Journal articles on the topic 'Mental Diagnosis Australia'
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1
Edward, Karen-leigh, Rhonda Nelson Hearity, and Boyce Felstead. "Service integration for the dually diagnosed." Australian Journal of Primary Health 18, no. 1 (2012): 17. http://dx.doi.org/10.1071/py11031.
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The needs of dually diagnosed clients in mental health services have been and remain a focus for service development and improvement in Australia. The Council of Australian Governments committed to a five-year National Action Plan on Mental Health with a $1.8 billion injection into mental health services. In Australia there have been great advances in the service initiatives and service deliverables to those clients who experience a dual diagnosis. These advances include that dual diagnosis is systematically identified and responded to in a timely, evidence-based manner as a core business in mental health and alcohol and other drug services. These advances are brought to life by specialist mental health and alcohol and other drug services that establish effective partnerships and agreed mechanisms to support integrated care and collaborative practice. Here, four case studies are offered as a means of illustrating the ways in which projects undertaken in local community health services have approached dual diagnosis treatment for clients. These case studies reflect how cooperation and cross-referral between services, as well as effective management of dual diagnosis clients by suitably qualified staff can produce benefits to clients who use the service.
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Ben-Tovim, David, Robert Elzinga, John Pilla, Stuart McAllister, Kay Wilhelm, George Lipton, Rene Pols, John Franklin, and Marlene M. Waters. "A Casemix for Mental Health Services: The Development of the Mental Health and Substance abuse Components of the Australian National Diagnosis-Related Groups." Australian & New Zealand Journal of Psychiatry 30, no. 4 (August 1996): 450–56. http://dx.doi.org/10.3109/00048679609065016.
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Objective: To describe the development of the mental health and substance abuse sections of the version of the Australian casemix system, Australian national diagnosis-related groups 3 (AN-DRG 3), released in July 1995. Method: The guiding principles and data sources used to construct the mental health and substance abuse components of AN-DRG 3 are described by the group who undertook that task. The group used data sets of patients separating from hospitals throughout Australia, and from hospitals in South Australia, to examine the capacity of existing and revised diagnosis-related groups (DRGs) to predict patients' lengths of hospital stay. They also reviewed the lists of conditions allowed as complicating and comorbid conditions within the AN-DRG system. Results: A variety of recommendations were made including: moving organic mental disorder DRGs to a neuroscience area of the AN-DRG; completely reorganising the mental health section of the casemix; creating a number of narrowly defined DRGs covering areas such as schizophrenia, major affective disorders, anxiety disorders and eating disorders, while allowing for a limited number of more heterogenous DRGs; and simplifying substance abuse DRGs into groups covering alcohol and other substances, and differentiating intoxication and withdrawal from abuse and dependency. Conclusions: A casemix dialect based on clinical diagnosis, which describes mental health and substance abuse problems in terms which should be familiar to clinicians, has been developed. Its applications and limitations are briefly discussed.
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Fitzpatrick, Scott J., Tonelle Handley, Nic Powell, Donna Read, Kerry J. Inder, David Perkins, and Bronwyn K. Brew. "Suicide in rural Australia: A retrospective study of mental health problems, health-seeking and service utilisation." PLOS ONE 16, no. 7 (July 21, 2021): e0245271. http://dx.doi.org/10.1371/journal.pone.0245271.
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Background Suicide rates are higher in rural Australia than in major cities, although the factors contributing to this are not well understood. This study highlights trends in suicide and examines the prevalence of mental health problems and service utilisation of non-Indigenous Australians by geographic remoteness in rural Australia. Methods A retrospective study of National Coronial Information System data of intentional self-harm deaths in rural New South Wales, Queensland, South Australia and Tasmania for 2010–2015 from the National Coronial Information System. Results There were 3163 closed cases of intentional self-harm deaths by non-Indigenous Australians for the period 2010–2015. The suicide rate of 12.7 deaths per 100,000 persons was 11% higher than the national Australian rate and increased with remoteness. Among people who died by suicide, up to 56% had a diagnosed mental illness, and a further 24% had undiagnosed symptoms. Reported diagnoses of mental illness decreased with remoteness, as did treatment for mental illness, particularly in men. The most reported diagnoses were mood disorders (70%), psychotic disorders (9%) and anxiety disorders (8%). In the six weeks before suicide, 22% of cases had visited any type of health service at least once, and 6% had visited two or more services. Medication alone accounted for 76% of all cases treated. Conclusions Higher suicide rates in rural areas, which increase with remoteness, may be attributable to decreasing diagnosis and treatment of mental disorders, particularly in men. Less availability of mental health specialists coupled with socio-demographic factors within more remote areas may contribute to lower mental health diagnoses and treatment. Despite an emphasis on improving health-seeking and service accessibility in rural Australia, research is needed to determine factors related to the under-utilisation of services and treatment by specific groups vulnerable to death by suicide.
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Roberts, Bridget M., and Darryl Maybery. "Dual Diagnosis Discourse in Victoria Australia: The Responsiveness of Mental Health Services." Journal of Dual Diagnosis 10, no. 3 (July 3, 2014): 139–44. http://dx.doi.org/10.1080/15504263.2014.929332.
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Foster, Gavin. "“The dual diagnosis attitudes survey”: understanding the attitudinal impact of training across mental health and alcohol and drug service systems." Advances in Dual Diagnosis 13, no. 4 (October 30, 2020): 137–49. http://dx.doi.org/10.1108/add-05-2020-0004.
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Purpose Anecdotal feedback obtained from alcohol and drug and mental health staff across the eastern metropolitan region of Melbourne, Australia suggests that attitudes towards working with people experiencing a dual diagnosis are becoming more positive. The purpose of this paper is to understand if dual diagnosis-specific training delivered to staff within mental health and alcohol and other drug services was a factor positively influencing attitudes. Design/methodology/approach No formal evaluation assessing the impact of dual diagnosis-specific training on staff attitudes had previously occurred within this region of Australia. Access to staff on two occasions from three distinct sectors provided an opportunity to examine if and, to what degree, attitudes can be influenced by dual diagnosis-specific training. Using a co-designed attitudes survey, information was gathered from mental health and alcohol and drug staff on their attitudes to working with people with co-occurring mental health and substance use problems. Findings Two surveys were conducted involving 186 staff in 2012 and 110 staff in 2016. The dual diagnosis attitudes survey showed that positive attitudes to working with people experiencing a dual diagnosis were associated with recency of training. While attitudes may be improved by dual diagnosis training, these findings cannot exclude the impact of other dual diagnosis capacity building activities. Originality/value This study highlights the benefits of a regional partnership between mental health and alcohol and drug services and people with lived experience of dual diagnosis and the benefit of recent co-designed dual diagnosis training on longitudinally assessed worker attitudes.
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Murphy, Andrea L., Claire L. O’Reilly, Randa Ataya, Steve P. Doucette, Ruth Martin-Misener, Alan Rosen, and David M. Gardner. "A survey of Canadian and Australian pharmacists’ stigma of suicide." SAGE Open Medicine 7 (January 2019): 205031211882034. http://dx.doi.org/10.1177/2050312118820344.
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Background: There is limited information available regarding community pharmacists’ stigma of suicide. Pharmacists regularly interact with people at risk of suicide and stigmatizing attitudes may impact care. Objective: To measure community pharmacists’ stigma of suicide. Method: Pharmacists in Canada and Australia completed an online survey with the Stigma of Suicide Scale–Short Form. Data were analysed descriptively and with univariate and multivariate analyses. Results: Three hundred and ninety-six pharmacists returned completed surveys (Canada n = 235; Australia n = 161; female 70%; mean age = 38.6 ± 12.7 years). The rate of endorsement of stigmatizing terms was low overall. Canadian and Australian pharmacists differed (p < 0.05) for several variables (e.g. age, friend or relative with a mental illness, training in mental health crisis). Pharmacists without someone close to them living with a mental illness were more likely to strongly agree/agree with words describing those who die by suicide as pathetic, stupid, irresponsible, and cowardly. Those without a personal diagnosis of mental illness strongly agreed/agreed with the terms immoral, irresponsible, vengeful, and cowardly. More Australian pharmacists strongly agreed/agreed that people who die by suicide are irresponsible, cowardly, and disconnected. Independent variables associated with a higher stigma were male sex, Australian, and negative perceptions about suicide preventability. Conclusion: Community pharmacists frequently interact with people at risk of suicide and generally have low agreement of stigmatizing terms for people who die by suicide. Research should focus on whether approaches such as contact-based education can minimize existing stigma.
