Australian and New Zealand Journal of Psychiatry最新文献

{"title":"Among key social determinants, connection associated with lowest odds of non-suicidal self-injury and suicidal ideation among Australian youth.","authors":"Alysia M Robertson, Veronica Sheanoda, Paul Campbell, Emma Knight, Tegan Cruwys, Jason DE Proulx, Joanne A Rathbone, Katherine J Reynolds","doi":"10.1177/00048674261438055","DOIUrl":"10.1177/00048674261438055","url":null,"abstract":"<p><strong>Objective: </strong>To test the relative importance of key social determinants (as specified in the Australian <i>National Suicide Prevention Strategy 2025-2035</i>) associated with suicidal ideation and non-suicidal self-injury in Australian youth.</p><p><strong>Methods: </strong>Representative data from the cross-sectional National Study of Mental Health and Wellbeing 2020-2022 were analysed for Australian youth aged 16-24 years. We used population-weighted multivariable logistic regression analyses to predict 12-month suicidal ideation and non-suicidal self-injury from several social determinants: household income, receipt of government pension/allowance payments, study/work engagement, experience of homelessness, household financial stress, urban residence and social connectedness.</p><p><strong>Results: </strong>Social connectedness was a statistically significant predictor in both models, such that a one-unit increase reduced the odds of 12-month suicidal ideation by 52% and non-suicidal self-injury by 55%. Other significant predictors were having ever experienced homelessness, which increased the odds of suicidal ideation by 116%, while each household financial stressor (e.g. not being able to pay bills on time) increased the odds of non-suicidal self-injury by 34%. No other social determinant was statistically significant in the multivariable models.</p><p><strong>Conclusion: </strong>Social connectedness was the only social determinant associated with lower odds of both suicidal ideation and non-suicidal self-injury in youth. Although further longitudinal studies are needed to confirm these benefits, our cross-sectional findings provide initial support for the National Suicide Prevention Strategy's emphasis on strengthening social inclusion and economic security as key prevention strategies. Our findings highlight the importance of implementing and evaluating connectedness interventions for youth as a priority next step in suicide and NSSI prevention efforts.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"666-676"},"PeriodicalIF":4.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147643801","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":"Middle childhood profiles of social-emotional competencies and difficulties differentiate risk of health service presentations with adolescent mental disorders.","authors":"Emma J Carpendale, Melissa J Green, Oliver J Watkeys, Stacy Tzoumakis, Vaughan J Carr, Kristin R Laurens","doi":"10.1177/00048674261426776","DOIUrl":"10.1177/00048674261426776","url":null,"abstract":"<p><strong>Objective: </strong>The dual-factor model of mental health postulates a role for positive mental health, alongside mental illness, in determining mental health care needs. Informed by this model, the present study delineated profiles of social-emotional competencies and difficulties during middle childhood in a population-based sample of girls and boys and determined their association with adolescent mental disorder diagnoses.</p><p><strong>Method: </strong>Latent profile analyses were conducted across five indices of social-emotional competency and four indices of psychopathology that were measured by questionnaire self-report among 13,349 girls and 13,488 boys at age ~11 years. The association of the profiles with adolescent presentations to hospital or ambulatory services (ages ~12-17 years) were determined using logistic regression.</p><p><strong>Results: </strong>Analyses yielded five profiles in each sex: <i>complete mental health</i> (44% girls; 42% boys), <i>average mental health</i> (30%; 33%), <i>internalising symptoms with poor relationship skills</i> (9%; 7%), <i>externalising symptoms with poor self-management</i> (12%; 9%) and <i>low mental health</i> (5%; 10%). Profiles associated differentially with adolescent presentations with any mental disorder, externalising disorders, internalising disorders and self-harm/suicidal ideation, identified in linked health records. Greater odds of any and specific mental disorder diagnoses were characteristic of all profiles relative to <i>average mental health</i> (adjusted odds ratios [aOR]: 1.7-3.3) except <i>complete mental health</i> (aOR: 0.7-0.9), with different strengths of association according to profile.</p><p><strong>Conclusion: </strong>Combining information on social-emotional competencies and psychopathology in middle childhood may help refine the provision of mental health promotion and early intervention to alleviate adolescent mental disorder.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"653-665"},"PeriodicalIF":4.