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In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Early Childhood Education (excl. Māori) | Mental Health | Health Promotion | Education Systems | Mental Health | Public Health and Health Services | Health And Community Services
Mental health | Telecommunications | Health education and promotion | Early childhood education |
Publisher: American Psychological Association (APA)
Date: 2001
Publisher: SAGE Publications
Date: 13-08-2014
Abstract: The aim of this paper was to explore attitudes towards people with mental disorders among Australian health professionals (psychiatrists, psychologists and general practitioners (GPs)) and to compare their attitudes with members of the general community. The study involved a postal survey of 518 GPs, 506 psychiatrists and 498 clinical psychologists and a telephone survey of 6019 members of the general community. Participants were given a case vignette describing a person with either depression, depression with suicidal thoughts, early schizophrenia, chronic schizophrenia, post-traumatic stress disorder (PTSD) or social phobia and two questionnaires to assess stigmatising attitudes (the Depression Stigma Scale and the Social Distance Scale). Exploratory structural equation modelling was used to elucidate the structure of stigma as measured by the two scales, to establish dimensions of stigma and to compare patterns of association according to gender, age, vignette and professional grouping. The measurement characteristics of stigmatising attitudes in health professionals were found to be comparable to those in members of the general community in social distance and also in personal and perceived attitude stigma, with each forming distinct dimensions and each comprising ‘Weak-not-sick’ and ‘Dangerous/unpredictable’ components. Among health professionals, female gender, age and being a GP were associated with higher scores on the personal stigma scales. Mental health professionals had lower scores on the personal ‘Weak-not-sick’ and ‘Dangerous/unpredictable’ scales than members of the general community, while there were no significant differences in the desire for social distance between health professionals and the general community. While mental health professionals have less stigmatising attitudes than the general public, the greater beliefs in dangerousness and personal weakness by GPs should be addressed.
Publisher: Wiley
Date: 21-12-2007
DOI: 10.1017/S0012162207000126.X
Abstract: This paper describes the development and psychometric properties of a condition-specific quality of life instrument for children with cerebral palsy (CP QOL-Child). A s le of 205 primary caregivers of children with CP aged 4 to 12 years (mean 8y 5mo) and 53 children aged 9 to 12 years completed the CP QOL-Child. The children (112 males, 93 females) were s led across Gross Motor Function Classification System (GMFCS) levels (Level I=18%, II=28%, III=14%, IV=11%, V=27%). Primary caregivers also completed other measures of child health (Child Health Questionnaire CHQ), QOL (KIDSCREEN), and functioning (GMFCS). Internal consistency ranged from 0.74 to 0.92 for primary caregivers and from 0.80 to 0.90 for child self-report. For primary caregivers, 2-week test-retest reliability ranged from 0.76 to 0.89. The validity of the CP QOL is supported by the pattern of correlations between CP QOL-Child scales with the CHQ, KIDSCREEN, and GMFCS. Preliminary statistics suggest that the child self-report questionnaire has acceptable psychometric properties. The questionnaire can be freely accessed at www.deakin.edu.ac/hmnbs/chase/cerebralpalsy/cp_qol_home.php.
Publisher: Informa UK Limited
Date: 06-2004
Publisher: JMIR Publications Inc.
Date: 30-07-2017
Publisher: Elsevier BV
Date: 05-2013
DOI: 10.1016/J.JAD.2012.11.036
Abstract: Program adherence has been associated with improved intervention outcomes for mental and physical conditions. The aim of the current study is to investigate adolescent adherence to an Internet-based depression prevention program in schools to identify the effect of adherence on outcomes and to ascertain the predictors of program adherence. Data for the current study (N=1477) was drawn from the YouthMood Project, which was conducted to test the effectiveness of the MoodGYM program in reducing and preventing symptoms of anxiety and depression in an adolescent school-based population. The current study compares intervention effects across three sub-groups: high adherers, low adherers and the wait-list control condition. When compared to the control condition, participants in the high adherence intervention group reported stronger intervention effects at post-intervention and 6-month follow-up than participants in the low adherence group for anxiety (d=0.34-0.39 vs. 0.11-0.22), and male (d=0.43-0.59 vs. 0.26-0.35) and female depression (d=0.13-0.20 vs. 0.02-0.04). No significant intervention effects were identified between the high and low adherence groups. Being in Year 9, living in a rural location and having higher pre-intervention levels of depressive symptoms or self-esteem were predictive of greater adherence to the MoodGYM program. The program trialled is Internet-based and therefore the predictors of adherence identified may not generalise to face-to-face interventions. The current study provides preliminary support for the positive relationship between program adherence and outcomes in a school environment. The identification of significant predictors of adherence will assist in identifying the type of user who will engage most with an online depression prevention program.
Publisher: Oxford University Press (OUP)
Date: 1996
Abstract: The influence of self-reported and informant-reported activity levels on Crystallized Intelligence, Fluid Intelligence, Memory and the Mini-Mental State Examination was investigated in a s le of 858 community-dwelling elderly subjects. Both self-reported and informant-reported activity levels explained variance beyond that accounted for by sex, sensory functioning, activities of daily living, medical conditions, current health problems and education. Age accounted for additional variance once activity and the other contextual variables were entered. Interaction effects indicated that inactivity was associated with poorer performance on fluid intelligence in older rather than younger elderly subjects and that inactivity was predictive of poor crystallized intelligence at younger ages. Higher informant-rated activity levels moderated the effects of education, so that higher activity offset effects associated with low education on memory tasks. The mount of variance explained by activity levels was modest.
Publisher: Public Library of Science (PLoS)
Date: 26-03-2013
Publisher: JMIR Publications Inc.
Date: 15-08-2019
DOI: 10.2196/13628
Abstract: Prevention of depression and anxiety disorders early in life is a global health priority. Evidence on risk and protective factors for youth internalizing disorders indicates that the family represents a strategic setting to target preventive efforts. Despite this evidence base, there is a lack of accessible, cost-effective preventive programs for parents of adolescents. To address this gap, we recently developed the Partners in Parenting (PiP) program—an in idually tailored Web-based parenting program targeting evidence-based parenting risk and protective factors for adolescent depression and anxiety disorders. We previously reported the postintervention outcomes of a single-blinded parallel-group superiority randomized controlled trial (RCT) in which PiP was found to significantly improve self-reported parenting compared with an active-control condition (educational factsheets). This study aimed to evaluate the effects of the PiP program on parenting risk and protective factors and symptoms of adolescent depression and anxiety using data from the final assessment time point (12-month follow-up) of this RCT. Parents (n=359) and adolescents (n=332) were recruited primarily from secondary schools and completed Web-based assessments of parenting and adolescent depression and anxiety symptoms at baseline, postintervention (3 months later), and 12-month follow-up (317 parents, 287 adolescents). Parents in the PiP intervention condition received personalized feedback about their parenting and were recommended a series of up to 9 interactive modules. Control group parents received access to 5 educational factsheets about adolescent development and mental health. Both groups received a weekly 5-min phone call to encourage progress through their program. Intervention group parents completed an average of 73.7% of their intended program. For the primary outcome of parent-reported parenting, the intervention group showed significantly greater improvement from baseline to 12-month follow-up compared with controls, with a medium effect size (Cohen d=0.51 95% CI 0.30 to 0.72). When transformed data were used, greater reduction in parent-reported adolescent depressive symptoms was observed in the intervention group (Cohen d=−0.21 95% CI −0.42 to −0.01). Mediation analyses revealed that these effects were mediated by improvements in parenting (indirect effect b=−0.08 95% CI −0.16 to −0.01). No other significant intervention effects were found for adolescent-reported parenting or adolescent depression or anxiety symptoms. Both groups showed significant reductions in anxiety (both reporters) and depressive (parent reported) symptoms. PiP improved self-reported parenting for up to 9 months postintervention, but its effects on adolescent symptoms were less conclusive, and parent-reported changes were not perceived by adolescents. Nonetheless, given its scalability, PiP may be a useful low-cost, sustainable program to empower parents of adolescents. Australian Clinical Trials Registration Number (ACTRN): 12615000328572 www.anzctr.org.au/ACTRN12615000328572.aspx (Archived by WebCite at qgsZ3Aqj).
Publisher: Elsevier BV
Date: 11-2009
Publisher: SAGE Publications
Date: 12-05-2014
Abstract: The effects of pregnancy on depression and anxiety remain unclear. Previous research is predominantly cross-sectional, not representative of the general community, and does not include data on mental health prior to pregnancy. This study used longitudinal Australian population-based data to examine whether pregnancy is associated with increases in women’s anxiety and depression levels (from pre-pregnancy). A community s le of Australian women aged 20–24 years were recruited prospectively and assessed in 1999, 2003 and 2007. At the follow-up assessments 76 women were pregnant (with no prior children) and 542 remained nulliparous. Mixed models repeated measures analyses of variance were undertaken to compare change in levels of anxiety and depression (Goldberg Anxiety and Depression scales) between those who became pregnant and those who remained non-pregnant. Pregnancy was not associated with increased symptoms of depression or anxiety. No association was found with depression, while pregnancy was associated with a decrease in anxiety. Including somatic items in the measures of depression and anxiety resulted in higher symptom levels in pregnancy, suggesting possible item bias. This study is one of the first to follow a community s le of women from pre-pregnancy to pregnancy. The findings suggest that pregnancy is not typically detrimental to women’s mental health. The current study offers a starting point for future prospective studies to follow women from pre-pregnancy to postpartum. Study limitations to be improved upon in follow-up research include expanding the s le size, and including both pregnancy-specific measures and trimester-specific data. Future research should continue to identify those women who are most (and least) at risk during pregnancy in order to target resources and assistance most effectively.
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.SCHRES.2018.09.021
Abstract: Loneliness is an established risk factor for poor cardiometabolic health. People with psychotic disorders experience high rates of both cardiometabolic disease and loneliness, but how these factors are associated is poorly understood. Thus, using data from the second Australian National Survey of Psychosis we examined whether loneliness is associated with the likelihood of cardiometabolic disorder in psychotic illness. Loneliness was assessed using a single-item measure, with a 4-point scale (not lonely lonely occasionally some friends but lonely for company socially isolated and lonely) whilst cardiometabolic status was assessed in terms of the criteria used to determine metabolic syndrome (elevated waist circumference, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure, and elevated fasting glucose). Logistic regression was employed to examine whether loneliness was associated with metabolic syndrome status, and its in idual components, with and without adjustment for confounding variables. Increased loneliness was associated with an increased risk of metabolic syndrome in people with psychosis (OR 1.21, 95% CI 1.08-1.36, p < .001) and to the risk of elevated waist circumference (p < .01), elevated triglycerides (p < .05) and reduced high-density lipoprotein cholesterol (p < .05). Notably, these associations largely persisted when controlling for a range of covariates. Feeling lonely is significantly associated with metabolic syndrome, and dyslipidemia specifically, in people with psychotic disorders. These data suggest that the potential benefits of interventions to reduce loneliness in psychosis may extend to cardiovascular as well as psychosocial functioning, and should be explored in future research.
Publisher: Cambridge University Press (CUP)
Date: 2001
DOI: 10.1017/S0033291799002834
Abstract: Background. Higher education has been posited to protect against cognitive decline, either because the rate of decline is slower in the more highly educated or the start of decline is delayed. Latent growth models provide improved methodology to examine this issue. Methods. The s le consisted of 887 participants aged 70–93 years in 1991 and followed up in 1994 and 1998. Latent growth models and standard regression techniques were used to examine the rate of cognitive decline in four cognitive measures while controlling for health status and sex. A delayed start model was examined by incorporating interaction effects in a regression model. Results. Neither the latent growth models nor the regression techniques revealed a slower rate of decline for the more highly educated. The proportion of the highly educated showing no change was no larger than the proportion of the less well educated. There were no significant age by education interaction effects, no chronologically later accelerations in the rate of change as a function of education, and no differences in rate of decline between the first measurement interval and the second. Conclusions. Education may not protect against cognitive decline although it is associated with long-term in idual differences in level of functioning. The discrepancy between our study and others may be attributable to attrition effects, follow-up length, s le age, scaling artefacts and negative publication bias. Most importantly, practice effects may favour the better educated and hence account for the supposed protective effect in many longitudinal studies of cognitive change.
Publisher: Elsevier BV
Date: 10-2014
DOI: 10.1016/J.SCHRES.2014.07.011
Abstract: Child abuse has been associated with risk of mental illness, including schizophrenia and other psychotic disorders and, among those with mental illness, with a more severe clinical profile. Using an extensively characterised and epidemiologically representative s le of 1825 Australians with a psychotic illness aged 18-64 years and in contact with mental health services, we estimated the proportion of in iduals with psychotic disorders who self-reported child abuse and examined its relationship with clinical and other characteristics. The prevalence of child abuse in this nationally representative s le of people with psychotic illness was 30.6%. Women were almost three times more likely to report child abuse compared to males (OR, 2.8, 95% CI 2.3-3.4). When adjusted for age at interview and socio-economic status, there was no significant relationship between self-reported child abuse and type of psychosis or course of illness. Participants with child abuse were significantly more likely to have subjective thought disorder, lifetime suicide attempt and premorbid personality disorder (females only) and anxiety (males only). Our findings demonstrate that child abuse is relatively common across the range of psychotic disorders, with an elevated risk for women in particular, compounding the already high burden associated with psychotic illness. Clinicians need to inquire routinely about child abuse in order to develop appropriate treatment plans tailored to in idual needs.
Publisher: JMIR Publications Inc.
Date: 15-05-2022
DOI: 10.2196/12892
Publisher: Cambridge University Press (CUP)
Date: 1997
DOI: 10.1017/S0033291796004199
Abstract: Background . We report the outcome of depressive states after 3-4 years in a community s le of the elderly. Methods . A s le of 1045 persons aged 70+ years in 1990–1 was re-interviewed after 3·6 years. Results . Mortality (21·7%) and refusal or non-availability (10·4%) were higher in those who initially had had a diagnosis or symptoms of depression. Of those with an ICD-10 depressive episode in 1990–1, 13% retained that diagnosis. Of those who were not depressed initially only 2·5% had become cases. Depression was unrelated to age or apolipoprotein E genotype. The best predictors of the number of depressive symptoms at follow-up was the number at Wave 1, followed by deterioration in health and in activities of daily living, high neuroticism, poor current health, poor social support, low current activity levels and high service use. Depressive symptoms at Wave 1 did not predict subsequent cognitive decline or dementia. Conclusions . Non-random s le attrition is unavoidable. ICD-10 criteria yield more cases than other systems, while continuous measures of symptoms confer analytical advantages. Risk factors for depressive states in the elderly have been further identified. The prognosis for these states is favourable. At the community level, depressive symptoms do not seem to predict cognitive decline, as they do in referred series.
Publisher: Elsevier BV
Date: 06-1995
Publisher: Elsevier BV
Date: 12-2015
DOI: 10.1016/J.SCHRES.2015.10.027
Abstract: Loneliness involves subjective, rather than objective, social isolation and has a range of negative effects on mental and physical functioning. The purpose of this study was to examine the prevalence of loneliness in psychotic disorders and its association with symptoms and cognitive performance. Data were drawn from the second Australian National Survey of Psychosis and comprised responses from 1642 participants with an International Classification of Diseases 10 diagnosis of psychotic disorder who had completed a semi-structured interview of symptoms and social functioning (including loneliness), along with standardized assessments of current (digit symbol coding DSC) and premorbid (National Adult Reading Test) cognitive ability. We examined the prevalence of loneliness across the diagnostic categories of psychosis, and its association with psychotic and non-psychotic symptoms and digit symbol coding scores. The prevalence of loneliness was high, ranging from 74.75% in participants with delusional disorders to 93.8% in depressive psychosis, and was significantly higher than in the general population. Loneliness was also significantly associated with anhedonia and subjective thought disorder. Participants feeling socially isolated/lonely for company had significantly lower DSC scores than those who only felt lonely occasionally. Unexpectedly, participants who reported not feeling lonely had the lowest DSC scores. Loneliness is common across all psychotic disorders, particularly in depressive psychosis. It is specifically associated with ongoing loss of pleasure and disordered thoughts as well as impairment in current cognitive functioning. However, poor cognitive functioning is not inevitably associated with loneliness. Implications for personalized treatment of psychosis are discussed.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2004
DOI: 10.1097/01.NMD.0000126728.70060.FA
Abstract: Command hallucinations (CHs) are hallucinations that direct the patient to perform an action. Beyond issues related to the danger that some CHs may pose, comparatively little is known about the broader clinical context of CHs. To investigate this, 199 patients were interviewed using the Mental Health Research Institute Unusual Perceptions Scale. More than two thirds of the s le reported hearing CHs. A quarter of these patients felt unable to resist them. Patients with CHs reported their voices more negatively than those who did not hear commands. More of those unable to resist CHs rated their hallucinations as intrusive, they had fewer coping strategies than those able to resist, and they were prescribed higher dosages of medication. CHs are associated with a greater degree of adverse hallucinatory and illness experience. Patients who experience CHs may have a more malignant form of the underlying disorder. Thus, CHs warrant special therapeutic attention for reasons beyond any harm that their commands pose to themselves or others.
Publisher: JMIR Publications Inc.
Date: 03-03-2021
Abstract: igital mental health interventions stand to play a critical role in managing the mental health impact of the COVID-19 pandemic. Thus, enhancing their uptake is a key priority. General practitioners (GPs) are well positioned to facilitate access to digital interventions, but tools that assist GPs in identifying suitable patients are lacking. his study aims to evaluate the suitability of a web-based mental health screening and treatment recommendation tool ( i StepCare /i ) for improving the identification of anxiety and depression in general practice and, subsequently, uptake of digital mental health interventions. tepCare screens patients for symptoms of depression (9-item Patient Health Questionnaire) and anxiety (7-item Generalized Anxiety Disorder scale) in the GP waiting room. It provides GPs with stepped treatment recommendations that include digital mental health interventions for patients with mild to moderate symptoms. Patients (N=5138) from 85 general practices across Australia were invited to participate in screening. creening identified depressive or anxious symptoms in 43.09% (1428/3314) of patients (one-quarter were previously unidentified or untreated). The majority (300/335, 89.6%) of previously unidentified or untreated patients had mild to moderate symptoms and were candidates for digital mental health interventions. Although less than half were prescribed a digital intervention by their GP, when a digital intervention was prescribed, more than two-thirds of patients reported using it. mplementing web-based mental health screening in general practices can provide important opportunities for GPs to improve the identification of symptoms of mental illness and increase patient access to digital mental health interventions. Although GPs prescribed digital interventions less frequently than in-person psychotherapy or medication, the promising rates of uptake by GP-referred patients suggest that GPs can play a critical role in ch ioning digital interventions and maximizing the associated benefits. >
Publisher: Springer Science and Business Media LLC
Date: 2013
Publisher: American Psychological Association (APA)
Date: 2011
DOI: 10.1037/A0023300
Abstract: The dedifferentiation hypothesis proposes that specific cognitive abilities become more highly associated with general ability in old age as a result of increasing biological constraints on fluid intelligence. There is limited evidence for the hypothesis, and research has not tended to clearly distinguish age dedifferentiation from ability differentiation and other age-related phenomena. The present study examined age dedifferentiation using a structural equation model that controlled for ability differentiation, along with linear and quadratic effects of age. Time-to-death was examined as an alternative time metric to chronological age, as it may better represent biological constraints. The Canberra Longitudinal Study community-based cohort, consisting of 896 Australian adults aged 70 and over, provided data from 687 decedents who were followed for up to 17 years. Results indicated little support for the age dedifferentiation hypothesis, with only two of seven cognitive tests showing significant age dedifferentiation. The time-to-death metric showed more evidence of dedifferentiation, with four of the seven tests exhibiting dedifferentiation. However, after excluding participants with possible cognitive impairment, all of the dedifferentiation effects were attenuated to nonsignificance. Age dedifferentiation effects may therefore reflect dementia and other mortality-related pathology rather than being an inevitable outcome of advanced age. Alternative developmental theories for cognitive function must better account for the ersity of late-life abilities and pathology.
