Depressive Illness And The Heart: Identifying The Relation Between Affective Disorders And Coronary Heart Disease
Funder
National Health and Medical Research Council
Funding Amount
$503,625.00
Summary
Major depression is ranked fourth among the 10 leading causes of the global burden of disease and, if epidemiological projections are correct, by 2020 it will reach second place. Patients with depression are at increased risk of developing coronary heart disease. This elevated risk is independent of conventional risk factors such as smoking, obesity, hyperlipidaemia, diabetes and hypertension. Also conclusively demonstrated is the adverse effect of depression in patients following myocardial inf ....Major depression is ranked fourth among the 10 leading causes of the global burden of disease and, if epidemiological projections are correct, by 2020 it will reach second place. Patients with depression are at increased risk of developing coronary heart disease. This elevated risk is independent of conventional risk factors such as smoking, obesity, hyperlipidaemia, diabetes and hypertension. Also conclusively demonstrated is the adverse effect of depression in patients following myocardial infarction (MI), which materially increases mortality. The mechanism of increased cardiac risk attributable to depressive illness is at present uncertain but activation of the sympathetic nervous system, exaggerated platelet reactivity and-or altered baroreflex function are likely to be of prime importance. Preliminary data from our laboratory indicates that whole body and cardiac sympathetic nervous activity and cardiac baroreflex sensitivity are modified following antidepressant therapy. Identifying the underlying neurochemical mechanisms responsible for alterations in affective behaviour, and quantifying cardiac and whole body sympathetic activity directly and indirectly, and testing whether therapeutic and behavioural interventions can influence brain neurotransmitter turnover and modify cardiac sympathetic tone, platelet reactivity, and baroreflex function in a fashion likely to reduce cardiac risk, will be an important step forward in alleviating the burden of depressive illness on the community.Read moreRead less
Longitudinal Brain Changes In First-episode Psychosis: A 10 Year Follow-up MRI Study
Funder
National Health and Medical Research Council
Funding Amount
$165,250.00
Summary
It is now widely accepted that schizophrenia is associated with changes in the structure of the brain. Until recently these structural changes were considered to predate the onset of illness and to remain static. However, our own work has suggested an alternative model, which relates schizophrenia to brain changes at specific life stages. In order to demonstrate this, we intend to acquire repeat brain images on 100 patients who were initially scanned 10 years ago at the start of their psychotic ....It is now widely accepted that schizophrenia is associated with changes in the structure of the brain. Until recently these structural changes were considered to predate the onset of illness and to remain static. However, our own work has suggested an alternative model, which relates schizophrenia to brain changes at specific life stages. In order to demonstrate this, we intend to acquire repeat brain images on 100 patients who were initially scanned 10 years ago at the start of their psychotic illness. This would be the largest follow-up study of first episode psychosis in the world, with the longest interval between the first and second brain scan. Further, for a proportion of patients we will have 3 MRI scans, at illness onset, 2-4 years post-onset, followed by a third scan at 10 years, thereby providing unique follow-up brain imaging data. Based on our own and other research, we intend to explore the relationship between progressive brain change over a ten year period and: (i) the diagnosis of the patient (schizophrenia or other disorder), (ii) the clinical and functional outcome of the patient (still chronically ill or with no further episode of psychosis), and (iii) the cognitive state of the patient (their ability to perform well on tests of memory, planning and so on). We are able to conduct this study because of the existence of an infrastructure developed to follow-up patients, with a recontact rate of 70% of those patients admitted in 1992 and 1993. In this study we seek to implement these strategies for the patients identified after 1994. The results of this study will test our ideas derived from our model of the major psychotic illnesses and may identify the structural brain changes which are associated with the development of chronic schizophrenia and other psychoses. A further novel outcome will be the inclusion of patients who have remained well and identiifying the structural correlates of a good prognosis.Read moreRead less
Psychiatric disorders are associated with considerable social and economic burden which could be reduced if we understood mental health outcomes in high risk populations. This fellowship will use advanced brain imaging to understand the development of mental health disorders in those at high risk of bipolar disorder and dementia.
Kava For The Treatment Of Generalized Anxiety Disorder: A 16-Week Double-Blind RCT
Funder
National Health and Medical Research Council
Funding Amount
$680,489.00
Summary
Herbal medicines play a prominent role in traditional medicine to treat affective disorders (mood and anxiety disorders), however scientific studies are needed to truly assess their effectiveness. This clinical trial is examining the anxiolytic efficacy of Kava in treating chronic anxiety. As current response to antidepressant drugs can be inadequate, Kava may offer an additional affordable, safe, and effective option to reduce anxiety.
