Pub Date : 2024-04-01Epub Date: 2024-01-05DOI: 10.1177/00048674231219593
Myrto T Samara, Niki Michou, Andreas S Lappas, Aikaterini Argyrou, Elissavet Mathioudaki, Dimitra Rafailia Bakaloudi, Eirini Tsekitsidi, Zoi A Polyzopoulou, Nikos Christodoulou, Georgios Papazisis, Michail Chourdakis
Objectives: Binge spectrum disorders are prevalent worldwide. Psychiatric and medical comorbidities are common, and societal costs are significant. Evidence-based treatment remains underutilized. Cognitive behavioral therapy is the recommended first-line treatment, but pharmacotherapy may be easier to access.
Interventions: Meta-analytic evidence directly comparing cognitive behavioral therapy with pharmacotherapy is lacking. We aimed to compare the effects of cognitive behavioral therapy interventions with any pharmacological treatment for binge spectrum disorders. We searched PubMed, Embase, CENTRAL, ClinicalTrials.gov and reference lists for randomized controlled trials comparing cognitive behavioral therapy with any pharmacotherapy for bulimia nervosa/binge eating disorder and performed pairwise meta-analytic evaluations.
Primary outcomes: Primary outcomes are remission and frequency of binges. Secondary outcomes are frequency of purges, response, eating disorder psychopathology, weight/body mass index, depression, anxiety, quality of life and dropouts.
Results: Eleven randomized controlled trials comparing cognitive behavioral therapy with fluoxetine/imipramine/desipramine/methylphenidate/sibutramine were identified (N = 531). Cognitive behavioral therapy was superior to antidepressants in terms of remission, frequency of binges and eating disorder psychopathology. There were no statistically significant differences for any of the individual cognitive behavioral therapy vs drug comparisons in terms of response/depression/anxiety/weight/quality of life/dropouts. Cognitive behavioral therapy was not superior to sibutramine/methylphenidate for the primary outcomes.
Conclusions: Data are scarce, comparisons underpowered and, considering the inherent methodological limitations of psychotherapy trials, questions arise regarding the presumed superiority of cognitive behavioral therapy. Further research is needed.
目的:暴饮暴食谱系障碍在全球普遍存在。精神和医疗并发症很常见,社会成本也很高。循证治疗仍未得到充分利用。认知行为疗法是推荐的一线治疗方法,但药物疗法可能更容易获得:缺乏直接比较认知行为疗法和药物疗法的 Meta 分析证据。我们旨在比较认知行为疗法干预与任何药物治疗对暴饮暴食谱系障碍的效果。我们在PubMed、Embase、CENTRAL、ClinicalTrials.gov和参考文献列表中检索了比较认知行为疗法与任何药物疗法治疗暴食症/进食障碍的随机对照试验,并进行了配对荟萃分析评估:主要结果:缓解和暴食频率是主要结果。次要结果包括暴食频率、反应、进食障碍心理病理学、体重/体重指数、抑郁、焦虑、生活质量和辍学:结果:11 项随机对照试验比较了认知行为疗法与氟西汀/丙咪嗪/地西普胺/哌甲酯/西布曲明(N = 531)。在缓解率、暴食频率和饮食失调精神病理学方面,认知行为疗法均优于抗抑郁药物。在反应/抑郁/焦虑/体重/生活质量/辍学方面,认知行为疗法与药物的单项比较差异均无统计学意义。就主要结果而言,认知行为疗法并不优于西布曲明/哌醋甲酯:数据稀缺,对比研究动力不足,考虑到心理疗法试验固有的方法局限性,认知行为疗法的假定优越性会引起质疑。需要进一步研究。
{"title":"Is cognitive behavioral therapy more effective than pharmacotherapy for binge spectrum disorders? A systematic review and meta-analysis.","authors":"Myrto T Samara, Niki Michou, Andreas S Lappas, Aikaterini Argyrou, Elissavet Mathioudaki, Dimitra Rafailia Bakaloudi, Eirini Tsekitsidi, Zoi A Polyzopoulou, Nikos Christodoulou, Georgios Papazisis, Michail Chourdakis","doi":"10.1177/00048674231219593","DOIUrl":"10.1177/00048674231219593","url":null,"abstract":"<p><strong>Objectives: </strong>Binge spectrum disorders are prevalent worldwide. Psychiatric and medical comorbidities are common, and societal costs are significant. Evidence-based treatment remains underutilized. Cognitive behavioral therapy is the recommended first-line treatment, but pharmacotherapy may be easier to access.</p><p><strong>Interventions: </strong>Meta-analytic evidence directly comparing cognitive behavioral therapy with pharmacotherapy is lacking. We aimed to compare the effects of cognitive behavioral therapy interventions with any pharmacological treatment for binge spectrum disorders. We searched PubMed, Embase, CENTRAL, ClinicalTrials.gov and reference lists for randomized controlled trials comparing cognitive behavioral therapy with any pharmacotherapy for bulimia nervosa/binge eating disorder and performed pairwise meta-analytic evaluations.</p><p><strong>Primary outcomes: </strong>Primary outcomes are remission and frequency of binges. Secondary outcomes are frequency of purges, response, eating disorder psychopathology, weight/body mass index, depression, anxiety, quality of life and dropouts.