A Controlled Study Of Bilateral Electroconvulsive Therapy
Funder
National Health and Medical Research Council
Funding Amount
$423,257.00
Summary
Electroconvulsive therapy (ECT) is a highly effective treatment for depression, used in Australia and throughout the world to treat severe depression that has not responded to other treatments. Despite clear evidence of its effectiveness as a treatment, the use of ECT is limited by concerns over memory side effects. This study evaluates a new approach to ECT that has the potential to preserve its effectiveness, while greatly reducing effects on memory.
Cognitive Behaviour Therapy For Posttraumatic Stress Disorder In Police Officers
Funder
National Health and Medical Research Council
Funding Amount
$190,255.00
Summary
Posttraumatic stress disorder (PTSD) is a significant anxiety disorder that affects many serving police officers. Although cognitive behaviour therapy (CBT) is the treatment of choice to treat PTSD, it has never been validated in police offcers. This project represents the first controlled trial of applying CBT to reduce PTSD in police officers.
Randomised Trial Of Homocysteine Lowering Treatment Of Depression In Later Life (B-VITAge)
Funder
National Health and Medical Research Council
Funding Amount
$775,530.00
Summary
The causes of depression in later life are varied and complex, but available evidence suggests that cardiovascular disease plays an important role. High homocysteine (a robust risk factor for myocardial infarction and strokes) accounts for about 20% of all cases of depression in older age. We have previously shown that treatment with vitamins B12, B6 and folate reduces homocysteine. We propose to run a trial to test if lowering homocysteine decreases the severity and prevalence of depression.
Acceptance And Commitment Therapy For Medication-resistant Psychosis: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$558,200.00
Summary
In spite of advances in medication, approximately one third of people with schizophrenia continue to experience distressing symptoms such as hearing voices and paranoia. Psychological 'talking treatments' are effective in helping people to cope with and be less distressed by these experiences. This study will be the first trial of a new psychological treatment, called Acceptance and Commitment Therapy, which may be more effective, briefer and more easily provided than existing approaches.
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
Estrogen - A Potential New Treatment For Women & Men With Schizophrenia
Funder
National Health and Medical Research Council
Funding Amount
$227,545.00
Summary
Estrogen - the major female hormone, has been shown in animal studies to decrease the two main brain chemicals (dopamine and serotonin) that are implicated in causing schizophrenia. The effect of estrogen in the brain is similar to current antipsychotic drugs. We have carried out a study that showed that when we gave 12 young women with schizophrenia 100 micrograms of estrogen in a skin patch form plus standard antipsychotic drug treament they recovered more quickly than 12 young women who recei ....Estrogen - the major female hormone, has been shown in animal studies to decrease the two main brain chemicals (dopamine and serotonin) that are implicated in causing schizophrenia. The effect of estrogen in the brain is similar to current antipsychotic drugs. We have carried out a study that showed that when we gave 12 young women with schizophrenia 100 micrograms of estrogen in a skin patch form plus standard antipsychotic drug treament they recovered more quickly than 12 young women who received standard antipsychotic drug treatment only. 100mcg is a safe dose of estrogen. In this proposal we want to expand and clarify the pilot study resutls by conducting a 28 day trial in a total of 60 women with schizophrenia. 30 women would receive 100 mcg skin patch estrogen plus antipsychotic medication and 30 women would receive antipsychotic medicationly only. We also tested the value of adding a very small dose of oral estrogen to antipsychotic drug treatment in five men with schizophrenia and found that they made a better recovery compared to five men who received standard antipsychotic drugs only. We trialled the use of estrogen for seven days in men, but this may not have been long enough to examine the real impact of estrogen treatment in men. In this proposal we want to conduct a 14 day trial in a total of 60 men with schizophrenia. 30 men would receive 2mg of oral estrogen plus antipsychotic drug treatment and their results would be compared with 30 men who received standard antipsychotic drug treatment plus a placebo tablet identical in appearance to estrogen. For 14 days, this low dose of estrogen is very safe. Potentially estrogen may be a useful addition to the current standard treatment of schizophrenia. It may decrease the duration of acute illness and in women it may have a role in preventing relapses of schizophrenia as well as improving the general health of women with schizophrenia.Read moreRead less
A Double-blind Placebo Controlled Trial Of Transcranial Magnetic Stimulation In The Treatment Of Depression.