Gaining Two-way Understanding Of Recovery From Chronic And Recurring Mental Disorders In FNQ Indigenous Communities.
Funder
National Health and Medical Research Council
Funding Amount
$110,519.00
Summary
Little is known about the rates of chronic and recurring mental illness in the Indigenous population, particularly in remote Indigenous communities. This research aims to document the extent of the problem and explore the factors that place individuals at risk of poorer mental health outcomes as well as those factors that promote resiliency and recovery in the face of such risk. In addition, the concept of recovery in mental illness will be expanded to include Indigenous views.
Automatic detection and modelling of acoustic markers of speech timing. This project aims to create new automatic sensing, analysis and assessment of cognitive, affective, mental and physical state from voice for mobile and computing devices. This project expects to generate new understanding of the effects of these states on detailed timing indicators of speech motor control, and new signal processing and machine learning methods that best exploit it. Expected outcomes from this project include ....Automatic detection and modelling of acoustic markers of speech timing. This project aims to create new automatic sensing, analysis and assessment of cognitive, affective, mental and physical state from voice for mobile and computing devices. This project expects to generate new understanding of the effects of these states on detailed timing indicators of speech motor control, and new signal processing and machine learning methods that best exploit it. Expected outcomes from this project include a new and accurate deep neural network framework for learning, analysing and detecting human states from speech automatically using articulatory timing markers. This should provide significant benefits, such as individually-tailored, frequent and low-cost automatic detection, monitoring and analytics for adverse states.Read moreRead less
The Efficacy Of Adjunctive Garcinia Mangostana Linn. Pericarp For Bipolar Depression: A 24-week Double-blind, Randomized, Placebo-controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$1,227,272.00
Summary
Bipolar disorder, especially during episodes of depression, can be highly debilitating. There is scientific evidence now directing research towards new targets to produce new therapies for bipolar depression. The current study aims to utilise an entirely new agent made from the husk of the mangosteen fruit (mangosteen pericarp). Mangosteen pericarp has properties that we believe will assist in reducing symptoms for those with bipolar depression, when taken in addition to usual treatment.
Using Single Patient Trials To Determine The Effectiveness Of Psychostimulants In Fatigue In Advanced Cancer Patients
Funder
National Health and Medical Research Council
Funding Amount
$162,563.00
Summary
The lack of good evidence in palliative care (PC) is widely acknowledged but research in PC is difficult. Methodological barriers include: difficulties in recruitment, high rates of attrition, problems with maintaining distinct and sustainable intervention strategies, poorly chosen outcomes and opposition to randomization. Organizational barriers include: lack of research infrastructure, few trained clinical researchers, prioritisation of clinical responsibilities and funding difficulties. The h ....The lack of good evidence in palliative care (PC) is widely acknowledged but research in PC is difficult. Methodological barriers include: difficulties in recruitment, high rates of attrition, problems with maintaining distinct and sustainable intervention strategies, poorly chosen outcomes and opposition to randomization. Organizational barriers include: lack of research infrastructure, few trained clinical researchers, prioritisation of clinical responsibilities and funding difficulties. The hierarchy of evidence rates RCTs as the gold standard. An alternative is the n-of-1 trial: a randomized, double-blind cross-over comparison of active drug with placebo or another drug. The patient is in effect their own control. N-of-1 trials provide an objective means of testing the effectiveness of medicines in individual patients, providing evidence stronger than RCT evidence for the efficacy of that drug in that particular individual. If multiple n-of-1 trials are conducted, the resultant data amounts to RCT evidence for that treatment in a population. We propose n-of-1 trials as a workable option for researching the benefit of drugs and other therapies in PC patients. If successful, this model could be accepted internationally as the gold standard for research in this difficult population group. This would be a world first and of great national and international significance. In advanced cancer, the prevalence of fatigue is very high at 60-90% and can be related to the treatment or the disease itself. The impact of fatigue on function (physical, mental, social and spiritual) and hence quality of life (QOL) is very significant for many palliative patients as well as their families-carers. The role of pyschostimulants in the management of fatigue in patients with advanced cancer and life limiting disease needs to be defined. We will conduct n-of-1 trials of psychostimulants (i.e. methylphenidate) for fatigue in a group of 40 patients, recruited from 5 sites around Australia through a national clinical trial network recently set up for palliative care research. Managing fatigue with treatment supported by the best possible evidence for individual patients and producing any improvement in fatigue will improve patients� functional status, and will greatly improve QOL for patients and carers.Read moreRead less