Pub Date : 2020-07-01DOI: 10.1177/0004867419881499
C. Ko, Huang-chi Lin, Pai-Cheng Lin, J. Yen
Background: Many concerns have been raised regarding the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria for Internet gaming disorder and International Classification of Diseases, 11th Revision (ICD-11) criteria for gaming disorder. Aims: In this study, we demonstrated the diagnostic validity of each criterion for Internet gaming disorder in the DSM-5 in terms of their intensity and frequency thresholds and evaluated functional impairments, unhealthy behaviors and complications among adults with Internet gaming disorder and gaming disorder. Methods: We recruited 69 subjects with Internet gaming disorder, 69 regular gamers and 69 controls without regular gaming based on diagnostic interviewing conducted by a psychiatrist according to the DSM-5 Internet gaming disorder criteria. Results: Except for the ‘deceiving’ and ‘escapism’ criteria, all criteria for Internet gaming disorder had a diagnostic accuracy ranging from 84.7% to 93.5% in differentiating between adults with Internet gaming disorder and regular gamers. A total of 44 participants with Internet gaming disorder (63.8%) fulfilled the gaming disorder criteria. In addition, 89% and 100% of the Internet gaming disorder and gaming disorder groups, respectively, had academic, occupational or social functional impairment. Both the Internet gaming disorder and gaming disorder groups had higher rates of delayed sleep phase syndrome and insomnia. The gaming disorder group also had a higher obesity proportion. Conclusion: The ‘deceiving’ and ‘escapism’ criteria had relatively lower diagnostic accuracy. Both the Internet gaming disorder and gaming disorder groups demonstrated functional impairments and unhealthy behaviors. They also exhibited complications, such as obesity and sleep disorders. These results support the utility of the DSM-5 Internet gaming disorder and ICD-11 gaming disorder criteria in identifying individuals who need treatment for both gaming addiction symptoms and complications resulting from the addiction.
{"title":"Validity, functional impairment and complications related to Internet gaming disorder in the DSM-5 and gaming disorder in the ICD-11","authors":"C. Ko, Huang-chi Lin, Pai-Cheng Lin, J. Yen","doi":"10.1177/0004867419881499","DOIUrl":"https://doi.org/10.1177/0004867419881499","url":null,"abstract":"Background: Many concerns have been raised regarding the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria for Internet gaming disorder and International Classification of Diseases, 11th Revision (ICD-11) criteria for gaming disorder. Aims: In this study, we demonstrated the diagnostic validity of each criterion for Internet gaming disorder in the DSM-5 in terms of their intensity and frequency thresholds and evaluated functional impairments, unhealthy behaviors and complications among adults with Internet gaming disorder and gaming disorder. Methods: We recruited 69 subjects with Internet gaming disorder, 69 regular gamers and 69 controls without regular gaming based on diagnostic interviewing conducted by a psychiatrist according to the DSM-5 Internet gaming disorder criteria. Results: Except for the ‘deceiving’ and ‘escapism’ criteria, all criteria for Internet gaming disorder had a diagnostic accuracy ranging from 84.7% to 93.5% in differentiating between adults with Internet gaming disorder and regular gamers. A total of 44 participants with Internet gaming disorder (63.8%) fulfilled the gaming disorder criteria. In addition, 89% and 100% of the Internet gaming disorder and gaming disorder groups, respectively, had academic, occupational or social functional impairment. Both the Internet gaming disorder and gaming disorder groups had higher rates of delayed sleep phase syndrome and insomnia. The gaming disorder group also had a higher obesity proportion. Conclusion: The ‘deceiving’ and ‘escapism’ criteria had relatively lower diagnostic accuracy. Both the Internet gaming disorder and gaming disorder groups demonstrated functional impairments and unhealthy behaviors. They also exhibited complications, such as obesity and sleep disorders. These results support the utility of the DSM-5 Internet gaming disorder and ICD-11 gaming disorder criteria in identifying individuals who need treatment for both gaming addiction symptoms and complications resulting from the addiction.","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81524203","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 : 2020-05-01DOI: 10.1177/0004867419872248
T. Zhang, Xiaochen Tang, Huijun Li, K. Woodberry, E. Kline, Lihua Xu, Huiru Cui, Yingying Tang, Yanyan Wei, Chunbo Li, L. Hui, M. Niznikiewicz, M. Shenton, M. Keshavan, W. Stone, Jijun Wang
