Australasian Psychiatry最新文献

Acute affective responses to supervised, community-based exercise in a transdiagnostic clinical sample. 急性情感反应监督，社区运动在跨诊断临床样本。

IF 1.7 4区医学

Australasian Psychiatry Pub Date : 2026-10-20 DOI: 10.1177/10398562261500007

Chiara Mastrogiovanni, Amanda L Rebar, Grace McKeon, Oscar Lederman, Uzma Choudhry, Kemi Wright, Jacob Meyer, Sevasti Tefa, Simon Rosenbaum

{"title":"Acute affective responses to supervised, community-based exercise in a transdiagnostic clinical sample.","authors":"Chiara Mastrogiovanni, Amanda L Rebar, Grace McKeon, Oscar Lederman, Uzma Choudhry, Kemi Wright, Jacob Meyer, Sevasti Tefa, Simon Rosenbaum","doi":"10.1177/10398562261500007","DOIUrl":"https://doi.org/10.1177/10398562261500007","url":null,"abstract":"ObjectiveIndividuals experiencing mental health conditions often experience disturbances in affective state. While pharmacological and psychological treatments remain central, there is increasing interest in accessible strategies for immediate benefits. Evidence from largely non-clinical samples suggests that exercise is associated with positive changes in affect.MethodsThis pragmatic, retrospective, observational study examined pre-post changes in affective valence (Feeling Scale) and arousal (Felt Arousal Scale) across individualised exercise sessions delivered within a community exercise physiology service in Sydney, Australia. A transdiagnostic clinical sample (n = 24) contributed repeated session-level data (184 sessions in total). Linear mixed-effects models, variance partitioning and circumplex analyses were used to examine acute affective responses.ResultsExercise was associated with increases in affective valence (MΔ = +1.24 points, d = 0.82) and arousal (MΔ = +0.63 points, d = 0.52). Lower baseline valence showed greater improvements. Between-person differences accounted for 57% of variance in valence and 77% in arousal, indicating responses may be shaped by individual differences and contextual factors. Circumplex analysis confirmed shifts toward more pleasant affective states, with arousal moving toward moderate levels.ConclusionsIn a transdiagnostic clinical sample, community-based exercise was associated with immediate affective benefit. These findings potentially support exercise as a feasible strategy for short-term affective regulation.","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":" ","pages":"10398562261500007"},"PeriodicalIF":1.7,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Embedding mental health within paediatrics: A comprehensive consultation consultation-liaison psychiatry service at The Children's Hospital at Westmead. 将心理健康纳入儿科：韦斯特米德儿童医院的综合咨询-联络精神病学服务。

IF 1.7 4区医学

Australasian Psychiatry Pub Date : 2026-10-19 DOI: 10.1177/10398562261493839

Daniel You, Kasia Kozlowska, Siew Koo, Anna Agoroudis, Dina Mahmood

{"title":"Embedding mental health within paediatrics: A comprehensive consultation consultation-liaison psychiatry service at The Children's Hospital at Westmead.","authors":"Daniel You, Kasia Kozlowska, Siew Koo, Anna Agoroudis, Dina Mahmood","doi":"10.1177/10398562261493839","DOIUrl":"https://doi.org/10.1177/10398562261493839","url":null,"abstract":"ObjectiveTo present a detailed description of the Consultation-Liaison Psychiatry service at The Children's Hospital at Westmead, illustrating its integration of proactive, clinical mental health care, workforce development, and systems collaboration.MethodsA narrative description was developed, drawing on clinical practice, service documents, and the experience of the multidisciplinary team.ResultsThe CHW CL service provides integrated inpatient, outpatient, and rehabilitation care for children and adolescents with chronic medical illness and functional neurological disorder. Key features include (i) a proactive acute psychiatric pathway for inpatients with acute mental health concerns; (ii) the Mind-body Program, an inpatient rehabilitation intervention for children disabled by functional neurological disorder symptoms; (iii) integration of consultation-liaison clinicians within paediatric subspecialties; and (iv) system level contributions through workforce training, supervision, and policy development. The service also extends its reach through statewide consultation and supervision. It has produced resources and training initiatives to build capacity beyond the tertiary setting.ConclusionThe Children's Hospital at Westmead Consultation-Liaison Psychiatry Service demonstrates how mental health care can be embedded within tertiary paediatrics through a model that combines clinical care with prevention, workforce development, and systems integration. This model may inform the design and refinement of consultation-liaison services in other paediatric hospitals nationally and internationally.","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":" ","pages":"10398562261493839"},"PeriodicalIF":1.7,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Beyond the silo: Single-disorder ADHD clinics and the case for more integrated care. 超越孤岛：单一障碍多动症诊所和更综合护理的案例。

