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Aim: This paper uses the public record to explore the relationship between reputation damage and suicide. Method: The public record of the last 20 years was examined for examples of individuals without evidence of mental disorder who suffered actual or threatened reputation damage and suicided shortly thereafter. Results: Fifteen individual cases were identified; 18 additional cases, less comprehensively detailed, were mentioned in reports of The Wood Royal Commission and Operation Auxin. All cases were male. Of the 15 individual cases, the average age was 55 years, with a range of 40 to 76 years. The available details of the 18 additional cases were consistent with these findings. Conclusion: Middle-aged males without clear evidence of mental disorder, who suffer actual or threatened reputation damage, may be at increased risk of suicide. Naming and shaming needs to be conducted with caution. [ABSTRACT FROM AUTHOR]

Objective: Consumer involvement in mental health research is considered both a right and a benefit, despite the identified barriers to forming effective collaborative relationships. The purpose of this paper is to examine the literature relating to consumer involvement in mental health research with a view to articulating a model to guide this process. Method: A qualitative review of the relevant literature was undertaken. Literature referring to consumer roles in research was accessed and reviewed with the aim of articulating the benefits of, and barriers to, consumer participation in research. Results: The literature has identified a number of important benefits and some significant barriers to consumer involvement in mental health research. However, a clear model to articulate definitions of involvement is lacking. Four distinct levels of involvement were articulated. Conclusions: The identification of clearly defined models for consumer involvement in mental health research is important in order to facilitate collaboration and avoid tokenism. Research is required in order to determine the applicability of these models within actual research projects. [ABSTRACT FROM AUTHOR]

The purpose of the present paper was to identify, from the voluminous literature on efficacy and safety in new-generation antidepressants (NGAs) with depressed children and adolescents, practical clinical strategies for acute phase treatment. To this end a pragmatic survey of studies and reviews was undertaken. Meta-analyses of randomized controlled trials of NGAs in depressed children and adolescents have noted a comparative lack of efficacy, and a weak but statistically significant increased risk of self-harm and suicidal thoughts. But NGA prescription rates and youth suicide rates are generally inversely related, and ensuing 'black box' warnings about NGAs, by deterring NGA prescribing, have possibly contributed to rising youth suicide rates. In moderate-severe depression, benefits for fluoxetine and possibly other NGAs demonstrably outweigh risks. NGAs are not present in adolescents who die by suicide. Concern about NGA risks must be balanced against risks of non-treatment. While mild depression entails regular review, psychoeducation, self-care strategies and psychological interventions, NGAs should be administered concurrently with psychological treatments if depression is moderate- to severe, or if mild depression persists. Patients should be warned about off-label status of NGAs in depression, serious side-effects such as 'activation', suicidality, emotional blunting and manic switches, the need for adherence and avoiding abrupt discontinuation. They should be monitored early and regularly. Better evidence is required regarding psychological treatments, clinical course, and clinical practice trends. In moderate-severe depression the risk of suicide if NGAs are not used may outweigh any risk of self-harm associated with them. [ABSTRACT FROM AUTHOR]

Objective: Patients with mental health disorders frequently have difficulties with their cognitive functioning. Assessment of cognition in this population can be complicated by psychiatric symptomatology, making standard written and verbal assessment methods difficult. In these situations, observations by nursing and allied staff of patients' routine activities provide an important source of information about cognitive ability. The Behavioural Assessment Tool for Cognition and Higher Function (BATCH) was developed to record observations of patients' daily functioning under subheadings that reflect cognitive domains. Its capacity to provide a measure of cognitive function through observational means was assessed in a neuropsychiatric unit. Method: A consecutive sample of 76 adult neuropsychiatry inpatients were assessed over 6 months using BATCH. BATCH measures the frequency of given behaviours grouped under 10 functional and cognitive domains: orientation, attention/concentration, personal responsibility, volition, adaptation, problem-solving/judgement, executive function, memory, language, and visuospatial function. Data from routine standardized cognitive (Mini-Mental Status Examination, MMSE; Neuropsychiatry Unit Cognitive Screening Tool, NUCOG), psychiatric (Neuropsychiatric Inventory; Health of the Nation Outcome Scale) and functional (Bristol Activities of Daily Living Scale; Barthel Index) instruments were collected to determine the relative contribution of cognitive function to scores on the BATCH. Results: A strong correlation was found between total BATCH scores and total NUCOG and MMSE scores. BATCH and NUCOG subdomains correlated significantly in all subscales. BATCH demonstrated very high internal consistency. Linear regression analysis showed that the strongest determinant of BATCH scores was cognitive function as measured on the NUCOG. A significant subscale×group effect showed lower BATCH scores in memory, orientation, attention, executive function and language in dementia sufferers compared to psychiatric and neurological patient groups. Conclusion: BATCH scores correlated strongly with pencil-and-paper measures of cognitive function. BATCH provides clinicians with a means of assessing cognitive function through behavioural observation, thus enabling assessment of patients with behavioural disturbance or severe psychopathology. This tool has practical application for adult and aged clients across all observational mental health settings. [ABSTRACT FROM AUTHOR]