Objective: Since only 30% or fewer of individuals at clinical high risk convert to psychosis within 2 years, efforts are underway to refine risk identification strategies to increase their predictive power. The clinical high risk is a heterogeneous syndrome presenting with highly variable clinical symptoms and cognitive dysfunctions. This study investigated whether subtypes defined by baseline clinical and cognitive features improve the prediction of psychosis. Method: Four hundred clinical high-risk subjects from the ongoing ShangHai At Risk for Psychosis program were enrolled in a prospective cohort study. Canonical correlation analysis was applied to 289 clinical high-risk subjects with completed Structured Interview for Prodromal Syndromes and cognitive battery tests at baseline, and at least 1-year follow-up. Canonical variates were generated by canonical correlation analysis and then used for hierarchical cluster analysis to produce subtypes. Kaplan–Meier survival curves were constructed from the three subtypes to test their utility further in predicting psychosis. Results: Canonical correlation analysis determined two linear combinations: (1) negative symptom and functional deterioration-related cognitive features, and (2) Positive symptoms and emotional disorganization-related cognitive features. Cluster analysis revealed three subtypes defined by distinct and relatively homogeneous patterns along two dimensions, comprising 14.2% (subtype 1, n = 41), 37.4% (subtype 2, n = 108) and 48.4% (subtype 3, n = 140) of the sample, and each with distinctive features of clinical and cognitive performance. Those with subtype 1, which is characterized by extensive negative symptoms and cognitive deficits, appear to have the highest risk for psychosis. The conversion risk for subtypes 1–3 are 39.0%, 11.1% and 18.6%, respectively. Conclusion: Our results define important subtypes within clinical high-risk syndromes that highlight clinical symptoms and cognitive features that transcend current diagnostic boundaries. The three different subtypes reflect significant differences in clinical and cognitive characteristics as well as in the risk of conversion to psychosis.
{"title":"Clinical subtypes that predict conversion to psychosis: A canonical correlation analysis study from the ShangHai At Risk for Psychosis program","authors":"T. Zhang, Xiaochen Tang, Huijun Li, K. Woodberry, E. Kline, Lihua Xu, Huiru Cui, Yingying Tang, Yanyan Wei, Chunbo Li, L. Hui, M. Niznikiewicz, M. Shenton, M. Keshavan, W. Stone, Jijun Wang","doi":"10.1177/0004867419872248","DOIUrl":"https://doi.org/10.1177/0004867419872248","url":null,"abstract":"Objective: Since only 30% or fewer of individuals at clinical high risk convert to psychosis within 2 years, efforts are underway to refine risk identification strategies to increase their predictive power. The clinical high risk is a heterogeneous syndrome presenting with highly variable clinical symptoms and cognitive dysfunctions. This study investigated whether subtypes defined by baseline clinical and cognitive features improve the prediction of psychosis. Method: Four hundred clinical high-risk subjects from the ongoing ShangHai At Risk for Psychosis program were enrolled in a prospective cohort study. Canonical correlation analysis was applied to 289 clinical high-risk subjects with completed Structured Interview for Prodromal Syndromes and cognitive battery tests at baseline, and at least 1-year follow-up. Canonical variates were generated by canonical correlation analysis and then used for hierarchical cluster analysis to produce subtypes. Kaplan–Meier survival curves were constructed from the three subtypes to test their utility further in predicting psychosis. Results: Canonical correlation analysis determined two linear combinations: (1) negative symptom and functional deterioration-related cognitive features, and (2) Positive symptoms and emotional disorganization-related cognitive features. Cluster analysis revealed three subtypes defined by distinct and relatively homogeneous patterns along two dimensions, comprising 14.2% (subtype 1, n = 41), 37.4% (subtype 2, n = 108) and 48.4% (subtype 3, n = 140) of the sample, and each with distinctive features of clinical and cognitive performance. Those with subtype 1, which is characterized by extensive negative symptoms and cognitive deficits, appear to have the highest risk for psychosis. The conversion risk for subtypes 1–3 are 39.0%, 11.1% and 18.6%, respectively. Conclusion: Our results define important subtypes within clinical high-risk syndromes that highlight clinical symptoms and cognitive features that transcend current diagnostic boundaries. The three different subtypes reflect significant differences in clinical and cognitive characteristics as well as in the risk of conversion to psychosis.","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83711154","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 : 2020-04-01DOI: 10.1177/0004867419865618
