Pub Date : 2024-04-22DOI: 10.1177/00048674241246436
S. Kisely, Tessa-May Zirnsak, Amy Corderoy, C. Ryan, Lisa Brophy
AIMS Community treatment orders have been introduced in many jurisdictions with increasing use over time. We conducted a rapid umbrella review to synthesise the quantitative and qualitative evidence from systematic reviews and/or meta-analyses of their potential harms and benefits. METHODS A systematic search of Medline, PubMed, Embase and PsycINFO for relevant systematic reviews and/or meta-analyses. Where available, participants on community treatment orders were compared with controls receiving voluntary psychiatric treatment. This review is registered with PROSPERO (CRD42023398767) and the Open Science Framework (https://osf.io/zeq35). RESULTS In all, 17 publications from 14 studies met the inclusion criteria. Quantitative synthesis of data from different systematic reviews was not possible. There were mixed findings on the effects of community treatment orders on health service use, and clinical, psychosocial or forensic outcomes. Whereas uncontrolled evidence suggested benefits, results were more equivocal from controlled studies and randomised controlled trials showed no effect. Any changes in health service use took several years to become apparent. There was evidence that better targeting of community treatment order use led to improved outcomes. Although there were other benefits, such as in mortality, findings were mostly rated as suggestive using predetermined and standardised criteria. Qualitative findings suggested that family members and clinicians were generally positive about the effect of community treatment orders but those subjected to them were more ambivalent. Any possible harms were under-researched, particularly in quantitative designs. CONCLUSIONS The evidence for the benefits of community treatment orders remains inconclusive. At the very least, use should be better targeted to people most likely to benefit. More quantitative research on harms is indicated.
{"title":"The benefits and harms of community treatment orders for people diagnosed with psychiatric illnesses: A rapid umbrella review of systematic reviews and meta-analyses.","authors":"S. Kisely, Tessa-May Zirnsak, Amy Corderoy, C. Ryan, Lisa Brophy","doi":"10.1177/00048674241246436","DOIUrl":"https://doi.org/10.1177/00048674241246436","url":null,"abstract":"AIMS\u0000Community treatment orders have been introduced in many jurisdictions with increasing use over time. We conducted a rapid umbrella review to synthesise the quantitative and qualitative evidence from systematic reviews and/or meta-analyses of their potential harms and benefits.\u0000\u0000\u0000METHODS\u0000A systematic search of Medline, PubMed, Embase and PsycINFO for relevant systematic reviews and/or meta-analyses. Where available, participants on community treatment orders were compared with controls receiving voluntary psychiatric treatment. This review is registered with PROSPERO (CRD42023398767) and the Open Science Framework (https://osf.io/zeq35).\u0000\u0000\u0000RESULTS\u0000In all, 17 publications from 14 studies met the inclusion criteria. Quantitative synthesis of data from different systematic reviews was not possible. There were mixed findings on the effects of community treatment orders on health service use, and clinical, psychosocial or forensic outcomes. Whereas uncontrolled evidence suggested benefits, results were more equivocal from controlled studies and randomised controlled trials showed no effect. Any changes in health service use took several years to become apparent. There was evidence that better targeting of community treatment order use led to improved outcomes. Although there were other benefits, such as in mortality, findings were mostly rated as suggestive using predetermined and standardised criteria. Qualitative findings suggested that family members and clinicians were generally positive about the effect of community treatment orders but those subjected to them were more ambivalent. Any possible harms were under-researched, particularly in quantitative designs.\u0000\u0000\u0000CONCLUSIONS\u0000The evidence for the benefits of community treatment orders remains inconclusive. At the very least, use should be better targeted to people most likely to benefit. More quantitative research on harms is indicated.","PeriodicalId":117457,"journal":{"name":"The Australian and New Zealand journal of psychiatry","volume":"122 44","pages":"48674241246436"},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140677868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-22DOI: 10.1177/00048674241246443
Csongor G Oltvolgyi, Carla Meurk, Ed Heffernan