The purpose of the present paper was to determine what is currently documented about Indigenous Australians' understandings of mental health and mental disorders through a meta-synthesis of peer-reviewed qualitative empirical research. The following databases were electronically searched (1995-April 2006): AOA-FT and AIATSIS, Blackwell Synergy, CINAHL and Pre CINHAL, Health source: nursing/academic edition, Medline, Proquest health and medical complete, PsycInfo, Science Direct, Synergy and HealthInfoNet. Eligible studies were those written in English and published in peer-reviewed journals, empirical studies that considered Indigenous people's understandings of mental health and provided details on methodology. Five articles from four qualitative studies met these criteria. Meta-ethnography was used to identify common themes emerging from the original studies. Reciprocal translation was used to synthesize the findings to provide new interpretations extending beyond those presented in the original studies. An overarching theme emerged from the synthesis: the dynamic interconnectedness between the multi-factorial components of life circumstances. Reciprocal translations and synthesis regarding Indigenous understandings of mental health and illness resulted in five themes: (i) culture and spirituality; (ii) family and community kinships; (iii) historical, social and economic factors; (iv) fear and education; and (v) loss. The application of a meta-synthesis to these qualitative studies provided a deeper insight into Indigenous people's understandings of mental health and illness. The importance of understanding Indigenous descriptions and perceptions of mental health issues is crucial to enable two-way understandings between Indigenous people's constructs of wellness and Western biomedical diagnostic labels and treatment pathways for mental disorders and mental health problems. [ABSTRACT FROM AUTHOR]

Despite increasing concerns regarding the prevalence of violent behaviour in mainstream mental health settings, the impressive body of forensic research on violence risk assessment has thus far had only limited impact on front-line general mental health practice. The common objection raised by clinicians that risk assessment tools lack utility for clinical practice may contribute to this. The present paper argues that this objection, although understandable, is misplaced. Usage of appropriate, validated risk assessment tools can augment standard clinical approaches in a number of ways. Some of their advantages derive simply from having a well-structured approach, others from consideration of specific kinds of risk factors: 'static' and 'dynamic'. The inappropriate use of tools without a firm evidence base, however, is unlikely to enhance clinical practice significantly. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the present paper was to examine the disposition of individuals in Hunan, China who are found not criminally responsible due to a mental disorder or defect. Method: Self-developed questionnaires were mailed to the family members of 240 patients who had received forensic psychiatric evaluations at the forensic psychiatric assessment center of Central South University, between 2001 and 2002. Results: One hundred and seventy questionnaires were fully completed and returned by the patients' family members. According to the answers, 64.1% (109 patients) were found not criminally responsible due to a mental disorder or defect. In 87.6% of the cases, a judgement of guilty was in agreement with the psychiatrist's recommendation concerning criminal responsibility. A total of 61.8% of the patients found not guilty were discharged to their families and did not receive any further psychiatric treatment. Conclusion: In most cases, judicial decisions are consistent with a psychiatrist's opinion of criminal responsibility due to a mental disorder or defect. After such adjudication, further psychiatric treatment is often neglected due to the lack of resources and information. Hunan, China must make a continued investment into the availability and quality of outpatient mental health treatment for forensic patients after they have been discharged. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Our aim was to determine the views and experiences of carers of people with severe mental illness in regard to Community Treatment Orders (CTOs). Method: Questionnaires were posted using the mailing lists of two well-established carer support organisations in Victoria. The questionnaires included information about the person with a mental illness, the carer and their experience of care (ECI) and knowledge of recovery (RKI). Results: In total, 278 questionnaires were sent and 63 returned, of which 62 provided valid data. Those who responded were predominantly female (90%) and older (mean age 63 years), and were the carer of a person with a severe and recurrent mental illness. Some 60% had experience of caring for a person on a CTO. Most felt the CTO had been of benefit, and in 89% the person relapsed and needed further treatment when the CTO was stopped. Conclusion: Mental health legislation is shifting to bring a greater focus on rights, individual choice and autonomy in line with recovery-oriented care. This study describes the impact of severe mental illness and decisions in relation to CTOs on carers. [ABSTRACT FROM AUTHOR]

