Showing papers in "Australian and New Zealand Journal of Psychiatry in 1984"
TL;DR: The child-adult linkages are strongest with conduct disturbance in childhood and adult personality disorder, the mechanisms in this continuity are probably both constitutional and environmental.
Abstract: The childhood antecedents of psychiatric disorder in adult life are reviewed with regard to four groups of conditions that show sharply contrasting patterns of linkage between childhood and adult l...
69 citations
TL;DR: Analysis of responses indicated that team members experienced considerable stress during their postdisaster work but also gained a great deal at both professional and personal levels.
Abstract: The reactions of a volunteer mental health team which convened in the aftermath of the 1983 Ash Wednesday bushfires are reported. A questionnaire designed to explore psychological and physical responses was completed by the 19 staff who made up the team. Using both open-ended and closed questions, the questionnaire tapped such areas as motivation, goals, expectations and observations, initial and later emotional and physical reactions, fantasies and evoked memories; an evaluation of the service and the experience was also included. Analysis of responses indicated that team members experienced considerable stress during their postdisaster work but also gained a great deal at both professional and personal levels. Sources of stress are discussed as are recommendations for their alleviation.
66 citations
TL;DR: The psychological effects of bushfires that devastated areas of South Australia on Ash Wednesday 1983 are described and the need to assess the various components of a disaster to understand its immediate and long-term impact is emphasised.
Abstract: The psychological effects of bushfires that devastated areas of South Australia on Ash Wednesday 1983 are described. We emphasise the need to assess the various components of a disaster to understand its immediate and long-term impact. In the inventory phase, much of the symptomatic disturbance is different from that seen in psychiatric clinic populations and is best dealt with in the early stages using a consultation model. Providing information about the nature of these reactions is helpful for those affected and for service personnel managing disaster relief. In the reconstruction phase, it is important for relief agencies to be aware of the ways in which grief and psychological morbidity can interfere with people's ability to make decisions and carry out practical tasks.
66 citations
TL;DR: A review of some of the sociocultural features of Australia's recently arrived 51,000 Indochinese refugees is given, indicating high continuing levels of psychiatric dysfunction especially among refugees lacking social support or experiencing status dislocation.
Abstract: A review of some of the sociocultural features of Australia's recently arrived 51,000 Indochinese refugees is given. The severe disintegration of Vietnamese society by two decades of warfare would suggest the likelihood of significant psychopathology. This is supported by clinical surveys. The psychological responses to migration and resettlement, including persisting feelings of guilt, bewilderment and pining, are reviewed, with subsequent difficulties in marriage, family, employment and education. Research indicates high continuing levels of psychiatric dysfunction especially among refugees lacking social support or experiencing status dislocation. Suggestions are made for culturally acceptable forms of assessment and therapy.
60 citations
TL;DR: The present outlines report the resulting recommendations for the treatment of schizophrenia, which emphasise the consistent but conservative use of antipsychotic drugs, and the implementation of a specific type of family management program in addition to the customary social interventions.
Abstract: The Quality Assurance Project is developing explicit and detailed treatment outlines for each of the major psychiatric disorders. Three sources of information are used: a meta-analysis of the treatment outcome literature, the opinions of a sample of practising psychiatrists, and the views of a panel of nominated experts. The present outlines report the resulting recommendations for the treatment of schizophrenia. The three sources of information agree that anti-psychotic drugs are the principal treatment during the active phase of the disorder. As schizophrenia is so often a serious and disabling chronic illness, the treatment recommendations stress the need for continuity of care during the post-acute and residual phases in order to prevent relapse and minimise residual deficits. The outlines particularly emphasise the consistent but conservative use of antipsychotic drugs, and the implementation of a specific type of family management program in addition to the customary social interventions.
58 citations
TL;DR: The sparse literature on this subject is reviewed and a series of 25 cases of diverse and sometimes unusual aetiology reported, suggesting that ejaculatory control can be adversely affected by a variety of physical and psychological conditions.