D. McKay
{"title":"Passing the baton: Getting to grips with after-hours handovers","authors":"D. McKay","doi":"10.1177/0004867419865618","DOIUrl":"https://doi.org/10.1177/0004867419865618","url":null,"abstract":"","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79126118","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 : 2020-03-01DOI: 10.1177/0004867420903592
{"title":"Thanks to Reviewers","authors":"","doi":"10.1177/0004867420903592","DOIUrl":"https://doi.org/10.1177/0004867420903592","url":null,"abstract":"","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90928422","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 : 2020-03-01DOI: 10.1177/0004867419872254
Fei Ying Fang, J. Kulkarni
Australian & New Zealand Journal of Psychiatry, 54(3) interpreted with caution. Suggesting that gays/lesbians are as satisfied with their lives as non-SMs presents an incomplete picture of the reality of living as SM in New Zealand. This is concerning as it is extremely easy for research to be misinterpreted when published by mainstream media. Greater efforts are needed to engage SM groups before data can have meaningful impacts on policy and practice. Future research should examine how endemic forms of stigma impact the health of marginalized groups. Declaration of Conflicting Interests
{"title":"Somatic symptoms: A form of grandiose delusions in manic disorder?","authors":"Fei Ying Fang, J. Kulkarni","doi":"10.1177/0004867419872254","DOIUrl":"https://doi.org/10.1177/0004867419872254","url":null,"abstract":"Australian & New Zealand Journal of Psychiatry, 54(3) interpreted with caution. Suggesting that gays/lesbians are as satisfied with their lives as non-SMs presents an incomplete picture of the reality of living as SM in New Zealand. This is concerning as it is extremely easy for research to be misinterpreted when published by mainstream media. Greater efforts are needed to engage SM groups before data can have meaningful impacts on policy and practice. Future research should examine how endemic forms of stigma impact the health of marginalized groups. Declaration of Conflicting Interests","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90579515","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 : 2020-03-01DOI: 10.1177/0004867419877948
N. Newton, L. Stapinski, M. Teesson, T. Slade, K. Champion, E. Barrett, L. Birrell, E. Kelly, Marius Mather, P. Conrod
Objective: This study examined the secondary mental health outcomes of two contrasting alcohol prevention approaches, whereby one intervention targets common underlying personality risk for alcohol use and mental health problems (Preventure) and the other targets alcohol- and drug-related behaviours and cognitions (Climate Schools). Methods: A 2 × 2 cluster randomised controlled factorial design trial was conducted in 26 Australian schools randomised to the following 4 conditions: Climate Schools (n = 6), Preventure (n = 7), combined Climate Schools and Preventure (CAP; n = 6) or treatment as usual (TAU; n = 7). Participants completed questionnaires at baseline, 6, 12, 24 and 36 months post-baseline including the Brief Symptom Inventory anxiety and depression scales and hyperactivity and conduct scales of the Strengths and Difficulties Questionnaire. Analyses focused on students who were at high-risk based on personality traits (n = 947; Mage = 13.3). The effectiveness of each approach in reducing symptoms of internalising and externalising problems was assessed using multi-level mixed effects analysis. Results: Main effects for each intervention relative to not receiving that intervention revealed significant main effects of Preventure in reducing anxiety symptoms (d = −0.27, 95% confidence interval [CI] = [−0.53, −0.01], p < 0.05) and a marginal effect in reducing depressive symptoms (d = −0.24, 95% CI = [−0.49, 0.01], p = 0.06) over 3 years. Interaction effects revealed that when delivered alone, Preventure significantly reduced conduct problems (d = −0.45, 95% CI = [−0.78, −0.11], p < 0.05) and hyperactivity symptoms (d = −0.38, 95% CI = [−0.70,−0.07], p < 0.05) compared to TAU. Conclusion: This study is the first to report the effectiveness of personality-targeted alcohol prevention in reducing internalising and externalising symptoms relative to an active control, providing evidence in favour of its specificity in preventing concurrent substance use and mental health problems among high-risk youth.
