The Australian and New Zealand journal of psychiatry最新文献_第6页

Rising temperatures and suicidal behaviour in children and adolescents. 儿童和青少年的气温上升和自杀行为。

IF 4.6

The Australian and New Zealand journal of psychiatry

Pub Date : 2022-06-01 Epub Date: 2021-08-13 DOI: 10.1177/00048674211038848

Cybele Dey, Michael Dudley, Katherine Knight, Iain Perkes

Suicide is the leading cause of death in 15to 24-year olds in Australia (www. aihw.gov.au/reports/life-expectancydeath/deaths-in-australia/contents/ leading-causes-of-death) and self-harm requiring hospitalisation is both indicative of significant mental distress and a risk factor for future completed suicide (Christiansen and Jensen, 2007). Rates of self-harm requiring hospitalisation in children and adolescents have risen most years and overall for the past decade in New South Wales (NSW), Australia (www.healthstats. nsw.gov.au/Indicator/men_suihos/ men_suihos_compari son). The Intergovernmental Panel on Climate Change describes children as particularly vulnerable to impacts of anthropogenic climate change, including on mental health. Cumulative evidence of associations between higher air temperature and suicidal behaviour has recently been published (Charlson et al., 2021; Lawrance et al., 2021). Air temperatures have risen in NSW over the past decade, and across Australia, maximum summer temperatures rose 1.54°C from 2000 to 2020, compared with 1981–2010 as a baseline (Zhang et al., 2020). Further rises in temperature over the next 30 years are now unavoidable (https://naturaldisaster.royalcommission.gov.au/). Studies show a positive correlation between ambient temperature and number of emergency presentations for self-harm, strengthened at more extreme high temperatures, especially when adjusted for humidity to find the apparent temperature (Basu et al., 2017). Rates of hospitalisation for intentional self-harm in NSW appear to be rising more steeply in coastal regions of NSW, and higher humidity may be contributing. Indeed, there are increased mental health admissions to hospital during heatwaves (Lee et al. 2018; Williams et al., 2012). Moreover, suicide deaths are significantly elevated in weeks with anomalously high temperatures (Parks et al., 2020) and across populations (Burke et al., 2018; Dixon et al., 2014). In context of escalating presentations of children and adolescents to emergency departments with suicidal behaviour, the association of elevated temperatures with suicidal behaviour in children and adolescents requires dispassionate but urgent evaluation. Public policy to mitigate against rising temperatures due to anthropogenic climate change may be important in suicide prevention. At the same time, given the temperature rises expected over the next 30 years, we submit that clinical services ready themselves to respond to further increases in suicidal behaviour during spring, summer and heatwaves.

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引用次数: 2

Virtual guidance: Mood disorders guidelines '2. Oh'! 虚拟指导:情绪障碍指南’2。哦' !

IF 4.6

The Australian and New Zealand journal of psychiatry

Pub Date : 2022-06-01 Epub Date: 2021-05-02 DOI: 10.1177/00048674211010244

Gin S Malhi, Erica Bell, Darryl Bassett, Philip Boyce, Malcolm Hopwood, Greg Murray, Richard Porter, Ajeet Singh, Roger Mulder

引用次数: 0

Suicide mortality after a nonfatal suicide attempt: A systematic review and meta-analysis. 非致命性自杀企图后的自杀死亡率:一项系统回顾和荟萃分析。

IF 4.6

The Australian and New Zealand journal of psychiatry

Pub Date : 2022-06-01 Epub Date: 2021-09-01 DOI: 10.1177/00048674211043455

Alice Demesmaeker, Emmanuel Chazard, Aline Hoang, Guillaume Vaiva, Ali Amad

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.