Abstract: Secondary premature ejaculation is a definite entity which can be due to a variety of causes — physical, pharmacological and psychological. The sparse literature on this subject is reviewed and a series of 25 cases of diverse and sometimes unusual aetiology reported. The fact that ejaculatory control can be adversely affected by a variety of physical and psychological conditions has implications for theories as to the cause of the much commoner entity of primary premature ejaculation, for which there is still no generally agreed-upon aetiological formulation.
51 citations
TL;DR: Psychiatric illness occurs commonly during the course of medical and surgical illnesses, and commonly presents to non-psychiatric physicians inextricably mixed with physical symptoms.
Abstract: Psychiatric illness occurs commonly during the course of medical and surgical illnesses, and commonly presents to non-psychiatric physicians inextricably mixed with physical symptoms. Non-psychiatrists vary widely between themselves in their ability to detect such disorders, so that such disorders are often missed. Reasons for failure to detect such disorders include the diagnostic practices taught in medical schools, the inadequacy of psychiatric taxonomy of neurosis, and the fact that most doctors have not been taught how to interview their patients.
48 citations
Journal Article•
45 citations
TL;DR: A study of 296 primary school teachers in New Zealand revealed a very low correlation between mental health, measured by the General Health Questionnaire, and absence from work, and it is suggested that teachers' experiences of stress are associated with lack of satisfaction with intrinsic aspects of their job rather than with dissatisfaction at their conditions of employment.
Abstract: A study of 296 primary school teachers in New Zealand revealed a very low correlation between mental health, measured by the General Health Questionnaire, and absence from work. The correlations between mental health and feelings of stress at work and between mental health and job satisfaction were higher. The most highly rated sources of stress were ranked, as were the most highly rated sources of satisfaction. It is suggested that teachers' experiences of stress are associated with lack of satisfaction with intrinsic aspects of their job rather than with dissatisfaction at their conditions of employment.
44 citations
TL;DR: The immediate post-partum period should be included as a false-positive influence on the DST, because baseline cortisol levels were not associated with baseline morbidity as assessed on the questionnaires and were not predictive of morbidity assessed at the six-week follow-up.
Abstract: A consecutive series of 45 women admitted to an obstetric unit were given the dexamethasone suppression test (DST) on days three to five post-partum, 82% being abnormal. The likelihood of an abnormal DST on one or both occasions increased linearly across the days of testing. Subjects completed the Beck self-report depression measure and the General Health Questionnaire at baseline and at six weeks. Baseline cortisol levels were not associated with baseline morbidity as assessed on the questionnaires and were not predictive of morbidity assessed at the six-week follow-up. It is concluded that the immediate post-partum period be included as a false-positive influence on the DST.
36 citations
TL;DR: It is concluded that personality development cannot be reduced to the stabilisation of behavioural traits, to the production of a fixed personality structure or to the acquisition of social-cognitive skills, although there is some form of personality organisation in terms of habits, attitudes, concepts and styles of behaviour.
Abstract: Concepts and empirical findings are reviewed with regard to personality development and to the role of childhood experiences in that process. It is concluded that personality development cannot be reduced to the stabilisation of behavioural traits, to the production of a fixed personality structure or to the acquisition of social-cognitive skills, although there is some form of personality organisation in terms of habits, attitudes, concepts and styles of behaviour. Personality development takes place in a social context, with both continuities and discontinuities stemming from maturational and experiential factors and interactions between them. Chains of indirect linkages result from complex patterns of circular processes involving reciprocal interactions between children and their environments. No single mechanism is responsible and no one theory provides an explanation.
TL;DR: The literature on bulimia, which has regarded it as a psychiatric entity or as a form of disordered eating, suggests that this behaviour is now widespread among the obese, among those with anorexia nervosa and those of normal weight
Abstract: The literature on bulimia, which has regarded it as a psychiatric entity or as a form of disordered eating, suggests that this behaviour is now widespread among the obese, among those with anorexia...
TL;DR: The evidence pertaining to the level of violence amongst the mentally disordered is reviewed and the question remains as to whether there are definable groups or classes within the generality of mentally abnormal individuals for whom there is an increased risk of future violence.
Abstract: Psychiatrists are called upon to make judgements on the future dangerousness of mentally disordered subjects in civil commitment procedures, in the criminal courts, and during the decision process ...
