Showing papers in "Australian and New Zealand Journal of Psychiatry in 1975"
TL;DR: Comparisons were made between the overall scores on the Beck, Hamilton, Zung and a visual analogue rating scale in a group of depressed patients and significant correlations between the global scores were found.
Abstract: Comparisons were made between the overall scores on the Beck, Hamilton, Zung and a visual analogue rating scale in a group of depressed patients. The comparisons were made initially and at one, two and three weeks. Significant correlations between the global scores were found on these depression scales. The value of these scales in clinical research studies in depression is discussed wirh special mention of the value of the visual analogue scale.
103 citations
TL;DR: It is suggested that lithium carbonate and haloperidol together should be seriously considered in the treatment of HC when patients are excessively irritable and impulsive.
Abstract: Six patients with a family history of Huntington's chorea (HC) participated in a double blind crossover trial involving four treatments--lithium carbonate, haloperidol, lithium carbonate and haloperidol, and placebo. Each treatment was administered for three weeks and, at the end of each treatment period, assessments were made of chorea and a number of psychological variables. None of the treatments significantly affected chorea measurements. With regard to the psychological variables, the levels of irritability, the frequency of angry outbursts and depression did appear to be affected in some patients by the treatment. Three patients improved on a combination of lithium carbonate and haloperidol while the remaining three did not. Haloperidol alone significantly raised depression ratings above levels for other treatments including placebo. It is suggested that lithium carbonate and haloperidol together should be seriously considered in the treatment of HC when patients are excessively irritable and impulsive.
54 citations
TL;DR: The management of pathological grief is outlined; specifically the encouragement of the expression of suppressed affects especially sadness, anger and guilt; as well as the going over of memories and feelings to do with the lost relationship.
Abstract: Earlier descriptions of pathological grief are reviewed. From the study of recently bereaved widows major forms of pathological grief are outlined. These are suppressed or inhibited grief and disto...
48 citations
TL;DR: There is great reluctance, particularly on the part of investigators with an organic orientation, to acknowledge the significance of psychological factors for the development of obesity.
Abstract: (1975). Obesity and Anorexia Nervosa: Psychosocial Aspects. Australian and New Zealand Journal of Psychiatry: Vol. 9, No. 3, pp. 159-161.
39 citations
TL;DR: A double blind study in 28 patients with chronic schizophrenia was carried out comparing L-dopa (up to 1250 mgm daily) with placebo (both groups continuing to receive regular neuroleptic medication) over a six week period.
Abstract: A double blind study in 28 patients with chronic schizophrenia was carried out comparing L-dopa (up to 1250 mgm daily) with placebo (both groups continuing to receive regular neuroleptic medication) over a six week period. Assessments by the psychiatrists and psychologist using Rockland and Pollin Rating Scale showed differential improvement of insignificant proportions but the nurse's ratings showed clearly significant improvement in the subject group.
33 citations
TL;DR: It is illness behaviour upon which the long-neglected “psychosocial dimension’’ of disease or, to be more precise, a particular facet of it, is the subject of my presentation today.
Abstract: If the natural history of an illness were dependent for its characteristics only upon the nature of the pathological changes which underlay it, doctors would experience a professional existence of remarkable simplicity and predictability. We know full well, however, that such a state of affairs is incompatible with the nature of man, whose capacity for symbolic activity renders his every experience uniquely his own. While this fact has long been appreciated by many physicians, particularly as far as psychological disorders are concerned, it has taken longer for the non somatic dimensions of organic dysfunction, to receive the sort of systematic attention they so clearly deserve. This long-neglected “psychosocial dimension’’ of disease or, to be more precise, a particular facet of it, is the subject of my presentation today. As my title indicates, it is illness behaviour upon which I propose to focus my attention. The phenomenon of illness behaviour may be numbered amongst those whose ubiquity has rendered them virtually invisible. One may speculate, that in times when medical men were few and health care systems rudimentary, the many ways in which individuals reacted to bodily dysfunction, were of far less concern than the understanding of the pathological processes presented by those who were fortunate enough to actually reach medical assistance. Nonetheless, extreme reactions to bodily functioning were noted by physicians from the Hippocratic era onward, and not a few recorded cases of individuals who manifested pathological attitudes to their state of physical health.
