The Australian and New Zealand journal of psychiatry
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Aust N Z J Psychiatry · Jun 1993
Case ReportsLithium-associated transient thyrotoxicosis in 4 Chinese women with autoimmune thyroiditis.
Four Chinese female patients who suffered from manic-depressive disorder and underlying autoimmune thyroiditis developed transient episodes of thyrotoxicosis during maintenance lithium therapy. Endocrinologically speaking, three of them had "Hashitoxicosis", while the other had silent lymphocytic thyroiditis. ⋯ They seemed to involve multiple aetiological factors, such as autoimmune thyroid disease, the toxic and immunomodulatory roles of lithium and perhaps genetic and dietary factors. Because of their self-limiting nature, the importance of avoiding unnecessary and potentially deleterious antithyroid treatment is emphasised.
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Although sexual relationships between medical practitioners and their patients have been forbidden by most professional and statutory bodies, the reported prevalence of sexual misconduct does not appear to have altered in the last 20 years. A recent Australian study has also suggested that psychiatrists are over-represented in comparison to others in the medical workforce. The reasons that may account for this finding are discussed, and issues which require further debate by the profession are outlined. These include the acceptability of post-termination relationships, the applicability of criminal statutes, the role of treatment in the management of offenders, and whether mandatory reporting of sexual misconduct should be considered.
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A systematic review was carried out of all patients admitted to a specialised mother-baby unit who had significant phobic avoidance of their own infants. Demographic and diagnostic information on this group showed phobic avoidance to be common and associated with a range of psychiatric illnesses. ⋯ The relationship of such avoidance to attachment behaviour from mother to child is discussed. It is recommended that phobic symptoms warrant early recognition and treatment in their own right, simultaneously with treatment of the major illness.
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Community Psychiatry is sometimes regarded as a separate and even as a recent study. The history of its evolution in Australia shows it to have resulted from a logical progression since the earliest days of the psychiatric services. ⋯ Both methods resulted in the expansion of community services. Present day activities must be viewed in this light and community services recognised to be an indivisible portion of a professionally organised total mental health organisation.
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Aust N Z J Psychiatry · Mar 1992
ReviewSocial psychiatry and sociology of mental health: a view on their past and future relevance.
The origins of social psychiatry can be traced to the age of enlightenment and to the effects of the industrial revolution. Social psychiatry deals with social factors associated with psychiatric morbidity, social effects of mental illness, psycho-social disorders and social approaches to psychiatric care. Since the end of World War II up to the early seventies it has been claimed that social psychiatry should concentrate on the fight against war, poverty, racial discrimination, urban decay and all other social ills affecting people's mental health, and that the psychiatrist should be responsible for the mental health of the society. ⋯ The paper refutes this approach indicating that not the existence but the perception and presentation of psychiatric illness are socially determined. Acknowledging the contribution of sociology and social sciences to psychiatry, it is suggested that the heroic period of social psychiatry and the iconoclastic approach of sociology of mental health are over. However, social psychiatry, enriched by the use of epidemiological methods, has still much to offer to the daily practice of psychiatry.