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
Modelling The Characteristics And Symptoms In First-episode Psychosis From Baseline To Long-term Follow-up
Funder
National Health and Medical Research Council
Funding Amount
$22,257.00
Summary
Relatively little is known about the progression of first-episode psychosis over the longer term. This research will investigate the course and evolution of psychiatric symptoms in over 600 psychotic patients up to 10 years following initial admission. It may be possible to identify groupings of patients with similar patterns of change in symptoms, along with factors underlying different patterns of symptom course, which may help distinguish the fundamental mechanisms underlying psychosis.
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.
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
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