ORCID Profile
0000-0002-0744-0688
Current Organisation
Dhofar University College of Engineering
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Sociological Methodology and Research Methods | Sociology | Applied Sociology, Program Evaluation and Social Impact Assessment | Causes and Prevention of Crime
Expanding Knowledge through Studies of Human Society | Families and Family Services | Crime Prevention |
Publisher: Elsevier BV
Date: 05-2017
DOI: 10.1016/J.PSYCHRES.2017.02.029
Abstract: Disruptive behavior disorders (DBDs), inclusive of oppositional defiant disorder (ODD) and conduct disorder (CD), are associated with outcomes likely to increase risk of mortality. Using Danish National Registers, a total of 1.92 million in iduals including 9495 in iduals with DBDs diagnosed by specialist services were followed from their first birthday to 2013. Those with and without DBDs were compared using mortality rate ratios (MRRs) estimated using Poisson regression and adjusted for calendar period, age, sex, family history of psychiatric disorders, maternal age at time of birth, paternal age at time of birth, parental education status, and parental employment status. Over the course of follow up, which totalled 24.9 million person-years, 5580 cohort members died including 78 in iduals with DBDs. The mortality rate per 10,000 person-years was 9.66 for in iduals with DBDs compared to 2.22 for those with no diagnosis. This corresponded to a fully adjusted MRR of 2.57 (95% confidence interval 2.04-3.20). Comorbid substance use disorder and attention-deficit/hyperactivity disorder resulted in the highest MRR across all categories. These findings demonstrate the excess mortality associated with DBDs.
Publisher: Cambridge University Press (CUP)
Date: 2013
DOI: 10.1016/J.EURPSY.2011.09.004
Abstract: Delusional-like experiences (DLE) have been associated with low income, suggesting that more broadly defined socio-economic disadvantage may be associated with these experiences. We had the opportunity to explore the association between DLE and both in idual- and area-level measures of socio-economic disadvantage. Subjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007. The Composite International Diagnostic Interview was used to identify DLE, common psychiatric disorders, and physical disorders. In idual-level and area-level socio-economic disadvantage measures were available based on variables including income, educational attainment, employment status, and housing. We examined the relationship between the variables of interest using logistic regression, adjusting for potential confounding factors. Of the 8773 subjects, 8.4% ( n = 776) positively endorsed one or more DLE. DLE screen items were more likely to be endorsed by those who were (a) younger, (b) never married, or widowed, separated or orced status, (c) migrants, or (d) living in rented houses. There were significant associations between socio-economic disadvantage and increased DLE endorsement, and this was found for both in idual-level and area-level measures of socio-economic disadvantage. In general, the associations remained significant after adjusting for a range of potential confounding factors and in planned sensitivity analyses. DLE are associated with socio-economic disadvantage in the general population. We speculate that the link between socio-economic disadvantage and DLE may be mediated by psychosocial stress and general psychological distress.
Publisher: Wiley
Date: 12-07-2022
DOI: 10.1111/IMJ.15824
Abstract: Childhood maltreatment (CM) is associated with both dietary fat intake and obesity in later life. There is less information on associations with metabolic risk factors and specific types of CM such as physical, sexual and emotional abuse, as well as neglect. To assess the association between five types of self‐reported CM and a range of obesity and metabolic indicators in a subs le of a birth cohort. This was a study of 1689 adults born in a major metropolitan maternity hospital in Australia and followed up 30 years later. Body mass index, bioimpedance and fasting lipid levels/insulin resistance were measured. Details on self‐reported CM were collected using the Child Trauma Questionnaire. We adjusted for birth weight, parental income and relationship at participants' birth, as well as maternal age and alcohol or tobacco use. We also adjusted for participants' smoking, depression, educational level, marital and employment status at follow up. One‐fifth reported maltreatment ( n = 362), most commonly emotional neglect ( n = 175), followed by emotional abuse ( n = 128), physical neglect ( n = 123), sexual ( n = 121) and physical abuse ( n = 116). On adjusted analyses, there were significant associations for CM, particularly neglect or emotional abuse, and one or more of the following outcomes: obesity, the total cholesterol/high‐density lipoprotein cholesterol (TC/HDL‐C) ratio and HDL levels. Results for other outcomes were more equivocal. Of child maltreatment types, emotional abuse and neglect show the strongest associations with obesity and several cardiometabolic risk factors, therefore highlighting the public health importance of early intervention to reduce childhood adversity.
Publisher: Oxford University Press (OUP)
Date: 30-01-2017
Publisher: Elsevier BV
Date: 11-2018
Publisher: BMJ
Date: 05-2021
DOI: 10.1136/BMJOPEN-2020-047074
Abstract: Child maltreatment (physical abuse, sexual abuse, emotional abuse, neglect and exposure to domestic violence) is widely understood to be associated with multiple mental health disorders, physical health problems and health risk behaviours throughout life. However, Australia lacks fundamental evidence about the prevalence and characteristics of child maltreatment, its associations with mental disorders and physical health, and the associated burden of disease. These evidence gaps impede the development of public health strategies to better prevent and respond to child maltreatment. The aims of this research are to generate the first comprehensive population-based national data on the prevalence of child maltreatment in Australia, identify associations with mental disorders and physical health conditions and other adverse consequences, estimate attributable burden of disease and indicate targeted areas for future optimal public health prevention strategies. The Australian Child Maltreatment Study (ACMS) is a nationwide, cross-sectional study of Australia’s population aged 16 years and over. A survey of approximately 10 000 Australians will capture retrospective self-reported data on the experience in childhood of all five types of maltreatment (physical abuse, sexual abuse, emotional abuse, neglect and exposure to domestic violence). A customised, multimodule survey instrument has been designed to obtain information including: the prevalence and characteristics of these experiences diagnostic screening of common mental health disorders physical health health risk behaviours and health service utilisation. The survey will be administered in March–November 2021 to a random s le of the nationwide population, recruited through mobile phone numbers. Participants will be surveyed using computer-assisted telephone interviews, conducted by trained interviewers from the Social Research Centre, an agency with extensive experience in studies of health and adversity. Rigorous protocols protect the safety of both participants and interviewers, and comply with all ethical and legal requirements. Analysis will include descriptive statistics reporting the prevalence of in idual and multitype child maltreatment, multiple logistic and linear regression analyses to determine associations with mental disorders and physical health problems. We will calculate the population attributable fractions of these putative outcomes to enable an estimation of the disease burden attributable to child maltreatment. The study has been approved by the Queensland University of Technology Human Research Ethics Committee (#1900000477, 16 August 2019). Results will be published to the scientific community in peer-reviewed journals, scientific meetings and through targeted networks. Findings and recommendations will be shared with government policymakers and community and organisational stakeholders through erse engagement activities, a dedicated Advisory Board and a systematic knowledge translation strategy. Results will be communicated to the public through an organised media strategy and the ACMS website.
Publisher: Public Library of Science (PLoS)
Date: 23-01-2018
Publisher: SAGE Publications
Date: 06-2019
Publisher: SAGE Publications
Date: 02-2019
Publisher: Elsevier BV
Date: 03-2020
Publisher: Royal College of Psychiatrists
Date: 03-2018
DOI: 10.1192/BJO.2018.8
Abstract: Antineuronal antibodies are associated with psychosis, although their clinical significance in first episode of psychosis (FEP) is undetermined. To examine all patients admitted for treatment of FEP for antineuronal antibodies and describe clinical presentations and treatment outcomes in those who were antibody positive. In iduals admitted for FEP to six mental health units in Queensland, Australia, were prospectively tested for serum antineuronal antibodies. Antibody-positive patients were referred for neurological and immunological assessment and therapy. Of 113 consenting participants, six had antineuronal antibodies (anti- N -methyl-D-aspartate receptor antibodies [ n = 4], voltage-gated potassium channel antibodies [ n = 1] and antibodies against uncharacterised antigen [ n = 1]). Five received immunotherapy, which prompted resolution of psychosis in four. A small subgroup of patients admitted to hospital with FEP have antineuronal antibodies detectable in serum and are responsive to immunotherapy. Early diagnosis and treatment is critical to optimise recovery. None.
Publisher: Elsevier BV
Date: 02-2022
Publisher: Wiley
Date: 08-06-2020
DOI: 10.1111/BJC.12252
Publisher: Elsevier BV
Date: 05-2023
Publisher: Elsevier BV
Date: 10-2023
Publisher: Springer Science and Business Media LLC
Date: 23-08-2019
DOI: 10.1007/S00127-019-01760-4
Abstract: We investigated if (a) people with lower physical activity have an increased risk of subsequent mental disorders (compared to those with higher physical activity) and (b) people with mental disorders have reduced subsequent physical activity (compared to those without mental disorders). A systematic review of population-based longitudinal studies examining physical activity and mental disorders was conducted. Mental disorders were defined by International Classification of Diseases or Diagnostic and Statistical Manual of Mental Disorders. The results were described in a narrative summary. Twenty-two studies were included. The majority (19) examined mood disorders and physical activity. Only two studies found consistent association between lower physical activity and a reduced risk of subsequent mental disorders. One study found the bidirectional association between physical activity and major depression. Twelve studies found mixed results (i.e., no consistency in direction and significance of the findings), and seven studies found no association between the variables of interest. There is a lack of consistent evidence linking physical activity to be either a risk factor or consequence of mental disorders. CRD42017071737.
Publisher: Elsevier BV
Date: 12-2021
Publisher: SAGE Publications
Date: 28-07-2020
Abstract: This paper provides the rationale for the development of sub-specialty training in youth psychiatry. Training needs for youth psychiatry are discussed and the opportunities provided by sub-specialisation in youth psychiatry are presented. The majority of mental disorders have their onset prior to 25 years. There has been substantial recent growth in services to meet the clinical needs of young people. The development of these services has exposed gaps in current training for psychiatrists, which varies considerably between child and adolescent, and adult psychiatry. Competencies acquired by psychiatrists in youth mental health are non-standardised, which may hinder optimal care. Sub-specialty training in youth psychiatry is needed to meet workforce demands. The development of a certificate in youth psychiatry, by the RANZCP Section for Youth Mental Health, is underway. This will complement existing training and provide trainees and psychiatrists the opportunity to develop specialist skills in the provision of mental health care for young people negotiating the transition between adolescence and adulthood.
Publisher: Wiley
Date: 12-05-2015
DOI: 10.1111/EIP.12245
Abstract: Psychotic-like experiences (PLEs) are common in young people and are associated with both distress and adverse outcomes. The Community Assessment of Psychic Experiences-Positive Scale (CAPE-P) provides a 20-item measure of lifetime PLEs. A 15-item revision of this scale was recently published (CAPE-P15). Although the CAPE-P has been used to assess PLEs in the last 12 months, there is no version of the CAPE for assessing more recent PLEs (e.g. 3 months). This study aimed to determine the reliability and validity of the current CAPE-P15 and assess its relationship with current distress. A cross-sectional online survey of 489 university students (17-25 years) assessed lifetime and current substance use, current distress, and lifetime and 3-month PLEs on the CAPE-P15. Confirmatory factor analysis indicated that the current CAPE-P15 retained the same three-factor structure as the lifetime version consisting of persecutory ideation, bizarre experiences and perceptual abnormalities. The total score of the current version was lower than the lifetime version, but the two were strongly correlated (r = .64). The current version was highly predictive of generalized distress (r = .52) and indices that combined symptom frequency with associated distress did not confer greater predictive power than frequency alone. This study provided preliminary data that the current CAPE-P15 provides a valid and reliable measure of current PLEs. The current CAPE-P15 is likely to have substantial practical utility if it is later shown to be sensitive to change, especially in prevention and early intervention for mental disorders in young people.
Publisher: Elsevier BV
Date: 11-2018
DOI: 10.1016/J.SCHRES.2018.05.013
Abstract: Cross-sectional studies have suggested inhalant use is associated with psychosis. This association was examined in a longitudinal study accounting for other substance use and potential confounders. We used a prospective s le (N = 6542) from the Northern Finland Birth Cohort 1986. Self-report questionnaires on substance use and psychotic experiences were completed when the cohort members were 15-16 years old. Inhalant use was categorized into four groups (never, once, 2-4 times, 5 times or more). Subsequent psychosis diagnoses (ICD-10) until age 30 years were obtained from national registers. Cox regression analysis was used to examine the association between adolescent inhalant use and risk of psychosis. During the observation period 124 in iduals were diagnosed with incident psychosis. Overall, there were 225 (3.4%) subjects with any inhalant use, 18 (8.0%) of whom were diagnosed with psychosis during the follow up. Of non-inhalant users (n = 6317) 106 (1.7%) were diagnosed with psychosis. Compared to non-users, those using inhalants had increased risk of incident psychosis with most frequent inhalant use associated with the greatest risk (unadjusted HR = 9.46 3.86-23.20). After adjusting for baseline psychotic experiences, other substance use, comorbid mental disorder and parental substance abuse, the increased risk of psychosis persisted (HR = 3.06 1.05-8.95). Furthermore, a dose-response effect between inhalant use and risk of psychosis was identified (OR = 2.34 1.83-2.99). Inhalant use in adolescence was independently associated with incident psychosis. The adverse health outcomes associated with adolescent inhalant use provide compelling reasons for implementation of policies to reduce the use of volatile substances in adolescents.
Publisher: Frontiers Media SA
Date: 20-11-2018
Publisher: SAGE Publications
Date: 13-10-2020
Abstract: To determine the financial and non-financial costs of Attention-Deficit/Hyperactivity Disorder (ADHD) across the lifespan. The population costs of ADHD in Australia were estimated for the financial year 2018 to 2019 using a prevalence approach to cost estimation across all ages. Financial (healthcare, productivity, education and justice systems, and deadweight losses) and non-financial costs were measured (Disability Adjusted Life Years (DALYs)). The total social and economic cost of ADHD in 2018 to 2019 were US$12.76 billion (range US$8.40 billion to US$17.44 billion, with per person costs of US$15,664 per year). Productivity costs made up 81% of the total financial costs, followed by deadweight losses (11%), and health system costs (4%). Loss in terms of wellbeing was significant (US$5.31 billion). There is a need to raise public awareness of the considerable socioeconomic impact and burden of ADHD in order to drive investment and policy decisions that improve identification and treatment of ADHD.
Publisher: Springer Science and Business Media LLC
Date: 03-2019
Publisher: Elsevier BV
Date: 08-2014
DOI: 10.1016/J.PSYCHRES.2015.05.002
Abstract: Psychotic-like experiences (PLEs) have been associated with increased risk of suicidality, but it is unclear whether the level of risk varies with different types of PLE. A cross-sectional online survey was completed by 1610 university students. Respondents completed the Community Assessment of Psychic Experiences-15 (CAPE-P15) assessing PLEs on three subscales: Perceptual Abnormalities (PA), Persecutory Ideation (PI) and Bizarre Experiences (BE). Lifetime suicidal ideation, plans and attempts, cannabis, ecstasy and meth hetamine use and family history of mental disorder were also assessed. Multinomal logistic regression was used to examine unique determinants of lifetime suicidality, defined as any history of (i) suicidal ideation or plans and (ii) any attempt, relative to no lifetime history of suicidality. A lifetime history of PA and PI provided significant unique contributions to the prediction of suicide risk, after control for other significant predictors. BE were not associated with any suicide variable demonstrating the variation in risk of suicidality with different types of PLEs. Perceptual abnormalities and persecutory ideation as measured by the CAPE-P15 are the PLEs associated with a higher risk of lifetime suicidality.
Publisher: Cambridge University Press (CUP)
Date: 23-11-2005
DOI: 10.1017/S0033291705006392
Abstract: Background. Apart from in iduals with clinical psychosis, community surveys have shown that many otherwise well in iduals endorse items designed to identify psychosis. The aim of this study was to characterize the demographic correlates of in iduals who endorse psychosis screening items in a large general community s le. Method. The National Survey of Mental Health and Wellbeing interviewed 10641 in iduals living in private dwellings in Australia. As part of a diagnostic interview (the CIDI), respondents were asked between three and six items originally designed to screen for potential psychosis. We examined the impact of selected demographic variables on endorsement of these items including sex, age, marital status, migrant status, urban/rural status, employment, education, and socio-economic status. Results. An estimated 11·7% of the Australian population endorsed at least one psychosis-screening item. Significantly higher endorsement was associated with younger age, migrants from non-English-speaking backgrounds, those who had never married or who were orced/separated or unemployed, those living in urban regions and those from the lowest socio-economic levels. Conclusions. Many of the correlates of endorsement of psychosis-screen items are also associated with psychosis. Unravelling the factors that contribute to this broader non-clinical phenotype will aid our understanding of psychosis.
Publisher: Cambridge University Press (CUP)
Date: 22-08-2016
DOI: 10.1017/S1355617716000679
Abstract: Background: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a recently described life-threatening autoimmune disorder associated with a characteristic multi-stage neuropsychiatric syndrome. Although it is known that the majority of patients experience neuropsychological disturbance post-treatment, some aspects of the cognitive profile remain unclear. Methods: This study sought to investigate patterns of cognitive functioning in a s le of anti-NMDAR encephalitis patients. Seven (6F:1M mean age, 26.4 years range, 16–37 years) treated patients completed a comprehensive set of neurocognitive and social functioning measures. Performance was analyzed using normative data (where available), and comparison with matched controls (10F:4M mean age, 25.8 years range, 16–38 years). Results: In idual cognitive profiles ranged from within normal limits to extensive dysfunction. Relative to controls, the patient group’s performance was affected in the domains of verbal/ visual memory, working memory, attention, processing speed, executive functioning, and social cognition. The patient group also reported significantly higher levels of anxiety compared to controls. Conclusions: These results add to the accumulating evidence that neurocognitive deficits, consistent with the distribution and functions of the NMDAR system can persist during recovery from anti-NMDAR encephalitis. This is the first study to provide evidence of performance decrements on measures of social cognition, including some involving theory of mind. ( JINS , 2016, 22 , 828–838)
Publisher: Springer Science and Business Media LLC
Date: 08-04-2019
Publisher: Cambridge University Press (CUP)
Date: 03-12-2015
DOI: 10.1017/THG.2014.70
Abstract: Cytokines and vitamin D both have a role in modulating the immune system, and are also potentially useful biomarkers in mental illnesses such as major depressive disorder (MDD) and schizophrenia. Studying the variability of cytokines and vitamin D in a healthy population s le may add to understanding the association between these biomarkers and mental illness. To assess genetic and environmental contributions to variation in circulating levels of cytokines and vitamin D (25-hydroxy vitamin D: 25(OH)D3), we analyzed data from a healthy adolescent twin cohort (mean age 16.2 years standard deviation 0.25). Plasma cytokine measures were available for 400 in iduals (85 MZ, 115 DZ pairs), dried blood spot s le vitamin D measures were available for 378 in iduals (70 MZ, 118 DZ pairs). Heritability estimates were moderate but significant for the cytokines transforming growth factor-β1 (TGF-β1), 0.57 (95% CI 0.26–0.80) and tumor necrosis factor-receptor type 1 (TNFR1), 0.50 (95% CI 0.11–0.63) respectively. Measures of 25(OH)D3 were within normal range and heritability was estimated to be high (0.86, 95% CI 0.61–0.94). Assays of other cytokines did not generate meaningful results. These potential biomarkers may be useful in mental illness, with further research warranted in larger s le sizes. They may be particularly important in adolescents with mental illness where diagnostic uncertainty poses a significant clinical challenge.
Publisher: Informa UK Limited
Date: 17-02-2022
DOI: 10.1080/09540261.2022.2045260
Abstract: Bullying victimisation is a serious risk factor for mental health problems in children and adolescents. School bullying prevention programs have consistently produced small to moderate reductions in victimisation and perpetration. However, these programs do not necessarily help all students affected by bullying. Paradoxically whole-school programs lead to higher levels of depression and poorer self-esteem for students who continue to be victimised after program implementation. This may be because some elements of whole-school programs make victims more visible to their peers, thus further eroding their peer social status. Three main identified risk factors for children and adolescents who continue to be victimised following school bullying prevention programs are peer rejection, internalising problems, and lower quality parent-child relationships. All are potentially modifiable through family interventions. A large body of research demonstrates the influence of families on children's social skills, peer relationships and emotional regulation. This paper describes the theoretical foundations and empirical evidence for reducing the incidence and mental health outcomes of school bullying victimisation through family interventions. Family interventions should be available to complement school efforts to reduce bullying and improve the mental health of young people.
Publisher: Royal College of Psychiatrists
Date: 04-2007
DOI: 10.1192/BJP.BP.106.026708
Abstract: Surveys have found that otherwise well in iduals report delusional experiences. Previous studies have shown an association between psychotic symptoms and exposure to trauma. To explore the association between trauma and delusional experiences in a community s le. Respondents ( n = 10 641) were assessed for delusional experiences, exposure to various types of traumatic experiences and the presence of post-traumatic stress disorder (PTSD). The endorsement of delusional items was examined in people exposed to traumatic events who did or did not have PTSD. Exposure to any traumatic event but without the development of PTSD was associated with increased endorsement of delusional experiences (relative risk 2.68, 95% CI 2.18–3.30) and there was a significant dose–response relationship between the number of types of traumatic events and endorsement of such experiences (χ 2 =26.74, d.f. =2, P 0.001). A diagnosis of PTSD further increased endorsement of delusional experiences (RR = 9.24, 95% CI 6.95–12.27). The association between PTSD and delusional experiences remained significant after adjusting for factors associated with psychotic symptoms. Further investigation into the pathways between trauma, delusions and psychosis may provide insights into shared aetiological mechanisms underpinning these conditions.
Publisher: SAGE Publications
Date: 2008
DOI: 10.1080/00048670802050595
Abstract: Objective: Several large population-based studies have reported that otherwise-well in iduals endorse items related to delusion-like experiences. The aim of the present study was to examine selected correlates of delusion-like experiences in a s le of non-psychotic in iduals. Method: Subjects (n=310) were screened with the Diagnostic Interview for Psychosis in order to exclude psychotic disorders. Delusion-like experiences were assessed with the Peters Delusional Inventory (PDI). Non-parametric statistics were used to assess the relationship between total PDI score and a range of demographic (age, sex, migrant status, paternal age), physical (minor physical anomalies) symptom-related variables (hallucinations, awareness of thought disorder) and family history of mental illness. Results: The median (range) PDI score was 4 (0–26), while one-third of the subjects endorsed seven or more items. The presence of a family history of any psychiatric condition was significantly correlated with a higher PDI score. PDI score was significantly positively correlated with endorsement of hallucinations and awareness of thought disorder. PDI was not significantly associated with sex, family history of schizophrenia, paternal age, migrant status nor scores related to minor physical anomalies. There was a trend level association between younger age and higher PDI score. Conclusion: Delusion-like experiences are relatively common in non-psychotic in iduals. The association with a family history of mental disorders provides clues to the mechanisms underlying the profile of delusion-like experience.
Publisher: Elsevier BV
Date: 07-2021
Publisher: Elsevier BV
Date: 2021
Publisher: Elsevier BV
Date: 02-2014
Abstract: To determine trends in health status over a 10-year interval in a high-risk remote Australian Aboriginal community. Two health surveys were performed, one between 1992 and 1997 and the other between 2004 and 2006, on people aged five years or older. Outcomes were compared across age-matched and sex-matched pairs. There were 1,209 matched pairs. In the second survey, birthweights tended to be higher, and there were significant increases in heights of adolescents and young adults, and high density lipoprotein cholesterol (HDL-C) levels generally. Young adult males were lighter, had lower measurements for waist circumference and blood pressure and less frequently had overt-albuminuria, while elevated blood pressure was less common in older males. However, females≥15 years had higher measurements for waist circumference, waist to hip ratio (WHR), body mass index (BMI) and diastolic blood pressure and a higher proportion of diabetes, notably in those aged older than 45 years. Males aged 15-24 years were less likely to be smokers while women aged less than 45 years were more often current drinkers. Results indicative of better nutrition among youth, better health of young adult males, stable or lower levels of albuminuria and improved HDL levels are all encouraging. The waist circumference increase in females might reflect better food access. An increase in diabetes in older subjects probably reflects recent enhanced survival of middle-aged and older people with--and at risk for--diabetes.
Publisher: Wiley
Date: 18-02-2018
DOI: 10.1111/ACPS.12863
Abstract: Daily smoking has been associated with a greater risk of psychosis. However, we are still lacking studies to adjust for baseline psychotic experiences and other substance use. We examined associations between daily smoking and psychosis risk in a 15-year follow-up while accounting for these covariates in a prospective s le (N = 6081) from the Northern Finland Birth Cohort 1986. Self-report questionnaires on psychotic experiences (PROD-screen), tobacco smoking and other substance use were completed when the cohort members were 15-16 years old. Tobacco smoking was categorized into three groups (non-smokers, 1-9 cigarettes and ≥10 cigarettes/day). Psychosis diagnoses were obtained from national registers until the age of 30 years. Subjects in heaviest smoking category were at increased risk of subsequent psychosis (unadjusted HR = 3.15 95% CI 1.94-5.13). When adjusted for baseline psychotic experiences the association persisted (HR = 2.87 1.76-4.68) and remained significant even after adjustments for multiple known risk factors such as cannabis use, frequent alcohol use, other illicit substance use, parental substance abuse, and psychosis. Furthermore, number of smoked cigarettes increased psychosis risk in a dose-response manner (adjusted OR = 1.05 1.01-1.08). Heavy tobacco smoking in adolescence was associated with a greater risk for psychosis even after adjustment for confounders.
Publisher: Springer Science and Business Media LLC
Date: 22-11-2018
DOI: 10.1007/S00127-017-1462-1
Abstract: Bullying is a significant public health problem for children and adolescents worldwide. Evidence suggests that both being bullied (bullying victimisation) and bullying others (bullying perpetration) are associated with concurrent and future mental health problems. The onset and course of bullying perpetration are influenced by in idual as well as systemic factors. Identifying effective solutions to address bullying requires a fundamental understanding of why it occurs. Drawing from multi-disciplinary domains, this review provides a summary and synthesis of the key theoretical frameworks applied to understanding and intervening on the issue of bullying. A number of explanatory models have been used to elucidate the dynamics of bullying, and broadly these correspond with either system (e.g., social-ecological, family systems, peer-group socialisation) or in idual-level (e.g., developmental psychopathology, genetic, resource control, social-cognitive) frameworks. Each theory adds a unique perspective however, no single framework comprehensively explains why bullying occurs. This review demonstrates that the integration of theoretical perspectives achieves a more nuanced understanding of bullying which is necessary for strengthening evidence-based interventions. Future progress requires researchers to integrate both the systems and in idual-level theoretical frameworks to further improve current interventions. More effective intervention across different systems as well as tailoring interventions to the specific needs of the in iduals directly involved in bullying will reduce exposure to a key risk factor for mental health problems.
