Pub Date : 2022-04-01DOI: 10.1177/00048674221086498
Carl I Moller, C. Davey, Paul B. Badcock, A. Wrobel, Alice Cao, Sean Murrihy, Sonia Sharmin, S. Cotton
Objective: Depression is one of the most prevalent and disabling mental health conditions among young people worldwide. The health and economic burdens associated with depressive illness are substantial. Suicide and depression are closely intertwined, yet a diagnosis of depression itself lacks predictive specificity for suicidal behaviour. To better inform suicide prevention and early intervention strategies for young people, improved identification of modifiable intervention targets is needed. The objective of this review was to identify clinical, psychosocial and biological correlates of suicidality in young people diagnosed with a broad range of unipolar and bipolar depressive disorders. Method: Systematic searches were conducted across MEDLINE, Embase and PsycINFO to identify studies of young people aged 15–25 years diagnosed with unipolar or bipolar depressive disorders. An assessment of suicidality was required for inclusion. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 and Synthesis Without Meta-analysis guidelines. Results: We integrated findings from 71 studies including approximately 24,670 young people with clinically diagnosed depression. We identified 26 clinical, psychosocial and biological correlates of suicidality. Depression characteristics (type and severity), psychiatric comorbidity (particularly anxiety and substance use disorders) and neurological characteristics emerged as having the most evidence for being associated with suicidal outcomes. Our ability to pool data and conduct meaningful quantitative synthesis was hampered by substantial heterogeneity across studies and incomplete reporting; thus, meta-analysis was not possible. Conclusion: Findings of this review reinforce the notion that suicidality is a complex phenomenon arising from the interplay of multiple contributing factors. Our findings question the utility of considering a diagnosis of depression as a specific risk factor for suicidality in young people. Suicidality itself is transdiagnostic; adoption of a transdiagnostic approach to investigating its aetiology and treatment is perhaps warranted. Future research investigating specific symptoms, or symptom networks, might help to further our understanding of suicidality among young people experiencing mental illness.
{"title":"Correlates of suicidality in young people with depressive disorders: A systematic review","authors":"Carl I Moller, C. Davey, Paul B. Badcock, A. Wrobel, Alice Cao, Sean Murrihy, Sonia Sharmin, S. Cotton","doi":"10.1177/00048674221086498","DOIUrl":"https://doi.org/10.1177/00048674221086498","url":null,"abstract":"Objective: Depression is one of the most prevalent and disabling mental health conditions among young people worldwide. The health and economic burdens associated with depressive illness are substantial. Suicide and depression are closely intertwined, yet a diagnosis of depression itself lacks predictive specificity for suicidal behaviour. To better inform suicide prevention and early intervention strategies for young people, improved identification of modifiable intervention targets is needed. The objective of this review was to identify clinical, psychosocial and biological correlates of suicidality in young people diagnosed with a broad range of unipolar and bipolar depressive disorders. Method: Systematic searches were conducted across MEDLINE, Embase and PsycINFO to identify studies of young people aged 15–25 years diagnosed with unipolar or bipolar depressive disorders. An assessment of suicidality was required for inclusion. