Australian & New Zealand Journal of Psychiatry最新文献

{"title":"Kava for generalised anxiety disorder: A 16-week double-blind, randomised, placebo-controlled study","authors":"J. Sarris, G. Byrne, C. Bousman, Lachlan Cribb, K. Savage, O. Holmes, Jenifer A Murphy, P. Macdonald, Anika Short, Sonia Nazareth, E. Jennings, Stuart Thomas, E. Ogden, Suneel Chamoli, A. Scholey, C. Stough","doi":"10.1177/0004867419891246","DOIUrl":"https://doi.org/10.1177/0004867419891246","url":null,"abstract":"Objective: Previous randomised, double-blind, placebo-controlled studies have shown that Kava (a South Pacific medicinal plant) reduced anxiety during short-term administration. The objective of this randomised, double-blind, placebo-controlled study was to perform a larger, longer-term trial assessing the efficacy and safety of Kava in the treatment of generalised anxiety disorder and to determine whether gamma-aminobutyric acid transporter (SLC6A1) single-nucleotide polymorphisms were moderators of response. Methods: The trial was a phase III, multi-site, two-arm, 16-week, randomised, double-blind, placebo-controlled study investigating an aqueous extract of dried Kava root administered twice per day in tablet form (standardised to 120 mg of kavalactones twice/day) in 171 currently non-medicated anxious participants with diagnosed generalised anxiety disorder. The trial took place in Australia. Results: An analysis of 171 participants revealed a non-significant difference in anxiety reduction between the Kava and placebo groups (a relative reduction favouring placebo of 1.37 points; p = 0.25). At the conclusion of the controlled phase, 17.4% of the Kava group were classified as remitted (Hamilton Anxiety Rating Scale score < 7) compared to 23.8% of the placebo group (p = 0.46). No SLC6A1 polymorphisms were associated with treatment response, while carriers of the rs2601126 T allele preferentially respond to placebo (p = 0.006). Kava was well tolerated aside from poorer memory (Kava = 36 vs placebo = 23; p = 0.044) and tremor/shakiness (Kava = 36 vs placebo = 23; p = 0.024) occurring more frequently in the Kava group. Liver function test abnormalities were significantly more frequent in the Kava group, although no participant met criteria for herb-induced hepatic injury. Conclusion: While research has generally supported Kava in non-clinical populations (potentially for more ‘situational’ anxiety as a short-term anxiolytic), this particular extract was not effective for diagnosed generalised anxiety disorder.","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"477 1","pages":"288 - 297"},"PeriodicalIF":0.0,"publicationDate":"2019-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88189809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for postpartum depression and borderline personality disorder: Food for thought","authors":"E. di Giacomo, F. Colmegna, A. Dakanalis, Rodolfo Pessina, V. Placenti, F. Pescatore, M. Clerici","doi":"10.1177/0004867419893425","DOIUrl":"https://doi.org/10.1177/0004867419893425","url":null,"abstract":"Australian & New Zealand Journal of Psychiatry, 54(3) now collecting these labels, often in multiples. With them they collect medications and an identity that views themselves as fundamentally ‘disordered’. In child psychiatry, we need to find a way to keep the nuance of individual experience and the subtleties of understanding a child in context. This is an approach that keeps open possibilities for the future of each child, particularly those who are brought for help. My concern is that already campaigns of mental health literacy work to fix a child to their diagnostic identifications which become difficult to break free from. A childhood mental health literacy initiative can only serve to increase the diagnoses of childhood mental health disorders, while failing to consider the complexities of children in context. It is only an ‘illiteracy’ that allows a child, in conjunction with those they come into contact with, to find their own language to author their own lives.","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"261 1","pages":"319 - 320"},"PeriodicalIF":0.0,"publicationDate":"2019-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86334070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to: Media depictions of possible suicide contagion among celebrities: A cause for concern and potential opportunities for prevention – The role of grief","authors":"M. O’Connor","doi":"10.1177/0004867419893430","DOIUrl":"https://doi.org/10.1177/0004867419893430","url":null,"abstract":"","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"58 1","pages":"438 - 438"},"PeriodicalIF":0.0,"publicationDate":"2019-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85021435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to: Stimulating dangerous argument?","authors":"P. Fitzgerald, S. Pridmore","doi":"10.1177/0004867419891248","DOIUrl":"https://doi.org/10.1177/0004867419891248","url":null,"abstract":"Recent issues of the journal have contained an interesting, and we suspect somewhat entertaining, series of debate articles focused on the use of repetitive transcranial magnetic stimulation (rTMS) treatment for depression. Unfortunately, we are not sure if these have really advanced understanding of the field adequately. In the most recent follow-up article, ‘Stimulating dangerous argument?’ (we are not sure what is dangerous about this debate), Professor Malhi and colleagues (2019) have continued the debate but really failed to address the vast majority of factual or content issues that were raised by both of us in our responses that preceded this. Instead, they appear to have really focused on two points that we would like to address in turn:","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"73 1","pages":"344 - 345"},"PeriodicalIF":0.0,"publicationDate":"2019-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85765901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What the highest rated movie of all time may teach us about portraying suicide in film","authors":"M. Sinyor, S. Stack, T. Niederkrotenthaler","doi":"10.1177/0004867419891247","DOIUrl":"https://doi.org/10.1177/0004867419891247","url":null,"abstract":"Media portrayals of suicide can have a substantial, negative influence on suicide rates often described as the Werther effect (Sinyor et al., 2018). One of the most extreme examples of this phenomenon was the publicity surrounding the death of Robin Williams which was associated with an increase of more than 1800 deaths in the United States in late 2014 (Fink et al., 2018). Recently, there has been renewed interest in the potential deleterious effects of fictional media depictions given an association between the release of the Netflix show 13 Reasons Why and increased youth suicides (Niederkrotenthaler et al., 2019). In our conversations with members of the entertainment media (and the mainstream media), a common theme is frustration with what they perceive as an emphasis by the suicide prevention community on what we discourage them from publishing. Given that their job is ultimately to create and disseminate content, we have received feedback that models for how to do so safely and appropriately may be just as important as a list of elements to avoid. Historically, the best evidence in this area has been from non-fictional, news media coverage. Specifically, news stories emphasizing resilience and the absence of suicide attempts/ deaths in the face of suicidal crises have been associated with reductions in suicide across a population, the so-called Papageno effect (Sinyor et al., 2018) (following publication of newspaper stories in which people experiencing suicidal crises did not engage in suicidal behaviour and went on to survive [socalled ‘mastery of crisis’ articles], there was a small, statistically significant reduction in suicides in Austria). While the issues involved in fictional and non-fictional depictions have some overlap, they are not identical, and, ideally, fictional archetypes would inform this discussion. Numerous films have explored the topic of suicide in different ways, but The Shawshank Redemption (1994), the number 1 film of all time according to users of the Internet Movie Database (IMDB; see IMDB.com Top 250), provides a rich basis for discussion of the potential impacts of suicide-related content in fictional movies based on what is currently known about media impacts on suicide. The Shawshank Redemption tells the story of a wrongly imprisoned man who eventually escapes to freedom. During its 142-minute running time, it includes four potential or actual suicide vignettes relating to its two protagonists (Andy and Red) and two supporting characters (Brooks and Norton). The film is not entirely consistent with responsible media recommendations, specifically in relation to the latter two characters who both die by suicide. A major theme of the film is the impact of institutionalization that comes with lengthy incarceration on the human spirit. Brooks is released after five decades in prison to a world that appears foreign and terrifying. He contemplates engaging in crime so that he can be sent back to the world he knows.","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"11 