Gender (r)evolution and contemporary psychiatry.

Perlson et al's editorial 'Envisioning a future for transgender and gender-diverse people beyond the DSM' heralds the arrival of the ICD-11's gender incongruence categories among conditions related to sexual health, brightening the spotlight on the re- (or rather de-)classification of gender-related disorders, which is a step in the right direction.

Epidemiology of personality disorders in individuals with gender dysphoria.

Purpose Of Review: Prevalence estimates of personality disorders (PD) in individuals with gender dysphoria (GD) are variable and heterogeneous, as psychiatric comorbidity and long-term follow-up data from gender-diverse samples are still limited. This review aims to assess prevalence rates across age groups and discuss potential reasons for variability in PD prevalence estimates among transgender people.

Recent Findings: International epidemiological data from several countries indicate that the best available estimates of the prevalence of any PD diagnosis in transgender youth are around 20% for adolescents and tend to increase to nearly 50% in trans-adults.

Personality dimensions and disorders and coping with the COVID-19 pandemic.

Purpose Of Review: The COVID-19 pandemic has tested people's coping and resilience. This article reviews research and scholarly work aiming to shed more light on personality-based factors that account for adjustment to the pandemic situation.

Recent Findings: Most studies relied on a cross-sectional design and were conducted using personality dimensions based on the Big Five personality model.

Recovery in borderline personality disorder: time for optimism and focussed treatment strategies.

Purpose Of Review: Borderline personality disorder (BPD) is prevalent, debilitating and clinically challenging. The evolving field of intervention and outcomes in BPD research is considered with a focus on recent research.

Recent Findings: A pattern of clinical and functional improvement is to be expected in patients experiencing BPD.

Advancing social and emotional well-being in Aboriginal and Torres Strait Islander Australians: Clinicians' reflections.

Objective: An expert reference group met on four occasions to consider ways forward in terms of Indigenous mental health. This paper summarises the discussion and recommendations.

Conclusion: While the negative effects of colonisation and trans-generational trauma continue, we propose renewed emphasis on improving access, cultural orientation and trauma-informed care, and a focus on the needs of young Indigenous Australians.

Sleep profiles and CBT-I response in schizophrenia and related psychoses.

This study investigated sleep subtypes in schizophrenia, and their response to Cognitive Behavioural Therapy for Insomnia (CBT-I) treatment. Sleep profiling was conducted using latent class analysis on baseline Pittsburgh Sleep Quality Index data (N = 74 outpatients with schizophrenia who were poor sleepers, 52% male, mean age = 41.4 years).

'A matter for conjecture': leucotomy in Western Australia, 1947-70.

Very little has been published on the rise and fall of psychosurgery in Australia. In the mid-twentieth century, Western Australia was the largest but most sparsely-populated of the six Australian States, and its local psychiatry practice was, as one commentator put it, 'backward'. Nonetheless, electroconvulsive therapy was introduced in 1945, and leucotomy in 1947.

Pharmacotherapy of borderline personality disorder: replacing confusion with prudent pragmatism.

Purpose Of Review: The article aims to examine trends in the pharmacological treatment of borderline personality disorder (BPD) and shed more light on the attendant controversies.

Recent Findings: Although specialized, BPD-centred psychotherapy is considered first-line treatment for BPD and no psychotropic drug has been licensed for BPD, medications are frequently prescribed in the management of this condition. Various classes of psychopharmacological agents are used for BPD and there is a prominent polypharmacy.

Here and Now Aboriginal Assessment (HANAA): a follow-up survey of users.

Objectives: To explore users' views of, and experience with, the Here and Now Aboriginal Assessment (HANAA), an instrument developed for screening social and emotional wellbeing (SEWB) in Aboriginal adults. Over the last few years the HANAA has been widely disseminated across Australia.

Methods: All those on our database who had requested the HANAA package were contacted by email and invited to participate in the evaluation by completing an online survey.

Culture and personality disorder: a focus on Indigenous Australians.

Purpose Of Review: To examine the validity of concept and diagnosis of personality disorder in transcultural settings using Indigenous Australian people as an example.

Recent Findings: There are significant deficits in comparative research on personality disorders across cultures. There is also a dearth of information regarding Indigenous Australians, and cultural applicability and clinical utility of the diagnosis of personality disorder in this group.

Sleep in Schizophrenia: Exploring Subjective Experiences of Sleep Problems, and Implications for Treatment.

