The Australian and New Zealand journal of psychiatry
March 1, 1985
J Cawte
91 citations
Before Western contact, Indigenous peoples of the South Pacific used three major psychoactive plants: betel in Melanesia, kava in Polynesia, and pituri in Australia. Each was widely used in rituals, traded extensively, and valued for reducing tension or inducing altered states of consciousness, with potential for intoxication. The author, drawing on personal observation, reviews their traditional and likely future use, pharmacological and clinical properties, and cultural context. While these substances are unlikely to be adopted by Western drug enthusiasts as enthusiastically as coca, cannabis, opium, or tobacco, some Western use remains possible.
The Australian and New Zealand journal of psychiatry
September 1, 1985
W H Wessels
29 citations
Successful psychiatric treatment for rural Africans should incorporate traditional beliefs that illness is understood through magical, social, physical, and religious dimensions. Traditional healers distinguish between natural illnesses, such as epilepsy, schizophrenia, and mental retardation, and cultural disorders involving sorcery, spirit possession, and ancestral worship. These cultural disorders often challenge Western-trained psychiatrists. Healers in altered states use divination to determine the origin of misfortune. In therapy-resistant cases of culture-bound syndromes, consultation with reputable traditional healers yielded a notably high rate of success. The authors argue for greater recognition of these healers.
The Australian and New Zealand journal of psychiatry
June 1, 1976
C P Wijesinghe, S A Dissanayake, N Mendis
27 citations
In a survey of 7,653 people in a semi-urban area, 37 individuals experienced possession trance states. The study describes the trance manifestations, course, and outcomes. Subjects who experienced trance differed significantly from the general population in certain characteristics, including the presence of psychiatric disorder. Four psychodynamic syndromes were identified and illustrated with case examples. The paper reviews the functions of possession behavior and compares personal possession, ritual possession, and altered states of consciousness in Western society.
The Australian and New Zealand journal of psychiatry
October 1, 2024
Zohaib Nadeem, Stephen Parker, Hugh McGovern et al.
19 citations
A survey of 502 Australians, 64.5% of whom self-identified as having a mental illness, found that 43% favored legalizing psychedelics for medical use and 52.4% were open to their use, but only 24% viewed their effects positively and 33% considered them safe. Most participants (61%) had never used psychedelics. People with mental illness were more likely to have used psychedelics (44.1%) than those without (29.7%). Experience, perceived knowledge, and actual knowledge predicted attitudes toward legalization, effects, risks, and openness. While many Australians support medical legalization, safety concerns persist. Those with mental illness, prior recreational use, or greater knowledge held more positive attitudes.
The Australian and New Zealand journal of psychiatry
April 1, 2023
Gillinder Bedi, Susan M Cotton, Alexandre A Guerin et al.
17 citations
Media, public, and scientific interest in psychedelic medicine has grown rapidly, and Australia and New Zealand are now catching up. This paper critically reviews existing evidence, focusing on MDMA-assisted psychotherapy for post-traumatic stress disorder, the most advanced area of clinical psychedelic research. The authors detail Phase 2 and 3 studies and identify methodological and design limitations, as well as broader issues such as advocacy-group involvement in research and reliance on non-government financing that lead to simplistic public messaging. They call for large, high-quality, independent efficacy trials with design enhancements, effectiveness trials, and careful researcher engagement with media and public messaging to ensure rigorous, dispassionate science and safeguard participant welfare.
The Australian and New Zealand journal of psychiatry
April 1, 2025
Alene Sze Jing Yong, Suzie Bratuskins, Musa Samir Sultani et al.
16 citations
An umbrella review of 14 systematic reviews (20 primary studies, up to 353 participants) evaluating MDMA-assisted psychotherapy for post-traumatic stress disorder found that meta-analyses reported substantial benefits in symptom improvement, response, and remission compared to psychotherapy alone. However, when reviews assessed certainty of evidence, it was rated low to very low due to high risk of bias, indirectness, and imprecision. Moderate-quality evidence linked MDMA-assisted therapy to increased odds of transient adverse events, but reviews noted reliance on spontaneous rather than systematic reporting, discrepancies between published and registry data, and a lack of long-term safety information. The four high-quality reviews indicate low to very low certainty for efficacy and moderate to very low for safety.
The Australian and New Zealand journal of psychiatry
April 28, 2025
Salam Hussain, Chris Gale, Shanthi Sarma et al.
10 citations
The Royal Australian and New Zealand College of Psychiatrists has developed professional practice guidelines for using ketamine in psychiatric care in Australia and Aotearoa New Zealand. Based on scientific evidence and expert clinical consensus, the guidelines aim to help psychiatrists and clinicians deliver best practice and optimize patient outcomes. They balance promoting evidence-based practice with recognizing that evidence for ketamine use is still evolving.
The Australian and New Zealand journal of psychiatry
October 1, 2024
Alistair Carroll, Adam Bayes, Mark Montebello et al.
10 citations
Ketamine is a restricted medication in Australia and New Zealand, with regulations that vary by jurisdiction and generally limit its use in patients who have a history of drug dependence. There is substantial variation in how drug dependence is defined legally and clinically, with clinical definitions from the ICD-11 and DSM-5. This paper reviews evidence on the risk of ketamine misuse and dependence among patients with a history of illicit drug use, abuse, or dependence, and offers recommendations for psychiatrists prescribing ketamine for treatment-resistant depression in this population.
The Australian and New Zealand journal of psychiatry
February 1, 2024
Anthony Rodgers, Dilara Bahceci, Christopher G Davey et al.
8 citations
The repurposing of generic racemic ketamine for severe depression has been delayed and uncoordinated for over 20 years due to insufficient commercial incentives, while a patented intranasal formulation (Spravato) gained widespread registration through substantial commercial investment. Spravato costs $600-$900 per dose compared to about $5 per dose for generic ketamine, and an annual government investment of approximately AUD$100 million in Australia was rejected twice, leaving the treatment largely inaccessible. Emerging evidence suggests generic ketamine is at least as effective as Spravato, but no comparative trials have been conducted. Without systemic reforms—including commercial incentives, public funding, reduced regulatory barriers, and coordinated international support—this pattern will repeat with new psychedelic treatments.
The Australian and New Zealand journal of psychiatry
July 1, 2024
Nicollette Lr Thornton, Dean J Wright, Nick Glozier
5 citations
Innovative psychiatric treatments like ketamine therapy are emerging, but their resource-intensive nature makes them largely available only in the costly private sector, widening mental health inequity for those who cannot afford them. The Royal Prince Alfred Hospital's Ketamine Treatment Clinic, Australia's first public-sector clinic for complex mood disorders, offers a model. Based on three years of experience, the authors review the progress, perils, and pitfalls for clinicians and health services considering establishing a public-sector ketamine treatment service.
The Australian and New Zealand journal of psychiatry
October 1, 2007
John D Sellman, Michael P Baker, Simon J Adamson et al.
The paper argues that the concept of a higher power, whether experienced through religion, spirituality, entheogens, or cognitive behavioral development, plays an important role in recovery from drug addiction. It integrates five threads of literature: the universality of God experiences, spiritual experiences induced by hallucinogenic drugs, the evolutionary neurobiology of addiction, the 12 Step movement's use of God, and ingredients for successful recovery. A common final pathway is the strengthening of executive functions, described as the brain's 'higher power'. Practical implications for helping people recover through their own experience of God or development of a higher power are outlined.