Publisher: Wiley
Date: 06-2014
DOI: 10.1002/WPS.20130
Publisher: Cambridge University Press (CUP)
Date: 1997
DOI: 10.1017/S0033291796003923
Abstract: Data from a two-wave longitudinal study of an elderly community s le were used to assess whether cognitive complaints either predict subsequent cognitive decline or reflect past cognitive decline. Cognitive complaints and cognitive functioning were assessed on two occasions three and a half years apart. Cognitive complaints at Wave 1 were found not to predict future cognitive change on the Mini-Mental State Examination, an episodic memory test or a test of mental speed. Similarly, cognitive complaints at Wave 2 were unrelated to past cognitive changes on these tests after statistically controlling for the effects of anxiety and depression. Furthermore, cognitive complaints did not predict either mortality (after controlling for anxiety and depression) or future dementia. These results are evidence against the inclusion of cognitive complaints in diagnostic criteria for proposed disorders such as age-associated memory impairment, mild cognitive disorder and ageing-associated cognitive decline.
Publisher: Public Library of Science (PLoS)
Date: 18-12-2013
Publisher: Elsevier BV
Date: 2014
DOI: 10.1016/J.PSYCHRES.2013.10.034
Abstract: The aim of the current study was to assess the stigmatising attitudes of Japanese high school students towards people with depression, social phobia and psychosis/schizophrenia. In 2011, 311 students aged 15-18 years filled out an anonymous self-report questionnaire, which included a case vignette describing either depression, schizophrenia or social phobia and two questionnaires to assess stigmatising attitudes towards people with these disorders. Exploratory Structural Equation Modelling (ESEM) was used to determine the dimensionality and loading pattern of the stigma items in the two scales, to establish dimensions of stigma and to compare levels on these dimensions between genders. Stigmatising attitudes towards people with mental disorders in young Japanese people are substantial. ESEM revealed that the structure of stigmatising attitudes in young Japanese people is comparable in personal and perceived attitude stigma, with each forming distinct dimensions and each comprising 'weak not sick' and 'dangerous/unpredictable' components. The social distance dimension of stigma was separate from other components. Stigmatising attitudes relating to dangerousness/unpredictability were the lowest for social phobia and highest for schizophrenia. Females had lower stigmatising attitudes than males. These findings echo those of Australian studies and extend them by demonstrating a similar structure of stigma in another cultural group, namely young Japanese people.
Publisher: Elsevier BV
Date: 02-2012
DOI: 10.1016/J.BRAT.2011.11.007
Abstract: Command hallucinations represent a special problem for the clinical management of psychosis. While compliance with both non-harmful and harmful commands can be problematic, sometimes in the extreme, active efforts to resist commands may also contribute to their malignancy. Previous research suggests Cognitive Behaviour Therapy (CBT) to be a useful treatment for reducing compliance with harmful command hallucinations. The purpose of this trial was to evaluate whether CBT augmented with acceptance-based strategies from Acceptance and Commitment Therapy could more broadly reduce the negative impact of command hallucinations. Forty-three participants with problematic command hallucinations were randomized to receive 15 sessions of the intervention "TORCH" (Treatment of Resistant Command Hallucinations) or the control, Befriending, then followed up for 6 months. A sub-s le of 17 participants was randomized to a waitlist control before being allocated to TORCH or Befriending. Participants engaged equally well with both treatments. Despite TORCH participants subjectively reporting greater improvement in command hallucinations compared to Befriending participants, the study found no significant group differences in primary and secondary outcome measures based on blinded assessment data. Within-group analyses and comparisons between the combined treatments and waitlist suggested, however, that both treatments were beneficial with a differential pattern of outcomes observed across the two conditions.
Publisher: SAGE Publications
Date: 12-1993
DOI: 10.3109/00048679309075818
Abstract: Growing interest in the application of molecular biological techniques to psychiatric disorders has reinvigorated interest in the genetics of the psychoses. It is therefore timely to review the current state of knowledge of the genetics of bipolar disorder. Family, twin and adoption studies are all consistent in confirming the strongly heritable nature of this condition. As segregation analyses have been unable to determine the mode of transmission of bipolar disorder, ongoing linkage analyses using DNA markers will be crucial in determining whether this condition is due to a single major gene, a small number of genes, or multifactorial polygenic inheritance.
Publisher: SAGE Publications
Date: 2009
DOI: 10.1080/00048670802653331
Abstract: Objective: Suicidal behaviour is often considered in the context of depression. Taking an empirical, dimensional and population-based approach, this investigation examines two issues: first, whether it is justifiable to regard suicidality as a symptom of depression or an independent construct. Second, although suicidal behaviour has been shown to decline with increasing age and differ across gender, little is known about the stability of the underlying construct across the lifespan and between genders. Method: Data were derived from a community-based s le consisting of 7485 people aged 20–24, 40–44 or 60–64 years. Confirmatory factor analysis was used to assess the adequacy of model fit and measurement invariance across gender and then age groups. Results: The data fitted a two-factor model of depression and suicidality better than a single-factor model. Multi-group analysis indicated strict measurement invariance for both gender and age groups, indicating no significant differences between groups in measurement model fit. Conclusions: These analyses establish that suicidality is distinguishable from depression, although the factors are substantially correlated. Results suggest that the underlying factorial relationship between suicidality and depression appears not to vary considerably between genders or across cohorts aged 20–24, 40–44 and 60–64 years. Finally, the analyses also highlight the necessity of inventories with scales identifying symptoms of suicidality independent of depression symptoms.
Publisher: Wiley
Date: 15-06-2011
DOI: 10.1111/J.1365-2214.2011.01267.X
Abstract: Parent-proxy reports of quality of life (QOL) are often used to guide decisions about children with cerebral palsy (CP), although little is known about the factors that influence parent-proxy reports. The aim of this study was to examine (i) the relationship between parental psychosocial distress and parent proxy-reported QOL and (ii) whether parental psychosocial distress mediates the relationship between child impairment and proxy-reported QOL. A s le of 201 primary caregivers of children aged 4-12 years with CP completed the Cerebral Palsy Quality of Life Questionnaire for Children, a condition-specific QOL instrument, and a measure of psychosocial distress, the Kessler 10. The children, evenly distributed by gender (56% male) were s led across Gross Motor Function Classification System levels (Level I = 18%, II = 28%, III = 14%, IV = 11%, V = 27%). Consistent with the hypotheses, parental distress was negatively correlated with all domains of parent proxy-reported QOL (r = -0.18 to r = -0.55). The relationship between impairment and proxy-reported QOL was mediated by parental distress for five of the seven domains of QOL (social well-being and acceptance, feelings about functioning, participation and physical health, emotional well-being and self-esteem, and pain and impact of disability). Child impairment did not predict access to services or family health. This is the first study that assesses the relationship between parental distress and proxy-reported QOL for children with CP. Although the cross-sectional nature of the available data precludes any statements of causality, the results suggest that, when using parent proxy, the parents' psychological state should also be measured. This is particularly important when, as is often the case for child disability research, proxy-reported QOL are the only available data.
Publisher: Oxford University Press (OUP)
Date: 1996
Publisher: JMIR Publications Inc.
Date: 29-09-2006
DOI: 10.2196/JMIR.8.3.E20
Publisher: Elsevier BV
Date: 12-1996
Publisher: Royal College of Psychiatrists
Date: 02-2008
DOI: 10.1192/BJP.BP.106.032078
Abstract: An earlier paper reported positive outcomes immediately following access to a cognitive–behavioural therapy (CBT) internet intervention and a depression information website. To determine 6-month and 12-month outcomes of the interventions relative to a placebo control condition. Participants allocated to the depression information website condition, the CBT internet intervention and the placebo control condition were followed up at 6 and 12 months by survey. The primary outcome measure was the Center for Epidemiologic Studies – Depression (CES–D) scale. Of 525 participants recruited, 79% completed their assigned intervention and 60% were retained at 12-month follow-up. Attrition was handled using mixed-model repeated-measures ANOVA. Both the CBT site and depression information sites were associated with statistically significant benefits in CES–D score reduction compared with controls at post-test. At 6-months follow-up, the reduction seen for the people allocated to the CBT arm remained significant, whereas that for the depression information website arm was not. At 12 months, both active interventions were statistically significantly superior to the control condition. There is some evidence that benefits of these brief internet interventions are retained beyond their endpoint. The impact of human support provided by interviewers in the trial must be considered when comparing these outcomes to routine use of both internet interventions.
Publisher: SAGE Publications
Date: 03-07-2012
Abstract: To determine the prevalence of cardiometabolic risk factors in Australian adults with a psychotic disorder. Data were collected during the interview phase of the second Australian survey of psychosis, a population-based survey of Australians aged 18 to 64 years with a psychotic disorder. Body mass index, waist circumference and blood pressure were measured. Participants were asked about diagnoses of relevant medical conditions, medications, smoking and physical activity. Fasting blood s les were analysed for glucose, high-density lipoprotein cholesterol, total cholesterol and triglycerides. The prevalence of metabolic syndrome was determined using the harmonized criteria developed by the International Diabetes Federation and other bodies. A total of 1087 men (60%) and 738 women (40%) participated. Their mean age was 38.36 (SD 11.16) years 773 (42%) were aged 18–34 years and 1052 (58%) 35–64 years. Three-quarters were overweight or obese and 82% had abdominal obesity. Almost half were hypertensive. Two-thirds were current smokers and 81% had a lifetime history of smoking. Levels of physical activity were very low. About 30% reported a diagnosis of hypertension or high cholesterol, 20% knew they had diabetes or high blood sugar and 18% had cardiovascular disease. Half of those with self-reported hypertension were taking antihypertensive drugs, and about 40% with hypercholesterolemia or hyperglycaemia were receiving medication for these conditions. Seventy per cent ( N = 1286) of participants provided fasting blood s les. Abnormal levels of high-density lipoprotein cholesterol and triglycerides were each found in almost half of participants and almost one-third had elevated fasting glucose. More than half of participants (54.8%) met criteria for metabolic syndrome. Australians living with psychosis have high rates of cardiometabolic risk factors. There are a number of obvious targets for prevention and treatment, including obesity (especially in women), smoking (more prevalent in men), hypertension, hyperlipidaemia and sedentary lifestyle.
Publisher: Elsevier BV
Date: 11-1996
DOI: 10.1016/S0022-3956(96)00033-7
Abstract: Researchers comparing diagnostic systems or screening tests frequently need to compare indices of agreement such as the kappa coefficient. While asymptotic methods exist for comparing kappas derived from independent s les, no satisfactory approach exists for comparing kappas derived from the same or related s les. Res ling methods for comparing kappa coefficients obtained from the same s le are presented. Easily undertaken using readily available software, these methods are illustrated by application to a small s le of psychiatric data, as well as to several thousand s les of simulated data. An acceptable type I error rate was exhibited. Res ling techniques-easily implemented and making few assumptions-deserve wider application in psychiatric research.
Publisher: Wiley
Date: 2007
DOI: 10.1002/JCLP.20366
Abstract: Acceptance and mindfulness methods that emphasise the acceptance rather than control of symptoms are becoming more central to behavioural and cognitive therapies. Acceptance and Commitment Therapy (ACT) is the most developed of these methods recent applications of ACT to psychosis suggest it to be a promising therapeutic approach. However, investigation of the mechanisms of therapy within this domain is difficult because there are no acceptance-based measures available specifically for psychotic symptoms. This paper describes the preliminary evaluation of a self-report instrument designed to assess acceptance-based attitudes and actions in relation to auditory and command hallucinations. Following initial scale development, a 56-item version of the Voices Acceptance and Action Scale (VAAS) was administered to 43 participants with command hallucinations as part of their baseline assessment in a larger trial. Measures of symptoms, quality of life, and depression were also administered. The scale was examined for reliability using corrected item total statistics. Based on this method, 31 items were retained. Internal consistency and test-retest reliability for the 31-item VAAS were acceptable. Subsequent examination of construct validity showed the VAAS to correlate significantly in the expected directions with depression, quality of life, and coping with command hallucinations. It also discriminated compliance from non-compliance with harmful command hallucinations. Although these results are preliminary and subject to a number of limitations, the VAAS shows promise as a useful aid in the assessment of the psychological impact of voices.
Publisher: Wiley
Date: 2008
DOI: 10.1002/AJMG.B.30581
Abstract: Previous reports have identified an interaction between an MAOA promoter polymorphism and childhood adversity for antisocial behavioral outcomes in males. This study attempted to replicate this finding in an Australian community survey of 1,002 Caucasian men aged 20-24 years. Greater childhood adversity was associated with later antisocial behavior, but no association was observed between MAOA genotype and antisocial behavior, and no interaction was found between childhood adversity and MAOA genotype for antisocial behavior. This study does not support previous reports of an interaction between MAOA genotype and childhood adversity for antisocial behavior in males.
Publisher: American Psychological Association (APA)
Date: 2012
DOI: 10.1037/A0024517
Abstract: While there is consistent evidence that initial levels of cognitive ability predict mortality, there is mixed evidence for a relationship between changes in cognition and mortality. There have been few studies that have examined whether the level and slope of cognitive performance is predictive of subsequent mortality from all causes or from cardiovascular disease, stroke, heart disease, respiratory disease, or cancer. This study aimed to assess whether the level and slope of cognitive ability were associated with all-cause or cause-specific mortality. A cohort of 896 community-based elderly people in Australia was interviewed four times over 12 years, with vital status followed for up to 17 years. Of these, 592 participants completed two or more interviews and were included in survival models of six mortality outcomes. Cognitive change in five domains of ability was estimated using latent growth models. Poorer initial processing speed or verbal fluency was significantly associated with greater all-cause and/or cardiovascular mortality. In addition, declines in global ability were associated with greater all-cause, cardiovascular, and heart disease mortality. Vocabulary and episodic memory were not associated with mortality, and none of the cognitive tests significantly predicted respiratory or cancer mortality. Initial levels of cognitive ability tended to be better predictors of subsequent mortality than were changes in ability. The results suggest that vascular events may be largely responsible for the overall relationship between cognition and mortality.
Publisher: Elsevier BV
Date: 04-2014
DOI: 10.1016/J.PSYCHRES.2014.01.041
Abstract: Internet-based interventions are increasingly recognized as effective for the treatment and prevention of depression however, there is a paucity of research investigating potential secondary benefits. From a consumer perspective, improvements in indicators of wellbeing such as perceived quality of life may represent the most important outcomes for evaluating the effectiveness of an intervention. This study investigated the 'secondary' benefits for self-esteem, empowerment, quality of life and perceived social support of two 12-week online depression interventions when delivered alone and in combination. Participants comprised 298 adults displaying elevated psychological distress. Participants were randomised to receive: an Internet Support Group (ISG) an automated Internet psycho-educational training program for depression a combination of these conditions or a control website. Analyses were performed on an intent-to-treat basis. Following the automated training program immediate improvements were shown in participants׳ self-esteem and empowerment relative to control participants. Improvements in perceived quality of life were reported 6-months following the completion of the intervention when combined with an ISG. These findings provide initial evidence for the effectiveness of this online intervention for improving in idual wellbeing beyond the primary aim of the treatment. However, further research is required to investigate the mechanisms underlying improvement in these secondary outcomes.
Publisher: Oxford University Press (OUP)
Date: 21-11-2018
Publisher: American Psychological Association (APA)
Date: 1999
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.JAD.2012.12.015
Abstract: Stigma is a major impediment to help seeking for mental disorders by young people. To reduce stigma and improve help seeking, a better understanding of the influences on different components of stigma for different disorders is required. In 2011, a telephone interview was conducted with a national s le of 2522 Australians aged 15-25 years. Participants were presented with a vignette of a young person portraying either depression, depression with suicidal thoughts, social phobia, post-traumatic stress disorder or psychosis. They were then asked what they thought was wrong with the person, exposure to mental health problems in themselves and in family or friends, stigmatizing attitudes, and their awareness of beyondblue. Accurate psychiatric labeling of the mental disorder presented in the vignette and beyondblue awareness were the best predictors of less stigmatizing attitudes, followed closely by exposure to family or friends with mental health problems. Across vignettes, the personally held stigmatizing perception of mental health problems as a weakness rather than an illness was most strongly associated with these predictors. Stigma and labeling were assessed with reference to a vignette character and may not reflect actual experience or behaviors. Other limitations include the cross-sectional design and potential for social desirability bias in the stigma measure. Findings suggest that community awareness c aigns (such as those by beyondblue) that encourage appropriate close contact with others affected by mental health problems and improved accurate psychiatric label use may have potential to counter various aspects of stigma, especially personal beliefs that mental illness is a weakness.
Publisher: Elsevier BV
Date: 07-2004
Publisher: Springer Science and Business Media LLC
Date: 13-02-2014
Publisher: Springer Science and Business Media LLC
Date: 27-10-2014
Publisher: Wiley
Date: 03-1997
DOI: 10.1002/(SICI)1099-1166(199703)12:3<323::AID-GPS492>3.0.CO;2-N
Abstract: The association between education and cognitive change was investigated in a large community s le of elderly people followed up after 3.6 years. Lower education was predictive of decline on the Mini-Mental State Examination (MMSE) and on tests of language and knowledge, but not on tests of cognitive speed, memory or reaction time. The effects of education were not attenuated when adjusted for health, disability or activity level. The findings suggest that education slows the rate of decline on crystallized intelligence, but not other cognitive abilities. Education may compensate for neurodegenerative changes rather than protect against them.
Publisher: Cambridge University Press (CUP)
Date: 03-1999
DOI: 10.1017/S0033291798008150
Abstract: Background. There is debate as to whether the elderly are really at lower risk for depressive disorders, or whether endorsement of symptoms is artefactually low. The present paper assesses the effects of age on anxiety and depression, and examines whether age has direct effects on self-report of in idual symptoms independent of its effect on the underlying dimensions of anxiety and depression. Methods. Structural equation modelling was used to assess the structure of the items and their associations with age and a number of demographic variables. The s le of 2622 participants aged between 18 and 79 years from Canberra (Australia) was drawn from the Electoral Roll. Two instruments were used: the anxiety and depression scales of Goldberg et al . (1988) and the Personal Disturbance Scale from the DSSI of Bedford et al . (1976). Results. Both scales were found to fit satisfactorily to a two factor model. Age correlated negatively with depression. After controlling for the effects of gender, marital status, education and financial difficulty, direct effects of age were found on items from both instruments, indicating that certain depression items were associated with a differential probability of endorsement in older people, even when the level of depression was equal to that of younger people. Items with direct age effects reflected physical (feeling slowed down waking early) and psychological (hopeless about the future) components of depression. Direct effects of age on items from both anxiety scales were also found. Conclusions. The nature of the depression and anxiety experienced by younger and older people may differ qualitatively. Depression may be associated with an increase in somatic symptoms linked to physical changes and to an increase in endorsement of items which reflect the narrowing of opportunities in the long-term.
Publisher: Elsevier BV
Date: 05-2015
DOI: 10.1016/J.JSAMS.2014.04.006
Abstract: Currently, little is known about the prevalence of mental disorders in athletes. This study aims to investigate Australian elite athletes' symptoms of general psychological distress and common mental disorders. A cross-sectional survey design was employed to assess self-reported symptom prevalence. A total of 224 elite athletes (118 female, 106 male) from national sporting organisations in Australia were administered a self-report internet-based survey comprising measures of demographic status and mental health symptoms. Overall, 46.4% of athletes were experiencing symptoms of at least one of the mental health problems assessed. Percentages meeting criteria for mental disorders were similar to previous epidemiological studies of both international athlete and community s les: depression (27.2%), eating disorder (22.8%), general psychological distress (16.5%), social anxiety (14.7%), generalised anxiety disorder (7.1%), and panic disorder (4.5%). Injured athletes had higher levels of both symptoms of depression (t=3.23, p=.001) and generalised anxiety disorder (t=2.26, p=.025). The level of symptoms of mental health problems reported by elite athletes appears similar to that observed in the community. However, caution must be exercised in interpreting the findings, as possible demographic differences between athletes and comparison population datasets may exist. Furthermore, self-selection of respondents in the present study may have reduced the representativeness of the s le and the validity of the comparisons. Athletes, particularly those currently injured, should be well-supported to seek help for mental disorders through access to mental health professionals.
Publisher: JMIR Publications Inc.
Date: 02-11-2017
DOI: 10.2196/JMIR.8241
Publisher: JMIR Publications Inc.
