Stephen Allison, Jeffrey Cl Looi, Steve Kisely, Tarun Bastiampillai
{"title":"Mostly harmless? Clinical practice guidelines need further consideration of psychotherapy adverse effects.","authors":"Stephen Allison, Jeffrey Cl Looi, Steve Kisely, Tarun Bastiampillai","doi":"10.1177/10398562241282736","DOIUrl":"https://doi.org/10.1177/10398562241282736","url":null,"abstract":"<p><p>The Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines on mood disorders recommend psychotherapy as foundational care for patients with acute depression with minimal discussion of any potential adverse effects. Randomised controlled trial evidence on psychotherapy adverse effects is limited. This is problematic because clinicians must balance the benefits of treatment against the harms, and clinical decisions become skewed without data on adverse effects. We suggest that clinical practice guidelines should be more guarded about recommending psychotherapy and add consensus statements on adverse effects for informed consent and clinical decision-making.</p>","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145006","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}
{"title":"The Thought Broadcast: The importance of psychiatric journal clubs.","authors":"","doi":"10.1177/10398562241281098","DOIUrl":"https://doi.org/10.1177/10398562241281098","url":null,"abstract":"","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139163","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}
Jeffrey Cl Looi, Stephen Allison, Tarun Bastiampillai, Steve Kisely, Paul A Maguire, Luke S-C Woon, Katrina Anderson, Gin S Malhi
{"title":"Deprescribing antidepressants for depression - what is the evidence for and against?","authors":"Jeffrey Cl Looi, Stephen Allison, Tarun Bastiampillai, Steve Kisely, Paul A Maguire, Luke S-C Woon, Katrina Anderson, Gin S Malhi","doi":"10.1177/10398562241282377","DOIUrl":"10.1177/10398562241282377","url":null,"abstract":"<p><strong>Objective: </strong>Recent guidelines suggest that the overall quantity and duration of antidepressant prescriptions should be reduced. In this paper, we comment on the evidence both for and against this view.</p><p><strong>Methods: </strong>We critically review the arguments proposed by proponents of antidepressant deprescribing in the context of the evidence-base for the treatment of depression.</p><p><strong>Results: </strong>Proponents of deprescribing do not address the substantive issues of whether inappropriate prescribing has been demonstrated, and when prescribing is needed. Their arguments for deprescribing are rebutted in this context.</p><p><strong>Conclusions: </strong>Whether or not to deprescribe antidepressant medication needs to take into consideration the risk-benefit profile of the decision, the responsibility for which needs to be shared and based on the context of the patient's depression, their preferences, experiences and perspectives.</p>","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142143019","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}
{"title":"The Thought Broadcast: Truth telling and voices of justice - Personal reflections by Dr Mark Lawrence.","authors":"","doi":"10.1177/10398562241281088","DOIUrl":"https://doi.org/10.1177/10398562241281088","url":null,"abstract":"","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139164","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}
{"title":"The Thought Broadcast: How to critique a paper.","authors":"","doi":"10.1177/10398562241281089","DOIUrl":"https://doi.org/10.1177/10398562241281089","url":null,"abstract":"","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139162","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}
Stephen Allison, Jeffrey Cl Looi, Steve Kisely, Tarun Bastiampillai
{"title":"Reflection on the RANZCP position on the adverse effects of psychotherapy.","authors":"Stephen Allison, Jeffrey Cl Looi, Steve Kisely, Tarun Bastiampillai","doi":"10.1177/10398562241280362","DOIUrl":"10.1177/10398562241280362","url":null,"abstract":"<p><strong>Objective: </strong>In this perspective, we investigate how the Royal Australian and New Zealand College of Psychiatrists' (RANZCP) position statement on psychotherapy takes the potential for adverse effects into account.</p><p><strong>Conclusions: </strong>Psychotherapy has two critical outcomes - efficacy and adverse effects. Evidence-based psychotherapy is significantly more effective than care-as-usual for about one in 10 psychotherapy patients. However, a similar proportion also reports adverse effects. Despite this, the RANZCP position statement on psychotherapy focuses on efficacy with minimal discussion of the adverse effects. This is an oversight because psychiatrists have legal and ethical obligations to consider the adverse effects as well as the benefits of any treatment. We therefore reflect on the RANZCP's six recommendations in light of the adverse effects of psychotherapy.</p>","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124691","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}
Sharon Reutens, Christopher Dandolo, Richard C H Looi, George C Karystianis, Jeffrey C L Looi
