Anti-Estrogens - A Potential Treatment For Bipolar Affective Disorder In Women?
Funder
National Health and Medical Research Council
Funding Amount
$239,250.00
Summary
Bipolar Affective Disorder (BPAD) or Manic-Depressive Illness is a serious mental illness with high morbidity and mortality. The cause of the illness is still unclear and the underlying neurochemical changes are different for the manic phase compared with the depressive phase. The current treatments for BPAD are limited in scope and not biochemically well understood. There are gender differences in the presentation and outcomes for BPAD which adds to the complexity of the illness. We are proposi ....Bipolar Affective Disorder (BPAD) or Manic-Depressive Illness is a serious mental illness with high morbidity and mortality. The cause of the illness is still unclear and the underlying neurochemical changes are different for the manic phase compared with the depressive phase. The current treatments for BPAD are limited in scope and not biochemically well understood. There are gender differences in the presentation and outcomes for BPAD which adds to the complexity of the illness. We are proposing a study to develop a new type of treatment for the manic phase of BPAD and are exploring the use of anti-estrogens in women with mania. The background to our proposed study comes from a few case reports suggesting that anti-estrogen agents such as progesterone and tamoxifen may be useful adjuncts to treatment. We conducted a small pilot study comparing the addition of oral tamoxifen with oral progesterone and placebo in 10 women with mania and found that the women who received tamoxifen made significantly better improvements in their manic symptoms over a 28-day trial. The research study we are now proposing is a larger, three-arm, double blind, placebo controlled, 28-day adjunctive study in women with mania to expand and clarify our pilot study findings. Patients in our proposed study would receive either 40mg per day tamoxifen or 20mg per day progesterone or placebo in addition to standardised lithium medication. We will measure enzyme activity (protein kinase C) and estrogen-progesterone levels to understand more about the mechanisms of action by these new hormone treatments. BPAD is a crippling disorder and if we are successful, then tamoxifen treatment may be an important new treatment. This proposed study will also shed new light on some of the neurochemical mechanisms underlying BPAD as well as opening up the new area of hormone treatments for serious mental illness.Read moreRead less
Posttraumatic Mental Health: Advancing Understanding Of Diagnosis, Treatment And Mechanisms
Funder
National Health and Medical Research Council
Funding Amount
$7,590,920.00
Summary
Psychological disorders following exposure to trauma account for a significant proportion of the burden of disease in terms of personal suffering, decreased productivity, occupational dysfunction, and demands on health services. This project will enhance the nation's capacity to reduce psychological problems after trauma. This project will consolidate a critical mass of Australia's leading trauma researchers that will ensure that Australia retains its leading edge in posttraumatic research.
Behavioural And Neuropsychiatric Aspects Of Transition To Severe Conduct Disorder In Adolescence.
Funder
National Health and Medical Research Council
Funding Amount
$343,100.00
Summary
Conduct disorder represents an enormous cost to Australian society directly via the mental health and forensic systems, and indirect costs via its associations with other mental health problems, relationship problems, impaired social functioning, and substance use problems. Behavioural-family-based treatment have good success rates with young children with cooperative parents, however, there are a minority who progress to chronic problems despite this. Risk and resilience factors identifying chr ....Conduct disorder represents an enormous cost to Australian society directly via the mental health and forensic systems, and indirect costs via its associations with other mental health problems, relationship problems, impaired social functioning, and substance use problems. Behavioural-family-based treatment have good success rates with young children with cooperative parents, however, there are a minority who progress to chronic problems despite this. Risk and resilience factors identifying chronic patterns in early childhood are the key to early intervention. In previous research, this research team showed for the first time that callous-unemotional traits, a feature of chronic psychopathy, could be measured in children as young as 4 years, and was predictive of a range of negative outcomes. However, it was also found that the key neuropsychiatric markers characteristic of psychopathy, including reward dominance-punishment insensitivity and deficits in affective empathy, did not exist in conduct problem children prior to adolescence. Around the time of puberty, it appears that important changes occur in cognitive-affective processing styles that are associated with the adult form of psychopathy and antisocial behaviour. Thus, this research raises critical questions about the development of severe antisocial behaviour (or psychopathy) through the childhood to adolescent years. Our evidence indicates that early adolecence may be the period when intrapsychological characteristics representing chronic risk become concrete. The current research will be the first to map the development common neuropsychiatric markers (affective empathy, punishment insensitivity) of severe antisocial processes through the late childhood-adolescent period. The findings will have clear implications for models of antisocial behaviour and clinical approaches to working with conduct problem children and adolescents.Read moreRead less
Posttraumatic Mental Health: Enhancing Resilience And Recovery
Funder
National Health and Medical Research Council
Funding Amount
$5,043,011.00
Summary
Psychological disorders following exposure to trauma account for a significant proportion of the burden of disease in terms of personal suffering, decreased productivity, occupational and social dysfunction, medical disorders, and demands on health services. The overall goal of this project is to enhance the nation’s capacity in research into the identification of risk factors for posttraumatic mental disorders, study of neurophysiological factors mediating these disorders, and evaluation of tre ....Psychological disorders following exposure to trauma account for a significant proportion of the burden of disease in terms of personal suffering, decreased productivity, occupational and social dysfunction, medical disorders, and demands on health services. The overall goal of this project is to enhance the nation’s capacity in research into the identification of risk factors for posttraumatic mental disorders, study of neurophysiological factors mediating these disorders, and evaluation of treatment strategies to reduce psychological morbidity after trauma. This project will develop a critical mass of Australia’s leading trauma researchers that will ensure that Australia retains its leading edge in posttraumatic research.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.
