| 1. |
- Bogren, Mats, et al.
(författare)
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Lundby revisited: first incidence of mental disorders 1947-1997.
- 2007
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Ingår i: Australian and New Zealand Journal of Psychiatry. - : SAGE Publications. - 0004-8674 .- 1440-1614. ; 41:2, s. 178-186
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate how first incidence of various mental disorders changed between the periods of 1947-1972 to 1972-1997 in the Lundby cohort. Method: First-incidence rates of mental disorders were calculated for two 25 year periods and ten 5 year periods. Results: From 1947-1972 to 1972-1997 a decrease in almost all age- and sex-specific incidences of neurotic and organic brain disorders was observed, whereas incidence rates of psychotic disorders increased consistently in male subjects but decreased in most age intervals in female subjects. For both sexes the age-standardized 5 year period incidences of neurotic disorders decreased after 1972, fluctuated for psychotic disorders 1947-1997 and decreased steadily for organic disorders 1947-1997. Conclusions: The reduction in neurotic and organic brain disorder incidences may be linked to structural changes in society and medical advances.
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| 2. |
- Eratne, D., et al.
(författare)
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Plasma neurofilament light chain protein is not increased in treatment-resistant schizophrenia and first-degree relatives
- 2022
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Ingår i: Australian and New Zealand Journal of Psychiatry. - : SAGE Publications. - 0004-8674 .- 1440-1614. ; 56:10
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Schizophrenia, a complex psychiatric disorder, is often associated with cognitive, neurological and neuroimaging abnormalities. The processes underlying these abnormalities, and whether a subset of people with schizophrenia have a neuroprogressive or neurodegenerative component to schizophrenia, remain largely unknown. Examining fluid biomarkers of diverse types of neuronal damage could increase our understanding of these processes, as well as potentially provide clinically useful biomarkers, for example with assisting with differentiation from progressive neurodegenerative disorders such as Alzheimer and frontotemporal dementias. Methods: This study measured plasma neurofilament light chain protein (NfL) using ultrasensitive Simoa technology, to investigate the degree of neuronal injury in a well-characterised cohort of people with treatment-resistant schizophrenia on clozapine (n = 82), compared to first-degree relatives (an at-risk group, n = 37), people with schizophrenia not treated with clozapine (n = 13), and age- and sex-matched controls (n = 59). Results: We found no differences in NfL levels between treatment-resistant schizophrenia (mean NfL, M = 6.3 pg/mL, 95% confidence interval: [5.5, 7.2]), first-degree relatives (siblings, M = 6.7 pg/mL, 95% confidence interval: [5.2, 8.2]; parents, M after adjusting for age = 6.7 pg/mL, 95% confidence interval: [4.7, 8.8]), controls (M = 5.8 pg/mL, 95% confidence interval: [5.3, 6.3]) and not treated with clozapine (M = 4.9 pg/mL, 95% confidence interval: [4.0, 5.8]). Exploratory, hypothesis-generating analyses found weak correlations in treatment-resistant schizophrenia, between NfL and clozapine levels (Spearman's r = 0.258, 95% confidence interval: [0.034, 0.457]), dyslipidaemia (r = 0.280, 95% confidence interval: [0.064, 0.470]) and a negative correlation with weight (r = -0.305, 95% confidence interval: [-0.504, -0.076]). Conclusion: Treatment-resistant schizophrenia does not appear to be associated with neuronal, particularly axonal degeneration. Further studies are warranted to investigate the utility of NfL to differentiate treatment-resistant schizophrenia from neurodegenerative disorders such as behavioural variant frontotemporal dementia, and to explore NfL in other stages of schizophrenia such as the prodome and first episode.
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| 3. |
- Niederkrotenthaler, T, et al.
