Journal articles on the topic 'Depression, Mental Diagnosis Australia'
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Daluwatta, Amanda, Dushan Peiris, Kathryn Fletcher, Chris Ludlow, and Greg Murray. "Can Sri Lankan Australians Recognise Depression? The Influence of Acculturation, Age and Experiences with Depression on Recognition." International Journal of Environmental Research and Public Health 19, no. 22 (November 11, 2022): 14839. http://dx.doi.org/10.3390/ijerph192214839.
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Mental health literacy is an important determinant of mental health help-seeking and is associated with improved mental health. There is evidence that mental health literacy may be lower amongst some migrant communities in Australia. The present study conducted the first cross-sectional survey of mental health literacy in Sri Lankan Australians between April and October 2020. Participants (N = 404) were presented with a culturally-tailored vignette describing an individual with symptoms of major depressive disorder, with correct recognition determined by the coding of an open text response to the question ‘what’s wrong with Mr Silva?’. Binomial linear regression modelling was conducted to identify predictors of the correct recognition of depression. Approximately 74% of participants recognised the presented symptoms as depression, though multiple other labels were also used by the respondents. The results also suggested that younger age and having a prior diagnosis of depression were significant predictors of recognising depression in the vignette. In the first study of Sri Lankan migrants’ mental health literacy in an Australian context, the rates of depression recognition were comparable to those found in the general Australian population. Further research is urgently required to replicate and extend the present findings and ultimately support the development of tailored interventions aimed at improving mental health literacy across the diverse Sri Lankan Australian community.
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Cheema, Madiha, Nikola Mitrev, Leanne Hall, Maria Tiongson, Golo Ahlenstiel, and Viraj Kariyawasam. "Depression, anxiety and stress among patients with inflammatory bowel disease during the COVID-19 pandemic: Australian national survey." BMJ Open Gastroenterology 8, no. 1 (February 2021): e000581. http://dx.doi.org/10.1136/bmjgast-2020-000581.
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BackgroundThe global COVID-19 pandemic has impacted on the mental health of individuals, particularly those with chronic illnesses. We aimed to quantify stress, anxiety and depression among individuals with Inflammatory bowel disease (IBD) in Australia during the pandemic.MethodsAn electronic survey was made available to IBD patients Australia-wide from 17 June to 12 July 2020. Respondents with an underlying diagnosis of IBD and over 18 years of age were included. A validated questionnaire (Depression, Anxiety, Stress Score-21, DASS21) was used to assess depression, anxiety and stress. Data on potential predictors of depression, anxiety and stress were collected.Results352 participated in the survey across Australia. 60.5% of respondents fulfilled DASS criteria for at least moderate depression, anxiety or stress. 45% reported a pre-existing diagnosis of depression and/or anxiety. Over 2/3 of these respondents reported worsening of their pre-existing depression/anxiety due to the current pandemic. Of those without a pre-existing diagnosis of anxiety or depression, high rates of at least moderate to severe depression (34.9%), anxiety (32.0%) and stress (29.7%) were noted. Younger age (OR 0.96, 95% CI 0.94 to 0.98, p<0.001), lack of access to an IBD nurse (OR 1.81, 95% CI 1.03 to 3.19, p=0.04) and lack of education on reducing infection risk (OR 1.99, 95% CI 1.13 to 3.50, p=0.017) were associated with significant stress, anxiety and/or depression.ConclusionHigh prevalence of undiagnosed depression, anxiety and stress was identified among respondents. Improved access to IBD nurse support and greater attention to education are modifiable factors that may reduce depression, anxiety and/or stress among patients with IBD during the pandemic.
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Marmanidis, H., G. Holme, and R. J. Hafner. "Depression and Somatic Symptoms: A Cross-Cultural Study." Australian & New Zealand Journal of Psychiatry 28, no. 2 (June 1994): 274–78. http://dx.doi.org/10.1080/00048679409075639.
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The study was carried out by the same research team in two metropolitan hospitals, one in Greece (N = 60) and one in Australia (N q 56). Subjects comprised patients consecutively admitted with a DSM-III-R diagnosis of depressive disorder, all of whom completed questionnaire measures of depression, anxiety and somatic symptoms. Clinical concepts and practices in the two hospitals were very similar. Overall levels of depression, anxiety and somatic symptoms in the two samples were almost identical, but there were differences in the pattern of somatic complaints: Greeks scored significantly higher on dizziness, paraesthesiae and masticatory spasms, and Australians scored significantly higher on drowsiness, hypersomnia and non-refreshing sleep, with the latter two items being the best discriminators of the two samples using discriminant function analysis. These findings, combined with factor analysis, suggested that symptoms associated with hyperventilation in the Greek sample, and with sleep disturbance in the Australian sample, explained most of the differences between them.
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Lubman, Dan I., Leanne Hides, Anthony F. Jorm, and Amy J. Morgan. "Health Professionals’ Recognition of Co-Occurring Alcohol and Depressive Disorders in Youth: A Survey of Australian General Practitioners, Psychiatrists, Psychologists and Mental Health Nurses Using Case Vignettes." Australian & New Zealand Journal of Psychiatry 41, no. 10 (October 2007): 830–35. http://dx.doi.org/10.1080/00048670701579090.
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Objective: To examine whether health professionals who commonly deal with mental disorder are able to identify co-occurring alcohol misuse in young people presenting with depression. Method: Between September 2006 and January 2007, a survey examining beliefs regarding appropriate interventions for mental disorder in youth was sent to 1710 psychiatrists, 2000 general practitioners (GPs), 1628 mental health nurses, and 2000 psychologists in Australia. Participants within each professional group were randomly given one of four vignettes describing a young person with a DSM-IV mental disorder. Herein is reported data from the depression and depression with alcohol misuse vignettes. Results: A total of 305 psychiatrists, 258 GPs, 292 mental health nurses and 375 psychologists completed one of the depression vignettes. A diagnosis of mood disorder was identified by at least 83.8% of professionals, with no significant differences noted between professional groups. Rates of reported co-occurring substance use disorders were substantially lower, particularly among older professionals and psychologists. Conclusions: GPs, psychologists and mental health professionals do not readily identify co-occurring alcohol misuse in young people with depression. Given the substantially negative impact of co-occurring disorders, it is imperative that health-care professionals are appropriately trained to detect such disorders promptly, to ensure young people have access to effective, early intervention.
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Cosgrave, Elizabeth, Eóin Killackey, Alison Yung, Joe Buckby, Katherine Godfrey, Carrie Stanford, Antonia Stuart, and Patrick D. McGorry. "Depression, Substance Use and Suicidality in Help-Seeking Adolescents: A Survey of Prevalence." Australian Journal of Guidance and Counselling 14, no. 2 (December 2004): 162–75. http://dx.doi.org/10.1017/s1037291100002478.
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AbstractMental health problems affect a sizeable minority of Australian adolescents. Depression and substance use disorders are common mental disorders reported in this age group. Difficulties of this nature that manifest in adolescence will often continue into adulthood. This report describes a sample of adolescents referred to a public mental health service with respect to their psychiatric diagnoses, depressive symptoms, patterns of substance use and level of suicidality. Mood disorders and substance-use disorders were both prevalent in the sample of participants, with sizeable comorbidity reflected in the number ol participants meeting criteria for both of these diagnoses. Data revealed participants with a psychiatric diagnosis were significantly more likely to have made a suicide attempt than those with no diagnosis. High levels of depressive symptoms were associated with suicidality, illicit substance use, and the likelihood of having a psychiatric diagnosis. Heavy use of alcohol was prevalent in this group, but unrelated to the other variables of interest to the study. These results are discussed with respect to the importance of early detection of vulnerable students in a school setting.
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Almeida, Osvaldo P., and Jianguo Xiao. "Mortality Associated with Incident Mental Health Disorders After Stroke." Australian & New Zealand Journal of Psychiatry 41, no. 3 (March 2007): 274–81. http://dx.doi.org/10.1080/00048670601172772.
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Objective: Sparse information is currently available about the incidence of the major psychiatric syndromes following a stroke and their long-term contribution to morbidity and mortality. This study was designed to determine: (1) the incidence of first ever mental health disorder in amongst stroke patients; (2) the 10-year mortality associated with incident post-stroke mental health disorders. Methods: Design: Retrospective cohort study. Setting: Entire Western Australian community. Participants: First-ever stroke in 1990. Subjects with a prior recorded history of any mental health disorder were excluded from the study. Main outcomes of interest: Incident mental health diagnoses and 10-year mortality. Results: 1,129 hospital stroke contacts were recorded in 1990, with 21 people dying on the same day of contact. Between 1990-2002 36.6% of the survivors received a mental health diagnosis (6.1 per 1,000 person-years): alcohol-related disorders (16.2%), dementia (12.1%), delirium (7.6%), psychotic disorders (6.7%), and depression (5.5%). Mental health disorder onset was usually within 6 months of the stroke. Patients with an incident psychotic disorder were twice as likely to die during the subsequent 10 years as post-stroke controls with no mental health disorder (risk ratio = 2.03, 95%CI = 1.39-2.95). Being a widow (HR = 1.61, 95%CI = 1.13-2.30) or having been born in ‘other countries’ as opposed to Australia (HR = 1.56, 95%CI = 1.15-2.11) was also associated with increased death hazard. Conclusions: Approximately 1 in 3 patients develop a mental health disorder after stroke, although incidence estimates are relatively low. Post-stroke psychosis is associated with greater 10-year mortality, but the mechanisms underlying such an association are yet to be determined.
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Stanners, Melinda N., Christopher A. Barton, Sepehr Shakib, and Helen R. Winefield. "A qualitative investigation of the impact of multimorbidity on GP diagnosis and treatment of depression in Australia." Aging & Mental Health 16, no. 8 (July 27, 2012): 1058–64. http://dx.doi.org/10.1080/13607863.2012.702730.