27 citations
TL;DR: A two year study of attempted suicide in two Victorian regions found coincidence rates of 16.7 and 22.1 per 10,000 population were found in the metropolitan and provincial regions respectively.
Abstract: A two year study of attempted suicide was undertaken in two Victorian regions. Incidence rates of 16.7 and 22.1 per 10,000 population were found in the metropolitan and provincial regions respectively. A number of factors were considered and found relevant to the difference in incidence. In addition, other parameters including multiple attempts, seasonal distribution, method used, association with alcohol and referral to psychiatric care were considered. Our findings are compared with those of earlier studies reported in Australia.
26 citations
TL;DR: Many new towns have come into existence in Australia in recent years consequent upon the discovery of so many rich mineral deposits and an opportunity to market these, where two existing towns have expanded tenfold and many new towns, with populations of 3,000 to 14,000 have been built.
Abstract: Many new towns have come into existence in Australia in recent years consequent upon the discovery of so many rich mineral deposits and an opportunity to market these. The biggest concentration of these towns is in the Pilbara district in the North-West of Western Australia, where two existing towns have expanded tenfold and many new towns, with populations of 3,000 to 14,000 have been built. In 1973 a conference was held in Kanibalda. a nickel mining town in W.A. under the auspices of U.N.E.S.C.O., entitled Man and the Environment New Towns im Isolated Settings. The speakers were from many disciplines including, architecture, botany, engineering, local government, sociology, town planning, and psychiatry. One of the foci of interest was health, especially mental health, in these settings.
25 citations
TL;DR: Apparent conflicts between results of studies relating autonomic reactivity to depressive states, indicates the desirability of a substantial re-evaluation of the evidence.
Abstract: Measures of psychophysiological activity have recently assumed importance in the investigation of psychopathology (Claridge, 1967). In particular, indices of autonomic reactivity have been widely employed in the investigation of depressive states (Byrne, 1973; McCarron, 1973). However apparent conflicts between results of studies relating autonomic reactivity to depressive states, indicates the desirability of a substantial re-evaluation of the evidence. Experiments measuring electrodermal (skin conductance) and heart rate indices of autonomic reactivity in depressive states, appear prominent in the literature. Some (Greenfield et al., 1963; Riazansky, 1965; Spiegel & Acker, 1967; McCarron, 1970, 1973) have reported decreased electrodermal reactivity in depressive patients relative to normals. On the other hand, others (Goldstein, 1965) have presented evidence supporting an opposite view to this. Moreover others still (Lader & Wing, 1969; Noble & Lader, 1972) have argued that electrodermal reactivity among depressed patients, is a function of the type of depression. Depressive patients exhibiting behavioural agitation show increased electrodermal reactivity relative to normals. Depressive patients exhibiting behavioural retardation show decreased eIectrodermal reactivity relative to normals.
25 citations
TL;DR: This work is concerned with two relatively harmless agents, both relatively harmless, one called merphos and the other DEF, which together are used to make a cotton defoliant called Merphos.
Abstract: (1975) Merphos Poisoning or Mass Panic? Australian and New Zealand Journal of Psychiatry: Vol 9, No 4, pp 225-229
25 citations
TL;DR: A group of eight infants with a disorder termed the IDD syndrome and another group ofeight matched healthy infants taken into study at the same time have been followed-up for 6.75 years, with some findings that show recovery from severe developmental disturbance.
Abstract: A group of eight infants with a disorder termed the IDD syndrome and another group of eight matched healthy infants taken into study at the same time have been followed-up for 6.75 years. The follow-up technique and some findings are described. Three IDD syndrome children are still severely disturbed. Three others show recovery from severe developmental disturbance. But one child who was grossly abused after being taken into the study has been well since the third follow-up. The comparison children have not experienced comparable problems. A qualified affirmative to the question of predictive power is given and discussed.
TL;DR: The authors' impression was that the response of patients shown was more marked and immediate than with any other treatment apart from leucotomy.