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 and Synthesis Without Meta-analysis guidelines. Results: We integrated findings from 71 studies including approximately 24,670 young people with clinically diagnosed depression. We identified 26 clinical, psychosocial and biological correlates of suicidality. Depression characteristics (type and severity), psychiatric comorbidity (particularly anxiety and substance use disorders) and neurological characteristics emerged as having the most evidence for being associated with suicidal outcomes. Our ability to pool data and conduct meaningful quantitative synthesis was hampered by substantial heterogeneity across studies and incomplete reporting; thus, meta-analysis was not possible. Conclusion: Findings of this review reinforce the notion that suicidality is a complex phenomenon arising from the interplay of multiple contributing factors. Our findings question the utility of considering a diagnosis of depression as a specific risk factor for suicidality in young people. Suicidality itself is transdiagnostic; adoption of a transdiagnostic approach to investigating its aetiology and treatment is perhaps warranted. Future research investigating specific symptoms, or symptom networks, might help to further our understanding of suicidality among young people experiencing mental illness.","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"7 1","pages":"910 - 948"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79398538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-31DOI: 10.1177/00048674221090175
T. Nagamine
During the COVID-19 pandemic, patients with unknown fever require a careful differential diagnosis, and serotonin syndrome is one of the differential diseases in febrile patients taking antidepressants. A 74-year-old man developed depression last year and was in remission with fluvoxamine 150 mg/day. However, anorexia with tremor of the lower limbs appeared, which was diagnosed as an exacerbation of depression, and mirtazapine 30 mg/day was additionally administered. Two days later, high fever, anosmia and convulsions in the lower limbs appeared, and the patient was brought to our emergency room on suspicion of COVID19. On arrival, his temperature was 38.9°C, blood pressure 170/90 mm Hg, and he had tachycardia and sweating. Hyperreflexia in the lower extremities was noted, but head computed tomography (CT) showed no obvious lesions, and repeated polymerase chain reaction (PCR) tests for COVID19 were performed, all of which were negative. The patient was diagnosed as having serotonin syndrome according to the Hunter criteria (Dunkley et al., 2003), and all medications were discontinued and intravenous infusions were administered. A few days after discontinuation of antidepressants, tremor disappeared and body temperature became normal. Appetite and sense of smell recovered within a month after discontinuation of antidepressants, and a score of 5 on the Naranjo scale suggested the possibility of a relationship between serotonergic drugs and this adverse reaction. The patient’s family gave permission for the presentation. During the COVID-19 pandemic, fever, general malaise and olfactory disturbances should be considered COVID-19 infection. However, when increasing serotonergic agents, the possibility of serotonin syndrome should be considered (Silins et al., 2007). The diagnosis of serotonin syndrome is difficult, but one of the key diagnostic features is tremor with hyperreflexia. Serotonin regulates a variety of physiological functions, including food intake, reward, reproduction, sleep–wake cycle, memory, cognition, emotion and mood. Therefore, there is a danger that an excess of serotonin will alter all of these functions. The anorexia and decreased odor in the present case may be due to excess serotonergic neurotransmission rather than depression or COVID-19 symptoms. The serotonin controls the appetite center, so excess serotonin decreases appetite. Although there are no reports of transient olfactory loss in serotonin syndrome, the olfactory bulb is regulated by serotonergic neurotransmission with adult neurogenesis throughout life (Fomin-Thunemann and Garaschuk, 2022). Excess serotonin affects the neurogenesis of the olfactory bulb and may cause transient olfactory abnormalities. In conclusion, serotonin syndrome is also similar to the symptoms of COVID-19 and requires careful differential diagnosis in this pandemic situation.
在新冠肺炎大流行期间，不明原因发热患者需要仔细鉴别诊断，血清素综合征是服用抗抑郁药发热患者的鉴别疾病之一。一名74岁男子去年患上抑郁症，服用氟伏沙明150毫克/天后缓解。但出现厌食症伴下肢震颤，诊断为抑郁症加重，加用米氮平30 mg/天。两天后，患者出现高烧、嗅觉丧失、下肢抽搐等症状，疑似感染新冠肺炎被送至我院急诊室。到达时体温38.9°C，血压170/90 mm Hg，心动过速，出汗。下肢反射亢进，但头部CT未见明显病变，多次进行新冠病毒聚合酶链反应(PCR)检测均为阴性。根据Hunter标准(Dunkley et al.， 2003)，患者被诊断为血清素综合征，停用所有药物并静脉输注。停用抗抑郁药几天后，震颤消失，体温恢复正常。食欲和嗅觉在停用抗抑郁药后一个月内恢复，纳兰霍量表的5分表明，5 -羟色胺类药物与这种不良反应之间可能存在关系。病人家属同意了这次展示。在COVID-19大流行期间，发烧、全身不适和嗅觉障碍应考虑为COVID-19感染。然而，当增加血清素能药物时，应考虑血清素综合征的可能性(Silins et al.， 2007)。血清素综合征的诊断是困难的，但一个关键的诊断特征是震颤与反射性亢进。血清素调节多种生理功能，包括食物摄入、奖励、生殖、睡眠-觉醒周期、记忆、认知、情感和情绪。因此，过量的血清素有可能改变所有这些功能。本病例的厌食和气味减少可能是由于过度的血清素能神经传递，而不是抑郁症或COVID-19症状。血清素控制食欲中枢，所以过量的血清素会降低食欲。虽然没有5 -羟色胺综合征的短暂性嗅觉丧失的报道，但嗅球在成年神经发生过程中受到5 -羟色胺能神经传递的调节(famin - thunemann和Garaschuk, 2022)。过量的血清素会影响嗅球的神经发生，并可能导致短暂的嗅觉异常。总之，血清素综合征也与COVID-19的症状相似，在这种大流行的情况下需要仔细鉴别诊断。
