Journal articles on the topic 'Psychiatric clinics Australia'
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1
Reilly, Stephen P. "Australian Sojourn." Bulletin of the Royal College of Psychiatrists 9, no. 8 (August 1985): 155–56. http://dx.doi.org/10.1192/pb.9.8.155.
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Community psychiatry means different things to different people. Since the 1970s the American model of community psychiatry based on mental health clinics has attracted heavy criticism, whilst the UK concept of rooting community psychiatric services firmly within primary health care has gained increasing support. The need for community-orientated psychiatric services is generally agreed upon but definition of community and the mode of delivery are not. In Australia both free and private health care are available; community health centres and community mental health clinics exist (sometimes literally) side by side.
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James, David V. "Court Diversion in Perspective." Australian & New Zealand Journal of Psychiatry 40, no. 6-7 (June 2006): 529–38. http://dx.doi.org/10.1080/j.1440-1614.2006.01835.x.
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Court diversion schemes have been running for a decade in New Zealand and are increasing in number in Australia. This paper aims to give an international and historical context to these developments, by reference to psychiatric initiatives at courts in the US and in England and Wales. From a review of the specialist literature, an account is given of three forms of psychiatric intervention in courts over the last 90 years: court psychiatric clinics and mental health courts in the US, and court diversion schemes in England and Wales. High levels of psychiatric morbidity among prisoners, coupled with a continuing increase in prisoner numbers, demonstrate the need for systems for dealing with mentally ill people who come before the courts. Court diversion in England and Wales developed as part of a system where the mentally ill who are found guilty are sent to hospital in lieu of any other sentence. Its focus is on a form of psychiatric triage, and its ethos is the health of the patient. Court psychiatric clinics in the US grew up as an alternative to assessment in prison. Their focus has been on full psychiatric evaluation in an insanity and incompetence jurisdiction. The ethos has been that of serving the court. Mental health courts are heavily influenced by ideas of therapeutic jurisprudence, and their emphasis has been on a judge holding minor offenders in community care through the threat of judicial sanction. Experience in England and Wales has shown that court diversion can be a powerful and effective intervention. In order for it to function properly, those running court schemes need direct admission rights to psychiatric beds, both open and locked. Court diversion schemes are best as part of a spectrum of services to police stations, courts and prisons, which involved both general and forensic psychiatrists.
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Lorentzos, Michelle S., Isobel Heyman, Benjamin J. Baig, Anna E. Coughtrey, Andrew McWilliams, David R. Dossetor, Mary-Clare Waugh, et al. "Psychiatric comorbidity is common in dystonia and other movement disorders." Archives of Disease in Childhood 106, no. 1 (July 24, 2020): 62–67. http://dx.doi.org/10.1136/archdischild-2020-319541.
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ObjectiveTo determine rates of psychiatric comorbidity in a clinical sample of childhood movement disorders (MDs).DesignCohort study.SettingTertiary children’s hospital MD clinics in Sydney, Australia and London, UK.PatientsCases were children with tic MDs (n=158) and non-tic MDs (n=102), including 66 children with dystonia. Comparison was made with emergency department controls (n=100), neurology controls with peripheral neuropathy or epilepsy (n=37), and community controls (n=10 438).InterventionsOn-line development and well-being assessment which was additionally clinically rated by experienced child psychiatrists.Main outcome measuresDiagnostic schedule and manual of mental disorders-5 criteria for psychiatric diagnoses.ResultsPsychiatric comorbidity in the non-tic MD cohort (39.2%) was comparable to the tic cohort (41.8%) (not significant). Psychiatric comorbidity in the non-tic MD cohort was greater than the emergency control group (18%, p<0.0001) and the community cohort (9.5%, p<0.00001), but not the neurology controls (29.7%, p=0.31). Almost half of the patients within the tic cohort with psychiatric comorbidity were receiving medical psychiatric treatment (45.5%) or psychology interventions (43.9%), compared with only 22.5% and 15.0%, respectively, of the non-tic MD cohort with psychiatric comorbidity.ConclusionsPsychiatric comorbidity is common in non-tic MDs such as dystonia. These psychiatric comorbidities appear to be under-recognised and undertreated.
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Adegbite, Adebola, and George Howson. "The Effect of the First Coronavirus Lockdown on Psychiatric Outpatient Attendance, a North Fife Survey." BJPsych Open 8, S1 (June 2022): S147—S148. http://dx.doi.org/10.1192/bjo.2022.422.
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AimsThere has been a significant change in the way we see patients during psychiatric consultations, this has led to challenges we face in delivering safe and effective care to patients under our care. “Telepsychiatry” has been used in literature from countries like Australia and India, there is very little around coming from the UK but there appears to be many ongoing research making the rounds. It is interesting to know that the existing literature on remote/virtual consultations during the COVID-19 pandemic are on the rise. The idea of this study was conceived during outpatient clinics after making an observation that many patients were likely to miss their appointments when they had telephone appointments compared to video consultations. This prompted a study to know if this is more likely to be observed in other outpatient clinics. The purpose of this study was to establish if virtual/remote consulting has affected patient attendance rate and whether this is also affected by the type of virtual consultation.MethodsThe data were collected using the “2020 stats sheets” for inpatient appointments between North Fife consultants from January to October 2020. This was registered with the NHS Fife clinical effectiveness team in January 2021.ResultsThe results were categorized for the purpose of this survey as January – March (Pre-lockdown) and April – October (lockdown). It is important to note that some face-to-face appointments occurred during lockdown because there were emergency assessments and drug monitoring appointments scheduled.The results of this survey showed that there was a clear reduction in clinic appointments made during lockdown compared to pre-lockdown and slight observable improvement in attendance rates during the lockdown. There was no statistical significance seen using t-test comparing attendance rates between video and telephone consultations including new patient virtual consultations.ConclusionThe large sample size over this period suggests that the results are reliable and valid, we can therefore say virtual/telephone consultation does not affect attendance. It should be noted that the attendance rate may be a good indicator but we should also consider patient/clinician satisfaction, communication quality/effectiveness and other factors which could influence patient's compliance to outpatient follow-up. It is important to acknowledge the lack of a control group and the COVID-19 pandemic were major cofounding factors. Mental health services should continue the use of virtual consultation post-pandemic and possibly integrate it with in person consultations (hybrid), this may help with attendance rate of patients with difficulty attending face-to-face appointments.
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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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Zhong, Michael, Richard Peppard, Dennis Velakoulis, and Andrew H. Evans. "The relationship between specific cognitive defects and burden of care in Parkinson's disease." International Psychogeriatrics 28, no. 2 (October 5, 2015): 275–81. http://dx.doi.org/10.1017/s1041610215001593.