TL;DR: Unemployment raised the odds of having a psychiatric disorder by a factor of six in this sample of 401 young single people, and those particularly at risk for psychiatric disorder were men who were dismissed, who could not borrow money readily, and who had large debts.
Abstract: Unemployment raised the odds of having a psychiatric disorder by a factor of six in this sample of 401 young single people. The effect of unemployment was borne by men and women equally, since the difference between the sexes was preserved in the proportion who had a psychiatric disorder. Those particularly at risk for psychiatric disorder were men who were dismissed, who could not borrow money readily, and who had large debts. Women at high risk were those who resigned, and who could not borrow money readily.
TL;DR: This study compares firesetting children with an age- and sex-matched group of non-firesetting children referred to a child psychiatric outpatient service, finding similar high levels of emotional disorder at all ages.
Abstract: This study compares firesetting children with an age- and sex-matched group of non-firesetting children referred to a child psychiatric outpatient service. Firesetting was associated with male sex, separated parents and with previous contact with welfare agencies. It was not associated with socioeconomic status. Firesetters were distinguished from the contrast group by higher levels of conduct disordered behaviour, particularly in children above the age of 11 years. Both groups had similar high levels of emotional disorder at all ages. These clinical features emphasise that firesetters have a mixed clinical picture with widespread psychopathology.
TL;DR: The results of this double-blind, placebo-controlled, crossover study appear to support the contention that stimulant drug effects in hyperactive children are not paradoxical or atypical.
Abstract: Methylphenidate was administered to each of 12 adult volunteers in a double-blind, placebo-controlled, crossover study for purposes of comparison with previous studies in hyperactive children. Statistically significant changes occurred only on a minority of measures, but the results were generally in the direction of facilitated performance, reduced physical activity and increased emotional responsivity. As these results are similar to those in hyperactive and normal children, this appears to support the contention that stimulant drug effects in hyperactive children are not paradoxical or atypical.
TL;DR: ‘emic’ accounts of the illness (those current among the members of the society) are described in order to compare them with ‘etic” accounts of those who study the society from the outside.
Abstract: The Aboriginal people of Groote Eylandt, in the Northern Territory of Australia, are suffering from an unusual disease complex having neurological, psychiatric and teratological features, which admits no ready explanation. The island people at various times blame it on the spirits, or accuse enemies, or take some responsibility upon themselves. In this paper, ‘emic’ accounts of the illness (those current among the members of the society) are described in order to compare them with ‘etic’ accounts of those who study the society from the outside. Since emic views regulate people's behaviours toward illness, it is suggested these views should complement and inform etic views of researchers and therapists. This principle might apply to all mysterious or poorly understood illness.
TL;DR: Results suggest that children with strabismus have a higher prevalence of psychiatric disorder, particularly an emotional disorder or psychosis, and subjects also had an increased risk of having educational problems and of exhibiting difficulties with tasks involving visual perception.
Abstract: The results of a study investigating the relationship of psychiatric and cognitive disorder with strabismus and its treatment in primary school aged children are reported. Results suggest that children with strabismus have a higher prevalence of psychiatric disorder, particularly an emotional disorder or psychosis. Subjects also had an increased risk of having educational problems and of exhibiting difficulties with tasks involving visual perception. Variables related to the nature and treatment of the strabismus did not appear influential in the development of the psychiatric disorder. Family disruption was significantly associated with both the presence of strabismus and emotional and behaviourial problems in the children reported by parents and teachers.
TL;DR: The dexamethasone suppression test (DST) was used to test the non-suppression rate of agoraphobic patients suffering panic attacks with controls and with patients suffering major depression.
Abstract: The tricyclic antidepressants and the monoamine oxidase inhibitors have been shown to be effective in the treatment of some patients with phobic and panic disorders. To explain this action it has been suggested that a number of these patients may have an atypical biological depression. In an attempt to test this hypothesis we used the dexamethasone suppression test (DST), which has been proposed as a state dependent biological marker of depression. We compared the non-suppression rate of agoraphobic patients suffering panic attacks with controls and with patients suffering major depression. Twenty-nine per cent of the agoraphobics showed non-suppression compared with 12% of the control group and 64% of the depressives.
