Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists
August 1, 2009
David Maclaren, James Asugeni, Rowena Asugeni et al.
23 citations
A new mental health service at Atoifi Adventist Hospital in the Solomon Islands is working with the Kwaio community to blend local beliefs into care. In early 2008, interviews were conducted with 20 people who had experienced buru spirit possession and 30 family members across five remote hamlets. Buru spirits cause antisocial behavior, mutism, suicidal thoughts, delusions, aggression, and isolation. Traditional healers report that 50% of treated people are cured, 30% temporarily cured, and 20% see no effect. The service aims to incorporate these cultural understandings to improve prevention, treatment, and recovery.
Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists
August 1, 2025
Vera A Barata, Suzie Lavoie, Łukasz Gawęda et al.
3 citations
Among 43 individuals at ultra-high risk for psychosis, those who later remitted had lower baseline levels of basic self-disturbance than those whose symptoms persisted or who transitioned to psychosis. Basic self-disturbance scores predicted worse clinical outcomes at 12 months. Source monitoring deficits were greater in first-episode psychosis patients than in those at ultra-high risk whose symptoms persisted or transitioned. The findings suggest that high levels of basic self-disturbance may serve as a predictor of poor prognosis in ultra-high risk patients.
Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists
June 1, 2025
Tharshanan Edwin Peiris, Amrit Pokhrel, Yuvaraj Paudel
2 citations
Ketamine, originally an anaesthetic, can rapidly reduce depressive symptoms and suicidal thoughts within hours in people with treatment-resistant unipolar depression, with effects lasting up to one week. A systematic review of 44 studies found common side effects include temporary dissociation, elevated blood pressure, nausea, and dizziness, but long-term safety remains uncertain. The evidence suggests ketamine is a promising rapid-acting antidepressant, though optimal treatment protocols and long-term safety need further study before widespread clinical use.
Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists
July 13, 2026
Laurence Cobbaert
Psychiatry often scrutinizes patients' confidence and certainty as symptoms of poor insight or overconfidence, especially in psychosis research, while its own institutional confidence escapes similar examination. Drawing on epistemic injustice, phenomenology, and lived experience expertise, the article argues that professional confidence becomes ethically consequential when it shapes diagnosis, detention, treatment access, and responses to reported harm. It calls for epistemic reciprocity: if psychiatry interrogates patients' insight, it must also examine how its own certainty is authorized and operationalized. A humbler psychiatry would distinguish evidence from inference, dissent from pathology, and disengagement from non-compliance, centering experiential knowledge, cultural context, uncertainty, safety, and accountability in ethical practice.
Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists
June 11, 2026
Eden Mane, Saras Mane
A systematic review of telehealth-supported ketamine for depression and anxiety in adults found that, across three US commercial provider studies, symptom response rates ranged from 49.5% to 62.8% on the PHQ-9 and 47.6% to 62.9% on the GAD-7, with remission rates of 20.7% to 32.6% and 23.9% to 31.3%, respectively. However, all studies were at critical risk of bias, the evidence certainty was very low, and follow-up data were available for only a minority of the up to 16,876 patients. The review concludes that the evidence is provider-generated and insufficient to guide clinical practice, though it may inform future hybrid service design in Australasia.
Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists
June 5, 2026
Osama Bhatti, Mohammad Qasim Latifi
Psychiatry has long held an ambivalent stance toward religion and spirituality, recognizing their importance but remaining cautious about integrating them into clinical practice. This article examines the historical, conceptual, and clinical tensions surrounding spirituality in psychiatry, particularly in light of renewed interest from contemporary psychedelic research. The authors discuss definitions, diagnostic categories, and evidence linking spirituality and meaning to mental health. They explore how psychedelic-assisted therapies highlight both therapeutic potential and ethical risks in addressing existential suffering. Psychiatry faces a challenging opportunity to incorporate spiritual dimensions of distress without undermining scientific integrity, which will shape its future relationship with the sacred.
Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists
July 8, 2025
William Lugg
Despite high-quality evidence showing esketamine is not an effective treatment for depression beyond one to two weeks and data suggesting serious acute harms including suicide, the Pharmaceutical Benefits Advisory Committee (PBAC) conditionally recommended listing esketamine on the Pharmaceutical Benefits Scheme (PBS) in December 2024. Long-term harms data is insufficient, but animal and recreational use data is extremely concerning, and financial costs are substantial. This paper reviews the evidence, key deliberations, and potential influences behind the PBAC's decision and revisits related issues concerning the Therapeutic Goods Administration (TGA).
Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists
June 26, 2025
Adam Bayes
Australia has rescheduled psilocybin and MDMA as clinical therapies for treatment-resistant depression and post-traumatic stress disorder, despite limited evidence. A clinical-academic psychiatrist involved in psychedelic trial work identified eight domains needing further research: efficacy, safety including combining with psychotropics, psychotherapy models, psychological support, therapeutic touch, set/setting, and examination of naturalistic data. The clinical availability of psychedelic-assisted therapy gives greater impetus for careful research studies to inform treatment and improve patient outcomes.