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Mihalopoulos, Cathrine, Mary Lou Chatterton, Lidia Engel, Long Khanh-Dao Le, and Yong Yi Lee. "Whither economic evaluation in the case of COVID-19: What can the field of mental health economics contribute within the Australian context?" Australian & New Zealand Journal of Psychiatry 54, no. 12 (October 2, 2020): 1157–61. http://dx.doi.org/10.1177/0004867420963724.
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COVID-19 has resulted in broad impacts on the economy and aspects of daily life including our collective mental health and well-being. The Australian health care system already faces limitations in its ability to treat people with mental health diagnoses. Australia has responded to the COVID-19 outbreak by, among other initiatives, providing reimbursement for telehealth services. However, it is unclear if these measures will be enough to manage the psychological distress, depression, anxiety and post-traumatic distress shown to accompany infectious disease outbreaks and economic shocks. Decision making has focused on the physical health ramifications of COVID-19, the avoidance of over-burdening the health care system and saving lives. We propose an alternative framework for decision making that combines life years saved with impacts on quality of life. A framework that simultaneously includes mental health and broader economic impacts into a single decision-making process would facilitate transparent and accountable decision making that can improve the overall welfare of Australian society as we continue to address the considerable challenges that the COVID-19 pandemic is creating.
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Wood, Debra A., Debra A. Wood, and Philip M. Burgess. "Epidemiological Analysis of Electroconvulsive Therapy in Victoria, Australia." Australian & New Zealand Journal of Psychiatry 37, no. 3 (June 2003): 307–11. http://dx.doi.org/10.1046/j.1440-1614.2003.01182.x.
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Objective: To determine the population-based utilization rate of electroconvulsive therapy (ECT) in Victoria between 1998–1999, to examine the characteristics of the ECT treated group, and to identify patient factors independently associated with differential rates of ECT treatment. Method: Electroconvulsive therapy is reported under statute in Victoria, Australia. Crude, age-adjusted and age–sex specific utilization rates were calculated using this statutory data for the 1998–1999 financial year and estimated mid-year populations from the Australian Bureau of Statistics. Descriptive characteristics of those treated with ECT were derived from the statutory data. Patient factors associated with an increased likelihood of ECT in the public sector were explored with logistic regression analysis, using non-ECT treated mental health patients from the Victorian Psychiatric Case Register as the reference population. Results: The crude treated-person and age-adjusted rates for the State (both public and private sectors) were 39.9 and 44.0 persons per 100 000 resident population per annum, respectively. The crude and age-adjusted administration rates were 330.3 and 362.6 ECT administrations per 100 000 resident population per annum, respectively. Age–sex specific rates varied by age and sex, with rates generally increasing with age and female sex. Overall, 62.8% of the treated group were women, 32.9% aged over 64, and 75.2% had depression. Diagnosis, age and sex each independently predicted ECT in the public sector, with diagnosis the most important factor, followed by age then sex. Conclusions: Despite decades of use, the appropriate rate of ECT utilization is still unclear. Further research should be directed at exploring the factors, including provider variables, determining ECT treatment.
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Wang, Imogen, and Carolyn Breadon. "A retrospective audit of joint mother–baby admissions to the Werribee Mercy mother and baby unit (MBU) and of the severity of maternal depression over the course of admission." Australasian Psychiatry 28, no. 2 (September 30, 2019): 220–25. http://dx.doi.org/10.1177/1039856219878649.
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Objectives: This study examined (i) the demographic and illness profiles of mothers admitted to Werribee Mercy MBU in Victoria, Australia and (ii) the severity of maternal depressive symptoms over the course of admission. Method: A retrospective audit was conducted on consecutively admitted mother–baby dyads between January 2011 and June 2015. Routinely collected maternal Beck Depression Inventory, second edition (BDI-II) scores were analysed for severity and change. Results: A total of 307 mother–baby dyads were admitted during the study period. The majority of mothers was partnered and educated young adults. The average length of stay was 4.4 weeks. The mean age of babies was 3.3 months. One-third of mothers met International Classification of Diseases, 10th edition criteria for two or more psychiatric diagnoses. Unipolar major depression was the commonest diagnosis. Of the 307 mothers, 125 mothers completed BDI-II on admission and on discharge, which showed a mean reduction of 16 points ( p < 0.001) on discharge. Conclusions: This study notes the similarities between the clinical profiles of the study population with mother–baby admissions to MBUs worldwide. Maternal depressive symptoms improved by 16 points on the BDI-II over the course of MBU admission, which shows the utility of MBU admission on maternal depressive symptoms.
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Draper, Brian, and Lee-Fay Low. "Psychiatric services for the “old” old." International Psychogeriatrics 22, no. 4 (March 15, 2010): 582–88. http://dx.doi.org/10.1017/s1041610210000293.
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ABSTRACTBackground: Few studies have specifically examined mental health service delivery to persons aged over 84 years, often described as the “old” old. Our aim was to compare mental health service provision in Australia to persons aged 85 years and over with the “young” old and other age groups. We hypothesized that the “old” old would differ from the “young” old (65–84 years) by diagnostic category, rates of specialist psychiatric hospital admission, and use of Medicare funded psychiatric consultations in the community.Methods: Mental health service delivery data for 2001–02 to 2005–06 was obtained from Medicare Australia on consultant psychiatrist office-based, home visit and private hospital services subsidized by the national healthcare program and the National Hospital Morbidity database for separations (admitted episodes of patient care) from all public and most private hospitals in Australia on measures of age, gender, psychiatric diagnosis, location and type of psychiatric care.Results: Use of specialist psychiatric services in the community per annum per 1000 persons declined with age in men and women from 137.28 and 191.87 respectively in those aged 20–64 years to 11.84 and 14.76 respectively in those over 84 years. However, men and women over 84 years received psychiatric home visits at 377% and 472% respectively of the rates of persons under 65. The annual hospital separation rate per 1000 persons for specialist psychiatric care was lowest in those aged over 84 (3.98) but for inpatient non-specialized psychiatric care was highest in those over 84 (21.20). Depression was the most common diagnosis in specialized psychiatric hospitalization in those aged over 84 while organic disorders predominated in non-specialized care in each age group over 64 years with the highest rates in those aged over 84.Conclusion: Mental health service delivery to persons aged over 84 is distinctly different to that provided to other aged groups being largely provided in non-specialist hospital and residential settings.
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Smith, Graeme C. "The Future of Consultation–Liaison Psychiatry." Australian & New Zealand Journal of Psychiatry 37, no. 2 (April 2003): 150–59. http://dx.doi.org/10.1046/j.1440-1614.2003.01136.x.
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Objective: To review the status of consultation–liaison psychiatry and the factors shaping it, and suggest strategies for its future development. Method: In addition to searches of the main computerized psychiatric databases and review of relevant Commonwealth of Australia publications, the author drew on discussions with national and international colleagues in his role as convenor of the International Organization for Consultation–Liaison Psychiatry. Results: Physical/psychiatric comorbidity and somatization, the conditions in which consultation–liaison psychiatry specializes, are the commonest forms of psychiatric presentation in the community. They are as disabling as psychotic disorders, and comorbid depression in particular is a predictor of increased morbidity and mortality. Acknowledging this, the Second Australian National Mental Health Plan called for consultation–liaison psychiatry to be allowed to participate fully in the mental health care system. It stated that failure to define the term ‘severe mental health problems and mental disorders’ in the First Plan had led to some public mental health systems erroneously equating severity with diagnosis rather than level of need and disability. The call has been largely unheeded. The implication for patient care is both direct and indirect; the context created for psychiatry training by such a restricted focus is helping to perpetuate the neglect of such patients. This is a worldwide problem. Conclusions: Proactive involvement with consumers is required if the problem is to be redressed. At a service level, development of a seamless web of pre-admission/admission/post-discharge functions is required if patients with physical/psychiatric comorbidity and somatoform disorders are to receive effective care, and consultation–liaison psychiatry services are to be able to demonstrate efficacy. Focus on comorbidity in the Australian Third National Mental Health Plan may force resolution of the current problems.
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Jenkins, Bronwyn, Elspeth Hutton, Richard Stark, Rebeca Quintana, Veruska Carboni, Dania Yaghobian, Guillaume Wieliczko, and Pamela Vo. "122 ‘My migraine voice: burden of migraine and it’s management in an australian cohort’." Journal of Neurology, Neurosurgery & Psychiatry 90, e7 (July 2019): A39.3—A40. http://dx.doi.org/10.1136/jnnp-2019-anzan.108.
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IntroductionMigraine is the greatest cause of disability under the age of 50. It impairs ability to function, work and maintain relationships. This survey aimed to assess the impact of migraine and its management.MethodsA questionnaire was sent to patients >18 years old who had taken at least one preventive treatment for migraine in the past. We report here the Australian results.Results68% were women, mean age 41 years. 53% were in paid employment whilst 13% received a disability allowance due to migraine. All patients (n=320) in the Australian survey had ≥ 4 migraine days each month. 90% had taken at least one preventive (274), with 80% (194) needing to change the preventive treatments previously. Common comorbidities were depression (41%), anxiety (40%), chronic pain (29%), sleep disorder (25%) and overweight (24%).Diagnosis rate on initial GP visit was 57%, with 26% receiving a diagnosis in <1 month and 55% by 6 months.There was greater retention of use (60%) and satisfaction (60%) with acute therapies, compared with use (43%) and satisfaction (53%) with preventives. Dissatisfaction with preventives included lack of efficacy (54%) and too many side effects (36%). Most (>60%) patients reported fear of the next attack, feeling hopeless and difficulty thinking clearly during attacks. Employers were often (69%) aware of the migraines, but only 24% offered any support. Migraine had negative impacts on relationships.ConclusionThe Migraine Voice Survey highlights the true burden of migraine in Australia and limitations of current management options.
