Publisher: Sage Publications   (Total: 1166 journals)

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Showing 1 - 200 of 1166 Journals sorted alphabetically
AADE in Practice     Hybrid Journal   (Followers: 6)
Abstracts in Anthropology     Full-text available via subscription   (Followers: 29)
Academic Pathology     Open Access   (Followers: 6)
Accounting History     Hybrid Journal   (Followers: 18, SJR: 0.527, CiteScore: 1)
Acta Radiologica     Hybrid Journal   (Followers: 1, SJR: 0.754, CiteScore: 2)
Acta Radiologica Open     Open Access   (Followers: 2)
Acta Sociologica     Hybrid Journal   (Followers: 39, SJR: 0.939, CiteScore: 2)
Action Research     Hybrid Journal   (Followers: 53, SJR: 0.308, CiteScore: 1)
Active Learning in Higher Education     Hybrid Journal   (Followers: 398, SJR: 1.397, CiteScore: 2)
Adaptive Behavior     Hybrid Journal   (Followers: 9, SJR: 0.288, CiteScore: 1)
Administration & Society     Hybrid Journal   (Followers: 18, SJR: 0.675, CiteScore: 1)
Adoption & Fostering     Hybrid Journal   (Followers: 25, SJR: 0.313, CiteScore: 0)
Adsorption Science & Technology     Open Access   (Followers: 9, SJR: 0.258, CiteScore: 1)
Adult Education Quarterly     Hybrid Journal   (Followers: 262, SJR: 0.566, CiteScore: 2)
Adult Learning     Hybrid Journal   (Followers: 51)
Advances in Dental Research     Hybrid Journal   (Followers: 11, SJR: 1.791, CiteScore: 4)
Advances in Developing Human Resources     Hybrid Journal   (Followers: 35, SJR: 0.614, CiteScore: 2)
Advances in Mechanical Engineering     Open Access   (Followers: 156, SJR: 0.272, CiteScore: 1)
Advances in Methods and Practices in Psychological Science     Full-text available via subscription   (Followers: 20)
Advances in Structural Engineering     Full-text available via subscription   (Followers: 51, SJR: 0.599, CiteScore: 1)
AERA Open     Open Access   (Followers: 14)
Affilia     Hybrid Journal   (Followers: 6, SJR: 0.496, CiteScore: 1)
Africa Spectrum     Open Access   (Followers: 17)
Agrarian South : J. of Political Economy     Hybrid Journal   (Followers: 3)
Air, Soil & Water Research     Open Access   (Followers: 13, SJR: 0.214, CiteScore: 1)
Alexandria : The J. of National and Intl. Library and Information Issues     Full-text available via subscription   (Followers: 68)
Allergy & Rhinology     Open Access   (Followers: 5)
AlterNative : An Intl. J. of Indigenous Peoples     Full-text available via subscription   (Followers: 39, SJR: 0.194, CiteScore: 0)
Alternative Law J.     Hybrid Journal   (Followers: 12, SJR: 0.176, CiteScore: 0)
Alternatives : Global, Local, Political     Hybrid Journal   (Followers: 13, SJR: 0.351, CiteScore: 1)
Alternatives to Laboratory Animals     Full-text available via subscription   (Followers: 11, SJR: 0.297, CiteScore: 1)
American Behavioral Scientist     Hybrid Journal   (Followers: 26, SJR: 0.982, CiteScore: 2)
American Economist     Hybrid Journal   (Followers: 7)
American Educational Research J.     Hybrid Journal   (Followers: 260, SJR: 2.913, CiteScore: 3)
American J. of Alzheimer's Disease and Other Dementias     Hybrid Journal   (Followers: 23, SJR: 0.67, CiteScore: 2)
American J. of Cosmetic Surgery     Hybrid Journal   (Followers: 9)
American J. of Evaluation     Hybrid Journal   (Followers: 18, SJR: 0.646, CiteScore: 2)
American J. of Health Promotion     Hybrid Journal   (Followers: 35, SJR: 0.807, CiteScore: 1)
American J. of Hospice and Palliative Medicine     Hybrid Journal   (Followers: 47, SJR: 0.65, CiteScore: 1)
American J. of Law & Medicine     Full-text available via subscription   (Followers: 12, SJR: 0.204, CiteScore: 1)
American J. of Lifestyle Medicine     Hybrid Journal   (Followers: 7, SJR: 0.431, CiteScore: 1)
American J. of Medical Quality     Hybrid Journal   (Followers: 13, SJR: 0.777, CiteScore: 1)
American J. of Men's Health     Open Access   (Followers: 9, SJR: 0.595, CiteScore: 2)
American J. of Rhinology and Allergy     Hybrid Journal   (Followers: 11, SJR: 0.972, CiteScore: 2)
American J. of Sports Medicine     Hybrid Journal   (Followers: 249, SJR: 3.949, CiteScore: 6)
American Politics Research     Hybrid Journal   (Followers: 36, SJR: 1.313, CiteScore: 1)
American Review of Public Administration     Hybrid Journal   (Followers: 28, SJR: 2.062, CiteScore: 2)
American Sociological Review     Hybrid Journal   (Followers: 358, SJR: 6.333, CiteScore: 6)
American String Teacher     Full-text available via subscription   (Followers: 3)
Analytical Chemistry Insights     Open Access   (Followers: 26, SJR: 0.224, CiteScore: 1)
Angiology     Hybrid Journal   (Followers: 5, SJR: 0.849, CiteScore: 2)
Animation     Hybrid Journal   (Followers: 15, SJR: 0.197, CiteScore: 0)
Annals of Clinical Biochemistry     Hybrid Journal   (Followers: 10, SJR: 0.634, CiteScore: 1)
Annals of Otology, Rhinology & Laryngology     Hybrid Journal   (Followers: 20, SJR: 0.807, CiteScore: 1)
Annals of Pharmacotherapy     Hybrid Journal   (Followers: 59, SJR: 1.096, CiteScore: 2)
Annals of the American Academy of Political and Social Science     Hybrid Journal   (Followers: 51, SJR: 1.225, CiteScore: 3)
Annals of the ICRP     Hybrid Journal   (Followers: 4, SJR: 0.548, CiteScore: 1)
Anthropocene Review     Hybrid Journal   (Followers: 8, SJR: 3.341, CiteScore: 7)
Anthropological Theory     Hybrid Journal   (Followers: 48, SJR: 0.739, CiteScore: 1)
Antitrust Bulletin     Hybrid Journal   (Followers: 14)
Antiviral Chemistry and Chemotherapy     Open Access   (Followers: 2, SJR: 0.635, CiteScore: 2)
Antyajaa : Indian J. of Women and Social Change     Hybrid Journal   (Followers: 1)
Applied Biosafety     Hybrid Journal   (Followers: 1, SJR: 0.131, CiteScore: 0)
Applied Psychological Measurement     Hybrid Journal   (Followers: 21, SJR: 1.17, CiteScore: 1)
Applied Spectroscopy     Full-text available via subscription   (Followers: 27, SJR: 0.489, CiteScore: 2)
Armed Forces & Society     Hybrid Journal   (Followers: 25, SJR: 0.29, CiteScore: 1)
Arthaniti : J. of Economic Theory and Practice     Full-text available via subscription  
Arts and Humanities in Higher Education     Hybrid Journal   (Followers: 49, SJR: 0.305, CiteScore: 1)
Asia Pacific Media Educator     Hybrid Journal   (Followers: 1, SJR: 0.23, CiteScore: 0)
Asia-Pacific J. of Management Research and Innovation     Full-text available via subscription   (Followers: 3)
Asia-Pacific J. of Public Health     Hybrid Journal   (Followers: 15, SJR: 0.558, CiteScore: 1)
Asia-Pacific J. of Rural Development     Hybrid Journal   (Followers: 2)
Asian and Pacific Migration J.     Full-text available via subscription   (Followers: 8, SJR: 0.324, CiteScore: 1)
Asian Cardiovascular and Thoracic Annals     Hybrid Journal   (Followers: 2, SJR: 0.305, CiteScore: 0)
Asian J. of Comparative Politics     Hybrid Journal   (Followers: 5)
Asian J. of Legal Education     Full-text available via subscription   (Followers: 4)
Asian J. of Management Cases     Hybrid Journal   (Followers: 6, SJR: 0.101, CiteScore: 0)
ASN Neuro     Open Access   (Followers: 2, SJR: 1.534, CiteScore: 3)
Assessment     Hybrid Journal   (Followers: 19, SJR: 1.519, CiteScore: 3)
Assessment for Effective Intervention     Hybrid Journal   (Followers: 15, SJR: 0.578, CiteScore: 1)
Australasian J. of Early Childhood     Hybrid Journal   (Followers: 7, SJR: 0.535, CiteScore: 1)
Australasian Psychiatry     Hybrid Journal   (Followers: 18, SJR: 0.433, CiteScore: 1)
Australian & New Zealand J. of Psychiatry     Hybrid Journal   (Followers: 30, SJR: 1.801, CiteScore: 2)
Australian and New Zealand J. of Criminology     Hybrid Journal   (Followers: 547, SJR: 0.612, CiteScore: 1)
Australian J. of Career Development     Hybrid Journal   (Followers: 5)
Australian J. of Education     Hybrid Journal   (Followers: 51, SJR: 0.403, CiteScore: 1)
Australian J. of Management     Hybrid Journal   (Followers: 13, SJR: 0.497, CiteScore: 1)
Autism     Hybrid Journal   (Followers: 358, SJR: 1.739, CiteScore: 4)
Autism & Developmental Language Impairments     Open Access   (Followers: 17)
Avian Biology Research     Hybrid Journal   (Followers: 6, SJR: 0.401, CiteScore: 1)
Behavior Modification     Hybrid Journal   (Followers: 14, SJR: 0.877, CiteScore: 2)
Behavioral and Cognitive Neuroscience Reviews     Hybrid Journal   (Followers: 27)
Behavioral Disorders     Hybrid Journal   (Followers: 2)
Beyond Behavior     Hybrid Journal   (Followers: 2)
Bible Translator     Hybrid Journal   (Followers: 13)
Biblical Theology Bulletin     Hybrid Journal   (Followers: 24, SJR: 0.184, CiteScore: 0)
Big Data & Society     Open Access   (Followers: 56)
Biochemistry Insights     Open Access   (Followers: 7)
Bioinformatics and Biology Insights     Open Access   (Followers: 12, SJR: 1.141, CiteScore: 2)
Biological Research for Nursing     Hybrid Journal   (Followers: 7, SJR: 0.685, CiteScore: 2)
Biomarker Insights     Open Access   (Followers: 1, SJR: 0.81, CiteScore: 2)
Biomarkers in Cancer     Open Access   (Followers: 11)
Biomedical Engineering and Computational Biology     Open Access   (Followers: 14)
Biomedical Informatics Insights     Open Access   (Followers: 8)
Bioscope: South Asian Screen Studies     Hybrid Journal   (Followers: 4, SJR: 0.235, CiteScore: 0)
BMS: Bulletin of Sociological Methodology/Bulletin de Méthodologie Sociologique     Hybrid Journal   (Followers: 4, SJR: 0.226, CiteScore: 0)
Body & Society     Hybrid Journal   (Followers: 29, SJR: 1.531, CiteScore: 3)
Bone and Tissue Regeneration Insights     Open Access   (Followers: 2)
Brain and Neuroscience Advances     Open Access  
Brain Science Advances     Open Access  
Breast Cancer : Basic and Clinical Research     Open Access   (Followers: 12, SJR: 0.823, CiteScore: 2)
British J. of Music Therapy     Hybrid Journal   (Followers: 9)
British J. of Occupational Therapy     Hybrid Journal   (Followers: 253, SJR: 0.323, CiteScore: 1)
British J. of Pain     Hybrid Journal   (Followers: 31, SJR: 0.579, CiteScore: 2)
British J. of Politics and Intl. Relations     Hybrid Journal   (Followers: 39, SJR: 0.91, CiteScore: 2)
British J. of Visual Impairment     Hybrid Journal   (Followers: 14, SJR: 0.337, CiteScore: 1)
British J.ism Review     Hybrid Journal   (Followers: 18)
BRQ Business Review Quarterly     Open Access   (Followers: 1)
Building Acoustics     Hybrid Journal   (Followers: 4, SJR: 0.215, CiteScore: 1)
Building Services Engineering Research & Technology     Hybrid Journal   (Followers: 3, SJR: 0.583, CiteScore: 1)
Bulletin of Science, Technology & Society     Hybrid Journal   (Followers: 9)
Business & Society     Hybrid Journal   (Followers: 15)
Business and Professional Communication Quarterly     Hybrid Journal   (Followers: 9, SJR: 0.348, CiteScore: 1)
Business Information Review     Hybrid Journal   (Followers: 17, SJR: 0.279, CiteScore: 0)
Business Perspectives and Research     Hybrid Journal   (Followers: 3)
Cahiers Élisabéthains     Hybrid Journal   (Followers: 1, SJR: 0.111, CiteScore: 0)
Calcutta Statistical Association Bulletin     Hybrid Journal   (Followers: 1)
California Management Review     Hybrid Journal   (Followers: 37, SJR: 2.209, CiteScore: 4)
Canadian Association of Radiologists J.     Full-text available via subscription   (Followers: 2, SJR: 0.463, CiteScore: 1)
Canadian J. of Kidney Health and Disease     Open Access   (Followers: 8, SJR: 1.007, CiteScore: 2)
Canadian J. of Nursing Research (CJNR)     Hybrid Journal   (Followers: 15)
Canadian J. of Occupational Therapy     Hybrid Journal   (Followers: 168, SJR: 0.626, CiteScore: 1)
Canadian J. of Psychiatry     Hybrid Journal   (Followers: 28, SJR: 1.769, CiteScore: 3)
Canadian J. of School Psychology     Hybrid Journal   (Followers: 12, SJR: 0.266, CiteScore: 1)
Canadian Pharmacists J. / Revue des Pharmaciens du Canada     Hybrid Journal   (Followers: 3, SJR: 0.536, CiteScore: 1)
Cancer Control     Open Access   (Followers: 2)
Cancer Growth and Metastasis     Open Access   (Followers: 1)
Cancer Informatics     Open Access   (Followers: 4, SJR: 0.64, CiteScore: 1)
Capital and Class     Hybrid Journal   (Followers: 10, SJR: 0.282, CiteScore: 1)
Cardiac Cath Lab Director     Full-text available via subscription   (Followers: 1)
Cardiovascular and Thoracic Open     Open Access   (Followers: 1)
Career Development and Transition for Exceptional Individuals     Hybrid Journal   (Followers: 10, SJR: 0.44, CiteScore: 1)
Cartilage     Hybrid Journal   (Followers: 6, SJR: 0.889, CiteScore: 3)
Cell Transplantation     Open Access   (Followers: 5, SJR: 1.023, CiteScore: 3)
Cephalalgia     Hybrid Journal   (Followers: 8, SJR: 1.581, CiteScore: 3)
Cephalalgia Reports     Open Access   (Followers: 4)
Child Language Teaching and Therapy     Hybrid Journal   (Followers: 34, SJR: 0.501, CiteScore: 1)
Child Maltreatment     Hybrid Journal   (Followers: 11, SJR: 1.22, CiteScore: 3)
Child Neurology Open     Open Access   (Followers: 6)
Childhood     Hybrid Journal   (Followers: 19, SJR: 0.894, CiteScore: 2)
Childhood Obesity and Nutrition     Open Access   (Followers: 12)
China Information     Hybrid Journal   (Followers: 9, SJR: 0.767, CiteScore: 2)
China Report     Hybrid Journal   (Followers: 11, SJR: 0.221, CiteScore: 0)
Chinese J. of Sociology     Full-text available via subscription   (Followers: 5)
Christian Education J. : Research on Educational Ministry     Hybrid Journal   (Followers: 1)
Chronic Illness     Hybrid Journal   (Followers: 6, SJR: 0.672, CiteScore: 2)
Chronic Respiratory Disease     Hybrid Journal   (Followers: 12, SJR: 0.808, CiteScore: 2)
Chronic Stress     Open Access  
Citizenship, Social and Economics Education     Full-text available via subscription   (Followers: 6, SJR: 0.145, CiteScore: 0)
Cleft Palate-Craniofacial J.     Hybrid Journal   (Followers: 8, SJR: 0.757, CiteScore: 1)
Clin-Alert     Hybrid Journal   (Followers: 1)
Clinical and Applied Thrombosis/Hemostasis     Open Access   (Followers: 32, SJR: 0.49, CiteScore: 1)
Clinical and Translational Neuroscience     Open Access   (Followers: 1)
Clinical Case Studies     Hybrid Journal   (Followers: 3, SJR: 0.364, CiteScore: 1)
Clinical Child Psychology and Psychiatry     Hybrid Journal   (Followers: 45, SJR: 0.73, CiteScore: 2)
Clinical EEG and Neuroscience     Hybrid Journal   (Followers: 8, SJR: 0.552, CiteScore: 2)
Clinical Ethics     Hybrid Journal   (Followers: 13, SJR: 0.296, CiteScore: 1)
Clinical Medicine Insights : Arthritis and Musculoskeletal Disorders     Open Access   (Followers: 3, SJR: 0.537, CiteScore: 2)
Clinical Medicine Insights : Blood Disorders     Open Access   (Followers: 1, SJR: 0.314, CiteScore: 2)
Clinical Medicine Insights : Cardiology     Open Access   (Followers: 8, SJR: 0.686, CiteScore: 2)
Clinical Medicine Insights : Case Reports     Open Access   (Followers: 1, SJR: 0.283, CiteScore: 1)
Clinical Medicine Insights : Circulatory, Respiratory and Pulmonary Medicine     Open Access   (Followers: 4, SJR: 0.425, CiteScore: 2)
Clinical Medicine Insights : Ear, Nose and Throat     Open Access   (Followers: 2)
Clinical Medicine Insights : Endocrinology and Diabetes     Open Access   (Followers: 34, SJR: 0.63, CiteScore: 2)
Clinical Medicine Insights : Oncology     Open Access   (Followers: 3, SJR: 1.129, CiteScore: 3)
Clinical Medicine Insights : Pediatrics     Open Access   (Followers: 3)
Clinical Medicine Insights : Psychiatry     Open Access   (Followers: 10)
Clinical Medicine Insights : Reproductive Health     Open Access   (Followers: 1, SJR: 0.776, CiteScore: 0)
Clinical Medicine Insights : Therapeutics     Open Access   (Followers: 1, SJR: 0.172, CiteScore: 0)
Clinical Medicine Insights : Trauma and Intensive Medicine     Open Access   (Followers: 4)
Clinical Medicine Insights : Urology     Open Access   (Followers: 3)
Clinical Medicine Insights : Women's Health     Open Access   (Followers: 4)
Clinical Nursing Research     Hybrid Journal   (Followers: 34, SJR: 0.471, CiteScore: 1)
Clinical Pathology     Open Access   (Followers: 5)
Clinical Pediatrics     Hybrid Journal   (Followers: 25, SJR: 0.487, CiteScore: 1)
Clinical Psychological Science     Hybrid Journal   (Followers: 16, SJR: 3.281, CiteScore: 5)
Clinical Rehabilitation     Hybrid Journal   (Followers: 78, SJR: 1.322, CiteScore: 3)
Clinical Risk     Hybrid Journal   (Followers: 5, SJR: 0.133, CiteScore: 0)
Clinical Trials     Hybrid Journal   (Followers: 22, SJR: 2.399, CiteScore: 2)
Clothing and Textiles Research J.     Hybrid Journal   (Followers: 28, SJR: 0.36, CiteScore: 1)
Collections : A J. for Museum and Archives Professionals     Full-text available via subscription   (Followers: 3)
Common Law World Review     Full-text available via subscription   (Followers: 17)
Communication & Sport     Hybrid Journal   (Followers: 8, SJR: 0.385, CiteScore: 1)
Communication and the Public     Hybrid Journal   (Followers: 2)
Communication Disorders Quarterly     Hybrid Journal   (Followers: 15, SJR: 0.458, CiteScore: 1)
Communication Research     Hybrid Journal   (Followers: 24, SJR: 2.171, CiteScore: 3)
Community College Review     Hybrid Journal   (Followers: 8, SJR: 1.451, CiteScore: 1)
Comparative Political Studies     Hybrid Journal   (Followers: 293, SJR: 3.772, CiteScore: 3)
Compensation & Benefits Review     Hybrid Journal   (Followers: 8)
Competition & Change     Hybrid Journal   (Followers: 12, SJR: 0.843, CiteScore: 2)

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Similar Journals
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Australian & New Zealand Journal of Psychiatry
Journal Prestige (SJR): 1.801
Citation Impact (citeScore): 2
Number of Followers: 30  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0004-8674 - ISSN (Online) 1440-1614
Published by Sage Publications Homepage  [1166 journals]
  • Disrupted daily routines mediate the socioeconomic gradient of depression
           amid public health crises: A repeated cross-sectional study

    • Free pre-print version: Loading...

      Authors: Francisco Tsz Tsun Lai, Vivien Kin Yi Chan, Tsz Wai Li, Xue Li, Stevan E Hobfoll, Tatia Mei-Chun Lee, Wai Kai Hou
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:There is a socioeconomic gradient to depression risks, with more pronounced inequality amid macroenvironmental potential traumatic events. Between mid-2019 and mid-2020, the Hong Kong population experienced drastic societal changes, including the escalating civil unrest and the COVID-19 pandemic. We examined the change of the socioeconomic gradient in depression and the potential intermediary role of daily routine disruptions.Method:We conducted repeated territory-wide telephone surveys in July 2019 and July 2020 with 1112 and 2034 population-representative Cantonese-speaking Hong Kong citizens above 15 years old, respectively. Stratified by year, we examined the association between socioeconomic indicators (education attainment, household income, employment status and marital status) and probable depression (nine-item Patient Health Questionnaire [PHQ-9] ⩾ 10) using logistic regression. Differences in the socioeconomic gradient between 2019 and 2020 were tested. Finally, we performed a path analysis to test for the mediating role of daily routine disruptions.Results:Logistic regression showed that higher education attainment in 2019 and being married in 2020 were protective against probable depression. Interaction analysis showed that the inverse association of higher education attainment with probable depression attenuated in 2020 but that of being married increased. Path analysis showed that the mediated effects through daily routine disruptions accounted for 95.9% of the socioeconomic gradient of probable depression in 2020, compared with 13.1% in 2019.Conclusion:From July 2019 to July 2020, the mediating role of daily routine disruptions in the socioeconomic gradient of depression in Hong Kong increased. It is thus implied that infection control measures should consider the relevant potential mental health impacts accordingly.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-10-22T01:03:51Z
      DOI: 10.1177/00048674211051271
       
  • Positive mental health framework of transdiagnostic protective factors in
           elucidating the association between adverse childhood experiences and
           severe mental disorders

    • Free pre-print version: Loading...

      Authors: Jianlin Liu, Edimansyah Abdin, Janhavi Ajit Vaingankar, Matthew Sheng Mian Lim, Swapna Verma, Charmaine Tang, Saleha Shafie, Shazana Shahwan, Mythily Subramaniam
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objectives:Transdiagnostic risk factors—disrupted processes common to psychopathology—link adverse childhood experiences to severe mental disorders (i.e. major depressive disorder, bipolar disorder, and schizophrenia spectrum disorders); however, transdiagnostic protective factors are understudied. The present study investigated the association between a positive mental health framework of protective intra- and interpersonal resources and severe mental disorders in individuals with adverse childhood experiences. We hypothesized that (1) individuals with adverse childhood experiences will experience more severe mental disorders and poorer intra- and interpersonal resources than those without adverse childhood experiences; (2) intrapersonal (e.g. general coping) and interpersonal resources (e.g. emotional support) will interact to predict severe mental disorders.Methods:A total of 1929 adults participated in this population-based study. Participants were assessed for adverse childhood experiences, severe mental disorders, and intra- and interpersonal resources (general coping, general affect, emotional support, interpersonal skills, spirituality, and personal growth and autonomy) via structured interviews and self-reports.Results:As hypothesized, individuals with adverse childhood experiences (62.6%) experienced more severe mental disorders and poorer intra- and interpersonal resources than those without adverse childhood experiences. Among those with adverse childhood experiences, emotional support interacted with general coping and general affect to predict severe mental disorders; general coping and general affect were negatively associated with severe mental disorders at high (+1 SD) and low (−1 SD) emotional support, respectively.Conclusions:The present study identified interactions between specific intrapersonal (i.e. general coping and general affect) and interpersonal resources (i.e. emotional support); knowing among whom and when to intervene are essential for optimal treatment of adverse childhood experiences and severe mental disorders.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-10-20T05:54:46Z
      DOI: 10.1177/00048674211053568
       
  • Antipsychotic utilisation and persistence in Australia: A nationwide
           5-year study

    • Free pre-print version: Loading...

