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Australas Psychiatry 2019 Apr;27(2):199-200

Australas Psychiatry 2019 Apr;27(2):110-111

Australas Psychiatry 2019 Apr;27(2):198-199

Australas Psychiatry 2019 Apr;27(2):197

Australas Psychiatry 2019 Apr;27(2):201

Australas Psychiatry 2019 Apr;27(2):197-198

Australas Psychiatry 2019 Apr;27(2):109-110

Medical Unit Head, Helen Mayo House, Womens and Childrens Health Network, South Australia, Clinical Senior Lecturer, University of Adelaide, Adelaide, SA, Australia.

Australas Psychiatry 2019 Apr;27(2):203

Australas Psychiatry 2019 Apr 16:1039856219839480. Epub 2019 Apr 16.

Senior Clinical Lecturer, Department of Psychiatry, University of Sydney, Sydney, NSW, and; Senior Staff Specialist, Mood Disorders Unit, Cumberland Hospital, Westmead, NSW, and; Consultant Psychiatrist, St John of God Health, North Richmond, NSW, Australia.

Objectives: Dissociative identity disorder in relation to brain injury has only rarely been reported in literature. This case report, which illustrates a de novo onset of dissociative identity for the first time in an elderly man who had a left parietal haematoma, adds to this scant literature base and supports an integrative view of bridging the dichotomy between organic and functional to explain complex psychiatric phenomena.

Methods: It is a single case report collected through serial semi-structured interviews of the patient and his family over a 12-week period. Read More

Australas Psychiatry 2019 Apr 15:1039856219839488. Epub 2019 Apr 15.

Mental Health Drug and Alcohol, Dubbo and Regions, Western NSW Local Health District, Dubbo, NSW, and; Department of Psychiatry, Royal Prince Alfred Hospital, Camperdown, NSW, and School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.

Objectives: This literature review aimed to outline the evidence regarding the outcomes of formal mentoring programs for training psychiatrists.

Methods: An electronic search of Ovid MEDLINE, EMBASE, Ovid PsycINFO and The Cochrane Library was conducted.

Results: A total of 17 articles fulfilled inclusion criteria. Read More

Australas Psychiatry 2019 Apr 15:1039856219839467. Epub 2019 Apr 15.

Associate Professor and Acting Head, Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Woden, ACT, and; Clinical Associate Professor, Department of Psychiatry, Royal Melbourne Hospital, Parkville, VIC, and; Director, Research Centre for the Neurosciences of Ageing, Canberra Hospital, Canberra, ACT, Australia.

Objective: To explore the role of affect in risk perception and intention to adopt protective measures against pandemic swine influenza in people with schizophrenia.

Methods: A cross-sectional study was conducted exploring the responses of 71 adults with schizophrenia and 238 adults attending general practice settings without schizophrenia. Participants completed a questionnaire that included items relating to: self-predicted affect (affective forecast) were they to contract swine influenza; perceived risk from swine influenza; and willingness to adopt protective measures against swine influenza. Read More

Australas Psychiatry 2019 Apr 4:1039856219839489. Epub 2019 Apr 4.

Professor, Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, and; Ramsay Health Care (SA) Mental Health Services, Adelaide, SA, and; Northern Adelaide Local Health Network, Adelaide, SA, Australia.

Objective:: Janet Frame (1924-2004) was one of New Zealand's most celebrated authors. Much of her work stems from her experiences as a psychiatric patient. She was hospitalised for about eight years with a diagnosis of schizophrenia. Read More

Australas Psychiatry 2019 Apr 1:1039856219839479. Epub 2019 Apr 1.

Medical Student, University of Sydney, Sydney, NSW, Australia.

Objective:: Self-awareness is essential for combating burnout, promoting self-care, and wellbeing in health professionals. This article examines modern day roadblocks to developing this skill in medical practice and highlights some simple solutions for consideration.

Conclusion:: The capacity for self-awareness is essential to the modern-day physician seeking a long and fulfilling career. Read More

Australas Psychiatry 2019 Apr 1:1039856219839474. Epub 2019 Apr 1.

Registrar, Mental Health, Sunshine Coast Hospital and Health Services, Nambour, QLD, Australia.

Objectives:: This study aimed to highlight the interplay of intellectual disability and psychiatric presentation using a case series.

