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Other Artificial Intelligence | Mental Health | Artificial Intelligence and Image Processing
Publisher: SAGE Publications
Date: 27-08-2021
DOI: 10.1177/00048674211041917
Abstract: This paper describes the development of the third edition of the National Health and Medical Research Australian Guidelines for the Prevention and Treatment of Acute Stress Disorder, posttraumatic stress disorder and Complex posttraumatic stress disorder, highlighting key changes in scope, methodology, format and treatment recommendations from the previous 2013 edition of the Guidelines. Systematic review of the international research was undertaken, with GRADE methodology used to assess the certainty of the evidence, and evidence to decision frameworks used to generate recommendations. The Guidelines are presented in an online format using MAGICApp. Key changes since the publication of the 2013 Guidelines include a new conditional recommendation for Child and Family Traumatic Stress Intervention for children and adolescents with symptoms within the first 3 months of trauma, and a strong recommendation for trauma-focused cognitive behaviour therapy for the child alone or with a caregiver, for those with diagnosed posttraumatic stress disorder. For adults with posttraumatic stress disorder, strong recommendations are made for specific types of trauma-focused cognitive behaviour therapy and conditional recommendations are made for five additional psychological interventions. Where medication is indicated for adults with posttraumatic stress disorder, venlafaxine is now conditionally recommended alongside sertraline, paroxetine or fluoxetine. These Guidelines, based on systematic review of the international literature, are intended to guide decision making for practitioners, service planners, funders and those seeking treatment for trauma related mental health concerns. For an Australian Guideline, a critical limitation is the absence of research on the treatment of Australian Aboriginal and Torres Strait Islander peoples. The new online format of the Australian posttraumatic stress disorder Guidelines means that they can be updated as sufficient new evidence becomes available.
Publisher: Elsevier BV
Date: 10-2021
DOI: 10.1016/J.YFRNE.2021.100946
Abstract: Stress homeostatic mediators are the most consistently anomalous biomarkers observed in suicide and may therefore point to a common 'core biology' of stress susceptibility, and suicidal behaviour. Previously reported meta-analyses have demonstrated aberrant levels of stress cortisol and inflammatory cytokines in suicide patients compared to controls, and significant associations between the stress regulator FK506-binding protein 51 (FKBP5) gene and suicidal behaviour. Although these independent studies were investigated as separate entities in suicide, stress mediators interact in a dynamic system, collectively giving rise to system changes physiologically, and ultimately psychologically and behaviourally. It is therefore important to study the dynamic network these stress mediators. Network meta-analysis allows for the simultaneous comparison of more than two biological mediators, and for comparisons to be made between mediators that have not been directly compared before, using previously reported, pooled meta data. Such network approaches may help study the complex biological phenomena of suicide and may provide better prediction of biological risk of suicidal states. This study aimed to establish the comparative relationships between key stress mediators in suicidal patients compared to non-suicidal controls using a random-effects network meta-analysis approach.. The key stress mediators included cortisol, six inflammatory markers (interleukin-6 (IL-6), interleukin-4 (IL-4), interleukin-2 (IL-2), tumour necrosis factor-a (TNF-α), interferon (IFN-y) and transforming growth factor β (TGF-β), and the FKBP5 single nucleotide polymorphism (SNP) allele. Data was derived from three previously published meta-analysis. The study population comprised of 1348 suicidal patients, defined as suicide attempters, completers, or patients with severe suicidal ideation, and 1750 non-suicidal controls, defined as healthy controls and psychiatric patients without suicidal ideation or previous attempts. Pair-wise indirect effects of stress mediators in suicide compared to controls demonstrated that relative to the effect of the FKBP5 risk SNP allele on suicide risk, the magnitude of differences (suicide vs control) for the levels of IL-2 (SMD -0.72 95% CI, -0.135 to -0.09 and IL-4 (SMD -0.71 95% CI, -1.34 to -0.08) were significantly smaller (with 95% confidence intervals not crossing the null). The comparative relationships between stress mediators in suicidal behaviour demonstrates that the dynamic stress network relationship is dysregulated in suicide patients when compared to controls. This model suggests that a genetic stress susceptibility with downstream abnormal cortisol stress axis functioning, together with anomalous interactions between the inflammatory system, may be one of the neurobiological correlates of suicide behaviour. This biological state may leave the in idual physiologically susceptible and unable to cope with environmental stressors, which is consistent with the stress-diathesis hypothesis of suicide behaviour.
