bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modifiable Risk Factors for Hospitalization Among People with Psychosis: Evidence from the National Study of Low Prevalence (Psychotic) Disorders
Authors: Morgan Vera , Korten Ailsa , Jablensky Assen 
Published: December 2009

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.
Effect of Omega-3 Fatty Acids on the Lipid Profile of Patients Taking Clozapine
Authors: Caniato Riccardo N. , Alvarenga Marlies E. , Angel Garcia-Alcaraz Miguel 
Published: December 2009

Objective: This study aimed to assess the lipid-lowering properties of omega-3 fatty acids (also known as n-3 polyunsaturated fatty acids) in a group of patients taking clozapine. Method: Twenty-eight persons suffering from schizophrenia or schizoaffective disorder and currently taking clozapine participated in an open-label single-arm trial. Participants received supplements of 10 g of fish oil (containing 1.8 g of eicosopentaenoic acid and 1.2 g of docosahexaenoic acid) for a period of 28 days. Plasma lipids were measured on days 0 and 28. Results: This study demonstrated high rates of lipid abnormalities in the participants. Participants taking omega-3 fatty acids demonstrated a statistically significant reduction in mean serum triglyceride levels of 22%. There was an associated increase in total cholesterol (6.6%) and low-density lipoprotein cholesterol (22%). Common side-effects included fishy burps or breath, but no serious side-effects or interactions where observed. Conclusion: Omega-3 fatty acids may be of value in patients taking clozapine and who have elevated serum triglyceride levels. Limitations of the study, practical implications and directions for future research are discussed.
Web-Based Survey of Depression, Anxiety and Stress in First-Year Tertiary Education Students in Hong Kong
Authors: Wong Josephine G.W.S. , Cheung Erik P.T. , Chan Kitty K.C. , Ma Kamela K.M. , Wa Tang Siu 
Published: December 2009

Objective: The mental health of tertiary education students is an area of increasing concern worldwide. The objective of this study is to examine the prevalence of depression, anxiety and stress in first-year tertiary education students in Hong Kong. Method: Depression, anxiety and stress were measured by the 42-item Depression Anxiety Stress Scales, completed on the web by participating students anonymously. Results: A total of 7915 students completed the survey, yielding a response rate of 27.5%. Depression, anxiety and stress levels of moderate severity or above were found in 21%, 41% and 27% of our respondents, respectively. Conclusions: The web-based survey methodology was well accepted by our sample group of tertiary education students. We found high rates of psychological morbidity in first-year tertiary education students in Hong Kong. The high prevalence of depression, anxiety and stress symptoms in the first year of college life is alarming. It illustrates the need for primary and secondary prevention measures, with development of adequate and appropriate support services for this group.
Measuring Physical and Mental Health using the SF-12: Implications for Community Surveys of Mental Health
Authors: Windsor Timothy D. , Rodgers Bryan , Butterworth Peter , Anstey Kaarin J. , Jorm Anthony F. 
Published: December 2009

Objective: The effects of using different approaches to scoring the SF-12 summary scales of physical and mental health were examined with a view to informing the design and interpretation of community-based survey research. Method: Data from a population-based study of 7485 participants in three cohorts aged 20-24, 40-44 and 60-64 years were used to examine relationships among measures of physical and mental health calculated from the same items using the SF-12 and RAND12 approaches to scoring, and other measures of chronic physical conditions and psychological distress. Results: A measure of physical health constructed using the RAND-12 scoring showed a monotonic negative association with psychological distress as measured by the Goldberg depression and anxiety scales. However, a non-monotonic association was evident in the relationship between SF-12 physical health scores and distress, with very high SF-12 physical health scores corresponding with high levels of distress. These relationships highlight difficulties in interpretation that can arise when using the SF-12 summary scales in some analytical contexts. Conclusions: It is recommended that community surveys that measure physical and mental functioning using the SF-12 items generate summary scores using the RAND-12 protocol in addition to the SF-12 approach. In general, researchers should be wary of using factor scores based on orthogonal rotation, which assumes that measures are uncorrelated, to represent constructs that have an actual association.
Energy Expenditure and Physical Activity in Clozapine use: Implications for Weight Management
Authors: Sharpe Jenny-Kay , Stedman Terry J. , Byrne Nuala M. , Wishart Connie , Hills Andrew P. 
Published: December 2009

