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Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists

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https://www.readbyqxmd.com/read/27879426/the-successful-concurrent-use-of-two-long-acting-depot-antipsychotics-in-a-patient-with-treatment-resistant-schizophrenia-and-history-of-serious-violence-a-case-report
#1
Anna Lenardon, Mona Ahmed, Katie-Lynn Harfield, Mrigendra Das
OBJECTIVE: This case report describes a forensic psychiatric patient presenting with treatment-resistant schizophrenia and serious interpersonal violence complicated by poor adherence to oral medication who was treated successfully with two concurrent long-acting depot antipsychotics. METHOD: Treatment response was measured for a 6-month period at 6-weekly intervals, post-initiation using the Positive and Negative Symptoms of Schizophrenia with Excited Component score (PANSS-EC), Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression Scale (CGI)...
November 22, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27879425/clinical-teaching-and-supervision-in-postgraduate-psychiatry-training-the-trainee-perspective
#2
Alice Stephan, Gary Cheung
OBJECTIVE: We aimed to explore psychiatry trainees' perspectives on clinical teaching and supervision as well as how this might be improved. METHOD: New Zealand trainees (n=51) completed online the Maastricht Clinical Teaching Questionnaire (MCQT) and three open-ended questions. RESULTS: The majority rated 'agree' or 'strongly agree' to all items of the MCQT. Weaknesses in the feedback process including observation, feedback provision, and formulating learning goals were highlighted...
November 22, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27864569/repeated-self-harm-in-young-people-a-review
#3
Jo Robinson
OBJECTIVES: This paper provides a review of the rates of self-harm and repeated self-harm among young people. It describes some of the risk factors associated with these behaviours and summarises some of the barriers to delivering optimal treatment. CONCLUSIONS: The review concludes that there is an urgent need for the delivery of respectful and evidence-based practice to all young people who present with self-harm. In addition, improved monitoring of self-harm presentations to hospitals across Australia is required in order that robust data are collected and the impact of practice change can be reliably assessed...
November 18, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27856768/treatment-for-youth-paraphilic-disorders-opportunities-to-reduce-harm
#4
John Kasinathan
OBJECTIVE: To outline current understanding and recommended treatments for paraphilic or sexual deviant disorders in adolescents and youth. METHOD: An overview of the diagnosis, development and scope of paraphilic disorders. Evidence and an algorithm for pharmacological treatments in youth are outlined. RESULTS: Paraphilic disorders are relatively common in adolescents and youth, with fantasies and urges preceding the onset of deviant behaviour by a handful of years...
November 17, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27856767/suicidal-thinking-and-behaviour-as-of-600-bce-aesop-s-fables
#5
Julian Davis, Tammie T Money, Saxby Pridmore
OBJECTIVE: Psychiatry has ignored history, anthropology, sociology and literature in the search for enlightenment regarding suicide. Our objective was to determine what, if anything, Aesop's fables had to teach us about suicide in around 600 BCE. Aesop's account is around two centuries older than the oldest text (Herodotus: The histories) previously examined by our group. METHOD: We examined two translations of Aesop's fables, seeking accounts fitting the following categories: (1) suicidal thinking, (2) suicidal behaviour without fatal consequences, and (3) suicidal behaviour with fatal consequences...
November 17, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27733662/suicidal-ideation-and-non-fatal-deliberate-self-harm-presentations-in-the-kimberley-from-an-enhanced-police-mental-health-service-notification-database
#6
Cate McHugh, Sivasankaran Balaratnasingam, Anita Campbell, Murray Chapman
OBJECTIVES: To determine the rate of presentations for suicidal ideation and deliberate self-harm in the Kimberley region of Western Australia, characterized in terms of age, gender, rates of repetition and engagement with community mental health services. METHODS: An observational study of health service presentations over 12 months. SETTING: 10 sites across the region with police services were included, capturing the overwhelming majority of self-harm presentations in the region...
October 11, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27733661/housing-first-permanent-supported-accommodation-for-people-with-psychosis-who-have-experienced-chronic-homelessness
#7
Alex Holmes, Trevor Carlisle, Zoe Vale, George Hatvani, Camillie Heagney, Simon Jones
OBJECTIVES: The objective of this study was to determine whether a 'housing first' permanent supported accommodation was effective in improving housing stability, continuity of care and reducing mental health admissions for persons experiencing chronic homelessness with psychosis. METHODS: A quasi prospective cohort study of 42 chronic homeless persons with psychosis accommodated in a new purpose built facility in central Melbourne. Accommodation stability, mental health service contacts and psychiatric admissions were compared across the 2 years prior, the first 2 years of placement and the 2 years after leaving...