OBJECTIVE Increased suicidality and suicide deaths among veterans of the Australian Defence Force have gained recent prominence. A systematic scoping review was conducted to identify, summarise and synthesise the existing literature relating to Australian veteran suicide and suicidality, with the objective of identifying future research priorities. METHODS We conducted a PRISMA-compliant systematic search on PubMed/MEDLINE, Embase and CINAHL databases for all manuscripts reporting primary data on suicide and suicidality in Australian veterans. The search was supplemented by grey literature and a search of reference lists. Manuscripts of any study type, published in the English language since the Vietnam era, were eligible for inclusion. RESULTS A total of 26 articles and reports, utilising a variety of mostly quantitative approaches, were included in the review. Findings, especially in larger and more recent studies, indicate increased suicidality in the veteran population. Suicide deaths appeared to increase with transition out of the military. Mental illness was identified as an important risk factor for suicide and suicidality. Current service was identified as a protective factor against suicide. There was mixed evidence regarding the impact of operational deployment on suicide and suicidality. CONCLUSIONS Gaps were identified in relation to the relative contributions to risk from transition, the various psychosocial correlates (for example, relationships, finances, employment), pre-service factors and the extent to which these are causal or mediating in nature. A better understanding of health service utilisation would also aid in targeting preventive efforts. Future research in these areas is warranted.
{"title":"Suicide and suicidality in Australian Defence Force veterans: A systematic scoping review.","authors":"Csongor G Oltvolgyi, Carla Meurk, Ed Heffernan","doi":"10.1177/00048674241246443","DOIUrl":"https://doi.org/10.1177/00048674241246443","url":null,"abstract":"OBJECTIVE\u0000Increased suicidality and suicide deaths among veterans of the Australian Defence Force have gained recent prominence. A systematic scoping review was conducted to identify, summarise and synthesise the existing literature relating to Australian veteran suicide and suicidality, with the objective of identifying future research priorities.\u0000\u0000\u0000METHODS\u0000We conducted a PRISMA-compliant systematic search on PubMed/MEDLINE, Embase and CINAHL databases for all manuscripts reporting primary data on suicide and suicidality in Australian veterans. The search was supplemented by grey literature and a search of reference lists. Manuscripts of any study type, published in the English language since the Vietnam era, were eligible for inclusion.\u0000\u0000\u0000RESULTS\u0000A total of 26 articles and reports, utilising a variety of mostly quantitative approaches, were included in the review. Findings, especially in larger and more recent studies, indicate increased suicidality in the veteran population. Suicide deaths appeared to increase with transition out of the military. Mental illness was identified as an important risk factor for suicide and suicidality. Current service was identified as a protective factor against suicide. There was mixed evidence regarding the impact of operational deployment on suicide and suicidality.\u0000\u0000\u0000CONCLUSIONS\u0000Gaps were identified in relation to the relative contributions to risk from transition, the various psychosocial correlates (for example, relationships, finances, employment), pre-service factors and the extent to which these are causal or mediating in nature. A better understanding of health service utilisation would also aid in targeting preventive efforts. Future research in these areas is warranted.","PeriodicalId":117457,"journal":{"name":"The Australian and New Zealand journal of psychiatry","volume":"28 16","pages":"48674241246443"},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140673163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-17DOI: 10.1101/2023.03.16.23287385
S. Bendall, O. Eastwood, T. Spelman, P. McGorry, I. Hickie, A. Yung, P. Amminger, S. Wood, C. Pantelis, R. Purcell, L. Phillips
Objectives: Childhood trauma is common and associated with mental ill health. While high rates of trauma are observed across individual disorder groups, there is evidence that trauma is associated with an admixture of affective, anxiety, and psychotic symptoms in adults. Given that both early onset of mental disorder and trauma exposure herald poor outcomes, it is important to examine trauma prevalence rates in youth mental health services and to determine whether this trauma-related clustering is present in help-seeking young people. Methods: We used data from the Transitions Study, a longitudinal investigation of young people attending one of four headspace youth mental health services in Melbourne and Sydney, Australia between January 2011 and August 2012. Participants were 775 young people aged 12 to 25 (65.9% female; mean age = 18.3, SD = 3.2). Childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Multinomial regression was used to assess whether reported childhood trauma was more strongly associated with the co-occurrence of depression, anxiety, mania, and psychosis symptoms than with any one in isolation. Results: Approximately 84% of participants reported some form of abuse (emotional: 68%; physical: 32%; sexual: 22%) or neglect (emotional: 65%; physical: 46%) during childhood or adolescence. Exposure to multiple trauma types was common. Childhood trauma was significantly associated with each symptom domain (depression, mania, anxiety and psychosis). Childhood trauma was more strongly associated with the co-occurrence of these symptoms than with any one of these domains in isolation, such that trauma-exposed young people were more likely to experience increased symptom clustering than their non-exposed counterparts. Conclusions: Childhood trauma is pervasive in youth mental health services and associated with a heterogeneous symptom profile that cuts across traditional diagnostic boundaries.
