Introducing a competency based Fellowship programme for psychiatry in Australia and New Zealand.
CONCLUSIONS: The 2012 Fellowship programme is based on the CanMEDs educational framework. The Royal Australian and New Zealand College of Psychiatrists (RANZCP) underwent a comprehensive process, adapting the CanMEDs competencies to a psychiatric framework and mapping the curriculum to Fellowship competencies, learning outcomes and developmental descriptors of the various stages of training. The 2012 Fellowship programme introduced summative entrustable professional activities (EPAs), formative workplace-based assessments (WBAs) and revised external assessments. PMID: 26400448 [PubMed - as supplied by publisher] (Sour...
Source: Australasian Psychiatry - September 23, 2015 Category: Psychiatry Authors: Jurd S, de Beer W, Aimer M, Fletcher S, Halley E, Schapper C, Orkin M Tags: Australas Psychiatry Source Type: research

Community Treatment Orders (CTOs): a demographic cross-sectional analysis.
CONCLUSIONS: Men of middle age, with a diagnosis of schizophrenia, a history of aggression, current substance misuse and reported previous CTO efficacy are the primary individuals predicted to require ongoing CTOs. Improving CTO efficacy should focus on providing targeted intervention for this group and a closer analysis of the use of CTOs in other groups. PMID: 26400449 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - September 23, 2015 Category: Psychiatry Authors: Isobel S, Clenaghan P Tags: Australas Psychiatry Source Type: research

Social and emotional wellbeing, natural helpers, critical health literacy and translational research: connecting the dots for positive health outcomes.
CONCLUSIONS: There is a need for the development of translational research products that enhance the critical health literacy of natural helpers. The tripartite framework for principled practice supports reflective and accountable practice in the intercultural space to build trust and confidence between Aboriginal and non-Aboriginal people to enhance the opportunity for authentic knowledge production and transfer. PMID: 26400450 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - September 23, 2015 Category: Psychiatry Authors: Drew N Tags: Australas Psychiatry Source Type: research

Prevalence and symptomatology of catatonia in elderly patients referred to a consultation-liaison psychiatry service.
CONCLUSIONS: Routine psychiatric history and examination are likely sufficient to elicit catatonic signs in a consultation-liaison setting. Standardised screening examination may be more suited for conducting research or for use when examining for catatonia in psychiatric inpatient settings. PMID: 26400451 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - September 23, 2015 Category: Psychiatry Authors: Kaelle J, Abujam A, Ediriweera H, Macfarlane MD Tags: Australas Psychiatry Source Type: research

Implementing cognitive remediation therapy (CRT) in a mental health service: staff training.
CONCLUSIONS: Up skilling the mental health workforce to incorporate an understanding of the cognitive aspects of psychosis into care delivery can be facilitated by a tiered training structure. Fundamental training on the psychosocial aspects of psychosis can act as a platform for focussed CR skills based training. There is also a need for accessible therapy based supervision for staff wishing to develop competencies as CR therapists. PMID: 26400452 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - September 23, 2015 Category: Psychiatry Authors: Dark F, Newman E, Harris M, Cairns A, Simpson M, Gore-Jones V, Whiteford H, Harvey C, Crompton D Tags: Australas Psychiatry Source Type: research

Dissociative identity disorder (DID) in clinical practice - what you don't see may hurt you.
CONCLUSION: Better recognition, diagnosis and management of DID will lead to better and more cost effective outcomes. PMID: 26400453 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - September 23, 2015 Category: Psychiatry Authors: Leonard D, Tiller J Tags: Australas Psychiatry Source Type: research

Self-amputation of the hand: issues in diagnosis and general hospital management.
CONCLUSIONS: Deliberate limb self-amputation is a rare event with the majority of reported cases occurring during an episode of psychosis. This case illustrates the diagnostic utility of the literature supporting that a person who has self-inflicted amputation of a limb should be treated as psychotic until proven otherwise. The presence of a traumatic brain injury, with associated cognitive and psychosocial sequelae, affected diagnosis and management. Early and ongoing involvement of consultation-liaison psychiatry collaborating with a multidisciplinary general hospital team may improve mental and physical health outcomes ...
Source: Australasian Psychiatry - September 23, 2015 Category: Psychiatry Authors: Crawford A, Wand AP, Smith MA Tags: Australas Psychiatry Source Type: research