Date: 24-02-2021
DOI: 10.2196/25870
Abstract: In Australia, secondary school educators are well positioned to recognize mental illness among students and provide support. However, many report that they lack the knowledge and confidence to do so, and few mental health training programs available for educators are evidence based. To address this gap, the Black Dog Institute (BDI) developed a web-based training program (Building Educators’ Skills in Adolescent Mental Health [BEAM]) that aims to improve mental health knowledge, confidence, and helping behaviors among secondary school educators in leadership positions. A pilot study of the training program found it to be positively associated with increased confidence and helping behaviors among educators and reduced personal psychological distress. An adequately powered randomized controlled trial (RCT) is needed. The primary objective of this cluster RCT is to evaluate the effectiveness of the BEAM program for improving educators’ confidence in managing student mental health. The trial will also evaluate the effect of the BEAM program in increasing educators’ frequency of providing help to students and improving their mental health knowledge and reducing educators’ psychological distress and stigma toward students with mental health issues. The target s le size is 234 educators from 47 secondary schools across New South Wales, Australia. Four waves of recruitment and enrollment into the trial are planned. Schools will participate in one wave only and will be randomized to the intervention or waitlist control conditions. Participants from the same school will be assigned to the same condition. Assessments will be conducted at baseline, posttest (10 weeks after baseline), and follow-up (22 weeks after baseline) using the BDI eHealth research platform. Intervention participants will receive access to the BEAM program for 10 weeks upon completion of baseline, and the control condition will receive access for 10 weeks upon completion of the follow-up assessment. Recruitment for this trial began on July 21, 2020, with the first baseline assessments occurring on August 17, 2020. To date, 295 participants from 71 schools have completed baseline. Due to the unexpected success of recruitment in the first 3 waves, the final fourth wave has been abandoned. Intervention participants are currently receiving the program, with follow-up due for completion in March 2021. This is one of the first RCTs to examine the effectiveness of a web-based adolescent mental health training program for Australian secondary school educators in leadership positions. If found to be effective, this training program will offer a sustainable and scalable delivery method for upskilling educators in caring for students’ mental health. Australian New Zealand Clinical Trials Registry ACTRN12620000876998 tudies/crs-14669208 DERR1-10.2196/25870
Publisher: SAGE Publications
Date: 09-2011
DOI: 10.3109/00048674.2011.607130
Abstract: Objective: This study aimed to develop a National Depression Index and a National Anxiety Index to measure the depression and anxiety status of the Australian population, to compare data between surveys, and to compare relative risk in different population groups. Method: The indices were developed using cross-sectional data from four surveys: the 1997 and 2007 National Surveys of Mental Health and Wellbeing (NSMHWB) and the 2001 and 2004/5 National Health Surveys (NHS). Six items from the K10 that most closely related to the ICD-10 diagnosis of depression and four that most closely related to a diagnosis of an anxiety disorder were used to create separate scales. The indices were developed by estimating the predicted probabilities of depression and anxiety on these separate K10 scales in the 2007 NSMHWB and then applying these predicted probabilities to the same scales in the other surveys. The 1997 NSMHWB and 2001 NHS were used as benchmarks for the respective surveys, with values greater than or less than 100 on the indices indicating a higher or lower probability of depression and anxiety in the subsequent survey year. Overall mean risks of depression and anxiety were examined along with differences in mean risk by age, household income, employment status and geographic location for males and females. Results: There was an overall increase in the mean risk of anxiety between the 1997 and 2007 NSMHWB but no significant difference in the mean risk of depression. Significant increases in the mean risk of anxiety were observed for women aged 45–64, for employed men and women, and for women living in the inner city and non-regional rural areas. Conclusions: The increase in the mean risk of anxiety may support the need for public education to focus on anxiety disorders, particularly for middle-aged women and for employed men and women.
Publisher: Wiley
Date: 20-08-2021
DOI: 10.1111/EIP.13204
Abstract: Specialist early intervention (SEI) service models are designed to treat symptoms, promote social and vocational recovery, prevent relapse, and resource and up‐skill patients and their families. The benefits of SEI over the first few years have been demonstrated. While early recovery can be expected to translate to better long‐term outcomes by analogy with other illnesses, there is limited evidence to support this from follow‐up studies. The current study involves the long‐term follow‐up of a sub‐set of first episode psychosis (FEP) patients, with a range of diagnoses, who were first treated at Orygen's Early Psychosis Prevention and Intervention Centre (EPPIC) between 1998 and 2000. The aim of this paper is to present the methodology for this follow‐up study. Between January 1998 and December 2000, 786 patients between the ages of 15–29 years were treated at EPPIC, located in Melbourne, Australia. Our cohort consists of 661 people (82 were transferred/discharged and 43 were not diagnosed with a psychotic disorder at time of discharge). The 18‐month treatment characteristics of this cohort have been extensively examined in the First Episode Psychosis Outcome Study (FEPOS). The ≥15 year outcomes of this cohort are being examined in this study, known as FEPOS15. Participant follow‐up is ongoing. In order to extend and assess broader outcomes of the cohort, data linkage with health‐related databases will be conducted. This study will provide a comprehensive evaluation of the long‐term trajectory of psychotic disorders after treatment for FEP in a SEI service.
Publisher: Oxford University Press (OUP)
Date: 24-02-2012
DOI: 10.1093/IJE/DYR025
Publisher: S. Karger AG
Date: 20-10-2007
DOI: 10.1159/000096482
Abstract: i Background: /i Researchers have used the concept of brain reserve to explain the dissociation between pathological brain damage and cognitive and functional performance. A variety of brain reserve hypotheses exist, and different empirical strategies have been employed to investigate these variants. i Objective: /i The study investigates (i) the relationship between measures of brain burden (atrophy, white matter hyperintensities (WMH)) and measures of reserve (education, creativity, and intelligence) (ii) the relationship between cognitive decline and reserve (iii) whether measures of reserve mediate the effect of atrophy on estimated cognitive change, and (iv) the association between brain risk factors, education and atrophy. i Methods: /i A cross-sectional study of a s le of 446 in iduals 60–64 years of age who underwent MRI scans as part of a large epidemiological study. Measures were taken of education, intelligence, creativity, cognitive speed, brain volume, WMH, estimated cognitive decline from earlier in life and brain atrophy. i Results: /i No association was found between estimated cognitive decline and brain burden (atrophy, WMH). Risk factors for brain insult were not associated with greater brain atrophy in the less well educated. Neither education, nor any other measure including intelligence or creativity, provided a buffer for cognitive decline in in iduals with high levels of brain atrophy. i Conclusion: /i Little support was found for the brain reserve hypothesis.
Publisher: Elsevier BV
Date: 12-1993
Publisher: Elsevier BV
Date: 03-2009
Publisher: Wiley
Date: 24-09-2017
DOI: 10.1002/MPR.1588
Publisher: Oxford University Press (OUP)
Date: 1995
Abstract: This study aimed to determine the prevalence of the wish to die in elderly people and investigate the factors associated with it, in particular, whether factors other than depression contribute to the wish to die. Data were obtained from an Australian epidemiological survey of people aged 70 or more. Survey participants were asked whether, in the last two weeks, they had felt that they wanted to die and, if so, if they had had such thoughts repeatedly. Three classes of possible risk factors were investigated: sociodemographic factors (age, sex, marital status), mental health (depression, cognitive impairment), and physical health (poor self-rated health, disability, pain, sensory impairment, and living in a nursing home or hostel). Only 21 of 923 elderly persons reported repeatedly having had a wish to die during the previous two weeks. Although the wish to die was associated with depression, there were several other factors also associated with it independently of depression: not being married, poor self-rated health, disability, pain, hearing impairment, visual impairment, living in a nursing home or hostel. A small minority expressed the wish to die but had a normal mood state. It was concluded that the wish to die is associated with several factors in addition to depression and may be present in in iduals with few depressive symptoms. There is a need to investigate whether factors associated with the wish to die are treatable and whether this can restore the desire to live.
Publisher: JMIR Publications Inc.
Date: 12-2020
DOI: 10.2196/14296
Abstract: The proliferation of mental health apps purporting to target and improve psychological wellbeing is ever-growing and also concerning: Few apps have been rigorously evaluated, and, indeed, the safety of the vast majority of them has not been determined. Over 10,000 self-help apps exist but most are not used much after being downloaded. Gathering and analyzing usage data and the acceptability of apps are critical to inform consumers, researchers, and app developers. This paper presents pilot usage and acceptability data from the iBobbly suicide prevention app, an app distributed through a randomized controlled trial. Aboriginal and Torres Strait Islander participants from the Kimberley region of Western Australia completed a survey measuring their technology use in general (n=13), and data on their experiences with and views of the iBobbly app were also collected in semistructured interviews (n=13) and thematically analyzed. Finally, engagement with the app, such as the number of sessions completed and time spent on various acceptance-based therapeutic activities, was analyzed (n=18). Both groups were participants in the iBobbly app pilot randomized controlled trial (n=61) completed in 2015. Regression analysis indicated that app use improved psychological outcomes, although only minimally, and effects were not significant. However, results of the thematic analysis indicated that the iBobbly app was deemed effective, acceptable, and culturally appropriate by those interviewed. There is a scarcity of randomized controlled trials and eHealth interventions in Indigenous communities, while extremely high rates of psychological distress and suicide persist. In this environment, studies that can add evidence from mixed-methods approaches are important. While the regression analysis in this study did not indicate a significant effect of app use on psychological wellbeing, this was predictable considering the small s le size (n=18) and typically brief app use. The results on engagement with the iBobbly app were however positive. This study showed that Indigenous youth are early and frequent users of technology in general, and they regarded the iBobbly app to be culturally safe and of therapeutic value. Qualitative analyses demonstrated that iBobbly app use was associated with self-reported improvements in psychological wellbeing, mental health literacy, and reductions in shame. Importantly, participants reported that they would recommend other similar apps if available to their peers.
Publisher: BMJ
Date: 06-2013
Publisher: JMIR Publications Inc.
Date: 22-10-2009
DOI: 10.2196/JMIR.1294
Publisher: Wiley
Date: 24-07-2015
DOI: 10.1111/EIP.12079
Abstract: An estimated 75% of mental disorders begin before the age of 24 and approximately 25% of 13-24-year-olds are affected by mental disorders at any one time. To better understand and ideally prevent the onset of post-pubertal mental disorders, a clinical staging model has been proposed that provides a longitudinal perspective of illness development. This heuristic model takes account of the differential effects of both genetic and environmental risk factors, as well as markers relevant to the stage of illness, course or prognosis. The aim of the Transitions Study is to test empirically the assumptions that underpin the clinical staging model. Additionally, it will permit investigation of a range of psychological, social and genetic markers in terms of their capacity to define current clinical stage or predict transition from less severe or enduring to more severe and persistent stages of mental disorder. This paper describes the study methodology, which involves a longitudinal cohort design implemented within four headspace youth mental health services in Australia. Participants are young people aged 12-25 years who have sought help at headspace and consented to complete a comprehensive assessment of clinical state and psychosocial risk factors. A total of 802 young people (66% female) completed baseline assessments. Annual follow-up assessments have commenced. The results of this study may have implications for the way mental disorders are diagnosed and treated, and progress our understanding of the pathophysiologies of complex mental disorders by identifying genetic or psychosocial markers of illness stage or progression.
Publisher: JMIR Publications Inc.
Date: 24-08-2023
DOI: 10.2196/45963
Abstract: There is increasing evidence that depression can be prevented however, universal approaches have had limited success. Appropriate targeting of interventions to at-risk populations has been shown to have potential, but how to selectively determine at-risk in iduals remains unclear. Workplace stress is a risk factor for depression and a target for intervention, but few interventions exist to prevent depression among workers at risk due to heightened stress. This trial aimed to evaluate the efficacy of a smartphone-based intervention in reducing the onset of depression and improving related outcomes in workers experiencing at least moderate levels of stress. A randomized controlled trial was conducted with participants who were currently employed and reported no clinically significant depression and at least moderate stress. The intervention group (n=1053) were assigned Anchored, a 30-day self-directed smartphone app-based cognitive behavioral- and mindfulness-based intervention. The attention-control group (n=1031) were assigned a psychoeducation website. Assessment was performed via web-based self-report questionnaires at baseline and at 1-, 3-, and 6-month postbaseline time points. The primary outcome was new depression caseness aggregated over the follow-up period. The secondary outcomes included depressive and anxiety symptoms, stress, well-being, resilience, work performance, work-related burnout, and quality of life. Analyses were conducted within an intention-to-treat framework using mixed modeling. There was no significant between-group difference in new depression caseness (z score=0.69 P=.49) however, those in the Anchored arm had significantly greater depressive symptom reduction at 1 month (Cohen d=0.02 P=.049) and 6 months (Cohen d=0.08 P=.03). Anchored participants also showed significantly greater reduction in anxiety symptoms at 1 month (Cohen d=0.07 P=.04) and increased work performance at 1 month (Cohen d=0.07 P=.008) and 6 months (Cohen d=0.13 P=.01), compared with controls. Notably, for Anchored participants completing at least two-thirds of the intervention, there was a significantly lower rate of depression onset (1.1%, 95% CI 0.0%-3.7%) compared with controls (9.0%, 95% CI 6.8%-12.3%) at 1 month (z score=4.50 P .001). Significant small to medium effect sizes for most secondary outcomes were seen in the highly engaged Anchored users compared with controls, with effects maintained at the 6-month follow-up for depressive symptoms, well-being, stress, and quality of life. Anchored was associated with a small comparative reduction in depressive symptoms compared with controls, although selective prevention of case-level depression was not observed in the intention-to-treat analysis. When users adequately engaged with the app, significant findings pertaining to depression prevention, overall symptom reduction, and functional improvement were found, compared with controls. There is a need for a greater focus on engagement techniques in future research. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000178943 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378592
Publisher: Elsevier BV
Date: 04-2011
DOI: 10.1016/J.JAD.2010.07.029
Abstract: Observational studies link low folate levels to depressive symptoms and to poor antidepressant medication response. Evidence supports a role for folate in potentiating the effect of antidepressant medications. This prospective study examines the effects of folic acid+vitamin B12 supplementation and antidepressant medication in a community-based study of older adults with depressive symptoms. A randomised controlled trial investigated the effectiveness of a medicinal and two behavioural preventive interventions over a two year period. The medicinal intervention compared dietary supplementation of 400 mcg/d folic acid+100 mcg/d vitamin B12 to placebo. Self reported use of antidepressant medication over two years was recorded. Participants were screened for psychological distress using the Kessler Distress 10-Scale (K-10 >15 eligible) and the main outcome measure was change in depressive symptoms on the Patient Health Questionnaire-9 (PHQ-9) at six weeks, six, 12 and 24 months. Nine hundred adults aged 60-74 years were included in the analysis, of whom 209 (23.2%) reported antidepressant use during the follow-up period. A mixed model repeated measures analysis of variance for reduction in depressive symptoms found no significant three-way interaction between supplement group and antidepressant use over time on the PHQ-9 [F4, 825.1=0.32, p=0.87]. A small interaction between supplement group and antidepressant use over time was found for K-10 scores (F4, 799.5=2.50, p=0.0414). There was little evidence for the potentiation of antidepressant medication by folic acid+B12 supplementation on depressive symptomatology. Further research should examine whether effects might be found at higher folic acid dosages or among clinical populations.
Publisher: Public Library of Science (PLoS)
Date: 30-11-2011
Publisher: Springer Science and Business Media LLC
Date: 13-03-2011
Publisher: Springer Science and Business Media LLC
Date: 05-11-2012
DOI: 10.1007/S00127-010-0313-0
Abstract: Six previous reviews have found a relationship between depression and mortality. However, many past studies have failed to adequately control for the role of physical health. A proposed mechanism of the depression-mortality relationship suggests that physical health may mediate the relationship. The present study used new methods to examine relationships between mental health symptoms and mortality in an elderly community cohort while accounting for potential mediation of these relationships by physical health. 896 community-dwelling participants aged 70-97 were assessed four times over 12 years and vital status was tracked for up to 17 years. Relationships of depression and anxiety with survival time, controlling for physical health, age and gender, were tested using Cox proportional hazards regressions embedded in structural equation models. A significant unadjusted relationship between depression symptoms and mortality (HR = 1.09, p < .001) was attenuated to non-significance after controlling for measures of physical health (HR = 1.03, p = .18). No significant relationship was found between anxiety symptoms and mortality. The relationship between depression and mortality was accounted for by physical health status in this cohort. This finding casts doubt on studies that report a relationship between depression and mortality without adequately considering the effect of physical health.
Publisher: Elsevier BV
Date: 11-1993
Publisher: JMIR Publications Inc.
Date: 18-08-2019
Publisher: SAGE Publications
Date: 13-06-2012
Abstract: The 2010 Survey of High Impact Psychosis (SHIP) is Australia’s second national psychosis survey. This paper provides an overview of its findings, including comparisons with the first psychosis survey and general population data. The survey covered 1.5 million people aged 18–64 years, approximately 10% of Australians in this age group. A two-phase design was used. In phase 1, screening for psychosis took place in public mental health services and non-government organizations supporting people with mental illness. In phase 2, 1825 of those screen-positive for psychosis were randomly selected and interviewed. Data collected included symptomatology, substance use, functioning, service utilization, medication use, education, employment, housing, and physical health including fasting blood s les. The estimated 1-month treated prevalence of psychotic disorders in public treatment services was 3.1 people per 1000 population the 12-month treated prevalence was 4.5 people per 1000. The majority (63.0%) of participants met ICD-10 criteria for schizophrenia/schizoaffective disorder. One-half (49.5%) reported attempting suicide in their lifetime and two-thirds (63.2%) were rated as impaired in their ability to socialize. Over half (54.8%) had metabolic syndrome. The proportion currently smoking was 66.1%. Educational achievement was low. Only 21.5% were currently employed. Key changes in the 12 years since the first survey included: a marked drop in psychiatric inpatient admissions a large increase in the proportion attending community mental health clinics increased use of rehabilitation services and non-government organizations supporting people with mental illness a major shift from typical to atypical antipsychotics and large increases in the proportions with lifetime alcohol or drug abuse/dependence. People with psychotic illness face multiple challenges. An integrated approach to service provision is needed to ensure that their living requirements and needs for social participation are met, in addition to their very considerable mental and physical health needs.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2007
Publisher: Elsevier BV
Date: 09-1999
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.JAD.2012.07.002
Abstract: Joiner's Interpersonal Theory of Suicide (Van Orden et al., 2010 Joiner, 2005) predicts that suicide ideation is strongest in those experiencing both high perceived burdensomeness and thwarted belongingness, and that the combination of suicide ideation and acquired capability for suicide is critical in the development of suicide plans and attempts. However, few datasets exist which allow the examination of these predictions. The present study aimed to test predictions from the model in a population-based cohort. a survey was completed by 6133 participants from the PATH Through Life Project. Scales measuring perceived burdensomeness, thwarted belongingness, hopelessness, capability to self-injure, ideation, plans and attempts were developed using existing items. Regression models were used to predict the outcomes of ideation and of plans/attempts. consistent with the Interpersonal Theory, interactions were found between perceived burdensomeness and thwarted belongingness predicting ideation, and interactions of capability and ideation for plans/attempts. However, some predictions of the theory were not fulfilled. Nevertheless, the Interpersonal Theory explained more variance than epidemiological models using mental disorders as predictors. Age differences were evident, with models of older cohorts accounting for less variance. Gender models suggested thwarted belongingness was a stronger predictor of ideation in males than females. while the fit of the factors assessing the Interpersonal Theory was adequate, the findings will need to be confirmed using previously developed scales of these constructs. predictive models of suicide need to take into account multiple risk factors, gender differences and changes in associations over the life span.
Publisher: JMIR Publications Inc.
