bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Psychological Treatment Help Only Those Patients with Severe Irritable Bowel Syndrome Who Also Have a Concurrent Psychiatric Disorder?
Authors: Creed Francis , Guthrie Elspeth , Ratcliffe Joy , Fernandes Lakshmi , Rigby Christine , Tomenson Barbara , Read Nicholas , Thompson David G. 
Published: December 2009

Objective: We have previously reported improved health-related quality of life in patients with severe irritable bowel syndrome (IBS) following psychological treatments. In this paper, we examine whether this improvement was associated with improvement in psychological symptoms and was confined to those patients who had concurrent psychiatric disorder. Method: Two hundred and fifty-seven patients with severe IBS entering a psychological treatment trial were interviewed using the Schedules for Clinical Assessment in Neuropsychiatry. At entry to the trial and 15 months later, patients were also assessed using the Hamilton Depression Rating Scale, Symptom Cheecklist-90 (SCL-90) and Short Form-36 (SF36) physical component summary score as the main outcome measure. Partial correlation was used to compare changes in SF36 score and changes in psychological scores while controlling for possible confounders, treatment group and baseline scores. Multiple regression analysis was used to examine whether changes in psychological scores, changes in pain and a history of abuse could account for most of the variance of change in SF36 physical component score. Results: Of 257 patients with severe IBS, 107 (42%) had a depressive, panic or generalized anxiety disorder at trial entry. There were moderate but significant correlations (0.21–0.47) between change in the psychological scores and the change in SF36 physical component scores. The correlation coefficients were similar in the groups with and without psychiatric disorder. The superiority of psychotherapy and antidepressant groups over treatment as usual was similar in those with and without psychiatric disorder. Multiple regression found significant independent effects of change in depression, anxiety, somatization and abdominal pain but there was still variance explained by treatment group. Conclusions: In severe IBS improvement in health-related quality of life following psychotherapy or antidepressants is correlated with, but not explained fully by reduction of psychological scores. A more complete understanding of how these treatments help patients with medically unexplained symptoms will enable us to refine them further.
Patterns and Predictors of Substance use Disorders and Daily Tobacco use in First-Episode Psychosis
Authors: Wade Darryl , Harrigan Susy , Edwards Jane , Burgess Philip M. , Whelan Greg , Mcgorry Patrick D. 
Published: December 2009

Objective: To investigate the patterns and predictors of substance use disorders (SUD) and daily tobacco use in first-episode psychosis (FEP). Method: In this study, consecutive admissions of 126 patients with an initial presentation for FEP were recruited from three psychiatric services. Each patient was assessed with a comprehensive assessment package in order to collect demographic information, to diagnose psychotic disorders and SUD, to estimate the duration of untreated psychosis and to assess premorbid functioning and the severity of psychiatric symptoms. Results: The rates of lifetime SUD and daily tobacco use were 71% and 77%, respectively. The onset of SUD pre-dated the onset of positive psychotic symptoms in 91% of relevant cases. In multivariate analyses, male gender, younger age, Australian birth and unemployed status were the most consistent demographic predictors of SUD and daily tobacco use. There were no associations found between SUD and symptom severity, premorbid adjustment, psychotic disorder diagnosis or hospitalization. Conclusions: Male gender and younger age are reliable predictors of SUD in FEP. Patients with and without SUD appear to have similar clinical characteristics at initial presentation.
Relationships Between Self-Reported Potentially Traumatizing Events, Psychoform and Somatoform Dissociation, and Absorption, in Two Non-Clinical Populations
Authors: Näring Gérard , Nijenhuis Ellert R.S. 
Published: December 2009

Objective: Some authors have suggested that the personality characteristic ‘fantasy proneness’ may mediate the correlation between reported potentially traumatizing events and dissociative symptoms. Other authors question the reported magnitude of this correlation in non-clinical samples, because these are usually derived from student samples and may therefore suffer from a restriction of range. The primary aim of this study is to assess the relationship between a self-report measure of traumatization and psychoform dissociation as well as somatoform dissociation in a non-clinical population, while accounting for the influence of fantasy proneness. Method: Two random non-clinical samples, that is, a student and an adult non-student sample, completed a range of relevant self-report questionnaires. Absorption was used as an index of fantasy proneness. Results: The range of reported potentially traumatizing events was restricted in students, compared to non-students. In both samples a significant correlation was found between reported potentially traumatizing events and dissociation. After partialling out absorption, the relationship between reported potential traumatization and psychoform dissociation diminished substantially in both samples. The magnitude of the correlation with somatoform dissociation decreased to a lesser degree, so that it remained significant in both samples. Conclusions: The correlation between somatoform dissociation and reported traumatization, after partialling out absorption, gives a reliable estimate of the magnitude of the relationships between potentially traumatizing events and dissociation. Findings regarding traumatization and dissociation in students should be generalized to the general population cautiously.
Australia's National Mental Health Strategy and Deinstitutionalization: Some Empirical Results
Authors: Doessel Darrel P , Scheurer Roman W , Chant David C , Whiteford Harvey A 
Published: December 2009

