Australian and New Zealand Journal of Psychiatry最新文献

{"title":"Suicidal ideation, suicide plans and suicide attempts among Australian adults: Findings from the 2020-2022 National Study of Mental Health and Wellbeing.","authors":"Vikas Arya, Philip Burgess, Sandra Diminic, Meredith G Harris, Tim Slade, Matthew Sunderland, Caley Tapp, Joshua Vescovi, Jane Pirkis","doi":"10.1177/00048674241256753","DOIUrl":"10.1177/00048674241256753","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to describe the epidemiology of suicidal ideation, suicide plans and suicide attempts, examine services received for suicide attempts, and explore the relationship between suicide attempts and self-harm without suicidal intent.</p><p><strong>Methods: </strong>We used survey data from the 2020-2022 National Study of Mental Health and Wellbeing, which involved a nationally representative sample of Australian adults aged 16-85 (<i>n</i> = 15,893). Comparisons were made with the 2007 National Study of Mental Health and Wellbeing (<i>n</i> = 8841).</p><p><strong>Results: </strong>In 2020-2022, the proportions of adults who had experienced suicidal ideation, suicide plans and suicide attempts during their lifetime were 16.6%, 7.5% and 4.9%, respectively. The proportions who had experienced these in the past 12 months were 3.3%, 1.1% and 0.3%. The odds of experiencing suicidal ideation and making a suicide plan were significantly higher in 2020-2022 than in 2007. Groups at heightened risk of suicidal ideation, suicide plans and/or suicide attempts in the previous 12 months were males, young people, people who were gay, lesbian, or bisexual or used some other term to describe their sexual identity, people outside the labour force, people from disadvantaged areas and people with mental disorders. Two-fifths of those who attempted suicide during the previous 12 months did not use health services following their attempt, and two-thirds also self-harmed without suicidal intent.</p><p><strong>Conclusion: </strong>The implications of these findings for the forthcoming National Suicide Prevention Strategy are discussed. Suicidal thoughts and behaviours confer risk for suicide and are significant problems in their own right. Their prevention requires a strong whole-of-government response.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"500-509"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141299902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Positive outcomes for individuals participating in psychosis research.","authors":"Marko Milicevic, Cláudia C Gonçalves, Carl Moller, James McLure, Tracey Watson, Alison R Yung","doi":"10.1177/00048674251333573","DOIUrl":"10.1177/00048674251333573","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"482-484"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cost of editorial independence, and the free speech it supports, is eternal vigilance.","authors":"Jeffrey Cl Looi, Gin S Malhi, Steve Kisely","doi":"10.1177/00048674251335215","DOIUrl":"10.1177/00048674251335215","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"477-479"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the purpose of Psychiatric Emergency Care Centres? A qualitative study of health care staff.","authors":"Jacqueline Huber, Alyssa Milton, Matthew Brewer, Katherine Fry, Sean Evans, Jason Coulthard, Nick Glozier","doi":"10.1177/00048674251331466","DOIUrl":"10.1177/00048674251331466","url":null,"abstract":"<p><strong>Background: </strong>Psychiatric Emergency Care Centres do not have a clear treatment model or evidence base. An understanding of the patient population, clinical practice and approaches is needed to develop an evidence-based framework.</p><p><strong>Objectives: </strong>Identify staff perceptions of the purpose of Psychiatric Emergency Care Centres, who should be treated and how.</p><p><strong>Methods: </strong>A multidisciplinary sample of clinicians and administrators currently working in, or with administrative oversight of, Psychiatric Emergency Care Centres were interviewed. All New South Wales Psychiatric Emergency Care Centres were approached and staff self-selected. A total of 36 people participated, including nurses, doctors, social workers and managers. A critical realist qualitative thematic analysis approach was used, with an inductive orientation.</p><p><strong>Results: </strong>Having an achievable admission goal was important. Although 'harm minimization' was often cited as important, this meant conflicting, superimposed notions to different people, including minimizing self-harm, reducing iatrogenic harm from unnecessary or coercive intervention and limiting harm to a resource-constrained system. Participants reported significant clinical practice variation and confidence in their practice.</p><p><strong>Conclusion: </strong>The approach to the primary goal of 'harm minimization' reflects conflicting priorities in a complex system which are often not explicit. However, we identified a clinical practice framework upon which to base care pathways, training, intervention development and outcome assessment.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"552-563"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The epidemiology of mental and substance use disorders in Australia 2020-22: Prevalence, socio-demographic correlates, severity, impairment and changes over time.","authors":"Tim Slade, Joshua Vescovi, Cath Chapman, Maree Teesson, Vikas Arya, Jane Pirkis, Meredith G Harris, Philip M Burgess, Damian Santomauro, Siobhan O'Dean, Caley Tapp, Matthew Sunderland","doi":"10.1177/00048674241275892","DOIUrl":"10.1177/00048674241275892","url":null,"abstract":"<p><strong>Objective: </strong>Mental and substance use disorders are the leading causes of disability worldwide. Contemporary estimates of prevalence, severity and impairment are essential for service planning. This study provides estimates of prevalence, severity, impairment and demographic correlates of mental and substance use disorders in 2020-22 and changes in prevalence since 2007.