Pub Date : 2024-08-01Epub Date: 2024-06-15DOI: 10.1177/10398562241261251
Mathew Coleman, Andrew Gleason, Rahul Gupta, Jacqueline Huber, Emily Martin, Chris Ryan
{"title":"Any psychiatric assessment of a drowsy patient must be preliminary.","authors":"Mathew Coleman, Andrew Gleason, Rahul Gupta, Jacqueline Huber, Emily Martin, Chris Ryan","doi":"10.1177/10398562241261251","DOIUrl":"10.1177/10398562241261251","url":null,"abstract":"","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01Epub Date: 2024-05-24DOI: 10.1177/10398562241256801
Andrew James Amos
{"title":"Response to Barton et al. confirming that Burke et al. do not show a relationship between climate change and suicide.","authors":"Andrew James Amos","doi":"10.1177/10398562241256801","DOIUrl":"10.1177/10398562241256801","url":null,"abstract":"","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141092574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-30DOI: 10.1177/10398562241268261
Gordon Parker
Objective: Many with a bipolar disorder embark on a quest, most commonly during elevated mood states, and sometimes driven by a prescient delusion. This essay draws a parallel with a prominent literary plot - the Quest.
Method: Reference to the literary plot is made and an exemplar provided, being based on the personal stories of several patients.
Results: Parallels between the literary model and the current vignette are emphasized.
Conclusion: Manic prescience can sometimes be more than a delusion. The Quest is both a literary plot and at times may underlie manic behaviours and even illustrate its symbolic value.
{"title":"Journeying with a bipolar disorder: The quest plot.","authors":"Gordon Parker","doi":"10.1177/10398562241268261","DOIUrl":"https://doi.org/10.1177/10398562241268261","url":null,"abstract":"<p><strong>Objective: </strong>Many with a bipolar disorder embark on a quest, most commonly during elevated mood states, and sometimes driven by a prescient delusion. This essay draws a parallel with a prominent literary plot - the Quest.</p><p><strong>Method: </strong>Reference to the literary plot is made and an exemplar provided, being based on the personal stories of several patients.</p><p><strong>Results: </strong>Parallels between the literary model and the current vignette are emphasized.</p><p><strong>Conclusion: </strong>Manic prescience can sometimes be more than a delusion. The Quest is both a literary plot and at times may underlie manic behaviours and even illustrate its symbolic value.</p>","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.1177/10398562241267875
Michelle Atchison, Jeffrey Cl Looi, Stephen J Robson
Women with severe mental illness and pregnancy suffer substantial travails in accessing care for mental and perinatal health. Women with psychotic illnesses such as schizophrenia face higher risks of pregnancy and postnatal complications. Similarly, lack of access to holistic psychiatric care presents particular perils for these women and their children. Tailored care for these mothers-to-be and their babies is needed to prevent and ameliorate health complications, mental and physical. This will require targeted funding of services that connect women with and provide continuity of care.
{"title":"The travails of women with severe mental illness and pregnancy.","authors":"Michelle Atchison, Jeffrey Cl Looi, Stephen J Robson","doi":"10.1177/10398562241267875","DOIUrl":"https://doi.org/10.1177/10398562241267875","url":null,"abstract":"<p><p>Women with severe mental illness and pregnancy suffer substantial travails in accessing care for mental and perinatal health. Women with psychotic illnesses such as schizophrenia face higher risks of pregnancy and postnatal complications. Similarly, lack of access to holistic psychiatric care presents particular perils for these women and their children. Tailored care for these mothers-to-be and their babies is needed to prevent and ameliorate health complications, mental and physical. This will require targeted funding of services that connect women with and provide continuity of care.</p>","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141765066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-25DOI: 10.1177/10398562241268139
Rowena Kellett, Lillian Findlay, Sean Lubbe, Anne Pf Wand
Objective: To describe implementation of the Pathways to Community Living Initiative (PCLI) within an Older People's Mental Health (OPMH) service.
Method: A retrospective observational study was conducted. Implementation comprised partnership with a specialist Residential Aged Care Facility (RACF). Data were obtained from Clinical Advisory Committee (CAC) discussion and minutes, the PCLI database, and consumer medical records.