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Silove, Derrick, Ingrid Sinnerbrink, Annette Field, Vijaya Manicavasagar, and Zachary Steel. "Anxiety, depression and PTSD in asylum-seekers: Assocations with pre-migration trauma and post-migration stressors." British Journal of Psychiatry 170, no. 4 (April 1997): 351–57. http://dx.doi.org/10.1192/bjp.170.4.351.
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BackgroundResearch into the mental health of refugees has burgeoned in recent times, but there is a dearth of studies focusing specifically on the factors associated with psychiatric distress in asylum-seekers who have not been accorded residency status.MethodForty consecutive asylum-seekers attending a community resource centre in Sydney, Australia, were interviewed using structured instruments and questionnaires.ResultsAnxiety scores were associated with female gender, poverty, and conflict with immigration officials, while loneliness and boredom were linked with both anxiety and depression. Thirty subjects (79%) had experienced atraumatic event such as witnessing killings, being assaulted, or suffering torture and captivity, and 14 subjects (37%) met full criteria for PTSD. A diagnosis of PTSD was associated with greater exposure to pre-migration trauma, delays in processing refugee applications, difficulties in dealing with immigration officials, obstacles to employment, racial discrimination, and loneliness and boredom.ConclusionsAlthough based on correlational data derived from a convenient'sample, our findings raise the possibility that current procedures for dealing with asylum-seekers may contribute to high levels of stress and psychiatric symptoms in those who have been previously traumatised.
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Parslow, Ruth A., and Anthony F. Jorm. "Who Uses Mental Health Services in Australia? An Analysis of Data from the National Survey of Mental Health and Wellbeing." Australian & New Zealand Journal of Psychiatry 34, no. 6 (December 2000): 997–1008. http://dx.doi.org/10.1080/000486700276.
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Objective: This study sought to identify sociodemographic and psychological measures associated with utilisation of mental health services in Australia, using information collected through the 1997 National Survey of Mental Health and Wellbeing. Method: Twenty-one potential predictor variables were selected from the National Survey. Predisposing and enabling factors included age, sex, marital status, labour force status, geographical location and level of education. Predictor variables measuring need for services included the General Health Questionnaire score, a neuroticism scale, diagnoses of affective, anxiety and substance-abuse disorders from the Composite International Diagnostic Interview, and self-identified depression, anxiety and substance abuse. Simple and multiple logistic regressions were undertaken to identify predictor variables associated with use of mental health services from general practitioners, psychiatrists, psychologists and other health professionals. Results: General practitioners were the most commonly reported providers of mental health services with 76% of those receiving any mental health care reporting using this type of service. Using multiple logistic regression, the predictor variables most associated with use of mental health services were measures of the need for such services, such as psychological distress and mental disorder. After controlling for need variables, the sociodemographic variables associated with using services provided by any health professional were being female, level of education and being separated. Living in a remote area was associated with lower use of specialist services, but not with general practitioner services. Older age was associated with less use of psychologists and other health professionals. Income and having a usual language other than English did not affect service use. Conclusions: The factors most strongly related to Australians' use of mental health services are their having a diagnosed affective, anxiety or substance-abuse disorder and their self-identifying as having depression or anxiety. Although there are regional inequalities in levels of utilisation of mental health services, these are seen more with specialist services than with those provided by general practitioners.
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Eatt, Jodi, Stuart J. Watson, Helen L. Ball, Katherine Sevar, and Megan Galbally. "Maternal Depression and Early Parenting: A Comparison Between Culturally and Linguistically Diverse and Australian born Mothers." Australasian Psychiatry 30, no. 1 (January 6, 2022): 119–25. http://dx.doi.org/10.1177/10398562211052886.
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Objective: To examine the risk of perinatal depression, parenting stress and infant sleep practices in Australian culturally and linguistically diverse (CaLD) women. Method: Within the Mercy Pregnancy and Emotional Wellbeing Study, we examined 487 pregnant women of whom 52 were CaLD and 435 non-CaLD. Depression was measured using the Structured Clinical Interview for DSM-IV and the Edinburgh Postnatal Depression Scale. In addition, Parenting Stress Index and infant sleep measures were collected. Results: Fewer CaLD women had a depression diagnosis but there were no differences between CaLD and non-CaLD women for perinatal mental health symptoms. More mothers in the CaLD group were bed sharing with their infant during the night at six months; however, bedsharing was only associated with higher parenting stress for non-CaLD mothers. Conclusions: Findings suggest both differences in infant sleep parenting practices and in parenting stress but not general emotional wellbeing. Future research is required to replicate these findings.
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Rice, Simon M., Helen M. Aucote, Dina Eleftheriadis, and Anne Maria Möller-Leimkühler. "Prevalence and Co-Occurrence of Internalizing and Externalizing Depression Symptoms in a Community Sample of Australian Male Truck Drivers." American Journal of Men's Health 12, no. 1 (January 21, 2016): 74–77. http://dx.doi.org/10.1177/1557988315626262.
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Trucking industry employees are known to be at risk of elevated levels of stress and a range of behaviors that may compromise their mental health. Clinical reports indicate that in response to negative emotional states, men tend to engage in a cluster of externalizing behaviors including irritability, anger and aggression, risk taking, and substance misuse. However, as such symptoms fall outside standard diagnostic depression criteria, the diagnosis and treatment of depression in men may be impeded. The present exploratory study reports retrospective symptom ratings of internalizing and externalizing depression symptoms from 91 Australian male truck drivers. Moderate correlation between externalizing and internalizing symptoms was reported across the sample, though internalizing symptoms were reported more frequently. However, consistent with prediction, those meeting probable depression caseness ( n = 20) reported three times the number of externalizing symptoms relative to those in the nonclinical group (Cohen’s d = 1.31). Externalizing symptoms may be a particular phenotypic feature of depression in men, and assessment of such symptoms may assist in the detection of those unwilling to disclose typical internalizing symptoms (i.e., sadness, hopelessness). Results also highlight the need for targeted research into stress-related and mental health outcomes of men in high health risk occupations such as truck driving.
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Galbally, Megan, Stuart J. Watson, Philip Boyce, and Andrew J. Lewis. "The role of trauma and partner support in perinatal depression and parenting stress: An Australian pregnancy cohort study." International Journal of Social Psychiatry 65, no. 3 (March 27, 2019): 225–34. http://dx.doi.org/10.1177/0020764019838307.
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Background: Improving our understanding of the relationship between maternal depression and parenting stress is likely to lie in the range of additional factors that are associated with vulnerability to depression and also to parenting stress. Objectives: To examine the role of trauma and partner support, in understanding the relationship between perinatal depression and parenting stress. Methods: This study utilises data from 246 women in a pregnancy cohort study that followed women from early pregnancy until their infant was 12 months. Included were both women with a diagnosis of depression and those without depression. The measures included Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Edinburgh Postnatal Depression Scale, Childhood Trauma Questionnaire, Social Support Effectiveness Questionnaire and the Parenting Stress Index. Results: We found women with depression were more likely to report a history of childhood trauma. Depressive symptoms were positively associated with parenting stress while partner support was negatively associated with parenting stress. The protective role of partner support for parenting distress was observed in those with no history of childhood abuse and low depressive symptoms, but not in those with a trauma history and high depressive symptoms. Conclusions: These findings highlight the importance of early trauma in understanding the protective role of support on the relationship between parenting and depression. These findings can inform future studies and the refinement of future interventions aimed at both perinatal depression and parenting.
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Bryant, Joanne, Christy E. Newman, Martin Holt, Dana M. Paquette, Rebecca Gray, Peter G. Canavan, Deborah C. Saltman, Susan C. Kippax, and Michael R. Kidd. "Does drug and alcohol use undermine concordance between doctors' assessments of major depression and patients' scores on a screening tool for depression among gay men attending general practice?" Australian Journal of Primary Health 18, no. 2 (2012): 116. http://dx.doi.org/10.1071/py11011.
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General practitioners (GPs) identify that depression can be difficult to diagnose in populations with high rates of alcohol and other drug (AOD) use. This is a particular concern with gay men who are a population known to engage in high rates of AOD use and who are vulnerable to depression. This paper uses data from 563 gay men and their GPs to describe concordance between assessments of major depression and, in particular, whether AOD use undermines concordance. Data were collected as part of a larger study of male patients and GPs at high HIV-caseload general practices in Australia. Concordance was measured by comparing patients’ scores on the Patient Health Questionnaire-9 screening tool, which is based on the Diagnostic and Statistical Manual of Mental Disorders IV criteria, and GPs’ ratings of the likelihood of depression for each participant. We observed high concordance between GPs’ assessments of major depression and patients’ scores on the PHQ-9 (79% agreement), although our analysis also suggested that concordance was better when it related to cases in which there was no depression. The high concordance observed in our study did not appear to be undermined by gay male patients’ AOD use, with the exception of frequent use of crystal methamphetamine. Here, men who reported frequent use of methamphetamine were significantly less likely to have concordant assessments (adjusted odds ratio 0.3, 95% CI 0.1–0.8). Overall, GPs appear to identify depression among many of their gay male patients. While GPs should be aware of the potential complications presented by frequent crystal methamphetamine use, other AOD use may have less impact on the diagnosis of depression.
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Drissi, Nidal, Sofia Ouhbi, Mohammed Abdou Janati Idrissi, Luis Fernandez-Luque, and Mounir Ghogho. "Connected Mental Health: Systematic Mapping Study." Journal of Medical Internet Research 22, no. 8 (August 28, 2020): e19950. http://dx.doi.org/10.2196/19950.
