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
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
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
The Relationship Between Cannabis Use And Symptoms And Relapse In Psychosis
Funder
National Health and Medical Research Council
Funding Amount
$169,604.00
Summary
Cannabis is increasingly widely used and abused by young people. Use in young people with schizophrenia is even more extensive. There is some suggestion that this drug use is a result of their illness, ie to reduce unpleasant symptoms or feelings. Equally the drug may contribute to their psychosis. This study aims to assess the degree to which psychosis may be caused by cannabis use in vulnerable young people.
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
Models of adolescent drug use and its consequences. Recent concerns surround the impact of drug abuse - particularly binge drinking, inhalant abuse and cannabis use - on the mental health of adolescents. Early drug use is associated with mental health problems although the mechanisms involved are not well characterised. The present proposal aims to use animal models to characterise substance abuse that occurs during the adolescent period and to investigate its effects on brain and behaviour. Inc ....Models of adolescent drug use and its consequences. Recent concerns surround the impact of drug abuse - particularly binge drinking, inhalant abuse and cannabis use - on the mental health of adolescents. Early drug use is associated with mental health problems although the mechanisms involved are not well characterised. The present proposal aims to use animal models to characterise substance abuse that occurs during the adolescent period and to investigate its effects on brain and behaviour. Increasing our knowledge of the causes and consequences of adolescent drug abuse will improve Australia's ability to confront this problem and to develop early interventions and treatments that minimise associated harms.Read moreRead less
ADHD And Comorbidity: Implications For Clinical Practice And Molecular Genetics
Funder
National Health and Medical Research Council
Funding Amount
$284,878.00
Summary
ADHD is emerging as the most common, controversial childhood behavioural problem. Previously we have shown that much of the confusion may lie in the fact that ADHD is inherited as a continuum throughout the entire population, only some people having such a strong genetic potential that they warrant the label ADHD. The threshold to achieve this label is partly a community one, leading to the argument over who should be labelled and treated. This grant goes further in examining the possibility tha ....ADHD is emerging as the most common, controversial childhood behavioural problem. Previously we have shown that much of the confusion may lie in the fact that ADHD is inherited as a continuum throughout the entire population, only some people having such a strong genetic potential that they warrant the label ADHD. The threshold to achieve this label is partly a community one, leading to the argument over who should be labelled and treated. This grant goes further in examining the possibility that there is more than one type of ADHD. Some ADHD children have other behavioural problems such as conduct disorder or learning problems. Some have problems throughout their lives while others grow out of it. In Australia we are unique in having developed the most extensive twin databases world-wide and have already studied aspects of ADHD both in the children and their parents. In this grant we shall explore whether there are distinct genetic types of ADHD, characterised not just by their ADHD symptoms but also by the other behavioural problems they experience and by what happens as they grow-up. Such information is invaluable in developing a treatment program dealing with all aspects of the ADHD and also addresses the question of what will happen as they get older. No other study internationally has such extensive data to address these key questions., vital both to clinicians and families. Given the significant genetic component to ADHD, the next possibility is to find the genes involved in the different types. Knowing what these genes do may help in the development of medications more targeted to specific patterns of problems. Recently genes have been identified which may be involved in specific types of ADHD, as well as genes involved in associated problems such as reading disability and substance abuse. This study offers the potential to clearly identify the role of these genes and so assist in improved diagnosis and treatment interventions.Read moreRead less
ADHD Grown-up: Genetic And Environmental Determinants Of The Adult Outcomes Of Childhood ADHD And Comorbid Conditions
Funder
National Health and Medical Research Council
Funding Amount
$289,542.00
Summary
ADHD remains a controversial issue especially in adulthood. There are many related behavioural problems including substance abuse, anxiety, depression, and personality disorders. Australia is such a focus for twin research that many twin families have taken part in several studies of different aspects of mental health over the years. This grant allows us to link the various datasets to create a unique longitudinal genetic resource and to examine the longterm outcomes.