Improving metabolic monitoring in patients maintained on antipsychotics in Penang, Malaysia.
CONCLUSIONS: Responding to challenges in achieving improved routine metabolic monitoring of patients maintained on antipsychotics required on-going dialogue with the clinical staff, in order to address both service pressures and cultural concerns. PMID: 26400455 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - September 23, 2015 Category: Psychiatry Authors: Hor ES, Subramaniam S, Koay JM, Bharathy A, Vasudevan U, Panickulam JJ, Ng I, Arif NH, Russell V Tags: Australas Psychiatry Source Type: research

C-reactive protein: an early critical sign of clozapine-related myocarditis.
CONCLUSIONS: Current protocols monitoring for myocarditis have their limitations and can often only be used to support a presumptive diagnosis of myocarditis. In keeping with the current clozapine monitoring guidelines, we demonstrate that a rise in C-reactive protein levels can be a critical early sign of myocarditis warranting close monitoring and serious consideration for cessation of clozapine. PMID: 26400456 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - September 23, 2015 Category: Psychiatry Authors: Fehily SR, Forlano R, Fitzgerald PB Tags: Australas Psychiatry Source Type: research

Incidence and risk factors for clozapine-induced myocarditis and cardiomyopathy at a regional mental health service in Australia.
CONCLUSIONS: These results illustrate a high incidence of clozapine-induced myocarditis as well as cardiomyopathy, reinforcing the need for a standardised, mandatory monitoring scheme. Concomitant SSRI use as one such potential predictor merits further study. PMID: 26400457 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - September 23, 2015 Category: Psychiatry Authors: Youssef DL, Narayanan P, Gill N Tags: Australas Psychiatry Source Type: research

Exposure based therapy for problem gambling in a patient with Alzheimer's dementia.
CONCLUSION: Studies show good response to the use of exposure therapy in patients with cognitive impairment and further studies are needed to study the neurobiological changes and response to the therapy in patients with cognitive impairment. PMID: 26351301 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - September 8, 2015 Category: Psychiatry Authors: Dham P, Larsen A, Baigent M Tags: Australas Psychiatry Source Type: research

Evaluation of consultation-liaison psychiatry referrals from a critical care unit of an outer suburban hospital.
CONCLUSION: Those identified to have a pre-existing mental illness and who had engaged in treatment were found to be inadequately supervised. They require more extended care and monitoring for suicidality and co-morbid physical conditions. PMID: 26339069 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - September 2, 2015 Category: Psychiatry Authors: Devasagayam D, Clarke D Tags: Australas Psychiatry Source Type: research

Balint groups - helping trainee psychiatrists make even better use of themselves.
CONCLUSIONS: The pilot suggested that, within the public health training setting, a cohesive group could form such that trainees were able to make use of a Balint group experience. It suggested that this practice could be beneficial in managing the stresses, isolation and intense feelings of working with patients in this setting. The feedback indicated that the group helped trainees 'think differently' by fostering self-awareness and so furthered their development of psychodynamic skills. PMID: 26253524 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - August 7, 2015 Category: Psychiatry Authors: McKensey A, Sullivan L Tags: Australas Psychiatry Source Type: research

Early memories: Clinical relevance and significance.
CONCLUSIONS: The findings of this exploratory study suggest that earliest memories may be of clinical significance for diagnostic and therapeutic interventions in psychiatry. PMID: 26246445 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - August 5, 2015 Category: Psychiatry Authors: van der Watt G, Coall D, Sng A, Janca A Tags: Australas Psychiatry Source Type: research

A case report using the mental state examination scale (MSES): a tool for measuring change in mental state.
CONCLUSION: MSES may enhance the quality of clinical practice for clinicians, and potentially serve as an index of universal mental healthcare outcome that can be used in clinical practice, service evaluation, and healthcare economics. PMID: 26246446 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - August 5, 2015 Category: Psychiatry Authors: Fernando I, Carter G Tags: Australas Psychiatry Source Type: research

Should we be worrying about the status of anxiety research in Australia and New Zealand?
PMID: 26216796 [PubMed - in process] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 31, 2015 Category: Psychiatry Authors: Castle D Tags: Australas Psychiatry Source Type: research

Anxiety disorders deserve an integrated systems approach - An interview with Prof David Castle.
PMID: 26216797 [PubMed - in process] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 31, 2015 Category: Psychiatry Authors: Amos A Tags: Australas Psychiatry Source Type: research