</p><p><strong>Methods: </strong>Data were from the two Australian National Surveys of Mental Health and Wellbeing conducted in 2020-22 (<i>N</i> = 15,893) and 2007 (<i>N</i> = 8841). Descriptive statistics report prevalence of lifetime and 12-month mental and substance use disorder by sex and age, proportion of people with each mental disorder by levels of severity (mild, moderate and severe) and mean days out of role by mental disorder class (mood, anxiety, substance use). Logistic regression analyses examined demographic correlates of mental disorder class and assessed changes over time.</p><p><strong>Results: </strong>The lifetime prevalence of any mental or substance use disorder in 2020-22 was 40.2%. The 12-month prevalence was 20.2% (mood disorder - 7.4%, anxiety disorder - 15.7% and substance use disorder - 3.1%). Mood disorders were associated with significant impairment. The prevalence of mental disorders has changed over time, with mood and anxiety disorders increasing and substance use disorders decreasing. These changes were most evident among young adults.</p><p><strong>Conclusion: </strong>Mental disorders are common in Australia. Impairment associated with mental disorders remains significant. Particular focus should be paid to young adults aged 16-25 years who have shown the largest increases in anxiety and mood disorder prevalence over the past 13 years.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"510-521"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Roll call: Why the child and adolescent mental health sector must be present for severe school refusal.","authors":"Lux Ratnamohan, Peter McInnis, Beth Kotze, Rebecca Koncz, Michelle Cunich, David Heyne","doi":"10.1177/00048674251332727","DOIUrl":"10.1177/00048674251332727","url":null,"abstract":"<p><p>School refusal can be a complex and intractable transdiagnostic syndrome that derails psychosocial development and jeopardises the successful transition to adulthood. Amid a global youth mental health crisis and in the aftermath of the COVID-19 pandemic, school refusal rates appear to have surged, prompting calls for urgent action. With a focus on severe forms of school refusal, we present an agenda for how the child and adolescent mental health sector can support the education sector in answering this call. We first identify three core challenges that must be tackled: (1) the need for clearer distinctions between mild and severe forms of school refusal to support classification, research, and intervention planning; (2) the treatment gap, which leaves many young people without timely or appropriate care; and (3) the absence of an evidence base to guide interventions for treatment non-responders. Then, for each challenge, we identify potential solutions, namely: (1) developing clinical staging frameworks to enhance conceptual clarity and support targeted research; (2) exploring outreach models of care to improve treatment access and engagement; and (3) devising robust methodologies for evaluating intensive Tier-4 interventions to strengthen the evidence base for treatment non-responders. Just as a roll call ensures that every individual is accounted for, this paper calls on the child and adolescent mental health sector to be fully present in addressing severe school refusal. By strengthening collaboration between clinical practice, education systems, and researchers, the field can move towards more effective, integrated, and scalable solutions that better meet the needs of these students and their families.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"493-499"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Policy implications of the 2020-22 Australian study of mental health and wellbeing.","authors":"Maree Teesson, Harvey Whiteford, Marlee Bower, Scarlett Smout, Philip Burgess, Meredith G Harris, Jane Pirkis, Sandra Diminic, Andrew Baillie, Tim Slade, Cath Chapman","doi":"10.1177/00048674241292961","DOIUrl":"10.1177/00048674241292961","url":null,"abstract":"<p><p>The objective of this paper is to summarise the policy implications of key findings from the 2020-22 Australian National Study of Mental Health and Wellbeing (NSMHWB). We provide an analysis of policy implications of four papers in this issue of the journal from the 2020-22 NSMHWB (<i>N</i> = 15,893) and the 2007 NSMHWB (<i>N</i> = 8841). The 2020-2022 NSMHWB reported a lifetime prevalence rate of common mental disorders of 40.2% (95% confidence interval [CI] = 39.2-41.3) and 12-month prevalence rate of 20.2% (95% CI 19.5-21.0). Overall, adult Australians were significantly more likely to experience a 12-month mental disorder in 2020-22 compared with 2007, with the change most striking in among those aged 16-24 years (odds ratio [OR] 1.2, 95% CI 1.1-1.3). Individuals aged 16-24 years in 2020-22 were significantly more likely to experience a 12-month anxiety disorder (OR 2.9, 95% CI = 2.3-3.7, depressive disorder (OR 2.8 95% CI = 2.1-3.9) or comorbidity (relative risk [RR] = 1.4, 95% CI = 1.2-1.7) compared with those aged 16-24 years in 2007. In 2020-22, the proportion of Australians who had experienced suicidal ideation, suicide plans and suicide attempts in the past 12 months was 3.3%, 1.1% and 0.3%. Under half (46.5% 95% CI 44.1-48.8) of adults with a 12-month mental disorder sought treatment. Mental disorders remain an endemic feature of Australia's overall health landscape and appear to be increasing, especially in younger cohorts. While service use rates have improved over time, there is still some way to go. Epidemiological surveys such as the 2020-22 NSMHWB are important for understanding changing prevalence and the population not accessing services. Innovative prevention and treatment strategies will be needed to address the increasing rates of disorders in younger Australian adults. Equally innovative and bold policy responses will be essential.