Australian and New Zealand Journal of Psychiatry最新文献

Background: The Growth and Empowerment Measure was developed by and for Aboriginal and Torres Strait Islander adults to measure social and emotional well-being and empowerment. This study aimed to co-design and validate a version of the Growth and Empowerment Measure with Aboriginal and Torres Strait Islander young people experiencing youth detention.

Method: 103 Aboriginal and Torres Strait Islander young people experiencing youth detention participated. Participants directed seven adaptations from the Growth and Empowerment Measure for adults to create a Growth and Empowerment Measure-Youth (GEM-Youth). 78 participants completed the GEM-Youth version 7 and 57 participants completed both the full GEM-Youth version 7 and the Kessler psychological distress scale (K10). Cronbach's alpha and inter-item correlations were calculated for two components of the GEM-Youth: how I feel about myself and thinking about my everyday life. Associations between K10 and GEM-Youth scores were quantified using Pearson's correlation.

Results: How I feel about myself questions had a mean inter-item correlation of (0.21) and good internal consistency (α = 0.80). Thinking about my everyday life questions had a mean inter-item correlation of 0.18 and internal consistency of α = 0.69. How I feel about myself showed a strong negative correlation (r(55) = -0.61, [95% confidence interval: -0.42, -0.75] p < 0.001) with K10. Thinking about my everyday life showed a moderate negative correlation with K10 (-0.31, [95% confidence interval: -0.05, -0.52] p = 0.02).

Implications: The GEM-Youth provides a culturally grounded and validated measure to assess social and emotional well-being and empowerment for Aboriginal and Torres Strait Islander young people in detention settings. This measure has therapeutic and research value that should be further refined and explored. Future research should adapt and validate this tool for use with other groups and settings.

Objective: To develop a Service Needs Index that measures a young person's needs across domains relevant to care provision and to examine the index's construction under different assumptions.

Methods: A cohort of young people (n = 2193) aged 12-25 years who sought help at youth mental health services across Australia were invited to use a digital platform (Innowell) as part of their care and complete a multidimensional assessment. Using online assessment data from the eligible 1611 individuals (73.5%), a Service Needs Index comprising three sub-indices (Clinical, Psychosocial, and Comorbidity) was constructed under two weighting approaches, an equal weighted scheme and a weighting scheme constructed with expert input and correlation-optimisation. These approaches were examined and compared.

Results: The Clinical, Psychosocial, and Comorbidity Indices were derived using standardised questionnaires to assess mental health symptoms and history, work and social functioning, and physical health and substance use, respectively. The expert input weighting scheme was favoured with less output uncertainty. Among those with the top 25% of Clinical Index scores, almost half also belonged in the group with the top 25% of Psychosocial Index scores, while 11.9% of the total sample were in the bottom 25% percentiles for both Clinical and Psychosocial Index scores.

Conclusion: These indices should be assessed in real-world settings before recommendations are made about their feasibility and acceptability; however, the indices could differentiate between needs to guide individual-level decision-making about service pathways for young people. Furthermore, population-level analyses of these aggregated indices can inform strategic decisions related to service planning and design.

Background: We evaluated the reliability, validity and acceptability of the Pediatric Symptom Checklist-17, a free, brief measure of child mental health, in a sample of parents of preschool-age (3-5 years) and school-age children (6-17 years). This is the first study to examine parent-reported Pediatric Symptom Checklist-17 for children aged 3 years.

Method: A national community sample of Australian parents (N = 2097) completed a demographic questionnaire and the Pediatric Symptom Checklist-17. We used a cross-sectional, test-retest design to assess the structural validity, internal consistency, test-retest reliability, concurrent and predictive validity of the Pediatric Symptom Checklist-17 total and subscale scores. Predictive validity was evaluated using a sub-sample of parents (n = 122) who completed the Pediatric Symptom Checklist-17 and Child Behaviour Checklist at a second timepoint. Normative data were also produced.

