Journal articles on the topic 'Psychoses Australia'
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Galletly, Cherrie, Xiaoli Wu, Zili Han, and Dennis Liu. "M151. DIFFERENCES IN PATTERN OF OBESITY BETWEEN PEOPLE WITH SCHIZOPHRENIA LIVING IN CHINA AND IN AUSTRALIA." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S192—S193. http://dx.doi.org/10.1093/schbul/sbaa030.463.
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Abstract Background People with psychotic disorders, including schizophrenia, suffer premature cardiovascular morbidity and mortality. Obesity is a major factor in cardiometabolic disorders in this population. There has been very little research investigating differences in patterns of obesity in diverse ethnic populations. Guidelines for treatment of complex comorbidities in people with schizophrenia and related psychoses may need to provide specific recomendations for different ethnic groups. Methods The Chinese sample consisted 192 subjects were recruited from the outpatients and inpatients department of the psychiatry department of the third affiliated hospital of Sun Yat-sen. All enrolled subjects were Chinese Han ethnicity, aged 16–45 years, with a diagnosis of schizophrenia according to ICD-10 criteria for schizophrenia, excluding other acute psychiatric disorders. The Australian sample (N=1825) were drawn from the Survey of High Impact Psychosis. BMI and central obesity were measured in all subjects. Results 10.3% of men and 4.7% of women in the China sample were obese (BMI>30). In the Australian sample, 41.6% of men and 50.3% of women were obese. Overall, 7.8% of Chinese sample and 45.1% of the Australian sample were obese. However, amongst the non-obese China sample, 41.7% of men and 53.1% of women had central obesity; the mean for all non-obese Chinese people was 46.7%. 73% of non-obese Australian men and 81.5% of non-obese Australian women had central obesity; the mean for all non-obese Australians was 76%. Discussion Chinese Han people with schizophrenia have much lower rates of obesity than the Australian sample. In both groups, rates of abdominal obesity were higher than rates of obesity as defined by BMI. These ethnic differences may help in understanding the high rates of cardiometabolic disorder in people with psychotic disorders in Western countries. They may also inform interventions to assist Western people with psychoses to maintain better physical health.
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Carr, Vaughan J., Amanda L. Neil, Sean A. Halpin, Scott Holmes, and Terry J. Lewin. "Costs of Schizophrenia and Other Psychoses in Urban Australia: Findings from the Low Prevalence (Psychotic) Disorders Study." Australian & New Zealand Journal of Psychiatry 37, no. 1 (February 2003): 31–40. http://dx.doi.org/10.1046/j.1440-1614.2003.01092.x.
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Objective: To estimate the costs associated with the treatment and care of persons with psychosis in Australia based on data from the Low Prevalence Disorders Study (LPDS), and to identify areas where there is potential for more efficient use of existing health care resources. Method: The LPDS was a one-month census-based survey of people with psychotic disorders in contact with mental health services, which was conducted in four metropolitan regions in 1997–1998. Mental health and service utilization data from 980 interviews were used to estimate the economic costs associated with psychotic disorders. A prevalencebased, ‘bottom-up’ approach was adopted to calculate the government and societal costs associated with psychosis, including treatment and non-treatment related costs. Results: Annual societal costs for the average patient with psychosis are of the order of $46 200, comprising $27 500 in lost productivity, $13 800 in inpatient mental health care costs and $4900 in other mental health and community services costs. Psychosis costs the Australian government at least $1.45 billion per annum, while societal costs are at least $2.25 billion per annum (including $1.44 billion for schizophrenia). We also report relationships between societal costs and demographic factors, diagnosis, disability and participation in employment. Conclusions: Current expenditure on psychosis in Australia is probably inefficient. There may be substantial opportunity costs in not delivering effective treatments in sufficient volume to people with psychotic disorders, not intervening early, and not improving access to rehabilitation and supported accommodation.
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GUREJE, O., H. HERRMAN, C. HARVEY, V. MORGAN, and A. JABLENSKY. "The Australian National Survey of Psychotic Disorders: profile of psychosocial disability and its risk factors." Psychological Medicine 32, no. 4 (May 2002): 639–47. http://dx.doi.org/10.1017/s0033291702005627.
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Background. Knowledge of the level of psychosocial impairment associated with psychosis is important in evaluating the impact of the illness on those affected. When such knowledge is derived from community-based epidemiological surveys, it can help in providing a public health perspective for service planning with information derived from representative samples of patients.Methods. A two-phase epidemiological survey of persons with psychosis in four predominantly urban areas of Australia. First phase screening for psychosis (N = 5710) was followed by a semi-structured interview of a stratified random sample (N = 980) to assess psychopathology (lifetime and current) and psychosocial disability.Results. Most of the interviewees were unemployed and had never married. There was widespread impairment in sexual and social relationships and in the performance of activities of daily living. Over half expressed dissatisfaction with life in general. Persons with affective psychoses were often as disabled as those with schizophrenia and diagnostic categorizations were not important in the conferment of risk for disability. Rather, poor pre-morbid work or social adjustment and poor course of illness were potent risk factors for diverse forms of disability in persons with psychosis.Conclusion. A large proportion of persons with experience of psychosis living in the community suffers from significant levels of psychosocial disability. Disablement seems to reflect, in part, a diathesis of poor pre-morbid functioning and less than optimal response to treatment of the disorder.
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Jablensky, Assen, John McGrath, Helen Herrman, David Castle, Oye Gureje, Mandy Evans, Vaughan Carr, Vera Morgan, Ailsa Korten, and Carol Harvey. "Psychotic Disorders in Urban Areas: An Overview of the Study on Low Prevalence Disorders." Australian & New Zealand Journal of Psychiatry 34, no. 2 (April 2000): 221–36. http://dx.doi.org/10.1080/j.1440-1614.2000.00728.x.
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Objective: This paper reports on a study designed within the framework of the National Survey of Mental Health and Wellbeing to: estimate the prevalence of psychoses in urban areas of Australia; identify profiles of symptomatology, impairments and disabilities; collect information on services received and needed; and explore quality of life issues in a broadly representative sample of people with psychotic illnesses. Method: The study was conducted over four areas in the Australian Capital Territory, Queensland, Victoria and Western Australia, as a two-phase survey: (i) a census and screening for psychosis of all individuals who made contacts with mental health services during a period of 1 month in 1997; and (ii) interviews with a stratified random sample (n = 980) of the screen-positive individuals (n = 3800) using a standardised instrument. Results: The point prevalence (1 month) of psychotic disorders in the urban population aged 18–64 is in the range of 4–7 per 1000 with a weighted mean of 4.7 per 1000. People with psychotic disorders experience high rates of functional impairments and disability, decreased quality of life, persistent symptoms, substance-use comorbidity and frequent side effects of medication. Although the utilisation of hospital-based and community mental health services, as well as of public and non-governmental helping agencies, is high, the majority live in extreme social isolation and adverse socioeconomic circumstances. Among the many unmet needs, the limited availability of community-based rehabilitation, supported accommodation and employment opportunities is particularly prominent. Conclusions: The so-called ‘low-prevalence’ psychotic disorders represent a major and complex public health problem, associated with heavy personal and social costs. There is a need for a broad programmatic approach, involving various sectors of the community, to tackle the multiple dimensions of clinical disorder, personal functioning and socioeconomic environment that influence the course and outcome of psychosis and ultimately determine the effectiveness of service-based intervention.
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Morgan, V. A., A. V. Jablensky, and D. J. Castle. "Season of birth in schizophrenia and affective psychoses in Western Australia 1916±61." Acta Psychiatrica Scandinavica 104, no. 2 (August 2001): 138–47. http://dx.doi.org/10.1034/j.1600-0447.2001.00188.x.
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O’Donnell, Maryanne, Scott B. Teasdale, Xin-Yi Chua, Jamie Hardman, Nan Wu, Jackie Curtis, Katherine Samaras, et al. "The Role of the Microbiome in the Metabolic Health of People with Schizophrenia and Related Psychoses: Cross-Sectional and Pre-Post Lifestyle Intervention Analyses." Pathogens 11, no. 11 (November 1, 2022): 1279. http://dx.doi.org/10.3390/pathogens11111279.
