A Prospective Cohort Study Of Mortality, Abstinence, Criminality And Psychiatric Comorbidity
Funder
National Health and Medical Research Council
Funding Amount
$419,500.00
Summary
Over 70 000 Australians are dependent on heroin. Heroin dependence is remarkably persistent and is, in many cases, a lifelong condition. Long term treatment outcome and abstinence from heroin among this group are poor. Mortality among heroin users is high, with heroin users dying at a rate 13 times that of peers. Despite the extent of the problem, the natural history of heroin users has not yet been studied in Australia. The current study will be the first Australian study of the natural history ....Over 70 000 Australians are dependent on heroin. Heroin dependence is remarkably persistent and is, in many cases, a lifelong condition. Long term treatment outcome and abstinence from heroin among this group are poor. Mortality among heroin users is high, with heroin users dying at a rate 13 times that of peers. Despite the extent of the problem, the natural history of heroin users has not yet been studied in Australia. The current study will be the first Australian study of the natural history of heroin users. The study will follow up a large cohort of heroin users over a three year period. Estimates will be obtained of mortality rates, abstinence rates, criminal careers, and psychiatric problems among heroin users. It will also examine factors that predict abstinence, mortality, criminality and levels of psychopathology, and determine the health costs associated with heroin use careers. The study will provide essential data on how heroin use progresses, and on what factors predict a better outcome for heroin users.Read moreRead less
Efficacy Of Treatment For Resistant Command Hallucinations.
Funder
National Health and Medical Research Council
Funding Amount
$343,875.00
Summary
Auditory hallucinations (AHs), often described as voices, are a common symptom of schizophrenia and psychoses. Command hallucinations (CHs) are a type of AH in which the voice heard by the patient commands him or her to perform a particular action. The nature of the directive may vary from inconsequential actions to commands to harm the patient or others. There is widespread public concern about the danger individuals with schizophrenia or related disorders pose to themselves and to the communit ....Auditory hallucinations (AHs), often described as voices, are a common symptom of schizophrenia and psychoses. Command hallucinations (CHs) are a type of AH in which the voice heard by the patient commands him or her to perform a particular action. The nature of the directive may vary from inconsequential actions to commands to harm the patient or others. There is widespread public concern about the danger individuals with schizophrenia or related disorders pose to themselves and to the community. There is firm evidence pointing to the important role that CHs play in propelling psychotic individuals into serious and damaging actions. We have found, however, that most individuals who comply with dangerous CHs do so, not because they are angry, violent, antisocial or wish to cause harm, but because they feel powerless to resist. Though CHs are one of the most disturbing symptoms of psychosis, standard treatment has proved to be of limited benefit. This study will evaluate the effectiveness of Treatment of Resistant Command Hallucinations (TORCH), an innovative treatment for CHs. TORCH is an extension of an existing treatment for psychosis that we previously developed. TORCH aims to reduce the distress, worry and harmful or self-defeating behaviour associated with CHs by arming the patient with effective strategies that will enhance resistance and reduce compliance. The project has clear implications for improved clinical and therapeutic management of CHs with major public health, clinical and forensic repercussions. The consequences of being formally assessed as being at risk of acting violently result in the potential for substantial restrictions on the freedom of the individual. The availability of TORCH may prompt a less restrictive management of individuals at risk of dangerous behaviour and promote a more optimistic attitude amongst clinicians. Relatives and carers also stand to benefit through reduction in perplexing and fear-inducing behaviours.Read moreRead less
A Prospective Study Of The Psychiatric & Medical Characteristics Of Post-infective Fatigue & Chronic Fatigue Syndrome.
Funder
National Health and Medical Research Council
Funding Amount
$500,000.00
Summary
This project forms the central component of a larger set of studies which investigate competing psychiatric, immunological and infective models of the causes of a number of chronic fatigue syndromes, including post-infective fatigue. The study takes place in western NSW where certain viral illnesses (Glandular Fever, Ross River Virus) and a non-viral infection (QF) are common and have been associated with prolonged fatigue states. The study follows patients from laboratory-documented infections ....This project forms the central component of a larger set of studies which investigate competing psychiatric, immunological and infective models of the causes of a number of chronic fatigue syndromes, including post-infective fatigue. The study takes place in western NSW where certain viral illnesses (Glandular Fever, Ross River Virus) and a non-viral infection (QF) are common and have been associated with prolonged fatigue states. The study follows patients from laboratory-documented infections with appropriate infective, immunological and psychological measures throughout the course of their acute illness, the early recovery period and for the next 12 months. These patients are compared with people who present to their doctor with other forms of medically-unexplained fatigue. Very few previous studies have used an appropriate prospective design and followed patients with documented illness from the onset through to the development of specific forms of chronic fatigue. Further, the study is unique in terms of the range of viral and non-viral agents being investigated. It relies on the combined psychiatric, immunological and infective disease expertise of a group of researchers with an international reputation for the successful completion of such multidisciplinary projects. The initial phase of the study has demonstrated that the research team has the capacity to complete this project. Initial results have already demonstrated the potential roles of psychological and immunological factors in causing some cases of prolonged fatigue. Further, the initial results indicate that two key symptom sets (fatigue, psychological distress) can be adequately measured during the recovery phase and are predicted by differing psychological factors. The study will result in the identification of different psychiatric risk factors to chronic fatigue, assist development of clear diagnostic guidelines for post-infective fatigue and guide relevant aetiological and treatment research.Read moreRead less
A Prospective Study Of Inflammatory Cytokines As Common Factors In The Aetiology Of Both Depression And Osteoporosis.