TL;DR: A postal survey of all practising psychiatrists in Australia, conducted in 1980 with the purpose of establishing psychiatric manpower requirements for 1980–91, is described and a major maldistribution of psychiatrists is identified.
Abstract: A postal survey of all practising psychiatrists in Australia, conducted in 1980 with the purpose of establishing psychiatric manpower requirements for 1980–91, is described. It is estimated that in 1980 there was one Whole Time Equivalent psychiatrist, aged 65 years or less, per 19,400 population in Australia. The relativity of manpower requirements is emphasised. A number of different models of estimating future requirements is proposed. The two models most favoured estimate a shortfall for the whole of Australia of 294 and 349 psychiatrists, respectively, in 1980, and a need for an additional 621 or 692 by 1991. A major maldistribution of psychiatrists is identified, viz between states, between capital -cities and country areas, and between general psychiatry and specialised areas. The two issues of the number of trainees required and of how to train psychiatrists in special areas of expertise are discussed.
TL;DR: It is concluded that further development of consultation-liaison psychiatry should be encouraged to promote awareness of the influence of psychosocial factors on physical illness and their early management as both clinically important and cost-effective.
Abstract: Cost-containment of medical care has become of increasing importance to both medical administrators and politicians. Recently, studies have examined the impact of psychological and psychiatric treatments on medical care utilisation and hospitalisation rates and the cost-effectiveness of such treatments. These studies have demonstrated that interventions based on a consideration of psychosocial factors in physical illness are effective in reducing the morbidity, and mortality, of a wide range of illnesses and that they lead to reduced medical care utilisation and a lower rate of hospital treatment. It has also been demonstrated that holistic management based on the ‘biopsychosocial’ model of illness is cost-effective and that there is an overall reduction of expenditure after allowing for the cost of the psychological or psychiatric treatment. It is concluded that further development of consultation-liaison psychiatry should be encouraged to promote awareness of the influence of psychosocial factors on phy...
TL;DR: The ordinary dreams of Aborigines resemble those of modern Western subjects in aspects such as frequency, duration, clarity of recall, shifts in attention and derailment of the narrative, but they differ from them in being accorded more significance and in being more reflected upon during waking hours.
Abstract: The phenomena of dreams have been accorded significance by all branches of mankind of which there is record. Australian Aborigines in their traditional cultures are no exception, although unfortunately the printed record of their dreams is meagre. This paper reports nine dreams which were volunteered by Arnhem Landers of the present day. The subjects they dreamed about represent a melange of traditional and introduced concerns competing for attention, including lifting a taboo, portents and auguries, a shark attack, a brake failure in a truck, a mysterous light in a cave, a visit from the dead, a disappointing love tryst, a drink problem and the Christian revival movement. The ordinary dreams of Aborigines resemble those of modern Western subjects in aspects such as frequency, duration, clarity of recall, shifts in attention and derailment of the narrative, but they differ from them in being accorded more significance and in being more reflected upon during waking hours. In this respect, Aborigines infer ...
TL;DR: I have made another through reading your article and quite possibly there will be more before I am at a level where I am as “desensitised, as possible” as possible.
Abstract: I have made another through reading your article and quite possibly there will be more before I am at a level where I am as . . . “desensitised,, as possible.’ ~~~~, F. B. and Hoyt, W. F. Clinical Neuro-ophthalmology, Vol. I . 3rd edition. Baltimore, Williams and Wilkins Co. 1969: 309-313. 2. MacOregor. F. C., AbeL T. M.. Brut, A., Lauer, E. and Weissmann. S. Facial deformities and plastic surgery: A psychosocial study. Springfield, Illinois: Charles C. Thomas, 1953.
TL;DR: Evidence of organic dysfunction suggested by the presence of abnormal neurological soft signs, an abnormal EEG, and an atypical computerised tomographic head scan suggest that organic factors may play a role in the development of Capgras' syndrome.