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The microbiome has been implicated in the development of metabolic conditions which occur at high rates in people with schizophrenia and related psychoses. This exploratory proof-of-concept study aimed to: (i) characterize the gut microbiota in antipsychotic naïve or quasi-naïve people with first-episode psychosis, and people with established schizophrenia receiving clozapine therapy; (ii) test for microbiome changes following a lifestyle intervention which included diet and exercise education and physical activity. Participants were recruited from the Eastern Suburbs Mental Health Service, Sydney, Australia. Anthropometric, lifestyle and gut microbiota data were collected at baseline and following a 12-week lifestyle intervention. Stool samples underwent 16S rRNA sequencing to analyse microbiota diversity and composition. Seventeen people with established schizophrenia and five people with first-episode psychosis were recruited and matched with 22 age-sex, BMI and ethnicity matched controls from a concurrent study for baseline comparisons. There was no difference in α-diversity between groups at baseline, but microbial composition differed by 21 taxa between the established schizophrenia group and controls. In people with established illness pre-post comparison of α-diversity showed significant increases after the 12-week lifestyle intervention. This pilot study adds to the current literature that detail compositional differences in the gut microbiota of people with schizophrenia compared to those without mental illness and suggests that lifestyle interventions may increase gut microbial diversity in patients with established illness. These results show that microbiome studies are feasible in patients with established schizophrenia and larger studies are warranted to validate microbial signatures and understand the relevance of lifestyle change in the development of metabolic conditions in this population.
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Carr, Vaughan J., Terry J. Lewin, Amanda L. Neil, Sean A. Halpin, and Scott Holmes. "Premorbid, psychosocial and clinical predictors of the costs of schizophrenia and other psychoses." British Journal of Psychiatry 184, no. 6 (June 2004): 517–25. http://dx.doi.org/10.1192/bjp.184.6.517.
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BackgroundPredictors of the costs of psychosis have received insufficient research attention, particularly factors associated with indirect costs.AimsTo identify the predictors of direct mental health care costs and indirect or time-loss costs in psychotic disorders and to discuss their implications for future interventions.MethodStructured interview data from the Low Prevalence Disorders Study (n=980) were used to examine predictors of the costs of psychosis in Australia. Estimates of annual costs per patient were derived from the perspectives of government and society. Hierarchical regressions were used to assess the contributions to costs of premorbid, psychosocial and clinical factors.ResultsSchizophrenia involved greater costs than other psychotic disorders. Non-completion of high-school education and chronicity of illness course were predictive of higher costs across all categories, and some factors were linked primarily with mental health care costs (e.g. age at onset, current symptomatology) or indirect costs (e.g. male gender, overall disability).ConclusionsSeveral concurrent strategies were recommended, including early intervention programmes and assertive evidence-based rehabilitation and supported employment programmes aimed at reducing disability The cost-effectiveness of these approaches needs to be evaluated from the perspectives of both government and society.
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Copolov, David L., Patrick D. McGony, Nicholas Keks, Iraklis H. Minas, Helen E. Heman, and Bruce S. Singh. "Origins and Establishment of the Schizophrenia Research Programme at Royal Park Psychiatric Hospital." Australian & New Zealand Journal of Psychiatry 23, no. 4 (December 1989): 443–51. http://dx.doi.org/10.3109/00048678909062611.
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This paper documents the initial phase of a new research direction which began in 1984 at Royal Park Hospital. Attention is focussed on the place of the university and the research institute in the psychiatric hospital and on the perceived need for concerted research on the major psychoses in Australia. The focal point of the Royal Park research programme, the Aubrey Lewis Clinical Research Unit, has been open since October 1984. The development of the unit's research activities during the initial few years of its existence required an awareness of specific scientific, administrative and political issues. These are discussed in detail in order to convey something of the process, as well as the content of such development, and in an attempt to provide some assistance to others undertaking similar developments.
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Draper, Brian, Georgina Luscombe, and Stephanie Winfield. "The Senior Psychiatrist Survey II: Experience and Psychiatric Practice." Australian & New Zealand Journal of Psychiatry 33, no. 5 (October 1999): 709–16. http://dx.doi.org/10.1080/j.1440-1614.1999.00623.x.
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Objective: The aim of this study is to determine the effects of experience on the practice, roles, status and attitudes of psychiatrists within the Royal Australian and New Zealand College of Psychiatrists (RANZCP). Method: A postal survey of Fellows of the RANZCP resident in Australia or New Zealand was conducted. The main outcome measures were: years of psychiatric experience; higher medical qualifications; location and type of psychiatric practice; attitudes about senior psychiatrists and mentorship; changes in work practices over the career; and the perceived benefits and drawbacks of experience on psychiatric practice and case selection. Results: Of 1086 eligible subjects, 629 participated. Over 96% of respondents, particularly the younger and less experienced, believed that senior psychiatrists have wisdom to offer to junior colleagues. This wisdom principally related to mentor-ship/supervision. Increased ‘respect and tolerance’ of patients as a benefit of experience was more likely to be reported by respondents who were more experienced. Respondents more confident about treating younger patients and treating functional psychoses were more likely to be less experienced, as were those reluctant to take on psychotherapy cases. Those respondents reluctant to take on ‘dangerous or acting-out patients’ were more experienced. The field of psychiatric practice significantly influenced case selection. Conclusions: Senior psychiatrists have accumulated wisdom through experience that is sought by junior colleagues via mentorship. It is recommended that the RANZCP should specifically address the needs of early career and senior psychiatrists.
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Lincoln, Clare, Susy Harrigan, and Pat D. McGorry. "Understanding the topography of the early psychosis pathways." British Journal of Psychiatry 172, S33 (June 1998): 21–25. http://dx.doi.org/10.1192/s0007125000297614.
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Background This study aims to gain an understanding of treatment delays and their nature in initial psychotic episodes. We investigated to whom people turn for help, how long that approach takes and subsequent delays in commencing treatment.Method Qualitative and quantitative methods were combined with interviews of 62 people suffering from first-episode psychoses, aged 16–30 years, who had recently accessed a specialist mental health service in Melbourne, Australia. A modified version of the World Health Organization Encounter Form was analysed in conjunction with other data.ResultsPathways to care and the ways in which they were experienced were highly variable, with 50% of people experiencing psychotic symptoms before approaching any service. The general practitioner played a key role with 50% of people having had GP contact at some point prior to commencing effective treatment. Where an individual's own efforts to seek early help failed, the role of relatives and others was subsequently vital.Conclusions Opportunities exist for shortening delays through targeted health promotion activities and professional training. The need is indicated for a multi-layered or topographical strategy to identify and minimise critical barriers on the route to early intervention. Refinement of interview techniques and instruments of measurement are needed to enhance the explanatory power of data collected.
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Sheehan, Garry. "An Early Settler in Sickness and in Health." Australian & New Zealand Journal of Psychiatry 33, no. 6 (December 1999): 926–34. http://dx.doi.org/10.1046/j.1440-1614.1999.00620.x.
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Objective: This paper is an examination of an early Australian settler's states of mind in episodes of psychosis and some issues from her life which may have contributed to the psychoses. Method: Hospital records of her psychoses and her diary entries in the months surrounding the onset of illness were investigated from a psychoanalytic perspective, and inferences about her underlying personality are drawn from a recent publication about her diaries. Results: An historical interpretation of her life and states of mind based on the documents is presented. Conclusions: Failure to resolve psychic conflict led to restrictions in how she and her family lived, and left her susceptible to decompensation.
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Saha, S., V. A. Morgan, D. Castle, D. Silove, and J. J. McGrath. "Sociodemographic and clinical correlates of migrant status in adults with psychotic disorders: data from the Australian Survey of High Impact Psychosis." Epidemiology and Psychiatric Sciences 24, no. 6 (August 27, 2014): 534–41. http://dx.doi.org/10.1017/s2045796014000535.
