The Australian and New Zealand journal of psychiatry
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Aust N Z J Psychiatry · Jul 2018
Deep brain stimulation for severe treatment-resistant obsessive-compulsive disorder: An open-label case series.
Deep brain stimulation can be of benefit in carefully selected patients with severe intractable obsessive-compulsive disorder. The aim of this paper is to describe the outcomes of the first seven deep brain stimulation procedures for obsessive-compulsive disorder undertaken at the Neuropsychiatry Unit, Royal Melbourne Hospital. The primary objective was to assess the response to deep brain stimulation treatment utilising the Yale-Brown Obsessive Compulsive Scale as a measure of symptom severity. Secondary objectives include assessment of depression and anxiety, as well as socio-occupational functioning. ⋯ Deep brain stimulation was an effective treatment for obsessive-compulsive disorder in these highly selected patients. The extent of the response to deep brain stimulation varied between patients, as well as during the course of treatment for each patient. The results of this series are comparable with the literature, as well as having similar efficacy to ablative psychosurgery techniques such as capsulotomy and cingulotomy. Deep brain stimulation provides advantages over lesional psychosurgery but is more expensive and requires significant multidisciplinary input at all stages, pre- and post-operatively, ideally within a specialised tertiary clinical and/or academic centre. Ongoing research is required to better understand the neurobiological basis for obsessive-compulsive disorder and how this can be manipulated with deep brain stimulation to further improve the efficacy of this emerging treatment.
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Aust N Z J Psychiatry · Jul 2018
Randomized Controlled Trial Comparative StudyTreating anxiety and depression in young adults: A randomised controlled trial comparing clinician-guided versus self-guided Internet-delivered cognitive behavioural therapy.
Internet-delivered cognitive behaviour therapy may increase access by young adults to evidence-based treatments for anxiety and depression. ⋯ These results indicate the potential of carefully developed Internet-delivered cognitive behaviour therapy interventions for young adults with anxiety and depression provided in either self or therapist-guided format. Further large-scale research is required to determine the short- and long-term advantages and disadvantages of different models of support.
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Aust N Z J Psychiatry · Jun 2018
Historical ArticleAttention-deficit hyperactivity disorder in ancient Greece: The Obtuse Man of Theophrastus.
We present an ancient Greek description written by the philosopher Theophrastus in his classic book ' Characters' comparable with modern attention-deficit hyperactivity disorder. The arguments are based in one chapter of this book-The Obtuse Man-presenting features of a character closely resembling the modern description of attention-deficit hyperactivity disorder. ⋯ To our knowledge, this is the oldest description compatible with the current conception of attention-deficit hyperactivity disorder in adults in the Western literature. Differently than the moralistic view of ancient Greece regarding those symptoms, the medical attention-deficit hyperactivity disorder conception may be advantageous to patients since it might reduce prejudice and allow individuals to seek treatment.
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Aust N Z J Psychiatry · Jan 2018
Unmet need for professional mental health care among adolescents with high psychological distress.
This study reports the rate of unmet needs for professional mental health care in a large multi-state sample of adolescents. We also sought to describe barriers to professional help, informal help seeking and future help-seeking intentions among adolescents with wholly unmet needs for counselling for mental illness. ⋯ A concerning proportion of adolescents have untreated high psychological distress with wholly unmet mental health needs. This group is rendered particularly vulnerable by low rates of access to non-professional sources of help and low engagement in self-management strategies. Further research is needed to support this vulnerable group to access needed professional mental health help.
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Corrigendum to: Carter G, Page A, Large M, et al. (2016) Royal Australian and New Zealand College of Psychiatrists clinical practice guideline for the management of deliberate self-harm. Australian and New Zealand Journal of Psychiatry 50: 939-1000. Readers should note an error in the published version of this article: The previous list of authors and affiliations inadvertently omitted the details of Dr Michael Dudley. The correct author list and affiliation details appear below: Gregory Carter1,2,3, Andrew Page1,4, Matthew Large1,5, Sarah Hetrick1,6, Allison Joy Milner1,7,8, Nick Bendit1,9,10, Carla Walton1,11, Brian Draper1,12,13, Philip Hazell1,14, Sarah Fortune1,15,16,17, Jane Burns1,18,19,20, George Patton1,21,22,23,24, Mark Lawrence1,25, Lawrence Dadd1,26,27,28,29, Michael Dudley1, 12, Jo Robinson1,6, and Helen Christensen1,30 1 Clinical Practice Guideline for Deliberate Self-harm Working Group, RANZCP, Melbourne, Victoria, Australia 2 Centre for Translational Neuroscience and Mental Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia 3 Department of Consultation Liaison Psychiatry, Calvary Mater Newcastle Hospital, Waratah, NSW, Australia 4 Centre for Health Research, Western Sydney University, Richmond, NSW, Australia 5 School of Psychiatry, The University of New South Wales, Sydney, NSW, Australia 6 Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia 7 Centre for Population Health Research, School of Health and Social Development, Deakin University, Burwood VIC, Australia 8 Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia 9 School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia 10 School of Psychology, Faculty of Science and Information Technology, The University of Newcastle, Callaghan, NSW, Australia 11 Centre for Psychotherapy, Hunter New England Mental Health Service and Centre for Translational Neuroscience and Mental Health, The University of Newcastle, Callaghan, NSW, Australia 12 School of Psychiatry, The University of New South Wales, Sydney, NSW, Australia 13 Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Sydney, NSW, Australia 14 Discipline of Psychiatry, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia 15 The University of Auckland, Auckland, New Zealand 16 University of Leeds, Leeds, UK 17 Kidz First, Middlemore Hospital, Auckland, New Zealand 18 Young and Well Cooperative Research Centre, The University of Melbourne, Melbourne, VIC, Australia 19 Brain & Mind Research Institute, The University of Sydney, Sydney, NSW, Australia 20 Orygen Youth Health Research Centre, Melbourne, VIC, Australia 21 Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia 22 National Health and Medical Research Council, Canberra, ACT, Australia 23 Centre for Adolescent Health, The Royal Children's Hospital, Melbourne, VIC, Australia 24 Murdoch Children's Research Institute, Melbourne, VIC, Australia 25 Tauranga Hospital, Bay of Plenty, New Zealand 26 Mental Health & Substance Use Service, Hunter New England, NSW Health, Waratah, NSW, Australia 27 Awabakal Aboriginal Medical Service, Hamilton, NSW, Australia 28 Pital Tarkin, Aboriginal Medical Student Mentoring Program, The Wollotuka Institute, The University of Newcastle, Callaghan, NSW, Australia 29 Specialist Outreach NT, Darwin, Northern Territory, Australia 30 Black Dog Institute, The University of New South Wales, Sydney, NSW, Australia The authors apologise for this oversight.