故意自残和自杀企图具有共同的危险因素，但具有不同的流行病学特征。虽然在荟萃分析中已经评估了故意自残后的自杀率，但在之前的自杀企图后自杀的具体死亡率从未被评估过。我们研究的目的是估计非致命性自杀企图后自杀死亡的发生率。方法:我们制定并遵循标准的荟萃分析方案(系统评价注册号:prospero 2021: CRD42021221111)。1970年至2020年间发表的随机对照试验和队列研究，重点关注自杀未遂后的自杀率，这些研究在PubMed、PsycInfo和Scopus中得到了确认，并进行了定性描述。非致命性自杀未遂后1年、5年和10年的自杀死亡率采用随机效应模型进行了荟萃分析。还进行了亚组分析和元回归。结果:我们的荟萃分析基于41项研究。非致命性自杀未遂后的自杀率为1年2.8%(2.2-3.5)，5年5.6%(3.9-7.9)，10年7.4%(5.2-10.4)。对自杀率的估计差异很大，这取决于精神病诊断、自杀企图所用的方法、研究类型和考虑的年龄组。结论:有证据表明，非致命性自杀企图后一年的自杀死亡率较高，这应促使预防系统在此期间特别警惕。

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引用次数: 2

Scrutinising the evidence for long term benzodiazepine use in anxiety - response to Tibrewal et al. 审视长期使用苯二氮卓类药物治疗焦虑的证据——对Tibrewal等人的反应。

IF 4.6

The Australian and New Zealand journal of psychiatry

Pub Date : 2022-06-01 Epub Date: 2022-01-27 DOI: 10.1177/00048674211073042

William Lugg

in the treatment of anxiety after four months’ continuous treatment. It considered that an appropriate warning regarding long-term efficacy be included in the recommendations, particularly in view of the high proportion of patients receiving repeated prescriptions for extended periods of time ’.

引用次数: 1

Setting a youth-focused research agenda for eating disorders during the COVID-19 pandemic. 在2019冠状病毒病大流行期间制定以青年为重点的饮食失调研究议程。

IF 4.6

The Australian and New Zealand journal of psychiatry

Pub Date : 2022-06-01 Epub Date: 2021-10-26 DOI: 10.1177/00048674211054743

Stephen Allison, Tracey Wade, Ulrike Schmidt, Janet Treasure, Tarun Bastiampillai, Jeffrey Cl Looi

Over 80% of eating disorders (EDs) have their onset in youth (Garland et al., 2019). The peak age of onset for anorexia nervosa (AN) and bulimia nervosa is 16, with the mean illness duration of AN being approximately 10 years. The optimal period for early intervention for EDs is the first 3 years of illness i.e. age 16–19, which straddles the age-based transition from child to adult mental health services in many countries. Since about 30% of young people treated in child and adolescent ED services require further treatment in adult ED services, they have an in-built disruption in their care. Overall, less than 5% of adolescents with a mental health disorder experience a satisfactory transition between child and adult mental health services (Singh et al., 2010). Patients with AN typically do not maintain treatment progress over transition (Garland et al., 2019). The separation between child and adult specialty ED services also undermines the development of a transformative research agenda to meet the needs of young people during the COVID-19 pandemic. The Australian National Eating Disorder Collaboration surveyed 25 ED-specific services and found that there has been a marked increase in presentations of both new and relapsing EDs, with higher acuity and severity of these presentations (https://nedc.com.au/research-andresources/show/issue-69-the-impactof-covid-19-on-eating-disorders). In Australia and the United Kingdom, the past year has seen an almost doubling of both urgent and routine referrals for child and adolescent ED services (Solmi et al., 2021; www.abc.net.au/ news/2021-08-31/eating-disordersr e g i on a l t e en s cov i d 19 p an demic-/100417812). The increased ED presentations have occurred on the background of substantially higher youth mental health-related presentations to primary care settings, community mental health services, and hospitals (www.theage.com.au/national/it-scompletely-shocking-when-it-s-yourchild-what-s-driving-the-youth-mentalhealth-crisis-20210902-p58oa5.html). Unpublished data from the rollout across England of the ‘First Episode Rapid Early Intervention for EDs’ (FREED) service model for young people, aged 16–25 (Potterton et al., 2020), found a relative increase of new AN presentations (vs other ED presentations) from around 30–50% during the pandemic. Postulated predictors of worsening mental health among young people during lockdowns include social isolation, increased screen time and excessive social media use, and parental stress. Uniquely for people with AN, the pandemic has highlighted the contradictory messaging between the fields of obesity care and EDs, with public health messages emphasising weight gain resulting from lockdowns, and social media focusing on weight loss and exercise (Solmi et al., 2021). The effects of a stream of public health messaging and social media content about obesity care should be investigated for its effect on those with AN.

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引用次数: 6

Whose values are represented in value-based healthcare? 谁的价值观在基于价值的医疗保健中得到体现?

