Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists
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This paper is a guide to the general psychiatric assessment of the late career medical practitioner (LCP) from a clinical viewpoint. ⋯ Late career is a specific developmental stage in medical practitioners, a time of transition towards retirement. The treating psychiatrist should be mindful of the welfare of the practitioner, the public and the profession during the assessment, which is conducted from a complex therapeutic and regulatory viewpoint. It is important to assess the physical, psychological and cognitive health of the LCP. Although rates of burnout, depression and suicidal ideation are lowest in Australian doctors over 60, only a small minority of LCPs over 75 are likely to perform at a cognitive level similar to that of younger colleagues. There are a number of therapeutic challenges, including the practitioner's acceptance of their own ageing.
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Australas Psychiatry · Apr 2016
Incidence and risk factors for clozapine-induced myocarditis and cardiomyopathy at a regional mental health service in Australia.
To determine the incidence of clozapine-induced myocarditis and cardiomyopathy and identify risk factors. ⋯ These results illustrate a high incidence of clozapine-induced myocarditis as well as cardiomyopathy, reinforcing the need for a standardised, mandatory monitoring scheme. Concomitant SSRI use as one such potential predictor merits further study.
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Australas Psychiatry · Feb 2016
Preliminary evaluation of a brief mindfulness-based stress reduction intervention for mental health professionals.
Mental health professionals are particularly susceptible to occupational stress; however, there are limited formal programmes to address the problem. This paper discusses the preliminary results of a brief mindfulness-based stress reduction (MBSR) programme for practising professionals in a public hospital mental health unit. ⋯ A brief MBSR programme can be incorporated into the full-time workloads of practicing mental health professionals, potentially addressing a significant unmet workplace need.
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Australas Psychiatry · Dec 2015
Implementation Science for closing the treatment gap for mental disorders by translating evidence base into practice: experiences from the PRIME project.
This paper utilizes the experience of PRIME (Programme for Improving Mental health care) to exemplify how implementation science provides key insights and approaches to closing the treatment gap for mental disorders. ⋯ The real-world application of strategies described in the implementation science literature, accompanied by use of alternative, rigorous evaluation methods to assess their impact on patient outcomes, can help in closing the mental health treatment gap in disadvantaged populations.
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Australas Psychiatry · Oct 2015
Assessing and managing suicidal patients in the emergency department.
The objective of this article is to set out consensus guidelines for the assessment and management of "suicidal patients" in the emergency department. ⋯ Clinicians should be respectful and reassuring. They should review old notes, conduct a full history and examination, and talk to friends, family and any practitioners already involved in the patient's care. Management should be guided, where possible, by the patient's preferences, not by notions of risk. Every negotiated management plan and its rationale should be carefully documented.