Publisher: Elsevier BV
Date: 11-2021
DOI: 10.1016/J.JPSYCHORES.2021.110600
Abstract: Urinary tract infections (UTIs) are among the most common bacterial infections in pregnant women. This is the first longitudinal study investigating the association between gestational UTIs and the risk of maternal antenatal and postnatal depressive and anxiety symptoms. Data were utilised from the Avon Longitudinal Study of Parents and Children (ALSPAC). Maternal depressive and anxiety symptoms during pregnancy and the postpartum period were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the Crown-Crisp Experiential Index (CCEI), respectively. We used logistic regression analyses to examine the associations using the recommended EPDS and CCEI cut-off scores. We also ran sensitivity analyses and repeated the analyses with the continuous scores. More than 10,000 mothers had completed exposure and outcome measures during pregnancy and the postpartum period. After adjustments were made for a wide range of confounders, our findings showed that mothers with UTI during pregnancy were 1.72 (95% CI 1.45-2.04) and 1.70 (95% CI: 1.44-1.99) times more likely to report antenatal depressive and anxiety symptoms compared with mothers without UTI, respectively. Mothers with UTI also had a 35% and a 28% higher risk of postnatal depressive symptoms at eight weeks and eight months, respectively, and the risk of postnatal anxiety was 55% higher in mothers who had UTI during pregnancy (aOR = 1.55 95% CI, 1.26-1.91). The present study found positive associations between UTI during pregnancy and antenatal and postnatal depressive and anxiety symptoms. Replication and further research determining the cause of these associations is warranted.
Publisher: Wiley
Date: 09-03-2018
DOI: 10.1111/ACPS.12865
Publisher: Oxford University Press (OUP)
Date: 17-08-2009
Publisher: Informa UK Limited
Date: 23-11-2015
DOI: 10.1080/13803395.2015.1100276
Abstract: Current literature points to a clear and consistent association between poor emotion control and psychopathology in adolescence, a critical developmental period during which most adult mental health problems emerge. However, nearly all of the studies in this literature have assessed emotion regulation in nonclinical cohorts, or indexed this construct using only self-report methodology. The present study compared adolescents with a mental illness (n = 41) to demographically matched controls (n = 45) on an experimental task that required them to either suppress or lify their emotion expressive behavior in response to images that were either negative or positive in affective valence. Clinical participants (like controls) showed evidence of being able to regulate their behavioral expression of emotion, indicating that the presence of mental health problems in adolescence does not prevent a basic level of control being exercised over the emotions that are expressed to others. However, the capacity to lify expressive behavior was reduced, particularly for negative emotions. In addition, poorer emotion regulation in the clinical group was associated with reduced quality of life. These data indicate that specific aspects of emotion expressive behavior are disrupted in adolescents with mental illness and are discussed in the context of theoretical models that regard emotion dysregulation as a core, transdiagnostic feature of mental illness.
Publisher: SAGE Publications
Date: 2008
DOI: 10.1080/10398560701636955
Abstract: Objective: The aim of this study was to develop and pilot an instrument for the assessment of self-injury in adolescent inpatients. Methods: The Self-Injury Motivation Scale was modified for use in adolescents. Thirty-eight consenting adolescent inpatients with a history of self-injury completed the Self-Injury Motivation Scale – Adolescent version (SIMS-A) and the Self-Injury Interview (SII) to collect information about a range of factors associated with self-injury, other clinical variables and demographic details. Results: The SIMS-A was acceptable to this adolescent s le and motivations for self-injury were similar to those of adults using the original SIMS scale. Adolescents were, however, more likely to use self-injury for communicating to/influencing others compared to adults. The participants most frequently reported self-injury by hitting, cutting and burning. The clinical diagnosis most frequently associated with self-injury was major depression. Females reported earlier onset, higher frequency and multiple methods of self-injury compared to males. Distraction from emotional pain was the most common motivation for self-injury in both males and females. Conclusions: This pilot study suggests the SIMS-A is a useful self-report measure to assist clinicians and adolescent patients to understand a behaviour that may be associated with shame, guilt or other difficult emotions for the adolescent. Results also support the contention that there are often multiple and conflicting motivations for self-injury. Self-injury in this population was more common and severe in female adolescents compared to males, while clinical depression was a risk factor for self-injury in both males and females. The small s le size of adolescent inpatients is an important limitation of this pilot study, and research using the SIMS-A in larger s les is warranted.
Publisher: Wiley
Date: 04-02-2022
DOI: 10.1111/ACPS.13398
Abstract: Clozapine is the most effective medication for treatment‐refractory schizophrenia, but it is associated with severe cardiac adverse events including myocarditis and cardiomyopathy. To aid treatment decision‐making for clinicians, patients and their carers, we conducted a systematic review and meta‐analysis to identify potential risk factors for clozapine‐induced myocarditis and cardiomyopathy. A systematic search was conducted of PubMed, Embase, CINAHL, Web of Science, Cochrane and PsycInfo for studies reporting myocarditis and cardiomyopathy among people on clozapine and potential risk factors. We calculated pooled effect sizes on risk factors using a random‐effects meta‐analytic model. Risk of publication bias was assessed using the Newcastle‐Ottawa scale. Seven studies met the inclusion criteria, of which six studies had quantitative data included in the meta‐analysis. The odds of clozapine‐induced myocarditis increased with concurrent sodium valproate use ( k = 6, n = 903, pooled OR 3.58, 95% CI 1.81–7.06), but were not significantly greater with the use of quetiapine, lithium or selective serotonin reuptake inhibitors. Our qualitative review identified conflicting results reported for increasing age and higher clozapine dose as risk factors for myocarditis. No other factors, including genetic risk, sex, ethnicity, smoking, alcohol, substance abuse or cardiometabolic disease, were associated with greater odds of myocarditis. No risk factors for cardiomyopathy were identified in the literature. Concurrent use of sodium valproate increases the odds of clozapine‐induced myocarditis. Thus, clinicians should consider the temporary cessation of sodium valproate during the initial titration phase of clozapine.
Publisher: Wiley
Date: 10-2021
Publisher: SAGE Publications
Date: 04-2022
DOI: 10.1177/00048674221089560
Abstract: The Royal Australian and New Zealand College of Psychiatrists recommends screening for a range of antibodies in first-episode psychosis, including anti-glutamic acid decarboxylase antibodies. Glutamic acid decarboxylase antibody–associated encephalitis occurs with high antibody titres and may cause cognitive dysfunction, seizures and psychiatric symptoms. However, glutamic acid decarboxylase antibodies are more frequently found in lower titre in association with other autoimmune disorders (such as diabetes mellitus type 1) and in healthy in iduals. The utility of testing unselected populations of consumers with psychosis is unclear. The psychiatric manifestations of this disorder are also poorly described. First, systematic review of cohort and case–control studies that tested for IgG glutamic acid decarboxylase antibodies in psychiatric populations was conducted. Random-effects meta-analysis of odds ratio for antibody positivity in cases with psychosis and controls assessed prevalence. Second, literature review of all published cases and case series of glutamic acid decarboxylase antibody–associated limbic encephalitis was assessed for frequency and description of psychotic symptoms. There were 17 studies, in which 2754 in iduals with psychotic disorders were tested for glutamic acid decarboxylase IgG antibodies. Thirty-one consumers with psychosis (0.7%) had positive glutamic acid decarboxylase antibodies compared to 24 controls (1.0%), all at low titre and not fulfilling diagnostic criteria for autoimmune encephalitis. Meta-analysis found no significant difference in rates of glutamic acid decarboxylase antibody positivity (odds ratio = 1.8, 95% confidence interval: [0.90, 3.63]). Literature review found 321 cases of glutamic acid decarboxylase antibody–associated limbic encephalitis, with psychosis in 15 (4.3%) cases. Clinical screening would have identified all cases that presented to psychiatric services. Glutamic acid decarboxylase antibodies were uncommon in consumers with psychosis, with no significant difference in prevalence from controls and no cases of encephalitis identified. In cases with established glutamic acid decarboxylase antibody–associated limbic encephalitis, psychotic symptoms were uncommon and identifiable by clinical assessment. Targeted antibody testing guidelines should be further considered.
Publisher: Cambridge University Press (CUP)
Date: 19-09-2019
DOI: 10.1017/S2045796019000489
Abstract: There is now a strong body of literature showing that bullying victimisation during childhood and adolescence precedes the later development of anxiety and depressive disorders. This study aimed to quantify the burden of anxiety and depressive disorders attributable to experiences of bullying victimisation for the Australian population. This study updated a previous systematic review summarising the longitudinal association between bullying victimisation and anxiety and depressive disorders. Estimates from eligible studies published from inception until 18 August 2018 were included and meta-analyses were based on quality-effects models. Pooled relative risks were combined with a contemporary prevalence estimate for bullying victimisation for Australia in order to calculate population attributable fractions (PAFs) for the two mental disorder outcomes. PAFs were then applied to estimates of the burden of anxiety and depressive disorders in Australia expressed as disability-adjusted life years (DALYs). The findings from this study suggest 7.8% of the burden of anxiety disorders and 10.8% of the burden of depressive disorders are attributable to bullying victimisation in Australia. An estimated 30 656 DALYs or 0.52% (95% uncertainty interval 0.33–0.72%) of all DALYs in both sexes and all ages in Australia were attributable to experiences of bullying victimisation in childhood or adolescence. There is convincing evidence to demonstrate a causal relationship between bullying victimisation and mental disorders. This study showed that bullying victimisation contributes a significant proportion of the burden of anxiety and depressive disorders. The investment and implementation of evidence-based intervention programmes that reduce bullying victimisation in schools could reduce the burden of disease arising from common mental disorders and improve the health of Australians.
Publisher: SAGE Publications
Date: 17-05-2017
Abstract: Bullying prevalence studies are limited by varied measurement methods and a lack of representative s les. This study estimated the national prevalence of bullying victimisation, perpetration and combined victim-perpetration experiences in a representative population-based s le of Australian youth. The relationships between the three types of bullying involvement with a range of mental health symptoms and diagnoses were also examined. A randomly selected nationally representative s le aged 11-17 years ( N = 2967, M The 12-month prevalence of bullying victimisation was 13.3%, perpetration 1.6% and victim-perpetration 1.9%. Logistic regression models showed all forms of involvement in bullying were associated with increased risk of psychological distress, emotional and behavioural problems, substance use, self-harm and attempted suicide. Victimisation and victim-perpetration were associated with youth-reported major depressive disorder. There were also significant associations between bullying involvement and parent-reported diagnoses of major depressive disorder, any anxiety disorder and any externalising disorder. Bullying continues to be frequently experienced by Australian adolescents. The current findings showed that involvement in any bullying behaviour was associated with increased risk of concurrent mental health problems. This evidence can be used to inform decisions concerning the allocation of resources to address this important health issue.
Publisher: Research Square Platform LLC
Date: 08-05-2023
DOI: 10.21203/RS.3.RS-2887580/V1
Abstract: Background The Attachment Style Questionnaire (ASQ) is used to assess an in idual’s inner working model of interpersonal relationships and attachment style. The study evaluated the factor structure, sex invariance, and convergent validity of the ASQ among middle-aged women and their young adult offspring. Methods Middle aged mothers (n = 3,605, M age =46.5 years) and their 3,712 offspring were administered the ASQ when their offspring were young adults ( M age =21.6-years). Symptom measures of anxiety and depression were concurrently administered to mothers (Delusions Symptoms States Inventory) and offspring (Young Adult Self-Report). Confirmatory factor analyses were conducted to test the structural validity in both groups as well as sex invariance in the offspring cohort. Convergent and ergent validity were assessed using depression/anxiety subscales. Latent class analyses (LCA) were performed to examine patterns of responses across ASQ items. Results Confirmatory analyses supported the utility of a shortened 33-item ASQ for both cohorts, and the structure was invariant between male and female offspring. Strong convergence was found between anxious subscales on the ASQ and depression/anxiety symptoms in both cohorts. Measures of anxiety and depression correlated positively with ASQ anxiety and avoidance subscales. LCA identified four latent classes across a continuum of secure and insecure attachment rather than four distinct attachment styles (i.e., Bartholomew & Horowitz, 1991). Conclusions The ASQ-33 is a reliable and valid instrument that measures internal working models of relationships in both male and female young adults, and women in middle-age. Findings support a dimensional view of attachment security/insecurity over the four-part categorisation of attachment styles.
Publisher: SAGE Publications
Date: 20-08-2016
Publisher: Wiley
Date: 22-01-2014
DOI: 10.1111/JCPP.12186
Abstract: The Global Burden of Disease Study 2010 (GBD 2010) is the first to include conduct disorder (CD) and attention-deficit/hyperactivity disorder (ADHD) for burden quantification. A previous systematic review pooled the available epidemiological data for CD and ADHD, and predicted prevalence by country, region, age and sex for each disorder. Prevalence was then multiplied by a disability weight to calculate years lived with disability (YLDs). As no evidence of deaths resulting directly from either CD or ADHD was found, no years of life lost (YLLs) were calculated. Therefore, the number of disability-adjusted life years (DALYs) was equal to that of YLDs. Globally, CD was responsible for 5.75 million YLDs/DALYs with ADHD responsible for a further 491,500. Collectively, CD and ADHD accounted for 0.80% of total global YLDs and 0.25% of total global DALYs. In terms of global DALYs, CD was the 72nd leading contributor and among the 15 leading causes in children aged 5-19 years. Between 1990 and 2010, global DALYs attributable to CD and ADHD remained stable after accounting for population growth and ageing. The global burden of CD and ADHD is significant, particularly in male children. Appropriate allocation of resources to address the high morbidity associated with CD and ADHD is necessary to reduce global burden. However, burden estimation was limited by data lacking for all four epidemiological parameters and by methodological challenges in quantifying disability. Future studies need to address these limitations in order to increase the accuracy of burden quantification.
Publisher: SAGE Publications
Date: 18-09-2022
DOI: 10.1177/00048674221126458
Abstract: The Royal Australian and New Zealand College of Psychiatrists’ (RANZCP) 2018 position statement supports increased, regulated availability of e-cigarettes (ECs) as a harm-reduction measure and recommends further research into their use. Aligned with this recommendation, we aimed to critically evaluate the RANZCP’s stance on this issue through a literature review focused on the areas identified in the position statement as requiring further investigation: (1) the adverse health effects attributable to ECs (2) use of ECs for smoking cessation (particularly for people living with severe mental illness) and (3) EC-associated risks for nicotine naïve young people. We identified and summarised evidence of harm attributable to ECs that is particularly relevant to young people through direct adverse health sequelae, onset of nicotine dependence and increased risk of combustible cigarette (CC) use. A small number of studies suggest ECs can be used for harm-reduction purposes in people diagnosed with nicotine dependence and severe mental illness. However, these results must be considered alongside robust evidence supporting the effectiveness of existing pharmacological interventions for smoking cessation in people with severe mental illness. The position statement is in urgent need of review in line with the available evidence.
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.SCHRES.2018.02.041
Abstract: Previous studies have examined the distribution of psychotic like experiences (PLE) with the aim of informing the debate concerning the categorical versus continuous nature of psychosis. We extend this research by subjecting a number of competing models of delusional ideation to validation analysis to further examine previous findings. We constructed latent variable models representing the factor structure of delusional ideation reported previously, using self-reported delusional ideation (Peter's Delusional Inventory PDI) at age 21 in a general population prospective birth cohort study. After firstly eliminating models which exhibited poor fit we performed a longitudinal validation analyses among the competing models to investigate whether increasing levels of ideation were associated with developmental antecedents, correlates and distal indicators of psychotic disorder. Four latent variable models were found to adequately represent the delusional ideation data, two comprised exclusively of continua (a multidimensional 5 factor model and a bifactor model with 1 general and 4 specific factors), and two which included both categories and continua (two factor mixture models, each with 3 classes and 1 factor per class, but with varying levels of parameter restrictions). Exclusively categorical latent models obtained poor fit and the categorical components of hybrid models failed to discriminate on psychotic illness, while among the models incorporating continuous latent factors validation analyses did not clearly identify any model as better than the others. We provide novel evidence of the importance of continua in adequately and validly representing delusional ideation in the general population. Beyond this, our data suggests it is not possible to further refine the structure of delusional ideation in the general population.
Publisher: Elsevier BV
Date: 02-2009
DOI: 10.1016/J.SCHRES.2008.11.002
Abstract: There is an emerging interest in children and adolescents who have hallucinations and other psychotic-like experiences to enable identification of those potentially at risk for schizophrenia in adulthood. This study examines the prevalence, demographic and clinical correlates of hallucinations in the adolescent subgroup of the Australian National Survey of Mental Health and Well-Being. Participants were a nationally representative s le of 1261 adolescents aged 13-17 years. Adolescents completed self-report questionnaires with two questions relating to hallucinations and questions pertaining to depressive symptoms and cannabis use. Parents completed the Child Behavior Checklist (CBCL) and the Diagnostic Interview Schedule for Children (DISC-IV). Hallucinations were reported by 8.4% of adolescents. Those living in blended or sole parent families were more likely to report hallucinations than those living with both biological parents (OR 3.27 95% CI 1.93, 5.54 OR 2.60 95% CI 1.63, 4.13 respectively). Hallucinations were more prevalent in adolescents who scored in the highest decile of the CBCL or had elevated depression symptoms (OR 3.30 95% CI 2.10, 5.20 OR 5.02 95% CI 3.38, 7.45 respectively). Hallucinations were associated with depressive disorder (OR 2.70 95% CI 1.16, 6.28) and were more prevalent in those adolescents who had smoked cannabis more than twice in the month prior to the survey (OR 3.27 95% CI 1.76, 6.08). Hallucinations occur relatively frequently in adolescents and are associated with a range of demographic and clinical correlates. Further research may assist in understanding the variable trajectory of children and adolescents who hallucinate.
Publisher: Wiley
Date: 04-08-2008
DOI: 10.1111/J.1600-0447.2008.01214.X
Abstract: Psychotic-like experiences (PLE) in the general community are common. The aims of this study were to examine the prevalence and demographic correlates of PLE in young adults. The s le consisted of 2441 subjects aged 18-23 years. Subjects completed the Composite International Diagnostic Interview (CIDI) and the 21-item Peters Delusional Inventory (PDI). Associations between age, gender, hallucinations and delusions were examined using logistic regression. Both CIDI hallucinations and delusions predicted high scores on the PDI. Younger age was significantly associated with endorsement of CIDI delusions [odds ratio (OR) = 0.66, 95% confidence interval (CI) 0.48-0.92) and with PDI total scores (OR = 0.68, 95% CI 0.55-0.83). Women were significantly more likely to endorse items related to hallucinations (OR = 1.49, 95% CI 1.14-1.95) but not delusions. PLE are common in young adults. The mechanisms underpinning the age and gender gradients in PLE may provide clues to the pathogenesis of psychotic disorders.
Publisher: Walter de Gruyter GmbH
Date: 2013
Publisher: Wiley
Date: 03-12-2023
DOI: 10.1002/GPS.5847
Abstract: To investigate whether vitamin D supplementation reduces depressive symptoms and incidence of antidepressant use. We used data from the D‐Health Trial ( N = 21,315), a randomized double‐blind placebo‐controlled trial of monthly vitamin D 3 for the prevention of all‐cause mortality. Participants were Australians aged 60–84 years. Participants completed the Patient Health Questionnaire (PHQ–9) at 1, 2 and 5 years after randomization to measure depressive symptoms national prescribing records were used to capture antidepressant use. We used mixed models and survival models. Analyses of PHQ‐9 scores included 20,487 participants (mean age 69·3 years, 46% women) the mean difference (MD) in PHQ‐9 score (vitamin D vs. placebo) was 0·02 (95% CI −0·06, 0·11). There was negligible difference in the prevalence of clinically relevant depression (PHQ‐9 score ≥10) (odds ratio 0·99 95% CI 0·90, 1·08). We included 16,670 participants in the analyses of incident antidepressant use (mean age 69·4 years, 43% women). Incidence of antidepressant use was similar between the groups (hazard ratio [HR] 1·04 95% CI 0·96, 1·12). In subgroup analyses, vitamin D improved PHQ‐9 scores in those taking antidepressants at baseline (MD −0·25 95% CI −0·49, −0·01 p‐interaction = 0·02). It decreased risk of antidepressant use in participants with predicted 25(OH)D concentration nmol/L (HR 0·88 95% CI 0·75, 1·02 p‐interaction = 0·01) and increased risk in those with predicted 25(OH) D ≥ 50 nmol/L (HR 1·10 95% CI 1·01, 1·20). Monthly supplementation with high‐dose vitamin D 3 was not of benefit for measures of depression overall, but there was some evidence of benefit in subgroup analyses. The trial is registered on the Australian New Zealand Clinical Trials Registry: ACTRN12613000743763. www.anzctr.org.au/ .
Publisher: Cambridge University Press (CUP)
Date: 12-2020
DOI: 10.1017/THG.2020.83
Abstract: The ‘16Up’ study conducted at the QIMR Berghofer Medical Research Institute from January 2014 to December 2018 aimed to examine the physical and mental health of young Australian twins aged 16−18 years ( N = 876 371 twin pairs and 18 triplet sets). Measurements included online questionnaires covering physical and mental health as well as information and communication technology (ICT) use, actigraphy, sleep diaries and hair s les to determine cortisol concentrations. Study participants generally rated themselves as being in good physical (79%) and mental (73%) health and reported lower rates of psychological distress and exposure to alcohol, tobacco products or other substances than previously reported for this age group in the Australian population. Daily or near-daily online activity was almost universal among study participants, with no differences noted between males and females in terms of frequency or duration of internet access. Patterns of ICT use in this s le indicated that the respondents were more likely to use online information sources for researching physical health issues than for mental health or substance use issues, and that they generally reported partial levels of satisfaction with the mental health information they found online. This suggests that internet-based mental health resources can be readily accessed by adolescent Australians, and their computer literacy augurs well for future access to online health resources. In combination with other data collected as part of the ongoing Brisbane Longitudinal Twin Study, the 16Up project provides a valuable resource for the longitudinal investigation of genetic and environmental contributions to phenotypic variation in a variety of human traits.
Publisher: Wiley
Date: 31-07-2022
DOI: 10.1111/AJO.13585
Abstract: Adverse childhood experiences (ACEs) are associated with many health problems in women during pregnancy, including depression/anxiety, gestational diabetes and adverse birth outcomes. However, unlike other health risk factors, screening for ACEs has not been widely implemented in antenatal care settings. The aim of the scoping review was to explore the challenges in screening for ACEs in antenatal care settings and to provide the lessons learnt and evidence that guide the practice of ACE screening for both healthcare providers and pregnant women. A five‐stage process for conducting the scoping review was utilised. Searches of four key databases (PubMed, PsycINFO, CINAHL and SCOPUS) and reference lists from relevant studies were conducted. Seven publications met the inclusion criteria. Challenges identified for healthcare providers in screening for ACEs include lack of knowledge and confidence in ACE tool and shortage of time and resources to undertake screening. Impediments for pregnant women include concerns about privacy. However, there were ex les of effective practice for ACE screening in antenatal care settings that could apply widely. Addressing impediments to ACE screening is critical in implementing trauma‐informed practices that can identify women at risk of adverse health outcomes during pregnancy. A study on screening for ACEs in antenatal care in both public and private settings is needed to examine its feasibility and acceptability in the Australian context before being included in the National Perinatal Data Collection.
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.JAAC.2016.06.016
Abstract: Attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) are common externalizing disorders. Despite previous research demonstrating that both are longitudinally associated with adverse outcomes, there have been no systematic reviews examining all of the available evidence linking ADHD and CD with a range of health and psychosocial outcomes. Electronic databases (EMBASE, Medline, and PsycINFO) were searched for studies published from 1980 up to March 2015. Published cohort and case-control studies were included if they reported a longitudinal association between ADHD or CD and adverse outcomes with a minimum follow-up of 2 years. Outcomes with sufficient data were pooled in a random effects meta-analysis to give overall odds ratios (ORs) with corresponding 95% CIs. Of the 278 studies assessed, 114 met inclusion criteria and 98 were used in subsequent meta-analyses. ADHD was associated with adverse outcomes including academic achievement (e.g. failure to complete high school odds ratio [OR] = 3.7, 95% CIs 2.0-7.0), other mental and substance use disorders (e.g. depression OR = 2.3, 1.5-3.7), criminality (e.g. arrest OR = 2.4, 1.5-3.8), and employment (e.g., unemployment OR = 2.0, 1.0-3.9). CD was associated with outcomes relating to academic achievement (e.g. failure to complete high school OR = 2.7, 1.5-4.7), other mental and substance use disorders (e.g., illicit drug use OR = 2.1, 1.7-2.6), and criminality (e.g. violence OR = 3.5, 2.3-5.3). This study demonstrated that ADHD and CD are associated with disability beyond immediate health loss. Although the analyses could not determine the mechanisms behind these longitudinal associations, they demonstrate the importance of addressing ADHD and CD early in life so as to potentially avert a wide range of future adverse outcomes.
Publisher: Elsevier BV
Date: 2021
DOI: 10.1016/J.JADOHEALTH.2021.05.012
Abstract: In low- and middle-income countries, there are limited data on mental disorders among adolescents. To address this gap, the National Adolescent Mental Health Surveys (NAMHS) will provide nationally representative prevalence data of mental disorders among adolescents in Kenya, Indonesia, and Vietnam. This paper details the NAMHS study protocol. In each country, a multistage stratified cluster s ling design will be used. Participants will be eligible pairs of adolescents aged 10-17 years and their primary caregiver. Adolescents will be assessed for social phobia, generalized anxiety disorder, major depressive disorder, attention-deficit/hyperactivity disorder, conduct disorder, and post-traumatic stress disorder using the Diagnostic Interview Schedule for Children, version 5. Demographics, risk and protective factors, and service use information will also be collected. In the parallel clinical calibration study, diagnoses of major depressive disorder, social phobia, and generalized anxiety disorder made using the Diagnostic Interview Schedule for Children, version 5 will be calibrated against a diagnostic assessment by in-country clinicians in a separate s le. Data collection for the national survey and clinical calibration study will commence in 2021, with dissemination of findings and methodology due to occur in 2022. Accurately quantifying the prevalence of mental disorders in adolescents is essential for service planning. NAMHS will address this lack of prevalence data, both within the NAMHS countries and within their respective regions, while establishing a gold-standard methodology for data collection on adolescent mental health in low- and middle-income countries. More broadly, NAMHS will encourage capacity building within each country by establishing linkages between researcher, clinician, government, and other networks.