Methods:: A brief review of the current literature and an illustrative case series of five intellectually disabled patients with psychiatric patients whose diagnosis were clarified over time who presented with a psychiatric illness are provided.

Results:: The presence of intellectual disability often compounds the difficulty of establishment of mental-health diagnosis. Read More

Australas Psychiatry 2019 Apr 1:1039856219834074. Epub 2019 Apr 1.

Chair of Psychiatry, St. Vincent's Mental Health, Department of Psychiatry, University of Melbourne, VIC, Australia.

Objectives:: To explore the relevance and adaptability of the Optimal Health Program for mental and primary healthcare providers in Malaysia.

Methods:: Evaluate stakeholder engagement and training programme for psychiatrists, family medicine specialists, public health specialists, physicians, clinical psychologists, counsellors, and representatives from a patient support group. Evaluate the programme for applicability, as well as participant's knowledge and confidence in using key components. Read More

Australas Psychiatry 2019 Apr 1:1039856219839477. Epub 2019 Apr 1.

Research Fellow, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, and; Centre for Mental Health, Swinburne University, Hawthorn, VIC, and; Department of Psychiatry, St. Vincent's Mental Health, Melbourne, VIC, and; Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, VIC, and; Department of Mental Health, Austin Hospital, Melbourne, VIC, Australia.

Objectives:: Anorexia nervosa and body dysmorphic disorder share a hallmark clinical feature of severe body image disturbance. This study aimed to document major demographic and clinical characteristics in anorexia nervosa versus body dysmorphic disorder, and it was the first to compare specific body parts related to body image dissatisfaction across these disorders directly.

Methods:: Anorexia nervosa ( n=26) and body dysmorphic disorder ( n=24) patients were administered a range of clinical measures, including key questions about the specificities of their body image concerns. Read More

Australas Psychiatry 2019 Mar 28:1039856219839462. Epub 2019 Mar 28.

Australas Psychiatry 2019 Mar 28:1039856219839470. Epub 2019 Mar 28.

Senior staff specialist psychogeriatrician; Sydney Local Health District, Concord Centre for Mental Health, Concord, NSW, Australia.

Objectives:: This study reviewed the evidence regarding the efficacy of acute electroconvulsive therapy for primary psychotic conditions in the elderly.

Methods:: A literature search was performed using the Medline, Embase and Cochrane databases.

Results:: Acute electroconvulsive therapy resulted in an improvement of psychotic symptoms in almost all elderly patients, a large proportion of whom had treatment-resistant conditions. Read More

Australas Psychiatry 2019 Mar 25:1039856219833800. Epub 2019 Mar 25.

Director, Monash Alfred Psychiatry Research Centre, Melbourne, Melbourne, VIC, Australia.

Background:: Doctors are known to have poor mental health compared with the general population. Psychiatrists are exposed to a number of unique stressors that may increase the risk of poor mental health. The aim of this study was to undertake a meta-analysis of burnout rates in psychiatrists. Read More

Australas Psychiatry 2019 Apr 21;27(2):129-131. Epub 2019 Mar 21.

Senior Staff Specialist, Obstetrics and Gynecology, Redcliffe Hospital, Caboolture, QLD, and; Conjoint Site Coordinator, Northside Clinical School, Faculty of Medicine, University of Queensland, Redcliffe, QLD, Australia.

Objective: Psychiatrists may become involved in circumstances where a child is seeking termination of pregnancy. Potential roles include capacity advice and advocacy, but ethical and legal uncertainties abound. This paper uses illustrative cases, in an Australian jurisdiction, to exemplify the issues. Read More

Australas Psychiatry 2019 Mar 18:1039856219833776. Epub 2019 Mar 18.

Visiting Psychiatrist, Division of Psychiatry, UWA Medical School, The University of Western Australia, Fremantle Hospital, Fremantle, WA, and; Kimberley Mental Health and Drug Service, Broome, Fremantle, WA, Australia.

Objective:: The aim of this paper is to evaluate the effectiveness of ongoing physical health monitoring for Indigenous Australians with mental health issues in the Kimberley region of Western Australia.

Method:: This longitudinal, within-groups investigation assessed physical health parameters such as blood pressure and blood glucose levels at baseline and at 18 months for the same cohort. No standardised intervention was in place, but action was taken if results were found to be abnormal. Read More

Australas Psychiatry 2019 Mar 12:1039856219833792. Epub 2019 Mar 12.