{"title":"Childhood trauma is prevalent and associated with co-occurring depression, anxiety, mania and psychosis in young people attending Australian youth mental health services","authors":"S. Bendall, O. Eastwood, T. Spelman, P. McGorry, I. Hickie, A. Yung, P. Amminger, S. Wood, C. Pantelis, R. Purcell, L. Phillips","doi":"10.1101/2023.03.16.23287385","DOIUrl":"https://doi.org/10.1101/2023.03.16.23287385","url":null,"abstract":"Objectives: Childhood trauma is common and associated with mental ill health. While high rates of trauma are observed across individual disorder groups, there is evidence that trauma is associated with an admixture of affective, anxiety, and psychotic symptoms in adults. Given that both early onset of mental disorder and trauma exposure herald poor outcomes, it is important to examine trauma prevalence rates in youth mental health services and to determine whether this trauma-related clustering is present in help-seeking young people. Methods: We used data from the Transitions Study, a longitudinal investigation of young people attending one of four headspace youth mental health services in Melbourne and Sydney, Australia between January 2011 and August 2012. Participants were 775 young people aged 12 to 25 (65.9% female; mean age = 18.3, SD = 3.2). Childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Multinomial regression was used to assess whether reported childhood trauma was more strongly associated with the co-occurrence of depression, anxiety, mania, and psychosis symptoms than with any one in isolation. Results: Approximately 84% of participants reported some form of abuse (emotional: 68%; physical: 32%; sexual: 22%) or neglect (emotional: 65%; physical: 46%) during childhood or adolescence. Exposure to multiple trauma types was common. Childhood trauma was significantly associated with each symptom domain (depression, mania, anxiety and psychosis). Childhood trauma was more strongly associated with the co-occurrence of these symptoms than with any one of these domains in isolation, such that trauma-exposed young people were more likely to experience increased symptom clustering than their non-exposed counterparts. Conclusions: Childhood trauma is pervasive in youth mental health services and associated with a heterogeneous symptom profile that cuts across traditional diagnostic boundaries.","PeriodicalId":117457,"journal":{"name":"The Australian and New Zealand journal of psychiatry","volume":"100 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133145359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-23DOI: 10.1101/2023.02.19.23286151
D. Eratne, M. Kang, C. Malpas, S. Simpson-Yap, C. Lewis, Christa Dang, Jasleen Grewal, Amy Coe, H. Dobson, M. Keem, Wei-Hsuan Chiu, T. Kalincik, Suyi Ooi, D. Darby, A. Brodtmann, O. Hansson, S. Janelidze, K. Blennow, H. Zetterberg, A. Walker, O. Dean, Michael Berk, C. Wannan, C. Pantelis, S. Loi, M. Walterfang, S. Berkovic, A. Santillo, D. Velakoulis
Objective Blood biomarkers of neuronal injury such as neurofilament light (NfL) are being intensively studied to improve diagnosis and treatment of neurodegenerative disorders, but gaps remain in its ability to assist in distinguishing neurodegenerative from primary psychiatric disorders (PPD) with overlapping clinical presentations that commonly cause diagnostic dilemmas. This study aimed to investigate plasma NfL in a range of PPDs, and the diagnostic utility of plasma NfL in differentiating PPD from behavioural variant frontotemporal dementia (bvFTD), a neurodegenerative disorder commonly misdiagnosed initially as PPD. Furthermore, improved understanding of NfL in a diverse range of PPDs, the role and performance of a large normative/reference data sets and models to facilitate precision interpretation of an