Hallucinations in adolescent inpatients with post-traumatic stress disorder and schizophrenia: similarities and differences.

OBJECTIVE: This study compares the phenomenology of hallucinations in a series of hospitalized adolescents diagnosed with post-traumatic stress disorder (PTSD) and schizophrenia. METHODS: Subjects admitted to a tertiary adolescent inpatient unit were screened for hallucinations. Those reporting hallucinations were asked standardized questions relating to these experiences. Hallucinations in subjects with a primary diagnosis of schizophrenia or PTSD were compared. RESULTS: Hallucinations in both schizophrenia and PTSD have similar form and content. Frequent, vivid, realistic, external hallucinations occurred in both disorders. Hallucinations in PTSD were usually derogatory and related to self-harm, but not direct reflections of traumatic events. Patients with PTSD reported greater emotional distress, self-harm and suicidal ideation than those with schizophrenia. CONCLUSIONS: This case series suggests that the phenomenology of hallucinations in adolescents with schizophrenia and PTSD is similar.

Hallucinations in adolescents with post-traumatic stress disorder and psychotic disorder.

OBJECTIVE: The aim of the study was to compare the phenomenology of hallucinations in hospitalized adolescents diagnosed with post-traumatic stress disorder (PTSD) and psychotic disorder. METHODS: Diagnoses were ascertained in 66 adolescents consecutively admitted to an acute adolescent unit in Australia. Hallucinations were examined to compare their phenomenology in PTSD with psychotic disorder. RESULTS: On most measures, hallucinations did not differ significantly in form or content between those adolescents with PTSD and those with psychotic disorder. In a minority of patients with PTSD, the hallucinations reflected a previous traumatic experience. CONCLUSIONS: Hallucinations were found to be unreliable in distinguishing adolescent inpatients with PTSD from those with psychotic disorder.

The impact of poster advertising in buses on young people's awareness and knowledge of a telephone counselling service.

OBJECTIVE: To evaluate the impact of a public poster advertising campaign for Kids Help Line, a national Australian telephone counselling service providing young people with 24-hour access to trained counsellors. METHODS: Posters were displayed in the interior of 50% of all Brisbane City Council buses for a period of six months. 1,642 high school students were surveyed at the end of the campaign to determine their awareness and knowledge of Kids Help Line services. Awareness and knowledge of frequent bus users was compared with that of non-bus users and the linear relationship between bus usage and awareness and knowledge was investigated. RESULTS: After controlling for age, socio-economic status and gender effects, there was evidence of a linear relationship between exposure to advertisements and expectation that Kids Help Line could assist with a larger range of problems. There was a trend towards a relationship between exposure and knowledge of Kids Help Line. CONCLUSIONS AND IMPLICATIONS: Although effect size was small, the results suggest that the advertising campaign had a modest but potentially important impact.

Telephone counselling for adolescent suicide prevention: changes in suicidality and mental state from beginning to end of a counselling session.

Telephone counselling is an accessible and confidential means by which distressed young people can seek help. Telephone counselling services were funded under Australia's National Youth Suicide Prevention Strategy between 1997 and 2000. In this study, the effectiveness of telephone counselling for young people seeking help in the context of suicidal ideation or intent was evaluated in an investigation of calls made by suicidal young people to a telephone counselling service. Independent raters measured callers' suicidality and mental state at the beginning and end of 100 taped counselling sessions. Changes in suicidality and mental state were measured using a reliable rating scale developed for the study. Significant decreases in suicidality and significant improvement in mental state were found to occur during the course of counselling sessions, suggesting positive immediate impact. Limitations of the study with respect to longer-term outcomes and the relevance of the results for suicide prevention are discussed. Notwithstanding the study limitations, the results lend support for continuing development of hotline services.