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Enticott, Joanne C., I.-Hao Cheng, Grant Russell, Josef Szwarc, George Braitberg, Anne Peek, and Graham Meadows. "Emergency department mental health presentations by people born in refugee source countries: an epidemiological logistic regression study in a Medicare Local region in Australia." Australian Journal of Primary Health 21, no. 3 (2015): 286. http://dx.doi.org/10.1071/py13153.
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This study investigated if people born in refugee source countries are disproportionately represented among those receiving a diagnosis of mental illness within emergency departments (EDs). The setting was the Cities of Greater Dandenong and Casey, the resettlement region for one-twelfth of Australia’s refugees. An epidemiological, secondary data analysis compared mental illness diagnoses received in EDs by refugee and non-refugee populations. Data was the Victorian Emergency Minimum Dataset in the 2008–09 financial year. Univariate and multivariate logistic regression created predictive models for mental illness using five variables: age, sex, refugee background, interpreter use and preferred language. Collinearity, model fit and model stability were examined. Multivariate analysis showed age and sex to be the only significant risk factors for mental illness diagnosis in EDs. ‘Refugee status’, ‘interpreter use’ and ‘preferred language’ were not associated with a mental health diagnosis following risk adjustment for the effects of age and sex. The disappearance of the univariate association after adjustment for age and sex is a salutary lesson for Medicare Locals and other health planners regarding the importance of adjusting analyses of health service data for demographic characteristics.
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Goldney, Robert D., Penny Kent, and Robert H. Elzinga. "Casemix and Affective Disorders: A Comparison of Private and Public Psychiatric Systems." Australian & New Zealand Journal of Psychiatry 30, no. 4 (August 1996): 511–15. http://dx.doi.org/10.3109/00048679609065025.
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Objective: To determine whether there is a difference in length of stay for patients with affective disorders between private and public psychiatric hospitals. Method: The casemix Australian national diagnosis-related group (AN-DRG) diagnoses of all inpatient separations from private and public psychiatric hospitals in South Australia for 1 year were abstracted from records. The average length of stay for patients with affective disorders was calculated. Results: There was no significant difference in the average length of stay for patients with affective disorders treated in private and public psychiatric hospitals. Conclusions: These results should allay fears that the treatment of patients with affective disorders in any particular treatment setting will be compromised by the introduction of casemix.
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Donath, Susan. "The Validity of the 12-Item General Health Questionnaire in Australia: A Comparison Between Three Scoring Methods." Australian & New Zealand Journal of Psychiatry 35, no. 2 (April 2001): 231–35. http://dx.doi.org/10.1046/j.1440-1614.2001.00869.x.
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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.
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Scott, Russ. "Fetal Alcohol Syndrome Disorder: diminished responsibility and mitigation of sentence." Australasian Psychiatry 26, no. 1 (July 12, 2017): 20–23. http://dx.doi.org/10.1177/1039856217716289.
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Objective: The objective of this study was to consider the implications of a recent Western Australia Court of Appeal decision in which an indigenous youth who had been sentenced for the manslaughter of his neonate child was later diagnosed with Fetal Alcohol Syndrome Disorder. Conclusion: The increased use of the 2016 Australian guide to the diagnosis of fetal alcohol spectrum disorder should be encouraged to enable clinicians to not only diagnose and manage Fetal Alcohol Syndrome Disorder, but also counsel families to prevent it.
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Daluwatta, Amanda, Dushan Peiris, Kathryn Fletcher, Chris Ludlow, and Greg Murray. "Can Sri Lankan Australians Recognise Depression? The Influence of Acculturation, Age and Experiences with Depression on Recognition." International Journal of Environmental Research and Public Health 19, no. 22 (November 11, 2022): 14839. http://dx.doi.org/10.3390/ijerph192214839.
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Mental health literacy is an important determinant of mental health help-seeking and is associated with improved mental health. There is evidence that mental health literacy may be lower amongst some migrant communities in Australia. The present study conducted the first cross-sectional survey of mental health literacy in Sri Lankan Australians between April and October 2020. Participants (N = 404) were presented with a culturally-tailored vignette describing an individual with symptoms of major depressive disorder, with correct recognition determined by the coding of an open text response to the question ‘what’s wrong with Mr Silva?’. Binomial linear regression modelling was conducted to identify predictors of the correct recognition of depression. Approximately 74% of participants recognised the presented symptoms as depression, though multiple other labels were also used by the respondents. The results also suggested that younger age and having a prior diagnosis of depression were significant predictors of recognising depression in the vignette. In the first study of Sri Lankan migrants’ mental health literacy in an Australian context, the rates of depression recognition were comparable to those found in the general Australian population. Further research is urgently required to replicate and extend the present findings and ultimately support the development of tailored interventions aimed at improving mental health literacy across the diverse Sri Lankan Australian community.
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Bobevski, I., A. Rosen, and G. Meadows. "Mental health service use and need for care of Australians without diagnoses of mental disorders: findings from a large epidemiological survey." Epidemiology and Psychiatric Sciences 26, no. 6 (June 19, 2017): 596–606. http://dx.doi.org/10.1017/s2045796017000300.
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Aims.While epidemiological surveys worldwide have found a considerable proportion of people using mental health services not to have a diagnosis of a mental disorder, with possible implications of service overuse, other work has suggested that most people without a current diagnosis who used services exhibited other indicators of need. The aims of the present study were, using somewhat different categorisations than previous work, to investigate whether: (1) Australians without a diagnosis of a mental disorder who used mental health services had other indicators of need; and (2) how rate and frequency of service use in Australia related to level of need, then to discuss the findings in light of recent developments in Australian Mental Health Policy and other epidemiological and services research findings.Methods.Data from the Australian National Survey of Mental Health and Wellbeing (NSMHWB) 2007 was analysed.Results.Most people using mental health services had evident indicators of need for mental health care (MHC), and most of those with lower evident levels of need did not make heavy use of services. Only a small proportion of individuals without any disorders or need indicators received MHC (4%). Although this latter group comprises a fair proportion of service users when extrapolating to the Australian population (16%), the vast majority of these individuals only sought brief primary-care or counselling treatment rather than consultations with psychiatrists. Access and frequency of MHC consultations were highest for people with diagnosed lifetime disorders, followed by people with no diagnosed disorders but other need indicators, and least for people with no identified need indicators. Limitations include some disorders not assessed in interview and constraints based on survey size to investigate subgroups defined, for instance, by socioeconomic advantage and disadvantage individually or by characteristics of area.Conclusions.MHC for individuals with no recognised disorders or other reasonable need for such care may be occurring but if so is likely to be an area-specific phenomenon. Rather than revealing a large national pool of treatment resources being expended on the so-called ‘worried well’, the findings suggested a generally appropriate dose–response relationship between need indicators and service use. Definitive ascertainment of area-specific disparities in this national pattern would require a different survey approach. Government proposals for widespread introduction of stepped-care models that may seek to divert patients from existing treatment pathways need to be implemented with care and well informed by local data.
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Clapperton, Angela, Stuart Newstead, Charlotte Frew, Lyndal Bugeja, and Jane Pirkis. "Pathways to Suicide Among People With a Diagnosed Mental Illness in Victoria, Australia." Crisis 41, no. 2 (March 2020): 105–13. http://dx.doi.org/10.1027/0227-5910/a000611.
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Abstract. Background: People who have mental illness are at increased risk of suicide. Therefore, identifying "typical" trajectories to suicide in this population has the potential to improve the effectiveness of suicide prevention strategies. Aim: The aim of this study was to explore the pathways to suicide among a sample of Victorians with a diagnosed mental illness. Method: Victorian Suicide Register (VSR) data were used to generate life charts and identify typical life trajectories to suicide among 50 Victorians. Results: Two distinct pathways to suicide were identified: (1) where diagnosis of mental illness appeared to follow life events/stressors; and (2) where diagnosis appeared to precede exposure to life events/stressors. Some events acted as distal factors related to suicide, other events were more common as proximal factors, and still others appeared to act as both distal and proximal factors. Limitations: The data source might be biased because of the potential for incomplete information, or alternatively, the importance of some factors in a person's life may have been overstated. Conclusion: Strategies to reduce suicide need to consider the chronology of exposure to stressors in people's lives and clearly need to be different depending on whether proximal or distal risk factors are the target of a given strategy or intervention.
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Carr, Vaughan J., Amanda L. Neil, Sean A. Halpin, Scott Holmes, and Terry J. Lewin. "Costs of Schizophrenia and Other Psychoses in Urban Australia: Findings from the Low Prevalence (Psychotic) Disorders Study." Australian & New Zealand Journal of Psychiatry 37, no. 1 (February 2003): 31–40. http://dx.doi.org/10.1046/j.1440-1614.2003.01092.x.