Publisher: Wiley
Date: 12-11-2013
DOI: 10.1016/J.ADOLESCENCE.2013.10.006
Abstract: Prospective longitudinal birth cohort data was used to examine the association between peer aggression at 14 years and mental health and substance use at 17 years. A s le of 1590 participants from the Western Australian Pregnancy Cohort (Raine) study were ided into mutually exclusive categories (victims, perpetrators, victim‐perpetrators and uninvolved). Involvement in any type of peer aggression as a victim (10.1%), perpetrator (21.4%), or a victim‐perpetrator (8.7%) was reported by 40.2% of participants. After adjusting for confounding factors, those who were a victim of peer aggression had increased odds of later depression and internalising symptoms whilst perpetrators of peer aggression were found to be at increased risk of depression and harmful alcohol use. Victim‐perpetrators of peer aggression were more likely to have externalising behaviours at 17 years. These results show an independent temporal relationship between peer aggression and later mental health and substance use problems in adolescence.
Publisher: American Speech Language Hearing Association
Date: 08-08-2018
DOI: 10.1044/2018_JSLHR-L-17-0210
Abstract: The current study aimed to compare traditional logistic regression models with machine learning algorithms to investigate the predictive ability of (a) communication performance at 3 years old on language outcomes at 10 years old and (b) broader developmental skills (motor, social, and adaptive) at 3 years old on language outcomes at 10 years old. Participants ( N = 1,322) were drawn from the Western Australian Pregnancy Cohort (Raine) Study (Straker et al., 2017). A general developmental screener, the Infant Monitoring Questionnaire (Squires, Bricker, & Potter, 1990), was completed by caregivers at the 3-year follow-up. Language ability at 10 years old was assessed using the Clinical Evaluation of Language Fundamentals–Third Edition (Semel, Wiig, & Secord, 1995). Logistic regression models and interpretable machine learning algorithms were used to assess predictive abilities of early developmental milestones for later language outcomes. Overall, the findings showed that prediction accuracies were comparable between logistic regression and machine learning models using communication-only performance as well as performance on communication and broader developmental domains to predict language performance at 10 years old. Decision trees are incorporated to visually present these findings but must be interpreted with caution because of the poor accuracy of the models overall. The current study provides preliminary evidence that machine learning algorithms provide equivalent predictive accuracy to traditional methods. Furthermore, the inclusion of broader developmental skills did not improve predictive capability. Assessment of language at more than 1 time point is necessary to ensure children whose language delays emerge later are identified and supported. 0.23641/asha.6879719
Publisher: BMJ
Date: 03-2018
DOI: 10.1136/BMJOPEN-2017-018959
Abstract: The Nineteen and Up study (19Up) assessed a range of mental health and behavioural problems and associated risk factors in a genetically informative Australian cohort of young adult twins and their non-twin siblings. As such, 19Up enables detailed investigation of genetic and environmental pathways to mental illness and substance misuse within the Brisbane Longitudinal Twin S le (BLTS). Twins and their non-twin siblings from Queensland, Australia mostly from European ancestry. Data were collected between 2009 and 2016 on 2773 participants (age range 18–38, 57.8% female, 372 complete monozygotic pairs, 493 dizygotic pairs, 640 non-twin siblings, 403 singleton twins). A structured clinical assessment (Composite International Diagnostic Interview) was used to collect lifetime prevalence of diagnostic statistical manual (4th edition) (DSM-IV) diagnoses of major depressive disorder, (hypo)mania, social anxiety, cannabis use disorder, alcohol use disorder, panic disorder and psychotic symptoms. Here, we further describe the comorbidities and ages of onset for these mental disorders. Notably, two-thirds of the s le reported one or more lifetime mental disorder. In addition, the 19Up study assessed general health, drug use, work activity, education level, personality, migraine/headaches, suicidal thoughts, attention deficit hyperactivity disorder (ADHD) symptomatology, sleep–wake patterns, romantic preferences, friendships, familial environment, stress, anorexia and bulimia as well as baldness, acne, asthma, endometriosis, joint flexibility and internet use. The overlap with previous waves of the BLTS means that 84% of the 19Up participants are genotyped, 36% imaged using multimodal MRI and most have been assessed for psychological symptoms at up to four time points. Furthermore, IQ is available for 57%, parental report of ADHD symptomatology for 100% and electroencephalography for 30%. The 19Up study complements a phenotypically rich, longitudinal collection of environmental and psychological risk factors. Future publications will explore hypotheses related to disease onset and development across the waves of the cohort. A follow-up study at 25+years is ongoing.
Publisher: Elsevier BV
Date: 2016
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2013
Publisher: Public Library of Science (PLoS)
Date: 27-11-2012
Publisher: Cambridge University Press (CUP)
Date: 23-12-2014
DOI: 10.1017/S0033291714002888
Abstract: Mental and substance use disorders are common and often persistent, with many emerging in early life. Compared to adult mental and substance use disorders, the global burden attributable to these disorders in children and youth has received relatively little attention. Data from the Global Burden of Disease Study 2010 was used to investigate the burden of mental and substance disorders in children and youth aged 0–24 years. Burden was estimated in terms of disability-adjusted life years (DALYs), derived from the sum of years lived with disability (YLDs) and years of life lost (YLLs). Globally, mental and substance use disorders are the leading cause of disability in children and youth, accounting for a quarter of all YLDs (54.2 million). In terms of DALYs, they ranked 6th with 55.5 million DALYs (5.7%) and rose to 5th when mortality burden of suicide was reattributed. While mental and substance use disorders were the leading cause of DALYs in high-income countries (HICs), they ranked 7th in low- and middle-income countries (LMICs) due to mortality attributable to infectious diseases. Mental and substance use disorders are significant contributors to disease burden in children and youth across the globe. As reproductive health and the management of infectious diseases improves in LMICs, the proportion of disease burden in children and youth attributable to mental and substance use disorders will increase, necessitating a realignment of health services in these countries.
Publisher: Springer Science and Business Media LLC
Date: 16-11-2022
DOI: 10.1038/S41562-022-01477-6
Abstract: Climate change affects mental health through multiple pathways, including direct and indirect impacts, physical health and awareness of the climate crisis. Climate change increases the magnitude and frequency of extreme events with little or no time for recovery. This Review aims to provide an overview of the current evidence to inform the mental health field's response to climate change. While further innovation is needed, promising approaches for health professionals are identified at the levels of interventions for in iduals, community and system-wide responses, and advocacy and education. Health worker training is important, so we offer guidance on mental health assessment and clinical risks from climate change. We also outline strategies to enhance in idual and community psychological resilience and promising approaches to working with people experiencing emerging climate-related disorders. Beyond clinical care, mental health professionals can lead on climate action and sustainability in health care and can research and educate on the health effects of climate change.
Publisher: Wiley
Date: 18-01-2022
DOI: 10.1111/JPC.15880
Abstract: This study examines 3 years of child and adolescent health data from Australian onshore and offshore immigration detention centres from 2014 to 2017, quantifying the health presentation data of children and adolescents in Australian immigration detention and comparing rates between onshore and offshore detention. This study utilised the Quarterly Immigration Detention Health Reports over a period of 3 years. To compare onshore and offshore datasets, we calculated the rate of health events per quarter against the estimated quarterly onshore and offshore detention population of children. We ran a series of two‐proportion z ‐tests for each matched quarter to calculate median z and P values for all quarters. These were used as an indicator as to whether the observed differences between onshore and offshore events were statistically significant. The estimated number of children detained per quarter onshore ranged from 700 in 2014 (quarter 3) to 13 in 2016 (quarters 3 and 4) the estimated quarterly population of children in offshore detention ranged from 186 in 2014 (quarter 3) to 42 in 2017 (quarter 2). Children offshore had significantly higher rates of consultations with a mental health nurse ( z = −1.96 P = 0.002), psychologist ( z = −2.32 P = 0.01) and counsellor ( z = −3.41 P 0.001). As for reasons for presentation to general practitioners and psychiatrists, complaints related to skin ( z = −1.97 P = 0.05), respiratory issues ( z = −1.96 P = 0.05) and urological issues ( z = −2.21 P = 0.03) were significantly higher amongst children detained offshore. Compared to children in the Australian community, children detained both onshore and offshore had greater health needs. Children offshore also presented more frequently with a range of complaints and accessed health services at higher rates than children detained onshore this adds to growing evidence about the harms of offshore detention and detention more generally.
Publisher: SAGE Publications
Date: 11-07-2018
Abstract: Despite growing literature on psychotic experiences, no nationally representative study has reported on the prevalence of both hallucinatory experiences and delusional experiences in Australian adolescents. Also, while many studies have examined the association between psychotic experiences and certain demographic and clinical correlates, there are more variables of interest to be investigated, including disordered eating behaviour and hours of sleep. The aims of this study were to examine (1) the prevalence of hallucinatory experiences and delusional experiences in Australian adolescents, and (2) the associations between different types of psychotic experiences with a broad range of demographic, clinical, and psychosocial variables. A random s le of Australian adolescents aged 14- to 17-year-olds were recruited in 2013–2014 as part of the Young Minds Matter Survey. Participants completed self-report questions regarding five different psychotic experience types (auditory and visual hallucinatory experiences, and thoughts read, special messages, spied upon) experienced in the past 12 months. Using logistic regression analyses, we investigated associations between psychotic experiences and demographic, clinical, and psychosocial factors. The 12-month prevalence ranged from 3.3% (95% confidence interval = [2.6, 4.3]) for special messages to 14.0% (95% confidence interval = [12.3, 15.8]) for auditory hallucinatory experiences. At the bivariate level, each psychotic experience subtype was associated with increased likelihood of major depression, being bullied, psychological distress, low self-esteem, mental health service use and insufficient sleep ( hours per night). Multivariate analyses revealed both auditory and visual hallucinatory experiences were associated with an increased likelihood of four of these variables (depression, being bullied, service use, insufficient sleep), whereas associations with delusional experiences were inconsistent. Hallucinatory and delusional experiences are common in Australian adolescents. Hallucinatory experiences, rather than delusional experiences, may be more clinically relevant in this demographic. When psychotic experiences are endorsed by adolescents, further assessment is indicated so as to ascertain more detail on the phenomenology of the experiences to better understand their clinical relevance.
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.SCHRES.2016.06.009
Abstract: Hallucinations, once equated with serious mental disorders, are common in adolescents. Given the high prevalence of hallucinations, it is important to determine if they are associated with adverse mental health outcomes in adulthood. This study compared the mental health outcomes of participants (aged 30-33years) in the Mater-University of Queensland Study of Pregnancy (MUSP) who reported hallucinations at (a) 14years only and (b) 14 and 21years versus cohort members without hallucinations. Participants (n=333) were aged between 30 and 33years and (a) reported hallucinations on the Youth Self-Report Questionnaire at 14 and/or the Young Adult Self-Report Questionnaire at 21years and (b) controls (n=321) who did not report hallucinations. Lifetime diagnoses of mental disorders were ascertained by the Structured Clinical Interview for DSM Disorders (DSM IV-TR) administered by clinical psychologists. Suicidal behaviour was measured by self report. Hallucinations at 14years only were not associated with an increased risk of mental disorders in adulthood. Hallucinations reported at both 14 and 21years were associated with lifetime diagnoses of psychotic disorders (OR, 8.84 95% CI: 1.61-48.43 and substance use disorders (OR, 2.34 95% CI: 1.36-4.07) and also strongly associated with lifetime suicide attempts (OR, 7.11 95% CI: 2.68-18.83). Most adolescents who experience hallucinations do not have an increased rate of mental disorder in adulthood however, those with hallucinations that are experienced at more than one point in time are at increased risk of suicidal behaviour and both psychotic and non-psychotic psychopathology.
Publisher: Wiley
Date: 09-10-2017
DOI: 10.1111/BJC.12161
Abstract: Social Cognition and Interaction Training (SCIT) has demonstrated effectiveness in improving social cognition and functioning of people with schizophrenia. This pilot study examines the acceptability, feasibility, and effectiveness of SCIT with in iduals who have schizophrenia-spectrum disorders and are receiving care through a public mental health service. In a pragmatic randomized waitlist controlled trial, 36 participants (aged 19-55 years) with a schizophrenia spectrum disorder were randomly allocated to SCIT or treatment as usual (TAU). Measures of theory of mind, emotion perception, attributional bias, social skills, quality of life, life skills, depression, anxiety, and stress were administered pre- and post-intervention with follow-up conducted 4 months later. All wait-list controls subsequently received the intervention and a secondary within-group analysis was conducted including these participants. While no significant differences were found between groups on any outcomes, there was strong engagement with the SCIT intervention. Of the 21 participants in the intervention group, the completion rate was 85.71% with a median attendance rate of 17 sessions. Within subject analyses of SCIT participants over time showed significant improvements in quality of life, emotion recognition, social skills, and a trend towards better life skills from pre- to post-intervention. These gains were sustained at the 4-month follow-up time. Although this study showed limited benefits in outcomes associated with SCIT compared with TAU, it demonstrated the acceptability of SCIT to participants in a real world public health setting shown by high retention, attendance, and positive feedback. This pilot shows SCIT can be implemented in routine clinical practice and lays the foundation for a larger pragmatic study. SCIT can be implemented successfully in a real-world community mental health setting. SCIT had high levels of acceptability to these participants. Limitations The small s le size meant there was insufficient power to detect differences between groups on outcome measures. The study did not include measures of psychiatric symptoms or neuropsychological functioning which may have influenced participants' capacity to benefit from SCIT.
Publisher: Springer Science and Business Media LLC
Date: 07-04-2017
Publisher: SAGE Publications
Date: 05-2014
Abstract: Restrictive interventions (seclusion, physical restraint, and use of acute .r.n. sedation) may have negative effects on patients. Identifying factors associated with use of restrictive interventions and examining their effect on admission outcomes is important for optimising inpatient psychiatric care. This study documented use of restrictive interventions within a child and adolescent psychiatric inpatient unit for 15 months. Two models examined predictors of use of restrictive interventions: (i) incident characteristics and (ii) patient characteristics. The relationship between use of restrictive interventions and global clinical outcomes was also examined. Of 134 patients admitted during the study period (61.9% female, mean age=13.8±2.9 years), 26.9% received at least one restrictive intervention. Incident factors associated with restrictive interventions were: physical aggression, early admission stage, and occurrence in private space. Patient factors that predicted use of restrictive interventions were developmental disorder and younger age. Use of restrictive interventions was not associated with increased length of stay or diminished improvement in global symptom ratings. Further research is needed to identify best practice in children at high risk for receiving restrictive interventions.
Publisher: American Psychiatric Association Publishing
Date: 05-2009
DOI: 10.1176/APPI.AJP.2008.08081182
Abstract: Community surveys have shown that many otherwise well in iduals report delusional-like experiences. The authors examined psychopathology during childhood and adolescence as a predictor of delusional-like experiences in young adulthood. The authors analyzed prospective data from the Mater-University of Queensland Study of Pregnancy, a birth cohort of 3,617 young adults born between 1981 and 1983. Psychopathology was measured at ages 5 and 14 using the Child Behavior Checklist (CBCL) and at age 14 using the Youth Self-Report (YSR). Delusional-like experiences were measured at age 21 using the Peters Delusional Inventory. The association between childhood and adolescent symptoms and later delusional-like experiences was examined using logistic regression. High CBCL scores at ages 5 and 14 predicted high levels of delusional-like experiences at age 21 (odds ratios for the highest versus the other quartiles combined were 1.25 and 1.85, respectively). Those with YSR scores in the highest quartile at age 14 were nearly four times as likely to have high levels of delusional-like experiences at age 21 (odds ratio=3.71). Adolescent-onset psychopathology and continuous psychopathology through both childhood and adolescence strongly predicted delusional-like experiences at age 21. Hallucinations at age 14 were significantly associated with delusional-like experiences at age 21. The general pattern of associations persisted when adjusted for previous drug use or the presence of nonaffective psychoses at age 21. Psychopathology during childhood and adolescence predicts adult delusional-like experiences. Understanding the biological and psychosocial factors that influence this developmental trajectory may provide clues to the pathogenesis of psychotic-like experiences.
Publisher: Wiley
Date: 26-07-2022
DOI: 10.1002/JAD.12080
Abstract: Peer victimization and aggression in adolescence are associated with later mental health morbidity. However, studies examining this association have not controlled for adolescent substance use. We aimed to study the associations between peer victimization, peer aggression, and mental disorders in adulthood, adjusting for substance use in adolescence. Participants were from the prospective Northern Finland Birth Cohort 1986. Data were available for 6682 in iduals (70.8% of the original s le). Peer victimization and peer aggression were assessed with items from the Achenbach Youth Self Report at ages 15−16 years. Outcomes were nonorganic psychosis, anxiety disorder, mood disorder, substance use disorder, and any mental disorder (a none‐vs‐any indicator) at age 33 years collected from nationwide health care, insurance, and pension registers. Family structure, alcohol intoxication frequency, daily smoking, illicit drug use, and baseline psychopathology using Youth Self‐Report total score, and parental mental disorders were considered as confounding factors. In multivariable analyses, the association between peer victimization and psychosis (Hazard ratio [HR]: 2.9, 95% confidence interval [CI]: 1.2−6.9, p = .020) and mood disorder (HR: 1.7, 95% CI: 1.2−2.4, p = .012) in females remained significant after adjusting for confounders. Other associations between female and male peer victimization or aggression and the studied outcomes attenuated after adjustments. Some associations between peer victimization and aggression and later mental health morbidity are explained by adolescent substance use. For females, substance use does not account for the increased risk of psychosis and mood disorder in those who experience peer victimization.
Publisher: Cold Spring Harbor Laboratory
Date: 02-09-2021
DOI: 10.1101/2021.08.31.21262937
Abstract: Cognitive impairments in psychosis are one of the strongest predictors of functional decline. Cortico-striatal dysfunction may contribute to both psychosis and cognitive impairment in psychotic illnesses. The decision-making processes underlying goal-directed action and serial reversal learning can be measured and are sensitive to changes reflecting cortico-striatal dysfunction. As such, changes in decision-making performance may assist with predicting functional decline in people with psychosis. We assessed decision-making processes in healthy controls (N=34), and those with early psychosis (N=15) and persistent psychosis (N=45). We subclassified subjects based on intact/impaired goal-directed action. Compared with healthy controls ( %), a large proportion (58%) of those with persistent psychosis displayed impaired goal-directed action, predicting poor serial reversal learning performance. Computational approaches indicated that those with persistent psychosis were less deterministic in their decision-making. Those with impaired goal-directed action had a decreased capacity to rapidly update their prior beliefs in the face of changing contingencies. In contrast, the early psychosis group included a lower proportion of in iduals with impaired goal-directed action (20%) and displayed a different cognitive phenotype from those with persistent psychosis. These findings suggest prominent decision-making deficits, indicative of cortico-striatal dysfunction, are present in a large proportion of people with persistent psychosis while those with early psychosis have relatively intact decision-making processes compared to healthy controls. It is unclear if there is a progressive decline in decision-making processes in some in iduals with psychosis or if the presence of decision-making processes in early psychosis is predictive of a persistent trajectory of illness.
Publisher: Korean College of Neuropsychopharmacology
Date: 31-05-2019
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.SCHRES.2019.06.002
Abstract: People with schizophrenia often experience difficulties with prospective memory (PM), but few empirical studies have directly compared the effectiveness of different types of reminders in remediating these difficulties. In the present study, two distinct types of reminders were compared to a standard (no reminder) condition in outpatients with schizophrenia (n = 30) and controls (n = 30). Using an adapted version of the well-validated laboratory PM measure, Virtual Week, participants were asked to complete three different conditions (counterbalanced), in which they were (i) provided with access to self-initiated reminders, (ii) provided with experimenter-initiated reminders, and (iii) completed a standard (no-reminder) condition. Both groups benefited from the provision of reminders, but self-initiated reminders were the most beneficial, particularly for time-based tasks. These data align with a broader literature that shows PM can be enhanced by the use of reminders. However, it extends this literature in an important way by showing that these benefits are equivalent for people with schizophrenia, and may be greatest where access to reminders is self-initiated. The implications of these data for the development of rehabilitative interventions are discussed.
Publisher: SAGE Publications
Date: 23-04-2022
DOI: 10.1177/08862605221090565
Abstract: The long-term mental and physical health consequences of childhood maltreatment have been well documented. Less known are the longer-term consequences of childhood maltreatment, specifically the extent to which childhood maltreatment predicts adult life success. To prospectively assess the extent to which childhood experiences of physical, sexual, emotional abuse and childhood neglect predict life success at 30 years of age. Data are from the Mater-University of Queensland Study of Pregnancy (MUSP), a pre-birth cohort study which follows children from conception to 30 years of age. Details of childhood maltreatment are from two sources child safety agency notifications (and substantiations) linked to the survey data with self-reports of childhood experiences of maltreatment obtained at the 30-year follow-up using the Child Trauma Questionnaire (CTQ). Life success is a 9-item composite measure (alpha = 0.76) obtained at the 30-year follow-up. We use logistic regression models (with control for covariates) to examine the association between overall as well as specific forms of childhood maltreatment on adult life success. We further test these models using different cut-offs and propensity analyses to adjust for loss to follow-up. Childhood maltreatment whether measured by agency report or self-report predicts overall low life success agency substantiation OR = 1.88(1.14,3.08) & self-report OR = 2.60 (2.10,3.25). Self-report physical abuse, OR = 2.37(1.72,3.28) sexual abuse, OR = 2.85(2.05,3.96) emotional abuse, OR = 2.53(1.85,3.45) and neglect, OR = 2.36(1.83,3.03) all predict higher levels of low life success. Our findings suggest that the long-term consequences of childhood maltreatment extend to a wide range of day-to-day circumstances and extend into mid- to later life.
Publisher: Springer Science and Business Media LLC
Date: 03-03-2023
DOI: 10.1038/S41398-023-02381-X
Abstract: The mixed cognitive outcomes in early psychosis (EP) have important implications for recovery. In this longitudinal study, we asked whether baseline differences in the cognitive control system (CCS) in EP participants would revert toward a normative trajectory seen in healthy controls (HC). Thirty EP and 30 HC undertook functional MRI at baseline using the multi-source interference task—a paradigm that selectively introduces stimulus conflict—and 19 in each group repeated the task at 12 months. Activation of the left superior parietal cortex normalized over time for the EP group, relative to HC, coincident with improvements in reaction time and social-occupational functioning. To examine these group and timepoint differences, we used dynamic causal modeling to infer changes in effective connectivity between regions underlying the MSIT task execution, namely visual, anterior insula, anterior cingulate, and superior parietal cortical regions. To resolve stimulus conflict, EP participants transitioned from an indirect to a direct neuromodulation of sensory input to the anterior insula over timepoints, though not as strongly as HC participants. Stronger direct nonlinear modulation of the anterior insula by the superior parietal cortex at follow-up was associated with improved task performance. Overall, normalization of the CCS through adoption of more direct processing of complex sensory input to the anterior insula, was observed in EP after 12 months of treatment. Such processing of complex sensory input reflects a computational principle called gain control, which appears to track changes in cognitive trajectory within the EP group.
Publisher: Elsevier BV
Date: 03-2021
Publisher: SAGE Publications
Date: 21-08-2016
Abstract: The frequency and emotional response to bullying victimisation are known to be associated with adolescent mental ill health. A potentially important under-investigated factor is the form of bullying. Four common forms of bullying behaviours are name-calling, physical threats or harm, rumour spreading and social exclusion. To more comprehensively understand bullying victimisation in adolescence, we examined the association of all three factors ( frequency, emotional response, form) to psychological distress and emotional wellbeing. A stratified, random s le of adolescents ( n = 10, 273 mean age = 14.33 years, standard deviation = 1.68 years) completed validated measures of bullying victimisation (Gatehouse Bullying Questionnaire), psychological distress (K10) and emotional wellbeing (Mental Health Inventory) in classroom time. Associations between the form of bullying victimisation and mental health outcomes were examined. Adolescents reported a high prevalence of all four forms of bullying: teased or called names (30.6%), rumour spreading (17.9%), social exclusion (14.3%) and physical threats or harm (10.7%). Victimisation was independently associated with significantly higher levels of psychological distress and reduced levels of emotional wellbeing for all forms of bullying. In particular, social exclusion had a strong association with mental ill health. Adolescents who experienced frequent bullying that was upsetting reported higher psychological distress and reduced emotional wellbeing. Different forms of bullying victimisation were independently associated with psychological distress and reduced emotional wellbeing. In particular, frequent and upsetting social exclusion requires a targeted and measured response by school communities and health practitioners.
Publisher: Springer Science and Business Media LLC
Date: 18-02-2021
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.PSYCHRES.2018.12.123
Abstract: Attention-deficit/hyperactivity disorder (ADHD) is a prevalent heterogeneous neurodevelopmental syndrome associated with various environmental factors. This study examined the association between maternal pre-ecl sia and offspring ADHD at 7- and 10-years. The study cohort consisted of more than 7200 children who participated in Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort study. ADHD was diagnosed using parent reported Development and Wellbeing Assessment (DAWBA). Log-binomial regression and Generalized Estimating Equation (GEE) models were used. The GEE analysis showed that pre-ecl sia was associated with increased risk of ADHD in offspring (adjusted risk ratio [RR] = 2.77 95% confidence interval [CI] = 1.42-5.38). Similarly, the results of multivariable log-binomial regression analysis at each time point showed that pre-ecl sia was associated with an almost threefold increase risk of offspring ADHD. This study suggests that offspring of mothers with pre-ecl sia are at increased risk of ADHD, although residual and unmeasured confounding by environmental and genetic factors warrants further study. If our findings are replicated by others, early screening for ADHD and other developmental delays may be recommended in offspring of women with pre-ecl sia.
Publisher: Elsevier BV
Date: 11-2020
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.JPSYCHIRES.2019.01.001
Abstract: The effect of hypertensive disorders of pregnancy (HDP) on offspring anxiety disorders in adolescence is not yet known. This study aims to examine the association between HDP and offspring anxiety disorders at age 15 years. We used data from 5231 mother-offspring pairs from the United Kingdom based Avon Longitudinal Study of Parents and Children (ALSPAC). Anxiety disorder was diagnosed in the offspring at the age of 15 years using the Development and Well-Being Assessment (DAWBA). Among those who had anxiety disorders, 16.4% were exposed to HDP. After adjusting for a wide range of known confounders, we found that adolescents of women with HDP had a 2.43 fold (95% CI: 1.41-4.19) increase risk of anxiety disorders compared with adolescents of women without HDP. Our study showed that adolescents exposed to HDP had higher risk of anxiety disorders compared with unexposed adolescents and suggests that prevention and treatment of maternal HDP could possibly prevent offspring anxiety in adolescence. Early screening for anxiety disorders in offspring of women with HDP may also be warranted. Further research is needed to explain the pathways by which HDP may increase the risk of offspring psychopathology.
