Homelessness in Australia.
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Biomedical subjects
Publications and source records attributed to N Buhrich.
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Forty-two long-stay hospital patients with chronic schizophrenia were divided into age and sex-matched groups with and without temporal disorientation, and assessed for premorbid academic performance and past physical treatment. The schooling of schizophrenic patients who had cognitive impairment, as identified by gross temporal disorientation, did not differ from those who were cognitively intact. The groups did not differ in past history of ECT, insulin coma, neuroleptic treatment, or psychosurgery. Patients with age disorientation were on lower mean doses of neuroleptic or anticholinergic medication. Gross cognitive impairment thus appears to occur in the course of the disease and is not due to physical treatment.
Patients with acquired immunodeficiency syndrome (AIDS), who present with or develop psychotic symptoms, almost invariably have evidence of cognitive impairment. Three psychotic patients, one with AIDS, and two with AIDS-related complex (ARC), who showed no evidence of cognitive impairment, are reported. It is suggested that the human immunodeficiency virus (HIV) may produce symptoms indistinguishable from those seen in the functional psychoses.
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Psychiatric consultation was requested for 22 of 150 patients with the acquired immunodeficiency syndrome (AIDS) or AIDS-related complex (ARC) admitted to St Vincent's Hospital, Sydney. The mean age of the patients was 35 years and all were homosexual or bisexual men. Ten patients had an organic brain syndrome: six as a result of cerebral opportunistic infection, two due to metabolic or iatrogenic causes and two apparently due to the direct neurotropic effects of the human immunodeficiency virus (HIV). Hallucinations and delusions were documented in five patients, of whom two had symptoms that fulfilled the criteria for a diagnosis of functional psychosis. Four patients were diagnosed as having adjustment disorder-depressive mood and one patient may have had a major depressive illness. Marked denial of illness was seen in two patients and four had markedly slow mentation with only mild or no evidence of cognitive impairment. It is concluded that patients with AIDS may have a wide variety of neuropsychiatric manifestations.
Feminine behaviors during the childhood and adolescence of volunteer male transvestites who had shown a period of fetishism were investigated. The transvestites were categorized into two groups. Twenty who were satisfied with cross-dressing were termed nuclear transvestites, and 14 who desired at least a partial feminization were termed marginal transvestites. It was found that during their preadult years marginal transvestites showed significantly more feminine behaviors than nuclear transvestites, and both transvestite groups reported significantly more feminine behaviors than "normal" controls.
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The prevalence of schizophrenia in a large hostel for homeless men in an inner city area was found to be in the order of 15%. Concern is expressed that this figure represents a recent increase in the number of mentally ill among homeless men and may be related to changes in the management of chronic mental illness. Literature relating mental illness and homelessness is reviewed.
Social aspects of tattooed compared to non-tattooed narcotic addicts attending a methadone maintenance programme were investigated. It was found that those who were tattooed reported greater current social instability and a more deprived background compared to those without tattooes. None of the tattooes specifically identified the subjects as belonging to the drug scene nor could the age at which the subject was first tattooed be used to predict subsequent drug abuse. The presence of tattooes was unrelated to the current dose of methadone and to the duration of attendance on the methadone programme.
If the frequency of seizures by police of hallucinogens reflects the frequency with which various hallucinogens are ingested in Australasia, most toxic states resulting from hallucinogen abuse are due to Bromo-DMA and not to LSD as is commonly reported by the subjects. Two cases of intoxication with the new hallucinogen, Bromo-DMA, are reported. Both recovered within 24 hours following treatment with haloperidol.
The sexual identity of 65 Malaysian male medical students was investigated by anonymous questionnaire. Of these students, 40% were aware of homosexual feelings prior to age 15 years, and 16% were so aware currently. There were correlations between current homosexual feelings and feminine sex dimorphic behavior during childhood and between current homosexual feelings and feminine gender identity. The results are discussed in light of results of a similar questionnaire completed by 138 male medical students in Sydney, Australia.
The study investigated the social background and current social stability of 45 tattooed males. Tattooed subjects compared to non-tattooed controls were more likely to report leaving home and school early, to report spending a period in a boys' institution and in prison, and showed greater current instability with regard to accommodation and employment. Tattoos were significantly associated with a current diagnosis of personality disorder and alcoholism and past treatment for drug abuse and parasuicide.
Information concerning gender identity, sexual orientation, cross-dressing behavior, fetishism, and bondage was obtained from a questionnaire which was posted to members of two transvestite clubs, one in the United States and one in Australia. This study reports the responses of 136 American and 86 Australian self-designated transvestites who reported a period of fetishism to women's clothes at some stage of development. Characteristics of transvestism of subjects in both countries were remarkably similar; all were male, almost half the subjects first cross-dressed in prepuberty, and in the large majority cross-dressing was well established by late adolescence; intense fetishism was usually experienced during adolescence but waned in later years; in almost a quarter of subjects fetishism ceased, although the desire to cross-dress continued; in many subjects transvestism was associated with fantasies of bondage, usually of the subjects bound while cross-dressed; sexual orientation was predominantly or exclusively heterosexual in more than three-quarters of the subject. Subjects were categorized into two groups. One group, termed nuclear transvestites, were satisfied with cross-dressing. The second group, termed marginal transvestites, desired feminization by hormone ingestion or by surgical intervention. Marginal compared to nuclear transvesites reported significantly stronger feminine gender identity and tended to report a stronger interest in the homosexual direction. The differences appeared to be present from childhood. No significant differences were found between the nuclear and marginal transvestites with regard to characteristics of fetishism, bondage, and cross-dressing except that in the American group marginal transvestites currently cross-dressed more frequently than did nuclear transvestites.
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Demographic characteristics of all patients with a diagnosis of alcoholism or alcoholic psychoses admitted between 1975 and 1978 to the Psychiatry Department, General Hospital, Kuala Lumpur, were examined. The diagnosis of alcoholism or alcoholic psychoses accounted for 2% of the total psychiatric admissions. Males greatly predominated over females and Indians greatly predominated over Malays and Chinese. Reasons for these differences are discussed.
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Demographic and drug abuse characteristics of 3,484 new drug abuse contacts presenting to the General Hospital, Kuala Lumpur, Malaysia are reported. The large majority were heroin inhalers. They were different from the traditional Eastern opium inhalers and similar to Western heroin injectors in that they were young, male, single, and frequently unemployed. These features and the relative underrepresentation of Chinese suggest that the Chinese of this study did not learn narcotic abuse from opium-smoking relatives.