{"title":"Beware of serotonin syndrome during the COVID-19 pandemic","authors":"T. Nagamine","doi":"10.1177/00048674221090175","DOIUrl":"https://doi.org/10.1177/00048674221090175","url":null,"abstract":"During the COVID-19 pandemic, patients with unknown fever require a careful differential diagnosis, and serotonin syndrome is one of the differential diseases in febrile patients taking antidepressants. A 74-year-old man developed depression last year and was in remission with fluvoxamine 150 mg/day. However, anorexia with tremor of the lower limbs appeared, which was diagnosed as an exacerbation of depression, and mirtazapine 30 mg/day was additionally administered. Two days later, high fever, anosmia and convulsions in the lower limbs appeared, and the patient was brought to our emergency room on suspicion of COVID19. On arrival, his temperature was 38.9°C, blood pressure 170/90 mm Hg, and he had tachycardia and sweating. Hyperreflexia in the lower extremities was noted, but head computed tomography (CT) showed no obvious lesions, and repeated polymerase chain reaction (PCR) tests for COVID19 were performed, all of which were negative. The patient was diagnosed as having serotonin syndrome according to the Hunter criteria (Dunkley et al., 2003), and all medications were discontinued and intravenous infusions were administered. A few days after discontinuation of antidepressants, tremor disappeared and body temperature became normal. Appetite and sense of smell recovered within a month after discontinuation of antidepressants, and a score of 5 on the Naranjo scale suggested the possibility of a relationship between serotonergic drugs and this adverse reaction. The patient’s family gave permission for the presentation. During the COVID-19 pandemic, fever, general malaise and olfactory disturbances should be considered COVID-19 infection. However, when increasing serotonergic agents, the possibility of serotonin syndrome should be considered (Silins et al., 2007). The diagnosis of serotonin syndrome is difficult, but one of the key diagnostic features is tremor with hyperreflexia. Serotonin regulates a variety of physiological functions, including food intake, reward, reproduction, sleep–wake cycle, memory, cognition, emotion and mood. Therefore, there is a danger that an excess of serotonin will alter all of these functions. The anorexia and decreased odor in the present case may be due to excess serotonergic neurotransmission rather than depression or COVID-19 symptoms. The serotonin controls the appetite center, so excess serotonin decreases appetite. Although there are no reports of transient olfactory loss in serotonin syndrome, the olfactory bulb is regulated by serotonergic neurotransmission with adult neurogenesis throughout life (Fomin-Thunemann and Garaschuk, 2022). Excess serotonin affects the neurogenesis of the olfactory bulb and may cause transient olfactory abnormalities. In conclusion, serotonin syndrome is also similar to the symptoms of COVID-19 and requires careful differential diagnosis in this pandemic situation.","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"29 1","pages":"862 - 862"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84638399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-18DOI: 10.1177/00048674221087163
P. Tibrewal, Milanduth K Kanigere, J. Looi, S. Allison, T. Bastiampillai
