Abstract
This month's issue of the ANZJP opens with an article on voluntary euthanasia and assisted suicide, one of the most controversial issues facing the medical profession. There have been many attempts to legislate for voluntary euthanasia in Australia. Psychiatrists have an essential role as these proposals usually require a psychiatric examination to certify that applicants for euthanasia have capacity to consent, and do not suffer a state of mind (such as depression) that might impact on their decision.
The Consent to Medical Treatment and Palliative Care (End of Life Arrangements) Amendment Bill 2010 is now before both houses of State Parliament in South Australia. This bill would allow adult persons of sound mind to formally request that their life be ended by the administration of voluntary euthanasia. A certificate from a psychiatrist would be required. The AMA (SA) and the SA Law Society oppose the Bill, describing it as deficient, lacking safeguards and failing to offer adequate protection to all involved.
Nitschke and Stewart [1] describe an increasing demand for assisted suicide by people who are elderly and “tired of life”. These people are not suffering from terminal illnesses but do not wish to become older and eventually frail or sick. They would not meet the usual criteria for euthanasia, but want to end their lives on their own terms, at a time of their own choosing. The emergence of this group adds another layer of complexity to an already challenging debate.
The theme of suicide continues, with Page et al [2] investigating whether the number of Google searches relating to suicide is related to population suicide rates in Australia. They propose that the volume of Internet searches might provide a measure of suicidal ideation and behaviour in the community. Suicidality could therefore be tracked, at a population level, utilising readily available information from Internet search engines. However, Page et al [2] did not find strong associations between the volume of Google searches for terms related to suicide and other factors usually associated with suicide, and concluded that trends in Internet searches do not provide a reliable indication of suicidal behaviour.
This issue of the Journal also includes two papers describing measures to improve mood and wellbeing. Pasco et al [3] found that women with higher levels of habitual physical activity had higher positive affect scores. This association was present even after controlling for age, BMI, alcohol consumption, smoking and socioeconomic status. Dinan and Quigley [4] distill from the evidence that the consumption of probiotic-containing foods can improve mood and reduce psychological distress. Probiotics might therefore have a role in the treatment of depression, perhaps by reduction in pro-inflammatory cytokines or modulation of the Hypothalamic-Pituitary Adrenal axis. Probiotic foods could eventually be as well accepted as omega-3 fatty acids, as a supplement in both physical and psychiatric disorders. The authors point out that very few of the “probiotic” foods presently on the market actually contain beneficial live organisms, therefore better quality preparations would be needed.
No doubt many more words will be written and spoken before the final version of DSM5 is released in 2013 (for more information see www.DSM5.org), and in this context Korver-Nieberg et al [5] assessed more than one thousand people with non-affective psychoses to test the validity of the clarifications of non-affective psychoses. Their results did not support the validity of schizophrenia subtypes, and the boundary between schizophrenia and schizoaffective disorder was unclear.
New Year is traditionally a time for reflection on the achievements (and disasters) of the past year, and setting goals for the year ahead. Perhaps a resolution to contribute to the Journal in 2012, by submitting an article, viewpoint, or letter, might be a good start to 2012. Your contribution to the science, or to the various debates and controversies, would be very welcome. Whilst not everything submitted can be published, we invite unpublished authors to give it a try; and experienced researchers to consider the Journal first with new and interesting findings.