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Background Although mental health issues constitute an increasing global burden affecting a large number of people, the mental health care industry is still facing several care delivery barriers such as stigma, education, and cost. Connected mental health (CMH), which refers to the use of information and communication technologies in mental health care, can assist in overcoming these barriers. Objective The aim of this systematic mapping study is to provide an overview and a structured understanding of CMH literature available in the Scopus database. Methods A total of 289 selected publications were analyzed based on 8 classification criteria: publication year, publication source, research type, contribution type, empirical type, mental health issues, targeted cohort groups, and countries where the empirically evaluated studies were conducted. Results The results showed that there was an increasing interest in CMH publications; journals were the main publication channels of the selected papers; exploratory research was the dominant research type; advantages and challenges of the use of technology for mental health care were the most investigated subjects; most of the selected studies had not been evaluated empirically; depression and anxiety were the most addressed mental disorders; young people were the most targeted cohort groups in the selected publications; and Australia, followed by the United States, was the country where most empirically evaluated studies were conducted. Conclusions CMH is a promising research field to present novel approaches to assist in the management, treatment, and diagnosis of mental health issues that can help overcome existing mental health care delivery barriers. Future research should be shifted toward providing evidence-based studies to examine the effectiveness of CMH solutions and identify related issues.
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O'Connor, Daniel W., Richard Rosewarne, and Ann Bruce. "Depression in Primary Care 1: Elderly Patients' Disclosure of Depressive Symptoms to Their Doctors." International Psychogeriatrics 13, no. 3 (September 2001): 359–65. http://dx.doi.org/10.1017/s1041610201007748.
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Background: This article examines some of the factors responsible for older patients' decision to report current depressive symptoms to their general medical practitioner. A companion article considers factors contributing to general practitioners' (GPs') recognition of major depressive episode when it was present. Methods: A survey was conducted of a stratified sample of 1,021 patients aged 70+ years of 30 GPs in Melbourne, Australia, to gauge the prevalence of depressive symptoms, the frequency with which patients had informed GPs of their symptoms, and GPs' recognition of major depressive episodes. Patients and informants were questioned using the Canberra Interview for the Elderly, which generates rigorous ICD-10 research diagnoses. Results: Logistic regression analysis showed that symptom disclosure was associated in descending order of importance with higher depressive scores, previous contact with a psychiatrist, and female gender. Even so, 48% of persons with ICD-10 moderate or severe depressive episode had not reported any current complaints to their doctor at the time of interview. Conclusion: Older patients often do not report depressive symptoms to their medical practitioner. Men and patients lacking “psychological mindedness” may be at special risk.
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Clarke, David M., Ahmad Hatim, Brian Ho, Jiyang Pan, Chee Ng, Kang-Seob Oh, Wu Wenyuan, and Mak Ki-Yan. "Somatic Symptoms of Depression and Anxiety in the Western Pacific Region: Questions and Answers." CNS Spectrums 14, S4 (April 2009): 1–8. http://dx.doi.org/10.1017/s109285290002633x.
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It is a commonly held belief among mental health care providers that patients from the Western Pacific region with major depressive disorder (MDD) and anxiety disorders disproportionately present with somatic symptoms as opposed to emotional symptoms. Cultural norms, such as the stigma associated with psychiatric disorders, may lead members of this population to ignore the emotional aspects of these disorders or deny the presence of psychological symptoms. Empirical support is provided by the lower prevalence of these disorders in some Western Pacific nations in relation to the rest of the world. For example, MDD rates in India (9%), Japan (2%), China (2% to 4%), Malaysia (8%) and Australia (3%) are generally lower than rates in the United States (16%) and worldwide (10%). These discrepancies may be the result of missed diagnoses. Misdiagnosis is related to the increased somatization of MDD symptoms in these populations. As defined by the WHO, the Western Pacific region consists of 37 countries with a total population of 1.8 billion people (1.3 billion in China alone) with diverse cultural backgrounds and demographic profiles, which makes the issue of cultural effects on MDD diagnosis more complex.Patients with MDD or anxiety disorders worldwide often present with somatic symptoms, which frequently accompany psychological symptoms. For example, in a recent report of pooled data from Canada, scores on the Somatic Symptoms Inventory, the 17-item Hamilton Rating Scale for Depression (HAM-D17), and the Hamilton Rating Scale for Anxiety (HAM-A) were used to evaluate the association between somatic symptoms and MDD. Of the 2,191 patients randomly enrolled in the study, 78% reported moderate-to-severe fatigue and weakness. Painful physical symptoms commonly occur in patients with anxiety disorders as well. In a European study, painful physical symptoms were reported by 28% of those without anxiety disorders and 45% of those with anxiety disorders.
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Sakashita, Chika, Tim Slade, and Gavin Andrews. "Empirical Investigation of Two Assumptions in the Diagnosis of DSM-IV Major Depressive Episode." Australian & New Zealand Journal of Psychiatry 41, no. 1 (January 2007): 17–23. http://dx.doi.org/10.1080/00048670601050440.
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Objective: The aim of the current study was to examine two major assumptions behind the DSM-IV diagnosis of major depressive episode (MDE): that depression represents a distinct category defined by a valid symptom threshold, and that each depressive symptom contributes equally to the diagnosis. Methods: Data were from the Australian National Survey of Mental Health and Wellbeing. Participants consisted of a random population-based sample of 10 641 community volunteers, representing a response rate of 78%. DSM-IV diagnoses of MDE and other mental disorders were obtained using the Composite International Diagnostic Interview, version 2.0. Analyses were carried out on the subsample of respondents who endorsed either depressed mood or loss of interest (n =2137). Multivariate linear regression analyses examined the relationship between the number and type of symptoms and four independent measures of impairment. Results: The relationship between the number of depressive symptoms and the four measures of impairment was purely linear. Three individual symptoms (sleep problems, energy loss, and psychomotor disturbance) were all independent predictors of three of the four measures of impairment. Conclusions: Counting symptoms alone is limited in guiding a clear diagnostic threshold. The differential impact of individual symptoms on impairment suggests that impairment levels may be more accurately estimated by weighting the particular symptoms endorsed.
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Andrews, Gavin, Cathy Issakidis, and Greg Carter. "Shortfall in mental health service utilisation." British Journal of Psychiatry 179, no. 5 (November 2001): 417–25. http://dx.doi.org/10.1192/bjp.179.5.417.
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BackgroundTreatment coverage for mental disorders is poor in most developed countries.AimsTo explore some reasons for the poor treatment coverage for mental disorders in developed countries.MethodData were taken from Australian national surveys and from the World Health Report.ResultsOnly one-third of people with a mental disorder consulted. Probability of consulting varied by diagnosis: 90% for schizophrenia, which is accounted for by external factors; 60% for depression; and 15% for substance use and personality disorders. The probability of consulting varied by gender, age, marital status and disability, from 73% among women aged 25–54 years, disabled and once married to 9% among males without these risk factors. Those who did not consult but were disabled or comorbid said that they “preferred to manage themselves”. Data from five countries showed no evidence that overall health expenditure, out-of-pocket cost or responsiveness of the health system affected the overall consulting rates.ConclusionsSocietal, attitudinal and diagnostic variables account for the variation. Funding does not. Public education about the recognition and treatment of mental disorders and the provision of effective treatment by providers might remedy the shortfall.
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O'toole, Brian I., Richard P. Marshall, Ralph J. Schureck, and Matthew Dobson. "Risk Factors for Posttraumatic Stress Disorder in Australian Vietnam Veterans." Australian & New Zealand Journal of Psychiatry 32, no. 1 (February 1998): 21–31. http://dx.doi.org/10.3109/00048679809062702.
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Objective: The aims of this paper are to determine the risk factors for combat-related posttraumatic stress disorder (PTSD) and to examine the relative contribution of pre-military factors, pre-trauma psychiatric diagnoses, military factors such as combat posting, and combat and casualty stress exposure. Method: An epidemiological cohort study using standardised psychiatric, social and health interviews was undertaken with a national random sample of male Australian Army Vietnam veterans. Multivariate logistic regression was used to examine the relative contribution of factors derived from interview and from military records in four categories: pre-enlistment circumstances including home life, education, major life stress; pre-Vietnam psychiatric diagnoses; military experiences before and during Vietnam; and combat and stress experiences. Results: Of the 128 data items examined, significant associations were found for 39, in addition to combat stress. Pre-enlistment items accounted for about 3% of the deviance towards PTSD diagnosis, pre-enlistment psychiatric diagnosis about 13%, military variables about 7% and combat stress about 18%; all factors together accounted for 42%. Conclusions: The results confirm that pre-military and military variables make only a small but significant contribution to PTSD either alone or after controlling for combat stress; that psychiatric diagnoses of depression, dysthymia and agoraphobia make strong contributions to PTSD; but that combat stress makes the largest contribution even after controlling for the effects of other variables. Psychiatric diagnoses and combat stress appear to be independent in their effects on PTSD.
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Burvill, P. W., G. A. Johnson, K. D. Jamrozik, C. S. Anderson, E. G. Stewart-Wynne, and T. M. H. Chakera. "Anxiety Disorders After Stroke: Results from the Perth Community Stroke Study." British Journal of Psychiatry 166, no. 3 (March 1995): 328–32. http://dx.doi.org/10.1192/bjp.166.3.328.
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BackgroundThe prevalence of anxiety disorders in 294 patients who survived to four months in the Perth Community Stroke Study (Perth, Australia), and a follow-up of these patients at 12 months, are presented.MethodDiagnoses are described both in the usual DSM hierarchic format and by a non-hierarchic approach. Adoption of the hierarchic approach alone greatly underestimates the prevalence of anxiety disorders.ResultsMost cases were of agoraphobia, and the remainder were generalised anxiety disorder. The prevalence of anxiety disorders alone was 5% in men and 19% in women; in community controls, it was 5% in men and 8% in women. Adopting a non-hierarchic approach to diagnosis gave a prevalence of 12% in men and 28% in women. When those who showed evidence of anxiety disorder before stroke were subtracted, the latter prevalence was 9% in men and 20% in women.ConclusionOne-third of the men and half of the women with post-stroke anxiety disorders showed evidence of either depression or an anxiety disorder at the time of the stroke. At 12 month follow-up of 49 patients with agoraphobia by a non-hierarchic approach, 51 % had recovered, and equal proportions of the remainder had died or still had agoraphobia. The only major difference in outcome between those with anxiety disorder alone and those with comorbid depression was the greater mortality in the latter.