October 11, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27765840/evaluating-complex-medical-treatment-options-a-case-report
#8
Irosh Fernando, Frans Henskens, Masoud Talebian
OBJECTIVE: Complex treatment decisions can be suboptimal due to lack of a reliable decision-making model, a need this paper aims to meet. METHOD: A model for making complex treatment decisions is introduced. RESULTS: The utility of the proposed method is demonstrated by making a complex treatment decision involving evaluation of clozapine treatment in a treatment-resistant patient. CONCLUSION: The proposed method implemented as a software tool can provide a framework for shared decision-making involving the patient...
October 10, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27765838/mental-health-care-for-indigenous-young-people-moving-culture-from-the-margins-to-the-centre
#9
Alasdair Vance, Janet McGaw, Jo Winther, Moira Rayner, Selena White, Alison Smith
OBJECTIVE: Recently, Indigenous academics have evolved an Indigenist discourse that centralises Indigenous 'ways of knowing, being and doing'. Through this dialogue, Indigenous 'ways of knowing and being' augment Western biopsychosocial treatments. METHODS: This paper outlines the authors' clinical encounters with young people from the Koori community and ongoing consultation with Koori community Elders in Victoria that led to engaging young people and their families in an Indigenist dialogue...
October 7, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27707949/the-physical-health-of-indigenous-and-non-indigenous-patients-participating-in-residential-rehabilitation-programs-a-comparison-study
#10
Tom Meehan, Donna Jones, Terry Stedman, Dean Johnson, Shuichi Suetani, Emma Foreman
OBJECTIVE: To examine the differences in the physical health of Indigenous and non-Indigenous patients with severe mental illness (SMI) undergoing psychiatric rehabilitation. METHODS: An audit of the physical health of patients (n = 361) in all publicly funded residential rehabilitation programs in Queensland was carried out in late 2014. Data collection focused on clinical and lifestyle factors associated with physical health. RESULTS: The prevalence of smoking, substance use and type 2 diabetes in Indigenous patients was significantly higher than rates found in non-Indigenous patients...
October 5, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27694646/the-conundrum-of-hanging-points-in-correctional-facilities
#11
Saxby Pridmore, William Pridmore
OBJECTIVE: We aimed to explore aspects of the removal of hanging points from correctional facilities. CONCLUSION: An argument can be made that individuals have a right to die/suicide. The United Nations holds that except for freedom of movement, prisoners have the same rights as non-prisoners. The rights of the individual and the duty of many custodial institutions are in conflict. This introduces a conundrum; when all hanging points are removed from correctional facilities, prisoners without mental disorder, but with a sustained wish to die, will not be able to achieve that end, while non-prisoners will be well able to do so...
September 30, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27694645/alcohol-drug-and-related-health-and-wellbeing-issues-among-young-people-completing-an-online-screen
#12
S Fiona Barker, Victoria Manning, David W Best, Michael Savic, Dan I Lubman
OBJECTIVE: Despite high levels of alcohol use, drug use and risky behaviors, rates of help-seeking amongst young people are typically low. This study explored the profile of young people (under the age of 25 years) completing an online screen, assessing substance use problem severity and wellbeing in comparison with adults completing the same screen, so as to inform development of better targeted approaches for this in-need population. METHODS: Between 2012 and 2014, an online alcohol and drug screen was promoted across Australia on a national online counseling service...
September 30, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27694644/transition-in-adhd-attention-to-the-lifespan
#13
Alison S Poulton
OBJECTIVES: This paper reviews the importance of transition to adult services for young people with ADHD. METHOD: Different models are described and evidence sought for their effectiveness in clinical practice. RESULTS: Models of care for children with ADHD include specialised mental health services, individual paediatricians and child and adolescent psychiatrists. Although it might be expected that transition would be to equivalent adult teams or specialists, studies have shown that transition may not run smoothly, and the adult services are frequently inadequate...
September 30, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27683657/methylphenidate-in-the-treatment-of-an-adolescent-female-with-obsessive-compulsive-disorder-and-attention-deficit-hyperactivity-disorder-a-case-report
#14
Joel King, Nathan Dowling, Fiona Leow
OBJECTIVES: We describe a case whereby a 15-year-old female with treatment-resistant obsessive-compulsive disorder (OCD) was treated with methylphenidate for co-morbid attention deficit hyperactivity disorder (ADHD). The ADHD-OCD co-morbidity has often been overlooked clinically due to conflicting opinions about their underlying neurobiology and treatment options. CONCLUSIONS: In this adolescent with co-morbid ADHD and OCD, we observed that the adjunctive use of methylphenidate resulted in enhanced treatment response to both psychological and pharmacological interventions for OCD...