Sleep dysfunction is a pervasive issue in schizophrenia and psychosis. Current knowledge is drawn almost exclusively from studies using quantitative research methodologies that include measures and tools developed in healthy population groups. Qualitative studies investigating the first-person perspectives of sleep problems are therefore important for designing better assessment and treatment tools to meet consumer needs.

Mindfulness for personality disorders.

Purpose Of Review: Third-wave cognitive-behaviour therapies such as dialectical behaviour therapy have demonstrated effectiveness in the treatment of personality disorders, which are considered difficult to treat. These therapies typically incorporate some component of mindfulness practice. The current study examines current applications and effectiveness of mindfulness to the treatment of personality disorders.

Towards culturally appropriate assessment of Aboriginal and Torres Strait Islander social and emotional well-being.

Objective: Identification of need for specialist assessment and the use of relevant cultural information to inform mental health assessment and care are two key factors in improving Aboriginal and Torres Strait Islander access to and experience of mental health care. This paper describes the Here and Now Aboriginal Assessment tool (HANAA) and the Cultural Information Gathering Tool (CIGT), two instruments developed to be used respectively by non-mental health clinicians and Aboriginal and Torres Strait Islander mental health workers.

Method: Following widespread consultations and feedback, two independent groups of mental health clinicians based in Western Australia and Queensland were involved in developing the HANAA and CIGT.

Future-proofing the psychiatry workforce in Australia: evaluation of an innovative enrichment programme for medical students.

Objective: The Claassen Institute of Psychiatry for Medical Students (the Institute) is an innovative enrichment programme aimed at attracting medical students to psychiatry. This paper reports on the effectiveness of the Institute as a strategy to increase interest in psychiatry as a career, and the career pathways of students who have attended since 2008.

Method: Students completed a baseline questionnaire on day 1 and the final day of the Institute.

Cognitive and Behavioral Factors Associated With Insomnia in Inpatients With Schizophrenia and Related Psychoses.

This study examines cognitive and behavioral factors linked to insomnia in individuals with schizophrenia and other psychotic disorders (with and without insomnia) and healthy controls (with and without insomnia). Fifty-five psychiatric inpatients and 66 healthy controls (n = 25 with insomnia in both groups) completed the Insomnia Severity Index, Thought Control Questionnaire for Insomnia-Revised, Dysfunctional Beliefs and Attitudes about Sleep scale, Sleep Hygiene Knowledge scale, and Beliefs about Causes of Sleep Problems questionnaires. Both insomnia groups demonstrated night-time rumination, aggressive suppression as a thought control strategy, and exaggerated views regarding the health consequences of poor sleep.

Early memories: Clinical relevance and significance.

Objective: The purpose of this research was to examine earliest memories in patients with a mental disorder and their clinical relevance to diagnosis and treatment.

Method: A semi-structured early memory questionnaire was developed and 50 patients with anxiety, depression or a psychotic disorder were interviewed. A thematic analysis was conducted to extract dominant themes from the qualitative data.

Preferences for different insomnia treatment options in people with schizophrenia and related psychoses: a qualitative study.

Symptoms of psychosis such as hallucinations and delusions can be intrusive and unwanted and often remain treatment-resistant. Due to recent progress in basic and clinical sciences, novel approaches such as sleep-based interventions are increasingly becoming offered to address the physical and mental health issues of people with severe mental illness. While the primary outcome is to improve sleep, studies have demonstrated that interventions that target symptoms of insomnia can also produce improvements in the severity of psychotic symptoms, quality of life, and functional outcomes.

Here and Now Aboriginal Assessment: background, development and preliminary evaluation of a culturally appropriate screening tool.

Objective: Assessment of Aboriginal social and emotional wellbeing (SEWB) is a complex and challenging task, in part due to a lack of suitable assessment tools. This paper reports the development and evaluation of a culturally appropriate screening tool called the Here and Now Aboriginal Assessment (HANAA).

Method: The initial phase included development of a glossary of Aboriginal terms and concepts relating to SEWB.

Impact of a psychiatry clerkship on stigma, attitudes towards psychiatry, and psychiatry as a career choice.

Background: Mental illnesses are a major public health problem around the world and the prevalence and burden of common mental disorders is growing. Psychiatry is an unpopular career choice for many medical students and this impacts negatively on the supply of psychiatrists to the workforce. The psychiatry clerkship can play an important role in influencing students' attitudes towards psychiatry, either positively or negatively.