1","pages":"223 - 224"},"PeriodicalIF":0.0,"publicationDate":"2019-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82366307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinical staging approach to improving diagnostics in anxiety disorders: Is it the way to go?","authors":"Wicher A Bokma, N. Batelaan, A. Hoogendoorn, B. Penninx, A. V. van Balkom","doi":"10.1177/0004867419887804","DOIUrl":"https://doi.org/10.1177/0004867419887804","url":null,"abstract":"Background: Clinical staging is a paradigm in which stages of disease progression are identified; these, in turn, have prognostic value. A staging model that enables the prediction of long-term course in anxiety disorders is currently unavailable but much needed as course trajectories are highly heterogenic. This study therefore tailored a heuristic staging model to anxiety disorders and assessed its validity. Methods: A clinical staging model was tailored to anxiety disorders, distinguishing nine stages of disease progression varying from subclinical stages (0, 1A, 1B) to clinical stages (2A–4B). At-risk subjects and subjects with anxiety disorders (n = 2352) from the longitudinal Netherlands Study of Depression and Anxiety were assigned to these nine stages. The model’s validity was assessed by comparing baseline (construct validity) and 2-year, 4-year and 6-year follow-up (predictive validity) differences in anxiety severity measures across stages. Differences in depression severity and disability were assessed as secondary outcome measures. Results: Results showed that the anxiety disorder staging model has construct and predictive validity. At baseline, differences in anxiety severity, social avoidance behaviors, agoraphobic avoidance behaviors, worrying, depressive symptoms and levels of disability existed across all stages (all p-values < 0.001). Over time, these differences between stages remained present until the 6-year follow-up. Differences across stages followed a linear trend in all analyses: higher stages were characterized by the worst outcomes. Regarding the stages, subjects with psychiatric comorbidity (stages 2B, 3B, 4B) showed a deteriorated course compared with those without comorbidity (stages 2A, 3A, 4A). Conclusion: A clinical staging tool would be useful in clinical practice to predict disease course in anxiety disorders.","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"60 1","pages":"173 - 184"},"PeriodicalIF":0.0,"publicationDate":"2019-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89482419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential biomarker signatures in unipolar and bipolar depression: A machine learning approach","authors":"B. Wollenhaupt-Aguiar, D. Librenza-Garcia, G. Bristot, Laura Przybylski, L. Stertz, Renan Kubiachi Burque, K. Ceresér, L. Spanemberg, M. Caldieraro, B. Frey, M. Fleck, M. Kauer-Sant'Anna, Ives Cavalcante Passos, F. Kapczinski","doi":"10.1177/0004867419888027","DOIUrl":"https://doi.org/10.1177/0004867419888027","url":null,"abstract":"Objective: This study used machine learning techniques combined with peripheral biomarker measurements to build signatures to help differentiating (1) patients with bipolar depression from patients with unipolar depression, and (2) patients with bipolar depression or unipolar depression from healthy controls. Methods: We assessed serum levels of interleukin-2, interleukin-4, interleukin-6, interleukin-10, tumor necrosis factor-α, interferon-γ, interleukin-17A, brain-derived neurotrophic factor, lipid peroxidation and oxidative protein damage in 54 outpatients with bipolar depression, 54 outpatients with unipolar depression and 54 healthy controls, matched by sex and age. Depressive symptoms were assessed using the Hamilton Depression Rating Scale. Variable selection was performed with recursive feature elimination with a linear support vector machine kernel, and the leave-one-out cross-validation method was used to test and validate our model. Results: Bipolar vs unipolar depression classification achieved an area under the receiver operating characteristics (ROC) curve (AUC) of 0.69, with 0.62 sensitivity and 0.66 specificity using three selected biomarkers (interleukin-4, thiobarbituric acid reactive substances and interleukin-10). For the comparison of bipolar depression vs healthy controls, the model retained five variables (interleukin-6, interleukin-4, thiobarbituric acid reactive substances, carbonyl and interleukin-17A), with an AUC of 0.70, 0.62 sensitivity and 0.7 specificity. Finally, unipolar depression vs healthy controls comparison retained seven variables (interleukin-6, Carbonyl, brain-derived