IF 1.7 4区医学

Australasian Psychiatry Pub Date : 2026-10-19 DOI: 10.1177/10398562261491671

Soumitra Das, Seshadri Sekhar Chatterjee

{"title":"Beyond the silo: Single-disorder ADHD clinics and the case for more integrated care.","authors":"Soumitra Das, Seshadri Sekhar Chatterjee","doi":"10.1177/10398562261491671","DOIUrl":"https://doi.org/10.1177/10398562261491671","url":null,"abstract":"ObjectiveThe rapid growth of ADHD assessment and prescribing in Australia reflects a gap between demand and service availability. Workforce shortages, restrictive stimulant regulations and limited adult ADHD care within public mental health services have contributed to this gap. ADHD-focused clinics have emerged in response. Using two de-identified clinical scenarios, this paper examines the drivers of this model and its potential harms.ConclusionFocused clinics can improve access and provide expertise. However, a narrow scope and fee-for-service model may also encourage transactional and fragmented care. We describe this risk as organisational iatrogenesis. Potential harms include incomplete formulation, uncoordinated prescribing and missed psychiatric, neurodevelopmental or neurocognitive comorbidity. Broader concerns include inequity, cost, discontinuity of care and erosion of generalist skills. The solution is not to restrict focused practice, but to integrate it more effectively with mainstream care. Priorities include nationally consistent prescribing rules, stronger shared-care arrangements with general practitioners, greater adult ADHD capacity within public services and clearer standards for scope-restricted practice. These issues are also relevant to other single-disorder models of psychiatric care.","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":" ","pages":"10398562261491671"},"PeriodicalIF":1.7,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Feigned psychiatric symptoms in forensic settings: Diagnostic challenges and lessons from a case series. 在法医设置的假装精神症状：诊断的挑战和教训，从一个案例系列。

IF 1.7 4区医学

Australasian Psychiatry Pub Date : 2026-10-16 DOI: 10.1177/10398562261493830

Seshan Kumar, Aparna Goyal, Shipra Singh, Pratibha Gehlawat, Deepak Kumar

{"title":"Feigned psychiatric symptoms in forensic settings: Diagnostic challenges and lessons from a case series.","authors":"Seshan Kumar, Aparna Goyal, Shipra Singh, Pratibha Gehlawat, Deepak Kumar","doi":"10.1177/10398562261493830","DOIUrl":"https://doi.org/10.1177/10398562261493830","url":null,"abstract":"BackgroundIn forensic psychiatry, malingering poses unique diagnostic and ethical challenges. Individuals may feign mental illness to avoid criminal liability or gain legal advantage, placing a burden on clinicians to distinguish the genuine psychopathology from simulation. To describe the presentation, evaluation process, and diagnostic dilemmas in seven medico-legal cases suspected of malingering, referred to a tertiary neuropsychiatric institute in India.MethodsA retrospective descriptive analysis was conducted of seven adult male cases referred from court or law enforcement agencies for mental status examination or fitness. Comprehensive assessments were performed by a multidisciplinary team comprising psychiatrists, clinical psychologists, psychiatric social workers, and occupational therapists. Observational data during inpatient stay and psychological testing outcomes were reviewed.ResultsAll patients had inconsistent symptom reports and ward observation. None fulfilled the criteria for a syndromal psychiatric diagnosis. Psychological testing in several cases revealed over-reporting or intact cognitive functioning inconsistent with the clinical picture. Discrepancies between claimed and observed behaviors, improvement without pharmacological treatment, and selective cooperation were noted as red flags.ConclusionIn-depth inpatient observation and multidisciplinary evaluation are crucial for identifying cases of malingering. Strengthening forensic psychiatry training and implementing systematic documentation can enhance diagnostic accuracy and support the legal system in discerning feigned illnesses.","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":" ","pages":"10398562261493830"},"PeriodicalIF":1.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Post-discharge alcohol-related emergency department use among older adults following involuntary inpatient treatment for alcohol use disorder. 老年人非自愿住院治疗酒精使用障碍后，出院后与酒精相关的急诊科使用。