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Objective: To estimate the costs associated with the treatment and care of persons with psychosis in Australia based on data from the Low Prevalence Disorders Study (LPDS), and to identify areas where there is potential for more efficient use of existing health care resources. Method: The LPDS was a one-month census-based survey of people with psychotic disorders in contact with mental health services, which was conducted in four metropolitan regions in 1997–1998. Mental health and service utilization data from 980 interviews were used to estimate the economic costs associated with psychotic disorders. A prevalencebased, ‘bottom-up’ approach was adopted to calculate the government and societal costs associated with psychosis, including treatment and non-treatment related costs. Results: Annual societal costs for the average patient with psychosis are of the order of $46 200, comprising $27 500 in lost productivity, $13 800 in inpatient mental health care costs and $4900 in other mental health and community services costs. Psychosis costs the Australian government at least $1.45 billion per annum, while societal costs are at least $2.25 billion per annum (including $1.44 billion for schizophrenia). We also report relationships between societal costs and demographic factors, diagnosis, disability and participation in employment. Conclusions: Current expenditure on psychosis in Australia is probably inefficient. There may be substantial opportunity costs in not delivering effective treatments in sufficient volume to people with psychotic disorders, not intervening early, and not improving access to rehabilitation and supported accommodation.
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Almeida, Osvaldo P., and Jianguo Xiao. "Mortality Associated with Incident Mental Health Disorders After Stroke." Australian & New Zealand Journal of Psychiatry 41, no. 3 (March 2007): 274–81. http://dx.doi.org/10.1080/00048670601172772.
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Objective: Sparse information is currently available about the incidence of the major psychiatric syndromes following a stroke and their long-term contribution to morbidity and mortality. This study was designed to determine: (1) the incidence of first ever mental health disorder in amongst stroke patients; (2) the 10-year mortality associated with incident post-stroke mental health disorders. Methods: Design: Retrospective cohort study. Setting: Entire Western Australian community. Participants: First-ever stroke in 1990. Subjects with a prior recorded history of any mental health disorder were excluded from the study. Main outcomes of interest: Incident mental health diagnoses and 10-year mortality. Results: 1,129 hospital stroke contacts were recorded in 1990, with 21 people dying on the same day of contact. Between 1990-2002 36.6% of the survivors received a mental health diagnosis (6.1 per 1,000 person-years): alcohol-related disorders (16.2%), dementia (12.1%), delirium (7.6%), psychotic disorders (6.7%), and depression (5.5%). Mental health disorder onset was usually within 6 months of the stroke. Patients with an incident psychotic disorder were twice as likely to die during the subsequent 10 years as post-stroke controls with no mental health disorder (risk ratio = 2.03, 95%CI = 1.39-2.95). Being a widow (HR = 1.61, 95%CI = 1.13-2.30) or having been born in ‘other countries’ as opposed to Australia (HR = 1.56, 95%CI = 1.15-2.11) was also associated with increased death hazard. Conclusions: Approximately 1 in 3 patients develop a mental health disorder after stroke, although incidence estimates are relatively low. Post-stroke psychosis is associated with greater 10-year mortality, but the mechanisms underlying such an association are yet to be determined.
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Elder-Robinson, Elaina, Abbey Diaz, Kirsten Howard, Darshit Rajeshkumar Parikh, Giam Kar, and Gail Garvey. "Quality of Life in the First Year of Cancer Diagnosis among Aboriginal and Non-Aboriginal People Living in Regional and Remote Areas of Australia." International Journal of Environmental Research and Public Health 19, no. 1 (December 29, 2021): 330. http://dx.doi.org/10.3390/ijerph19010330.
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Little is known of the quality of life (QoL) of cancer patients in the Northern Territory (NT) of Australia, where healthcare delivery is geographically challenged. This exploratory study describes QoL among Aboriginal and non-Aboriginal cancer patients in the NT, in the first year of diagnosis. Participants were recruited from the only cancer care centre in the NT and completed the Assessment of Quality-of-Life questionnaire (AQoL-4D). The results were descriptively analysed. The participants’ (n = 63; mean age 58.8 years) mean AQoL utility score was 0.72 (SD 0.26); patients scored lowest in the relationships and mental health dimensions of the questionnaire (mean 0.89, SD 0.19, and 0.89, SD 0.17, respectively). Participants living in remote and very remote areas (46%) reported higher QoL scores, compared with participants in the outer regional capital city of the NT in the overall (mean 0.76, SD 0.22 and 0.78, SD 0.20 vs. 0.67, SD 0.29, respectively), and mental health dimensions (mean 0.92, SD 0.09 and mean 0.94, SD 0.06 vs. 0.85, SD 0.22, respectively). The findings were suggestive of clinically meaningful differences across socioeconomic groups, cancer and treatment types, and comorbidity status. Mean QoL scores were consistent with previous reports in other Australian cancer cohorts. The findings suggest a need to support cancer patients’ mental health and relationships during the diagnosis and treatment phase of their cancer journey.
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Roberts, Bridget, and Rebecca Jones. "Dual Diagnosis Narratives and Their Implications for the Alcohol and other Drug Sector in Australia." Contemporary Drug Problems 39, no. 4 (December 2012): 663–85. http://dx.doi.org/10.1177/009145091203900404.
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Dual diagnosis discourse, concerning people who are diagnosed with both mental health and substance use problems, has attracted little critical analysis. This article aids reflection on its implications for alcohol and other drug (AOD) treatment services. Qualitative analysis of 19 interviews with a purposive sample of service providers and public servants was validated with informants. Three contrasting narratives emerged—progressive (dual diagnosis discourse has lifted the sector to a level where services can better respond to complex needs in general); remedial (it has simply helped to improve the workforce's expertise in AOD treatment and “catch up”with mental health services); and radical (by patching a fragmented system it has dampened demands for major system reform). The diversity of views supports an argument for a metanarrative which, combining the strengths of the three narratives, continues to pioneer, to educate and, crucially, is explicitly conceptualized as part of a broader picture of well-resourced structural reform.
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Ross, Victoria, Kairi Kõlves, and Diego De Leo. "Beyond psychopathology: A case–control psychological autopsy study of young adult males." International Journal of Social Psychiatry 63, no. 2 (January 23, 2017): 151–60. http://dx.doi.org/10.1177/0020764016688041.
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Background: As young Australian males are at a high risk of suicide, the identification of risk factors other than psychopathology is vital for the development of comprehensive suicide prevention measures. Aims: The study investigated whether there were differences in risk factors and pathways to suicide in young adult males from Queensland, Australia, with and without a diagnosable psychiatric disorder. Methods: A case–control, psychological autopsy method was applied using a control group of young males who had died suddenly from causes other than suicide. Results: Suicide cases without a psychiatric diagnosis more frequently displayed behaviours indicative of their suicidality (such as previous attempts, disposing of possessions and making statements of hopelessness) than controls without a diagnosis. Suicides without a diagnosis also displayed more ‘difficult’ personality traits, such as higher levels of neuroticism and aggression. They also experienced poorer quality of life and were significantly more likely than their controls to have experienced a recent separation from a spouse or partner. Conclusion: The results of this study confirmed the existence of several distinct characteristics of young males who die by suicide in the absence of any diagnosable psychiatric disorder.
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Wearne, Deborah, Amanda Genetti, Sam Restifo, and Alina Harriss. "Are we missing dementia with Lewy bodies?: a case report." Australasian Psychiatry 26, no. 4 (March 13, 2018): 381–83. http://dx.doi.org/10.1177/1039856218762305.
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Objectives: We aim to explore the importance of early diagnosis of dementia with Lewy bodies in order to facilitate effective psychiatric management. We present a case where delayed diagnosis stemming from an atypical presentation illustrates the complex issues involved in identifying and treating this type of dementia. Conclusions: We discuss the difficulty of diagnosis of this disorder in the absence of obvious memory dysfunction or parkinsonian symptoms. We use the case to draw attention to the limited availability of certain investigations and treatment options in Australia.
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Gibbs, Vicki, Fiona Aldridge, Elizabeth Sburlati, Felicity Chandler, Karen Smith, and Lauren Cheng. "Missed opportunities: An investigation of pathways to autism diagnosis in Australia." Research in Autism Spectrum Disorders 57 (January 2019): 55–62. http://dx.doi.org/10.1016/j.rasd.2018.10.007.