Results: Factor analysis supported the three-factor model for the Pediatric Symptom Checklist-17. Total (r = 0.82-0.93) and subscale scores (r = 0.75-0.89) strongly correlated with the Child Behaviour Checklist and demonstrated strong internal consistency (total scores α = 0.87-0.88). Test-retest reliability was acceptable for school-age children. The Pediatric Symptom Checklist-17 demonstrated excellent classification accuracy for preschool children; however, it did not perform as strongly in older age ranges. Normative data for age and gender were produced for the measure. Results indicated high levels of parent acceptability for the measure.

Conclusion: Findings contribute new validation evidence for the use of the Pediatric Symptom Checklist-17 as a screening and assessment measure in research and clinical settings, for parents of children from 3 years and above. This study is the first to ascertain Australian normative data for the Pediatric Symptom Checklist-17.

In 2024, WHO published the Clinical Descriptions and Diagnostic Requirements for International Classification of Diseases 11th Revision Mental, Behavioural and Neurodevelopmental Disorders manual. Stated objectives were to determine valid and reliable diagnoses and defined so as to differentiate conditions both from other conditions and from normative states. This paper provides a critique of the criteria sets derived for both the depressive and the bipolar disorders. It is argued that failure to specify a minimum number of criteria for certain conditions compromises valid intrinsic and differential definitions, while additional reasons leading to the quantified low reliability of dysthymia are noted. Several idiosyncratic definitions and rulings are noted, while numerous boundary issues (differentiating disorder categories and clinical depression from normative depression) are noted. The use and application of 'postcoordination' codes (in addition to 'specifiers') appears enigmatic and potentially unserviceable.

Introduction: Young-onset dementia (YOD) is a dementia where symptom onset occurs at less than 65 years of age. There has been increased recognition of YOD with improved diagnostic assessments and the introduction of the National Disability Insurance Scheme (NDIS). The Joint Solutions project aimed to evaluate the gaps and barriers along the pathway of care in Australia from a range of stakeholder perspectives to investigate access to services from those who have YOD and those who provide care for them.

Methods: A cross-sectional quantitative approach was used, with questionnaires designed in consultation with general practitioners (GPs), clinicians, people with YOD, caregivers and community service providers.

Results: 313 people responded, including 45% lived experience (n = 33 people with YOD; 105 caregivers), 30% clinicians (n = 7 GPs; n = 86 clinicians), and 25% community providers. All states of Australia were represented, with Victoria having the largest proportion of respondents (39%). Time to diagnosis was 12 months from symptom onset for 70% of caregivers. Up to 90% of caregivers reported their family member with YOD had cognitive testing and neuroimaging. Access to age-appropriate post-diagnostic support varied, with 40% of caregivers reporting their family member received allied health and psychological support. There was limited information provided on employment, driving, legal and financial issues. Sixty percent of people with lived experience stated they had difficulties accessing the NDIS.

Discussion: There is improvement in the diagnosis of YOD but access to and availability of post-diagnostic support varies. More work is needed to improve equity and collaboration between service providers and clinicians and those affected by YOD.

Objectives: We used a large, representative sample of adults with psychotic disorders (N = 1825) from the 2010 Australian national survey of psychotic disorders (Survey of High Impact Psychosis - SHIP) to report on 12-month prevalence of both any and violent criminal offending among people with psychotic disorders, and examine correlates of criminal offending, modelling the impact of clinical factors over known sociodemographic and behavioural risk factors.

Methods: Any past year criminal offending was the main outcome variable, based on self-reported criminal offending, charge and/or arrest. We assessed the additional impact of clinical variables over other risk factors associated with criminal offending. Odds ratio and 95% confidence intervals determined from logistic regression summarised the association of risk factors with offending outcomes.

Results: Of 1784 participants with valid responses, 305 (220 men, 85 women) reported criminal offending; 38 men and 6 women reporting some violent offending. Compared with non-offenders, younger age, male sex, homelessness, cannabis and other drug use, and past year delusions and mania were associated with offending in logistic regression models.

Conclusion: We found that known sociodemographic risk factors such as sex and homelessness were predictive of both any offending and violent offending. Other significant correlates of any offending behaviour were cannabis use, other illicit substance use and violent victimisation. Clinical factors including past year delusions, mania and deliberate self-harm, and premorbid personality disorder were associated with any offending but not with violent offending. Our study challenges the importance given to many clinical factors, especially in regard to risk of violent offending.