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Aw, Jessica Yi Han, Kayla Smurthwaite, and Nasser Bagheri. "Investigating spatial convergence of diagnosed dementia, depression and type 2 diabetes prevalence in West Adelaide, Australia." Journal of Affective Disorders 277 (December 2020): 524–30. http://dx.doi.org/10.1016/j.jad.2020.08.032.
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Kelly, Brian, Beverley Raphael, Fiona Judd, Michael Perdices, Graeme Kernutt, Graham D. Burrows, Paul C. Burnett, and Michael Dunne. "Psychiatric Disorder in HIV Infection." Australian & New Zealand Journal of Psychiatry 32, no. 3 (June 1998): 441–53. http://dx.doi.org/10.3109/00048679809065539.
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Objective: This study aimed to investigate rates of psychiatric disorder in human immunodeficiency virus (HIV) infection, in an Australian sample of homosexual and bisexual men. Method: A cross-sectional study of a total of 65 HIV sero-negative (HIV-) and 164 HIV sero-positive men (HIVt) (79 CDC stage 1 1/1 11 and 85 CDC stage IV) was conducted in three centres. Lifetime and current prevalence rates of psychiatric disorder were evaluated using the Diagnostic Interview Schedule Version lllR (DIS-IIIR). Results: Elevated current and lifetime rates of major depression were detected in both HIV negative and HIV positive homosexual/bisexual men. Lifetime rates of alcohol abuseldependence were significantly elevated in HIV positive men (CDC group IV) when compared with HIV negative men. Among the HIV positive group the majority of psychiatric disorders detected were preceded by a pre-HIV diagnosis of psychiatric disorder. Major depression represented the disorder most likely to have first onset after HIV infection diagnosis. Conclusions: Lifetime rates of major depression were elevated in this sample of HIV-negative and HIV-positive men, In the HIV-positive men, psychiatric disorder was significantly associated with the presence of lifetime psychiatric disorder prior to HIV infection diagnosis, The findings indicate the importance of evaluation of psychiatric history prior to HIV infection and the clinical significance of depressive syndromes in this population.
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O'toole, Brian I., Richard P. Marshall, Ralph J. Schureck, and Matthew Dobson. "Posttraumatic Stress Disorder and Comorbidity in Australian Vietnam Veterans: Risk Factors, Chronicity and Combat." Australian & New Zealand Journal of Psychiatry 32, no. 1 (February 1998): 32–42. http://dx.doi.org/10.3109/00048679809062703.
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Objective: The objective of this study was to examine the relationship between combat-related posttraumatic stress disorder (PTSD) and comorbid DSM-III-R psychiatric diagnoses to determine commonalities in risk factors, relative onsets and the role of combat exposure. Method: An epidemiological cohort study using standardised psychiatric, social and health interviews was undertaken with a national random sample of male Australian Army Vietnam veterans. Interviews and searches of military records yielded risk factors for PTSD, which were examined for association with each psychiatric diagnosis. Relative onsets of PTSD and each Diagnostic Interview Schedule diagnosis were compared. Comorbidity odds ratios were adjusted for combat exposure effects using logistic regression, and the relation between each diagnosis and combat was assessed after controlling for PTSD. Results: Commonality of risk factor profile was evident for several diagnoses, and for many their onset preceded PTSD onset. Combat was independently related to only a few diagnoses after controlling for PTSD, and PTSD remained strongly associated with several conditions after controlling for combat exposure. Conclusions: The analysis suggests that the disorders that may constitute risk factors or vulnerabilities for PTSD comprise depression and dysthymia, antisocial personality disorder, agoraphobia and simple phobia, while those that may be consequent on PTSD are panic and generalised anxiety disorder, drug use disorders and somatoform pain disorder. Alcohol and drug use disorders and social phobia may have a mixed aetiology, while obsessive-compulsive disorder may be serendip-itously related to PTSD through an association with risk of combat. Gambling disorder is unrelated.
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Haque, Umme Marzia, Enamul Kabir, and Rasheda Khanam. "Detection of child depression using machine learning methods." PLOS ONE 16, no. 12 (December 16, 2021): e0261131. http://dx.doi.org/10.1371/journal.pone.0261131.
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Background Mental health problems, such as depression in children have far-reaching negative effects on child, family and society as whole. It is necessary to identify the reasons that contribute to this mental illness. Detecting the appropriate signs to anticipate mental illness as depression in children and adolescents is vital in making an early and accurate diagnosis to avoid severe consequences in the future. There has been no research employing machine learning (ML) approaches for depression detection among children and adolescents aged 4–17 years in a precisely constructed high prediction dataset, such as Young Minds Matter (YMM). As a result, our objective is to 1) create a model that can predict depression in children and adolescents aged 4–17 years old, 2) evaluate the results of ML algorithms to determine which one outperforms the others and 3) associate with the related issues of family activities and socioeconomic difficulties that contribute to depression. Methods The YMM, the second Australian Child and Adolescent Survey of Mental Health and Wellbeing 2013–14 has been used as data source in this research. The variables of yes/no value of low correlation with the target variable (depression status) have been eliminated. The Boruta algorithm has been utilized in association with a Random Forest (RF) classifier to extract the most important features for depression detection among the high correlated variables with target variable. The Tree-based Pipeline Optimization Tool (TPOTclassifier) has been used to choose suitable supervised learning models. In the depression detection step, RF, XGBoost (XGB), Decision Tree (DT), and Gaussian Naive Bayes (GaussianNB) have been used. Results Unhappy, nothing fun, irritable mood, diminished interest, weight loss/gain, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue, thinking or concentration problems or indecisiveness, suicide attempt or plan, presence of any of these five symptoms have been identified as 11 important features to detect depression among children and adolescents. Although model performance varied somewhat, RF outperformed all other algorithms in predicting depressed classes by 99% with 95% accuracy rate and 99% precision rate in 315 milliseconds (ms). Conclusion This RF-based prediction model is more accurate and informative in predicting child and adolescent depression that outperforms in all four confusion matrix performance measures as well as execution duration.
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Middeldorp, Christel M., Andrew J. Birley, Danielle C. Cath, Nathan A. Gillespie, Gonneke Willemsen, Dixie J. Statham, Eco J. C. de Geus, et al. "Familial Clustering of Major Depression and Anxiety Disorders in Australian and Dutch Twins and Siblings." Twin Research and Human Genetics 8, no. 6 (December 1, 2005): 609–15. http://dx.doi.org/10.1375/twin.8.6.609.
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AbstractThe aim of this study was to investigate familial influences and their dependence on sex for panic disorder and/or agoraphobia, social phobia, generalized anxiety disorder and major depression. Data from Australian (N = 2287) and Dutch (N = 1185) twins and siblings who were selected for a linkage study and participated in clinical interviews to obtain lifetime Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) diagnoses were used. In a liability model, tetrachoric correlations were estimated in sibling pairs and sex differences between sibling correlations were tested. For each diagnosis, the sibling correlations could be constrained to be equal across the Australian and Dutch samples. With the exception of panic disorder and/or agoraphobia, all sibling correlations were the same for brother, sister and opposite-sex sibling pairs and were around .20. For panic disorder and/or agoraphobia, the correlation was .23 in brother and sister pairs, but absent in opposite-sex sibling pairs. From these results it can be concluded that upper heritability estimates, based on twice the correlations in the sibling pairs, vary between 36% (major depression) and 50% (social phobia). Furthermore, different genetic risk factors appear to contribute to the vulnerability for panic disorder and/or agoraphobia in men and women. No other sex differences were found.
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Sim, Wan Hua, Anthony F. Jorm, Katherine A. Lawrence, and Marie B. H. Yap. "Development and evaluation of the Parenting to Reduce Child Anxiety and Depression Scale (PaRCADS): assessment of parental concordance with guidelines for the prevention of child anxiety and depression." PeerJ 7 (May 30, 2019): e6865. http://dx.doi.org/10.7717/peerj.6865.
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Background Involving parents in the prevention of mental health problems in children is prudent given their fundamental role in supporting their child’s development. However, few measures encapsulate the range of risk and protective factors for child anxiety and depression that parents can potentially modify. The Parenting to Reduce Child Anxiety and Depression Scale (PaRCADS) was developed as a criterion-referenced measure to assess parenting against a set of evidence-based parenting guidelines for the prevention of child anxiety and depressive disorders. Methods In Study 1, 355 parents of children 8–11 years old across Australia completed the PaRCADS and measures of parenting, general family functioning, child anxiety and depressive symptoms, and parent and child health-related quality of life. Their children completed measures of parenting, anxiety and depressive symptoms, and health-related quality of life. In Study 2, six subject-experts independently evaluated the PaRCADS items for item-objective congruence and item-relevance. Item analysis was conducted by examining item-total point-biserial correlation, difficulty index, B-index, and expert-rated content validity indices. Reliability (or dependability) was assessed by agreement coefficients for single administration. Construct validity was examined by correlational analyses with other measures. Results Four items were removed to yield a 79-item, 10-subscale PaRCADS. Reliability estimates for the subscale and total score range from .74 to .94. Convergent validity was indicated by moderate to strong correlations with other parenting and family functioning measures, and discriminant validity was supported by small to moderate correlations with a measure of parents’ health-related quality of life. Higher scores on the PaRCADS were associated with fewer anxiety and depressive symptoms and better health-related quality of life in the child. PaRCADS total score was associated with parental age, parent reported child’s history of mental health diagnosis and child’s current mental health problem. Discussion Results showed that the PaRCADS demonstrates adequate psychometric properties that provide initial support for its use as a measure of parenting risk and protective factors for child anxiety and depression. The scale may be used for intervention and evaluative purposes in preventive programs and research.