IF 4.6

The Australian and New Zealand journal of psychiatry

Pub Date : 2022-06-01 Epub Date: 2021-11-02 DOI: 10.1177/00048674211056006

Jeffrey Cl Looi, Tarun Bastiampillai, Stephen R Kisely, Stephen Allison

Value-based healthcare is a model where providers, such as hospitals and physicians, are paid based on health outcomes against the cost of their delivery (Porter, 2010). This is in contrast to fee-for-service, capitated approaches, and activity-based funding where payment is dependent on the volume, factoring in case complexity, of healthcare services provided to people. For instance, public mental health services in Australia are largely funded through block grants. Value-based healthcare features in the submission of Honeysuckle Health (HH) to the Australian Competition and Consumer Commission (ACCC) for the formation of a buying group that would act on behalf of a significant proportion of private health insurers (PHIs) and other third-party payors, such as worker’s compensation providers. HH is a joint venture of Australian health insurer NIB and Cigna Corporation, a global health services company based in the United States. Although superficially attractive, much depends on how valuebased healthcare is defined. Of concern is the possibility that PHI-payors will use a narrow interpretation of valuebased healthcare as a way to reduce costs through inducements and financial penalties rather than one that encompasses healthcare outcomes that are important to patients and carers (Zanotto et al., 2021). We discuss the implications of a narrow PHIpayor-driven implementation of valuebased healthcare, based primarily on cost reduction, for private psychiatric practice in Australia. There is a danger that PHI-driven value-based healthcare could replace existing practitioner and patient-driven assessments of the quality and safety of healthcare, including outcomes and cost-effectiveness. For instance, private and public hospitals and community services have already adopted outcome measurement as a routine. In mental healthcare, casemix and outcome data are collected by the Australian Private Hospitals Association Private Psychiatric Hospitals Data Reporting and Analysis Service, the Australian Institute of Health and Welfare, and the Australian Mental Health Outcomes and Classification Network. To date, the focus has been largely on patient outcomes rather than solely on costs. However, the HH interpretation of value-based healthcare may change the status quo primarily towards cost containment. The evidence to date is not encouraging, with limited data on outcome measures that are relevant to mental health patients. More broadly, a systematic qualitative review of the outcome research on value-based healthcare in general found that of 47 included studies, only 16 used patientreported outcome measures, and only 3 reported comprehensive outcomes (Zanotto et al., 2021). This was less than those specifically reporting cost-saving outcomes. Importantly, these data are derived entirely from studies of primary care, medical and surgical specialities, and not mental health services. Zanotto et al. (2021) concluded that a more comprehensive approach to assessme

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引用次数: 1

A Delphi study to identify intervention priorities to prevent the occurrence and reduce the impact of adverse childhood experiences. 德尔菲研究，以确定干预重点，以防止发生和减少不良的童年经历的影响。

IF 4.6

The Australian and New Zealand journal of psychiatry

Pub Date : 2022-06-01 Epub Date: 2021-07-07 DOI: 10.1177/00048674211025717

Berhe W Sahle, Nicola J Reavley, Amy J Morgan, Marie Bee Hui Yap, Andrea Reupert, Anthony F Jorm

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.

目的:缺乏一种系统的、协调的方法来减少不良童年经历的发生和影响。因此，确定这一领域可行的干预优先事项将有助于为现行服务提供的政策和改革提供信息。本研究的目的是确定专家共识驱动的优先干预措施，以减少澳大利亚8岁以下儿童不良童年经历的发生和影响。方法:进行三轮在线德尔菲调查，通过文献检索确定34种儿童不良经历的干预措施，以建立共识。6项是一般干预措施，6项是广泛干预方案，22项是具体干预措施。参与者包括17名保健从业人员、15名研究人员、9名政策专家、7名教育工作者和3名具有不良童年经历或儿童心理健康专业知识的消费者权益倡导者。共识被定义为根据其重要性和所有专家的75%的可行性将干预评为“非常高优先级”或“高优先级”。结果:34项干预措施中有7项被认可为儿童不良经历的优先干预措施。这些措施包括四大类干预措施:社区干预措施、养育方案、家访方案和心理干预措施。还批准了两项广泛的干预方案:以学校为基础的反欺凌干预和对遭受创伤的儿童的心理治疗。积极育儿计划是唯一达成共识的具体干预措施。结论:这是第一个从利益相关者的角度来确定预防不良童年经历发生和影响的干预重点的研究。将有效、可行和可执行的干预方案列为优先事项，是朝着更好地整合和协调正在提供的服务，以有效预防和应对不利的儿童经历迈出的重要一步。