Publisher: BMJ
Date: 2012
Publisher: Springer Science and Business Media LLC
Date: 06-03-2019
Publisher: Emerald
Date: 11-07-2016
DOI: 10.1108/JACPR-11-2015-0196
Abstract: – Whilst overt bullying has received considerable attention for its negative impact on the emotional well-being of children and adolescents, peer problems such as excessive teasing and social exclusion have received less consideration. The purpose of this paper is to examine the prevalence, demographic, and clinical correlates of frequent peer problems in children and adolescents who participated in the Australian National Survey of Mental Health and Well-Being. – Participants were a nationally representative s le of 2,107 children (aged 6-12 years), and 1,490 adolescents (aged 13-17 years). Frequent peer problems (excessive teasing or social exclusion) were measured by parental report for children, and self and parental report for adolescents. Associations with a number of mental health problems were examined, including being in the clinical range for internalising and externalising symptoms, having major depressive disorder, attention deficit hyperactivity disorder or conduct disorder, low self-esteem, experiencing suicidal ideation and behaviour, or using marijuana and alcohol. – One in 30 children and one in 20 adolescents experienced frequent peer problems. Parents less commonly identified frequent peer problems than were self-reported by their adolescent children. Frequent peer problems were strongly associated with all mental health problems except alcohol and marijuana use. – Frequent peer problems are associated with a greatly increased risk of mental health problems. Identifying those children and adolescents with frequent peer problems provides opportunity for assessment and intervention of emotional and behavioural problems.
Publisher: American Medical Association (AMA)
Date: 03-2019
Publisher: Wiley
Date: 02-04-2023
DOI: 10.5694/MJA2.51892
Abstract: To examine associations between child maltreatment and health service use, both overall, by type and by the number of types of maltreatment reported. Cross‐sectional, retrospective survey using the Juvenile Victimization Questionnaire‐R2: Adapted Version (Australian Child Maltreatment Study) computer‐assisted mobile telephone interviews using random digit dialling, Australia, 9 April – 11 October 2021. Australians aged 16 years or more. The target s le size was 8500 respondents: 3500 people aged 16–24 years and 1000 respondents each from the five age groups (25–34, 35–44, 45–54, 55–64, 65 years or more). Self‐reported health service use during the past twelve months: hospital admissions, length of stay, and reasons for admission and numbers of consultations with health care professionals, overall and by type. Associations between maltreatment and health service use are reported as odds ratios adjusted for age group, gender, socio‐economic status, financial hardship (childhood and current), and geographic remoteness. A total of 8503 participants completed the survey. Respondents who had experienced child maltreatment were significantly more likely than those who had not to report a hospital admission during the preceding twelve months (adjusted odds ratio [aOR], 1.39 95% confidence interval [CI], 1.16–1.66), particularly admission with a mental disorder (aOR, 2.4 95% CI, 1.03–5.6). The likelihood of six or more visits to general practitioners (aOR, 2.37 95% CI, 1.87–3.02) or of a consultation with a mental health nurse (aOR, 2.67 95% CI, 1.75–4.06), psychologist (aOR, 2.40 95% CI, 2.00–2.88), or psychiatrist (aOR, 3.02 95% CI, 2.25–4.04) were each higher for people who reported maltreatment during childhood. People who reported three or more maltreatment types were generally most likely to report greater health service use. Child maltreatment has a major impact on health service use. Early, targeted interventions are vital, not only for supporting children directly, but also for their longer term wellbeing and reducing their health system use throughout life.
Publisher: Springer Science and Business Media LLC
Date: 20-04-2022
DOI: 10.1007/S40653-022-00451-8
Abstract: This study aimed to estimate the prevalence of different forms of bullying victimization experiences and their association with family functioning, peer relationships and school connectedness among adolescents across 40 lower and middle income to high-income countries (LMIC-HICs). Data were drawn from the Health Behaviour in School-Aged Children (HBSC) school-based survey of adolescents aged 11–15 years, between 2013 and 2014. We estimated the weighted prevalence by categorising experiences into traditional bullying victimization only, cyberbullying victimization only, and combined traditional and cyberbullying victimization, at country and country income classification. We used multinominal logistic regression models to estimate the adjusted association with the form of bullying victimization by demographic characteristics, family functioning, peer relationships and school connectedness. Overall, 8.0% reported traditional bullying victimization only (8.8% males, 7.4% females), 2.3% of adolescents reported cyberbullying victimization only (2.1% males, 2.2% females), and 1.7% reported combined traditional and cyber bullying victimization (1.7% males, 1.8% females). All three forms of bullying victimization during adolescence were significantly associated with poor family functioning, poor peer relations and poor school connectedness. A consistent finding is that traditional bullying victimization is considerably more common among adolescents across both LMICs and HICs than cyberbullying victimization. This study also demonstrated that a significant proportion of adolescent’s experience victimization in both forms. Positive family functioning, strong peer relationships and greater school connectedness are associated with a lower risk of both forms of bullying victimization.
Publisher: Wiley
Date: 04-06-2013
DOI: 10.1111/JCPP.12080
Abstract: While cytokines have been implicated in the pathophysiology of depression in adults, the potential role in younger age groups such as adolescents is less clear. This article therefore reviews the literature (a) to explore the relationship between cytokines and depression in adolescents, and (b) to examine how cytokines may be related to adolescent depression in the context of other neurobiological theories of depression. A systematic review of the scientific literature on the subject was conducted in February 2013, searching the Web of Knowledge, PubMed (Medline), PsycInfo and Cochrane electronic databases. Eighteen studies were identified measuring both depression or depressive symptoms and cytokines or immune markers in adolescents. Adolescents with depression show age-specific characteristics of the immune and inflammatory system, specifically in NK cell activity and in pro-inflammatory cytokines (such as IL-1β and TNF-α). In addition, the role of cytokines in adolescent depression is influenced by neurodevelopment, hormonal changes, stress and trauma. There may be differences in the neurobiology of adolescent major depressive disorder (MDD) compared with adult MDD. Increased understanding of the role of cytokines in adolescent MDD may lead to improved outcomes in the treatment of adolescent depression.
Publisher: Wiley
Date: 15-03-2010
DOI: 10.1111/J.1600-0447.2009.01470.X
Abstract: Adults with non-affective psychosis show subtle deviations in a range of developmental trajectories as children and adolescents. Based on a birth-cohort (n = 3801), we examined the Peabody Picture Vocabulary Test (PPTV) at age 5, and Raven's Standard Progressive Matrices (RSPM) and Wide Range Achievement Test reading scale (WRAT-R) at age 14. Items related to speech problems and attentional dysfunction were available from maternal- or self-report. At age 21, we identified 60 cohort members who were screen-positive for non-affective psychosis (SP-NAP). Impaired performance on the PPVT and RSPM (but not WRAT-R) predicted SP-NAP for males only. Male cohort members in the highest quartile for attentional dysfunction at ages 5 and 14 were about 5-8 times more likely to develop SP-NAP. SP-NAP in males was significantly associated with speech problems at age 14. Males who develop non-affective psychoses have subtle impairments in cognitive capacity prior to the development of their psychotic disorder.
Publisher: SAGE Publications
Date: 20-06-2018
Publisher: SAGE Publications
Date: 2021
DOI: 10.1177/20451253211045248
Abstract: There is limited evidence on interventions to minimise weight gain at clozapine commencement. We compared the effect of adjunctive metformin versus placebo at clozapine initiation. People with schizophrenia commencing on clozapine were randomised to either metformin or placebo for 24 weeks. The primary outcome was difference in the change of body weight. Secondary outcomes included comparative rates of weight gain of more than 5%, overall weight gain/loss, and differences in metabolic and psychosis outcomes. The study was closed prematurely in March 2020 due to COVID-19 restrictions. Ten participants were randomised to each of the metformin and placebo groups. Eight metformin group and five placebo group participants completed the trial and were included in the analysis. The study was insufficiently powered to detect difference between the metformin and placebo groups for the primary outcome of change in weight (0.09 kg vs 2.88 kg, p = 0.231). In terms of secondary outcomes, people in the metformin group were significantly less likely to gain % of their body weight (12.5% vs 80%, p = 0.015) and were more likely to lose weight (37.5% vs 0% p = 0.024) compared to placebo. There was no difference between the groups in terms of adverse drug reactions (ADRs). While limited by the forced premature closure of the trial due to COVID19, the findings from this randomised controlled trial are promising. Clozapine and metformin co-commencement may be a promising treatment to prevent clozapine-associated weight gain, especially given the low rates of ADRs associated with metformin. This supports the consideration of use of metformin to prevent weight gain in people initiated on clozapine however, further studies are needed to confirm this finding. ACTRN12617001547336
Publisher: American Medical Association (AMA)
Date: 10-11-2020
Publisher: SAGE Publications
Date: 11-04-2012
Publisher: Elsevier BV
Date: 08-2015
Publisher: Elsevier BV
Date: 09-2013
DOI: 10.1016/J.SCHRES.2013.05.020
Abstract: Psychotic-like experiences (PLEs) are common, and are markers of poor mental health. This study examined the internal structure of a screening test, the Community Assessment of Psychic Experiences-Positive scale (CAPE-P) in a young Australian s le. A cross-sectional online survey, which included the CAPE-P, was completed by 1610 university students aged between 18 and 25 years. Confirmatory factor analyses compared 1-, 4-, and 5-factor models, and examined effects of omitting selected items. A 3-factor model, omitting items on magical thinking, grandiosity, paranormal beliefs and a cross-loading item produced the best fit. The resultant 15-item CAPE (CAPE-P15) had three subscales - Persecutory Ideation, Perceptual Abnormalities and Bizarre Experiences, all with high levels of internal consistency. The CAPE-P15 shows promise as a measure of positive, psychosis-like experiences, but further validation of this measure is required in community s les.
Publisher: Elsevier BV
Date: 05-2013
DOI: 10.1016/J.NBD.2012.10.023
Abstract: Schizophrenia and autism are two poorly understood clinical syndromes that differ in age of onset and clinical profile. However, recent genetic and epidemiological research suggests that these two neurodevelopmental disorders share certain risk factors. The aims of this review are to describe modifiable risk factors that have been identified in both disorders, and, where available, collate salient systematic reviews and meta-analyses that have examined shared risk factors. Based on searches of Medline, Embase and PsycINFO, inspection of review articles and expert opinion, we first compiled a set of candidate modifiable risk factors associated with autism. Where available, we next collated systematic-reviews (with or without meta-analyses) related to modifiable risk factors associated with both autism and schizophrenia. We identified three modifiable risk factors that have been examined in systematic reviews for both autism and schizophrenia. Advanced paternal age was reported as a risk factor for schizophrenia in a single meta-analysis and as a risk factor in two meta-analyses for autism. With respect to pregnancy and birth complications, for autism one meta-analysis identified maternal diabetes and bleeding during pregnancy as risks factors for autism whilst a meta-analysis of eight studies identified obstetric complications as a risk factor for schizophrenia. Migrant status was identified as a risk factor for both autism and schizophrenia. Two separate meta-analyses were identified for each disorder. Despite distinct clinical phenotypes, the evidence suggests that at least some non-genetic risk factors are shared between these two syndromes. In particular, exposure to drugs, nutritional excesses or deficiencies and infectious agents lend themselves to public health interventions. Studies are now needed to quantify any increase in risk of either autism or schizophrenia that is associated with these modifiable environmental factors.
Publisher: Oxford University Press (OUP)
Date: 04-08-2022
Abstract: The nature of the robust association between cannabis use and schizophrenia remains undetermined. Plausible hypotheses explaining this relationship include the premise that cannabis use causes schizophrenia, increased liability for schizophrenia increases the risk of cannabis use initiation (eg, self-medication), or the bidirectional causal hypothesis where both factors play a role in the development of the other. Alternatively, factors that confound the relationship between schizophrenia and cannabis use may explain their association. Externalizing behaviors are related to both schizophrenia and cannabis use and may influence their relationship. This study aimed to evaluate whether externalizing behaviors influence the genetic relationship between cannabis use and schizophrenia. We conducted a multivariate genome-wide association analysis of 6 externalizing behaviors in order to construct a genetic latent factor of the externalizing spectrum. Genomic structural equation modeling was used to evaluate the influence of externalizing behaviors on the genetic relationship between cannabis use and schizophrenia. We found that externalizing behaviors partially explained the association between cannabis use and schizophrenia by up to 42%. This partial explanation of the association by externalizing behaviors suggests that there may be other unidentified confounding factors, alongside a possible direct association between schizophrenia and cannabis use. Future studies should aim to identify further confounding factors to accurately explain the relationship between cannabis use and schizophrenia.
Publisher: IOP Publishing
Date: 29-03-2019
Publisher: Springer Science and Business Media LLC
Date: 09-08-2021
DOI: 10.1007/S40258-021-00676-Y
Abstract: There is a shortage of information on the costs and benefits of anti-bullying programs implemented in Australia. Information on the costs and benefits of anti-bullying programs is vital to assist policy making regarding the adoption of these programs. The aim of this study was to estimate the changes to costs and health benefits of implementing the "Friendly Schools Friendly Families" (FSFF) anti-bullying intervention in Australia. A societal perspective cost-effectiveness analysis was undertaken based on randomised controlled trial data for an anti-bullying intervention implemented in primary schools in Western Australia. The modelling strategy addressed changes to costs comprising intervention costs, less cost-savings, and then changes to health benefits measured by avoidable disability-adjusted life years (DALYs). Costs and health benefits were identified, measured, and valued in 2016 Australian dollars. Intermediate events modelled included anxiety disorders, depressive disorders, intentional self-harm, cost-savings accrued by educator time, and reduced productivity losses for carers associated with absenteeism. Uncertainty analysis and scenario analyses were also conducted. The prevalence of bullying victimisation was reduced by 18% by the Friendly Schools Friendly Families anti-bullying intervention. At a national level, this is expected to result in the avoidance of 9114 DALYs (95% CI 8770-9459) and cost-savings of A$120 million per year. The majority of cost-savings were associated with the reduction in mental healthcare. The model results demonstrated that the FSFF anti-bullying intervention is likely to be a cost-effective approach to reduce bullying in Australia, relative to a threshold of A$50,000 per DALY averted, with an ICER of A$1646. The Friendly Schools Friendly Families anti-bullying intervention represents a good investment compared to usual activities for the management of child and adolescent bullying in Australia. The investment and implementation of evidence-based interventions that reduce bullying victimisation and bullying perpetration in schools could reduce the economic burden associated with common mental health disorders and thereby improve the health of many Australians.
Publisher: American Psychiatric Association Publishing
Date: 2023
DOI: 10.1176/APPI.NEUROPSYCH.21080214
Abstract: Anti-
Publisher: Springer Science and Business Media LLC
Date: 14-02-2020
Publisher: Wiley
Date: 02-04-2023
DOI: 10.5694/MJA2.51877
Abstract: To estimate associations between all five types of child maltreatment (emotional abuse, neglect, physical abuse, sexual abuse, and exposure to domestic violence) and health risk behaviours and conditions. Nationally representative survey of Australian residents aged 16 years and older conducted by computer‐assisted telephone interviewing. Associations between child maltreatment and the following health risk behaviours and conditions: current smoker, binge drinking (at least weekly in past 12 months), cannabis dependence (according to the Cannabis Severity of Dependence Scale), obesity (based on body mass index), self‐harm in past 12 months, and suicide attempt in past 12 months. A total of 8503 participants completed the survey. All five types of child maltreatment were associated with increased rates of all of the health risk behaviours and conditions that we considered. The strongest associations were in the youngest age group (16–24‐year‐olds). Sexual abuse and emotional abuse were associated with the highest odds of health risk behaviours and conditions. Cannabis dependence, self‐harm and suicide attempts were most strongly associated with child maltreatment. Experiencing more than one type of child maltreatment was associated with higher rates of health risk behaviours and conditions than experiencing one type of child maltreatment. Child maltreatment is associated with substantially increased rates of health risk behaviours and conditions. Prevention and intervention efforts should be informed by trauma histories, and holistic psychosocial care should be incorporated into programs focusing on behaviour change.
Publisher: Springer Science and Business Media LLC
Date: 31-03-2021
DOI: 10.1007/S10578-021-01164-Z
Abstract: A large number of early life exposures predict child maltreatment. Using data from a 30-year birth cohort study we examine 12 early life course risk factors of four types of self-reported childhood maltreatment recalled at the 30-year follow-up. Of the 7223 children in the s le at birth, 2425 responded to the Child Trauma Questionnaire at the 30-year follow-up. On adjusted analysis being a teenage mother predicts childhood physical and sexual abuse, as well as child neglect. More numerous maternal marital partner changes in the 5 years after the birth predict offspring experiences of emotional abuse, sexual abuse and childhood neglect. Policy responses should focus on the broad social context in which children are reared as the most effective approach to reducing the high level of childhood abuse and neglect.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2013
Publisher: Springer Science and Business Media LLC
Date: 25-07-2020
Publisher: Springer Science and Business Media LLC
Date: 07-03-2014
Publisher: Elsevier BV
Date: 12-2018
Publisher: Elsevier BV
Date: 04-2020
DOI: 10.1016/J.SLEH.2019.12.007
Abstract: To quantify the changes in sleep duration over two generations of young adults. We used data from the Mater-University of Queensland Study of Pregnancy cohort to compare sleep duration in mother and offspring. The analyses were restricted to 1,731 mothers who were young adults (mean age 21.96 years SD±1.90) at the baseline measurement, and their offspring who were about the same age (mean age 20.6 years SD±0.86) when assessed 21 years later. Maternal sleep was explored by asking the mother, during the first trimester, about her typical sleep duration prior to pregnancy, while offspring participants were asked about the sleep duration in the last month at the time assessed. Multinomial logistic regression for correlated responses was used to assess generational changes. We found that offspring had 3.2 (2.7, 3.9) times the odds of sleeping for short duration (≤6 hours/night) and 1.7 (1.5, 1.9) times the odds of sleeping for a longer duration (≥9 hours/night) compared with their mothers. Gender-based analysis found that daughters had 3.0 (2.3, 5.0) times the odds of sleeping for a short duration, while sons had 3.4 (2.6, 6.4) times the odds of sleeping for a short duration compared with their mothers. There is a significant decline in sleep duration below recommendations as well as a substantial increase in long-duration above the recommendations over two generations of young adults. Therefore, the focus of sleep health should not be limited to short sleep, but on the need for achieving optimal sleep recommended for the age.
Publisher: SAGE Publications
Date: 29-07-2013
Abstract: The objective of this article is to examine national trends in prescribing second-generation antipsychotic (SGA) medications to Australian children and youth (0–24 years) and to report deficiencies in available data. We conducted a retrospective review of government data on all dispensed SGA prescriptions between 2002 and 2007. Scripts were converted to defined daily dose (DDD)/1000 population/day using census data. Trends in utilisation of dispensed SGAs were analysed by gender and age. The total amount of SGAs dispensed to children (0–14 years) remained stable over the five-year study period. In 2007, according to available data, total SGA medication dispensed to Australian children equated to fewer than three in 10,000 children receiving the equivalent of a standard adult dose of medication each day. In contrast to many other countries, the dispensed use of SGA medication in Australian children and youth has remained relatively stable. In our opinion, this is almost certainly because of limitations in data collection and accessibility. Given the safety concerns associated with SGAs prescribed to children and young people and the need to improve the quality use of medicines, it is essential that methods are developed in Australia to accurately capture prescribing of SGAs to Australian children and youth.
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.JCOMDIS.2016.10.002
Abstract: This study examined the parental and early childhood risk factors of different receptive vocabulary developmental profiles from childhood to adulthood. The s le (n=1914), comprised of monolingual English speaking participants, from the Mater University of Queensland Study of Pregnancy (MUSP). Receptive vocabulary was measured using the Peabody Picture Vocabulary Test-Revised (PPVT-R) at the 5 and 21-year follow ups. Four vocabulary profiles were evident: persistently typical, persistently impaired, later onset of difficulties, and resolved delays. The presence of internalising behaviours at 5 years, lower paternal educational attainment, and maternal smoking during pregnancy were associated with later onset vocabulary impairment. These findings have clinical and educational implications for identifying children 'at risk' of later deterioration in language skills.
Publisher: SAGE Publications
Date: 31-12-2022
DOI: 10.1177/00048674211069874
Abstract: Mental health service use by in iduals without a diagnosed mental disorder is sometimes termed ‘met un-need’. However, provision of services for this group may be necessary to provide appropriate assessment, referral and early intervention. This study quantified child and adolescent use of, and perceived need for, mental health services to inform population-level service planning. Young people in Australia’s Young Minds Matter survey ( n = 5837, 5–17 years), were categorised into four ‘need’ groups: (1) 12-month mental disorder diagnosis (2) remitted for more than 12 months (or experiencing a condition not surveyed) (3) 12-month subthreshold mental health problem and (4) no indication of need for help (i.e. did not meet the requirements of the first three categories). Service demand (use of, or perceived need for, a mental health service) and number of sessions received were estimated for each, separately for children (5–11 years) and adolescents (12–17 years). Some 20.1% (95% CI: [18.6, 21.7]) of children and 32.3% (95% CI: [30.5, 34.2]) of adolescents expressed a demand for mental health services in the past year. Service demand decreased across the need groups. Perceived need without service use was higher among those with a 12-month subthreshold mental health problem (13.8/20.2%) than those who had experienced a mental health problem that had remitted for more than 12 months (or were experiencing a condition not surveyed) (9.3/12.6%). In addition, 23.6% of children and 24.6% of adolescents with a demand for mental health services were classified as experiencing no indication of need for help. This study quantified the number of children and adolescents in Australia who are likely to require mental health services. Findings suggest that not everyone in this group who has an expressed service demand meets diagnostic thresholds, but among those who do, service demand is higher.
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1016/J.SLEEP.2012.07.003
Abstract: To examine the continuity and discontinuity of trouble sleeping behaviors (TSB) from childhood to adolescence and young adulthood in a community-based prospective birth cohort study. The original study comprised 7223 mother-offspring pairs who were followed prospectively at pregnancy, 6 months, 5, 14 and 21 years post-delivery. Participant numbers differ by follow-up stages. There were 3184 offspring for whom we have consistently collected information on TSB retrospectively at 2-4 years, and prospectively at 14 and 21 years of age. These comprised maternal-reported offspring TSB at 2-4 years and 14 years, and offspring-reported trouble sleeping at 14 and 21 years. One in two children had persistent trouble sleeping from 2-4 to 14 years and two-thirds from 14 to 21 years. In the adjusted analysis, compared with 2-4-years-old children with no trouble sleeping, those who experienced trouble sleeping were 1.20 (95% CI: 1.00, 1.44) times more likely to have trouble sleeping at 21 years. Similarly, adolescents who experienced trouble sleeping were 1.94 (95% CI: 1.66, 2.27) times more likely to experience trouble sleeping at 21 years. There is a continuity of TSB from early childhood through adolescence and young adulthood, although the persistence of TSB is strongest from adolescence to young adulthood. Interventions improving sleep in young children may prevent longer term difficulties in adolescents and young adults.
Publisher: MDPI AG
Date: 23-04-2021
Abstract: Climate change is negatively impacting the mental health of populations. This scoping review aims to assess the available literature related to climate change and mental health across the World Health Organisation’s (WHO) five global research priorities for protecting human health from climate change. We conducted a scoping review to identify original research studies related to mental health and climate change using online academic databases. We assessed the quality of studies where appropriate assessment tools were available. We identified 120 original studies published between 2001 and 2020. Most studies were quantitative (n = 67), cross-sectional (n = 42), conducted in high-income countries (n = 87), and concerned with the first of the WHO global research priorities—assessing the mental health risks associated with climate change (n = 101). Several climate-related exposures, including heat, humidity, rainfall, drought, wildfires, and floods were associated with psychological distress, worsened mental health, and higher mortality among people with pre-existing mental health conditions, increased psychiatric hospitalisations, and heightened suicide rates. Few studies (n = 19) addressed the other four global research priorities of protecting health from climate change (effective interventions (n = 8) mitigation and adaptation (n = 7) improving decision-support (n = 3) and cost estimations (n = 1)). While climate change and mental health represents a rapidly growing area of research, it needs to accelerate and broaden in scope to respond with evidence-based mitigation and adaptation strategies.
Publisher: SAGE Publications
Date: 2009
DOI: 10.1080/00048670902721095
Abstract: Objective: The primary purpose of the present study was to examine changes in utilization of pro re nata (PRN ‘as required’) sedation over time within a child and adolescent psychiatric inpatient unit. The secondary purpose was to assess whether changes in PRN sedation were related to changing patient characteristics. Methods: A retrospective chart review examined 257 medical charts from a child and youth mental health inpatient service over two time periods (wave I, n = 122 wave II, n = 135) and collected data on PRN sedation, patient characteristics and routine medications. Results: Over time a significant reduction was observed in the proportion of patients prescribed PRN sedation from 70% to 54% (p 0.01), and a reduction in the proportion of patients given PRN sedation from 46% to 26% (p 0.01). The most commonly administered drug was chlorpromazine in wave I, and diazepam in wave II. Multivariate analysis indicated that reductions in PRN sedation occurred independently of changes in patient characteristics. Conclusions: High utilization rates of PRN sedation are not inevitable in a child and adolescent psychiatric inpatient unit and may be reduced over time. Changing utilization of PRN sedation occurred independently from changing patient characteristics. More treatment outcome studies are required to optimize use of PRN sedation in young people.