</p><p><strong>Results: </strong>Eleven randomized controlled trials comparing cognitive behavioral therapy with fluoxetine/imipramine/desipramine/methylphenidate/sibutramine were identified (<i>N</i> = 531). Cognitive behavioral therapy was superior to antidepressants in terms of remission, frequency of binges and eating disorder psychopathology. There were no statistically significant differences for any of the individual cognitive behavioral therapy vs drug comparisons in terms of response/depression/anxiety/weight/quality of life/dropouts. Cognitive behavioral therapy was not superior to sibutramine/methylphenidate for the primary outcomes.</p><p><strong>Conclusions: </strong>Data are scarce, comparisons underpowered and, considering the inherent methodological limitations of psychotherapy trials, questions arise regarding the presumed superiority of cognitive behavioral therapy. Further research is needed.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"308-319"},"PeriodicalIF":4.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139097218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2023-12-06DOI: 10.1177/00048674231215030
Paul M Jenkinson, Susan L Rossell
Body dysmorphic disorder is a severe psychiatric condition characterised by a preoccupation with a perceived appearance flaw or flaws that are typically not observable to others. Although significant advances in understanding the disorder have been made in the past decade, current explanations focus on cognitive, behavioural and visual perceptual disturbances that contribute to the disorder. Such a focus does not consider how perception of the internal body or interoception may be involved, despite (1) clinical observations of disturbed perception of the body in body dysmorphic disorder and (2) disturbed interoception being increasingly recognised as a transdiagnostic factor underlying a wide range of psychopathologies. In this paper, we use an existing model of hierarchical brain function and neural (predictive) processing to propose that body dysmorphic disorder involves defective interoception, with perceived appearance flaws being the result of 'interoceptive prediction errors' that cause body parts to be experienced as 'not just right'. We aim to provide a framework for interoceptive research into body dysmorphic disorder, and outline areas for future research.
{"title":"Disturbed interoception in body dysmorphic disorder: A framework for future research.","authors":"Paul M Jenkinson, Susan L Rossell","doi":"10.1177/00048674231215030","DOIUrl":"10.1177/00048674231215030","url":null,"abstract":"<p><p>Body dysmorphic disorder is a severe psychiatric condition characterised by a preoccupation with a perceived appearance flaw or flaws that are typically not observable to others. Although significant advances in understanding the disorder have been made in the past decade, current explanations focus on cognitive, behavioural and visual perceptual disturbances that contribute to the disorder. Such a focus does not consider how perception of the internal body or <i>interoception</i> may be involved, despite (1) clinical observations of disturbed perception of the body in body dysmorphic disorder and (2) disturbed interoception being increasingly recognised as a transdiagnostic factor underlying a wide range of psychopathologies. In this paper, we use an existing model of hierarchical brain function and neural (predictive) processing to propose that body dysmorphic disorder involves defective interoception, with perceived appearance flaws being the result of 'interoceptive prediction errors' that cause body parts to be experienced as 'not just right'. We aim to provide a framework for interoceptive research into body dysmorphic disorder, and outline areas for future research.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"300-307"},"PeriodicalIF":4.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138486560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2023-11-09DOI: 10.1177/00048674231209225
Amy-Leigh Rowe, Tania Perich, Tanya Meade
Objective: Trauma, social support and stress have been identified as factors which may be associated with the bipolar disorder illness course. However, these are yet to be examined in prospective studies as predictors of illness outcomes and overall quality of life in bipolar disorder.