Objective: The management of atypical antipsychotic-induced weight gain is a significant challenge for people with mental illness. Fundamental research into energy metabolism in people taking atypical antipsychotic medication has been neglected. The current study of men with schizophrenia taking clozapine aimed to measure total energy expenditure (TEE) and energy expended on physical activity – activity energy expenditure (AEE) and to consider the clinical implications of the findings. Method: The well-established reference method of doubly labelled water (DLW) was used to measure TEE and AEE in men with schizophrenia who had been taking clozapine for more than 6 months. Resting energy expenditure was determined using indirect calorimetry. Results: The TEE was 2511 ± 606 kcal day−1 which was signifcantly different to World Health Organization recommendations (more than 20% lower). The Physical activity level (PAL) was 1.39 ± 0.27 confirming the sedentary nature of people with schizophrenia who take clozapine. Conclusions: The findings support the need for weight management strategies for people with schizophrenia who take clozapine to focus on the enhancement of energy expenditure by increasing physical activity and reducing inactivity or sedentary behaviours, rather than relying primarily on strategies to reduce energy intake.
Te Rau Hinengaro: The New Zealand Mental Health Survey: Overview of Methods and Findings
Authors: Elisabeth Wells J. , Oakley Browne Mark A. , Scott Kate M. , Mcgee Magnus A. , Baxter Joanne , Kokaua Jesse ,   For The New Zealand Mental Health Survey Research Team
Published: December 2009

Objective: To estimate the prevalence and severity of anxiety, mood, substance and eating disorders in New Zealand, and associated disability and treatment. Method: A nationwide face-to-face household survey of residents aged 16 years and over was undertaken between 2003 and 2004. Lay interviewers administered a computerized fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview. Oversampling doubled the number of Māori and quadrupled the number of Pacific people. The outcomes reported are demographics, period prevalences, 12 month severity and correlates of disorder, and contact with the health sector, within the past 12 months. Results: The response rate was 73.3%. There were 12 992 participants (2595 Māori and 2236 Pacific people). Period prevalences were as follows: 39.5% had met criteria for a DSM-IV mental disorder at any time in their life before interview, 20.7% had experienced disorder within the past 12 months and 11.6% within the past month. In the past 12 months, 4.7% of the population experienced serious disorder, 9.4% moderate disorder and 6.6% mild disorder. A visit for mental health problems was made to the health-care sector in the past 12 months by 58.0% of those with serious disorder, 36.5% with moderate disorder, 18.5% with mild disorder and 5.7% of those not diagnosed with a disorder. The prevalence of disorder and of serious disorder was higher for younger people and people with less education or lower household income. In contrast, these correlates had little relationship to treatment contact, after adjustment for severity. Compared with the composite Others group, Māori and Pacific people had higher prevalences of disorder, unadjusted for sociodemographic correlates, and were less likely to make treatment contact, in relation to need. Conclusions: Mental disorder is common in New Zealand. Many people with current disorder are not receiving treatment, even among those with serious disorder.
Mental Disorder Comorbidity in Te Rau Hinengaro: The New Zealand Mental Health Survey
Authors: Scott Kate M. , McGee Magnus A. , Oakley Browne Mark A. , Wells J. Elisabeth 
Published: December 2009

Objective: To show the extent and patterning of 12 month mental disorder comorbidity in the New Zealand population, and its association with case severity, suicidality and health service utilization. Method: A nationwide face-to-face household survey was carried out in October 2003 to December 2004 with 12 992 participants aged 16 years and over, achieving a response rate of 73.3%. The measurement of mental disorder was with the World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0). Comorbidity was analysed with hierarchy, consistent with a clinical approach to disorder count. Results: Comorbidity occurred among 37% of 12 month cases. Anxiety and mood disorders were most frequently comorbid. Strong bivariate associations occurred between alcohol and drug use disorders and, to a lesser extent, between substance use disorders and some anxiety and mood disorders. Comorbidity was associated with case severity, with suicidal behaviour (especially suicide attempts) and with health sector use (especially mental health service use). Conclusion: The widespread nature of mental disorder comorbidity has implications for the configuration of mental health services and for clinical practice.
Suicidal Behaviour in Te Rau Hinengaro: The New Zealand Mental Health Survey
Authors: Beautrais Annette L. , Elisabeth Wells J. , Mcgee Magnus A. , Oakley Browne Mark A. ,   For The New Zealand Mental Health Survey Research Team
Published: December 2009