Publisher: SAGE Publications
Date: 25-10-2018
Abstract: Ondansetron is a serotonin 3 receptor antagonist widely used to prevent nausea and vomiting in pregnancy and in patients receiving chemotherapy. There is growing evidence that adjunctive ondansetron treatment improves symptomatology associated with schizophrenia, particularly with respect to the positive, negative and cognitive symptoms. Further studies that are applicable to real world practice are required to assess the efficacy and effectiveness of this treatment, which could be readily and rapidly translated into clinical practice. This randomized control trial compared adjunctive (8 mg/daily) ondansetron or placebo to commonly prescribed atypical antipsychotics for people suffering with chronic schizophrenia ( ClinicalTrials.gov NCT01121042). The study involved 85 outpatients aged 18-65 years with a diagnosis of schizophrenia or schizoaffective disorder who participated in a two-arm randomized control trial. Longitudinal analyses revealed adjunctive ondansetron provided significant improvement in the cognitive domain ( p<0.05) as measured by the Positive and Negative Syndrome Scale between baseline and week 12. The analysis of "Combination" showed ondansetron effect on Total Positive and Negative Syndrome Scale, approaching significance by week 12 ( p=0.06). No group differences were obtained in the Montgomery-Asberg Depression Rating Scale or Positive and Negative Syndrome Scale subscales. This treatment trial provides some support for adjunctive ondansetron medication as a treatment for the cognitive disorganization symptoms of schizophrenia.
Publisher: Springer Science and Business Media LLC
Date: 02-2018
Publisher: SAGE Publications
Date: 25-02-2022
DOI: 10.1177/10398562221077900
Abstract: This study aims to assess the reliability and construct validity of the City Birth Trauma Scale (BiTS) in Oceania and confirm the latent factor structure of postpartum posttraumatic stress disorder (PTSD). Participants completed the City BiTS, demographic and obstetric information via an online survey. Psychometric properties of the City BiTS were investigated using confirmatory factor analyses (CFA). The study included 195 women, with 39 participating in repeat administration. CFA confirmed a two-factor model which included a birth-related symptom (BRS) subscale and general symptom (GS) subscale. High reliability and construct validity was observed for subscales and total score at baseline and follow-up. The City BiTS represents a potentially useful tool to assist with screening for postpartum PTSD.
Publisher: JMIR Publications Inc.
Date: 16-06-2021
DOI: 10.2196/27807
Abstract: Body image and eating disorders represent a significant public health concern however, many affected in iduals never access appropriate treatment. Conversational agents or chatbots reflect a unique opportunity to target those affected online by providing psychoeducation and coping skills, thus filling the gap in service provision. A world-first body image chatbot called “KIT” was designed. The aim of this study was to assess preliminary acceptability and feasibility via the collection of qualitative feedback from young people and parents/carers regarding the content, structure, and design of the chatbot, in accordance with an agile methodology strategy. The chatbot was developed in collaboration with Australia’s national eating disorder support organization, the Butterfly Foundation. A conversation decision tree was designed that offered psychoeducational information on body image and eating disorders, as well as evidence-based coping strategies. A version of KIT was built as a research prototype to deliver these conversations. Six focus groups were conducted using online semistructured interviews to seek feedback on the KIT prototype. This included four groups of people seeking help for themselves (n=17 age 13-18 years) and two groups of parents/carers (n=8 age 46-57 years). Participants provided feedback on the cartoon chatbot character design, as well as the content, structure, and design of the chatbot webchat. Thematic analyses identified the following three main themes from the six focus groups: (1) chatbot character and design, (2) content presentation, and (3) flow. Overall, the participants provided positive feedback regarding KIT, with both young people and parents/carers generally providing similar reflections. The participants approved of KIT’s character and engagement. Specific suggestions were made regarding the brevity and tone to increase KIT’s interactivity. Focus groups provided overall positive qualitative feedback regarding the content, structure, and design of the body image chatbot. Incorporating the feedback of lived experience from both in iduals and parents/carers allowed the refinement of KIT in the development phase as per an iterative agile methodology. Further research is required to evaluate KIT’s efficacy.