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Objective.The links between migrant status and psychosis have attracted considerable attention in recent decades. The aim of the study was to explore the demographic and clinical correlates of migrant v. Australia-born status in individuals with psychotic disorders using a large community-based sample.Method.Data were drawn from a population-based prevalence survey of adults with psychotic disorders. Known as the Survey of High Impact Psychosis (SHIP), it was conducted in seven Australian catchment areas in 2010. Logistic regression was used for the main analyses, examining associations of migrant status with sociodemographic and clinical variables.Results.Of the 1825 participants with psychotic disorders, 17.8% (n = 325) were migrants, of whom 55.7% (n = 181) were male. Compared to Australia-born individuals with psychosis, migrants were more likely to be currently married, to have completed a higher level at school, to have left school later, and to be employed with full-time jobs. Migrants with psychosis were either no different from or less impaired or disadvantaged compared to their Australian-born counterparts on a range of clinical and demographic variables.Conclusions.In a sample of individuals with psychotic disorders, there was no evidence to suggest that migrant status was associated with worse clinical or socio-economic outcomes compared to their native-born counterparts.
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New, TR. "The Psychopsidae (Insecta : Neuroptera) of Australia and the Oriental region." Invertebrate Systematics 2, no. 7 (1988): 841. http://dx.doi.org/10.1071/it9880841.
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An illustrated synopsis is given of the described Psychopsidae of Australia (12 spp.) and the Oriental Region (2 spp.), together with the description of one new Australian species of Psychopsis. Generic limitations in the family are reassessed and several genera raised on venational features (Balmes Navas, Magallanes Navas, Wernzia Navas) are shown to closely resemble typical Psychopsis Newman on genitalic characters; they are synonymised with Psychopsis, and keys are given to world genera of the family and the species of Psychopsis (14 spp.). Megapsychops Tillyard (1 sp.) is retained as a distinct genus.
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Weickert, Thomas, Seetha Ramanathan, Rhoshel Lenroot, Dennis Liu, Ryan Balzan, Cherrie Galletly, and Cynthia Shannon Weickert. "M62. PERIPHERAL INFLAMMATION MARKERS IDENTIFY SUBSET OF PATIENTS WITH SCHIZOPHRENIA AND RELATED PSYCHOSES WHO HAVE INTELLECTUAL DECLINE FROM PREMORBID LEVELS." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S158—S159. http://dx.doi.org/10.1093/schbul/sbaa030.374.
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Abstract Background Higher inflammation has been identified in a substantial subset of both high-risk and chronically ill patients with schizophrenia and related psychoses and this may account for some of the heterogeneity of the schizophrenia. There is also much heterogeneity in cognitive deficits related to schizophrenia with some patients showing a marked decline from premorbid intellectual levels while others show little change from either normal or low intellect. However, the relationship between intellectual change with the illness onset and inflammation in schizophrenia has not been established. Methods Here, we report the assessment of two common markers of inflammation from two independent samples of generally chronically ill patients with schizophrenia and related psychoses (one sample of 73 patients versus 70 healthy controls from Sydney, NSW, Australia and one sample of 297 patients from Syracuse, NY, USA). Peripheral venous blood samples were collected from all patients and blood markers of inflammation (C-Reactive Protein, CRP, and Neutrophil to Lymphocyte Ratio, NLR) were assayed using standard procedures. Assessment of premorbid and current intellectual abilities were obtained from the Sydney cohort of patients. Results Grouping the patients and controls from the Sydney sample into those with elevated (> 3 mg/L) versus normal (< 3 mg/L) CRP levels revealed 42% of the patients versus 20% of the healthy controls had elevated CRP (Chi Square = 9.16, p = .002) and further evidence of inflammation with an elevated mean NLR of 2.5. The frequency of peripheral inflammation was confirmed by the independent sample from Syracuse in which 39% of the patients (n= 115) had an elevated NLR above a cutoff score for normal of 2.2 which was consistent with the Sydney sample. Patients from the Sydney sample who had an elevated CRP also had a significant mean 15-point IQ decline from premorbid IQ levels, whereas the patients with CRP levels within normal limits did not show a statistically significant drop in IQ from premorbid levels (mean IQ decline 7.6 points). Healthy controls with normal CRP had no IQ change (0.0 points) and healthy controls with elevated CRP has a slight, non-significant IQ decline (mean 2.3 points). Discussion Thus, our study showed supportive evidence of elevated peripheral inflammation markers in subgroups of chronically ill patients with schizophrenia from two independent samples and a link between marked intellectual decline from premorbid levels and current peripheral inflammation in one chronically ill subgroup of patients with schizophrenia suggesting a role for inflammation in the cognitive impairment of a substantial proportion (40%) of patients with schizophrenia.
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Stain, Helen J., Cherrie A. Galletly, Scott Clark, Jacqueline Wilson, Emily A. Killen, Lauren Anthes, Linda E. Campbell, Mary-Claire Hanlon, and Carol Harvey. "Understanding the social costs of psychosis: The experience of adults affected by psychosis identified within the second Australian national survey of psychosis." Australian & New Zealand Journal of Psychiatry 46, no. 9 (May 29, 2012): 879–89. http://dx.doi.org/10.1177/0004867412449060.
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Background: Social inclusion is a key priority of the Fourth National Mental Health Plan for Australia (2009–2014), with strong evidence for its protective impact on mental health. Social integration has been associated with enhanced well-being for people with mental illnesses such as psychosis. Objective: To explore the impact of psychosis on an individual’s social and community participation. Method: The second Australian national survey of psychosis was conducted across seven Australian sites. Semi-structured interviews with adults living with psychosis assessed mental health status, social and role functioning, life satisfaction and future goals. The cohort comprised 1825 adults with a psychotic illness (59.6% were male; 42.4% were aged 18–34 years; 31.5% had 12 years or more of education) of whom 32.7% had been employed in the past year. Results: Most adults indicated experiencing loneliness (80.1%) and a need for more friends (48.1%). Men were more likely to have never had a long-term relationship (59.4% M, 33.2% F). Even though women were more likely to experience anxiety in social situations [(χ2(1) = 8.95, p < 0.01)], they were more likely to have attended a social activity in the past year [χ2(2) = 11.84, p < 0.01]. Just over half of the survey participants (56.7%) reported having daily or nearly daily contact with family members. In the past year, 69% had not attended any social activity and 43% described stigma as a barrier. Although 63.2% showed significant impairment in social functioning, only 29.5% had received help for this in the last year. Social isolation and loneliness were rated as major challenges by 37.2% of the cohort. Conclusions: Social isolation and dysfunction experienced by people with psychosis have not decreased since the last Australian national survey of people with psychosis. Alongside education and employment, social functioning and participation must be addressed to improve social inclusion for people with psychosis. Programs targeting social opportunities (befriending, peer support), social anxiety and social functioning for all stages of psychosis are warranted.
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SCOTT, JAMES, DAVID CHANT, GAVIN ANDREWS, and JOHN McGRATH. "Psychotic-like experiences in the general community: the correlates of CIDI psychosis screen items in an Australian sample." Psychological Medicine 36, no. 2 (November 23, 2005): 231–38. http://dx.doi.org/10.1017/s0033291705006392.
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Background. Apart from individuals with clinical psychosis, community surveys have shown that many otherwise well individuals endorse items designed to identify psychosis. The aim of this study was to characterize the demographic correlates of individuals who endorse psychosis screening items in a large general community sample.Method. The National Survey of Mental Health and Wellbeing interviewed 10641 individuals living in private dwellings in Australia. As part of a diagnostic interview (the CIDI), respondents were asked between three and six items originally designed to screen for potential psychosis. We examined the impact of selected demographic variables on endorsement of these items including sex, age, marital status, migrant status, urban/rural status, employment, education, and socio-economic status.Results. An estimated 11·7% of the Australian population endorsed at least one psychosis-screening item. Significantly higher endorsement was associated with younger age, migrants from non-English-speaking backgrounds, those who had never married or who were divorced/separated or unemployed, those living in urban regions and those from the lowest socio-economic levels.Conclusions. Many of the correlates of endorsement of psychosis-screen items are also associated with psychosis. Unravelling the factors that contribute to this broader non-clinical phenotype will aid our understanding of psychosis.
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Harvey, Carol, Eoin Killackey, Aaron Groves, and Helen Herrman. "A place to live: Housing needs for people with psychotic disorders identified in the second Australian national survey of psychosis." Australian & New Zealand Journal of Psychiatry 46, no. 9 (May 22, 2012): 840–50. http://dx.doi.org/10.1177/0004867412449301.