IF 1.7 4区医学

Australasian Psychiatry Pub Date : 2026-10-14 DOI: 10.1177/10398562261497181

Yoon Park, Georgina Luscombe, Stanley Theodorou, Lynette Bullen, Mark Montebello

{"title":"Post-discharge alcohol-related emergency department use among older adults following involuntary inpatient treatment for alcohol use disorder.","authors":"Yoon Park, Georgina Luscombe, Stanley Theodorou, Lynette Bullen, Mark Montebello","doi":"10.1177/10398562261497181","DOIUrl":"https://doi.org/10.1177/10398562261497181","url":null,"abstract":"ObjectiveThe New South Wales Involuntary Drug and Alcohol Treatment (IDAT) program provides last-resort involuntary inpatient treatment for severe substance dependence. This study described older adults with severe alcohol use disorder (AUD) admitted to IDAT and their alcohol-related emergency department (ED) use after discharge.MethodsThis retrospective cohort study included patients aged ≥60 years with primary AUD admitted to an IDAT unit during 2016-2022. Demographic, social and clinical variables were summarised. Alcohol-related ED presentations before admission and after discharge were compared; time to first post-discharge presentation was examined using Kaplan-Meier analysis.ResultsOf 374 admissions, 37 older adults met inclusion criteria. Medical and psychiatric comorbidity, living alone and residence outside major cities were common. Among 36 participants included in post-discharge analyses, alcohol-related ED presentations were lower in the 6 months after discharge than in the 6 months before admission (median 1 vs 3, P < 0.001). Within 6 months, 22 participants (61%) re-presented, of whom 18 (82%) first re-presented within 3 months.ConclusionsOlder adults admitted to IDAT for severe AUD formed a clinically and socially complex cohort. Alcohol-related ED re-presentations were concentrated within 3 months of discharge, highlighting a high-risk transition period requiring structured continuity of care.","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":" ","pages":"10398562261497181"},"PeriodicalIF":1.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How should referrals to consultation-liaison psychiatry be made? A multisite study of consultation-liaison psychiatry clinicians and medical referrers. 如何转介到咨询联络精神病学？会诊联络精神病学临床医生和医学转诊者的多地点研究。

IF 1.7 4区医学

Australasian Psychiatry Pub Date : 2026-10-13 DOI: 10.1177/10398562261493848

Murray G Tucker, Julia Hunt, Kabir Ahmad, Steven Moylan, Emma Nicholson

{"title":"How should referrals to consultation-liaison psychiatry be made? A multisite study of consultation-liaison psychiatry clinicians and medical referrers.","authors":"Murray G Tucker, Julia Hunt, Kabir Ahmad, Steven Moylan, Emma Nicholson","doi":"10.1177/10398562261493848","DOIUrl":"https://doi.org/10.1177/10398562261493848","url":null,"abstract":"ObjectiveTo investigate views of consultation-liaison psychiatry (CLP) clinicians and medical referrers regarding optimal referral processes, referral form content, responses to unsatisfactory referrals, and referral appropriateness for inpatient CLP services in Australian hospitals.MethodA cross-sectional mixed-methods survey was distributed to CLP clinicians (n = 121) working across Australia and medical referrers (n = 73) recruited from two hospitals in Victoria and Tasmania. Ratings of referral processes and referral form content were compared between groups. Free-text responses on referral appropriateness were thematically analysed.ResultsBoth groups preferred digital referral systems supplemented by telephone calls, and referral forms combining free-text fields with checkboxes. Cross-group consensus emerged on the five most important referral form fields: patient identification, reason for referral, referrer details, Mental Health Act status, and urgency. CLP clinicians rated 14 of 25 referral form headings as significantly more important than medical referrers. Thematic analysis of referral appropriateness yielded five interpretive themes. A dominant view framed referral appropriateness as a quality threshold, while a minority argued that any genuine clinical uncertainty warrants CLP review.ConclusionThese findings provide an empirical foundation for optimal referral systems in CLP. Referral system design should combine hybrid electronic forms with targeted education, low-threshold discussion pathways and co-design with referrers.","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":" ","pages":"10398562261493848"},"PeriodicalIF":1.7,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ketamine administered biomedically or as psychedelic-assisted therapy in treatment-resistant depression: Differing efficacy based on depressive subtype or presence of childhood trauma? 生物医学或迷幻辅助治疗氯胺酮治疗难治性抑郁症：基于抑郁亚型或儿童创伤的不同疗效？