Publisher: JMIR Publications Inc.
Date: 12-02-2021
Abstract: ody image and eating disorders represent a significant public health concern however, many affected in iduals never access appropriate treatment. Conversational agents or chatbots reflect a unique opportunity to target those affected online by providing psychoeducation and coping skills, thus filling the gap in service provision. world-first body image chatbot called “KIT” was designed. The aim of this study was to assess preliminary acceptability and feasibility via the collection of qualitative feedback from young people and parents/carers regarding the content, structure, and design of the chatbot, in accordance with an agile methodology strategy. The chatbot was developed in collaboration with Australia’s national eating disorder support organization, the Butterfly Foundation. conversation decision tree was designed that offered psychoeducational information on body image and eating disorders, as well as evidence-based coping strategies. A version of KIT was built as a research prototype to deliver these conversations. Six focus groups were conducted using online semistructured interviews to seek feedback on the KIT prototype. This included four groups of people seeking help for themselves (n=17 age 13-18 years) and two groups of parents/carers (n=8 age 46-57 years). Participants provided feedback on the cartoon chatbot character design, as well as the content, structure, and design of the chatbot webchat. hematic analyses identified the following three main themes from the six focus groups: (1) chatbot character and design, (2) content presentation, and (3) flow. Overall, the participants provided positive feedback regarding KIT, with both young people and parents/carers generally providing similar reflections. The participants approved of KIT’s character and engagement. Specific suggestions were made regarding the brevity and tone to increase KIT’s interactivity. ocus groups provided overall positive qualitative feedback regarding the content, structure, and design of the body image chatbot. Incorporating the feedback of lived experience from both in iduals and parents/carers allowed the refinement of KIT in the development phase as per an iterative agile methodology. Further research is required to evaluate KIT’s efficacy.
Publisher: SAGE Publications
Date: 30-12-2022
DOI: 10.1177/00048674211068788
Abstract: Following on from the publication of the Royal Australian and New Zealand Journal of Psychiatry Mood Disorder Clinical Practice Guidelines (2020) and criticisms of how these aberrantly addressed repetitive transcranial magnetic stimulation treatment of depression, questions have continued to be raised in the journal about this treatment by a small group of authors, whose views we contend do not reflect the broad acceptance of this treatment nationally and internationally. In fact, the evidence supporting the use of repetitive transcranial magnetic stimulation treatment in depression is unambiguous and substantial, consisting of an extensive series of clinical trials supported by multiple meta-analyses, network meta-analysis and umbrella reviews. Importantly, the use of repetitive transcranial magnetic stimulation treatment in depression has also been subject to a series of health economic analyses. These indicate that repetitive transcranial magnetic stimulation is a cost-effective therapy and have been used in some jurisdictions, including Australia, in support of public funding. An argument has been made that offering repetitive transcranial magnetic stimulation treatment may delay potentially effective pharmacotherapy. In fact, there is considerably greater danger of the opposite happening. Repetitive transcranial magnetic stimulation is as, if not more effective, than antidepressant medication after two unsuccessful medication trials and should be a consideration for all patients under these circumstances where available. There is no meaningful ongoing debate about the use of repetitive transcranial magnetic stimulation treatment in depression - it is a safe, effective and cost-effective treatment.
Publisher: SAGE Publications
Date: 29-11-2021
Publisher: SAGE Publications
Date: 12-10-2021
Abstract: To examine psychological distress in healthcare workers (HCWs) during the COVID-19 pandemic in April–May 2020. A cross-sectional survey examining demographic, employment and mental health characteristics of HCWs in a large metropolitan hospital in Australia. HCWs showed significant symptoms of moderate-severe level depression (21%), anxiety (20%) and posttraumatic stress disorder (PTSD 29%), associated with burnout, prior psychiatric history, profession and resilience. Despite low levels of COVID contact, moderate to high levels of psychological distress were reported. Continued monitoring and support for HCWs’ mental well-being is warranted as the COVID-19 pandemic develops.
Publisher: SAGE Publications
Date: 22-01-2020
No related organisations have been discovered for jayashri kulkarni.
Start Date: 11-2006
End Date: 10-2012
Amount: $147,900.00
Funder: Australian Research Council
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