{"title":"The uses and misuses of artificial intelligence in psychiatry: Promises and challenges.","authors":"Sharon Reutens, Christopher Dandolo, Richard C H Looi, George C Karystianis, Jeffrey C L Looi","doi":"10.1177/10398562241280348","DOIUrl":"https://doi.org/10.1177/10398562241280348","url":null,"abstract":"","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118889","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}
{"title":"Mental health of the Pacific Island Nation communities: What the rest in the world can contribute to and learn from?","authors":"Rahul Shidhaye","doi":"10.1177/10398562241278542","DOIUrl":"https://doi.org/10.1177/10398562241278542","url":null,"abstract":"<p><strong>Introduction: </strong><i>Creating Futures</i> initiative has established a network of mental health professionals, researchers, and community members from the Pacific Island Nations (PIN), Australia, and New Zealand to address the growing challenges of mental health conditions compounded by the climate change crisis. The enormous amount of work done in Global Mental Health can be particularly helpful to improve population-level mental health. However, translation of this evidence base into practice poses several challenges.</p><p><strong>Objective: </strong>This perspective paper discusses the role of local culture and health systems context in determining the feasibility and acceptability of implementing and scaling up evidence-based interventions designed in an American-European context. The paper also advocates development (and evaluation) of mental health interventions in the PIN communities particularly and Global South generally and exporting these interventions to the rest of the world.</p><p><strong>Conclusions: </strong>COVID-19 crisis underlined the role of global cooperation as well as national level 'self-reliance'. In this post COVID-19 world, it will be desirable for the mental health community to cooperate and collaborate to scale up evidence-based interventions through rigorous contextualization and at the same time main-stream mental health interventions developed in the Global South by incorporating them in the Global Mental Health discourse.</p>","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103875","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}
{"title":"Describing the burden of disease amongst inpatients with treatment resistant major depressive disorder in Australia.","authors":"Melanie Hurley, Angela Komiti, Malcolm Hopwood","doi":"10.1177/10398562241278959","DOIUrl":"https://doi.org/10.1177/10398562241278959","url":null,"abstract":"<p><strong>Objective: </strong>To describe the quality of life and clinical characteristics of treatment-resistant depression (TRD) patients in an Australian patient cohort recruited cross-sectionally during admission.</p><p><strong>Method: </strong>Inpatients admitted for TRD treatment completed a quality of life questionnaire (AQoL-8D) and a depression severity assessment (HAM-D). A chart review and patient interview occurred for demographic and patient characteristics. Comparisons between the mean AQoL-8D scores of the study population and Australian population norms occurred.</p><p><strong>Results: </strong>79 TRD inpatients (70.9% female), mean age of 44.8 ± 14.9 years, were recruited, with 78.5% having an anxiety disorder, 48.1% post-traumatic stress disorder, and 30.4% a personality disorder. Adjunctive to antidepressants, 92.4% were taking antipsychotics and 55.7% were taking mood stabilisers. Approximately 42% of patients received transcranial magnetic stimulation, and 35.4% received electroconvulsive therapy. Mean HAM-D score was 20.3 ± 5.2, and AQoL-8D score (120.1 ± 16.5) was significantly higher than Australian population norms (<i>p</i> < .001) indicating reduced quality of life.</p><p><strong>Conclusions: </strong>Personal and clinical characteristics of patients hospitalised for TRD were similar to TRD globally with impaired quality of life relative to the general Australian population. TRD patients on average presented with moderate/severe depression, highlighting the need for greater support for these individuals.</p>","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103872","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}
Alison Clayton, Andrew James Amos, Jillian Spencer, Patrick Clarke
{"title":"Implications of the Cass Review for health policy governing gender medicine for Australian minors.","authors":"Alison Clayton, Andrew James Amos, Jillian Spencer, Patrick Clarke","doi":"10.1177/10398562241276335","DOIUrl":"https://doi.org/10.1177/10398562241276335","url":null,"abstract":"<p><strong>Objective: </strong>To summarize the key recommendations of England's independent inquiry into gender identity services for children and young people (the Cass Review) and to evaluate their relevance to Australian health policy.</p><p><strong>Conclusions: </strong>The Cass Review's findings and recommendations have clear applicability to Australian health policy. As a matter of priority, Australian health authorities need to seriously engage with the Cass Review's findings and recommendations. To not do so will put the health and well-being of vulnerable children and young people at risk.</p>","PeriodicalId":8630,"journal":{"name":"Australasian Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103874","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}