Method: One hundred and fourteen participants (N = 97; 85.1% female) living with bipolar disorder I (41.2%) or II (58.8%) completed a semi-structured interview and a range of self-report measures assessing trauma history, social support, perceived stress, depression, anxiety, mania, suicidality, number of mood episodes and quality of life, at baseline and 6-month follow-up.
Results: Childhood cumulative trauma, social support and perceived stress accounted for a substantial and significant portion of the variance in quality of life (62%; 23.6%), anxiety severity (34.6%; 24.5%) and depression severity (49.6%; 26.7%), at both baseline and 6-month follow-up. Perceived stress made significant unique contributions to the prediction of all outcomes, and social support made significant unique contributions to depression and quality of life in bipolar disorder.
Conclusion: Stress and social support play an important role in bipolar disorder and in quality of life for people living with this condition. Given that stress and social support are modifiable risk factors, this provides a promising direction for future intervention-based research.
{"title":"Childhood cumulative trauma, social support and stress as predictors of illness outcomes and quality of life in bipolar disorder.","authors":"Amy-Leigh Rowe, Tania Perich, Tanya Meade","doi":"10.1177/00048674231209225","DOIUrl":"10.1177/00048674231209225","url":null,"abstract":"<p><strong>Objective: </strong>Trauma, social support and stress have been identified as factors which may be associated with the bipolar disorder illness course. However, these are yet to be examined in prospective studies as predictors of illness outcomes and overall quality of life in bipolar disorder.</p><p><strong>Method: </strong>One hundred and fourteen participants (<i>N</i> = 97; 85.1% female) living with bipolar disorder I (41.2%) or II (58.8%) completed a semi-structured interview and a range of self-report measures assessing trauma history, social support, perceived stress, depression, anxiety, mania, suicidality, number of mood episodes and quality of life, at baseline and 6-month follow-up.</p><p><strong>Results: </strong>Childhood cumulative trauma, social support and perceived stress accounted for a substantial and significant portion of the variance in quality of life (62%; 23.6%), anxiety severity (34.6%; 24.5%) and depression severity (49.6%; 26.7%), at both baseline and 6-month follow-up. Perceived stress made significant unique contributions to the prediction of all outcomes, and social support made significant unique contributions to depression and quality of life in bipolar disorder.</p><p><strong>Conclusion: </strong>Stress and social support play an important role in bipolar disorder and in quality of life for people living with this condition. Given that stress and social support are modifiable risk factors, this provides a promising direction for future intervention-based research.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"334-344"},"PeriodicalIF":4.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10960312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71520336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2023-10-27DOI: 10.1177/00048674231207583
Mau Te Rangimarie Clark, Jenni Manuel, Cameron Lacey, Suzanne Pitama, Ruth Cunningham, Jennifer Jordan
Background: Eating disorders are as common in Māori, the Indigenous people of Aotearoa-New Zealand, as they are in non-Māori; however, research has focused on the experiences of non-Māori. This paper will describe explanatory factors, treatment experiences and what helps with recovery for Māori.
Methods: Kaupapa Māori research methodology informed the methods and analysis. Fifteen semi-structured interviews comprised thirteen Māori participants with eating disorders (anorexia nervosa, bulimia nervosa and binge eating disorder) and two whānau (support network) members. A thematic analysis was undertaken by a first cycle of coding that used deductive structural coding to identify data describing participants' perceived causes of eating disorders, their experience of treatment and recovery. A second cycle of coding used inductive analysis with descriptive and pattern coding.
Results: Three overarching themes were antecedents (cumulative exposure), treatment (a system of complexities) and recovery (resource empowerment). Antecedents comprised cumulative exposure to body and sporting ideals and adversity as causal factors of eating disorders. In the treatment theme, a system of complexities critiqued rural settings for generalised mental health services, allocation of Māori cultural support, the economic burden of treatment, culturally incongruent treatment (methods, values) and a weight-focused discharge criterion. Recovery (resource empowerment) found appropriate health information, self-determination and connection to Māori culture and whānau aspirations helped with recovery.
