bluuebunny/crossref_metadata_2025_split huggingface dataset:
SPECT Scan in Somatization Disorder Patients: An Exploratory Study of Eleven Cases
Authors: Garcia-Campayo Javier , Sanz-Carrillo Concepcion , Baringo Teresa , Ceballos Concepción 
Published: March 2003

Objective: There are no previous studies using single photon emission computed tomography (SPECT) scans in somatization disorder (SD) patients. The aim of this paper is to assess SPECT imaging abnormalities in SD patients and study any relation to laterality. Method: Eleven SD patients from the Somatization Disorder Unit of Miguel Servet University Hospital, Zaragoza, Spain, not fulfilling criteria for any other psychiatric disorder and showing normal computed tomography (CT) and magnetic resonance imaging (MRI) images were studied with SPECT. Patients with DSM-IV axis I comorbidity were ruled out because it has been demonstrated that SPECT scans can show abnormalities in patients with depression and anxiety disorders. The technique used for SPECT was 99mTc-D,1,hexamethylpropyleneamide- oxime (99mTc-HMPAO) in four patients and 99mTc-bicisate in the other seven. The SPECT scans were evaluated without knowledge of clinical data and entirely by visual inspection. Results: Seven out of 11 (63.6%) SD patients showed hypoperfusion in SPECT imaging. In four cases there was hypoperfusion in the non-dominant hemisphere and the predominance of pain symptoms took place in the contralateral hemibody. In the other three patients hypoperfusion was bilateral. The anatomical regions affected were cerebellum (four cases), frontal and prefrontal areas (three cases), temporoparietal areas (two cases) and the complete hemisphere (one case). Conclusions: A proportion of SD patients may present hypoperfusion in SPECT images, uni- or bilaterally, in different brain areas. Possible aetiological explanations for this finding are discussed. Controlled studies are necessary to confirm or refute this hypothesis.
Prevalence of Psychological Distress and Psychiatric Disorders Among Homeless Youth in Australia: A Comparative Review
Authors: Kamieniecki Gregory W. 
Published: March 2003

Objective: To review the prevalence literature on psychological distress and psychiatric disorders among homeless youth in Australia, and to compare these rates with Australian youth as a whole. Method: Computerized databases were utilized to access all published Australian studies on psychological distress (as measured by standardized symptom scales and suicidal behaviour) and psychiatric disorders among homeless youth; in addition, unpublished Australian studies were utilized whenever accessible. A total of 14 separate studies were located, only three of which have included non-homeless control groups. In the current review, prevalence data from uncontrolled youth homelessness studies are compared with data from Australian community and student surveys. Results: Homeless youth have usually scored significantly higher on standardized measures of psychological distress than all domiciled control groups. Youth homelessness studies have also reported very high rates of suicidal behaviour, but methodological limitations in these studies make comparisons with community surveys difficult. Furthermore, rates of various psychiatric disorders are usually at least twice as high among homeless youth than among youth from community surveys. Conclusions: Homeless youth in Australia have extremely high rates of psychological distress and psychiatric disorders. As homeless youth are at risk of developing psychiatric disorders and possibly self-injurious behaviour the longer they are homeless, early intervention in relevant health facilities is required.
Psychiatric Assessment in Remote Aboriginal Communities
Authors: Sheldon Mark 
Published: March 2003

Objective: The objective of this study was to describe the psychiatric assessment of Aboriginal patients from remote Aboriginal communities in Central Australia. Method: The method consisted of a summary of the experiences gained during a dissertation year placement as senior registrar with the Northern Territory Remote Area Mental Health Team. Results: Remote area Aboriginal psychiatry entails learning a whole new set of skills in terms of history taking and the mental state examination, a knowledge of the importance of extended kinship ties and cultural issues, the use of Aboriginal mental health workers as partners in assessing and managing patients via their families and accepting referrals from a wide range of sources. Conclusions: Working on a service providing psychiatric care to remote area Aboriginal communities can be a deeply rewarding personal and professional experience.
Timing, Space and ADHD: The Dopamine Theory Revisited
Authors: Levy Florence , Swanson James M 
Published: March 2003