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LAMPE, L., T. SLADE, C. ISSAKIDIS, and G. ANDREWS. "Social phobia in the Australian National Survey of Mental Health and Well-Being (NSMHWB)." Psychological Medicine 33, no. 4 (May 2003): 637–46. http://dx.doi.org/10.1017/s0033291703007621.
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Background. This article reports data on social phobia from the first large scale Australian epidemiological study. Prevalence rates, demographic correlates and co-morbidity in the sample that met criteria for social phobia are reported and gender differences examined.Method. Data were obtained from a stratified sample of 10641 participants as part of the Australian National Survey of Mental Health and Well-Being (NSMHWB). A modified version of the Composite International Diagnostic Interview (CIDI) was used to determine the presence of social phobia, as well as other DSM-IV anxiety, affective and substance use disorders. The interview also screened for the presence of nine ICD-10 personality disorders, including anxious personality disorder, the equivalent of DSM-IV avoidant personality disorder (APD).Results. The estimated 12 month prevalence of social phobia was 2·3%, lower than rates reported in several recent nationally representative epidemiological surveys and closer to those reported in the Epidemiological Catchment Area study (ECA) and other DSM-III studies. Considerable co-morbidity was identified. Data indicated that the co-morbidity with depression and alcohol abuse and dependence were generally subsequent to onset of social phobia and that the additional diagnosis of APD was associated with a greater burden of affective disorder. Social phobia most often preceded major depression, alcohol abuse and generalized anxiety disorder.Conclusions. Social phobia is a highly prevalent, highly co-morbid disorder in the Australian community. Individuals with social phobia who also screen positively for APD appear to be at greater risk of co-morbidity with all surveyed disorders except alcohol abuse or dependence.
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Leonard, David, Susan Brann, and John Tiller. "Dissociative Disorders: Pathways to Diagnosis, Clinician Attitudes and Their Impact." Australian & New Zealand Journal of Psychiatry 39, no. 10 (October 2005): 940–46. http://dx.doi.org/10.1080/j.1440-1614.2005.01700.x.
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Objectives: To study the attitudes and experiences of Australian clinicians with dissociative disorders and the paths to diagnosis and experiences of patients. Method: The attitudes of Australian clinicians to dissociative disorders and the experiences of patients were assessed by questionnaires. The clinicians were mental health specialists and a small number of general medical practitioners. The patients had all been diagnosed with a dissociative disorder. Results: Of the 250 clinicians, 21% reported experience with more than six cases on average of any one of the dissociative disorders, 38% with less than six, 42% with none; 55% regarded them as valid diagnoses, 35% dubiously valid and 10% invalid. Of the 55 patients, 76% reported delays in diagnosis (57%, <3 years and 25%, <10 years) with adverse consequences in 64%; 80% had experienced sceptical or antagonistic attitudes from clinicians, rated as destructive by 48%. They were disabled (60% rated as <50% impaired) and were heavy consumers of health services (48% hospitalized, 68% <5 times). There was considerable comorbidity including moderate or severe depression (96%), self-harm (68%), suicide attempts (69%), panic disorder (53%), eating disorders (75%), substance abuse (25%), poor physical health (44%), major interpersonal (70%) and sexual problems (90%). Patients rated individual psychotherapy as the most helpful treatment (90%) but medications, such as antidepressants, were also valued (60%). Conclusions: Although over half of the responding Australian clinicians thought that dissociative disorders were valid, the rest were dubious about their validity with 10% believing them to be invalid. Only 21% had considerable experience with the disorders. These findings may relate to some of the difficulties perceived by patients, which included delays in diagnosis, suboptimal treatment and negative experiences with clinicians.
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Allnutt, Stephen, Lucinda Wedgwood, Kay Wilhelm, and Tony Butler. "Temperament, Substance Use and Psychopathology in a Prisoner Population: Implications for Treatment." Australian & New Zealand Journal of Psychiatry 42, no. 11 (January 1, 2008): 969–75. http://dx.doi.org/10.1080/00048670802415350.
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Objective: The association between temperament and drug use or temperament and psychopathology has previously been restricted to community clinical or non-clinical samples. The aim of the present study was therefore to examine these associations in a large cohort of Australian offenders using Cloninger's Temperament and Character Inventory (TCI). Methods: A total of 1322 prisoners from New South Wales (NSW) who completed all dimensions of the TCI and were screened for mental illness using the Australian National Survey of Mental Health and Wellbeing were included in the study. Results: A total of 15% of the sample fulfilled the criteria for a diagnosis for depression, 36% for anxiety disorders and 54% for a substance abuse disorder. Using logistic regression analysis, the TCI dimensions of harm-avoidance and low self-direction predicted depression. Being female, a poly-substance user and having high harm-avoidance, persistence, self-direction and self-transcendence predicted anxiety disorders. Significant stepped trends across age, gender, and type of drug use were found for all TCI dimensions. Conclusions: The TCI is useful in identifying prisoners with a history of psychopathology and substance misuse. This tool also provides clinically relevant information about at-risk individuals and has the potential to guide the development of intervention programmes for inmates.
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Wilhelm, Kay, Philip Mitchell, Ayse Sengoz, Ian Hickie, Henry Brodaty, and Philip Boyce. "Treatment Resistant Depression in an Australian Context II: Outcome of a Series of Patients." Australian & New Zealand Journal of Psychiatry 28, no. 1 (March 1994): 23–33. http://dx.doi.org/10.3109/00048679409075842.
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The clinical characteristics and treatment outcome of a series of 107 patients referred to a mood disorders unit with an episode of “treatment resistant” Major Depression are reviewed. Subjects were categorised by diagnosis (into melancholic and non-melancholic subtypes) and by adequacy of previous treatment. At subsequent review (mean period of 37.5 months) these patients were re-assessed both in terms of outcome and which treatments had been considered to be most effective. Forty one percent of the patient group were fully recovered and a further 43% were partially improved. Different treatments were considered effective for melancholic and non-melancholic sub-types.
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Marshall, Richard P., Anthony F. Jorm, David A. Grayson, and Brian I. O'Toole. "Medical-Care Costs Associated with Posttraumatic Stress Disorder in Vietnam Veterans." Australian & New Zealand Journal of Psychiatry 34, no. 6 (December 2000): 954–62. http://dx.doi.org/10.1080/000486700269.
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Objective: This study examined the relationship between medical-care costs of Vietnam veterans and predictor factors, including posttraumatic stress disorder (PTSD). Method: We merged medical-care cost data from the Department of Veterans' Affairs and the Health Insurance Commission with data from an epidemiological study of 641 Australian Vietnam veterans. Posttraumatic stress disorder and other factors were examined as predictors of medical-care cost using regression analysis. Results: We found that a diagnosis of PTSD was associated with medical costs 60% higher than average. Those costs appeared to be partly associated with higher treatment costs for physical conditions in those with PTSD and also related mental health comorbidities. Major predictors of medical-care cost were age ($137 per year for each 5-year increase in age) and number of diagnoses reported ($81 to $112 per year for each diagnosis). Mental health factors such as depression ($14 per year for each symptom reported) and anxiety ($27 per year for each symptom reported) were also important predictors. Conclusions: The findings indicate that, however they are incurred, high healthcare and, presumably, also economic and personal costs are associated with PTSD. There is an important social obligation as well as substantial economic reasons to deal with these problems. From both perspectives, continued efforts to identify and implement effective prevention and treatment programs are warranted.
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Middeldorp, Christel M., Naomi R. Wray, Gavin Andrews, Nicholas G. Martin, and Dorret I. Boomsma. "Sex Differences in Symptoms of Depression in Unrelated Individuals and Opposite-Sex Twin and Sibling Pairs." Twin Research and Human Genetics 9, no. 5 (October 1, 2006): 632–36. http://dx.doi.org/10.1375/twin.9.5.632.
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AbstractDiagnosis of a major depressive episode by the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association requires 5 out of 9 symptoms to be present. Therefore, individuals may differ in the specific symptoms they experience and reach a diagnosis of depression via different pathways. It has been suggested that depressed women more often report symptoms of sleep disturbance, appetite or weight disturbance, fatigue, feelings of guilt/worthlessness and psychomotor retardation than depressed men. In the current study, we investigate whether depressed men and women differ in the symptoms they report. Two samples were selected from a sample of Dutch and Australian twins and siblings. First, Dutch and Australian unrelated depressed individuals were selected. Second, a matched epidemiological sample was created consisting of opposite-sex twin and sibling pairs in which both members were depressed. No sex differences in prevalence rates for symptoms were found, with the exception of decreased weight in women in the sample of unrelated individuals. In general, the similarities in symptoms seem to far outweigh the differences in symptoms between men and women. This signifies that men and women are alike in their symptom profiles for major depression and genes for depression are probably expressed in the same way in the two sexes.
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Damone, Anna L., Anju E. Joham, Deborah Loxton, Arul Earnest, Helena J. Teede, and Lisa J. Moran. "Depression, anxiety and perceived stress in women with and without PCOS: a community-based study." Psychological Medicine 49, no. 09 (August 22, 2018): 1510–20. http://dx.doi.org/10.1017/s0033291718002076.