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Objective: Access to adequate housing consistent with personal preferences and needs is a human right and supports recovery from psychosis. This study aimed to: (1) describe people with psychosis living in different housing types, and their preferences and needs; (2) explore selected demographic and social inclusion correlates in relation to housing; and (3) compare two subgroups – participants living in supported group accommodation and supported housing – on key demographic, functional, clinical and social inclusion variables. Method: Current housing, preferences, needs and assistance, and housing-related social inclusion variables were assessed in a two-phase prevalence survey conducted within seven catchment areas across five Australian states. Two supported housing models were compared: supported group accommodation and supported housing (rental accommodation with in-reach support). Descriptive statistics were used. Results: Of the total participants (n = 1825), one half were living in public or private rented housing (48.6%) and 22.7% were waiting for public housing. Despite being the preferred form of housing, only 13.1% were living in their own home. One in 20 participants (5.2%) was currently homeless; 12.8% had been homeless in the previous 12 months. Residents of supported group accommodation felt safer in their locality than those in supported housing, but experienced less privacy and choice. Conclusions: Although fewer participants were homeless compared with the first Australian survey of psychosis, the proportion remains high. Housing difficulties are experienced by people with psychoses living in various accommodation and concern housing adequacy and safety as well as autonomy and choice. Access to public housing is restricted compared with the identified need. Since residents of supported group accommodation felt safer in their locality than those in supported housing, but experienced less privacy and choice, each supported housing model may offer different advantages to people with psychosis, and contribute to services that support and maintain recovery.
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Moss, Beverley, and Nick O'Connor. "The Development of Consensus Guidelines for the Treatment of Young People with First Episode Psychosis." Australasian Psychiatry 10, no. 2 (June 2002): 111–14. http://dx.doi.org/10.1046/j.1440-1665.2002.00418.x.
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Objective: The aim is to describe the process adopted in Northern Sydney, Sydney, Australia for developing consensus guidelines for the treatment of young people with first episode psychosis. Method: The process included academic detailing with psychiatrists working in Northern Sydney adolescent and adult mental health services, two clinician forums, and a survey. While the guidelines were based on the Australian Clinical Guidelines for Early Psychosis and published studies, the expertise of clinicians in Northern Sydney was also sought. Results: The consensus guidelines have been endorsed for use in Northern Sydney. The guidelines cover the issues of assessment and treatment of psychosis in young people, investigations, use of parenteral medication, diagnosis, and information for clients. Conclusions: The authors make several observations about the process of guideline development. Academic detailing proved to be a more effective way than questionnaires for obtaining information from clinicians. The process of developing the guidelines seemed to be, in some ways, more important than the final product.
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Smith, J., P. D. McGorry, D. Shiers, J. Mahoney, E. Davis, M. Birchwood, F. Macmillan, J. Edwards, A. Sheehan, and C. Prior. "UK/Australia Early Psychosis Declaration." Acta Psychiatrica Scandinavica 106 (September 2002): 69–106. http://dx.doi.org/10.1034/j.1600-0447.106.s413.1_123.x.
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COTTON, JAMES. "AN AUSTRALIAN INTERNATIONALIST PARTS COMPANY WITH THE LEAGUE OF NATIONS: H. DUNCAN HALL AND THE FREUDIAN RESPONSE TO GLOBAL IRRATIONALISM." Modern Intellectual History 13, no. 3 (October 30, 2014): 653–80. http://dx.doi.org/10.1017/s1479244314000341.
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The most senior Australian in the League of Nations secretariat, H. Duncan Hall became an established advocate of institutional internationalism as a mitigator of conflict. From 1933, however, the advent of totalitarian movements and his exposure to Freudianism through his association with Dr Robert Waelder led him to the conviction that psychoanalysis provided the key to the irrationality of the times. He endeavoured to use his League position, including his influence in Australia, to convince opinion leaders of the profound dangers of national mass psychosis to the survival of the international order. Frustrated in the League, he then sought to convey the same message in the United States. Although largely unsuccessful in his efforts, and unable to establish an academic vehicle for the study of the issue in America, he was able to help bring to Australia the first practitioners of Freudian psychoanalysis trained in Europe.
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Thomas-Anttila, Kerry. "[Review of the Sixth International Conference on the Work of Frances Tustin: On Bringing Patients to Life.]." Ata: Journal of Psychotherapy Aotearoa New Zealand 16, no. 1 (October 22, 2012): 113–17. http://dx.doi.org/10.9791/ajpanz.2012.12.
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Frances Tustin (1913-1994) was a British child psychotherapist who trained at the Tavistock Clinic in London and who was an analysand of Wilfred Bion. She is internationally recognised for her work with autistic children and wrote around thirty articles and four books: Autism and Childhood Psychosis (Tustin, 1972), Autistic States in Children (Tustin, 1981), Autistic Barriers in Neurotic Patients (Tustin, 1986), and The Protective Shell in Children and Adults (Tustin, 1990). In 1995, a year after Tustin’s death, the Frances Tustin Memorial Trust was established by Dr Judith Mitrani (see the Frances Tustin Memorial Trust, 2012). The Trust is dedicated to the teaching, expansion and extension of Frances Tustin’s work on the understanding and treatment of autistic spectrum disorders in children, adolescents and adults. This includes the sponsorship of international conferences on Tustin’s work, which have been held in London, UK (2004); Caen, France (2005); Venice, Italy (2006); Berlin, Germany (2007); Tel-Aviv, Israel (2008); and, this year in Sydney, Australia. This Sixth International Conference, entitled On Bringing Patients to Life, was organized by the Trust, in conjunction with the Australian Psychoanalytical Society, the New South Wales Institute of Psychoanalytic Psychotherapy, The Institute of Child and Adolescent Psychoanalytic Psychotherapy, and the Couples and Family Psychoanalytic Psychotherapy Association of Australasia.
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Brady, Nicole S., Matthew J. Spittal, Lisa Mary Brophy, and Carol Ann Harvey. "Patients’ Experiences of Restrictive Interventions in Australia: Findings From the 2010 Australian Survey of Psychosis." Psychiatric Services 68, no. 9 (September 2017): 966–69. http://dx.doi.org/10.1176/appi.ps.201600300.
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Clark, M. L., F. Waters, T. M. Vatskalis, and A. Jablensky. "On the Interconnectedness and Prognostic Value of Visual and Auditory Hallucinations in First-Episode Psychosis." European Psychiatry 41, no. 1 (2017): 122–28. http://dx.doi.org/10.1016/j.eurpsy.2016.10.011.
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AbstractBackgroundVisual hallucinations (VH) are common symptoms in schizophrenia and other psychoses. An understanding of their cross-sectional and longitudinal patterns of association with auditory hallucinations (AH) is essential for developing accurate models of hallucinatory phenomena.ObjectiveThis study presents the most comprehensive examination of the association between VH and AH, and its change over time, in 1303 individuals with first-episode psychosis (FEP) and 469 individuals with chronic schizophrenia.MethodThe samples included data from the WHO multicentre study on the Determinants of Outcome of Severe Mental Disorders and the Western Australian Family Study of Schizophrenia (WAFSS). Standardized assessment of symptoms and functioning were used to examine the clinical profile and symptom co-occurrence of hallucinations over time.ResultsVH were approximately half as frequent as AH, almost always co-occurred with AH, and tended to be linked to a more severe psychopathological profile. AH and VH at baseline also predicted higher disability, risk of relapse and duration of psychosis after 1 and 2 years, especially when occurring in combination.ConclusionsThe findings point to three hallucination ‘subtypes’ with different symptom profile. The VH + AH combination signals greater psychopathology and a less favourable prognosis, than hallucinations occurring in isolation, and no hallucinations. This conclusion points to one common mechanism for all hallucinations, which can separate into distinct pathways and modalities. For a more complete clinical picture, clinicians should carefully probe for both auditory and VHs in presenting patients.
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Carr, Vaughan J., Amanda L. Neil, and Terry J. Lewin. "Resource allocation for psychosis in Australia." International Psychiatry 1, no. 6 (October 2004): 5–6. http://dx.doi.org/10.1192/s1749367600006937.