Funder
National Health and Medical Research Council
Funding Amount
$366,775.00
Summary
Depression is a severe and often disabling illness that occurs frequently in the general population. Depression is a treatable illness and the majority of patients will respond to anti-depressant medication, a form of psychotherapy or a combination of these. However, a significant percentage of patients with depression fail to respond to these therapies and currently require electroconvulsive therapy (ECT). This entails the complications and costs of multiple anaesthetics, memory impairment and ....Depression is a severe and often disabling illness that occurs frequently in the general population. Depression is a treatable illness and the majority of patients will respond to anti-depressant medication, a form of psychotherapy or a combination of these. However, a significant percentage of patients with depression fail to respond to these therapies and currently require electroconvulsive therapy (ECT). This entails the complications and costs of multiple anaesthetics, memory impairment and substantial social stigma. Transcranial magnetic stimulation is being researched as a potential alternative for these patients. It is administered to patients who are awake and alert and appears to have fewer side effects. TMS uses the unique properties of a magnetic field to produce or disrupt electrical activity in superficial areas of the brain, targeted to the areas thought to be involved in the cause of depression. Our research study will compare the two most promising types of TMS with an inactive or placebo condition. This is important to establish that the effects of TMS arise from the actual stimulation and to investigate whether one of two types of TMS administered is superior. We will administer this treatment for between 2 and 4 weeks and assess the response. We anticipate that our research will contribute to the development of TMS as a treatment methodology for this important patient group. It is crucial that a new treatment be thoroughly evaluated prior to wide dissemination of it in clinical practice. We will help define the effectiveness of this treatment and the most appropriate way in which it can be administered.Read moreRead less
A Double-blind Controlled Trial Of RTMS In The Treatment Of Bipolar Depression
Funder
National Health and Medical Research Council
Funding Amount
$401,605.00
Summary
Bipolar affective disorder (BPAD) is a serious mental illness of substantive impact but there has been relatively sparse investigation of treatments for it. One of the only substantially new treatments developed for depression in recent years has been rTMS. Repetitive TMS has been evaluated in over 30 trials conducted, but no substantive trials have explored its use in bipolar depression. We propose to do this, conducting a large scale clinical trial.
Self-help And Guided Self-help For Bulimia Nervosa In Primary Care: A Randomised Control Trial.
Funder
National Health and Medical Research Council
Funding Amount
$206,113.00
Summary
Bulimia nervosa (BN) is a major health problem in Australian women with an estimated prevalence of 1.5%. It is frequently invisible, however as women with BN are often self-blaming, ashamed and reluctant to seek specialist help. Therapist led cognitive behavioural therapy (CBT) for BN, while effective, is expensive and frequently difficult to access. This research aims to evaluate the effectiveness of two accessible and promising treatments: CBT self-help alone and guided CBT self-help treatment ....Bulimia nervosa (BN) is a major health problem in Australian women with an estimated prevalence of 1.5%. It is frequently invisible, however as women with BN are often self-blaming, ashamed and reluctant to seek specialist help. Therapist led cognitive behavioural therapy (CBT) for BN, while effective, is expensive and frequently difficult to access. This research aims to evaluate the effectiveness of two accessible and promising treatments: CBT self-help alone and guided CBT self-help treatment conducted in primary care in which the patient receives regular guidance from a general practitioner (GP). Women with BN from the community will be randomly assigned to one of 3 conditions: self-help alone, guided self-help or delayed treatment control and symptoms assessed before and after treatment. Patient characteristics associated with improvement will be examined. We anticipate patients in guided self-help will show greatest improvement, then those in the self-help alone treatment. This information will be extremely valuable in both Australia and internationally for a number of reasons. It is ethically inappropriate to recommend any treatment before it has been shown to be effective and a careful design such as the one proposed is the best way to determine treatment effectiveness. In addition, a treatment delivered in primary care is likely to be one of the most accessible within Australia?s health care system in which specialist services tend to be centralised. Further, it is essential to know which patients are likely to benefit from less resource intensive interventions. Finally, if GPs have at their disposal an effective, evidence based treatment for BN, they would be in an ideal position for secondary prevention. They are likely under these circumstances to be more alert to the symptoms of eating disorders and confident in their ability to manage them. If successful, this research will result in more widespread treatment of this disturbing disorder.Read moreRead less