Search

Objective: There has been a growing interest in psychiatry enrichment programmes such as summer schools and institutes for medical students in the last 10 years. Evaluation of enrichment programmes shows that they can be an effective method of increasing students' interest in psychiatry as a career. However, despite initial enthusiasm and motivation within an academic department, establishing a programme can be a daunting task. The aim of this paper is to provide a background of how to establish and implement a psychiatry summer school or institute. The steps that can be taken to establish and implement a psychiatry enrichment programme such as a summer school or institute are described and discussed. This includes how to structure a programme, content to include, costs and budget, programme promotion, selection of students and programme evaluation.Conclusion: Establishing an enrichment programme can provide academic departments of psychiatry with the opportunity to demonstrate excellence and innovation in teaching and positively promote psychiatry to students and other non-medical academics involved in medical education. For students interested in psychiatry, enrichment programmes have the potential to extend interest and knowledge beyond the curriculum and encourage serious consideration of psychiatry as a career. [ABSTRACT FROM AUTHOR]

Objective: Pediatric bipolar disorder (PBD) reflects shifts in conceptualizing bipolar disorder among children and adolescents since the mid-1990s. Since then, PBD diagnoses, predominantly in the United States, have increased dramatically, and the diagnosis has attracted significant controversy. During the same period, psychiatric theory and practice has become increasingly biological. The aim of this paper is to examine the rise of PBD in terms of wider systemic influences. Method: In the context of literature referring to paradigm shifts in psychiatry, we reviewed the psychiatric literature, media cases, and information made available by investigative committees and journalists. Results: Social historians and prominent psychiatrists describe a paradigm shift in psychiatry over recent decades: from an era of “brainless psychiatry,” when an emphasis on psychodynamic and family factors predominated to the exclusion of biological factors, to a current era of “mindless psychiatry” that emphasizes neurobiological explanations for emotional and behavioral problems with limited regard for contextual meaning. Associated with this has been a tendency within psychiatry and society to neglect trauma and attachment insecurity as etiological factors; the “atheoretical” (but by default biomedical) premise of the Diagnostic and Statistical Manual of Mental Disorders (3rd and 4th eds.); the influence of the pharmaceutical industry in research, continuing medical education, and direct-to-consumer advertising; and inequality in the U.S. health system that favors “diagnostic upcoding.” Harm from overmedicating children is now a cause of public concern. Conclusion: It can be argued that PBD as a widespread diagnosis, particularly in the United States, reflects multiple factors associated with a paradigm shift within psychiatry rather than recognition of a previously overlooked common disorder. [ABSTRACT FROM PUBLISHER]

Recent rises in the incidence of HIV infections among gay men in Australia have produced widespread discussion about appropriate health promotion responses. This has sometimes included calls for a return to fear-based campaigns, exemplified by the Grim Reaper advertisements in HIV. This paper discusses results from four focus groups that tested mock campaign material based on an appeal to fear. Five different poster images were tested among groups distinguished by age and HIV serostatus. Three posters used side-effects from treatments as the fear trigger and two used death from AIDS. A number of themes arose in response to the material including ‘othering’, shame and scepticism about HIV treatments. The meanings of these themes are explored in the light of current health-promotion theory. This data demonstrates that fear is an ineffective tool for HIV health promotion. It further demonstrates that feelings of shame and stigma are likely to be exacerbated in gay men, leading to poorer health outcomes in various ways. [ABSTRACT FROM AUTHOR]

The article explores the use of recovery orientation, medication, and shared responsibility in contemporary mental health services in Australia. It highlights the importance of improving the relationships between psychiatrists, other clinicians and consumers as well as the influence of the personal recovery paradigm in mental health. Challenges in clinical practice are mentioned.

The article focuses on the adoption of a historically accurate and psychiatrically important play written by several visiting academics in Australia. It highlights several elements of producing a play which include the name of the theatre company as well as finding lawyers to oversee contracts offered to and developed by the theatre company and hiring a rehearsal space. It also highlights the concept of public relations and public awareness.

