How informative is the print media coverage of colorectal cancer?

AIM: To date there has been no assessment of the educational content of colorectal newspaper articles. We aimed to analyse articles in the print media concerning colorectal cancer for their public health content. METHOD: Articles mentioning colorectal cancer in the top 10 UK newspapers were analysed over a 1-year period for their educational content. The number of articles mentioning 'red flag' symptoms, celebrity connections or specific cancer charities was recorded. RESULTS: Of the 349 articles identified, 146 were not relevant. Of the remaining 203 articles, 62 (30%) were concerned with celebrities with colon cancer, 13 (6.4%) made reference to red flag symptoms and 14 (6.9%) mentioned cancer charities by name. CONCLUSION: About 13% of newspaper articles have any educational content. If this increased, the general public might benefit.

How does the media profile of cancer compare with prevalence?

INTRODUCTION: Knowledge and understanding of disease can influence time to presentation and potentially, therefore, cancer survival rates. The media is one of the most important sources of public health information and it influences the awareness and perception of cancer. It is not known if the reportage of cancer by the media is representative to the true incidence of disease. MATERIALS AND METHODS: The top 10 UK daily newspapers were assessed over a 1-year period for the 10 most common UK cancers via their on-line search facilities. RESULTS: Of the 5832 articles identified, there was marked over-representation of breast, kidney and stomach cancer with ratios of prevalence to reporting of 1.4, 1.9 and 3.2 to 1, respectively. Colorectal, non-Hodgkin lymphoma, bladder and oesophageal cancers are all markedly under-represented with ratios of 0.4, 0.2, 0.6 and 0.4 to 1, respectively. CONCLUSIONS: A policy of media advocacy by health professionals could enhance the information provided by the media and thus reflect the true extent of disease. A partnership between health professionals and journalists could result in articles that are relevant to the population, informative and in a style and format that is easily comprehendible. Targeted public health information could highlight the 'red-flag' symptoms and break down any stigma associated with cancer. This enhanced awareness could improve the health-seeking behaviour of the general population and reduce the delay from symptoms to diagnosis.

Comparison between register and structured interview diagnoses of schizophrenia: a case for longitudinal diagnostic profiles.

OBJECTIVE: Mental health registers contain diagnoses from serial contacts with mental health facilities over many years. This study examines the relationship between longitudinal diagnostic profiles and structured interview diagnoses. The aim is to improve the definition of diagnoses drawn from clinical case registers. METHOD: The Tasmanian Mental Health Case Register includes 1922 individuals, each with at least one diagnosis of schizophrenia between 1965 and 1990. A representative subsample of 29 individuals were assessed by the structured diagnostic interview for DSM-III-R (SCID). Diagnostic agreement between Register and SCID diagnoses was compared. RESULTS: Twenty-four subjects (82.8%) received a lifetime diagnosis of schizophrenia on the SCID. For each subject, 'schizophrenia diagnostic dominance', the percentage of register entries with schizophrenia diagnoses over total entries, was calculated. Agreement between register and SCID correlated positively with schizophrenia diagnostic dominance and negatively with register mood diagnoses. CONCLUSIONS: Longitudinal diagnostic profiles on databases may be superior to cross-sectional clinical diagnoses in predicting structured interview diagnoses, and may be useful in defining caseness in epidemiological studies using register diagnoses.

Predictability of rehospitalisation over 5 years for schizophrenia, bipolar disorder and depression.

OBJECTIVE: The aim of this study was to examine the rate of rehospitalisation for schizophrenia, bipolar disorder and depression over a 5-year period in Tasmania, and to identify predictors of the number and duration of readmissions. METHOD: The Tasmanian Mental Health Register was used to study the 5-year pattern of rehospitalisation for all patients admitted to a Tasmanian public psychiatric inpatient facility with a primary diagnosis of schizophrenia, bipolar disorder or depression, in 1983 or 1984. RESULTS: Seventy-one percent of patients receiving a diagnosis of schizophrenia were readmitted in the 5-year period, compared to 59% for bipolar disorder and 48% for depression. For all three diagnoses, the number of prior admissions was a predictor of the number of readmissions and the total number of days spent in hospital in the follow-up period. Age and sex also had significant effects, which varied across diagnostic groups. CONCLUSIONS: A substantial proportion of patients hospitalised for schizophrenia, bipolar disorder or schizophrenia were rehospitalised during the next 5 years. Patients with more previous admissions had more readmissions than those with fewer previous admissions.

Season of birth and schizophrenia in Tasmania.

OBJECTIVE: The purpose of the present study was to determine whether there was a significant seasonal variation in the birth dates of patients with schizophrenia born in Tasmania. METHOD: The season of birth in Tasmanian-born patients with schizophrenia (n = 1412), born between 1919-1970, was compared with general population data. RESULTS: No significant variation in month or quarter of birth was detected for the subjects with schizophrenia. Neither was there any significant seasonal excess when data from different decades were analysed separately, nor for subsidiary analyses of gender or paranoid/non paranoid subtype. CONCLUSION: These results are compared with those of six other published studies of Australasian-born subjects identified through registers in different States. While both positive and negative results are reported, no clear pattern emerges. The relevance of season of birth to the development of schizophrenia in Australia remains an open question.