IF 1.7 4区医学

Australasian Psychiatry Pub Date : 2026-10-13 DOI: 10.1177/10398562261494440

Adam Bayes, Colleen Loo

引用次数: 0

Maintaining the viability of private psychiatric hospitals: The role of independently determined health insurance payments. 维持私立精神病医院的生存能力：独立确定的健康保险付款的作用。

IF 1.7 4区医学

Australasian Psychiatry Pub Date : 2026-10-07 DOI: 10.1177/10398562261492164

Jeffrey C L Looi, Stephen Allison, Tarun Bastiampillai, Steve Kisely, Luke S-C Woon, Wai-Man Liu

引用次数: 0

Response to: 'Knowing where we work: The value of psychiatric unit histories'. 回应：“知道我们在哪里工作：精神科历史的价值”。

IF 1.7 4区医学

Australasian Psychiatry Pub Date : 2026-10-01 DOI: 10.1177/10398562261493833

Madeleine Leung

引用次数: 0

Eating disorder management in acute tertiary hospitals without specialist beds: The importance of a standardised management approach. 没有专科床位的急性三级医院的饮食失调管理：标准化管理方法的重要性。

IF 1.7 4区医学

Australasian Psychiatry Pub Date : 2026-10-01 Epub Date: 2026-03-04 DOI: 10.1177/10398562261431150

Lucinda Collecutt, Madeleine Neff, Andrea Elliott, Kristelle Gregg, Lisa A Barker

{"title":"Eating disorder management in acute tertiary hospitals without specialist beds: The importance of a standardised management approach.","authors":"Lucinda Collecutt, Madeleine Neff, Andrea Elliott, Kristelle Gregg, Lisa A Barker","doi":"10.1177/10398562261431150","DOIUrl":"10.1177/10398562261431150","url":null,"abstract":"AimHealth service usage for eating disorders (EDs) has increased substantially; however, many tertiary hospitals lack resources for specialist ED services. Evidence-based guidelines outline ED management approaches for acute medical stabilisation in non-specialised services, including protocols for care across key disciplines (psychiatry, medicine and dietetics). The study aim was to evaluate collaboration of care within an Australian tertiary hospital following an eating disorder Inpatient Access and Treatment Pathway (IATP).MethodsThis retrospective cohort study reviewed 40 patients admitted with an ED diagnosis pre- (2019) and post- (2022) implementation of the IATP. The electronic medical record was utilised to gather patient demographics and health outcomes, and organisation of care (multidisciplinary team meetings, discharge planning).ResultsFollowing the implementation of the IATP, there was a 40% (p = .01) increase in appropriate discharge planning, classified as ED service referral or suitable community dietetic, medical and psychology follow-up. There was a significant increase in the Care Adherence Score (p = .004) which quantified organisation of care, utilising four key dichotomous variables. There was also a significant an increase in starting energy prescription (5900 KJ vs 4480 KJ, p = .046).ConclusionsA local IATP supported a significant increase in multidisciplinary collaboration and care adherence, appropriate discharge planning and starting energy provision.","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":" ","pages":"456-463"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147353531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0