individual levels, and the influence of covariates, will be critical for future research and clinical translation. Methods Plasma NfL was analysed using Single molecule array (Simoa) technology in major depressive disorder (MDD, n=42), bipolar affective disorder (BPAD, n=121), treatment-resistant schizophrenia (TRS, n=82), and bvFTD (n=22). Comparisons were made between the four clinical cohort groups, and the reference cohort (Control Group 2, n=1926, using generalised additive models for location, scale, and shape (GAMLSS), and age-matched controls (Control Group 1, n=96, using general linear models), Results Large differences were seen between bvFTD (mean NfL 34.9pg/mL) and all PPDs and controls (all <11pg/mL). Plasma NfL distinguished bvFTD from PPD with high accuracy; a 13.3pg/mLcut-off resulted in 86% sensitivity, 88% specificity. GAMLSS models using the large Control Group 2 performed equally to or outperformed models using local controls. An internet-based application was developed to provide individualised z-scores and percentiles based on this reference cohort, which can facilitate precision interpretation of an individual level. Slightly higher plasma NfL levels were found in BPAD, compared to both control groups, and compared to TRS. Conclusions This study adds further evident on the strong diagnostic utility of NfL to distinguish bvFTD from clinically relevant PPDs, and includes the largest cohort of BPAD to date. The finding of higher plasma NfL levels in the largest cohort of BPAD to date should prompt further investigation. Use of large reference cohorts and GAMLSS modelling may have important implications for future research and clinical translation. Studies are underway investigating clinical and diagnostic utility of plasma NfL and the serviceability of the internet-based application for diverse neurodegenerative and primary psychiatric conditions in real-world primary care and specialist clinical settings.
{"title":"Plasma neurofilament light in behavioural variant frontotemporal dementia compared to mood and psychotic disorders","authors":"D. Eratne, M. Kang, C. Malpas, S. Simpson-Yap, C. Lewis, Christa Dang, Jasleen Grewal, Amy Coe, H. Dobson, M. Keem, Wei-Hsuan Chiu, T. Kalincik, Suyi Ooi, D. Darby, A. Brodtmann, O. Hansson, S. Janelidze, K. Blennow, H. Zetterberg, A. Walker, O. Dean, Michael Berk, C. Wannan, C. Pantelis, S. Loi, M. Walterfang, S. Berkovic, A. Santillo, D. Velakoulis","doi":"10.1101/2023.02.19.23286151","DOIUrl":"https://doi.org/10.1101/2023.02.19.23286151","url":null,"abstract":"Objective Blood biomarkers of neuronal injury such as neurofilament light (NfL) are being intensively studied to improve diagnosis and treatment of neurodegenerative disorders, but gaps remain in its ability to assist in distinguishing neurodegenerative from primary psychiatric disorders (PPD) with overlapping clinical presentations that commonly cause diagnostic dilemmas. This study aimed to investigate plasma NfL in a range of PPDs, and the diagnostic utility of plasma NfL in differentiating PPD from behavioural variant frontotemporal dementia (bvFTD), a neurodegenerative disorder commonly misdiagnosed initially as PPD. Furthermore, improved understanding of NfL in a diverse range of PPDs, the role and performance of a large normative/reference data sets and models to facilitate precision interpretation of an individual levels, and the influence of covariates, will be critical for future research and clinical translation. Methods Plasma NfL was analysed using Single molecule array (Simoa) technology in major depressive disorder (MDD, n=42), bipolar affective disorder (BPAD, n=121), treatment-resistant schizophrenia (TRS, n=82), and bvFTD (n=22). Comparisons were made between the four clinical cohort groups, and the reference cohort (Control Group 2, n=1926, using generalised additive models for location, scale, and shape (GAMLSS), and age-matched controls (Control Group 1, n=96, using general linear models), Results Large differences were seen between bvFTD (mean NfL 34.9pg/mL) and all PPDs and controls (all <11pg/mL). Plasma NfL distinguished bvFTD from PPD with high accuracy; a 13.3pg/mLcut-off resulted in 86% sensitivity, 88% specificity. GAMLSS models using the large Control Group 2 performed equally to or outperformed models using local controls. An internet-based application was developed to provide individualised z-scores and percentiles based on this reference cohort, which can facilitate precision interpretation of an individual level. Slightly higher plasma NfL levels were found in BPAD, compared to both control groups, and compared to TRS. Conclusions This study adds further evident on the strong diagnostic utility of NfL to distinguish bvFTD from clinically relevant PPDs, and includes the largest cohort of BPAD to date. The finding of higher plasma NfL levels in the largest cohort of BPAD to date should prompt further investigation. Use of large reference cohorts and GAMLSS modelling may have important implications for future research and clinical translation. Studies are underway investigating clinical and diagnostic utility of plasma NfL and the serviceability of the internet-based application for diverse neurodegenerative and primary psychiatric conditions in real-world primary care and specialist clinical settings.","PeriodicalId":117457,"journal":{"name":"The Australian and New Zealand journal of psychiatry","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123946382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-05DOI: 10.1177/00048674221089837
R. Lee, H. Brown, Sarah Salih, Anita C. Benoit
Objective: To assess the effects of psychological, psychosocial, educational and alternative interventions on mental health outcomes of Indigenous adult populations in Australia, Canada, New Zealand and the United States and the Indigenous involvement and content in each study. Methods: We systematically searched databases, key journals and gray literature, for records until June 2020. Eligible studies were in English or French and examined the impact of interventions on mental health outcomes including anxiety disorders, posttraumatic stress disorder, depression, psychological distress or stress for Indigenous adults (⩾16 years). Data were extracted using a modified Cochrane Data Extraction Form and the Template for Intervention Description and Replication. Quality was evaluated using the Effective Public Health Practice Project quality assessment form. Results: In total, 21 studies were eligible, comprising 8 randomized controlled trials, 10 single-group pre–post studies and 3 pre–post studies with comparison groups. Twenty studies had Indigenous individuals or organizations involved in some decision-making capacity, though extent of involvement varied widely. In total, 9 studies were rated moderate and 12 weak in the Effective Public Health Practice Project quality assessment. Eight studies measuring depression, three measuring posttraumatic stress disorder, three measuring psychological distress and two measuring stress showed statistically significant improvements following the intervention. Conclusion: A wide range of interventions demonstrated mental health improvements. However, it is difficult to draw generalizable conclusions on intervention effectiveness, given heterogeneity among studies. Studies should employ a thorough assessment of the Indigenous involvement and content of their interventions for reporting and for critical consideration of the implications of their research and whether they address Indigenous determinants of mental health.