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147509098","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":"Suicides in general hospitals: Meta-analysis of incidence and trends.","authors":"Jack Schrader, Swapnil Sharma, Anthony Azer, Matthew M Large","doi":"10.1177/00048674261441088","DOIUrl":"10.1177/00048674261441088","url":null,"abstract":"<p><strong>Objective: </strong>To synthesise the primary literature reporting the incidence of suicide in general hospitals.</p><p><strong>Method: </strong>Peer-reviewed papers reporting suicides among the medically and surgically admitted patients of general hospitals were located by searches of MEDLINE, PsycINFO and EMBASE between 1946 and 2025. Random effects meta-analyses were used to estimate the number of suicides per 1,000,000 admissions, the rate of suicide per 100,000 patient years and the proportion of suicides by common suicide methods. Temporal trends were examined with mixed-effects meta-regression.</p><p><strong>Results: </strong>The pooled number of suicides per 1,000,000 admissions was 16.3 (95% confidence interval = [9.8, 27.0]). The pooled rate of suicide per 100,000 patient-years was 82.7 suicides (95% confidence interval = [49.6, 115.7]). Jumping accounted for 52.1% (95% confidence interval = [39.4, 64.4]) of suicides, and 20.6% (95% confidence interval = [13.1, 30.8]) were by hanging. The number of suicides per admission declined over time (point estimate of slope = -0.039, standard error = 0.01, <i>p</i> < 0.0004) to 4.7 suicides per 1,000,000 admissions (95% confidence interval = [1.7, 12.9], <i>I</i>² = 97) in nine studies published after 2010. The rate of suicide per patient year was unchanged over 60 years of primary research (slope ⩽ -0.0001, standard error = 0.0001, <i>p</i> = 0.97).</p><p><strong>Conclusion: </strong>The rate of suicide in general hospital inpatients is an order of magnitude higher than the global suicide rate. While general hospital suicide is a critical patient safety concern, the stability in suicide rates over time highlights the persistent difficulty of suicide prevention in this setting.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"687-698"},"PeriodicalIF":4.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760748","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":"Effectiveness of mobile-based cognitive behavioural therapy for adolescent depression: A systematic review and meta-analysis.","authors":"Aditya Sathe, Abhir Nainani, Ahmed Elaraby, Adam L Jones, Melissa Lowe","doi":"10.1177/00048674261439533","DOIUrl":"10.1177/00048674261439533","url":null,"abstract":"<p><strong>Objective: </strong>Adolescent depression is a significant public health concern, with prevalence rates increasing globally over recent years. Mobile-based cognitive behavioural therapy applications are increasingly used to address adolescent depression, but their effectiveness remains unclear. This study evaluated the impact of mobile-based cognitive behavioural therapy apps on depressive symptoms in this population, with secondary analyses examining anxiety, quality of life, usability and adverse events.</p><p><strong>Method: </strong>A systematic review identified 10 randomized controlled trials containing 1896 participants. These studies were published since 2014 and assessed the effects of mobile-based cognitive behavioural therapy for depression in adolescents (aged 13-25 years). Databases searched included MEDLINE, PsycINFO, Embase, PubMed and the Cochrane Library. Subsequent meta-analysis was conducted on nine studies (<i>n</i> = 1127). Studies reporting depressive symptom outcomes were included in meta-analyses using a random-effects model.</p><p><strong>Results: </strong>Meta-analysis showed a significant reduction in depressive symptoms compared with the control groups (Cohen's <i>d</i> = -0.24; 95% confidence interval = [-0.36, -0.13], <i>p</i> < 0.001), with negligible heterogeneity (<i>I</i>² = 0%). Meta-regression showed no significant association between follow-up duration and effect size. No significant effects were found for anxiety (<i>d</i> = -0.16), but improvements were observed in quality of life (<i>d</i> = 0.37) and usability (<i>d</i> = 0.37). Adverse event rates were lower in the intervention groups (risk ratio = 0.68).</p><p><strong>Conclusion: </strong>Mobile-based cognitive behavioural therapy is a moderately effective short-term intervention for adolescent and young adult depression. These findings support its integration into mental health service delivery, although strategies to sustain long-term benefits are needed.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"633-642"},"PeriodicalIF":4.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687729","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":"Persistence of antidepressant treatment in children and adolescents: A population-based cohort study.","authors":"Gizat M Kassie, Jenni Ilomaki, Stephen J Wood, Jacqueline Gould, Melissa Raven, Jon N Jureidini, Luke E Grzeskowiak","doi":"10.1177/00048674261418458","DOIUrl":"10.1177/00048674261418458","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence and predictors of persistent antidepressant use among Australian children and adolescents.