ObjectiveThis article examines an epistemic double standard in psychiatry: patients' confidence, certainty and conviction are often treated as clinically interpretable, particularly in research on metacognition, insight and overconfidence in psychosis, while psychiatry's own institutional confidence is less consistently subjected to scrutiny. Drawing on literature concerning epistemic...
ObjectivesTo systematically review the effectiveness, safety, and care models of telehealth-supported ketamine for depression and/or anxiety in adults and consider implications for Australasian clinical practice.MethodsFollowing PRISMA 2020, we searched for randomised or observational studies of adults receiving at-home telehealth-supported ketamine for depression and/or anxiety, to August...
BackgroundPsychiatry has long maintained an ambivalent relationship with religion and spirituality, often acknowledging their relevance while remaining cautious about clinical engagement.ObjectivesThis article examines the historical, conceptual, and clinical tensions surrounding spirituality in psychiatry and explores how contemporary psychedelic research has renewed attention to meaning and...
ObjectiveThis study examined stimulant and medicinal cannabis prescribing in individuals before and after referral to an early psychosis (EP) service in Queensland, Australia.MethodsA retrospective review of 220 consecutive EP referrals (2019-2023) was conducted, extracting data on stimulant and medicinal cannabis prescriptions from clinical records. Longitudinal prescribing patterns were...
Australasian PsychiatryMarch 31, 2026Shuichi Suetani, Faraz Honarparvar, Peter Muller et al.
Background Given that both attention-deficit hyperactivity disorder (ADHD) and cannabis use are known independent risk factors for psychosis, people with ADHD who consume cannabis may be especially vulnerable. The main objective of the current study was to explore the links between ADHD, cannabis use and psychosis outcomes. Methods A systematic review was conducted to examine the risk of...
IntroductionWe previously proposed a neurophenomenological model of schizophrenia, linking basic self-disturbance with neural deficits of source monitoring and aberrant salience. Baseline comparisons in ultra-high risk (UHR) and first-episode psychosis (FEP) samples indicated a relationship between basic self-disturbance and source monitoring deficits, but not aberrant salience. The current...
ObjectivesTo review the available evidence, key deliberations, and potential influences behind the Pharmaceutical Benefits Advisory Committee's (PBAC's) conditional recommendation for esketamine to be listed on the Pharmaceutical Benefits Scheme (PBS).ConclusionsThis paper forms part 2 of the esketamine story in Australia-its handling by the Therapeutic Goods Administration (TGA) and,...
BackgroundDespite a limited evidence base to inform clinicians, Australia has adopted a national approach in rescheduling psilocybin and MDMA as clinical therapies for treatment-resistant depression (TRD) and post-traumatic stress disorder (PTSD), respectively.PurposeThis paper explores clinical research domains warranting further investigation through outlining the reflections of a...
BackgroundUnipolar depression is a prevalent mental health disorder with persistent, treatment-resistant symptoms. Traditional antidepressants take weeks to show effects, underscoring the need for faster alternatives. Ketamine, originally an anaesthetic, has emerged as a rapid-acting antidepressant.ObjectiveThis systematic review evaluates ketamine's efficacy and safety in unipolar...
ObjectiveThough there is a rich psychoanalytic tradition investigating the content and phenomenology of dreams, the clinical use of this has fallen into widespread disuse. We have undertaken a narrative review of the clinical significance and utility of dream content.FindingsDream content may have useful clinical and prognostic value in a number of neurological and psychiatric conditions,...
Objective To review the usefulness of esketamine for treatment-resistant depression. Method Pivotal trials of intranasal esketamine in treatment-resistant depression were synthesized as a narrative review. Results Esketamine is postulated to act through antagonism of N-methyl-D-aspartate (NMDA) glutamate receptors, but opioidergic effects may also be involved. Unlike intravenous ketamine,...
To assess Australian psychiatrists' and psychiatry trainees' knowledge of and attitudes towards psychedelics as treatment for psychiatric disorders. Australian members of the Royal Australian and New Zealand College of Psychiatrists were invited to participate in an anonymous survey that ran from October 1 to November 30 2021. Participants were asked about their knowledge of the risks and...