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ABSTRACTBackground:In spite of the recognized physical and psychosocial effects of caring for patients with Parkinson's disease (PD), caregiver burden (CB) in this setting is poorly understood. The objective of this research was to identify factors that were associated with CB in an Australian population of PD caregivers using a novel instrument – the Parkinson's Disease Caregiver Burden (PDCB) questionnaire.Methods:Fifty patient–caregiver couples were recruited from three movement disorders clinics in Melbourne, Australia. Burden on caregivers was rated using the PDCB questionnaire. Burden scores were correlated with patient factors, including motor symptom severity (Unified Parkinson's Disease Ratings Scale and Hoehn & Yahr (H&Y) scale), patient cognition (Neuropsychiatry Unit Cognitive Assessment Tool; NUCOG), presence of impulsive and compulsive behaviors (Questionnaire for Impulsive–Compulsive Disorders in Parkinson's disease), and patient olfaction. Caregiver and patient demographics, as well as results for depression and anxiety (Hospital Anxiety and Depression Scale; HADS), were also examined for their relationship with CB.Results:H&Y stage, depression or anxiety in either caregiver or patient, and decreased patient NUCOG score were significantly associated with higher PDCB score. Multiple linear regression analysis identified caregiver and patient depression score and patient score for the visuoconstructional subscale of NUCOG to predict burden score. In addition, disease duration, duration of caregiving, and increased hours per day spent in giving care were significantly associated with increased burden.Conclusions:We found psychiatric and cognitive factors to be the most relevant factors in the perception of burden in PD caregivers. On top of this, we found deficits in the domain of visuoconstruction predicted burden – a relationship not yet described in literature. Targeting depression and anxiety in this setting as well as identifying caregivers at high risk of burden may give clinicians the chance to optimize care of patients with PD through the caregiver.
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Woodward, Michael Clifford, and Erin Woodward. "A national survey of memory clinics in Australia." International Psychogeriatrics 21, no. 4 (August 2009): 696–702. http://dx.doi.org/10.1017/s1041610209009156.
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ABSTRACTBackground:There is limited information describing memory clinics at a national level in Australia. The aim of this study was to gather information about the resourcing, practices and clinical diagnoses of Australian memory clinics.Methods:A postal survey was sent to all Australian memory clinics identified by key specialists working in dementia assessment services.Results:Of 23 surveys sent out, 14 were returned. Most clinics are located in Victoria where they receive Victorian state funding. The average clinic has 1.67 effective full time clinical staff including 0.42 medical staff, 0.24 allied health staff, 0.53 clinical nursing staff and 0.48 psychologists. Clinics are open on average twice a week and each half-day clinic has two new and three review patients, seeing new patients twice initially then once more over 12 months. Patients wait 10 weeks for initial assessment with 59% referred by general practitioners. The Mini-mental State Examination and clock drawing are utilized universally. The most common diagnoses are Alzheimer's disease (37.8%) and mild cognitive impairment (19.8%) but 6.9% of patients have no cognitive impairment.Conclusions:This survey has provided useful benchmarking data on Australian memory clinics which can also be used by other countries for comparative analyses.
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Goldney, Robert D., Maxine Donald, Michael G. Sawyer, Robert J. Kosky, and Susan Priest. "Emotional Health of Indonesian Adoptees Living in Australian Families." Australian & New Zealand Journal of Psychiatry 30, no. 4 (August 1996): 534–39. http://dx.doi.org/10.3109/00048679609065029.
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Objective: To compare the prevalence of emotional and behavioural problems in adolescent adoptees from Indonesia living in South Australian families with that of adolescents living in the community and those referred to mental health clinics in South Australia. Method: Thirty-four Indonesian adoptees completed the Youth Self-Report and their adoptive mothers completed the Child Behaviour Checklist. The results on these instruments were compared with the scores of a community sample and a mental health clinic population. Results: There was a striking similarity between scores on the Youth Self-Report and the Child Behaviour Checklist instruments for the adoption and community groups. Both these groups had significantly fewer problems than adolescents referred to mental health clinics. Conclusions: These results indicate that the outcome in terms of emotional and behavioural health for intercountry adoptions between Indonesia and Australia is favourable.
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O'Connor, Daniel W., David M. Clarke, and Ian Presnell. "How is Psychiatry Taught to Australian and New Zealand Medical Students?" Australian & New Zealand Journal of Psychiatry 33, no. 1 (February 1999): 47–52. http://dx.doi.org/10.1046/j.1440-1614.1999.00512.x.
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Objective: This study aimed to describe the amount, format and content of psychiatry teaching programs in all 12 Australian and New Zealand medical schools. Method: A structured questionnaire which included definitions and coding instructions was completed by class coordinators for the years of 1995 or 1996. Missing and inconsistent data were checked by coordinators and results were confirmed by heads of department. Results: Most departments of psychiatry taught throughout the undergraduate course. Only three made no contribution to pre-clinical teaching. The time devoted to clinical tuition ranged from 279 to 454 h per university with a mean of 353 h. Clinical attachments occupied most time (mean = 70%), followed by small group teaching (mean = 19%) and lectures (mean = 11%). Medical schools varied greatly in the attention given to history taking and mental state examination, psychological therapies and the sub-specialties of child and aged psychiatry. Clinical attachments were mostly to adult inpatient units. Private psychiatric hospitals and clinics were used infrequently as were consultation-liaison psychiatry services and primary care. Conclusion: There is a need to broaden the clinical experience of students to better equip them for future medical practice. There appears to be a serious mis-match between the settings in which most students are taught and the settings in which most will work later as non-psychiatric practitioners. It was disappointing that psychological therapies received so little attention given the central place of counselling in modern medical practice.
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Stratford, Joe A., Dina Logiudice, Leon Flicker, Roslyn Cook, Wendy Waltrowicz, and David Ames. "A Memory Clinic at a Geriatric Hospital: A Report on 577 Patients Assessed with the CAMDEX Over 9 Years." Australian & New Zealand Journal of Psychiatry 37, no. 3 (June 2003): 319–26. http://dx.doi.org/10.1046/j.1440-1614.2003.01174.x.
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Objective: To report 9 years’ experience of an Australian memory clinic using the Cambridge Mental Disorders in the Elderly Examination (CAMDEX) assessment schedule, summarizing patient demographics, diagnoses at presentation and the utility of four instruments used in distinguishing patients with and without dementia. Methods: All patients seen at the clinic between December 1989 and September 1998 were assessed using the CAMDEX. Diagnoses were determined according to criteria of the International Classification of Diseases, tenth edition (ICD-10). Results: The mean age of 577 patients seen was 72.9 years and 60.8% were female. Over 40% fulfilled ICD-10 diagnostic criteria for dementia in Alzheimer's disease. A further 24% had another dementing illness. Only 28 patients were ‘normal’. There was no significant difference in the ability of the 107-item Cambridge cognitive examination, the 30-item mini-mental state examination, the 10-item abbreviated mental test score and the 26-item informant questionnaire on cognitive decline in the elderly to differentiate dementia patients from those who were normal or had functional psychiatric disorders. The four cognitive screening tools had high correlations with one another (r = −0.57 to 0.93). Conclusion: Patient demographics and diagnoses were similar to those found in other clinics. Most people who attended the memory clinic had significant cognitive or psychiatric disorders.
