A systematic review of the quality of life of carers of children with cleft lip and/or plate

Caring for an infant or child requires a significant amount of time, energy and resources; this burden is further increased when the infant or child has a chronic condition or disability. Prior research has demonstrated that caregiving for a child with special needs impacts upon parents or carers mental health, well-being and quality of life. This article systematically reviews the literature pertaining to the impact of caring for a child with cleft lip and /or palate upon parental quality of life. A search of four databases was conducted with a number of key terms; the titles, abstracts and finally the whole article were read and assessed for relevance. Only articles written in English were included in the review. The results yielded four relevant articles; that displayed inconsistent results. The results of these articles are reviewed. It was evident that the construct of quality of life was narrowly operationalised in all four articles either being assessed as health-related quality of life or as the impact upon the family. Further all four studies emanated from the same country. The limitations are discussed with recommendations made for future research endeavours

Negative symptoms of schizophrenia: a historical, contemporary, and futuristic view

This paper explores the evolution of the conceptualization of schizophrenia. Specifically, the paper focuses upon negative symptomology and the emphasis that such symptoms have garnered over time. Negative symptoms are associated with higher levels of impairment and poorer outcomes in schizophrenia. Historically, negative symptoms were the core feature of schizophrenia in the early conceptualizations of Kraepelin and Bleuler, holding precedence until the emergence of Schneiderian theory in the 1970\u27s. The focus on negative symptoms then changed to positive symptoms; which is still the key focus today. This shift in emphasis has resulted in a dearth of knowledge and treatment for such symptoms and as such an area requiring further research. The paper also addresses the conceptual changes in the nosology of Schizophrenia and other psychosis with respect to the Diagnostic and Statistical Manual of Mental Disorders-5. Further the potential for the clinical assessment interview for negative symptoms to facilitate understanding and treatments for negative symptomology in schizophrenia is also discussed

Negative symptoms in schizophrenia: The prevailing challenges

Although many advances in the understanding and treatment of schizophrenia have been made many challenges still remain. Most notably is the lack of understanding pertaining to the negative symptoms dimension of schizophrenia and the treatment of such symptomology? Primary negative symptoms affect 20-40% of individuals with schizophrenia and are associated with the greatest impacts upon functional impairment and quality of life. A qualitative review of the prevailing challenges related to the nature, assessment and treatment of negative symptoms was conducted. The current literature in each of the aforementioned areas pertaining to primary negative symptoms was reviewed with a focus upon the key challenges and directions for future research. The results of the qualitative review indicate that the construct of negative symptoms requires further delineation and recent work in the area of the assessment of negative symptoms necessitates further development. In regards to the treatment of negative symptoms no definitive directions are espoused due to the extent of the dearth of knowledge in the area as highlighted in the discussion. The area of negative symptoms research requires multi-disciplinary collaborative research to address the major challenges to the understanding, assessment and treatment of negative symptoms in schizophrenia to improve the quality of life and functional outcomes of those with primary negative symptoms

A narrative review of potential treatment strategies for food addiction

The concept of food addiction (FA) remains controversial with research being in the nascent stages; FA like any addiction can have a devastating impact on the lives of those afflicted. There exists a clinical need for treatment strategies for those affected. This article reviews potential treatment strategies for FA. The treatment strategies target four core behaviours of the addiction phenotype specifically craving through the opioid system, impulsivity as a personality trait, compulsivity through the serotonergic system and lastly motivation through the dopaminergic system. A range of pharmacological and psychological interventions are reviewed. Future research should seek to test and validate the proposed clinical treatment strategies

Are community treatment orders counterproductive?

Objective This article briefly reviews the literature pertaining to community treatment orders (CTOs) specifically how and why they are utilised and how effective mandated community treatment really is. This review discusses the use of CTOs in the context of the recovery model. Conclusions This article highlights the shortfalls in the current CTO system while also demonstrating the increase in acute coercive care. The literature pertaining to the effectiveness of CTOs is inconsistent with more recent reviews denoting that there is now robust evidence the CTOs are not effective. Further treatment that aligns with the recovery model as oppose to mandated treatment is known to increase treatment compliance

Does the Australian mental health system provide mental health or psychiatric care? Returning to Engel 40 years on