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.JPSYCHIRES.2017.07.006
Abstract: Lower levels of circulating iron have been associated with depression. Our objective was to investigate the phenotypic and genetic relationship between measures of circulating levels of iron (serum iron, transferrin, transferrin saturation, and ferritin) and depressive symptoms. Data were available from ongoing studies at QIMR Berghofer Medical Research Institute (QIMRB), including twin adolescents (mean age 15.1 years, standard deviation (SD) 3.2 years), and twin adults (mean age 23.2 years, SD 2.2 years). In the adolescent cohort, there were 3416 participants from 1688 families. In the adult cohort there were 9035 participants from 4533 families. We estimated heritabilities of, and phenotypic and genetic correlations between, traits. We conducted analyses that linked results from published large-scale genome-wide association studies (including iron and Major Depressive Disorder) with our study s les using single SNP and multi-SNP genetic risk score analyses, and LD score regression analyses. In both cohorts, measures of iron, transferrin, transferrin saturation, and log 10 of ferritin (L10Fer) were all highly heritable, while depressive measures were moderately heritable. In adolescents, depression measures were higher in those in the middle 10th versus top 10th percentile of transferrin saturation measures (p = 0.002). Genetic profile risk scores of the iron measures were not significantly associated with depression in study participants. LD score analyses showed no significant genetic relationship between iron and depression. Genetic factors strongly influence iron measures in adolescents and adults. Using several different strategies we find no evidence for a genetic contribution to the relationship between blood measures of iron and measures of depression.
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.PSYCHRES.2019.01.079
Abstract: Few studies have compared the content and appraisal of hallucinatory experiences (HE) by people with psychosis and those without. This study compared the characteristics of HE, and their appraisals, in in iduals with psychotic disorder, non-psychotic mental disorder and no disorder in the general population. Participants (n = 253) aged between 30-33 years who reported HE were recruited from a birth cohort and assessed for lifetime diagnoses of mental disorders. They were allocated to groups based on their diagnosis and their HE were rated to assess their form, content and associated appraisals. Compared to those with no mental disorder, participants with a psychotic disorder had almost twelve times the odds of appraising their HE as distressing and dangerous and nine times the odds of experiencing recurrent HE. Those with a non-psychotic disorder had more than twice the odds of recurrent HE compared to those with no disorder. Overall, HE showed more similarities than differences across the diagnostic groups. Negative appraisals of HE and their recurrence differentiated clinical from non-clinical populations. Screening for HE and assessment of their associated appraisals is essential in those seeking care for mental health difficulties. Interventions aimed at modifying maladaptive appraisals can assist in reducing hallucination related distress.
Publisher: Wiley
Date: 02-04-2023
DOI: 10.5694/MJA2.51873
Abstract: To estimate the prevalence in Australia of each type of child maltreatment to identify gender‐ and age group‐related differences in prevalence. Cross‐sectional national survey mobile telephone interviews using random digit dialling (computer‐generated), Australia, 9 April – 11 October 2021. Retrospective self‐report data using validated questionnaire (Juvenile Victimisation Questionnaire‐R2 Adapted Version (Australian Child Maltreatment Study). People aged 16 years or more. The target s le size was 8500 respondents: 3500 people aged 16–24 years and 1000 respondents each from five further age groups (25–34, 35–44, 45–54, 55–64, 65 years or more). Proportions of respondents reporting physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence to age 18 years, assessed with the Juvenile Victimization Questionnaire‐R2 Adapted Version (Australian Child Maltreatment Study), overall and by gender and age group, and weighted to reflect characteristics of the Australian population aged 16 years or more in 2016. Complete survey data were available for 8503 eligible participants (14% response rate). Physical abuse was reported by 32.0% of respondents (95% confidence interval [CI], 30.7–33.3%), sexual abuse by 28.5% (95% CI, 27.3–29.8%), emotional abuse by 30.9% (95% CI, 29.7–32.2%), neglect by 8.9% (95% CI, 8.1–9.7%), and exposure to domestic violence by 39.6% (95% CI, 38.3–40.9%). The proportions of respondents who reported sexual abuse, emotional abuse, or neglect were each statistically significantly larger for women than men. The reported prevalence of physical abuse by respondents aged 16–24 years was lower than for those aged 25–34 years, and that of sexual abuse was lower than for those aged 35–44 years, suggesting recent declines in the prevalence of these maltreatment types. Child maltreatment is common in Australia, and larger proportions of women than men report having experienced sexual abuse, emotional abuse, and neglect during childhood. As physical and sexual abuse may have declined recently, public health policy and practice may have positive effects, justifying continued monitoring and prevention activities.
Publisher: Public Library of Science (PLoS)
Date: 21-08-2013
Publisher: Baishideng Publishing Group Inc.
Date: 2017
DOI: 10.5498/WJP.V7.I1.60
Publisher: Wiley
Date: 02-04-2023
DOI: 10.5694/MJA2.51870
Abstract: To examine the associations between experiences of child maltreatment and mental disorders in the Australian population. Population‐representative survey conducted by computer‐assisted telephone interviewing. Australian residents aged 16 years and older. Mental disorder diagnoses of lifetime major depressive disorder, current alcohol use disorder (mild, moderate and severe), current generalised anxiety disorder and current post‐traumatic stress disorder. More than one in three Australians (3606/8503 surveyed participants 38.0% 95% CI, 36.7–39.3%) met the diagnostic criteria for a mental disorder. The prevalence of mental disorders in non‐maltreated participants was 21.6% (95% CI, 19.9–23.3% n = 851). This increased to 36.2% (95% CI, 33.5–38.9% n = 764) for those who experienced a single type of maltreatment and 54.8% (95% CI, 52.6–56.9% n = 1991) for participants who experienced multi‐type maltreatment. Compared with non‐maltreated Australians, maltreated participants had about three times the odds of any mental disorder (odds ratio [OR], 2.82 95% CI, 2.47–3.22), generalised anxiety disorder (OR, 3.14 95% CI, 2.48–3.97), major depressive disorder (OR, 3.19 95% CI, 2.68–3.80) and severe alcohol use disorder (OR, 2.62 95% CI, 1.83–3.76), and almost five times the odds of post‐traumatic stress disorder (OR, 4.60 95% CI, 3.00–7.07). Associations between experiences of child maltreatment and mental disorders were strongest for sexual abuse, emotional abuse and multi‐type maltreatment. The strength of the associations did not differ by gender. Adjustment for childhood and current financial hardship and for current socio‐economic status did not significantly attenuate the associations. Mental disorders are significantly more likely to occur in in iduals who experience child maltreatment, particularly multi‐type maltreatment. Prevention of child maltreatment provides an opportunity to substantially reduce the prevalence of mental illness and improve the health of the Australian population.
Publisher: Informa UK Limited
Date: 20-06-2014
DOI: 10.3109/09638237.2014.924051
Abstract: Abstract Background: Strategies proposed to promote recruitment of representative s les to trials and mental health research have focused on researchers external to clinical services. How clinicians approach recruitment as researchers and particularities of recruiting people with first episode of psychosis warrant investigation. To describe recruitment, by clinicians, of people with first-episode psychosis (FEP) and factors influencing process and enrolment. Observational study nested within longitudinal examination of trauma and outcomes for patients experiencing first psychotic episode. Data collected during 20 scheduled meetings of clinicians recruiting from services in Australia. Timely recruitment of 60 young people demonstrates that clinicians can successfully engage patients in research. Success depends on satisfaction of organisational preconditions and clinician motivation grounded in considering the study worthwhile. Pre-selection of participants was informed by judgments about health, insight and quality of the therapeutic alliance. Patients' decisions were influenced by family support, acceptance of diagnosis and altruism. Honoraria had variable effect. Clinicians are well placed to recruit when appropriately supported, and people with FEP are willing to engage in research that fits their personal circumstances. Research should examine the meaning of participation in such studies and ways participation could support recovery.
Publisher: Wiley
Date: 02-04-2023
DOI: 10.5694/MJA2.51872
Publisher: Wiley
Date: 03-05-2019
DOI: 10.1111/BJEP.12223
Abstract: Intervention on adolescent bullying is reliant on valid and reliable measurement of victimization and perpetration experiences across different behavioural expressions. This study developed and validated a survey tool that integrates measurement of both traditional and cyber bullying to test a theoretically driven multi-dimensional model. Adolescents from 10 mainstream secondary schools completed a baseline and follow-up survey (N = 1,217 M The Bullying and cyberbullying Scale for Adolescents (BCS-A) developed for this study comprised parallel victimization and perpetration subscales, each with 20 items. Additional measures of bullying (Olweus Global Bullying and the Forms of Bullying Scale [FBS]), as well as measures of internalizing and externalizing problems, school connectedness, social support, and personality, were used to further assess validity. Factor structure was determined, and then, the suitability of items was assessed according to the following criteria: (1) factor interpretability, (2) item correlations, (3) model parsimony, and (4) measurement equivalence across victimization and perpetration experiences. The final models comprised four factors: physical, verbal, relational, and cyber. The final scale was revised to two 13-item subscales. The BCS-A demonstrated acceptable concurrent and convergent validity (internalizing and externalizing problems, school connectedness, social support, and personality), as well as predictive validity over 6 months. The BCS-A has sound psychometric properties. This tool establishes measurement equivalence across types of involvement and behavioural forms common among adolescents. An improved measurement method could add greater rigour to the evaluation of intervention programmes and also enable interventions to be tailored to subscale profiles.
Publisher: Wiley
Date: 02-04-2023
DOI: 10.5694/MJA2.51867
Publisher: Wiley
Date: 02-04-2023
DOI: 10.5694/MJA2.51868
Abstract: To determine the prevalence in Australia of multi‐type child maltreatment, defined as two or more maltreatment types (physical abuse, sexual abuse, emotional abuse, neglect, or exposure to domestic violence) and to examine its nature, family risk factors, and gender and age cohort differences. Retrospective cross‐sectional survey using a validated questionnaire. Mobile phone random digit‐dial s le of the Australian population aged 16 years and older. National estimates of multi‐type child maltreatment up to age 18 years using the Juvenile Victimisation Questionnaire‐R2: Adapted Version (Australian Child Maltreatment Study). Of 8503 participants, 62.2% (95% CI, 60.9–63.6%) experienced one or more types of child maltreatment. Prevalence of single‐type maltreatment was 22.8% (95% CI, 21.7–24.0%), whereas 39.4% (95% CI, 38.1–40.7%) of participants reported multi‐type maltreatment and 3.5% (95% CI, 3.0–4.0%) reported all five types. Multi‐type maltreatment was more common for gender erse participants (66.1% [95% CI, 53.7–78.7%]) and women (43.2% [95% CI, 41.3–45.1%]) than for men (34.9% [95% CI, 33.0–36.7%]). Multi‐type maltreatment prevalence was highest for those aged 25–44 years. Family‐related adverse childhood experiences — especially mental illness and alcohol or substance misuse — increased risk. Exposure to domestic violence was the maltreatment type most often present in multi‐type maltreatment patterns. Multi‐type child maltreatment is prevalent in Australia and more common in women and gender erse in iduals. Child protection services, health practitioners, and prevention and intervention services must assess and manage multi‐type maltreatment in children and address its health consequences across the lifespan. Public health policy should consider prevention services or strategies that target multi‐type child maltreatment.
Publisher: Wiley
Date: 02-04-2023
DOI: 10.5694/MJA2.51869
Abstract: To describe the aims, design, methodology, and respondent s le representativeness of the Australian Child Maltreatment Study (ACMS). Cross‐sectional, retrospective survey computer‐assisted mobile telephone interviewing using random digit dialling (computer‐generated), Australia, 9 April – 11 October 2021. People aged 16 years or more. The target s le size was 8500 respondents: 3500 people aged 16–24 years and 1000 respondents each from five further age groups (25–34, 35–44, 45–54, 55–64, 65 years or more). Primary outcomes: Emotional abuse, neglect, physical abuse, sexual abuse, exposure to domestic violence during childhood, assessed with the Juvenile Victimization Questionnaire‐R2 Adapted Version (Australian Child Maltreatment Study). Secondary outcomes: selected mental disorder diagnoses (Mini International Neuropsychiatric Interview, MINI), selected physical health conditions, health risk behaviours, health service use. The demographic characteristics of the ACMS s le were similar to those of the Australian population in 2016 with respect to gender, Indigenous status, region and remoteness category of residence, and marital status, but larger proportions of participants were born in Australia, lived in areas of higher socio‐economic status, had tertiary qualifications, and had income greater than $1250 per week. Population weights were derived to adjust for these differences. Associations between the number of calls required to recruit participants and maltreatment rates and health outcomes were not statistically significant. The ACMS provides the first reliable estimates of the prevalence of each type of child maltreatment in Australia. These estimates, and those of associated mental health and health risk behaviours reported in this supplement can inform policy and practice initiatives for reducing the prevalence of child maltreatment and its consequences. Our benchmark study also provides baseline data for repeated waves of the ACMS that will assess the effectiveness of these initiatives.
Publisher: Springer Science and Business Media LLC
Date: 14-08-2021
DOI: 10.1007/S10519-021-10076-6
Abstract: We test whether genetic influences that explain in idual differences in aggression in early life also explain in idual differences across the life-course. In two cohorts from The Netherlands ( N = 13,471) and Australia ( N = 5628), polygenic scores (PGSs) were computed based on a genome-wide meta-analysis of childhood/adolescence aggression. In a novel analytic approach, we ran a mixed effects model for each age (Netherlands: 12–70 years, Australia: 16–73 years), with observations at the focus age weighted as 1, and decaying weights for ages further away. We call this approach a ‘rolling weights’ model. In The Netherlands, the estimated effect of the PGS was relatively similar from age 12 to age 41, and decreased from age 41–70. In Australia, there was a peak in the effect of the PGS around age 40 years. These results are a first indication from a molecular genetics perspective that genetic influences on aggressive behavior that are expressed in childhood continue to play a role later in life.
Publisher: SAGE Publications
Date: 04-2011
DOI: 10.3109/00048674.2010.543413
Abstract: Objective: Internationally there has been an increase in the prescriptions of stimulant medication. The aim of this study was to examine longitudinal national trends of stimulant dispensing in Australia between 2002 and 2009. Method: Government databases were retrospectively reviewed for all dispensed stimulant prescriptions between 2002 and 2009. Prescriptions were converted to defined daily dose (DDD)/1000 population/day using census data. Utilization of dex hetamine and methylphenidate were analysed by source (subsidized or non-subsidized), prescriber (general practitioner, psychiatrist or other specialists), gender and age of patient. Results: Between 2002 and 2009, dispensing of stimulants in Australia increased 87% from 2.93 to 5.47 DDD/1000 population/day. Dex hetamine remained the most commonly dispensed stimulant, with rates of dispensing falling 13% from 2.02 to 1.75 DDD/1000 population/day. Dispensed prescriptions of methylphenidate increased 300% from 0.45 in 2002 to 1.81 DDD/1000 population/day in 2009, attributable to the availability of long-acting preparations. Dispensing of stimulants to males was four-fold greater than to females. There was substantial dispensing of dex hetamine to those older than 25 years. Conclusions: Stimulant dispensing in Australia increased between 2002 and 2009 as a result of increased dispensing of long-acting preparations of methylphenidate. Further research is required to determine if the increase in stimulant dispensing in Australia is clinically appropriate.
Publisher: American Academy of Pediatrics (AAP)
Date: 02-2016
Abstract: This study aimed to determine the prevalence of autism spectrum disorder (ASD) by using the Autism Diagnostic Observation Schedule-Generic (ADOS-G) classifications in children born very preterm during their toddler years. Two birth cohorts of toddlers (2 and 4 years old) each recruited over 12 months and born at & weeks’ gestation were administered the Modified Checklist of Autism in Toddlers–Follow-up Interview (M-CHAT-FI) screen, the ADOS-G, and developmental assessments. The ADOS-G was conducted on toddlers with M-CHAT-FI–positive screens. Data were available on 88% (169/192) of children. In total, 22 (13%) toddlers screened positive and 3 (1.8%) were confirmed diagnostically with ASD. These 3 cases reached the highest ADOS-G threshold classification of autism. All but 1 child who scored below the ADOS-G thresholds (11/12) demonstrated some difficulty with social communication. Risk was significantly increased for co-occurring neurodevelopmental problems in 21 of the 22 positive-screen ASD cases. Adaptive behavior (P & .001) was the only co-occurring factor independently predictive of ASD in toddlers. Children born very preterm are at increased risk of ASD. By using the ADOS-G, we found a lower incidence of ASD in children born at & weeks’ gestation compared with previous studies. Children who screened positive for ASD on the M-CHAT-FI had developmental delays consistent with subthreshold communication impairment.
Publisher: Elsevier BV
Date: 2023
Publisher: SAGE Publications
Date: 28-05-2020
Publisher: Springer Science and Business Media LLC
Date: 03-2020
Publisher: Elsevier BV
Date: 2015
Publisher: SAGE Publications
Date: 30-04-2021
DOI: 10.1177/00048674211009610
Abstract: Differences between adolescent self-reported and parent-reported emotional and behavioural difficulties may influence psychiatric epidemiological research. This study examined concordance between adolescents and their parents about mental health symptoms using the Strengths and Difficulties Questionnaire. The study comprised a randomly selected, nationally representative s le of adolescents aged 11–17 years who participated in the Second Australian Child and Adolescent Survey of Mental Health and Wellbeing ( N = 2967). Matched adolescent and parent responses across the five Strengths and Difficulties Questionnaire subscales (emotional problems, hyperactivity, peer problems, conduct problems and prosocial behaviour), as well as total difficulties and total impact scores were examined to estimate concordance. Concordance patterns were analysed by sex, after stratifying the s le by age group (younger adolescents: 11–14 years older adolescents: 15–17 years). Concordance was 86.7% for total difficulties, 77.5% for total impact and ranged from 82.4% to 94.3% across the five Strengths and Difficulties Questionnaire subscales. There were no differences in concordance between sexes on the total difficulties score. Older females were more likely to disagree with their parents about emotional problems compared to males of the same age. Younger males were more likely to disagree with their parents compared to same-aged females about peer problems, hyperactivity, conduct problems and prosocial skills, as well as the impact of their problems. Older males were more likely to disagree with their parents about their prosocial skills compared to older females. Overall, concordance between adolescents and parents on the Strengths and Difficulties Questionnaire was largely driven by the high proportion of respondents who reported having no problems. Discordance on a subscale increased as the prevalence of problems in a sex and age demographic subgroup increased. These findings highlight the need for a multi-informant approach to detect emotional and behavioural difficulties in adolescents, particularly when assessing the impact of symptoms, as this subscale had the lowest concordance.
Publisher: Springer Science and Business Media LLC
Date: 27-02-2017
DOI: 10.1007/S10803-016-3014-Z
Abstract: The current study examined the relationship between early language ability and autistic-like traits in adulthood, utilising data from 644 participants from a longitudinal study of the general population. Language performance at 2 years was measured with the Language Development Survey (LDS), and at 20 years the participants completed the Autism-Spectrum Quotient (AQ). Vocabulary size at 2 years was negatively associated with Total AQ score, as well as scores on the Communication, and Social Skills subscales. Adults who had been late talkers were also more likely to have 'high' scores on the Communication subscale. This is the first study to show an association between early language ability and autistic-like traits in adulthood.
Publisher: BMJ
Date: 10-2023
Publisher: SAGE Publications
Date: 26-02-2015
Abstract: To describe the prevalence and demographic, clinical and functional correlates of childhood trauma in patients attending early psychosis clinics. Participants were recruited from outpatients attending four early psychosis services. Exposure to childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Psychopathology was measured using the Positive and Negative Syndrome Scale and the Depression, Anxiety and Stress Scale. Social and vocational functioning and substance use were also assessed. Over three-quarters of the 100 patients reported exposure to any childhood trauma. Emotional, physical and sexual abuse were reported by 54%, 23% and 28% of patients, respectively, while 49% and 42% of patients reported emotional and physical neglect, respectively. Female participants were significantly more likely to be exposed to emotional and sexual abuse. Exposure to childhood trauma was correlated with positive psychotic symptoms and higher levels of depressive, anxiety and stress symptoms however, it had no impact on social or vocational functioning or recent substance use. Exposure to childhood trauma was common in patients with early psychosis, and associated with increased symptomatology. Existing recommendations that standard clinical assessment of patients with early psychosis should include inquiry into exposure to childhood trauma are supported.
Publisher: American Medical Association (AMA)
Date: 03-06-2020
Publisher: Elsevier
Date: 2018
Publisher: Cambridge University Press (CUP)
Date: 15-01-2016
DOI: 10.1017/S2045796015001043
Abstract: Despite overwhelming evidence demonstrating a persisting gap in life expectancy between those with psychotic illness and the general population, there has been no widespread implementation of interventions to improve the physical wellbeing of people with psychotic illness. This article explores opportunities to ‘Bridge the Gap’ in life expectancy. We describe an Australian evidence-based intervention that has substantially improved the physical health of young people recently commenced on antipsychotic medication. Further epidemiological research, accompanied by cultural change within mental health services, is an essential precursor to the implementation of effective and sustainable lifestyle interventions. There are other relatively neglected areas of physical wellbeing for people with psychotic illness, such as screening and diagnosis of malignancies, which need more research and clinical attention. While there has been progress with intervention development and evaluation, translation of evidence-based short-term intervention studies into feasible and sustainable system-wide changes within routine mental health service settings remains a challenge. Developing an implementation framework to support such change is an urgent priority so as to bridge the persisting premature mortality in people living with psychotic illness.
Publisher: Cambridge University Press (CUP)
Date: 26-07-2019
DOI: 10.1017/S0954579419000944
Abstract: Hypertensive disorders of pregnancy (HDP) may increase the risk of offspring depression in childhood. Low birth weight is also associated with increased risk of mental health problems, including depression. This study sought to investigate (a) whether there is an association between HDP and the risk of depression in childhood and (b) whether low birth weight mediates this association. The current study is based on the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective, population-based study that has followed a cohort of offspring since their mothers were pregnant ( n = 6,739). Depression at the age of 7 years was diagnosed using parent reports via the Development and Well-Being Assessment (DAWBA). Log-binomial regression and mediation analyses were used. Children exposed to HDP were 2.3 times more likely to have a depression diagnosis compared with nonexposed children, adjusted Risk Ratio [RR], 2.31 95% CI, [1.20, 4.47]. Low birth weight was a weak mediator of this association. Results were adjusted for confounding variables including antenatal depression and anxiety during pregnancy.This study suggests that fetal exposure to maternal hypertensive disorders of pregnancy increased the risk of childhood depression. The study adds to the evidence suggesting that the uterine environment is a critical determinant of neurodevelopmental and psychiatric outcomes.
Publisher: Wiley
Date: 30-06-2022
DOI: 10.1111/EIP.13182
Abstract: No biological treatment has been firmly established for the at‐risk stage of psychotic disorder. In this study we aim to test if subthreshold psychotic symptoms can be effectively treated with cannabidiol (CBD), a non‐psychoactive compound of the plant Cannabis sativa . The question has taken on increased importance in the wake of evidence questioning both the need and efficacy of specific pharmacological interventions in the ultra‐high risk (UHR) for psychosis group. Three‐arm randomized controlled trial of 405 patients (135 per arm) aged 12–25 years who meet UHR for psychosis criteria. The study includes a 6‐week lead‐in phase during which 10% of UHR in iduals are expected to experience symptom remission. Participants will receive CBD (per oral) at doses 600 or 1000 mg per day (fixed schedule) for 12 weeks. Participants in the third arm of the trial will receive matching placebo capsules. Primary outcome is severity of positive psychotic symptoms as measured by the Comprehensive Assessment of At‐Risk Mental States at 12 weeks. We hypothesize that CBD will be significantly more effective than placebo in improving positive psychotic symptoms in UHR patients. All participants will also be followed up 6 months post baseline to evaluate if treatment effects are sustained. This paper reports on the rationale and protocol of the Cannabidiol for At Risk for psychosis Youth (CanARY) study. This study will test CBD for the first time in the UHR phase of psychotic disorder.
Publisher: Wiley
Date: 09-2020
DOI: 10.1111/NICC.12545
Publisher: Elsevier BV
Date: 02-2010
DOI: 10.1016/J.APNU.2009.01.002
Abstract: Aggression is common in mental health services, but little research has examined exposure to aggression and its impact on staff in children and adolescent settings. Staff members within a child and adolescent psychiatric inpatient unit were interviewed to examine exposure to aggression and perceptions about the impact of aggression. Involvement in episodes of physical aggression was common (84.8%, 28/33) and was linked to difficulty attending work and other emotional and professional sequelae. These findings suggest that aggression is an important issue for staff working in child and adolescent settings and that aggression may impair the therapeutic capacity of staff.
Publisher: Cambridge University Press (CUP)
Date: 17-07-2014
DOI: 10.1017/S0033291714001615
Abstract: Recent cross-sectional studies have shown psychotic experiences (PEs) are associated with suicidal ideation and behaviours. We aimed to examine associations between psychotic experiences (including persistent PE), and contemporaneous and incident non-suicidal self-injury (NSSI) and suicide attempts. Participants were from an Australian longitudinal cohort of 1896 adolescents (12–17 years). NSSI and suicide attempts were measured using the Self-Harm Behaviour Questionnaire. Items from the Diagnostic Interview Schedule for Children were used to assess psychotic experiences, and the General Health Questionnaire-12 measured psychological distress. Adolescents both psychologically distressed and endorsing psychotic experiences had increased odds of contemporaneous and incident NSSI and attempted suicide. Psychotic experiences alone did not predict future risk. Persistent psychotic experiences were associated with increased risk of NSSI and suicide attempts. Psychological distress with accompanying psychotic experiences and persistent psychotic experiences are important predictors of NSSI and suicide attempts. Screening these phenotypes in adolescents will assist in discerning those adolescents most at risk, providing opportunities for targeted suicide prevention strategies.
Publisher: BMJ
Date: 08-2023
DOI: 10.1136/BMJOPEN-2022-063826
Abstract: Adverse childhood experiences (ACEs) have a profound negative impact on health. However, the strength of the association between ACEs and pregnancy complications and adverse pregnancy outcomes is not well quantified or understood. To conduct a systematic review and meta-analysis of the association between ACEs and risk of pregnancy complications and adverse pregnancy outcomes. A comprehensive search was conducted using PubMed, Embase, CINAHL, PsycINFO, ClinicalTrials.gov and Google scholar up to July 2022. Two reviewers independently conducted the screening and quality appraisal using a validated tool. Meta-analysis using the quality-effects model on the reported odds ratio (OR) was conducted. Heterogeneity and inconsistency were examined using the I 2 statistics. 32 studies from 1508 met a priori inclusion criteria for systematic review, with 21 included in the meta-analysis. Pooled analyses showed that exposure to ACEs increased the risk of pregnancy complications (OR 1.37, 95% CI 1.20 to 1.57) and adverse pregnancy outcomes (OR 1.31, 95% CI 1.17 to 1.47). In sub-group analysis, maternal ACEs were associated with gestational diabetes mellitus (OR 1.39, 95% CI 1.11 to 1.74), antenatal depression (OR 1.59, 95% CI 1.15 to 2.20), low offspring birth weight (OR 1.27, 95% CI 1.02 to 1.47), and preterm delivery (OR 1.41, 95% CI 1.16 to 1.71). The results suggest that exposure to ACEs increases the risk of pregnancy complications and adverse pregnancy outcomes. Preventive strategies, screening and trauma-informed care need to be examined to improve maternal and child health.