To review the sequence of events that led to the Therapeutic Goods Administration (TGA) approval of esketamine in Australia, and to explore the potential ethical and clinical consequences of it. Trust in the TGA is of paramount importance to Australian psychiatrists. The approval of esketamine raises serious questions about the processes, independence and authority of the TGA, and therefore the...
OBJECTIVE: To explore the knowledge and attitudes of psychiatrists about psychedelics therapies. METHOD: Access to a cross-sectional survey was distributed to psychiatrists through social media channels. Attitudes and knowledge about psychedelic therapies were recorded using Likert scales and ranking questions. RESULTS: Fifty-eight complete responses were collected (44 fully trained +14 trainee...
To report the development and feedback on a newly created mindfulness-based cognitive therapy (MBCT) informed virtual wellbeing programme for psychiatry trainees. Thirteen of the 14 trainees participated in the programme provided feedback via an online questionnaire. Qualitative data was analysed using thematic analysis. Thematic analysis revealed three main themes: timing of the intervention...
Background Intranasal esketamine has been recently approved for the treatment of resistant depression. It is the only form of ketamine approved. The formulation costs around $600 per dose while plain injected ketamine, on which most research has been done, costs less than $20 per dose. Research shows that intranasal esketamine is less effective and has more unwanted effects than injected...
Objectives: The differential diagnosis of psychotic symptoms is broad and extends beyond primary psychotic and affective disorders. We aim to illustrate that the chronology and phenomenological nature of hallucinatory symptoms may provide clues towards alternative diagnoses, such as hallucinogen persisting perceptual disorder (HPPD). We describe the resurgence of visual pseudo-hallucinations in...
Youth mental health disorders are rising across the world. Mindful Parenting could be a potential tool to promote youth mental health. The primary distinction between Mindful Parenting programs and other behavioral parenting programs is the focus on emotional literacy and compassion. However, this emerging field has gaps in its theory and evidence. In order to objectively evaluate the impact of...
Objective: There has been widespread interest from the public and media in the potential of ketamine as a novel treatment for depression. This paper reviews whether current evidence supports the use of ketamine for the clinical treatment of depression. Conclusions: Clinical trials have investigated the use of intravenous ketamine for the treatment of depressive symptoms over the past 15 years....
Objectives: Mental health professionals are particularly susceptible to occupational stress; however, there are limited formal programmes to address the problem. This paper discusses the preliminary results of a brief mindfulness-based stress reduction (MBSR) programme for practising professionals in a public hospital mental health unit. Method: A mixed-group of nine mental health professionals...
This paper firstly explores the historical concept of pseudohallucinations and their phenomenology. It then examines the experience of hallucinosis in two subject groups, one with post-traumatic stress disorder with dissociative symptoms and the second with schizophrenia. The two groups were assessed using the Psychotic Symptoms Rating Scale with a view to identifying differences in the...
The aim of this paper is to describe a Māori traditional healing approach to assessment and treatment of distressing psychiatric symptoms in a young man. We describe the case of a 17 year old Māori male with voice hearing and pseudoseizures and the assessment and intervention by one of the authors (WN). We report on the young man's and his family's experience of this treatment. We outline...
The aim of this paper is to describe the newly established mental health services at Atoifi Adventist Hospital, Solomon Islands, the sociocultural context in which it operates, and illustrate how the service is engaging with the Kwaio community to understand and incorporate local sociocultural beliefs into prevention, treatment and recovery journeys. Five remote hamlets in East Kwaio, Malaita...
Extended mind theory, a recent development in the field of cognitive philosophy, suggests that the information and processes contained in external objects such as notebooks and computers can be considered as much a part of a person's mind as the processes contained within the brain itself. This paper aims to outline extended mind theory, and to explore how it might be applied to an...
Objective: This paper aims to explore the interface between religion and psychosis, and to comment on its relevance in clinical practice. Method: The context of religious psychotic phenomena is briefly discussed, leading to an examination of the biological substrates of religious experiences, the hypothesized process of religious psychotic symptom formation, and the clinical implications when...