      Authors: Mark Taylor, Dante Dangelo-Kemp, Dennis Liu, Steve Kisely, Simon Graham, Jodie Hartmann, Sam Colman
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objectives:To evaluate the utilisation and persistence of antipsychotics for the treatment of schizophrenia in Australia.Methods:A retrospective study using the Australian Pharmaceutical Benefits Scheme database of a representative 10% sample. All adults with schizophrenia who were dispensed three or more supplies of oral (including clozapine) or long-acting injectable antipsychotics between 1 June 2015 and 31 May 2020 were included. Persistence time in treatment was evaluated using survival analysis and Cox hazard ratios.Results:In all, 26,847 adults with schizophrenia were studied. Oral second-generation antipsychotics were more frequently dispensed than the other antipsychotic groups studied. Median treatment persistence times were 18.3 months for second-generation antipsychotic long-acting injectables, 10.7 months for oral second-generation antipsychotics and were significantly lower for both formulations of first-generation antipsychotics at 5.2 months (long-acting injectables) and 3.7 months (oral). The median persistence time for clozapine was significantly longer than all other antipsychotics groups.Conclusions:Oral second-generation antipsychotics and second-generation antipsychotic long-acting injectables accounted for over 75% and 13% of all antipsychotics in Australia, respectively. Concerns over medication adherence and subsequent relapse have not translated into increased long-acting injectable usage despite their significantly longer persistence. Clozapine, the single most ‘persistent’ antipsychotic, was only used in 9% of people, although up to a third of all cases are likely to be treatment-resistant. Our data suggest clinicians should give consideration to the earlier use of second-generation antipsychotic long-acting injectables and clozapine, to ameliorate prognosis in schizophrenia.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-10-16T11:16:24Z
      DOI: 10.1177/00048674211051618
       
  • The incidence and admission rate for first-episode psychosis in young
           people before and during the COVID-19 pandemic in Melbourne, Australia

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      Authors: Brian O’Donoghue, Hannah Collett, Sophie Boyd, Yuanna Zhou, Emily Castagnini, Ellie Brown, Rebekah Street, Barnaby Nelson, Andrew Thompson, Patrick McGorry
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:The COVID-19 pandemic has had a profound effect on global mental health, with one-third of infected individuals developing a psychiatric or neurological disorder 6 months after infection. The risk of infection and the associated restrictions introduced to reduce the spread of the virus have also impacted help-seeking behaviours. Therefore, this study aimed to determine whether there was a difference during the COVID-19 pandemic in the treated incidence of psychotic disorders and rates of admission to hospital for psychosis (including involuntary admission).Methods:Incident cases of first-episode psychosis in young people, aged 15 to 24, at an early intervention service in Melbourne from an 8-month period before the pandemic were compared with rates during the pandemic. Hospital admission rates for these periods were also compared.Results:Before the pandemic, the annual incidence of first-episode psychosis was 104.5 cases per 100,000 at-risk population, and during the pandemic it was 121.9 (incidence rate ratio = 1.14, 95% confidence interval = [0.92, 1.42], p = 0.24). Immediately after the implementation of restrictions, there was a non-significant reduction in the treated incidence (incidence rate ratio = 0.80, 95% confidence interval = [0.58, 1.09]), which was followed by a significant increase in the treated incidence in later months (incidence rate ratio = 1.94, 95% confidence interval = [1.52, 2.49]; incidence rate ratio = 1.64, 95% confidence interval = [1.25, 2.16]). Before the pandemic, 37.3% of young people with first-episode psychosis were admitted to hospital, compared to 61.7% during the pandemic (odds ratio = 2.71, 95% confidence interval = [1.73, 4.24]). Concerning the legal status of the admissions, before the pandemic, 27.3% were admitted involuntarily to hospital, compared to 42.5% during the pandemic (odds ratio = 1.97, 95% confidence interval = [1.23, 3.14]).Conclusion:There was a mild increase, which did not reach statistical significance, in the overall incidence of first-episode psychosis; however, the pattern of presentations changed significantly, with nearly twice as many cases presenting in the later months of the restrictions. There was a significant increase in both voluntary and involuntary admissions, and the possible explanations for these findings are discussed.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-10-15T11:02:24Z
      DOI: 10.1177/00048674211053578
       
  • A comparison of experiences of care and expressed emotion among caregivers
           of young people with first-episode psychosis or borderline personality
           disorder features

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      Authors: Sue M Cotton, Jennifer K Betts, Dina Eleftheriadis, Kate Filia, Mirra Seigerman, Victoria K Rayner, Ben McKechnie, Carol Anne Hulbert, Louise McCutcheon, Martina Jovev, Sarah Bendall, Emma Burke, Catharine McNab, Sumudu Mallawaarachchi, Mario Alvarez-Jimenez, Andrew M Chanen, John FM Gleeson
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Caregivers of individuals with severe mental illness often experience significant negative experiences of care, which can be associated with higher levels of expressed emotion. Expressed emotion is potentially a modifiable target early in the course of illness, which might improve outcomes for caregivers and patients. However, expressed emotion and caregiver experiences in the early stages of disorders might be moderated by the type of severe mental illness. The aim was to determine whether experiences of the caregiver role and expressed emotion differ in caregivers of young people with first-episode psychosis versus young people with ‘first-presentation’ borderline personality disorder features.Method:Secondary analysis of baseline (pre-treatment) data from three clinical trials focused on improving caregiver outcomes for young people with first-episode psychosis and young people with borderline personality disorder features was conducted (ACTRN12616000968471, ACTRN12616000304437, ACTRN12618000616279). Caregivers completed self-report measures of experiences of the caregiver role and expressed emotion. Multivariate generalised linear models and moderation analyses were used to determine group differences.Results:Data were available for 265 caregivers. Higher levels of negative experiences and expressed emotion, and stronger correlations between negative experiences and expressed emotion domains, were found in caregivers of young people with borderline personality disorder than first-episode psychosis. Caregiver group (borderline personality disorder, first-episode psychosis) moderated the relationship between expressed emotion and caregiver experiences in the domains of need to provide backup and positive personal experiences.Conclusion:Caregivers of young people with borderline personality disorder experience higher levels of negative experiences related to their role and expressed emotion compared with caregivers of young people with first-episode psychosis. The mechanisms underpinning associations between caregiver experiences and expressed emotion differ between these two caregiver groups, indicating that different supports are needed. For borderline personality disorder caregivers, emotional over-involvement is associated with both negative and positive experiences, so a more detailed understanding of the nature of emotional over-involvement for each relationship is required to guide action.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-10-11T07:13:49Z
      DOI: 10.1177/00048674211050299
       
  • Psychological distress among Australian workers accessing the COVID-19
           Superannuation Early Access Scheme

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      Authors: Isabella Choi, Jen-Kui Maxwell, Nick Glozier
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-10-04T11:29:40Z
      DOI: 10.1177/00048674211051280
       
  • Are people with treatment resistance among those requiring high inpatient
           mental health care' A longitudinal casemix profile from an Australian
           regional area

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      Authors: Bianca Suesse, Luise Lago, Nagesh Pai
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-09-30T10:16:51Z
      DOI: 10.1177/00048674211049990
       
  • Deep brain stimulation for treatment-refractory obsessive-compulsive
           disorder should be an accepted therapy in Australia

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      Authors: Nicola Acevedo, Susan Rossell
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-09-29T01:56:30Z
      DOI: 10.1177/00048674211049344
       
  • Aftermath of anti-police protests in Nigeria: Burden and predictors of
           psychiatric morbidity among protesters and non-protesters

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      Authors: Olatunde Olayinka Ayinde, Oluwasemiloore Peace Atere, Ugonna Ibeawuchi, Toyin Bello, Abiola Ogunkoya, Olayinka Asafa, Jibril Abdulmalik
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objectives:Anti-police (#EndSARS) protests took place in October 2020 across several Nigerian cities, resulting in deaths, injuries and loss of property, but the psychological sequelae of these protests have not been studied.Method:In a cross-sectional online survey, we collected data on psychiatric morbidity and potential risk factors from 426 Nigerian social media users, who self-identified as participants or non-participants in a recent anti-police protest.Results:We found elevated rates of psychiatric morbidity, with worse outcomes for protesters compared to non-protesters (psychological distress [44.2% vs 29.8%], depression [26.0% vs 14.9%], anxiety [51.0% vs 29.8%], post-traumatic stress disorder [7.4% vs 1.8%], current substance use [11.2% vs 4.5%] and suicidal ideation [7.1% vs 4.4%], respectively). After adjusting for the effects of COVID-19 pandemic and previous mental health diagnosis, the predictors of poor mental health among non-protesters were being unmarried (odds ratio = 7.4, p = 0.01) and low resilience (odds ratio range = 4.1–5.4, p 
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-09-28T11:35:57Z
      DOI: 10.1177/00048674211049332
       
  • Pharmacist-led interventions for people living with severe and persistent
           mental illness: A systematic review

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      Authors: Ricki Ng, Sarira El-Den, Victoria Stewart, Jack C Collins, Helena Roennfeldt, Sara S McMillan, Amanda J Wheeler, Claire L O’Reilly
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:People living with severe and persistent mental illness experience poorer physical health, often due to medication and preventable lifestyle factors, and exacerbated by barriers to accessing healthcare services. Pharmacists are well-positioned to improve the physical and mental health of this population. However, little is known about pharmacists’ current practices when providing services to this population nor the impact of pharmacist-led interventions on consumer health outcomes. We undertook a systematic review to identify, describe and assess the effectiveness of pharmacist-led interventions for supporting people living with severe and persistent mental illness and the impact on consumer outcomes.Methods:MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, Scopus, Cochrane Library, International Pharmaceutical Abstracts and ProQuest Dissertations and Theses were searched between January 1990 and April 2020. Full-text studies exploring pharmacist-led interventions in any setting for people living with severe and persistent mental illness were included. A risk of bias assessment was conducted.Results:A total of 37 studies were included. More than half of the pharmacist interventions were multifaceted. The most common components of pharmacist-led interventions included education and/or patient counselling, providing recommendations to healthcare professionals and conducting medication reviews. Multifaceted interventions demonstrated improvements in clinical outcomes, whereas single interventions focused mostly on consumer-reported outcomes. The methodological quality of included studies was moderate-to-high risk of bias and there was considerable heterogeneity in the study design, interventions described, and outcomes reported.Conclusion:There is evidence that pharmacist-led interventions improve consumer-reported and clinical outcomes for people living with severe and persistent mental illness. Pharmacists are capable and have a role in supporting people living with severe and persistent mental illness, either individually or as interprofessional collaborators with other healthcare professionals. Future research should attempt to better understand which particular intervention components have the greatest impact and also evaluate the implementation and long-term sustainability of such interventions.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-09-25T05:37:37Z
      DOI: 10.1177/00048674211048410
       
  • Response to Myles et al.: Changing the policy narrative on psychiatric
           inpatient care

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      Authors: Stephen Allison, Tarun Bastiampillai, Jeffrey CL Looi, David Copolov
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-09-24T11:25:00Z
      DOI: 10.1177/00048674211048408
       
  • Psychiatric well-being among men leaving prison reporting a history of
           injecting drug use: A longitudinal analysis

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      Authors: Ashleigh C Stewart, Reece Cossar, Anna Lee Wilkinson, Nick Scott, Paul Dietze, Brendan Quinn, Stuart A Kinner, Campbell Aitken, Shelley Walker, Michael Curtis, Tony Butler, James R. P. Ogloff, Mark Stoové
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Background:Community reintegration from prison is typically stressful, with several health and social outcomes impacting psychiatric well-being during this time, often exacerbated among individuals with histories of drug use. Longitudinal data was used to assess change in psychiatric well-being over 2 years following release from prison among men who reported a recent history of injecting drug use.Methods:Data for this study come from the Prison and Transition Health cohort study of 400 men recruited in prison prior to release and followed up over three time points. Psychiatric well-being was assessed using the 12-item General Health Questionnaire. We calculated change in individual General Health Questionnaire scores between interviews and identified covariates associated with General Health Questionnaire score using linear mixed-effects regression.Results:Data from 690 follow-up interviews among 326 participants were included in analyses. There was considerable variation in individuals’ General Health Questionnaire scores. Moving accommodation frequently and frequent illicit drug injections were associated with an increase in General Health Questionnaire score (i.e. decline in psychiatric well-being). Two or more prior adult imprisonment episodes, social supports and past month primary healthcare attendance were associated with a decrease in General Health Questionnaire score.Conclusion:Our findings identify health, social and structural influences on psychiatric well-being after release from prison that can inform re-entry programmes to support community reintegration.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-09-24T11:23:59Z
      DOI: 10.1177/00048674211048143
       
  • Prevalence and 5-year trend of incidence for medical illnesses after the
           diagnosis of bipolar disorder: A nationwide cohort study

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      Authors: Pao-Huan Chen, Shang-Ying Tsai, Chun-Hung Pan, Yi-Lung Chen, Sheng-Siang Su, Chiao-Chicy Chen, Chian-Jue Kuo
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Medical comorbidities are prevalent in patients with bipolar disorder. Evaluating longitudinal trends of the incidence of medical illnesses enables implementation of early prevention strategies to reduce the high mortality rate in this at-risk population. However, the incidence risks of medical illnesses in the early stages of bipolar disorder remain unclear. This study investigated the incidence and 5-year trend of medical illnesses following bipolar disorder diagnosis.Methods:We identified 11,884 patients aged 13–40 years who were newly diagnosed as having bipolar disorder during 1996–2012 and 47,536 age- and sex-matched controls (1:4 ratio) who represented the general population from Taiwan’s National Health Insurance Research Database. We estimated the prevalence and incidence of individual medical illnesses yearly across the first 5 years after the index date. The adjusted incidence rate ratio was calculated to compare the occurrence of specific medical illnesses each year between the bipolar disorder group and control group using the Poisson regression model.Results:Apart from the prevalence, the adjusted incidence rate ratios of most medical illnesses were>1.00 across the first 5-year period after bipolar disorder diagnosis. Cerebrovascular diseases, ischaemic heart disease, congestive heart failure, other forms of heart disease, renal disease and human immunodeficiency virus infection exhibited the highest adjusted incidence rate ratios during the first year. Except for that of renal disease, the 5-year trends of the adjusted incidence rate ratios decreased for cerebrovascular diseases, cardiovascular diseases (e.g. ischaemic heart disease, other forms of heart disease, and vein and lymphatic disease), gastrointestinal diseases (e.g. chronic hepatic disease and ulcer disease) and communicable diseases (e.g. human immunodeficiency virus infection, upper respiratory tract infection and pneumonia).Conclusion:Incidence risks of medical illnesses are increased in the first year after bipolar disorder diagnosis. Clinicians must carefully evaluate medical illnesses during this period because the mortality rates from medical illnesses are particularly high in people with bipolar disorder.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-09-24T11:22:41Z
      DOI: 10.1177/00048674211046891
       
  • Correlates of anxiety and depression in a community cohort of people who
           smoke methamphetamine

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      Authors: Zoe Duncan, Rebecca Kippen, Keith Sutton, Bernadette Ward, Paul A Agius, Brendan Quinn, Paul Dietze
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Anxiety and depression are the most common mental health disorders experienced by Australians. These disorders are commonly found in people who use methamphetamine; however, much of this research has involved participants recruited from treatment settings who inject methamphetamine. We therefore explored (1) the prevalence of moderate to severe anxiety and depression in a community-recruited cohort who smoked methamphetamine and (2) examined potential factors associated with moderate to severe anxiety or depression in this cohort.Method:Data were derived from baseline surveys of 725 participants of the prospective ‘VMAX’ study, recruited from metropolitan and non-metropolitan areas of Victoria, Australia, via snowball and respondent-driven sampling. Anxiety and depression were measured using the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-9 instruments. Independent associations between moderate to severe scores on these measures and demographic, socio-economic, substance use and other health and social characteristics were examined using multivariable logistic regression.Results:More than half (60%) of the participants were classified as experiencing moderate to severe anxiety and/or depression. In the multivariable models, having poor/very poor self-rated health, methamphetamine dependence and being unemployed were associated with higher odds of experiencing both moderate to severe depression and moderate to severe anxiety. Living in a large rural town, identifying as Aboriginal and Torres Strait Islander and smoking methamphetamine were associated with lower odds of experiencing moderate to severe depression. Being female was associated with higher odds of experiencing moderate to severe anxiety.Conclusion:The high rates of anxiety and/or depression found in the VMAX cohort were associated with demographic, socio-economic, substance use and other health and social factors. The prevalence of moderate to severe anxiety is a novel finding that warrants further study. Further work is needed to determine how anxiety and depression change over time among people who smoke methamphetamine, to help identify key intervention points.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-09-24T11:19:59Z
      DOI: 10.1177/00048674211048152
       
  • How has private psychiatry in Australia responded to the COVID-19
           pandemic'

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      Authors: Jeffrey CL Looi, Tarun Bastiampillai, Stephen R Kisely, Stephen Allison
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-09-24T11:16:36Z
      DOI: 10.1177/00048674211048148
       
  • Transitioning to civilian life: The importance of social group engagement
           and identity among Australian Defence Force veterans

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      Authors: Anthony Barnett, Michael Savic, David Forbes, David Best, Emma Sandral, Ramez Bathish, Alison Cheetham, Dan I Lubman
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Veterans transitioning to civilian life after leaving the military face unique health concerns. Although there is a significant body of research exploring veterans’ experiences of transition and predictors of well-being, there are limited studies examining how social group engagement influences veterans’ transition. We explored how Australian Defence Force veterans’ social group engagement and identity influenced their adjustment to civilian life and well-being.Methods:Forty Australian veterans (85% male; mean age = 37 years, range = 25–57 years) took part in in-depth, semi-structured interviews. Participants completed two mapping tasks (a social network map and life course map) that provided a visual component to the interviews. Interview transcripts were analysed thematically and interpreted by adopting a social identity approach.Results:Joining the military involved a process of socialisation into military culture that for most participants led to the development of a military identity. An abrupt or difficult discharge from defence was often associated with a negative impact on social group engagement and well-being in civilian life. Veterans’ social group memberships may act not only as positive psychological resources during transition but also as a potential source of conflict, especially when trying to re-engage with civilian groups with different norms or beliefs. Military values inscribed within a veteran’s sense of self, including a strong sense of service, altruism and giving back to their community, may operate as positive resources and promote social group engagement.Conclusion:Engaging with supportive social groups can support transition to civilian life. Reintegration may be improved via effective linkage with programmes (e.g. volunteering, ex-service support organisations) that offer supportive social networks and draw upon veterans’ desire to give back to community. Social mapping tasks that visualise veterans’ social group structures may be useful for clinicians to explore the roles and conflicts associated with veterans’ social group memberships during transition.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-09-20T09:56:26Z
      DOI: 10.1177/00048674211046894
       
  • A biomarker and endophenotype for anorexia nervosa'

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      Authors: Andrea Phillipou, Susan L Rossell, Caroline Gurvich, David J Castle, Denny Meyer, Larry A Abel
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Recent research has suggested that a type of atypical eye movement, called square wave jerks, together with anxiety, may distinguish individuals with anorexia nervosa from those without anorexia nervosa and may represent a biomarker and endophenotype for the illness. The aim of this study was to identify the presence of this proposed marker in individuals currently with anorexia nervosa relative to healthy controls, and to identify the state independence and heritability of this putative marker by exploring whether it also exists in individuals who are weight-restored from anorexia nervosa and first-degree relatives (i.e. sisters of people with anorexia nervosa).Methods:Data from 80 female participants (20/group: current anorexia nervosa, weight-restored from anorexia nervosa, sisters of people with anorexia nervosa and healthy controls) were analysed. Square wave jerk rate was acquired during a fixation task, and anxiety was measured with the State Trait Anxiety Inventory.Results:Current anorexia nervosa, weight-restored from anorexia nervosa and sisters of people with anorexia nervosa groups made significantly more square wave jerks than healthy controls, but did not differ from one another. Square wave jerk rate and anxiety were found to discriminate groups with exceptionally high accuracy (current anorexia nervosa vs healthy control = 92.5%; weight-restored from anorexia nervosa vs healthy control = 77.5%; sisters of people with anorexia nervosa vs healthy control = 77.5%; p 
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-09-18T12:37:12Z
      DOI: 10.1177/00048674211047189
       
  • Non-response to psychotherapy for borderline personality disorder: A
           systematic review

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      Authors: Jane Woodbridge, Michelle Townsend, Samantha Reis, Saniya Singh, Brin FS Grenyer
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Highlight:This is the first systematic review to investigate non-response to psychotherapy for borderline personality disorder.Background:Psychotherapy is the recommended treatment for borderline personality disorder. While systematic reviews have demonstrated the effectiveness of psychotherapy for borderline personality disorder, effect sizes remain small and influenced by bias. Furthermore, the proportion of people who do not respond to treatment is seldom reported or analysed.Objective:To obtain an informed estimate of the proportion of people who do not respond to psychotherapy for borderline personality disorder.Methods:Systematic searches of five databases, PubMed, Web of Science, Scopus, PsycINFO and the Cochrane Library, occurred in November 2020. Inclusion criteria: participants diagnosed with borderline personality disorder, treated with psychotherapy and data reporting either (a) the proportion of the sample that experienced ‘reliable change’ or (b) the percentage of sample that no longer met criteria for borderline personality disorder at conclusion of therapy. Exclusion criteria: studies published prior to 1980 or not in English. Of the 19,517 studies identified, 28 met inclusion criteria.Results:Twenty-eight studies were included in the review comprising a total of 2436 participants. Average treatment duration was 11 months using well-known evidence-based approaches. Approximately half did not respond to treatment; M = 48.80% (SD = 22.77).Limitations:Data regarding within sample variability and non-response are seldom reported. Methods of reporting data on dosage and comorbidities were highly divergent which precluded the ability to conduct predictive analyses. Other limitations include lack of sensitivity analysis, and studies published in English only.Conclusion:Results of this review suggest that a large proportion of people are not responding to psychotherapy for borderline personality disorder and that factors relating to non-response are both elusive and inconsistently reported. Novel, tailored or enhanced interventions are needed to improve outcomes for individuals not responding to current established treatments.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-09-16T05:27:01Z
      DOI: 10.1177/00048674211046893
       
  • Indian psychiatrists in the Australian workforce – From brain drain
           to brain exchange

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      Authors: Nagesh Pai, Rahul Gupta, Vinay Lakra, Shae-Leigh Vella, Harish Kalra, Tarun Yadav, Shailja Chaturvedi, Neeraj S Gill
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Worldwide doctors have been migrating from low- and middle-income countries to high-income countries for decades. This contributes to dearth of doctors, especially psychiatrists, in low- and middle-income countries – often referred to as ‘brain drain’. Australia has a fair share of psychiatrists of Indian origin in its workforce. This article endeavours to re-formulate the migration phenomenon as ‘brain exchange’ through the experiential insight of the authors along with published literature and discusses the contribution of substantial number of psychiatrists of Indian origin to the Australian society. Furthermore, the article highlights the potential for the Royal Australian and New Zealand College of Psychiatrists to be a leader in this area by facilitating globally responsible practice by giving back to countries from which psychiatrists originate. The key observations and recommendations are transferrable to other similar countries and equally to other medical specialities.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-09-09T09:38:25Z
      DOI: 10.1177/00048674211044099
       
  • Using the Patient Health Questionnaire to estimate prevalence and gender
           differences of somatic symptoms and psychological co-morbidity in a
           secondary inpatient population with abdominal pain

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      Authors: Melissa Stieler, Peter Pockney, Cassidy Campbell, Vaisnavi Thirugnanasundralingam, Lachlan Gan, Matthew Spittal, Gregory Carter
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Background:Somatic disorders and somatic symptoms are common in primary care populations; however, little is known about the prevalence in surgical populations. Identification of inpatients with high somatic symptom burden and psychological co-morbidity could improve access to effective psychological therapies.Methods:Cross-sectional analysis (n = 465) from a prospective longitudinal cohort study of consecutive adult admissions with non-traumatic abdominal pain, at a tertiary hospital in New South Wales, Australia. We estimated somatic symptom prevalence with the Patient Health Questionnaire-15 at three cut-points: moderate (⩾10), severe (⩾15) and ‘bothered a lot’ on ⩾3 symptoms; and psychological co-morbidity with the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 at standard (⩾10) cut-points. We also examined gender differences for somatic symptoms and psychological co-morbidity.Results:Prevalence was moderate (52%), female predominance (odds ratio = 1.71; 95% confidence interval = [1.18, 2.48]), severe (20%), no gender difference (1.32; [0.83, 2.10]) and ‘bothered a lot’ on ⩾3 symptoms (53%), female predominance (2.07; [1.42, 3.03]). Co-morbidity of depressive, anxiety and somatic symptoms ranged from 8.2% to 15.9% with no gender differences.Conclusion:Somatic symptoms were common and psychological triple co-morbidity occurred in one-sixth of a clinical population admitted for abdominal pain. Co-ordinated surgical and psychological clinical intervention and changes in clinical service organisation may be warranted to provide optimal care.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-09-04T07:27:42Z
      DOI: 10.1177/00048674211044639
       
  • Tackling the ‘digital pandemic’: The effectiveness of psychological
           intervention strategies in problematic Internet and smartphone use—A
           meta-analysis

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      Authors: Christoph Augner, Thomas Vlasak, Wolfgang Aichhorn, Alfred Barth
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Problematic Internet and smartphone use is associated with serious mental health problems. We thus investigated the effectiveness of psychological interventions on problematic Internet and smartphone use.Methods:We conducted a systematic review and meta-analysis and searched in PubMed, PsyArticles, PsycInfo, Medline and Google Scholar for peer-reviewed experimental and quasi-experimental research published between 2008 and 2021.Results:A total of 10 studies accompanied by 14 effect sizes were included in the meta-analyses for problematic Internet use and 3 studies accompanied by 4 effect sizes for problematic smartphone use. The total sample size was n = 1439 with a mean age of 20.34 (SD = 6.63) years. Psychological interventions were effective for both problematic Internet use (g = −1.41, 95% confidence interval = [−1.90, −0.91], p 
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-09-03T11:28:14Z
      DOI: 10.1177/00048674211042793
       
  • Prolonged and severe post-electroconvulsive therapy delirium with
           concurrent clozapine therapy

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      Authors: Eliza Melnikoff, Evan Thomas Johnson, Frances Walker, Quratulain Itrat, Karuppiah Jagadheesan
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-09-01T07:18:45Z
      DOI: 10.1177/00048674211044098
       