Physiotherapists report using a range of psychosocial strategies in their practice, yet, barriers to implementation include lack of time, limited knowledge, and minimal training. This research aimed to establish what training physiotherapists have had with regards to psychosocial strategies, why they think they would benefit from more training, what training they want, and delivery preferences. Content analysis of answers to four open‐ended, online survey questions collected from Australian physiotherapists (N = 208) was conducted. Physiotherapists reported having minimal training specific to psychosocial strategies. Physiotherapists reported wanting training in assessment and management of psychosocial issues, and practical application of specific psychosocial strategies. Didactic and interactive training delivered by experts who understand the psychosocial needs of their patients, and the constraints of physiotherapy practice was preferred. These findings suggest that training in psychosocial strategies at the undergraduate level and continued professional development are necessary. Specifically, training in the assessment and management of psychosocial factors, and in referral processes is warranted, and should be applicable and appropriate for rehabilitation settings. Training should be both didactic and interactive as outlined in the proposed framework. [ABSTRACT FROM AUTHOR]

Aims: In a sample of newly diagnosed children with attention-deficit/hyperactivity disorder (ADHD), the aims were to examine (1) paediatrician assessment and management practices; (2) previous assessments and interventions; (3) correspondence between parent-report and paediatrician identification of comorbidities; and (4) parent agreement with diagnosis of ADHD.Methods: Design: cross-sectional, multi-site practice audit with questionnaires completed by paediatricians and parents at the point of ADHD diagnosis.Setting: private/public paediatric practices in Western Australia and Victoria, Australia.Main Outcome Measures: paediatricians: elements of assessment and management were indicated on a study-designed data form. Parents: ADHD symptoms and comorbidities were measured using the Conners 3 ADHD Index and Strengths and Difficulties Questionnaire, respectively. Sleep problems, previous assessments and interventions, and agreement with ADHD diagnosis were measured by questionnaire.Results: Twenty-four paediatricians participated, providing data on 137 patients (77% men, mean age 8.1 years). Parent and teacher questionnaires were used in 88% and 85% of assessments, respectively. Medication was prescribed in 75% of cases. Comorbidities were commonly diagnosed (70%); however, the proportion of patients identified by paediatricians with internalising problems (18%), externalising problems (15%) and sleep problems (4%) was less than by parent report (51%, 66% and 39%). One in seven parents did not agree with the diagnosis of ADHD.Conclusions: Australian paediatric practice in relation to ADHD assessment is generally consistent with best practice guidelines; however, improvements are needed in relation to the routine use of questionnaires and the identification of comorbidities. A proportion of parents do not agree with the diagnosis of ADHD made by their paediatrician. [ABSTRACT FROM AUTHOR]

The article focuses on a research which explores the predictors of the length of stay in a psychiatric emergency care centre (PECC) in Australia. It examines demographic and clinical characteristics through file audit in 477 patients who were presented to a PECC within a six-month period. An overview of the results of the study is provided.

The article outlines the need to update medical school psychiatry education in Australia to better equip doctors in recognising and treating mental disorders. It examines major challenges to the delivery of medical school mental health curricula as well as possible directions for reform in an effort to stimulate collaboration and enhance the efficiency across schools. The country's medical school psychiatry curriculum is mentioned.

Approximately 10% of the global population is left-handed. Much research has been directed at handedness and health, with reports of left-handers suffering higher rates of numerous health conditions, accidents, injuries and ultimately, significantly reduced lifespans. Most previous research focused on 'well' or general-population samples; no previous investigations of the effects of handedness on injecting drug users' (IDUs) health are known. Aim: To investigate associations between handedness and health outcomes among IDUs-a marginalized population subgroup with significantly worse health than average. Methods: A total of 346 self-identified left- (9.5%) or right-handed current IDUs were recruited in the Australian states of Queensland, New South Wales and Victoria in late 2006 and interviewed about their health and behaviour. Findings: Many socio-demographic, health status and injury occurrence variables were evaluated univariately, but only two were significantly associated with handedness. Left-handers were significantly less likely to report recent scarring or bruising, and significantly more likely to report accidentally penetrating an artery; these variables were also significantly and independently associated (negatively and positively, respectively) with handedness in binary logistic regression. Conclusions: The lack of biological plausibility of the aforementioned variables' associations with handedness, and the contradiction in their directions of association, suggest that left-handedness among IDUs is not associated with significantly worse health outcomes. [ABSTRACT FROM AUTHOR]