Results: Eighteen consumers were accepted onto the program between April 2019 and March 2023. Their PCLI and rating scale outcomes alongside interventions facilitating placements are described. Interventions included OPMH case management, wide-reaching liaison, and inservices. Challenges included communication, confusion regarding roles, and differing views on capacity to accommodate complex consumers. Solutions included streamlining communication, including clinical updates in the CAC, facility appointment of a lead PCLI-nurse, and targeted RACF education.
Conclusions: Considered interventions strengthened the OPMH and specialist RACF partnership over time. Clarification of professional roles and intersection with other services was crucial. Successful placement for PCLI consumers required consideration of personalised needs and existing resident mix, liaison with stakeholders, and targeted staff training. These strategies may apply to other health services implementing similar initiatives supporting community placements for OPMH consumers with complex needs.
{"title":"The Pathways to Community Living Initiative (PCLI) for older adults: implementation and outcomes.","authors":"Rowena Kellett, Lillian Findlay, Sean Lubbe, Anne Pf Wand","doi":"10.1177/10398562241268139","DOIUrl":"https://doi.org/10.1177/10398562241268139","url":null,"abstract":"<p><strong>Objective: </strong>To describe implementation of the Pathways to Community Living Initiative (PCLI) within an Older People's Mental Health (OPMH) service.</p><p><strong>Method: </strong>A retrospective observational study was conducted. Implementation comprised partnership with a specialist Residential Aged Care Facility (RACF). Data were obtained from Clinical Advisory Committee (CAC) discussion and minutes, the PCLI database, and consumer medical records.</p><p><strong>Results: </strong>Eighteen consumers were accepted onto the program between April 2019 and March 2023. Their PCLI and rating scale outcomes alongside interventions facilitating placements are described. Interventions included OPMH case management, wide-reaching liaison, and inservices. Challenges included communication, confusion regarding roles, and differing views on capacity to accommodate complex consumers. Solutions included streamlining communication, including clinical updates in the CAC, facility appointment of a lead PCLI-nurse, and targeted RACF education.</p><p><strong>Conclusions: </strong>Considered interventions strengthened the OPMH and specialist RACF partnership over time. Clarification of professional roles and intersection with other services was crucial. Successful placement for PCLI consumers required consideration of personalised needs and existing resident mix, liaison with stakeholders, and targeted staff training. These strategies may apply to other health services implementing similar initiatives supporting community placements for OPMH consumers with complex needs.</p>","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-24DOI: 10.1177/10398562241267149
The The Aung, Win Wah, Arnob Chakraborti, Vikas Garg
Objective: The systematic review evaluated the association of subclinical hypothyroidism (SCH) with metabolic syndrome (MetS) and specific MetS components in people with major psychiatric disorders.
Methods: A systematic review and meta-analysis was conducted to evaluate the association of SCH with MetS and its components in people with major psychiatric conditions.
Results: Five studies incorporating 24,158 participants met the inclusion criteria. All five studies comprised patients with depression and/or anxiety. Three studies incorporating 3365 participants were suitable for the meta-analysis. The pooled Odds Ratio (OR) of MetS was 3.46 (95% Confidence Interval/CI = 1.39-8.62) in major depressive disorder (MDD) and anxiety disorders patients with concurrent SCH compared to those without SCH. Meta-analysis showed a significant positive association between SCH and high body mass index (OR = 2.58, 95%CI = 1.33-5.01), high fasting plasma glucose (OR = 3.05, 95%CI = 1.79-5.18) and low high-density lipoprotein cholesterol (OR = 2.30, 95%CI = 1.82-2.92).
Conclusions: These findings suggest a significant positive association between MetS and SCH in people with MDD and anxiety disorders. This review informed the clinical implications of MetS in MDD with comorbid SCH and the importance of early diagnosis and treatment for SCH and MetS in psychiatric patients.