Decline in diagnoses of schizophrenia in Tasmania during the period 1965-1990.

Changes in the rates of diagnosis of schizophrenia in Tasmania, Australia during the period of 1965-1990 were examined using records from the State mental health case register. Analyses were restricted to subjects with diagnoses recorded between the ages of 20 and 29 years in order to reduce possible errors caused by age-standardized methods. There was a significant decrease in the rate of non-paranoid subtypes of schizophrenia in female subjects, accompanied by a commensurate rise in the rate of bipolar diagnoses in that group. Differential changes in male and female subjects support explanations of phenotypic shifts in presentation of psychosis as well as changes in diagnostic practice.

Psychiatric characteristics of female prisoners in Tasmania.

OBJECTIVE: The aim of the paper is to describe some of the psychiatric, social and criminological features of female prisoners in Tasmania between 1981 and 1990 inclusive. METHOD: Data were collated from prison records for all 210 women prisoners incarcerated between the above dates. Using the Mental Health Services database it was determined which prisoners had prior contact with State Psychiatric Services, their clinical state, various demographic data and ICD-9 diagnoses. Forensic data obtained from prison records were compared for those with and those without a psychiatric history of attendance at Mental Health Services; appropriate privacy safeguards were used in handling the material. RESULTS: Thirty-five per cent of prisoners had prior contact with the Mental Health Services before imprisonment. They were predominantly persons with an abnormal personality. Non-addictive drug abuse was the next most common psychiatric category (19%). Only 3% suffered from schizophrenia or affective disorder. Those with prior psychiatric presentation had greater social maladjustment, longer sentences for similar offences and a higher recidivism rate. There was an increase in the number of prisoners with and without a psychiatric diagnosis during the decade. CONCLUSIONS: Thirty-five per cent of the female prison population had previously attended psychiatric services in the State. This is fewer than reported in Britain and the US, probably because of the different social structure of this community. These persons differ from other prisoners by showing greater impairment in social adjustments and relationships. They appear to be treated differently with respect to sentencing. There was no evidence of a simple reciprocal relationship between deinstitutionalisation and imprisonment.

Towards a sociobiological model of depression. A marsupial model (Petaurus breviceps).

BACKGROUND: This is a sociobiological approach to depression using hierarchy and its hypothesised relevance to self-esteem in the marsupial sugar glider (Petaurus breviceps). METHOD: Differential access to resources between the dominant and submissive animal is measured by observation in four stable colonies. The dominant animals from two of these colonies are then introduced into the other two, resulting in the transferred former dominants becoming subordinate. Behavioural and biochemical measures relevant to depression and involving access to resources are then repeated. These measures include eating, drinking, social and sexual access, motility, grooming and biochemical estimates of cortisol and testosterone. RESULTS: Subordinate animals have significantly less access to resources, both in the stable colony and when the formerly dominant animals become subordinate. CONCLUSIONS: A sociobiological approach using a hierarchy model equating resource-holding potential with self-esteem, exemplified by this study, may provide new concepts and insights into the phenomenology and pathophysiology of depression. It allows comparisons to be made between animal behaviour and cognition: the lack of such has been a major difficulty in animal studies hitherto. The findings are possibly more relevant to dysthymia than to affective disorder and imply a relationship between low resource-holding potential in sub-human animals as a phylogenetic antecedent of some of the cognitive and affective aspects of depression in man.

Cell-mediated immunity in combat veterans with post-traumatic stress disorder.

OBJECTIVE: To explore immune function in patients with chronic post-traumatic stress disorder (PTSD). DESIGN: A case-control study using the standardised Cell-mediated Immunity (CMI) Multitest. PARTICIPANTS: Cases were 25 Vietnam combat veterans undergoing treatment for clinically diagnosed PTSD. Controls had no diagnosed psychiatric disorders: 28 were civilians and 20 were servicemen who had had South-east Asian postings but no combat experience. MAIN OUTCOME MEASURES: The sum score, the number of reactions and the compound scores from the CMI Multitest were assessed as a measure of immune function. RESULTS: Psychometric tests distinguished between cases and controls at a highly significant level (P < 0.001). Veterans with PTSD had enhanced cell-mediated immunity compared with civilians (P = 0.008) and servicemen (P = 0.02). CONCLUSION: PTSD in combat veterans is associated with enhanced cell-mediated immune responsiveness. This could have wide implications for psychiatry and general medicine.

Long term secure care in Tasmania.

The aim was to determine the requirement in Tasmania for long term (greater than 28 days) secure ward beds, and to characterise the patients who use them. There was complete enumeration over an 18 month period. The results included that 3.6 long term secure beds were used per 100,000 general population. Compared to those who were discharged during the survey, those who were not discharged were older, had spent longer in psychiatric hospitals and were more likely to be male and to suffer from schizophrenia. All patients were white Australians. The conclusions included that for planning purposes a minimum of 4.6 long term secure beds was required per 100,000 general population. Also, Aboriginal people and people from non-English speaking backgrounds were not over represented in long term secure care in Tasmania. Finally, "good" and "poor" prognosis groups were identified and further work is required to determine how these can best be managed.