Objective: To describe prevalence and correlates of suicidal behaviour in the New Zealand population aged 16 years and over. Method: Data are from Te Rau Hinengaro: The New Zealand Mental Health Survey, a nationally representative household survey conducted from October 2003 to December 2004 in a sample of 12 992 participants aged 16 years and over to study prevalences and correlates of mental disorders assessed using the World Mental Health Composite International Diagnostic Interview. Lifetime and 12 month prevalences and onset distributions for suicidal ideation, plans and attempts, and sociodemographic and mental disorder correlates of these behaviours were examined. Results: Lifetime prevalences were 15.7% for suicidal ideation, 5.5% for suicide plan and 4.5% for suicide attempt, and were consistently significantly higher in females than in males. Twelve-month prevalences were 3.2% for ideation, 1.0% for plan and 0.4% for attempt. Risk of ideation in the past 12 months was higher in females, younger people, people with lower educational qualifications, and people with low household income. Risk of making a plan or attempt was higher in younger people and in people with low household income. After adjustment for sociodemographic factors, there were no ethnic differences in ideation, although Māori and Pacific people had elevated risks of plans and attempts compared with non-Māori non-Pacific people. Individuals with a mental disorder had elevated risks of ideation (11.8%), plan (4.1%) and attempt (1.6%) compared with those without mental disorder. Risks of suicidal ideation, plan and attempt were associated with mood disorder, substance use disorder and anxiety disorder. Major depression was the specific disorder most strongly associated with suicidal ideation, plan and attempt. Less than half of those who reported suicidal behaviours within the past 12 months had made visits to health professionals within that period. Less than one-third of those who had made attempts had received treatment from a psychiatrist. Conclusions: Risks of making a suicide plan or attempt were associated with mental disorder and sociodemographic disadvantage. Most people with suicidal behaviours had not seen a health professional for mental health problems during the time that they were suicidal.
Ethnic Comparisons of the 12 Month Prevalence of Mental Disorders and Treatment Contact in Te Rau Hinengaro: The New Zealand Mental Health Survey
Authors: Baxter Joanne , Kokaua Jesse , Wells J. Elisabeth , McGee Magnus A. , Oakley Browne Mark A. 
Published: December 2009

Objective: To compare ethnic groups for the 12 month prevalence of mental disorders and 12 month treatment contact in Te Rau Hinengaro: The New Zealand Mental Health Survey. Method: Te Rau Hinengaro: The New Zealand Mental Health Survey, undertaken in 2003 and 2004, was a nationally representative face-to-face household survey of 12 992 New Zealand adults aged 16 years and over, including M ori (n = 2595), Pacific people (n = 2236) and a composite Other ethnic group (predominantly European) (n = 8161). Ethnicity was measured using the 2001 census ethnicity question. A fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0) was used to measure disorder. The overall response rate was 73.3%. Results: The 12 month prevalence of any mental disorder was highest in M ori (29.5%; 26.6, 32.4), followed by Pacific people (24.4%; 21.2, 27.6) and Others (19.3%; 18.0, 20.6). Adjustment for age, sex, education and household income reduced differences: Māori (23.9%; 21.3, 26.4), Pacific (19.2%; 16.4, 22.1) and Other (20.3%; 18.9, 21.6). A similar pattern was seen for serious disorder and most individual disorders or disorder groups. After adjustment, M ori were most different from Pacific people and Others for substance use disorder. Both M ori and Pacific people had a higher prevalence of bipolar disorder than Others. Pacific people had the lowest prevalence of major depressive disorder. Among those with disorder, the proportion with a visit for mental health problems to any service was highest among Others (41.1%; 38.1, 44.1), with M ori (32.5%; 28.3, 36.7) intermediate and Pacific (25.4%, 19.4, 31.4) lowest. Adjustment did not alter ethnic differences in service contact. Conclusion: M ori, and to a lesser extent Pacific people, have a higher prevalence of 12 month mental disorders than Others. Differences are reduced after adjusting for sociodemographic correlates. Relative to need, Pacific people in particular and M ori are less likely than Others to have contact with services (health or non-health), regardless of sociodemographic circumstances.
What is the Value of Treating Schizophrenia?
Authors: Carr Vaughan J. , Lewin Terry J. , Neil Amanda L. 
Published: December 2009

Objective: Recent generalized cost-effectiveness analyses contrasting schizophrenia with high prevalence mental disorders have noted a need to investigate the mechanisms by which the tensions between equity and efficiency can be reconciled and inform priority setting in resource allocation. This paper explores and illustrates some possible strategies for valuing mental health states, with the broad goal of improving resource allocation decisions. Method: Health utility gains derived for current and optimal treatments for schizophrenia, depression and anxiety disorders, potential societal preference weightings, and annual costs per treated case, are used to illustrate the magnitude of the impacts on relative costefficiency and societal welfare estimates. These estimates are based on costs per additional quality adjusted life year (QALY) and costs per additional S-QALY (i.e. QALYs adjusted for societal value of health gains) respectively. Results: When broader societal preferences are ignored, current and optimal treatments for depression and anxiety are around 10 times more efficient than those for schizophrenia, but treatments for all three disorders appear to give rise to similar levels of societal welfare when weighting factors reflecting equity concerns are incorporated. Conclusions: There is manifest inequality in health between individuals with schizophrenia and those with high prevalence mental disorders, even with optimal treatment. Schizophrenia is much more costly to treat but other factors require consideration. Inclusion of societal preferences should lead to more rational decisionmaking and improved societal welfare. In turn, greater effort needs to be given to the development and validation of appropriate weighting factors reflecting distributive preferences in mental health.
Insanity Acquittee Outcomes in New Zealand
Authors: Skipworth Jeremy , Brinded Phil , Chaplow David , Frampton Chris 
Published: December 2009

