Perceived injustice: a historical and clinical review of a useful concept for psychiatry.

OBJECTIVE: Perceived injustice, a concept that arose in pain medicine, refers to an individual's experiences and perceptions of victimisation from injuries resulting in chronic pain. Here, we have undertaken a historical and clinical review on the role of perceived injustice medicine in psychiatry and a systematic review on psychotherapeutic interventions for perceived injustice. METHOD: For the systematic review, two studies were identified from a search of six databases. RESULTS: Though evidence is limited, psychotherapeutic interventions show promise in addressing perceived injustice and associated symptomatology. CONCLUSION: Perceived injustice is a concept which may have great potential utility to psychiatry, particularly in occupational and medicolegal areas. Interventions addressing perceived injustice may help improve clinical outcomes.

Betting on Australian Rules Football: Can Expert Tipsters beat Randomness?

Betting on the various codes of football in Australia accounts for the majority of sports betting, with Australian rules football (AFL) by far the most popular sport in Australia. Several studies have revealed the heavy presence of gambling advertising during AFL broadcasts, and a frequently used advertising strategy involves the use of well-known AFL commentators outlining their tips and betting suggestions. To date, no research has examined the hypotheses that skill may help in predicting AFL matches and monetary outcomes from AFL betting. Rather than merely discounting such ideas, it is important to test them empirically. The aims of this study were therefore, to examine if (1) expert AFL tipsters made better predictions than random picks, (2) expert AFL tipsters gained greater monetary reward than random selection, and (3) expert tipsters' prediction accuracy improved with betting experience. To this end, six seasons of AFL matches, odds data, and expert tipster data were analysed retrospectively, totalling 1141 matches. Random selections were calculated for each match using an inbuilt random number generator within Microsoft Excel and a $2 simulated wager was applied for each AFL match. The results of mixed-effects modelling showed that experts picked more correct outcomes than random selection; experts' correct predictions were partially mediated by home-game selections; no difference in monetary outcome was observed for experts compared to random selection; experts' predictions did not improve over time. The results of this study may be used to inform both psychological interventions that target gamblers' illusions of control, and public health gambling harm prevention messaging.

The neuropsychiatric effects of vitamin C deficiency: a systematic review.

BACKGROUND: Vitamin C deficiency may be more common than is generally assumed, and the association between vitamin C deficiency and adverse psychiatric effects has been known for centuries. This paper aims to systematically review the evidence base for the neuropsychiatric effects of vitamin C deficiency. METHODS: Relevant studies were identified via systematic literature review. RESULTS: Nine studies of vitamin C deficiency, including subjects both with and without the associated physical manifestations of scurvy, were included in this review. Vitamin C deficiency, including scurvy, has been linked to depression and cognitive impairment. No effect on affective or non-affective psychosis was identified. CONCLUSIONS: Disparate measurement techniques for vitamin C, and differing definitions of vitamin C deficiency were apparent, complicating comparisons between studies. However, there is evidence suggesting that vitamin C deficiency is related to adverse mood and cognitive effects. The vitamin C blood levels associated with depression and cognitive impairment are higher than those implicated in clinical manifestations of scurvy. While laboratory testing for ascorbic acid can be practically difficult, these findings nonetheless suggest that mental health clinicians should be alerted to the possibility of vitamin C deficiency in patients with depression or cognitive impairment. Vitamin C replacement is inexpensive and easy to deliver, although as of yet there are no outcome studies investigating the neuropsychiatric impact of vitamin C replacement in those who are deficient.

Use of ultrabrief pulse width electroconvulsive therapy to induce therapeutic seizures in an elderly patient with a high seizure threshold: a case report.

OBJECTIVE: This case report describes a 73-year-old man suffering from unipolar major depression with melancholic features, in whom treatment with electroconvulsive therapy (ECT) proved difficult due to inadequate seizure generation. METHODS: A number of augmentation strategies were trialled in an attempt to improve seizure quality. Pre-ECT and Post-ECT measurement of symptoms, quality of life and cognition were undertaken with a variety of validated scales. RESULTS: The single most efficacious strategy to elicit therapeutic seizures was the use of right unilateral (RUL) electrode placement with an ultrabrief pulse width. The patient subsequently had a resolution of his depressive illness, with a concomitant improvement in cognitive functioning. CONCLUSION: This case demonstrates that a number of ECT augmentation strategies can be used in routine clinical practice for patients with high seizure thresholds. It highlights that UB pulse width may be considered earlier in the treatment course for patients in whom conventional brief pulse ECT fails to generate effective seizures.

Assessment and Management of Depression and Anxiety in Children and Adolescents with Epilepsy.

Anxiety and depression in children and adolescents with epilepsy are common comorbidities which place a significant burden on patients and families and complicate the clinical management of epilepsy. This paper presents a narrative review on the aetiology, phenomenology, assessment, and management of depression and anxiety among paediatric patients with epilepsy. The recognition of affective comorbidity in paediatric epilepsy is limited at present, and the contributory role of antiepileptic medication towards such comorbidity must be considered by clinicians.

Pharmacists' role in targeted cancer therapy in Australia and implications for pharmacy education.

OBJECTIVES: To investigate the pharmacists' role in providing targeted therapies to patients and its implications for pharmacy education. METHODS: Nine pharmacy faculty members, 12 clinical pharmacists, and 4 oncologists from across Australia and New Zealand participated in semistructured interviews, which were analysed using the framework method. RESULTS: Education about targeted therapies was seen as being important, although content about pharmacodiagnostic tests was taught inconsistently among 7 universities. Issues including funding, clinical and diagnostic validity of tests, and time taken for turnaround of tests were perceived as impediments to the acceptance by clinicians of the utility of pharmacodiagnostic tests. CONCLUSIONS: Pharmacists may be the ideal professionals to interpret test results and provide counselling for patients to assist them in compliance with targeted cancer therapies. Pharmacy education in cancer therapies is critical to training pharmacists who can assist patients in the correct use of these therapies.

Sexual dysfunction in men treated with depot antipsychotic drugs: a pilot study.

BACKGROUND: Sexual dysfunction is common, but often under-recognised, in people with schizophrenia. Many antipsychotic drugs are known to cause prolactin elevation, and it is often assumed that sexual dysfunction is a consequence of prolactin elevation. We investigated the relationship between sexual function and serum concentrations of prolactin and testosterone in men receiving regular long-acting depot injections of antipsychotic medication. METHODS: Twenty-two men attending a community depot clinic participated. A structured interview was used to collect information about sexual function, and serum prolactin and testosterone concentrations were measured. RESULTS: Sexual dysfunction was common, with 73% of men reporting problems in at least one area of sexual function. Six men had elevated serum prolactin and one had reduced serum testosterone. Antipsychotic drug dose was positively correlated with serum prolactin and negatively correlated with serum testosterone, but there was no association between serum prolactin or testosterone concentrations and any measure of sexual dysfunction. CONCLUSION: Sexual dysfunction is a major problem for men living with chronic schizophrenia, but our results suggest that it is not directly attributable to elevated prolactin or reduced testosterone concentrations.