{"title":"A Delphi study to identify intervention priorities to prevent the occurrence and reduce the impact of adverse childhood experiences.","authors":"Berhe W Sahle, Nicola J Reavley, Amy J Morgan, Marie Bee Hui Yap, Andrea Reupert, Anthony F Jorm","doi":"10.1177/00048674211025717","DOIUrl":"https://doi.org/10.1177/00048674211025717","url":null,"abstract":"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.","PeriodicalId":117457,"journal":{"name":"The Australian and New Zealand journal of psychiatry","volume":" ","pages":"686-694"},"PeriodicalIF":4.6,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00048674211025717","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39159952","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}

引用次数: 3

The impact of COVID-19 on antipsychotic prescriptions for patients with schizophrenia in Australia. COVID-19对澳大利亚精神分裂症患者抗精神病药物处方的影响

IF 4.6

The Australian and New Zealand journal of psychiatry

Pub Date : 2022-06-01 Epub Date: 2021-07-09 DOI: 10.1177/00048674211025716

Steve Kisely, Dante Dangelo-Kemp, Mark Taylor, Dennis Liu, Simon Graham, Jodie Hartmann, Sam Colman

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.

目的:与过去4年同期相比，评估在澳大利亚，COVID-19封锁对精神分裂症患者在新医疗咨询处方后的抗精神病药物供应的影响。第二个目的是评估同一时期所有抗精神病药物的供应量，包括新处方和重复处方。方法:采用人类服务部药品福利计划10%的样本进行回顾性药品索赔数据库研究。研究人群包括2015年6月1日至2020年5月31日期间服用三种或三种以上口服或长效注射抗精神病药物治疗精神分裂症的所有成年患者。主要结果比较了2016年至2020年每年4月1日至5月31日期间新处方(需要医疗咨询)分配的抗精神病药物的数量。这是为了分析澳大利亚政府因COVID-19而实施封锁的期间(2020年4月至5月)，并与往年同期进行比较。结果:2019年4月至5月和2020年同期，新处方中需要咨询的抗精神病药物数量分别从15,244种减少到14,372种，减少幅度较小(5.7%)。然而，在调整治疗类别、年龄、性别、地点和提供者类型后，这种减少没有统计学意义(p = 0.75)。结论:2020年4月至5月新冠肺炎限制措施对精神分裂症患者新处方抗精神病药物的配药量与前几年同期新处方抗精神病药物配药量无显著影响。

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引用次数: 4

Dietary patterns and internalizing symptoms in children and adolescents: A meta-analysis. 儿童和青少年的饮食模式和内化症状:一项荟萃分析

IF 4.6

The Australian and New Zealand journal of psychiatry

Pub Date : 2022-06-01 Epub Date: 2021-07-27 DOI: 10.1177/00048674211031486

Laura Orlando, Katarina A Savel, Sheri Madigan, Marlena Colasanto, Daphne J Korczak

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 < 0.001, 95% confidence interval [-0.12, 0.06]) and depressive symptoms (r = -0.10, p < 0.001, 95% confidence interval [-0.18, -0.08]). Effect sizes were larger for studies of healthy dietary patterns and internalizing and depressive symptoms using self-report versus parent-report measures, as well as in cross-sectional studies of healthy dietary patterns and depression compared to prospective studies. Unhealthy dietary patterns were positively associated with internalizing (r = 0.09, p < 0.001, 95% confidence interval [0.06, 0.14]) and depressive symptoms (r = 0.10, p < 0.01, 95% CI [0.05, 0.17]). Larger effect sizes were observed for studies of unhealthy dietary patterns and internalizing and depressive symptoms using self-report versus parent-report measures.

Limitations: A lack of studies including clinical samples and/or physician diagnosis, and a paucity of studies in which anxiety symptoms were the primary mental health outcome.

Conclusion: Greater depression and internalizing symptoms are associated with greater unhealthy dietary patterns and with lower healthy dietary intake among children and adolescents.

