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P McGorry

Publications and source records attributed to P McGorry.

34 records · Page 2Linked to original sources
PubMed1998

Cognitively-oriented psychotherapy for early psychosis (COPE). Preliminary results.

BACKGROUND: The present study describes the results of the pilot testing of a therapy we have developed for people with first-episode psychosis. Cognitively-oriented psychotherapy for early psychosis (COPE) is aimed at facilitating the adjustment of the person, and at preventing or alleviating secondary morbidity in the wake of the first psychotic episode. METHOD: Eighty people formed three groups: those who were offered and accepted COPE (COPE subjects); those who refused COPE (refusal subjects); and those who were offered neither COPE nor any other continuing treatment from our service (control subjects). The individuals were assessed prior to, and at the end of, COPE treatment (a 12-month period) on the Integration/Sealing Over, Explanatory Model, Scale for the Assessment of Negative Symptoms, Brief Psychiatric Rating Scale, Quality of Life, SCL-90-R, and Beck Depression Inventory measures. RESULTS: People who received COPE obtained significantly superior scores (P < 0.05) to the control group on four of the seven measures but only significantly out-performed the refusal group on one of the seven measures (P < 0.05). The COPE group performed significantly worse on the BDI than the refusal group (P < 0.05). Effect sizes are also provided for each measure. CONCLUSIONS: There seems to be a place for psychological therapy in this group of people but our results need to be replicated in a more definitive randomised controlled trial and such a study is now in progress.

Adult↗
PubMed1995

Who cares? Pathways to psychiatric care for young people experiencing a first episode of psychosis.

OBJECTIVE: The authors reviewed the literature to better understand pathways to psychiatric care among young persons experiencing a first episode of psychosis. Because no discrete body of literature exists about how young people with psychotic illness gain access to psychiatric services, the authors examined three related areas: illness recognition, help-seeking, and referral pathways. METHODS: Automated and manual searches of primarily medical and psychological sources from 1977 to 1995 were conducted. RESULTS: The review found evidence of delay in obtaining early treatment among young people with an emerging psychosis, although comparisons between studies are difficult. Early psychiatric intervention is believed to significantly aid recovery and is an increasingly important clinical issue. Recognizing psychiatric illness is problematic for professionals and nonprofessionals. CONCLUSIONS: Understanding of help seeking by patients experiencing a first psychotic episode and of their referral pathways is limited. Taken together, studies suggest factors affecting access to treatment but provide neither sufficient empirical information nor an adequate conceptual framework to better target secondary prevention strategies. Formulation of a pathways-to-care model appears to offer a useful way of understanding mental health care use. Exploration of consumer experiences would enrich the model. Strategies to reduce treatment delay could then be developed and evaluated. Increased consumer involvement might help ensure that services are better tailored to patients' needs.

Adolescent↗
PubMed1995

Working with survivors of torture and trauma: the Victorian Foundation for Survivors of Torture in perspective.

The health and welfare needs of refugee survivors of torture and trauma have in recent years belatedly found a prominent place on the policy agendas of Federal and State Governments. The development of a statewide service to meet these needs provides an opportunity to illustrate some of the general issues in developing a model specialist community health service, as well as the specific and complex elements involved in the care and resettlement of refugee survivors of torture and trauma. The early experience of the Victorian Foundation for Survivors of Torture is described and some descriptive data presented. Unresolved issues are highlighted, particularly the difficulty in providing skilled psychotherapeutic assistance to relatively large numbers of traumatised refugees.

Acculturation↗
PubMed1995

Psychological sequelae of torture and trauma in Chilean and Salvadorean migrants: a pilot study.

Torture has existed since the earliest times, usually as public punishment prior to death. Today it is predominantly used in secret with the aim of destroying the individual's personality. The effects of torture include severe physical and psychological sequelae which have only recently come under scrutiny. In recent years many Chilean and El Salvadorean migrants have left their countries after being tortured and severely traumatised as a result of organised violence. The aim of this study was to pilot an investigation into the psychological sequelae of torture. Subjects were 30 Chileans and El Salvadoreans classified into three groups: torture, trauma and non-torture/trauma migrants. It was found to be feasible to access and interview survivors from a clinical research perspective without causing additional psychological morbidity. The subjects were interviewed and administered three scales: the Post-Traumatic Stress Disorder Scale, SCL-90-R, and the Impact of Event Scale. The results from the scales and the descriptive data presented indicate some support for the hypothesis that torture survivors show higher levels of PTSD, psychosomatic impairment and stress response disturbance than the trauma and non-torture/trauma groups. Methodological issues are discussed. The strengths and limitations of this preliminary study are considered in relation to future research.

Adult↗
PubMed1994

The use of psychiatric services before imprisonment: a survey and case register linkage of sentenced prisoners in Melbourne.

Information about contact with psychiatric services before imprisonment was obtained for a stratified random sample of sentenced prisoners, who were not receiving prison psychiatric care, in Melbourne's three metropolitan prisons. The sample of 158 men and 31 women was matched with the longitudinal person-linked records of state psychiatric service use in the Victorian Psychiatric Case Register (VPCR). Records of contact with the state services were found for 54 men (34%) and 19 women (61%), including records of in-patient treatment for 25 men (16%) and 15 women (48%). For 64% of individuals with a positive match, the case-note diagnoses were substance use disorders only. Diagnoses of psychotic disorders were recorded for four prisoners, and mood disorders for another six. In addition, clinicians conducted standardized diagnostic interviews and enquired about treatment and personal history. A further 24 prisoners reported specialist psychiatric treatment outside the state treatment sector. This study links the findings from an interview survey of psychiatric morbidity in prisoners with the records available in the VPCR, and emphasizes a number of matters important to the public health. The high rates of previous treatment for substance abuse disorders, the apparent pool of prisoners with largely untreated major depression, and the service needs of those with chronic psychotic disorders are discussed.