Objective: The objective of this study was to review the dopamine theory of attention deficit hyperactivity disorder (ADHD) in terms of advances made over the last decade. Method: ‘Hyper’ and ‘hypo’ dopaminergic theories are discussed, as well as noradrenergic and neuropsychological findings in ADHD. A model incorporating both anterior and posterior attention systems, involved in orienting, inhibition, vigilance and working memory, is described. Neuropsychological studies of covert orienting are reviewed. Results: The dopamine theory is supported by neuroimaging, genetic and stimulant medication studies, which confirm an inhibitory dopaminergic effect at striatal/prefrontal level. Work in rodents and primates, as well as humans has shown that noradrenergic systems are also important in prefrontal regulation, in particular α2A noradrenergic agonists have a beneficial effect on cognitive tasks. Neuropsychological studies implicate posterior parietal mechanisms in the orienting of attention. Working memory may require integration of spatial and temporal information, involving anterior and posterior systems. Conclusions: Anterior and posterior attention systems are involved in inhibition, working memory and orientation. Attention deficit hyperactivity disorder symptoms and subtypes are likely to reflect deficits in both inhibition and working memory, and may be heterogenous. While the dopamine theory is supported by genetic and stimulant medication studies, the work of Arnsten and colleagues suggests a potential role for α2 noradrenergic agonists such as guanfacine.
Predictors of Partially Met or Unmet Need Reported by Consumers of Mental Health Services: An Analysis of Data from the Australian National Survey of Mental Health and Wellbeing
Authors: Parslow Ruth A. , Parslow Ruth A. , Jorm Anthony F. 
Published: March 2003

Objective: We examined data from the 1997 National Survey of Mental Health and Wellbeing to identify factors associated with consumers of mental health help reporting that their needs were unmet or only partially met. Predictor factors included sociodemographic variables, psychological morbidity measures and type of health practitioner seen. Method: Five types of mental health help were considered: information, medication, psychological therapy, social interventions and skills training. A respondent's unmet need for each type of mental health help was given one of three values: 0: no unmet need reported; 1: some but not enough help of this type provided; and 2: no help of this type provided although it was needed. Multiple ordered logistic regressions were undertaken to identify predictor variables associated with reporting unmet need for each type of help. Results: Few sociodemographic factors were found to be associated with consumers reporting unmet need for mental health help. Those with less education were more likely to report unmet need for medication. Being male, living alone and being unemployed were associated with unmet need for skills training. Having seen a general practitioner for mental health reasons was found to be associated with reporting unmet need for both information and social interventions. Self-identifying, or being diagnosed, as having an anxiety disorder was associated with reporting unmet need for four of the five types of help. Conclusions: In this exploratory analysis, we examined factors associated with consumers of mental health help reporting that their needs were unmet or partially met. We found that the needs of those with anxiety problems were not generally well met. Our findings also indicate there is a need to continue to improve collaboration between the medical and community services sectors.
Suicidal Behaviour in People with HIV/AIDS: A Review
Authors: Komiti Angela , Judd Fiona , Grech Paul , Mijch Anne , Hoy Jenny , Lloyd John H. , Street Alan 
Published: March 2003

Objective: To review the existing literature on suicidal behaviour in people with HIV/AIDS infection. Method: A search on the Index Medicus/MEDLINE database was performed, for articles that investigated and/or reviewed suicidal behaviour in people with HIV at any stage of the illness. Only articles written in English were used in this review. Results: Most studies have been done on homosexual/bisexual groups, with little data available for heterosexual populations or women. Studies show an increased rate of suicidal ideation, suicide attempts and completed suicide in individuals with HIV/AIDS. Of note, there is a high prevalence of psychiatric illness and substance abuse in those with suicidal behaviour. Conclusions: The increased rate of suicidal behaviour in HIV-infected persons is consistent with findings in other medically ill groups with chronic, life-threatening disorders. However, assessment of any possible direct effect of HIV/AIDS on suicidal behaviour is confounded by methodological limitations of many of the studies. More longitudinal studies encompassing other affected groups including heterosexual populations and women are needed to elucidate the relationship between suicidal behaviour and HIV/AIDS.
Types of Patients in a Psychiatric Intensive Care Unit
Authors: Wynaden Dianne , Mcgowan Sunita , Chapman Rose , Castle David , Lau Peter , Headford Craig , Finn Michael 
Published: March 2003

Objective: This paper reports the findings of a descriptive study of a patient population over a three-month period on an eight bed psychiatric intensive care unit (PICU) in Western Australia. The report provides a quantitative insight into the profile of patients in PICUs. It provides information on patients’ diagnoses, presenting signs, symptoms and/or behaviours, legal codes assigned to patients, treatment interventions and management. Method: Data were collected prospectively from August to October 1999. A total of 122 patients were admitted to the PICU during the review period. Data were entered into an Access program then exported to SPSS (Version 9 for Windows) for analysis and frequency distributions were obtained. Results: The results confirmed that the majority of patients admitted to the PICU were assessed as a high level of risk or needed containment. This finding is in line with the admission criteria developed by staff working in the PICU. It also supports the view that staff working in these units require expertise and confidence to communicate with and manage potentially aggressive and highly aroused patients. Conclusion: This study demonstrates the importance of ongoing evaluations of patient populations in promoting best practice initiatives in psychiatric care.
The Identification and Treatment of Depression by General Practitioners
Authors: Krupinski Jerzy , Tiller John W.G. 
Published: March 2003

