I am a consultant psychiatrist and clinical researcher. Over the last 15 years I have been trying to detect people at risk of development of schizophrenia and other psychotic disorders by the prospective identification of the prodromal phase of these diso
Emerging Mental Disorders In Young People: Using Clinical Staging For Prediction, Prevention And Early Intervention
Funder
National Health and Medical Research Council
Funding Amount
$10,598,601.00
Summary
Mental disorders are a major cause of disability in Australia, especially for young people. We have developed a clinical staging model covering the earliest symptoms through persistent disorder to chronic disability. We are investigating neurobiological, personal and social factors which increase the risk of progression through these stages, and novel treatment strategies which may prevent or delay onset and relapse, reduce the impact of illness, and promote recovery. Major public health benefit ....Mental disorders are a major cause of disability in Australia, especially for young people. We have developed a clinical staging model covering the earliest symptoms through persistent disorder to chronic disability. We are investigating neurobiological, personal and social factors which increase the risk of progression through these stages, and novel treatment strategies which may prevent or delay onset and relapse, reduce the impact of illness, and promote recovery. Major public health benefits and better understanding of the onset and progression of illness will result.Read moreRead less
Promotion Of Self-help Strategies For Sub-threshold Depression Via The Internet: Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$91,573.00
Summary
Depressive symptoms are common, impair individual functioning, and may develop into a full depressive disorder. Self-help for depressive symptoms is well-liked and often used, but some strategies are not as effective as others. This project will test the feasibility of promoting helpful self-help strategies to those with a high level of depressive symptoms, using the internet. The aim is to reduce the overall level of depressive symptoms and the number developing a full depressive disorder.
Early Detection Of Infants And Young Children With Autism
Funder
National Health and Medical Research Council
Funding Amount
$268,250.00
Summary
Autism is a severely handicapping condition adversely affecting social interaction, communication, behaviour, interests, and activities. Autism requires treatment at an early age (before 4 years). Despite finding that parents notice problems with their child's development within the first 2 years, on average diagnoses are made around 6 years of age. Treatment for autism should begin as early as possible to improve outcome. Diagnosis requires specialist assessment and these services are limited. ....Autism is a severely handicapping condition adversely affecting social interaction, communication, behaviour, interests, and activities. Autism requires treatment at an early age (before 4 years). Despite finding that parents notice problems with their child's development within the first 2 years, on average diagnoses are made around 6 years of age. Treatment for autism should begin as early as possible to improve outcome. Diagnosis requires specialist assessment and these services are limited. Therefore it is not possible to undertake such assessments with all children who have developmental problems. This project therefore proposes to evaluate a method for screening large populations of children for autism, thus enabling timely and more appropriate referral to assessment services. Previous work by the investigators has developed a potential screening tool (DBC Early Screen) for autism in young children under 4 years with developmental delay that has high levels of accuracy in identifying those infants and children who are at risk of autism and require specialist assessment. This project proposes to undertake a community field trial to assess the accuracy and reliability of this early screen and to establish its suitability for wide use as a population screening tool. The preliminary testing of DBC Early Screen demonstrated that a community field trial was feasible. The results of this study will facilitate the referral of infants and young children to specialist autism assessment services, thus enabling the commencement of appropriate early intervention for children and their families from an early age.Read moreRead less
The Role Of Stress, HPA-axis Dysfunction And CNS Structural And Functional Change In The Development Of Psychosis.
Funder
National Health and Medical Research Council
Funding Amount
$345,538.00
Summary
This research will further understanding of the processes underlying the development of serious mental illnesses such as schizophrenia and may lead to the development of strategies to prevent these devastating disorders. Although there have been advances in the management of psychotic disorders in recent years, their underlying causes remain largely unknown. We aim to investigate the potential roles of stress, HPA-axis function and structural and functional brain changes. The neurodevelopmental ....This research will further understanding of the processes underlying the development of serious mental illnesses such as schizophrenia and may lead to the development of strategies to prevent these devastating disorders. Although there have been advances in the management of psychotic disorders in recent years, their underlying causes remain largely unknown. We aim to investigate the potential roles of stress, HPA-axis function and structural and functional brain changes. The neurodevelopmental model of psychosis suggests that small structural CNS changes occur very early in life conferring a degree of vulnerability on the affected individual. We propose that the psychological and neurobiological processes listed above interact with the pre-existing vulnerability, resulting in the development of psychotic symptoms. This is in line with the stress-vulnerability model of psychosis. We aim to investigate this model by monitoring the level of stress reported by young people at risk of psychosis over 12 months. We will also obtain measures of their biological response to stress by assessing cortisol levels over time and brain structure and functioning will be assessed. By monitoring these processes in the high risk group, we will be able to identify any changes that occur if a psychotic illness develops. This research also has practical applications in the identification of young people at high risk of developing a psychotic disorder, Moreover it will inform the development of medical and psychological strategies aimed at preventing or delaying the onset of schizoprenia and related illnesses in the high risk population.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
Early Detection Of MCI And Dementia Using Multidimensional Analysis Of Structural MRI By Computational Methods
Funder
National Health and Medical Research Council
Funding Amount
$583,601.00
Summary
Dementia in elderly is a major public health problem, and mild cognitive impairment (MCI), is even more common. We propose to use recent computational anatomy algorithms from our group to develop novel multidimensional imaging biomarkers for early detection of brain anatomical changes due to MCI-dementia. We aim at identifying early signatures of MCI-dementia, thus making early treatment possible. The completion of our research will provide clinicians with new methods for the early diagnosis.
Psychiatric Morbidity, Quality Of Life And Coping Styles Of Patients With Early Stage & Advanced Prostate Cancer
Funder
National Health and Medical Research Council
Funding Amount
$281,018.00
Summary
Prostate cancer affects thousands of men each year. Advances in treatment are continuing, but side-effects frequently create disruptions to daily living. If the quality of care for prostate cancer patients is to be further improved, there is much to be learned about the psychosocial impact of the disease and its treatment across its different phases. There has not been a systematic prospective study of psychosocial adjustment in men with prostate cancer. In this study, we longitudinally follow t ....Prostate cancer affects thousands of men each year. Advances in treatment are continuing, but side-effects frequently create disruptions to daily living. If the quality of care for prostate cancer patients is to be further improved, there is much to be learned about the psychosocial impact of the disease and its treatment across its different phases. There has not been a systematic prospective study of psychosocial adjustment in men with prostate cancer. In this study, we longitudinally follow two separate groups of men with prostate cancer, those with early disease and those with advanced illness. We focus on the particular side-effects of urinary incontinence, impotence and bowel symptoms and the potential these have to affect the patient's sense of wellbeing. We use a standardised interview and questionnaires to assess for the presence of psychiatric disorders and psychological problems, overall quality of life and coping styles in these men. We seek to recognise the predictors of men who may have coping problems. A statistical approach termed pathway analysis will help us understand the relative contributions of different factors associated with these problems. The outcome of this systematic, longitudinal study will be a body of knowledge concerning risk factors for poorer psychosocial adjustment and optimum coping strategies for managing the impact of prostate cancer and its treatment, thereby empowering a range of targeted interventions to be developed to enhance the wellbeing and quality of life of these men.Read moreRead less