Psychosis prevalence and physical, metabolic and cognitive co-morbidity: data from the second Australian national survey of psychosis.

BACKGROUND: There are insufficient data from nationwide surveys on the prevalence of specific psychotic disorders and associated co-morbidities. METHOD: The 2010 Australian national psychosis survey used a two-phase design to draw a representative sample of adults aged 18-64 years with psychotic disorders in contact with public treatment services from an estimated resident population of 1 464 923 adults. This paper is based on data from 1642 participants with an International Classification of Diseases (ICD)-10 psychotic disorder. Its aim is to present estimates of treated prevalence and lifetime morbid risk of psychosis, and to describe the cognitive, physical health and substance use profiles of participants. RESULTS: The 1-month treated prevalence of psychotic disorders was 3.10 cases per 1000 population aged 18-64 years, not accounting for people solely accessing primary care services; lifetime morbid risk was 3.45 per 1000. Mean premorbid intelligence quotient was approximately 0.5 s.d.s below the population mean; current cognitive ability (measured with a digit symbol coding task) was 1.6 s.d.s below the population mean. For both cognitive tests, higher scores were significantly associated with better independent functioning. The prevalence of the metabolic syndrome was high, affecting 60.8% of participants, and pervasive across diagnostic groups. Of the participants, two-thirds (65.9%) were current smokers, 47.4% were obese and 32.4% were sedentary. Of the participants, half (49.8%) had a lifetime history of alcohol abuse/dependence and 50.8% lifetime cannabis abuse/dependence. CONCLUSIONS: Our findings highlight the need for comprehensive, integrative models of recovery to maximize the potential for good health and quality of life for people with psychotic illness.

Prospective study of early bereavement on psychological and behavioural cardiac risk factors.

BACKGROUND: Increasing evidence supports the role of emotional stress in the onset of cardiovascular disease. Although bereavement is a major emotional stress with both acute and more long-term features, the mechanism of its association with cardiovascular risk is not well understood, in particular because of limited studies of acute bereavement. The aim of the study was to identify psychological and behavioural changes in acute bereavement and potential modifiers of these changes. METHODS: Bereaved (n= 62) and non-bereaved individuals (n= 50) were evaluated within 2 weeks and at 6 months following loss using the Centre for Epidemiologic Studies -- Depression, Spielberger State Anxiety and Anger, Social Support Questionnaire and changes in appetite, cigarette and alcohol consumption, cortisol and lipids. RESULTS: Compared with non-bereaved, acutely bereaved had increased symptoms of depression (26.7 +/- 1.7 vs 5.9 +/- 0.7, P < 0.001), anxiety (47.4 +/- 2.0 vs 28.2 +/- 1.4, P < 0.001) and anger (median 16.0 vs 15.0, P < 0.001). Greater depressive symptoms were associated with being unprepared for the death, decreased sleep duration and younger age. Acutely, bereaved slept less than non-bereaved (5.8 +/- 0.2 vs 7.2 +/- 0.2 h, P < 0.001). Reduced sleep time was associated with increased anger and depression and decreased satisfaction with social support. Compared with the non-bereaved, the acutely bereaved had higher cortisol (median 306 vs 266, P= 0.003), reduced appetite (P < 0.001) and lower total cholesterol (median 4.9 vs 5.4, P= 0.006) and low-density lipoprotein (median 2.4 vs 2.9, P < 0.001). CONCLUSION: These results offer insight into the psychological, behavioural and physical changes that may contribute to cardiovascular risk in bereavement.

Neurological changes induced by a mobile phone.

Dysaesthesiae of the scalp after mobile phone use have been previously reported, but the basis for this has not been clear. We report a case of a 34-year-old journalist who complained of symptoms associated with use of a mobile phone. She agreed to a provocation study with her phone. Current perception threshold testing before and after exposure showed marked changes in the C-fibre nerves of the affected area compared with the opposite side. The case is supportive of a neurological basis for some cases of dysaesthesiae associated with mobile phone use.

Neurological abnormalities associated with CDMA exposure.

Dysaesthesiae of the scalp and neurological abnormality after mobile phone use have been reported previously, but the roles of the phone per se or the radiations in causing these findings have been questioned. We report finding a neurological abnormality in a patient after accidental exposure of the left side of the face to mobile phone radiation [code division multiple access (CDMA)] from a down-powered mobile phone base station antenna. He had headaches, unilateral left blurred vision and pupil constriction, unilateral altered sensation on the forehead, and abnormalities of current perception thresholds on testing the left trigeminal ophthalmic nerve. His nerve function recovered during 6 months follow-up. His exposure was 0.015-0.06 mW/cm(2) over 1-2 h. The implications regarding health effects of radiofrequency radiation are discussed.

Management of radiofrequency radiation overexposures.