(författare)
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Healthcare utilization, psychiatric medication and risk of rehospitalization in suicide-attempting patients with common mental disorders
- 2020
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Ingår i: The Australian and New Zealand journal of psychiatry. - : SAGE Publications. - 1440-1614 .- 0004-8674. ; 54:4, s. 409-422
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Tidskriftsartikel (refereegranskat)abstract
- Common mental disorders are strong risk factors for suicide attempt. We compared common mental disorder patients with and without suicide attempt regarding health care utilization and psychiatric medication, assessed gender differences and identified how psychotropic medication of attempters is associated with subsequent rehospitalization.Methods:We used administrative claims data of 22,276 common mental disorder patients with inpatient care in Lower Austria between 1 January 2006 and 31 December 2011. Suicide attempters (cases, n = 615) and non-attempters (controls, n = 21,661) were compared regarding specific healthcare utilization by calculating mean differences of time-dependent contact probabilities and psychiatric medication (i.e. prescribed defined daily doses) ± 0.5 years around their suicide attempt (cases)/common mental disorder diagnosis (controls). Cluster analysis was used to group suicide attempters according to their psychiatric medication. The risk of rehospitalization 0.5–3 years after the attempt was calculated with regression analysis controlling for sex, age and morbidity-related factors.Results:Contacts with general practitioners were lower for attempters than non-attempters (mean difference of contact probabilities over observation period, males = −0.05, 95% confidence interval = [−0.07, −0.03]; females: mean difference = −0.04, 95% confidence interval = [−0.05, −0.03]). Regarding psychiatrists, female attempters had markedly higher contact probabilities after the attempt compared to female non-attempters (mean difference = 0.02, 95% confidence interval = [0.007, 0.04]); male attempters had lower contact probabilities before the attempt compared to male non-attempters (mean difference = −0.01, 95% confidence interval = [−0.004, −0.02]). Attempters had higher dosages of psychiatric medication across the entire period. Antidepressant and antipsychotic medication peaked at the time of common mental disorder diagnosis/attempt. Benzodiazepine prescriptions were considerably higher for male attempters than their female counterparts and were constantly elevated for male attempters across the observation period. A cluster of attempters with long-term benzodiazepine prescriptions had an increased risk of rehospitalization (adjusted odds ratio = 2.4, 95% confidence interval = [1.1, 5.5]).Conclusion:Despite lower contact probabilities, common mental disorder patients with suicide attempt are prescribed more psychiatric medication, particularly benzodiazepines, with an elevated risk of rehospitalization. Strong sex differences were found.
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| 4. |
- Titov, N, et al.
(författare)
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The first 30 months of the MindSpot Clinic: Evaluation of a national e-mental health service against project objectives
- 2017
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Ingår i: The Australian and New Zealand journal of psychiatry. - : SAGE Publications. - 1440-1614 .- 0004-8674. ; 51:12, s. 1227-1239
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Tidskriftsartikel (refereegranskat)abstract
- The MindSpot Clinic provides online mental health services to Australian adults with anxiety and depression. This paper describes users of MindSpot between January 2013 and June 2015. Outcomes are considered against three key objectives: improving access to mental health services, improving public awareness of how to access services and providing evidence-based treatments. Method: Website traffic data were examined to determine patterns of use. Demographic characteristics, past service utilisation and reasons for contacting MindSpot were analysed. Outcomes for patients enrolled in a MindSpot treatment course were also analysed. Primary outcomes were scores on the 9-Item Patient Health Questionnaire, Generalised Anxiety Disorder 7-Item, Yale–Brown Obsessive Compulsive Scale and Post-Traumatic Stress Disorder Checklist–Civilian Version, administered at assessment, post-treatment and 3-month follow-up. Results: The website was visited by almost 500,000 Australians, of which 33,990 adults started assessments, and 25,469 people completed assessment and were eligible for analysis. Mean age was 36.4 years (standard deviation = 13.3 years; range = 18–94 years), and 72% were female. The proportion living in rural or remote regions and who identified as Aboriginal and Torres Strait Islander closely matched national statistics. The majority (82%) reported that they were not currently in contact with mental health services. Most patients sought an assessment, information about treatment options, or referral to another service, and only 24% of those completing an assessment commenced a MindSpot treatment course. Of these, large clinical effects ( d: 0.7–2.4; average symptom reductions: 25.5% to 61.6%) were found from assessment to follow-up on all outcome measures. Deterioration ranged from 1.0% to 4.3%. Conclusion: Based on the number of website visits, completed assessments and treatment outcomes, MindSpot achieved its three programme objectives. This model of service provision has considerable value as a complement to existing services, and is proving particularly important for improving access for people not using existing services.