目的:本研究检查了两种不同的酒精预防方法的二级心理健康结果，其中一种干预措施针对酒精使用和心理健康问题的共同潜在人格风险(Preventure)，另一种干预措施针对酒精和药物相关行为和认知(Climate Schools)。方法:对26所澳大利亚学校进行2 × 2聚类随机对照析因设计试验，随机分为以下4种情况:气候学校(n = 6)、Preventure (n = 7)、气候学校和Preventure (CAP;n = 6)或照常治疗(TAU;n = 7)。参与者分别在基线、6、12、24和36个月后完成问卷调查，包括焦虑和抑郁简短症状量表、多动和行为量表的优势和困难问卷。分析的重点是基于人格特征的高风险学生(n = 947;法师= 13.3)。采用多级混合效应分析评估了每种方法在减少内化和外化问题症状方面的有效性。结果:与未接受干预相比，每项干预的主要效果显示，在3年内，Preventure在减轻焦虑症状方面有显著的主要效果(d = - 0.27, 95%可信区间[CI] = [- 0.53， - 0.01]， p < 0.05)，在减轻抑郁症状方面有边际效果(d = - 0.24, 95% CI = [- 0.49, 0.01]， p = 0.06)。相互作用效应显示，与TAU相比，单独给药时，Preventure显著减少行为问题(d = - 0.45, 95% CI = [- 0.78， - 0.11]， p < 0.05)和多动症状(d = - 0.38, 95% CI = [- 0.70， - 0.07]， p < 0.05)。结论:本研究首次报道了针对个性的酒精预防在减少内化和外化症状方面相对于主动控制的有效性，为其在预防高危青少年同时使用物质和精神健康问题方面的特异性提供了证据。
{"title":"Evaluating the differential effectiveness of social influence and personality-targeted alcohol prevention on mental health outcomes among high-risk youth: A novel cluster randomised controlled factorial design trial","authors":"N. Newton, L. Stapinski, M. Teesson, T. Slade, K. Champion, E. Barrett, L. Birrell, E. Kelly, Marius Mather, P. Conrod","doi":"10.1177/0004867419877948","DOIUrl":"https://doi.org/10.1177/0004867419877948","url":null,"abstract":"Objective: This study examined the secondary mental health outcomes of two contrasting alcohol prevention approaches, whereby one intervention targets common underlying personality risk for alcohol use and mental health problems (Preventure) and the other targets alcohol- and drug-related behaviours and cognitions (Climate Schools). Methods: A 2 × 2 cluster randomised controlled factorial design trial was conducted in 26 Australian schools randomised to the following 4 conditions: Climate Schools (n = 6), Preventure (n = 7), combined Climate Schools and Preventure (CAP; n = 6) or treatment as usual (TAU; n = 7). Participants completed questionnaires at baseline, 6, 12, 24 and 36 months post-baseline including the Brief Symptom Inventory anxiety and depression scales and hyperactivity and conduct scales of the Strengths and Difficulties Questionnaire. Analyses focused on students who were at high-risk based on personality traits (n = 947; Mage = 13.3). The effectiveness of each approach in reducing symptoms of internalising and externalising problems was assessed using multi-level mixed effects analysis. Results: Main effects for each intervention relative to not receiving that intervention revealed significant main effects of Preventure in reducing anxiety symptoms (d = −0.27, 95% confidence interval [CI] = [−0.53, −0.01], p < 0.05) and a marginal effect in reducing depressive symptoms (d = −0.24, 95% CI = [−0.49, 0.01], p = 0.06) over 3 years. Interaction effects revealed that when delivered alone, Preventure significantly reduced conduct problems (d = −0.45, 95% CI = [−0.78, −0.11], p < 0.05) and hyperactivity symptoms (d = −0.38, 95% CI = [−0.70,−0.07], p < 0.05) compared to TAU. Conclusion: This study is the first to report the effectiveness of personality-targeted alcohol prevention in reducing internalising and externalising symptoms relative to an active control, providing evidence in favour of its specificity in preventing concurrent substance use and mental health problems among high-risk youth.","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90628726","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 : 2020-02-01DOI: 10.1177/0004867419872804
Chun-Ya Kuo
Tuvalu is a Polynesian island country located in the Pacific Ocean, about midway between Hawaii and Australia. It has a total land area of 26 square kilometres across nine coral atolls, with a population of 11,192 (Commonwealth Health Online, 2019; The World Bank, 2017). A limited medical service is provided by the only hospital, Princess Margaret Hospital (PMH); no psychiatric specialist services are available. Cooperative projects between PMH and the Chung Shan Medical University Hospital (CSMUH) of Taiwan have operated since 2006. In 2016, at the request from PMH, between October 18 to 27, a mobile team provided the first psychiatric intervention in Tuvalu. One psychiatrist