{"title":"Systematic review of Indigenous involvement and content in mental health interventions and their effectiveness for Indigenous populations","authors":"R. Lee, H. Brown, Sarah Salih, Anita C. Benoit","doi":"10.1177/00048674221089837","DOIUrl":"https://doi.org/10.1177/00048674221089837","url":null,"abstract":"Objective: To assess the effects of psychological, psychosocial, educational and alternative interventions on mental health outcomes of Indigenous adult populations in Australia, Canada, New Zealand and the United States and the Indigenous involvement and content in each study. Methods: We systematically searched databases, key journals and gray literature, for records until June 2020. Eligible studies were in English or French and examined the impact of interventions on mental health outcomes including anxiety disorders, posttraumatic stress disorder, depression, psychological distress or stress for Indigenous adults (⩾16 years). Data were extracted using a modified Cochrane Data Extraction Form and the Template for Intervention Description and Replication. Quality was evaluated using the Effective Public Health Practice Project quality assessment form. Results: In total, 21 studies were eligible, comprising 8 randomized controlled trials, 10 single-group pre–post studies and 3 pre–post studies with comparison groups. Twenty studies had Indigenous individuals or organizations involved in some decision-making capacity, though extent of involvement varied widely. In total, 9 studies were rated moderate and 12 weak in the Effective Public Health Practice Project quality assessment. Eight studies measuring depression, three measuring posttraumatic stress disorder, three measuring psychological distress and two measuring stress showed statistically significant improvements following the intervention. Conclusion: A wide range of interventions demonstrated mental health improvements. However, it is difficult to draw generalizable conclusions on intervention effectiveness, given heterogeneity among studies. Studies should employ a thorough assessment of the Indigenous involvement and content of their interventions for reporting and for critical consideration of the implications of their research and whether they address Indigenous determinants of mental health.","PeriodicalId":117457,"journal":{"name":"The Australian and New Zealand journal of psychiatry","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116583858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-12DOI: 10.1163/9789004467378_007
R. Medlicott
{"title":"Oedipus.","authors":"R. Medlicott","doi":"10.1163/9789004467378_007","DOIUrl":"https://doi.org/10.1163/9789004467378_007","url":null,"abstract":"","PeriodicalId":117457,"journal":{"name":"The Australian and New Zealand journal of psychiatry","volume":"100 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124603510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-07DOI: 10.1177/0004867419885165
S. Colloby, R. Watson, A. Blamire, J. O'Brien, John-Paul Taylor
Background: We investigated the structural changes associated with Alzheimer’s disease, dementia with Lewy bodies and Parkinson disease dementia by means of cortical thickness analysis. Methods: Two hundred and forty-five participants: 76 Alzheimer’s disease, 65 dementia with Lewy bodies, 29 Parkinson disease dementia and 76 cognitively normal controls underwent 3-T T1-weighted magnetic resonance imaging and clinical and cognitive assessments. We implemented FreeSurfer to obtain cortical thickness estimates to contrast patterns of cortical thinning across groups and their clinical correlates. Results: In Alzheimer’s disease and dementia with Lewy bodies, a largely similar pattern of regional cortical thinning was observed relative to controls apart from a more severe loss within the entorhinal and parahippocampal structures in Alzheimer’s disease. In Parkinson disease dementia, regional cortical thickness was indistinguishable from controls and dementia with Lewy bodies, suggesting an ‘intermediate’ pattern of regional cortical change. In terms of global cortical thickness, group profiles were controls > Parkinson disease dementia > dementia with Lewy bodies > Alzheimer’s disease (F3, 241 ⩽ 123.2, p < 0.001), where percentage wise, the average difference compared to controls were −1.8%, −5.5% and −6.4%, respectively. In these samples, cortical thinning was also associated with cognitive decline in dementia with Lewy bodies but not in Parkinson disease dementia and Alzheimer’s disease. Conclusion: In a large and well-characterised cohort of people with dementia, regional cortical thinning in dementia with Lewy bodies was broadly similar to Alzheimer’s disease. There was preservation of the medial temporal lobe structures in dementia with Lewy bodies compared with Alzheimer’s disease, supporting its inclusion as a supportive biomarker in the revised clinical criteria for dementia with Lewy bodies. However, there was less global cortical thinning in Parkinson disease dementia, with no significant regional difference between Parkinson disease dementia and controls. These findings highlight the overlap across the Alzheimer’s disease/Parkinson disease dementia spectrum and the potential for differing mechanisms underlying neurodegeneration and cognition in dementia with Lewy bodies and Parkinson disease dementia.