{"title":"Subclinical hypothyroidism and metabolic syndrome in psychiatric patients: A systematic literature review and meta-analysis.","authors":"The The Aung, Win Wah, Arnob Chakraborti, Vikas Garg","doi":"10.1177/10398562241267149","DOIUrl":"https://doi.org/10.1177/10398562241267149","url":null,"abstract":"<p><strong>Objective: </strong>The systematic review evaluated the association of subclinical hypothyroidism (SCH) with metabolic syndrome (MetS) and specific MetS components in people with major psychiatric disorders.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted to evaluate the association of SCH with MetS and its components in people with major psychiatric conditions.</p><p><strong>Results: </strong>Five studies incorporating 24,158 participants met the inclusion criteria. All five studies comprised patients with depression and/or anxiety. Three studies incorporating 3365 participants were suitable for the meta-analysis. The pooled Odds Ratio (OR) of MetS was 3.46 (95% Confidence Interval/CI = 1.39-8.62) in major depressive disorder (MDD) and anxiety disorders patients with concurrent SCH compared to those without SCH. Meta-analysis showed a significant positive association between SCH and high body mass index (OR = 2.58, 95%CI = 1.33-5.01), high fasting plasma glucose (OR = 3.05, 95%CI = 1.79-5.18) and low high-density lipoprotein cholesterol (OR = 2.30, 95%CI = 1.82-2.92).</p><p><strong>Conclusions: </strong>These findings suggest a significant positive association between MetS and SCH in people with MDD and anxiety disorders. This review informed the clinical implications of MetS in MDD with comorbid SCH and the importance of early diagnosis and treatment for SCH and MetS in psychiatric patients.</p>","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-22DOI: 10.1177/10398562241265261
Jeffrey Cl Looi, Andrew Amos, Tarun Bastiampillai, Samantha Loi, Edward Miller, Sharon Reutens
The process of medical scientific journal publishing merits further explanation for authors and readers. Prospective authors need to understand the scope of the journal and the article types that are published. We give an overview of the editorial process, including selection of reviewers, peer review and decisions regarding revision, acceptance and rejection of papers for Australasian Psychiatry. We encourage authors and readers to submit papers, and volunteer as peer reviewers, working together with the journal editorial team.
{"title":"Behind the curtain of <i>Australasian Psychiatry</i>: The practice of a medical journal and a call for reviewers.","authors":"Jeffrey Cl Looi, Andrew Amos, Tarun Bastiampillai, Samantha Loi, Edward Miller, Sharon Reutens","doi":"10.1177/10398562241265261","DOIUrl":"https://doi.org/10.1177/10398562241265261","url":null,"abstract":"<p><p>The process of medical scientific journal publishing merits further explanation for authors and readers. Prospective authors need to understand the scope of the journal and the article types that are published. We give an overview of the editorial process, including selection of reviewers, peer review and decisions regarding revision, acceptance and rejection of papers for <i>Australasian Psychiatry</i>. We encourage authors and readers to submit papers, and volunteer as peer reviewers, working together with the journal editorial team.</p>","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-21DOI: 10.1177/10398562241265592
Jeffrey C L Looi, Fiona Wilkes, Stephen Allison, Paul A Maguire, Steve Kisely, Tarun Bastiampillai
Objective: The RANZCP conducted an anonymous survey of 7200 members (trainees and psychiatrists) in December 2023, receiving 1269 responses, representing the views of roughly 1 in 6 members, and of the respondents, three quarters reported experiencing burnout in the last 3 years. We provide a commentary, citing evidence from relevant previous research, discussing the implications and proposing potential interventions.
Conclusions: Members of the RANZCP reported worsening workforce shortages, with 9 in 10 respondents stating that these negatively impacted patient care, and 7 in 10 experiencing symptoms of burnout. Eighty per cent identified workforce shortages as the top contributing factor to such burnout. The aetiology of workforce shortages and burnout is likely due to operational and structural shortfalls in psychiatric services. However, public and private sector employment information was not included in the report. There are a range of strategic, evidence-based interventions to address the psychiatrist and trainee workforce challenges, comprising general healthcare service as well as specific initiatives. Based on the findings of the report, such interventions are needed, now.