Date: 14-02-2018
DOI: 10.2196/JMIR.8595
Publisher: Oxford University Press (OUP)
Date: 1994
Abstract: The association between health status and cognitive performance was examined in a s le of 708 community dwelling elderly people aged 70 years or over. Cognitive performance declined significantly across the age groups 70-74, 75-79, 80-84, and 85-89 years on the Mini-Mental State Examination and on measures of fluid intelligence and memory, but not on measures of crystallized intelligence. Health status declined significantly across age for five of 49 past and current medical conditions, for measures of Activities of Daily Living (ADL) and for systolic blood pressure, but did not decline significantly for global self-ratings of health, diastolic blood pressure or reports of smoking. Weak but significant correlations between health and cognitive performance were found for self-reported global ratings of health and for self-reports of some physical symptoms but not for diastolic or systolic blood pressure, or for many other physical conditions. Both self- and informant-based ratings of ADL correlated with cognitive performance. Age differences remained after cognitive performance was adjusted for health variables such as ADL, self-ratings of health and current health problems. It is concluded that, at the population level, lower levels of cognitive performance in community-dwelling elderly subjects are not strongly mediated by ill health.
Publisher: Wiley
Date: 17-10-2011
DOI: 10.1111/J.1360-0443.2011.03574.X
Abstract: To evaluate the relationship between change in cannabis use and changed cognitive performance over 8 years. We used survey methodology with a cohort design. An Australian community s le aged 20-24 years at baseline. We assessed cognitive performance with the California Verbal Learning Test (CVLT) (immediate and delayed), Spot-the-Word test (STW), Symbol Digit Modality test (SDMT) and Digit Backwards (DB). Groups of cannabis users were defined from self-reports across three waves as: 'never' (n= 420) 'remain light' (n= 71), 'former light' (n= 231), 'remain heavy' (n= 60), 'former heavy' (n= 60) and 'always former' (since start of study) (n= 657). Planned contrasts within mixed model repeated-measures analysis of variance was used for longitudinal analysis with an adjusted alpha of 0.01. Data were obtained from 2404 participants with 1978 (82.3%) completing wave 3. At baseline there were significant differences between cannabis groups on CVLT (immediate and delayed) and SDMT. However, after controlling for education, gender, gender × group and gender × wave, there were no significant between-group differences and only CVLT immediate recall reached adjusted statistically significant longitudinal change associated with changed cannabis use (group × wave P= 0.007). Specifically, former heavy users improved their performance relative to remaining heavy users (estimated marginal means: former heavy 6.1-7.5: remain heavy 6.4-6.6). Cessation of cannabis use appears to be associated with an improvement in capacity for recall of information that has just been learned. No other measures of cognitive performance were related to cannabis after controlling for confounds.
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.RIDD.2012.08.018
Abstract: To assess the measurement properties of a new QOL instrument, the Cerebral Palsy Quality of Life Questionnaire-Teen (CP QOL-Teen), in adolescents with cerebral palsy (CP) aged 13-18 years, examining domain structure, reliability, validity and adolescent-caregiver concordance. Based on age, 695 eligible families were invited to participate by mail. Questionnaires were returned by 112 primary caregivers (71.8% of questionnaires sent). 87 adolescents aged 12-18 years also completed the questionnaires. CP QOL-Teen, generic QOL instruments (KIDSCREEN, Pediatric Quality of Life Inventory), functioning (Gross Motor Function Classification System) and a condition-specific instrument (PedsQL-CP) were used. Principal components analysis produced seven scales: wellbeing and participation communication and physical health school wellbeing social wellbeing access to services family health feelings about functioning. Cronbach's alphas for the derived scales ranged from 0.81 to 0.96 (primary caregiver report) and 0.78 to 0.95 (adolescent report). Test-retest reliability (4 weeks) ranged from 0.57 to 0.88 for adolescent self-report and 0.29 to 0.83 for primary caregiver report. Moderate correlations were observed with other generic and condition specific measures of QOL, indicating adequate construct validity. Moderate correlations were observed between adolescent self-report and primary caregiver proxy report. This study demonstrates acceptable psychometric properties of both the adolescent self-report and the primary caregiver proxy report versions of the CP QOL-Teen.
Publisher: JMIR Publications Inc.
Date: 14-03-2023
Abstract: hift is a novel smartphone app for providing a digital-first mental health resource to junior doctors. It contains psychoeducational material, cognitive behavioral modules, guided mediations, information on common work stressors, and a section on help-seeking options for psychological problems through workplace and private avenues. his study aimed to conduct a preliminary investigation of the use and potential effectiveness of i Shift /i on depressive and anxiety symptoms (primary outcomes) and work and social functioning, COVID-19 safety concerns, and help seeking (secondary outcomes). This study also sought feedback on whether i Shift /i was seen as an acceptable tool. unior doctors in New South Wales, Australia, were approached through promotional activities from the Ministry of Health, specialist medical colleges, and social media advertisements between June and August 2020. Consenting participants provided web-based baseline data, used the i Shift /i app for 30 days, and were asked to complete a poststudy web-based questionnaire. Outcomes were analyzed under the intention-to-treat principle. total of 222 (n=156 female, 70.3% mean age 29.2, SD 4.61 years) junior doctors provided full baseline data. Of these, 89.2% (198/222) downloaded the app, logged into the app approximately 6 times (mean 5.68, SD 7.51), completed 4 in-app activities (mean 3.77, SD 4.36), and spent a total of 1 hour on in-app activities (mean 52:23, SD 6:00:18) over 30 days. Postintervention and app use data were provided by 24.3% (54/222) of participants. Depressive and anxiety symptoms significantly decreased between the pre- and postassessment points as expected however, physicians’ COVID-19 safety concerns significantly increased. Work and social functioning, COVID-19 concerns for family and friends, and help seeking did not change significantly. There was no significant relationship between symptom changes and app use (number of log-ins, days between first and last log-in, and total activity time). Most poststudy completers (31/54, 57%) rated i Shift /i highly or very highly. espite high levels of nonresponse to the poststudy assessment and increases in COVID-19 safety concerns, junior doctors who used the app reported some improvements in depression and anxiety, which warrant further exploration in a robust manner.
Publisher: Oxford University Press (OUP)
Date: 1993
Abstract: The influence of mental, social and physical activity on fluid, crystallized and memory tasks was examined in 60 young and 56 elderly subjects using multiple regression. Once the influence of education, age, health and psychiatric morbidity was removed, physical activity was associated with higher fluid test performance in old but not in young subjects. Moreover, mental activity was associated with higher performance on fluid and crystallized tasks for subjects with low education but not for subjects with high education.
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.SCHRES.2013.02.036
Abstract: The diagnostic and clinical overlap between schizophrenia and schizoaffective disorder is an important nosological issue in psychiatry that is yet to be resolved. The aim of this study was to compare the clinical and functional characteristics of an epidemiological treated cohort of first episode patients with an 18-month discharge diagnosis of schizophrenia (FES) or schizoaffective disorder (FESA). This study was part of the larger First Episode Psychosis Outcome Study (FEPOS) which involved a medical file audit study of all 786 patients treated at the Early Psychosis Prevention and Intervention Centre between 1998 and 2000. Of this cohort, 283 patients had an 18-month discharge diagnosis of FES and 64 had a diagnosis of FESA. DSM-IV diagnoses and clinical and functional ratings were derived and validated by two consultant psychiatrists. Compared to FES patients, those with FESA were significantly more likely to have a later age of onset (p=.004), longer prodrome (p=.020), and a longer duration of untreated psychosis (p<.001). At service entry, FESA patients presented with a higher illness severity (p=.020), largely due to the presence of more severe manic symptoms (p<.001). FESA patients also had a greater number of subsequent inpatient admissions (p=.017), had more severe depressive symptoms (p=.011), and higher levels of functioning at discharge. The findings support the notion that these might be considered two discernable disorders however, further research is required to ascertain the ways and extent to which these disorders are discriminable at presentation and over time.
Publisher: Elsevier BV
Date: 06-2012
DOI: 10.1016/J.SCHRES.2012.02.011
Abstract: It has been reported that people with schizophrenia who are homozygous at the c.267C>A single nucleotide polymorphism of the cholinergic muscarinic M1 receptor (CHRM1) perform less well on the Wisconsin Card Sorting Test than those who are heterozygous. We investigated whether CHRM1 sequence is associated with impaired executive function, a common problem in schizophrenia. We sequenced the CHRM1 using peripheral DNA from 97 people with schizophrenia who completed the Wisconsin Card Sorting Test, a verbal fluency test and the National Adult Reading Test. Clinical severity was assessed using the Positive and Negative Syndrome Scale. To determine whether CHRM1 sequence affected receptor expression, we used post-mortem data, from another cohort, to investigate associations between CHRM1 sequence and mRNA levels. On the Wisconsin Card Sorting Test, 267C/C participants with schizophrenia made more perseverative errors (p<0.05) and perseverative responses (p<0.05) than 267C/A participants. Genotype had no effect on verbal fluency (p=0.8) or National Adult Reading test (p=0.62). Cortical CHRM1 mRNA levels did not vary with gene sequence (p=0.409). The clinical study supports the proposal that CHRM1 sequence is associated with alterations in some aspects of executive function. However, the post-mortem study indicates this is not simply due to altered expression at the level of mRNA, suggesting this sequence alteration may affect the functionality of the CHRM1.
Publisher: JMIR Publications Inc.
Date: 21-09-2022
DOI: 10.2196/38497
Abstract: Shift is a novel smartphone app for providing a digital-first mental health resource to junior doctors. It contains psychoeducational material, cognitive behavioral modules, guided mediations, information on common work stressors, and a section on help-seeking options for psychological problems through workplace and private avenues. This study aimed to conduct a preliminary investigation of the use and potential effectiveness of Shift on depressive and anxiety symptoms (primary outcomes) and work and social functioning, COVID-19 safety concerns, and help seeking (secondary outcomes). This study also sought feedback on whether Shift was seen as an acceptable tool. Junior doctors in New South Wales, Australia, were approached through promotional activities from the Ministry of Health, specialist medical colleges, and social media advertisements between June and August 2020. Consenting participants provided web-based baseline data, used the Shift app for 30 days, and were asked to complete a poststudy web-based questionnaire. Outcomes were analyzed under the intention-to-treat principle. A total of 222 (n=156 female, 70.3% mean age 29.2, SD 4.61 years) junior doctors provided full baseline data. Of these, 89.2% (198/222) downloaded the app, logged into the app approximately 6 times (mean 5.68, SD 7.51), completed 4 in-app activities (mean 3.77, SD 4.36), and spent a total of 1 hour on in-app activities (mean 52:23, SD 6:00:18) over 30 days. Postintervention and app use data were provided by 24.3% (54/222) of participants. Depressive and anxiety symptoms significantly decreased between the pre- and postassessment points as expected however, physicians’ COVID-19 safety concerns significantly increased. Work and social functioning, COVID-19 concerns for family and friends, and help seeking did not change significantly. There was no significant relationship between symptom changes and app use (number of log-ins, days between first and last log-in, and total activity time). Most poststudy completers (31/54, 57%) rated Shift highly or very highly. Despite high levels of nonresponse to the poststudy assessment and increases in COVID-19 safety concerns, junior doctors who used the app reported some improvements in depression and anxiety, which warrant further exploration in a robust manner.
Publisher: Wiley
Date: 20-02-2003
DOI: 10.1046/J.1365-2788.2003.00470.X
Abstract: The Developmental Behaviour Checklist (DBC) is a 96-item instrument designed for assessing behavioural and emotional problems among young people with intellectual disability. The present study investigated the validity of the DBC as a measure of change. Changes in in idual's DBC scores were correlated with changes in expert clinicians' ratings of the same subjects. A high correlation was found between expert clinician ratings of change in behaviour and change in the total behaviour problem score of the DBC. The DBC is able to measure changes in behaviour and emotions which are recognized by an experienced clinician who is following the progress of a child with ID.
Publisher: Elsevier BV
Date: 10-1994
Publisher: Wiley
Date: 03-2008
DOI: 10.1111/J.1469-8749.2008.02031.X
Abstract: Given that quality of life (QOL) is commonly confused with functioning, the aim of this study was to examine the association between functioning and QOL domains for children with cerebral palsy (CP). Two hundred and five parents of children aged 4 to 12 years with CP and 53 children aged 9 to 12 years with CP, completed the Cerebral Palsy Quality of Life Questionnaire for Children. Children were distributed reasonably evenly between sex (male, 54.6%) and Gross Motor Function Classification System levels (I 17.8%, II 28.3%, III 14.1%, IV 11.2%, and V 27.3%). For parent proxy-report, all domains of QOL were significantly associated with functioning level except access to services. For child self-report, feelings about functioning, participation and physical health, and pain and feelings about disability, were significantly associated with functioning level. Physical type domains of QOL accounted for more of the variance in functioning than psychosocial type domains. Children with CP have the potential to report a high psychosocial QOL score even if they have poor functioning.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-1996
DOI: 10.1097/00005053-199603000-00004
Abstract: Many patients with psychotic disorders experience persistent auditory hallucinations despite rigorous pharmacological treatment. The experience of auditory hallucinations can heighten anxiety and depression. The high risk of suicide among patients experiencing auditory hallucinations is well recognized. Research in this area has been restricted to small s les or has collected information only on the use of such strategies without investigating their efficacy. The Mental Health Research Institute Unusual Perceptions Schedule incorporates a module focusing on coping strategies. This schedule was administered to 100 subjects, with the aim of investigating the relationship between strategy use and effectiveness, as well as the characteristics of subjects and their disorders. Eighty-one percent of the subjects were worried or upset by their hallucinations. The majority (66%) of the subjects reported they had ways of managing the voices, and 69% of them described at least some success using one or more strategies. There was a striking lack of correspondence between the number of subjects using a method and its related efficacy. No relationship was found between length of illness and number of strategies used. Multidimensional scaling of use and efficacy data revealed three groups of strategies. These groups do not correspond to previous classifications made on the basis of features of the strategies themselves. The pattern of results also suggests that training methods might be used to increase the options for patients troubled by auditory hallucinations.
Publisher: Wiley
Date: 05-1997
DOI: 10.1002/(SICI)1099-1166(199705)12:5<581::AID-GPS571>3.0.CO;2-B
Abstract: The aims were to (i) report the outcome of mild cognitive disorder (MCD) 3.6 years after initial interview and diagnosis (ii) identify predictors of new cases of MCD. The hypotheses were that (i) persons with MCD are more likely to develop dementia than those without MCD (ii) symptoms of anxiety or depression predict MCD caseness at follow-up. Longitudinal cohort study. Community of elderly people (age 70-97 years). 612 of 897 elderly subjects (mean 76 years) were reinterviewed. Of the 36 MCD cases originally identified, 25 were available at follow-up. 24 incident cases of MCD were identified. ICD-10 dementia, DSM-III-R dementia, ICD-10 mild cognitive disorder diagnoses made by the Canberra Interview for the Elderly, tests of anxiety, depression, neuroticism and cognitive performance. Of the original 25 MCD cases available at follow-up, two had a diagnosis of MCD, and three had a diagnosis of both ICD-10 and DSM-III-R dementia. The prevalence of MCD and DSM-III-R dementia at follow-up was no greater for MCD cases diagnosed at initial interview than in normal subjects at initial interview. There was, however, an increased prevalence of ICD-10 dementia among original MCD cases. At initial interview and at follow-up MCD cases were more anxious and depressed but had similar cognitive performance to normals. For incident cases of MCD the only significant predictor was age. MCD cannot be seen to be a specific forerunner of dementia. Those with a diagnosis of MCD are distinguished more by their anxiety, depression and neuroticism than by their cognitive deficits.
Publisher: Royal College of Psychiatrists
Date: 02-2010
DOI: 10.1192/BJP.BP.109.068635
Abstract: Research has reported that pregnant women and mothers become forgetful. However, in these studies, women are not recruited prior to pregnancy, s les are not representative and studies are underpowered. The current study sought to determine whether pregnancy and motherhood are associated with brief or long-term cognitive deterioration using a representative s le and measuring cognition during and before the onset of pregnancy and motherhood. Women aged 20–24 years were recruited prospectively and assessed in 1999, 2003 and 2007. Seventy-six women were pregnant at follow-up assessments, 188 became mothers between study waves and 542 remained nulliparous. No significant differences in cognitive change were found as a function of pregnancy or motherhood, although late pregnancy was associated with deterioration on one of four tests of memory and cognition. The hypothesis that pregnancy and motherhood are associated with persistent cognitive deterioration was not supported. Previous negative findings may be a result of biased s ling.
Publisher: S. Karger AG
Date: 2006
DOI: 10.1159/000093657
Abstract: i Background: /i Cross-sectional studies have demonstrated that age-related effects on many cognitive and biological functioning variables are shared. A number of theories postulate that these associations arise from a common causal mechanism responsible for change across a wide range of functions. However, it has been claimed that the finding of shared variance among variables in these studies may be spurious because most studies have been cross-sectional and based on age-heterogeneous s les. i Objective: /i To examine evidence for changes with age in variance shared by cognitive variables using a narrow-age cohort design. i Methods: /i Three s les of adults with age ranges 20–24 years (n = 2,404), 40–44 years (n = 2,530) and 60–64 years (n = 2,510) were drawn from a population-based study. These groups were supplemented by data from an older s le of in iduals (77 years and over) from a second population-based study (n = 374). Four models of the structure of a range of cognitive, speed and biological variables derived from previous cross-sectional research were fitted to data. These models were complete independence of variables within a cohort, a single common factor, multiple independent factors, and a second order factor model. i Results: /i Model fit and the magnitude of loadings from multiple-group confirmatory factor analyses was compared between age groups. The fit for all four models was worse in the 60–64 year age group. Factor loadings on the common factor specified in these models varied between the groups, but the speed factor rather than the biological factor showed increased loadings as a function of age. i Conclusions: /i This narrow age-cohort study did not support the existence of developmental changes in the structure of cognitive and biological variables across the lifespan. Shared variation between measures of cognition and biological function may be an artifact of the research designs that have generated these findings. This casts doubt of the existence of a common causal mechanism. However, it may be that such changes manifest only in later old age.
Publisher: Wiley
Date: 02-1998
Publisher: Springer Science and Business Media LLC
Date: 23-06-2008
DOI: 10.1007/S00127-008-0388-Z
Abstract: There is robust epidemiological and clinical evidence that a greater number of women than men experience depression and anxiety. This study investigated a number of socio-demographic, health and lifestyle, psychological and social factors as possible mediators for the gender difference in depression and anxiety in three cohorts (20-24, 40-44, 60-64). Responses were from a representative, community based survey (n = 7,485) conducted in Canberra and Queanbeyan (NSW), in Australia. Depression and anxiety were measured using the self-report Goldberg Anxiety and Depression Scales. The analyses initially identified gender differences in the potential mediators, followed by univariate and multivariate mediation models. The results indicated several shared mediators for depression and anxiety across the three age groups including: childhood adversity, mastery, behavioural inhibition, ruminative style, neuroticism, physical health, physical activity, and perceived interpersonal and employment problems. There was a decrease in the number of social mediators as age increased. The multivariate models accounted for gender differences in both conditions for all age groups, except for anxiety in the 20-24 years old. This suggests further important unmeasured mediators for this age group. These findings add to the literature surrounding gender differences in depression and anxiety, and provide a basis for future research exploring variation in these gender disparities over the adult lifespan.
Publisher: Springer Science and Business Media LLC
Date: 04-11-2014
Publisher: American Psychological Association (APA)
Date: 2007
DOI: 10.1037/1040-3590.19.4.459
Abstract: Intellectual ability is assessed with the Spot-the-Word (STW) test (A. Baddeley, H. Emslie, & I. Nimmo Smith, 1993) by asking respondents to identify a word in a word-nonword item pair. Results in moderate-sized s les suggest this ability is resistant to decline due to dementia. The authors used a 3-parameter item response theory model to investigate the measurement properties of the STW in a large community-dwelling s le (n=2,480) 60 to 64 years of age. A number of poorly performing items were identified. Substantial guessing was present however, the number of words correctly identified was found to be an accurate index of ability. Performance was moderately related to a number of tests of cognitive performance and was effectively unrelated to visual acuity and to physical or mental health status. The STW is a promising test of ability that, in the future, may be refined by the deletion or replacement of poorly functioning items.
Publisher: Elsevier BV
Date: 05-2006
Publisher: JMIR Publications Inc.