{"title":"Cortical thinning in dementia with Lewy bodies and Parkinson disease dementia","authors":"S. Colloby, R. Watson, A. Blamire, J. O'Brien, John-Paul Taylor","doi":"10.1177/0004867419885165","DOIUrl":"https://doi.org/10.1177/0004867419885165","url":null,"abstract":"Background: We investigated the structural changes associated with Alzheimer’s disease, dementia with Lewy bodies and Parkinson disease dementia by means of cortical thickness analysis. Methods: Two hundred and forty-five participants: 76 Alzheimer’s disease, 65 dementia with Lewy bodies, 29 Parkinson disease dementia and 76 cognitively normal controls underwent 3-T T1-weighted magnetic resonance imaging and clinical and cognitive assessments. We implemented FreeSurfer to obtain cortical thickness estimates to contrast patterns of cortical thinning across groups and their clinical correlates. Results: In Alzheimer’s disease and dementia with Lewy bodies, a largely similar pattern of regional cortical thinning was observed relative to controls apart from a more severe loss within the entorhinal and parahippocampal structures in Alzheimer’s disease. In Parkinson disease dementia, regional cortical thickness was indistinguishable from controls and dementia with Lewy bodies, suggesting an ‘intermediate’ pattern of regional cortical change. In terms of global cortical thickness, group profiles were controls > Parkinson disease dementia > dementia with Lewy bodies > Alzheimer’s disease (F3, 241 ⩽ 123.2, p < 0.001), where percentage wise, the average difference compared to controls were −1.8%, −5.5% and −6.4%, respectively. In these samples, cortical thinning was also associated with cognitive decline in dementia with Lewy bodies but not in Parkinson disease dementia and Alzheimer’s disease. Conclusion: In a large and well-characterised cohort of people with dementia, regional cortical thinning in dementia with Lewy bodies was broadly similar to Alzheimer’s disease. There was preservation of the medial temporal lobe structures in dementia with Lewy bodies compared with Alzheimer’s disease, supporting its inclusion as a supportive biomarker in the revised clinical criteria for dementia with Lewy bodies. However, there was less global cortical thinning in Parkinson disease dementia, with no significant regional difference between Parkinson disease dementia and controls. These findings highlight the overlap across the Alzheimer’s disease/Parkinson disease dementia spectrum and the potential for differing mechanisms underlying neurodegeneration and cognition in dementia with Lewy bodies and Parkinson disease dementia.","PeriodicalId":117457,"journal":{"name":"The Australian and New Zealand journal of psychiatry","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127895752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Author Index.","authors":"119, Collado, Davidson, 24, C. Eagleson, 117, Foulkes, 64, Fursland, 26, Gabriëls, 108, Galletly","doi":"10.1177/0004867417707097","DOIUrl":"https://doi.org/10.1177/0004867417707097","url":null,"abstract":"","PeriodicalId":117457,"journal":{"name":"The Australian and New Zealand journal of psychiatry","volume":"14 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123685337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-11-01DOI: 10.1177/0004867416673454
J. Lappin, M. Heslin, Peter B. Jones, G. Doody, U. Reininghaus, A. Demjaha, T. Croudace, T. Jamieson-Craig, K. Donoghue, B. Lomas, P. Fearon, R. Murray, P. Dazzan, C. Morgan
Objective: To compare baseline demographics and 10-year outcomes of a first-episode psychosis patient incidence cohort in order to establish whether current youth-focussed age-based criteria for early intervention services are justified by patient needs. The patients in this cohort were treated prior to the establishment of early intervention services. The study aimed to test the hypothesis that those who develop psychosis at a younger age have worse outcomes than those who develop psychosis at an older age. Methods: Data on first-episode psychosis patients from the ÆSOP-10 longitudinal follow-up study were used to compare baseline characteristics, and 10-year clinical, functional and service use outcomes between those patients who would and would not have met age-based criteria for early intervention services, in Australia or in the United Kingdom. Results: In total, 58% men and 71% women with first-episode psychosis were too old to meet current Australian-early intervention age-entry criteria (χ2 = 9.1, p = 0.003), while 21% men and 34% women were too old for UK-early intervention age-entry criteria (χ2 = 11.1, p = 0.001). The 10-year clinical and functional outcomes did not differ significantly between groups by either Australian- or UK-early intervention age-entry criteria. Service use was significantly greater among the patients young enough to meet early intervention age-criteria (Australia: incidence rate ratio = 1.35 [1.19, 1.52], p < 0.001; United Kingdom: incidence rate ratio = 1.65 [1.41, 1.93], p < 0.001). Conclusion: Current early intervention services are gender- and age-inequitable. Large numbers of patients with first-episode psychosis will not receive early intervention care under current service provision. Illness outcomes at 10-years were no worse in first-episode psychosis patients who presented within the age range for whom early intervention has been prioritised, though these patients had greater service use. These data provide a rationale to consider extension of early intervention to all, rather than just to youth.