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Wood, Debra A., Debra A. Wood, and Philip M. Burgess. "Epidemiological Analysis of Electroconvulsive Therapy in Victoria, Australia." Australian & New Zealand Journal of Psychiatry 37, no. 3 (June 2003): 307–11. http://dx.doi.org/10.1046/j.1440-1614.2003.01182.x.
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Objective: To determine the population-based utilization rate of electroconvulsive therapy (ECT) in Victoria between 1998–1999, to examine the characteristics of the ECT treated group, and to identify patient factors independently associated with differential rates of ECT treatment. Method: Electroconvulsive therapy is reported under statute in Victoria, Australia. Crude, age-adjusted and age–sex specific utilization rates were calculated using this statutory data for the 1998–1999 financial year and estimated mid-year populations from the Australian Bureau of Statistics. Descriptive characteristics of those treated with ECT were derived from the statutory data. Patient factors associated with an increased likelihood of ECT in the public sector were explored with logistic regression analysis, using non-ECT treated mental health patients from the Victorian Psychiatric Case Register as the reference population. Results: The crude treated-person and age-adjusted rates for the State (both public and private sectors) were 39.9 and 44.0 persons per 100 000 resident population per annum, respectively. The crude and age-adjusted administration rates were 330.3 and 362.6 ECT administrations per 100 000 resident population per annum, respectively. Age–sex specific rates varied by age and sex, with rates generally increasing with age and female sex. Overall, 62.8% of the treated group were women, 32.9% aged over 64, and 75.2% had depression. Diagnosis, age and sex each independently predicted ECT in the public sector, with diagnosis the most important factor, followed by age then sex. Conclusions: Despite decades of use, the appropriate rate of ECT utilization is still unclear. Further research should be directed at exploring the factors, including provider variables, determining ECT treatment.
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DEANS, C., and R. SOAR. "Caring for clients with dual diagnosis in rural communities in Australia: the experience of mental health professionals." Journal of Psychiatric and Mental Health Nursing 12, no. 3 (June 2005): 268–74. http://dx.doi.org/10.1111/j.1365-2850.2005.00830.x.
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Rossi, Alberto, Vera Morgan, Francesco Amaddeo, Marco Sandri, Michele Tansella, and Assen Jablensky. "Psychiatric Out-Patients Seen Once Only in South Verona and Western Australia: A Comparative Case-Register Study." Australian & New Zealand Journal of Psychiatry 39, no. 5 (May 2005): 414–22. http://dx.doi.org/10.1080/j.1440-1614.2005.01590.x.
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Objective: This study examined variables associated with having a once-only contact with the out-patient department of two community mental health services in Italy and Australia. Method: Two 8-year cohorts of patients, who had a new episode of care with out-patient psychiatric departments in South Verona and in Western Australia, were followed-up for 3 months after the first contact, to identify those patients who had no further contact with services. Potential determinants of once-only contact were analysed. Results: Thirty percent of new episodes of care for persons who met the inclusion criteria of the study were once-only contacts with the service in South Verona. In Western Australia, the figure was 24%. Moreover, the proportion of once-only contact patients has increased over time in South Verona whereas, in Western Australia, it has remained stable. In Western Australia, once-only contact patients were younger whereas in South Verona they tended to be older. At both research sites, patients who had a once-only contact were more likely to be male and to have a less severe mental illness. Conclusions: The results of this study suggest that only clinical characteristics were significant determinants of this pattern of contact with services consistently at both sites: the less severe the patient's diagnosis, the more likely the patient is to have a once-only contact. This may well indicate good screening at the initial point of contact by both sets of mental health service providers. Prospective studies are necessary to clarify the problem of ‘onceonly contact’ and to organize a proper psychiatric care.
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Browne, Graeme, Mary Courtney, and Tom Meehan. "Type of housing predicts rate of readmission to hospital but not length of stay in people with schizophrenia on the Gold Coast in Queensland." Australian Health Review 27, no. 1 (2004): 65. http://dx.doi.org/10.1071/ah042710065.
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Accommodation is considered to be important by institutions interested in mental health care both in Australia andinternationally. Some authorities assert that no component of a community mental health system is more importantthan decent affordable housing. Unfortunately there has been little research in Australia into the consequences ofdischarging people with a primary diagnosis of schizophrenia to different types of accommodation. This paper usesarchival data to investigate the outcomes for people with schizophrenia discharged to two types of accommodation.The types of accommodation chosen are the person's own home and for-profit boarding house. These two were chosenbecause the literature suggests that they are respectively the most and least desirable types of accommodation.Results suggest that people with schizophrenia who were discharged to boarding houses are significantly more likelyto be readmitted to the psychiatric unit of Gold Coast Hospital, although their length of stay in hospital is notsignificantly different.
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Draper, Brian, and Lee-Fay Low. "Psychiatric services for the “old” old." International Psychogeriatrics 22, no. 4 (March 15, 2010): 582–88. http://dx.doi.org/10.1017/s1041610210000293.
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ABSTRACTBackground: Few studies have specifically examined mental health service delivery to persons aged over 84 years, often described as the “old” old. Our aim was to compare mental health service provision in Australia to persons aged 85 years and over with the “young” old and other age groups. We hypothesized that the “old” old would differ from the “young” old (65–84 years) by diagnostic category, rates of specialist psychiatric hospital admission, and use of Medicare funded psychiatric consultations in the community.Methods: Mental health service delivery data for 2001–02 to 2005–06 was obtained from Medicare Australia on consultant psychiatrist office-based, home visit and private hospital services subsidized by the national healthcare program and the National Hospital Morbidity database for separations (admitted episodes of patient care) from all public and most private hospitals in Australia on measures of age, gender, psychiatric diagnosis, location and type of psychiatric care.Results: Use of specialist psychiatric services in the community per annum per 1000 persons declined with age in men and women from 137.28 and 191.87 respectively in those aged 20–64 years to 11.84 and 14.76 respectively in those over 84 years. However, men and women over 84 years received psychiatric home visits at 377% and 472% respectively of the rates of persons under 65. The annual hospital separation rate per 1000 persons for specialist psychiatric care was lowest in those aged over 84 (3.98) but for inpatient non-specialized psychiatric care was highest in those over 84 (21.20). Depression was the most common diagnosis in specialized psychiatric hospitalization in those aged over 84 while organic disorders predominated in non-specialized care in each age group over 64 years with the highest rates in those aged over 84.Conclusion: Mental health service delivery to persons aged over 84 is distinctly different to that provided to other aged groups being largely provided in non-specialist hospital and residential settings.
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Moss, Beverley, and Nick O'Connor. "The Development of Consensus Guidelines for the Treatment of Young People with First Episode Psychosis." Australasian Psychiatry 10, no. 2 (June 2002): 111–14. http://dx.doi.org/10.1046/j.1440-1665.2002.00418.x.
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Objective: The aim is to describe the process adopted in Northern Sydney, Sydney, Australia for developing consensus guidelines for the treatment of young people with first episode psychosis. Method: The process included academic detailing with psychiatrists working in Northern Sydney adolescent and adult mental health services, two clinician forums, and a survey. While the guidelines were based on the Australian Clinical Guidelines for Early Psychosis and published studies, the expertise of clinicians in Northern Sydney was also sought. Results: The consensus guidelines have been endorsed for use in Northern Sydney. The guidelines cover the issues of assessment and treatment of psychosis in young people, investigations, use of parenteral medication, diagnosis, and information for clients. Conclusions: The authors make several observations about the process of guideline development. Academic detailing proved to be a more effective way than questionnaires for obtaining information from clinicians. The process of developing the guidelines seemed to be, in some ways, more important than the final product.
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Husodo, Cortney, Brett McDermott, Calogero Longhitano, and Gabrielle Matta. "Functional outcomes in rural Australia of two continuing care teams: a regional town–city comparison of the 16-item Life Skills Profile." Australasian Psychiatry 29, no. 2 (February 24, 2021): 139–44. http://dx.doi.org/10.1177/1039856221992652.
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Objective: The primary aim was to examine differences in functional health outcomes in consumers entering a regional mental health service compared with a city service. Method: A retrospective analysis of consumer outcomes and characteristics was undertaken. Consumer demographics and diagnoses were compared between the two services. Functional outcomes were measured using the 16-item Life Skills Profile (LSP-16). The data analysis plan utilised descriptive statistics. For between-clinic comparisons, relevant inferential statistics was used. Results: Patients attending the regional health service were five times more likely to be in the high impairment category on the LSP-16, independent of demographic factors and diagnosis. Other independent contributions to high impairment were being male, Indigenous and a diagnosis of schizophrenia. Of the four LSP-16 subscales, regional consumers scored relatively higher on withdrawal, compliance and anti-social but not self-care subscales. Conclusions: There was a greater level of functional impairment in consumers attending the regional service. The independent contributions did not explain the higher impairment; therefore, other factors such as socioeconomic disadvantage may explain the difference. Regional clinicians may need to consider recovery-orientated interventions that address a greater burden of functional impairments in regional services.
