Search

Objective: The aim of this paper was to examine self-efficacy and perceived appropriateness among rural general practitioners (GPs) in regards to screening and intervention for physical, lifestyle and mental health issues. Method: Fifty GPs from 25 practices in eight rural Queensland towns completed a written survey designed for the study. Results: General practitioners rated opportunistic screening or assessment for smoking and for detection of relapse of mental disorders as the most appropriate, with even cardiovascular and diabetes risk falling behind these. Self-efficacy was highest for medical disorders for smoking assessment. It was significantly lower for alcohol, mental health issues, and addressing risks of physical disorder in people with mental disorders. Conclusions: High appropriateness ratings suggest that current strategies to boost self-efficacy of GPs in addressing mental health issues are timely. [ABSTRACT FROM AUTHOR]

Objective: This paper outlines a rationale for expanding research and clinical innovations focused upon relapse prevention following a first episode of psychosis. Some general principles for further progress are extracted from an overview of the first-episode psychosis (FEP) relapse literature. A cognitive behaviour therapy intervention for relapse prevention for FEP, that has been developed at the Early Psychosis Prevention and Intervention Centre, is described to illustrate these principles. Conclusions: Further progress is needed in refining interventions specific to the prevention of relapse following FEP. Future progress is dependent upon improved understanding of the interaction of biological, interpersonal and psychological processes underpinning relapse. [ABSTRACT FROM AUTHOR]

Objective: To review various concepts of psychiatric comorbidity, their implications, surrounding controversies and underlying issues. A further aim is to propose an alternative term that might be more clinically useful and meaningful for describing the coexistence of mental disorders. Conclusions: There is wide dissatisfaction with the concepts of psychiatric comorbidity because of different meanings, speculations on which they are often based and consequent confusion. Although the coexistence of mental disorders should be studied further so that any patterns in the corresponding relationships can be elucidated, there is a need for conceptual clarity and making the concept more meaningful for clinical practice and treatment. With that in mind, this present paper proposes avoidance of the term comorbidity and introduction of the term ‘co-occurrence’. The latter is defined in this article, and the distinction made between diagnostic co-occurrence and clinically significant co-occurrence. [ABSTRACT FROM AUTHOR]

Objective: People with borderline personality disorder (BPD) confront multiple agencies with behaviours that are often alarming and bewildering. However, different service providers appear to respond to the same patient population in different ways. We aimed to explore the emotional reactions, concerns and beliefs related to working with the person with BPD by health and non-health related agencies. Method: A specifically designed questionnaire was completed by different agencies prior to their receiving educational training on an organizational and community-based model of care for people with BPD. Results: Police believed that people with BPD are best medicated and hospitalized until they are no longer suicidal. A universal human response was noted as was support for interagency collaboration. Conclusions: Different agencies respond in different ways towards people with BPD. These differences reflect ideological splits between agency groups. [ABSTRACT FROM AUTHOR]

Aim: This article examines whether neurocognitive deficits or age prevents people with borderline personality disorder from being considered responsible and competent. Method: A review of the literature was undertaken relating to borderline personality disorder (BPD), personal responsibility and competency. Result: Neither neurobiological differences nor age automatically disqualify the person with BPD from being responsible and competent for decisions relating to their own life and death. Conclusion: Clinical, legal and ethical literature support this result and thereby re-establishes a basis for the recognition and respect of an individual's dignity. [ABSTRACT FROM AUTHOR]

Objectives: Psychiatrists use biopsychosocial models in identifying aetiological factors in assessing their patients and similar approaches in planning management. Models in decision making will be influenced by previous experience, training, age and gender, among other factors. Critical thinking and evidence base are both important components in the process of reaching clinical decisions. Expected outcome of treatment may be another factor. The way we think influences our decision making, clinical or otherwise. With patients expecting and taking larger roles in their own management, there needs to be a shift towards patient-centred care in decision making. Conclusions: Further exploration in how clinical decisions are made by psychiatrists is necessary. An understanding of the manner in which therapeutic alliances are formed between the clinician and the patient is necessary to understand decision making. [ABSTRACT FROM AUTHOR]