The Australian and New Zealand journal of psychiatry
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Aust N Z J Psychiatry · Jun 2006
Family and social influences on offending in men with schizophrenia.
Environmental influences have been reported to play a role in the genesis of both schizophrenia and violent behaviour. ⋯ We were able to identify characteristic unfavourable family and social influences which were associated in schizophrenic patients with a high risk of offending behaviour. This offers the prospect of early detection of those with schizophrenia who will go on to offend.
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Aust N Z J Psychiatry · Mar 2006
Firearms legislation and reductions in firearm-related suicide deaths in New Zealand.
To examine the impact of introducing more restrictive firearms legislation (Amendment to the Arms Act, 1992) in New Zealand on suicides involving firearms. ⋯ Following the introduction of legislation restricting ownership and access to firearms, firearm-related suicides significantly decreased, particularly among youth. Overall rates of youth suicide also decreased over this time but it is not possible to determine the extent to which this was accounted for by changes in firearms legislation or other causes.
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Aust N Z J Psychiatry · Nov 2005
Historical ArticleAustralia's National Mental Health Strategy and deinstitutionalization: some empirical results.
To determine the role of the National Mental Health Strategy in the deinstitutionalization of patients in psychiatric hospitals in Queensland. ⋯ In large part, the two policies associated with deinstitutionalization, namely a discharge policy ('opening the back door') and an admission policy ('closing the front door') had been implemented before the advent of the National Mental Health Strategy in January 1993. Deinstitutionalization was most rapid in the 30-year period to the early 1980s: the process continued in the 1990s, but at a much slower rate. Deinstitutionalization was, in large part, over before the Strategy was developed and implemented.
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Aust N Z J Psychiatry · Sep 2005
Randomized Controlled Trial Comparative StudyDoes psychological treatment help only those patients with severe irritable bowel syndrome who also have a concurrent psychiatric disorder?
We have previously reported improved health-related quality of life in patients with severe irritable bowel syndrome (IBS) following psychological treatments. In this paper, we examine whether this improvement was associated with improvement in psychological symptoms and was confined to those patients who had concurrent psychiatric disorder. ⋯ In severe IBS improvement in health-related quality of life following psychotherapy or antidepressants is correlated with, but not explained fully by reduction of psychological scores. A more complete understanding of how these treatments help patients with medically unexplained symptoms will enable us to refine them further.
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Aust N Z J Psychiatry · Aug 2005
ReviewMaintenance therapies in bipolar disorder: focus on randomized controlled trials.
Lithium remains the cornerstone of maintenance therapy for bipolar disorder despite growing use of other agents, including divalproex, lamotrigine, carbamazepine and the atypical antipsychotics. Lithium has the largest body of data to support its continued use as a prophylactic agent; however, most of this data comes from early studies that did not use contemporary analytic methods. Alternatives to lithium are needed because of the relatively high rate of non-response to lithium monotherapy and the drug's frequent side-effects. This article reviews available data with an emphasis on double-blind, placebo-controlled studies that examine the efficacy of lithium and other putative mood stabilizers: carbamazepine, divalproex, lamotrigine and olanzapine. ⋯ Any monotherapy for use as a maintenance therapy of bipolar disorder appears to be inadequate for long-term use in the management of the majority of patients with bipolar disorder. Combination therapy has become the standard of care in the treatment of bipolar disorder and particularly in patients with treatment-refractory variants such as those with rapid-cycling. The emerging consensus is that patients on monotherapy, if followed for sufficiently long periods, will eventually require concomitant treatment to maintain a full remission. There exists a need for controlled trials that use random assignment to parallel arms including combination therapy followed by data analyses that include both relapse rate and survival techniques.