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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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Mowry, Bryan J. "Psychiatric genetics in Australia." Psychiatric Genetics 13, no. 3 (September 2003): 131–41. http://dx.doi.org/10.1097/00041444-200309000-00001.
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Forster, Benjamin C., Helen Proskurin, Brian Kelly, Melanie R. Lovell, Ralf Ilchef, and Josephine M. Clayton. "Psychiatry trainees’ views and educational needs regarding the care of patients with a life-limiting illness." Palliative and Supportive Care 15, no. 2 (June 20, 2016): 231–41. http://dx.doi.org/10.1017/s1478951516000365.
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AbstractObjective:People with a life-limiting physical illness experience high rates of significant psychological and psychiatric morbidity. Nevertheless, psychiatrists often report feeling ill-equipped to respond to the psychiatric needs of this population. Our aim was to explore psychiatry trainees’ views and educational needs regarding the care of patients with a life-limiting physical illness.Method:Using semistructured interviews, participants’ opinions were sought on the role of psychiatrists in the care of patients with a life-limiting illness and their caregivers, the challenges faced within the role, and the educational needs involved in providing care for these patients. Interviews were audiotaped, fully transcribed, and then subjected to thematic analysis.Results:A total of 17 psychiatry trainees were recruited through two large psychiatry training networks in New South Wales, Australia. There were contrasting views on the role of psychiatry in life-limiting illness. Some reported that a humanistic, supportive approach including elements of psychotherapy was helpful, even in the absence of a recognizable mental disorder. Those who reported a more biological and clinical stance (with a reliance on pharmacotherapy) tended to have a nihilistic view of psychiatric intervention in this setting. Trainees generally felt ill-prepared to talk to dying patients and felt there was an educational “famine” in this area of psychiatry. They expressed a desire for more training and thought that increased mentorship and case-based learning, including input from palliative care clinicians, would be most helpful.Significance of Results:Participants generally feel unprepared to care for patients with a life-limiting physical illness and have contrasting views on the role of psychiatry in this setting. Targeted education is required for psychiatry trainees in order to equip them to care for these patients.
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Evans, Andrew, Victor SC Fung, John O’Sullivan, Rick Stell, Richard White, David Williams, and Koray Onuk. "026 Characteristics of advanced parkinson’s disease patients seen in movement disorder clinics – australian results from the cross-sectional observe study." Journal of Neurology, Neurosurgery & Psychiatry 89, no. 6 (May 24, 2018): A11.1—A11. http://dx.doi.org/10.1136/jnnp-2018-anzan.25.
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IntroductionTo evaluate the proportion of Parkinson’s disease (PD) patients identified as having advanced Parkinson’s disease (APD) according to physician’s judgement: Australian results.MethodsThis cross-sectional, non-interventional observational study was performed in movement disorder clinics from 18 countries. Results from the Australian cohort are presented here. Participants included consecutive adults with PD attending a routine clinical visit, or inpatients at participating clinical sites, and who could speak English. The primary outcome was the proportion of patients diagnosed with APD via physician judgement. Secondary objectives included to evaluate clinical characteristics of APD versus non-APD; to assess the percentage of APD considered for device-aided therapies (DAT); to explore referral practices for APD; and to compare the percentage of APD identified in routine clinical practice by physician’s judgment to APD identified based on APD criteria derived using the Delphi method.Results100 patients were recruited in Australia: 61.0% (95%CI 51.4%–70.6%) diagnosed with APD by physician judgement. Patients were 66.6±8.5 years, 65% were male, were living at home (97%), and diagnosed for median 10.7 years (0–30.5 years). Motor fluctuations were present in 68%. For those with APD, referral was predominantly to enable access to DAT (49%), while for non-APD, referral was largely for diagnostic purposes (41%). Referral to a movement disorder clinic occurred 4.8 years (median) following diagnosis for APD, or 3.6 years for non-APD. While 62% were eligible for DAT, only two-thirds of these received them. The most commonly used DAT was deep brain stimulation (64.3%). There was fair agreement between physician’s judgement and the APD criteria by Delphi method (Cohen’s kappa) 0.325 (95%CI 0.150–0.500).ConclusionThe definition of APD requires refinement in order to facilitate greater agreement among movement disorder specialists. A third of PD patients eligible for DAT remain untreated. Current Australian practice is weighted towards deep brain stimulation.
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Emmerson, Brett, Aaron Frost, Jacinta Powell, Warren Ward, Mark Barnes, and Rowena Frank. "Evaluating a GP Consultative Psychiatric Service in an Australian Metropolitan Hospital District." Australasian Psychiatry 11, no. 2 (June 2003): 195–98. http://dx.doi.org/10.1046/j.1039-8562.2003.00547.x.
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Objective: The aim was to develop a psychiatric assessment and advisory service for local general practitioners (GPs). Method: In July 2001, five full-time psychiatrists at Royal Brisbane Hospital each dedicated a 1-h appointment per week in their hospital private practice clinic to assess patients referred by local GPs. The ‘Psych Opinion’ clinic was advertised through the Division of General Practice Newsletter. After 12 months, the referrals to the clinic had been disappointing so two surveys were carried out: one to the GPs who had used the service and the other to those who had not referred. Results: Feedback from the GPs who had used the service showed a high level of satisfaction with the service. The second survey of the GPs who had not referred showed a strong endorsement of the concept but there was poor awareness of the service's existence. Conclusions: This model offers a way for public sector psychiatrists to provide timely assessments to local GPs without additional funding. There is strong support and willingness from the GPs to refer. However, the need to actively market the service both initially and on an ongoing basis is highlighted.
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Mathai, John. "Improving Initial Attendance to a Child and Family Psychiatric Clinic: Australian Experience." Australasian Psychiatry 3, no. 2 (April 1995): 89. http://dx.doi.org/10.3109/10398569509080393.
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Mathai, John. "Improving initial attendance to a child and family psychiatric clinic: Australian experience." Psychiatric Bulletin 19, no. 7 (July 1995): 453–54. http://dx.doi.org/10.1192/pb.19.7.453-b.
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Wand, Anne P. F., and James George. "Observations of a traveling fellow: consultation–liaison psychiatry versus joint units for delirium management." International Psychogeriatrics 25, no. 7 (February 21, 2013): 1204–6. http://dx.doi.org/10.1017/s1041610213000124.
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There are various approaches to providing specialist care for patients with delirium in general hospitals. Those described in the literature include joint geriatric/psychiatric units and consultation–liaison (CL) psychiatry services. The Ferdinande Johanna Kanjilal Travelling Fellowship, from the Royal College of Psychiatrists, UK, provided an opportunity to more fully understand each model. This letter outlines observations of the Australian Fellow (AW) of different service structures in the care of hospitalized older people with delirium in the United Kingdom and Ireland.