American Psychiatric Association (APA) (1990) Benzodiazepine Dependence, Toxicity, and Abuse: A Task Force Report of the American Psychiatric Association (APA). APA. Available at: https:// books.google.com.au/books?id=FoTursyqFP8C (accessed 2021). Calcaterra NE and Barrow JC (2014) Classics in chemical neuroscience: Diazepam (valium). ACS Chemical Neuroscience 5(4): 253–260. Committee on the Review of Medicines (CRM) (1980) Systematic review of the benzodiazepines: Guidelines for data sheets on diazepam, chlordiazepoxide, medazepam, clorazepate, lorazepam, oxazepam, temazepam, triazolam, nitrazepam, and flurazepam. Committee on the Review of Medicines. British Medical Journal 280(6218): 910. Greenblatt D, Shader R, Divoll M, et al. (1981) Benzodiazepines: A summary of pharmacokinetic properties. British Journal of Clinical Pharmacology 11: 11S–16S. Hollister LE (1981) Benzodiazepines: An overview. British Journal of Clinical Pharmacology 11: 117S–119S. Laughren TP, Battey Y, Greenblatt DJ, et al. (1982) A controlled trial of diazepam withdrawal in chronically anxious outpatients. Acta Psychiatrica Scandinavica 65: 171–179. Maletzky BM and Klotter J (1976) Addiction to diazepam. International Journal of the Addictions 11: 95–115. Marks J (1983) The benzodiazepines: An international perspective. Journal of Psychoactive Drugs 15: 137–149. Rickels K (1983) Benzodiazepines in emotional disorders. Journal of Psychoactive Drugs 15: 49–54. Silberman E, Balon R, Starcevic V, et al. (2020) Benzodiazepines: It’s time to return to the evidence. The British Journal of Psychiatry 218: 125–127. Sullivan W (1963) WARNING IS ISSUED ON TRANQUILIZERS; Some of most popular drugs can be addictive, expert tells science meeting BUT VALUE IS STRESSED doctor at U.S. Center cites usefulness, but declares caution is necessary six are specified increases in doses WARNING IS ISSUED ON TRANQUILIZERS. New York Times, 30 December, p. 23. Tibrewal P, Haeusler C, Kanigere MK, et al. (2021a) Are the benefits of benzodiazepines for anxiety disorders underestimated and their risks overestimated? Australian and New Zealand Journal of Psychiatry 55: 1109–1110. Vorspan F, Barré T, Pariente A, et al. (2018) Faut-il limiter la durée des traitements par benzodiazépines ? La Presse Médicale 47(10): 892–898.
{"title":"The evidence for the use of long-term benzodiazepines in the setting of treatment-refractory anxiety disorders","authors":"P. Tibrewal, Milanduth K Kanigere, J. Looi, S. Allison, T. Bastiampillai","doi":"10.1177/00048674221087163","DOIUrl":"https://doi.org/10.1177/00048674221087163","url":null,"abstract":"American Psychiatric Association (APA) (1990) Benzodiazepine Dependence, Toxicity, and Abuse: A Task Force Report of the American Psychiatric Association (APA). APA. Available at: https:// books.google.com.au/books?id=FoTursyqFP8C (accessed 2021). Calcaterra NE and Barrow JC (2014) Classics in chemical neuroscience: Diazepam (valium). ACS Chemical Neuroscience 5(4): 253–260. Committee on the Review of Medicines (CRM) (1980) Systematic review of the benzodiazepines: Guidelines for data sheets on diazepam, chlordiazepoxide, medazepam, clorazepate, lorazepam, oxazepam, temazepam, triazolam, nitrazepam, and flurazepam. Committee on the Review of Medicines. British Medical Journal 280(6218): 910. Greenblatt D, Shader R, Divoll M, et al. (1981) Benzodiazepines: A summary of pharmacokinetic properties. British Journal of Clinical Pharmacology 11: 11S–16S. Hollister LE (1981) Benzodiazepines: An overview. British Journal of Clinical Pharmacology 11: 117S–119S. Laughren TP, Battey Y, Greenblatt DJ, et al. (1982) A controlled trial of diazepam withdrawal in chronically anxious outpatients. Acta Psychiatrica Scandinavica 65: 171–179. Maletzky BM and Klotter J (1976) Addiction to diazepam. International Journal of the Addictions 11: 95–115. Marks J (1983) The benzodiazepines: An international perspective. Journal of Psychoactive Drugs 15: 137–149. Rickels K (1983) Benzodiazepines in emotional disorders. Journal of Psychoactive Drugs 15: 49–54. Silberman E, Balon R, Starcevic V, et al. (2020) Benzodiazepines: It’s time to return to the evidence. The British Journal of Psychiatry 218: 125–127. Sullivan W (1963) WARNING IS ISSUED ON TRANQUILIZERS; Some of most popular drugs can be addictive, expert tells science meeting BUT VALUE IS STRESSED doctor at U.S. Center cites usefulness, but declares caution is necessary six are specified increases in doses WARNING IS ISSUED ON TRANQUILIZERS. New York Times, 30 December, p. 23. Tibrewal P, Haeusler C, Kanigere MK, et al. (2021a) Are the benefits of benzodiazepines for anxiety disorders underestimated and their risks overestimated? Australian and New Zealand Journal of Psychiatry 55: 1109–1110. Vorspan F, Barré T, Pariente A, et al. (2018) Faut-il limiter la durée des traitements par benzodiazépines ? La Presse Médicale 47(10): 892–898.","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"11 1","pages":"723 - 724"},"PeriodicalIF":0.0,"publicationDate":"2022-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73238958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-08DOI: 10.1177/00048674221084245