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| 5. |
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| 6. |
- Bogren, Mats, et al.
(författare)
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Incidence of psychotic disorders in the 50 year follow up of the Lundby population.
- 2010
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Ingår i: Australian and New Zealand Journal of Psychiatry. - : SAGE Publications. - 1440-1614 .- 0004-8674. ; 44:1, s. 31-39
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of the present study was to analyse first incidence of psychotic disorders in the Lundby population during a 50 year period by comparing male and female age at onset, overall incidence rates and age-specific incidence rates. METHOD: The Lundby Study is a prospective study of the mental health of a complete community population (n = 3563), which was followed from 1947 to 1997. Data from interviews, registers, case files and key informants were accumulated via four waves of field work (1947 1957, 1972 and 1997). Mean and median age at onset, and overall and age-specific incidence rates, for the first episodes of major groups of psychotic disorders according to the DSM-IV were calculated (the major groups were: any psychotic disorder, psychotic disorder due to a general medical condition, substance-induced psychotic disorder, non-affective psychotic disorder, schizophrenia, other non-affective psychotic disorder and affective psychotic disorder). Male-female differences in mean ages at onset and overall incidence rates were tested. Male-female differences in incidence by age patterns were described. RESULTS: The overall 50 year incidence rate in male subjects was higher than in female subjects for substance-induced psychotic disorder, but for the other disorders the overall rates did not differ significantly between the sexes. The male mean age at onset was lower than that for female subjects for any psychotic disorder, psychotic disorder due to a general medical condition, non-affective psychotic disorder and schizophrenia. Male and female subjects had different incidences by age patterns for any psychotic disorder, non-affective psychotic disorder, schizophrenia and other non-affective psychotic disorder, with a male preponderance among early-onset cases, and a female preponderance among late-onset cases. CONCLUSION: The differences in incidence between the sexes in this 50 year follow up may indicate psychotic disorder-delaying mechanisms in female subjects, or different aetiologies of psychosis in male and female subjects.
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| 7. |
- Bruce, C., et al.
(författare)
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Hazard Perception Skills Of Young Drivers With Attention-Deficit Hyperactivity Disorder Can Be Improved With Computer-Based Training : A Feasibility Trial
- 2017
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Ingår i: Australian and New Zealand journal of psychiatry (Print). - : Sage Publications. - 0004-8674 .- 1440-1614. ; 51:Suppl. 1, s. 122-122
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Tidskriftsartikel (refereegranskat)abstract
- Background: Young drivers with attention-deficit hyperactivity disorder (ADHD) are at higher risk of road traffic injuries than their peers. Increased risk correlates with poor hazard perception skill. Few studies have investigated hazard perception training using computer applications such as DriveSmart with this group of drivers.Objectives: To: determine the magnitude of the between-group and within-subject change in hazard perception skills among young drivers with ADHD-exposed/delayed exposure to DriveSmart training and determine whether training-facilitated change in hazard perception is maintained over time.Methods: Australian feasibility study. Twenty-five drivers with a diagnosis of ADHD were randomized to the intervention or control group. Participants in the intervention group received a computer training session using DriveSmart, while the control group watched a documentary video. The design included a delayed treatment for the control group. The participants’ hazard perception skill was measured on the University of Queensland Hazard Perception Test (HPT) post training and at 6-week follow-up.Findings: After adjusting for baseline scores, there was a significant between-group difference (p = 0.023, partial η2 = 0.212) and a significant within-subject difference post intervention in the experimental group. There was no significant difference between post intervention and 6-week follow-up scores in the experimental group.Conclusions: The hazard perception skills of participants improved following training and were largely sustained. We found a large effect size consistent with one prior study. A full-scale trial is feasible.
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