Publisher: Cambridge University Press (CUP)
Date: 08-2014
DOI: 10.1017/S003329171400172X
Abstract: Autism spectrum disorders (ASDs) are persistent disabling neurodevelopmental disorders clinically evident from early childhood. For the first time, the burden of ASDs has been estimated for the Global Burden of Disease Study 2010 (GBD 2010). The aims of this study were to develop global and regional prevalence models and estimate the global burden of disease of ASDs. A systematic review was conducted for epidemiological data (prevalence, incidence, remission and mortality risk) of autistic disorder and other ASDs. Data were pooled using a Bayesian meta-regression approach while adjusting for between-study variance to derive prevalence models. Burden was calculated in terms of years lived with disability (YLDs) and disability-adjusted life-years (DALYs), which are reported here by world region for 1990 and 2010. In 2010 there were an estimated 52 million cases of ASDs, equating to a prevalence of 7.6 per 1000 or one in 132 persons. After accounting for methodological variations, there was no clear evidence of a change in prevalence for autistic disorder or other ASDs between 1990 and 2010. Worldwide, there was little regional variation in the prevalence of ASDs. Globally, autistic disorders accounted for more than 58 DALYs per 100 000 population and other ASDs accounted for 53 DALYs per 100 000. ASDs account for substantial health loss across the lifespan. Understanding the burden of ASDs is essential for effective policy making. An accurate epidemiological description of ASDs is needed to inform public health policy and to plan for education, housing and financial support services.
Publisher: Elsevier BV
Date: 09-2023
Publisher: Oxford University Press (OUP)
Date: 02-03-2023
Abstract: Impairments in the expression, experience, and recognition of emotion are common in early psychosis (EP). Computational accounts of psychosis suggest disrupted top-down modulation by the cognitive control system (CCS) on perceptual circuits underlies psychotic experiences, but their role in emotional deficits in EP is unknown. The affective go/no-go task was used to probe inhibitory control during the presentation of calm or fearful faces in young persons with EP and matched controls. Computational modeling of functional magnetic resonance imaging (fMRI) data were performed using dynamic causal modeling (DCM). The influence of the CCS on perceptual and emotional systems was examined using parametric empirical bayes. When inhibiting motor response to fearful faces, EP participants showed higher brain activity in the right posterior insula (PI). To explain this, we used DCM to model effective connectivity between the PI, regions from the CCS activated during inhibition (dorsolateral prefrontal cortex [DLPFC] and anterior insula [AI]), and a visual input region, the lateral occipital cortex (LOC). EP participants exerted a stronger top-down inhibition from the DLPFC to the LOC than controls. Within the EP cohort, increased top-down connectivity between the LOC and AI was associated with a higher burden of negative symptoms. Young persons with a recent onset of psychosis show a disturbance in the cognitive control of emotionally salient stimuli and the suppression of irrelevant distractors. These changes are associated with negative symptoms, suggesting new targets for the remediation of emotional deficits in young persons with EP.
Publisher: Emerald
Date: 16-05-2011
DOI: 10.1108/17596591111132936
Abstract: The purpose of this paper is to report on the association between bullying victimisation and various internalizing and externalizing behaviours including anxiety and depression, somatic problems, withdrawn behaviour, aggressive and delinquent behaviour. Data for this research come from the Mater‐University of Queensland Study of Pregnancy and its Outcomes (MUSP) a prospective cohort study of mothers and their children which began in Brisbane in 1981, assessing the impact of experiences of being bullied at 14 years of age and YASR outcomes at 21 years of age. Brisbane is the capital city of the State of Queensland, Australia. The site for the research was the Brisbane Mater Misericordiae Mothers' Hospital (MMH), which is one of the two major obstetric units in Brisbane. In effect all pregnant women attending a publicly‐funded obstetrical service over a three‐year period were recruited to the study (about 50 percent of women attend public obstetrical services in Queensland). The authors find that: first, there is no association between the experience of being bullied and young adult anxiety and depression, as well as some other outcomes (withdrawn, intrusive behaviour) second, for both males and females, there are increased rates of attention problems for those children who have been bullied and third, males and females respond somewhat differently to being bullied, with males reporting more aggressive behaviour and females reporting more somatic problems. Overall, the findings suggest that the likely impact of being bullied may not be widespread across mental health domains, and that the impact may differ somewhat depending upon whether the person bullied is a male or female.
Publisher: Springer Science and Business Media LLC
Date: 26-11-2019
DOI: 10.1007/S00127-018-1629-4
Abstract: The association between psychotic experiences (PEs) and non-accidental self-injury (NASI including self-harm and suicide attempts) is well established, although variables influencing this relationship have not been comprehensively examined. This study aimed to investigate (1) the cross-sectional PE-NASI association before and after adjustment for confounders, and (2) the in idual contribution of each confounding and potentially mediating variable to the association. A random s le of Australian adolescents aged 14-17 years (n = 1998) completed self-report questions regarding any self-harm, suicidality or PEs experienced in the past 12 months in 2013-2014 as part of the Young Minds Matter Survey, a national household survey. We conducted logistic regression analyses to investigate the association between NASI and PEs, after controlling for confounders (sociodemographics, substance use, and parental mental illness) as well as the influence of potential mediators (major depression, bullying, psychological distress, sleep, self-esteem, disordered eating behaviour, social isolation, and intervention factors). Except for special messages, all PE subtypes (auditory and visual hallucinatory experiences [HEs], and two of the three delusional experiences [DEs]) were associated with NASI after adjustment for confounders (OR range: 2.60-5.21). Depression and psychological distress significantly influenced all PE-NASI associations, where depression appeared to fully explain the DE-NASI association, and partially attenuate the HE-NASI association. Variables such as parental mental illness, disordered eating behaviour, and social isolation had negligible effects in nearly all self-harm and attempted suicide models. Adolescents reporting any PE in the past 12 months reported increased likelihood of NASI in the same time period and, auditory HEs in particular, were strongly and independently associated with self-harm and suicide attempts. These results highlight the importance of PEs as indicators of risk of self-injurious behaviour among Australian youth.
Publisher: Wiley
Date: 05-07-2021
DOI: 10.1111/AJO.13403
Abstract: Caesarean section (CS) is associated with an increased risk of adverse health outcomes for both mothers and offspring. The evidence for an association between CS and reduced offspring cognitive and academic performance has been inconsistent, with considerable limitations. The aim of this study is to compare cognitive and academic performance in childhood and early adulthood in offspring delivered by CS with those delivered vaginally at term. Data on 4327 mothers and offspring from a longitudinal birth cohort study were analysed. Offspring cognitive performance was measured by the Picture Peabody Vocabulary Test‐Revised (PPVT‐R) at ages five and 21 and the Raven’s Standard Progressive Matrices at age 14. Academic achievement was assessed using the Wide Range Achievement Test at age 14. After adjustment for confounding factors, there was no statistically significant association between cognitive performance and offspring birth mode at age five ( P = 0.11). The adjusted difference of mean scores at five years on the PPVT‐R for elective CS birth compared to those born by vaginal delivery was −2.2 (95% confidence interval (CI) −4.3 to −0.2), whereas for emergency CS it was 0.0 (95% CI −2.0 to 2.0). There were no differences in cognitive or academic performance at ages 14 and 21. Birth mode was not significantly associated with offspring cognitive or academic performance. Our study does not support concerns that CS is associated with a reduction in cognitive performance.
Publisher: Springer Science and Business Media LLC
Date: 31-01-2018
DOI: 10.1038/S41398-017-0071-9
Abstract: The stagnation in drug development for schizophrenia highlights the need for better translation between basic and clinical research. Understanding the neurobiology of schizophrenia presents substantial challenges but a key feature continues to be the involvement of subcortical dopaminergic dysfunction in those with psychotic symptoms. Our contemporary knowledge regarding dopamine dysfunction has clarified where and when dopaminergic alterations may present in schizophrenia. For ex le, clinical studies have shown patients with schizophrenia show increased presynaptic dopamine function in the associative striatum, rather than the limbic striatum as previously presumed. Furthermore, subjects deemed at high risk of developing schizophrenia show similar presynaptic dopamine abnormalities in the associative striatum. Thus, our view of subcortical dopamine function in schizophrenia continues to evolve as we accommodate this newly acquired information. However, basic research in animal models has been slow to incorporate these clinical findings. For ex le, psychostimulant-induced locomotion, the commonly utilised phenotype for positive symptoms in rodents, is heavily associated with dopaminergic activation in the limbic striatum. This anatomical misalignment has brought into question how we assess positive symptoms in animal models and represents an opportunity for improved translation between basic and clinical research. The current review focuses on the role of subcortical dopamine dysfunction in psychosis and schizophrenia. We present and discuss alternative phenotypes that may provide a more translational approach to assess the neurobiology of positive symptoms in schizophrenia. Incorporation of recent clinical findings is essential if we are to develop meaningful translational animal models.
Publisher: Springer Science and Business Media LLC
Date: 22-11-2019
DOI: 10.1007/S00787-019-01443-0
Abstract: There is evidence that offspring of mothers who have hypertensive disorders of pregnancy (HDP) are at increased risk of adverse health outcomes. This study aims to examine the association between maternal HDP and emotional- and behavioural problems in offspring at age 11 years as reported by teachers and parents. The current study is based on the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective, population-based study that has followed a cohort of offspring since their mothers were pregnant. Childhood emotional- and behavioural problems were measured using the Strengths and Difficulties Questionnaire (SDQ), completed by parents (n = 7196) and the child's teacher (n = 7411). Maternal preecl sia, but not gestational hypertension, was associated with teacher-reported total behavioural difficulties (RR = 1.62 95% CI 1.03-2.52) and internalising problems in children [peer problems (RR = 1.48 95% CI 1.06-2.08) and emotional problems (RR = 1.68 95% CI 1.13-2.51)]. No associations between preecl sia and/or gestational hypertension and parent-reported emotional- and behaviour problems were observed. Our study showed that children exposed to preecl sia had higher risk of teacher-reported total behavioural difficulties and internalising problems compared with unexposed children. The findings suggest emotional- and behavioural difficulties may not be evident in all settings, hence the importance of collecting evidence from multiple informants.
Publisher: Elsevier BV
Date: 06-2019
Publisher: SAGE Publications
Date: 08-11-2022
DOI: 10.1177/10398562211054656
Abstract: To present a practical, easy-to-implement clinical framework designed to support evidence-based quality prescribing for people with early psychosis. Identification and explanation of key principles relating to evidence-based pharmacotherapy for people with early psychosis. These were derived from the literature, practice guidelines and clinical experience. Key principles include (1) medication choice informed by adverse effects (2) metabolic monitoring at baseline and at regular intervals (3) comprehensive and regular medication risk–benefit assessment and psychoeducation (4) early consideration of long-acting injectable formulations (preferably driven by informed patient choice) (5) identification and treatment of comorbid mood disorders and (6) early consideration of clozapine when treatment refractory criteria are met. Current prescribing practices do not align with the well-established evidence for quality pharmacotherapy in early psychosis. Adopting evidence-based prescribing practices for people with early psychosis will improve outcomes.
Publisher: Springer Science and Business Media LLC
Date: 12-2021
DOI: 10.1186/S13063-021-05890-6
Abstract: Schizophrenia is a persistent psychotic disorder often accompanied by severe disability and premature mortality. New pharmacological treatments are urgently needed. Sodium benzoate, a common food preservative holds potential to be an effective, accessible treatment for schizophrenia, though the optimal dosing and mechanism of action of the compound requires further investigation. In iduals with persistent treatment-refractory schizophrenia ( n =52) will be recruited. Patients will be randomised in a 1:1:1:1 ratio to receive treatment of one of three active doses (1000, 2000 or 4000 mg daily) of sodium benzoate or placebo for 6 weeks duration. The primary outcome measurement is change in the Positive and Negative Syndrome Scale (PANSS) total score. Secondary outcome measurements are PANSS subscales, Global Assessment of Function (GAF), Clinical Global Impression (CGI) and Patient Global Impression (PGI-I). Change in concentrations of peripheral amino acids (D-alanine, L-alanine, D-serine, L-serine, glycine and glutamate), plasma sodium benzoate, plasma catalase, 3-nitrotyrosine, malondialdehyde and high-sensitivity C-reactive protein (hs-CRP) will be determined as tertiary measures. This trial seeks to build upon previous research indicating potential efficacy of sodium benzoate for reduction of symptoms in in iduals with treatment-refractory schizophrenia. The trial aims to improve the understanding of the mechanism of action of the compound. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12621000327886 . Registered on 23 March 2021.
Publisher: Springer Science and Business Media LLC
Date: 07-2020
Publisher: Springer Science and Business Media LLC
Date: 17-05-2021
DOI: 10.1007/S43465-020-00327-9
Abstract: Fractures through the physis account for 18–30% of paediatric fractures and can lead to growth arrest in 5–10% of these cases. Long-term radiographic follow-up is usually necessary to monitor for signs of growth arrest at the affected physis. Given plain radiographs of a physeal fracture obtained throughout patient follow-up, different surgeons may hold different opinions about whether or not early growth arrest has occurred despite using identical radiographs to guide decision-making. This study aims to assess the inter-rater and intra-rater reliability of early growth arrest diagnosis among orthopaedic surgeons given a set of identical plain radiographs. A retrospective chart review was conducted on patients aged 2–18 years previously treated for a physeal fracture at a paediatric tertiary care hospital between 2011 and 2018. De-identified anteroposterior (AP) and lateral radiographs of 39 patients from the date of injury and minimum one-year post-injury were administered in a survey to international paediatric orthopaedic surgeons. Each surgeon was asked whether they would diagnose the patient with growth arrest based on the radiographs provided. Surgeons were asked to complete this process again two weeks after the initial review, but using identical shuffled radiographs. Inter-rater and intra-rater reliability was calculated using appropriate kappa statistics. A total of 11 paediatric orthopaedic surgeons completed the first round of the survey, and 9 of these 11 completed the second round. The inter-rater reliability for the first round was 0.22 [95% CI (0.06, 0.35)] and 0.21 [95% CI (0.02, 0.32)] for the second round. The average kappa for intra-rater reliability was − 0.05 [95% CI (− 0.31, 0.21)]. Comparison by injury side showed no significant variation in diagnosis { p = 0.509, OR = 0.90, [95% CI (0.67, 1.22)]}, while comparison by location of injury varied significantly ( p = 0.003). Radiographic diagnosis of growth arrest among paediatric orthopaedic surgeons demonstrated ‘fair’ inter-rater agreement and no intra-rater agreement, suggesting critical differences in identifying growth arrest on plain radiographs. Further research is necessary to develop an improved diagnostic approach for growth arrest among orthopaedic surgeons. Diagnostic level III.
Publisher: SAGE Publications
Date: 19-05-2015
Abstract: Compared to the substantial body of research examining links between cannabis use and psychosis, there has been relatively little attention to the role of tobacco as a potential risk factor for psychosis. This study explored the association between age at first tobacco use and psychosis-related outcomes in a birth cohort. This study is based on a large birth cohort (the Mater-University Study of Pregnancy). At approximately 21 years of age, cohort members ( N = 3752) were assessed for three psychosis-related outcomes (International Classification of Diseases non-affective psychosis, the presence of any hallucination and total count of delusional-like experiences) with the Composite International Diagnostic Interview and the Peters Delusional Inventory. Associations between age at first tobacco use and psychosis-related outcomes were examined using logistic regression in a model (a) adjusted for sex and age and (b) in a second model excluding all respondents who had a history of past problematic and current cannabis use. When adjusted for age and sex, those who commenced tobacco at 15 years of age or younger were significantly more likely to (a) have non-affective psychosis, (b) be in the highest quartile of total score of the Peters Delusional Inventory and (c) report hallucinations. After excluding all those with a history of a cannabis use disorder, or who were current (last month) cannabis users, a significant association between age at first tobacco use and the presence of hallucinations persisted. There is an association between age at first tobacco use and subsequent psychosis-related outcomes in young adults. While the findings cannot be used to deduce causality, it adds weight to the hypothesis that early tobacco use may contribute to the risk of developing psychosis-related outcomes.
Publisher: Wiley
Date: 29-12-2016
Abstract: Population-based studies have found that early language delays are associated with poorer long-term outcomes in adolescence and adulthood. Few studies have explored the influence of change in language ability over time on adult outcomes. To examine the educational, vocational and mental health outcomes for adults accounting for different vocabulary developmental profiles over a 16-year period. A total of 1914 participants of the Mater-University of Queensland Study of Pregnancy (MUSP) were categorized into four groups based on their vocabulary skills at 5 and 21 years: (1) persistently good (n = 1679), (2) persistently poor (n = 33), (3) improved (n = 160), and (4) deteriorated (n = 42). The associations between vocabulary group and educational, vocational, and mental health outcomes at 21 years were investigated. Adults with deteriorated and persistently poor vocabulary skills were less likely to have completed secondary school with the improved, deteriorated and persistently poor groups being less likely to be engaged in education, employment or training at the 21-year follow-up, compared with the persistently good group. Adults with deteriorated performance were at an increased risk of affective disorders, as well as substance and alcohol abuse/misuse. These findings provide evidence that impaired vocabulary skills in adulthood, regardless of whether the deficit was acquired early or later, are associated with adverse outcomes. Clinicians and educators need to be aware of these adversities and ensure they are supporting children and adolescents in whom language difficulties exist or emerge so as to prevent poor long-term outcomes from occurring.
Publisher: Wiley
Date: 02-2016
DOI: 10.1111/IMJ.12974
Abstract: Over the past decade, the clinical spectrum of autoimmune encephalitis has expanded with the emergence of several new clinicopathological entities. In particular, autoimmune encephalitis has recently been described in association with antibodies to surface receptors and ion channels on neurological tissues. Greater clinician awareness has resulted in autoimmune encephalitis being increasingly recognised in patients with unexplained neurological and psychiatric symptoms and signs. The clinical spectrum of presentations, as well as our understanding of disease mechanisms and treatment regimens, is rapidly developing. An understanding of these conditions is important to all subspecialties of Internal Medicine, including neurology and clinical immunology, psychiatry, intensive care and rehabilitation medicine. This review provides a contemporary overview of the aetiology, investigations and treatment of the most recently described autoimmune encephalitides.
Publisher: Cambridge University Press (CUP)
Date: 20-09-2017
DOI: 10.1017/S0033291717002677
Abstract: Psychotic experiences (PEs), including hallucination- and delusion-like experiences, are robustly associated with self-injurious thoughts and behaviours (SITB) in the general population. However, it remains unclear as to why there is an association. The purpose of this systematic review was to elucidate the role of other factors that influence the association between PEs and SITB and, in doing so, highlight potential mechanisms underlying the relationship. A search of electronic international databases was undertaken, including PubMed, PsycINFO and EMBASE, and eligible studies were grouped according to seven confounder categories: sociodemographics, mental disorders, alcohol and substance use, environmental, psychological, intervention and family history/genetic factors. The systematic search strategy identified 41 publications reporting on 1 39 427 participants from 16 different countries. In the majority of studies, where adjustment for other variables occurred, the association between PEs and SITB persisted, suggesting PEs have an independent role. Common mental disorders, psychological distress and negative environmental exposures explained a substantial amount of the variance and therefore need to be considered as potential underlying mechanisms. There was high variability in the variables adjusted for in these studies, and so the question still remains as to whether the association between PEs and self-harm/suicidality can be attributed (fully or in part) to confounding and mediating factors or directly causal mechanisms. Regardless of causality, the now extensive literature reporting an association between these two clinical phenomena supports the broad usefulness of PEs as an indicator of risk for SITB.
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.JPSYCHIRES.2017.06.013
Abstract: Previous studies provide mixed evidence that physical activity engagement (PAE) in adolescence is associated with later mental health outcomes. This study aimed to examine the association between PAE at age 14 and mental health outcomes at age 21 using a large birth cohort study. Prospective data from the Mater-University of Queensland Study of Pregnancy, consisting of 3493 young adults, were analyzed. PAE at age 14 was estimated using self-report, and participants were categorized into (1) frequent, (2) infrequent, or (3) no PAE group. Mental health outcomes at age 21 consisted of (1) common mental disorders, (2) psychosis-related outcomes, and, (3) emotional and behavioral problems. The association between PAE in adolescence and later mental health outcomes in young adulthood was examined using logistic regression, adjusted for age, sex, body mass index, and adolescent psychopathology. No PAE at age 14 was associated with the increased likelihood of lifetime diagnosis of any affective disorder, elevated delusional ideation, and endorsement of visual perceptual disturbance at age 21. Conversely, infrequent PAE at age 14 was associated with the decreased likelihood of subsequent lifetime diagnosis of any substance use disorder. Our findings suggest that lack of PAE in adolescence influences some, but not all, later mental health outcomes. Interventions to increase PAE in adolescence may represent an opportunity to prevent future mental health problems.
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.JPSYCHIRES.2018.12.003
Abstract: Low physical activity is a major public health concern. There has been extensive research examining the role of physical activity as a potentially modifiable risk factor for the onset of mental illness. However, fewer studies have reported how mental disorders affect future physical activity. Using data from a large birth cohort, the current study explored the association between the longitudinal course of common mental disorders (affective disorders, anxiety disorders, and substance use disorders, as well as any common mental disorder) and subsequent physical activity status among young adults living in Australia. Prospective data from the Mater-University of Queensland Study of Pregnancy, consisting of 1611 young adults, were analyzed. The longitudinal course of mental disorder diagnoses between ages 21 and 30 was derived from the Composite International Diagnostic Interview. Physical activity status at age 30 was estimated using International Physical Activity Questionnaire long form. Logistic regression was used to examine the association between the longitudinal course of common mental disorders between 21 and 30 years and subsequent physical activity status at age 30. After adjusting for confounding factors, there was no association between the longitudinal course of affective disorders, anxiety disorders, substance use disorders, or any common mental disorder at ages 21 and 30 and physical activity status at age 30. Our findings suggest that there is no longitudinal association between the common mental disorder diagnoses and physical activity status among young adults living in Australia.
Publisher: SAGE Publications
Date: 21-12-2016
Abstract: Having sufficient sera concentrations of 25-hydroxyvitamin D is important for a range of health outcomes including cardiometabolic diseases. Clinical studies in people with psychotic disorders suggest that a sizable proportion has suboptimal vitamin D status (i.e. vitamin D deficiency or insufficiency). In iduals with psychosis also have many of the risk factors associated with suboptimal vitamin D status such as smoking, obesity, and reduced physical activity. The aim of this study was to examine the prevalence and socio-demographic and clinical correlates of vitamin D status using a large, population-based s le of adults with psychotic disorders. Data were collected as part of the Survey of High Impact Psychosis, a population-based survey of Australians aged 18-64 years with a psychotic disorder. 25-Hydroxyvitamin D concentration was measured in 463 participants. 25-Hydroxyvitamin D concentration was dichotomised into optimal (above 50 nmol/L) and suboptimal (below 50 nmol/L). The influence of a range of socio-demographic and clinical variables on vitamin D status was examined using logistic regression. Nearly half (43.6%) of the participants had suboptimal vitamin D status. Those with (a) increased physical activity or (b) positive symptoms had significantly reduced odds of having suboptimal vitamin D status. However, there were no significant associations between suboptimal vitamin D status and other psychiatric symptom measures or cardiometabolic risk factors. Many people with psychotic disorders have suboptimal vitamin D status. As part of the routine assessment of physical health status, clinicians should remain mindful of vitamin D status in this vulnerable population and encourage the use of appropriate vitamin D supplements.
Publisher: Elsevier BV
Date: 11-2019
Publisher: Springer Science and Business Media LLC
Date: 13-01-2022
Publisher: Oxford University Press (OUP)
Date: 12-05-2018
Publisher: Informa UK Limited
Date: 22-09-2023
Publisher: Elsevier BV
Date: 05-2020
DOI: 10.1016/J.JAAC.2019.10.010
Abstract: Youth with chronic medical conditions (CMCs) have been reported to be at increased risk for developing anxiety disorders. Importantly, suffering from anxiety may also have an impact on their disease-related outcomes. This study set out to systematically review the literature on anxiety and seven CMCs (asthma, congenital heart disease, diabetes, epilepsy, inflammatory bowel disease, juvenile idiopathic arthritis, and sickle cell disease) among youth. A systematic review was performed according to the PRISMA statement. Searches were conducted across PubMed, PsycNET, Embase, and reference lists of the included studies (1990-2018). Three independent reviewers screened titles and abstracts and conducted full-text assessment. Studies were included if they reported the prevalence of anxiety or the association of anxiety on disease-related outcomes in children and/or adolescents with the focal CMCs. A total of 53 studies met the predetermined inclusion criteria. Across the CMCs, the prevalence of anxiety disorder was increased in youths with CMCs compared to the general population. Evidence for a relationship between anxiety and adverse disease-related outcomes was limited. For asthma, inflammatory bowel disease, and sickle cell disease, there was some evidence indicating that anxiety was associated with adverse outcomes supported by two longitudinal studies, one in asthma and one in inflammatory bowel disease. For diabetes, results were inconsistent with some studies indicating that anxiety was associated with worse and others with better treatment adherence. The prevalence of anxiety disorders in youth with CMCs is higher than that in the general population. Anxiety may also be associated with adverse disease-related outcomes for youths, but it is not possible to draw definitive conclusions. Longitudinal studies making use of parent/youth composite anxiety measures and a combination of parent/youth reported and objective measures of disease-related outcomes are needed. Given the burden of disease of anxiety disorders, regardless of the impact on the disease outcomes, screening for and treatment of anxiety is recommended in youths with CMCs.
Publisher: Informa UK Limited
Date: 25-04-2017
DOI: 10.1080/17549507.2017.1296191
Abstract: The aim of the current study was to investigate the risk factors present at 2 years for children who showed language difficulties that persisted from 2 to 10 years and difficulties that emerged later, at 10 years. Participants (n = 783) were drawn from the Raine Study in Western Australia. Patterns of change from 2 to 10 years were identified based on child performance on the Language Development Survey and the Clinical Evaluation of Language Fundamentals, respectively. Logistic regression analyses were conducted to test whether parental, family and child characteristics present at 2 years predicted poorer language outcomes at age 10. Across the 8 year period, 5.6% of the children displayed consistently low language skills, 5.9% improved skills and 23.2% deteriorated skills. Compared to children with consistently typical skills, the deteriorated group was more likely to have mothers who smoked during pregnancy, fathers with incomplete secondary education, low family income, poor early literacy environment and be male. Children showing consistently low language skills were more likely to have mothers who smoked during pregnancy than late talkers whose early delays improved. Results provide evidence of some modifiable risk factors at 2 years which are associated with language outcome.
