Not heading in the right direction: Five hundred psychiatrists' views on resourcing, demand, and workforce across New Zealand mental health services.

Objective: To explore the views of psychiatrists (including trainees) regarding the current state and future direction of specialist mental health and addictions services in Aotearoa New Zealand.

Methods: Psychiatrists and trainee psychiatrists (registrars) in Aotearoa New Zealand were surveyed in August 2021. Of 879 eligible doctors, 540 participated (83% qualified and 17% trainee psychiatrists), a response rate of over 60%.

Outcomes of Acute Repair Versus Nonrepair of Zone I Flexor Digitorum Profundus Tendon Injuries.

Purpose: The aim of this study was to determine whether the clinical results of zone I flexor digitorum profundus (FDP) tendon injuries managed with acute surgical repair are comparable to the clinical results of those managed without repair (eg, primary FDP excision or observation).

Methods: Patients aged ≥18 years presenting to a level 1 trauma center between 2015 and 2020 with zone I FDP tendon injury were identified with retrospective chart review. We assessed the following data: age, sex, physical therapy visits, surgical intervention, surgical complications (including infection, repeat surgery after the primary intervention, and rupture of repair), and patient-reported outcomes measurement information system scores.

Experiences of Weight-Loss Surgery in People With Serious Mental Illness: A Qualitative Study.

Background: Bariatric surgery is seldom accessed by people with serious mental illness, despite high rates of obesity in this population. It is sometimes assumed that patients with complex psychiatric histories will have poor post-surgical weight loss or exacerbation of psychiatric symptoms, although this is unsubstantiated.

Objectives: A qualitative descriptive study to explore personal experiences and the impact of bariatric surgery on physical and mental well-being and life-quality in individuals with serious mental illness.

Trainee welfare: a New Zealand perspective.

Objective: To explore key sources of stress experienced during training by psychiatry registrars and identify which coping strategies they found helpful or unhelpful.

Method: We used three data sources: a) 'stress' vignettes written by Stage 3 trainees; b) minutes of regular registrar meetings; c) focus groups. We analysed these using abbreviated grounded theory, generating themes.

Long-term psychiatric inpatients' perspectives on weight gain, body satisfaction, diet and physical activity: a mixed methods study.

Background: Obesity is a significant problem for people with serious mental illness. We aimed to consider body size from the perspective of long-stay psychiatric inpatients, focussing on: weight gain and its causes and impacts; diet and physical activity; and the perceived ability to make meaningful change in these domains.

Method: A mixed methods study with 51 long-term psychiatric forensic and rehabilitation inpatients using semi-structured interviews combined with biometric and demographic data.

Crying, oral contraceptive use and the menstrual cycle.

Background: Crying, a complex neurobiological behavior with psychosocial and communication features, has been little studied in relationship to the menstrual cycle.

Methods: In the Mood and Daily Life study (MiDL), a community sample of Canadian women aged 18-43 years, n=76, recorded crying proneness and crying frequency daily for six months along with menstrual cycle phase information.

Results: Crying proneness was most likely during the premenstruum, a little less likely during menses and least likely during the mid-cycle phase, with statistically significant differences although the magnitude of these differences were small.

Actigraphic and self-reported sleep quality in women: associations with ovarian hormones and mood.

Background: Sleep and mood disturbances in women have often been linked to the menstrual cycle, implying an ovarian hormonal causation. However, most studies in this area have used self-reported menstrual cycle phase rather than direct measurement of ovarian hormone concentrations. Further, many studies have focused primarily on peri- and postmenopausal populations reporting clinical sleep difficulty.

'Is it the crime of the century?': factors for psychiatrists and service users that influence the long-term prescription of hypnosedatives.

Given the longstanding controversy about hypnosedative use, we aimed to investigate the attitudes of prescribing psychiatrists and service users towards long-term use of hypnosedative medication, and their perceptions of barriers to evidence-based nonmedication alternatives. Qualitative data from focus groups in Aotearoa/NZ were analysed thematically. A novel research design involved a service user researcher contributing throughout the research design and process.

Sleep quality and the menstrual cycle.

Objective: This study aimed to assess the temporal relationship of subjective sleep quality to menstrual cycle phase in a community (non help-seeking) sample of adult women over six months. Previous work has produced contradictory results and often used student samples.

Patients/methods: This was a cohort study, using daily electronic data collection in the Greater Toronto Area, Ontario, Canada; 76 women aged 18-42 years recruited by random digit telephone dialing, recorded mood, sleep quality, and other health variables on a daily basis for 24 weeks.

Dysfunctional cognitions about sleep in psychiatric patients.

The optimal management of sleep problems is a significant challenge, particularly in patients with psychiatric illness, because disturbed sleep is a known risk factor for relapse. This study used the short Dysfunctional Beliefs and Attitudes Scale to assess beliefs about sleep in adults with acute psychiatric disorders (N=100) recruited from inpatient and outpatient clinics. The subjects showed highly dysfunctional beliefs and attitudes about sleep and held diverse opinions about, but had low confidence in, their own capacity for optimal sleep management.