Anxiety disorders.
Authors: PMID: 26216798 [PubMed - in process] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 31, 2015 Category: Psychiatry Tags: Australas Psychiatry Source Type: research

Book review: Perplexing prophet: a biography of Reginald Ellery.
PMID: 26216799 [PubMed - in process] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 31, 2015 Category: Psychiatry Authors: Haslam N Tags: Australas Psychiatry Source Type: research

A survey of psychiatrists and trainees to determine their level of familiarity with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis.
PMID: 26216800 [PubMed - in process] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 31, 2015 Category: Psychiatry Authors: Briggs E, Wang G, Orr K Tags: Australas Psychiatry Source Type: research

R: A statistical package and metaphorical free lunch.
PMID: 26216801 [PubMed - in process] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 31, 2015 Category: Psychiatry Authors: Muncer S Tags: Australas Psychiatry Source Type: research

Duty of care versus least restrictive care. The High Court weighs in.
PMID: 26216802 [PubMed - in process] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 31, 2015 Category: Psychiatry Authors: Keightly P, Jones M Tags: Australas Psychiatry Source Type: research

From the President.
Authors: PMID: 26216803 [PubMed - in process] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 31, 2015 Category: Psychiatry Tags: Australas Psychiatry Source Type: research

From the CEO.
Authors: PMID: 26216804 [PubMed - in process] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 31, 2015 Category: Psychiatry Tags: Australas Psychiatry Source Type: research

Congress welcomes over 1300 delegates in Brisbane.
Authors: PMID: 26216805 [PubMed - in process] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 31, 2015 Category: Psychiatry Tags: Australas Psychiatry Source Type: research

RANZCP Awards presented at Congress 2015.
Authors: PMID: 26216806 [PubMed - in process] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 31, 2015 Category: Psychiatry Tags: Australas Psychiatry Source Type: research

College Medal of Honour - Professor Basil James.
Authors: PMID: 26216807 [PubMed - in process] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 31, 2015 Category: Psychiatry Tags: Australas Psychiatry Source Type: research

The Ian Simpson Award - Professor David Castle.
Authors: PMID: 26216808 [PubMed - in process] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 31, 2015 Category: Psychiatry Tags: Australas Psychiatry Source Type: research

The College Citation - Dame Marie Bashir.
Authors: PMID: 26216809 [PubMed - in process] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 31, 2015 Category: Psychiatry Tags: Australas Psychiatry Source Type: research

The College Citation - Professor Gin Malhi.
Authors: PMID: 26216810 [PubMed - in process] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 31, 2015 Category: Psychiatry Tags: Australas Psychiatry Source Type: research

The College Citation - Professor Graham Martin.
Authors: PMID: 26216811 [PubMed - in process] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 31, 2015 Category: Psychiatry Tags: Australas Psychiatry Source Type: research

New Fellows.
Authors: PMID: 26216812 [PubMed - in process] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 31, 2015 Category: Psychiatry Tags: Australas Psychiatry Source Type: research

Upcoming RANZCP conferences and events.
Authors: PMID: 26216813 [PubMed - in process] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 31, 2015 Category: Psychiatry Tags: Australas Psychiatry Source Type: research

Gut feelings 1. Mind, mood and gut in irritable bowel syndrome: approaches to psychiatric care.
CONCLUSIONS: IBS affects up to 15% of the population. Antidepressants and brief psychotherapy can reduce symptom severity and improve coping. These treatments are effective for patients without comorbid mental illness, as well as those with increased somatisation, health-care seeking and sexual abuse histories. PMID: 26148736 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 6, 2015 Category: Psychiatry Authors: Keightley P, Pavli P, Platten J, Looi JC Tags: Australas Psychiatry Source Type: research

Recovery-based services in a psychiatric intensive care unit - the consumer perspective.
CONCLUSIONS: Recovery principles can be successfully introduced in a psychiatric intensive care unit environment. Introduction of recovery based practice was associated with a reduction in seclusion. PMID: 26148737 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 6, 2015 Category: Psychiatry Authors: Ash D, Suetani S, Nair J, Halpin M Tags: Australas Psychiatry Source Type: research