背景:对儿童和青少年内化症状和饮食模式的研究产生了不同的结果。目的:量化儿童和青少年饮食模式与包括抑郁在内的内化症状之间的关系。数据来源:Embase, PsycINFO, MEDLINE, Web of Science和Cochrane截止至2021年3月。研究选择:观察性研究和随机对照试验，平均年龄≥18岁，报告饮食模式和内化症状之间的关联。数据提取:在随机效应模型下确定平均效应大小和95%置信区间。结果:26项研究为横断面研究，12项为前瞻性研究，1项采用病例对照设计。参与者的总人数从73726人到116546人不等。健康的饮食模式与内在化呈负相关(r = -0.07, pr = -0.10, pr = 0.09, pr = 0.10, p)局限性:缺乏包括临床样本和/或医生诊断在内的研究，并且缺乏将焦虑症状作为主要心理健康结果的研究。结论:在儿童和青少年中，更大的抑郁和内化症状与更大的不健康饮食模式和更低的健康饮食摄入量有关。

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引用次数: 7

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. 治疗焦虑和/或抑郁的青少年父母的治疗师辅助在线育儿策略干预的短期结果:单臂双基线试验。

IF 4.6

The Australian and New Zealand journal of psychiatry

Pub Date : 2022-06-01 Epub Date: 2021-07-07 DOI: 10.1177/00048674211025695

Sarah Pheik Hoon Khor, Catherine Margaret Fulgoni, Deborah Lewis, Glenn A Melvin, Anthony F Jorm, Katherine Lawrence, Bei Bei, Marie Bee Hui Yap

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.

目的:本研究旨在评估治疗师辅助的在线育儿策略项目是否增加了对经历焦虑和/或抑郁的青少年有支持作用的育儿行为。父母自我效能、父母适应、照顾者负担、亲子依恋、家庭功能和父母痛苦的二级养育结果，以及焦虑和抑郁症状、自杀意念和睡眠的青少年结果。方法:在澳大利亚招募71名接受抑郁和/或焦虑治疗的父母(94.4%为女性)及其青少年(73.2%为女性)，年龄为12-18岁(Mean = 15.02, SD = 1.56)，进行单组双基线开放标签试验。家长们接受了治疗师辅助的在线育儿策略，其中包括多达九个基于网络的模块，每个模块都辅以视频会议的指导课程。使用潜在生长曲线模型分析结果，以确定干预后(第2秒基线后4个月)结果的变化是否超过间隔1个月测量的两条基线之间的变化。结果:65名家长(91.6%)至少完成了在线育儿干预的一个模块，平均接受了9次辅导(SD = 2)。在干预后，治疗师辅助的在线育儿策略所针对的育儿行为有所改善(Cohen’s d = 1.16, 95%可信区间[0.78,1.51])。父母自我效能感和亲子依恋增加(Cohen’s d分别= 1.44[1.05,1.82]和0.39[0.05,0.74])，而家庭功能障碍和父母痛苦减少(Cohen’s d分别= -0.51[-0.86，-0.16]和-0.84[-1.23，-0.44])。青少年焦虑、抑郁和睡眠的变化不显著。结论:在接受焦虑和/或抑郁治疗的青少年家长中，治疗师辅助的在线育儿策略干预改善了自我报告的育儿行为、父母自我效能感、父母痛苦程度、亲子依恋和家庭功能。然而，没有观察到干预后青少年心理健康和睡眠结果的显著变化。指出了治疗师支持的在线育儿计划在解决寻求专业帮助的父母的服务差距方面的有用性。试验注册:澳大利亚新西兰临床试验注册号(ACTRN) 12618000290291，预计于2018年2月26日注册;https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368031。

{"title":"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.","authors":"Sarah Pheik Hoon Khor, Catherine Margaret Fulgoni, Deborah Lewis, Glenn A Melvin, Anthony F Jorm, Katherine Lawrence, Bei Bei, Marie Bee Hui Yap","doi":"10.1177/00048674211025695","DOIUrl":"https://doi.org/10.1177/00048674211025695","url":null,"abstract":"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.","PeriodicalId":117457,"journal":{"name":"The Australian and New Zealand journal of psychiatry","volume":" ","pages":"695-708"},"PeriodicalIF":4.6,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00048674211025695","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39159868","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}

引用次数: 4