Hypnosedative prescribing in outpatient psychiatry.

The objective of this study was to describe hypnosedative (HS) prescribing patterns in a typical sample of psychiatric outpatients. Prescription information was extracted from the clinical records of all current outpatients at two New Zealand public mental health centres. This included the type and duration of HS use and documentation of a clinical review of longstanding (>3 months) use, patient sex, age and ICD10 diagnoses.

Mood and the menstrual cycle.

Background: Premenstrual mood symptoms are considered common in women, but such prevailing attitudes are shaped by social expectations about gender, emotionality and hormonal influences. There are few prospective, community studies of women reporting mood data from all phases of the menstrual cycle (MC). We aimed (i) to analyze daily mood data over 6 months for MC phase cyclicity and (ii) to compare MC phase influences on a woman's daily mood with that attributable to key alternate explanatory variables (physical health, perceived stress and social support).

Mood and the menstrual cycle: a review of prospective data studies.

Background: The human menstrual cycle (MC) has historically been the focus of myth and misinformation, leading to ideas that constrain women's activities.

Objectives: We wished to examine one pervasive idea, that the MC is a cause of negative mood, by studying the scientific literature as a whole. We briefly reviewed the history of the idea of premenstrual syndrome and undertook a systematic review of quality studies.

The role of ovarian steroid hormones in mood.

Fluctuations in ovarian hormones across the menstrual cycle have long been considered a determinant of mood in women. The majority of studies, however, use menstrual cycle phase as proxy for hormone levels. We measured ovarian hormone levels directly in order to examine the relationship between daily hormone levels and mood in non-help-seeking women.

Sleep medication in acute psychiatric illness: patient's knowledge and prescription patterns in New Zealand.

Adult patients (N = 100) being treated for acute psychiatric illness were interviewed about their sleep problems and attitudes toward available treatments. Most (74%) were using at least one prescribed psychotropic drug with hypnotic or sedative effects. Participants prescribed three or more drugs were less likely to name them correctly compared with those prescribed less.

Evaluating childhood adversity.

Childhood adversity increases risk of psychological and physical disorders. The comprehensive psychosomatic assessment of an individual's vulnerability to illness includes the evaluation of early life events, especially exposure to physical, emotional, sexual abuse and neglect. Many self-report and observer-rated instruments are now available to aid this evaluation and increase its validity.

Measuring estrogens and progestagens in humans: an overview of methods.

Estrogens and progestagens (ovarian steroids) not only play an important a role in sexual behavior and reproduction, but they are involved in the development, regulation, and function of all body systems, including aging, sleep, pain, pharmacodynamics, immune response, and cognition. They are essential to the maintenance of cardiovascular, renal, mental, and bone health. Often, their effects are positive and their absence, negative.

Mood and anxiety disorders in a sample of Canadian perinatal women referred for psychiatric care.

Perinatal depression currently receives considerable attention, but not all perinatal women presenting for psychiatric care are depressed. The Edinburgh Postnatal Depression Scale (EPDS) is now routinely administered, but high scores are interpreted as evidence for depressive illness only. This study examined psychiatric diagnoses and mean EPDS scores among perinatal women at a tertiary center.

Indicators for measuring mental health: towards better surveillance.

Accurate measurement and improvement of population mental health requires the recording of indicators that capture the full spectrum of disease severity. This paper describes four different strategies for measuring the prevalence of depression and anxiety in Canada based on data from the 2002 Canadian Community Health Survey - Mental Health and Well-being (Cycle 1.2) and the 2003 Quebec medical services claims database.

Rates of depression and anxiety in urban and rural Canada.

Background: Studies of urban-rural differences in rates of non-psychotic psychiatric disorders have produced contradictory results, with some finding higher urban rates and others no difference.

Aims: This study aimed to compare geographic variability of rates of depression and three anxiety disorders in a large, random community sample of Canadian residents.

Method: Data from the 2002 Canadian Community Health Survey 1.

Traditional postpartum practices and rituals: clinical implications.

Objectives: In many cultures, postpartum rituals are observed because they are believed to have beneficial mental health effects. Our systematic review examines the research literature investigating the effects of postpartum rituals on postpartum depression (PPD) to determine if the rituals protect against PPD.

Methods: MEDLINE, CINAHL, PsycINFO, EMBASE, and the Cochrane Library were searched (from 1966 to October 31, 2008).

Women's perceptions of influences on their mood.

Aims: Knowledge of prevailing community ideas about mood determination can guide research about variability in mood. A random sample of urban Canadian women, aged 18-40 years (n = 507), was asked to compare the relative importance of three specified domains (physical health, social support, stress) as influences on their mood and then to list additional life experiences they considered important. They also rated the frequency and recurrence patterns (cyclicity) of their daily positive and negative moods.