Objective: To assess the level of recognition and knowledge about treatment of depression by General Practitioners (GPs). Method: Analysis of questionnaires completed by participants commencing a series of workshops aimed at improving their knowledge of the diagnosis and treatment of depression. Of the 3289 GPs involved in the program 2500 (76%% respondent rate) completed the questionnaires in a group situation. There was no difference between respondents and nonrespondents in terms of age, gender and year of graduation. Results: The majority of GPs believe they have a satisfactory competence in the recognition and treatment of depression, although a sizeable minority based their diagnosis predominantly on somatic symptoms. The GPs felt confident about their knowledge and skills in counselling and the use of antidepressant medication, but not in dealing with children and suicidal or pregnant patients. The most common symptoms used to identify ‘depression’ were sleep disorders and only 54%% listed depressed mood as a symptom on which the diagnosis is based. Only 28%% reported sufficient symptoms to meet criteria for DSM-IV major depressive disorder, which supports views that these criteria are inappropriate for general practice. Fifty-seven percent of doctors used medicine together with nonpharmacological treatment in the majority of patients, and medications doses were almost all within the range recommended in the product information. Conclusions: There is a need to improve GPs knowledge in diagnosing depression, in child psychiatry and in dealing with pregnant and suicidal patients.
Reduction of Trauma Symptoms Following Group Therapy
Authors: Nisbet Wallis Denise A. 
Published: March 2003

Objective: We examined the effect of a group programme for the treatment of adults suffering the sequelae of childhood abuse and/or neglect. Symptom reduction was the indicator of whether this group programme was an effective treatment modality. Method: This was an experimental field study using a prepost design and General Linear Model (GLM) analyses. The group programme was conducted for adult survivors of child abuse and neglect and took place at Specialty Clinics, Central Coast Mental Health Services. There were 83 participants, comprising 64 women and 19 men; 56 were in the experimental group, and 17 in the control (waitlist) group. The Trauma Symptom Inventory (TSI) was administered to both experimental and control groups prior to receiving treatment and again three months later. Results: General Linear Model analyses indicated there was a reduction of trauma symptoms for the experimental group on seven of the 10 scales of the TSI and on the three composite scales; no similar reduction was found for the control group. Conclusions: The study indicates that this group programme may have been an effective treatment modality for abuse survivors. The level of symptomatology was reduced for those in the group programme compared with the control group for whom there were no changes.
Depictions of Mental Illness in Print Media: A Prospective National Sample
Authors: Coverdale John , Nairn Raymond , Claasen Donna 
Published: March 2003

Objective: Because there are no published reports of depictions of mental illness in print media based on national samples, we set out to prospectively collect and analyse a near complete New Zealand sample of print media. Methods: A commercial clipping bureau was contracted to provide cuttings of all items with any mental health or illness aspect over a four week period. These items were analysed for potentially positive and negative depictions and how mental illness was represented within each item. An independent search for additional newspaper items concerning one prominently featured topic indicated that the rate of identification of relevant stories was at least 91%. Result: The collection consisted of six hundred print items which were most commonly news or editorial pieces (n = 562, 93.7%). Negative depictions predominated, with dangerousness to others (n = 368, 61.3%) and criminality (n = 284, 47.3%) being the most common. Positive depictions, including human rights themes, leadership and educational accomplishments occurred in 27% (n = 164) of all items. Generic mental illness terminology without reference to specific diagnostic categories was present in 47% of all items (n = 284). Conclusions: Negative depictions that predominate confirm the stereotypic understanding of mental illness that is stigmatizing. These findings underscore the challenge facing us as mental health professionals attempting to change attitudes towards mental disorders when the stereotypes are so regularly reinforced.
Parent and Child Report of Family Functioning in a Clinical Child and Adolescent Eating Disorders Sample
Authors: Mcdermott Brett M , Batik Mary , Roberts Lynne , Gibbon Peter 
Published: March 2003

