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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/30407073/switch-associated-adverse-events-focus-on-olanzapine
#1
Lily Xu, Saroja Krishnaswamy
OBJECTIVES: Switching between different antipsychotic therapies is a frequent occurrence in the management of patients with schizophrenia and other psychotic disorders. This paper provides a review of the principles of antipsychotic switching and discusses pharmacological principles underlying adverse events that occur while switching olanzapine to another antipsychotic medication. It offers suggestions for management of switch-associated adverse events in clinical settings. CONCLUSIONS: Few publications explore olanzapine switch-related adverse events, the underlying pharmacological principles and appropriate switching strategies to minimise the risk of adverse events...
November 8, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30407072/comparison-of-public-mother-baby-psychiatric-units-in-australia-similarities-strengths-and-recommendations
#2
M Galbally, A Sved-Williams, D Kristianopulos, K Mercuri, P Brown, A Buist
BACKGROUND: Mother-baby units are innovative and important models of care that allow inpatient treatment of postpartum maternal mental disorders whilst preserving and promoting the attachment relationship with their young infants. OBJECTIVES: To report data across five public mother-baby units in Australia in order to explore similarities and distinguishing features of each model. METHOD: Each unit also provided 12 months of data on key characteristics of their unit...
November 8, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30407071/organisational-impact-of-the-national-disability-insurance-scheme-transition-on-mental-health-care-providers-the-experience-in-the-australian-capital-territory
#3
Mary Anne Furst, Jose A Salinas-Perez, Luis Salvador-Carulla
OBJECTIVES: Concerns raised about the appropriateness of the National Disability Insurance Scheme (NDIS) in Australia for people with mental illness have not been given full weight due to a perceived lack of available evidence. In the Australian Capital Territory (ACT), one of the pilot sites of the Scheme, mental health care providers across all relevant sectors who were interviewed for a local Atlas of Mental Health Care described the impact of the scheme on their service provision...
November 8, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30403149/the-crucible-of-early-career-psychiatry
#4
Lillian Ng, Richard Steane, Natalie Scollay, Stephen Harris, Jasminka Milosevic, Kirsten Young, David Tan, Samantha Chow
OBJECTIVE: To capture the voices of psychiatrists as they reflect on challenges at the early stages of the career trajectory. METHOD: Early career psychiatrists contributed reflections that identified various challenges in the transition from trainee to consultant psychiatrist. RESULTS: Common difficulties included negotiating role transition and conflict. Specific events had deep impact such as involvement with a patient who had committed suicide...
November 7, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30403145/reviewing-the-clinical-significance-of-fear-of-abandonment-in-borderline-personality-disorder
#5
Venura Palihawadana, Jillian H Broadbear, Sathya Rao
OBJECTIVES: To review and highlight the clinical significance of the symptom 'fear of abandonment' in borderline personality disorder (BPD). METHODS: A systematic search of the literature was conducted using MEDLINE and PubMed, employing search terms including 'fear of abandonment', 'borderline personality disorder' and 'rejection'. The most relevant English-language articles and books were selected for this review. RESULTS: Fear of abandonment is widely recognised as a core symptom in BPD; a biopsychosocial explanation for the occurrence of the symptom is presented...
November 7, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30382755/perceptions-of-pregnant-women-regarding-antidepressant-and-anxiolytic-medication-use-during-pregnancy
#6
Alka Kothari, John de Laat, Joel M Dulhunty, George Bruxner
OBJECTIVE: The objective of this study was to explore attitudes and decision-making by pregnant women regarding antidepressant and anxiolytic use during pregnancy. METHOD: An observational study at an outer metropolitan hospital in Brisbane, Queensland. Pregnant women presenting for their first antenatal clinic visit were invited to complete a questionnaire. Participants were asked about current or previous antidepressant/anxiolytic use, influences on drug decision-making and the adequacy of information received...
November 1, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30382752/methamphetamine-use-in-patients-presenting-to-emergency-departments-and-psychiatric-inpatient-facilities-what-are-the-service-implications
#7
Anish Unadkat, Su Subasinghe, Richard J Harvey, David J Castle
OBJECTIVES: The aim of this study is to understand better the service implications of patients presenting to an inner city Australian Emergency Department (ED) and Acute Psychiatric Inpatient Service (AIS) with a history of recent crystal methamphetamine use. METHODS: An audit was taken of all patients with recent crystal methamphetamine use presenting to St Vincent's Hospital Melbourne ED and AIS over the month of September 2017. Recorded information included patient demographics, diagnosis, aggressive episodes, restrictive interventions and other risk incidents...