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Using a census-based prevalence survey (Jablensky et al, 2000), we estimated the cost of psychosis in urban Australia at AU$2.25 billion (£0.86 billion) per year when valued at prices pertaining in the year 2000 (Carr et al, 2003). About 40% of these costs were spent on direct mental health care, the remainder being the costs of lost productivity (limited to unemployment in our study). The total costs amounted to AU$46 200 (£17 722) per person per year, 20% higher than the average annual male income. The bulk of the treatment cost was accounted for by in-patient care, which appeared to have become the default option in the absence of adequate levels of supported community accommodation. This was indicated by the fact that after ‘non-discretionary’ treatment costs (42% of direct costs) were accounted for (i.e. visits to a general practitioner, medication, crisis or emergency care, acute hospitalisation), almost three-quarters of the remainder was spent on long-stay hospitalisation (Neil et al, 2003). When patterns of community-based service delivery were examined, we found a marked paucity of delivery of psychosocial treatments, rehabilitation and substance use interventions, reflecting the skewing of expenditure towards long-term hospitalisation and away from community care.
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Castle, David J. "Should early psychosis intervention be the focus for mental health services?" Advances in Psychiatric Treatment 17, no. 6 (November 2011): 398–400. http://dx.doi.org/10.1192/apt.bp.111.009563.
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SummaryThis issue of Advances carries two articles from Melbourne, Australia, outlining the rationale for, and implementation of, early psychosis services. Their publication provides an opportunity to address some of the more contentious issues relating to the early psychosis intervention movement.
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Morgan, Vera, Ailsa Korten, and Assen Jablensky. "Modifiable Risk Factors for Hospitalization Among People with Psychosis: Evidence from the National Study of Low Prevalence (Psychotic) Disorders." Australian & New Zealand Journal of Psychiatry 40, no. 8 (August 2006): 683–90. http://dx.doi.org/10.1080/j.1440-1614.2006.01868.x.
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Objective: Relatively little has been published on dynamic, that is, modifiable, as opposed to static risk factors for hospitalization in the research literature on risk factors for hospitalization in serious mental illness. The aim of this study was to develop a model to determine modifiable predictors of hospitalization using data from the Australian National Study of Low Prevalence (Psychotic) Disorders. Method: The Study of Low Prevalence Disorders used a two-phase design to estimate the prevalence of psychoses and identify characteristics of people with psychotic illness. This paper compares people hospitalized at the time of census and those using outpatient services. Logistic regression was used to examine the relative impact of dynamic characteristics including service utilization, symptom profile and risky behaviours on a base model for risk of hospitalization. Results: In the base model, course of disorder and age but not type of psychosis were significantly associated with hospitalization. Among symptoms, delusions (but not hallucinations) and negative symptoms significantly increased the odds of hospitalization. Service utilization, especially case management, reduced the odds significantly and substantially. Results for risky behaviours (e.g. substance abuse, offending) were ambiguous. Conclusions: The results highlight the impact of dynamic factors, particularly case management, over and above static factors in reducing the risk of hospitalization in psychosis, and point to a potential for targeted interventions to avert some of the burden, both emotional and financial, associated with the hospitalization of people with psychotic disorders. These findings have important clinical and policy implications.
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Campbell, Linda, Mary-Claire Hanlon, Abner Weng Cheong Poon, Stefania Paolini, Melanie Stone, Cherrie Galletly, Helen J. Stain, and Martin Cohen. "The experiences of Australian parents with psychosis: The second Australian national survey of psychosis." Australian & New Zealand Journal of Psychiatry 46, no. 9 (July 25, 2012): 890–900. http://dx.doi.org/10.1177/0004867412455108.
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Objective: Being a parent is an important part of one’s identity and role. Previous research outlines many challenges associated with parenting by people with severe mental illness. However, there is a limited research describing parenting experiences of mothers and fathers who have psychosis. Method: The second Australian national survey of psychosis recruited 1825 people living with symptoms of, or a diagnosis of, psychosis. The survey was conducted through face-to-face interviews and included key clinical and demographic information, as well as parenting specific information. Results: Over half of all women and a quarter of men were parents. Almost a quarter of women but only 5.5% of the men had dependent children (own and/or stepchildren) living at home with them. Of parents with dependent children, the most common diagnosis was schizophrenia (48.2% fathers, 28.9% mothers), and there were high rates of comorbidity with substance abuse/dependence (alcohol: fathers 69.2%, mothers 44.3%; cannabis: fathers 69.22%, mothers 47.8%). A substantial proportion of parents with dependent children experienced challenges including low educational attainment, unemployment, poverty, and social isolation. Although many parents living with dependent children functioned in the average range, a significant proportion was moderately to severely disabled on global independent functioning ratings (fathers 49.1%, mothers 35.7%) and some were identified as having obvious/severe impairments in their ability to care for their child(ren) (fathers 28.3%, mothers 21.3%). Conclusions: Most parents living with psychosis function well. However, a significant proportion has impairments in parenting and general functioning that could have adverse consequences for both the parent and children. This study brings into focus the need for interventions to optimise successful parenting outcomes.
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Lloyd, Chris, Jo Bassett, and Pam Samra. "Rehabilitation Programmes for Early Psychosis." British Journal of Occupational Therapy 63, no. 2 (February 2000): 76–82. http://dx.doi.org/10.1177/030802260006300205.
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Early psychosis is a relatively new area of practice in the field of mental health. Early intervention for people with psychosis is increasingly being recognised as a crucial component of quality care. Rehabilitation interventions in early psychosis assist in promoting recovery and involvement in community life, reduce the development of disability and facilitate the achievement of personal goals. The development of models of care and best practice in early psychosis intervention has been promoted by the Commonwealth of Australia. This paper describes a model of care and best practice in early psychosis intervention — the Early Psychosis Programme — which has been implemented in an integrated mental health service.
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GEREVICH, JOZSEF, and GABOR S. UNGVARI. "Psychogenic Psychoses. By A. Wimmer. Edited and translated with an Introduction by J. Schioldann. Forewords by G. Berrios and N. Retterstol. (Pp. 265; AUS$50.00, ISBN 0-9578585-3-1.) Adelaide Academic Press: Adelaide, Australia. 2003." Psychological Medicine 34, no. 8 (November 2004): 1588–90. http://dx.doi.org/10.1017/s0033291704223790.
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Beames, Lee, Esben Strodl, Frances Dark, Jennifer Wilson, Judith Sheridan, and Nicholas Kerswell. "A Feasibility Study of the Translation of Cognitive Behaviour Therapy for Psychosis into an Australian Adult Mental Health Clinical Setting." Behaviour Change 37, no. 1 (March 3, 2020): 22–32. http://dx.doi.org/10.1017/bec.2020.1.
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AbstractThere is evidence that Cognitive Behaviour Therapy for Psychosis (CBTp) is an effective intervention for reducing psychotic symptoms. The recently updated Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines (RANZCP CPG) recommend CBTp for the therapeutic management of schizophrenia and related disorders. Translational research is required to examine how well CBTp can be applied into public mental health services. This feasibility study aimed to provide preliminary evidence on how acceptable, implementable, and adaptable individual or group CBTp may be within a public mental health service in Australia. Twenty-seven participants initially agreed to participate in the study with 16 participants being randomised to either group or individual therapy, 11 starting therapy and 7 completing therapy. The intervention involved approximately 20 h of manualised CBTp. Attendance was higher in the individual therapy. Subjective reports indicated that the therapy was acceptable to all completers. Participants who engaged in individual or group CBTp experienced a similar level of reduction in the severity of hallucinations and delusions. Individual CBTp may be a feasible, acceptable, and effective intervention to include in Australian public mental health services. A pilot trial is now required to provide further evidence for and guidance of how best to translate CBTp protocols to Australian mental health services.
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Ali, Robert, John Marsden, Manit Srisurapanont, Agueda Sunga, Michael Baigent, and Maristela Monteiro. "Methamphetamine Psychosis in Australia, Philippines, and Thailand." Addictive Disorders & Their Treatment 9, no. 4 (December 2010): 143–49. http://dx.doi.org/10.1097/adt.0b013e3181cf58f2.