neurotrophic factor, interleukin-10, interleukin-17A, interleukin-4 and tumor necrosis factor-α), with an AUC of 0.74, a sensitivity of 0.68 and 0.70 specificity. Conclusion: Our findings show the potential of machine learning models to aid in clinical practice, leading to more objective assessment. Future studies will examine the possibility of combining peripheral blood biomarker data with other biological data to develop more accurate signatures.","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"4 1","pages":"393 - 401"},"PeriodicalIF":0.0,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88632021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seasonal and temperature effect on serum lithium concentrations","authors":"S. Cheng, N. Buckley, W. Siu, A. Chiew, E. Vecellio, B. Chan","doi":"10.1177/0004867419889160","DOIUrl":"https://doi.org/10.1177/0004867419889160","url":null,"abstract":"Background: Lithium remains the gold standard treatment for bipolar disorder. However, it has a very narrow therapeutic index (0.6–0.8 mmol/L). It has been suggested that high environmental temperature can lead to dehydration, elevated plasma lithium concentration and then lithium toxicity. Objectives: We aimed to investigate the effect of seasonal and short-term changes in temperature on serum lithium concentrations in Sydney, Australia. Methods: We retrospectively analysed data from all patients who had serum lithium concentrations taken from the Prince of Wales and Sutherland Hospitals between 2008 and 2018. Temperature data came from the Bureau of Meteorology. We examined correlations between lithium concentrations and the preceding 5 days maximum temperatures, month and season. We also performed a longitudinal analysis of the effect of temperature and seasons within selected patients who had repeated levels. Results: A total of 11,912 serum lithium concentrations from 2493 patients were analysed. There was no significant association between higher lithium concentration and preceding higher temperatures (r = –0.008, p = 0.399). There was also no important seasonal or monthly variation, across all patients or in the smaller cohort with longitudinal data (n = 123, r = 0.008, 95% confidence interval: [–0.04, 0.06]). Conclusion: There were no clinically important differences in serum lithium concentration related to seasons, months or temperatures, which suggests that patients on lithium are able to adequately maintain hydration during hot weather in Sydney.","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"36 1","pages":"282 - 287"},"PeriodicalIF":0.0,"publicationDate":"2019-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87516173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep brain stimulation removal after successful treatment for heroin addiction","authors":"Chencheng Zhang, Jun Li, Dianyou Li, Bomin Sun","doi":"10.1177/0004867419890671","DOIUrl":"https://doi.org/10.1177/0004867419890671","url":null,"abstract":"Australian & New Zealand Journal of Psychiatry, 54(5) the normal range, and lenograstim increased to 250 μg on 29 June. On 5 July, 11 days after CIA occurrence, the patient’s ANC increased to 9560 cells/ mm3. After that, his ANC returned to a stable range. Examination of HLA alleles revealed the following: HLAA*11:01/24:02, HLA-B*54:01/55:02, HLA-Cw*01:02/03:03, HLA-RB1*04:05/ 08:03, HLA-DQB1*04:01/06:01. Several pharmacogenetic studies found that HLA alleles that differ between ethnics are implicated in the development of CIA (Numata et al., 2018). Because agranulocytosis is a rare adverse drug reaction, only 22 patients with CIA were included for detection of the responsible alleles in a study of Japanese (Saito et al., 2016). We suspected that HLA-DRB1*04:05 is in linkage disequilibrium and HLA-DRB1*04:05 might be an independent risk factor for CIA in Japanese. Further pharmacogenetic studies are needed to clarify the HLA alleles associated with CIA.","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"93 1","pages":"543 - 544"},"PeriodicalIF":0.0,"publicationDate":"2019-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80292907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of childhood exogenous hormones on mood","authors":"L. Sturm, J. Kulkarni","doi":"10.1177/0004867419889407","DOIUrl":"https://doi.org/10.1177/0004867419889407","url":null,"abstract":"","PeriodicalId":8576,"journal":{"name":"Australian & New Zealand Journal of Psychiatry","volume":"40 1 1","pages":"437 - 438"},"PeriodicalIF":0.0,"publicationDate":"2019-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85236160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}