D. Eratne, Qiao-Xin Li, S. Loi, M. Walterfang, S. Farrand, A. Evans, R. Mocellin, C. Masters, S. Collins, D. Velakoulis
Australian & New Zealand Journal of Psychiatry, 56(7) Cerebrospinal fluid Alzheimer disease biomarkers for assessing cognitive and neuropsychiatric symptoms: Expanding the ‘toolkit’ in the psychiatrist’s diagnostic armamentarium Dhamidhu Eratne1,2,3,4 , Qiao-Xin Li4, Samantha M Loi1,2,3 , Mark Walterfang1,2,3, Sarah Farrand1,2 , Andrew Evans1, Ramon Mocellin5, Colin L Masters4, Steven Collins4,6 and Dennis Velakoulis1,2,3
脑脊髓液阿尔茨海默病生物标志物在认知和神经精神疾病诊断工具箱中的应用[j] .中华精神病学杂志，56(7):Eratne1,2,3,4，李乔欣4,Samantha M lo1,2,3, Mark Walterfang1,2,3, Sarah Farrand1,2, Andrew Evans1, Ramon Mocellin5, Colin L master4, Steven collin4,6, Dennis Velakoulis1,2,3
{"title":"Cerebrospinal fluid Alzheimer disease biomarkers for assessing cognitive and neuropsychiatric symptoms: Expanding the ‘toolkit’ in the psychiatrist’s diagnostic armamentarium","authors":"D. Eratne, Qiao-Xin Li, S. Loi, M. Walterfang, S. Farrand, A. Evans, R. Mocellin, C. Masters, S. Collins, D. Velakoulis","doi":"10.1177/00048674221084245","DOIUrl":"https://doi.org/10.1177/00048674221084245","url":null,"abstract":"Australian & New Zealand Journal of Psychiatry, 56(7) Cerebrospinal fluid Alzheimer disease biomarkers for assessing cognitive and neuropsychiatric symptoms: Expanding the ‘toolkit’ in the psychiatrist’s diagnostic armamentarium Dhamidhu Eratne1,2,3,4 , Qiao-Xin Li4, Samantha M Loi1,2,3 , Mark Walterfang1,2,3, Sarah Farrand1,2 , Andrew Evans1, Ramon Mocellin5, Colin L Masters4, Steven Collins4,6 and Dennis Velakoulis1,2,3","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"110 1","pages":"865 - 866"},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76281902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-08DOI: 10.1177/00048674221083874
Izaak Lim, Vesna Newman-Morris, R. Hill, Elisabeth Hoehn, N. Kowalenko, Rochelle Matacz, C. Paul, R. Powrie, Lynn E. Priddis, Vibhay Raykar, Tanya Wright, L. Newman, S. Sundram
Perinatal and infant psychiatry has been described as ‘a specialty in search of a home’ (Newman, 2020), referring to its awkward placement between adult and child mental health services. Inherent tension comes from bringing together two distinct clinical traditions – infant mental health, with its focus on parent–child relationships and infant development, and perinatal psychiatry, with its focus on maternal mental illness in pregnancy and the postpartum. The practical challenge lies in holding the interests of parents and infants in mind as one works with a parent–child dyad. At a systems level, this can produce structurally separate services for parents and infants, resulting in the fragmentation of care for families in need. A fundamental challenge for perinatal and infant psychiatry is integration. Psychiatrists working in this field must attend to the mental health of new and expectant parents, the socialemotional well-being and development of young children, the quality of parent–child and co-parenting relationships, and the cohesion of the family-as-a-whole. Such a holistic and complex view of the life of families with young children demands interdisciplinary collaboration, as the different perspectives brought to bear by clinicians from various professional backgrounds help shed light on the distinct but interconnected facets of this crucial developmental transition. At the heart of integrated care is a commitment to prioritising the needs and perspectives of families who use these services, a recognition that the whole is greater than the sum of the parts, and an understanding of the primacy of relationships – within the family, between the family and the service system, and between various parts of the system that support families. We present the case for an integrated approach to perinatal and infant mental health (PIMH) services, to help guide review and reform.