Date: 16-09-2021
DOI: 10.2196/28369
Abstract: Digital mental health interventions stand to play a critical role in managing the mental health impact of the COVID-19 pandemic. Thus, enhancing their uptake is a key priority. General practitioners (GPs) are well positioned to facilitate access to digital interventions, but tools that assist GPs in identifying suitable patients are lacking. This study aims to evaluate the suitability of a web-based mental health screening and treatment recommendation tool (StepCare) for improving the identification of anxiety and depression in general practice and, subsequently, uptake of digital mental health interventions. StepCare screens patients for symptoms of depression (9-item Patient Health Questionnaire) and anxiety (7-item Generalized Anxiety Disorder scale) in the GP waiting room. It provides GPs with stepped treatment recommendations that include digital mental health interventions for patients with mild to moderate symptoms. Patients (N=5138) from 85 general practices across Australia were invited to participate in screening. Screening identified depressive or anxious symptoms in 43.09% (1428/3314) of patients (one-quarter were previously unidentified or untreated). The majority (300/335, 89.6%) of previously unidentified or untreated patients had mild to moderate symptoms and were candidates for digital mental health interventions. Although less than half were prescribed a digital intervention by their GP, when a digital intervention was prescribed, more than two-thirds of patients reported using it. Implementing web-based mental health screening in general practices can provide important opportunities for GPs to improve the identification of symptoms of mental illness and increase patient access to digital mental health interventions. Although GPs prescribed digital interventions less frequently than in-person psychotherapy or medication, the promising rates of uptake by GP-referred patients suggest that GPs can play a critical role in ch ioning digital interventions and maximizing the associated benefits.
Publisher: BMJ
Date: 30-11-2009
Abstract: Little is known about how participants perceive prevention trials, particularly trials designed to prevent mental illness. This study examined participants' motives for participating in a trial and their views of randomisation and the ability to withdraw from a randomised controlled trial (RCT) for prevention of depression. Participants were older adults reporting elevated depression symptoms (N = 900) living in urban and regional locations in Australia who had consented to participate in an RCT of interventions to prevent depression. Participants rated their agreement with various statements describing motivations for enrolment in the trial and opinions regarding randomisation and withdrawal. The majority of participants expressed a triad of altruistic motivation for participation, relative lack of concern about randomisation and commitment to the trial. Certain subgroups of participants, such as women and those with higher depression scores, reported higher levels of concern about specific issues. The findings suggest that participants enrolled in prevention trials for mental illness are likely to hold positive attitudes (eg, high commitment, low expectation of personal gain) towards research trials. The identification of relationships between key person factors and trial-related attitudes enabled profiling of participant groups, which can inform recruitment strategies and interactions of participants and research projects in future prevention trials.
Publisher: Springer Science and Business Media LLC
Date: 10-03-2009
DOI: 10.1007/S00520-009-0606-6
Abstract: Screening oncology patients for clinically significant emotional distress is a recommended standard of care in psycho-oncology. However, principles regarding the interpretation of screening and diagnostic tests developed in other areas of medicine have not been widely applied in psycho-oncology. This paper explores the application of the concepts of likelihood ratios and post-test probabilities to the interpretation of psychological screening instruments and demonstrates the development of an algorithm for screening for emotional distress and common psychopathology. Three hundred forty oncology/haematology outpatients at the Calvary Mater Newcastle, Australia completed the Distress Thermometer (DT), the PSYCH-6 subscale of the Somatic and Psychological Health Report and the Kessler-10 scale. The Hospital Anxiety and Depression Scale (HADS) (cutoff 15+) was used as the gold standard. Likelihood ratios showed that a score over threshold on the DT was 2.77 times more likely in patients who were cases on the HADS. These patients had a 53% post-test probability of being cases on the HADS compared with the pretest probability of 29%. Adding either the PSYCH-6 (3+) or the Kessler-10 (22+) to the DT (4+) significantly increased this post-test probability to 94% and 92%, respectively. The significance of these improvements was confirmed by logistic regression analysis. This study demonstrated the application of probability statistics to develop an algorithm for screening for distress in oncology patients. In our s le, a two-stage screening algorithm improved appreciably on the performance of the DT alone to identify distressed patients. Sequential administration of a very brief instrument followed by selective use of a longer inventory may save time and increase acceptability.
Publisher: Oxford University Press (OUP)
Date: 08-08-2014
Abstract: very few studies have examined the association between intra-in idual reaction time variability and subsequent mortality. Furthermore, the ability of simple measures of variability to predict mortality has not been compared with more complex measures. a prospective cohort study of 896 community-based Australian adults aged 70+ were interviewed up to four times from 1990 to 2002, with vital status assessed until June 2007. From this cohort, 770-790 participants were included in Cox proportional hazards regression models of survival. Vital status and time in study were used to conduct survival analyses. The mean reaction time and three measures of intra-in idual reaction time variability were calculated separately across 20 trials of simple and choice reaction time tasks. Models were adjusted for a range of demographic, physical health and mental health measures. greater intra-in idual simple reaction time variability, as assessed by the raw standard deviation (raw SD), coefficient of variation (CV) or the intra-in idual standard deviation (ISD), was strongly associated with an increased hazard of all-cause mortality in adjusted Cox regression models. The mean reaction time had no significant association with mortality. intra-in idual variability in simple reaction time appears to have a robust association with mortality over 17 years. Health professionals such as neuropsychologists may benefit in their detection of neuropathology by supplementing neuropsychiatric testing with the straightforward process of testing simple reaction time and calculating raw SD or CV.
Publisher: Wiley
Date: 19-02-2009
DOI: 10.1111/J.1469-8749.2008.03194.X
Abstract: Quality of life (QOL) has emerged over the past 20 years as an outcome for measuring the effectiveness of health-improvement interventions. The Cerebral Palsy Quality of Life Questionnaire for Children (CPQOL-Child) is well regarded and now integrated into research internationally. We describe the results of qualitative research, using grounded research in which we aimed to identify domains of QOL for adolescents with cerebral palsy (CP) from adolescent and parent perspectives to guide the development of an adolescent version. Seventeen adolescents (nine males, eight females) aged 13 to 18 years (mean=15.53 SD=1.74), with varying levels of impairment (Gross Motor Function Classification System levels I n=5, II n=2, III n=6, IV n=4, and V n=6) and their parents (n=23) participated in semi-structured interviews. Questions included: 'What do you think is important to your (child's) QOL?' and 'How does CP impact on your (child's) life?' Fifteen themes were identified, including domains related to health issues in adolescence, participation, education, specific CP-related issues (pain and discomfort, communication), family issues, practical issues (financial resources), and changes associated with adolescence (sexuality, independence). The composition of these QOL domains reflects the developmental concerns of adolescents with CP, adding to the views of children, and strongly supports adolescent participation in the development of self-reported well-being and QOL measures. Many of the domains are consistent with child reports of QOL and thus it appears feasible and valid to develop a measure that will be transferable across childhood and adolescence.
Publisher: Elsevier BV
Date: 07-2007
DOI: 10.1016/J.PSYCHRES.2006.11.005
Abstract: This study assessed the screening utility of the 12-item Short-Form Health Survey's (SF-12) mental health component scale (MCS-12) for diagnosable depression and anxiety disorders in a general population s le, and thus, the validity of this scale as a measure of mental health in epidemiological research. Data were from the Australian National Survey of Mental Health and Wellbeing (N=10,504). Diagnoses were made using the Composite International Diagnostic Interview. The MCS-12 was compared to other brief scales: the RAND Mental Health Component scale (RAND MHC-12, an alternative scoring method for the MCS-12), the 12-item General Health Questionnaire (GHQ-12), the Kessler Psychological Distress Scale (K10 and K6), and an estimate of the Mental Health Inventory (MHI-5). The MCS-12 and RAND MHC-12 were equally able to discriminate respondents with the target diagnoses. The MCS-12 performed better than the GHQ-12, and equally to the K6 for diagnoses of depression, though not anxiety disorders, where the K6 showed greater utility. The K10 out-performed the MCS-12 for all diagnoses. Areas under receiver operating characteristics curves (AUC) indicated that the MCS-12 is valid measure of mental health in epidemiological research, and a useful screening tool for both depression (AUC=0.92) and anxiety disorders (AUC=0.83).
Publisher: Springer Science and Business Media LLC
Date: 22-11-2009
Publisher: Elsevier BV
Date: 10-2014
Publisher: Springer Science and Business Media LLC
Date: 25-02-2015
Publisher: American Psychological Association (APA)
Date: 1994
Publisher: JMIR Publications Inc.
Date: 29-06-2012
DOI: 10.2196/JMIR.1864
Publisher: JMIR Publications Inc.
Date: 05-04-2022
Abstract: hift is a novel smartphone application (app) to provide a digital-first mental health resource to junior doctors. It contains psychoeducational material, cognitive behavioural modules, guided mediations, information on common work stressors, and a section on help-seeking options for psychological problems through workplace and private avenues. o conduct a preliminary investigation of the usage and potential effectiveness of Shift on depressive and anxiety symptoms (primary outcomes), and work and social functioning, coronavirus safety concerns, and help-seeking (secondary outcomes). This study also sought feedback on whether Shift was seen as an acceptable tool. unior doctors in New South Wales, Australia were approached through promotional activities from the Ministry of Health, specialist medical colleges, and social media advertisements between June and August 2020. Consenting participants provided online baseline data, used the Shift app for 30 days, and were asked to complete a post-study online questionnaire. Outcomes were analysed under the ITT principle. total of 222 (156/222 female, 70% mean age = 29.2 years) junior doctors provided full baseline data. Of those, 198/222 (89%) downloaded the app, logged into the app about 6 times (M = 5.68, SD = 7.51), completed 4 in-app activities (M = 3.77, SD = 4.36), and spent a total of one hour on in-app activities (M = 52:23, SD = 6:00:18) over 30 days. Post-intervention data were provided by 54/222 (24%) of participants. Depressive and anxiety symptoms significantly decreased between the pre- and post-assessment points as expected, however, doctors’ coronavirus safety concerns significantly increased. Work and social functioning, coronavirus concerns for family and friends, and help seeking did not change significantly. There was no significant relationship between symptom changes and app usage (number of logins, days between first and last login, and total activity time). Most post-study completers (31/54, 57%) rated Shift highly or very highly. espite high levels of non-response to the post-study assessment and increases in coronavirus safety concerns, junior doctors who used the app reported some improvements in depression and anxiety that warrant further exploration in a robust manner. he study was prospectively registered with the Australian New Zealand Clinical Trials Registry under the trial number ACTRN12620000571976.
Publisher: Elsevier BV
Date: 08-1995
DOI: 10.1016/0920-9964(94)00069-K
Abstract: The Mental Health Research Institute Unusual Perceptions Schedule (MUPS) is a comprehensive instrument developed to record subjects' experiences of auditory hallucinations as completely as possible. The Schedule comprises a semi-structured interview and documents the physical characteristics of auditory hallucinations such as their onset and course, number, volume, tone, location, as well as other phenomena associated with them such as delusions. In addition, other aspects of hallucinations, such as coping strategies, contributing factors and subjects' personal views and reactions are also explored. In a s le of 100 subjects drawn primarily from the in-patient wards at Royal Park Hospital the MUPS was found to be an acceptable instrument to subjects in the field. Interrater reliability assessed in a subs le of 30 subjects was found to be high at the level of the in idual items. Whether used in whole or part, the MUPS provides a reliable and acceptable method of assessing patients' experience of auditory hallucinations.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2008
Publisher: Elsevier BV
Date: 04-2014
Publisher: Springer Science and Business Media LLC
Date: 30-04-2010
Publisher: Wiley
Date: 2001
DOI: 10.1002/GPS.326
Abstract: The Cognitive Decline scale of the Psychogeriatric Assessment Scales (PAS)1 uses informant data to assess retrospectively change from earlier in life. Data from a 7-8-year longitudinal study were used to assess the validity of this scale against changes in cognitive performance and mortality. PAS data were collected on three occasions, with gaps of 3.6 and 4.1 years between the waves. The Cognitive Decline score at Wave 3 was validated retrospectively against actual change on a brief test of current cognitive status (the PAS Cognitive Impairment scale) over the three waves, while the Cognitive Decline score at Wave 1 was assessed for predictive validity against future mortality and cognitive change. A community survey in the Australian cities of Canberra and Queanbeyan. Participants were aged 70+ at the beginning of the study. The s le size varied from 729 to 279, depending on the number of waves involved. Participants with scores of 4+ on the Cognitive Decline scale at Wave 3 showed substantial deterioration over the previous 7-8 years. Scores of 4+ at Wave 1 predicted mortality and further cognitive deterioration. The Cognitive Decline scale allows a valid retrospective assessment of change and has predictive validity for subsequent cognitive deterioration and increased mortality.
Publisher: Elsevier BV
Date: 2012
DOI: 10.1016/J.SCHRES.2011.08.018
Abstract: Depressive symptoms in 'non-affective' first episode schizophrenia spectrum disorders (FES) are common, but poorly understood, resulting in a range of conceptual and clinical management issues. This study had three aims: (i) to determine the prevalence of moderate to severe depressive symptoms (defined as a Clinical Global Impressions Scale-Bipolar Disorder (CGI-BP depression) score >3) in a large representative s le of FES patients (ii) to compare the clinical and functional characteristics of FES patients with and without these depressive symptoms at service entry and (iii) to compare the characteristics of FES patients with and without persistent depressive symptoms. Medical file audit methodology was employed to collect information on 405 patients with FES treated at the Early Psychosis Prevention and Intervention Centre (EPPIC), Melbourne, Australia. 26.2% (n=106) of the patients had moderate to severe depression at service entry. At service entry and at discharge, those with depressive symptoms had greater insight into their illness but did not differ from those without depressive symptoms in terms of severity of overall psychopathology. Substance use was significantly less common in those with depressive symptoms at service entry and at discharge. Of those who were depressed at baseline, 14.2% (n=15) continued to have moderate to severe depressive symptoms at discharge. Depressive symptoms are common in patients with FES. Understanding the nature and characteristics of depression in FES has important clinical implications for both early intervention and treatment.
Publisher: Royal College of Psychiatrists
Date: 07-2010
DOI: 10.1192/BJP.BP.109.075291
Abstract: Few randomised controlled trials (RCTs) have examined potential preventive agents in high-risk community populations. To determine whether a mental health literacy intervention, the promotion of physical activity, or folic acid plus vitamin B 12 reduce depression symptoms in community-dwelling older adults with elevated psychological distress. An RCT with a completely crossed 2 × 2 × 2 factorial design: (400 mcg/d folic acid + 100 mcg/d vitamin B 12 v. placebo)×(physical activity v. nutrition promotion control) × (mental health literacy v. pain information control). The initial target s le size was 2000 however, only 909 adults (60–74 years) met the study criteria. Interventions were delivered by mail with telephone calls. The main outcome was depressive symptoms on the Patient Health Questionnaire (PHQ–9) at 6 weeks, 6, 12 and 24 months. The Clinicaltrials.gov registration number is NCT00214682. The drop-out rate was low (13.5%) from randomisation to 24-month assessment. Neither folic acid + B 12 ( F (3,856) = 0.83, P = 0.476) nor physical activity ( F (3,856) = 1.65, P = 0.177) reduced depressive symptoms at any time point. At 6 weeks, depressive symptoms were lower for the mental health literacy intervention compared with its control condition ( t (895) = 2.04, P = 0.042). Mental health literacy had a transient effect on depressive symptoms. Other than this, none of the interventions significantly reduced symptoms relative to their comparator at 6 weeks or subsequently. Neither folic acid plus B 12 nor physical activity were effective in reducing depressive symptoms.
Publisher: American Medical Association (AMA)
Date: 12-2003
Publisher: JMIR Publications Inc.
Date: 29-11-2017
Abstract: epression and anxiety disorders are significant contributors to burden of disease in young people, highlighting the need to focus preventive efforts early in life. Despite substantial evidence for the role of parents in the prevention of adolescent depression and anxiety disorders, there remains a need for translation of this evidence into preventive parenting interventions. To address this gap, we developed a single-session, Web-based, tailored psychoeducation intervention that aims to improve parenting practices known to influence the development of adolescent depression and anxiety disorders. he aim of this study was to evaluate the short-term effects of the intervention on parenting risk and protective factors and symptoms of depression and anxiety in adolescent participants. e conducted a single-blind, parallel group, superiority randomized controlled trial comparing the intervention with a 3-month waitlist control. The intervention is fully automated and consists of two components: (1) completion of an online self-assessment of current parenting practices against evidence-based parenting recommendations for the prevention of adolescent depression and anxiety disorders and (2) an in idually tailored feedback report highlighting each parent’s strengths and areas for improvement based on responses to the self-assessment. A community s le of 349 parents, together with 327 adolescents (aged 12-15 years), were randomized to either the intervention or waitlist control condition. Parents and adolescents completed online self-reported assessments of parenting and adolescent symptoms of depression and anxiety at baseline, 1-month (parent-report of parenting only), and 3-month follow-up. ompared with controls, intervention group parents showed significantly greater improvement in parenting risk and protective factors from baseline to 1-month and 3-month follow-up (F2,331.22=16.36, P .001), with a small to medium effect size at 3-month follow-up (d=0.33). There were no significant effects of the intervention on adolescent-report of parenting or symptoms of depression or anxiety in the adolescents (all P .05). indings suggest that a single-session, in idually tailored, Web-based parenting intervention can improve parenting factors that are known to influence the development of depression and anxiety in adolescents. However, our results do not support the effectiveness of the intervention in improving adolescent depression or anxiety symptoms in the short-term. Long-term studies are required to adequately assess the relationship between improving parenting factors and adolescent depression and anxiety outcomes. Nonetheless, this is a promising avenue for the translation of research into a low-cost, sustainable, universal prevention approach. ustralian New Zealand Clinical Trials Registry: ACTRN12615000247572 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12615000247572 (Archived by WebCite at v1ha19XG)
Publisher: JMIR Publications Inc.
Date: 09-10-2017
Abstract: epression and anxiety disorders in young people are a global health concern. Parents have an important role in reducing the risk of these disorders, but cost-effective, evidence-based interventions for parents that can be widely disseminated are lacking. his study aimed to examine the postintervention effects of the Partners in Parenting (PiP) program on parenting risk and protective factors for adolescent depression and anxiety, and on adolescent depression and anxiety symptoms. two-arm randomized controlled trial was conducted with 359 parent-adolescent dyads, recruited primarily through schools across Australia. Parents and adolescents were assessed at baseline and 3 months later (postintervention). Parents in the intervention condition received PiP, a tailored Web-based parenting intervention designed following Persuasive Systems Design (PSD) principles to target parenting factors associated with adolescents’ risk for depression and anxiety problems. PiP comprises a tailored feedback report highlighting each parent’s strengths and areas for improvement, followed by a set of interactive modules (up to nine) that is specifically recommended for the parent based on in idually identified areas for improvement. Parents in the active-control condition received a standardized package of five Web-based factsheets about adolescent development and well-being. Parents in both conditions received a 5-min weekly call to encourage progress through their allocated program to completion. Both programs were delivered weekly via the trial website. The primary outcome measure at postintervention was parent-reported changes in parenting risk and protective factors, which were measured using the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS). Secondary outcome measures were the adolescent-report PRADAS, the parent- and child-report Short Mood and Feelings Questionnaire (depressive symptoms), and parent- and child-report Spence Children’s Anxiety Scale (anxiety symptoms). arents in the intervention condition completed a mean of 73.7% of their intended personalized PiP program. A total of 318 parents (88.6%, 318/359) and 308 adolescents (92.8%, 308/332) completed the postintervention assessment. Attrition was handled using mixed model of repeated measures analysis of variance. As hypothesized, we found a significant condition-by-time interaction on the PRADAS, with a medium effect size, Cohen d=0.57, 95% CI 0.34-0.79. No significant differences between conditions were found at postintervention on any of the secondary outcome measures, with adolescent depressive (parent-report only) and anxiety (both parent- and adolescent-report) symptoms decreasing significantly from baseline to postintervention in both conditions. he fully automated PiP intervention showed promising short-term effects on parenting behaviors that are associated with adolescents’ risk for depression and anxiety. Long-term follow-up is required to ascertain whether these effects translate into reduced adolescent depression and anxiety problems. The intervention may be useful as a low-cost universal public health program to increase parenting practices believed to benefit adolescents’ mental health. ustralia New Zealand Clinical Trials Registry: ACTRN12615000328572 www.anzctr.org.au/ Trial/Registration/TrialReview.aspx? id=368274 (Archived by WebCite at qgsZ3Aqj)
Publisher: JMIR Publications Inc.