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Vallesi, Shannen, Matthew Tuson, Andrew Davies, and Lisa Wood. "Multimorbidity among People Experiencing Homelessness—Insights from Primary Care Data." International Journal of Environmental Research and Public Health 18, no. 12 (June 16, 2021): 6498. http://dx.doi.org/10.3390/ijerph18126498.
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Background: Although the poor health of people experiencing homelessness is increasingly recognised in health discourse, there is a dearth of research that has quantified the nature and magnitude of chronic health issues and morbidity among people experiencing homelessness, particularly in the Australian context. Methods: Analysis of the medical records of 2068 “active” patients registered with a specialist homeless health service in Perth, Western Australia as of 31 December 2019. Results: Overall, 67.8% of patients had at least one chronic physical health condition, 67.5% had at least one mental health condition, and 61.6% had at least one alcohol or other drug (AOD) use disorder. Nearly half (47.8%) had a dual diagnosis of mental health and AOD use issues, and over a third (38.1%) were tri-morbid (mental health, AOD and physical health condition). Three-quarters (74.9%) were multimorbid or had at least two long-term conditions (LTCs), and on average, each patient had 3.3 LTCs. Conclusions: The study findings have substantial implications from both a health risk and healthcare treatment perspective for people experiencing homeless. The pervasiveness of preventable health conditions among people experiencing homelessness also highlights the imperative to improve the accessibility of public health programs and screening to reduce their morbidity and premature mortality.
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Smith, Graeme C. "The Future of Consultation–Liaison Psychiatry." Australian & New Zealand Journal of Psychiatry 37, no. 2 (April 2003): 150–59. http://dx.doi.org/10.1046/j.1440-1614.2003.01136.x.
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Objective: To review the status of consultation–liaison psychiatry and the factors shaping it, and suggest strategies for its future development. Method: In addition to searches of the main computerized psychiatric databases and review of relevant Commonwealth of Australia publications, the author drew on discussions with national and international colleagues in his role as convenor of the International Organization for Consultation–Liaison Psychiatry. Results: Physical/psychiatric comorbidity and somatization, the conditions in which consultation–liaison psychiatry specializes, are the commonest forms of psychiatric presentation in the community. They are as disabling as psychotic disorders, and comorbid depression in particular is a predictor of increased morbidity and mortality. Acknowledging this, the Second Australian National Mental Health Plan called for consultation–liaison psychiatry to be allowed to participate fully in the mental health care system. It stated that failure to define the term ‘severe mental health problems and mental disorders’ in the First Plan had led to some public mental health systems erroneously equating severity with diagnosis rather than level of need and disability. The call has been largely unheeded. The implication for patient care is both direct and indirect; the context created for psychiatry training by such a restricted focus is helping to perpetuate the neglect of such patients. This is a worldwide problem. Conclusions: Proactive involvement with consumers is required if the problem is to be redressed. At a service level, development of a seamless web of pre-admission/admission/post-discharge functions is required if patients with physical/psychiatric comorbidity and somatoform disorders are to receive effective care, and consultation–liaison psychiatry services are to be able to demonstrate efficacy. Focus on comorbidity in the Australian Third National Mental Health Plan may force resolution of the current problems.
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Coulson, Brett S., Brett S. Coulson, Stephen G. Fenner, and Osvaldo P. Almeida. "Successful Treatment of Behavioural Problems in Dementia Using a Cholinesterase Inhibitor: The Ethical Questions." Australian & New Zealand Journal of Psychiatry 36, no. 2 (April 2002): 259–62. http://dx.doi.org/10.1046/j.1440-1614.2002.00977.x.
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Objective: To review the effect of cholinesterase inhibitors on the behavioural and neuropsychiatric symptoms of dementia and discuss the current clinical guidelines for the prescription of cholinesterase inhibitors in Australia. Method: This paper reports the case of a patient with clinical diagnosis of dementia with lewy bodies (DLB) who was referred to an old age psychiatry service for the treatment of severe visual hallucinations and behavioural problems. Results: Pharmacological treatment with olanzapine produced marked parkinsonism, agitation and confusion. A cholinesterase inhibitor, donepezil, was introduced. The introduction of donepezil was associated with cognitive improvement (mini-mental state examination [MMSE] increased from 23 to 27) and complete remission of behavioural symptoms. Conclusion: That cholinesterase inhibitors may have a role in the management of behavioural symptoms of dementia and the current Australian PBS guidelines for prescribing cholinesterase inhibitors are clinically restrictive. This has clinical and ethical implications that need to be addressed by consumers, the medical community and regulating authorities.
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Black, Christopher M., Michael Woodward, Baishali M. Ambegaonkar, Alana Philips, James Pike, Eddie Jones, Joseph Husbands, and Rezaul K. Khandker. "Quantifying the diagnostic pathway for patients with cognitive impairment: real-world data from Australia." International Psychogeriatrics 32, no. 5 (November 25, 2019): 601–10. http://dx.doi.org/10.1017/s1041610219001856.
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ABSTRACTObjectives:Rapid diagnosis of dementia is essential to ensure optimum patient care. This study used real-world data to quantify the dementia diagnostic pathway in Australia.Design:A real-world, cross-sectional survey of physicians and patients.Setting:Clinical practice.Participants:Primary care or specialist physicians managing patients with cognitive impairment (CI).Measurements:Descriptive analyses focused on key events in the diagnostic pathway. Regression modeling compared the duration between first consultation and formal diagnosis with various factors.Results:Data for 600 patients were provided by 60 physicians. Mean time from initial symptoms to first consultation was 6.1 ± 4.4 months; 20% of patients had moderate or severe CI at first consultation. Mean time from first consultation to formal diagnosis was 4.0 ± 7.4 months (1.2 ± 3.6 months if not referred to a secondary physician, and 5.3 ± 8.3 months if referred). Time from first consultation to diagnosis was significantly associated with CI severity at first consultation; time was shorter with more severe CI. There was no association of disease severity and referral to a secondary physician; 69.5% of patients were referred, the majority (57.1%) to a geriatrician. The highest proportion of patients were diagnosed by geriatricians (47.4%). Some form of test or scale was used to aid diagnosis in 98.8% of patients.Conclusions:A substantial number of Australians experience cognitive decline and behavioral changes some time before consulting a physician or being diagnosed with dementia. Increasing public awareness of the importance of early diagnosis is essential to improve the proportion of patients receiving comprehensive support prior to disease progression.
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Milton, A. C., B. Mullan, C. MacCann, and C. Hunt. "An evaluation of communication barriers and facilitators at the time of a mental health diagnosis: a survey of health professional practices." Epidemiology and Psychiatric Sciences 27, no. 4 (January 24, 2017): 357–68. http://dx.doi.org/10.1017/s2045796016001153.
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Aims.To examine health professionals’ views and practices relating to the specific barriers to communication that arise at the time of mental health diagnosis, and the strategies used to support individuals throughout this process.Methods.An online survey of the beliefs and practices of 131 mental health clinicians working in different clinical settings across Australia was conducted.Results.Exploratory factor analysis of the items relating to barriers to communication resulted in three latent factors (‘stigma, diagnosis and risk’; ‘service structure’; and ‘individual circumstances’ such as the person receiving the diagnosis being young, having a culturally and linguistically diverse background or being unwell at the time of conversation). Using linear regression it was found that variance in ‘stigma, diagnosis and risk’ was significantly explained by whether participating clinicians had medical training, their experience working with serious mental health problems, their confidence handling distress and attitude towards diagnosis. Variance in ‘individual circumstances’ was significantly explained by participating clinicians’ confidence handling distress. The most frequently used strategies to support diagnostic discussions centred on the health professionals’ communication skills, gauging the individual's perception of their circumstances, responding with empathy, following-up after discussion, addressing stigma concerns, using collaborative practice and setting up for the conversation.Conclusions.Three main areas for health professionals to reflect on, plan for and ultimately address when discussing news with the individual concerned emerged (‘stigma, diagnosis and risk’; ‘service structure’; and ‘individual circumstances’). Variations in practice indicate that practitioners should be cognisant of their own beliefs and background and how this impacts their communication practice.
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Thomas, Trang. "Health Issues for Women of Non-English Speaking Backgrounds." Australian Journal of Primary Health 4, no. 3 (1998): 93. http://dx.doi.org/10.1071/py98035.