{"title":"You can’t have one without the other: The case for integrated perinatal and infant mental health services","authors":"Izaak Lim, Vesna Newman-Morris, R. Hill, Elisabeth Hoehn, N. Kowalenko, Rochelle Matacz, C. Paul, R. Powrie, Lynn E. Priddis, Vibhay Raykar, Tanya Wright, L. Newman, S. Sundram","doi":"10.1177/00048674221083874","DOIUrl":"https://doi.org/10.1177/00048674221083874","url":null,"abstract":"Perinatal and infant psychiatry has been described as ‘a specialty in search of a home’ (Newman, 2020), referring to its awkward placement between adult and child mental health services. Inherent tension comes from bringing together two distinct clinical traditions – infant mental health, with its focus on parent–child relationships and infant development, and perinatal psychiatry, with its focus on maternal mental illness in pregnancy and the postpartum. The practical challenge lies in holding the interests of parents and infants in mind as one works with a parent–child dyad. At a systems level, this can produce structurally separate services for parents and infants, resulting in the fragmentation of care for families in need. A fundamental challenge for perinatal and infant psychiatry is integration. Psychiatrists working in this field must attend to the mental health of new and expectant parents, the socialemotional well-being and development of young children, the quality of parent–child and co-parenting relationships, and the cohesion of the family-as-a-whole. Such a holistic and complex view of the life of families with young children demands interdisciplinary collaboration, as the different perspectives brought to bear by clinicians from various professional backgrounds help shed light on the distinct but interconnected facets of this crucial developmental transition. At the heart of integrated care is a commitment to prioritising the needs and perspectives of families who use these services, a recognition that the whole is greater than the sum of the parts, and an understanding of the primacy of relationships – within the family, between the family and the service system, and between various parts of the system that support families. We present the case for an integrated approach to perinatal and infant mental health (PIMH) services, to help guide review and reform.","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"22 1","pages":"586 - 588"},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86619182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-04DOI: 10.1177/00048674221081763
S. Muthukumaraswamy, A. Forsyth, R. Sumner
With the extensive public, commercial and scientific interest from what has been widely termed the psychedelic renaissance, it is important that the scientific practices and results obtained from its implementation into medicine are put under a critical microscope. While there are numerous works on the potential benefits and applications of psychedelics as medicines, relatively little has been written about the challenges this field will face when incorporated into modern medical practice. Indeed, as a new or at least revived area of investigation, psychedelic medicine has a particular set of challenges which need to be addressed. In this viewpoint, we identify a number of these challenges. First, challenges related to the design of individual research studies are discussed, particularly focusing on current practices surrounding blinding, expectancy, the use of therapy and sources of bias. Second, the broader context of the research environment is considered, including how medical science typically establishes evidence, funding bodies and the impact of psychedelics being scheduled at odds with their risk profile. Finally, we describe challenges relating to the implementation of psychedelic therapies into modern medicine, considering the social and economic context. Alongside, we provide suggestions for what could be included into current research protocols to mitigate these challenges.
{"title":"The challenges ahead for psychedelic ‘medicine’","authors":"S. Muthukumaraswamy, A. Forsyth, R. Sumner","doi":"10.1177/00048674221081763","DOIUrl":"https://doi.org/10.1177/00048674221081763","url":null,"abstract":"With the extensive public, commercial and scientific interest from what has been widely termed the psychedelic renaissance, it is important that the scientific practices and results obtained from its implementation into medicine are put under a critical microscope. While there are numerous works on the potential benefits and applications of psychedelics as medicines, relatively little has been written about the challenges this field will face when incorporated into modern medical practice. Indeed, as a new or at least revived area of investigation, psychedelic medicine has a particular set of challenges which need to be addressed. In this viewpoint, we identify a number of these challenges. First, challenges related to the design of individual research studies are discussed, particularly focusing on current practices surrounding blinding, expectancy, the use of therapy and sources of bias. Second, the broader context of the research environment is considered, including how medical science typically establishes evidence, funding bodies and the impact of psychedelics being scheduled at odds with their risk profile. Finally, we describe challenges relating to the implementation of psychedelic therapies into modern medicine, considering the social and economic context. Alongside, we provide suggestions for what could be included into current research protocols to mitigate these challenges.","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"19 1","pages":"1378 - 1383"},"PeriodicalIF":0.0,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72932412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-03DOI: 10.1177/00048674221079218
G. Parker
While effectively the ‘first antidepressants’, the psychostimulants are rarely prescribed as antidepressant drugs seemingly in light of their judged low effectiveness, side effects, tolerance as well as concerns about dependency and abuse. Recent meta-analyses do find some support for them as being effective antidepressants for those with major depression, but they have not been closely evaluated in terms of their specific nuanced role for treating treatment-resistant (unipolar and bipolar) melancholic depression. The author has so prescribed them for over a decade and offers a case for their benefits for a distinct percentage of those with such conditions and notes their relatively few side effects.
