bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increasing Diagnosis of Nicotine Dependence in Adolescent Mental Health Patients
Authors: Sellman J. Douglas , Wootton Alexander R. , Stoner David B. , Deering Daryle E. , Craig Brian J. 
Published: March 2003

Objective: The aim of this study was to investigate the routine recording patterns of patients' smoking by clinical staff of an adolescent mental health service over a 3-year period. Method: A systematic examination of the clinical files of all patients who underwent an initial assessment or reassessment at the Youth Specialty Service (Mental Health; YSS) over a 2-month period (1 April-31 May) was carried out in 1996, 1997 and 1998. A range of data were collected including: demographics; diagnoses; amount of total information recorded and history of nicotine dependence. Results: A stable historical record of cigarette smoking in the region of 30–40% across the 3 years sampled was found, but the rate of formal diagnosis of nicotine dependence rose from 3.6% in 1996 to 26.3% in 1998. This rise was in the context of relative stability over this time period of: size of reports and relevant sections (alcohol and drug history, cigarette smoking history); three other key diagnoses, major depression, conduct disorder and alcohol dependence; and demographic data. The rise in rate of diagnosis proceeded specific discussion within the clinical team about nicotine dependence. Conclusions: Adolescent mental health settings are a key venue to address heavy and potentially chronic cigarette smoking, but nicotine dependence has been traditionally a neglected diagnosis in mental health patients. The rate of diagnosis is likely to rise when specific discussion is undertaken within clinical teams.
Early Developmental Experiences of Female Sex Workers: A Comparative Study
Authors: Potter Kathleen , Martin Judy , Romans Sarah 
Published: March 2003

Objective: The aim of this paper is to explore the early family environment of a sample of female sex workers and compare the findings with a large community data set of similarly aged women. Method: Sex workers recruited by a snowball method were given a semi-structured interview, which included the Parental Bonding Instrument. These results were compared to those from the Otago Women's Child Sexual Abuse (OWCSA) study. Results: The sex workers' families were of lower socioeconomic status and had experienced more parental separation than had the OWCSA families. The mothers of sex workers were more frequently the family's main wage earner. Sex workers described both parents as less caring than did the OWCSA women. They were significantly more likely than the OWCSA women to report childhood sexual abuse. The sex workers were more likely to have left home early, to have become pregnant before the age of 19 years and to not have completed tertiary study. Conclusions: The sex workers studied came from families with more interpersonal difficulties during childhood and adolescence than did a control community sample of similarly aged women. The relevance and generalisability of this conclusion to the wider sex worker population is difficult to determine, given the non-random selection of this sex worker sample.
A Conceptual Review of Functioning: Implications for the Development of Consumer Outcome Measures
Authors: Fossey Ellie M. , Harvey Carol A. 
Published: March 2003

Objective: Australia's National Mental Health Strategy aims to achieve improved consumer outcomes. The development and refinement of consumer outcome measures is targeted within the Second National Mental Health Plan. The National Standards for Mental Health Services identify measures of functioning, quality of life and satisfaction with services as relevant to assessing and monitoring consumer outcome. Consumers have described gauging their own recovery through the achievement of functional goals in everyday life. This paper reviews how functioning is viewed within the mental health field, and implications for developing better functional outcome measures. Method: Literature describing the development of measures of functioning, principles of outcome measurement, and functional outcomes for people with severe mental illness was identified, using PsycLIT. A review yielded themes reflecting a number of assumptions about the concept of functioning. Results: Functioning is inadequately defined, raising issues about what is focused on, and from whose viewpoint, each of which has implications for using measures of functioning to monitor consumer outcome. Conflation of dissimilar functional domains, and flawed assumptions about the importance of symptomatology in influencing functional outcome limit the sensitivity to meaningful change of functional measures. Consumer perspectives are relatively neglected in functional tool development. Conclusions: A conceptual framework that recognizes lived experience and the interaction between persons and their environment is much needed to guide the development of functional outcome measures. Qualitative and quantitative research methodologies should be used to advance understanding of functioning and to address limitations of current approaches to functional outcome measurement.
Stalking: New Constructions of Human Behaviour
Authors: Mullen Paul E. , Pathé Michele , Purcell Rosemary 
Published: March 2003