Honorary Clinical Lecturer, University of Melbourne, Melbourne, VIC, Australia.

Objective:: This article describes the voice hearing experiences of a young Māori man, and the joint Māori healing and psychiatry assessment he received, in which the Māori healer (WN) concluded that some of the young man's experiences could be accounted for by ancestral kaitiaki (spiritual guardians).

Conclusions:: Kaitiaki are commonly accepted in Te Ao Māori (the Māori world) as an explanation for some types of voice hearing experiences. Collaboration between a Māori healer and a psychiatrist can offer Māori whānau (individuals and families) more appropriate mental health assessment and intervention than conventional psychiatric assessment alone when Māori spiritual experiences are suspected. Read More

Australas Psychiatry 2019 Mar 11:1039856219833793. Epub 2019 Mar 11.

Professor of General Practice, Sydney Medical School, The University of Sydney, Sydney, NSW, and; Director of Primary Care, Macquarie University Hospital, Sydney, NSW, Australia.

Objective:: To evaluate the effectiveness of a workshop intervention to promote wellbeing for Australian physician trainees using a randomized-controlled design.

Methods:: Participants were randomly assigned into intervention and control groups. The intervention group attended a half-day workshop. Read More

Australas Psychiatry 2019 Feb 19:1039856219828125. Epub 2019 Feb 19.

Youth Mental Health Team, Brain and Mind Centre, University of Sydney, Camperdown, NSW and; Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia.

Objectives:: Neurocognitive assessment and feedback to a young adult inpatient.

Methods:: Computerised neurocognitive assessment and feedback.

Results:: A collaborative process of personalised intervention. Read More

Australas Psychiatry 2019 Feb 18:1039856219828134. Epub 2019 Feb 18.

Professor, School of Medicine, University of Tasmania, Hobart, TAS.

Objectives:: This study aimed to explore the effects of a four-week course of transcranial magnetic stimulation (TMS) on the following symptoms of major depressive episode (MDE): mood, work activities, health concerns, guilt, anxiety and retardation.

Method:: Patients underwent 20 daily sessions of 10 Hz TMS (two sets of 10 daily treatments separated by two days of rest). The six-item Hamilton Depression Rating Scale (HAMD-6) was administered before and after treatment. Read More

Australas Psychiatry 2019 Feb 18:1039856219829225. Epub 2019 Feb 18.

3 Team Leader, Te Whare Mārie, Māori Mental Health Service, Capital Coast District Health Board, Porirua, New Zealand.

Objective:: The aims of this paper are to describe a Māori approach to assessment and intervention planning using the Māori creation narrative Te Ara a Tāne (The Journey of Tāne) and to outline an evaluation one year after the model was implemented.

Conclusions:: Te Ara Waiora a Tāne is a kaupapa Māori (Māori-centred) mental-health engagement, assessment, goal setting and planning approach designed to enhance the mana (spiritual and personal authority) of whānau (individuals and family/families) at the point they enter a Māori service and during ongoing mental-health work. Preliminary evaluation indicated that staff considered the model user-friendly and helpful for whānau. Read More

Australas Psychiatry 2019 Feb 18:1039856219828191. Epub 2019 Feb 18.

Honorary Clinical Lecturer, University of Melbourne, Melbourne, VIC, Australia.

Objective:: The aim of this article is to give an overview of Māori concepts informing a collaboration between a Māori healer (NiaNia) and psychiatrist (Bush).

Conclusions:: Wairua (spiritual) problems can resemble psychiatric disorders or symptoms. Knowledge of relevant Māori concepts such as mauri, tapu, mana, matekite and manaakitanga may assist psychiatrists in collaborating with Māori healers and kaumātua (elders) to enable more appropriate cultural and clinical assessment, as well as helping to build rapport and clinical interactions with Māori whānau (individuals and families). Read More

Australas Psychiatry 2019 Feb 14:1039856219828119. Epub 2019 Feb 14.

Community Health and Epidemiology, Dalhousie University, Canada and University of Queensland, Rural and Southern Clinical Schools, Wooloongabba, Australia.

Objectives:: Mindfulness is a proven treatment in clinical settings. Our objective was to examine the feasibility and effect of a mindfulness-training program on the mental resilience and emotional intelligence of amateur basketball players.