Conclusion: The diversity of birdcalls reminds us of the individuality of eating disorders. Health practitioners are reminded that just as the Tūī, Kākā and Kererū possess their own unique birdcalls, so do Māori with eating disorders and their whānau have their own experiences, needs and required treatment responses.
{"title":"'E koekoe te Tūī, e ketekete te Kākā, e kuku te Kererū, The Tūī chatters, the Kākā cackles, and the Kererū coos': Insights into explanatory factors, treatment experiences and recovery for Māori with eating disorders - A qualitative study.","authors":"Mau Te Rangimarie Clark, Jenni Manuel, Cameron Lacey, Suzanne Pitama, Ruth Cunningham, Jennifer Jordan","doi":"10.1177/00048674231207583","DOIUrl":"10.1177/00048674231207583","url":null,"abstract":"<p><strong>Background: </strong>Eating disorders are as common in Māori, the Indigenous people of Aotearoa-New Zealand, as they are in non-Māori; however, research has focused on the experiences of non-Māori. This paper will describe explanatory factors, treatment experiences and what helps with recovery for Māori.</p><p><strong>Methods: </strong>Kaupapa Māori research methodology informed the methods and analysis. Fifteen semi-structured interviews comprised thirteen Māori participants with eating disorders (anorexia nervosa, bulimia nervosa and binge eating disorder) and two whānau (support network) members. A thematic analysis was undertaken by a first cycle of coding that used deductive structural coding to identify data describing participants' perceived causes of eating disorders, their experience of treatment and recovery. A second cycle of coding used inductive analysis with descriptive and pattern coding.</p><p><strong>Results: </strong>Three overarching themes were antecedents (cumulative exposure), treatment (a system of complexities) and recovery (resource empowerment). Antecedents comprised cumulative exposure to body and sporting ideals and adversity as causal factors of eating disorders. In the treatment theme, a system of complexities critiqued rural settings for generalised mental health services, allocation of Māori cultural support, the economic burden of treatment, culturally incongruent treatment (methods, values) and a weight-focused discharge criterion. Recovery (resource empowerment) found appropriate health information, self-determination and connection to Māori culture and whānau aspirations helped with recovery.</p><p><strong>Conclusion: </strong>The diversity of birdcalls reminds us of the individuality of eating disorders. Health practitioners are reminded that just as the Tūī, Kākā and Kererū possess their own unique birdcalls, so do Māori with eating disorders and their whānau have their own experiences, needs and required treatment responses.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"365-372"},"PeriodicalIF":4.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54227502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2023-12-26DOI: 10.1177/00048674231219587
Nicola J Reavley, Nina Logan, Amy Morgan, Anna Ross, Anthony F Jorm
{"title":"Research Letter: Could ChatGPT and Bard provide helpful responses to a person seeking advice on how to support someone with a mental health problem?","authors":"Nicola J Reavley, Nina Logan, Amy Morgan, Anna Ross, Anthony F Jorm","doi":"10.1177/00048674231219587","DOIUrl":"10.1177/00048674231219587","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"373-375"},"PeriodicalIF":4.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139039441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2023-11-09DOI: 10.1177/00048674231210209
Ramya Padmavathy Radha Krishnan, Christopher Harrison, Nicholas Buckley, Jacques Eugene Raubenheimer
Objective: To determine antipsychotic utilisation patterns in Australian adults from 2005 to 2021, with a focus on on-label and off-label prescriptions.
Methods: We examined antipsychotic dispensing trends in adults from 2005 to 2021 using a 10% sample of the Pharmaceutical Benefits Scheme (PBS) dataset, which contains patient-level information on medicines dispensed throughout Australia. The lack of diagnostic information in PBS was substituted by analysing BEACH (Bettering the Evaluation And Care of Health) dataset, a cross-sectional national survey from 2000 to 2016, consisting of data from general practitioner-patient encounters.