Abstract: Behaviouristic theories of obsessive-compulsive neurosis are reviewed and their relationship indicated to the introduction of ritual prevention as a form of treatment for this condition. Studies investigating aspects of ritual prevention are summarised. The treatment of six obsessive-compulsive patients in a psychiatric ward of a general hospital is described and the difficulties encountered outlined. The authors' impression was that the response of patients shown was more marked and immediate than with any other treatment apart from leucotomy.
TL;DR: It was found that the more psychotic the patient the more likely it was that mistakes in interpreting from patient to doctor would occur and that it is well worthwhile formally assessing an interpreter's command of his second language.
Abstract: This article examines the problems of foreign language interpreting in psychiatric practice. It is demonstrated how an interpreter's apparent competence may readily be mistaken for true competence and that it is well worthwhile formally assessing an interpreter's command of his second language. In interpreting from patient to psychiatrist, the omission of important material was found to be a noteworthy feature. Here the meaninglessness of material not only favoured its omission but also often indicated important psychopathology. It was found that the more psychotic the patient the more likely it was that mistakes in interpreting from patient to doctor would occur.
TL;DR: In this article, the authors present a plasminriptyline and clinical response of patients in the Australian and New Zealand Journal of Psychiatry: Vol. 9, No. 4, pp. 249-253.
Abstract: (1975). Plasma Nortriptyline and Clinical Response. Australian and New Zealand Journal of Psychiatry: Vol. 9, No. 4, pp. 249-253.
TL;DR: Results showed active electrosleep to be no better than placebo in bettering quality of sleep or in lessening symptoms of depression or anxiety.
Abstract: The study assessed the effectiveness of electrosleep therapy in the treatment of depression, anxiety, and sleep difficulties in a small, heterogeneous sample of psychiatric inpatients. A double-bli...
TL;DR: Data presented showed a higher rate in aborigines compared with nonaborigines, but many reservations were made regarding the validity of the aboriginal rates.
Abstract: A study of attempted suicides in the Perth Statistical Division for 1971-72 has been presented. The average annual rate was 8.5 per 10,000 for males and 20.3 for females. There had been a doubling in rate since 1961, the increase being greater for females than males. Age standardised rates were greater than the Australian born for immigrant males but not for females. There were marked differences in rates between different individual immigrant groups of each sex. Data presented showed a higher rate in aborigines compared with non-aborigines, but many reservations were made regarding the validity of the aboriginal rates.
TL;DR: The findings show a higher general practice consultation attendance rate for both sexes, and a higher rate of psychiatric illness among females, in Jaburoo than in Gynalla, a new expanding town in the Pilbara area and the South West.
Abstract: SynopsisThe results are presented of a survey of patients identified by their general practitioner as having conspicuous psychiatric morbidity, according to Kessel's (1960) Classification, during a three months general practice survey in two Western Australian towns, one, Gynalla, a new expanding town in the Pilbara area and the other, Jaburoo, an established economically stagnant town in the South West. The findings show a higher general practice consultation attendance rate for both sexes, and a higher rate of psychiatric illness among females, in Jaburoo than in Gynalla. In Gynalla psychiatric cases among women formed a disproportionately high percentage of all general practice attendances. The implications of these findings are discussed.
TL;DR: A questionnaire designed to assist in the classification of depressive illness, was administered and it was found that a preponderance of patients classified as “endogenous depressives” by the questionnaire technique, also had clinical diagnoses of endogenous depression, and had low G.S.R. inhibition thresholds relative to normals.
Abstract: A questionnaire designed to assist in the classification of depressive illness, was administered to 20 acute depressive patients and 10 normal controls. Patient classification according to the decision rules employed by the questionnaire, were compared with patient classification arrived at by symptomatic (diagnostic) and physiological (G.S.R. inhibition threshold) means. It was found that a preponderance of patients classified as "endogenous depressives" by the questionnaire technique, also had clinical diagnoses of endogenous depression, and had low G.S.R. inhibition thresholds relative to normals. Furthermore a preponderance of patients classified as "non-endogenous depressives" by the questionnaire technique, had clinical diagnoses of neurotic depressive illness, and had high G.S.R. inhibition thresholds relative to normals. This supports the assertion that the questionnaire technique has some validity in the classification of depressive illness.