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Duindam, David. "Transitioning to Sustainable Healthcare: Decarbonising Healthcare Clinics, a Literature Review." Challenges 13, no. 2 (December 19, 2022): 68. http://dx.doi.org/10.3390/challe13020068.
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Background: Climate change is one of the largest threats to human health and well-being globally. The healthcare industry itself currently contributes to fueling the climate crisis with its emissions and material consumption. There has been much research on decarbonising hospitals ecological/carbon footprints but very limited study on ways to assist healthcare clinics in transitioning to a low-carbon healthcare system. Methods: A structured literature review was conducted, and the results analysed. Results: The literature review revealed four important areas to act upon to decarbonise a healthcare clinic most efficiently. These are: energy use, waste minimisation/management, the behaviors/attitudes of staff, and decarbonising the supply chain. Conclusions: The pooled literature reveals an evidence-based set of recommendations or guiding principles to decarbonise healthcare clinics the most effectively. To maximise operational effectiveness, how this is achieved will differ between clinics. Although this research is written with reference to Australia, these identified ini-tiatives are likely to be relatable to many other countries healthcare systems. Decarbonising health clinics will contribute to a sector-wide transition to more sustainable healthcare that will lead to improved environmental, social, economic and health outcomes.
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Quinlivan, Julie A., Rodney W. Petersen, and Lyle C. Gurrin. "Adolescent Pregnancy: Psychopathology Missed." Australian & New Zealand Journal of Psychiatry 33, no. 6 (December 1999): 864–68. http://dx.doi.org/10.1046/j.1440-1614.1999.00592.x.
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Objectives: Few data exist that explore the level of psychosocial problems and drug abuse in an Australian, adolescent, antenatal population. We set out to audit these data from a population of pregnant Western Australian adolescents. We also set out to examine whether social issues and the use of non-prescription drugs are routinely addressed in general public antenatal clinics. Methods: One hundred and sixty patients were involved in the prospective cohort study. In the assessed group, 100 consecutive patients from the King Edward Memorial Hospital Adolescent Antenatal Clinic were interviewed during the antenatal period to determine if any major psychosocial issues or a history of non-prescription drug abuse was present. The control group consisted of 60 adolescent patients who delivered in general antenatal clinics at three Perth metropolitan hospitals. Results: Sixty percent of the assessed group were identified as having a major psychosocial problem that interfered with their ability to carry out acts of daily living. Consumption of cigarettes, alcohol, marijuana, heroin and solvents were higher than that reported for the general Australian adolescent population. Of note, in the control group, many patients did not have a social, psychological, or drug use history taken by their caregivers. Conclusion: Failure to identify psychosocial problems and drug abuse during the antenatal period will result in missed opportunities for positive intervention. These problems are common in this population and interventions are required to offer these women alternative foundations upon which to base their mothercraft skills.
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Mullen, P., and J. Ogloff. "Providing mental health services to adult offenders in Victoria, Australia: Overcoming barriers." European Psychiatry 24, no. 6 (September 2009): 395–400. http://dx.doi.org/10.1016/j.eurpsy.2009.07.003.
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AbstractPurposeTo illustrate the development of the interface between general and forensic mental health services in Victoria, Australia.MethodDeveloping effective cooperation between the general and forensic mental health services requires overcoming a number of barriers. The attitude of general services that antisocial behaviour was none of their business was tackled through ongoing workshops and education days over several years. The resistance to providing care to those disabled by severe personality disorders or substance abuse was reduced by presenting and promoting models of care developed in forensic community and inpatient services which prioritised these areas. The reluctance of general services to accept offenders was reduced by involving general services in court liaison clinics and in prisoner release plans. Cooperation was enhanced by the provision of risk assessments, the sharing of responsibility for troublesome patients, and a problem behaviours clinic to support general services in coping with stalkers, sex offenders and threateners.ConclusionsActive engagement with general services was promoted at the level of providing education, specialised assessments and a referral source for difficult patients. This generated a positive interface between forensic and general mental health services, which improved the quality of care delivered to mentally abnormal offenders.
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Kosky, Robert, Ian McAlpine, Sven Silburn, and John Richmond. "A Survey of Child Psychiatry Outpatients. 1. Clinical and Demographic Characteristics." Australian & New Zealand Journal of Psychiatry 19, no. 2 (June 1985): 158–66. http://dx.doi.org/10.3109/00048678509161313.
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This paper describes clinical and demographic characteristics of 664 children who attended outpatient child psychiatry clinics in Perth, Western Australia, over a one-year period. All social classes were represented; parents were the most common source of referral and typically the child had been assessed or treated for emotional or behavioural problems by other agencies previously. Referrals from the juvenile justice system were uncommon. The accessibility of clinics to the child population was found to have a significant effect on the rate of referral. Only 10% of the sample received conduct disorder diagnoses, whereas 16.5% had mixed disorders of conduct and emotion, and 42% had emotional disorders. Environmental circumstances, particularly recent marital break-up, family discord and recent experience of loss, were contributing factors to the child's clinical presentation in a large proportion of cases.
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Kidson, Malcolm A., John C. Douglas, and J. Holwill. "Post‐traumatic stress disorder in Australian World War II veterans attending a psychiatric outpatient clinic." Medical Journal of Australia 158, no. 9 (May 1993): 563–66. http://dx.doi.org/10.5694/j.1326-5377.1993.tb121877.x.
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Dobson, Matthew. "Post‐traumatic stress disorder in Australian World War II veterans attending a psychiatric outpatient clinic." Medical Journal of Australia 159, no. 3 (August 1993): 212. http://dx.doi.org/10.5694/j.1326-5377.1993.tb137801.x.
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Kidson, Malcolm, John Douglas, and Brendan Holwill. "Post‐traumatic stress disorder in Australian World War II veterans attending a psychiatric outpatient clinic." Medical Journal of Australia 159, no. 3 (August 1993): 212. http://dx.doi.org/10.5694/j.1326-5377.1993.tb137802.x.
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Alroe, Christopher. "Post‐traumatic stress disorder in Australian World War II veterans attending a psychiatric outpatient clinic." Medical Journal of Australia 159, no. 3 (August 1993): 212–13. http://dx.doi.org/10.5694/j.1326-5377.1993.tb137803.x.
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Kldson, Malcolm, John Douglas, and Brendan Holwill. "Post‐traumatic stress disorder in Australian World War II veterans attending a psychiatric outpatient clinic." Medical Journal of Australia 159, no. 3 (August 1993): 213. http://dx.doi.org/10.5694/j.1326-5377.1993.tb137804.x.
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Gillespie, Nathan A., Anjali K. Henders, Tracy A. Davenport, Daniel F. Hermens, Margie J. Wright, Nicholas G. Martin, and Ian B. Hickie. "The Brisbane Longitudinal Twin Study: Pathways to Cannabis Use, Abuse, and Dependence Project—Current Status, Preliminary Results, and Future Directions." Twin Research and Human Genetics 16, no. 1 (November 28, 2012): 21–33. http://dx.doi.org/10.1017/thg.2012.111.