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Nielssen, Olav, and Matthew Large. "Migration and risk of psychosis in Australia." Australasian Psychiatry 25, no. 5 (September 28, 2017): 524. http://dx.doi.org/10.1177/1039856217711050.
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Sara, Grant, Clifford Baxter, Patricia Menendez, and Julia Lappin. "Amphetamine availability predicts amphetamine-related mental health admissions: A time series analysis." Australian & New Zealand Journal of Psychiatry 52, no. 11 (March 19, 2018): 1050–56. http://dx.doi.org/10.1177/0004867418763538.
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Objective: Amphetamine use and availability have increased in Australia and there are concerns that this has led to more frequent hospital admissions with amphetamine-related psychosis. This study examines whether amphetamine-related admissions to mental health units are more common at times of greater amphetamine availability. Methods: We conducted an ecological study using aggregate crime and health service data for NSW, Australia, from January 2000 to March 2015. Amphetamine-related criminal incidents (arrests or cautions for possession or use) were used as an indirect measure of amphetamine availability. Semiparametric time series analysis was used to compare monthly arrest rates to monthly hospitalisation rates for (1) amphetamine abuse or dependence, (2) amphetamine-related psychosis and (3) any psychosis. Results: Amphetamine-related admissions to NSW mental health units have increased four- to fivefold since 2009 and comprised approximately 10% of all admissions to these units in early 2015. There was a significant association between arrests and amphetamine-related admissions. After adjustment for seasonal variation, this effect demonstrated a time lag of 1–2 months. There was no relationship between amphetamine arrests and overall admissions for psychosis. Conclusion: Greater amphetamine availability significantly predicts admissions for amphetamine use disorders and amphetamine-related psychosis. Better treatment strategies are needed to break the nexus between drug availability and drug-related harm.
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Bruxner, George, Peter Burvill, Sam Fazio, and Sam Febbo. "Aspects of Psychiatric Admissions of Migrants to Hospitals in Perth, Western Australia." Australian & New Zealand Journal of Psychiatry 31, no. 4 (August 1997): 532–42. http://dx.doi.org/10.3109/00048679709065075.
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Objective: Recent Australian Government initiatives have emphasised problems with service provision to the ethnic mentally ill. This study aims to address the paucity of contemporary data describing the disposition of the ethnic mentally ill in hospital settings. Method: Patterns of admissions for psychiatric disorders to all hospitals in Perth, Western Australia, for the 3 years from 1990 to 1992, of migrants and the Australian born were compared using data from the Western Australian Mental Health Information System. Results: The overall rates for European migrants showed a ‘normalisation’ towards those of the Australian-born. There were high rates for the schizophrenic spectrum disorders in Polish and Yugoslavian (old terminology) migrants. There were low admission rates for South-East Asian migrants, predominantly those from Vietnam and Malaysia. Rates for alcoholism were low in Italian and all Asian migrants. There were high rates of organic psychosis, especially in those older than 75 years, among the Italian and Dutch migrants. The relative risk of a first admission in the 3 years being an involuntary admission to a mental hospital was almost twice that of the Australian-born for migrants from Poland, Yugoslavia, Malaysia and Vietnam. Conclusions: The results imply the possibility of significant untreated and/or undiagnosed psychiatric morbidity in the South-East Asian-born. They also indicate a need for further exploration of the unexpectedly high levels of psychiatric morbidity among some ethnic elderly groups, specifically the Dutch- and Italian-born. The findings demonstrate the persistence of high rates of presentation for psychotic disorders among Eastern European-born populations, many years post migration.
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Harvey, C., J. Lewis, and J. Farhall. "Receipt and targeting of evidence-based psychosocial interventions for people living with psychoses: findings from the second Australian national survey of psychosis." Epidemiology and Psychiatric Sciences 28, no. 6 (June 12, 2018): 613–29. http://dx.doi.org/10.1017/s2045796018000288.
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Aims.Clinical Practice Guidelines (CPGs) recommend evidence-based psychosocial interventions (EBPIs) to improve consumer recovery; however, availability appears limited. We describe receipt of six EBPIs, reported by people with psychoses, and associations with service and consumer characteristics, including indicators of need (eligibility) and benefit (suitability).Methods.Participants in the 2010 Australian national survey of psychosis (n= 1825) were interviewed to assess demographic, functional, mental and physical health characteristics and service use in the previous year. Six EBPIs (Cognitive Behaviour Therapy for psychosis; Family Psycho-Education (FPE); Relapse Prevention Planning (RPP); Skills Training; Supported Employment; and Assertive Community Treatment) were chosen, based on the strength and consistency of CPG recommendations. Associations between receipt of interventions and eligibility and suitability indicators were examined via correlations and χ2. Logistic regression was used to predict receipt of one or more EBPIs and to identify predictors of each individual EBPI.Results.Less than one-quarter of the sample reported receipt of an evidence-based level of any intervention: rates ranged from 3.4% (FPE) to 21.1% (RPP). The model predicting receipt of one or more EBPIs was statistically significant (χ2(20,n= 1746) = 216.12,p< 0.01) and marginally useful. Nine variables contributed uniquely, of which six were service characteristics. The strongest predictors of receipt were being assigned a psychologist as a case manager (p< 0.01, OR(CI) = 2.36(1.50–3.72)) and accessing a non-clinical mental health support service in the past year (p< 0.01, OR(CI) = 2.01(1.60–2.51)).Conclusions.Prior reports of limited receipt of EBPIs are reinforced. There is patchy evidence for targeting of EBPIs to those who might benefit most. Service characteristics contribute more to the prediction of receipt than clinical characteristics. Greater implementation effort and better targeting are required to bridge evidence-practice gaps, including improved evidence-based practice literacy among professionals and needs-based service re-design to improve provision and optimise consumer outcomes.
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Moore, Elizabeth, Serafino G. Mancuso, Tim Slade, Cherrie Galletly, and David J. Castle. "The impact of alcohol and illicit drugs on people with psychosis: The second Australian national survey of psychosis." Australian & New Zealand Journal of Psychiatry 46, no. 9 (April 3, 2012): 864–78. http://dx.doi.org/10.1177/0004867412443900.
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Objective: To provide the most up-to-date prevalence estimates of alcohol and illicit drug use among individuals with psychosis in Australia, and explore correlates associated with a lifetime diagnosis of both alcohol abuse/dependence and cannabis abuse/dependence. Method: This paper uses data from the Survey of High Impact Psychosis (SHIP), conducted as a follow-up to the first Australian National Low Prevalence (Psychotic) Disorders Study (1997–1998). The SHIP was a national study, carried out across five states, in which a sample of 1825 individuals was recruited through a two-phase sampling framework. Results: Alcohol and illicit drug use was highly prevalent for the entire sample. There were few significant differences in the prevalence or frequency of use across the diagnostic categories examined. Substantial increases in substance abuse/dependence were noted since the 1997–1998 survey (51% diagnosed with alcohol abuse/dependence, 51% with cannabis abuse/dependence and 32% with other illicit drug abuse/dependence, compared to 28%, 23% and 12% respectively, in the 1997–1998 survey by Kavanagh et al., 2004). Factors significantly associated with both lifetime alcohol and cannabis dependence included male gender, younger age, single marital status, lower educational attainment, shorter duration of illness, lifetime presence of hallucinations, higher negative syndrome score and lower body mass index (BMI). A number of other factors were found to be differentially associated with either lifetime alcohol or cannabis dependence. Conclusions: The use of alcohol and illicit substances is common among people with a psychotic illness, with a concerning upward trend in rates of substance abuse/dependence since the 1997–1998 survey. Clinicians should be aware of the potential impact of concurrent substance use and provide integrated treatment for individuals presenting with psychotic illnesses. More research and investment in new intervention programs is required.
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Roy, D. "First Episode Psychosis Service (EPS): Evaluation of Implementation in a Rural Australian Setting." European Psychiatry 41, S1 (April 2017): s785. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1499.