Objective: To determine the role of the National Mental Health Strategy in the deinstitutionalization of patients in psychiatric hospitals in Queensland. Method: Regression analysis (using themaximumlikelihood method) has been applied to relevant time-series datasets on public psychiatric institutions in Queensland. In particular, data on both patients and admissions per 10 000 population are analysed in detail from 1953–54 to the present, although data are presented from 1883–84. Results: These Queensland data indicate that deinstitutionalization was a continuing process from the 1950s to the present. However, it is clear that the experience varied from period to period. For example, the fastest change (in both patients and admissions) took place in the period 1953–54 to 1973–74, followed by the period 1974–75 to 1984–85. Conclusions: In large part, the two policies associated with deinstitutionalization, namely a discharge policy (‘opening the back door’) and an admission policy (‘closing the front door’) had been implemented before the advent of the National Mental Health Strategy in January 1993. Deinstitutionalization was most rapid in the 30-year period to the early 1980s: the process continued in the 1990s, but at amuch slower rate. Deinstitutionalization was, in large part, over before the Strategy was developed and implemented.
Projections of Future Numbers of Dementia Cases in Australia with and Without Prevention
Authors: Jorm Anthony F , Dear Keith B.G. , Burgess Nicole M 
Published: December 2009

Objective: To produce projections of the number of dementia cases in Australia from 2000 to 2050. These projections examine the effects of an ageing population on number of dementia cases and also the potential impact of preventive strategies that delay age of dementia onset. Method: Data from several meta-analyses of dementia prevalence and incidence were combined with age-specific population projections to arrive at estimates of future numbers of cases. A statistical model of dementia incidence was developed and used to estimate the effects of delaying onset by up to 5 years. Results: Without prevention, prevalence of dementia is estimated to increase from 172 000 in 2000 to 588 000 in 2050. Over the same period, the incidence of dementia is estimated to increase from 43 000 to 143 000 new cases a year. Delaying onset by 5 years would decrease prevalence in 2050 by 44%. Even a 6-month delay would reduce prevalence by 6%. Conclusions: Ageing of the population will lead to a rapid increase in number of dementia cases and an increasing burden for the working-age population. However, even modest prevention efforts could lessen the impact.
Mapping the Onset of Psychosis: The Comprehensive Assessment of At-Risk Mental States
Authors: Yung Alison R. , Yung Alison R. , Pan Yuen Hok , Mcgorry Patrick D. , Phillips Lisa J. , Kelly Daniel , Dell'olio Margaret , Francey Shona M. , Cosgrave Elizabeth M. , Killackey Eoin , Stanford Carrie , Godfrey Katherine , Buckby Joe 
Published: December 2009

Objective: Recognizing the prodrome of a first psychotic episode prospectively creates the opportunity of intervention, which could delay, ameliorate or even prevent onset. Valid criteria and a reliable methodology for identifying possible prodromes are needed. This paper describes an instrument, the Comprehensive Assessment of At-Risk Mental States (CAARMS), which has been designed for such a purpose. It has two functions: (i) to assess psychopathology thought to indicate imminent development of a first-episode psychotic disorder; and (ii) to determine if an individual meets criteria for being at ultra high risk (UHR) for onset of first psychotic disorder. This paper describes the pilot evaluation of the CAARMS. Method: Several methodologies were used to test the CAARMS. First, CAARMS scores in a group of UHR young people and the association between CAARMS scores and the risk of transition to psychotic disorder, were analysed. Second, CAARMS scores in a UHR group were compared to a control group. To assess concurrent validity, CAARMS-defined UHR criteria were compared to the existing criteria for identifying the UHR cohort. To assess predictive validity, the CAARMS-defined UHR criteria were applied to a sample of 150 non-psychotic help-seekers and rates of onset of psychotic disorder at 6-month follow-up determined for the CAARMS-positive (i.e. met UHR criteria) group and the CAARMS-negative (i.e. did not meet UHR criteria) group. The inter-rater reliability of the CAARMS was assessed by using pairs of raters. Results: High CAARMS score in the UHR group was significantly associated with onset of psychotic disorder. The control group had significantly lower CAARMS scores than the UHR group. The UHR criteria assessed by the CAARMS identified a similar group to the criteria measured by existing methodology. In the sample of non-psychotic help-seekers those who were CAARMS-positive were at significantly increased risk of onset of psychotic disorder compared to those who were CAARMS-negative (relative risk of 12.44 (95% CI=1.5–103.41, p=0.0025)). The CAARMS had good to excellent reliability. Conclusions: In these preliminary investigations, the CAARMS displayed good to excellent concurrent, discriminant and predictive validity and excellent inter-rater reliability. The CAARMS instrument provides a useful platform for monitoring sub threshold psychotic symptoms for worsening into full-threshold psychotic disorder.
Integrating Approaches to Psychotherapy in Psychosis
Authors: Margison Frank 
Published: December 2009