Methods:: This was a parallel-group, pre- and post- test, randomised controlled trial. Read More

Australas Psychiatry 2019 Apr 14;27(2):125-128. Epub 2019 Feb 14.

Consultant Psychiatrist and staff specialist, Fellow Royal Australian and New Zealand College of Psychiatrists, Redcliffe-Caboolture Mental Health Service, Metro-North Mental Health Service, Brisbane, QLD, Australia.

Objectives: To describe prescription of sodium valproate (SV) for bipolar mood disorder to potentially child-bearing women within one public mental health service and describe risks of fetal exposure, and safe prescribing practices among psychiatrists.

Methods: A 24-month retrospective chart review with descriptive analysis; narrative review of literature and guidelines.

Results: Review of 383 charts demonstrated prescription of valproate to 20% of 98 women aged 15-45, with little evidence of advice regarding risk and contraception. Read More

Australas Psychiatry 2019 Feb 14:1039856219828164. Epub 2019 Feb 14.

Associate Professor, MD Education Unit, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, WA, Australia.

Objective:: The aim of this study was to introduce new approaches to conduct qualitative research that may provide valuable insight into issues related to education, training and patient care in psychiatry.

Conclusions:: A variety of data-collection tools is available for researchers and practitioners in psychiatry. These can be used independently or in conjunction with other quantitative and qualitative methods. Read More

Australas Psychiatry 2019 Feb 14:1039856219828168. Epub 2019 Feb 14.

Senior Psychiatrist, FRANZCP, Flinders Medical Centre, Adelaide, SA, Australia.

Objectives:: This paper outlines the use of psychodynamic psychotherapy as an adjunct to treatment as usual for addressing challenging behaviours in a patient with schizophrenia under the care of a community mental health team (CMHT) in South Australia.

Methods:: Ms P suffered from schizophrenia and demonstrated challenging behaviours in the context of being administered depot medication under a community treatment order (CTO). Multiple attempts at addressing non-compliance and consistently disruptive behaviour through conventional methods had failed. Read More

Australas Psychiatry 2019 Feb;27(1):96

Australas Psychiatry 2019 Feb;27(1):6-7

Australas Psychiatry 2019 Feb;27(1):93-94

Australas Psychiatry 2019 02;27(1):94-95

Australas Psychiatry 2019 Feb;27(1):94

Australas Psychiatry 2019 02;27(1):5-6

Professor of Psychiatry, the University of Melbourne, Melbourne, VIC, and; Chair of Psychiatry, St Vincent's Health, Melbourne, VIC Australia.

Australas Psychiatry 2019 Feb;27(1):92-93

Australas Psychiatry 2019 02;27(1):92

Australas Psychiatry 2019 Jan 22:1039856218822747. Epub 2019 Jan 22.

Australas Psychiatry 2019 Jan 21:1039856218822749. Epub 2019 Jan 21.

Director, Turning Point, Eastern Health, Richmond, VIC, and; Professor of Addiction Studies and Services, Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia.

Objective:: Synthetic cannabinoid use disorder is emerging as a significant clinical issue. This article provides the general psychiatrist with an overview of the physical and psychiatric adverse effects of chronic synthetic cannabinoid use, as well as specific clinical responses.

Method:: We performed electronic searches of Ovid MEDLINE and Ovid Embase to identify key articles, of all methodological designs, published up to June 2018. Read More

Australas Psychiatry 2019 Apr 21;27(2):192-194. Epub 2019 Jan 21.

Manager, Accreditation, CPD and Reporting, Royal Australian and New Zealand College of Psychiatry, Melbourne, VIC, Australia.

Objective: This paper outlines the current status of the Royal Australian and New Zealand College of Psychiatrists' (RANZCP) Continuing Professional Development (CPD) programme, its main drivers and influences, and outlines potential future changes.

Conclusions: The three features that appear to be essential for an effective CPD programme are the presence of high internal motivation for CPD participation, membership valuing workplace learning, and to ensure that the content for learning remains largely work-focused. The need to incorporate best learning evidence has witnessed the international trend to include peer, reflective and interactive learning tasks into the CPD programme. Read More

Australas Psychiatry 2019 Apr 21;27(2):121-124. Epub 2019 Jan 21.

