ORCID Profile
0000-0002-7909-1560
Current Organisations
Monash University
,
The Alfred
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Publisher: Royal College of Psychiatrists
Date: 06-1995
Publisher: Elsevier BV
Date: 10-2006
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: Elsevier BV
Date: 2017
Publisher: Elsevier BV
Date: 2010
Publisher: Wiley
Date: 11-2009
DOI: 10.1111/J.1751-7893.2009.00146.X
Abstract: This paper assesses the impact of different models of early intervention (EI) service provision on functional recovery and inpatient hospital admission. The study compares the outcome of a comprehensive EI team with a partial model (community mental health team (CMHT) plus specialist support) and traditional care (generic CMHT) over a 10-year period. The design is in comparison with historical control. The study compares the functional recovery outcomes of three cohorts from the same geographical area over the period 1998-2007. The primary outcomes were partial and full functional recovery defined with respect to readily identifiable UK benefit system thresholds and psychiatric inpatient admission days at 1 and 2 years post-referral. Only 15% of in iduals made a full or partial functional recovery at 2 years under the care of a traditional generic CMHT in 1998. In 2007, 52% of the cases were making a full or partial functional recovery under the care of the comprehensive EI team. A large reduction in inpatient admissions was associated with the EI strategy. The implementation of comprehensive EI teams can have a major impact in improving functional recovery outcomes in psychosis and reducing inpatient admissions. Partial implementation using limited funding of specialist workers in collaboration with traditional care appeared to have a more limited effect on these recovery dimensions. The implementation of targeted EI in psychosis strategies can result in substantive functional benefits.
Publisher: Cambridge University Press (CUP)
Date: 05-1999
DOI: 10.1017/S0033291798007715
Abstract: Background. Neuropsychological function and cognitive correlates of depression have not previously been examined in a rigorously defined population of patients suffering from premenstrual dysphoric disorder (PMDD). Method. Mood, neuropsychological function and cognition were measured in 10 PMDD patients and 10 age-matched controls in both phases of the menstrual cycle in a random order, counter-balanced design. Results. The BDI was significantly elevated in the luteal phase of PMDD patients only while other cognitive measures showed no significant differences. Working memory was impaired in the luteal phase of the menstrual cycle with no significant differences between PMDD and control subjects. Conclusion. Despite the small s le size, these results show that the BDI is sensitive to the mood fluctuations of PMDD patients. An impairment in working memory was also found although this is a general menstrual cycle effect.
Publisher: Springer Science and Business Media LLC
Date: 17-01-2019
Publisher: Wiley
Date: 02-2007
DOI: 10.1111/J.1751-7893.2007.00014.X
Abstract: We aimed to establish the relative proportions of all diagnoses in people aged 14-35 years presenting to an early intervention in psychosis service, and to compare demographic variables, symptoms and outcomes between the bipolar psychoses and other psychoses at 3-6 months and 1 year post referral. Prospective 3- to 6-month diagnostic and symptomatic assessments were carried out. Diagnoses were established using the Diagnostic Interview for Psychoses - Diagnostic Module. Symptoms and outcomes were assessed using standardized instruments at 3-6 months and 1 year. Bipolar diagnoses were grouped together in a bipolar group (n=16) and compared with all other diagnoses, in a non-bipolar group (n=62). Parallel analysis was carried out using groups of lifetime elevated, expansive or irritable mood (n=32) and no lifetime elevated, expansive or irritable mood (n=46). Bipolar disorders account for 20.5% of all new presentations to our service. Differences in outcomes over the range of psychotic diagnoses relate to early presence of negative symptoms. Psychoses with bipolar diagnoses or lifetime elevated, expansive or irritable mood showed lower rates of negative symptoms than other psychoses and had a higher quality of life and higher function at 3-6 months and 1 year. Planning for future early intervention services should take the high rate of affective psychoses and their need for diagnosis-specific, evidence-based treatments into account. Lifetime elevated, expansive or irritable mood may predict improved outcomes in early psychoses, possibly mediated by lower levels of negative symptoms.
Publisher: Elsevier BV
Date: 10-2006
Publisher: Royal College of Psychiatrists
Date: 02-2001
Abstract: Twenty per cent of patients with bipolar affective disorder suffer an illness that responds inadequately to treatment and has a poor outcome. Many patients, but not all, with bipolar disorder show white matter abnormalities on T 2 -weighted magnetic resonance imaging (MRI). To explore the hypothesis that white matter abnormalities on MRI are seen more frequently in subjects whose illness has a poor outcome compared with those with a good outcome or controls. Two groups of age- and gender-matched patients with bipolar disorder (14 with a good outcome and 15 with a poor outcome) and 15 controls, aged 20–65 years, were studied. Axial T 2 -weighted MRI scans were examined for the presence and severity of white matter abnormalities. Significantly more poor outcome group members had deep subcortical punctate, but not periventricular, white matter hyperintensities than the good outcome group ( P =0.035) or controls ( P =0.003) and these abnormalities were of greater severity ( P =0.030 and P 0.014, respectively). Subcortical white matter lesions are associated with poor outcome bipolar disorder.
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: SAGE Publications
Date: 28-08-2013
Publisher: Elsevier BV
Date: 2016
Publisher: BMJ
Date: 18-09-2013
DOI: 10.1136/BMJ.F5270
Publisher: Cambridge University Press (CUP)
Date: 04-2009
Publisher: Elsevier BV
Date: 10-2006
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 2023
End Date: 2027
Funder: National Institute of Mental Health
View Funded ActivityStart Date: 2012
End Date: 2015
Funder: National Institute for Health and Care Research
View Funded ActivityStart Date: 2004
End Date: 2006
Funder: Medical Research Council
View Funded Activity