Australasian Psychiatry最新文献

ObjectiveResearch has repeatedly failed to account for the high suicide rate post-discharge from a psychiatric hospital. It is apparent that research in this field largely focuses on simple categorical variables and fails to consider inpatient experiences of their admission and treatment.ConclusionsEmpirically investigating how the treatment experience itself can contribute to post-discharge adverse outcomes is required. Failure to broaden our investigation into causes of post-discharge suicide will hamper our efforts in addressing this devastating issue.

IntroductionData sharing is the practice of making de-identified participant-level data available for use by other researchers. It increases the potential of a dataset to answer new questions, accelerates knowledge creation and increases research integrity by allowing conclusions to be replicated, verified or corrected. Data sharing helps fulfil the ethical obligation to make the most of research participants' contributions to science.Analysis and EvidenceThere is evidence that research participants and the general public are supportive of data sharing. However, those who conducted the original studies may be reluctant to share data, and datasets may be difficult to access, and there may be ethical and governance concerns.DiscussionThis paper describes the Mental Health Node, an Australian Government initiative that aims to increase mental health data sharing. The Mental Health Node works with primary researchers (those who conduct original studies), and secondary researchers (those who reuse data generated by others) to promote ethical data sharing that respects the role of primary researchers and the privacy concerns of research participants.ConclusionPrimary and secondary researchers can collaborate to maximise the value of data collected. This paper includes recommendations for good practice in data sharing and links to resources.

ObjectiveNegative emotional states are well-established risk factors for technological addictions because some individuals use games, social media, or pornography excessively as a coping strategy. Given these links, perceived social support should act as a buffer against the effects of negative emotional states. Consequently, the current exploratory study aimed to examine the role of perceived social support in moderating the effects of negative emotional states on technological addictions.MethodsThere was a total of 169 participants (71.6% females, 27.2% males, and 1.2% others). They completed instruments that assess negative emotional states, perceived social support, internet gaming disorder (IGD), social media addiction (SMA), and problematic pornography use (PPU).ResultsThe results showed that perceived social support had buffering effects (reducing symptoms of technological addictions), paradoxical effects (exacerbating symptoms of technological addictions), and no significant effects. Specifically, individuals with low negative emotional states had lower PPU with perceived social support from significant other and family. However, individuals with high negative emotional states had higher IGD and PPU with perceived social support from family.ConclusionLimitations include the lack of distinction between online and offline perceived social support and the omission of the last item of the instrument for PPU. Limitations notwithstanding, the study extended on previous research and highlighted the complex relationships between negative emotional states, perceived social support, and technological addictions.

BackgroundThe impact of client and programme-related variables on employment outcomes among participants of Individual Placement and Support programmes has been sub-optimally researched. We evaluated the effectiveness of an Individual Placement and Support programme and examined selected demographic, clinical, and programme-related variables associated with obtaining competitive employment.MethodsData were collected retrospectively from consecutive participants with severe mental illness enrolled in an Individual Placement and Support programme co-located as a partnership between a disability employment service provider and a public mental health service in Western Australia. Demographic, clinical, and service engagement characteristics of the groups that obtained and did not obtain competitive employment were collated, compared, and analysed to predict successful employment outcomes.ResultsOf the 84 participants, 36 (42.9%) secured competitive employment. The absence of psychiatric comorbidity (p = .037) and especially, shorter time between the programme commencement and first face-to-face contact (p < .001) were strongly associated with positive employment outcome.ConclusionModifiable participant and programme-related characteristics can significantly impact the outcome of Individual Placement and Support services for people with severe mental illness implemented at everyday clinical settings. Managing these within clinical services and Individual Placement and Support programmes has potential to improve participant outcomes.

Transcranial magnetic stimulation (TMS) is essential for the comprehensive treatment of major depressive disorder (MDD). Around Australia, it is widely available in private practice, but in few Public Mental Health Services. TMS is a revolutionary treatment. Using electromagnetic apparatus, the function of precise local and distant regions of the brain can be modulated, with minimal side effects. Half of patients with MDD do not respond to antidepressant medication. However, a large proportion of medication non-responders can be brought to remission using TMS. This intervention is cost-effective and availability in public practice should be increased.

ObjectivesTo determine bidirectional relationships between incarceration and mental disorders. We hypothesized that (1) pre-existing mental disorders would be associated with increased incarceration risk, and (2) incarceration would be associated with increased incident mental disorder diagnosis risk in adolescents without prior psychiatric diagnosis.MethodThis retrospective cohort study included 1551 adolescents (aged 10-17 years) from four New South Wales (NSW) health surveys linked to justice and health records. Modified Poisson regression examined associations between pre-existing mental disorders and incarceration. Prentice-Williams-Peterson Total-Time models examined associations between time-varying incarceration exposure and incident mental disorder diagnoses among those without prior diagnosis.ResultsAmong 1551 adolescents (87.7% male; median age 15 years), pre-existing mental disorders were associated with an increased incarceration risk (adjusted Risk Ratio [RR]: 1.26, 95% Confidence Interval [CI]: 1.09-1.45), which was more pronounced among those with violent offences. Among 1424 adolescents without prior diagnosis, incarceration was associated with increased incident diagnosis risk (adjusted Hazard Ratio [aHR]: 1.22, 95% CI: 1.09-1.37), with stronger associations among adolescents residing in areas of higher socioeconomic disadvantage.ConclusionsFindings suggest incarceration may be associated with adverse mental health outcomes, with implications for diversionary pathways and custodial mental health care.