Objective: The evidence base for specific psychological treatments for psychosis is now well established, but many practitioners see themselves as integrationist in approach. The basic tenets of integration are explored with an emphasis on understanding how different levels of need can be conceptualized and then used to ‘adapt’ a treatment to meet those needs in an individual. The needs are then incorporated into an integrated treatment formulation. Method: The evidence base is strongest for cognitive behavioural and family approaches, but the present paper summarizes concepts from two specific models of therapy that are intrinsically integrational in their approach: cognitive analytic therapy and psychodynamic interpersonal therapy. Results: Both approaches show aspects of integration. However, following this approach to integration to its limit would ultimately lead to one undifferentiated therapy. Conclusions: Both approaches share a common set of values of developing specific ways of increasing collaboration and working together, and these values are shown to underpin adaptive ways of working with psychosis, but further critical analysis of the development of integrative models is needed.
Mental Health First aid Training: Review of Evaluation Studies
Authors: Kitchener Betty A. , Jorm Anthony F. 
Published: December 2009

Objective: To review studies evaluating mental health first aid (MHFA) training. Method: Review of three published trials: one uncontrolled with members of the public in a city, one randomized controlled efficacy trial in a workplace setting and one cluster randomized effectiveness trial with the public in a rural area. Results: Most mental health first aiders tend to be middle-aged women whose work involves people contact. All trials found the following statistically significant benefits 5– 6months post-training: improved concordance with health professionals about treatments, improved helping behaviour, greater confidence in providing help to others and decreased social distance from people with mental disorders. Only one trial evaluated the mental health benefits to participants and this found positive effects. Conclusions: Although MHFA training has been found to change knowledge, attitudes and helping behaviours, and even benefit the mental health of participants, there has not yet been an evaluation of the effects on those who are the recipients of the first aid.
Changes in Depression Awareness and Attitudes in Australia: The Impact of Beyondblue: The National Depression Initiative
Authors: Jorm Anthony F. , Christensen Helen , Griffiths Kathleen M. 
Published: December 2009

Objective: To assess changes in depression awareness and attitudes in Australia and the effect that beyondblue: the national depression initiative has had on these. Method: Data from national surveys of mental health literacy in 1995 and 2003–2004 were analysed to see if states and territories that funded beyondblue (the high-exposure states) had greater changes than those that did not (the low-exposure states). In both surveys, participants were shown a depression vignette and asked whether they themselves or family or friends had ever had a similar problem, whether they thought the person would be discriminated against, and questions about the likelihood of long-term positive and negative outcomes for the person. Participants were also assessed for symptoms of psychological distress in the past month. Results: There was an increase in the percentage of people who said that they or their family or friends had a problem like the person in the vignette. This increase was greater in the high-exposure states. However, therewas no change in reports of current psychological distress, suggesting that there is greater depression awareness or openness rather than a real increase in symptoms. People in the high-exposure states also showed an increase in the belief that discrimination would occur. There was little change in beliefs about longterm outcomes, apart from people in high-exposure states believing that a depressed person would be more understanding of other people's feelings. Conclusions: The data are consistent with beyondblue having had an effect on awareness of depression and of discrimination against depressed people.
Changes in Psychological Distress in Australia over an 8-Year Period: Evidence for Worsening in Young Men
Authors: Jorm Anthony F. , Butterworth Peter 
Published: December 2009