Results: There were 5.6 million dispensings for 164,993 patients in PBS throughout this period; 69% patients had >1 dispensing, with a median of 6 per patient. Calculating the estimated period of exposure gave a total of 693,562 treatment episodes, with a median duration of 80 days. There were steady increases in both the incidence and prevalence of antipsychotic dispensings, mainly due to oral second-generation antipsychotics. The most commonly prescribed antipsychotics were quetiapine, olanzapine and risperidone, with a significant portion of patients receiving low-dose quetiapine without dose titration. Analysis of diagnostic indications from BEACH indicated that 27% of antipsychotic prescriptions were off-label for indications such as depression, dementia, anxiety and insomnia, at much lower prescribed daily dosages.
Conclusion: The increasing prescribing and off-label use highlights concerns about chronic adverse effects caused by antipsychotics. The combined analysis of medication dispensings and the diagnostic indications for which they are prescribed is a novel approach and throws a spotlight on the need for additional monitoring of antipsychotics.
{"title":"On- and off-label utilisation of antipsychotics in Australia (2000-2021): Retrospective analysis of two medication datasets.","authors":"Ramya Padmavathy Radha Krishnan, Christopher Harrison, Nicholas Buckley, Jacques Eugene Raubenheimer","doi":"10.1177/00048674231210209","DOIUrl":"10.1177/00048674231210209","url":null,"abstract":"<p><strong>Objective: </strong>To determine antipsychotic utilisation patterns in Australian adults from 2005 to 2021, with a focus on on-label and off-label prescriptions.</p><p><strong>Methods: </strong>We examined antipsychotic dispensing trends in adults from 2005 to 2021 using a 10% sample of the Pharmaceutical Benefits Scheme (PBS) dataset, which contains patient-level information on medicines dispensed throughout Australia. The lack of diagnostic information in PBS was substituted by analysing BEACH (Bettering the Evaluation And Care of Health) dataset, a cross-sectional national survey from 2000 to 2016, consisting of data from general practitioner-patient encounters.</p><p><strong>Results: </strong>There were 5.6 million dispensings for 164,993 patients in PBS throughout this period; 69% patients had >1 dispensing, with a median of 6 per patient. Calculating the estimated period of exposure gave a total of 693,562 treatment episodes, with a median duration of 80 days. There were steady increases in both the incidence and prevalence of antipsychotic dispensings, mainly due to oral second-generation antipsychotics. The most commonly prescribed antipsychotics were quetiapine, olanzapine and risperidone, with a significant portion of patients receiving low-dose quetiapine without dose titration. Analysis of diagnostic indications from BEACH indicated that 27% of antipsychotic prescriptions were off-label for indications such as depression, dementia, anxiety and insomnia, at much lower prescribed daily dosages.</p><p><strong>Conclusion: </strong>The increasing prescribing and off-label use highlights concerns about chronic adverse effects caused by antipsychotics. The combined analysis of medication dispensings and the diagnostic indications for which they are prescribed is a novel approach and throws a spotlight on the need for additional monitoring of antipsychotics.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"320-333"},"PeriodicalIF":4.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10960313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71520315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2023-12-14DOI: 10.1177/00048674231216601
Julie A Blake, Taya L Farugia, Brooke Andrew, Eva Malacova, David Lawrence, Hannah J Thomas, James G Scott
Introduction: The 10-item Kessler Psychological Distress Scale (K10) is used to screen adolescents for mental disorders in Australian clinical practice; however, there are no Australian adolescent normative data.
Methods: Data were drawn from a nationally representative sample (N = 2964) of Australian adolescents (11-17 years). This study had three aims: (1) to examine concurrent validity between the K10 and Strengths and Difficulties Questionnaire (SDQ) emotional symptoms subscale, (2) to establish normative Australian adolescent K10 data and (3) to determine optimal K10 cut-off scores for screening for major depressive disorder (MDD) via receiver operator characteristic curve analysis and stratum-specific likelihood ratios.
Results: The K10 and SDQ emotional symptoms scales were moderately correlated (rs = 0.63, p < 0.001). Older female adolescents reported higher total K10 scores compared with younger female adolescents (15-17 years: M = 20.2, standard error [SE] = 0.3; 11-14 years: M = 16.8, SE = 0.3) and male adolescents (11-14 years: M = 16.6, SE = 0.2; 15-17 years: M = 16.0, SE=0.2). K10 scores to optimally discriminate those with and without MDD varied by age and sex and had low specificities. Stratum-specific likelihood ratios indicated adolescents with a K10 score of ≥30 will have a 12.9 (95% confidence interval = [10.2, 16.2]) increased likelihood of MDD.