  • Characterising DSCATT: A case series of Australian patients with
           debilitating symptom complexes attributed to ticks

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      Authors: Jesse Schnall, Georgina Oliver, Sabine Braat, Richard Macdonell, Katherine B Gibney, Richard A Kanaan
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objectives(s):To characterise the clinical profile, aetiology and treatment responsiveness of ‘Australian Lyme’, or Debilitating Symptom Complexes Attributed to Ticks.Methods:Single-centre retrospective case analysis of patients referred to the Infectious Diseases Unit at Austin Health – a tertiary health service in Heidelberg, Australia – between 2014 and 2020 for investigation and treatment of suspected Debilitating Symptom Complexes Attributed to Ticks. Patients were included if they had debilitating symptoms suggested by either themselves or the referring clinician as being attributed to ticks.Results:Twenty-nine Debilitating Symptom Complexes Attributed to Ticks cases were included in the analysis. Other than Lyme disease (83%), the most common prior medical diagnoses were Epstein–Barr virus (38%), chronic fatigue syndrome (28%) and fibromyalgia (24%). Prior histories of anxiety (48%) and depression (41%) were common. The most frequently reported symptoms included fatigue (83%), headache (72%) and arthralgia (69%). National Association of Testing Authorities/Royal College of Pathologists of Australasia–accredited serology was not diagnostic of acute infective causes, including Lyme disease, in any patient. Of 25 cases with available data, 23 (92%) had previously been prescribed antimicrobials, with 53% reporting benefit from them. The most common diagnoses made by our hospital were chronic fatigue syndrome (31%), migraines (28%) and fibromyalgia (21%). Only one patient’s symptoms were not accounted for by other diagnoses.Conclusion:This is the first case series of patients with Debilitating Symptom Complexes Attributed to Ticks. They had high rates of other medically unexplained syndromes, and no evidence of acute Lyme disease, or any common organic disease process. Debilitating Symptom Complexes Attributed to Ticks remains medically unexplained, and may therefore be due to an as yet unidentified cause, or may be considered a medically unexplained syndrome similar to conditions such as chronic fatigue syndrome.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-09-01T07:18:06Z
      DOI: 10.1177/00048674211043788
       
  • Suicide mortality after a nonfatal suicide attempt: A systematic review
           and meta-analysis

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      Authors: Alice Demesmaeker, Emmanuel Chazard, Aline Hoang, Guillaume Vaiva, Ali Amad
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Introduction:Deliberate self-harm and suicide attempts share common risk factors but are associated with different epidemiological features. While the rate of suicide after deliberate self-harm has been evaluated in meta-analyses, the specific rate of death by suicide after a previous suicide attempt has never been assessed. The aim of our study was to estimate the incidence of death by suicide after a nonfatal suicide attempt.Method:We developed and followed a standard meta-analysis protocol (systematic review registration—PROSPERO 2021: CRD42021221111). Randomized controlled trials and cohort studies published between 1970 and 2020 focusing on the rate of suicide after suicide attempt were identified in PubMed, PsycInfo and Scopus and qualitatively described. The rates of deaths by suicide at 1, 5 and 10 years after a nonfatal suicide attempt were pooled in a meta-analysis using a random-effects model. Subgroup analysis and meta-regressions were also performed.Results:Our meta-analysis is based on 41 studies. The suicide rate after a nonfatal suicide attempt was 2.8% (2.2–3.5) at 1 year, 5.6% (3.9–7.9) at 5 years and 7.4% (5.2–10.4) at 10 years. Estimates of the suicide rate vary widely depending on the psychiatric diagnosis, the method used for the suicide attempt, the type of study and the age group considered.Conclusion:The evidence of a high rate of suicide deaths in the year following nonfatal suicide attempts should prompt prevention systems to be particularly vigilant during this period.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-09-01T07:15:17Z
      DOI: 10.1177/00048674211043455
       
  • The case for discontinuation of the ‘discontinuation syndrome’

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      Authors: William Lugg
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-31T06:39:01Z
      DOI: 10.1177/00048674211043443
       
  • Prevalence of dental disorders among people with mental illness: An
           umbrella review

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      Authors: Jisu Choi, Josh Price, Samuel Ryder, Dan Siskind, Marco Solmi, Steve Kisely
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Psychiatric patients have increased rates of comorbid physical illness. There are less data on dental disease, especially decay, despite risk factors including lifestyle and psychotropic side effects such as xerostomia. We therefore undertook an umbrella review of all meta-analyses on the association between mental illness and oral health.Methods:We searched PubMed, MEDLINE, PsycINFO, the Cochrane Central Register of Controlled Trials, Embase and CINAHL. Articles were independently assessed. Outcomes were caries, periodontal disease, erosion, and partial or total tooth loss (edentulism), measured where possible with standardised measures such as the mean number of decayed, missing and filled teeth or surfaces. Quality was assessed in line with National Institutes of Health guidelines.Results:We identified 11 meta-analyses. The most information and strongest association was between dental decay and severe mental illness or substance use, as well as erosion and eating disorders. Depressive, anxiety and eating disorders were also associated with caries, but the datasets were small. People with severe mental illness had nearly three times the odds of having lost all their teeth than the general community (odds ratio = 2.81, 95% confidence interval = [1.73, 4.57]) and those with depression between 1.17 and 1.32. Findings for periodontal disease were more equivocal, possibly because of study heterogeneity.Conclusion:Mental health clinicians should screen for oral diseases when treating those with mental illness and facilitate referral to affordable dental clinics when indicated. Prevention should be a priority, including the promotion of dental care, as well as the management of xerostomia when psychopharmacologic agents are prescribed.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-31T06:38:07Z
      DOI: 10.1177/00048674211042239
       
  • The evidence is in: Repetitive transcranial magnetic stimulation is an
           effective, safe and well-tolerated treatment for patients with major
           depressive disorder

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      Authors: Paul B Fitzgerald, Mark S George, Saxby Pridmore
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Despite more than 25 years of research establishing the antidepressant efficacy of repetitive transcranial magnetic stimulation, there remains uncertainty about the depth and breadth of this evidence base, resulting in confusion as to where repetitive transcranial magnetic stimulation fits in the therapeutic armamentarium in the management of patients with mood disorders. The purpose of this article is to provide a concise description of the evidence base supporting the use of repetitive transcranial magnetic stimulation in the context of the stages of research that typically accompanies the development of evidence for a new therapy. The antidepressant efficacy for the use of repetitive transcranial magnetic stimulation in the treatment of depression has been established through a relatively traditional pathway beginning with small case series, progressing to single-site clinical trials and then to larger multisite randomised double-blind controlled trials. Antidepressant effects have been confirmed in numerous meta-analyses followed more recently by large network meta-analysis and umbrella reviews, with evidence that repetitive transcranial magnetic stimulation may have greater efficacy than alternatives for patients with treatment-resistant depression. Finally, repetitive transcranial magnetic stimulation has been shown to produce meaningful response and remission rates in real-world samples of greater than 5000 patients. The evidence for the antidepressant efficacy of repetitive transcranial magnetic stimulation therapy is overwhelming, and it should be considered a routine part of clinical care wherever available.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-28T09:57:24Z
      DOI: 10.1177/00048674211043047
       
  • Australian guidelines for the prevention and treatment of posttraumatic
           stress disorder: Updates in the third edition

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      Authors: Andrea J Phelps, Ros Lethbridge, Sue Brennan, Richard A Bryant, Penelope Burns, John A Cooper, David Forbes, Joanne Gardiner, Graham Gee, Kim Jones, Justin Kenardy, Jayashri Kulkarni, Brett McDermott, Alexander C McFarlane, Louise Newman, Tracey Varker, Carolyn Worth, Derrick Silove
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective: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.Method: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.Results: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.Conclusion: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.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-27T09:15:18Z
      DOI: 10.1177/00048674211041917
       
  • N-acetylcysteine is effective as add-on therapy to risperidone-based
           combination for children with autistic disorders

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      Authors: Cheuk-Kwan Sun, Yu-Shian Cheng, Kuo-Chuan Hung
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-26T09:58:03Z
      DOI: 10.1177/00048674211041932
       
  • Mood disorders increase mortality mainly through dementia: A
           community-based prospective cohort study

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      Authors: Hoyoung An, Hee Won Yang, Dae Jong Oh, Eunji Lim, Jin Shin, Dong Gyu Moon, Seung Wan Suh, Seonjeong Byun, Tae Hui Kim, Kyung Phil Kwak, Bong Jo Kim, Shin Gyeom Kim, Jeong Lan Kim, Seok Woo Moon, Joon Hyuk Park, Seung-Ho Ryu, Dong Woo Lee, Seok Bum Lee, Jung Jae Lee, Jin Hyeong Jhoo, Jong Bin Bae, Ji Won Han, Ki Woong Kim
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:The effects of mood disorders on mortality may be mediated by their effects on the risk of dementia, and interventions to reduce the occurrence of dementia may reduce their overall mortality. This study aimed to investigate the direct effects of depressive and bipolar disorders on the 6-year risk of mortality and also their indirect effects on mortality due to their effect on the risk of dementia.Methods:A total of 5101 Koreans were selected from a community-based prospective cohort study, and 6-year risks of mortality and dementia in participants with depressive and bipolar disorders were estimated by Cox proportional hazard analysis. The direct and indirect effects of depressive and bipolar disorders on the risk of mortality were estimated using structural equation modeling.Results:The depressive and bipolar disorder groups showed 51% and 85% higher 6-year mortality, and 82% and 127% higher risk of dementia, respectively, compared to euthymic controls. The effects of depressive and bipolar disorders on mortality were mainly mediated by their effects on the risk of dementia in a structural equation model. The direct effects of each mood disorder on mortality were not significant.Conclusion:Both depressive and bipolar disorders increased the risks of mortality and dementia, and the effects of mood disorders on mortality were mainly mediated through dementia. As dementia occurs later in life than mood disorders, measures to prevent it may effectively reduce mortality in individuals with a history of mood disorders, as well as being more feasible than attempting to control other causes of death.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-21T11:33:50Z
      DOI: 10.1177/00048674211041937
       
  • Mortality in dementia is predicted by older age of onset and cognitive
           presentation

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      Authors: Samantha M Loi, Paraskevi Tsoukra, Zhiben Chen, Pierre Wibawa, Tamara Mijuskovic, Dhamidhu Eratne, Maria A Di Biase, Andrew Evans, Sarah Farrand, Wendy Kelso, Anita MY Goh, Mark Walterfang, Dennis Velakoulis
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objectives:Survival information in dementia is important for future planning and service provision. There have been limited Australian data investigating survival duration and risk factors associated with mortality in younger-onset dementia.Methods:This was a cross-sectional retrospective study investigating survival in inpatients with a diagnosis of dementia admitted to a tertiary neuropsychiatry service from 1991 to 2014. The Australian Institute of Health and Welfare National Death Index was used to obtain mortality information.Results:A total of 468 inpatients were identified, of which 75% had symptom onset at ⩽65 years of age (defined as younger-onset dementia). Dementia was categorised into four subtypes, Alzheimer’s dementia, frontotemporal dementia, vascular dementia and other dementias; 72% of the patients had died. Overall median survival duration was 10.6 years with no significant differences in duration within the dementia subtypes (p = 0.174). Survival in older-onset dementia (symptom onset at>65 years of age) was about half of that in younger-onset dementia (median survival 6.3 years compared to 12.7 years, respectively). Independent predictors of mortality were having older-onset dementia (hazard ratio: 3.2) and having initial presenting symptoms being cognitive in nature (hazard ratio: 1.5). Females with an older-onset dementia had longer survival compared to males with an older-onset dementia, and this was reversed for younger-onset dementia. Older-onset dementia and younger-onset dementia conferred 3 and 6 times, respectively, increased risk of death compared to the general population.Conclusion:This is the largest Australian study to date investigating survival and risk factors to mortality in dementia. We report important clinical information to patients with dementia and their families about prognosis which will assist with future planning. Our findings suggest that for both older-onset dementia and younger-onset dementia, ‘new onset’ psychiatric symptoms precede the cognitive symptoms of a neurodegenerative process. This, and sex differences in survival depending on the age of onset of the dementia warrant further investigation.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-21T11:32:49Z
      DOI: 10.1177/00048674211041003
       
  • The dazzling guidelines

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      Authors: Stephen Rosenman
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-20T11:28:58Z
      DOI: 10.1177/00048674211037886
       
  • Self-immolation in borderline personality disorder: A cultural perspective

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      Authors: Prabhath Gujjadi Kodancha, Gaurav Deva, Karuppiah Jagadheesan
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-20T11:28:03Z
      DOI: 10.1177/00048674211037550
       
  • Underestimating the complexity of managing mood disorders in pregnancy:
           Commentary on the 2020 RANZCP Clinical Practice Guidelines for mood
           disorders

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      Authors: Fiona Judd, Rebecca Hill, Megan Galbally, Anne Buist
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-19T06:40:32Z
      DOI: 10.1177/00048674211040715
       
  • Rates of homicide and homicide associated with severe mental illness in
           NSW between 1993 and 2016

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      Authors: Olav Nielssen, Georgia Lyons, Katya Oldfield, Anina Johnson, Kimberlie Dean, Matthew Large
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:To describe the characteristics of offenders found not guilty on the grounds of mental illness (NGMI) in New South Wales and rates of NGMI and other homicide verdicts.Method:Demographic, legal and clinical data after referral to the NSW Mental Health Review Tribunal following an NGMI verdict for homicide matched with results from the National Homicide Monitoring Program.Results:Between 1993 and 2016, a total of 2159 homicide offenders were dealt with by the NSW courts, including 169 (7.8%) who were found NGMI. Over this period, the rate of non-NGMI homicide convictions fell from 1.83 per 100,000 per annum to 0.65 per 100,000 per annum (Kendall’s tau = −0.79, p ⩽ 0.001) while the rate of NGMI homicide fluctuated, with an average annual rate of about 0.1 per 100,000 per annum (Kendall’s tau = 0.17, p = 0.23). There was no association between the annual rates of NGMI and non-NGMI homicides (Pearson r = −0.3, p = 0.16) but falling rate of non-NGMI homicide meant that the proportion of NGMI offences doubled from 5.5% in the first 12 years to 11% in the second 12 years. Nearly all (88.7%) of those found NGMI had a schizophrenia-related psychosis. However, there were high rates of psychiatric comorbidity including substance use disorder (60.7%) and a history of a prior head injury (41.1%). Most (83.4%) of the NGMI offenders had previous contact with mental health services, but only half of these had received treatment with antipsychotic medication.Conclusion:The fall in conviction for homicide offences in the last 24 years has not been matched by a reduction in NGMI homicide verdicts. More assertive treatment of emerging psychosis and comorbid substance use disorders, and improved continuity of care of chronic psychosis might prevent some homicides.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-18T09:18:01Z
      DOI: 10.1177/00048674211040016
       
  • Cui bono' Is Australia taking a step to managed healthcare as in the
           United States'

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      Authors: Jeffrey CL Looi, Stephen Allison, William Pring, Stephen R Kisely, Tarun Bastiampillai
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-18T09:17:02Z
      DOI: 10.1177/00048674211038851
       
  • Bilateral symmetrical dystonia secondary to aripiprazole

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      Authors: Ibrahim Merei, Mille Ho, Matthew D Gardiner
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-16T07:01:01Z
      DOI: 10.1177/00048674211040014
       
  • Psychiatric disorders: A plea for complexity

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      Authors: Christophe Gauld
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-14T06:42:05Z
      DOI: 10.1177/00048674211038858
       
  • Rising temperatures and suicidal behaviour in children and adolescents

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      Authors: Cybele Dey, Michael Dudley, Katherine Knight, Iain Perkes
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-14T06:41:39Z
      DOI: 10.1177/00048674211038848
       
  • Clinical management of medication overdose: Three-monthly paliperidone
           palimitate injectable medication

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      Authors: Robert Parker, Kane Vellar, Usman Khalid, Daniel Wood
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-13T08:55:17Z
      DOI: 10.1177/00048674211038855
       
  • Ketamine treatment for depression: A model of care

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      Authors: Adam Bayes, Vanessa Dong, Donel Martin, Angelo Alonzo, Michael Kabourakis, Colleen Loo
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Ketamine and related compounds are emerging as rapidly acting therapies for treatment-resistant depression. Ketamine differs from standard antidepressants in its speed of action, specific acute and cumulative side effects, risk of dependence and regulatory requirements. However, there is currently little guidance offering translation from research studies into clinical practice. We therefore detail a comprehensive model of care for ketamine treatment of depression.Method:We formulated a set of policies and procedures for a ‘compassionate use’ ketamine programme that developed out of our clinical research in ketamine. These policies and procedures were formulated into a detailed model of care.Results:The current Australian and New Zealand regulatory frameworks and professional bodies’ recommendations regarding ketamine are detailed along with clinical governance and infrastructure considerations. We next describe a four-step model comprising initial assessment, pre-treatment, treatment and post-treatment phases. The model comprises thorough psychiatric and medical assessments examining patient suitability, a rigorous consenting process and structured safety monitoring across an acute treatment course or maintenance therapy. Our ketamine dose-titration method is detailed allowing flexible dosing of patients across a treatment course enabling individualised treatment.Conclusion:The model of care aims to bridge the gap between efficacy studies and clinical care outside of research settings as ketamine and related compounds become increasingly important therapies for treatment-resistant depression.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-13T08:54:29Z
      DOI: 10.1177/00048674211039166
       
  • Theory of mind and stereotypic behavior promote daily functioning in
           patients with schizophrenia

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      Authors: Margherita Bechi, Ahmad Abu-Akel, Giulia Agostoni, Mariachiara Buonocore, Marta Bosia, Francesca Martini, Roberto Cavallaro
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objectives:Functional disruption is a main feature of schizophrenia and still represents a major treatment challenge. A more in-depth identification of functional predictors is crucial for the creation of individualized rehabilitation treatments, which can translate into better functional outcomes. In this study, we aimed at pinpointing specific domains that affect different functional profiles, using a data-driven approach.Methods:We included a comprehensive evaluation of functional predictors, namely demographic, cognitive, sociocognitive and clinical variables, with a focus on constituent subdomains of autistic symptoms that have been associated with functioning in the recent literature.Results:In 123 schizophrenia patients, a two-step cluster analysis identified two groups of patients with different functional profiles (low vs high functioning). A backward stepwise logistic regression analysis showed that the odds of being a member of the high functioning group are significantly higher for individuals with (1) more years of education, (2) better Theory of Mind abilities, (3) higher levels of stereotypies/narrowed interests, (4) lower difficulties in social interaction, (5) lower communication difficulties and with (6) being male.Conclusion:Findings raise the intriguing possibility that stereotypic behaviors may have a beneficial effect on functioning in schizophrenia. While the underlying mechanism is currently unknown, we hypothesize that patients may benefit from contexts in which more predictive relationships between environmental entities can systematically be established. This study underscores the potential utility of routinely assessing autistic symptomatology in schizophrenia, which can be instrumental in identifying novel therapeutic targets that can be utilized to improve daily functioning.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-11T07:29:50Z
      DOI: 10.1177/00048674211038513
       
  • Eating disorders and meat avoidance: A call to understand the ‘why’
           instead of the ‘what’

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      Authors: Courtney P McLean, Jayashri Kulkarni, Gemma Sharp
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-09T04:49:50Z
      DOI: 10.1177/00048674211037889
       
  • Treating schizophrenia – Thinking beyond the choice of antipsychotic

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      Authors: William Lugg
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-05T04:38:21Z
      DOI: 10.1177/00048674211037242
       
  • Electroconvulsive therapy during COVID-19: A case report of a new
           treatment protocol for older adults on maintenance treatment

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      Authors: Thomas Rego, Sameera Hapuarachchi, Julie Jambon, Karuppiah Jagadheesan, Brett Coulson
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-04T08:55:56Z
      DOI: 10.1177/00048674211036362
       
  • Deliberate self-harm masquerading as psychogenic purpura: The dangers of
           misdiagnosis and imperative for psychiatric assessment

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      Authors: Robert Donald Gillies, Adele Storch, William C Cranwell
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-04T08:54:38Z
      DOI: 10.1177/00048674211036352
       
  • Characteristics of people on community treatment orders in Australia: Data
           from the 2010 National Survey of High Impact Psychosis

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      Authors: Shuichi Suetani, Steve Kisely, Stephen Parker, Anna Waterreus, Vera A Morgan, Dan Siskind
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Existing evidence on factors associated with community treatment order placement is largely restricted to administrative data. We utilised the data from a large nationally representative sample to compare the demographic, clinical, social functioning, substance use and service utilisation profiles of people living with psychosis under community treatment orders with those who were not.Methods:Participants were grouped based on whether they had been subject to a community treatment order in the past 12 months or not. We conducted logistic regressions to examine demographic, clinical, social functioning, substance use and service utilisation profiles associated with the two groups.Results:People who had recently been subject to community treatment orders were more likely to be treated with long-acting injectable antipsychotics and lacked insight but were less likely to report suicidal ideation. They also had higher psychiatric inpatient admission rates but a lower frequency of general practitioner visits.Conclusion:People on community treatment orders in Australia may differ from those who are not under a community treatment order in their treatment needs. Resources and care provision must match the needs of this particularly vulnerable group.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-08-03T06:19:10Z
      DOI: 10.1177/00048674211036032
       
  • Antidepressant tolerance is not trivial

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      Authors: Alyosha Jacobson
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-30T04:55:20Z
      DOI: 10.1177/00048674211036034
       
  • Capacity, consent and electroconvulsive therapy: What is the next step
           forward'

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      Authors: Karuppiah Jagadheesan, Vinay Lakra
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-29T06:13:47Z
      DOI: 10.1177/00048674211036347
       
  • Dietary patterns and internalizing symptoms in children and adolescents: A
           meta-analysis

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      Authors: Laura Orlando, Katarina A Savel, Sheri Madigan, Marlena Colasanto, Daphne J Korczak
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Context:Studies of child and adolescent internalizing symptoms and dietary pattern have produced mixed results.Objectives:To quantify the association between dietary patterns and internalizing symptoms, including depression, in children and adolescents.Data sources:Embase, PsycINFO, MEDLINE, Web of Science and Cochrane up to March 2021.Study selection:Observational studies and randomized controlled trials with mean age ⩽ 18 years, reporting associations between diet patterns and internalizing symptoms.Data extraction:Mean effect sizes and 95% confidence intervals were determined under a random-effects model.Results:Twenty-six studies were cross-sectional, 12 were prospective, and 1 used a case-control design. The total number of participants enrolled ranged from 73,726 to 116,546. Healthy dietary patterns were negatively associated with internalizing (r = –0.07, p 
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-27T12:56:48Z
      DOI: 10.1177/00048674211031486
       
  • Diagnostic overlap: Complex post-traumatic stress disorder and borderline
           personality disorder

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      Authors: David Lin, Jayashri Kulkarni
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-27T10:51:06Z
      DOI: 10.1177/00048674211034730
       
  • Association between COVID-19 and inpatient self-harm

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      Authors: Andrew C Page, Geoff R Hooke, Karen M Sinel
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-27T10:50:05Z
      DOI: 10.1177/00048674211034305
       
  • Traditionalism vs egalitarianism: Is there an association between gender
           attitudes and mental health'

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      Authors: Tania King, Francisco Perales, Ankur Singh, Lyle Gurrin, Bradley Crammond
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:This study sought to assess the extent to which gender attitudes are associated with mental health among Australian men and women.Methods:This study used a sample of 26,188 individuals drawn from five waves of the Household, Income and Labour Dynamics in Australia Survey. Gender attitudes were classified into three groups (traditional, moderate-egalitarian and egalitarian), and were constructed from six items. Mental health was measured using the Mental Health Inventory (MHI-5). We calculated the magnitude of associations between gender attitudes and mental health, stratified by gender, and adjusted for potential confounding.Results:Compared to men with egalitarian attitudes, poorer mental health was observed among men with moderate-egalitarian (−1.16, 95% confidence interval = [−1.84, −0.49]) and traditional gender attitudes (−2.57, 95% confidence interval = [−3.33, −1.81]). Among women, poorer mental health was observed among those with moderate-egalitarian (−0.78, 95% confidence interval = [−1.34, −0.22]) and traditional attitudes (−1.91, 95% confidence interval = [−2.55, −1.26]) compared to those with egalitarian attitudes.Conclusions:For both men and women, egalitarian gender attitudes were associated with better mental health.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-27T10:48:46Z
      DOI: 10.1177/00048674211031488
       
  • Psychological distress, loneliness, alcohol use and suicidality in New
           Zealanders with mental illness during a strict COVID-19 lockdown

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      Authors: Caroline Bell, Jonathan Williman, Ben Beaglehole, James Stanley, Matthew Jenkins, Philip Gendall, Charlene Rapsey, Susanna Every-Palmer
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Introduction:People with pre-existing mental health conditions may have been disproportionally impacted by the COVID-19 pandemic and associated public health restrictions. In this study, we compared psychological outcomes, experiences and sources of stress over the pandemic lockdown in New Zealanders with and without a previous diagnosis of mental illness.Methods:Two online surveys were conducted in New Zealand over the level 4 lockdown in April 2020 measuring psychological distress, anxiety, well-being, suicidality, alcohol use and subjective experiences. They included 3389 participants, of whom 18.4% reported having been previously diagnosed with a mental illness.Results:During the lockdown, people previously diagnosed with a mental illness had about twice the risk of reporting moderate-high levels of psychological distress (K10 ⩾ 12), at least moderate levels of anxiety (GAD-7 ⩾ 10) and poor well-being (WHO-5 ⩽ 12). They reported increased alcohol use and were about four times as likely to have experienced suicidal thoughts with 3% reporting having made a suicide attempt over the lockdown period. They reported less satisfaction with, and poorer relationships with people in their ‘bubble’, reduced social contacts and greater loneliness. They also reported higher levels of health and financial concerns.Conclusion:During the COVID-19 lockdown in New Zealand, people with a previous diagnosis of a mental illness were at increased risk of detrimental psychological outcomes. This highlights the importance of recognising this and the challenges people face in pandemics.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-27T10:46:23Z
      DOI: 10.1177/00048674211034317
       
