This chapter attempts to attain consensus on some key questions in the field of debriefing, derived from a consensus conference held in 1996 in Australia. The Debriefing Consensus Forum brought together senior Australasian academics, practitioners and researchers to discuss traumatic stress debriefing. Providing debriefing to those who have experienced or witnessed a traumatic incident remains a controversial issue for mental health professionals. There was a consensus view that those conducting debriefing should be knowledgeable and skilled mental health professionals. Although debriefing may have effect on long-term psychological consequences of traumatic exposure, it may have an effect on short-term outcomes. Participants agreed that the promise of debriefing as a potential preventive intervention in mental health should not be abandoned, despite the limitations and inconsistency of the evidence supporting its effectiveness. The Forum highlighted the need for further research and suggested how future studies could make useful contributions to knowledge about debriefing.
In our study we examined the relationship between the perceived adequacy of social support and post-stroke depression in 76 hospitalized Australian patients. Social support or the perception of its lack, particularly from a spouse care-giver, was associated significantly with both the presence and severity of depressive disorder. Furthermore, depressed patients who perceived their support to be inadequate had a longer duration of depressive illness than depressed patients who perceived their support in a more favorable light. We conclude that following stroke, perception of social support from key relationships may mediate the emotional response to this life crisis. The implications of these findings are discussed.
The aims of this study were (i) to determine the frequency of emotional lability following first ever stroke, and (ii) to identify factors associated with this condition. Sixty-six consecutive inpatients with first ever stroke were surveyed two months post stroke for the presence of emotional lability. Demographic, clinical, psychiatric and stroke lesion characteristics were also assessed. Emotional lability was present in 12 of the 66 patients (prevalence: 18%). Emotional lability occurred independently of post stroke depression. Single lesions located in anterior regions of the cerebral hemispheres had four times the odds of emotional lability than lesions located anywhere else (p<0.05). Emotional lability is a common emotional-behavioural syndrome following stroke and is probably a separate condition from post stroke depression. The aetiology of this condition is possibly related to the consequences of injury to anterior regions of the cerebral hemispheres.
The aim of this study was to determine whether personality neuroticism or extroversion traits are associated with post-stroke depression.Ninety-four stroke inpatients undergoing rehabilitation were examined two months post-stroke for the presence and severity of depression and a retrospective assessment was made of life-time neuroticism and extroversion.Depressed patients (N = 35) had higher neuroticism scores than non-depressed patients. Neuroticism was correlated positively with depressive symptomatology. Extroversion was not associated with depression diagnosis or depressive symptomatology.We conclude that personality neuroticism may be a risk factor for depression following stroke.
I enjoyed reading Professor Andrews' ideas on the changing nature of psychiatry in a recent issue of the Journal [1]. He raised several points, a number of which deserve closer examination.
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