Abstract: It has been suggested that neurological abnormalities may act in the pathogenesis of Capgras' phenomena. In this case, a schizophrenic male with Capgras' symptoms exhibited evidence of organic dysfunction suggested by the presence of abnormal neurological soft signs, an abnormal EEG, and an atypical computerised tomographic (CT) head scan. These findings suggest that organic factors may play a role in the development of Capgras' syndrome.
TL;DR: It is pointed out that the concept of the changeling has ancient provenance in man's thought down the ages, and that its occurrence in psychosis does not justify its ascription as a syndrome.
Abstract: A case of so-called Capgras' syndrome occurring in an elderly woman showing several degenerative conditions is presented as a basis for questioning the value of preserving this diagnostic term. It is pointed out that the concept of the changeling has ancient provenance in man's thought down the ages, and that its occurrence in psychosis does not justify its ascription as a syndrome. ‘Changeling’ or ‘imposture’ are terms which describe this kind of delusion usually occurring in underlying schizophrenic, affective and organic syndromes.
TL;DR: It is concluded that conflicts relating to separation/individuation and autonomy versus dependency and fear are crucial in these families and they are defended against by mechanisms of phobic avoidance, counterphobia and alcoholism.
Abstract: Marital systems of agoraphobic women may reinforce or support the phobic condition and in some cases entire families are affected. Four case histories are presented in which agoraphobia and related disturbances and alcoholism are traced through three generations. Other studies are reviewed relating agoraphobia to alcoholism, examining the characteristics of parents and siblings and the marital adjustments of agoraphobic patients. A relationship with sex role stereotyping is suggested, particularly as relevant to the differing adjustments of males and females in these families. It is concluded that conflicts relating to separation/individuation and autonomy versus dependency and fear are crucial in these families and they are defended against by mechanisms of phobic avoidance, counterphobia and alcoholism.
TL;DR: Evidence suggests that the peptides found in the brain and pituitary that mimic the biological properties of opiates may act as neurotransmitters, neurohormones or neuromodulators.
Abstract: The term ‘endorphin’ (a combination of endogenous-morphine) is used to designate the entire group of peptides found in the brain and pituitary that mimic the biological properties of opiates. ‘Endogenous opioid peptides’, ‘endogenous opioids’ ‘opioid peptide’ and ‘endopioids’ can be considered as synonymous. Since the identification of stereospecific opiate receptors2J and the pentapeptides methionine and leucine enke~halin,~ more than 20 endogenous peptides have. been discovered and additional synthetic analogues have been developed. Although their precise function remains unknown evidence suggests they may act as neurotransmitters, neurohormones or neuromodulators.
TL;DR: It is concluded that a better insight into the aetiology and progress of depression may be gained by combining receptor markers with such neuroendocrine markers as the DST.
Abstract: The role of antidepressants in bringing about adaptive changes in peripheral and central neurotransmitter receptors is briefly reviewed and extended to show how changes in platelet and lymphocyte adrenoceptor and serotonin receptor activity may correlate with the depressed state and normalise following effective treatment. By contrast, the 3H-imipramine binding sites on the platelet membrane do not change following successful treatment and may therefore reflect a trait-dependent (genetic) change. The neuroendocrine markers, such as the dexamethasone suppression test (DST), have the advantage over the receptor markers in that they require less sophisticated laboratory facilities. It is concluded that a better insight into the aetiology and progress of depression may be gained by combining receptor markers with such neuroendocrine markers as the DST.
TL;DR: A model for multidisciplinary teamwork in community mental health centres is provided, which oscillated between group decisions by all staff members, and the acceptance of the leading role of the psychiatrist with the active Involvement of the test of the staff.
Abstract: This paper describes the staffing aspects of an experimental community mental health centre (Melville Clinic). The different components of staff roles of members of a team consisting of different health professionals, crystallised during the three-year period with a shift from a ‘nondisciplinary’ to a ‘multidisciplinary’ approach, with preservation of ‘generalised’ and ‘specialised’, ‘clinical’ and ‘community’ roles of all staff members. The decision-making in the centre oscillated between group decisions by all staff members, and the acceptance of the leading role of the psychiatrist with the active Involvement of the test of the staff. This paper provides a model for multidisciplinary teamwork in community mental health centres.