  • Characteristics and treatment outcome of suicidal depression: Two large
           naturalistic cohorts of depressed outpatients

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      Authors: Bénédicte Nobile, Emilie Olié, Jonathan Dubois, Sebastien Guillaume, Philip Gorwood, Philippe Courtet
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:The emergence of new drugs for managing suicidal ideation (e.g. ketamine) raises the question of whether suicidal depression (i.e. moderate to severe depression with concomitant suicidal ideation) is a specific depression phenotype. Therefore, this study characterized patients with suicidal depression (baseline clinical characteristics, suicidal ideation and depression evolutions, suicide risk) in two large cohorts of outpatients with depression.Methods:LUEUR and GENESE are two large, prospective, naturalistic cohorts of French adult outpatients with depression (Diagnostic and Statistical Manual of Mental Disorders, fourth edition, criteria), treated and followed up for 6 weeks. Depression severity was assessed with the Hospital Anxiety and Depression Scale, and suicidal ideation with the suicidal item of the Montgomery–Åsberg Depression Rating Scale. Patients with moderate or severe depression (Hospital Anxiety and Depression Scale–Depression subscale score>11) were selected and classified as without suicidal ideation (suicidal item of the Montgomery–Åsberg Depression Rating Scale
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-20T07:05:11Z
      DOI: 10.1177/00048674211025697
       
  • Genetic risk for chronic pain is associated with lower antidepressant
           effectiveness: Converging evidence for a depression subtype

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      Authors: Adrián I Campos, Trung Thanh Ngo, Sarah E Medland, Naomi R Wray, Ian B Hickie, Enda M Byrne, Nicholas G Martin, Miguel E Rentería
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Introduction:Chronic pain and depression are highly comorbid and difficult-to-treat disorders. We previously showed this comorbidity is associated with higher depression severity, lower antidepressant treatment effectiveness and poorer prognosis in the Australian Genetics of Depression Study.Objective:The current study aimed to assess whether a genetic liability to chronic pain is associated with antidepressant effectiveness over and above the effect of genetic factors for depression in a sample of 12,863 Australian Genetics of Depression Study participants.Methods:Polygenic risk scores were calculated using summary statistics from genome-wide association studies of multisite chronic pain and major depression. Cumulative linked regressions were employed to assess the association between polygenic risk scores and antidepressant treatment effectiveness across 10 different medications.Results:Mixed-effects logistic regressions showed that individual genetic propensity for chronic pain, but not major depression, was significantly associated with patient-reported chronic pain (PainPRS OR = 1.17 [1.12, 1.22]; MDPRS OR = 1.01 [0.98, 1.06]). Significant associations were also found between lower antidepressant effectiveness and genetic risk for chronic pain or for major depression. However, a fully adjusted model showed the effect of PainPRS (adjOR = 0.93 [0.90, 0.96]) was independent of MDPRS (adjOR = 0.96 [0.93, 0.99]). Sensitivity analyses were performed to assess the robustness of these results. After adjusting for depression severity measures (i.e. age of onset; number of depressive episodes; interval between age at study participation and at depression onset), the associations between PainPRS and patient-reported chronic pain with lower antidepressant effectiveness remained significant (0.95 [0.92, 0.98] and 0.84 [0.78, 0.90], respectively).Conclusion:These results suggest genetic risk for chronic pain accounted for poorer antidepressant effectiveness, independent of the genetic risk for major depression. Our results, along with independent converging evidence from other studies, point towards a difficult-to-treat depression subtype characterised by comorbid chronic pain. This finding warrants further investigation into the implications for biologically based nosology frameworks in pain medicine and psychiatry.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-16T08:53:27Z
      DOI: 10.1177/00048674211031491
       
  • Development of a suspicion index for secondary schizophrenia using the
           Delphi method

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      Authors: Olivier Bonnot, Jose Luis Insua, Mark Walterfang, Juan Vincente Torres, Stefan Armin Kolb
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Aim:The aim of this study was to develop a suspicion index that aids diagnosis of secondary schizophrenia spectrum disorders in regular clinical practice.Method:We used the Delphi method to rate and refine questionnaire items in consecutive rounds. Differences in mean expert responses for schizophrenia spectrum disorders and secondary schizophrenia spectrum disorders populations allowed to define low/middle/high predictive items, which received different weights. Algorithm performance was tested in 198 disease profiles by means of sensitivity and specificity.Results:Twelve experts completed the Delphi process, and consensus was reached in 19/24 (79.2%) items for schizophrenia spectrum disorders and 17/24 (70.8%) for secondary schizophrenia spectrum disorders. We assigned rounded values to each item category according to their predictive potential. A differential distribution of scores was observed between schizophrenia spectrum disorders and secondary schizophrenia spectrum disorders when applying the suspicion index for validation to 198 disease profiles. Sensitivity and specificity analyses allowed to set a>8/10/16 risk prediction score as a threshold to consider medium/high/very high suspicion of secondary schizophrenia spectrum disorders.Conclusion:Our final outcome was the Secondary Schizophrenia Suspicion Index, the first paper-based and reliable algorithm to discriminate secondary schizophrenia spectrum disorders from schizophrenia spectrum disorders with the potential to help improve the detection of secondary schizophrenia spectrum disorder cases in clinical practice.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-16T08:52:47Z
      DOI: 10.1177/00048674211025715
       
  • Culturally competent, safe and equitable clinical care for Ma¯ori with
           bipolar disorder in New Zealand: The expert critique of Ma¯ori patients
           and Wha¯nau

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      Authors: Tracy Haitana, Suzanne Pitama, Donna Cormack, Mau Te Rangimarie Clark, Cameron Lacey
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Research designed to increase knowledge about Māori with bipolar disorder is required to understand how health services support wellbeing and respond to identified levels of community need. This paper synthesises the expert critique of Māori patients with bipolar disorder and their whānau regarding the nuances of cultural competence and safety in clinical encounters with the health system.Methods:A qualitative Kaupapa Māori Research methodology was used. A total of 24 semi-structured interviews were completed with Māori patients with bipolar disorder and members of their whānau. Structural, descriptive and pattern coding was completed using an adapted cultural competence framework to organise and analyse the data.Results:Three themes were evident from participants’ critique of clinical components of the health system. Theme 1 established that the efficacy of clinical care for bipolar disorder was dependent on Māori patients and whānau having clear pathways through care, and being able to access timely, consistent care from clinically and culturally competent staff. Theme 2 identified the influence of clinical culture in bipolar disorder services, embedded into care settings, expressed by staff, affecting the safety of clinical care for Māori. Theme 3 focused on the need for bipolar disorder services to prioritise clinical work with whānau, equip staff with skills to facilitate engagement and tailor care with resources to enhance whānau as well as patient wellbeing.Conclusion:The standard of clinical care for Māori with bipolar disorder in New Zealand does not align with practice guidelines, Māori models of health or clinical frameworks designed to inform treatment and address systemic barriers to equity. Research also needs to explore the role of structural and organisational features of the health system on Māori patient and whānau experiences of care.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-15T11:36:19Z
      DOI: 10.1177/00048674211031490
       
  • Deep brain stimulation for treatment-refractory obsessive-compulsive
           disorder should be an accepted therapy in Australia

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      Authors: Philip E Mosley, Dennis Velakoulis, Sarah Farrand, Rodney Marsh, Adith Mohan, David Castle, Perminder S Sachdev
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Deep brain stimulation has shown promise for the treatment of severe, treatment-refractory obsessive-compulsive disorder. With the recent publication of the first Australian, randomised, sham-controlled trial of deep brain stimulation for obsessive-compulsive disorder, there are now four placebo-controlled trials demonstrating the efficacy of this therapy. Together with recent data identifying a biological substrate of effective stimulation that can predict response and that has been successfully reproduced, studies comparing and finding equivalent efficacy among different targets, as well as recent, large, open trials supporting the long-term effectiveness of deep brain stimulation, we argue that this should now be considered an accepted therapy for a select group of patients in the Australasian setting. We call on the Royal Australian and New Zealand College of Psychiatrists to revise their memorandum describing deep brain stimulation for obsessive-compulsive disorder as an ‘experimental’ treatment and recognise that it has proven efficacy. We stress that this should remain a therapy offered only to those with high treatment-refractory illnesses and only at specialised centres where there is an experienced multidisciplinary team involved in work-up, implantation and follow-up and also where frameworks are in place to provide careful clinical governance and ensure appropriate fully informed consent.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-15T11:34:15Z
      DOI: 10.1177/00048674211031482
       
  • The mediating effect of brain-derived neurotrophic factor levels on
           childhood trauma and psychiatric symptoms in patients with first-episode
           schizophrenia

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      Authors: Leilei Wang, Yi Yin, Yanfang Zhou, Junchao Huang, Ping Zhang, Song Chen, Hongzhen Fan, Yimin Cui, Xingguang Luo, Shuping Tan, Zhiren Wang, Chiang-Shan R Li, Baopeng Tian, Li Tian, L Elliot Hong, Yunlong Tan
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Background:Previous studies have implicated childhood trauma and abnormal brain-derived neurotrophic factor in the pathogenesis of schizophrenia. Here, we explored whether brain-derived neurotrophic factor levels mediated the relationship between childhood trauma and psychopathological symptoms in patients with first-episode schizophrenia.Methods:Patients with first-episode schizophrenia (n = 192) and healthy controls (n = 136) were enrolled. Childhood traumatic experiences and psychopathology were assessed by Childhood Trauma Questionnaire and Positive and Negative Syndrome Scale, respectively. Enzyme-linked immunosorbent assay was used to quantify brain-derived neurotrophic factor levels.Results:The patients with first-episode schizophrenia experienced more severe childhood trauma and had lower serum brain-derived neurotrophic factor levels than healthy controls. Emotional abuse and Childhood Trauma Questionnaire total score showed positive correlation with Positive and Negative Syndrome Scale positive, general psychopathological subscore and total score. Emotional neglect showed positive correlation with Positive and Negative Syndrome Scale positive subscore. Physical neglect was positively associated with Positive and Negative Syndrome Scale negative subscore. Emotional neglect and Childhood Trauma Questionnaire total score were negatively correlated with serum brain-derived neurotrophic factor levels. The serum brain-derived neurotrophic factor levels mediated the relationship between both Childhood Trauma Questionnaire total score and Positive and Negative Syndrome Scale total score and negative symptoms in the patients. The brain-derived neurotrophic factor levels also mediated the relationship between emotional neglect and Positive and Negative Syndrome Scale total score in the patients.Conclusion:Childhood trauma might contribute to the clinical symptoms of schizophrenia by affecting brain-derived neurotrophic factor levels. Perhaps we can prevent schizophrenia by reducing childhood traumatic experiences.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-15T11:33:42Z
      DOI: 10.1177/00048674211031478
       
  • The Productivity Commission inquiry into mental health

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      Authors: Harvey Whiteford
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      The report of the Productivity Commission Inquiry into mental health was released in November 2020, estimating the economic cost of mental illness in Australia at over $200 billion a year. The report makes wide-ranging recommendations for improving the mental health of the population, reforming the mental health treatment system, and in the way mental health is managed in other sectors of society.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-14T12:25:04Z
      DOI: 10.1177/00048674211031159
       
  • COVID-19 and loneliness: A rapid systematic review

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      Authors: Nagesh Pai, Shae-Leigh Vella
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Background:Loneliness is known to be associated with both poorer physical and mental health, being associated with increased mortality. Responses throughout the world to the current COVID-19 pandemic all incorporate varying degrees of social distancing and isolation. There is an imperative to provide a timely review and synthesis of the impact of COVID-19 on loneliness in the general population.Methods:PubMed was searched using the key terms ‘COVID-19’, ‘coronavirus’, ‘SARS-COV2’ and ‘loneliness’. Fifty-four articles were identified and screened against the inclusion criteria. The inclusion criteria stipulated that the study needed to incorporate a measure of loneliness with participants being drawn from the general adult population. Twenty-four studies met the inclusion criteria.Results:The key data extracted from the 24 reviewed studies are presented and summarised with a focus on key demographics of participants, the research designs utilised, the measures of loneliness employed and the other variables assessed in the studies. Overall, the findings indicate that loneliness has been a significant issue during the current COVID-19 pandemic and loneliness is positively associated with mental health symptoms. However, there were inconsistencies in the results evident across studies.Conclusion:To our knowledge, this is the first systematic review of research investigating loneliness during the current COVID-19 pandemic in the general adult population. Despite the inconsistencies evident in some of the results across the studies, it is clearly apparent that loneliness is having an impact on the mental health and wellbeing of the general adult population. Furthermore, it is apparent that the current COVID-19 pandemic has had an impact on loneliness in the general adult population and that loneliness is significantly positively associated with mental illness symptomatology. Thus, there is an imperative to address loneliness through public policy and interventions. The limitations of this review are noted and directions given for future research.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-14T05:04:45Z
      DOI: 10.1177/00048674211031489
       
  • Prevalence of antidepressant use and unmedicated depression in pregnant
           New Zealand women

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      Authors: Charlotte A Svardal, Karen Waldie, Barry Milne, Susan MB Morton, Stephanie D’Souza
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Background:Throughout pregnancy, women are at an increased risk of depression, with prevalence estimates between 6.5% and 18%. Global prevalence of antenatal antidepressant use is considerably lower at 3%.Objective:The present study determined the proportion of women taking antidepressants across pregnancy in New Zealand. We investigated whether variation exists across age bands, area-level deprivation and ethnicities, and identified how many women experienced unmedicated depression.Method:Antenatal data (n = 6822) consisted of primarily third-trimester interviews conducted with mothers participating in Growing Up in New Zealand, a longitudinal study investigating child development. Women were asked about their antidepressant intake during pregnancy and assessed on antenatal depression symptoms using the Edinburgh Postnatal Depression Scale. Antidepressant use data were also compared to population-level data from Statistics New Zealand’s Integrated Data Infrastructure.Results:Antidepressant prevalence across pregnancy was 3.2%, with a 2.7% prevalence in trimester one and 2.6% following the first trimester. There was no significant difference in usage within age bands and area-level deprivation quintiles. Ethnicity-specific data revealed that Pasifika and Asian ethnicities had the lowest antidepressant use, and New Zealand Europeans the highest. The rate of unmedicated depression, where women met the Edinburgh Postnatal Depression Scale criteria for significant depressive symptoms but did not receive antidepressants during pregnancy, was 11.8%, indicating that antenatal depression treatment may be inadequate. Greater rates of unmedicated depression were seen for younger women (⩽24 years), those living in high deprivation areas and mothers of Pasifika, Asian and Māori ethnicities.Conclusions:Antenatal antidepressant use in New Zealand follows global prevalence estimates and highlights possible undertreatment of antenatal depression in New Zealand. Future research including other treatment types (e.g. behavioural therapy) is needed to evaluate whether undertreatment occurs across all treatment options.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-14T05:01:28Z
      DOI: 10.1177/00048674211025699
       
  • The health service contact patterns of people with psychotic and
           non-psychotic forms of severe mental illness in New South Wales,
           Australia: A record-linkage study

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      Authors: Rachael C Cvejic, Preeyaporn Srasuebkul, Adrian R Walker, Simone Reppermund, Julia M Lappin, Jackie Curtis, Katherine Samaras, Kimberlie Dean, Philip Ward, Julian N Trollor
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:To describe and compare the health profiles and health service use of people hospitalised with severe mental illness, with and without psychotic symptoms.Methods:We conducted a historical cohort study using linked administrative datasets, including data on public hospital admissions, emergency department presentations and ambulatory mental health service contacts in New South Wales, Australia. The study cohort comprised 169,306 individuals aged 12 years and over who were hospitalised at least once with a mental health diagnosis between 1 July 2002 and 31 December 2014. Of these, 63,110 had a recorded psychotic illness and 106,196 did not. Outcome measures were rates of hospital, emergency department and mental health ambulatory service utilisation, analysed using Poisson regression.Results:People with psychotic illnesses had higher rates of hospital admission (adjusted incidence rate ratio (IRR) 1.26; 95% confidence interval [1.23, 1.30]), emergency department presentation (adjusted IRR 1.17; 95% confidence interval [1.13, 1.20]) and ambulatory mental health treatment days (adjusted IRR 2.90; 95% confidence interval [2.82, 2.98]) than people without psychotic illnesses. The higher rate of hospitalisation among people with psychotic illnesses was driven by mental health admissions; while people with psychosis had over twice the rate of mental health admissions, people with other severe mental illnesses without psychosis (e.g. mood/affective, anxiety and personality disorders) had higher rates of physical health admissions, including for circulatory, musculoskeletal, genitourinary and respiratory disorders. Factors that predicted greater health service utilisation included psychosis, intellectual disability, greater medical comorbidity and previous hospitalisation.Conclusion:Findings from this study support the need for (a) the development of processes to support the physical health of people with severe mental illness, including those without psychosis; (b) a focus in mental health policy and service provision on people with complex support needs, and (c) improved implementation and testing of integrated models of care to improve health outcomes for all people experiencing severe mental illness.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-14T05:01:05Z
      DOI: 10.1177/00048674211031483
       
  • Distinguishing multimodal versus multisensory hallucinations in psychosis:
           Key definitions and a way forward

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      Authors: Wei Lin Toh, Mikaela Bere, Susan L Rossell
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      The study of hallucinations across multiple senses in psychosis has garnered renewed interest. Recent studies have adopted the term multimodal hallucinations to describe these experiences, yet some appear to be investigating a different, but related, phenomenon. In the current paper, we suggest use of the terms multimodal hallucinations and multisensory hallucinations to categorise distinct events that involve unusual sensory experiences across multiple domains. We propose that the constructs of temporality and relatedness are critical to delineating these experiences, where multimodal hallucinations refer to hallucinations in two or more sensory modes occurring concurrently in time and/or with significant thematic overlaps. Multisensory hallucinations conversely denote similar multisensory experiences, but with no temporal or relatedness constraints. This is accompanied by a decision-making framework for identifying whether a set of unusual perceptual experiences constitutes multimodal hallucinations or otherwise. We conclude by suggesting several priorities for future research, including empirical validation of our proposed model, further investigation of phenomenology, developing appropriate assessment tools and investigating underlying cognitive and other aetiological mechanisms.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-14T04:59:05Z
      DOI: 10.1177/00048674211031455
       
  • Discrimination experienced by Aboriginal and Torres Strait Islander males
           

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      Authors: Tilahun Haregu, Anthony F Jorm, Yin Paradies, Bernard Leckning, Jesse T Young, Gregory Armstrong
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Introduction:Globally, Indigenous populations have higher rates of suicidal behavior and psychological distress compared to non-Indigenous populations. Indigenous populations also report high rates of exposure to discrimination, which could potentially contribute to poor mental health outcomes. The objectives of this paper were to estimate the prevalence of discrimination among Aboriginal and Torres Strait Islander males in Australia and to examine the role of discrimination in the association between Aboriginal and Torres Strait Islander status and suicidal thoughts and depressive symptoms.Methods:We used cross-sectional data on 13,697 males aged 18–55 years from the Australian Longitudinal Study on Male Health. We undertook a Poisson regression with robust standard error analyses to examine Aboriginal and Torres Strait Islander status and self-perceived exposure to discrimination in the past 2 years as correlates of recent suicidal ideation. We used zero-inflated negative binomial regression to assess Aboriginal and Torres Strait Islander status and self-perceived exposure to discrimination as correlates of recent depressive symptoms.Results:Aboriginal and Torres Strait Islander males have a twofold higher prevalence of self-perceived discrimination (39.2% vs 19.3%, p 
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-14T04:56:53Z
      DOI: 10.1177/00048674211031168
       
  • Life stress, sleep disturbance and depressive symptoms: The moderating
           role of prefrontal activation during emotion regulation

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      Authors: Kyung Hwa Lee, Ha Young Lee, Inkyung Park, Jeong Eun Jeon, Nambeom Kim, Seong Min Oh, Sehyun Jeon, Soohyun Kim, Yu Jin Lee, Seog Ju Kim
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objectives:Evidence suggests that emotion regulation difficulty may play an important role in the association between life stress, sleep disturbance and depressive symptoms. We proposed two models depicting the possible moderating roles of prefrontal cortex activation during emotion regulation in the associations among these variables and tested them. We hypothesized that (1) the association between stress and sleep disturbance would differ across prefrontal cortex activation during emotion regulation (moderation model) and (2) the indirect effects of stress on depressive symptoms through sleep disturbance would depend on prefrontal cortex activation during emotion regulation (moderated mediation model).Methods:Forty-eight healthy adults without sleep disorders based on nocturnal polysomnography participated in this study. They received functional magnetic resonance imaging scans while performing an emotion regulation task. They also completed questionnaires assessing life stress, sleep disturbance and depressive symptoms. The proposed models were tested using the PROCESS macro for SPSS.Results:As hypothesized, there was a significant moderating effect of prefrontal cortex activation during emotion regulation on the association between life stress and sleep disturbance. Furthermore, right lateral prefrontal cortex activation had a moderating role in the indirect effect of life stress on depressive symptoms through sleep disturbance.Conclusion:These findings highlight the important role of prefrontal cortex function during emotion regulation in the associations between stress, sleep disturbance and depressive symptoms. Increasing lateral prefrontal cortex recruitment when regulating the emotional response to negative life events may be critical for the prevention and intervention of depression as well as sleep problems.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-13T10:36:31Z
      DOI: 10.1177/00048674211025729
       
  • Insight in nonpsychotic disorders: A new model of insight and a systematic
           review of measures

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      Authors: Asala Halaj, Jonathan D Huppert
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:There is substantial research examining insight in psychotic disorders and in some nonpsychotic disorders. However, there has been little attention given to many nonpsychotic disorders. Research on insight in psychosis distinguishes between cognitive and clinical insight. In most studies examining insight in nonpsychotic disorders, definitions and assessments of insight vary significantly. The purpose of this review is to suggest a definition of insight in nonpsychotic disorders such that it can be used across different disorders.Method:We systematically review the extant literature of insight in nonpsychotic disorders and analyze the assessments used in order to determine how well they capture these two types of insight. Then, we discuss how these two constructs can provide better understanding of the phenomenology of insight in nonpsychotic disorders.Results:The systematic search resulted in 99 articles. These articles used 17 different methods of measuring insight, containing 127 questions. Results of the content analysis of items suggested that measures of insight used in nonpsychotic disorders do not distinguish between cognitive and clinical insight, but that most questions (90%) can indeed be reliably differentiated.Conclusion:We provide a multidimensional model of cognitive and clinical insight in nonpsychotic disorders, emphasizing the complexity of assessment and the importance of accurately defining insight. Such definitions have important theoretical and clinical implications, offering a better understanding of the concept of insight in nonpsychotic disorders.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-13T10:34:51Z
      DOI: 10.1177/00048674211025722
       
  • Sexual violence within mental health units: The forgotten fight'

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      Authors: Bettina Belet, Estelle Demeulemeester, Guillaume Vaiva
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-13T10:33:27Z
      DOI: 10.1177/00048674211025708
       
  • Understanding treatment delay: Perceived barriers preventing
           treatment-seeking for eating disorders

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      Authors: Amber Hamilton, Deborah Mitchison, Christopher Basten, Susan Byrne, Mandy Goldstein, Phillipa Hay, Gabriella Heruc, Christopher Thornton, Stephen Touyz
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Only a small proportion of individuals with an eating disorder will receive targeted treatment for their illness. The aim of this study was to examine the length of delay to treatment-seeking and determine the barriers preventing earlier access and utilisation of eating disorder treatment for each diagnostic group – anorexia nervosa, bulimia nervosa, binge eating disorder and other specified feeding or eating disorder.Method:Participants were recruited as part of the TrEAT multi-phase consortium study. One hundred and nineteen Australians (13–60 years; 96.9% female) with eating disorders currently accessing outpatient treatment for their illness completed an online survey comprised of self-report measures of eating disorder severity, treatment delay and perceived barriers to treatment-seeking. The treating clinician for each participant also provided additional information (e.g. body mass index and diagnosis).Results:Overall, the average length of delay between onset of eating disorder symptoms and treatment-seeking was 5.28 years. Controlling for age, latency to treatment-seeking was significantly longer for individuals with bulimia nervosa and binge eating disorder compared to anorexia nervosa. However, when perceived barriers to treatment-seeking were investigated, there were no significant differences between the diagnostic groups in regard to the perceived barriers they experienced. Stigma was rated as the most impactful barrier for each diagnostic group.Conclusion:Findings suggest that individuals with eating disorders face substantial delays in accessing appropriate treatment and that latency to treatment-seeking is often magnified for counter-stereotypical eating disorder presentations. Further research is required to investigate other factors contributing to this delay.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-12T11:48:39Z
      DOI: 10.1177/00048674211020102
       
  • Incidence and risk factors of mental disorders in the elderly: The
           European MentDis_ICF65+ study