Objective: In the last decade stalking has emerged as a significant social problem, which now constitutes a specific form of criminal offence in most English-speaking nations. This paper examines why stalking has become a major social problem and why it should be of particular concern to mental health professionals. Method: Using the extant literature, the history of the emergence of stalking as social, legal and behavioural science discourses is presented. An attempt is made to understand the social and cultural forces which shaped our current understanding of the phenomenon of stalking. Results: Stalking flourishes in a variety of contexts; the social conditions conducive to such behaviour include greater instability in intimate relationships, a culture of blame and entitlement and a growing social anxiety that emphasizes vulnerability to crime and suspicion regarding the intentions of strangers. Stalking is now an established category whose utility is in directing social, legal and health energies to support victims and relieve stalkers of their burden of pursuit. Conclusions: Stalking is a curious construction born of a range of tensions in contemporary culture but has proved to be a useful label and a useful concept. In part due to the emergence of the concept of stalking, laws are now available to protect, and services increasingly geared to support, the victims of persistent harassment.
Cognitive–Behavioural Therapy via Videoconferencing to a Rural Area
Authors: Cowain Taryn 
Published: March 2003

Objective: This case report describes the use of cognitive–behavioural therapy via twoway, interactive audiovisual videoconferencing and identifies issues involved in using this form of technology to provide therapy. Clinical picture: A 38-year-old married woman living in rural South Australia presented with panic disorder with agoraphobia and major depression. The patient had refused antidepressant treatment. Treatment: The patient was treated with 12 sessions of cognitive–behavioural therapy delivered via videoconferencing. Outcome: Anxiety and depressive symptoms resolved with concomitant improvement in function. Conclusions: Providing this form of therapy via videoconferencing can be effective.
Assessing Stressful Life Events in Relation to Liability and Compensation
Authors: Tennant Christopher 
Published: March 2003

Objective: The aim of this paper is to outline limitations in the assessment of the relationship between stressful experiences and psychological disorder in the medico-legal setting. Method: A research-derived approach to more objectively assessing stressful life events and disorder is discussed in the light of limitations or biases which may arise in the evaluation of the clinical significance of stressors in psychological disorder particularly in a medico-legal context. Results: There may be considerable bias in the assessment of stressful experiences in a medico-legal setting. In addition to the purely subjective approach used in the appraisal of stressful life events it may be useful to (i) apply common sense and population-based appraisal as an initial basis for assessing the significance of a stressor; (ii) use evidencebased findings to support the link between stressors and disorder; and (iii) apply recognized criteria of causality where applicable. Conclusions: Conflicting psychiatric opinions in the medico-legal setting may arise both from psychiatrists' positional biases, from the often complex relationships that may exist between stressors and depression, and from a failure to use evidence-based findings to support psychological explanations.
The Validity of the 12-Item General Health Questionnaire in Australia: A Comparison Between Three Scoring Methods
Authors: Donath Susan 
Published: March 2003

Objective: To investigate the specificity and sensitivity of three different scoring methods of the 12-item General Health Questionnaire (GHQ-12) and hence to determine the best GHQ-12 threshold score for the detection of mental illness in community settings in Australia. Method: Secondary data analysis of the 1997 Australian National Survey of Health and Wellbeing (n = 10 641), using the Composite International Diagnostic Interview as the gold standard for diagnosis of mental illness. Results: The area under the Receiver Operating Characteristic (ROC) curve for the C-GHQ scoring method was 0.84 (95% CI = 0.83–0.86) compared with the area for the standard scoring method of 0.78 (95% CI = 0.76–0.80). The best threshold with C-GHQ was 3/4, with sensitivity 82.9% (95% CI = 80.2–85.5%) and specificity 69.0% (95% CI = 68.6–69.4%). The best threshold score with the standard scoring method was 0/1, with sensitivity 75.4% (95% CI = 72.5–78.4%) and specificity 69.9% (95% CI = 69.5–70.3%). These were also the best thresholds for a subsample of the population who had consulted a health practitioner in the previous 4 weeks. Conclusion: In the Australian setting, the C-GHQ scoring method is preferable to the standard method of scoring the GHQ-12. In Australia the GHQ-12 appears to be a less useful instrument for detecting mental illness than in many other countries.
Family History of Schizophrenia and the Relationship of Stress to Symptoms: Preliminary Findings
Authors: Norman Ross M. G. , Malla Ashok K. 
Published: March 2003