'Teaching' the therapeutic alliance Part 2. Treating patients, supporting trainees: towards a broader view of psychotherapy training.
CONCLUSION: Some preliminary suggestions for affective or "right-brain" training, including supervision for psychotherapy with patients with developmental trauma and Balint-style groups are made. PMID: 26148738 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 6, 2015 Category: Psychiatry Authors: Chazan L Tags: Australas Psychiatry Source Type: research

What happens to episode duration and cycle length over the course of bipolar disorder?
Abstract OBJECTIVES: Published scientific literature on cycle acceleration over the course of bipolar disorder has been equivocal. The present analysis aimed to find whether episode duration and cycle lengths become shorter over the course of bipolar disorder with predominantly manic polarity. METHODS: The present study comprised 150 patients diagnosed with bipolar I disorder using SCID-I for DSM-IV TR. The course of illness was charted according to the NIMH Life Chart Methodology - Clinician Retrospective Chart (NIMH - LCM CRC). Spearman correlation was used to assess the relationship of episode duration and...
Source: Australasian Psychiatry - July 2, 2015 Category: Psychiatry Authors: Subramanian K, Kattimani S, Rajkumar RP, Bharadwaj B, Sarkar S Tags: Australas Psychiatry Source Type: research

Implementing evidence-based physical activity interventions for people with mental illness: an Australian perspective.
CONCLUSIONS: PA is a feasible, effective and acceptable adjunct to usual care for a variety of mental disorders. There is a clear need for greater investment in initiatives aiming to increase PA among people experiencing mental illness, given the benefits to both mental and physical health outcomes. PMID: 26139698 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 2, 2015 Category: Psychiatry Authors: Rosenbaum S, Tiedemann A, Stanton R, Parker A, Waterreus A, Curtis J, Ward PB Tags: Australas Psychiatry Source Type: research

A decade of peace: Mental health issues and service developments in the Solomon Islands since 2003.
CONCLUSIONS: Continued investment in mental health, including the treatment and prevention of mental and substance use disorders, is essential for mental health and development outcomes. All development stakeholders, including civil society, government, academic and research institutions, and development partners, have a role to play. PMID: 26139699 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 2, 2015 Category: Psychiatry Authors: Maukera R, Blignault I Tags: Australas Psychiatry Source Type: research

Experience from mental health clinics held during medical service camps in Fiji.
CONCLUSIONS: The accessibility of mental health support services is a challenge in Fiji. Medical service camps can form an important pathway in promoting mental health awareness, especially amongst the rural communities of Fiji, and a useful platform for medical students to acquire some clinical exposure. PMID: 26139700 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 2, 2015 Category: Psychiatry Authors: Sivakumaran H, George K, Naker G, Nadanachandran K Tags: Australas Psychiatry Source Type: research

Anxiety and substance use disorders: A worrying combination.
CONCLUSIONS: A comprehensive assessment can assist in formulating a holistic management plan that incorporates adapted psychological and pharmacological therapies to address both substance use and anxiety disorders in an integrated manner. PMID: 26139701 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 2, 2015 Category: Psychiatry Authors: Arunogiri S, Lubman DI Tags: Australas Psychiatry Source Type: research

Visualizing psychiatric formulation.
CONCLUSIONS: It is expected that this paper will assist educators and learners to better conceptualise psychiatric formulation through activating prior knowledge through this visual metaphor. Future educational research will determine the effectiveness of this proposed learning tool. PMID: 26139702 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 2, 2015 Category: Psychiatry Authors: Alyami H, Sundram F, Hill AG, Alyami M, Cheung G Tags: Australas Psychiatry Source Type: research

An audit of assessment and outcome of intervention at a quit smoking clinic in a homeless hostel.
Abstract OBJECTIVE: We aim to report on smoking history, mental and physical health, and the results of interventions provided by a Quit Smoking Clinic (QSC) at a Sydney homeless men's shelter. METHODS: We undertook an audit of questionnaires administered during the first QSC visit and a review of outcomes of QSC clients who attended the clinic more than once. RESULTS: A total of 144 men were assessed at the QSC, with mean age 45.2 years (22-71) and mean smoking duration of 29 years. About half were receiving treatment for psychotic illness, and there were high rates of other psychiatric disorders, physi...
Source: Australasian Psychiatry - July 2, 2015 Category: Psychiatry Authors: Power J, Mallat C, Bonevski B, Nielssen O Tags: Australas Psychiatry Source Type: research