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AbstractBackgroundPolycystic ovary syndrome (PCOS) is associated with increased psychological distress in clinical populations. We aimed to assess depression, anxiety and perceived stress in women with and without PCOS in a large community-based sample and investigate the role of stress in contributing to and mediating the relationship between PCOS, depression and anxiety.MethodsA cross-sectional analysis was performed from the Australian Longitudinal Study of Women's Health (ALWSH) comparing women with (n = 478) or without (n = 8134) a self-reported diagnosis of PCOS. Main outcome measures were depression, anxiety and perceived stress measured using validated scales. The χ2 and t tests were used to assess differences between groups. Univariable and multivariable regression were performed to determine factors contributing to each outcome.ResultsWomen reporting PCOS, compared with women not reporting PCOS, reported higher prevalence of depression (27.3% v. 18.8%), anxiety symptoms (50% v. 39.2%) and greater score for perceived stress (1.01 ± 0.03 v. 0.88 ± 0.01). After adjusting for body mass index, infertility and socio-demographic factors, women with PCOS were still more likely to be depressed, anxious and to have a higher level of perceived stress. There was a high-level mediation effect of stress between PCOS and both depression and anxiety.ConclusionCompared with women not reporting PCOS, women reporting PCOS have increased depression, anxiety and perceived stress. Stress may play a role in the association between PCOS, depression and anxiety. Further studies should consider assessment and management of stress in PCOS as it may be relevant for understanding the aetiology and treatment of psychological distress.
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Morgan, Vera A., Helen Leonard, Jenny Bourke, and Assen Jablensky. "Intellectual disability co-occurring with schizophrenia and other psychiatric illness: population-based study." British Journal of Psychiatry 193, no. 5 (November 2008): 364–72. http://dx.doi.org/10.1192/bjp.bp.107.044461.
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BackgroundThe epidemiology of intellectual disability co-occurring with schizophrenia and other psychiatric illness is poorly understood. The separation of mental health from intellectual disability services has led to a serious underestimation of the prevalence of dual diagnosis, with clinicians ill-equipped to treat affected individuals.AimsTo estimate the prevalence of dual diagnosis and describe its clinical profile.MethodThe Western Australian population-based psychiatric and intellectual disability registers were cross-linked (totaln=245 749).ResultsOverall, 31.7% of people with an intellectual disability had a psychiatric disorder; 1.8% of people with a psychiatric illness had an intellectual disability. Schizophrenia, but not bipolar disorder and unipolar depression, was greatly overrepresented among individuals with a dual diagnosis: depending on birth cohort, 3.7–5.2% of those with intellectual disability had co-occurring schizophrenia. Pervasive developmental disorder was identified through the Intellectual Disability Register and is therefore limited to individuals with intellectual impairment. None the less, pervasive developmental disorder was more common among people with a dual diagnosis than among individuals with intellectual disability alone. Down syndrome was much less prevalent among individuals with a dual diagnosis despite being the most predominant cause of intellectual disability. Individuals with a dual diagnosis had higher mortality rates and were more disabled than those with psychiatric illness alone.ConclusionsThe facility to combine records across administrative jurisdictions has enhanced our understanding of the epidemiology of dual diagnosis, its clinical manifestations and aetiological implications. In particular, our results are suggestive of a common pathogenesis in intellectual disability co-occurring with schizophrenia.
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GRABSCH, BRENDA, DAVID M. CLARKE, ANTHONY LOVE, DEAN P. McKENZIE, RAYMOND D. SNYDER, SIDNEY BLOCH, GRAEME SMITH, and DAVID W. KISSANE. "Psychological morbidity and quality of life in women with advanced breast cancer: A cross-sectional survey." Palliative and Supportive Care 4, no. 1 (March 2006): 47–56. http://dx.doi.org/10.1017/s1478951506060068.
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Objective:Our purpose was to determine the frequency of psychiatric morbidity and to assess the quality of life of women with advanced breast cancer.Methods:The 227 women in the sample were recruited in Melbourne, Australia, and were interviewed (prior to intervention) for a randomized controlled trial of supportive-expressive group therapy. The main outcome measures were DSM–IV psychiatric diagnoses plus quality of life data based on the EORTC QLQ-C30 (core) and QLQ-BR23 (breast module) instruments.Results:Forty-two percent of the women (97/227) had a psychiatric disorder; 35.7% (81) of these had depression or anxiety or both. Specific diagnoses were minor depression in 58 women (25.6%), major depression in 16 (7%), anxiety disorder in 14 (6.2%), and phobic disorder in 9 (4%). Seventeen (7.5%) women had more than one disorder. In terms of quality of life, one-third felt less attractive, one-quarter were dissatisfied with their body image, and, in most, sexual interest had waned. Menopausal symptoms such as hot flashes affected less than one-third, whereas symptoms of lymphedema were experienced by 26 (11.5%).Significance:Women with advanced breast cancer have high rates of psychiatric and psychological disturbance. Quality of life is substantially affected. Clinicians need to be vigilant in monitoring psychological adjustment as part of a comprehensive biopsychosocial approach.
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Hope, Judith, Nicholas A. Keks, William Pring, Voula Adamopoulos, David Toffler, Stephen Macfarlane, and Debbie Van Sebille. "Comparison of inpatients who were readmitted within 28 days of discharge with those not readmitted: an audit at an Australian private psychiatric hospital." Australasian Psychiatry 29, no. 2 (January 12, 2021): 169–74. http://dx.doi.org/10.1177/1039856220984049.
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Objective: To compare inpatients who had been readmitted within 28 days of discharge with patients not readmitted within the same period in a private psychiatric hospital. Method: Of 118 readmissions within 28 days in 2017 (7% of admissions), 50 were randomly selected and matched by age and gender with control patients who had not been readmitted within 28 days. Differences in demographics, diagnosis, length of stay and number of admissions in the previous 12 months were examined. Results: Readmitted cases were 64% female, were aged 49.8 ± 18.2 years (range 19–89), 40% were in relationships and 24% were receiving disability support. Most patients were suffering an episode of depression. Cases had higher rates of multiple psychiatric diagnoses ( p < .001) and physical disorders ( p < .05). There were no significant differences between cases and controls on psychiatric diagnoses. Cases had a longer length of stay in their previous admission ( p < .01) and a higher number of admissions in the preceding 12 months ( p < .05) compared to controls. Conclusion: This study indicates that inpatients readmitted within 28 days of discharge were more likely to have multiple diagnoses, physical co-morbidity and relapsing conditions than patients who were not readmitted.
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Carr, Vaughan J., Terry J. Lewin, Jane M. Walton, Catherine Faehrmann, and Alexander L. A. Reid. "Consultation—Liaison Psychiatry in General Practice." Australian & New Zealand Journal of Psychiatry 31, no. 1 (February 1997): 85–94. http://dx.doi.org/10.3109/00048679709073804.
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Objective:This paper describes the characteristics of 303 consecutive referrals, over a 12-month period, to a consultation—liaison (C—L) psychiatry service provided to eight group general practices in Newcastle, Australia. Method:A purpose designed service audit form was used throughout the evaluation period to collect information about demographic characteristics, reasons for referral, service contacts, psychiatric diagnoses and clinical management. In addition, patients were invited to participate in a separate, prospective outcome evaluation study, which involved structured interviews and questionnaires. Results:The most common reasons for referral were: depression (33%); anxiety (12%); diagnostic assessment (9%); and impaired relationships (8%). The most common psychiatric diagnoses were: mood disorders (29%); mild, transient conditions (29%); anxiety (14%); and substance abuse disorders (12%). Following the psychiatric consultation(s), GPs were actively involved in patients’ treatment in 53% of cases. However, there was a higher than expected rate of referral (44%) to another mental health agency. Selected comparisons are also reported between patients referred to the C—L service (n = 303) and a sample of non-referred GP attenders (n = 535). Conclusions:As expected, the diagnostic profiles of patients attending the C—L service differed in several respects from those using similar services in general hospitals. There were comparatively low rates of organic brain syndromes, suicide risk evaluations, and problems of differential diagnosis of somatic symptoms. Greater emphasis needs to be placed on more formal psychiatric education for GPs, on ways of screening out from the referral process those patients with mild, transient conditions who do not require specialist expertise, and on the development of strategies to help GPs manage such conditions.
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Draper, Brian, Henry Brodaty, Lee-Fay Low, and Vicki Richards. "Prediction of Mortality in Nursing Home Residents: Impact of Passive Self-Harm Behaviors." International Psychogeriatrics 15, no. 2 (June 2003): 187–96. http://dx.doi.org/10.1017/s1041610203008871.
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Objective: The aim of this study was to determine whether indirect self-destructive behaviors predict mortality in nursing home residents. Method: This cross-sectional study with follow-up after 2 years and 3 months surveyed 593 residents in 10 nursing homes in the eastern suburbs of Sydney, Australia. The following instruments were used: Harmful Behaviors Scale (HBS), Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), Functional Assessment Staging Scale, Resident Classificatin Index, Cumulative Illness Rating Scale, Even Briefer Assessment Scales for Depression, and the suicide item from the Structured Hamilton Depression Rating Scale. Diagnoses of depression, dementia, and psychosis were obtained from nursing home records. Mortality data were obtained in August 1999. Results: At follow-up, 297 (50.1%) residents were still alive with a mean survival time of 565.4 days. Survival analyses found that mortality was predicted by older age, male gender, lower level of functioning, lower levels of behavioral disturbance on the BEHAVE-AD, and higher scores on the HBS “passive self-harm” factor-based subscale, which includes refusal to eat, drink, or take medication. Discussion: These results suggest that passive self-harm behaviors predict mortality in nursing home residents.
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Snow, Pamela, Emina McLean, and Margarita Frederico. "The language, literacy and mental health profiles of adolescents in out-of-home care: An Australian sample." Child Language Teaching and Therapy 36, no. 3 (July 23, 2020): 151–63. http://dx.doi.org/10.1177/0265659020940360.