Objective: To describe the core components of the Early Psychosis Prevention and Intervention Centre service model as the template agreed with the Australian Federal Government for national upscaling. The Early Psychosis Prevention and Intervention Centre model of early intervention has two main goals: to reduce the period of time between the onset of psychosis and the commencement of treatment and to bring about symptomatic recovery and restore the normal developmental trajectory as early as possible.Conclusions: The Early Psychosis Prevention and Intervention Centre comprises three elements of service provision for young people experiencing a first episode of psychosis: (i) early detection; (ii) acute care during and immediately following a crisis; (iii) recovery-focused continuing care, featuring multimodal interventions to enable the young person to maintain or regain their social, academic and/or career trajectory during the critical first 2-5 years following the onset of a psychotic illness. It does this via a combination of 16 core components, which provide a flexible, comprehensive, integrated service that is able to respond quickly, appropriately and consistently to the individual needs of the young person and their family. Innovative service reforms, such as Early Psychosis Prevention and Intervention Centre, that recognise the value of early intervention are crucial to reducing the impact of serious mental illness on young people and their families and, ultimately, on our society. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In recent years, research on psychological processes has greatly advanced our understanding of various psychopathologies. Defense mechanisms, for example, have been described as observable phenomena, and studies have shown meaningful relationships among these processes and other measurable dimensions of health and illness. Despite some notable exceptions, one area that has been overlooked is the empirical study of defenses in psychotic disorders. This is in part due to the lack of valid instruments measuring psychotic-level defenses. Propadeutic to creating an empirical scale for measuring psychotic defenses, the psychoanalytic and empirical literature on psychotic defenses is reviewed, after which the concept of psychotic defenses as measured by the P-DMRS (Psychotic-Defense Mechanism Rating Scales)—which can be used independently or in combination with the current DMRS (Defense Mechanism Rating Scales)—is operationalized. Finally, current research directions applying the P-DMRS to the clinical setting are presented, as well as its implications for guiding current clinical practice. [ABSTRACT FROM PUBLISHER]

The article presents the quantitative analysis of the concepts of order and normality underlying the psychiatric practice of two mental health institutions between 1870 and 1970 in Zurich, Switzerland. The analysis is based on a representative random sample of 1330 records of patients from two institutions in the Canton of Zurich. The analysis encompasses the types of psychiatric measures for various cases and the explanation of the fundamental reasons and principles behind them.

The purpose of this article is to link empirical literature to the theoretical background of the concept of psychopathy and the impact that this has had on the development of treatment and intervention procedures for psychopathic offenders. This article begins with a discussion of the different theories of psychopathy, which leads into considerations of different developmental pathways of psychopathy in the individual. The discussion will then lead on to the psychometrics and measurement tools used to assess psychopathy in the individual. The measurement section will primarily be focused on Hare's Psychopathy Checklist-Revised (PCL-R), as this is the most frequently used and validated measure of psychopathy. The relationship between psychopathy and different types of crime is also discussed. The final section of the article considers the treatment and interventions that are available to psychopathic offenders and the implications this has for future research. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article presents information on changes related to mental illness and its treatment. It concentrates on the areas of mental illness and personal maladjustment. It focuses on whether folk beliefs concerning causes of mental disorder, folk attitudes toward the victims of disorder, and folk prescriptions for treatment give way to concepts and attitudes based on modern science. It analyzes changes that are taking place in generations of people and the conclusions be drawn by sociologists, social workers, and psychiatrists. It is concluded that the public have become more open to accepting modern and scientific viewpoints about mental illness. It is stated that the psychiatrist is being considered by the public as a logical person to handle cases of mental disorder.