Adolescent↗
PubMed1991

Hidden severe psychiatric morbidity in sentenced prisoners: an Australian study.

OBJECTIVE: The aim of this survey was to estimate the prevalence of severe mental disorders in a representative sample of sentenced prisoners. METHOD: The subjects were selected as a random sample of sentenced prisoners in Melbourne's three metropolitan prisons. Interviews were conducted with 158 men and 31 women. Clinicians used the Structured Clinical Interview for DSM-III-R (SCID) to diagnose psychotic, affective, and substance use disorders. RESULTS: Six prisoners (3%) received current diagnoses of psychotic disorders, and 23 (12%) were diagnosed as having current mood disorders, mainly major depression. A lifetime diagnosis of at least one mental disorder each was made for 82% of the respondents, and in 26% more than one lifetime disorder was diagnosed. Sixty-nine percent received lifetime diagnoses of dependence on or abuse of alcohol, other psychoactive substances, or a combination of these. CONCLUSIONS: These findings do not indicate a large-scale shift of deinstitutionalized psychotically ill people from mental hospitals to prisons. They do, however, highlight the diversion into the corrections system of substance-dependent people and the apparent pool of prisoners with largely untreated major depression.

Adolescent↗
PubMed1990

Basal and haloperidol-stimulated prolactin in neuroleptic-free men with schizophrenia defined by 11 diagnostic systems.

Forty-four male, neuroleptic-free, acutely psychotic patients with at least one diagnosis of schizophrenia among 11 diagnostic systems, and 28 healthy controls, underwent measurement of prolactin (PRL) concentrations before and after intravenous administration of haloperidol (0.5 mg). Basal PRL concentrations were lower in the patients with Research Diagnostic Criteria (RDC) DSM-III, Cloninger, and Taylor and Abrams schizophrenias than in controls. Compared with the controls, the PRL response to haloperidol was lower in the patients with schizophrenia defined by all diagnostic systems except those of Schneider and M. Bleuler. Neither basal nor stimulated PRL concentrations were correlated with positive symptoms, but basal PRL was correlated with the Brief Psychiatric Rating Scale (BPRS) depression-related subscore. This study lends further support for the presence of dopaminergic dysfunction in schizophrenia, and demonstrates the advantages and problems in the use of multidiagnostic psychopathological evaluation to categorize a disorder where there is major disagreement among diagnostic systems.

Acute Disease↗
PubMed1990

Prolactin response to low-dose haloperidol challenge in schizophrenic, non-schizophrenic psychotic, and control subjects.

Haloperidol was administered IV to 46 male psychotic inpatients and 28 male control subjects. A two-way analysis of covariance, with age as the covariate, revealed that DSM-III schizophrenics (n = 27) had a lower prolactin response to haloperidol than did the controls (n = 28). There were no significant differences between the prolactin responses in schizophrenics, patients with affective disorders (n = 7), and those with other psychoses (n = 12), which included patients with paranoia, schizophreniform, schizoaffective disorder, and atypical psychoses. These findings support the proposition that tuberoinfundibular dopaminergic dysfunction may occur in certain patients with DSM-III schizophrenia.

Adult↗
PubMed1990

Relationship between expressed emotion and family burden in psychotic disorders: an exploratory study.

This study explored the relationship between level of expressed emotion (EE) and level of family burden in 20 families of individuals with psychotic disorder. Results indicated that a relationship between EE and family burden did exist, but it appeared to be strongly influenced by demographic and illness-related variables. The usefulness of the 5-min speech sample method of assessing EE was limited by the aversion of some family members to being videotaped and by denial of patient symptoms by some relatives. Other methodological weaknesses are discussed. The relationship between demographic and illness-related variables and level of EE needs further exploration.

Affective Disorders, Psychotic↗
PubMed1989

Prevalence of severe mental disorders in disaffiliated and homeless people in inner Melbourne.

The authors determined the prevalence of mental illness in 382 people representative of the occupants of shelters for the homeless and cheap single-room accommodations in inner-city areas of Melbourne. Clinicians were trained to use a standardized diagnostic instrument, the Structured Clinical Interview for DSM-III-R, to diagnose a range of severe mental disorders, including psychotic, affective, and substance-related disorders. Almost half the people interviewed received diagnoses of current disorders, and over 70% received lifetime diagnoses. There was considerable comorbidity. Many factors are likely to contribute to the concentration of people with mental disorders in such homeless and disaffiliated groups.

Adolescent↗
PubMed1985

Stress and anxiety.

Explore the source record for details and available documents.

Anxiety Disorders↗
PubMedDate not supplied

The nosology and prognosis of puerperal psychosis: a review.

Functional psychosis in the puerperal period is a dramatic phenomenon that presents a unique set of diagnostic and therapeutic challenges. Despite its omission from modern classificatory systems such as DSM-III and DSM-III-R, the concept of puerperal psychosis continues to receive support from clinicians on the basis of the apparently distinctive clinical picture that characterizes psychoses occurring at this time. The range of possible nosological models is considered in light of relevant studies of puerperal illness, and the evidence for and against each model is presented. The question of the prognosis of puerperal psychosis is reviewed and guidelines for its estimation in the individual case proposed. The heuristic importance of puerperal psychosis in terms of basic research and preventive psychiatry is also stressed.

Adult↗