Staff experience, knowledge and attitudes regarding the management of adolescent patients in adult mental health units.

Objective: Inpatient psychiatric care of adolescents should, where possible, be provided in specialized units. However, admission of adolescent patients to adult mental health units does occur. There is a paucity of data about this practice.

Amphetamine availability and admissions for psychosis in New South Wales, 2001-2009.

Objective: Clinicians have raised concerns about the impact of amphetamines on demand for mental health services. However, evidence for this link is limited. This study explores whether changes in the availability of amphetamines in NSW in the last decade have been associated with variations in admission to mental health units for amphetamine related conditions and for psychoses more generally.

Homicide due to mental disorder in England and Wales over 50 years.

Background: It has been stated that rates of homicide due to mental disorder are constant over time.

Aims: To examine whether there were changes in the rates of homicide due to mental disorder over time, and whether changes in these rates were associated with changes in the rates of other homicides in England and Wales.

Method: Examination of four sets of official homicide statistics from England and Wales from 1946 to 2004.

Acute myocarditis associated with clozapine.

Objective: A case of acute myocarditis associated with the commencement of clozapine is described, highlighting the onset, course and possible contributing factors. There is an urgent need to raise awareness about this potentially fatal complication of clozapine use.

Results: A 20-year-old male with schizophrenia developed a sudden onset of myocarditis after commencement of clozapine.

Drug-induced psychosis associated with crystalline methamphetamine.

Objective: A case of drug-induced psychosis related to crystalline methamphetamine is described, highlighting the phenomenology and relevant treatment.

Results: A 44-year-old woman with borderline personality traits and severe drug dependence developed a protracted drug-induced psychosis related to chronic high-dose crystalline methamphetamine use. Complete resolution of symptoms occurred with antipsychotic medication and abstinence from methamphetamine.

Neurocognitive functioning and quality of life among dually diagnosed and non-substance abusing schizophrenia inpatients.

The aim of this study was to compare the domains of intellectual, memory and executive functions of persons with schizophrenia who concurrently have substance abuse disorders (the dually diagnosed) with a group of non-substance-abusing patients with schizophrenia and to ascertain if there were differences between the two groups in their perceptions of quality of life. Neuropsychological and quality of life data of 46 dually diagnosed and 43 non-substance-abusing patients with schizophrenia was analysed retrospectively. All subjects were inpatients of a state psychiatric hospital.

Methadone maintenance treatment: outcomes from the Otago methadone programme.

Aim: To provide information on methadone treatment outcomes for opiate-dependent individuals.

Methods: Questionnaires and random urine tests were completed for 112 Otago clients comparing outcomes before and during methadone maintenance treatment.

Results: Treatment retention rates were high, with 86% of clients remaining on the programme six months or more.

Clinical response to clozapine treatment of 11 chronic patients in a state psychiatric hospital.

The aim of this study was to evaluate the clinical response to clozapine of 11 treatment-resistant patients with schizophrenia. Nine male and two female inpatients of a state psychiatric hospital, with at least a 2-year history of unresponsiveness to adequate trials of at least three antipsychotics and from chemically distinct groups, were challenged with clozapine. Clinical assessment involved baseline and repeated post-baseline ratings using the Brief Psychiatric Rating Scale (BPRS), the Clinical Global Impressions Scale (CGI), the Nurses Observation Scale for Inpatient Evaluation (NOSIE-30), and the Abnormal Involuntary Movement Scale (AIMS).

Stories from mental health.

Mental health nursing has always been a particularly challenging area in which to work. Not only in providing quality nursing care for clients who can be unpredictable, demanding and at times aggressive, but also in adjusting to changes in philosophy, focus and even contexts of work. It would be fair to say that mental health services in NSW are in a state of crisis.

Antibiotic and benzodiazepine prescribing by general practice trainees.

Objective: To study the prescribing of antibiotics and benzodiazepines by a group of general practice trainees.

Methods: Forty-six trainees in their general practice term with the Royal Australian College of General Practitioners Training Program and 495 experienced general practitioners were compared with regard to patients managed, prescribing of antibiotics for respiratory tract infections and prescribing of benzodiazepines for anxiety, sleep disorders and depression.

Results: Trainees saw more young patients and patients with acute respiratory infections, and fewer patients with psychological problems, than the experienced practitioners.

Interns' performances with simulated patients at the beginning and the end of the intern year.

Objective: To determine whether interns' performances of technical, preventive, and communication aspects of patient care improve during the intern year.

Design: A descriptive study. At the beginning and end of the intern year, interns' consultations with three simulated (standardized) patients were videotaped and scored according to explicit criteria set by an expert panel.

The diagnosis of alcohol-related brain damage: a retrospective study in alcoholics undergoing in-patient rehabilitation.

Alcohol-related brain damage (ARBD) is a common and prognostically relevant complication of alcohol dependence. Clinical sensitivity for ARBD by routine mental state examination (MSE) is important, but unlikely given the documented insensitivity of the MSE in detecting less subtle disorders. We sought to determine the predictive capacity of a well-documented MSE in 32 detoxified alcohol-dependent patients who had undergone neuropsychological testing.

The acquired immunodeficiency syndrome: a tuberculosis threat?

In the United States there has been an increase in mycobacterial infections that is attributable to the acquired immunodeficiency syndrome (AIDS). Since 1983, when the first case of AIDS was reported in Australia, there have been 523 patients (to June 30, 1987) notified with group-IV AIDS and, of these, 361 (69%) cases have been in New South Wales. Of these 361 notifications, 59 (16%) patients have had concurrent mycobacterial infection.

Clinical relevance of therapeutic drug level estimation with respect to clonazepam and carbamazepine: preliminary report.

This paper compares the results of plasma drug level estimations for 30 patients receiving clonazepam and 39 patients taking carbamazepine (assessing total and free carbamazepine concentrations together with carbamazepine epoxide levels) with the clinical features of seizure control. Owing to the small numbers of seizure-free patients, the power of the study was insufficient to justify absolute conclusions being drawn. However there appeared to be a trend which suggested that drug level estimations in both situations had virtually no clinical relevance.