September 28, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27683656/effectiveness-of-a-single-day-induction-programme-in-changing-medical-students-attitudes-towards-the-speciality-of-forensic-psychiatry
#15
Ann Archer, Joshana Guliani, Francesca Johns, Emily McCartney, E Naomi Smith, Callum C Ross, Samrat Sengupta, Mrigendra Das
OBJECTIVES: We aimed to investigate the effectiveness of a day visit in changing attitudes towards a high-security forensic psychiatric hospital, with regard to the current recruitment difficulties in psychiatry. METHODS: Broadmoor Hospital, a UK high-security psychiatric hospital, runs day visits for medical students, led by doctors. At the beginning and the end of the day students wrote their responses to the question, 'What do you think of Broadmoor?' Attitudes and themes were identified, and their prevalence was analysed...
September 28, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27683655/mental-health-services-planning-for-g20-summit-in-brisbane-and-assessment-of-impact
#16
Brett Emmerson, Anna Praskova, Lisa Fawcett, David Crompton, Edward Heffernan
OBJECTIVE: The objective of this study was to inform planning for similar events, our aim was to describe planning undertaken by Brisbane Mental Health Services for the 2014 G20 Summit and the impact of the Summit on service use. METHODS: We analysed routinely collected service data comparing presentations and discharges for the same time period in two consecutive years. RESULTS: While presentations to mental health services increased from the previous year across a five-month period (including the month of G20), the week of the G20 Summit showed little change...
September 28, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27683654/things-i-wish-i-d-known-desiderata-for-early-career-psychiatrists
#17
Lillian Ng, Richard Steane, Emme Chacko, Natalie Scollay
OBJECTIVE: The objective of this study was to disseminate advice imparted to early career psychiatrists by a panel of senior colleagues at a Royal Australian and New Zealand College of Psychiatrists symposium, reflecting on things they wished they had known at the earlier stage in their careers. METHODS: Key themes were extracted from notes taken at the symposium, where opinions were expressed by three senior psychiatrists. RESULTS: There are components in building a sustainable career as a psychiatrist, which include considering one's work environment and relationships with colleagues; self-care, mentorship and reflective practice; and seeking opportunities to teach and research for career progression...
September 28, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27679636/the-misleading-concept-of-initial-severity-in-depression-clinical-trials-development-and-results-from-a-mathematical-model
#18
Konstantinos N Fountoulakis
OBJECTIVE: Recently, meta-analytic studies have suggested a positive relationship between initial severity and magnitude of treatment efficacy. The aim of the current study was to develop a mathematical model to test the assumption concerning the role of initial severity in treatment response. METHODS: A number of experimental artificial datasets were developed on the basis of three different scenarios which reflect a pre-determined effect of initial severity. They were used to test for correlations at the patient level as well as at the meta-analysis level (trial level)...
September 27, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27679635/establishment-and-implementation-of-a-psychiatry-enrichment-programme-for-medical-students
#19
Zaza Lyons
OBJECTIVE: There has been a growing interest in psychiatry enrichment programmes such as summer schools and institutes for medical students in the last 10 years. Evaluation of enrichment programmes shows that they can be an effective method of increasing students' interest in psychiatry as a career. However, despite initial enthusiasm and motivation within an academic department, establishing a programme can be a daunting task. The aim of this paper is to provide a background of how to establish and implement a psychiatry summer school or institute...
September 27, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27679634/violence-and-self-harm-in-severe-mental-illness-inpatient-study-of-associations-with-ethnicity-cannabis-and-alcohol
#20
Vajira Dharmawardene, David B Menkes
OBJECTIVE: We examined the extent to which ethnicity, cannabis and alcohol use could predict prevalence of violence and self-harm in an inpatient psychiatric sample. METHOD: We collected demographic and clinical data in a series of 141 adult psychiatric inpatients in Hamilton, New Zealand. The Alcohol Use Disorders Identification Test (AUDIT) and Cannabis Use Disorders Identification Test, Revised (CUDIT-R) were used to measure substance use. Clinical assessment and file review were used to verify histories of self-harm and violence...
September 27, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
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