</p><p><strong>Methods: </strong>A population-based cohort study was conducted, including children and adolescents aged from 5 to 18 years who initiated an antidepressant between 2014 and 2022, using 10% randoms sample of Pharmaceutical Benefits Scheme (PBS) dispensing data. We measured persistence at 1 and 2 years after initiation, as defined by continuous supply of any antidepressant with no gaps of more than 90 days between dispensings.</p><p><strong>Results: </strong>A total of 44,366 children and adolescents initiated on antidepressants during the study period. Approximately one-quarter (23.1%) received only a single antidepressant dispensing, with a further 33.0% considered persistent users after 1 year and 19.8% considered persistent users after 2 years. Persistence at 1 year was significantly higher in females (adjusted odds ratios (aOR) 1.13 [1.09-1.18]) than males, and in concurrent users of antipsychotics (aOR 1.37 [1.22-1.54]) or psychostimulants (aOR 1.60 [1.49-1.71]) than non-users. The likelihood of persistent antidepressant use at 1 year was lower in individuals with a concession card (aOR 0.81 [0.78-0.85]) than general beneficiaries and in those who initiated with serotonin and norepinephrine reuptake inhibitors (aOR 0.60 [0.54-0.67]) or mirtazapine (aOR 0.45 [0.34-0.51]) compared with selective serotonin reuptake inhibitors. Findings were similar for persistent antidepressant use at 2 years.</p><p><strong>Conclusion: </strong>Persistent antidepressant use beyond 1 or 2 years is common among children and adolescents and shows an increasing trend over time. The reasons for and appropriateness of prolonged treatment with antidepressants in this population warrant further investigation.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"643-652"},"PeriodicalIF":4.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321225","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":"Specialisation of psychiatric services can deliver more effective person-centred care.","authors":"Vlasios Brakoulias, Vinay Lakra, David Copolov","doi":"10.1177/00048674251406037","DOIUrl":"10.1177/00048674251406037","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"615-617"},"PeriodicalIF":4.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145843595","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":"Mobilising community-managed organisations: A call to action to confront physical health inequities in people living with complex mental health challenges.","authors":"Oscar Lederman, Hamish Fibbins, Evelyne Tadros, Justin Chapman, Mark Orr, Philip B Ward, Andrew Watkins, Gemechu Wirtu, Regan Lamble, Jackie Curtis, Simon Rosenbaum","doi":"10.1177/00048674261450383","DOIUrl":"https://doi.org/10.1177/00048674261450383","url":null,"abstract":"<p><p>Australia is failing people with complex mental health challenges, who experience poorer physical health and a reduced life expectancy of 15-20 years. This inequity is driven largely by preventable physical illnesses, many linked to lifestyle-related behaviours including physical inactivity, poor nutrition, smoking and sleep disturbance. Evidence shows integrated physical health and lifestyle interventions are feasible and effective. Yet translation into routine care remains fragmented, with most initiatives failing to scale beyond pilots. As a cornerstone of Australia's mental health system, community-managed organisations (CMOs) are central providers of recovery-oriented and peer-led psychosocial care to adults with complex mental health challenges. This uniquely positions CMOs to tackle such physical health inequities, yet they are under-resourced and underfunded, and their capability remains insufficiently recognised within national health policy frameworks. This Perspective presents a case for harnessing the capacity and capability of CMOs as a pathway for system reform, enabling better access to interventions that improve health outcomes and minimise health disparities. We outline opportunities for structured models of intervention, integrated care pathways, workforce development and policy and research priorities - all critical levers to enable sustainable, equitable physical health outcomes. It is time to elevate CMOs within mainstream health policy and strategically invest in their capacity to lead a systemic response to the physical health inequities of people living with mental health challenges.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674261450383"},"PeriodicalIF":3.7,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155171","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":"Nonrestrictive aggression management interventions for adults with psychotic disorders: A systematic review.","authors":"Melisa Bulut, Nazmiye Yıldırım","doi":"10.1177/00048674261425812","DOIUrl":"10.1177/00048674261425812","url":null,"abstract":"<p><strong>Objective: </strong>Aggression is a persistent clinical challenge, particularly prevalent in individuals with psychotic disorders. This systematic review aimed to compile current non-restrictive clinical interventions for aggression management in this population and identify those supported by a high level of evidence.