Objective: To assess whether psychological distress has changed in the Australian population. Method: Data were obtained from national household surveys of 1964 Australian adults in 1995 and 3507 in 2003–2004. Psychological distress was measured using the 4-NS, which asks about symptoms of depression, anxiety, irritability and nervousness in the past month. The data were analysed by gender and by age group, from 20–24 years to 70–74 years. Results: Psychological distress was found to have increased in men aged 20–29 years. This change was observed even when the same cohorts were compared. No change was found in women or in other male age groups. Conclusions: These data show the need for routine population monitoring of mental health to determine subgroups requiring priority action.
Free Range users and One Hit Wonders: Community Users of an Internet-Based Cognitive Behaviour Therapy Program
Authors: Christensen Helen , Griffiths Kathy , Groves Chloe , Korten Ailsa 
Published: December 2009

Objective: Little is known about the predictors of symptom change or the methods that might increase user ‘compliance’ on websites designed to improve mental health outcomes. The present paper: (i) examines predictors of expected final depression and anxiety scores on the MoodGYM website as a function of user characteristics; and (ii) compares the compliance rates of the original site with the new public version of the site (MoodGYM Mark II). The latter site requires compulsory completion of ‘core’ online assessments and may increase completion of site questionnaires. Method: MoodGYM Mark I participants were 19 607 visitors (public registrants) between April 2001 and September 2003 plus 182 participants who had been randomly assigned to MoodGYM in an earlier trial (The BlueMood Trial). MoodGYM Mark II participants were 38 791 public registrants of the MoodGYM Mark II site collected between September 2003 and October 2004. Symptom assessments are repeated within the website intervention to allow the examination of change in symptoms. Outcome variables were gender, initial depression severity scores, number of assessments completed and final anxiety and depression scores. Results: Men are predicted to be 0.19 units (SE = 0.095) higher than women on depression, controlling for the initial depression level and number of modules completed. For initial depression scores above 2, it is predicted that the final score will indicate improvement relative to the initial score, the magnitude of the improvement increasing as a function of the number of modules attempted. For initial anxiety scores above 2, it is predicted that the final score will indicate improvement relative to the initial score, the magnitude of the improvement increasing as a function of the number of modules attempted. Mark II registrants were more likely than to Mark I registrants to complete onsite assessments. Conclusions: Visitors to the MoodGYM site are likely to have better psychological outcomes if they complete more of the site material. Compulsory completion of core sections increases assessment completion. There is a need to examine further the significance of attrition from online interventions, to develop methods of handling missing data, and to investigate strategies to improve visitor dropout.
Who Treats whom? An Application of the Pathways to Care Model in Australia
Authors: Issakidis Cathy , Andrews Gavin 
Published: December 2009

Objective: The present paper applies Goldberg and Huxley's Pathways to Care (PTC) model to the Australian health-care system to ask: who is treated in each sector and what does this tell us about the performance of the health-care system? It examines the factors associated with reaching primary care, outpatient and inpatient sectors, as well as private and public mental health services. Method: Data from the Australian National Survey of Mental Health and Wellbeing were used to determine the proportion of the population treated in each sector. Sociodemographic and clinical characteristics were examined and logistic regression was used to determine which factors were associated with use of different sectors of care. Results: Of the total population, 80.5% reached primary care, 8.2% primary care for mental health problems, 6.5% outpatient care and 0.4% reached the mental health inpatient sector. Clinical severity increased across these sectors and was an important determinant of access to care. Those consulting private practitioners were clinically similar to those consulting in the public sector. Sociodemographic characteristics were important determinants of access to primary, specialist and private mental health care. Being aged over 55 years or living in a rural area was associated with lower access to several sectors. Conclusions: Although at a broad level the health-care system is performing as expected, limited access among some groups is cause for concern. Applying the PTC model to a population sample offered useful insights into the performance of the Australian healthcare system.
Cannabis use and the Mental Health of Young People
Authors: Hall Wayne D. 
Published: December 2009

Objective: To review the evidence on the mental health and psychosocial consequences of rising rates of cannabis use among young people in developed countries.Method: This paper critically reviews epidemiological evidence on the following psychosocial consequences of adolescent cannabis use: cannabis dependence; the use of heroin and cocaine; educational underachievement; and psychosis. Leading electronic databases such as PubMed have been searched to identify large-scale longitudinal studies of representative samples of adolescents and young adults conducted in developed societies over the past 20 years.Results: Cannabis is a drug of dependence, the risk of which increases with decreasing age of initiation. Cannabis dependence in young people predicts increased risks of using other illicit drugs, underperforming in school, and reporting psychotic symptoms. Uncertainty remains about which of these relationships are causal although the evidence is growing that cannabis is a contributory cause of psychotic symptoms.Conclusions: We face major challenges in communicating with young people about the most probable risks of cannabis use (dependence, educational underachievement and psychosis) given uncertainties about these risks and polarized community views about the policies that should be adopted to reduce them.