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We describe the data being collected from the Brisbane Longitudinal Twin Study in Australia as part of the US National Institute on Drug Abuse (NIDA)-funded project, Pathways to Cannabis Use, Abuse and Dependence. The history, recruitment, assessment, and retention of twin families in this project are described in detail, along with preliminary findings and plans for future research. The goal of this NIDA project is to make a significant contribution to the discovery of quantitative trait loci influencing cannabis use disorders. Although the focus is cannabis use, abuse, and dependence in young adults, measures of comorbid illicit drug use disorders are also being collected. In addition, a variety of internalizing and externalizing disorders are being assessed, funded by support from the Australian National Health and Medical Research Council. Because these same twins have participated in numerous twin studies since 1992, future plans will include linking different phenotypes to investigate relationships between drug use, psychiatric disorders, and psychological phenotypes within cross-sectional and longitudinal or developmental frameworks.
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Page, Andrew C., Geoffrey R. Hooke, and Elizabeth M. Rutherford. "Measuring Mental Health Outcomes in a Private Psychiatric Clinic: Health of the Nation Outcome Scales and Medical Outcomes Short Form SF-36." Australian & New Zealand Journal of Psychiatry 35, no. 3 (June 2001): 377–81. http://dx.doi.org/10.1046/j.1440-1614.2001.00908.x.
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Objective: This study reports on data collected from the routine use of the Health of the Nation Outcome Scales (HoNOS) and the Medical Outcomes Short Form (SF-36). Three main aims were addressed in using these measures: (i) to establish patient disability levels; (ii) to determine the level of treatment effectiveness; and (iii) to explore the ability of these instruments to predict length of stay and mood change. Method: The clinician-rate HoNOS and the patient-rated SF-36 were included in the assessment battery, at admission and discharge, of consecutive inpatients (n = 754) at one private psychiatric facility over a 2-year period. Results: The sample, on admission, was comparable in illness severity to levels reported at other Australian private psychiatric facilities. Treatment was shown to be effective, and the degree of changes in HoNOS ratings compared favourably with other private psychiatric facilities. Certain factors underlying the structure of the HoNOS and the SF-36 only weakly predicted length of stay and changes in depression and anxiety levels. Conclusion: The HoNOS and the SF-36 provided valid and reliable data on patient function, with the HoNOS being most sensitive to treatment change. However, neither instrument proved useful in predicting length of stay or levels of depression and anxiety at discharge.
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Oyebode, Femi. "9 Psychopathology & the nature of the Self." Journal of Neurology, Neurosurgery & Psychiatry 93, no. 12 (November 14, 2022): e3.42. http://dx.doi.org/10.1136/jnnp-2022-bnpa.9.
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Femi Oyebode graduated from University of Ibadan with distinction in Medicine in 1977 & trained as a psychiatrist in Newcastle-Upon-Tyne. He has been Consultant Psychiatrist in Birmingham since 1986 & retired in 2021. He has been Honorary Professor of Psychiatry at the University of Birmingham since 1999. He was Head of Department of Psychiatry from 2003–2009. He is Honorary Professor, Department of Anthropology & African Studies University of Birmingham. He is Associate Editor the British Journal of Psychiatry, & on the Editorial Boards of BJPsych Bulletin and BJPsych Advances. He was Chief Examiner of the Royal College of Psychiatrists from 2002 to 2005. He has been ASB Visiting Professor at University of Auckland, Raine Visiting Professor at University of Western Australia, & Visiting Professor University of Ibadan. His research interests include clinical psychopathology, delusional misidentification syndromes, medical humanities and medical ethics. He is author of Sims’ Symptoms in the Mind (4–6th editions), Psychopathology of Rare and Unusual Syndromes, Madness and the Theatre and edited Mindreadings: Literature and Psychiatry. He is also a poet and literary critic. His volumes of poetry include Naked to your softness & other dreams, Master of the Leopard Hunt and Adagio for Oblong Mirrors. He contributed critical essays to the Oxford Companion to 20th century Poetry and Oxford Companion to Modern Poetry. He received the Royal College of Psychiatrists’ Lifetime Achievement Award in 2016 and the highest award of the Royal College of Psychiatrists, the Honorary FRCPsych., in 2019.AbstractPsychopathology is the systematic study of abnormal psychological experience and includes the precise description, definition and categorisation of abnormal phenomena. In this lecture I will focus on the potential role of psychopathology as a means of revealing the underlying brain processes that make possible our experience of reality. I will examine phantom limb phenomenon, Charles Bonnet Syndrome, musical hallucinations and autoscopy to illustrate and develop my thesis. My ultimate aim is to demonstrate that the value of psychopathology is over and above the merely descriptive and that its value includes theorising about neural mechanisms.
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Mudiyanselage, Irangani, and Madhvi Belgamwar. "A study to improve the quality of writing clinic letters to patients attending the outpatient clinic." BJPsych Open 7, S1 (June 2021): S211. http://dx.doi.org/10.1192/bjo.2021.565.
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AimsIn many countries (including the UK and Australia) it is still common practice for hospital doctors to write letters to patients’ general practitioners (GPs) following outpatient consultations, and for patients to receive copies of these letters. However, experience suggests that hospital doctors who have changed their practice to include writing letters directly to patients have more patient centred consultations and experience smoother handovers with other members of their multidisciplinary teams. (Rayner et al, BMJ 2020)The aim of the study was to obtain patient's views to improve the quality of clinical letters sent to them, hence the level of communication and standards of care.MethodAn anonymous questionnaire was designed and posted to collect information from patients attending one of the South County Mental Health outpatient clinic in Derbyshire. 50 random patients were selected between March to November 2020. Patients were asked to provide suggestions to improve the quality of their clinic letters written directly to them and copies sent to their GPs.ResultOut of 50 patients 48% (n = 24) responded. Majority of patients (92%) expressed their wish to receive their clinic letters written directly to them and 79% preferred to be addressed as a second person in the letters. More than half (54%, N = 13) of them would like to have letter by post. Majority of them (92%, N = 22) wished to have their letter within a week of their consultations.Patients attending clinics felt that the communication could be better improved through writing clearly: a) reflection of what was discussed during the consultation b) updated diagnosis c) a clear follow-up plan d) current level of support e) medication change f) emergency contact numbers g) actions to be carried out by their GP and further referrals should there be any.ConclusionPatients in community prefer to have their clinic letters directly addressing them in second person. It was noted that the letters needed to reflect accurately on what was discussed during the consultation in order to have patient centered consultations. This in turn would improve communication and thus rapport, trust and overall therapeutic relationship.
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Northam, Jaimie Chloe, and Lynne Elizabeth Magor-Blatch. "Adolescent therapeutic community treatment – an Australian perspective." Therapeutic Communities: The International Journal of Therapeutic Communities 37, no. 4 (December 12, 2016): 204–12. http://dx.doi.org/10.1108/tc-01-2016-0002.