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The shift away from focusing only on physical factors in health to more on psycho-social factors means that, in a multicultural society like Australia, we have to pay attention to the influence of cultural factors in health and health promotion. Living healthily in a culturally diverse society is a challenge. Issues concerning cultural factors in maintaining and promoting the health of women of non-English speaking backgrounds are discussed here. Cultural differences and knowledge gaps create difficulties not only for the people in need of service, but for service providers as well. There is a need for bilingual and culturally sensitive trained professionals. Access to health care, especially preventive measures, and the role of ethnic women as carers are discussed. Another issue for attention is mental health. Risk factors in developing mental illness, and barriers to effective diagnosis and treatment are identified. Difficulties in handling health crises bring serious problems. Many women came from countries with traditional ways of handling crises which may not be possible or appropriate in Australia.
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McCausland, Ruth, and Eileen Baldry. "‘I feel like I failed him by ringing the police’: Criminalising disability in Australia." Punishment & Society 19, no. 3 (March 3, 2017): 290–309. http://dx.doi.org/10.1177/1462474517696126.
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The stigmatisation, control, criminalisation and incarceration of people with disability have a long history. While in recent decades there has been increasing commitment to the rights of people with disabilities by governments in western nations, the over-representation of people with mental and cognitive disability in criminal justice systems has continued. Although there are similarities amongst Western jurisdictions in regard to the treatment of people with disability in justice systems, there are particularities in Australia that will be drawn out in this article. We argue that disadvantaged people with mental and cognitive disability are being managed by and entrenched in criminal justice systems across Australia’s six states and two territories, including so-called diversionary and therapeutic measures that appear to accommodate their disability. In the absence of early and appropriate diagnosis, intervention and support in the community, some disadvantaged and poor persons with mental and cognitive disability, in particular Indigenous Australians, are being systematically criminalised. Criminal justice agencies and especially youth and adult prisons have become normalised as places of disability management and control. Drawing on research that focuses in detail on the jurisdictions of the Northern Territory and New South Wales, we argue for a reconstruction of the understanding of and response to people with these disabilities in the criminal justice system.
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Jenkins, Bronwyn, Elspeth Hutton, Richard Stark, Rebeca Quintana, Veruska Carboni, Dania Yaghobian, Guillaume Wieliczko, and Pamela Vo. "122 ‘My migraine voice: burden of migraine and it’s management in an australian cohort’." Journal of Neurology, Neurosurgery & Psychiatry 90, e7 (July 2019): A39.3—A40. http://dx.doi.org/10.1136/jnnp-2019-anzan.108.
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IntroductionMigraine is the greatest cause of disability under the age of 50. It impairs ability to function, work and maintain relationships. This survey aimed to assess the impact of migraine and its management.MethodsA questionnaire was sent to patients >18 years old who had taken at least one preventive treatment for migraine in the past. We report here the Australian results.Results68% were women, mean age 41 years. 53% were in paid employment whilst 13% received a disability allowance due to migraine. All patients (n=320) in the Australian survey had ≥ 4 migraine days each month. 90% had taken at least one preventive (274), with 80% (194) needing to change the preventive treatments previously. Common comorbidities were depression (41%), anxiety (40%), chronic pain (29%), sleep disorder (25%) and overweight (24%).Diagnosis rate on initial GP visit was 57%, with 26% receiving a diagnosis in <1 month and 55% by 6 months.There was greater retention of use (60%) and satisfaction (60%) with acute therapies, compared with use (43%) and satisfaction (53%) with preventives. Dissatisfaction with preventives included lack of efficacy (54%) and too many side effects (36%). Most (>60%) patients reported fear of the next attack, feeling hopeless and difficulty thinking clearly during attacks. Employers were often (69%) aware of the migraines, but only 24% offered any support. Migraine had negative impacts on relationships.ConclusionThe Migraine Voice Survey highlights the true burden of migraine in Australia and limitations of current management options.
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Smith, Jodie, Rhylee Sulek, Ifrah Abdullahi, Cherie C. Green, Catherine A. Bent, Cheryl Dissanayake, and Kristelle Hudry. "Comparison of mental health, well-being and parenting sense of competency among Australian and South-East Asian parents of autistic children accessing early intervention in Australia." Autism 25, no. 6 (April 25, 2021): 1784–96. http://dx.doi.org/10.1177/13623613211010006.
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Parents from individualist cultures (those focused on autonomy of individuals; that is, Australian) may view their autistic children differently compared to parents from collectivist cultures (where community needs are valued over an individual’s, that is, South-East Asian cultures). As most research on autism and parenting has been undertaken in Western individualist cultures, knowledge of parenting beliefs and mental health within collectivist cultures is lacking. We compared the mental health, quality of life, well-being and parenting sense of competency between families raising an autistic child from two groups: 97 Australian parents and 58 parents from South-East Asian backgrounds. Children from both groups were receiving the same community-based early intervention. No group differences were found on the measures of mental health but, when compared to Australian parents, parents from South-East Asian backgrounds reported higher well-being and less impact on their quality of life resulting from their child’s autism-specific difficulties. Furthermore, a positive association between well-being and quality of life was only observed for South-East Asian parents. Hence, the views of, and responses to, disability for South-East Asian parents may act as a protective factor promoting well-being. This novel research indicates that culture plays a role in parenting autistic children and highlights the need to accurately capture cultural background information in research. Lay abstract We know that parents of autistic children experience poorer mental health and lower well-being than parents of non-autistic children. We also know that poorer mental health among parents of autistic children has been observed across different cultures. Most research focuses on Western cultures, so we know little about parental mental health and well-being of parents from different cultural backgrounds; yet, it is likely that cultural background contributes to how parents view their child’s condition and respond to the diagnosis. Here, we compared mental health, quality of life and well-being between families raising an autistic child from Australian backgrounds to families from South-East Asian backgrounds. All children in the current study were receiving the same community-based early intervention. When compared to the general population, parents had poorer mental health overall, but there were no differences between the two groups of parents. However, parents from South-East Asian backgrounds reported higher well-being and fewer difficulties associated with their child’s autism. These findings suggest that cultural background likely influences not only parent’s view of, and response to, their child’s autism, but also their own sense of well-being. As researchers and clinicians working with families of autistic children, we should more explicitly consider family’s cultural background within our work.
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Eagle, Kerri, Trevor Ma, and Barbara Sinclair. "Integrated substance use rehabilitation in a secure forensic facility." Journal of Forensic Practice 21, no. 1 (January 31, 2019): 50–60. http://dx.doi.org/10.1108/jfp-09-2018-0037.
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Purpose The purpose of this paper is to inform the development of an evidence-based and effective rehabilitation programme to address substance use disorders in a population of patients with severe mental illness and mental disorders detained in a secure forensic psychiatric facility. A clinical review identified a high prevalence of substance use disorders in the patient population at a secure forensic facility in Sydney, Australia with only a limited number of patients being assessed and offered interventions for substance use problems. Design/methodology/approach A literature review was undertaken specifically looking at articles between 2009 and 2017 that considered models of care or approaches to substance use rehabilitation in patients with co-morbid psychiatric disorders. Articles were considered based on their relevance to the purpose and the environment of a secure forensic facility. Findings The literature review emphasised the need for a cohesive model of care integrating substance use rehabilitation with mental health care. Comprehensive assessment and individualised approaches that incorporated patient choice and stages of change were considered essential components to any dual diagnosis rehabilitation programme. Practical implications The literature regarding rehabilitation approaches for those with severe mental illness and co-morbid substance use disorders was reasonably consistent with the models of care used in relation to criminal offenders and mental illness generally. Integrated and individualised rehabilitation approaches for dual diagnosis patients could play a significant role in forensic settings. Originality/value Limited robust evidence for substance use rehabilitation has been published. The authors consider the existing evidence base and the underlying theory behind substance use rehabilitation to propose a model for rehabilitation in secure forensic settings. This is the first known review of substance use rehabilitation involving mentally ill offenders with dual diagnoses in secure forensic settings. This paper is the original work of the authors.
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Davidson, Sandra, Fiona Judd, Damien Jolley, Barbara Hocking, Sandra Thompson, and Brendan Hyland. "Risk Factors for HIV/AIDS and Hepatitis C Among the Chronic Mentally Ill." Australian & New Zealand Journal of Psychiatry 35, no. 2 (April 2001): 203–9. http://dx.doi.org/10.1046/j.1440-1614.2001.00867.x.
