Australian & New Zealand Journal of Psychiatry

Parasuicide rates have shown a marked increase in recent years and now consume a substantial proportion of medical services. To reduce hospital admission rates for parasuicide is probably desirable. While there has been considerable research on parasuicide, it is apparent that many of the findings have limited application to prevention. It is argued that attempts at primary prevention should be directed at those factors in the population considered to have a substantial function in promoting this group of behaviours. The first step in such a program should be the empirical delineation of a typology of parasuicide, since it is not a unitary phenomenon and a single preventive measure is therefore unlikely to have widespread success. Following the recognition of different requirements for different population groups, an experiment in prevention might be attempted by monitoring the parasuicide rates in two closely similar populations, one of which has alterations made sequentially to variables such as the following: the availability of tablets and the form of their presentation; the availability of personal advisory services; and community attitudes to parasuicide. Possible dangers inherent in such experimental epidemiology are acknowledged but it is argued thai aspects of the current approach to the problem of parasuicide may be in need of revision.

Recent literature on conversion reactions is reviewed. Four different perspectives emerged—the neurological, psychoanalytic and sociological standpoints and the view that malingering was responsible for so-called conversion reactions. A questionnaire survey of the opinions of Melbourne psychiatrists on this issue is reported. No concensus of opinion was evident on most points. The association between the psychiatrist's background and his pattern of responses is explored. Experience overseas in Britain or America was associated with particular patterns of response. This suggests that international differences in outlook retard understanding in this area. Research approaches aimed at clarifying the subject are discussed.

This prospective cohort sutdy of Australian university students assesses the relation between social stress, adolescence and mental health. First-year students experience primarily the stress of social transition from school to university, augmented by problems of the late phase of adolescence. This stress is associated with impaired mental health. In Second Year, the sources of social stress, and those most associated with impaired mental health, shift from the social transition area towards more personal concerns over self-view, sexual attitudes, philosophical and social values. These latter concerns typify the identity achievement tasks of late adolescence. Female students appear more susceptible man males to the occurrence and effects of social stress on mental health.

Galvanic skin response (G.S.R.) inhibition thresholds, giving an index of barbiturate tolerance, were determined for 20 depressive and 10 normal subjects. Barbiturate tolerance was found to effectively differentiate neurotic from psychotic depressives, and both these groups from normal controls. Neurotic depressives generally exhibited high G.S.R. inhibition thresholds relative to normals, while psychotic depressives exhibited low thresholds relative to normals. These results are discussed in terms of previous research on the sedation threshold.

The G.S.R. inhibition threshold was found in some groups, to be systematically influenced by manifest anxiety. However, neither depressive severity nor age influenced barbiturate tolerance. Some potential clinical and experimental uses of the G.S.R. inhibition threshold are discussed.

This paper gives an indication of the importance of physical disease in contributing to psychiatric admission. The study was conducted in a situation in which the psychiatric unit dealt with all the psychiatric referrals and admissions for a fairly circumscribed population. Most admissions were made at the request of general practitioners who had equally easy access to either psychiatric or medical beds. The figures suggest that undervalued or unsuspected physical illness is particularly important in the apparent psychiatric breakdown of middle aged men.