The Australian and New Zealand journal of psychiatry
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Aust N Z J Psychiatry · Oct 2021
Revisiting lorazepam challenge test: Clinical response with dose variations and utility for catatonia in a psychiatric emergency setting.
Catatonia can be life-threatening unless timely identified and treated. Lorazepam's ubiquitous response has led to its universal acceptance as being the first-line management of catatonia and alludes to catatonia's neurobiological underpinnings. Lorazepam challenge test (LCT) is widely used to either confirm a catatonia diagnosis or determine lorazepam sensitivity. It has a proposed schedule for administering lorazepam. However, efficacy of recommended LCT doses lack systematic evidence, resulting in variable LCT doses used in clinical and research settings contributing to findings that are challenging to generalize or assist with developing standardized lorazepam treatment protocols for catatonia. Given the same, this study aimed to objectively compare the response between two groups receiving different LCT doses and factors influencing the same. ⋯ This study suggests 2 mg lorazepam may be an optimal LCT dose, given significant response to most catatonic signs thereby ensuring accurate detection and preventing misinterpretation of response. It offers future studies direction for standardizing lorazepam dosing schedules for catatonia management and exploring neurobiological underpinnings for individual catatonic signs that may be potentially different, given these findings.
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Aust N Z J Psychiatry · Jul 2021
The health service contact patterns of people with psychotic and non-psychotic forms of severe mental illness in New South Wales, Australia: A record-linkage study.
To describe and compare the health profiles and health service use of people hospitalised with severe mental illness, with and without psychotic symptoms. ⋯ Findings from this study support the need for (a) the development of processes to support the physical health of people with severe mental illness, including those without psychosis; (b) a focus in mental health policy and service provision on people with complex support needs, and (c) improved implementation and testing of integrated models of care to improve health outcomes for all people experiencing severe mental illness.
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Aust N Z J Psychiatry · Jun 2021
Meta AnalysisAssociation between mode of delivery and postpartum depression: A systematic review and network meta-analysis.
Both elective (OR 1.47, 1.16-1.86) and emergency (OR 1.53, 1.22-1.91) caesarean section is associated with mild postpartum depression in this network meta-analysis.
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Aust N Z J Psychiatry · Dec 2020
Prospective study of association of characteristics of hotline psychological intervention in 778 high-risk callers with subsequent suicidal act.
This study aimed to assess the association of the quality scores of hotline psychological intervention and the reduction of subsequent suicidal acts among high suicidal risk callers. ⋯ Several characteristics of a hotline intervention for suicide prevention were associated with decreased risk of suicidal acts during follow-up. Intervention skill training for hotline operators should emphasize these specific counseling skills.