Funder
National Health and Medical Research Council
Funding Amount
$291,230.00
Summary
Both depression and osteoporosis are common, debilitating and expensive diseases and there is research to suggest that these conditions are related. This study will examine a potential common mechanism, inflammation, which may underlie both diseases. It will focus on circulating proteins which are associated with both depression and fragility fractures, and examine the role they play in both disorders.
A Genetic Study Of Schizophrenia In The Brahmin Of Tamil Nadu
Funder
National Health and Medical Research Council
Funding Amount
$267,226.00
Summary
The cause of schizophrenia is unknown, but there is good evidence that genes play a role. Geneticists do not fully understand how it is inherited, but it is very complex, and several interacting genes as well as environmental factors are probably involved. Societies such as Australia are genetically diverse because people from many different ethnic groups have intermarried. To detect susceptibility genes in this type of population, we must study very large patient samples. Alternatively, we can ....The cause of schizophrenia is unknown, but there is good evidence that genes play a role. Geneticists do not fully understand how it is inherited, but it is very complex, and several interacting genes as well as environmental factors are probably involved. Societies such as Australia are genetically diverse because people from many different ethnic groups have intermarried. To detect susceptibility genes in this type of population, we must study very large patient samples. Alternatively, we can study genetically homogenous patient samples, found in isolated gene-pool populations. One such population is the Brahmin people in Tamil Nadu, a south-eastern state of India. The Brahmin are descended from the Aryan peoples who migrated into southern India 2000 years ago. In the Hindu caste system, Brahmin are the highly educated priest class, and enjoy a privileged position in society. Traditionally, marriages among the Brahmin of Tamil Nadu have been prearranged, with a preference for first-cousin marriages. As well as this cultural and historical evidence, genetic marker studies confirm that this population is a suitable genetic isolate. In this project, genetic material (DNA) will be collected from Brahmin schizophrenic patients and their families. Diagnostic data, detailed family data, and blood samples will be gathered from 90-100 extended families, each containing two or more ill individuals. Analysis of their genetic code will enable a search for possible schizophrenia susceptibility genes and a systematic search for a mutation. If found, this will greatly improve our understanding of schizophrenia, and stimulate the search for similar genes in other samples world-wide, including Australia where schizophrenia costs $3 billion annually in terms of treatment and lost jobs. If schizophrenia genes can be found, it may be possible to find better treatments that correct the basic causes of the illness and identify factors that protect against the illness.Read moreRead less
A Prospective Study Investigating Implications Of Bioactive Lipids For Diagnosis And Treatment Of Schizophrenia
Funder
National Health and Medical Research Council
Funding Amount
$324,480.00
Summary
This study will investigate the role of fatty acids (lipids) in schizophrenia. Studies in blood cells and in the brains of patients with schizophrenia have shown that these lipids and related products are altered in schizophrenia. We are now able to measure separate lipid metabolites in the living human brain using a technique called magnetic resonance spectroscopy. Until recently it was only possible to assess lipid metabolites as a group, limiting interpretation. Thanks to a newly available im ....This study will investigate the role of fatty acids (lipids) in schizophrenia. Studies in blood cells and in the brains of patients with schizophrenia have shown that these lipids and related products are altered in schizophrenia. We are now able to measure separate lipid metabolites in the living human brain using a technique called magnetic resonance spectroscopy. Until recently it was only possible to assess lipid metabolites as a group, limiting interpretation. Thanks to a newly available imaging system at the Brain Imaging Research Institute and a new analysis technique, we will be able to measure single lipid metabolites in the living human brain. Simultaneously we will also measure lipids and related enzymes in red blood cells that are responsible for the regulation of these lipids. Preliminary data has shown that there is a strong correlation between these two measures. Furthermore we will investigate the genes that are responsible for the production of these enzymes. By repeating the same tests after 12 weeks we hope to understand how the newer antipsychotic drugs act. Two easy clinical tests (a skin and breath test) will help us to implement the findings in daily clinical practice (diagnostic markers for patients at risk) . With such a multi-level approach we hope to contribute to a new understanding of the origins of schizophrenia going beyond the traditional concepts. The findings might also have direct implications for treatment. Preliminary results are very promising but also contradictory. Therefore it is even more important to carefully investigate the role of these lipids in schizophrenia.Read moreRead less