribed antipsychotics.
The Mental Health Status of Filipinas in Queensland
Authors: Thompson Samantha , Hartel Gunter , Manderson Lenore , Stirling Nicole , Kelaher Margaret 
Published: March 2003

Objective: To determine the prevalence and investigate potential predictors of psychological distress in Filipino women living in Queensland, Australia. Methods: The sample of n = 487 women (88% response rate) was drawn from Filipino organization membership lists and supplemented by snowball sampling. Participants were interviewed in their homes or at a community event in 1996/1997. Follow-up in 1997/1998 involved n = 346 women (71% response rate) who were interviewed either in their homes or by telephone. The two surveys included measurement of demographic, immigration, physical health, satisfaction with life in Australia and life event variables. The GHQ-28 was included in the follow-up survey as a measure of psychological distress. Results: The proportion of women having an above threshold score (using the cut-off of 4/5) on the GHQ-28 was 23%. Women who were single, dissatisfied with life in Australia, had reported a major change in their financial situation, their relationship or their health in the year between surveys were significantly more likely to have an above threshold score. Conclusions: The level of mental distress among Filipinas in Queensland appears to be slightly higher than the levels reported in the general population but lower than other migrant groups. The determinants of mental distress in this population contrast with those in the general Australian population and other migrant groups. The social context of these determinants in Filipinas needs to be elicited for an understanding of these differences.
The Esperance Primary Prevention of Suicide Project
Authors: Slaven Janine , Kisely Stephen 
Published: March 2003

Background: Suicide has been a major community concern in Esperance, a geographically isolated port on the south coast of Western Australia. Aims: To evaluate the effect of three evidence-based initiatives for the primary prevention of suicide: (i) providing suicide awareness sessions for staff members in health, education and social services; (ii) limiting the sale of over the counter analgesics (aspirin and paracetamol) to packets containing less than the minimum lethal dose; and (iii) implementing Commonwealth media guidelines in the reporting of suicides by media. Methods: Changes in knowledge, awareness, attitudes, comfort and use, before and after each intervention were assessed using standardized instruments and pro forma derived from previous work, such as the Youth Suicide Prevention Training Manual and Suicide Intervention Beliefs Scale. Percentage changes in the number of retail outlets selling over the counter analgesics to less than potentially lethal quantities (less than 8 g of paracetamol or aspirin) were also measured. Media representatives were interviewed to gain their perceptions of Commonwealth Guidelines for the reporting of suicide, and encouraged to consult the project team before reporting suicide related issues. Results: The baseline survey illustrated that mental health staff and general practitioners were more aware of suicide issues, risk factors for suicide and awareness of professional and ethical responses than staff from other services, and were more willing to raise the issue with a person at risk. Thirty-three subjects participated in suicide awareness training of whom 21 (66%) returned questionnaires. There were significant increases in awareness of suiciderelated issues and risk factors, as well as reported levels of knowledge of professional and ethical responses and comfort, competence and confidence levels when assisting a person at risk. Only three media representatives were aware of the Commonwealth Health Department Guidelines for reporting suicide and only one believed that the guidelines influenced their reporting. The local newspapers subsequently contacted the researchers to check that their reporting met the guidelines. As regards access to analgesics, one out of seven retailers agreed to implement the strategy (pending agreement from other retailers), another claimed increased awareness of the danger of analgesics, and three maintained that they would attempt to monitor excessive amounts sold to one individual. Conclusions: Local initiatives can improve the awareness and knowledge of staff in the assessment of suicide risk, as well as of local media. These need to be complemented by initiatives at State or Commonwealth level to produce change in statewide media, or sales of over the counter analgesics.
Cortical Excitability of Psychiatric Disorders: Reduced Post-Exercise Facilitation in Depression Compared to Schizophrenia and Controls
Authors: Reid Philip D. , Daniels Brett , Rybak Marzena , Turnier-Shea Yvonne , Pridmore Saxby 
Published: March 2003

Objective: In normal subjects, motor evoked potentials (MEPs) produced by transcranial magnetic stimulation (TMS) from the motor cortex are increased after non-fatiguing exercise of hand muscles. This phenomenon is called post-exercise facilitation. This study aims to test the hypothesis that psychiatric syndromes (major depressive episode, schizophrenia) have different levels of post-exercise facilitation compared to controls. Methods: Patients with DSM-IV major depressive episode (six female, four male), schizophrenia (two female, nine male) and a control group (nine female, four male) participated. MEPs were elicited pre- and post-exercise from the contralateral abductor pollicis brevis by TMS over the primary motor cortex. Results: Post-exercise facilitation expressed as a percentage of baseline was 510% in controls, 110% in depression and 190% in schizophrenia. There were significant differences in patients with depression and schizophrenia compared to controls (p = 0.0001, p = 0.0008). Conclusions: Post-exercise facilitation was reduced in depression and schizophrenia, suggesting impaired cortical excitability in these disorders. Further studies may discriminate between the two groups.
What is Duty/Triage? Understanding the Role of Duty/Triage in an Area Mental Health Service
Authors: Grigg Margaret , Herrman Helen , Harvey Carol 
Published: March 2003

Objective: To describe the duty/triage system within one urban area mental health service in Australia and to investigate the factors that affect the decision to organize a comprehensive assessment. Method: Data was collected from 3 months of duty/triage information and key informant interviews. Policies and procedures related to duty/triage were reviewed. Quantitative and qualitative analyses were conducted. Results: Two thousand, six hundred and three contacts with duty/triage occurred over a 3-month period. Half of these were related to patients new to the service. Most contacts were self-referrals or referrals from a carer. Few referrals came through the primary health care sector. New patients were more likely to be assessed if the referral was presented in technical language and if it was initiated by a health professional, particularly a general practitioner, emergency department or other mental health service. Assessment was less likely if the patient or carer initiated the referral, if the problem was presented in vague or non-technical terms, if there was a drug or alcohol problem or if the person refused care. Conclusions: A substantial number of potential patients contact a duty/triage worker every day. However, there is little interaction with the primary care sector, limited documentation of risk and a lack of consistency in the documented reasons for the service response. Further investigation is needed of the conditions conducive to consistent quality decision making at the point of entry to a specialist mental health service.