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Objective: The objective of this study was to document the prevalence of risk factors for HIV/AIDS and hepatitis C among people with chronic mental illness treated in a community setting. Method: 234 patients attending four community mental health clinics in the North-western Health Care Network in Melbourne, Australia, completed an interviewer-administered questionnaire which covered demographics, risk behaviour and psychiatric diagnosis. Results: The sample was 58% male, and 79% of the sample had a primary diagnosis of schizophrenia. Forty-three per cent of mentally ill men and 51% of mentally ill women in the survey had been sexually active in the 12 months preceding the survey. One-fifth of mentally ill men and 57% of mentally ill women who had sex with casual partners never used condoms. People with mental illness were eight times more likely than the general population to have ever injected illicit drugs and the mentally ill had a lifetime prevalence of sharing needles of 7.4%. Conclusions: The prevalence of risk behaviours among the study group indicate that people with chronic mental illness should be regarded as a high-risk group for HIV/AIDS and hepatitis C. It is essential that adequate resources and strategies are targeted to the mentally ill as they are for other high-risk groups.
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Tyagi, Himanshu, and Lisa Quigley. "Obsessive compulsive disorder in coroners’ reports." BJPsych Open 7, S1 (June 2021): S298. http://dx.doi.org/10.1192/bjo.2021.789.
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AimsThe frequency and burden of suicidality in obsessive-compulsive and related disorders have historically been under-reported, despite research pointing to a significant association between OCD and suicidality. Likewise, OCD is frequently undiagnosed or misdiagnosed. This study looks at coroners’ reports relating to suicides in UK, Australia and Canada in order to:Explore characteristics of suspected or confirmed cases of OCD in coroners’ reportsIdentify instances of possible undiagnosed or misdiagnosed OCDIdentify recurring themes in the reportsMethod1869 publicly available coroners’ reports were accessed from England (n = 200), Scotland (n = 128), Canada (n = 680) and Australia (n = 861). Reports were screened in order to identify individuals who had either a diagnosis of OCD (n = 16), a diagnosis of a related condition (n = 4), or indications of possible undiagnosed OCD (n = 12). Wherever possible, demographic and psychiatric characteristics were extracted for statistical analysis. Qualitative thematic analysis was carried out on selected reports.Result32 cases of interest were identified from analysis of coroners’ reports of suicides that took place between the years of 2000 and 2020. Breakdown by country was as follows:United Kingdom: n = 6 (1.8% of total reports analysed from United Kingdom)Canada n = 3 (0.4% of total reports analysed from Canada)Australia n = 23 (2.7% of total reports analysed from Australia)Among those with possible undiagnosed OCD, common experiences were fear of causing harm, intrusive thoughts of guilt and shame, and compulsive checking and/or reassurance seeking. Further themes included: misdiagnosis, failings in mental health care, stigma and discrimination.ConclusionIndividuals with OCD are thought to be up to ten times more likely to die by suicide, with this risk increasing in the presence of psychiatric comorbidities. However, OCD remains underdiagnosed, and this may be reflected in the relatively low number of suicides identified for this study where OCD was diagnosed before death. The low numbers may also point to a tendency among both coroners and healthcare professionals to underestimate the association between OCD and suicidality.Qualitative analysis of the coroners’ reports identified a theme of intolerable distress. This distress was documented most extensively in reports where OCD was strongly indicated but never diagnosed, highlighting the impact of missed, late or incorrect diagnosis.Notably, nearly all of the reports reveal repeated attempts by the individual to seek help. Despite this, many experienced stigma, mental health service failings and missed opportunities for help in the months preceding their deaths.
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Stanners, Melinda N., Christopher A. Barton, Sepehr Shakib, and Helen R. Winefield. "A qualitative investigation of the impact of multimorbidity on GP diagnosis and treatment of depression in Australia." Aging & Mental Health 16, no. 8 (July 27, 2012): 1058–64. http://dx.doi.org/10.1080/13607863.2012.702730.
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Marmanidis, H., G. Holme, and R. J. Hafner. "Depression and Somatic Symptoms: A Cross-Cultural Study." Australian & New Zealand Journal of Psychiatry 28, no. 2 (June 1994): 274–78. http://dx.doi.org/10.1080/00048679409075639.
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The study was carried out by the same research team in two metropolitan hospitals, one in Greece (N = 60) and one in Australia (N q 56). Subjects comprised patients consecutively admitted with a DSM-III-R diagnosis of depressive disorder, all of whom completed questionnaire measures of depression, anxiety and somatic symptoms. Clinical concepts and practices in the two hospitals were very similar. Overall levels of depression, anxiety and somatic symptoms in the two samples were almost identical, but there were differences in the pattern of somatic complaints: Greeks scored significantly higher on dizziness, paraesthesiae and masticatory spasms, and Australians scored significantly higher on drowsiness, hypersomnia and non-refreshing sleep, with the latter two items being the best discriminators of the two samples using discriminant function analysis. These findings, combined with factor analysis, suggested that symptoms associated with hyperventilation in the Greek sample, and with sleep disturbance in the Australian sample, explained most of the differences between them.
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Krishnadas, Natasha, and Bruce Taylor. "080 The incidence, diagnosis and outcomes of idiopathic intracranial hypertension in the southern tasmanian catchment." Journal of Neurology, Neurosurgery & Psychiatry 90, e7 (July 2019): A25.3—A26. http://dx.doi.org/10.1136/jnnp-2019-anzan.68.
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IntroductionThis study aimed to identify the incidence of idiopathic intracranial hypertension (IIH) in Southern Tasmania, Australia. Secondary aims were to elucidate demographics, current approaches to investigation, treatment and outcomes. To our knowledge, similar regional studies have not been performed.MethodsThe study was approved by the University of Tasmania Human Ethics Committee. Patients presented between June 2016-June 2018 to Royal Hobart Hospital, the single tertiary Neurology service in Tasmania. Cases were identified by screening lumbar punctures (LP) performed by Neurology services (inpatient, outpatient, Radiologically-assisted) and by surveying all regional Neurologists. Medical records were used to corroborate LP results and determine whether patients met Modified Dandy Criteria (MDC) (used to define IIH in current literature). Regional population statistics were obtained from the Australian Bureau of Statistics (ABS). Duplicate records were excluded. Exclusion criteria included age <18 at data collection, LP opening pressure <20cm of water or secondary causes for IIH.Results45 cases identified; 30 within the Greater Hobart region, population of 229,088 (June 2016-June 2017). Cumulative incidence was 6.55/100,000 (incidence rate 0.06/1000) with classification based on Neurologist diagnosis and 5.46/100,000 (0.05/1000) with classification according to MDC. 100% of the cohort were female. Mean age was 26.7 (range 17–45) and mean weight was 105.3kg (range 78–170). Headache was the most commonly reported symptom. 8.9% (4/45) of the total cohort were medically refractory (requiring VP/LP shunting). Ophthalmology services initiated 51% (23/45) of the referrals.ConclusionsOur incidence rates are higher than rates in previous studies for population subsets of young women.
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Cheema, Madiha, Nikola Mitrev, Leanne Hall, Maria Tiongson, Golo Ahlenstiel, and Viraj Kariyawasam. "Depression, anxiety and stress among patients with inflammatory bowel disease during the COVID-19 pandemic: Australian national survey." BMJ Open Gastroenterology 8, no. 1 (February 2021): e000581. http://dx.doi.org/10.1136/bmjgast-2020-000581.
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BackgroundThe global COVID-19 pandemic has impacted on the mental health of individuals, particularly those with chronic illnesses. We aimed to quantify stress, anxiety and depression among individuals with Inflammatory bowel disease (IBD) in Australia during the pandemic.MethodsAn electronic survey was made available to IBD patients Australia-wide from 17 June to 12 July 2020. Respondents with an underlying diagnosis of IBD and over 18 years of age were included. A validated questionnaire (Depression, Anxiety, Stress Score-21, DASS21) was used to assess depression, anxiety and stress. Data on potential predictors of depression, anxiety and stress were collected.Results352 participated in the survey across Australia. 60.5% of respondents fulfilled DASS criteria for at least moderate depression, anxiety or stress. 45% reported a pre-existing diagnosis of depression and/or anxiety. Over 2/3 of these respondents reported worsening of their pre-existing depression/anxiety due to the current pandemic. Of those without a pre-existing diagnosis of anxiety or depression, high rates of at least moderate to severe depression (34.9%), anxiety (32.0%) and stress (29.7%) were noted. Younger age (OR 0.96, 95% CI 0.94 to 0.98, p<0.001), lack of access to an IBD nurse (OR 1.81, 95% CI 1.03 to 3.19, p=0.04) and lack of education on reducing infection risk (OR 1.99, 95% CI 1.13 to 3.50, p=0.017) were associated with significant stress, anxiety and/or depression.ConclusionHigh prevalence of undiagnosed depression, anxiety and stress was identified among respondents. Improved access to IBD nurse support and greater attention to education are modifiable factors that may reduce depression, anxiety and/or stress among patients with IBD during the pandemic.