目的:比较首发精神病患者发病率队列的基线人口统计学和10年结果，以确定当前以青少年为重点的基于年龄的早期干预服务标准是否符合患者需求。本队列患者在早期干预服务建立之前接受治疗。这项研究旨在验证一个假设，即那些在年轻时患上精神病的人比那些在年老时患上精神病的人有更糟糕的结果。方法:来自ÆSOP-10纵向随访研究的首发精神病患者的数据用于比较基线特征和10年临床、功能和服务使用结果，这些患者将在澳大利亚或英国满足基于年龄的早期干预服务标准。结果:总的来说，58%的男性和71%的女性首发精神病患者年龄太大，无法满足澳大利亚早期干预的年龄进入标准(χ2 = 9.1, p = 0.003)，而21%的男性和34%的女性年龄太大，无法满足英国早期干预的年龄进入标准(χ2 = 11.1, p = 0.001)。根据澳大利亚和英国的早期干预年龄入组标准，10年的临床和功能结果在两组之间没有显著差异。满足早期干预年龄标准的年轻患者的服务使用率显著更高(澳大利亚:发病率比= 1.35 [1.19,1.52]，p < 0.001;英国:发病率比= 1.65 [1.41,1.93]，p < 0.001)。结论:目前的早期干预服务存在性别和年龄不平等。在目前的服务条件下，大量首发精神病患者无法接受早期干预治疗。在优先考虑早期干预的年龄范围内出现的首发精神病患者，10年的疾病结果并没有更糟，尽管这些患者有更多的服务使用。这些数据为考虑将早期干预扩大到所有人而不仅仅是青少年提供了依据。
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Pub Date : 2016-11-01DOI: 10.1177/0004867416676374
Scott, Henderson
Australian & New Zealand Journal of Psychiatry, 50(11) Hearing the Hindi greeting, ‘Aap Kaise Ho?’, echo across a conference foyer enunciated with a Scottish twang is a memory that for me sums up Scott Henderson to a tee. Scott is both perfectly Scottish and delightfully skittish. Known for mischievously imbuing conversation with humour and skilfully immingling esoteric phrases, summoned with ease from his illimitable knowledge, with more serious questions, Scott manages to disguise his genuine interest in others and their betterment. Quintessentially a pedagogue, he uses the flourishes that his Scottish accent naturally affords to full effect and enthusiastically emphasizes the importance of curiosity at every opportunity presented to him. As his very many friends and colleagues around the globe can attest, Scott, an ornithologist himself, is indeed a rare bird.
{"title":"An erudite encounter with: Scott Henderson, AO.","authors":"Scott, Henderson","doi":"10.1177/0004867416676374","DOIUrl":"https://doi.org/10.1177/0004867416676374","url":null,"abstract":"Australian & New Zealand Journal of Psychiatry, 50(11) Hearing the Hindi greeting, ‘Aap Kaise Ho?’, echo across a conference foyer enunciated with a Scottish twang is a memory that for me sums up Scott Henderson to a tee. Scott is both perfectly Scottish and delightfully skittish. Known for mischievously imbuing conversation with humour and skilfully immingling esoteric phrases, summoned with ease from his illimitable knowledge, with more serious questions, Scott manages to disguise his genuine interest in others and their betterment. Quintessentially a pedagogue, he uses the flourishes that his Scottish accent naturally affords to full effect and enthusiastically emphasizes the importance of curiosity at every opportunity presented to him. As his very many friends and colleagues around the globe can attest, Scott, an ornithologist himself, is indeed a rare bird.","PeriodicalId":117457,"journal":{"name":"The Australian and New Zealand journal of psychiatry","volume":"163 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115265524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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