November 1, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30382749/standardized-drug-and-alcohol-questions-at-admission-to-an-acute-adult-mental-health-unit-clarifying-the-burden-of-dual-diagnoses-across-a-five-year-period
#8
John Reilly, Brett McDermott, John Dillon
OBJECTIVES: We aimed to report substance use across a five-year period in individuals admitted to an acute mental health unit, utilizing data from a routine clinical measure, diagnoses, and findings related to gender, ethnicity and the implementation of a new dual-diagnosis policy. METHODS: Data was extracted from the electronic records of 2118 individuals who had consecutive admissions to the acute inpatient unit. Analysis focused on demographic and diagnosis variables and the drug and alcohol question in the Health of the Nations Outcome Scale...
November 1, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30379087/clinically-what-ought-we-to-believe
#9
John D Little, Lorraine Davison, Robert D Little
OBJECTIVE: To question the status of the randomised controlled trial (RCT) in the hierarchy of evidence. CONCLUSIONS: The RCT provides important and clinically relevant information, particularly in psychopharmacology. However, and as with other methodologies, RCTs too are flawed and automatic abdication to their conclusions, especially in complex social interventions, is unwise. A clinical example with conflicting and polarising views, each with their evidence base, is described alongside a suggested clinical strategy for resolving differences of opinion...
October 31, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30379083/widespread-emergency-department-access-block-a-human-rights-issue-in-australia
#10
Stephen Allison, Tarun Bastiampillai, Richard O'Reilly, Steven S Sharfstein, David Castle
OBJECTIVE: There are increasing demands on emergency psychiatrists with higher numbers of mental health presentations, and longer stays in emergency departments (EDs). Australia, like other English speaking countries, funds considerably lower numbers of psychiatric beds than average for Organisation for Economic Co-operation and Development (OECD) countries. Consequently, acute bed occupancy is high, and a bed is frequently unavailable when a person needs admission. Patients with serious mental illness can wait days in busy and overstimulating EDs, become agitated and assaultive, and then require chemical and physical restraint...
October 31, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30379082/trainee-welfare-a-new-zealand-perspective
#11
Lorraine Davison, Huma Amer, Jamuna Krishnan, Elisha Seale, Kirsten Young, Sarah Romans
OBJECTIVE: To explore key sources of stress experienced during training by psychiatry registrars and identify which coping strategies they found helpful or unhelpful. METHOD: We used three data sources: a) 'stress' vignettes written by Stage 3 trainees; b) minutes of regular registrar meetings; c) focus groups. We analysed these using abbreviated grounded theory, generating themes. RESULTS: The main sources of stress during training were disempowerment, adverse events, difficult supervision and cultural perspectives...
October 31, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30298754/survey-of-australian-psychiatrists-and-psychiatry-trainees-knowledge-about-and-attitudes-towards-medicinal-cannabinoids
#12
Nathan I Jacobs, Mark Montebello, Lauren A Monds, Nicholas Lintzeris
OBJECTIVE: To assess Australian psychiatrists' and psychiatry trainees' knowledge about and attitudes towards medicinal cannabinoids, given the recent relaxation of cannabinoid-prescribing laws in Australia. METHOD: All Australian members of the Royal Australian and New Zealand College of Psychiatrists were invited to participate in an anonymous, 64-item online questionnaire, through Royal Australian and New Zealand College of Psychiatrists' newsletters. The questionnaire ran for a 10-week period from March to May 2017...
October 9, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30298743/pattern-based-formulation-clinical-case-5
#13
Irosh Fernando, Mahesh Rajasuriya, Lisa Lampe
OBJECTIVE: To demonstrate how the Pattern-based Formulation can be used to integrate biological, psychological and sociocultural factors in constructing the case formulation in a patient who developed schizophrenia and post-psychotic depression. CONCLUSIONS: Three new patterns are introduced and used to construct a comprehensive case formulation. This expands the suite of patterns in the pattern-based method of psychiatric case formulation, and further demonstrates its broad utility as an educational resource in psychiatry training...