BACKGROUND: Radiofrequency radiation (RFR) has been in use for some time but is now proliferative with the burgeoning radiocommunications industry. OBJECTIVE: To inform the profession of the possible health effects from overexposure to radiofrequency radiation (RFR) and the clinical approach to cases. An introduction to the health effects of overexposure to RFR is given. A clinical approach to integrating the patient's symptoms and the circumstances of the exposure is given. Emergency treatment and ongoing care is outlined, and sources of expert advice given. CONCLUSION: Overexposure to RFR is a complex injury. Advice is given in this article for emergency care and planning ongoing care.

Cardiovascular risk factors for people with mental illness.

OBJECTIVE: The objective of this study was to document the prevalence of risk factors for cardiovascular disease among people with chronic mental illness. METHOD: A cross-sectional survey was conducted of 234 outpatients attending a community mental health clinic in the North-western Health Care Network in Melbourne, Australia. Prevalence of smoking, alcohol consumption, body mass index, hypertension, salt intake, exercise and history of hypercholesterolemia was assessed. RESULTS: Compared with a community sample, the mentally ill had a higher prevalence of smoking, overweight and obesity, lack of moderate exercise, harmful levels of alcohol consumption and salt intake. No differences were found on hypertension. Men, but not women, with mental illness were less likely to undertake cholesterol screening. CONCLUSIONS: Psychiatric outpatients have a high prevalence of cardiovascular risk factors which may account for the higher rate of cardiovascular mortality among the mentally ill. Further research is needed to trial and evaluate interventions to effectively modify risk factors in this vulnerable population.

Risk factors for HIV/AIDS and hepatitis C among the chronic mentally ill.

OBJECTIVE: The objective of this study was to document the prevalence of risk factors for HIV/AIDS and hepatitis C among people with chronic mental illness treated in a community setting. METHOD: 234 patients attending four community mental health clinics in the North-western Health Care Network in Melbourne, Australia, completed an interviewer-administered questionnaire which covered demographics, risk behaviour and psychiatric diagnosis. RESULTS: The sample was 58% male, and 79% of the sample had a primary diagnosis of schizophrenia. Forty-three per cent of mentally ill men and 51% of mentally ill women in the survey had been sexually active in the 12 months preceding the survey. One-fifth of mentally ill men and 57% of mentally ill women who had sex with casual partners never used condoms. People with mental illness were eight times more likely than the general population to have ever injected illicit drugs and the mentally ill had a lifetime prevalence of sharing needles of 7.4%. CONCLUSIONS: The prevalence of risk behaviours among the study group indicate that people with chronic mental illness should be regarded as a high-risk group for HIV/AIDS and hepatitis C. It is essential that adequate resources and strategies are targeted to the mentally ill as they are for other high-risk groups.

Microwave sickness: a reappraisal.

Microwave sickness (MWS) has been a disputed condition. The syndrome involves the nervous system and includes fatigue, headaches, dysaesthesia and various autonomic effects in radiofrequency radiation workers. This paper describes the early reports of the syndrome from Eastern Europe and notes the scepticism expressed about them in the West, before considering comprehensive recent reports by Western specialists and a possible neurological basis for the condition. It is concluded that MWS is a medical entity which should be recognized as a possible risk for radiofrequency radiation workers.

Neurological abnormalities associated with mobile phone use.

Dysaesthesiae of the scalp after mobile phone use have been previously reported but the pathological basis of these symptoms has been unclear. We report finding a neurological abnormality in a patient after prolonged use of a mobile phone. He had permanent unilateral dysaesthesiae of the scalp, slight loss of sensation, and abnormalities on current perception threshold testing of cervical and trigeminal nerves. A neurologist found no other disease. The implications regarding health effects of mobile phones and radio-frequency radiation is discussed.

Comments on "A critical review of epidemiologic studies of radiofrequency exposure and human cancers".

Comments on Elwood's article: A critical review of epidemiologic studies of radiofrequency exposure and human cancers. Environ Health Perspect 107(suppl 1):155-168 (1999).

Radiofrequency electrocution (196 MHz).

Radiofrequency (RF) electrocutions are uncommon. A case of electrocution at 196 MHz is presented partly because there are no previous reports with frequencies as high as this, and partly to assist in safety standard setting. A 53-year-old technician received two brief exposures to both hands of 2A current at 196 MHz. He did not experience shock or burn. Progressively over the next days and months he developed joint pains in the hands, wrists and elbows, altered temperature and touch sensation and parasthesiae. Extensive investigation found no frank neurological abnormality, but there were changes in temperature perception in the palms and a difference in temperature between hands. His symptoms were partly alleviated with ultra-sound therapy, phenoxybenzamine and glyceryl trinitrate patches locally applied, but after several months he continues to have some symptoms. The biophysics and clinical aspects are discussed. It is postulated that there was mainly surface flow of current and the micro-vasculature was effected. Differences to 50 Hz electrocution are noted. Electrocution at 196 MHz, even in the absence of burns may cause long-term morbidity to which physicians should be alerted. Safety standards should consider protection from electrocution at these frequencies.