{"title":"Psychostimulants as antidepressants: Their nuanced role?","authors":"G. Parker","doi":"10.1177/00048674221079218","DOIUrl":"https://doi.org/10.1177/00048674221079218","url":null,"abstract":"While effectively the ‘first antidepressants’, the psychostimulants are rarely prescribed as antidepressant drugs seemingly in light of their judged low effectiveness, side effects, tolerance as well as concerns about dependency and abuse. Recent meta-analyses do find some support for them as being effective antidepressants for those with major depression, but they have not been closely evaluated in terms of their specific nuanced role for treating treatment-resistant (unipolar and bipolar) melancholic depression. The author has so prescribed them for over a decade and offers a case for their benefits for a distinct percentage of those with such conditions and notes their relatively few side effects.","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"95 1","pages":"1226 - 1229"},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74661720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-02DOI: 10.1177/00048674221078165
Xiaoyu Zhu, Ran Li, Yu Zhu, Xiaole Han, Yunlong Tan
Eratne D, Loi SM, Li Q, et al. (2022) Cerebrospinal fluid neurofilament light chain differentiates primary psychiatric disorders from rapidly progressive, Alzheimer’s disease and frontotemporal disorders in clinical settings. Alzheimer’s & Dementia. Epub ahead of print 1 February. DOI: 10.1002/alz.12549. Loi SM, Goh AMY, Mocellin R, et al. (2020) Time to diagnosis in younger-onset dementia and the impact of a specialist diagnostic service. International Psychogeriatrics. Epub ahead of print 28 August. DOI: 10.1017/S1041610220001489. Shaw LM, Arias J, Blennow K, et al. (2018) Appropriate use criteria for lumbar puncture and cerebrospinal fluid testing in the diagnosis of Alzheimer’s disease. Alzheimer’s & Dementia 14: 1505–1521. Table 1. Details of five patients with changed diagnoses and impacts on clinical care and management.
{"title":"Empty sella and periodic mental symptoms: A report of two cases","authors":"Xiaoyu Zhu, Ran Li, Yu Zhu, Xiaole Han, Yunlong Tan","doi":"10.1177/00048674221078165","DOIUrl":"https://doi.org/10.1177/00048674221078165","url":null,"abstract":"Eratne D, Loi SM, Li Q, et al. (2022) Cerebrospinal fluid neurofilament light chain differentiates primary psychiatric disorders from rapidly progressive, Alzheimer’s disease and frontotemporal disorders in clinical settings. Alzheimer’s & Dementia. Epub ahead of print 1 February. DOI: 10.1002/alz.12549. Loi SM, Goh AMY, Mocellin R, et al. (2020) Time to diagnosis in younger-onset dementia and the impact of a specialist diagnostic service. International Psychogeriatrics. Epub ahead of print 28 August. DOI: 10.1017/S1041610220001489. Shaw LM, Arias J, Blennow K, et al. (2018) Appropriate use criteria for lumbar puncture and cerebrospinal fluid testing in the diagnosis of Alzheimer’s disease. Alzheimer’s & Dementia 14: 1505–1521. Table 1. Details of five patients with changed diagnoses and impacts on clinical care and management.","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"1 1","pages":"866 - 868"},"PeriodicalIF":0.0,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83870646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-01DOI: 10.1177/0004867421991746
{"title":"Thanks to Reviewers","authors":"","doi":"10.1177/0004867421991746","DOIUrl":"https://doi.org/10.1177/0004867421991746","url":null,"abstract":"","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"87 1","pages":"332 - 334"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86814338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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