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.
The Role Of Trauma Related Anger And The Cycles Of Violence In Post Conflict Countries: A Follow Up Study In Timor Leste
Funder
National Health and Medical Research Council
Funding Amount
$560,618.00
Summary
Our 2004 East Timor study showed that men who suffered abuses remain angry. We will follow-up these men to see if those who remained angry were more likely to be involved in social unrest and violence. We will also find out what factors make angry men more likely to act violently. This study will provide information to help agencies assist men overcome anger to avoid future violence.
Impact Of The Refugee Application Process On The Psychiatric Status Of Traumatized Asylum Seekers: A Prospective Study
Funder
National Health and Medical Research Council
Funding Amount
$147,859.00
Summary
Although the numbers of persons who identify themselves as fleeing from persecution (asylum seekers) residing in Western countries has increased substantially in the last decade, very little research has been undertaken on the psychiatric and physical health of this group. The only studies published in professional journals have been produced by members of the applicant team. The results indicate that approximately 50% have suffered gross human rights violations including torture, detention in c ....Although the numbers of persons who identify themselves as fleeing from persecution (asylum seekers) residing in Western countries has increased substantially in the last decade, very little research has been undertaken on the psychiatric and physical health of this group. The only studies published in professional journals have been produced by members of the applicant team. The results indicate that approximately 50% have suffered gross human rights violations including torture, detention in concentration camps and brainwashing, and 37% are affected by ongoing posttraumatic stress disorder (PTSD) - terrifying memories of past abuses, avoidance of experiences that trigger such memories, social withdrawal, and constant anxiety. The research has also shown that psychiatric symptoms may be worsened by the fears and insecurities associated with the asylum seeking process, but the exact impact of stresses such as rejection of their primary application at 2-3 months, could not be determined. We therefore aim to conduct the first study of its kind that traces the impact of such stresses on the mental health of asylum seekers. In addition, we will track asylum seekers' general health problems and the difficulties they may experience in accessing basic medical health services. This evidence will provide scientific confirmation of how stress can worsen PTSD; indicate that some asylum seekers may be in special need of support throughout the asylum assessment process; assist policy makers to re-assess the methods and processs of assessing asylum claims; and provide impetus to establishing better services for the medical and psychiatric problems faced by asylum seekers.Read moreRead less
High-Throughput Screening Of The Genome And Proteome In Postmortem CNS From Subjects With Schizophrenia
Funder
National Health and Medical Research Council
Funding Amount
$553,190.00
Summary
Schizophrenia is a serious psychiatric illness that effects ~1% of the Australia population. The underlying pathology of the illness remains unknown. This application seeks funding to use new technologies to screen approximately 60% of the expressed human genome and proteome to determine which genes are being differentially expressed in two regions thought to be important in generating the symptoms of the illness, the frontal cortex and hippocampus. This project will generate a large amount of d ....Schizophrenia is a serious psychiatric illness that effects ~1% of the Australia population. The underlying pathology of the illness remains unknown. This application seeks funding to use new technologies to screen approximately 60% of the expressed human genome and proteome to determine which genes are being differentially expressed in two regions thought to be important in generating the symptoms of the illness, the frontal cortex and hippocampus. This project will generate a large amount of data, however by comparing the data from subjects with schizophrenia to that from control subjects and subjects with bipolar disorder who were psychotic and being treated with antipsychotic drugs close to death will allow us to identify changes that are specific to schizophrenia. Genes that are expressing different levels of mRNA and protein will become prime targets for future investigations as they are likely to be central to the pathology of the illness.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