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"485-492"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coercive, treatment or sensible: What is the place of community treatment orders in psychiatry?","authors":"Giles Newton-Howes, Ben Beaglehole","doi":"10.1177/00048674251331450","DOIUrl":"10.1177/00048674251331450","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"480-481"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and risk profiles for pneumonia in patients with schizophrenia receiving home-care case management intervention in Taiwan.","authors":"Yu-Ting Liu, Wen-Ying Chen, Po-Yu Chen, Chih-Chiang Chiu, Chun-Hung Pan, Sheng-Siang Su, Shang-Ying Tsai, Chiao-Chicy Chen, Chian-Jue Kuo","doi":"10.1177/00048674251332559","DOIUrl":"10.1177/00048674251332559","url":null,"abstract":"<p><strong>Background: </strong>Home-care case management is a type of community outreach service. However, research on the incidence of infectious diseases in patients receiving home-care case management is limited. This study investigated the incidence of various infectious diseases and risk factors for pneumonia in patients with schizophrenia receiving home-care case management.</p><p><strong>Methods: </strong>We used data from Taiwan's National Health Insurance Research Database between January 1, 2000, and December 31, 2019, to construct a schizophrenia cohort receiving home-care case management (<i>n</i> = 19,687). Pneumonia was the most common infectious disease at follow-up (<i>n</i> = 3966). To identify risk factors for pneumonia, a nested case-control study was conducted. Risk-set sampling was conducted to randomly select controls for each pneumonia case. Conditional logistic regression was employed for statistical analysis.</p><p><strong>Results: </strong>Among various infectious diseases, pneumonia had the highest standardized incidence ratio in our cohort. Of the 3966 patients with pneumonia identified, 56.9% were men. After pairing, 3961 case-control pairs were established. Psychiatric comorbidities, specifically dementia and depressive disorders, were associated with a higher risk of pneumonia (adjusted incidence rate ratios [aIRRs] = 2.73 and 1.34, respectively). In contrast to oral antipsychotics, long-acting injectables were not associated with an increased pneumonia risk, suggesting that long-acting injectables could be a safer treatment option for patients with schizophrenia.</p><p><strong>Conclusion: </strong>Our results revealed a significantly elevated pneumonia risk in this patient population, especially in those with physical and psychiatric comorbidities. The findings advocate for comprehensive care strategies to reduce the risk of pneumonia in this population.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"541-551"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-occurring mental and substance use disorders in Australia 2020-2022: Prevalence, patterns, conditional probabilities and correlates in the general population.","authors":"Matthew Sunderland, Joshua Vescovi, Cath Chapman, Vikas Arya, Meredith Harris, Philip Burgess, Christina Marel, Katherine Mills, Andrew Baillie, Maree Teesson, Tim Slade","doi":"10.1177/00048674241284913","DOIUrl":"10.1177/00048674241284913","url":null,"abstract":"<p><strong>Background: </strong>Previous estimates from 2007 found that co-occurring mental and/or substance use disorders were a pervasive feature of Australia's mental health. Since that time there have been shifts and improvements in the conceptualisation and incorporation of co-occurring disorders in research and treatment settings. The current study provides up-to-date estimates on the prevalence of co-occurring mental and/or substance use disorders, highlights common patterns of co-occurrence, identifies significant correlates and examines any changes in the extent of co-occurring disorders since 2007.</p><p><strong>Methods: </strong>Data were from the two Australian National Surveys of Mental Health and Wellbeing conducted in 2020-2022 (<i>N</i> = 15,893) and 2007 (<i>N</i> = 8841). Descriptive statistics were estimated for the number of co-occurring conditions, correlations and pairwise conditional probabilities. Multinomial logistic and robust Poisson regressions were used to identify significant correlates and compare changes in co-occurring conditions across surveys.</p><p><strong>Results: </strong>Approximately 46% of people with a mental or substance use disorder in the past 12 months experienced two or more diagnosable conditions. There was little evidence to suggest that the prevalence of co-occurring disorders has changed since 2007 (Prevalence Ratio (PR) = 1.08, 95% CI = 0.98-1.18). Subgroup analysis indicated that those aged 16-24 years were significantly more likely to experience any co-occurrence in 2020-2022 compared with those aged 16-24 years in 2007 (PR = 1.44, 95% CI = 1.17-1.77).</p><p><strong>Conclusions: </strong>Co-occurring mental and substance use disorders remain endemic in Australia. Indeed, they appear to be increasingly problematic in younger, more recent cohorts. The results suggest that continued effort is needed to develop and implement transdiagnostic interventions that target broad contextual and/or societal factors.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"522-532"},"PeriodicalIF":4.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}