TL;DR: A ‘guided fantasy’ technique is described to relieve insomnia in children without the use of chemotherapy or the more conventional forms of hypnotherapy, presented by the parents as a novel bedtime story rather than as a therapy procedure by the therapist.
Abstract: A “guided fantasy” technique is described to relieve insomnia in children without the use of chemotherapy or the more conventional forms of hypnotherapy. In children at an age where fantasy is a sp...
TL;DR: This paper describes the special role of a community psychiatrist in the field and, in particular, how this role tended to be rejected by the community at the outset, only to become accepted as the expectation of the community about psychiatry and the psychiatrist changed.
Abstract: The greatest benefits to the health of man havu arisen not so much from an ability to treat his individual illnesses as from a general improvement in his social and economic environment. Social and community psychiatry involve both preventing and treating psychiatric disease by concerning itself not only with individuals but also with the factors in their environment which affect their mental health and social functioning. Many writings on this subject are of a theoretical nature. This paper describes the special role of a community psychiatrist in the field and, in particular, how this role tended to be rejected by the community at the outset, only to become accepted as the expectation of the community about psychiatry and the psychiatrist changed.
TL;DR: Nine cohorts of patients admitted between 1919 and 1962 have been followed up until 1971, and data have been compared with those available since the introduction of the statistical system in Victoria in 1961.
Abstract: SynopsisNine cohorts of patients admitted between 1919 and 1962 have been followed up until 1971. Comparison has been made in terms of sex and age specific incidences of selected psychiatric disorders throughout the whole period.The results of treatment have been evaluated in terms of discharge and death rates, length of stay, re-admission rates to psychiatric institutions and total period under hospitalization. These data have been compared with those available since the introduction of the statistical system in Victoria in 1961.
TL;DR: A cohort of 54 mothers with puerperal psychoses admitted between 1965 and 1969 to a joint mother and baby short stay treatment programme is reported with a follow-up at the end of 1973.
Abstract: A cohort of 54 mothers with puerperal psychoses admitted between 1965 and 1969 to a joint mother and baby short stay treatment programme is reported with a follow-up at the end of 1973. The outcomes indicate that this treatment routine is as satisfactory as other programmes. Those who, for various reasons, did not complete the joint programme of treatment did not do so well.
TL;DR: In this paper, the relative efficacy of 4 tranquilizers was investigated in 66 chronic schizophrenics who had been hospitalized for 10.01 years (mean) and the role of adding an anti-depressant was also studied.
Abstract: SynopsisThe relative efficacy of 4 tranquilizers was investigated in 66 chronic schizophrenics who had been hospitalized for 10.01 years (mean). The role of adding an anti-depressant was also studied. Following a 4 week placebo period, high dosage tranquilizers were given for 16 weeks and amitriptyline was added for the following 16 weeks.Statistical analyses of the various change measures revealed that patients worsened significantly on placebo, all 4 tranquilizers were significantly better than placebo for symptom reduction and maximum improvement was attained within 16 weeks of tranquilizer administration. No significant differences in efficacy were observed among the 4 tranquilizers and addition of amitriptyline did not confer any additional therapeutic advantage.
TL;DR: Within the collected works of A. A. Milne the creative genius who introduced to the world the tales of Christopher Robin, Pooh, Piglet and a host of lesser animals any psychiatrist who takes the trouble to look can uncover a vast treasure house of descriptive psychopathology and clinical wisdom.
Abstract: Within the collected works of A. A. Milne the creative genius who introduced to the world the tales of Christopher Robin, Pooh, Piglet and a host of lesser animals any psychiatrist who takes the trouble to look can uncover a vast treasure house of descriptive psychopathology and clinical wisdom. One of these stories has a special relevance to my theme tonight. Many of you, I am sure, will recall the exciting chapter in which Christopher Robin musters what he chooses to call an Expotition to discover the North Pole. The ensuing drama has many salutary lessons for those of us who care to define what we are seeking, and to establish the most effective means of progressing towards our goal. Pooh, the conscience of the party (was he perhaps a social worker?), puts the question to Christopher Robin before they set out: “What is the North Pole?” to which Christopher Robin, not being quite sure himself, replies carelessly “It’s just a thing you discover”. Later in the day, as Christopher Robin’s courage begins to wane, he initiates the following illuminating dialogue with Rabbit (who was probably training to be a health service administrator, as he is described as “looking important”): C.R.: “Rabbit, I suppose you don’t know, what does
TL;DR: Patients who had attempted suicide and were referred to the out-patient clinic of the Royal Adelaide Hospital failed to attend, and it seems surprising that their non-attendance has not been more fully investigated.