Objective: This paper examines clinical and forensic outcomes for defendants found not guilty by reason of insanity in New Zealand, and explores the implications for policy development and clinical rehabilitation in this population. Method: All insanity acquittees disposed of by the courts as special patients after 1976 and released before 2004 are described. Their duration of inpatient care, rates of reconviction and rehospitalization following release are examined. The high resolution rate for violent crime reported to police suggests that reconviction rates are a reasonable proxy for violent reoffending. Factors predicting duration of inpatient care and reoffending are analysed. Results: Severity of Index Offence was the only variable predicting duration of inpatient care of the 135 special patients. Offenders of more serious offences were securely detained for longer periods – averaging 6 years in the case of those charged with murder. Most patients were readmitted over the decade following discharge. Only 6% had violently reoffended 2 years after release into the community. Prior offending, age at release, ethnicity and gender predicted reoffending, but not diagnosis or duration of inpatient admission. Conclusions: Following discharge into the community, insanity acquittees are reconvicted of violent crimes at a very low rate, although readmission to hospital is common. It may be that insanity acquittees are initially detained in hospital longer than is clinically indicated, and that safe forensic community treatment can occur at an earlier stage of recovery without compromising public safety.
Prevalence of Victimization, Posttraumatic Stress Disorder and Violent Behaviour in the Seriously Mentally Ill
Authors: Mcfarlane Alexander , Schrader Geoff , Bookless Clara , Browne Derek 
Published: December 2009

Aims: There is evidence that individuals with a mental illness are more likely to report a history of victimization and to be at an increased risk for future victimization. The aims of the current study are to determine lifetime rates of different types of victimization in a population of psychiatric inpatients and to examine the associations between a history of victimization and measures of adverse outcome and rates of posttraumatic stress disorder (PTSD). Method: A total of 130 psychiatric inpatients with a range of psychiatric diagnoses were surveyed. Information collected included history of victimization, aggression and violence levels, suicidal ideation, PTSD symptomatology, rates of hospitalization and pension status. Results: A lifetime history of victimization was reported in 87.7% of patients with 46% having lifetime and 32% current PTSD. Most clinicians did not identify the high rates of comorbid PTSD in these patients. Victimization was associated significantly with receipt of the disability support pension and number of previous psychiatric hospitalizations, both measures of more adverse outcome. Conclusion: Victimization may have a negative impact on outcome and may further disadvantage an already vulnerable population. These findings have both clinical and policy implications for the long-term management of people with mental illness.
How Soon Should Patients with Smear-Positive Tuberculosis Be Released from Inpatient Isolation?
Authors: Horne David J. , Johnson Catherine O. , Oren Eyal , Spitters Christopher , Narita Masahiro 
Published: December 2009

Objective.In patients with smear-positive pulmonary tuberculosis who are hospitalized or reside in congregate settings, guidelines recommend airborne infection isolation until sputum smear results are negative. Studies have identified factors associated with delayed sputum smear and culture conversion in patients with tuberculosis. Because these studies did not use methods of survival analysis, estimates of time to sputum smear conversion that are based on initial patient characteristics are not available. The ability to predict time to sputum smear conversion could be useful for programmatic planning and patient counseling.Methods.We performed a cohort study using survival analysis to identify factors associated with time to sputum smear and culture conversion. We defined the time to sputum smear conversion as the time elapsed from the start of treatment to the first date of sustained conversion.Results.Ninety-eight patients had sputum smear samples positive for acid-fast bacilli. Lower initial smear grade (on 1+ to 4+ scale) and absence of cavitation on chest radiograph were associated with earlier sputum smear conversion in bivariate analysis. In multiple regression analysis, initial smear grade (hazard ratio, 0.45; 95% confidence interval, 0.35-0.57) and drug resistance (hazard ratio, 2.30; 95% confidence interval, 1.08-4.89) remained statistically significant; a model comprising only initial smear grade performed almost as well. Predictors of sputum culture conversion were similar.Conclusions.Initial smear grade was the strongest predictor of time to sputum smear and culture conversion in patients with pulmonary tuberculosis and may be a useful predictor for programmatic planning and patient counseling.