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Purpose The purpose of this paper is to provide an overview of the adolescent therapeutic community (ATC) literature – drawing on studies primarily from the USA with consideration made to the Australian context. Design/methodology/approach A review of the efficacy research for ATCs is considered, and the characteristics of Australians accessing ATC treatment are discussed in the context of developmental needs. Findings Similarities are found in what precipitates and perpetuates adolescent substance use in the USA and Australia, and therefore, what appears to facilitate effective treatment utilising the therapeutic community model. Originality/value The paper provides a valuable perspective for Australian services, and explores the application of the ATC model within the Australian treatment context.
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Rey, Joseph M. "Comorbidity between Disruptive Disorders and Depression in Referred Adolescents." Australian & New Zealand Journal of Psychiatry 28, no. 1 (March 1994): 106–13. http://dx.doi.org/10.3109/00048679409075851.
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Parent questionnaires from large Australian (N=2093) and American (N=500) clinic cohorts of adolescents were used to diagnose depression, attention deficit disorder with hyperactivity, and oppositional and conduct disorders. Co-occurrence of diagnoses was very high. Comorbidity between depression and conduct disorder was not higher than that expected for any psychiatric disorder (odds ratios =1.20 and 1.45 respectively for each cohort) while comorbidity between attention deficit disorder with hyperactivity and oppositional disorder was higher than expected (odds ratios =7.03 and 9.02) but comparable to that between conduct and oppositional disorder (odds ratios =7.35 and 6.14). Co-occurrence of depression with other disorders did not increase the likelihood of comorbid conduct disorder.
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McGillivray, Lauren, Rodrigo Becerra, and Craig Harms. "Alexithymia stability and therapeutic outcome in an Australian psychiatric outpatient sample." Clinical Psychologist 23, no. 1 (February 17, 2018): 37–46. http://dx.doi.org/10.1111/cp.12148.
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Erasmus, Jaco. "Monash Gender Clinic: an overview of the current model of care." Australasian Psychiatry 28, no. 5 (May 11, 2020): 533–35. http://dx.doi.org/10.1177/1039856220917079.
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Objective: This paper provides an update on recent developments at the largest state-funded gender clinic for adults in Australia. It focuses on the current staffing profile, the role of the mental health professional and the evolution of the clinic as a provider of specialist care supporting primary care providers who offer an informed consent model of care in accessing gender-affirming treatments. Conclusions: While significant improvements have been made at the clinic to provide comprehensive care in a framework that is viewed more favourably by clients, gaps in clinical service provision persist and are in need of urgent attention.
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Lin, Xiaoping, Christina Bryant, Jennifer Boldero, and Briony Dow. "Psychological well-being of older Chinese immigrants living in Australia: a comparison with older Caucasians." International Psychogeriatrics 28, no. 10 (July 8, 2016): 1671–79. http://dx.doi.org/10.1017/s1041610216001010.
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ABSTRACTBackground:Few current studies explore psychological well-being among older Chinese immigrants in Australia. The study addressed this gap and provided preliminary data on psychological well-being among this group. Four indicators, namely depression, anxiety, loneliness, and quality of life, were used to present a comprehensive picture of psychological well-being.Methods:Participants were two groups of community-dwelling older people, specifically 59 Chinese immigrants and 60 Australian-born people (median age=77 and 73, respectively). Data were collected through standardized interviews. The Geriatric Depression Scale, the Hospital Anxiety and Depression Scale, the de Jong Gierveld Loneliness Scale and the WHO Quality of Life questionnaire were used to measure depression, anxiety, loneliness, and quality of life, respectively.Results:Chinese participants’ median quality of life score was higher than the scale mid-point, indicating relatively high levels of quality of life. However, 10% exhibited symptoms of depression, 6% had symptoms of anxiety, and 49% felt lonely. Compared to Australian participants, Chinese participants reported poorer quality of life and higher levels of loneliness. Importantly, the difference in quality of life remained when the impact of socio-demographic factors was controlled for.Conclusions:This study was the first to use multiple indicators to explore psychological well-being among older Chinese immigrants in Australia. Its results suggest that their psychological well-being might be worse than that of Australian-born people when using loneliness and quality of life as indicators. In particular, loneliness is a common psychological problem among this group, and there is a need for public awareness of this problem.
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Clough, Alan R. "Does kava cause hallucinations in Aboriginal populations in eastern Arnhem Land (Australia)?" South Pacific Journal of Psychology 13 (2001): 34–37. http://dx.doi.org/10.1017/s0257543400000341.
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AbstractBackground: Isolated reports exist in the literature of hallucinations occurring as harmful outcomes of kava use. Kava's well-known mood-altering qualities contrast sharply with reports of such serious unwanted side effects. Arnhem Land Aboriginal people have used kava since 1982. Is there any evidence that kava use is associated with these kinds of effects in this population?Objectives: This paper describes the context and circumstances for 18 individuals who were reported to have experienced hallucinations in a sample of the Miwatj population in eastern Arnhem Land (Northern Territory. NT) (see Clough. Cairney. Maruff, Burns & Currie. 2001). The role of kava use in these occurrences is discussed. Alcohol, tobacco, cannabis use and petrol sniffing as well as psycho-social factors were also noted in community health clinic files and health worker reports.Results and conclusions: There was no evidence that hallucinations recorded in individuals were related to kava use. Instead, social and personal stress, pre-existing psychiatric conditions and excessive use of alcohol were more prominent. To describe the kinds of perceptual shifts experienced by kava users as hallucinations would seem imprudent without consideration of other environmental factors.
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Upadhyay, Viral, Aloysius Ng, and Manori Wijayath. "126 Incidence of dementia in elderly patients with epilepsy." Journal of Neurology, Neurosurgery & Psychiatry 90, e7 (July 2019): A41.1—A41. http://dx.doi.org/10.1136/jnnp-2019-anzan.112.