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      Authors: Sylke Andreas, Holger Schulz, Jana Volkert, Jonas Lüdemann, Maria Dehoust, Susanne Sehner, Anna Suling, Karl Wegscheider, Berta Ausín, Alessandra Canuto, Michael J Crawford, Chiara Da Ronch, Luigi Grassi, Yael Hershkovitz, Manuel Muñoz, Alan Quirk, Ora Rotenstein, Ana Belén Santos-Olmo, Arieh Shalev, Kerstin Weber, Hans-Ulrich Wittchen, Martin Härter
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:While incidence rates of depression and anxiety disorders in the elderly have been comprehensively investigated, the incidence rates of other mental disorders have rarely been researched. The incidence rate and predictors of various mental disorders in the elderly were evaluated in different European and associated countries.Methods:A cross-sectional and longitudinal multi-centre survey of Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnoses was conducted in different European and associated countries (Germany, Italy, Spain, Switzerland, the United Kingdom and Israel) to collect data on the prevalence and incidence of mental disorders in the elderly. The sample size of the longitudinal wave was N = 2592 elderly.Results:The overall 1-year incidence rate for any mental disorder in the elderly is 8.65%. At 5.18%, any anxiety disorder had the highest incidence rate across all diagnostic groups. The incidence rate for any affective disorder was 2.97%. The lowest incidence rates were found for agoraphobia (1.37%) and panic disorder (1.30%). Risk factors for the development of any mental disorder were never having been married, no religious affiliation, a higher number of physical illnesses and a lower quality of life.Conclusion:In comparison to other studies, lower incidence rates for any affective disorder and middle-range incidence for any anxiety disorder were found. To the authors’ knowledge, no prior studies have reported 1-year incidence rates for somatoform disorder, bipolar disorder and substance misuse in community-dwelling elderly. These findings indicate the need to raise awareness of psychosocial problems in the elderly and to ensure adequate availability of mental health services.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-10T10:18:41Z
      DOI: 10.1177/00048674211025711
       
  • Associations of childhood emotional and physical neglect with mental
           health and substance use in young adults

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      Authors: Lucinda Rachel Grummitt, Erin Veronica Kelly, Emma Louise Barrett, Siobhan Lawler, Katrina Prior, Lexine A Stapinski, Nicola Clare Newton
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Background:Childhood neglect is a risk factor for subsequent mental health problems. However, research on the unique contribution of emotional and physical subtypes of neglect is lacking. Importantly, if emotional and physical neglect have different impacts on mental health, they must be examined separately to understand how to prevent and treat their effects.Objective:This study aimed to examine associations of emotional and physical neglect with depression, anxiety, stress, alcohol and drug use in 18- to 20-year-olds.Methods:Participants (N = 569, mean age = 18.9, 70% female) responded in an online survey to questions on childhood emotional and physical neglect, childhood abuse, symptoms of depression, anxiety and stress, and alcohol and drug use and problems. Procedures were approved by the University of Sydney Human Ethics Committee. Hierarchical linear regressions were performed, controlling for socio-demographic characteristics and other adverse childhood experiences.Results:Combined neglect was associated with depression (B = 2.895, p 
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-10T10:08:21Z
      DOI: 10.1177/00048674211025691
       
  • Risk and protective factors of Internet gaming disorder among Chinese
           people: A meta-analysis

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      Authors: Yinan Ji, Margaret Xi Can Yin, Anna Yan Zhang, Daniel Fu Keung Wong
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objectives:Effective prevention and intervention of Internet gaming disorder require the identification of risk and protective factors. This study aims to exhaustively review the risk and protective factors of Internet gaming disorder among Chinese people.Method:We searched for articles published from database inception to February 2020 in MEDLINE, PsycINFO, Embase, PubMed, Web of Science and two Chinese databases, CNKI and Wanfang Data. Studies were included in the meta-analysis if they addressed Internet gaming disorder, sampled people in China, presented correlational factors of Internet gaming disorder and reported the effect sizes for correlations. Reviewers independently selected the studies, assessed their validity and extracted the data. Pooled Pearson’s correlations were calculated using the random effects model.Result:In the meta-analysis, 153 studies covering 115,975 subjects were included. We identified 56 risk factors and 28 protective factors. Most risk factors strongly correlated with Internet gaming disorder fell into the category of maladaptive cognitions and motivations. Other factors that showed high effect sizes fell into various categories, including psychopathological characteristics, personality traits, cognition emotion regulation style and gaming-related factors. The only protective factor strongly correlated with Internet gaming disorder was self-control. We found that the factors related to the ‘environments’ show modest effect sizes compared to those related to the individual. The pooled effect sizes for most factors were not influenced by outliers and publication bias.Conclusion:Factors strongly correlated with Internet gaming disorder, especially maladaptive cognitions and motivations, are more likely to be proximal correlates of Internet gaming disorder and may be considered the focus of interventions. We encourage further empirical and experimental studies to examine the causal pathway and the treatment efficacy.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-10T10:08:01Z
      DOI: 10.1177/00048674211025703
       
  • Validation of a Dari translation of the Edinburgh Postnatal Depression
           Scale among women of refugee background at a public antenatal clinic

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      Authors: Rebecca Blackmore, Melanie Gibson-Helm, Glenn Melvin, Jacqueline A Boyle, Mina Fazel, Kylie M Gray
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Identifying women at risk of depression and anxiety during pregnancy provides an opportunity to improve health outcomes for women and their children. One barrier to screening is the availability of validated measures in the woman’s language. Afghanistan is one of the largest source countries for refugees yet there is no validated measure in Dari to screen for symptoms of perinatal depression and anxiety. The aim of this study was to assess the screening properties of a Dari translation of the Edinburgh Postnatal Depression Scale.Methods:This cross-sectional study administered the Edinburgh Postnatal Depression Scale Dari version to 52 Dari-speaking women at a public pregnancy clinic in Melbourne, Australia. A clinical interview using the depressive and anxiety disorders modules from the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) was also conducted. Interview material was presented to an expert panel to achieve consensus diagnoses. The interview and diagnostic process was undertaken blind to Edinburgh Postnatal Depression Scale screening results.Results:Cronbach’s alpha coefficient for the Edinburgh Postnatal Depression Scale Dari version was good (α = 0.79). Criterion validity was assessed using the receiver operating characteristics curve and generated excellent classification accuracy for depression diagnosis (0.90; 95% confidence interval [0.82, 0.99]) and for anxiety diagnosis (0.94; 95% confidence interval [0.88, 1.00]). For depression, a cut-off score of 9, as recommended for culturally and linguistically diverse groups, demonstrated high sensitivity (1.00; 95% confidence interval [0.79, 1.00]) and specificity (0.88; 95% confidence interval [0.73, 0.97]). For anxiety, a cut-off score of ⩾5 provided the best balance of sensitivity (1.00; 95% confidence interval [0.72, 1.00]) and specificity (0.80; 95% confidence interval [0.65, 0.91]).Conclusion:These results support the use of this Edinburgh Postnatal Depression Scale Dari version to screen for symptoms of depression and anxiety during pregnancy as well as the use of a lowered cut-off score.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-10T10:06:21Z
      DOI: 10.1177/00048674211025687
       
  • Long-term efficacy of metacognitive therapy and cognitive behaviour
           therapy for depression

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      Authors: Janet D Carter, Jennifer Jordan, Virginia VW McIntosh, Christopher MA Frampton, Cameron Lacey, Richard J Porter, Roger T Mulder
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:To examine the two-year outcomes for depression, anxiety, cognitive and global social functioning after cognitive behavioural therapy (CBT) and metacognitive therapy (MCT) for depression.Method:Participants were 31 adults with a diagnosis of major depressive disorder in a randomised pilot study comparing MCT and CBT. Therapy modality differences in change in depression and anxiety symptoms, dysfunctional attitudes, metacognitions, rumination, worry and global social functioning were examined at the two-year follow-up for those who completed therapy.Results:Significant improvements, with large effect sizes, were evident for all outcome variables. There were no significant differences in outcome between CBT and MCT. The greatest change over time occurred for depression and anxiety. Large changes were evident for metacognitions, rumination, dysfunctional attitudes, worry and global social functioning. Sixty-seven percent had not experienced a major depression and had been well during all of the past year, prior to the follow-up assessment.Conclusion:The finding at end treatment, of no modality specific differences, was also evident at two-year follow-up. Although CBT and MCT targeted depression, improvements were much wider, and although CBT and MCT take different approaches, both therapies produced positive change over time across all cognitive variables. CBT and MCT provide treatment options, that not only improve the longer-term outcome of depression, but also result in improvements in anxiety, global social functioning and cognitive status.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-10T10:04:21Z
      DOI: 10.1177/00048674211025686
       
  • Personality change in the Nottingham Study of Neurotic Disorder: 30-Year
           cohort study

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      Authors: Min Yang, Helen Tyrer, Tony Johnson, Peter Tyrer
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Background:Persistence is said to be a feature of personality disorder, but there are few long-term prospective studies of the condition. A total of 200 patients with anxiety and depressive disorders involved in a randomised controlled trial initiated in 1983 had full personality status assessed at baseline. We repeated assessment of personality status on three subsequent occasions over 30 years.Methods:Personality status was recorded using methods derived from the Personality Assessment Schedule, which has algorithms for allocating Diagnostic and Statistical Manual of Mental Disorders (DSM) and the 11th International Classification of Diseases (ICD-11) categories. The category and severity of personality diagnosis were recorded at baseline in the randomised patients with DSM-III anxiety and depressive diagnoses. The same methods of assessing personality status was repeated at 2, 12 and 30 years after baseline.Results:Using the ICD-11 system, 47% of patients, mainly those with no personality disturbance at baseline, retained their personality status; of the others 16.8% improved and 20.4% worsened to more severe disorder. In DSM-III diagnosed patients, those diagnosed as Cluster A and Cluster C increased in frequency (from 14% to 40%, p 
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-10T09:59:40Z
      DOI: 10.1177/00048674211025624
       
  • rTMS and treatment-resistant depression: The need to consider class
           action!

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      Authors: Gin S Malhi, Erica Bell, Zola Mannie, Phil Boyce, Malcolm Hopwood, Darryl Bassett, Roger Mulder, Richard J Porter, Bill Lyndon
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-10T09:58:07Z
      DOI: 10.1177/00048674211025094
       
  • Psychodynamic therapy of depression

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      Authors: Falk Leichsenring, Patrick Luyten, Allan Abbass, Christiane Steinert
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-09T09:21:41Z
      DOI: 10.1177/00048674211031481
       
  • The impact of COVID-19 on antipsychotic prescriptions for patients with
           schizophrenia in Australia

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      Authors: Steve Kisely, Dante Dangelo-Kemp, Mark Taylor, Dennis Liu, Simon Graham, Jodie Hartmann, Sam Colman
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:To assess the impact, in the Australian setting, of the COVID-19 lockdown on antipsychotic supplies for patients with schizophrenia following a prescription from a new medical consultation when compared to the same periods in the previous 4 years. A secondary objective was to assess the volume of all antipsychotic supplies, from new and repeat prescriptions, over these same periods.Methods:A retrospective pharmaceutical claims database study was undertaken, using the Department of Human Services Pharmaceutical Benefits Scheme 10% sample. The study population included all adult patients with three or more supplies of oral or long-acting injectable antipsychotics for the treatment of schizophrenia at any time between 1 June 2015 and 31 May 2020. The primary outcome compared volumes of dispensed antipsychotics from new prescriptions (which require a medical consultation) between 1 April and 31 May each year from 2016 to 2020. This was to analyse the period during which the Australian Government imposed a lockdown due to COVID-19 (April to May 2020) when compared the same periods in previous years.Results:There was a small (5.7%) reduction in the number of antipsychotics dispensed from new prescriptions requiring a consultation, from 15,244 to 14,372, between April and May 2019 and the same period in 2020, respectively. However, this reduction was not statistically significant (p = 0.75) after adjusting for treatment class, age, gender, location and provider type.Conclusion:The COVID-19 restrictions during April and May 2020 had no significant impact on the volume of antipsychotics dispensed from new prescriptions for patients with schizophrenia when compared to the volume of antipsychotics dispensed from new prescriptions during the same period in previous years.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-09T09:20:01Z
      DOI: 10.1177/00048674211025716
       
  • How do lipids influence risk of violence, self-harm and suicidality in
           people with psychosis' A systematic review

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      Authors: Piyal Sen, Danielle Adewusi, Alexandra I Blakemore, Veena Kumari
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objectives:Low cholesterol has been linked with violent and suicidal behaviour in people with schizophrenia. This association, if consistently present, may be a promising biological marker that could assist clinicians in decision making regarding risk and treatment. We conducted a systematic review to assess whether there is a reliable association between lipid profile (total cholesterol, high- and low-density lipoprotein cholesterol, and triglycerides) and aggression, self-harm or suicide in people with schizophrenia, and whether effects are similar in males and females.Method:Relevant databases were searched to identify primary research studies (up to November 2020) that (1) involved adults (some samples also included 16- to 18-year olds) with a confirmed diagnosis of schizophrenia, schizoaffective disorder or psychosis; and (2) included a standardised assessment of verbal aggression, physical aggression against objects, physical aggression against self (including suicide) or others. The search yielded 23 studies eligible for inclusion following a quality appraisal.Results:Suicidality was the most commonly assessed subtype of aggression (20 studies). For suicidality, about half the studies, including the study with the largest sample size, found a link with total cholesterol. An association between low total cholesterol and violence towards others was found in six of nine studies that investigated this. The evidence for a link with violence was the strongest for total cholesterol, followed by low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, and the weakest for triglycerides. Only a few studies investigated sex differences and yielded mixed evidence. Studies focussed on self-harm as well as involving females in forensic settings were lacking.Conclusion:There is encouraging evidence of an association between low total cholesterol and aggression towards others as well as suicidality in schizophrenia. Future studies should systematically explore this association in people with schizophrenia who have a significant history of violence, suicidality and self-harm, both inpatients and community, and also investigate underlying mechanisms.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-09T09:17:48Z
      DOI: 10.1177/00048674211025608
       
  • Prolonged grief disorder in DSM-5-TR: Early predictors and longitudinal
           measurement invariance

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      Authors: Paul A Boelen, Lonneke IM Lenferink
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision includes prolonged grief disorder as a novel disorder. Prolonged grief disorder can be diagnosed when acute grief stays distressing and disabling, beyond 12 months following bereavement. Evidence indicates that elevated prolonged grief disorder symptoms in the first year of bereavement predict pervasive grief later in time; targeting early elevated grief may potentially prevent symptoms getting chronic. There is limited knowledge about the characteristics of people in the first year of bereavement who have an elevated chance of developing full prolonged grief disorder beyond the 12-month time point. This study examined these characteristics.Methods:We used self-reported data from 306 adults who all completed questions on socio-demographic and loss-related characteristics plus a measure of prolonged grief disorder within the first year of bereavement (Wave 1; time since loss: M = 4.97, SD = 3.13 months) and again 1 year later (Wave 2; time since loss: M = 17.84, SD = 3.38 months). We examined the prevalence rates of probable prolonged grief disorder (Wave 2), measurement invariance of prolonged grief disorder symptoms between waves, and associations of socio-demographic and loss-related variables, and Wave 1 prolonged grief disorder with probable prolonged grief disorder at Wave 2.Results:Regarding prevalence, 10.1% (n = 31) met criteria for probable prolonged grief disorder (Wave 2). Multigroup confirmatory factor analysis supported longitudinal measurement invariance of prolonged grief disorder symptoms. People meeting criteria at Wave 1 (except the time criterion) had a significantly increased risk of meeting criteria at Wave 2. Variables best predicting probable prolonged grief disorder at Wave 2 were prolonged grief disorder at Wave 1, lower education, loss of a child and loss to unnatural/violent causes (sensitivity = 56.67%, specificity = 98.12%, 93.92% correct classifications).Conclusion:People meeting criteria for prolonged grief disorder (except the time criterion) before the first anniversary of the death are at risk of full-blown prolonged grief disorder beyond this time point, particularly those who have lower education, confronted the death of a child and confronted unnatural/violent loss. Findings may inform advances in preventive bereavement care.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-08T05:45:32Z
      DOI: 10.1177/00048674211025728
       
  • Five facts about rTMS

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      Authors: Gin S Malhi, Erica Bell
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-07T11:15:16Z
      DOI: 10.1177/00048674211026760
       
  • Re-balancing Victorian psychiatric services: Will increasing the supply of
           community services impact upon hospital demand'

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      Authors: Stephen Allison, Tarun Bastiampillai, Jeffrey CL Looi, Sven Delaney, David Copolov
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-07T11:13:56Z
      DOI: 10.1177/00048674211025727
       
  • A Delphi study to identify intervention priorities to prevent the
           occurrence and reduce the impact of adverse childhood experiences

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      Authors: Berhe W Sahle, Nicola J Reavley, Amy J Morgan, Marie Bee Hui Yap, Andrea Reupert, Anthony F Jorm
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:There is a lack of a systematic, coordinated approach to reducing the occurrence and impact of adverse childhood experiences. Hence, identifying feasible intervention priorities in this field will help inform policy and reformation of ongoing service delivery. The objective of this study was to identify expert consensus-driven priority interventions for reducing the occurrence and impact of adverse childhood experiences in children under 8 years of age in the Australian context.Methods:A three-round online Delphi survey was conducted to establish consensus on 34 interventions for adverse childhood experiences identified through a literature search. Six were general categories of interventions, 6 were broad intervention programmes and 22 were specific interventions. Participants were 17 health practitioners, 15 researchers, 9 policy experts, 7 educators and 3 consumer advocates with expertise in adverse childhood experiences or child mental health. Consensus was defined as an intervention being rated as ‘very high priority’ or ‘high priority’ according to its importance and feasibility by ⩾75% of all experts.Results:Seven of the 34 interventions were endorsed as priority interventions for adverse childhood experiences. These included four general categories of intervention: community-wide interventions, parenting programmes, home-visiting programmes and psychological interventions. Two broad intervention programmes were also endorsed: school-based anti-bullying interventions and psychological therapies for children exposed to trauma. Positive Parenting Program was the only specific intervention that achieved consensus.Conclusion:This is the first study to identify stakeholder perspectives on intervention priorities to prevent the occurrence and impact of adverse childhood experiences. Prioritisation of effective, feasible and implementable intervention programmes is an important step towards better integration and coordination of ongoing service delivery to effectively prevent and respond to adverse childhood experiences.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-07T11:06:17Z
      DOI: 10.1177/00048674211025717
       
  • Clozapine-associated pneumonia: Under-recognised morbidity and mortality
           risk

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      Authors: Madeleine Robertson, Tarun Bastiampillai, Arun Gupta
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-07T11:03:37Z
      DOI: 10.1177/00048674211025707
       
  • The hospitalist movement and the benefits for Australian Psychiatry
           Services

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      Authors: Shanna Lee, Milanduth K Kanigere, Prashant Tibrewal, Rohan Dhillon, Tarun Bastiampillai
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-07T11:01:36Z
      DOI: 10.1177/00048674211025702
       
  • Effect of suicide prevention law and media guidelines on copycat suicide
           of general population following celebrity suicides in South Korea,
           2005–2017

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      Authors: Jihoon Jang, Woojae Myung, Seongcheol Kim, Minhee Han, Vidal Yook, Eun Ji Kim, Hong Jin Jeon
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:To prevent copycat suicides following media reporting of celebrity suicides, the South Korean government enacted a ‘suicide prevention law’ in 2012 and revised the media guidelines for suicide reporting in 2013. This study examined how these two regulatory measures affected suicide trends among the general population in South Korea.Methods:We analyzed the individual effect estimates for the general population within 30 days following the media report of 24 celebrity suicides using multivariate negative binomial regression. We performed a meta-analysis to compute the pooled rate ratios of the two regulations. We examined the trends in daily suicides by month during three time intervals before and after enactment using an autoregressive model and tested their significance using a piecewise linear regression.Results:Total suicides increased by 6.27 daily during the 30-day period after celebrity suicides. Compared with the 30 days prior to the reports on the suicide of 24 celebrities, the number of suicidal deaths in the general population increased by 13% during the 30 days after the reports were announced (pooled rate ratio 1.13, 95% confidence interval: 0.06–0.18; p 
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-07T10:49:15Z
      DOI: 10.1177/00048674211025701
       
  • Short-term outcomes of the Therapist-assisted Online Parenting Strategies
           intervention for parents of adolescents treated for anxiety and/or
           depression: A single-arm double-baseline trial

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      Authors: Sarah Pheik Hoon Khor, Catherine Margaret Fulgoni, Deborah Lewis, Glenn A Melvin, Anthony F Jorm, Katherine Lawrence, Bei Bei, Marie Bee Hui Yap
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:This study aimed to evaluate whether the Therapist-assisted Online Parenting Strategies programme increased parenting behaviours known to be supportive of adolescents experiencing anxiety and/or depression. Secondary parenting outcomes of parental self-efficacy, parental accommodation, carer burden, parent–adolescent attachment, family functioning and parent distress were also examined, along with adolescent outcomes of anxiety and depression symptoms, suicidal ideation and sleep.Method:Seventy-one parents (94.4% females) and their adolescents (73.2% females) aged 12–18 years (Mean = 15.02, SD = 1.56) being treated for depression and/or anxiety in Australia were recruited into a single-arm double-baseline open-label trial. Parents received Therapist-assisted Online Parenting Strategies, which comprised up to nine web-based modules each supplemented with coaching sessions via videoconferencing. Outcomes were analysed using latent growth curve modelling to determine if changes to outcomes at post-intervention (4 month post-second baseline) exceeded changes between two baselines measured 1 month apart.Results:Sixty-five parents (91.6%) completed at least one module of the online parenting intervention and on average received nine coaching sessions (SD = 2). Parenting behaviours targeted by Therapist-assisted Online Parenting Strategies improved at post-intervention (Cohen’s d = 1.16, 95% confidence interval [0.78, 1.51]). Parent-reported parental self-efficacy and parent−adolescent attachment increased (Cohen’s d = 1.44 [1.05, 1.82] and 0.39 [0.05, 0.74], respectively), while impairments to family functioning and parent distress decreased (Cohen’s d = −0.51 [−0.86, −0.16] and −0.84 [−1.23, −0.44], respectively). Changes to adolescent anxiety, depression and sleep were not significant.Conclusion:The Therapist-assisted Online Parenting Strategies intervention improved self-reported parenting behaviours, parental self-efficacy, parent levels of distress, parent–adolescent attachment, and family functioning in parents with adolescents being treated for anxiety and/or depression. However, significant changes in adolescent mental health and sleep outcomes at post-intervention were not observed. The usefulness of a therapist-supported online parenting programme in addressing a service gap for parents seeking professional help is indicated.Trial Registration:Australian New Zealand Clinical Trials Registry Number (ACTRN) 12618000290291, prospectively registered on 26 February 2018; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx'id=368031
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-07T10:47:19Z
      DOI: 10.1177/00048674211025695
       
  • The impact of parental mental health problems on the educational outcomes
           of their offspring: Findings from the Raine Study

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      Authors: Getinet Ayano, Ashleigh Lin, Berihun Assefa Dachew, Robert Tait, Kim Betts, Rosa Alati
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objectives:There is limited evidence on the impact of parental mental health problems on offspring’s educational outcomes. We investigated the impact of maternal anxiety and depressive symptoms, as well as paternal emotional problems on the educational outcomes of their adolescent and young adult offspring.Methods:We used data from a longitudinal birth cohort recruited between 1989 and 1991 in Australia (the Raine Study). The Depression, Anxiety and Stress Scale was used to assess maternal depressive and anxiety symptoms, and a self-reported question was used to measure paternal mental health problems. Both were assessed when the offspring was aged 10 years. Outcomes included offspring’s self-reported education attainment—not completing year 10 at age 17, not attending tertiary education at ages 17 and 22 and primary caregiver’s reports of offspring’s academic performance at age 17.Results:A total of 1033, 1307 and 1364 parent–offspring pairs were included in the final analysis exploring the association between parental mental health problems and offspring’s academic performance at school, completing year 10 and attending tertiary education, respectively. After adjusting for potential confounders, the offspring of mothers with anxiety symptoms were 3.42 times more likely than the offspring of mothers without anxiety symptoms to have poor or below-average academic performance (odds ratio = 3.42; 95% confidence interval = [1.31, 8.92]) and more than 2 times more likely to not attend tertiary education (odds ratio = 2.55; 95% confidence interval = [1.10, 5.5.88]) and not to have completed year 10 (odds ratio = 2.13; 95% confidence interval = [1.04, 4.33]). We found no significant associations between maternal depressive symptoms or paternal emotional problems and offspring educational attainment.Conclusion:Maternal anxiety symptoms, but not depression and paternal emotional problems, are associated with poor educational attainment and achievement in adolescent offspring. The findings highlight that efforts to improve the outcomes of offspring of mothers with anxiety could focus on educational attainment.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-06T09:21:24Z
      DOI: 10.1177/00048674211025633
       
  • Psychiatric care implications of the Aged Care Royal Commission: Putting
           the cart before the horse

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      Authors: Jeffrey CL Looi, Steve Kisely, Tarun Bastiampillai, Stephen Allison
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-05T09:09:43Z
      DOI: 10.1177/00048674211025700
       
  • Clozapine use and prevalence in Australia 2016–2020

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      Authors: Samantha A Hollingworth, Adrian Oliver, Karl Winckel, Dan Siskind
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-05T09:08:42Z
      DOI: 10.1177/00048674211025693
       
  • Welcome to the Breakfast Club: Building academic psychiatry capacity in
           Queensland

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      Authors: Shuichi Suetani, Bjorn Burgher, Phil Mosley, Stephen Parker
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-05T09:07:43Z
      DOI: 10.1177/00048674211025630
       
  • The imperative for longitudinal follow-up in renal transplant candidates
           with psychiatric contraindications to surgery