who is also a board-certified child and adolescent psychiatrist from CSMUH began to conduct assessments and interventions, including the use of medication and psychotherapy. During six working days in this period, 31 patients made a total of 62 visits to psychiatric services. The majority were female (64.5%), single (64.5%), educated to elementary school level or below (48.3%) and were aged between 4 and 66 years (mean age of 30.5). As shown in Table 1, the major psychiatric disorders seen included psychosis, depressive disorders, adjustment disorder/sleep disorders, anxiety disorders, autism spectrum disorder, attention deficit/hyperactivity disorder and developmental delay. Special issues such as intellectual disability, a history of brain injury/neurological illness, domestic violence/child abuse, alcohol-related disorders/problems and Internet gaming disorder were also noted. First, local PMH medical staff referred 23 patients with potential psychotic symptoms, impaired cognitive functions or alcohol-use problems. These individuals were being cared for within the wider family/society, where there is a local culture of sharing. The successful referral rate was about 60.9%. After this, other patients who suffered from neurotic symptoms or family issues came by themselves. These patients were repressing their symptoms in their daily lives. It is difficult to conduct crosscultural diagnosis and interventions, especially in island countries with limited resources and relevant literature (Allan and Hunter, 1985). To our knowledge, this is the first report concerning mental health conditions in Tuvalu. Since 2000, the threat of rising sea levels has caused about a third of Tuvalu’s population to resettle to New Zealand (Commonwealth Health Online, 2019). With the current growth in globalization and migration, it is important to understand more about mental health conditions in Letters 872804 ANP ANZJP CorrespondenceANZJP Correspondence
图瓦卢是一个波利尼西亚岛国，位于太平洋上，大约在夏威夷和澳大利亚之间。它的总面积为26平方公里，横跨9个珊瑚环礁，人口为11192人(英联邦健康在线，2019年;世界银行，2017)。唯一的医院——玛嘉烈医院提供有限的医疗服务;没有精神病专科服务。PMH与台湾中山医科大学医院(CSMUH)的合作项目自2006年开始运作。2016年10月18日至27日，应PMH的要求，一个流动小组在图瓦卢提供了第一次精神病学干预。一名精神科医生也是CSMUH委员会认证的儿童和青少年精神科医生，他开始进行评估和干预，包括使用药物和心理治疗。在此期间的6个工作天内，共有31名病人到精神科服务机构求诊62次。大多数是女性(64.5%)，单身(64.5%)，小学及以下文化程度(48.3%)，年龄在4至66岁之间(平均年龄30.5岁)。如表1所示，所见的主要精神障碍包括精神病、抑郁症、适应障碍/睡眠障碍、焦虑症、自闭症谱系障碍、注意缺陷/多动障碍和发育迟缓。还注意到智力残疾、脑损伤/神经系统疾病史、家庭暴力/虐待儿童、与酒精有关的失调/问题和网络游戏失调等特殊问题。首先，当地PMH医务人员转诊了23名有潜在精神病症状、认知功能受损或酗酒问题的患者。这些人在更广泛的家庭/社会中得到照顾，那里有一种分享的当地文化。转诊成功率约为60.9%。在此之后，其他患有神经症症状或家庭问题的患者自行前来。这些患者在日常生活中压抑着自己的症状。进行跨文化诊断和干预是困难的，特别是在资源和相关文献有限的岛国(Allan and Hunter, 1985)。据我们所知，这是关于图瓦卢精神健康状况的第一份报告。自2000年以来，海平面上升的威胁已导致图瓦卢约三分之一的人口重新定居新西兰(英联邦健康在线，2019年)。随着当前全球化和移民的增长，在Letters 872804 ANP ANZJP Correspondence中更多地了解心理健康状况是很重要的
{"title":"Encounter mental health in Tuvalu: The prior study","authors":"Chun-Ya Kuo","doi":"10.1177/0004867419872804","DOIUrl":"https://doi.org/10.1177/0004867419872804","url":null,"abstract":"Tuvalu is a Polynesian island country located in the Pacific Ocean, about midway between Hawaii and Australia. It has a total land area of 26 square kilometres across nine coral atolls, with a population of 11,192 (Commonwealth Health Online, 2019; The World Bank, 2017). A limited medical service is provided by the only hospital, Princess Margaret Hospital (PMH); no psychiatric specialist services are available. Cooperative projects between PMH and the Chung Shan Medical University Hospital (CSMUH) of Taiwan have operated since 2006. In 2016, at the request from PMH, between October 18 to 27, a mobile team provided the first psychiatric intervention in Tuvalu. One psychiatrist who is also a board-certified child and adolescent psychiatrist from CSMUH began to conduct assessments and interventions, including the use of medication and psychotherapy. During six working days in this period, 31 patients made a total of 62 visits to psychiatric services. The majority were female (64.5%), single (64.5%), educated to elementary school level or below (48.3%) and were aged between 4 and 66 years (mean age of 30.5). As shown in Table 1, the