Date: 27-06-2012
DOI: 10.2196/JMIR.1859
Publisher: Elsevier BV
Date: 10-2014
DOI: 10.1016/J.PSYCHRES.2014.05.029
Abstract: The Interpersonal-Psychological Theory of Suicide (IPTS) has been supported by recent research. However, the nature of the models׳ three major constructs--perceived burdensomeness, thwarted belongingness and acquired capability - requires further investigation. In this paper, we test a number of hypotheses about the predictors and correlates of the IPTS constructs. Participants aged 32-38 from an Australian population-based longitudinal cohort study (n=1167) were assessed. IPTS constructs were measured by items from the Interpersonal Needs Questionnaire (INQ) and Acquired Capability for Suicide Scale (ACSS), alongside demographic and additional measures, measured concurrently or approximately 8 years earlier. Cross-sectional analyses evaluating the IPTS supported earlier work. Mental health was significantly related to all three IPTS constructs, but depression and anxiety caseness were associated only with perceived burdensomeness. Various social support measures were differentially associated with the three constructs. Stressful events and lifetime traumas had robust independent associations with acquired capability for suicide only. The IPTS model provides a useful framework for conceptualising suicide risk. The findings highlight the importance of perceived social support in suicide risk, identify the importance of personality and other factors as new avenues of research, and provide some validation for the independence of the constructs.
Publisher: JMIR Publications Inc.
Date: 13-05-2013
DOI: 10.2196/JMIR.2307
Publisher: Public Library of Science (PLoS)
Date: 28-12-2012
Publisher: Elsevier BV
Date: 10-2014
DOI: 10.1016/J.SCHRES.2014.07.042
Abstract: To determine mortality-related estimates and causes of death in young people with first-episode psychosis (FEP), and to identify baseline predictors of mortality. Mortality outcomes in 723 young people presenting to an early psychosis service were prospectively ascertained up to 20 years. Predictors of all-cause and unnatural death were investigated using survival techniques. Forty-nine participants died by study end. Most deaths (n=41) occurred within 10 years of service entry. All-cause mortality was 5.5% at 10 years, rising to 8.0% after 20 years. Unnatural death rates at 10 and 20 years were 5.0% and 5.9%, respectively. Three risk factors consistently predicted all-cause mortality and unnatural deaths. A substantial proportion of excess mortality was due to non-suicide unnatural death, and, later, natural deaths. This suggests that mental health services should expand their current focus on suicide to incorporate strategies to prevent accidental death and promote healthier lifestyles.
Publisher: Elsevier BV
Date: 10-2013
DOI: 10.1016/J.JAD.2013.05.085
Abstract: There is a need for brief, accurate screening when assessing multiple mental disorders. Two-stage hierarchical screening, consisting of brief pre-screening followed by a battery of disorder-specific scales for those who meet diagnostic criteria, may increase the efficiency of screening without sacrificing precision. This study tested whether more efficient screening could be gained using two-stage hierarchical screening than by administering multiple separate tests. Two Australian adult s les (N=1990) with high rates of psychopathology were recruited using Facebook advertising to examine four methods of hierarchical screening for four mental disorders: major depressive disorder, generalised anxiety disorder, panic disorder and social phobia. Using K6 scores to determine whether full screening was required did not increase screening efficiency. However, pre-screening based on two decision tree approaches or item gating led to considerable reductions in the mean number of items presented per disorder screened, with estimated item reductions of up to 54%. The sensitivity of these hierarchical methods approached 100% relative to the full screening battery. Further testing of the hierarchical screening approach based on clinical criteria and in other s les is warranted. The results demonstrate that a two-phase hierarchical approach to screening multiple mental disorders leads to considerable increases efficiency gains without reducing accuracy. Screening programs should take advantage of prescreeners based on gating items or decision trees to reduce the burden on respondents.
Publisher: Elsevier BV
Date: 04-2003
DOI: 10.1016/S0895-4356(03)00009-X
Abstract: This study sought to determine whether the augmentation of cognitive testing with an informant report questionnaire could improve accuracy in screening for dementia in a community setting. The s le consisted of 646 subjects aged 70-93 years. Cognitive state was assessed using the Mini-Mental State Examination (MMSE). Informants completed the 16-item short form of the Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE). Dementia was diagnosed according to DSM-III-R criteria. Combination of the IQCODE with the MMSE resulted in more accurate prediction of caseness than either test alone. Receiver Operating Characteristic analysis demonstrated the superior screening performance of a logical "or" rule and a weighted sum of scores on the two tests over other methods of combination, replicating previous clinically based research. The findings also suggest that the appropriate combination of existing tests may be a fruitful method of improving screening accuracy in a variety of situations.
Publisher: Elsevier BV
Date: 2012
Abstract: Evidence remains unclear as to whether folic acid (FA) and vitamin B-12 supplementation is effective in reducing depressive symptoms. The objective was to determine whether oral FA + vitamin B-12 supplementation prevented cognitive decline in a cohort of community-dwelling older adults with elevated psychological distress. A randomized controlled trial (RCT) with a completely crossed 2 × 2 × 2 factorial design comprising daily oral 400 μg FA + 100 μg vitamin B-12 supplementation (compared with placebo), physical activity promotion, and depression literacy with comparator control interventions for reducing depressive symptoms was conducted in 900 adults aged 60-74 y with elevated psychological distress (Kessler Distress 10-Scale scores >15). The 2-y intervention was delivered in 10 modules via mail with concurrent telephone tracking calls. Main outcome measures examined change in cognitive functioning at 12 and 24 mo by using the Telephone Interview for Cognitive Status-Modified (TICS-M) and the Brief Test of Adult Cognition by Telephone (processing speed) the Informant Questionnaire on Cognitive Decline in the Elderly was administered at 24 mo. FA + vitamin B-12 improved the TICS-M total (P = 0.032 effect size d = 0.17), TICS-M immediate (P = 0.046 d = 0.15), and TICS-M delayed recall (P = 0.013 effect size d = 0.18) scores at 24 mo in comparison with placebo. No significant changes were evident in orientation, attention, semantic memory, processing speed, or informant reports. Long-term supplementation of daily oral 400 μg FA + 100 μg vitamin B-12 promotes improvement in cognitive functioning after 24 mo, particularly in immediate and delayed memory performance. This trial was registered at clinicaltrials.gov as NCT00214682.
Publisher: Wiley
Date: 04-2006
Publisher: Cambridge University Press (CUP)
Date: 07-1997
DOI: 10.1017/S0033291797005217
Abstract: We report on the change in cognitive function in a population s le of elderly people who have been examined on two occasions more than 3 years apart. A s le of 1135 persons aged 70-102 years was interviewed at base-line then re-interviewed 3.6 years later with the Canberra Interview for the Elderly, which included tests of episodic memory and cognitive speed as well as the Mini-Mental State Examination and the National Adult Reading Test (NART). Mortality and loss to follow-up reduced the s le to 736, of whom 614 completed at least one test of cognitive performance on both occasions. Cognitive performance decreased with age, except on the NART. Decline over the follow-up period increased as a function of age in all cognitive measures, except the NART. Change in cognitive scores was close to normal distribution. Incident dementia was associated strongly with age and current level of cognitive performance, but not with rate of decline. Cognitive decline and the risk of incident dementia did not differ by gender. A score indicating possible impairment in the very elderly carries a worse prognosis than for the younger elderly. Decline is almost universal in at least one cognitive area among those over the age of 85.
Publisher: Elsevier BV
Date: 05-2011
Publisher: Wiley
Date: 13-08-2014
DOI: 10.1111/EIP.12166
Abstract: US authorities have recommended 'black-box' warnings for antidepressants because of the increased risk of suicidality for in iduals up to age 25. There is thus a clinical and ethical imperative to provide effective treatment for youth depression with an acceptable risk-benefit balance. Long-chain omega-3 polyunsaturated fatty acids (PUFAs) play an important role in a range of physiological processes in living organisms. Supplementation with omega-3 PUFAs has been shown to have a range of beneficial effects on both physical and mental health, and results of previous trials suggest that omega-3 PUFAs may be a safe and effective treatment for depression. However, conclusions from these trials have been limited by their relatively small s le sizes. This trial will test the effectiveness of a 12-week parallel group, double-blind, randomized, placebo-controlled trial of 1.4 g day(-1) omega-3 PUFAs in help seeking 15- to 25-year-olds (N = 400) presenting with major depressive disorder. The primary hypothesis is that young people will show greater improvement of depressive symptoms after 12 weeks of treatment with omega-3 PUFAs plus cognitive behavioural case management compared with treatment with placebo plus cognitive behavioural case management. Because of using a large s le, results from this study will provide the strongest evidence to date to inform the use of omega-3 PUFAs as first-line therapy in young people presenting with major depressive disorder. The study also heralds an important step towards indicated prevention of persistent depression, which may reduce the burden, stigmatization, disability and economic consequences of this disorder.
Publisher: JMIR Publications Inc.
Date: 05-02-2019
Abstract: revention of depression and anxiety disorders early in life is a global health priority. Evidence on risk and protective factors for youth internalizing disorders indicates that the family represents a strategic setting to target preventive efforts. Despite this evidence base, there is a lack of accessible, cost-effective preventive programs for parents of adolescents. To address this gap, we recently developed the Partners in Parenting (PiP) program—an in idually tailored Web-based parenting program targeting evidence-based parenting risk and protective factors for adolescent depression and anxiety disorders. We previously reported the postintervention outcomes of a single-blinded parallel-group superiority randomized controlled trial (RCT) in which PiP was found to significantly improve self-reported parenting compared with an active-control condition (educational factsheets). his study aimed to evaluate the effects of the PiP program on parenting risk and protective factors and symptoms of adolescent depression and anxiety using data from the final assessment time point (12-month follow-up) of this RCT. arents (n=359) and adolescents (n=332) were recruited primarily from secondary schools and completed Web-based assessments of parenting and adolescent depression and anxiety symptoms at baseline, postintervention (3 months later), and 12-month follow-up (317 parents, 287 adolescents). Parents in the PiP intervention condition received personalized feedback about their parenting and were recommended a series of up to 9 interactive modules. Control group parents received access to 5 educational factsheets about adolescent development and mental health. Both groups received a weekly 5-min phone call to encourage progress through their program. ntervention group parents completed an average of 73.7% of their intended program. For the primary outcome of parent-reported parenting, the intervention group showed significantly greater improvement from baseline to 12-month follow-up compared with controls, with a medium effect size (Cohen d=0.51 95% CI 0.30 to 0.72). When transformed data were used, greater reduction in parent-reported adolescent depressive symptoms was observed in the intervention group (Cohen d=−0.21 95% CI −0.42 to −0.01). Mediation analyses revealed that these effects were mediated by improvements in parenting (indirect effect b=−0.08 95% CI −0.16 to −0.01). No other significant intervention effects were found for adolescent-reported parenting or adolescent depression or anxiety symptoms. Both groups showed significant reductions in anxiety (both reporters) and depressive (parent reported) symptoms. iP improved self-reported parenting for up to 9 months postintervention, but its effects on adolescent symptoms were less conclusive, and parent-reported changes were not perceived by adolescents. Nonetheless, given its scalability, PiP may be a useful low-cost, sustainable program to empower parents of adolescents. ustralian Clinical Trials Registration Number (ACTRN): 12615000328572 www.anzctr.org.au/ACTRN12615000328572.aspx (Archived by WebCite at qgsZ3Aqj).
Publisher: American Psychological Association (APA)
Date: 2011
DOI: 10.1037/A0021845
Abstract: Differences in the time of onset and magnitude of terminal decline were examined in three cognitive domains: processing speed, episodic memory, and global function. In addition, cognitive reserve was investigated by testing whether education affected the onset or rate of decline across these domains. Eight hundred ninety-six community-dwelling Australian adults aged ≥ 70 years were assessed up to four times over 12 years, with vital status followed for 17 years. For each of the cognitive measures, a series of change point models were fitted across the 20 years before death to find the optimal point at which terminal decline was distinguished from preterminal decline. Change points were then assessed separately for high- and low-education groups. The change points were 8.5 years for processing speed (95% CI: 6.0-11.2 years), 7.1 years for global function (6.2-9.3), and 6.6 years for episodic memory (5.3-7.1). The rate of decline was two to four times greater in the terminal phase relative to the preterminal phase, depending on the domain. Increased education changed the terminal decline effect differently for each of the three tests, either by significantly hastening the onset of terminal decline and decreasing the rate of decline, or by increasing the rate of either preterminal or terminal decline. Analyses were repeated excluding participants diagnosed with dementia, with no substantive change to the outcomes. In conclusion, the rate and onset of terminal decline varied somewhat across cognitive domains. Education affected terminal decline differently across the domains, but this modification was not consistent with the predictions of cognitive reserve theory.
Publisher: Elsevier BV
Date: 09-2013
DOI: 10.1016/J.JAD.2013.03.018
Abstract: Despite strong evidence for increased suicide mortality among in iduals experiencing thoughts of suicide, the effect of suicidal ideation on increased natural mortality has not been evaluated. The present study aimed to assess whether there is excess mortality from all natural causes or from specific natural causes that is attributable to suicidal ideation. Adjustments were made for a range of demographic, mental health and physical health measures to examine evidence for specific mechanisms of the relationship. A community-based Australian cohort of 861 older adults was followed for up to 17 years. Vital status and cause of death were ascertained from a national death registry. After adjusting for demographics, physical health and mental health, presence of suicidal ideation was associated with a 23% increase in the risk of mortality from natural causes (p=0.034). The increased mortality was largely attributable to heart disease deaths (hazard ratio=1.43, p=0.041). There was a limited number of deaths from respiratory disease or stroke, and modest rates of suicidal ideation in the cohort. Assessment of suicidal ideation was brief, while adjustment for mental health symptoms relied on non-diagnostic measures. Although the relationship between suicidal ideation and mortality from natural causes was partly explained by physical and mental health status, thoughts of suicide independently accounted for an increased risk of mortality. Further research should examine whether this relationship is mediated by poorer health behaviours among in iduals experiencing thoughts of suicide.
Publisher: Elsevier BV
Date: 12-2006
DOI: 10.1016/J.PEC.2005.11.010
Abstract: To develop and validate a questionnaire to screen for potential nonadherence in patients with chronic ailments. Themes from qualitative interviews with chronic obstructive pulmonary disease patients were used in developing content of the questionnaire. The questionnaire was distributed to 525 ambulatory patients with chronic lung diseases. Principal components analysis was performed to identify the subscales in the questionnaire. Internal consistency, validity and stability of the subscales were also evaluated. The 30-item Beliefs and Behaviour Questionnaire (BBQ) measures beliefs, experiences and adherent behaviour on five-point Likert-type scales. Two hundred and eighty patients (53.3%) with a mean age of 71.1 years responded to the questionnaire. The 'beliefs' section had a two-factor solution-'confidence' and 'concerns' with internal consistencies of 0.82 and 0.45, respectively. The two domains identified from the section 'experiences'-satisfaction' and 'disappointment' had internal consistencies of 0.85 and 0.52, respectively. The 'behaviour' section, separately entitled the Tool for Adherence Behaviour Screening (TABS), had a two-factor solution--'adherence' and 'nonadherence', with internal consistencies of 0.80 and 0.59, respectively. All the domains demonstrated comparable reliabilities across two different patient populations. Their temporal stabilities ranged between 0.62 and 0.94. The validity, reliability and utility of the BBQ and the TABS, a sub-scale of the BBQ that screens both intentional and unintentional nonadherence to pharmacological and non-pharmacological disease management, have been established. The BBQ and the TABS have potential applications in screening adherence beliefs, experiences and behaviour in both clinical practice and research.
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.SCHRES.2019.11.059
Abstract: Seeking risk factors and constructing prediction models for transition to psychosis in in iduals at ultra-high risk (UHR) has been an important research area. Our previous work showed that dynamic prediction could perform better than the conventional approach of using only baseline predictors in predicting transition to a psychotic disorder in UHR in iduals. Dynamic prediction is the prediction of the occurrence of an event outcome using longitudinal data and has been made possible using a statistical methodology called joint modelling. The application of joint modelling and dynamic prediction in our previous work was relatively simple. In this paper, we examined extensions to our previous work in three ways: how to use the estimated changes in transition probability at repeated assessments over time to perform prediction, how to model the trajectory of the longitudinal data and how to model the relationship between the longitudinal data and the risk of transition to psychosis. Data from the Pace400 study (n = 398 UHR in iduals), a follow-up study with transition to psychosis as the primary outcome, were used to investigate these extensions. Our results indicated that these extensions can enhance improvement in terms of model fit and sensitivity and specificity values. We have shown that dynamic prediction through joint modelling not only can utilize the richness of longitudinal data but also offers versatility in how prediction can be conducted. Our results have again confirmed that dynamic prediction via joint modelling should be considered as a useful tool for predicting transition to psychosis.
Publisher: American Psychological Association (APA)
Date: 12-2009
DOI: 10.1037/A0017391
Abstract: The aim in the current study was to investigate the effectiveness of an online, self-directed cognitive-behavioral therapy program (MoodGYM) in preventing and reducing the symptoms of anxiety and depression in an adolescent school-based population. A cluster randomized controlled trial was conducted with 30 schools (N = 1,477) from across Australia, with each school randomly allocated to the intervention or wait-list control condition. At postintervention and 6-month follow-up, participants in the intervention condition had significantly lower levels of anxiety than did participants in the wait-list control condition (Cohen's d = 0.15-0.25). The effects of the MoodGYM program on depressive symptoms were less strong, with only male participants in the intervention condition exhibiting significant reductions in depressive symptoms at postintervention and 6-month follow-up (Cohen's d = 0.27-0.43). Although small to moderate, the effects obtained in the current study provide support for the utility of universal prevention programs in schools. The effectiveness of booster sessions should be explored in future research.
Publisher: Wiley
Date: 1997
DOI: 10.1002/(SICI)1099-1166(199701)12:1<93::AID-GPS468>3.0.CO;2-C
Abstract: The PAS is a standardized interview which assesses the changes seen in dementia and depression using a set of scales. There are three scales derived from an interview with the subject (cognitive impairment, depression, stroke) and three from an interview with an informant (cognitive decline, behaviour change, stroke). The aim was to provide data on the psychometric properties and validity of the PAS. The scales were originally developed using data from the first wave of a longitudinal study of the elderly. Reported here are further data on the PAS from the second wave of the same study, carried out 3 1/2 years later. The setting was a community survey carried out in the Australian city of Canberra. Seven hundred and nine elderly persons, with a mean age of 80 years, and 641 informants participated. Besides the PAS, participants were administered several other scales: the Mini-Mental State Examination, the Informant Questionnaire on Cognitive Decline in the Elderly, the National Adult Reading Test and the Goldberg anxiety and depression scales. Diagnoses of dementia and depression were made with the Canberra Interview for the Elderly, from which the PAS is derived. Confirmatory factor analysis replicated the five-factor model which underpins the PAS. The PAS was found to correlate with the other scales having similar content and showed correspondence with diagnoses of dementia and depression derived from the Canberra Interview for the Elderly. Longitudinal data supported the validity of the cognitive decline scale as a measure of change. Overall, the results support the original psychometric and validity research on the PAS.
Publisher: Elsevier BV
Date: 11-2011
Publisher: Springer Science and Business Media LLC
Date: 11-12-2006
DOI: 10.1007/S00127-006-0138-Z
Abstract: Many people with a mental disorder do not access help from mental health services. Internet websites may be a useful tool for disseminating mental health information to those who remain untreated, however little is known about people's perceptions of websites as mental health information sources. The current study examined characteristics that may influence belief in the helpfulness of websites as modes of delivering information about mental health. The study compared belief in the helpfulness websites to two traditional sources (bibliotherapy and health educators). A total of 3,998 Australians aged 18 and above were surveyed. Logistic regression was used to explore the factors associated with rating a website, book and health educator as helpful sources of mental health information for a person described as having either depression, depression with suicidal thoughts, early schizophrenia or chronic schizophrenia. Factors investigated were demographics, exposure to mental illness, beliefs about dealing with mental illness alone, and personal and perceived stigmatising attitudes. Considerably more participants rated bibliotherapy and health educators as helpful in comparison to websites. Predictors of rating a website and book as helpful were identical younger age, belief that it is helpful to deal with mental illness alone and being presented with depression and early schizophrenia vignettes in comparison to chronic schizophrenia. Predictors of rating a health educator as helpful were younger age, less personal stigma and being presented with a depression (without suicidal thoughts) vignette in comparison to chronic schizophrenia. These findings suggest the need for multiple modes of delivering mental health information. While many people feel that information delivered face-to-face is likely to be helpful, websites and other tools that maintain anonymity may be preferred by those who choose to or find themselves dealing with mental illness alone.
