A Randomised Control Trial Of A Group-Based Intervention For Substance Abuse In Psychosis.
Funder
National Health and Medical Research Council
Funding Amount
$345,250.00
Summary
The use of alcohol and illicit substances is common amongst people with psychotic illnesses, and is associated with a poor outcome in terms of severity of symptoms, treatment adherence, work-studies, family cohesion, aggression and quality of life. All this adds significantly to the cost of mental health services and society more broadly. The proposed study aims to refine, pilot, and rigorously evaluate a group-based intervention that targets substance use in such individuals at different stages ....The use of alcohol and illicit substances is common amongst people with psychotic illnesses, and is associated with a poor outcome in terms of severity of symptoms, treatment adherence, work-studies, family cohesion, aggression and quality of life. All this adds significantly to the cost of mental health services and society more broadly. The proposed study aims to refine, pilot, and rigorously evaluate a group-based intervention that targets substance use in such individuals at different stages of their illness, and within a number of different treatment settings. The intervention will be informed by an enhanced understanding of the motivations for substance use in people with psychotic illnesses The specific aims are to: Refine, implement and evaluate, using a controlled experimental design, a novel group-based intervention for reducing substance abuse comorbidity in people with psychotic disorders; Determine reasons for substance use by these individuals, to inform the intervention procedures; Pilot the intervention in a series of different treatment settings, including early episode and rehabilitation programs, and non-government organisations dealing with people with psychotic disorders, to ensure generalisability, adaptability, and acceptability; Augment case managers' knowledge and skills in dealing with comorbid drug and alcohol use Enhance detection, motivation to change, ongoing monitoring and relapse prevention of substance misuse in clients with psychotic disorders. It will also be possible, once the treatment intervention is finalised and evaluated, to expand its use to patients with non-psychotic mental illnesses.Read moreRead less
Evaluation Of Cognitive-behaviour Therapy For Alcohol And Other Drug Problems Among People With A Psychotic Illness
Funder
National Health and Medical Research Council
Funding Amount
$217,465.00
Summary
Abuse of alcohol and other drugs among people with a major psychiatric illness is a serious public health problem and cost-effective treatments need to be developed and assessed. The aim of this project is to evaluate the effectiveness of a counselling intervention. 180 individuals with a psychotic illness and concurrent alcohol and other drug (AOD) problems will be randomly assigned to counselling or usual treatment and followed up for a period of 12 months. The indicators of interest include: ....Abuse of alcohol and other drugs among people with a major psychiatric illness is a serious public health problem and cost-effective treatments need to be developed and assessed. The aim of this project is to evaluate the effectiveness of a counselling intervention. 180 individuals with a psychotic illness and concurrent alcohol and other drug (AOD) problems will be randomly assigned to counselling or usual treatment and followed up for a period of 12 months. The indicators of interest include: current drug use; psychiatric symptoms; self-harm; social functioning; and use of health services. Findings from the proposed study will assist in the selection of particular treatment strategies and will aid the overall development of services for people with both major mental illness and substance abuse.Read moreRead less
A Comparative Structural And Functional Cerebral MRI Study Of First Episode Schizophrenia And Long-term Cannabis Use.