An audit of general practitioner involvement in public community mental health care.
CONCLUSION: Although the medical comorbidities of serious mental illness are becoming increasingly recognised, our findings suggest the need for ongoing and coordinated efforts by policymakers, general practitioners, mental health services and patients to ensure the health and longevity of people with serious mental illness. PMID: 26139704 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 2, 2015 Category: Psychiatry Authors: Jang J, Futeran S, Large M, Curtis J Tags: Australas Psychiatry Source Type: research

Marriage equality is a mental health issue.
CONCLUSION: Marriage equality is still lacking in Australia and as a positive correlate of health should be strongly supported. PMID: 26139705 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - July 2, 2015 Category: Psychiatry Authors: Kealy-Bateman W, Pryor L Tags: Australas Psychiatry Source Type: research

Mental health in the Solomon Islands: developing reforms and partnerships.
CONCLUSIONS: Key learning points from the collaboration included the critical need to establish partnerships with community stakeholders, the importance of sustaining a well-functioning mental health team, and optimising the strengths of the local resources in the Solomon Islands. Through this project, national policies, promotion and service delivery were strengthened, through the exchange of experiences and mobilisation of north-south (Australia-Solomon Islands) and south-south (Solomon Islands-other Pacific nations) technical expertise. This project demonstrates the potential for international partnerships to contribute...
Source: Australasian Psychiatry - June 30, 2015 Category: Psychiatry Authors: Ryan B, Orotaloa P, Araitewa S, Gaoifa D, Moreen J, Kiloe E, Same W, Goding M, Ng C Tags: Australas Psychiatry Source Type: research

Implementing music therapy on an adolescent inpatient unit: a mixed-methods evaluation of acceptability, experience of participation and perceived impact.
CONCLUSIONS: Integration of music therapy in inpatient treatment of adolescents is feasible and acceptable, and is valued by staff and patients as a complement to 'talking therapies'. Participation is enjoyed and associated with outcomes including improvement in mood, expression of feelings and social engagement consistent with recovery. PMID: 26129812 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - June 30, 2015 Category: Psychiatry Authors: Patterson S, Duhig M, Darbyshire C, Counsel R, Higgins N, Williams I Tags: Australas Psychiatry Source Type: research

No duty owed to the relatives of a victim of a person with mental illness.
CONCLUSIONS: By a narrow interpretation, the High Court found that the exercise of the powers and duties in relation to the involuntary detention of a mentally ill person as prescribed by the Mental Health Act were inconsistent with a common law duty of care to another person or the relatives of another person. PMID: 26129813 [PubMed - as supplied by publisher] (Source: Australasian Psychiatry)
Source: Australasian Psychiatry - June 30, 2015 Category: Psychiatry Authors: Scott R Tags: Australas Psychiatry Source Type: research

Reflections on Aboriginal perinatal mental health, mothers, babies, families and community: A South Australian trainee's experience.
CONCLUSIONS: ESTP provided a fertile area to hone an advanced trainee's skills in the niche areas of Aboriginal mental health, perinatal mental health, culture and psychiatry. In addition, it provided skills in the area of leadership, health advocacy and the establishment and maintenance of successful programs in disadvantaged, culturally and linguistically diverse communities. The ESTP Aboriginal Mental Health rotation provides a unique experience for training, and the learning opportunities are limited only by the creativity of the trainee and supervisor. PMID: 26129814 [PubMed - as supplied by publisher] (Source: A...
Source: Australasian Psychiatry - June 30, 2015 Category: Psychiatry Authors: Laddipeerla A, Alexander J, Lattanzio A Tags: Australas Psychiatry Source Type: research

Educating for diversity: an evaluation of a sexuality diversity workshop to address secondary school bullying.
Abstract OBJECTIVE: To evaluate the potential of a 60-minute sexuality diversity workshop to address bullying in secondary schools. METHODS: Students completed pre- and post-workshop questionnaires. Descriptive statistics were used to summarise results with pre- to immediate post-workshop changes compared using t-tests. Thematic analysis was used to analyse open-ended questionnaire responses. RESULTS: We had 229 students (mean age 13.7 years) attending 10 workshops participate in the study. Three-quarters of students thought the workshop would reduce bullying in schools, and over 95% of the participants ...
Source: Australasian Psychiatry - June 30, 2015 Category: Psychiatry Authors: Lucassen MF, Burford J Tags: Australas Psychiatry Source Type: research