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Khalil, H., A. Downie, and E. Ristevski. "Mapping palliative and end of care research in Australia (2000–2018)." Palliative and Supportive Care 18, no. 6 (January 20, 2020): 713–21. http://dx.doi.org/10.1017/s1478951519001111.
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AbstractObjectiveThe objective of this study is to map the existent research undertaken in Australia into broad thematic areas and identify the characteristics of the studies and areas of future research in the literature.MethodsA scoping review methodology was employed to map the current areas of research undertaken in Australia since January 2000 until the end of December 2018 according to years of publications, types of studies, populations studied, research themes, and areas of focus.ResultsOur review identified 1,405 Australian palliative care research publications between January 2000 and December 2018. Nearly 40% of the studies were quantitative (39%) and a third were qualitative studies (31%). The remainder of the studies were reviews, mixed methods, quality improvement projects, and others. One-third (30%) of the research was done with carers' participants followed by nurses (22%) and doctors and physicians (18%). The most frequently reported diagnosis in the studies was cancer with 42% of the publication total. The most frequently explored theme was physical symptoms (such as pain, breathlessness, nausea, delirium, and dyspnea) with a total of 16% of all articles followed by communication (15%). There was a large gap to the next most frequently explored theme with service delivery (9%) and coordination of care (8%). Assessment of patients (7%), end-of-life decision-making (6%), and rural/regional (6%) all produced a similar number of publications. Very few studies addressed topics such as quality of life, E-Health, after-hours care, spirituality, and health economics. Moreover, there were only 15 (1%) studies focused on the last days of life.Significance of the resultsThe current review presented a comprehensive search of the literature across almost two decades in Australia in the palliative care setting. It has covered a breadth of research topics and highlighted urgent areas for further research.
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Siskind, D. J., M. Harris, A. Phillipou, V. A. Morgan, A. Waterreus, C. Galletly, V. J. Carr, C. Harvey, and D. Castle. "Clozapine users in Australia: their characteristics and experiences of care based on data from the 2010 National Survey of High Impact Psychosis." Epidemiology and Psychiatric Sciences 26, no. 3 (July 18, 2016): 325–37. http://dx.doi.org/10.1017/s2045796016000305.
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Aims.Clozapine is the most effective medication for treatment refractory schizophrenia. However, descriptions of the mental health and comorbidity profile and care experiences of people on clozapine in routine clinical settings are scarce. Using data from the 2010 Australian Survey of High Impact Psychosis, we aimed to examine the proportion of people using clozapine, and to compare clozapine users with other antipsychotic users on demographic, mental health, adverse drug reaction, polypharmacy and treatment satisfaction variables.Methods.Data describing 1049 people with a diagnosis of schizophrenia or schizoaffective disorder, who reported taking any antipsychotic medication in the previous 4 weeks, were drawn from a representative Australian survey of people with psychotic disorders in contact with mental health services in the previous 12 months. We compared participants taking clozapine (n= 257, 22.4%) with those taking other antipsychotic medications, on a range of demographic, clinical and treatment-related indicators.Results.One quarter of participants were on clozapine. Of participants with a chronic course of illness, only one third were on clozapine. After adjusting for diagnosis and illness chronicity, participants taking clozapine had significantly lower odds of current alcohol, cannabis and other drug use despite similar lifetime odds. Metabolic syndrome and diabetes were more common among people taking clozapine; chronic pain was less common. Psychotropic polypharmacy did not differ between groups.Conclusions.Consistent with international evidence of clozapine underutilisation, a large number of participants with chronic illness and high symptom burden were not taking clozapine. The lower probabilities of current substance use and chronic pain among clozapine users warrant further study.
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Rosenman, Stephen, Ailsa Korten, Jo Medway, and Mandy Evans. "Characterising Psychosis in the Australian National Survey of Mental Health and Wellbeing Study on Low Prevalence (Psychotic) Disorders." Australian & New Zealand Journal of Psychiatry 34, no. 5 (October 2000): 792–800. http://dx.doi.org/10.1080/j.1440-1614.2000.00824.x.
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Objective: This study examines the factorial structure of symptoms and signs in psychosis in data from the Study on Low Prevalence (psychotic) Disorders which is part of the National Survey of Mental Health and Wellbeing, Australia 1997–1998. Method: The present study examined a wide variety of symptoms taken from the Schedules for Clinical Assessment in Neuropsychiatry items and the substance use items in the Diagnostic Interview for Psychosis, an instrument specially constructed for the national study. The instrument was applied to 980 community and hospital subjects with a wide range of psychotic illness diagnoses. The data were factor analysed and scales of ‘domains of psychopathology’ derived. Results: The data were best fitted by five principal factors (‘domains’) which can be approximately labelled dysphoria, positive symptoms, substance use, mania and negative symptoms/incoherence. These factors together explained 55.4% of variance in symptoms. Solutions with more numerous factors did not improve the representation. Conclusion: The five domains successfully characterise a large part of the variance in psychopathology found in the present study of low prevalence (psychotic) disorders. The approach allows sufferer's symptom range and severity to be well expressed without multiple comorbid diagnoses or the limits imposed by categorical diagnosis. Knowledge of alternative dimensional representations of psychopathology may usefully complement our use of categories, enhance awareness of symptoms and ensure that important psychopathology is heeded in practice and research.
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Mahfouda, Simone, Christina Panos, Andrew J. O. Whitehouse, Cati S. Thomas, Murray Maybery, Penelope Strauss, Florian D. Zepf, et al. "Mental Health Correlates of Autism Spectrum Disorder in Gender Diverse Young People: Evidence from a Specialised Child and Adolescent Gender Clinic in Australia." Journal of Clinical Medicine 8, no. 10 (September 20, 2019): 1503. http://dx.doi.org/10.3390/jcm8101503.
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Research suggests an overrepresentation of autism spectrum diagnoses (ASD) or autistic traits in gender diverse samples, particularly in children and adolescents. Using data from the GENTLE (GENder identiTy Longitudinal Experience) Cohort at the Gender Diversity Service at the Perth Children’s Hospital, the primary objective of the current retrospective chart review was to explore psychopathology and quality of life in gender diverse children with co-occurring ASD relative to gender diverse children and adolescents without ASD. The Social Responsiveness Scale (Second Edition) generates a Diagnostic and Statistical Manual of Mental Disorders (DSM-5) score indicating a likely clinical ASD diagnosis, which was used to partition participants into two groups (indicated ASD, n = 19) (no ASD indicated, n = 60). Indicated ASD was far higher than would be expected compared to general population estimates. Indicated ASD on the Social Responsiveness Scale 2 (SRS 2) was also a significant predictor of Internalising behaviours (Anxious/Depressed, Withdrawn/Depressed, Somatic Complaints, Thought Problems subscales) on the Youth Self Report. Indicated ASD was also a significant predictor of scores on all subscales of the Paediatric Quality of Life Inventory. The current findings indicate that gender diverse children and adolescents with indicated ASD comprise an especially vulnerable group that are at marked risk of mental health difficulties, particularly internalising disorders, and poor quality of life outcomes. Services working with gender diverse young people should screen for ASD, and also provide pathways to appropriate care for the commonly associated mental health difficulties.
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Ramachandran, Prashanth, Ric N. Price, and James Burrow. "High incidence of neurosyphilis in the ‘top end’ of australia: a systematic approach to its diagnosis." Journal of Neurology, Neurosurgery & Psychiatry 88, no. 5 (May 2017): e1.48-e1. http://dx.doi.org/10.1136/jnnp-2017-316074.5.
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Radhamony, Reshmy. "A Contemplation on Rehabilitation Models for Adult Clients with Dual Diagnosis of Acquired Brain Injury and Mental Illness in Australia." Universal Journal of Public Health 4, no. 6 (November 2016): 298–308. http://dx.doi.org/10.13189/ujph.2016.040602.
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Tran, Quang Nhat, Leonard G. Lambeth, Kristy Sanderson, Barbara Graaff, Monique Breslin, Viet Tran, Emma J. Huckerby, and Amanda L. Neil. "Emergency department presentations with a mental health diagnosis in Australia, by jurisdiction and by sex, 2004–05 to 2016–17." Emergency Medicine Australasia 32, no. 3 (December 18, 2019): 383–92. http://dx.doi.org/10.1111/1742-6723.13438.
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