{"title":"The RANZCP Workforce Report: Action is needed, now.","authors":"Jeffrey C L Looi, Fiona Wilkes, Stephen Allison, Paul A Maguire, Steve Kisely, Tarun Bastiampillai","doi":"10.1177/10398562241265592","DOIUrl":"https://doi.org/10.1177/10398562241265592","url":null,"abstract":"<p><strong>Objective: </strong>The RANZCP conducted an anonymous survey of 7200 members (trainees and psychiatrists) in December 2023, receiving 1269 responses, representing the views of roughly 1 in 6 members, and of the respondents, three quarters reported experiencing burnout in the last 3 years. We provide a commentary, citing evidence from relevant previous research, discussing the implications and proposing potential interventions.</p><p><strong>Conclusions: </strong>Members of the RANZCP reported worsening workforce shortages, with 9 in 10 respondents stating that these negatively impacted patient care, and 7 in 10 experiencing symptoms of burnout. Eighty per cent identified workforce shortages as the top contributing factor to such burnout. The aetiology of workforce shortages and burnout is likely due to operational and structural shortfalls in psychiatric services. However, public and private sector employment information was not included in the report. There are a range of strategic, evidence-based interventions to address the psychiatrist and trainee workforce challenges, comprising general healthcare service as well as specific initiatives. Based on the findings of the report, such interventions are needed, now.</p>","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-19DOI: 10.1177/10398562241265221
Kirra Solterbeck, Lauren Staples, Logan Woodman, Nicholas Burns, Rebecca Mitchell, Olav Nielssen
Objective: Describe patterns of substance use and comorbid conditions among clinic attenders in homeless shelters in Sydney.
Method: Retrospective cohort study of 2498 people who attended a psychiatric clinic at one of three homeless hostels between February 2008 and May 2020. Multivariable logistic regression was used to identify factors associated with self-reported substance use, psychiatric diagnosis and measures of social function.
Results: A total of 2041 of the 2498 (81.7%) reported the harmful use of at least one substance, with alcohol (61.8%), cannabis (50.9%) and stimulant drugs (34.9%) the three most common. Those reporting the regular use of two or more substances (1466, 58.7%) were more likely to have a history of early life and adult trauma, a diagnosis of personality disorder, a criminal conviction, receive the Disability Support Pension, be chronically homeless and sleep in the open.
Conclusions: The study found a high rate of polysubstance use among homeless clinic attenders in Sydney, and an increase in the prevalence of substance use compared to previous studies. Substance use is both a cause and a consequence of homelessness, and services to address substance use have to be part of any program to reduce homelessness and sleeping in the open.
{"title":"Substance use by homeless clinic attenders in Sydney.","authors":"Kirra Solterbeck, Lauren Staples, Logan Woodman, Nicholas Burns, Rebecca Mitchell, Olav Nielssen","doi":"10.1177/10398562241265221","DOIUrl":"https://doi.org/10.1177/10398562241265221","url":null,"abstract":"<p><strong>Objective: </strong>Describe patterns of substance use and comorbid conditions among clinic attenders in homeless shelters in Sydney.</p><p><strong>Method: </strong>Retrospective cohort study of 2498 people who attended a psychiatric clinic at one of three homeless hostels between February 2008 and May 2020. Multivariable logistic regression was used to identify factors associated with self-reported substance use, psychiatric diagnosis and measures of social function.</p><p><strong>Results: </strong>A total of 2041 of the 2498 (81.7%) reported the harmful use of at least one substance, with alcohol (61.8%), cannabis (50.9%) and stimulant drugs (34.9%) the three most common. Those reporting the regular use of two or more substances (1466, 58.7%) were more likely to have a history of early life and adult trauma, a diagnosis of personality disorder, a criminal conviction, receive the Disability Support Pension, be chronically homeless and sleep in the open.</p><p><strong>Conclusions: </strong>The study found a high rate of polysubstance use among homeless clinic attenders in Sydney, and an increase in the prevalence of substance use compared to previous studies. Substance use is both a cause and a consequence of homelessness, and services to address substance use have to be part of any program to reduce homelessness and sleeping in the open.</p>","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141726817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}