Conclusion: The K10 has utility for assessing psychological distress in health care and epidemiological research in Australian adolescents. Adolescents with K10 scores in the 'very high' range are at increased risk of MDD. Further assessment of these young people is indicated to identify those with or at risk of developing MDD.
{"title":"The Kessler Psychological Distress Scale in Australian adolescents: Analysis of the second Australian Child and Adolescent Survey of Mental Health and Wellbeing.","authors":"Julie A Blake, Taya L Farugia, Brooke Andrew, Eva Malacova, David Lawrence, Hannah J Thomas, James G Scott","doi":"10.1177/00048674231216601","DOIUrl":"10.1177/00048674231216601","url":null,"abstract":"<p><strong>Introduction: </strong>The 10-item Kessler Psychological Distress Scale (K10) is used to screen adolescents for mental disorders in Australian clinical practice; however, there are no Australian adolescent normative data.</p><p><strong>Methods: </strong>Data were drawn from a nationally representative sample (<i>N</i> = 2964) of Australian adolescents (11-17 years). This study had three aims: (1) to examine concurrent validity between the K10 and Strengths and Difficulties Questionnaire (SDQ) emotional symptoms subscale, (2) to establish normative Australian adolescent K10 data and (3) to determine optimal K10 cut-off scores for screening for major depressive disorder (MDD) via receiver operator characteristic curve analysis and stratum-specific likelihood ratios.</p><p><strong>Results: </strong>The K10 and SDQ emotional symptoms scales were moderately correlated (<i>r<sub>s</sub></i> = 0.63, <i>p</i> < 0.001). Older female adolescents reported higher total K10 scores compared with younger female adolescents (15-17 years: M = 20.2, standard error [SE] = 0.3; 11-14 years: M = 16.8, SE = 0.3) and male adolescents (11-14 years: M = 16.6, SE = 0.2; 15-17 years: M = 16.0, SE<i>=</i>0.2). K10 scores to optimally discriminate those with and without MDD varied by age and sex and had low specificities. Stratum-specific likelihood ratios indicated adolescents with a K10 score of <u>≥</u>30 will have a 12.9 (95% confidence interval = [10.2, 16.2]) increased likelihood of MDD.</p><p><strong>Conclusion: </strong>The K10 has utility for assessing psychological distress in health care and epidemiological research in Australian adolescents. Adolescents with K10 scores in the 'very high' range are at increased risk of MDD. Further assessment of these young people is indicated to identify those with or at risk of developing MDD.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"345-354"},"PeriodicalIF":4.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138795743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-12-14DOI: 10.1177/00048674231215021
Jesse Gates, Sarah Bendall, Hailey Tremain, Clare Shelton, Dylan Hammond, Craig Macneil, Patrick McGorry, Michael Berk, Sue Cotton, Greg Murray, Aswin Ratheesh
{"title":"Research Letter: What do Australian consumers with lived experience of bipolar disorder want from early intervention services?","authors":"Jesse Gates, Sarah Bendall, Hailey Tremain, Clare Shelton, Dylan Hammond, Craig Macneil, Patrick McGorry, Michael Berk, Sue Cotton, Greg Murray, Aswin Ratheesh","doi":"10.1177/00048674231215021","DOIUrl":"10.1177/00048674231215021","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"280-283"},"PeriodicalIF":4.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138795740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-12-29DOI: 10.1177/00048674231219175
Rebecca White
{"title":"Letter to the Editor: Letter to the Editor regarding 'Abuses in psychiatric care: The shameful story of the Lake Alice Child and Adolescent unit in Aotearoa New Zealand'.","authors":"Rebecca White","doi":"10.1177/00048674231219175","DOIUrl":"10.1177/00048674231219175","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"284"},"PeriodicalIF":4.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-06-23DOI: 10.1177/00048674231181039
Amanda L Baker, Kristen McCarter, Alyna Turner, Catherine Segan, David Castle, Lisa Brophy, Ron Borland, Peter J Kelly, Billie Bonevski, Donita Baird, Sacha Filia, John Attia, Stuart Szwec, Kerrin Palazzi, Sarah L White, Jill M Williams, Anna L Wrobel, Andrew Ireland, Karinna Saxby, Peter Ghijben, Dennis Petrie, Rohan Sweeney
Objective: The aim of this study was to test the effectiveness of a tailored quitline tobacco treatment ('Quitlink') among people receiving support for mental health conditions.