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      Authors: Jacqueline Evans, Robert Donald Gillies, Louise Seward
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-05T09:02:09Z
      DOI: 10.1177/00048674211025622
       
  • The impact of social unrest and pandemic on mental health of young people
           in Hong Kong: The transdiagnostic role of event-based rumination

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      Authors: Stephanie MY Wong, Christy LM Hui, Yi Nam Suen, Corine SM Wong, Sherry KW Chan, Edwin HM Lee, Wing Chung Chang, Eric YH Chen
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Co-occurring population-level events, such as social unrest and coronavirus disease 2019, are observed in many societies today. Few studies have explored their combined mental health effects on young people. While self-focused rumination has been suggested to be a key mechanism underlying depression, the role of event-based rumination in mediating the impact of population stressors has yet to be elucidated.Methods:Data were collected from 6988 young people in a large-scale community online survey in Hong Kong. The survey assessed symptoms of post-traumatic stress disorder and depression, direct exposure to social unrest-related traumatic events, coronavirus disease 2019 pandemic-related events, personal stressful life events, event-based rumination and other individual risk factors.Results:High levels of comorbid post-traumatic stress disorder and depressive symptoms were observed. Logistic regression analysis revealed that probable post-traumatic stress disorder was associated with traumatic events (odds ratio = 1.73, 95% confidence interval = [1.64, 1.82]), pandemic-related events (odds ratio = 1.08, confidence interval = [1.01, 1.16]), stressful life events (odds ratio = 1.20, confidence interval = [1.21, 1.37]), high event-based rumination (odds ratio = 3.00, confidence interval = [2.58, 3.48]), lower resilience (odds ratio = 1.18, confidence interval = [1.15, 1.21]), higher smartphone reliance (odds ratio = 1.09, confidence interval = [1.05, 1.13]) and financial concerns (odds ratio = 1.25, confidence interval = [1.18, 1.33]). The odds for probable post-traumatic stress disorder was also significantly higher when two or more traumatic events were experienced (odds ratio = 4.03, confidence interval = [3.52, 4.62]). Factors associated with moderate-to-severe level depressive symptoms were similar. Event-based rumination significantly mediated between different types of external events (traumatic events, pandemic-related events, stressful life events) and both post-traumatic stress disorder and depressive symptoms.Conclusion:These findings suggest that diverse types of stressful events during population-level crises could add to personal stressors to affect mental health outcomes in young people. Among other protective and risk factors, event-based rumination presented as a prominent transdiagnostic mediator for different symptom dimensions which may be a potentially important target for early risk detection and intervention.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-06-26T02:33:25Z
      DOI: 10.1177/00048674211025710
       
  • ‘In the night kitchen’: A scoping review on the night eating
           syndrome

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      Authors: Maria Rosaria Anna Muscatello, Giovanna Torre, Laura Celebre, Bernardo Dell’Osso, Carmela Mento, Rocco Antonio Zoccali, Antonio Bruno
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Background:First described in 1955, night eating syndrome refers to an abnormal eating behavior clinically defined by the presence of evening hyperphagia (>25% of daily caloric intake) and/or nocturnal awaking with food ingestion occurring ⩾ 2 times per week.Aims:Although the syndrome is frequently comorbid with obesity, metabolic and psychiatric disorders, its etiopathogenesis, diagnosis, assessment and treatment still remain not fully understood.Methods:This review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines; PubMed database was searched until 31 October 2020, using the key terms: ‘Night Eating Syndrome’ AND ‘complications’ OR ‘diagnosis’ OR ‘drug therapy’ OR ‘epidemiology’ OR ‘etiology’ OR ‘physiology’ OR ‘physiopathology’ OR ‘psychology’ OR ‘therapy’.Results:From a total of 239 citations, 120 studies assessing night eating syndrome met the inclusion criteria to be included in the review.Conclusion:The inclusion of night eating syndrome into the Diagnostic and Statistical Manual of Mental Disorders-5 ‘Other Specified Feeding or Eating Disorders’ category should drive the attention of clinician and researchers toward this syndrome that is still defined by evolving diagnostic criteria. The correct identification and assessment of NES could facilitate the detection and the diagnosis of this disorder, whose bio-psycho-social roots support its multifactorial nature. The significant rates of comorbid illnesses associated with NES and the overlapping symptoms with other eating disorders require a focused clinical attention. Treatment options for night eating syndrome include both pharmacological (selective serotonin reuptake inhibitors, topiramate and melatonergic drugs) and non-pharmachological approaches; the combination of such strategies within a multidisciplinary approach should be addressed in future, well-sized and long-term studies.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-06-25T09:49:31Z
      DOI: 10.1177/00048674211025714
       
  • Femicide in early adolescence: The potential role of girl-child marriage
           as a risk factor

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      Authors: Thiago Henrique Roza, Angelita Machado-Rios, Pedro Vieira da Silva Magalhães, Lisieux Elaine de Borba Telles
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-06-23T10:48:54Z
      DOI: 10.1177/00048674211025713
       
  • The Butterfly Effect: Poor access to non-acute psychiatric beds and the
           emergency department congestion crisis in WA

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      Authors: Stephen Allison, Tarun Bastiampillai, Jeffrey CL Looi, David Copolov
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-06-23T10:47:48Z
      DOI: 10.1177/00048674211025638
       
  • In Response to: Lee S, Kanigere MK, Tibrewal P, Dhillon R and
           Bastiampillai T (2021). The hospitalist movement and the benefits for
           Australian psychiatry services. Australian and New Zealand Journal of
           Psychiatry

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      Authors: Nagesh Pai
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-06-23T10:45:36Z
      DOI: 10.1177/00048674211025604
       
  • Treating schizophrenia: Should we emphasise ‘first do no
           harm’'

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      Authors: Tom English, David Castle
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-06-19T05:37:40Z
      DOI: 10.1177/00048674211025696
       
  • Antipsychotic-induced supersensitivity – A reappraisal

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      Authors: William Lugg
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objectives:Tardive dyskinesia, psychotic relapse and treatment-refractory psychosis have long been associated. A common underlying mechanism involving antipsychotic-induced ‘supersensitivity’, albeit in different brain pathways, was proposed as early as 1978. This piece seeks to reappraise the concept and potential implications of antipsychotic-induced supersensitivity.Conclusions:Evidence increasingly suggests that chronic antipsychotic exposure induces neuroadaptive physiological changes in dopaminergic, and other, neurotransmitter systems that may render some individuals more vulnerable to psychotic relapse - including those receiving continuous antipsychotic treatment. It is possible that in treating every episode of psychosis with prolonged or indefinite antipsychotic therapy, we paradoxically increase the risk of psychotic relapse in a significant proportion of people. A greater appreciation of supersensitivity may allow us to optimise any potential benefits of antipsychotics while minimising the risk of inadvertent iatrogenic harms. More research is needed to improve our understanding of the underlying neurophysiology of supersensitivity and to better identify which individuals are most vulnerable to its development. It is time we paid more attention to the concept, emerging evidence and potential implications of antipsychotic-induced supersensitivity and, where appropriate, adjusted our practice accordingly.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-06-19T05:36:40Z
      DOI: 10.1177/00048674211025694
       
  • Increasing trans and gender diverse education for Australian medical
           students: An opportunity to improve access and mental health care

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      Authors: Thomas P Nguyen, Asiel Yair Adan Sanchez
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-06-19T05:35:08Z
      DOI: 10.1177/00048674211025692
       
  • Atrial tachycardia associated with risperidone

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      Authors: Alexandra Casanova Clarke, Dhiren Singh
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-06-18T09:19:06Z
      DOI: 10.1177/00048674211025635
       
  • Complex post-traumatic stress disorder and pre-menstrual dysphoric
           disorder

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      Authors: Jasleen Kaur Grewal, Jayashri Kulkarni
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-06-17T08:03:36Z
      DOI: 10.1177/00048674211025627
       
  • Re-positioning rTMS: From ECT magic, to magical thinking!

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      Authors: Gin S Malhi, Erica Bell
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-27T09:12:55Z
      DOI: 10.1177/00048674211016050
       
  • ‘Wasn’t offered one, too poorly to ask for one’ – Reasons why some
           patients do not receive a psychosocial assessment following self-harm:
           Qualitative patient and carer survey

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      Authors: Leah Quinlivan, Louise Gorman, Donna L Littlewood, Elizabeth Monaghan, Stephen J Barlow, Stephen Campbell, Roger T Webb, Nav Kapur
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Psychosocial assessment following self-harm presentations to hospital is an important aspect of care. However, many people attending hospital following self-harm do not receive an assessment. We sought to explore reasons why some patients do not receive a psychosocial assessment following self-harm from the perspective of patients and carers.Methods:Between March and November 2019, we recruited 88 patients and 14 carers aged ⩾18 years from 16 mental health trusts and community organisations in the United Kingdom, via social media, to a co-designed qualitative survey. Thematic analyses were used to interpret the data.Results:Patients’ reasons for refusing an assessment included long waiting times, previous problematic interactions with staff and feeling unsafe when in the emergency department. Two people refused an assessment because they wanted to harm themselves again. Participants reported organisational reasons for non-assessment, including clinicians not offering assessments and exclusion due to alcohol intoxication. Other patients felt they did not reach clinically determined thresholds because of misconceptions over perceived heightened fatality risk with certain self-harm methods (e.g. self-poisoning vs self-cutting).Conclusion:Our results provide important insights into some of the reasons why some people may not receive a psychosocial assessment following self-harm. Parallel assessments, compassionate care and specialist alcohol services in acute hospitals may help reduce the number of people who leave before an assessment. Education may help address erroneous beliefs that self-injury and self-harm repetition are not associated with greatly raised suicide risk.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-21T08:01:04Z
      DOI: 10.1177/00048674211011262
       
  • Irritability in developmental age: A narrative review of a dimension
           crossing paediatric psychopathology

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      Authors: Maria Breda, Ignazio Ardizzone
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Irritability is an important theme in paediatric psychiatry considering its high frequency in developmental age, its association with negative outcomes and consequently significant public health impact. Present as main or associated feature of several psychiatric diagnoses, irritability represents a challenge for clinicians who try to understand its origin and role in developmental psychopathology. In this review we try to: (1) get an overview of this dimension and its relationship with each of the main neuropsychiatric disorders in paediatric population and (2) provide a summary of currently available instruments to assess irritability in children and adolescents.Method:In this narrative review, an overview of irritability in children and adolescents is proposed focusing on selected literature.Results:Irritability as feature of many paediatric psychiatric conditions has been evaluated by many authors and included in classifications of paediatric psychiatric diseases. Framework of irritability evolved over time and dimension of irritability has been investigated using different tools and methodologies, both qualitative and quantitative. Metrics of irritability as clinical dimension are important in the diagnostic process of paediatric diseases.Conclusion:Investigating the presence of irritability in all children with related disorders is mandatory if we consider the risk for functional impairment and affective and behavioural disorders associated with high levels of irritability. Using rigid threshold in developmental age to differentiate physiological from pathological irritability could lead many children having subthreshold levels of irritability to receive no diagnosis and, consequently, no treatment where instead a dimensional approach to irritability could allow to identify prodromal phase and prevent the evolution towards clinical pathological expressions.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-21T06:21:34Z
      DOI: 10.1177/00048674211011245
       
  • Anxiety and depression in primary aldosteronism: Overlooked and neglected

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      Authors: Kay Weng Choy
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-20T06:40:45Z
      DOI: 10.1177/00048674211011261
       
  • Lymphadenopathy—A rare but important side effect of lamotrigine

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      Authors: Kate Eggleston, Richard Porter
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-20T06:39:55Z
      DOI: 10.1177/00048674211011260
       
  • The IDeAS in MIDAS: ‘Keeping it real!’

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      Authors: Gin S Malhi, Erica Bell, Phil Boyce, Malcolm Hopwood, Darryl Bassett, Roger Mulder, Richard J Porter
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-20T06:39:08Z
      DOI: 10.1177/00048674211011257
       
  • The clinical practice guidelines

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      Authors: Stephen J Rosenman
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-20T06:38:24Z
      DOI: 10.1177/00048674211010334
       
  • Neural, behavioural and real-life correlates of social context sensitivity
           and social reward learning during interpersonal interactions in the
           schizophrenia spectrum

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      Authors: Esther Hanssen, Mariët van Buuren, Nienke Van Atteveldt, Imke LJ Lemmers-Jansen, Anne-Kathrin J Fett
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Recent findings suggest that diminished processing of positive contextual information about others during interactions may contribute to social impairment in the schizophrenia spectrum. This could be due to general social context processing deficits or specific biases against positive information. We studied the impact of positive and negative social contextual information during social interactions using functional neuroimaging and probed whether these neural mechanisms were associated with real-life social functioning in schizophrenia spectrum disorders.Methods:Patients with a schizophrenia spectrum disorder (N = 23) and controls disorder (N = 25) played three multi-round trust games during functional magnetic resonance imaging scanning, with no, positive and negative information about the counterpart’s trustworthiness, while all counterparts were programmed to behave trustworthy. The main outcome variable was the height of the shared amount in the trust game, i.e. investment, representing an indication of trust. The first investment in the game was considered to be basic trust, since no behavioural feedback was given yet. We performed region-of-interest analyses and examined the association with real-life social functioning using the experience sampling method.Results:Social contextual information had no effect on patients’ first investments, whereas controls made the lowest investment after negative and the highest investments after positive contextual information was provided. Over trials, patients decreased investments, suggesting reduced social reward learning, whereas controls increased investments in response to behavioural feedback in the negative context. Patients engaged the dorsolateral prefrontal cortex less than controls during context presentation and showed reduced activity within the caudate during repayments. In patients, lower investments were associated with more time spent alone and social exclusion and lower caudate activation was marginally significantly associated with higher perceived social exclusion.Conclusion:The failure to adapt trust to positive and negative social contexts suggests that patients have a general insensitivity to prior social information, indicating top-down processing impairments. In addition, patients show reduced sensitivity to social reward, i.e. bottom-up processing deficits. Moreover, lower trust and lower neural activation were related to lower real-life social functioning. Together, these findings indicate that improving trust and social interactions in schizophrenia spectrum needs a multi-faceted approach that targets both mechanisms.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-19T05:09:00Z
      DOI: 10.1177/00048674211010327
       
  • Macrophage migration inhibitory factor as a potential novel biomarker for
           cognitive function in patients with first-episode schizophrenia

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      Authors: Jian-Jin Yu, Qing Zhao, Hong-Na Li, Jia-Qi Song, Da-Chun Chen
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Cognitive impairment is prevalent in schizophrenia. Macrophage migration inhibitory factor which is released into the circulation under stress or inflammation, is associated with cognition and also plays an important role in immunity. However, no study has investigated the relationship between macrophage migration inhibitory factor and cognitive function in first-episode schizophrenia patients at baseline or after treatment. This study investigated the pre- and post-risperidone treatment correlations between serum macrophage migration inhibitory factor levels and cognitive function in first-episode schizophrenia patients.Methods:A total of 83 first-episode schizophrenia patients who received risperidone monotherapy and 57 healthy controls – matched for sex, age, smoking status, education (years), marital status and waist-to-hip ratio – were included. Macrophage migration inhibitory factor levels were measured before and 10 weeks after treatment in the patient group and at baseline in the controls. Pre- and post-treatment cognitive functions in patients were assessed using the MATRICS Consensus Cognitive Battery.Results:At baseline, macrophage migration inhibitory factor levels were significantly higher in first-episode schizophrenia patients than those in healthy controls (p 
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-14T04:31:02Z
      DOI: 10.1177/00048674211013086
       
  • Factors that contribute to urban–rural gradients in risk of
           schizophrenia: Comparing Danish and Western Australian registers

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      Authors: Oleguer Plana-Ripoll, Patsy Di Prinzio, John J McGrath, Preben B Mortensen, Vera A Morgan
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Introduction:An association between schizophrenia and urbanicity has long been observed, with studies in many countries, including several from Denmark, reporting that individuals born/raised in densely populated urban settings have an increased risk of developing schizophrenia compared to those born/raised in rural settings. However, these findings have not been replicated in all studies. In particular, a Western Australian study showed a gradient in the opposite direction which disappeared after adjustment for covariates. Given the different findings for Denmark and Western Australia, our aim was to investigate the relationship between schizophrenia and urbanicity in these two regions to determine which factors may be influencing the relationship.Methods:We used population-based cohorts of children born alive between 1980 and 2001 in Western Australia (N = 428,784) and Denmark (N = 1,357,874). Children were categorised according to the level of urbanicity of their mother’s residence at time of birth and followed-up through to 30 June 2015. Linkage to State-based registers provided information on schizophrenia diagnosis and a range of covariates. Rates of being diagnosed with schizophrenia for each category of urbanicity were estimated using Cox proportional hazards models adjusted for covariates.Results:During follow-up, 1618 (0.4%) children in Western Australia and 11,875 (0.9%) children in Denmark were diagnosed with schizophrenia. In Western Australia, those born in the most remote areas did not experience lower rates of schizophrenia than those born in the most urban areas (hazard ratio = 1.02 [95% confidence interval: 0.81, 1.29]), unlike their Danish counterparts (hazard ratio = 0.62 [95% confidence interval: 0.58, 0.66]). However, when the Western Australian cohort was restricted to children of non-Aboriginal Indigenous status, results were consistent with Danish findings (hazard ratio = 0.46 [95% confidence interval: 0.29, 0.72]).Discussion:Our study highlights the potential for disadvantaged subgroups to mask the contribution of urban-related risk factors to risk of schizophrenia and the importance of stratified analysis in such cases.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-14T04:29:11Z
      DOI: 10.1177/00048674211009615
       
  • Clozapine treatment for Huntington’s disease psychosis

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      Authors: Tristan J Bampton, Daniel Hack, Cherrie A Galletly
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-13T12:21:03Z
      DOI: 10.1177/00048674211013082
       
  • Post-diagnosis young-onset dementia care in the National Disability
           Insurance Scheme

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      Authors: Monica Cations, Sally Day, Kate Laver, Adrienne Withall, Brian Draper
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Post-diagnosis service delivery for young-onset dementia (with onset prior to 65 years) recently moved to the disability system in an attempt to address systemic barriers to best practice in aged care. The objective of this study was to examine experiences and satisfaction with disability services so far among people with young-onset dementia and their care partners and identify strategies for service and system improvement.Methods:The 151 participating Australians living with young-onset dementia or providing informal care to a person with young-onset dementia were recruited via social media, advocacy bodies and specialist medical clinics. A cross-sectional online survey asked participants to provide a timeline of their interactions with the disability system so far and rate their satisfaction with the disability system, aged care and disability services.Results:Participants reported a mean age at symptom onset of 55 years. In all, 53% were diagnosed with Alzheimer’s disease and 25% were diagnosed with frontotemporal dementia. Sixty percent had received an approved plan from the National Disability Insurance Scheme, although 3% were rejected. More than 27% waited longer than 6 months to receive their plan, and half waited at least a month post-approval to access services. Less than 30% agreed that the National Disability Insurance Scheme understands dementia, and fewer than half felt that the process of accessing National Disability Insurance Scheme funding is easy and fast enough. Nonetheless, respondents remained overwhelmingly in favour of young-onset dementia services remaining in the disability system rather than in aged care.Conclusions:While people with young-onset dementia and their care partners strongly agree with their inclusion in the National Disability Insurance Scheme, a relatively low level of experience with dementia in the disability workforce and a lack of integration with the healthcare and aged care systems continue to create important barriers for accessing the services they need.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-13T12:19:41Z
      DOI: 10.1177/00048674211011699
       
  • Positioning TMS

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      Authors: Mark George, Saxby Pridmore
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-13T12:15:41Z
      DOI: 10.1177/00048674211011259
       
  • rTMS for depression: The difficult transition from research to clinical
           practice

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      Authors: Ali Amad, Thomas Fovet
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      The publication of the 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of mood disorders was followed by a series of correspondences discussing the place of repetitive transcranial magnetic stimulation (rTMS) in the sequence care for the routine treatment of depression. The controversy has led to an intense debate about the positioning of this neuromodulation technique in the clinical armamentarium for depression in the Australian and New Zealand Journal of Psychiatry. The many arguments presented by the authors to defend their respective points of view can be summarised in two main key issues: (i) the interpretation of the level of evidence of rTMS for depression and (ii) the characterisation of patients who could benefit from this treatment. In this viewpoint, we discuss the difficult transition from research to clinical practice regarding the use of rTMS to treat depression.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-13T12:15:18Z
      DOI: 10.1177/00048674211011242
       
  • A call to implement a multi-systems approach to suicide prevention in the
           justice system

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      Authors: Melanie L Simmons, Stuart Lee, Michelle Torok, Nina Papalia
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-11T04:34:59Z
      DOI: 10.1177/00048674211013098
       
  • Are the benefits of benzodiazepines for anxiety disorders underestimated
           and their risks overestimated'

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      Authors: Prashanth Tibrewal, Claudia Haeusler, Milanduth K Kanigere, Tarun Bastiampillai
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-11T04:29:13Z
      DOI: 10.1177/00048674211013089
       
  • Care for the mental health of foster children in the Asia-Pacific merits
           further study

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      Authors: Charlotte Solmssen, Timothy R Rice
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-11T04:27:53Z
      DOI: 10.1177/00048674211011252
       
  • Why does clozapine cause increased rebound psychosis and catatonia,
           compared to quetiapine'

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      Authors: Tarun Bastiampillai, Wini Wei Lam Woo, Sherry Kit Wa Chan, Pramod C Nair
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-11T04:25:13Z
      DOI: 10.1177/00048674211011246
       
  • Antipsychotic treatment in clinical high risk for psychosis: Iatrogenesis
           related to dopamine supersensitivity psychosis'

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      Authors: Tarun Bastiampillai, Sherry Kit Wa Chan, Stephen Allison, David Copolov, Jeffrey CL Looi
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-11T04:24:13Z
      DOI: 10.1177/00048674211011243
       
  • Evaluation of a Housing First programme for people from the public mental
           health sector with severe and persistent mental illnesses and precarious
           housing: Housing, health and service use outcomes

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      Authors: David Robert Dunt, Susan Elizabeth Day, Laura Collister, Beth Fogerty, Rosie Frankish, David J Castle, Cayte Hoppner, Simon Stafrace, Sharon Sherwood, J Richard Newton, Suzy Redston
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Aims and context:This paper reports the evaluation of the Doorway program (2015-18) in Melbourne, Australia. Doorway extends the original Housing First (HF) model in providing housing support to people with precarious housing at-risk of homelessness with Serious and Persistent Mental Illnesses (SPMIs) receiving care within Victoria’s public mental health system. Doorway participants source and choose properties through the open rental market, and receive rental subsidies, assistance, advocacy and brokerage support through their Housing and Recovery Worker (HRW). The aim of this study is to estimate Doorway’s impact on participants’ housing, quality of life and mental health service use.Methodology:The study employed a a quasi-experimental study design with a comparison group, adjusted for ten potential confounders. The primary outcome measure was days of secure housing per participant. Secure housing status, health service usage and quality of life (HoNOS) data were extracted from participants’ electronic hospital and Doorway records in deidentified, non-reidentifiable form. Analysis for continuous outcome variables was based on multivariate GLM modelling.Results:Doorway housed 89 (57%) of 157 accepted participants. The 157 Doorway participants overall were also housed for significantly more days (119.4 extra days per participant) than control participants, albeit after some delay in locating and moving into housing (mean 14 weeks). There was a significant, positive Doorway effect on health outcomes (all and one dimension of the HoNOS). Doorway participants had significantly reduced length of stay during acute and community hospital admissions (7.4 fewer days per participant) compared with the control group.Conclusion:The Doorway model represents a new and substantial opportunity to house, enhance health outcomes and reduce mental health service use for people with SPMIs from the public mental health sector and at-risk of homelessness.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-10T04:28:39Z
      DOI: 10.1177/00048674211011702
       
  • RANZCP clinical practice guidelines – time to digitise

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      Authors: William Lugg
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-06T05:04:45Z
      DOI: 10.1177/00048674211010341
       
  • Clozapine- and Olanzapine-induced oesophagitis and haematemesis: A case
           report

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      Authors: Edith Chau, Karuppiah Jagadheesan
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-06T05:03:05Z
      DOI: 10.1177/00048674211010333
       
  • Distinct clinical manifestations of obsessive-compulsive disorder are
           associated with cortical thickness alteration

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      Authors: Hai-di Shan, Ya-fei Liu, Qing Zhao, Yi Wang, Yong-ming Wang, Eric F Cheung, Raymond C Chan, Zhen Wang
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Background:Although brain structural changes have been reported in patients with obsessive-compulsive disorder (OCD), results from previous studies have been inconsistent. A growing number of studies have focused on obsessive beliefs and impulsivity which could be involved in the occurrence and maintenance of OCD symptoms. The present study aimed to examine whether there are distinct brain structural changes in patients with different OCD subgroups.Methods:Eighty-nine patients with OCD and 42 healthy controls were recruited to undergo structural magnetic resonance imaging brain scan. OCD patients were classified into subgroups according to scores of the Obsessive Belief Questionnaire (OBQ-44) and the Barratt Impulsiveness Scale (BIS-11) using cluster analysis. Group comparisons in cortical thickness and subcortical volumes between all OCD patients and healthy controls, as well as between subgroups of OCD patients and healthy controls, were carried out.Results:OCD patients with more obsessive beliefs and attentional impulsivity (OCD_OB_AT) had reduced cortical thickness at the inferior parietal gyrus, the superior and middle temporal gyrus and the insula compared with OCD patients with higher score on the non-planning impulsivity (OCD_NP, corrected p 
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-06T05:01:45Z
      DOI: 10.1177/00048674211009623
       