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IntroductionRecent decades, has seen an increasing focus on developing specific early or first episode psychosis services, in various parts of the world. There has been a growing awareness of the emotional impact of psychosis like trauma at onset, suicide and loss of social network. There is also a co relational link between the duration of untreated psychosis (DUP) and outcomes. The first 2–3 years following first episode onset have been argued to be a critical period for treatment.MethodOur study was an evaluation of an early psychosis service (EPS) in a rural Australian MHS ‘experiencing’ or ‘at risk’ of experiencing first episode psychosis. The guidelines were based on the Australian clinical guidelines for early psychosis (1998). The audit tool used was a checklist based on 10 treatment guidelines developed by the EPS special interest group evaluation sub-committee.ResultsThe overall results show that 7 out of the 10 treatment guidelines were well adhered throughout the implementation process. Guidelines strongly adhered to were numbers 2, 3, 5, 6, 7, 8, and 10, whereas guidelines 1, 4, and 9 were poorly adhered to.DiscussionThe implementation process was found to be generally effective. The factors that influenced the effectiveness will be discussed in the poster.ConclusionThere were a number of trends when we looked at the overall results which included aspects of the guidelines that were done well and aspects that needed improvement which will be further discussed in the poster.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
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Neil, Amanda L., Terry J. Lewin, and Vaughan J. Carr. "Allocation of Resources and Psychosis." Australian & New Zealand Journal of Psychiatry 37, no. 1 (February 2003): 15–23. http://dx.doi.org/10.1046/j.1440-1614.2003.01117.x.
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Objective: This commentary reviews current expenditure on psychosis in Australia, identifies discretionary expenditure that could be used more efficiently, discusses the factors influencing resource allocation and intervention selection decisions, and suggests priorities for change. Method: Cost-of-illness findings from the Low Prevalence Disorders Study (LPDS), and related service use and psychosocial data, are used to highlight patterns of expenditure on psychosis and potential resource allocation issues. Arguments are also presented suggesting that mental health resource allocation in Australia should be informed primarily by treatment efficiency, equity and humanitarian considerations, not differences in the global burden of disease. However, our evidence-base about the effectiveness and costs associated with individual treatments, programmes, and organizational structures is also shown to be limited. Conclusions: The patterns of service use and expenditure on psychosis suggest certain imbalances, including an over-reliance on hospitalization, low levels of supported community accommodation, and inadequate provision of evidence-based psychosocial treatments, rehabilitation and supported employment programmes. We need to identify and develop efficient interventions and programmes, re-orientate our services to better utilize those interventions, increase community awareness, improve monitoring of outcomes and costs, and undertake timely evaluations at multiple levels, from the individual to the societal perspective.
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Renner, Matt A. M., Nicolas Devos, Elizabeth A. Brown, and Matt J. von Konrat. "New records, replacements, reinstatements and four new species in the Radula parvitexta and R. ventricosa species groups (Jungermanniopsida) in Australia: cases of mistaken identity." Australian Systematic Botany 26, no. 4 (2013): 298. http://dx.doi.org/10.1071/sb13027.
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Various published hypotheses regarding circumscription and relationships of species within the Radula parvitexta and R. ventricosa species groups were tested using molecular data from three chloroplast markers. The phylogeny resolves five clades within the R. parvitexta species group in Australia, which proves polyphyletic across two subgenera, or three subgenera if R. madagascariensis is included. One clade represents an undescribed species, R. psychosis sp. nov., one corresponds to R. madagascariensis, a new record for Australia, the others to R. ratkowskiana, R. tasmanica and R. robinsonii. R. ratkowskiana is reinstated from synonymy of R. tasmanica, and R. parvitexta is placed into synonymy of R. robinsonii. A second new species belonging to the R. parvitexta species group, R. kilgourii sp. nov., is described; however, it was not included in the phylogeny. Three clades were resolved within the R. ventricosa species group in Australia, which is nested within subg. Metaradula. These clades corresponded to R. jovetiana, R. loriana, which is reinstated from synonymy of R. ventricosa, and two new species, namely, R. myriopoda sp. nov. and R. forficata sp. nov. R. ventricosa is excluded from the Australian flora, because all material is referrable to R. loriana. R. forficata and R. kilgourii had not been collected before the present study. R. myriopoda and R. jovetiana exhibit overlap in morphology of the sterile gametophyte and can be reliably separated only on characters associated with the perianth mouth. They can be considered semicryptic species, and would not have been recognised independent of fieldwork and molecular investigations conducted as part of the present study.
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Neil, Amanda L., Vaughan J. Carr, Cathrine Mihalopoulos, Andrew Mackinnon, Terry J. Lewin, and Vera A. Morgan. "What difference a decade? The costs of psychosis in Australia in 2000 and 2010: Comparative results from the first and second Australian national surveys of psychosis." Australian & New Zealand Journal of Psychiatry 48, no. 3 (November 12, 2013): 237–48. http://dx.doi.org/10.1177/0004867413508453.
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Brown, Ellie, and Brian O’Donoghue. "T238. RATES AND PREDICTORS OF RELAPSE IN AN AUSTRALIAN FIRST EPISODE PSYCHOSIS COHORT." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S323. http://dx.doi.org/10.1093/schbul/sbaa029.798.
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Abstract Background Clinical and functional recovery is usually achieved after treatment for a first episode of psychosis (FEP). Unfortunately, subsequent relapse remains common, occurring within a year for approximately 30% of individuals and within five years for 80%. What makes someone more likely to relapse remains poorly understood. Methods This study is a naturalistic cohort study of young people (15–25 years old) accessing an early intervention in psychosis service in Melbourne, Australia between 1st January 2011 and 31st December 2016. Demographic and clinical predictors of relapse were collected from patient records and analysed using Cox regression analysis. Results A total of 1220 young people presented with a FEP during the study period and 37.7% (N=460) experienced at least one relapse during their episode of care. Over half of all relapses resulted in an admission to hospital. Non-adherence to medication, substance use and psychosocial stressors precipitated relapses. Significant predictors of relapse in this sample were a diagnosis of a schizophrenia spectrum disorder or an affective psychotic disorder, amphetamine use, and substance use during treatment. Discussion These findings suggest that relapse occurs frequently for young people who have experienced FEP. This is one of the first studies to find that amphetamine use increases the risk of relapse. Clinical services, especially in Australasia, need to consider how best to manage this co-morbidity in young people with FEP.
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Nielssen, Olav B., and Matthew M. Large. "Potentially Lethal Suicide Attempts Using Sharp Objects During Psychotic Illness." Crisis 32, no. 1 (January 1, 2011): 37–42. http://dx.doi.org/10.1027/0227-5910/a000058.
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Background: Recent studies have reported that serious violence toward self and others is more common in the first episode of psychosis than after treatment. Aims: To estimate the proportion of survivors of potentially lethal suicide attempts with sharp objects who have a diagnosis of psychotic illness, and the proportion of those patients who had never received treatment for psychosis with antipsychotic medication. Methods: An audit of the medical records of patients from three major teaching hospitals in Sydney, Australia, who survived a self inflicted stab wound to the abdomen, torso, or a laceration to the neck. Results: The files of 95 survivors of self-inflicted wounds by cutting or stabbing who met the inclusion criteria for the study were examined. A psychotic illness was diagnosed in 46 cases (48%), of which 26 (57%) had never received treatment with antipsychotic medication and, hence, were in the first episode of psychosis. Conclusions: Psychosis is strongly associated with potentially lethal suicide attempts using sharp objects and patients who have never received treatment for psychosis appear to be at particular risk.
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DEGENHARDT, LOUISA, and WAYNE HALL. "The association between psychosis and problematical drug use among Australian adults: findings from the National Survey of Mental Health and Well-Being." Psychological Medicine 31, no. 4 (May 2001): 659–68. http://dx.doi.org/10.1017/s0033291701003865.
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Background. The present paper aimed to: (a) provide Australian estimates of the population-level association between psychotic ‘caseness’ and substance use; (b) examine liability to problematical substance use according to ‘caseness’ via the conditional prevalence (prevalence among users); and (c) examine associations between problematical substance use and the number of psychotic symptoms using ordinal logistic regression.Method. Data were from the National Survey of Mental Health and Well-Being (NSMHWB), a stratified multi-stage probability sample of Australian adults, using a subset of persons under the age of 50 years (N = 6722). A screener assessed the presence of characteristic psychotic symptoms. Associations between ‘case’ status and DSM-IV alcohol, cannabis and other drug use disorders were examined. Ordinal logistic regressions predicting psychosis scores were carried out, including demographic, mental health and drug use variables.Results. Ninety-nine persons (1·2 %) screened positively for psychosis. Regular tobacco, alcohol and cannabis use were much more common among persons screening positively, as were alcohol, cannabis and other drug use disorders. Among alcohol and cannabis users, psychosis ‘cases’ were much more likely to be dependent. Ordinal logistic regressions revealed that regular tobacco use, cannabis and alcohol dependence, and opiate abuse were predictors of psychosis scores.Conclusions. The mental health risks of problematical substance use need to be disseminated to persons at risk of, or suffering from, psychotic illness, and to heavy substance users. Work is needed to develop effective treatment approaches for problematical substance use among persons with psychosis.