Objective: To investigate parent and self-report of family dysfunction in children and adolescents with eating disorders. Further, to investigate family functioning differences across the eating disorders diagnostic groups; anorexia nervosa, eating disorders not otherwise specified (EDNOS) and bulimia nervosa, and between the restricting and binge-purge eating disorders behavioural subtypes. Methods: The Family Adjustment Device General Functioning Scale (FAD-GFS) was administered to 100 children and their parents who presented consecutively at an eating disorders assessment clinic. DSM-IV eating disorders diagnoses in this group included 42 children diagnosed with anorexia nervosa, 26 with EDNOS, 12 with bulimia nervosa and 20 diagnosed as having no eating disorder. Results: Both the parent and child FAD-GFS report demonstrated high internal consistency supporting the suitability of this instrument for research with this sample. Parent and child reports were moderately positively correlated. Total scores for all eating disorders diagnostic categories were significantly higher than community norms. Anorexia nervosa, EDNOS and bulimia nervosa groups did not significantly differ on parent or child reports. FAD-GFS profiles for restricters and binge-purgers suggest higher levels of family dysfunction in the families of binge purgers. Conclusions: The FAD-GFS has suitable psychometric properties for use as a summary instrument with young people diagnosed with an eating disorder. However, more informative instruments assaying a greater range of constructs, especially in the impulsive, dyscontrol domain, are required to investigate differences among eating disorders diagnostic groups and behavioural subtypes.
A Cognitive Remediation Programme for Adults with Attention Deficit Hyperactivity Disorder
Authors: Stevenson Caroline S , Whitmont Stephanie , Bornholt Laurel , Livesey David , Stevenson Richard J 
Published: March 2003

Objective: This is the first systematic examination of the efficacy of a cognitive remediation programme (CRP) for management of adult Attention Deficit Hyperactivity Disorder (ADHD). The CRP was designed to target problems commonly associated with adult ADHD, namely, attention problems, poor motivation, poor organizational skills, impulsivity, reduced anger control and low self-esteem. Method: In a randomized, controlled trial, a representative sample of adults with ADHD (some medicated, some not) were assigned to either a CRP (n = 22) or a waiting list control (n = 21). The CRP was delivered in an intensive format with eight two-hour, weekly sessions with support people who acted as coaches, and participant workbooks with homework exercises. Results: Participants who completed the CRP reported reduced ADHD symptomatology (effect size (d) = 1.4), improved organizational skills (d = 1.2) and reduced levels of anger (d = 0.5). Clinically significant improvements in ADHD symptomatology (d = 1.4) and organizational skills (d = 1.3) were maintained one year after the intervention. Conclusions: These findings suggest that the CRP provides a practical way of enhancing daily functioning for adults with ADHD.
The Social and Cultural Context of the Mental Health of Filipinas in Queensland
Authors: Thompson Samantha , Manderson Lenore , Woelz-Stirling Nicole , Cahill Amanda , Kelaher Margaret 
Published: March 2003

Objective: To describe the social and cultural context of risk surrounding the mental health of Filipino women living in Queensland, Australia and elicit the meaning and experience of mental health and illness for these women. Methods: One hundred and thirty-nine in-depth interviews and 7 focus group discussions (FGDs) were nested within the baseline survey of the Filipina cohort of the Australian Longitudinal Study on Women's Health. Seventy-four in-depth interviews and 8 FGDs were conducted at follow-up. A semi-structured interview guide that included sections on emotional health, social support and changes guided these. A subset of responses was fully transcribed and analysed for ethnographic content and themes. Results: ‘Mental’ problems are highly stigmatized, in comparison to ‘emotional’ problems that are believed to result largely from the absence of close family ties. The loss of these ties and the transition from a collectivist to individualist society are key themes related to emotional distress in Filipinas. Conclusions: This understanding of meaning and context of mental health and its risk factors in migrants is important for informing public health and clinical practice and for the improvement of quantitative research instruments.
Demoralization: Its Phenomenology and Importance
Authors: Clarke David M. , Kissane David W. 
Published: March 2003

Objective: Demoralization, as described by Jerome Frank, is experienced as a persistent inability to cope, together with associated feelings of helplessness, hopelessness, meaninglessness, subjective incompetence and diminished self-esteem. It is arguably the main reason people seek psychiatric treatment, yet is a concept largely ignored in psychiatry. The aim here is to review and summarize the literature pertaining to demoralization in order to examine the validity of the construct. Method: A narrative review of demoralization and the related concepts of hope, hopelessness, and meaning is presented, drawing on a range of empirical and observational studies in the medical and psychiatric literature. Results: An examination of the concepts of the ‘Giving Up–Given Up’ syndrome (George Engel), ‘suffering’ (Eric Cassell), and demoralization (Jerome Frank), demonstrate considerable convergence of ideas. Demoralization has been commonly observed in the medically and psychiatrically ill and is experienced as existential despair, hopelessness, helplessness, and loss of meaning and purpose in life. Although sharing symptoms of distress, demoralization is distinguished from depression by subjective incompetence in the former and anhedonia in the latter. Demoralization can occur in people who are depressed, cancer patients who are not depressed and those with schizophrenia. Hopelessness, the hallmark of demoralization, is associated with poor outcomes in physical and psychiatric illness, and importantly, with suicidal ideation and the wish to die. Conclusions: Demoralization is an important construct with established descriptive and predictive validity. A place needs to be found for it in psychiatric nomenclature.