Objective: It has been hypothesized that patients with a diagnosis of schizophrenia who have a positive family history for schizophrenia will show greater reactivity of their symptoms to increasing levels of stress or negative affect than will patients without such a family history. In the past this hypothesis has only been tested through manipulations of negative affect in laboratory settings. In this paper we test this hypothesis using longitudinal clinical data. Method: Data were derived from an earlier longitudinal study using monthly assessments of daily stressors (Hassles Scale) and symptom measures (the Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms). We compared longitudinal stress to symptom relations in 12 patients with schizophrenia for whom a positive family history of schizophrenia could be identified with 12 matched schizophrenic patients without any known family history of psychiatric illness. Results: There was evidence that patients with a family history of schizophrenia demonstrated a stronger relation between stress and total score on the Scale for the Assessment of Positive Symptoms. This difference appears to have primarily reflected a greater reactivity to stress of reality distortion symptoms in the positive family history group. The two groups did not differ in apparent reactivity to stress of the disorganization and psychomotor poverty dimensions of symptomatology. Conclusions: The results of this study provide support from a naturalistic, longitudinal clinical study for the hypothesis that reactivity to stress of some symptoms of schizophrenia may vary as a function of family history of the disorder.
A 12-Month Follow Up of the Implementation of Clinical Indicators in a Consultation–Liaison Service
Authors: Holmes Alex C.N. , Judd Fiona K. , Yeatman Richard , Lloyd John H. , Dakis Jennifer , Cairns Fiona , Kiang Maria , Kerr Louise , Mckinnon Jonathan 
Published: March 2003

Objectives: This paper reviews the use of clinical indicators in a consultation–liaison (C–L) service over a 12-month period at the Royal Melbourne Hospital, Melbourne, Australia. Method: Clinical indicators and C–L data were collected during the 1999 calendar year. A review of the process was conducted during and after completion of the 12-month period. Results: The system was found to be practical and useful. The use of clinical indicators led to the identification of problems and stimulated effective interventions. The use of the clinical indicators was associated with improvement in communication between C–L staff, parent units and practitioners providing follow-up. Conclusions: The implementation of a database and clinical indicators was a useful addition to the C–L service. The use of clinical indicators was effective in improving clinical performance. These benefits need to be balanced against increased administrative burden.
Psychiatry has Much to Offer for Chronic Pain
Authors: Pridmore Saxby , Oberoi Gajinder , Harris Newman 
Published: March 2003

Objective: The objective of this study was to make an argument in favour of the inclusion of psychiatrists on chronic pain clinic teams. Method: The argument takes the form of answers to four central questions: (i) does pain involve an emotional experience; (ii) do psychiatric disorders accompany chronic pain; (iii) can psychiatric disorders present as chronic pain; and (iv) which patients present to pain units, and what do we know of their personalities? Results: The affirmative case was substantiated in respect of the first three questions. In examining the last question, evidence indicates that patients who present to chronic pain units frequently have personality features that make assessment and therapy difficult. Conclusions: Psychiatry is the field of medicine where practitioners have the most experience with emotional states and personality, and is the only field where they have specialized skills in the diagnosis and treatment of psychiatric disorders. Psychiatry has much to offer in chronic pain management and chronic pain management teams should include a psychiatrist. This conclusion has resourcing and training implications.
Depression and Smoking: Examining Correlates in a Subset of Depressed Patients
Authors: Roy Kay , Parker Gordon , Mitchell Philip , Wilhelm Kay 
Published: March 2003

Objective: The objective of this study was to examine for associations between depression and cigarette smoking. Method: A sample of 92 depressed smokers was compared with a control sample of depressed non-smokers, matched for age, gender and diagnostic variables. Comparisons were made across a range of demographic, depression, family history, developmental factors, anxiety and personality style variables, as well as use of alcohol and illicit drugs. Results: We failed to find any difference between smokers and non-smokers in history or severity of depression. Cigarette smokers were distinguished principally by greater exposure to aversive experiences in childhood, disordered personality function, greater use of illicit drugs, anxiolytics and alcohol. Logistic regression identified dysfunctional personality ‘domains’, physical violence in childhood, long-term anxiolytic use and illicit drug use as the most significant predictor set. Conclusions: Results favour a model of cigarette smoking and depression as linked by shared early deprivational variables, rather than cigarette smoking causing depression or the converse.
Major Depression: Does a Gender-Based Down-Rating of Suicide Risk Challenge Its Diagnostic Validity?
Authors: Blair-West George W. , Mellsop Graham W. 
Published: March 2003