Objective: This article discusses the treatment that is actually provided by the Australian mental health system, arguing that the treatment provided constitutes purely psychiatric care in the sense that it is solely reliant on pharmaceuticals. This issue is framed in the context of an increasing mental health disease burden and the need to move to more holistic care in accordance with that advocated by Engel. Conclusion: Thus, with the predictions of an increase in mental and substance use in the next 30 years, it is imperative to take measures to try to negate this increasing burden and associated costs. Therefore, returning to the holistic views of Engel and incorporating the psychological and social needs of patients in treatment is recommended as a way to attempt to minimise the impact

A theoretical review of psychological resilience: Defining resilience and resilience research over the decades

Recent times have seen a shift in interest from a focus upon the deficits of individuals to a focus upon individual\u27s strengths. Resilience is a positive psychology construct that has been investigated for decades, prior to this paradigm shift. This article reviews definitions of resilience over time. Although there is no single agreed definition; resilience is commonly described as the ability to bounce back. The risk of stress and negative life events in triggering mental illness has long been recognized. Similarly, the positive outcomes of some individuals to highly adverse situations have also been of interest for a long time. These positive responses or outcomes in the face of significant risk or adversity are generally known as resilience. This article provides a review of definitions of resilience and resilience related phenomena as well as a historical review of the focus of resilience research across the decades in order to inform future research and theorizing. The article concludes with recommendations to researchers to explicitly define their definition and conceptualization of the construct as well as the imperative to move towards a unified view of the construct of resilience. Further, it is clear that research on resilience has progressed and evolved over the decades however this does not denote that research in the area is complete. As such researchers should still seek to understand the complexities of resilience, how to build resilience in different populations, or in individuals experiencing similar adversities

The importance of primary care psychiatry: an Australian perspective with global implications

This paper provides a review of the importance of primary care psychiatry within an Australian context. The aims of this review are: (1) to emphasize the integral role of mental health in overall health and well-being, (2) to elucidate the factors that make the provision of primary care psychiatry essential, and (3) to review the impact of the Australian government’s mental health policy initiatives on the mental health of the Australian population as well as on the practice of primary care psychiatry. From this review, it is evident that the discipline of psychiatry is integral to the overall health of the community. Furthermore, it is apparent that primary care psychiatry has a large and pivotal role to play in the prevention, treatment, and early detection of mental disorders in Australia and worldwide. The article concludes with some simple, actionable recommendations for the practice of primary care psychiatry. </jats:p

What is in a name? Is food addiction a misnomer?

Recently interest in the phenomenon of food addiction has increased substantially since the inclusion of gambling disorder in the DSM-5. However the phenomenon of food addiction remains controversial and the designation continues to lack clear consideration. Few researchers have offered an explicit theoretical definition of the phenomenon which is fundamental; as it not only pertains to the aetiology it also directs research and management of the phenomenon. Therefore this review explores \u27what is in a name\u27? Specifically possible aetiologies of food addiction, eating addiction and food addiction as an eating disorder are reviewed and the potential DSM-5 classification espoused. It is evident that the phenomenon requires further research and evaluation in order to delineate whether the phenomenon constitutes a disorder and if the phenomenon is found to be a valid entity the most appropriate designation. As it is too early to draw definitive conclusions regarding the concept all plausible designations and the associated aetiologies require further investigation

Reason for clozapine cessation

Objective:  Approximately 30% of individuals diagnosed with schizophrenia suffer from treatment-resistant or refractory schizophrenia. The gold standard for treatment of refractory schizophrenia is clozapine. However, a significant number of patients cease clozapine therapy; therefore this study explores patient’s motives for cessation. Method:  The motives for cessation and duration of clozapine treatment from a retrospective database of 151 patients with schizophrenia or schizo-affective disorder who had ceased clozapine once or more were reviewed, with the motives for cessation coded. The general motives for cessation were non-compliance, own decision, medical, poor response and other. In addition, the medical reasons for cessation were further codified: cardiac complications, neutropenia, fevers, other side effects and pregnancy. Results:  The majority of patients ceased clozapine owing to non-compliance with medical protocols or citing their own decision. Approximately half ceased after a period of 6 months or less. Seventeen per cent of patients ceased owing to medical reasons, with the largest proportions discontinuing treatment because of other side effects or neutropenia. Conclusion:  Future research should seek to further investigate why patients decide to be non-compliant and formulate their own decision to cease treatment, as this will facilitate strategies to promote adherence amongst these two groups that are potentially the most amenable to change