Director and Medical Unit Head, Perinatal and Infant Mental Health Services, Women's and Children's Health Network, North Adelaide, SA, and; Clinical Senior Lecturer, Faculty of Health Sciences, University of Adelaide, Adelaide, SA, Australia.

Objectives: To describe characteristics and treatments of mother-baby dyads affected by postpartum psychosis admitted to a specialist mother-baby inpatient psychiatric unit in Australia.

Methods: A retrospective review of medical records for all mothers with postpartum psychosis and their babies admitted to a mother-baby unit over a 5-year period was conducted.

Results: A total of 25 dyads met the study criteria. Read More

Australas Psychiatry 2019 Jan 17:1039856218822735. Epub 2019 Jan 17.

Psychiatrist, Northern Adelaide Local Health Network, Adelaide, SA, and; Discipline of Psychiatry, Adelaide Medical School, Adelaide, SA, and; Ramsay Health Care Mental Health, Adelaide, SA, Australia.

Objective:: A mentoring programme was established in South Australia in 2014 by psychiatry trainees, with the goal of reducing stress and burnout amongst first-year trainees. All first-year trainees are offered the opportunity to have a senior trainee as a mentor. This article describes the mentoring programme, presents feedback from participants and identifies areas for further development. Read More

Australas Psychiatry 2019 Jan 17:1039856218822748. Epub 2019 Jan 17.

Drug and Alcohol Services, Central Coast Local Health District, Wyong Hospital, Hamlyn Terrace, NSW, Australia.

Objectives:: To describe the baseline characteristics, treatment and retention in patients electively admitted for gamma-hydroxybutyrate (GHB) withdrawal management.

Methods:: All patients admitted between July 2010 to June 2016 who used GHB two or more times per week with a minimum duration of 3 months were identified and data extracted by file review.

Results:: Twelve cases satisfied the inclusion criteria, of whom 50% were female; 75% were using GHB daily, with an average daily amount of 16 ml. Read More

Australas Psychiatry 2019 Apr 17;27(2):165-170. Epub 2019 Jan 17.

Director, Walker Unit, Concord Centre for Mental Health, Concord, NSW, and; Senior Clinical Lecturer, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.

Objectives: We describe the use of responsive art therapy in an inpatient child and adolescent mental health services unit, including its acceptability rated through a satisfaction questionnaire.

Methods: A patient satisfaction questionnaire was developed to collect feedback from 46 adolescents. Images from therapy were photographed and collated looking for patterns across diagnoses and stages of treatment. Read More

Australas Psychiatry 2019 Jan 14:1039856218822759. Epub 2019 Jan 14.

Senior Clinical Lecturer, Sydney University, Sydney, NSW, and; Staff Specialist Psychogeriatrician, Northern Sydney Local Health District, Sydney University, Sydney, NSW, Australia.

Objectives:: Older adults utilise health care systems to a higher frequency than younger groups, and are more vulnerable to system bias regarding ageing and expectations of old age. This narrative review attempts to outline the available literature regarding how various health support systems perceive the older adult, with an Australian focus.

Conclusions:: Perspectives on ageing are generally negative regardless of health industry. Read More

Australas Psychiatry 2018 Dec 20:1039856218819135. Epub 2018 Dec 20.

Scientia Professor, School of Psychiatry, University of New South Wales, Sydney, NSW, and; Black Dog Institute, Randwick, NSW, Australia.

Objective:: We examined current pathways of training for junior clinical academic psychiatrists in Australia. An initiative of the School of Psychiatry, University of New South Wales, is described from the perspective of two junior clinical academics.

Conclusions:: Australia has limited defined clinical academic pathways for psychiatrists when compared internationally. Read More

Australas Psychiatry 2018 Dec 3:1039856218816372. Epub 2018 Dec 3.

Consultant Psychiatrist, Great Southern Mental Health Service, Western Australia Country Health Service, Albany, WA, and; Clinical Senior Lecturer, The Rural Clinical School of Western Australia and University of Western Australia, Nedlands, WA, Australia.

Objectives:: Smoking rates in people with mental illness in Australia remain alarmingly high whilst they have been declining in the general population. This study reviews a smoking cessation programme in a mental health service, as a pilot for future studies and program development. We aim to assess the effectiveness of this intervention and the ease of implementation after upskilling the clinical workforce. Read More