Publisher: JMIR Publications Inc.
Date: 26-04-2018
DOI: 10.2196/JMIR.9499
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2008
Publisher: JMIR Publications Inc.
Date: 19-01-2018
DOI: 10.2196/JMIR.9139
Publisher: Cambridge University Press (CUP)
Date: 14-12-2012
DOI: 10.1017/S003329171100287X
Abstract: Although mental health information on the internet is often of poor quality, relatively little is known about the quality of websites, such as Wikipedia, that involve participatory information sharing. The aim of this paper was to explore the quality of user-contributed mental health-related information on Wikipedia and compare this with centrally controlled information sources. Content on 10 mental health-related topics was extracted from 14 frequently accessed websites (including Wikipedia) providing information about depression and schizophrenia, Encyclopaedia Britannica , and a psychiatry textbook. The content was rated by experts according to the following criteria: accuracy, up-to-dateness, breadth of coverage, referencing and readability. Ratings varied significantly between resources according to topic. Across all topics, Wikipedia was the most highly rated in all domains except readability. The quality of information on depression and schizophrenia on Wikipedia is generally as good as, or better than, that provided by centrally controlled websites, Encyclopaedia Britannica and a psychiatry textbook.
Publisher: Springer Science and Business Media LLC
Date: 09-08-2013
DOI: 10.1007/S00127-012-0559-9
Abstract: There is substantial literature suggesting that the mental health benefits of marriage (compared to being single) are greater for those in 'good-quality' relationships in comparison to those in 'poor-quality' relationships. However, little of this research utilises large population-based surveys. Large surveys in psychiatric epidemiology have focused almost exclusively on the association between marital status and mental health. The current study explores some of the reasons for this gap in the literature, and adopts a large, representative community-based s le to investigate whether associations between relationship status and levels of depression and anxiety are moderated by relationship quality. Participants were from Wave 3 of the PATH Survey, a longitudinal community survey assessing the health and well-being of residents of the Canberra region, Australia (n = 3,820). Relationship quality was measured using the 7 item dyadic adjustment scale (DAS-7), and levels of depression and anxiety were measured using the Goldberg scales. Both cross-sectional and prospective analyses showed that associations between relationship status and mental health were moderated by relationship quality for both men and women, such that only good-quality relationships bestowed mental health benefits over remaining single. For women, being in a poor-quality relationship was associated with greater levels of anxiety than being single. Epidemiological studies need to measure relationship quality to qualify the effect of relationship status on mental health.
Publisher: Springer Science and Business Media LLC
Date: 03-11-2011
Publisher: SAGE Publications
Date: 08-10-2014
Abstract: The objective of this study was to identify factors associated with poor dietary intake (less than four servings of fruit and vegetables daily) in a large nationally representative s le of adults with psychotic disorders. The s le comprised 1286 adults aged 18–64 years who took part in the second Australian national survey of psychosis. Dietary information was obtained using a standardised questionnaire all participants provided fasting blood s les. Variables that may be related to diet and nutritional intake were investigated these included demographics, physical health outcomes, physical activity, substance use, symptom severity and financial difficulty. Dietary status was explored by sex, age and body mass index using univariate analyses, while a multivariate analysis was performed to identify predictors of low nutritional intake. Approximately 74% of participants ate less than four servings of fruit and vegetables daily. This was associated with a lower body mass index ( p .05), lower levels of physical activity ( p .05), sedentary behaviour ( p .05), substance use ( p .001), more negative symptoms ( p .05), eating less frequently ( p .001), consuming whole fat milk compared to low fat milk ( p .05), adding salt to food ( p .05) and financial difficulty ( p .05). Male sex and younger age (18–34 years) were also associated with lower fruit and vegetable intake ( p .001). A multivariate regression analysis showed that current smoking ( p .001) and alcohol ( p .01) and cannabis abuse ( p .05) were risk factors for lower fruit and vegetable intake. The findings suggest that poor diet in people with psychosis, as reflected by less than four servings of fruit and vegetables daily, is accompanied by other unhealthy behaviours, which has important implications for the development of effective interventions. Importantly, current smoking is a significant predictor of dietary inadequacy.
Publisher: Elsevier BV
Date: 09-2008
DOI: 10.1016/J.PSYCHRES.2007.08.005
Abstract: The pre-test-post-test design (PPD) is predominant in trials of psychotherapeutic treatments. Missing data due to withdrawals present an even bigger challenge in assessing treatment effectiveness under the PPD than under designs with more observations since dropout implies an absence of information about response to treatment. When confronted with missing data, often it is reasonable to assume that the mechanism underlying missingness is related to observed but not to unobserved outcomes (missing at random, MAR). Previous simulation and theoretical studies have shown that, under MAR, modern techniques such as maximum-likelihood (ML) based methods and multiple imputation (MI) can be used to produce unbiased estimates of treatment effects. In practice, however, ad hoc methods such as last observation carried forward (LOCF) imputation and complete-case (CC) analysis continue to be used. In order to better understand the behaviour of these methods in the PPD, we compare the performance of traditional approaches (LOCF, CC) and theoretically sound techniques (MI, ML), under various MAR mechanisms. We show that the LOCF method is seriously biased and conclude that its use should be abandoned. Complete-case analysis produces unbiased estimates only when the dropout mechanism does not depend on pre-test values even when dropout is related to fixed covariates including treatment group (covariate-dependent: CD). However, CC analysis is generally biased under MAR. The magnitude of the bias is largest when the correlation of post- and pre-test is relatively low.
Publisher: Informa UK Limited
Date: 04-2013
Publisher: Oxford University Press (OUP)
Date: 09-2003
Abstract: A cognitive test and an informant report questionnaire were used together to investigate whether their combined use could improve the accuracy of detecting dementia in a memory clinic, compared with either test used alone. The subjects were 323 patients assessed at a memory clinic. The Mini-Mental State Examination and the short form of the Informant Questionnaire on Cognitive Decline in the Elderly were used. A method of combining the test scores developed by Mackinnon and Mulligan [Am J Psychiatry 1998 155: 1529-35] was used. Dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised criteria. Logistic regression analysis showed that the combination of the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly produced a slightly more accurate prediction of dementia caseness than either test used alone. Using receiver operating characteristic analysis the performance of the combination of the tests according to a weighted sum rule was compared with the performance of either test used alone. This way of combining the tests resulted in a more accurate screening for dementia than when the Informant Questionnaire on Cognitive Decline in the Elderly was used alone. The area under the receiver operating characteristic curve for the Mini-Mental State Examination combined with the Informant Questionnaire on Cognitive Decline in the Elderly was 0.89 compared with 0.82 for the Informant Questionnaire on Cognitive Decline in the Elderly alone (chi-square = 10.63 P = 0.0011). However, there was no improvement in screening performance when the combination of Mini-Mental State Examination and Informant Questionnaire on Cognitive Decline in the Elderly was compared with the Mini-Mental State Examination used alone (area under the receiver operating characteristic curve = 0.89 versus 0.86 chi-square = 3.54 P = 0.060). The combination of cognitive testing and an informant report according to a weighted sum rule in this population did not result in any advantage over the use of the Mini-Mental State Examination alone. The mixed results of this study contrast with those of Mackinnon and Mulligan.
Publisher: Springer Science and Business Media LLC
Date: 18-10-2005
DOI: 10.1007/S00127-005-0991-X
Abstract: The public tends to have different views from professionals about the treatment of mental disorders. It has been proposed that these differences do not simply reflect a lack of knowledge about treatments, but also the operation of pre-existing general belief systems about health interventions. The present study uses factor analysis to examine the structure of public beliefs about interventions for depression and schizophrenia, using case vignettes that vary in severity or stage of illness. In a national survey of 3,998 Australian adults, respondents were presented with one of four vignettes: depression, depression with suicidal thoughts, early schizophrenia and chronic schizophrenia. Respondents were asked about the likely helpfulness or harmfulness of a wide range of interventions for the person in the vignette. Methods suitable for ordinal data were used to explore a range of factor analytic solutions. Once identified, the location of participants on each factor was estimated by calculating a mean score for items loading highly on that factor. These scale means were compared between subgroups of participants. Four factors were found. Three of these-Lifestyle, Psychological and Medical-corresponded to previously found factors. An additional factor named Information-seeking was defined by items that had not been included in earlier research. These items concerned obtaining information or advice from a variety of sources including the internet, books and health educators. Differences on the factors were a function of socio-demographic factors and ability to identify the condition portrayed in the vignette. However, the magnitude of these differences was small. Differences between factors were more pronounced, with mean ratings on the Medical factor falling between harmful and neutral, while mean ratings on other factors lay between neutral and helpful. The public tends to favour psychological and lifestyle interventions over medical ones. These beliefs do not reflect specific knowledge about the effectiveness of particular treatments, but rather general commitments to broad classes of treatment that are applied irrespective of the type of mental disorder. Educational c aigns to improve public knowledge about treatments will need to take account of these pre-existing belief systems.
Publisher: Oxford University Press (OUP)
Date: 23-12-0002
Publisher: Springer Science and Business Media LLC
Date: 15-12-2010
Publisher: Wiley
Date: 31-07-2003
DOI: 10.1034/J.1399-5618.2003.00024.X
Abstract: The purpose of this study was to determine whether there are changes in the density of ionotropic glutamate receptors in the hippoc us of subjects with bipolar disorder. Using in situ radioligand binding with semiquantitative autoradiography, we measured the density of [3H]MK-801, [3H]CGP39653, [3H]AMPA and [3H]kainate binding in hippoc i, obtained postmortem, from eight subjects with type 1 bipolar disorder and 8 age- and sex-matched controls. In subjects with bipolar disorder there were significant decreases in the density of [3H]MK-801 binding in the Cornu Ammonis (CA) 3 (mean +/- SEM 108.8 +/- 12.2 versus 166.2 +/- 18.0 fmol/mg ETE, p < 0.005) as well as the pyramidal (102.8 +/- 9.2 versus 136.6 +/- 11.2 fmol/mg ETE, p < 0.05) and polymorphic (21.73 +/- 6.5 versus 53.26 +/- 11.6 fmol/mg ETE, p < 0.05) layers of the subiculum. In addition, two-way analysis of variance (ANOVA) revealed a decrease in the density of [3H]CGP39653 binding across the hippoc al formation in bipolar subjects, which did not reach significance in any subregion. There were no changes in the densities of [3H]AMPA or [3H]kainate binding in these subjects. [3H]CGP39653 and [3H]MK-801 bind to the glutamate binding site and open ion channel of the n-methyl-d-aspartate (NMDA) receptor, respectively. Therefore, these data suggest that there is a decrease in the number of open ion channels associated with no significant change in the apparent density of NMDA receptors in regions of the hippoc us from subjects with bipolar disorder.
Publisher: Springer Science and Business Media LLC
Date: 08-03-2010
Publisher: S. Karger AG
Date: 2006
DOI: 10.1159/000091829
Abstract: i Background: /i It has been proposed that active engagement with life may protect against cognitive decline. However, existing instruments for measuring life engagement have covered limited domains. i Objective: /i To present a new instrument to measure engagement with life the RIASEC Activities List draws on activities categorised according to interest categories previously developed by Holland: Realistic, Investigative, Artistic, Social, Enterprising and Conventional (RIASEC). i Methods: /i Participants in a longitudinal, community-based survey were drawn from 3 age groups: 2,404 participants aged 20–24 2,530 aged 40–44, and 2,551 aged 60–64 years. They provided information on which of 54 selected activities they had performed in the 6 months prior to their survey interview. Other information obtained from participants included measures of sociodemographic characteristics, personality attributes and mental and physical health. Two measures of cognition were also examined. Analyses were conducted separately for men and women in each of the 3 age groups. i Results: /i Confirmatory factor analyses identified six scales of activity types corresponding to Holland’s six interest categories. The number of activities of any type undertaken in the past 6 months was significantly associated with cognitive measures, better physical health, and better mental health although these findings varied for men and women across the 3 age groups. Further, for both men and women in all age groups, performing activities of any type was associated with having higher extraversion and mastery scores, and lower levels of neuroticism. Associations were also found between performing specific types of activities and cognitive measures. i Conclusions: /i This instrument has the potential to identify more clearly types of activities that may offer cognitive benefits and warrants further testing in longitudinal studies.
Publisher: Elsevier BV
Date: 08-2009
DOI: 10.1016/J.SCHRES.2009.05.008
Abstract: An early response to antipsychotic treatment in patients with psychosis has been associated with a better course and outcome. However, factors that predict treatment response are not well understood. The onset of schizophrenia and related disorders has been associated with increased levels of stress and hyper-activation of the hypothalamic-pituitary-adrenal (HPA) axis. This study examined whether pituitary volume at the onset of psychosis may be a potential predictor of early treatment response in first-episode psychosis (FEP) patients. We investigated the relationship between baseline pituitary volume and symptomatic treatment response over 12 weeks using mixed model analysis in a s le of 42 drug-naïve or early treated FEP patients who participated in a controlled dose-finding study of quetiapine fumarate. Logistic regression was used to examine predictors of treatment response. Pituitary volume was measured from magnetic resonance imaging scans that were obtained upon entry into the trial. Larger pituitary volume was associated with less improvement in overall psychotic symptoms (Brief Psychiatric Rating Scale (BPRS) P=0.031) and positive symptoms (BPRS positive symptom subscale P=0.010). Regardless of gender, patients with a pituitary volume at the 25th percentile (413 mm(3)) were approximately three times more likely to respond to treatment by week 12 than those at the 75th percentile (635 mm(3)) (odds ratio=3.07, CI: 0.90-10.48). The association of baseline pituitary volumes with early treatment response highlights the importance of the HPA axis in emerging psychosis. Potential implications for treatment strategies in early psychosis are discussed.
Publisher: Geological Society of America
Date: 02-04-2021
DOI: 10.1130/GES02247.1
Abstract: Continental sedimentation was widespread across the Central Anatolian Plateau in Miocene–Pliocene time, during the early stages of plateau uplift. Today, however, most sediment produced on the plateau is dispersed by a well-integrated drainage and released into surrounding marine depocenters. Residual long-term (106–107 yr) sediment storage on the plateau is now restricted to a few closed catchments. Lacustrine sedimentation was widespread in the Miocene–Pliocene depocenters. Today, it is also restricted to the residual closed catchments. The present-day association of closed catchments, long-term sediment storage, and lacustrine sedimentation suggests that the Miocene–Pliocene sedimentation also occurred in closed catchments. The termination of sedimentation across the plateau would therefore mark the opening of these closed catchments, their integration, and the formation of the present-day drainage. By combining newly dated volcanic markers with previously dated sedimentary sequences, we show that this drainage integration occurred remarkably rapidly, within 1.5 m.y., at the turn of the Pliocene. The evolution of stream incision documented by these markers and newly obtained 10Be erosion rates allow us to discriminate the respective contributions of three potential processes to drainage integration, namely, the capture of closed catchments by rivers draining the outer slopes of the plateau, the overflow of closed lakes, and the avulsion of closed catchments. Along the southern plateau margin, rivers draining the southern slope of the Central Anatolian Plateau expanded into the plateau interior however, only a small amount of drainage integration was achieved by this process. Instead, avulsion and/or overflow between closed catchments achieved most of the integration, and these top-down processes left a distinctive sedimentary signal in the form of terminal lacustrine limestone sequences. In the absence of substantial regional climate wetting during the early Pliocene, we propose that two major tectonic events triggered drainage integration, separately or in tandem: the uplift of the Central Anatolian Plateau and the tectonic completion of the Anatolian microplate. Higher surface uplift of the eastern Central Anatolian Plateau relative to the western Central Anatolian Plateau promoted more positive water balances in the eastern catchments, higher water discharge, and larger sediment fluxes. Overflow/avulsion in some of the eastern catchments triggered a chain of avulsions and/or overflows, sparking sweeping integration across the plateau. Around 5 Ma, the inception of the full escape of the Anatolian microplate led to the disruption of the plateau surface by normal and strike-slip faults. Fault scarps partitioned large catchments fed by widely averaged sediment and water influxes into smaller catchments with more contrasted water balances and sediment fluxes. The evolution of the Central Anatolian Plateau shows that top-down processes of integration can outcompete erosion of outer plateau slopes to reintegrate plateau interior drainages, and this is overlooked in current models, in which drainage evolution is dominated by bottom-up integration. Top-down integration has the advantage that it can be driven by more subtle changes in climatic and tectonic boundary conditions than bottom-up integration.
Publisher: American Association on Intellectual and Developmental Disabilities (AAIDD)
Date: 09-2009
DOI: 10.1352/1944-7558-114.5.307
Abstract: In idual change and variation in emotional/behavioral disturbance in children and adolescents with intellectual disability has received little empirical investigation. Based on 11 years of longitudinal data from the Australian Child to Adult Development Study, we report associations among in idual differences in level, rate of change, and occasion-specific variation across subscales of the Developmental Behavior Checklist (DBC) with 506 participants who had intellectual disability and were ages 5 to 19 years at study entry. Correlations among the five DBC subscales ranged from .43 to .66 for level, .43 to .88 for rate of change, and .31 to .61 for occasion-specific variation, with the highest correlations observed consistently between disruptive, self-absorbed, and communication disturbance behaviors. These interdependencies among dimensions of emotional/behavioral disturbance provide insight into the developmental dynamics of psychopathology from childhood through young adulthood.
Publisher: JMIR Publications Inc.
Date: 25-01-2023
Abstract: here is increasing evidence that depression can be prevented however, universal approaches have had limited success. Appropriate targeting of interventions to at-risk populations has been shown to have potential, but how to selectively determine at-risk in iduals remains unclear. Workplace stress is a risk factor for depression and a target for intervention, but few interventions exist to prevent depression among workers at risk due to heightened stress. his trial aimed to evaluate the efficacy of a smartphone-based intervention in reducing the onset of depression and improving related outcomes in workers experiencing at least moderate levels of stress. randomized controlled trial was conducted with participants who were currently employed and reported no clinically significant depression and at least moderate stress. The intervention group (n=1053) were assigned i Anchored /i , a 30-day self-directed smartphone app-based cognitive behavioral- and mindfulness-based intervention. The attention-control group (n=1031) were assigned a psychoeducation website. Assessment was performed via web-based self-report questionnaires at baseline and at 1-, 3-, and 6-month postbaseline time points. The primary outcome was new depression caseness aggregated over the follow-up period. The secondary outcomes included depressive and anxiety symptoms, stress, well-being, resilience, work performance, work-related burnout, and quality of life. Analyses were conducted within an intention-to-treat framework using mixed modeling. here was no significant between-group difference in new depression caseness ( i z /i score=0.69 i P /i =.49) however, those in the i Anchored /i arm had significantly greater depressive symptom reduction at 1 month (Cohen i d /i =0.02 i P /i =.049) and 6 months (Cohen i d /i =0.08 i P /i =.03). i Anchored /i participants also showed significantly greater reduction in anxiety symptoms at 1 month (Cohen i d /i =0.07 i P /i =.04) and increased work performance at 1 month (Cohen i d /i =0.07 i P /i =.008) and 6 months (Cohen i d /i =0.13 i P /i =.01), compared with controls. Notably, for i Anchored /i participants completing at least two-thirds of the intervention, there was a significantly lower rate of depression onset (1.1%, 95% CI 0.0%-3.7%) compared with controls (9.0%, 95% CI 6.8%-12.3%) at 1 month ( i z /i score=4.50 i P /i & .001). Significant small to medium effect sizes for most secondary outcomes were seen in the highly engaged i Anchored /i users compared with controls, with effects maintained at the 6-month follow-up for depressive symptoms, well-being, stress, and quality of life. lt i Anchored /i was associated with a small comparative reduction in depressive symptoms compared with controls, although selective prevention of case-level depression was not observed in the intention-to-treat analysis. When users adequately engaged with the app, significant findings pertaining to depression prevention, overall symptom reduction, and functional improvement were found, compared with controls. There is a need for a greater focus on engagement techniques in future research. ustralian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000178943 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378592
Publisher: Elsevier BV
Date: 07-2007
DOI: 10.1016/J.SCHRES.2007.02.022
Abstract: mRNA for 14-3-3zeta, an abundant signalling protein in human CNS, is reported as decreased or unchanged in cortex from subjects with schizophrenia. Addressing this dichotomy, using Western blot analyses, we measured levels of 14-3-3zeta proteins in cortex and caudate nucleus from subjects with schizophrenia, bipolar disorder, age/sex matched controls and in analogous CNS regions from rats treated with psychotropic drugs. Anti-14-3-3zeta antibody bound to three proteins (molecular weights: 27, 54 and 70 kDa), in all CNS tissue. Levels of all proteins did not vary with diagnoses (27 kDa: F(2,42.0)=0.35, p=0.71 54 kDa: F(2,42.1)=0.62, p=0.54 70 kDa: F(2,41.0)=2.43, p=0.10). By contrast, independent of diagnoses, there were significant increases in the levels of the 27 kDa protein (+32% p<0.001) and 54 kDa protein (51% p=0.001) in the caudate nucleus from males compared to females. In addition, there was a trend (-25% p=0.06) to decreased levels of the 70 kDa protein in BA 9 in males compared to females. Treating with haloperidol, olanzapine, lithium or a combination thereof did not alter 14-3-3zeta levels in rat cortex or striatum. Therefore, this study suggests that 14-3-3zeta proteins are not altered in the cortex or caudate nucleus in schizophrenia, bipolar disorder or in analogous regions in psychotropic drug treated rats. By contrast, our study suggests that levels of 14-3-3zeta in some regions of the human CNS may be modulated by some sex-specific mechanism.