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Chaudhury, S., S. Chandra, and M. Augustine. "Prevalence of Australia Antigen (HBsAg) in Institutionalised Patients with Psychosis." British Journal of Psychiatry 164, no. 4 (April 1994): 542–43. http://dx.doi.org/10.1192/bjp.164.4.542.
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In a study of 100 institutionalised patients with psychosis and an equal number of age- and sex-matched healthy controls from the same regional background, the prevalence of Australia antigen (HBsAg) was 11 and 2, respectively. Institutionalised psychotic patients are a high-risk group for hepatitis B virus infection.
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Sadhu, Raja, Amin Pourzehad Gilani, Marc Lanteri, and Manoj Kumar. "Psychosis in paratyphoid fever – a case report from Australia." Australasian Psychiatry 22, no. 3 (May 12, 2014): 242–44. http://dx.doi.org/10.1177/1039856214534000.
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Waterreus, Anna, Vera A. Morgan, David Castle, Cherrie Galletly, Assen Jablensky, Patsy Di Prinzio, and Sonal Shah. "Medication for psychosis – consumption and consequences: The second Australian national survey of psychosis." Australian & New Zealand Journal of Psychiatry 46, no. 8 (June 11, 2012): 762–73. http://dx.doi.org/10.1177/0004867412450471.
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Scott, James G., David Gillis, Alex E. Ryan, Hethal Hargovan, Nagaraj Gundarpi, Gemma McKeon, Sean Hatherill, et al. "The prevalence and treatment outcomes of antineuronal antibody-positive patients admitted with first episode of psychosis." BJPsych Open 4, no. 2 (March 2018): 69–74. http://dx.doi.org/10.1192/bjo.2018.8.
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BackgroundAntineuronal antibodies are associated with psychosis, although their clinical significance in first episode of psychosis (FEP) is undetermined.AimsTo examine all patients admitted for treatment of FEP for antineuronal antibodies and describe clinical presentations and treatment outcomes in those who were antibody positive.MethodIndividuals admitted for FEP to six mental health units in Queensland, Australia, were prospectively tested for serum antineuronal antibodies. Antibody-positive patients were referred for neurological and immunological assessment and therapy.ResultsOf 113 consenting participants, six had antineuronal antibodies (anti-N-methyl-D-aspartate receptor antibodies [n = 4], voltage-gated potassium channel antibodies [n = 1] and antibodies against uncharacterised antigen [n = 1]). Five received immunotherapy, which prompted resolution of psychosis in four.ConclusionsA small subgroup of patients admitted to hospital with FEP have antineuronal antibodies detectable in serum and are responsive to immunotherapy. Early diagnosis and treatment is critical to optimise recovery.Declaration of interestNone.
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Galletly, Cherrie, Shuichi Suetani, Duncan McKellar, and David J. Castle. "T85. LIVING WITH PSYCHOSIS IN LATER LIFE." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S263—S264. http://dx.doi.org/10.1093/schbul/sbaa029.645.
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Abstract Background Whilst there is considerable focus on early intervention for young people with psychotic disorders, there is little research looking at older people. Although some of these individuals have a recent onset, most will have been living with psychosis for many years. The older population has increased risks of cardiometabolic complications and this is likely to be complicated by psychosis. Methods The Australian Survey of People Living with Psychosis included 1478 participants aged 18–49 years, and 346 participants aged 50–64 years. The two groups were compared across a range of demographic, diagnostic, physical health, substance abuse and lifestyle factors. Results The older group contained significantly more women (48.3% vs 38.6%, p<0.0001). There was a smaller proportion of people with ICD-10 schizophrenia (36.1% vs 45.4% p<0.012), and higher proportions with schizoaffective disorder and affective psychoses. Significantly fewer of the older participants were prescribed clozapine (11.0% vs 16.8%, p < 0.0001). The mean age of onset was later in the older group (30.05 vs 22.23 years, p < 0.0001). There was a striking difference in rates of drug and alcohol abuse. The older group had lower rates of hazardous, harmful or dependent drinking (15.3% vs 35.9%, p < 0.0001), lifetime cannabis use (35.6% vs 74.1%, p < 0.0001), past year cannabis use (11.1% vs 38.1%, p < 0.0001), lifetime amphetamine use (12.8% vs 47.0%, p < 0.0001), and past year amphetamine use (2.9% vs 14.9%, p < 0.0001). The older group were also less likely to currently smoke tobacco (56.9% vs 68.9%, p < 0.0001). Older people were more likely to live alone (45.1% vs 28.6%, p < 0.000). They were less likely to experience food poverty; in the last year 19.5% of older people and 30.7% of younger people had run out of food and did not have money to buy more. Cognitive function was poorer with slower processing speed in the older group, with the NART error score indicating premorbid intelligence was lower in the older group. Older people were more likely to be overweight or obese (80.6% vs 74.3%, p < 0.0001), as well as being more likely to have metabolic syndrome (56.1% vs 48.5%, p = 0.034). There was a greater proportion with very low exercise in the older group (41.6% vs 31.7% p = 0.003). Discussion Older people with psychosis are more likely to be female and more likely to be diagnosed with an affective psychosis. The poorer cognitive function and higher rates of obesity and metabolic syndrome are consistent with changes seen in aging in the normal population. The older group have much lower rates of both lifetime and current drug and alcohol abuse, and smoking. Whilst there is considerable attention to cardiovascular health as a determinant of premature mortality, our results suggest that lifetime alcohol, cannabis and amphetamine use may also be associated with failure to survive into older age.
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Neil, Amanda L., Vaughan J. Carr, Cathrine Mihalopoulos, Andrew Mackinnon, and Vera A. Morgan. "Costs of psychosis in 2010: Findings from the second Australian National Survey of Psychosis." Australian & New Zealand Journal of Psychiatry 48, no. 2 (October 4, 2013): 169–82. http://dx.doi.org/10.1177/0004867413500352.
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Waterreus, Anna, and Vera A. Morgan. "Treating body, treating mind: The experiences of people with psychotic disorders and their general practitioners – Findings from the Australian National Survey of High Impact Psychosis." Australian & New Zealand Journal of Psychiatry 52, no. 6 (September 9, 2017): 561–72. http://dx.doi.org/10.1177/0004867417728806.
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Objectives: To describe from the perspective of people living with psychotic illness their use of general practitioner services over a 12-month period and the experiences, attitudes and challenges general practitioners face providing health care to this population. Methods: A two-phase design was used. Phase 1, screening for psychosis, occurred in public specialised mental health services and non-government organisations within seven catchment sites across Australia. In Phase 2, 1825 people who were screened positive for psychosis were randomly selected for interview which included questions about frequency and reason for general practitioner contact in the 12 months prior to interview. General practitioners (1473) of consenting participants were also surveyed. Results: Almost all (90.3%) survey participants had consulted a general practitioner in the 12-month period, on average 8.9 times, and 28.8% of attenders had consulted 12 times or more. The majority (83.5%) attended one general practitioner practice. Most (77.6%) general practitioners wanted to be involved in the mental health care of their patient. Although 69.1% said the management of their patient was not problematic for their practice, one in five general practitioners reported issues related to patient non-compliance with treatment and non-attendance at scheduled appointments; time constraints; and lack of feedback from treating mental health services. Conclusion: People with psychotic disorders consult general practitioners, some very frequently. Most Australian general practitioners believe they have a responsibility to review the physical and mental health of their patients. Improved communication between general practitioners and mental health services, and easier access to mental health support, may help general practitioners manage the complex mental, physical and social problems of their patients.