Funder
National Health and Medical Research Council
Funding Amount
$373,125.00
Summary
Cannabis is used for its subjective effects that include euphoria, depersonalisation, somnolence, and altered perceptions of temporal contingency.It is a controlled substance yet one quarter of Australian adolescents and seven percent of adults use cannabis regularly. Chronic use of cannibis can impair frontal brain functioning, affecting the capacities for attention, working memory and concentration.These neurocognitive deficits bear striking similarities to those associated with the negative s ....Cannabis is used for its subjective effects that include euphoria, depersonalisation, somnolence, and altered perceptions of temporal contingency.It is a controlled substance yet one quarter of Australian adolescents and seven percent of adults use cannabis regularly. Chronic use of cannibis can impair frontal brain functioning, affecting the capacities for attention, working memory and concentration.These neurocognitive deficits bear striking similarities to those associated with the negative symptom cluster of schizophrenia,which is related to frontal brain dysfunction. The proposed study will be the first of it's kind to apply sophisticated neuroimaging techniques to investigate how long-term adolescent cannabis use effects the structure and function of the brain and to make comparative analyses with the brain changes associated with first episode schizophrenia. We predict that structural brain abnormalities that are consistent in localisation, if not in degree, will be detected in long-term cannabis using and first episode schizophreniaparticipants and that there will be even more profound abnormalities in the first episode schizophrenia cannabis users. We will use the Tower of London (TOL) task to activate certain areas associated with executive functioning (for instance attention, memory, and strategic planning). Here, we expect lower intensity activation of the prefrontal cortex during TOL performance both in the cannabis and first episode schizophrenia groups and that the activation will be lowest of all for the cannabis using first episode schizophrenia group. The methodology to be applied in this study offers a unique opportunity to enhance our understanding of the structural and functional markers of first episode schizophrenia and cannabis use in the neural substrate.Read moreRead less
Intervention For Tobacco Dependence Among People With A Psychotic Illness
Funder
National Health and Medical Research Council
Funding Amount
$387,625.00
Summary
The prevalence of smoking among people with a psychiatric illness, especially schizophrenia, is greater than that in the general population. Exposure to tobacco smoke has been identified as a cause of 32 different diseases as well as a cause of fire injuries. Tobacco smoke is known to contain carcinogens, as well as nicotine and numerous other poisonous substances. An extensive body of scientific evidence shows that active cigarette smoking increases the risk of many different cancers. Smoking r ....The prevalence of smoking among people with a psychiatric illness, especially schizophrenia, is greater than that in the general population. Exposure to tobacco smoke has been identified as a cause of 32 different diseases as well as a cause of fire injuries. Tobacco smoke is known to contain carcinogens, as well as nicotine and numerous other poisonous substances. An extensive body of scientific evidence shows that active cigarette smoking increases the risk of many different cancers. Smoking related diseases rate second in frequency to suicide as the greatest contributor to early mortality in schizophrenia. Popular opinion holds that people with mental illness are lacking in motivation to change their behaviour due to the effects of their mental illness. However, a recent survey of inpatients in a psychiatric hospital in Newcastle, NSW, revealed that over a quarter of smokers were either preparing to quit or cut down on their smoking or already had taken action to reduce their smoking. The present research proposal represents the first large randomised controlled trial of an intervention for tobacco dependence among people with a mental illness. This project will compare the effectiveness of nicotine replacement therapy combined with counselling with a self-help booklet on smoking. The proposed research follows a small clinical study of the feasibility of the intervention and a small randomised controlled trial supported by the Australian Rotary Health Research Fund. The proposed study brings together the expertise of several people across Australia who have experience in treating people with mental illness and drug dependence, including tobacco dependence. The results will inform future clinical interventions for smokers with a mental illness.Read moreRead less
Attentional Effects On Prepulse Inhibition Of The Acoustic Startle Reflex In Patients With Schizophrenia
Funder
National Health and Medical Research Council
Funding Amount
$278,625.00
Summary
People suffering from schizophrenia exhibit differences from healthy people in the startle reflex, which is a blink of the eyes when a sudden loud sound occurs. Normally, this reflex is reduced in size when a quiet sound occurs a few milliseconds before the startling sound, but this prepulse inhibition of the startle reflex or PPI does not occur to the same degree in people with schizophrenia. The underlying causes of this reduction in PPI in patients with schizophrenia is not known. The most co ....People suffering from schizophrenia exhibit differences from healthy people in the startle reflex, which is a blink of the eyes when a sudden loud sound occurs. Normally, this reflex is reduced in size when a quiet sound occurs a few milliseconds before the startling sound, but this prepulse inhibition of the startle reflex or PPI does not occur to the same degree in people with schizophrenia. The underlying causes of this reduction in PPI in patients with schizophrenia is not known. The most commonly accepted theory is that it reflects a deficit in a basic sensorimotor gating function which could underlie a variety of attentional abnormalities observed in schizophrenia. However, our data indicate that patients exhibit more PPI when they ignore the prepulse stimuli. We wish to test the hypothesis that alterations in PPI in schizophrenic patients are secondary to abnormalities in attention. This is significant because the theory can point to a specific cognitive deficit associated with schizophrenia. We have also found that patients treated with some kinds of antipsychotic medications (the newer atypical antipsychotic medications) do not show reductions in PPI, but patients treated with older types of antipsychotic drug do show reductions in PPI. We intend to investigate the effects of different types of antipsychotics on attentional modulation of PPI. This is significant because it may indicate that patients with a specific kind of cognitive impairment may show improvement with a specific type of medicine. Our data suggests that chronic cannabis use may associated with differences in the startle reflex and in PPI. Understanding how such cannabis use alters PPI may provide insights into why so many people with schizophrenia regularly abuse cannabis.Read moreRead less