Background: Private psychiatric services are produced and consumed on a fee-for-service (FFS) basis in Australia. The Commonwealth Government subsidises these (and all) medical services via Medicare, a universal, comprehensive, tax-financed medical and hospital financing mechanism. A key purpose of Medicare is to improve equality of access to medical services. Aims: To measure the distribution of “access”, as measured by utilization, to private FFS psychiatric services at a regional level; and to determine the temporal trend in equality in regional access to these services during the Medicare period. Method: Conventional measures of statistical dispersion and economic inequality (the coefficient of variation, Gini coefficient and the Atkinson measure) are applied to quarterly time-series data on quantities of private psychiatric services for Australia's regions since 1984. Equations are modelled statistically on the distributional data generated by applying these measures. Lorenz curves are also constructed. Results: The negative sign on the slope coefficients in all estimated equations, i.e., for each measure of the distribution, is statistically significant, but the slope coefficients are nearly zero. Conclusions: These preliminary results suggest relatively intractable movement in alleviating inequality in the private psychiatric services produced and consumed in Australia, at the broad level of the region, during two decades of Medicare subsidies. [ABSTRACT FROM AUTHOR]

The article discusses the cultural beliefs on the therapeutic use of music in the nineteenth and twentieth century by examining asylum records in Australia, Great Britain, Europe, and North America. Psychiatric illustrations of the role of music in therapeutic regimes in the period are described. According to the author, medical understandings of images of music as medicinal are contained within representation of the asylum, and have far-reaching resonance that can be rediscovered through careful analysis.

Background: The initial delay to seek treatment accounts for a significant proportion of the unmet need for treatment of common psychiatric conditions. This study aimed to examine the barriers to initial help-seeking and factors that facilitate help-seeking for anxiety and depression.Methods: Help-seeking history was retrospectively self-reported by 233 patients at a specialist anxiety clinic, all of whom had delayed seeking professional treatment for at least one month. Data gathered included age at onset, age at help-seeking, primary reason for the delay, prompt to seek help and first professional contacted.Results: The most frequently endorsed reasons for the delay related to lack of knowledge about mental illness or available treatment. Increasing illness severity or disability was the primary prompt to seek help for the majority of respondents. Reason for the delay showed some relationship with length of the delay, but prompt to seek help did not. A general medical practitioner (GP) was the first professional contacted in 71 % of cases.Conclusions: Lack of public 'mental health literacy' contributes to slow problem recognition. Increasing illness severity eventually facilitates problem recognition and prompts help-seeking. Structural barriers to initial help-seeking are relatively unimportant within the Australian health care system. General practitioners play an important role as gate-keepers to appropriate mental health care. [ABSTRACT FROM AUTHOR]

The article presents investigation by researchers among several Australian adults intention to give up smoking using an expanded protection motivation model. Most people in Australia know that smoking is harmful to health. Because so many people continue to smoke, researchers have formulated various health models to explain what leads people to practice good health behaviors. One such model is the protection motivation model which has its origins in expectancy value models of research and attitudes; it focuses on the cognitive mediational processes linking communication stimuli and behavior. In the case of smoking, the likelihood of smoking is decreased by belief in the severity of the diseases caused by smoking, belief in one's vulnerability to those diseases, belief that smoking cessation is an effective way to avoid the diseases, and belief that one can successfully stop smoking. On the other hand, the likelihood of cigarette smoking is increased by intrinsic rewards e.g., physical satisfaction, extrinsic rewards and the costs of an adaptive response. According to this model, the increased likelihood of an adaptive response not smoking depends primarily on four cognitive perceptions.

Clinical practice guidelines are playing an increasingly important role in defining quality care and consumers have a considerable interest in participating in the development of guidelines. The objective of this study was to explore consumer’s perceptions of guideline items relating to psychosocial care of women with breast cancer, developed by Australia’s National Health and Medical Research Council National Breast Cancer Centre. Women diagnosed with breast cancer in the previous 2 years (n = 313) received a letter about the study via their radiation oncologist. Consenting women were contacted by the researchers to complete a telephone survey. The survey asked women to rate the importance of draft guidelines items, including discussing prognosis, providing information and choice, doctor-patient communication, preparation for surgery, providing emotional support, providing social support, dealing with practical and cultural issues and continuity of care. One hundred and forty women (45%) completed the survey. The results indicated that at least 50% of respondents rated 28 of the 52 items as ‘essential’ components, with respondents identifying providing information and choice, and doctor-patient communication as the most important aspects of psychosocial care. The findings suggest the guidelines adequately reflect consumer opinions and identify priority areas for clinicians to address in providing psychosocial support to women with breast cancer. [ABSTRACT FROM AUTHOR]