Objective: This paper will summarize the authors' research that disproved the accepted lifetime suicide risk in major depression. It will then explore the pivotal issue of gender in understanding suicide risk in depression and raise questions as to whether this is adequately reflected in the current diagnostic construct of this condition. Method: The methods of two recent papers published by the authors are briefly recounted. In the first of these papers, an age-specific algorithm was developed to reflect the necessary mathematical relationship between the prevalence of major depression, total population suicide rates and suicide risk in depression. It allowed for deaths in each age group from other causes, corrected for official underreporting, and was calculated on the entire population of the USA. In the second paper this methodology was further refined and applied to gender and age data. Results: The suicide risk in major depression as it is currently defined diagnostically is of the order of 3.4% rather than the previously accepted figure of 15%. However, a single figure is misleading as it averages two highly disparate figures of almost 7% for men and only 1% for women. In youths (< age 25) the male : female ratio is even higher (10:1). Conclusions: Among sufferers of major depression, men and those who have been hospitalized have a much greater risk of suicide. These findings are sensitive to diagnostic inclusivity (the algorithm's denominator) which raises the question as to whether women with a depressive illness are more likely to be correctly identified than male sufferers? An argument is made for a gender-based nosological revision of the diagnostic criteria. In the interim, given the treatable morbidity of depression and the availability of safe, welltolerated antidepressants, there is a prima facie case for lowering our threshold of treatment in men and youths presenting with a history of anger dyscontrol, or substance abuse, who have decompensated from previous levels of functioning and who show features of either typical or atypical depression.
Challenges and Benefits of Assessment, Diagnosis, and Taxonomy for Clinical Practice and Research
Authors: Achenbach Thomas M. 
Published: March 2003

Objective: To outline nosological (top-down) and empirically based (bottom-up) approaches to assessment and taxonomy of psychopathology. Method: The two approaches were compared and contrasted to highlight similarities and differences between them. Results and Conclusions: To advance services and research, we need to make optimal use of assessment data (i) to identify the distinguishing features of each case, and (ii) to link individual patterns of functioning with taxonomic constructs that can help us apply previously accumulated knowledge to new cases. The time may be ripe for integrating nosological and empirically based approaches. One way to integrate these approaches is to construct empirically based and DSM-oriented scales from the same item pools and to generate age- and gender-specific standard scores and cut-off points from the same normative samples. Integration of the approaches was illustrated with profiles of empirically based and DSM-oriented scales scored from the same item pools and quantified in relation to the same normative samples. To facilitate use by clinicians and researchers under diverse conditions, data are readily obtained on forms completed independently by parents, teachers and others. The data can be quickly scored by hand or computer. To take account of situational and informant variations, the computer software systematically compares data from multiple informants on empirically based and DSM-oriented scales.
Mind Over Matter? II: Implications for Psychiatry
Authors: Schimmel Paul 
Published: March 2003

Objective: To explore concepts of causality within the mind and aetiology of psychiatric disorders in the light of the proposed formulation of the mind–brain problem. Method: Taking the two propositions of this formulation as ‘first principles’ a logical analysis is attempted. Results and conclusions: Neural activity cannot in principle be regarded as causing mental activity, or vice versa. Causal processes are most coherently conceptualised in terms of the ‘mind–brain’ system. Determination of causal and aetiological effects will always necessitate consideration of contextual evidence. Because of the ‘explanatory gap’ between explanation in neurophysiological terms and ‘mentalistic’ terms, whenever formulation in mentalistic terms is possible this will carry greater explanatory power; that is, it will carry meaning in the way a neural formulation cannot.
Association between Allergy and Anxiety Disorders in Youth
Authors: Kovalenko Pavel A , Hoven Christina W , Wu Ping , Wicks Judith , Mandell Donald J , Tiet Quyen 
Published: March 2003

Objective: Studies have documented associations between anxiety disorders and allergy in adults, but these associations have not been studied extensively in children. The objective of this study is to examine the associations between allergy and six anxiety disorders (AD) in youth. Method: This is a data analysis of two epidemiologic-services studies: (i) alternative service use patterns of youth with serious emotional disturbance (n = 936), and (ii) methods for the epidemiology of child and adolescent mental disorders (n = 1285). Child psychiatric diagnoses were measured by the diagnostic interview schedule for children. Allergy was assessed by the service utilization and risk factors interview. Results: Among ADs, the strongest association found was between allergy and panic disorder (adjusted odds ratio 5.0; p ≤?0.001). Associations of allergy and the other ADs do not seem to be clinically significant. Conclusions: Findings suggest that in some patients panic disorder may be associated with hypersensitivity of immune system. Panic disorder should be considered in anxious children reporting allergy when no organic cause of allergy is found, and likewise allergy should considered in children with panic disorder.