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IntroductionThe incidence of epilepsy is higher in patients with underlying dementia.1 The goal of the present study is to look at the incidence of dementia in patients presented to our epilepsy clinic and analyse electroencephalogram (EEG), imaging findings and response to antiepileptic drug (AED) in these individuals.MethodsA retrospective study was performed on patients presented to Nepean Hospital epilepsy clinic from 2015 to 2017. Multiple clinical parameters were obtained from electronic medical records.ResultsA total of 258 patients presented to the clinic, of which 38 patients were above the age of 65 years. 11 patients were excluded due to insufficient information or patients without any history of seizures. Out of the remaining 27 patients studied, nine patients (33%) had dementia including five patients (19%) with Alzheimer’s dementia. Sixteen patients (59%) experienced complex partial seizures. Brain MRI was performed in twenty one patients (78%). Sixteen patients (59%) had MRI-identified structural lesions including prior stroke or intracerebral haemorrhage. EEGs were performed in twenty patients (74%). Eight patients (40%) had abnormal EEG with one patient (5%) having epileptiform discharges, three patients (15%) having focal slowing and four patients (20%) having generalised slowing. Overall, nineteen patients (70%) were on AEDs with good control and four patients (15%) required more than one AED to achieve seizure control.ConclusionThe study showed that there is higher incidence of dementia in patients with epilepsy compared with general population.2 Most patients experience complex partial seizures and can be adequately controlled on single AED.ReferencesRao S, Dove G, Cascino G, Petersen R. Recurrent seizures in patients with dementia: Frequency, seizure types, and treatment outcome. Epilepsy & Behavior 2009, 14(1), pp.118–120.ABS (Australian Bureau of Statistics) 2016, Life Tables, States, Territories and Australia, 2013–2015, cat. no. 3302.0.55.001, ABS, Canberra
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Palmer, Susan, Pandora Patterson, and Kate Thompson. "A national approach to improving adolescent and young adult (AYA) oncology psychosocial care: The development of AYA-specific psychosocial assessment and care tools." Palliative and Supportive Care 12, no. 3 (May 10, 2013): 183–88. http://dx.doi.org/10.1017/s1478951512001083.
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AbstractObjective:Age-based screening tools and assessment measures are crucial to the provision of best practice care for adolescent and young adult (AYA) cancer patients. Unfortunately, there are limited psychosocial tools developed for this age group and pediatric or adult measures are often distributed with the assumption that they are “close enough.” We describe a collaborative Australian project that strives to improve what currently exists for the psychosocial assessment of and planning for the 15–25-year-old age group.Method:Using the National Comprehensive Cancer Network's Distress Thermometer and the HEADSS Assessment as a foundation, the tools were developed in consultation with Australia's leading AYA clinicians, AYAs currently undergoing medical treatment, and a group of AYA survivors through a process of discussion groups and clinical interviews.Results:The result is the first available AYA-specific screening tool, care plan pro forma, and psychosocial assessment measure developed for use within the oncology sector. These new tools will assist clinicians working with this population group to support psychosocial coping during active treatment and promote healthy post-treatment survivorship.Significance of results:Over time, further validation procedures will add to the veracity of the measures. Until then, these measures represent the best available in Australia. They highlight a clinically recognized minimum standard of care that all young cancer patients, regardless of treatment location, have the right to receive.
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Olofsdotter, Susanne, Karin Sonnby, Sofia Vadlin, Tomas Furmark, and Kent W. Nilsson. "Assessing Adolescent Anxiety in General Psychiatric Care." Assessment 23, no. 6 (July 28, 2016): 744–57. http://dx.doi.org/10.1177/1073191115583858.
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This study examined the psychometric properties and diagnostic accuracy of the Swedish translations of the Spence Children’s Anxiety Scale, self- and parent report versions, in a sample of 104 adolescents presenting at two general psychiatric outpatient units. Results showed high informant agreement and good internal reliability and concurrent and discriminant validity for both versions and demonstrated that this scale can distinguish between adolescents with and without an anxiety disorder in a non–anxiety-specific clinical setting. The relative clinical utility of different cutoff scores was compared by looking at the extent to which dichotomized questionnaire results altered the pretest probability of the presence of a diagnosis as defined by the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Optimized for screening and diagnostic purposes in Sweden, cutoff scores obtained in the current study outperformed a previously identified cutoff score derived from an Australian community sample. The Spence Children’s Anxiety Scale is a useful clinical instrument for the assessment of anxiety in adolescents.
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Alóe, Flávio, André Pedroso, and Stella Márcia Tavares. "Epworth Sleepiness Scale outcome in 616 brazilian medical students." Arquivos de Neuro-Psiquiatria 55, no. 2 (June 1997): 220–26. http://dx.doi.org/10.1590/s0004-282x1997000200009.
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The Epworth Sleepiness Scale (ESS) measures daytime sleepiness in adults. This paper reports the following data in 616 medical students: 1 -ESS scores, 2-its correlation with the declared night sleep time, 3-comparison with ESS values obtained from Australia, 4-comparison of ESS values in a sub-population of 111 students tested early and late 1995. There were 387 males, 185 females and 4 not specified. Age = 20.16±2.23 (SD). ESS score = 10.00 ± 3.69 (SD), declared sleep time = 7.04± 1.03 (SD). ESS scores did not statistically correlate with sleep time. Average ESS score was statistically higher than in the Australian sample. Retesting of the medical students showed an increase in ESS values from March to November 1995. Sleep time difference was non-significant. Higher ESS scores in this sample seem to be related to shorter sleep time, but fatigue effects can not be ruled out.
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Kolves, Kairi, Urska Arnautovska, Angelo De Gioannis, and Diego De Leo. "Community care of individuals at risk of suicide: the Life Promotion Clinic model." Mental Illness 5, no. 2 (September 1, 2013): 41–45. http://dx.doi.org/10.1108/mi.2013.e12.
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Assistance to suicidal patients is problematic both at the hospital and community care level. Inadequacy of facilities, pressured personnel, long waiting time, and professional and social stigmatization are just some of the many issues that interfere with successful treatment. The goal of this paper is to present the functioning of the Life Promotion Clinic (LPC), Australia, and describe its users. The LPC is the first specialized outpatient service in Australia dedicated to the treatment of individuals with suicidal thoughts and behaviors. A description of the service and characteristics of its clients (demographic, psychopathology, risk of suicide) are herein presented. Data were collected for 63 male and 175 female patients who attended the LPC over a three-year period. Patients were mostly single females, aged up to 44 years, poorly educated, unemployed or on a pension/benefit. The majority of patients reported at least one suicide attempt, severe depression and anxiety scores, moderate-severe feelings of hopelessness, and high impulsiveness scores. Compared to females, male patients presented with more active desire to kill themselves and higher level of suicidal ideation. We can conclude that establishing a specialist service for treatment of individuals at increased risk for suicide requires consideration of both patient and clinicians needs. The LPC presents an innovative model of community service, capable of engaging patients with serious mental health issues, while making the service accessible to people from various social categories.
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Nightscales, Russell, Lara McCartney, Clarissa Auvrez, Gerard Tao, Sarah Barnard, Charles B. Malpas, Piero Perucca, et al. "Mortality in patients with psychogenic nonepileptic seizures." Neurology 95, no. 6 (July 20, 2020): e643-e652. http://dx.doi.org/10.1212/wnl.0000000000009855.