  • Occurrence and accuracy of a register-based diagnosis of pediatric bipolar
           disorder: A nationwide cohort study

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      Authors: Mathilde Frahm Laursen, Christoph U Correll, Rasmus W Licht, Maria Rodrigo-Domingo, Anne Katrine Pagsberg, René Ernst Nielsen
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:To investigate the accuracy of a diagnosis of pediatric bipolar disorder in the Danish National Register compared to the patient charts. Second, we reported on the occurrence of a diagnosis of pediatric bipolar disorder during the study period.Methods:All persons appearing in the Danish nationwide registers between 1995 and 2014 with an incident ICD-10 diagnosis of single hypomanic/manic episode or a diagnosis of bipolar disorder (summarized as bipolar disorder [BD]) before turning 18 years were identified (n = 521) and a random sample (n = 131) hereof was selected for chart review. Each chart was reviewed by two independent Schedules for Clinical Assessment in Neuropsychiatry (SCAN) certified raters to assess whether symptoms documented in the chart were consistent with a formal diagnosis of BD according to the ICD-10 criteria or not.Results:The formal diagnostic criteria for BD according to the ICD-10 were fulfilled in 48 charts (45.3%, 95% CI: [36.1%, 54.8%]) out of 106 reviewable charts, age at index = 16.4 ± 1.6 (range = 9.1–18.3) years. Cohen’s Kappa ranged from 94.4% to 100%. The estimate of a lifetime prevalence up till the current age for bipolar disorder for those of aged 5–18 years, was 0.019% in 2014.Conclusion:Less than half of the register-based pediatric BD diagnoses were confirmed by chart review, which was lower than expected. The occurrence of a register diagnosis of pediatric BD was relatively low.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-06T04:59:45Z
      DOI: 10.1177/00048674211009622
       
  • Comparison of accredited person and medical officer discharge decisions
           under the Mental Health Act of NSW: A cohort study of deliberate
           self-poisoning patients

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      Authors: Katie McGill, Matthew J Spittal, Jennifer Bryant, Terry J Lewin, Ian M Whyte, Clare Madden, Greg Carter
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Background:The Accredited Persons Programme was introduced in 2003. The relevant Mental Health Acts (NSW) authorised reviews by appropriately credentialed non-medical health professionals as part of the process of detaining and treating a person without consent: an authority previously held by medical officers. Evaluations of the Programme are needed.Objective:To compare discharge decisions for hospital-treated deliberate self-poisoning patients made by an Accredited Person and Medical Officers.Methods:For a 10-year cohort (2003–2012) of index hospital-treated deliberate self-poisoning admissions at the Calvary Mater Newcastle, we compared Accredited Person and Medical Officer discharge decisions from the general hospital. We specifically examined discharges to the psychiatric hospital under a Mental Health Act certificate (used as an index of the Accredited Person’s use of the authority under the Accredited Persons Programme) compared to any other discharge destination. Unadjusted and adjusted logistic regression models and a propensity score analysis were used to explore the relationship between clinician type and discharge destination.Results:There were 2237 index assessments (Accredited Person = 884; Medical Officer = 1443). One-quarter (27%) were referred for assessment under the Act at the psychiatric hospital, with the Accredited Person significantly more likely (32%) to require this compared to the Medical Officers (24%); Risk Difference: 8.3% (4.5 to 12.1). However, after adjusting for patient characteristics; Risk Difference: −3.0% (−5.9 to −0.1) and for propensity score, Risk Difference: −3.3% (−6.7 to 0.1), the Accredited Person and Medical Officer likelihood of discharging for an assessment under the Act was similar.Conclusions:The Accredited Person assessed more clinically complex patients than the Medical Officers. After adjusting for clinical complexity and propensity score, the likelihood of referral for involuntary psychiatric hospital care was similar for Accredited Person and Medical Officers. Our evaluation of the Accredited Person programme in the general hospital was favourable, and wider implementation and evaluation is warranted.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-06T04:49:43Z
      DOI: 10.1177/00048674211009613
       
  • Measuring drug concentrations in breast milk to improve therapeutic
           monitoring and patient adherence in bipolar disorder: A case report

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      Authors: Julia Pastol, Marguerite Le Marois, Romain Guilhaumou, Olivier Blin, Raoul Belzeaux
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-03T05:39:30Z
      DOI: 10.1177/00048674211010340
       
  • The 2020 mood disorders clinical practice guidelines: Dazzlingly
           bedazzling!

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      Authors: Gin S Malhi, Erica Bell, Darryl Bassett, Philip Boyce, Malcolm Hopwood, Greg Murray, Roger Mulder, Ajeet Singh, Richard Porter
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-03T05:34:22Z
      DOI: 10.1177/00048674211010262
       
  • Virtual guidance: Mood disorders guidelines ‘2. Oh’!

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      Authors: Gin S Malhi, Erica Bell, Darryl Bassett, Philip Boyce, Malcolm Hopwood, Greg Murray, Richard Porter, Ajeet Singh, Roger Mulder
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-03T05:32:42Z
      DOI: 10.1177/00048674211010244
       
  • Changing trends in quality of media reporting of suicide in the community
           following a celebrity suicide in India

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      Authors: Vikas Menon, Sujita Kumar Kar, Ramdas Ransing, Ginni Sharma, Jigyansa Ipsita Pattnaik, Charanya Kaliamoorthy, Natarajan Varadharajan, Srijeeta Mukherjee, Aditya Agrawal, Susanta Kumar Padhy, SM Yasir Arafat
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Little is known about changes in quality of media reporting of suicide in the community following a celebrity suicide. Our objective was to compare trends in quality of media reporting of suicide, before and after the suicide of an Indian entertainment celebrity, against the World Health Organization suicide reporting guidelines.Method:Online news portals of English and local language newspapers, as well as television channels, were searched to identify relevant suicide-related news articles. Comparison of reporting characteristics before and after the celebrity suicide was performed using chi-square test or Fisher’s exact test.Results:A total of 3867 eligible news reports were retrieved. There was a significant increase in harmful reporting characteristics, such as reporting the name, age and gender of the deceased (p 
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-03T05:28:22Z
      DOI: 10.1177/00048674211009618
       
  • Hospital-treated deliberate self-poisoning patients: Drug-induced delirium
           and clinical outcomes

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      Authors: Lindsay Gale, Katie McGill, Scott Twaddell, Ian M Whyte, Terry J Lewin, Gregory L Carter
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Drug-induced delirium has been attributed to opioid, benzodiazepine, antipsychotic, antihistaminic and anticholinergic drug groups at therapeutic doses. Delirium also occurs in hospital-treated self-poisoning (at supra-therapeutic doses), although the causative drug classes are not well established and co-ingestion is common. We tested the magnitude and direction of association of five major drug groups with incident cases of delirium.Methods:A retrospective longitudinal cohort (n = 5131) study was undertaken of deliberate and recreational/chronic misuse poisoning cases from a regional sentinel toxicology unit. We described ingestion and co-ingestion patterns and estimated the unadjusted and adjusted odds for developing a drug-induced delirium. We also estimated the odds of drug-induced delirium being associated with three outcomes: intensive care unit admission, general hospital length of stay and discharge to home.Results:Drug-induced delirium occurred in 3.9% of cases (n = 200). The unadjusted odds ratios for development of delirium were increased for anticholinergics 10.79 (5.43–21.48), antihistamines 6.10 (4.20–8.84) and antipsychotics 2.99 (2.20–4.06); non-significant for opioids 1.31 (95% confidence interval = [0.81, 2.13]); and reduced for benzodiazepines 0.37 (0.24–0.58); with little change after adjustment for age, gender and co-ingestion. Delirium was associated with intensive care unit admission, longer length of stay and discharge destination.Conclusion:Drug-induced delirium was uncommon in this population. Co-ingestion was common but did not alter the risk. In contrast to drug-induced delirium at therapeutic doses in older populations, opioids were not associated with delirium and benzodiazepines were protective. Drug-induced delirium required increased clinical services. Clinical services should be funded and prepared to provide additional supportive care for these deliriogenic drug group ingestions.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-03T05:19:22Z
      DOI: 10.1177/00048674211009608
       
  • An independent, replicable, functional and significant risk variant block
           at intron 3 of CACNA1C for schizophrenia

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      Authors: Zuxing Wang, Wenzhong Chen, Yuping Cao, Yikai Dou, Yingmei Fu, Yong Zhang, Xingqun Luo, Longli Kang, Na Liu, Yun Stone Shi, Chiang-shan R Li, Yifeng Xu, Xiaoyun Guo, Xingguang Luo
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objectives:Genome-wide association studies have identified a significant risk gene, CACNA1C, for schizophrenia. In this study, we comprehensively investigated a large set of CACNA1C single-nucleotide polymorphisms (SNPs) to identify the replicable risk alleles for schizophrenia and explore their biological functions.Methods:One Jewish (1044 cases vs 2052 controls), one European (1350 cases vs 1378 controls) and one exploratory African American samples (98 cases vs 20 controls) were analyzed to identify replicable single-nucleotide polymorphism–schizophrenia associations. The regulatory effects of risk alleles on CACNA1C messenger RNA expression were examined. The most robust risk tagSNP (rs1006737) was meta-analyzed on 17 studies (74,122 cases vs 109,062 controls), and associated with the gray matter volumes of seven subcortical structures in 38,258 Europeans, and the surface areas and thickness of 34 cortical regions in 33,992 Europeans and 2944 non-Europeans.Results:Forty-seven replicable risk single-nucleotide polymorphisms, including a 20-single-nucleotide polymorphism haplotype block, were identified in our samples (1.8 × 10−4 ⩽ p ⩽ 0.049). This variant block was consistently associated with schizophrenia across four independent Psychiatric Genomics Consortium cohorts (79,645 cases vs 109,590 controls; 2.5 × 10–17 ⩽ p ⩽ 0.017). This block showed significant expression quantitative trait loci in three independent European brain cohorts (5.1 × 10–12 ⩽ p ⩽ 8.3 × 10–3) and could be tagged by the most significant risk single-nucleotide polymorphism rs1006737. The minor allele A of rs1006737 significantly increased risk for schizophrenia across the Jewish and European samples (p = 0.029 and 0.004, respectively), and this association was highly significant in the meta-analysis (p = 1.62 × 10–42). This allele also significantly altered the CACNA1C messenger RNA expression in five brain regions (5.1 × 10–12 ⩽ p ⩽ 0.05), decreased the gray matter volume of thalamus (p = 0.010), the surface area of isthmus cingulate cortex (p = 0.013) and the thickness of transverse temporal and superior temporal sulcus cortexes (0.005 ⩽ p ⩽ 0.043).Conclusion:We identified an independent, replicable, functional, and significant risk variant block at CACNA1C for schizophrenia, which could be tagged by the most robust risk marker rs1006737, suggesting an important role of CACNA1C in the pathogenesis of schizophrenia.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-03T05:07:00Z
      DOI: 10.1177/00048674211009595
       
  • Concordance between adolescents and parents on the Strengths and
           Difficulties Questionnaire: Analysis of an Australian nationally
           representative sample

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      Authors: Emma J Gray, James G Scott, David M Lawrence, Hannah J Thomas
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective: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.Methods:The study comprised a randomly selected, nationally representative sample 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 sample by age group (younger adolescents: 11–14 years; older adolescents: 15–17 years).Results: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.Conclusion: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.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-04-30T08:00:17Z
      DOI: 10.1177/00048674211009610
       
  • Tobacco smoking and mental disorders in Australian adolescents

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      Authors: David Lawrence, Sarah E Johnson, Francis Mitrou, Sharon Lawn, Michael Sawyer
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objectives:This study aimed to (1) examine the strength of the association between mental disorders/mental health problems, risk behaviours and tobacco smoking among Australian adolescents, (2) compare rates of tobacco smoking among Australian adolescents with major depressive disorder, attention-deficit/hyperactivity disorder and/or conduct disorder in 2013/14 vs 1998, and (3) identify the extent to which an association between tobacco smoking and mental health problems among adolescents can be attributed to non-mental health risk factors.Methods:The study utilised data from the first (1998) and second (2013/14) child and adolescent components of the National Surveys of Mental Health and Wellbeing. Both surveys identified nationally representative samples of Australian young people aged 4–17 years, living in private dwellings. Information was collected from parents and 13- to 17-year-olds about mental disorders, mental health problems, risk behaviours and tobacco smoking.Results:In the 2013/14 survey, the rate of current tobacco smoking among those with a mental disorder was 20% compared to 5% in those without a mental disorder. Rates were highest for young people with conduct disorder (50%), major depressive disorder (24%) and anxiety disorders (19%). In 2013/14, 38% of current tobacco smokers had a mental disorder and 32% reported self-harm and/or suicidal ideation vs 10% and 5%, respectively, among adolescents who had never smoked. Females with mental disorders or reporting self-harm or suicidal ideation had higher rates of current smoking than males. Other significant factors associated with current smoking included school-related problems, binge eating and having had more than one sexual partner.Conclusion:While smoking rates in 13- to 17-year-olds with mental disorders had declined since 1998, the strength of the association between mental disorders and smoking had increased, especially among females. Our findings highlight the need to address the tobacco smoking among adolescents with mental disorders, particularly females.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-04-28T10:19:08Z
      DOI: 10.1177/00048674211009617
       
  • Suicide crisis calls to emergency services: Cohort profile and findings
           from a data linkage study in Queensland, Australia

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      Authors: Carla Meurk, Lisa Wittenhagen, Emma Bosley, Megan L Steele, Denise Bunting, Elissa Waterson, Bronwen Edwards, Ben Martain, Ed Heffernan
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Background and Aims:Police and paramedics play a crucial role in responding to suicide crises in the community. However, little is known about the nature, extent, precipitating factors, pathways and outcomes of a suicide-related call to emergency services and what responses will most effectively and compassionately meet the needs of those in crisis. Partners in Prevention: Understanding and Enhancing First Responses to Suicide Crisis Situations (PiP) was established to address these knowledge gaps.Methods:This article describes (1) the methodology used to construct the PiP dataset, a population-wide linked dataset that investigates the characteristics and health pathways of individuals in Queensland who were the subject of a suicide-related call to police or paramedics; and (2) preliminary findings on service demand, demographics and health services utilisation.Results:We identified 219,164 suicide-related calls to Queensland Police Service or Queensland Ambulance Service that were made over the 3-year period 1 February 2014 to 31 January 2017. A total of 70,893 individuals were identifiable via records linkage. The cohort linked to more than 7,000,000 health records. We estimated that police or paramedics in Queensland received on average 209 calls per day, with increases year on year over the study period. Analysis of demographic data highlighted the heterogeneous nature of this cohort and important demographic variations between individuals in contact with police versus ambulance services.Discussion:The PiP dataset provides a strong foundation for a multi-modal dataset that can be built on over time, both cross-sectionally and longitudinally. Further linkages to Medicare Benefits Schedule, Pharmaceutical Benefits Scheme and social care datasets are planned.Conclusion:Detailed population-level analysis that data linkage can provide is critical to improving understanding and responses to suicide crisis situations. The PiP study is a world first and provides a unique opportunity to improve responses to this public health problem.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-04-27T09:23:52Z
      DOI: 10.1177/00048674211009604
       
  • Ageing with psychosis – Fifty and beyond

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      Authors: Cherrie Galletly, Shuichi Suetani, Lisa Hahn, Duncan McKellar, David Castle
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:While there is considerable current emphasis on youth and early psychosis, relatively little is known about the lives of people who live with psychotic disorders into middle age and beyond. We investigated social functioning, physical health status, substance use and psychiatric symptom profile in people with psychotic disorders aged between 50 and 65 years.Methods:Data were collected as part of the Survey of High Impact Psychosis, a population-based survey of Australians aged 18–65 years with a psychotic disorder. We compared those aged 50–65 years (N = 347) with those aged 18–49 years (N = 1478) across a range of measures.Results:The older group contained more women and more people with affective psychoses compared to the younger group. They were also more likely to have had a later onset and a chronic course of illness. The older group were more likely to have negative symptoms but less likely to exhibit positive symptoms; they also had lower current cognition, compared to the younger group. Compared to the younger group, the older group were more likely to be divorced/separated, to be living alone and to be unemployed. They had substantially lower lifetime use of alcohol and illicit substances, but rates of obesity, metabolic syndrome and diabetes mellitus were higher.Conclusion:Our findings suggest that the characteristics of people with psychosis change significantly as they progress into the middle age and beyond. A better understanding of these differences is important in informing targeted treatment strategies for older people living with psychosis.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-04-27T09:23:33Z
      DOI: 10.1177/00048674211009619
       
  • Course trajectories of anxiety disorders: Results from a 6-year follow-up
           in a general population study

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      Authors: Simone ME Schopman, Margreet ten Have, Anton J van Balkom, Ron de Graaf, Neeltje M Batelaan
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Little is known about the course of anxiety disorders in the general population. This study provides insights into the course of anxiety disorders in the general population taking into account transition to residual symptoms and to other diagnostic categories.Methods:Using data from three waves of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2; n = 6646), subjects with anxiety disorders (T0; n = 243) were divided into three mutually exclusive course trajectories according to their diagnostic status at 3-year (T1) and 6-year (T2) follow-up: remission group (no disorder at T2), intermittent course group (no disorder at T1 and disorder at T2) and chronic course group (disorder at all measurements). Transition to residual symptoms or other psychopathology were studied. In addition, predictors of course trajectories were assessed.Results:During 6-year follow-up, 77.8% of subjects achieved remission, 14.0% followed an intermittent course and 8.2% a chronic course. Of those in remission, residual anxiety symptoms remained in 46.6%, while 7.9% developed another disorder between T0 and T2. Compared with the remitting group, a chronic course was predicted by not living with a partner, multiple negative life events, neuroticism, lower mental functioning, severity of anxiety symptoms, use of mental health care and medication use.Limitations:The intermittent and chronic course groups were small, limiting statistical power. As a result, certain predictors may not have reached significance.Conclusions:In the general population at 6-year follow-up, 77.8% of subjects with anxiety disorders achieved remission. Because of transition to residual symptoms or another diagnostic category, only 52.4% of those subjects had a true favourable outcome.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-04-23T05:02:24Z
      DOI: 10.1177/00048674211009625
       
  • The regulation of driving with non-epileptic seizures must be made clearer

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      Authors: Richard A Kanaan, Kasia Kozlowska, Alex Lehn
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Patients with epilepsy have their authorisation to drive restricted under detailed guidelines, but the rules for those with non-epileptic seizures are far less clear. We surveyed specialist clinicians in Australia and found little agreement as to whether such guidelines existed for non-epileptic seizures or what they might be. A number of possible interpretations of the Australian fitness to drive guidelines are explored, and these are often vague in themselves, as well as uncertain in their scope. This means clinicians making momentous driving decisions for their patients with non-epileptic seizures are doubly challenged, first in interpreting what guidelines exist, and second in what they mean. The International League Against Epilepsy proposed specific guidelines for driving with non-epileptic seizures, which reflect the range of presentations of non-epileptic seizures in a decision-making algorithm. We believe a specific algorithm such as this is essential in removing one level of uncertainty and responsibility for clinicians, and restoring equity for patients with non-epileptic seizures.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-04-23T04:59:44Z
      DOI: 10.1177/00048674211009621
       
  • Medicinal psychedelics for mental health and addiction: Advancing research
           of an emerging paradigm

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      Authors: Daniel Perkins, Jerome Sarris, Susan Rossell, Yvonne Bonomo, David Forbes, Christopher Davey, Daniel Hoyer, Colleen Loo, Greg Murray, Sean Hood, Violeta Schubert, Nicole Leite Galvão-Coelho, Meaghen O’Donnell, Olivia Carter, Paul Liknaitzky, Martin Williams, Dan Siskind, David Penington, Michael Berk, David Castle
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      The medical use of psychedelic substances (e.g. psilocybin, ayahuasca, lysergic acid diethylamide and 3,4-methylenedioxymethamphetamine) is attracting renewed interest, driven by a pressing need for research and development of novel therapies for psychiatric disorders, as well as promising results of contemporary studies. In this Viewpoint, we reflect upon the ‘Clinical Memorandum on Psychedelics’ recently released by the Royal Australian and New Zealand College of Psychiatrists and note subsequent developments including the application for down-scheduling of psilocybin and 3,4-methylenedioxymethamphetamine presently being considered by the Therapeutic Goods Administration and approvals for access via the Special Access Scheme. We suggest that this field is worthy of rigorous research to assess potential benefits, address safety parameters and clarify therapeutic mechanisms. To this end, we outline recent research findings, provide an overview of current knowledge relating to mechanisms of action and discuss salient aspects of the psychedelic-assisted psychotherapy treatment model. The sum of this research points towards medicinal psychedelics as a potential new class of psychiatric treatments when used within a medically supervised framework with integrated psychotherapeutic support. However, before widespread translation into clinical use can occur, appropriately designed and sufficiently powered trials are required to detect both potential positive and negative outcomes. Unique safety and regulatory challenges also need to be addressed. As for any new medical therapy, psychedelic research needs to be conducted in a rigorous manner, through the dispassionate lens of scientific enquiry. Carte blanche availability to practitioners, without specific protocols and appropriate training, would be potentially harmful to individuals and detrimental to the field.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-03-22T04:26:22Z
      DOI: 10.1177/0004867421998785
       
  • Fatal poisonings involving clozapine: A 16-year review of Australian
           coronial investigations

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      Authors: Jessica L Dawson, Janet K Sluggett, Jennifer L Schumann, Nicholas G Procter, J Simon Bell
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Concerns about intentional and unintentional poisoning present a barrier to wider use of clozapine in treatment-resistant schizophrenia. The objective of this study was to investigate decedent demographics and trends in fatal poisonings in Australia involving clozapine.Methods:This was a retrospective case series of all fatal drug toxicity reported to an Australian coroner between 1 May 2000 and 31 December 2016 where toxicological analysis detected clozapine. Cases were identified using the National Coronial Information System. Demographics extracted included age and gender of the decedent, year and location of death, cause and manner of death and drugs detected in post-mortem samples.Results:There were 278 poisoning deaths where clozapine was detected in toxicological analyses. Three-quarters of all cases (n = 207) involved men and the median age at death was 38.5 years (interquartile range: 16 years). Three-quarters of the deaths occurred in the home. Overall, 15.8% of deaths were deemed intentional, 57.5% unintentional and 24.5% of unknown intent. While the annual number of intentional self-poisonings remained constant with 
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-03-19T04:56:46Z
      DOI: 10.1177/0004867421998788
       
  • Gray matter volume differences between transgender men and cisgender
           women: A voxel-based morphometry study

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      Authors: Taku Fukao, Kazutaka Ohi, Toshiki Shioiri
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Gender dysphoria (GD) is characterized by distress due to inconsistency between gender identity and biological sex. Individuals with GD often desire to be the other gender, which is called transgender. Although altered brain volumes in transgender people, particularly transgender women, have been reported, the particular brain regions have been inconsistent among studies. This study aimed to investigate neuroanatomical differences in transgender men without physical interventions.Method:T1-weighted magnetic resonance images (MRIs) were acquired in 21 transgender men and 21 cisgender women matched for biological sex and age. Whole-brain comparisons using voxel-based morphometry (VBM) were performed to identify gray matter volume (GMV) differences between transgender men and cisgender women.Results:Transgender men showed greater GMV in the right posterior cingulate gyrus (PFWE-corr = 3.06×10-6) and the left occipital pole (PFWE-corr = 0.017) and lower GMV in the left middle temporal gyrus (PFWE-corr = 0.017) than cisgender women. Even after including serum sex hormone levels as covariates, the posterior cingulate gyrus was still significant (PFWE-corr  0.05), especially affected by testosterone but not estradiol.Conclusion:These findings suggest that transgender men have altered brain structure. We suggest that larger posterior midline structures may contribute to sensitivity to self-referential processing through altered visual perception in transgender people.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-03-17T05:22:13Z
      DOI: 10.1177/0004867421998801
       
  • Physical diseases and elderly suicide in rural China: A case–control
           psychological autopsy study

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      Authors: Guojun Wang, Cunxian Jia, Zhenyu Ma, Liang Zhou
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objectives:Physical diseases are well-established risk factor for suicide, particularly among older adults. However, little is known about the underlying mechanism of the association. This study aimed to describe the prevalence of physical diseases and their influences on the elderly in rural China and to examine the underlying mechanisms of the relationship between physical diseases and suicide.Methods:This matched case–control psychological autopsy study was conducted from June 2014 to September 2015. Consecutive suicide cases (242) among people aged 60 years or above were identified in three Chinese provinces. The suicide cases were 1:1 matched with living comparisons based on age, gender and residential area. Two informants for each participant were interviewed to collect data on their demographic characteristics, the severity index of physical diseases, depressive symptoms, feelings of hopelessness, mental disorders and social support.Results:A significant difference was found between suicide cases and living comparisons regarding the prevalence of physical diseases (83.5% vs 66.5%, p 
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-03-17T05:18:23Z
      DOI: 10.1177/0004867421998804
       
  • Emotional availability in women with bipolar disorder and major
           depression: A longitudinal pregnancy cohort study