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Adolescents in the care of the state have complex developmental needs that include low academic attainment. The aim of this study was to describe the language and literacy profiles of adolescents (aged 13–19) in out-of-home care (‘looked after children’). Mental health status, biopsychosocial history, and education and employment histories were also documented. Twenty-six adolescents were assessed by a speech and language therapist. Ninety-two percent had oral language skills below the average range on the Clinical Evaluation of Language Fundamentals: 4th edition, with 62% scoring two or more standard deviations below the mean. Ninety-two percent of participants scored below the average range on two or more subtests of the Test of Language Competence: Expanded edition. On the York Assessment of Reading Comprehension, 92% scored in the very low range and 65% were below-average on single-word reading. Fifty percent of participants reported a diagnosis/symptoms of depression and 54% reported a diagnosis/symptoms of anxiety. The correlation between oral language and literacy was modest but significant ( r = 0.502; p ⩽ 0.05); no significant correlations were found between oral language, literacy and mental health status, suggesting that mental health problems are a comorbidity rather than a correlate of language and literacy difficulties. Language and literacy difficulties are highly prevalent in this population. Language disorders are likely to be undiagnosed in the context of significant mental health problems, and disrupted schooling and accommodation. Speech-language therapy scope of practice needs to include out-of-home care populations in order to foster developmentally appropriate language and literacy skills that maximize school success, both academically and socially.
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Burnett, A., C. G. Davey, S. J. Wood, M. Wilson-Ching, C. Molloy, J. L. Y. Cheong, L. W. Doyle, and P. J. Anderson. "Extremely preterm birth and adolescent mental health in a geographical cohort born in the 1990s." Psychological Medicine 44, no. 7 (August 28, 2013): 1533–44. http://dx.doi.org/10.1017/s0033291713002158.
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BackgroundPreterm birth confers risk for poor outcome, including mental health problems. Survival of extremely preterm (EP; <28 weeks' gestation) or extremely low birthweight (ELBW; <1000 g) infants increased in the 1990s but psychiatric outcomes in older adolescents born preterm since 1990 are not well documented. This study aimed to characterize mental health and personality traits in a prospective geographical cohort of adolescents born EP/ELBW in Victoria, Australia in 1991 and 1992.MethodAt age 18 years, 215 EP/ELBW and 157 normal birthweight (>2499 g) control adolescents completed the Structured Clinical Interview for DSM-IV Disorders, Axis 1 Non-Patient version (SCID-I/NP), the Children's Interview for Psychiatric Syndromes (ChIPS) attention deficit hyperactivity disorder (ADHD) module, and questionnaires assessing recent depression and anxiety symptoms and personality traits.ResultsADHD prevalence was significantly elevated in EP/ELBW adolescents compared with controls [15% v. 7%; odds ratio (OR) 2.67, 95% confidence interval (CI) 1.08–6.58]. Aside from ADHD, however, EP/ELBW and control adolescents reported very similar outcomes, with other lifetime diagnoses identified in 23% of EP/ELBW and 21% of controls. These were predominantly mood and anxiety disorders (21% EP/ELBW, 20% controls). The groups did not differ in recent depression or anxiety symptoms assessed using questionnaires, and personality traits were also similar.ConclusionsADHD was more prevalent in EP/ELBW adolescents than controls, which is consistent with some, but not all, reports on preterm survivors born before the 1990s, and younger preterm children born in the 1990s. The high rates of anxiety and mood disorders were similar in both groups, and comparable with population-based estimates.
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Bailey, Eleanor, Alexandra Boland, Imogen Bell, Jennifer Nicholas, Louise La Sala, and Jo Robinson. "The Mental Health and Social Media Use of Young Australians during the COVID-19 Pandemic." International Journal of Environmental Research and Public Health 19, no. 3 (January 19, 2022): 1077. http://dx.doi.org/10.3390/ijerph19031077.
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Young people may be particularly vulnerable to the mental health impacts of the COVID-19 pandemic and may also be more likely to use social media at this time. This study aimed to explore young people’s mental health and social media use during the COVID-19 pandemic and examined their use of social media to seek and provide support for suicidal thoughts and self-harm during this period. Young people aged 16–25 (n = 371, M = 21.1) from the general population in Australia completed an anonymous, cross-sectional online survey advertised on social media from June to October 2020. Participants reported high levels of psychological distress, with over 40% reporting severe levels of anxiety and depression, and those with a mental health diagnosis were more likely to perceive the pandemic to have had a negative impact on their mental health. Gender-diverse participants appeared the most negatively impacted. Social media use was high, with 96% reporting use at least once a day, and two-thirds reporting an increase in social media use since the start of the pandemic. One-third had used social media to seek support for suicidal thoughts or self-harm, and half had used it to support another person. This study adds to a growing literature suggesting social media can provide an opportunity to support young people experiencing psychological distress and suicide risk. Uniquely, this study points to the utility of using social media for this purpose during high-risk periods such as pandemics, where access to face-to-face support may be limited. To promote the quality and safety of support provided on social media, resources for help-seekers and help-givers should be developed and disseminated. Social media companies must consider the vulnerability of some users during pandemics and do what they can to promote wellbeing and safety.
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TRELOAR, S. A., A. C. HEATH, and N. G. MARTIN. "Genetic and environmental influences on premenstrual symptoms in an Australian twin sample." Psychological Medicine 32, no. 1 (January 2002): 25–38. http://dx.doi.org/10.1017/s0033291701004901.
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Background. We aimed to explore the prevalence and factor structure of premenstrual symptoms in a sample of Australian twins; to investigate phenotypic associations between reported premenstrual symptoms, personality and reproductive dimensions; and to identify the relative contributions of genes and environment to premenstrual symptoms and the extent of genetic and environmental covariation with the personality trait Neuroticism and lifetime major depression.Method. Seven hundred and twenty female twin pairs (454 monozygotic and 266 dizygotic) from the Australian National Health and Medical Research Council Twin Register reported on experience of 17 premenstrual symptoms during the previous 12 months. In the same questionnaire twins also responded to questions on symptom states, and personality dimensions including neuroticism. Interview data enabling diagnosis of lifetime history of DSM-IV major depression were also available. We fitted univariate and multivariate genetic models to the data.Results. Most frequently reported symptoms were breast tenderness/pain and bloating/weight gain, followed by affective symptoms. Twelve-month prevalence was 2·4% for the combination of symptoms and functional interference meeting a very rough approximation of DSM-III-R criteria for late luteal dysphoric disorder. Principal factor analysis identified a single premenstrual (PMS) factor. Additive genetic influences (44% of total variance) were identified for PMS. Although we found genetic correlations of 0·62 between reported PMS and neuroticism, and 0·70 with lifetime major depression, 39% of the genetic variance of PMS was not explained by these factors.Conclusions. Our findings support the existence of genetic influences on premenstrual symptoms, but we were unable to distinguish between liability to symptom experience and symptom reporting. Retrospective reporting may have contributed to our finding that PMS genes were shared in part with neuroticism and liability to lifetime major depression.
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Peisah, C., and K. Wilhelm. "Physician don't heal thyself: a descriptive study of impaired older doctors." International Psychogeriatrics 19, no. 5 (May 16, 2007): 974–84. http://dx.doi.org/10.1017/s1041610207005431.
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Background: The growing and welcome interest in the issues leading to distress and impairment in younger doctors has not been mirrored by a focus on the similar issues in older doctors which is surprising given the aging medical workforce.Objectives: To improve understanding of impairment in older doctors and to facilitate the planning of primary prevention strategies.Method: Consecutive case records of notifications to the Impaired Registrants Program of the New South Wales Medical Board, Australia, of doctors over 60 years from January 2000 to January 2006 (N = 41) were examined. Details of demographics, type of practice, nature of referral, medical morbidity, cognitive examination, psychiatric diagnosis and outcome of assessment were recorded.Results: Impaired older doctors suffered cognitive impairment (54%), substance abuse (29%) and depression (22%) and 17% had two comorbid psychiatric conditions. Twelve percent had frank dementia. Two work patterns – the “workhorse” and the “dabbler” – were observed, as was a culture of postponed retirement due to a sense of obligation and working “until you drop.” Impaired older doctors were found to have higher chronic illness burden compared with community norms. Almost half were the subject of patient complaints or of poor performance within ten years of presentation.Conclusion: To our knowledge there has been no other comprehensive examination of patterns of impairment in older doctors. Older doctors are prone to suffer “the four Ds”: dementia, drugs, drink and depression. We need to encourage mature doctors to adapt to age-related changes and illness and validate their right to timely and appropriate retirement.
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Collie, Alexander, Ruxsana Shafiq-Antonacci, Paul Maruff, Peter Tyler, and Jon Currie. "Norms and the Effects of Demographic Variables on a Neuropsychological Battery for Use in Healthy Ageing Australian Populations." Australian & New Zealand Journal of Psychiatry 33, no. 4 (August 1999): 568–75. http://dx.doi.org/10.1080/j.1440-1614.1999.00570.x.
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Objective: The current study examined the performance of a healthy ageing population on the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological test battery in order to determine norms for use in an Australian setting. The effects of age, education, gender and mood on cognitive performance in healthy older individuals were also explored. Method: The CERAD neuropsychological battery was administered to a sample of healthy elderly subjects (n = 243). Subjects also completed an anxiety inventory and a depression scale. Means and standard deviations of different age, gender and education groups are reported as normative data. A Principal Components Analysis (PCA) was also calculated. Linear regression was applied to the five factors extracted from the PCA using age, education, gender and mood as independent variables. Results: All recorded means were within 1 SD of those reported in the original CERAD normative study. Five factors that loaded on measures of memory and learning, language, praxis and executive function were extracted. The independent variables age, education and gender all had significant effects on cognitive performance. However, mood had no such effect. Conclusions: Risk factors for cognitive decline indicated by the CERAD battery include age, education and gender. Anxiety and depression are not associated with CERAD cognitive performance. The CERAD battery is a valid and reliable neuropsychological tool that may assist in the detection and diagnosis of Alzheimer's disease in Australian populations.