Abstract: 46% of patients who had attempted suicide and were referred to the out-patient clinic of the Royal Adelaide Hospital failed to attend. Similar findings have been reported from other centres. Though it is not known why this is so, tentative speculation is possible. Since it has been shown that persons who attempt suicide are more at risk for suiciding in the future, it seems surprising that their non-attendance has not been more fully investigated.
TL;DR: Most of those living outside hospital said that they were happier than when living in hospital, and formed a relatively homogeneous socio-economic group with the majority living in boarding houses and convalescent homes and being unemployed.
Abstract: SynopsisOne hundred and forty long-stay patients discharged from Callan Park Hospital were followed up. All except nine were accounted for and 90 who were living outside hospital at the time of the study were interviewed. Thirty percent of the total sample were readmitted during the mean follow up period of 20.4 months. Most of those living outside hospital said that they were happier than when living in hospital. They formed a relatively homogeneous socio-economic group with the majority living in boarding houses and convalescent homes and being unemployed.
TL;DR: An alternative formulation of attempted suicide is offered, in which the phenomenon is considered within the context of social learning theory, and the treatment principles and practice are outlined.
Abstract: An alternative formulation of attempted suicide is offered, in which the phenomenon is considered within the context of social learning theory. The suicidal behaviour is viewed as an operant which is reinforced and maintained by the consequent interpersonal contingencies. The modification of the suicidal behaviour then involves alteration of the contingent consequences. This theoretical formulation is elaborated and the treatment principles and practice are outlined.
TL;DR: Throughout the history of the hospital, local social institutions, formal and informal, tended to perform casualty and receiving functions so that the Royal Derwent has always served as institution of last resort.
Abstract: SynopsisThroughout the history of the hospital, local social institutions, formal and informal, tended to perform casualty and receiving functions so that the Royal Derwent has always served as institution of last resort. Case books show that both illnesses and treatment conformed to those familiar elsewhere in the British Empire and developed no local peculiarities. The records provide epidemiological evidence of a dramatic decline in incidence of first admission for psychosis after the period when convict transportation created a high rate of social dependency.
TL;DR: Nothing in my training prepared me for problems such as devising suitable treatment for a young giant of a man with severe chronic bronchitis who ultimately disclosed he was smoking 100-200 cigarettes a day.
Abstract: The complexity of motivation that results in the decision to study and practice psychiatry probably makes it impossible for the doctor who so chooses, to analyse it in all its details. A psychoanalysis may provide understanding though not necessarily a complete one. Amongst the more immediate influences in my own case, as far as I am able to judge it, was a period of general practice just after I graduated. Nothing in my training prepared me for problems such as devising suitable treatment for a young giant of a man with severe chronic bronchitis who ultimately disclosed he was smoking 100-200 cigarettes a day. Other clinical experiences in a variety of circumstances turned up many other problems for which I was quite unprepared. Finally I decided to train in psychiatry which seemed the best way to acquire the skills to help patients whose difficulties challenged me most.
TL;DR: An intensive group psychotherapy treatment program in a public psychiatric hospital to which patients with severe personality disorder are referred and the results of evaluation of progress of the unit's first eleven closed groups are presented.
Abstract: SynopsisThis paper describes an intensive group psychotherapy treatment program in a public psychiatric hospital to which patients with severe personality disorder are referred. A unique structure within the patient/staff community is described concerning the inter-relationships of the closed psychotherapy groups and the relationships between the groups and staff within the broader therapeutic milieu.The regular arrival and departure of the closed groups serves to activate relevant latent instinctual conflicts which are of significance in personality disorder.The advantages of this approach to treatment of personality disorder are discussed and the results of evaluation of progress of the unit's first eleven closed groups are presented.