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ObjectiveTo investigate the hypothesis that patients diagnosed with psychogenic nonepileptic seizures (PNES) on video-EEG monitoring (VEM) have increased mortality by comparison to the general population.MethodsThis retrospective cohort study included patients evaluated in VEM units of 3 tertiary hospitals in Melbourne, Australia, between January 1, 1995, and December 31, 2015. Diagnosis was based on consensus opinion of experienced epileptologists and neuropsychiatrists at each hospital. Mortality was determined in patients diagnosed with PNES, epilepsy, or both conditions by linkage to the Australian National Death Index. Lifetime history of psychiatric disorders in PNES was determined from formal neuropsychiatric reports.ResultsA total of 5,508 patients underwent VEM. A total of 674 (12.2%) were diagnosed with PNES, 3064 (55.6%) with epilepsy, 175 (3.2%) with both conditions, and 1,595 (29.0%) received other diagnoses or had no diagnosis made. The standardized mortality ratio (SMR) of patients diagnosed with PNES was 2.5 (95% confidence interval [CI] 2.0–3.3). Those younger than 30 had an 8-fold higher risk of death (95% CI 3.4–19.8). Direct comparison revealed no significant difference in mortality rate between diagnostic groups. Among deaths in patients diagnosed with PNES (n = 55), external causes contributed 18%, with 20% of deaths in those younger than 50 years attributed to suicide, and “epilepsy” was recorded as the cause of death in 24%.ConclusionsPatients diagnosed with PNES have a SMR 2.5 times above the general population, dying at a rate comparable to those with drug-resistant epilepsy. This emphasizes the importance of prompt diagnosis, identification of risk factors, and implementation of appropriate strategies to prevent potential avoidable deaths.
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Davidson, Sandra, Fiona Judd, Damien Jolley, Barbara Hocking, Sandra Thompson, and Brendan Hyland. "Cardiovascular Risk Factors for People with Mental Illness." Australian & New Zealand Journal of Psychiatry 35, no. 2 (April 2001): 196–202. http://dx.doi.org/10.1046/j.1440-1614.2001.00877.x.
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Objective: The objective of this study was to document the prevalence of risk factors for cardiovascular disease among people with chronic mental illness. Method: A cross-sectional survey was conducted of 234 outpatients attending a community mental health clinic in the North-western Health Care Network in Melbourne, Australia. Prevalence of smoking, alcohol consumption, body mass index, hypertension, salt intake, exercise and history of hypercholesterolemia was assessed. Results: Compared with a community sample, the mentally ill had a higher prevalence of smoking, overweight and obesity, lack of moderate exercise, harmful levels of alcohol consumption and salt intake. No differences were found on hypertension. Men, but not women, with mental illness were less likely to undertake cholesterol screening. Conclusions: Psychiatric outpatients have a high prevalence of cardiovascular risk factors which may account for the higher rate of cardiovascular mortality among the mentally ill. Further research is needed to trial and evaluate interventions to effectively modify risk factors in this vulnerable population.
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Ames, David, Michael Woodward, Karen Boundy, and Henry Brodaty. "P01. Baseline Demographics of Dementia Patients Seen at Australian Clinics: Preliminary Data from Prime." Australian & New Zealand Journal of Psychiatry 41, no. 1_suppl (January 2007): A102. http://dx.doi.org/10.1080/00048670701387247.
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Trauer, Tom. "Ethnic Differences in the Utilisation of Public Psychiatric Services in An Area of Suburban Melbourne." Australian & New Zealand Journal of Psychiatry 29, no. 4 (December 1995): 615–23. http://dx.doi.org/10.3109/00048679509064976.
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Objective: The main aim of this study was to compare levels of service use by English and non-English speaking background people. Method: A comparison of service use in 1991/1992 between clients of English speaking (ESB) and non English-speaking (NESB) background was undertaken using hospital inpatient statistics, community mental health centre contact data, interpreter usage figures, and the 1991 Australian census. Results: The main findings indicated: (a) longer median lengths of stay of NESB than ESB inpatients; (b) roughly equal involuntary hospitalisation rates between ESB and NESB residents, but significantly lower rates of voluntary hospitalisation for NESB residents; (c) NESB face-to-face clinic contacts significantly shorter (by between five to ten minutes) than ESB; and (d) variable and generally low use of interpreters. No significant associations between ethnicity, legal status and gender were found. There were limitations in the available data and conclusions could be drawn only with caution. Conclusions: Recommendations include better routine collection of ethnically relevant information, and measures designed to improve the acceptability and accessibility of inpatient services.
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Saligheh, M., B. Mcnamara, and R. Rooney. "Exercise participation in postpartum women in Western Australia." European Psychiatry 26, S2 (March 2011): 1682. http://dx.doi.org/10.1016/s0924-9338(11)73386-7.
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IntroductionResearch evidence suggests that the prevalence rate of postpartum depression in Western countries is 10–25% (Beck, 2001; O’ Hara & Swain, 1996). Many women diagnosed with postnatal depression(PND) are reluctant to take antidepressant medication (Whitton,1996). Coupled with the limited availability of psychological therapies, the consideration of adjunctive interventions for managing PND would appear worthwhile. Physical activity(PA) has been demonstrated to both mediate and improve outcomes for depression (Dimeo, 2001; Nabkasorn et al., 2006) in the general population, and in moderating the impact of PND (Daley, 2009).ObjectivesTo describe physical activity participation in a cohort of postpartum women in Western AustraliaTo investigate the factors associated with physical activity participation in postpartum women Examine the differences between women reporting PND and those without on physical activityAimsStudy 1 was the distribution of a postpartum physical activity questionnaire through child health clinics to mothers within the 6 weeks to12 months postpartum period.MethodsCohort design was used to recruit mothers within postpartum periodResultsThe results from the study showed that mothers who were at the risk of PND had the same level of physical activity in compare to normal mothers. The T-test showed there was not any significant correlation. Analysis revealed that there was a significant correlation between the effect of PND on parental self-confidence and partner support.ConclusionFindings suggest that further exploration needs to be considered to explore mothers’ experience of physical activity, its barriers and the interaction of their partners in order to exercise after child birth.
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Boulton, Kelsie A., Veena Raghupathy, Adam J. Guastella, and Michael R. Bowden. "Reducing seclusion use in an Australian child and adolescent psychiatric inpatient unit." Journal of Affective Disorders 305 (May 2022): 1–7. http://dx.doi.org/10.1016/j.jad.2022.02.066.
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Ellis, Andrew. "Forensic psychiatry and mental health in Australia: an overview." CNS Spectrums 25, no. 2 (October 7, 2019): 119–21. http://dx.doi.org/10.1017/s1092852919001299.
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This article reviews the development of forensic psychiatry and mental health services in Australia for the international reader. It covers the legacy of a series of colonial systems that have contributed to a modern health service that interacts with justice systems. The development of relevant legislation, hospitals, prison services, community, and courts services is reviewed. The training and academic development of professionals is covered. Gaps in service delivery and future directions are considered.
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Taylor, Richard, Andrew Page, Stephen Morrell, James Harrison, and Greg Carter. "Social and Psychiatric Influences on Urban-Rural Differentials in Australian Suicide." Suicide and Life-Threatening Behavior 35, no. 3 (June 2005): 277–90. http://dx.doi.org/10.1521/suli.2005.35.3.277.
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