October 9, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30293459/why-it-s-time-to-focus-on-masculinity-in-mental-health-training-and-clinical-practice
#14
Zac E Seidler, Simon M Rice, Haryana M Dhillon, Helen Herrman
OBJECTIVE: Men present with complex, diverse and often contradictory expressions of masculinity that are relevant to their health status. This article argues for the inclusion of masculinity into mental health curricula in Australia. Masculinity mediates health outcomes by influencing help seeking and engagement with treatment. CONCLUSION: An online curricula audit of publicly available information from Australian medical programs and their professional bodies reveals increasing awareness of the needs, but limited practical inclusion of masculinity models in training and practice...
October 8, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30293454/no-gold-medals-assessing-australia-s-international-mental-health-performance
#15
Sebastian Rosenberg, Ian Hickie
OBJECTIVE: The objective of this study was to present an assessment of Australia's mental health system performance, within its social context, by comparison with other countries. METHOD: A review of existing literature and databases from both Australia and overseas was undertaken. Systems permitting international comparison of mental health and its social context are few. The review is limited in scope. RESULTS: Although Australia was one of the first nations to develop and adopt a national mental health policy (in 1992), the data that are available suggest that we are not World leaders across the identified domains...
October 8, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30293446/how-secure-are-the-secure-psychiatric-units-in-new-south-wales
#16
Jonathon Adams, Stuart Thomas, Tobias Mackinnon, Damien Eggleton
OBJECTIVES: To evaluate the therapeutic security characteristics of the secure forensic mental health inpatient units in New South Wales, Australia. METHODS: This study evaluated all eight secure inpatient units in New South Wales using a validated tool, the Security Needs Assessment Profile. RESULTS: A pattern of decreasing therapeutic security across the secure units was found, consistent with their intended security levels, from high security through to open security...
October 8, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30293442/psychiatry-trainee-welfare-from-words-to-action
#17
Hannah Kim, Shuichi Suetani, Malcolm Forbes, David Nguyen
OBJECTIVE: To review selected literature available on trainee welfare and reflect on our own experiences to provide practical advice to our colleagues and suggest strategies to enhance trainee welfare. CONCLUSIONS: Promoting the welfare of psychiatry trainees requires a three-pronged approach. We must care for ourselves through individual strategies; we must advocate for optimization of the systems we work in to minimize modifiable factors associated with burnout; and we must continue on the perennial challenge of culture change to reduce stigma around stress and mental illness and promote a healthier workplace...
October 8, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30284918/the-girl-in-the-book-a-screenplay-on-child-abuse-personality-dysfunction-and-recovery-of-interest-to-not-only-psychiatry
#18
Geoffrey Windle, K Martin Beckmann
No abstract text is available yet for this article.
October 4, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30284912/characteristics-diagnoses-illness-course-and-risk-profiles-of-inpatients-admitted-for-at-least-21-days-to-an-australian-private-psychiatric-hospital
#19
Nicholas A Keks, Judy Hope, William Pring, Saji Damodaran, Shashjit Varma, Voula Adamopoulos
OBJECTIVES: To perform a clinical and risk audit of private hospital inpatients staying in hospital at least 21 days. METHODS: Of 492 admissions for ≥21 days in 2016, 40 were randomly selected for audit. Characteristics, illness severity and course using the Clinical Global Impression severity (CGI-S) subscale and improvement (CGI-I) subscale, and clinical risk profiles were ascertained at admission, day 15 and discharge by two psychiatrists. RESULTS: The cases were 65% female, age 50...
October 4, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/30244584/a-new-paradigm-for-mental-health-quality-and-safety-are-we-ready
#20
Brooke Short, Carrie Marr, Murray Wright
OBJECTIVE: Development of a Mental Health Quality and Safety Framework with co-designed priority areas for improvement. METHOD: A qualitative and inductive approach was utilised, including a literature search, consultations with staff and focus groups with consumers and carers. RESULTS: Thematic analysis resulted in 32 categories, grouped into seven key themes. Combined with the evidence base, these were distilled into component parts of the Framework...
September 24, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
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