Jerzy Krupinski

Health and quality of life

Abstract The Health and Social Survey of the North-West Region of Melbourne (1000 households with 3000 subjects) made it possible to relate the physical and psychological health of interviewees to their “quality of life”. “Quality of life” was measured by objective indicators such as work, income, housing and time spent on specific activities and by the subjective perception of life by respondents. The importance of specific areas of life was compared with the existing situation. The survey has shown a lack of association between ill-health and almost all social factors. Further, the amount of time spent on specific activities did not seem to have an influence on the prevalence of either physical or psychological disorders. On the other hand, marked associations were found between the level of fulfilment in specific areas and the prevalence of psychiatric disorders. It is suggested that we should not aim in health education programmes at imposing our values on the population at large but rather should try to help individuals to determine and to fulfil their desires in actual life.

Psychiatric disorders in East European refugees now in Australia

Abstract A sample of eastern European refugees who had arrived in Australia prior to 1955, and who were patients of any facility of the Victorian Mental Health Department during the period 1961–1968, were intensively interviewed to determine their war experiences, socio-cultural backgrounds, family settings, educational and work histories and adjustment problems in Australia. A control sample of non-patient refugees was interviewed along the same lines. Three groups of refugees, distinguished in terms of the severity of their war experiences (1. Jewish; 2. Polish, Russian and Ukrainian; and 3. all others) were compared with each other, and their psychiatric morbidity was related to their war experiences and other factors. Each of these groups responded differently to the hardships they had gone through.

Sociological aspects of mental ill-health in migrants☆

Abstract An analysis of all first admissions to hospitals and out-patient clinics of the Mental Health Department, Victoria, Australia, revealed that some psychiatric disorders, mainly schizophrenic states, occured much more frequently in non-British immigrants, especially in those from Eastern Europe, than in Britons and Australian-born. An attempt was made to determine some of the social factors which could be responsible for the observed phenomenon.

The identification and treatment of depression by General Practitioners

Objective: To assess the level of recognition and knowledge about treatment of depression by General Practitioners (GPs). Method: Analysis of questionnaires completed by participants commencing a series of workshops aimed at improving their knowledge of the diagnosis and treatment of depression. Of the 3289 GPs involved in the program 2500 (76%% respondent rate) completed the questionnaires in a group situation. There was no difference between respondents and nonrespondents in terms of age, gender and year of graduation. Results: The majority of GPs believe they have a satisfactory competence in the recognition and treatment of depression, although a sizeable minority based their diagnosis predominantly on somatic symptoms. The GPs felt confident about their knowledge and skills in counselling and the use of antidepressant medication, but not in dealing with children and suicidal or pregnant patients. The most common symptoms used to identify ‘depression’ were sleep disorders and only 54%% listed depressed mood as a symptom on which the diagnosis is based. Only 28%% reported sufficient symptoms to meet criteria for DSM-IV major depressive disorder, which supports views that these criteria are inappropriate for general practice. Fifty-seven percent of doctors used medicine together with nonpharmacological treatment in the majority of patients, and medications doses were almost all within the range recommended in the product information. Conclusions: There is a need to improve GPs knowledge in diagnosing depression, in child psychiatry and in dealing with pregnant and suicidal patients.

Attempted suicides admitted to the mental health department, Victoria, Australia: a socio-epidemiological study.

THE shortcomings of statistics concerned with completed suicides have been discussed by many authors.(5, 23) However, a much more arduous task is to assess the real numbers of suicide attempts. Some authors have based their figures on admissions to one or more hospitals,<8, 11, 1~, 21, 22) whilst others have claimed to cover all recorded cases of attempted suicide. Thus, according to Kessel and Lee, (15) all cases of attempted suicide in Edinburgh are sent to one institution (Ward 3 of the Royal Infirmary). Dorpat and Boswell,~6> similarly claim to cover attempted suicides in Washington, since all are sent to the King County Hospital in accordance with the law (suicide being a crime in Washington State). From Australia, Gold(1O) claimed to cover all cases of attempted suicide in North Eastern Tasmania.

A Survey of Community Attitudes Towards Mental Illness : Part 1 the Questionnaire

Selected respondents drawn from metropolitan Melbourne (N = 318), when asked to express their opinions and attitudes in relation to four hypothetical characters, recognized mental illness in the paranoid schizophrenic, were hesitant to acknowledge it in the simple schizophrenic and the alcoholic, and denied it almost absolutely in the anxiety neurotic. Failure to diagnose a condition as mental illness did not, however, necessarily preclude recognition that the person described was in need of psychiatric help. Certain respondent characteristics and, in particular, education were related to the opinions and attitudes expressed.

Urbanization and Mental Health: Psychiatric Morbidity, Suicide and Violence in the State of Victoria

Australia is one of the most urbanized countries in the world with over 85% of the population living in metropolitan and other urban areas. More important, the change from a predominantly rural society to an urbanized society has occurred within the last 100 years. To assess the effects of urbanization on mental health, rates of admissions to psychiatric institutions, suicides and violent crime in Victoria have been analysed for the last hundred years. Data on admissions to psychiatric facilities in Victoria from metropolitan, other urban and rural areas, as well as results of community health surveys carried out in metropolitan and rural areas were compared to examine for evidence of urban-rural differences in psychiatric morbidity. The findings do not support the notion that the level of psychiatric and psychosocial disorders in Victoria are related to urbanization or to urban living.

Changing Patterns of Psychiatric Hospitalization in past Fifty Years: A Cohort Study*

Nine cohorts of patients admitted between 1919 and 1962 have been followed up until 1971. Comparison has been made in terms of sex and age specific incidences of selected psychiatric disorders throughout the whole period. The results of treatment have been evaluated in terms of discharge and death rates, length of stay, re-admission rates to psychiatric institutions and total period under hospitalization. These data have been compared with those available since the introduction of the statistical system in Victoria in 1961.

Patterns of psychiatric morbidity in Victoria, Australia, in relation to changes in diagnostic criteria 1848–1978

SummaryPsychiatric records dating back to 1848 (when Yarra Bend, the first mental asylum in Victoria, Australia, was opened) were used to determine admission patterns of Victorian psychiatric institutions. Whilst the overall rate of admissions per 100,000 of population has remained constant up to the early 1950s the diagnosis of mania, which was one of the most prevalent in the 19th century, has almost disappeared as a cause for admission to psychiatric institutions. On the other hand, there has been an evident increase in admissions with depressive illness (in the past recorded as melancholia) and especially with schizophrenia (previously recorded as dementia praecox and/or delusional insanity). Modified DSM III criteria were used to assess retrospectively the diagnostic decisions made. Whilst past diagnoses of schizophrenia would be supported today, only 2.5% diagnoses of mania made in the mid to late 19th century would be confirmed today. With the decline in the number of patients with a diagnosis of mania the percentage agreement between the original and DSM III diagnosis increased to 70% in the 1950s. Changes noted in diagnostic habits were related to the development of psychiatry.

Occupational Hierarchy of First Admissions to the Victorian Mental Health Department, 1962-1965

ECOLOGICAL studies of mental illness have been orientated for some time towards social class, as an important environmental variable influencing the incidence and prevalence of mental disorders in the population. Apart from some epidemiological studies, reporting different rates of psychiatric disturbances for different groups of population, the classical surveys in this area were made by Faris and Dunham’ and Hollingshead and Redlich.’