Publisher: Elsevier BV
Date: 07-2020
Publisher: Frontiers Media SA
Date: 15-06-2021
DOI: 10.3389/FPSYT.2021.626486
Abstract: Background: Cognitive impairment is prevalent and often highly burdensome in people with schizophrenia. The aim of this study was to investigate if mangosteen ( Garcinia mangostana Linn.) pericarp extract may be an effective intervention to improve cognitive performance in this population. Methods: This was a secondary analysis of a larger randomized placebo-controlled trial that investigated a 24-weeks intervention of mangosteen pericarp extract supplementation in people diagnosed with schizophrenia. A subset of n = 114 participants with completed cognitive outcomes at follow up were included in this analysis. Using the Cogstate Brief Battery, the following cognitive outcomes were assessed: psychomotor function, attention, visual learning and memory (visual and working). Subgroup analyses investigated whether baseline clinical parameters (baseline cognitive functioning, illness severity and duration, depressive symptoms) moderated the relationship between mangosteen pericarp extract intervention and change in cognitive outcomes. Results: There were no significant between-group changes in any cognitive outcomes assessed. Subgroup analysis based on baseline cognition and clinical characteristics did not reveal any significant between-group difference in change. Conclusions: Mangosteen pericarp extract did not affect cognitive outcomes in people with schizophrenia. Further investigation regarding optimal dosing strategies for mangosteen interventions and the testing of additional cognitive domains may be warranted. Trial Registration: ANZCTR.org.au identifier: ACTRN12616000859482, registered 30 June 3 2016.
Publisher: Springer Science and Business Media LLC
Date: 03-01-2021
Publisher: Wiley
Date: 04-06-2015
DOI: 10.1016/J.ADOLESCENCE.2015.05.007
Abstract: This study used prospective birth cohort data to analyse the relationship between peer aggression at 14 years of age and educational and employment outcomes at 17 years ( N = 1091) and 20 years ( N = 1003). Participants from the Western Australian Pregnancy Cohort (Raine) study were ided into mutually exclusive categories of peer aggression. Involvement in peer aggression was reported by 40.2% (10.1% victims 21.4% perpetrators 8.7% victim–perpetrators) of participants. Participants involved in any form of peer aggression were less likely to complete secondary school. Perpetrators and victim–perpetrators of peer aggression were more likely to be in the ‘No Education, Employment or Training’ group at 20 years of age. This association was explained by non‐completion of secondary school. These findings demonstrate a robust association between involvement in peer aggression and non‐completion of secondary school, which in turn was associated with an increased risk of poor educational and employment outcomes in early adulthood.
Publisher: Wiley
Date: 20-12-2017
DOI: 10.1002/AB.21694
Abstract: Bullying is defined as repeated negative actions involving a power differential, and intention to harm. There is limited research on harmful intention as a definitional component. This study explored the role of the perpetrator's harmful intention and the target's perception of harmful intention. Some 209 students (M = 14.5 years 66.5% female) and 447 parents (M = 46.4 years 86.4% female) were randomly assigned in an online survey. Participants assessed the likelihood of bullying in five hypothetical scenarios (physical, verbal, rumor, exclusion, and cyber) across five intention conditions, that also involved repetition and a power differential. The five intention conditions were: 1) harm intended by perpetrator (I) and perceived as intended to harm by target (I) [II condition] 2) harm not intended by perpetrator (N) but perceived as intended to harm by target (I) [NI condition] 3) harm intended by perpetrator (I) but not perceived as intended to harm by target (N) [IN condition] 4) harm not intended by perpetrator (N) and not perceived as intended to harm by target N [NN condition] and 5) a control which did not state any actual or perceived harmful intention [C condition]. For students and parents, the perpetrator's harmful intention and the target's perception of harmful intention were important when considering whether a peer interaction constituted bullying. These findings confirm the applicability of the three-part definition of bullying, and highlight the importance of assessing these two dimensions of harmful intention when determining whether a problematic peer interaction should be regarded as bullying. Aggr. Behav. 43:352-363, 2017. © 2016 Wiley Periodicals, Inc.
Publisher: SAGE Publications
Date: 05-05-2021
DOI: 10.1177/00048674211009620
Abstract: Prescribing antipsychotic medications to children and adolescents with severe mental and developmental disorders is common however, there is a lack of consensus on appropriate metabolic monitoring for this population. This review systematically evaluates studies examining metabolic monitoring of children and adolescents prescribed antipsychotic medication to understand the clinical practice of metabolic monitoring and identify opportunities to improve the safety of antipsychotic prescribing in this population. A systematic search for original research on metabolic monitoring in children and adolescents prescribed antipsychotics was conducted in six databases (PubMed, EMBASE, PsycINFO, The Cochrane Library [Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CENTRAL], Cochrane Methodology Register and Web of Science [Science and Social Science Citation Index]) from inception to February 2020 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were assessed for quality and findings summarised using narrative synthesis. Fifteen papers were identified. Studies agreed on the need for metabolic monitoring however, there was a gap between guideline-recommended practice and clinical practice. Variable rates of baseline and subsequent monitoring were reported for both physical and biochemical parameters, with particularly low rates for monitoring requiring venesection. Younger age was also associated with lower monitoring rates. Implementation of quality improvement activities (new guidelines, staff education and checklists) improved monitoring rates although the measurement of biochemical parameters still occurred in only a minority of children. Despite widespread awareness and concern regarding metabolic side-effects, monitoring occurred inconsistently and infrequently, particularly for biochemical parameters requiring venesection. Monitoring of anthropometric measures (weight, body mass index and waist circumference) with escalation to more laboratory testing where metabolic concerns are identified may improve monitoring. Minimising iatrogenic harm, through reduced antipsychotic prescription where possible, is a clinical priority in this population.
Publisher: Cambridge University Press (CUP)
Date: 20-01-2017
DOI: 10.1017/S2045796015001158
Abstract: Children and adolescents make up almost a quarter of the world's population with 85% living in low- and middle-income countries (LMICs). Globally, mental (and substance use) disorders are the leading cause of disability in young people however, the representativeness or ‘coverage’ of the prevalence data is unknown. Coverage refers to the proportion of the target population (ages 5–17 years) represented by the available data. Prevalence data for conduct disorder (CD), attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorders (ASDs), eating disorders (EDs), depression, and anxiety disorders were sourced from systematic reviews conducted for the Global Burden of Disease Study 2010 (GBD 2010) and 2013 (GBD 2013). For each study, the location proportion was multiplied by the age proportion to give study coverage. Location proportion was calculated by iding the total study location population by the total country population. Age proportion was calculated by iding the population of the country aged within the age range of the study s le by the country population aged 5–17 years. If a study only s led one sex, study coverage was halved. Coverage across studies was then summed for each country to give coverage by country. This method was repeated at the region and global level, and separately for GBD 2013 and GBD 2010. Mean global coverage of prevalence data for mental disorders in ages 5–17 years was 6.7% (CD: 5.0%, ADHD: 5.5%, ASDs: 16.1%, EDs: 4.4%, depression: 6.2%, anxiety: 3.2%). Of 187 countries, 124 had no data for any disorder. Many LMICs were poorly represented in the available prevalence data, for ex le, no region in sub-Saharan Africa had more than 2% coverage for any disorder. While coverage increased between GBD 2010 and GBD 2013, this differed greatly between disorders and few new countries provided data. The global coverage of prevalence data for mental disorders in children and adolescents is limited. Practical methodology must be developed and epidemiological surveys funded to provide representative prevalence estimates so as to inform appropriate resource allocation and support policies that address mental health needs of children and adolescents.
Publisher: SAGE Publications
Date: 26-07-2019
Abstract: Muscarinic receptor dysfunction has been suggested to play an important role in the pathophysiology of schizophrenia. Recently, it has also become clear that immune reactivity directed against neurotransmitter receptors may play a pathogenic role in some cases of schizophrenia. The aim of this review is to summarize the case for muscarinic receptor dysfunction in schizophrenia and the evidence supporting the hypothesis that this dysfunction is related to the development of muscarinic receptor–targeting antibodies. The article reviews studies of muscarinic receptors and the presence and potential role(s) of anti-muscarinic acetylcholine receptor antibodies in people with schizophrenia. There is accumulating evidence that altered or deficient muscarinic signalling underlies some of the key clinical features of schizophrenia. Although the number of studies investigating anti-muscarinic acetylcholine receptor antibodies in schizophrenia is relatively small, they consistently demonstrate that such antibodies are present in a proportion of patients. This evidence suggests that these antibodies could have pathogenic effects or exist as a biomarker to an unknown pathophysiological process in schizophrenia. The presence of elevated levels of anti-muscarinic acetylcholine receptor antibodies may identify a subgroup of people with schizophrenia, potentially informing aetiopathogenesis, clinical presentation and treatment. To date, all studies have examined antibodies in participants with chronic schizophrenia, who have likely received antipsychotic medication for many years. As these medications modulate immune functions and regulate receptor densities, it is recommended that future studies screen for the presence of anti-muscarinic antibodies in people experiencing their first episode of psychosis.
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: 03-2023
Publisher: Royal College of Psychiatrists
Date: 03-2008
Publisher: Elsevier BV
Date: 2021
DOI: 10.1016/J.ANNEPIDEM.2020.08.015
Abstract: This study examined the effect of hypertensive disorders during pregnancy on trajectories of emotional and behavioral problems in offspring. We used data from the Avon Longitudinal Study of Parents and Children, a prospective birth cohort study in Avon, United Kingdom. A group-based trajectory modeling was used to identify the distinct trajectories of emotional and behavioral problems in children at four time points: at age 3.5, 6.75, 9, and 11 years. Multinomial logistic regression analyses were used to examine the association between hypertensive disorders during pregnancy and trajectories of emotional and behavioral problems. We identified four trajectories of offspring emotional and behavioral problems: normal (42.6%), borderline decreasing (40.6%), borderline stable (10.0%), and persistently elevated (6.8%). We found that children exposed to maternal pre-ecl sia were more likely to be in the persistently elevated symptom trajectory (OR = 2.72 95% CI: 1.10-6.74) than in the normal trajectory group. We found no associations between maternal gestational hypertension and trajectories of offspring emotional and behavioral problems. Maternal pre-ecl sia, but not gestational hypertension was associated with persistently elevated trajectory of offspring emotional and behavioral problems. Our findings highlight that the antenatal environment is important for children's behavioral and emotional development.
Publisher: Wiley
Date: 24-05-2016
DOI: 10.1111/ACPS.12594
Abstract: In the light of the high prevalence of physical comorbidities in people with psychotic illness, there is a need to explore modifiable risk factors that may contribute to this disease burden. The benefits of physical activity to both physical and mental health have been well established. We aimed to examine the prevalence and correlates of physical activity in a national s le of adults living with psychotic illness. Physical activity was assessed in 1801 people using the International Physical Activity Questionnaire. Participants were dichotomised into low and moderate-high physical activity groups and associations between physical activity and a range of sociodemographic, clinical and physical comorbidity variables were examined using logistic regression. More than half the participants were categorised in the moderate-high physical activity group with nearly half of the s le engaged in physical activity every day. There were significant associations between low physical activity and older age, unemployment, educational non-participation, antipsychotic medication use, social dysfunction, self-reported loneliness and obesity. However, there was no significant association between physical activity and sex, psychosis type, illness duration, physical comorbidity or negative symptoms. The findings from this study may inform future interventions designed to increase physical activity in people with psychotic illness.
Publisher: Oxford University Press (OUP)
Date: 06-09-2022
Abstract: The sexual and reproductive health (SRH) of young people with psychosis has been largely overlooked. We hypothesised that there are key deficiencies in the existing literature on the SRH of adolescents and young adults with psychotic disorders. We conducted a systematic scoping review using Pubmed, Web of Science, Embase, PsycINFO, and CINAHL. We included empirical studies and case reports focused on SRH issues in young people (aged 14–24 years) with psychotic disorders. A qualitative synthesis was completed. Joanna Briggs Institute Critical Appraisal Tools were utilized to assess study quality. Seventeen empirical studies and 52 case reports met inclusion criteria. Most focused on sexual dysfunction which was identified as common among this cohort and associated with both psychotic disorders and antipsychotics. The study population was more likely to engage in sexual risk-taking behavior and was at higher risk of sexually transmissible infections than those without psychosis. SRH topics of clinical relevance in older patients with psychosis such as pregnancy, abortion, sexual violence, coercion, sexual identity, and gender were poorly addressed in this younger group. We found empirical studies generally lacked identification and controlling of confounders whilst case reports provided limited description of mental health and SRH outcomes following clinical intervention. Research and clinical practice addressing sexual and reproductive health is needed for young people living with psychosis. To address research gaps future studies should focus on women’s health, sexual violence, gender, and sexuality in young people with psychosis.
Publisher: Springer Science and Business Media LLC
Date: 02-08-2022
DOI: 10.3758/S13415-022-01026-8
Abstract: Cognitive impairment in psychosis is one of the strongest predictors of functional decline. Problems with decision-making processes, such as goal-directed action and reversal learning, can reflect cortico-striatal dysfunction. The heterogenous symptoms and neurobiology observed in those with psychosis suggests that specific cognitive phenotypes may reflect differing causative mechanisms. As such, decision-making performance could identify subgroups of in iduals with more severe cortico-striatal dysfunction and help to predict their functional decline. The present work evaluated the relationship between goal-directed action, reversal learning, and symptom profiles in those with psychosis. We assessed decision-making processes in healthy controls (N = 34) and those with persistent psychosis (N = 45), subclassifying subjects based on intact/impaired goal-directed action. Compared with healthy controls ( %), a large proportion (58%) of those with persistent psychosis displayed impaired goal-directed action, predicting poor serial reversal learning performance. Computational approaches indicated that those with impaired goal-directed action had a decreased capacity to rapidly update their prior beliefs in the face of changing contingencies. Impaired decision-making also was associated with reduced levels of grandiosity and increased problems with abstract thinking. These findings suggest that prominent decision-making deficits, indicative of cortico-striatal dysfunction, are present in a large proportion of people with persistent psychosis. Moreover, these impairments would have significant functional implications in terms of planning and abstract thinking.
Publisher: Elsevier BV
Date: 06-2007
Publisher: Cambridge University Press (CUP)
Date: 25-01-2012
DOI: 10.1017/S2045796011000862
Abstract: Population-based studies have identified that delusional-like experiences (DLEs) are common in the general population. While there is a large literature exploring the relationship between poor social support and risk of mental illness, there is a lack of empirical data examining the association of poor social support and DLEs. The aim of the study was to explore the association between social support and DLEs using a large, nationally representative community s le. Subjects were drawn from a national multistage probability survey of 8841 adults aged between 16 and 85 years. The Composite International Diagnostic Interview was used to identify DLEs, common psychiatric disorders and physical disorders. Eight questions assessed various aspects of social support with spouse artners and other family and friends. We examined the relationship between DLEs and social support using logistic regression, adjusting for potential confounding factors. Of the s le, 8.4% ( n = 776) positively endorsed one or more DLEs. In iduals who (a) had the least contact with friends, or (b) could not rely on or confide in spouse artner, family or friends were significantly more likely to endorse DLEs. The associations remained significant after adjusting for a range of potential confounding factors. DLEs are associated with impoverished social support in the general population. While we cannot exclude the possibility that the presence of isolated DLEs results in a reduction of social support, we speculate that poor social support may contribute in a causal fashion to the risk of DLEs.
Publisher: Elsevier BV
Date: 2022
DOI: 10.1016/J.CHIABU.2021.105424
Abstract: Epidemiological surveys measuring the prevalence of child maltreatment generate essential knowledge that is required to enhance human rights, promote gender equality, and reduce child abuse and neglect and its effects. Yet, evidence suggests Institutional Review Boards (IRBs) may assess the risk of these studies using higher than normal thresholds, based on a perception they may cause high distress to participants. It is essential for IRBs and researchers to have an accurate understanding of the nature and extent of participant distress associated with these studies, and of the duties of researchers towards survey participants, so that meritorious research is endorsed and duties to participants discharged. Assessment by IRBs of the ethics of such research must be appropriately informed by scientific evidence, ethical principles, and legal requirements. This article adds to knowledge by considering participant distress in child maltreatment surveys and its appropriate ethical and operational treatment. We provide an updated overview of scientific evidence of the frequency and severity of distress in studies of child maltreatment, a review of ethical requirements including a focus on beneficence and participant welfare, and a new analysis of researchers' legal duties towards participants. Our analyses demonstrate that participant distress is infrequent and transitory, that researchers can satisfy ethical requirements towards participants, and that legal liability does not extend to emotional distress. Informed by these bodies of knowledge, we distil key principles of good epidemiological practice to provide solutions to operational requirements in these surveys, which both fulfil ethical requirements to participants, and demonstrate trauma-informed practice.
Publisher: Wiley
Date: 10-08-2012
DOI: 10.1111/J.1600-0447.2012.01905.X
Abstract: Delusional-like experiences (DLE) are common in the general community and are associated with a family history of mental illness. The aim of this study was to estimate the heritability of DLE. The Peter's Delusional Inventory (PDI) was administered to a population-based cohort of mothers (n = 2861, aged 35-67 years) and their adult offspring (n = 3079, aged 18-23 years). Heritability of DLE was estimated from the sum scores of the 21 item PDI under the assumption that the covariance between mother-offspring scores is attributable to shared additive genetic factors. The means (medians and standard deviations) for the total PDI scores for the mothers and their offspring were 3.6 (3.0, 3.0) and 5.0 (4.0, 3.5), respectively. The Pearson correlation coefficient between mother and offspring PDI scores was 0.17 (P < 0.001). The heritability was estimated to be 0.35 (standard error 0.04). Heritable factors contribute to over a third of the variance of PDI scores in this population. In light of the association between a family history of a wide range of mental disorders and DLE, these experiences may represent a useful quantitative endophenotype for genetic studies of common mental disorders in population settings.
Publisher: American Medical Association (AMA)
Date: 30-09-2021
Publisher: Springer Science and Business Media LLC
Date: 27-10-2021
DOI: 10.1038/S41398-021-01673-4
Abstract: Executive dysfunctions in early psychosis (EP) are subtle but persistent, hindering recovery. We asked whether changes in the cognitive control system (CCS) disrupt the response to increased cognitive load in persons with EP. In all, 30 EP and 30 control participants undertook multimodal MRI. Computational models of structural and effective connectivity amongst regions in the CCS were informed by cortical responses to the multi-source interference task, a paradigm that selectively introduces stimulus conflict. EP participants showed greater activation of CCS regions, including the superior parietal cortex, and were disproportionately slower at resolving stimulus conflict in the task. Computational models of the effective connectivity underlying this behavioral response suggest that the normative (control) group resolved stimulus conflict through an efficient and direct modulation of gain between the visual cortex and the anterior insula (AI). In contrast, the EP group utilized an indirect path, with parallel and multi-region hops to resolve stimulus conflict at the AI. In idual differences in task performance were dependent on initial linear gain modulations in the EP group versus a single nonlinear modulation in the control group. Effective connectivity in the EP group was associated with reduced structural integration amongst those connections critical for task execution. CCS engagement during stimulus conflict is h ered in EP owing to inefficient use of higher-order network interactions, with high tonic gain impeding task-relevant (phasic) signal lification.
Publisher: BMJ
Date: 08-2022
DOI: 10.1136/BMJOPEN-2022-065823
Abstract: The increasing prevalence of developmental disorders in early childhood poses a significant global health burden. Early detection of developmental problems is vital to ensure timely access to early intervention, and universal developmental surveillance is recommended best practice for identifying issues. Despite this, there is currently considerable variation in developmental surveillance and screening between Australian states and territories and low rates of developmental screening uptake by parents. This study aims to evaluate an innovative web-based developmental surveillance programme and a sustainable approach to referral and care pathways, linking primary care general practice (GP) services that fall under federal policy responsibility and state government-funded child health services. The proposed study describes a longitudinal cluster randomised controlled trial (c-RCT) comparing a ‘Watch Me Grow Integrated’ (WMG-I) approach for developmental screening, to Surveillance as Usual (SaU) in GPs. Forty practices will be recruited across New South Wales and Queensland, and randomly allocated into either the (1) WMG-I or (2) SaU group. A cohort of 2000 children will be recruited during their 18-month vaccination visit or opportunistic visit to GP. At the end of the c-RCT, a qualitative study using focus groups/interviews will evaluate parent and practitioner views of the WMG-I programme and inform national and state policy recommendations. The South Western Sydney Local Health District (2020/ETH01625), UNSW Sydney (2020/ETH01625) and University of Queensland (2021/HE000667) Human Research Ethics Committees independently reviewed and approved this study. Findings will be reported to the funding bodies, study institutes and partners families and peer-reviewed conferences ublications. ANZCTR12621000680864.
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.NEUBIOREV.2019.03.007
Abstract: Typically, we try to protect our own bodies and this is supported by internal representations that specify one's body identity, spatial parameters, and bodily sensations, but in self-harm the body becomes the target. First acts of self-harm are typically reported in adolescence. At this age, the body also becomes more salient to one's self-concept. It may be possible that disturbances in representations of one's own body and its sensations contribute to self-harm. To investigate these links, we conducted a systematic review critically examining the potential role of body representation and sensation disturbances in self-harm (non-suicidal or suicidal) in adolescents and young adults (12-25 years). The search strategy identified 64 studies (275,183 participants) and overall, young people engaging in self-harm reported greater levels of body dissatisfaction, body disownership, and deficits in the experience and evaluation of bodily sensations compared to non-injuring control groups however, there was subscale variability and gender differences. Our results emphasise the strong link between body representations and self-protection, as well as a need for investigating self-harm interventions that take body image and awareness into account.
Publisher: Frontiers Media SA
Date: 13-03-2019
Publisher: SAGE Publications
Date: 2008
DOI: 10.1080/00048670802050587
Abstract: Objective: Aggressive behaviour is common in young people admitted to child and adolescent inpatient services. Little is known about how physical aggression during admission influences patient outcomes. The aim of the present study was to identify predictors of aggression in a child and adolescent inpatient unit and examine differences in clinical outcomes between aggressive and non-aggressive patients. Method: Episodes of aggression occurring within a child and adolescent inpatient unit were prospectively documented between October 2004 and December 2005. Patient factors (demographics, diagnoses, clinical history) were examined as predictors of aggression. Outcomes for admissions in which more than one episode of physical aggression occurred were compared to those in which no aggression occurred. Outcomes assessed were changes in symptom severity (as rated by the Health of the Nation Outcome Scales for Children and Adolescents) length of stay, and initiation of medications. Results: A total of 134 patients were admitted during the study period (61.9% female, mean age=13.8years, SD=2.9) 31 patients (23.1%) exhibited physical aggression during admission and 20 of these exhibited more than one episode of physical aggression. Factors that predicted persistent physical aggression included history of aggression, use of medications at presentation and absence of self-harm. Persistent aggression was also associated with increased length of stay, but did not compromise improvements in clinical symptom ratings between admission and discharge or lead to increased medication prescribing Conclusion: Contrary to hypotheses and existing research, aggression during admission does not appear to be a barrier to clinical improvement. Further research is necessary to clarify how aggressive children can receive the most benefit from inpatient admission while minimizing the risks to the patient and those around them.
Publisher: Cambridge University Press (CUP)
Date: 08-07-2008
DOI: 10.1017/S0033291708003760
Abstract: Birth cohort studies have shown that in iduals who develop non-affective psychoses display subtle deviations in behaviour during childhood and adolescence. We had the opportunity to examine the widely used Child Behavior Checklist (CBCL) and the Youth Self-Report (YSR) to explore the antecedents of non-affective psychosis. Based on a birth cohort of 3801 young adults, psychopathology was assessed at years 5 and 14 using the CBCL and/or the YSR. Screen-positive non-affective psychosis (SP-NAP) was assessed at year 21 by using the Composite International Diagnostic Interview (CIDI) or a self-report checklist. The association between childhood symptoms and SP-NAP was examined using logistic regression. Of the cohort, 60 subjects were classified as SP-NAP. In males, SP-NAP was associated with higher scores: ( a ) on year 5 CBCL ‘Total’, ‘Aggression’ and ‘Social, Attention and Thought’ scores ( b ) on year 14 CBCL ‘Social’, ‘Attention’ and ‘Delinquency’ scores, and ( c ) YSR ‘Total’ and many YSR subscores. These associations were less clear for females. Hallucinations at year 14 were associated with SP-NAP for both sexes. Boys with high ‘Total’ scores at both years 5 and 14 were at greatest risk of SP-NAP (a 5-fold risk), followed by boys and girls whose ‘Social, Attention and Thought’ scores either increased or remained high from years 5 to 14 (3- to 13-fold risk). In iduals who screen positive for non-affective psychosis show increased psychopathology during childhood and adolescence. The psychopathological trajectory of children who go on to develop schizophrenia anticipates the heterogeneity associated with the full clinical syndrome.
Publisher: Elsevier BV
Date: 05-2017
DOI: 10.1016/J.JPSYCHIRES.2017.01.006
Abstract: There is conflicting evidence about the contribution of maternal depression and family adversity to depression experienced by offspring. Because maternal depression and family adversity are related, there is a need to determine how they independently contribute to offspring depression. Data are from a long-running prospective birth cohort study (Mater-University of Queensland Study of Pregnancy and its outcomes - MUSP). For this study some 2200 offspring were followed up at 30 years of age. We first examine the association between maternal depression and family adversity over the period from the pregnancy to the child reaching adulthood. Then we consider the extent to which maternal depression and family adversity trajectories over this period predict CIDI/DSM-IV episodes of depression in the offspring of these mothers at 30 years of age. We find a strong bi-directional association between maternal depression and family experiences of adverse life events over the entire period the child is at home. After adjustment, children reared in a family experiencing high levels of adverse life events are more likely to experience a lifetime ever DSM-IV diagnosis of depression, are more likely to have experienced multiple episodes of lifetime ever depression, and are more likely to report their first episode of depression was at a younger age. The findings suggest the association between maternal depression and offspring depression appears to be partly attributable to the higher levels of family adversity characteristic of depressed mothers.
