Cybersecurity lessons from the Vastaamo psychotherapy data breach for psychiatrists and other mental healthcare providers.

Objective: The Vastaamo psychotherapy data breach in Finland is perhaps the largest cybersecurity incident in mental healthcare to date, resulting in significant patient harm. There are specific lessons for mental healthcare providers from an analysis of the incident.

Method: Case study of this specific electronic health record data breach, based on detailed media reporting.

Behind the curtain of : The practice of a medical journal and a call for reviewers.

The process of medical scientific journal publishing merits further explanation for authors and readers. Prospective authors need to understand the scope of the journal and the article types that are published. We give an overview of the editorial process, including selection of reviewers, peer review and decisions regarding revision, acceptance and rejection of papers for .

Characteristics of domestic violence perpetrators with dementia from police records using text mining.

Aim: Few studies have examined the characteristics of domestic violence (DV) committed by people with dementia. We provide an overview of DV perpetrated by people with dementia in the community based on police reports of attendances at DV events.

Method: A text mining method was used on 416,441 New South Wales (NSW) police narratives of DV events from January 2005 to December 2016 to extract information for Persons of Interest (POIs) with mentions of dementia.

A comparison of older and younger offenders with delusional jealousy.

We sought to determine whether or not there were differences in medical, criminological and legal factors between older and younger offenders with diagnoses of delusional jealousy by undertaking a retrospective case-file search of Australian legal databases. Our results demonstrate that older offenders were more likely to have comorbid dementia whereas younger offenders were more likely to have comorbid substance use and chronic psychotic conditions. A history of domestic violence frequently predated the index offence but we were unable to determine if this was due to psychosis or a pre-existing tendency for violence.

Homicides by older offenders in New South Wales between 1993 and 2010.

Objective: Homicides by older people are rare and might differ from those committed by younger people. To investigate the characteristics of older homicide offenders in New South Wales (NSW), Australia.

Methods: A systematic search of legal, criminological and media databases for cases of homicide committed by people in NSW aged 55 and over, during the 18 years from 1993 to 2010.

Frontotemporal dementia - features, diagnosis and management.

Background: Frontotemporal dementia is the third or fourth most common form of dementia in the 45-65 years age group. It causes significant morbidity as well as a six to eightfold increase in mortality risk.

Objective: This article provides an overview of the pathophysiology of frontal lobe function and the genetics of frontotemporal dementia.

Practical guidelines for the acute emergency sedation of the severely agitated older patient.

The vulnerability of older people to serious underlying medical illness and adverse effects of psychotropics means that the safe and effective treatment of severe agitation can be lifesaving, the primary management goals being to create a safe environment for the patient and others, and to facilitate assessment and treatment. We review the literature on acute sedation and provide practical guidelines for the management of this problem addressing a range of issues, including aetiology, assessment, pharmacological and non-pharmacological strategies, restraint and consent. The assessment of the agitated older patient must include concurrent assessment of the likely aetiology of, the risks posed by, and the risks/benefits of management options for, the agitation.

Creative solutions for severe dementia with BPSD: a case of art therapy used in an inpatient and residential care setting.

Behavioral and psychological symptoms of dementia (BPSD) are common, distressing and compromise care. Their diverse etiology necessitates targeted, individualized treatment. We present a case of an 82-year-old with severe dementia and BPSD, and with limited response to a range of pharmacological and non-pharmacological treatments.

Depersonalization disorder.

Purpose Of Review: There is increasing interest in depersonalization disorder, in part because of the increased community awareness of the condition via the Internet. The disorder may be more prevalent than schizophrenia but is often misdiagnosed; hence, an update is timely.

Recent Findings: Recent research has included characterization of the nosology and phenomenology of the disorder, whereas emerging evidence demonstrates a neurophysiological dampening down in addition to psychological dampening in the face of emotional stimulation.

Management and outcomes of delirious patients with hyperactive symptoms in a secured behavioral unit jointly used by geriatricians and pyschogeriatricians.

To compare the clinical outcomes and length of stay (LOS) between delirious patients with hyperactive symptoms admitted directly and those admitted indirectly from Emergency Department into a secured, behavioral unit jointly used by geriatricians and pyschogeriatricians (the Unit). A retrospective study analyzing data from the medical records of 122 patients with an admission diagnosis of delirium with hyperactive symptoms and subsequently discharged from the Unit, including restraint, one-to-one nursing care, falls, absconding, duration of delirium, recovery from delirium, destination and LOS. Significantly fewer patients with direct admission (n=68) required physical restraint or chemical restraint compared with those transferred (n=54).

Workforce and advanced training survey of the RANZCP Faculty of Psychiatry of Old Age: issues and challenges for the field.

Objectives: There is concern that there are insufficient old age psychiatrists in an ageing population. We aim to describe the work patterns of old age psychiatrists in Australia and New Zealand in order to identify barriers to training and practice.

Methods: Members of the Faculty of Psychiatry of Old Age (FPOA) and other psychiatrists who have completed the Certificate of Psychiatry of Old Age were notified of the online survey by email in October 2008.

Clinical outcomes and length of stay of a co-located psychogeriatric and geriatric unit.

To examine the effect of co-location of psychogeriatric and geriatric services on length of stay and changes in patients' psychosocial characteristics. A retrospective analysis of the performance indices of psychogeriatric patients aged > or =50 years admitted to a co-located psychogeriatric and geriatric unit at Bankstown-Lidcombe Hospital, New South Wales (NSW), Australia from April 2004 to June 2006. Comparisons were made between the performance of the Bankstown-Lidcombe's unit and the NSW state average (consisting of traditional solitary models of care) with respect to patients' length of stay (LOS) and changes in psychosocial indices.

Periodic limb movements and other movement disorders in sleep: neuropsychiatric dimensions.

Movement disorders such as Parkinson's disease and Tourette's syndrome, primarily manifest during wakefulness, intrude into sleep. There are some disorders, however, such as periodic limb movements in sleep, restless legs syndrome, paroxysmal nocturnal dystonia, bruxism, and somnambulism, which occur primarily during sleep. The diagnosis and management of these disorders pose a challenge to neuropsychiatric practice, not only because they may be difficult to distinguish from other neuropsychiatric disorders, but also because psychiatric disorders are often co-morbid with them.

Homocysteine in neuropsychiatric disorders of the elderly.

Objective: There is increasing interest in homocysteine as a risk factor for neuropsychiatric disorders such as stroke, dementia, depression and Parkinson's disease. This article reviews the current literature on the relationship between homocysteine and these disorders to ascertain if any clinical recommendations can be made.

Method: A MEDLINE and EMBASE search was made for English language publications between 1966 and 2002 using the search terms 'Homocysteine' and 'Stroke', 'Dementia', 'Vascular Dementia', 'Alzheimer's dementia', 'Cognition disorders or cognitive decline or memory disorders', 'Depression or depressive disorders' or 'Parkinson's disease'.