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      Authors: Pavitra Aran, Andrew J Lewis, Stuart J Watson, Thinh Nguyen, Megan Galbally
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Poorer mother–infant interaction quality has been identified among women with major depression; however, there is a dearth of research examining the impact of bipolar disorder. This study sought to compare mother–infant emotional availability at 6 months postpartum among women with perinatal major depressive disorder, bipolar disorder and no disorder (control).Methods:Data were obtained for 127 mother–infant dyads from an Australian pregnancy cohort. The Structured Clinical Interview for the DSM-5 was used to diagnose major depressive disorder (n = 60) and bipolar disorder (n = 12) in early pregnancy (less than 20 weeks) and review diagnosis at 6 months postpartum. Prenatal and postnatal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, along with self-report psychotropic medication use. Mother and infant’s interaction quality was measured using the Emotional Availability Scales when infants reached 6 months of age. Multivariate analyses of covariance examining the effects of major depressive disorder and bipolar disorder on maternal emotional availability (sensitivity, structuring, non-intrusiveness, non-hostility) and child emotional availability (responsiveness, involvement) were conducted.Results:After controlling for maternal age and postpartum depressive symptoms, perinatal disorder (major depressive disorder, bipolar disorder) accounted for 17% of the variance in maternal and child emotional availability combined. Compared to women with major depressive disorder and their infants, women with bipolar disorder and their infants displayed lower ratings across all maternal and child emotional availability qualities, with the greatest mean difference seen in non-intrusiveness scores.Conclusions:Findings suggest that perinatal bipolar disorder may be associated with additional risk, beyond major depressive disorder alone, to a mother and her offspring’s emotional availability at 6 months postpartum, particularly in maternal intrusiveness.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-03-17T05:12:52Z
      DOI: 10.1177/0004867421998796
       
  • Odour identification impairment is a trait but not a disease-specific
           marker for bipolar disorders: Comparisons of bipolar disorder with
           different episodes, major depressive disorder and schizophrenia

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      Authors: Shu-bin Li, Ze-tian Li, Zhi-hong Lyu, Xiao-yuan Zhang, Lai-quan Zou
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Olfactory deficits have been reported in bipolar disorder, but this finding is controversial. This study investigated whether olfactory deficit can serve as a specific marker for bipolar disorder by comparing olfactory function in different mood episodes of bipolar disorder. We also compared olfactory function in bipolar disorder and other mental disorders – namely, major depressive disorder and schizophrenia.Methods:The study consisted of two experiments. Experiment 1 enrolled 175 bipolar disorder patients (70 depressed subgroup, 70 manic subgroup and 35 euthymic subgroup) and 47 controls. Experiment 2 enrolled the participants from Experiment 1, along with 85 major depressive disorder and 90 schizophrenia patients. The Sniffin’ Sticks test was used to evaluate odour identification ability and odour threshold (as a measure of odour sensitivity). The Hamilton Depression Rating Scale and Young Mania Rating Scale were used to assess depressive symptoms in all subjects and manic symptoms in bipolar disorder patients, respectively. We also used the Positive and Negative Syndrome Scale to assess clinical symptoms in schizophrenia patients.Results:All three bipolar disorder patient subgroups (depressed, manic and euthymic subgroup) showed reduced odour identification ability compared to controls; however, only patients in the acute phase of a mood episode (depressed, and manic subgroup) showed impaired odour sensitivity. Clinical symptoms were negatively correlated with odour sensitivity but not odour identification ability. Bipolar disorder and major depressive disorder patients showed less odour identification and sensitivity impairment than schizophrenia patients.Conclusion:Odour sensitivity is a potential dopaminergic marker for distinguishing between bipolar disorder patients in acute phase vs remission, while odour identification is a trait but a nonspecific marker of bipolar disorder.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-03-17T05:09:50Z
      DOI: 10.1177/0004867421998774
       
  • Prevalence and management of people with eating disorders presenting to
           primary care: A national study

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      Authors: Lorraine Ivancic, Sarah Maguire, Jane Miskovic-Wheatley, Christopher Harrison, Natasha Nassar
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Primary care practitioners are well placed to support diagnosis and appropriate treatment of eating disorders as they are often the first point of contact with the health care system. However, little is known about management of eating disorders in primary care. We aimed to estimate the prevalence of management of eating disorders in primary care and identify how these disorders are managed.Methods:This study used data from the Bettering the Evaluation of Care of Health programme, which annually surveys 1000 randomly sampled general practitioners in Australia who each record details of 100 successive patient encounters. In total, data were utilised from 1,568,100 primary care encounters between 2000/2001 and 2015/2016.Results:Eating disorders were managed in less than 1% of primary care encounters between 2000/2001 and 2015/2016. When extrapolated to the Australian population, up to 0.32% of the population were managed in primary care for a primary or probable eating disorder. In the majority of encounters where an eating disorder was managed (58.5%), the encounter was initiated for reasons other than the eating disorder itself. Of a group of patients identified with a clinically significant low body mass index (N = 5917), a small number (n = 118) had either no other diagnosis or a related condition that may be indicative of an eating disorder. In encounters where an eating disorder was managed, referrals to a mental health specialist/service, medical specialist and nutritionist/dietician were provided in 20%, 8% and 6% of encounters, respectively. Mental health treatment plans, which provide subsidised access to mental health services, were ascribed in approximately 7.7% of encounters where an eating disorder was managed.Conclusion:Primary care provides an opportunity to improve detection and management of eating disorders, particularly when patients present for ‘other’ issues or with unexplained low body mass index and one or more symptoms related to an eating disorder.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-03-16T04:33:20Z
      DOI: 10.1177/0004867421998752
       
  • When your patient requests involuntary treatment: A case report of a
           collaborative approach to treatment under the mental health act in
           anorexia nervosa and borderline personality disorder

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      Authors: Lucy McPhate, Lara McCartney, Hamish Lewis
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-03-15T07:24:08Z
      DOI: 10.1177/0004867421998803
       
  • Valuing the voice of lived experience of eating disorders in the research
           process: Benefits and considerations

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      Authors: Selma Musić, Rosiel Elwyn, Grace Fountas, Inge Gnatt, Zoe M Jenkins, Amy Malcolm, Stephanie Miles, Erica Neill, Tamara Simpson, Caitlin OB Yolland, Andrea Phillipou
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Although the inclusion of individuals with lived experience is encouraged within the research process, there remains inconsistent direct involvement in many mental health fields. Within the eating disorders field specifically, there is a very strong and increasing presence of lived experience advocacy. However, due to a number of potential challenges, research undertaken in consultation or in collaboration with individuals with lived experience of an eating disorder is scarce. This paper describes the significant benefits of the inclusion of individuals with lived experience in research. The specific challenges and barriers faced in eating disorders research are also outlined. It is concluded that in addition to existing guidelines on working with lived experience collaborators in mental health research, more specific procedures are required when working with those with eating disorders.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-03-15T07:20:33Z
      DOI: 10.1177/0004867421998794
       
  • Don’t forget about catatonia hidden behind bars

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      Authors: Marion Eck, Ali Amad, Mathilde Horn, Pierre Thomas, Thomas Fovet
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-03-15T07:19:16Z
      DOI: 10.1177/0004867421998782
       
  • Emotional dysregulation mediates the impact of childhood trauma on
           psychological distress: First Italian data during the early phase of
           COVID-19 outbreak

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      Authors: Delfina Janiri, Lorenzo Moccia, Luigi Dattoli, Maria Pepe, Marzia Molinaro, Valentina De Martin, Daniela Chieffo, Marco Di Nicola, Andrea Fiorillo, Luigi Janiri, Gabriele Sani
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Background:The coronavirus disease 2019 pandemic represents an unprecedented traumatic stressor to mental health. Psychological distress is considered a reliable proxy for psychopathology and can be negatively influenced by childhood trauma through sensitization effects. Emotion dysregulation has been proposed as a potential mediator of this mechanism. We aimed to test this hypothesis in a national Italian sample assessed in the early phase of the coronavirus disease 2019 outbreak.Methods:We investigated the relationship between psychological distress and childhood trauma in 500 healthy participants assessed through a survey-based study, after the coronavirus disease 2019 pandemic lockdown in Italy. Levels of psychological distress and history of childhood trauma were obtained using the Kessler-10 (K10) and the Childhood Trauma Questionnaire, respectively. We used bootstrapped mediation analysis to test the mediator role of emotional dysregulation, measured through the Difficulties in Emotion Regulation Scale, on the effect of childhood trauma on psychological distress.Results:In total, 190 (38%) reported psychological distress related to the coronavirus disease 2019 outbreak. Individuals with psychological distress experienced more childhood trauma, specifically emotional abuse (F = 23.51, df = 1, p 
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-03-10T04:46:07Z
      DOI: 10.1177/0004867421998802
       
  • Venlafaxine and desvenlafaxine to be included in the surface water Watch
           List

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      Authors: Unax Lertxundi, Saioa Domingo-Echaburu, Rafael Hernandez, Juan Medrano, Gorka Orive
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-02-27T05:48:08Z
      DOI: 10.1177/0004867421998787
       
  • Cognitive screening in electroconvulsive therapy: Don’t forget
           subjective cognition

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      Authors: Kate Eggleston, Richard Porter
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-02-27T05:46:28Z
      DOI: 10.1177/0004867421998784
       
  • Is the needle as risky as the knife' The prevalence and risks of body
           dysmorphic disorder in women undertaking minor cosmetic procedures

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      Authors: Toni D Pikoos, Susan L Rossell, Nicky Tzimas, Simone Buzwell
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objectives:Body dysmorphic disorder is commonly considered a contraindication for major cosmetic surgery, but whether body dysmorphic disorder relates to poorer outcomes from minor cosmetic treatment remains unknown. This study aimed to explore the prevalence of body dysmorphic disorder in clients seeking non-surgical cosmetic procedures and to examine whether body dysmorphic disorder clients are vulnerable in minor cosmetic settings. Vulnerability was explored in terms of psychological distress, unrealistic expectations and motivations for treatment outcome, and reduced satisfaction with past cosmetic procedures.Method:A cross-sectional online survey was completed by 154 women seeking minor cosmetic procedures which included the Body Dysmorphic Disorder Questionnaire – Dermatology Version to screen for body dysmorphic disorder, and measures of cosmetic treatment motivation, expectations and satisfaction.Results:Roughly 25% of women in the current sample screened positive for a potential body dysmorphic disorder diagnosis. Participants with suspected body dysmorphic disorder demonstrated higher levels of psychological distress and more unrealistic expectations and motivations for cosmetic treatment, such as improving social or romantic relationships. However, body dysmorphic disorder participants reported similar levels of satisfaction with past minor cosmetic treatments to the non–body dysmorphic disorder group.Conclusion:While the relationship between body dysmorphic disorder and treatment outcome warrants further investigation in prospective research tracking satisfaction and adverse reactions over time, this preliminary evidence suggests clients with suspected body dysmorphic disorder display several vulnerabilities in non-surgical cosmetic settings. Given the rapidly increasing accessibility of minor cosmetic procedures, further research is needed to determine their safety for clients with body dysmorphic disorder. Detection of body dysmorphic disorder in non-surgical cosmetic settings could facilitate earlier psychological intervention, promoting superior long-term outcomes.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-02-27T05:19:29Z
      DOI: 10.1177/0004867421998753
       
  • Psychosis in hypoxic-ischemic brain injury: Organic or postpartum'

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      Authors: Suravi Patra, Suprava Naik, Menka Jha, Tanu Kumari
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-02-01T07:15:18Z
      DOI: 10.1177/0004867420982067
       
  • Responses to the opinion-based algorithms driving the National Mental
           Health Service Planning Framework

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      Authors: Stephen Allison, Tarun Bastiampillai, Jeffrey CL Looi, David Copolov
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-01-13T07:30:44Z
      DOI: 10.1177/0004867420987890
       
  • Outcomes of Victorian Prevention and Recovery Care Services: A matched
           pairs comparison

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      Authors: John Farhall, Lisa Brophy, John Reece, Holly Tibble, Long Khanh-Dao Le, Cathrine Mihalopoulos, Justine Fletcher, Carol Harvey, Emma Morrisroe, Richard Newton, Georgina Sutherland, Matthew J Spittal, Graham Meadows, Ruth Vine, Jane Pirkis
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:In Victoria, Prevention and Recovery Care Services have been established to provide a partial alternative to inpatient admissions through short-term residential mental health care in the community. This study set out to determine whether Prevention and Recovery Care Services are achieving their objectives in relation to reducing service use and costs, fostering least restrictive care and leading to positive clinical outcomes.Methods:We matched 621 consumers whose index admission in 2014 was to a Prevention and Recovery Care (‘PARCS consumers’) with 621 similar consumers whose index admission in the same year was to an acute inpatient unit and who had no Prevention and Recovery Care stays for the study period (‘inpatient-only consumers’). We used routinely collected data to compare them on a range of outcomes.Results:Prevention and Recovery Care Services consumers made less subsequent use of acute inpatient services and, on balance, incurred costs that were similar to or lower than inpatient-only consumers. They were also less likely to spend time on an involuntary treatment order following their index admission. Prevention and Recovery Care Services consumers also experienced positive clinical outcomes over the course of their index admission, but the magnitude of this improvement was not as great as for inpatient-only consumers. This type of clinical improvement is important for Prevention and Recovery Care Services, but they may place greater emphasis on personal recovery as an outcome.Conclusion:Prevention and Recovery Care Services can provide an alternative, less restrictive care option for eligible consumers who might otherwise be admitted to an acute inpatient unit and do so at no greater cost.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-01-11T09:38:47Z
      DOI: 10.1177/0004867420983473
       
  • Paranoia in patients attending child and adolescent mental health services

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      Authors: Jessica C Bird, Emma C Fergusson, Miriam Kirkham, Christina Shearn, Ashley-Louise Teale, Lydia Carr, Hannah J Stratford, Antony C James, Felicity Waite, Daniel Freeman
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Paranoia may be particularly prevalent during adolescence, building on the heightened social vulnerabilities at this age. Excessive mistrust may be corrosive for adolescent social relationships, especially in the context of mental health disorders. We set out to examine the prevalence, symptom associations, and persistence of paranoia in a cohort of young people attending child and adolescent mental health services.Method:A total of 301 patients (11–17 years old) completed measures of paranoia, affect, peer difficulties and behavioural problems. Clinicians also rated each participant’s psychiatric symptoms. Patterns of association were examined using linear regressions and network analyses. In total, 105 patients repeated the measures several months later.Results:Most of the adolescents had affective disorders (n = 195), self-harm/suicidality (n = 82), or neurodevelopmental conditions (n = 125). Few had suspected psychosis (n = 7). Rates of paranoia were approximately double compared with previous reports from the general population. In this patient sample, 35% had at least elevated paranoia, 15% had at least moderate paranoia, and 6% had high paranoia. Paranoia had moderate associations with clinician-rated peer difficulties, self-harm, and trauma, and small associations with clinician-rated social anxiety, depression, generalised anxiety, and educational problems. Network analyses showed paranoia had the strongest unique relationship with peer difficulties. Paths from peer difficulties to anxiety, self-harm, post-traumatic stress disorder symptoms, and behavioural problems were all via paranoia. Both self-harm and post-traumatic stress disorder were solely associated with paranoia in the network. Paranoia remained persistent for three-quarters and was associated with greater psychological problems over time.Conclusion:Paranoia is relatively common and persistent across a range of clinical presentations in youth. When paranoia occurs alongside emotional problems, important peer interactions may be adversely affected. Wider consideration of paranoia in adolescent patients is needed.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-01-11T05:49:36Z
      DOI: 10.1177/0004867420981416
       
  • Atypical diabetes mellitus caused by olanzapine

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      Authors: Takahiko Nagamine
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-01-09T09:53:43Z
      DOI: 10.1177/0004867420984232
       
  • Zero Suicide requires a radical reimagining of inpatient care

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      Authors: Hannah Myles, Shih Yang Tan, Matthew Large
      First page: 935
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-07T11:12:36Z
      DOI: 10.1177/00048674211025720
       
  • The productivity commission report on mental health: Recommendations with
           negative consequences for clinical care in public and private sectors

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      Authors: Jeffrey CL Looi, Stephen R Kisely, Stephen Allison, Tarun Bastiampillai, William Pring
      First page: 937
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-03-15T07:20:14Z
      DOI: 10.1177/0004867421998789
       
  • The neuroscience of early intervention: Moving beyond our appeals to fear

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      Authors: Lena Palaniyappan
      First page: 942
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      This viewpoint is a continuation of the debate on the early intervention movement in psychiatry. The criticisms of Malhi and colleagues have generated some fundamental questions about the priorities of the early intervention movement and the need for further work. In particular, the summons sent to neuroscience need to be more specific in the near future. We may be doing well with what we have, but more directed efforts are needed to purposefully seek what we do not.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-02-27T05:28:08Z
      DOI: 10.1177/0004867421998765
       
  • Systematic review of the effects of evidence-based psychotherapies on
           neurocognitive functioning in mood disorders

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      Authors: Samantha J Groves, Katie M Douglas, Melissa Milanovic, Christopher R Bowie, Richard J Porter
      First page: 944
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Neurocognitive impairment is considered a core feature of mood disorders. Research has shown that neurocognitive impairment often persists beyond mood symptom resolution and can have significant deleterious effects on interpersonal relationships, academic achievement, occupational functioning and independent living. As such, neurocognitive impairment has become an important target for intervention. In this systematic review, we aimed to examine the extant literature to ascertain whether current standard evidence-based psychotherapies can improve neurocognitive functioning in mood disorders.Method:Studies examining changes in neurocognitive functioning following evidence-based psychotherapy were identified using MEDLINE, PsycINFO and Web of Science databases. Given the heterogeneity of study procedures, treatment protocols and patient samples, a narrative rather than meta-analytic review technique was employed.Results:Nineteen studies (21 articles) met inclusion criteria. There was preliminary evidence of improved executive functioning following evidence-based psychotherapy for Major Depressive Disorder and Bipolar Disorder. There was also some signal of reduced negative biases in emotional information processing following psychotherapy in depression. Due to methodological variability across studies however, it was difficult to draw clear conclusions.Conclusion:Findings from the current review suggest that evidence-based psychotherapies may influence some aspects of neurocognitive functioning in mood disorders. This continues to be an ongoing area of importance and warrants further research.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-07-19T10:05:10Z
      DOI: 10.1177/00048674211031479
       
  • Characteristics of people on long-acting injectable antipsychotics in
           Australia: Data from the 2010 National Survey of High Impact Psychosis

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      Authors: Shuichi Suetani, Dan Siskind, Andrea Phillipou, Anna Waterreus, Vera A Morgan, David Castle
      First page: 958
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:This study investigates (1) the proportion of people with psychosis who are on long-acting injectable antipsychotics; (2) the difference in the demographic, clinical, substance use and adverse drug reaction profiles of people taking long-acting injectables compared to oral antipsychotics; and (3) the differences in the same profiles of those on first-generation antipsychotic versus second-generation antipsychotic long-acting injectables.Methods:Data were collected as part of the Survey of High Impact Psychosis. For this study, participants with diagnoses of schizophrenia or schizoaffective disorder who were on any antipsychotic medication were included (N = 1049).Results:Nearly a third (31.5%) of people with psychosis were on long-acting injectables, of whom 49.7% were on first-generation antipsychotic long-acting injectables and 47.9% were on second-generation antipsychotic long-acting injectables. This contrasts with oral antipsychotics where there was a higher utilisation of second-generation antipsychotics (86.3%). Of note, compared to those on the oral formulation, people on long-acting injectables were almost four times more likely to be under a community treatment order. Furthermore, people on long-acting injectables were more likely to have a longer duration of illness, reduced degree of insight, increased cognitive impairment as well as poor personal and social functioning. They also reported more adverse drug reactions. Compared to those on first-generation antipsychotic long-acting injectables, people on SGA long-acting injectables were younger and had had a shorter duration of illness. They were also more likely to experience dizziness and increased weight, but less likely to experience muscle stiffness or tenseness.Conclusion:Long-acting injectable use in Australia is associated with higher rates of community treatment order use, as well as poorer insight, personal and social performance, and greater cognitive impairment. While long-acting injectables may have the potential to improve the prognosis of people with psychosis, a better understanding of the choices behind the utilisation of long-acting injectable treatment in Australia is urgently needed.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-04-28T06:18:39Z
      DOI: 10.1177/00048674211009602
       
  • Demonstration of automated non-adherence and service disengagement risk
           monitoring with active follow-up for severe mental illness

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      Authors: Niranjan Bidargaddi, Geoffrey Schrader, Hannah Myles, K Oliver Schubert, Yasmin van Kasteren, Tao Zhang, Tarun Bastiampillai, Elizabeth Roughead, Jorg Strobel
      First page: 976
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Aims:Medication cessation and service disengagement often precedes relapse in people with severe mental illnesses but currently specialist mental health services only become involved after a relapse. Early detection of non-adherence is needed to enable intervention to avert relapse. This paper aims to demonstrate how digitally automated non-adherence risk monitoring from Medicare data with active follow-up can work and perform in practice in a real-world mental health service setting.Methods:AI2 software is an automated risk monitoring tool to detect non-adherence using Medicare data. It was implemented prospectively in a cohort of 354 registered patients of a community mental health clinic between July 2019 and February 2020. Patients flagged as at risk by the software were reviewed by two clinicians. We describe the risks automatically flagged for non-adherence and the clinical responses. We examine differences in clinical and demographic factors in patients flagged at increased risk of non-adherence.Results:In total, 46.7% (142/304) were flagged by the software as at risk of non-adherence, and 22% (31/142) received an intervention following clinician review of their case notes. Patients flagged by the software were older in age and had more prior mental health treatment episodes. More alerts were associated with patients who had been transferred from the mental health service to the care of their general practitioners, and those with more alerts were more likely to receive a follow-up intervention.Conclusion:Digitally automated monitoring for non-adherence risk is feasible and can be integrated into clinical workflows in community psychiatric and primary care settings. The technology may assist clinicians and services to detect non-adherence behaviour early, thereby triggering interventions that have the potential to reduce rates of mental health deterioration and acute illness relapse.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-03-22T04:28:15Z
      DOI: 10.1177/0004867421998800
       
  • Patterns and predictors of trajectories for subjective quality of life in
           patients with early psychosis: Three-year follow-up of the randomized
           controlled trial on extended early intervention

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      Authors: Candice Tze Kwan Kam, Wing Chung Chang, Vivian Wing Yan Kwong, Emily Sin Ki Lau, Gloria Hoi Kei Chan, Olivia Tsz Ting Jim, Christy Lai Ming Hui, Sherry Kit Wa Chan, Edwin Ho Ming Lee, Eric Yu Hai Chen
      First page: 983
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.
      Objective:Subjective quality of life is an important outcome of psychotic disorders. However, longitudinal course of subjective quality of life in the early illness stage is under-studied. We aimed to investigate the patterns and baseline predictors of subjective quality of life trajectories over 3 years in early psychosis patients, utilizing growth mixing modeling analysis, in the context of a 3-year follow-up of a randomized controlled trial comparing 1-year extension of early intervention with step-down psychiatric care for first-episode psychosis.Method:One hundred sixty Chinese patients were recruited from specialized early intervention program for first-episode psychosis in Hong Kong after they had completed this 2-year early intervention service, and underwent 1-year randomized controlled trial as well as 2-year post–randomized controlled trial follow-up (i.e. 3-year follow-up). Assessments on premorbid adjustment, onset profile, psychopathology, functioning and treatment characteristics were conducted. Individual class membership of subjective quality of life trajectory derived from growth mixing modeling was based on the 36-Item Short Form Health Survey mental component summary scores measured at four different time-points (baseline, 1, 2 and 3 years) among 142 participants across 3-year follow-up.Results:Three distinct subjective quality of life trajectories were identified including higher-improving (68.3%, n = 97), lower-stable (24.6%, n = 35) and deteriorating (7%, n = 10) trajectories. Age of onset; duration of untreated psychosis; depressive, positive and negative symptoms; and intervention condition were significantly different between good (higher-improving trajectory) and poor (combined lower-stable and deteriorating trajectories) trajectory groups. Multiple regression analysis revealed that younger age of onset, more severe depression and receipt of step-down care independently predicted poor subjective quality of life trajectory.Conclusion:Approximately one-third of patients displayed poor subjective quality of life trajectory in the early phase of psychotic illness. Our results affirm depression as a critical determinant of prospective subjective quality of life and underscores positive effect of extended early intervention on sustained subjective quality of life improvement. Further longitudinal research is warranted to facilitate better characterization of subjective quality of life course patterns and development of targeted intervention to optimize subjective quality of life in patients with early psychosis.
      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-03T05:13:39Z
      DOI: 10.1177/00048674211009603
       
  • At what stage does staging become overly staged'

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      Authors: Gin S Malhi, Erica Bell
      First page: 1017
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-05-27T09:12:35Z
      DOI: 10.1177/00048674211016049
       
  • Why should psychiatrists advocate for electroconvulsive therapy'

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      Authors: N McLaren
      First page: 1020
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-03-15T07:18:14Z
      DOI: 10.1177/0004867421998754
       
  • How telemedicine could benefit perinatal psychiatry

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      Authors: Florence Gressier, Bruno Falissard, Emmanuelle Corruble
      First page: 1021
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-02-27T05:20:48Z
      DOI: 10.1177/0004867421998759
       
  • Psychosis induced by hypothyroidism mistaken for brief reactive psychosis

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      Authors: Robert Donald Gillies, Genevieve Moseley, Elisabeth Ng, Leon Bach, Jianyi Zhang
      First page: 1022
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-02-27T05:24:48Z
      DOI: 10.1177/0004867421998764
       
  • Peripheral edema: An easily overlooked side effect of long-acting
           injectable paliperidone

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      Authors: Yi-Chun Ho, Li-Yu Hu, Ying-Jay Liou
      First page: 1023
      Abstract: Australian & New Zealand Journal of Psychiatry, Ahead of Print.

      Citation: Australian & New Zealand Journal of Psychiatry
      PubDate: 2021-02-27T05:38:28Z
      DOI: 10.1177/0004867421998771
       
 
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