Publisher: SAGE Publications
Date: 23-12-2021
Abstract: Garcinia mangostana Linn. (“mangosteen”) pericarp contains bioactive compounds that may target biological pathways implicated in schizophrenia. We conducted a double-blind randomized placebo-controlled trial evaluating the efficacy of adjunctive mangosteen pericarp, compared to placebo, in the treatment of schizophrenia. People diagnosed with schizophrenia or schizoaffective disorder ( Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), recruited across 2 sites (Brisbane and Victoria, Australia), were randomized to receive 24 weeks of adjunctive mangosteen pericarp (1,000 mg/day) or matched placebo. The primary outcome measure was the Positive and Negative Symptom Scale total score. Secondary outcomes included positive and negative symptoms, general psychopathology, clinical global severity and improvement, participant reported overall improvement, depressive symptoms, functioning, quality of life, and safety data at 24 and 28 weeks (4 weeks postdiscontinuation). Data were collected from July 2016 to February 2019. Baseline assessments were conducted on 148 people (mangosteen = 74, placebo = 74) data analyses were conducted on 136 (92%) participants with postbaseline data. The treatment group had significantly higher symptom severity compared to placebo, and both groups significantly improved on all symptom, functioning, and quality of life measures over time. No between-group differences were found for the rate of change between baseline and 24 or 28 weeks. Despite promising preclinical and clinical work, our results do not support mangosteen pericarp extract as an adjunctive treatment for schizophrenia or schizoaffective disorder.
Publisher: Wiley
Date: 24-11-2021
DOI: 10.1111/EIP.13253
Abstract: To identify and describe key service components that should be incorporated into age‐appropriate integrated mental health care for young adults aged 18–24 years. Key service components were identified through a mixed‐methods approach including targeted examinations of the literature and structured discussions with experts in youth mental health. Seven key components were identified as important for providing age‐appropriate mental health care to young adults. Two were classified as clinical service components (structured psychological therapies care coordination and liaison), three were classified as non‐clinical service components (vocational support youth development peer support) and two as integrated non‐clinical and clinical service components (lifestyle interventions and family and network support). Ex le service models for each of these key service components were identified and described. This is the first study to identify and describe key service components for age‐appropriate mental health care for young adults. The findings provide mental health service planners with a framework of services that should be considered when planning and resourcing services for this age range.
Publisher: American Psychiatric Association Publishing
Date: 2021
DOI: 10.1176/APPI.NEUROPSYCH.20030049
Abstract: The authors examined patients' perceptions of the factors affecting their recovery from anti- Seven patients completed semistructured interviews exploring their experience of recovery. Participants were interviewed between 7 and 41 months after the initiation of treatment. Interviews were transcribed and subjected to qualitative content analysis. Facilitators of recovery included the presence of a support system and treatment-related factors. Barriers to recovery included perceived psychiatric stigma, insufficient illness education, and lifestyle disruptions to accommodate ongoing treatment. Adverse physical, psychological, and neurocognitive sequelae of anti-NMDAR encephalitis continued to affect participants' daily functioning. Most participants described strategies to manage neurocognitive deficits, fatigue, and anxiety. Anti-NMDAR encephalitis contributes to persistent burden on patients, their families, and health services after the resolution of acute symptoms. Physical, psychological, and cognitive changes contribute to long-term disease morbidity. To optimize recovery and reduce disability, further attention must be directed toward illness education, reducing stigma, and role disruption. Longer-term disability support may benefit those who do not fully recover.
Publisher: Elsevier BV
Date: 04-2023
Publisher: Springer Science and Business Media LLC
Date: 29-12-2017
Publisher: SAGE Publications
Date: 2009
DOI: 10.1080/00048670802534333
Abstract: Objective: While birth cohort studies have shown that in iduals who develop non-affective psychosis show subtle deviations in cognitive and behavioural developmental trajectories, there is less evidence about deviations in physical growth in these in iduals. The purpose of the present study was to examine the association between behaviour and growth and maturation from infancy, through childhood and adolescence to early adulthood and the development of non-affective psychosis in young adults. Method: Based on a birth cohort of 3801 young adults, weight and length/height were examined at birth and at years 5, 14 and 21, together with pubertal maturation at year 14. Behavioural measures taken at years 5 and 14 were also examined. Screen-positive non-affective psychosis (SP-NAP) was assessed at year 21 using Composite International Diagnostic Interview, or a self-report checklist. The association between the behavioural and growth measures at birth and at years 5, 14 and 21, and SP-NAP at year 21 was examined using logistic regression. Results: There were 60 subjects in the cohort who were classified as having SP-NAP. In female subjects SP-NAP was significantly associated with being longer with a larger head circumference at birth, and less likely to be associated with being shorter at 21 years, with consistent trend associations for height between. There were no differences for weight. There was no significant association between the variables of interest in male subjects or for the total group. There was also no significant association between pubertal development at age 14 and risk of SP-NAP in either sex. Conclusions: Unlike developmental behavioural problems, which showed continuity from childhood through adolescence, SP-NAP was not associated with marked deviations in growth trajectory for male subjects, but the present data suggests that female subjects with SP-NAP had an altered skeletal growth trajectory.
Publisher: SAGE Publications
Date: 29-04-2013
Abstract: Because comorbidity between mental and physical disorders is commonly found in patients, it would be expected that this pattern would also be reflected at the family level. During a recent population-based survey of common mental disorders, respondents were asked about the presence of selected mental and physical disorders in their relatives. The aim of this research was to describe the within-family co-occurrence of selected common physical and mental disorders in a population-based s le. Subjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007. A modified version of the World Mental Health Survey Initiative of the Composite International Diagnostic Interview (WMH-CIDI 3.0, henceforth CIDI) was used to identify lifetime-ever common psychiatric disorders (anxiety disorders, depression, drug or alcohol disorders). The respondents were asked if any of their relatives had one of a list of psychiatric (anxiety, bipolar disorder, depression, drug or alcohol problem, schizophrenia) or general physical disorders (cancer, heart problems, intellectual disability, memory problems). We examined the relationship between the variables of interest using logistic regression, adjusting for potential confounding factors. Compared to otherwise-well respondents, those who had a CIDI diagnosis of major depressive disorders, anxiety disorders, or drug or alcohol abuse/dependence were significantly more likely to have first-degree relatives with (a) the same diagnosis as the respondent, (b) other mental disorders not identified in the respondent, and (c) a broad range of general physical conditions. In iduals with common mental disorders report greater familial co-occurrence for a range of mental and physical disorders. When eliciting family histories, clinicians should remain mindful that both mental and physical disorders can co-occur within families.
Publisher: SAGE Publications
Date: 30-12-2020
Abstract: People with mental illness may be vulnerable to decline in mental health and reduced physical activity because of the COVID-19 pandemic and associated restrictions. The aim of this study was to inform the design of physical activity interventions for implementation under these conditions to improve/maintain well-being and physical activity in this population. People with mental illness who had participated in a physical activity program prior to the pandemic were invited to complete a survey about the impact of COVID-19 on mental health and physical activity and their preferences for engaging in a physical activity program under pandemic-related restrictions. More than half the 59 respondents reported worse mental health and lower physical activity during the pandemic. The preferred format for a physical activity program was one-on-one exercise instruction in-person in a park. Program components endorsed as helpful included incentivization, provision of exercise equipment and fitness devices, and daily exercise programs. About a third of the participants reported limitations in using technology for a physical activity program. In-person exercise support is preferred by people with mental illnesses during pandemic-related restrictions. Enablement strategies such as providing equipment and self-monitoring devices should be utilized assistance may be needed to incorporate the use of technology in exercise programs.
Publisher: SAGE Publications
Date: 13-07-2016
Abstract: Adolescence is characterized by major remodelling processes in the brain. Use of antipsychotic drugs (APDs) in adolescents has increased dramatically in the last 20 years however, our understanding of the neurobiological consequences of APD treatment on the adolescent brain has not kept the same pace and significant concerns have been raised. In this review, we examined currently available preclinical studies of the effects of APDs on the adolescent brain. In animal models of neuropsychiatric disorders, adolescent APD treatment appears to be protective against selected structural, behavioural and neurochemical phenotypes. In “neurodevelopmentally normal” adolescent animals, a range of short- and long-term alterations in behaviour and neurochemistry have been reported. In particular, the adolescent brain appears to be sensitive to long-term locomotor/reward effects of chronic atypical APDs in contrast with the outcomes in adults. Long-lasting changes in dopaminergic, glutamatergic and gamma-amino butyric acid-ergic systems induced by adolescent APD administration have been observed in the nucleus accumbens. A detailed examination of other potential target regions such as striatum, prefrontal cortex and ventral tegmental area is still required. Through identification of specific neural pathways targeted by adolescent APD treatment, future studies will expand the current knowledge on long-term neural outcomes which are of translational value.
Publisher: SAGE Publications
Date: 27-06-2019
Abstract: To examine the position statement of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) regarding the availability of electronic cigarettes in Australia. There is limited evidence supporting the efficacy of nicotine e-cigarettes as an effective tobacco harm-reduction or cessation strategy for people with mental illness. The recommendations to increase their availability under regulation must be balanced with the physical and mental health risks of vapour inhalation and nicotine use, particularly for youth. Future recommendations by the RANZCP in relation to e-cigarettes must consider both the available evidence for harm reduction and the potential risks associated with youth e-cigarette use.
Publisher: Informa UK Limited
Date: 22-02-2022
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.YGYNO.2018.11.018
Abstract: Psychotropic medications including antidepressants and anxiolytics are used to treat anxiety and depression in cancer patients however, little is known about the prescription practices in endometrial cancer. This study aimed to determine the prevalence, type, dose, frequency and timing of psychotropic medications prescribed to endometrial cancer patients. A secondary aim was to study sociodemographic and clinical characteristics associated with receiving a psychotropic medication prescription. Secondary data analysis of an international, multicentre, prospective randomised controlled trial was conducted. Patients aged >18 years diagnosed with Stage I endometrial cancer were included. Logistic regression models were fitted to estimate the association of receiving psychotropic medications with patient's socio-demographic and clinical characteristics. The overall prevalence of patients prescribed one or more psychotropic medications was 16.8% (n = 121/719) comprising antidepressants (12.6%, n = 91/719) and anxiolytics (5.8%, n = 42/719). The majority of patients (78.1%, n = 71/91) were already receiving antidepressants before cancer diagnosis, the remaining medications were newly prescribed perioperatively (21.9%, n = 20/91). Patients of younger age (18-50 years, OR (Odds Ratio): 2.61), who had hypertension (OR: 0.61), history of a previous cancer (OR: 1.96), and ≥2 comorbidities (2-3, OR: 2.97 4-5, OR: 7.85 ≥6, OR: 9.13) were significantly (p < 0.05) more likely to receive a prescription of psychotropic medications. While one in eight patients already had psychotropic medications prescribed before surgery for early stage endometrial cancer, only few women received a new prescription after surgery. The overall prescription rates were similar to other patients with cancer, but higher than those observed in the general population, likely reflecting the comorbidity burden of patients who develop endometrial cancer. Qualitative data could be used in future research to explore the psychological and quality of life impacts of endometrial cancer.
Publisher: Cambridge University Press (CUP)
Date: 19-06-2017
DOI: 10.1017/S0033291717001660
Abstract: The beneficial effects of physical activity (PA) for both physical and mental wellbeing are well established. Given that adolescence presents a critical developmental period during which life-long patterns of PA become established, the exploration of the longitudinal impact of adolescent psychopathology on adult PA status is of interest. We analysed prospective data from 3663 young adults who participated in the Mater-University of Queensland Study of Pregnancy. Psychopathology was measured using the Youth Self-Report (YSR) at age 14. Participants’ engagement in three types of PA (vigorous exercise, moderate exercise and walking) at age 21 were dichotomised into either ‘none’ or ‘any’. For our main analysis, we examined the association between the YSR score and subsequent PA engagement using logistic regression. We also conducted sensitivity analyses of longitudinal associations between the YSR internalising and externalising symptoms score at age 14 and PA engagement at age 21. We found no longitudinal association between the total YSR score at age 14 and PA engagement at age 21. In addition, there was no longitudinal association between the YSR internalising or externalising symptoms and PA engagement. Our findings suggest that there is no longitudinal association between adolescent psychopathology and PA in young adulthood.
Publisher: SAGE Publications
Date: 30-06-2021
DOI: 10.1177/10398562211025040
Abstract: People with mental illness may be vulnerable to psychological distress and reduced well-being during the COVID-19 pandemic. The aim of this study was to assess psychosocial and lifestyle predictors of distress and well-being in people with mental illness during the pandemic. People with mental illness who participated in an exercise programme prior to the pandemic were invited to complete surveys about mental health and lifestyle corresponding to before and during the pandemic. Social support reduced, alcohol intake increased, and sleep quality and diet worsened during the pandemic, contributing to distress. Psychological distress was associated with the two or more mental illnesses, and negatively associated with having a physical disease. Better diet appeared to protect against increases in distress loneliness hindered improvements in well-being. Healthy lifestyle programmes designed to improve social connection may improve health for people with mental illnesses during and after the COVID-19 pandemic.
Publisher: Informa UK Limited
Date: 2010
Publisher: Springer Science and Business Media LLC
Date: 10-11-2016
DOI: 10.1007/S00127-016-1307-3
Abstract: To explore the association between histories of common mental disorders, delusional-like experiences, and recent physical activity using a large nationally representative population-based s le from Australia. We predicted that a past history of a common mental disorder or delusional-like experiences would be associated with insufficient physical activity. The study was based on the Australian National Survey of Mental Health and Wellbeing 2007 (n = 8841). The Composite International Diagnostic Interview was used to identify a lifetime and past year history of common mental disorders and delusional-like experiences. Physical activity over the preceding week was estimated using the questions based on the Active Australia survey with respondents classified as (a) insufficiently physically active versus (b) sufficiently physically active based on national recommendations. We examined the relationship between the variables of interest using logistic regression, adjusting for potential confounding factors. Almost half of the participants (46.0%) were classified as sufficiently physically active. Compared to those with no past mental disorder, those with lifetime or past year history of common mental disorders did not differ on recent physical activity status. Furthermore, we found no significant association between the number of lifetime mental disorders or the presence of delusional-like experience and recent physical activity status. Our findings suggest that a diagnosis of common mental disorder, with or without recent symptoms and comorbid diagnoses, or even having self-ascribed perception of poor mental well-being, is not associated with insufficient physical activity.
Publisher: Public Library of Science (PLoS)
Date: 09-03-2017
Publisher: Springer Science and Business Media LLC
Date: 17-07-2021
DOI: 10.1186/S12888-021-03361-5
Abstract: There is concern that rates of mental disorders may be increasing although findings disagree. Using an innovative design with a daughter-mother data set we assess whether there has been a generational increase in lifetime ever rates of major depressive disorder, generalised anxiety disorder, panic disorder, and post-traumatic stress disorder (PTSD) experienced prior to 30 years of age. Pregnant women were recruited during 1981–1983 and administered the Composite International Diagnostic Interview (CIDI) at the 27-year follow-up (2008–11). Offspring were administered the CIDI at the 30-year follow-up (2010–2014). Comparisons for onset of diagnosis are restricted to daughter and mother dyads up to 30 years of age. To address recall bias, disorders were stratified into more (≥12 months duration) and less persistent episodes ( 12 months duration) for the purposes of comparison. Sensitivity analyses with inflation were used to account for possible maternal failure to differentially recall past episodes. When comparing life time ever diagnoses before 30 years, daughters had higher rates of persistent generalised anxiety disorder, and less persistent major depressive disorder, generalised anxiety disorder and PTSD. In the context of conflicting findings concerning generational changes in mental disorders we find an increase in generational rates of persistent generalised anxiety disorders and a range of less persistent disorders. It is not clear whether this finding reflects actual changes in symptom levels over a generation or whether there has been a generational change in recognition of and willingness to report symptoms of mental illness.
Publisher: Elsevier BV
Date: 07-2020
Publisher: Elsevier BV
Date: 05-2023
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.YEBEH.2013.11.009
Abstract: The objective of this study was to test for the measurement invariance of the Attention and Thought Problems subscales of the Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) in a population-based s le of adolescents with and without epilepsy. Data were obtained from the 14-year follow-up of the Mater University Study of Pregnancy in which 33 adolescents with epilepsy and 1068 healthy controls were included for analysis. Confirmatory factor analysis was used to test for measurement invariance between adolescents with and without epilepsy. Structural equation modeling was used to test for group differences in attention and thought problems as measured with the CBCL and YSR. Measurement invariance was demonstrated for the original CBCL Attention Problems and YSR Thought Problems. After the removal of ambiguous items ("confused" and "daydreams"), measurement invariance was established for the YSR Attention Problems. The original and reduced CBCL Thought Problems were noninvariant. Adolescents with epilepsy had significantly more symptoms of behavioral problems on the CBCL Attention Problems, β=0.51, p=0.002, compared with healthy controls. In contrast, no significant differences were found for the YSR Attention and Thought Problems, β=-0.11, p=0.417 and β=-0.20, p=0.116, respectively. In this population-based s le of adolescents with epilepsy, the CBCL Attention Problems and YSR Thought Problems appear to be valid measures of behavioral problems, whereas the YSR Attention Problems was valid only after the removal of ambiguous items. Replication of these findings in clinical s les of adolescents with epilepsy that overcome the limitations of the current study is warranted.
Publisher: SAGE Publications
Date: 09-05-2019
Abstract: Despite increased awareness of the adverse impact of bullying on mental health, the prevalence of bullying in Australia is uncertain. The aim of the current study was to conduct a systematic review and meta-analysis to estimate the prevalence of bullying (traditional and cyber) among Australian children and adolescents. This study synthesised bullying prevalence studies on victimisation experiences (being bullied) and perpetration experiences (bullying others). A systematic review of electronic databases (A+ Education, EMBASE, ERIC, PubMed, PsycINFO and Scopus up to 27 May 2017) was conducted. In addition, reference lists of included studies, theses recorded at the National Library of Australia, and government websites were surveyed to identify local area data as well as state and nationally representative data. Overall, 898 studies were screened and out of the 126 studies assessed for eligibility, 46 satisfied the pre-determined inclusion criteria. Meta-analyses based on quality-effects models generated pooled prevalence estimates for each of the two types of bullying involvement (victimisation and perpetration), as well as distinct models for traditional bullying and cyberbullying experiences by the type of involvement. Overall, the 12-month prevalence of bullying victimisation was 15.17% (95% confidence interval = [9.17, 22.30]) and perpetration was 5.27% (95% confidence interval = [3.13, 7.92]). The lifetime prevalence for traditional bullying victimisation was 25.13% (95% confidence interval = [18.73, 32.11]) and perpetration was 11.61% (95% confidence interval = [7.41, 16.57]). Cyberbullying victimisation and perpetration were less common with lifetime prevalence of 7.02% (95% confidence interval = [2.41, 13.54]) and 3.45% (95% confidence interval = [1.13, 6.84]), respectively. Bullying is common among children and adolescents in Australia. There is a need to improve the measurement of bullying using a standardised instrument and for prevalence estimates to be collected on a regular basis to assess change over time. Wide implementation of anti-bullying programmes in Australian schools is a viable public health approach for the prevention of mental health problems.
Publisher: Wiley
Date: 04-10-2013
DOI: 10.1111/JCPP.12144
Abstract: The most recent Global Burden of Disease Study (GBD 2010) is the first to include attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) for burden quantification. We present the epidemiological profiles of ADHD and CD across three time periods for 21 world regions. A systematic review of global epidemiology was conducted for each disorder (based on a literature search of the Medline, PsycInfo and EMBASE databases). A Bayesian metaregression tool was used to derive prevalence estimates by age and sex in three time periods (1990, 2005 and 2010) for 21 world regions including those with little or no data. Prior expert knowledge and covariates were applied to each model to adjust suboptimal data. Final prevalence output for ADHD were adjusted to reflect an equivalent value if studies had measured point prevalence using multiple informants while final prevalence output for CD were adjusted to reflect a value equivalent to CD only. Prevalence was pooled for males and females aged 5-19 years with no difference found in global prevalence between the three time periods. Male prevalence of ADHD in 2010 was 2.2% (2.0-2.3) while female prevalence was 0.7% (0.6-0.7). Male prevalence of CD in 2010 was 3.6% (3.3-4.0) while female prevalence was 1.5% (1.4-1.7). ADHD and CD were estimated to be present worldwide with ADHD prevalence showing some regional variation while CD prevalence remained relatively consistent worldwide. We present the first prevalence estimates of both ADHD and CD globally and for all world regions. Data were sparse with large parts of the world having no estimates of either disorder. Epidemiological studies are urgently needed in certain parts of the world. Our findings directly informed burden quantification for GBD 2010. As mental disorders gained increased recognition after the first GBD study in 1990, the inclusion of ADHD and CD in GBD 2010 ensures their importance will be recognized alongside other childhood disorders.
Publisher: Public Library of Science (PLoS)
Date: 03-06-2015
Publisher: SAGE Publications
Date: 18-10-2020
Abstract: To discuss challenges with the diagnosis of autoimmune psychosis (AP) in people with chronic psychotic disorders. We present a case of a 23-year-old man with an exacerbation of treatment-refractory psychosis after receiving intravenous immunoglobulin (IVIG) for suspected AP, diagnosed 4 years after the onset of psychosis. We highlight the diagnostic and management challenges in such cases. The diagnosis of AP in people with long-standing illness relies on the interpretation of non-specific clinical and laboratory findings in in iduals with psychosocial problems and challenges of acceptance and adherence to complex medical investigations and treatments. Equivocal results from investigations undertaken without logical clinical reasoning can lead to inappropriate interventions that are costly and can cause iatrogenic harm. Psychiatrists should restrict screening for antineuronal antibodies in people with chronic psychosis to those with higher risk features such as persistent treatment refractory symptoms with concurrent neurological signs and symptoms. Further research informing the clinical circumstances for antineuronal antibody testing is needed.
Publisher: Cold Spring Harbor Laboratory
Date: 29-11-2019
DOI: 10.1101/854927
Abstract: Childhood aggressive behavior (AGG) has a substantial heritability of around 50%. Here we present a genome-wide association meta-analysis (GWAMA) of childhood AGG, in which all phenotype measures across childhood ages from multiple assessors were included. We analyzed phenotype assessments for a total of 328 935 observations from 87 485 children aged between 1.5 and 18 years, while accounting for s le overlap. We also meta-analyzed within subsets of the data – i.e. within rater, instrument and age. SNP-heritability for the overall meta-analysis (AGG overall ) was 3.31% (SE=0.0038). We found no genome-wide significant SNPs for AGG overall . The gene-based analysis returned three significant genes: ST3GAL3 ( P =1.6E-06), PCDH7 ( P =2.0E-06) and IPO13 ( P =2.5E-06). All three genes have previously been associated with educational traits. Polygenic scores based on our GWAMA significantly predicted aggression in a holdout s le of children (variance explained = 0.44%) and in retrospectively assessed childhood aggression (variance explained = 0.20%). Genetic correlations ( r g ) among rater-specific assessment of AGG ranged from r g =0.46 between self- and teacher-assessment to r g =0.81 between mother- and teacher-assessment. We obtained moderate to strong r g ’s with selected phenotypes from multiple domains, but hardly with any of the classical biomarkers thought to be associated with AGG. Significant genetic correlations were observed with most psychiatric and psychological traits (range | r g | : 0.19 – 1.00), except for obsessive-compulsive disorder. Aggression had a negative genetic correlation ( r g =~ −0.5) with cognitive traits and age at first birth. Aggression was strongly genetically correlated with smoking phenotypes (range | r g | : 0.46 – 0.60). The genetic correlations between aggression and psychiatric disorders were weaker for teacher-reported AGG than for mother- and self-reported AGG. The current GWAMA of childhood aggression provides a powerful tool to interrogate the rater-specific genetic etiology of AGG.
Publisher: Wiley
Date: 08-12-2020
DOI: 10.1111/ACPS.13128
Abstract: Psychotic experiences, including auditory hallucinatory experiences (HEs), are strongly associated with both suicidal thoughts and behaviour. This study examined their role in the ideation-to-attempt transition in adolescents, including their direct and indirect effect via potential mediators. Participants were from an Australian prospective longitudinal cohort of 1669 adolescents (12-17 years) of which a subs le endorsing baseline suicidal ideation (n = 216) was the focus of most analyses. Suicidal thoughts and behaviours were measured using the Self-Harm Behaviour Questionnaire. The Diagnostic Interview Schedule for Children was used to assess auditory HEs. Potential mediators of interest were psychological distress and Interpersonal Theory of Suicide (IPTS) constructs. Among adolescents reporting suicidal ideation at baseline (n = 216), 6.5% had attempted suicide during follow-up. The size of auditory HEs' univariate effect suggests a possible strong relationship with increased risk of incident suicide attempts (OR = 2.40 95%CI = 0.76-7.56) however, there was inadequate statistical power to produce a precise estimate. When HEs were accompanied by distress there was a nine-fold increased risk of acting on suicidal thoughts. Distress was independently associated with risk of attempt transition (OR = 4.09), whereas IPTS constructs were poor explanatory variables in most models. Adolescents with psychological distress and auditory HEs are at high risk of incident suicide attempts. Further investigations on the role of negative/distressing content of hallucinations in the ideation-to-attempt transition are warranted.
Publisher: SAGE Publications
Date: 26-04-2017
Publisher: Informa UK Limited
Date: 06-06-2017
DOI: 10.1080/13803395.2017.1329408
Abstract: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an immune-mediated neurological disorder that (among other severe neuropsychiatric symptoms) affects cognition. This study aimed to summarize current knowledge regarding the rates, nature, and predictors of neuropsychological dysfunction in patients recovering from anti-NMDAR encephalitis. A systematic review of studies describing neuropsychological outcomes following anti-NMDAR encephalitis was conducted. Electronic databases Medline, PsycINFO, EMBASE, and CINAHL were searched from inception to September 2016. Results were summarized using descriptive statistics and a series of chi-square analyses. Of 4030 identified studies, 44 were included. These reported neuropsychological outcomes for 109 treated patients (83.5% female, M Neuropsychological deficits are prevalent at all points of recovery from anti-NMDAR encephalitis, although improvement in cognitive outcomes can be expected as patients recover. Some cognitive deficits may be less likely than others to resolve. Close neuropsychological monitoring is warranted in this population. Longitudinal studies of neuropsychological functioning of patients with anti-NMDAR encephalitis are needed to accurately inform prognosis.
Publisher: SAGE Publications
Date: 06-12-2013
Location: Korea, Republic of
Start Date: 03-2020
End Date: 04-2023
Amount: $560,468.00
Funder: Australian Research Council
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