</p><p><strong>Methods: </strong>A systematic literature search was conducted across Scopus/Elsevier/ClinicalKey/Embase, PubMed, Cochrane Library and CINAHL from 27 March to 10 May 2024. The review included randomized controlled trials (RCTs), non-randomized controlled trials and pre-post studies without a control group. From an initial pool of 575 records, 17 studies met the inclusion criteria for evidence assessment.</p><p><strong>Results: </strong>The 17 included studies comprised 15 RCTs, 1 non-randomized controlled trial and 1 pre-post study. Eleven studies demonstrated that the tested interventions were effective for aggression management, with evidence levels rated as high to moderate. Interventions were categorized into six groups: risk assessment (<i>n</i> = 2), cognitive skills improvement interventions (<i>n</i> = 2), social skills improvement interventions (<i>n</i> = 1), environmental management (<i>n</i> = 1), staff training (<i>n</i> = 3) and multicomponent interventions (<i>n</i> = 8). The findings underscore the necessity of multicomponent, holistic approaches over single-dimensional strategies.</p><p><strong>Conclusion: </strong>The review confirms the benefits of cognitive and social interventions and reinforces the effectiveness of staff de-escalation training. The positive results for sleep hygiene and therapeutic environment interventions support their integration into multidimensional aggression management protocols. Future research should employ larger RCTs to assess long-term sustainability, identify patient subgroups most likely to benefit from specific interventions and evaluate cost-effectiveness. This review is registered with PROSPERO (CRD42024579465).</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"521-537"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321175","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":"Research Letter: Using participatory approach to facilitate engagement of people with lived experience of schizophrenia in research: A co-designed Participant Information and Consent Form.","authors":"Urska Arnautovska, Rebecca Soole, Nicole Korman, Andrea Baker, Dan Siskind","doi":"10.1177/00048674251388547","DOIUrl":"10.1177/00048674251388547","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"599-601"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145562428","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 feasibility of resistance training versus aerobic exercise in a rehabilitation setting for people living with psychotic disorders: A randomised controlled trial.","authors":"Nicole Korman, Robert Stanton, Mike Trott, Brendon Stubbs, Andrea Baker, Cassandra Butler, Dan Siskind, Simon Rosenbaum, Joseph Firth, Rebecca Martland, Talia McIntosh, Nicola Warren, Edward Heffernan, Frances Dark, Justin Chapman","doi":"10.1177/00048674251361681","DOIUrl":"10.1177/00048674251361681","url":null,"abstract":"<p><strong>Objectives: </strong>People with psychotic disorders face significant functional impairments, high levels of disability, multimorbidity and physical health challenges. Despite unique health benefits, resistance training remains underexplored in this population and rarely implemented in real-world mental health settings.</p><p><strong>Methods: </strong>This randomised controlled trial comparing resistance training with aerobic interval training in people with psychotic disorders accessing psychiatric rehabilitation. Supervised exercise sessions by exercise physiologists were conducted 3 times per week over 8 weeks. Primary outcomes were feasibility, acceptability and adverse events. Secondary outcomes were psychiatric symptoms, global and physical functioning and the effect of randomisation to exercise type on participation rates.</p><p><strong>Results: </strong>In total, 54 participants (median age 31 years, 71.6% male, 75% diagnosed with schizophrenia/schizoaffective disorder, 55.5% with ⩾3 health conditions) were enrolled. Resistance training met predetermined feasibility and acceptability thresholds and showed comparable results to aerobic interval training with no significant exercise-related adverse events. Within-group analysis revealed significant increases in muscle strength following resistance training. Post-intervention, resistance training participants reported more total weekly minutes of physical activity compared to aerobic interval training, though no other significant between-group differences were observed. Randomisation to exercise type did not influence participation.</p><p><strong>Conclusion: </strong>In conclusion, resistance training was feasible and acceptable to people with psychotic disorders, with no serious adverse events and comparable to aerobic interval training. Resistance training was successfully implemented in rehabilitation settings with promising improvements in muscle strength and self-reported physical activity. In future, larger longer-term trials comparing resistance training with aerobic interval training, and in comparison with other psychosocial therapies are warranted. Further exploration of participant preference for exercise type on outcomes is recommended.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"538-552"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145487613","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}