Methods: We employed a prospective, cluster-randomised, open, blinded endpoint design to compare a control condition to our 'Quitlink' intervention. Both conditions received a brief intervention delivered by a peer researcher. Control participants received no further intervention. Quitlink participants were referred to a tailored 8-week quitline intervention delivered by dedicated Quitline counsellors plus combination nicotine replacement therapy. The primary outcome was self-reported 6 months continuous abstinence from end of treatment (8 months from baseline). Secondary outcomes included additional smoking outcomes, mental health symptoms, substance use and quality of life. A within-trial economic evaluation was conducted.
Results: In total, 110 participants were recruited over 26 months and 91 had confirmed outcomes at 8 months post baseline. There was a difference in self-reported prolonged abstinence at 8-month follow-up between Quitlink (16%, n = 6) and control (2%, n = 1) conditions, which was not statistically significant (OR = 8.33 [0.52, 132.09] p = 0.131 available case). There was a significant difference in favour of the Quitlink condition on 7-day point prevalence at 2 months (OR = 8.06 [1.27, 51.00] p = 0.027 available case). Quitlink costs AU$9231 per additional quit achieved.
Conclusion: The Quitlink intervention did not result in significantly higher rates of prolonged abstinence at 8 months post baseline. However, engagement rates and satisfaction with the 'Quitlink' intervention were high. While underpowered, the Quitlink intervention shows promise. A powered trial to determine its effectiveness for improving long-term cessation is warranted.
{"title":"'Quitlink': Outcomes of a randomised controlled trial of peer researcher facilitated referral to a tailored quitline tobacco treatment for people receiving mental health services.","authors":"Amanda L Baker, Kristen McCarter, Alyna Turner, Catherine Segan, David Castle, Lisa Brophy, Ron Borland, Peter J Kelly, Billie Bonevski, Donita Baird, Sacha Filia, John Attia, Stuart Szwec, Kerrin Palazzi, Sarah L White, Jill M Williams, Anna L Wrobel, Andrew Ireland, Karinna Saxby, Peter Ghijben, Dennis Petrie, Rohan Sweeney","doi":"10.1177/00048674231181039","DOIUrl":"10.1177/00048674231181039","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to test the effectiveness of a tailored quitline tobacco treatment ('Quitlink') among people receiving support for mental health conditions.</p><p><strong>Methods: </strong>We employed a prospective, cluster-randomised, open, blinded endpoint design to compare a control condition to our 'Quitlink' intervention. Both conditions received a brief intervention delivered by a peer researcher. Control participants received no further intervention. Quitlink participants were referred to a tailored 8-week quitline intervention delivered by dedicated Quitline counsellors plus combination nicotine replacement therapy. The primary outcome was self-reported 6 months continuous abstinence from end of treatment (8 months from baseline). Secondary outcomes included additional smoking outcomes, mental health symptoms, substance use and quality of life. A within-trial economic evaluation was conducted.</p><p><strong>Results: </strong>In total, 110 participants were recruited over 26 months and 91 had confirmed outcomes at 8 months post baseline. There was a difference in self-reported prolonged abstinence at 8-month follow-up between Quitlink (16%, <i>n</i> = 6) and control (2%, <i>n</i> = 1) conditions, which was not statistically significant (OR = 8.33 [0.52, 132.09] <i>p</i> = 0.131 available case). There was a significant difference in favour of the Quitlink condition on 7-day point prevalence at 2 months (OR = 8.06 [1.27, 51.00] <i>p</i> = 0.027 available case). Quitlink costs AU$9231 per additional quit achieved.</p><p><strong>Conclusion: </strong>The Quitlink intervention did not result in significantly higher rates of prolonged abstinence at 8 months post baseline. However, engagement rates and satisfaction with the 'Quitlink' intervention were high. While underpowered, the Quitlink intervention shows promise. A powered trial to determine its effectiveness for improving long-term cessation is warranted.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"260-276"},"PeriodicalIF":4.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10903138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10053451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}