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.JAGP.2014.01.004
Abstract: To evaluate the temporal association between depression symptoms and cognitive function in older adults over a 4-year period. Using a longitudinal, cross-lagged, population-based design, we studied depression symptoms and cognitive domains (including processing speed, verbal fluency, face and word recognition, episodic memory, and simple and choice reaction time) in 896 community-dwelling adults aged 70-97 years. Cross-lagged structural equation models suggested that initial depression symptoms affected subsequent processing speed and simple and choice reaction time but that cognition did not predict depression symptoms over time. The associations between depression and cognitive variables were attenuated when the models were adjusted for sensory impairment, physical health, and locus of control. The findings suggest that, causally, depression precedes cognitive impairment in this age group and that the association is related to physical health and perceptions of a lack of control.
Publisher: Springer Science and Business Media LLC
Date: 21-03-2010
Publisher: American Medical Association (AMA)
Date: 25-10-2006
Publisher: JMIR Publications Inc.
Date: 18-11-2020
Abstract: n Australia, secondary school educators are well positioned to recognize mental illness among students and provide support. However, many report that they lack the knowledge and confidence to do so, and few mental health training programs available for educators are evidence based. To address this gap, the Black Dog Institute (BDI) developed a web-based training program (Building Educators’ Skills in Adolescent Mental Health [BEAM]) that aims to improve mental health knowledge, confidence, and helping behaviors among secondary school educators in leadership positions. A pilot study of the training program found it to be positively associated with increased confidence and helping behaviors among educators and reduced personal psychological distress. An adequately powered randomized controlled trial (RCT) is needed. he primary objective of this cluster RCT is to evaluate the effectiveness of the BEAM program for improving educators’ confidence in managing student mental health. The trial will also evaluate the effect of the BEAM program in increasing educators’ frequency of providing help to students and improving their mental health knowledge and reducing educators’ psychological distress and stigma toward students with mental health issues. he target s le size is 234 educators from 47 secondary schools across New South Wales, Australia. Four waves of recruitment and enrollment into the trial are planned. Schools will participate in one wave only and will be randomized to the intervention or waitlist control conditions. Participants from the same school will be assigned to the same condition. Assessments will be conducted at baseline, posttest (10 weeks after baseline), and follow-up (22 weeks after baseline) using the BDI eHealth research platform. Intervention participants will receive access to the BEAM program for 10 weeks upon completion of baseline, and the control condition will receive access for 10 weeks upon completion of the follow-up assessment. ecruitment for this trial began on July 21, 2020, with the first baseline assessments occurring on August 17, 2020. To date, 295 participants from 71 schools have completed baseline. Due to the unexpected success of recruitment in the first 3 waves, the final fourth wave has been abandoned. Intervention participants are currently receiving the program, with follow-up due for completion in March 2021. his is one of the first RCTs to examine the effectiveness of a web-based adolescent mental health training program for Australian secondary school educators in leadership positions. If found to be effective, this training program will offer a sustainable and scalable delivery method for upskilling educators in caring for students’ mental health. ustralian New Zealand Clinical Trials Registry ACTRN12620000876998 tudies/crs-14669208 ERR1-10.2196/25870
Publisher: Informa UK Limited
Date: 20-10-2014
Publisher: JMIR Publications Inc.
Date: 03-04-2023
DOI: 10.2196/47277
Publisher: Elsevier BV
Date: 11-2002
DOI: 10.1097/00004583-200211000-00019
Abstract: To determine whether a subset of items from the Developmental Behavior Checklist (DBC) could be selected to construct a reliable autism screening tool. A 29-item scale-the Developmental Behavior Checklist-Autism Screening Algorithm (DBC-ASA)-was developed by using items from the DBC and evaluated in a s le comprising 180 children who met criteria for autism and 180 controls matched for age, sex, and IQ range. This study found that the DBC-ASA has good validity in discriminating young people (4-18 years) with autism and IQ ranging from normal to severe intellectual disability from others using a cutoff score of 17. The DBC-ASA is an effective autism screening questionnaire for at-risk young people, including those with intellectual disability.
Publisher: American Medical Association (AMA)
Date: 02-2010
DOI: 10.1001/ARCHGENPSYCHIATRY.2009.192
Abstract: The use of antipsychotic medication for the prevention of psychotic disorders is controversial. Long-chain omega-3 (omega-3) polyunsaturated fatty acids (PUFAs) may be beneficial in a range of psychiatric conditions, including schizophrenia. Given that omega-3 PUFAs are generally beneficial to health and without clinically relevant adverse effects, their preventive use in psychosis merits investigation. To determine whether omega-3 PUFAs reduce the rate of progression to first-episode psychotic disorder in adolescents and young adults aged 13 to 25 years with subthreshold psychosis. Randomized, double-blind, placebo-controlled trial conducted between 2004 and 2007. Psychosis detection unit of a large public hospital in Vienna, Austria. Eighty-one in iduals at ultra-high risk of psychotic disorder. A 12-week intervention period of 1.2-g/d omega-3 PUFA or placebo was followed by a 40-week monitoring period the total study period was 12 months. The primary outcome measure was transition to psychotic disorder. Secondary outcomes included symptomatic and functional changes. The ratio of omega-6 to omega-3 fatty acids in erythrocytes was used to index pretreatment vs posttreatment fatty acid composition. Seventy-six of 81 participants (93.8%) completed the intervention. By study's end (12 months), 2 of 41 in iduals (4.9%) in the omega-3 group and 11 of 40 (27.5%) in the placebo group had transitioned to psychotic disorder (P = .007). The difference between the groups in the cumulative risk of progression to full-threshold psychosis was 22.6% (95% confidence interval, 4.8-40.4). omega-3 Polyunsaturated fatty acids also significantly reduced positive symptoms (P = .01), negative symptoms (P = .02), and general symptoms (P = .01) and improved functioning (P = .002) compared with placebo. The incidence of adverse effects did not differ between the treatment groups. Long-chain omega-3 PUFAs reduce the risk of progression to psychotic disorder and may offer a safe and efficacious strategy for indicated prevention in young people with subthreshold psychotic states. Trial Registration clinicaltrials.gov Identifier: NCT00396643.
Publisher: Cambridge University Press (CUP)
Date: 29-08-2006
DOI: 10.1017/S0033291706008695
Abstract: Background. Effective internet-based programs for depression usually incorporate a component that provides telephone or email contact. Open access websites, without such contact, show high rates of attrition and poorer outcomes. The present study was designed as an exploratory investigation of the parameters that influence the effectiveness and retention of users on open access websites. We investigated whether brief cognitive behaviour therapy (CBT) was as effective as an extended version, whether add-on components of behaviour therapy or stress management contributed to positive outcomes, and whether longer programs were associated with greater attrition. Method. An online randomized controlled trial (RCT) was conducted between 13 January 2005 and 26 May 2005 (19 weeks). A total of 2794 registrants (1846 women and 948 men median age category 35–44 years) with elevated scores on the Goldberg Depression Scale of 5·96 ( S . D .=2·09) elected online to be randomized to one of six versions of a CBT website. The versions were compiled consisting of various components of brief CBT, extended CBT, behaviour strategies, stress management and problem solving. Results. A total of 20·4% of participants completed the assigned intervention. The interaction of measurement occasion and treatment version was significant [ F (13,131)=2·20, p =0·01]. A single module of brief introductory CBT was not effective in reducing depression symptoms. However, extended CBT with or without the addition of behaviour strategies resulted in the reduction of depression. Conclusions. Brief CBT-based interventions are not as effective as extended interventions. However, longer programs are associated with higher rates of dropout.
Publisher: Cambridge University Press (CUP)
Date: 02-01-2014
DOI: 10.1017/S0033291713002973
Abstract: There are insufficient data from nationwide surveys on the prevalence of specific psychotic disorders and associated co-morbidities. The 2010 Australian national psychosis survey used a two-phase design to draw a representative s le of adults aged 18–64 years with psychotic disorders in contact with public treatment services from an estimated resident population of 1 464 923 adults. This paper is based on data from 1642 participants with an International Classification of Diseases (ICD)-10 psychotic disorder. Its aim is to present estimates of treated prevalence and lifetime morbid risk of psychosis, and to describe the cognitive, physical health and substance use profiles of participants. The 1-month treated prevalence of psychotic disorders was 3.10 cases per 1000 population aged 18–64 years, not accounting for people solely accessing primary care services lifetime morbid risk was 3.45 per 1000. Mean premorbid intelligence quotient was approximately 0.5 s .d. s below the population mean current cognitive ability (measured with a digit symbol coding task) was 1.6 s .d .s below the population mean. For both cognitive tests, higher scores were significantly associated with better independent functioning. The prevalence of the metabolic syndrome was high, affecting 60.8% of participants, and pervasive across diagnostic groups. Of the participants, two-thirds (65.9%) were current smokers, 47.4% were obese and 32.4% were sedentary. Of the participants, half (49.8%) had a lifetime history of alcohol abuse/dependence and 50.8% lifetime cannabis abuse/dependence. Our findings highlight the need for comprehensive, integrative models of recovery to maximize the potential for good health and quality of life for people with psychotic illness.
Publisher: BMJ
Date: 12-08-2013
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1016/J.JPSYCHIRES.2012.08.023
Abstract: Although there is evidence of associations between anxiety, depression and cognitive function in old age, there is little work investigating relations between those variables over an extended period of time. Therefore, we used data from the Canberra Longitudinal Study to investigate 12-year cognitive change over four measurement points in relation to anxiety and depression symptoms. Latent growth models on over 836 community-dwelling persons aged 70 years and over, recruited from the electoral roll suggested that higher depression symptom scores were associated with poorer initial performance in processing speed, verbal fluency and episodic memory while higher anxiety symptom scores were associated with verbal fluency. We found no evidence that mental health variables affected change in cognition over time. Importantly, when possible mild cognitive impairment or dementia cases were removed from the models, associations between the cognitive variables and depression symptoms disappeared while those for anxiety symptoms strengthened. The findings are consistent with the possibility that depression-related cognitive deficits represent a prodrome or risk factor for dementia while associations between anxiety and cognition may be more characteristic of normal aging.
Publisher: Springer Science and Business Media LLC
Date: 22-11-2011
Publisher: Elsevier BV
Date: 06-2014
DOI: 10.1016/J.SOCSCIMED.2014.04.004
Abstract: Divorce has been identified as a risk factor for suicide. However, little research has been conducted on the time trajectory of the influence of relationship separation on suicidal outcomes. This study aimed to assess the effects over time of relationship breakdown and separation on suicidality. Data were drawn from 6616 Australian adults participating in the PATH through Life Project, a population-based longitudinal study. Suicidal ideation was reported by 406 participants (6.1%), and 99 (1.5%) reported a suicide plan or attempt in the past year. The effects of separation on suicidality were strongest soon after separation, with a nearly three-fold increase in ideation (adjusted OR = 2.73, p < 0.001) and an eight-fold increase in plans/attempts (adjusted OR = 7.75, p < 0.001) in the two years following separation, gradually diminishing subsequently. The period up to four years before a separation was also found to be a time of increased risk for suicidal thoughts and behaviours, while marriage was protective. Separation is a strong risk factor for suicidality and mental health services should target recently separated in iduals.
Publisher: JMIR Publications Inc.
Date: 29-08-2019
DOI: 10.2196/15915
Publisher: BMJ
Date: 12-2004
Publisher: Elsevier BV
Date: 11-1995
DOI: 10.1016/S0140-6736(95)92405-1
Abstract: From clinically based series it has been proposed that, in homozygotes for the apolipoprotein E epsilon 4 (apoE epsilon 4) allele, Alzheimer's disease is almost inevitable by the age of 80. A population s le of persons aged 70 years and over was interviewed in 1990-91 to ascertain the presence of dementia or cognitive impairment. The s le was reinterviewed in 1994, when the apoE genotype was also determined. Prevalence data for the 638 persons who completed the second examination revealed a linear association between having an apoE epsilon 4 allele and both dementia and cognitive impairment (for heterozygotes, odds ratio for dementia 1.89, 95% confidence interval 1.04-3.44 and for homozygotes OR 3.58, 95% CI 1.08-11.82 both adjusted for age). However, even in subjects homozygous for epsilon 4 the estimated prevalence of dementia by age 90 was only about 50%. Persons with one or two epsilon 4 alleles were more likely to have a family history of dementia than those with none. This study confirms in a population s le that the epsilon 4 allele is a risk factor for dementia, but refutes the suggestion that homozygosity for the epsilon 4 allele is sufficient for the development of Alzheimer's disease: persons with either one or two epsilon 4 alleles may reach late old age without cognitive impairment.
Publisher: Wiley
Date: 03-2008
Publisher: JMIR Publications Inc.
Date: 06-04-2019
Abstract: he proliferation of mental health apps purporting to target and improve psychological wellbeing is ever-growing and also concerning: Few apps have been rigorously evaluated, and, indeed, the safety of the vast majority of them has not been determined. Over 10,000 self-help apps exist but most are not used much after being downloaded. Gathering and analyzing usage data and the acceptability of apps are critical to inform consumers, researchers, and app developers. his paper presents pilot usage and acceptability data from the iBobbly suicide prevention app, an app distributed through a randomized controlled trial. boriginal and Torres Strait Islander participants from the Kimberley region of Western Australia completed a survey measuring their technology use in general (n=13), and data on their experiences with and views of the iBobbly app were also collected in semistructured interviews (n=13) and thematically analyzed. Finally, engagement with the app, such as the number of sessions completed and time spent on various acceptance-based therapeutic activities, was analyzed (n=18). Both groups were participants in the iBobbly app pilot randomized controlled trial (n=61) completed in 2015. egression analysis indicated that app use improved psychological outcomes, although only minimally, and effects were not significant. However, results of the thematic analysis indicated that the iBobbly app was deemed effective, acceptable, and culturally appropriate by those interviewed. here is a scarcity of randomized controlled trials and eHealth interventions in Indigenous communities, while extremely high rates of psychological distress and suicide persist. In this environment, studies that can add evidence from mixed-methods approaches are important. While the regression analysis in this study did not indicate a significant effect of app use on psychological wellbeing, this was predictable considering the small s le size (n=18) and typically brief app use. The results on engagement with the iBobbly app were however positive. This study showed that Indigenous youth are early and frequent users of technology in general, and they regarded the iBobbly app to be culturally safe and of therapeutic value. Qualitative analyses demonstrated that iBobbly app use was associated with self-reported improvements in psychological wellbeing, mental health literacy, and reductions in shame. Importantly, participants reported that they would recommend other similar apps if available to their peers.
Publisher: Wiley
Date: 18-02-2014
DOI: 10.1002/MPR.1433
Publisher: American Psychological Association (APA)
Date: 2002
Publisher: Springer Science and Business Media LLC
Date: 05-04-2006
Abstract: To date, there has been very little work investigating behaviour changes induced by interventions that are designed to increase help seeking. The present paper examines the effects of two Internet depression websites on help seeking. 414 in iduals with elevated scores on a depression assessment scale were randomly allocated to a depression information website, a cognitive-behavioural skills training website (CBT) or an attention control condition. Reports of help seeking for specific treatments, from specific sources and for categories of treatments were assessed. Relative to the control, the depression information site was associated with decreases in seeking support from friends and family, the use of music and of everyday treatments and no increase in seeking evidence based interventions. The CBT site was associated with the report of help seeking for CBT, massage and exercise. Methods to encourage the use of evidence-based treatments need further research to determine whether the assistance sought is evidence based and whether there are unintended effects.
Publisher: SAGE Publications
Date: 12-11-2013
Abstract: To assess differences in costs of psychosis between the first and second Australian national surveys of psychosis and examine them in light of policy developments. Cost differences due to changes in resource use and/or real price rises were assessed by minimizing differences in recruitment and costing methodologies between the two surveys. For each survey, average annual societal costs of persons recruited through public specialized mental health services in the census month were assessed through prevalence-based, bottom-up cost-of-illness analyses. The first survey costing methodology was employed as the reference approach. Unit costs were specific to each time period (2000, 2010) and expressed in 2010 Australian dollars. There was minimal change in the average annual costs of psychosis between the surveys, although newly included resources in the second survey’s analysis cost AUD$3183 per person. Among resources common to each analysis were significant increases in the average annual cost per person for ambulatory care of AUD$7380, non-government services AUD$2488 and pharmaceuticals AUD$1892, and an upward trend in supported accommodation costs. These increases were offset by over a halving of mental health inpatient costs of AUD$11,790 per person and a 84.6% (AUD$604) decrease in crisis accommodation costs. Productivity losses, the greatest component cost, changed minimally, reflecting the magnitude and constancy of reduced employment levels of in iduals with psychosis across the surveys. Between 2000 and 2010 there was little change in total average annual costs of psychosis for in iduals receiving treatment at public specialized mental health services. However, there was a significant redistribution of costs within and away from the health sector in line with government initiatives arising from the Second and Third National Mental Health Plans. Non-health sector costs are now a critical component of cost-of-illness analyses of mental illnesses reflecting, at least in part, a whole-of-government approach to care.
Publisher: SAGE Publications
Date: 17-09-2014
Abstract: To determine the effect of parent education on adaptive behaviour, autism symptoms and cognitive/language skills of young children with autistic disorder. A randomised group comparison design involving a parent education and counselling intervention and a parent education and behaviour management intervention to control for parent skills training and a control s le. Two rural and two metropolitan regions were randomly allocated to intervention groups ( n = 70) or control ( n = 35). Parents from autism assessment services in the intervention regions were randomly allocated to parent education and behaviour management ( n = 35) or parent education and counselling ( n = 35). Parent education and behaviour management resulted in significant improvement in adaptive behaviour and autism symptoms at 6 months follow-up for children with greater delays in adaptive behaviour. Parent education and behaviour management was superior to parent education and counselling. We conclude that a 20-week parent education programme including skills training for parents of young children with autistic disorder provides significant improvements in child adaptive behaviour and symptoms of autism for low-functioning children.
Publisher: Oxford University Press
Date: 08-04-2004
Publisher: Springer Science and Business Media LLC
Date: 14-07-2008
Publisher: Informa UK Limited
Date: 09-2003
No related organisations have been discovered for Andrew Mackinnon.
Start Date: 07-2006
End Date: 06-2009
Amount: $267,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 08-2010
End Date: 12-2013
Amount: $157,014.00
Funder: Australian Research Council
View Funded Activity