major psychiatric disorders seen included psychosis, depressive disorders, adjustment disorder/sleep disorders, anxiety disorders, autism spectrum disorder, attention deficit/hyperactivity disorder and developmental delay. Special issues such as intellectual disability, a history of brain injury/neurological illness, domestic violence/child abuse, alcohol-related disorders/problems and Internet gaming disorder were also noted. First, local PMH medical staff referred 23 patients with potential psychotic symptoms, impaired cognitive functions or alcohol-use problems. These individuals were being cared for within the wider family/society, where there is a local culture of sharing. The successful referral rate was about 60.9%. After this, other patients who suffered from neurotic symptoms or family issues came by themselves. These patients were repressing their symptoms in their daily lives. It is difficult to conduct crosscultural diagnosis and interventions, especially in island countries with limited resources and relevant literature (Allan and Hunter, 1985). To our knowledge, this is the first report concerning mental health conditions in Tuvalu. Since 2000, the threat of rising sea levels has caused about a third of Tuvalu’s population to resettle to New Zealand (Commonwealth Health Online, 2019). With the current growth in globalization and migration, it is important to understand more about mental health conditions in Letters 872804 ANP ANZJP CorrespondenceANZJP Correspondence","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90102058","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 : 2020-02-01DOI: 10.1177/0004867419877958
E. Tan
{"title":"Having schizophrenia is not being ‘schizophrenic’: Your words matter","authors":"E. Tan","doi":"10.1177/0004867419877958","DOIUrl":"https://doi.org/10.1177/0004867419877958","url":null,"abstract":"","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81677882","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 : 2020-02-01DOI: 10.1177/0004867419881206
J. Beilharz, M. Paterson, S. Fatt, Chloe E Wilson, A. Burton, E. Cvejic, A. Lloyd, U. Vollmer-Conna
Objective: Given the fundamental emotional, social and physical development that occurs during the early years of life, childhood experiences are formative in shaping a person’s life trajectory. Childhood trauma is a prevalent, multifaceted issue with well-documented long-term adverse health effects in clinical populations however; the impact of childhood trauma in the community is less clear. To address this, this study investigated how childhood trauma may impact physical and psychological health, sleep quality and autonomic function in a non-clinical community sample of adults. Method: Participants completed questionnaires, an in-laboratory autonomic assessment (including stress reactivity to mental and physical stressors) and overnight autonomic and sleep monitoring. Overall childhood trauma and its subtypes (e.g. physical abuse, emotional neglect) were defined using the Childhood Trauma Questionnaire. Results: We identified 22 childhood trauma cases (total score > 36) and, of the 89 non-childhood trauma cases, some individuals also experienced significant levels of trauma in one or more of the childhood trauma subtypes. Childhood trauma and some trauma subtypes were significantly correlated with a myriad of negative physiological and physical health outcomes including elevated psychological distress, increased sleep disturbances, reduced emotional wellbeing and lower perceived social support. Autonomic dysregulation was found in those with high levels of childhood trauma, which was reflected in an increased stress response to laboratory tasks. Notably, the experience of physical abuse in childhood was significantly associated with alterations in nocturnal heart rate and heart rate variability. Conclusion: Together, these results highlight that childhood trauma can have lasting detrimental consequences on an individual’s emotional and physical health, sleep quality and stress reactivity.
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