Australian and New Zealand Journal of Psychiatry最新文献

{"title":"Rural mental health strengths and social connectedness: Findings from the Australian National Study of Mental Health and Wellbeing.","authors":"Annika Luebbe, Zoe Rutherford, Harvey Whiteford, Sandra Diminic","doi":"10.1177/00048674261467613","DOIUrl":"10.1177/00048674261467613","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to describe rural data from the Australian National Study of Mental Health and Wellbeing survey (2020-2022) to assess strengths-based questions, differences by rurality, and factors associated with excellent social connectedness.</p><p><strong>Methods: </strong>Survey questions were mapped to the Rural Strengths Socioecological Framework. Descriptive and logistic analyses assessed rural adults' use of strengths by remoteness and presence of affective/anxiety disorders in the past 12 months. Logistic regression explored factors associated with social connectedness.</p><p><strong>Results: </strong>Survey questions reflected some strengths within the Framework including self-management techniques, family and friend support, social connectedness, and health care personnel. However, questions were primarily framed using a deficit perspective and many strengths from the Framework (i.e. nature, rural norms, culture, and lay personnel) were absent. Most strengths did not differ significantly between levels of rurality, though making healthy diet choices (as a self-management technique) was significantly lower in remote areas. Adults without affective/anxiety disorders more often reported good social support and self-efficacy. Conversely, those with affective/anxiety disorders were more likely to self-manage and access consultations for mental health. Excellent social connectedness was associated with better mental health.</p><p><strong>Conclusion: </strong>The survey questions reflected limited strengths. Future surveys should include a broader range of strengths-based questions spanning the extent of the Rural Strengths Socioecological Framework. Healthy diet choices as a self-management tool in remote areas may need to be prioritised. Findings also suggest the need for targeted approaches to protect, improve, or leverage social connectedness for those with more severe illness in rural areas.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"978-992"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700791","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":"CORRIGENDUM to \"Assessing the prevalence of cognitive impairment among Australians with schizophrenia: A systematic review\".","authors":"","doi":"10.1177/00048674261473868","DOIUrl":"10.1177/00048674261473868","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"1011"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598292","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":"Letter to the Editor regarding 'Oral health care for Australians living with mental ill-health: Unaffordable, inaccessible and invisible'.","authors":"Zhenxi Wang, Yanglin Liu","doi":"10.1177/00048674261467615","DOIUrl":"10.1177/00048674261467615","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"1008-1009"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468675","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":"Disparities in mental health service use in Australia: Analysis of the National Study of Mental Health and Wellbeing (2020-2022).","authors":"Firew Tekle Bobo, Kiddus Yitbarek, Joel Hollier, Kuo-Yi Jade Chang, Shane Clifton, Tim Slade, Jennifer Smith-Merry","doi":"10.1177/00048674261471003","DOIUrl":"10.1177/00048674261471003","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to quantify inequalities in mental health service use in Australia and identify the sociodemographic, economic, and geographic factors associated with access.</p><p><strong>Methods: </strong>We conducted a secondary analysis of the National Study of Mental Health and Wellbeing (NSMHWB, 2020-2022). We evaluated 12-month mental health service use before the survey among people who reported a mental disorder. We fitted multivariable logistic regression models adjusted for sociodemographic covariates and tested the joint (intersectional) effects of remoteness and socioeconomic area disadvantage on service use. Jackknife replicate weights accounted for the complex survey design.</p><p><strong>Results: </strong>The study included 15,893 respondents (weighted population: 19,828,348). Lifetime prevalence of any mental health disorder was 42.9% (95% CI = [42.5, 43.3]), and 21.5% (95% CI = [20.7, 22.3]) reported symptoms in the past 12 months. Among those with a 12-month disorder, 45.2% (95% CI = [39.9, 50.5]) had accessed care, and 16.5% (95% CI = [15.8, 17.2]) reported using digital or telephone services. Service use was higher in university graduates and residents of advantaged areas and lower in remote/outer regional residents and the most disadvantaged quintiles. Intersectional analysis revealed compounded inequities, with the lowest service use observed among socioeconomically disadvantaged populations in remote areas and the highest among advantaged major-city residents.</p><p><strong>Conclusion: </strong>Substantial and intersecting inequalities exist in access to mental health services, with the lowest coverage among remote, socioeconomically disadvantaged, older, and male populations. Targeted, place-based strategies - including expanded outreach and tailored digital and community-based models - are needed to reduce unmet need and improve equity.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"919-930"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590263","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":"Variables associated with variations in compulsory community treatment by health districts: A meta-regression analysis across four Australian jurisdictions.","authors":"Steve Kisely, Claudia Bull, Tessa Zirnsak, Vrinda Edan, Sharon Lawn, Edwina Light, Chris Maylea, Christopher James Ryan, Puneet Sansanwal, Penelope Weller, Lisa Brophy","doi":"10.1177/00048674261489461","DOIUrl":"https://doi.org/10.1177/00048674261489461","url":null,"abstract":"<p><strong>Objective: </strong>The use of compulsory community treatment in Australia varies widely within, and across, jurisdictions for reasons that are not fully understood. This study, therefore, used meta-regression to explore possible explanations for this variation in the following four Australian states: Queensland, South Australia, New South Wales and Victoria.</p><p><strong>Methods: </strong>Aggregated administrative data from the Australian Institute of Health and Welfare for 2018 were analysed, encompassing 402,060 individuals in contact with community mental health services. Meta-regression using logit-transformed proportions was employed to assess associations between compulsory community treatment rates and district-level sociodemographic variables, including age, sex, marital status, region of birth and metropolitan residence. Workforce data were also examined in New South Wales.</p><p><strong>Results: </strong>Compulsory community treatment use varied significantly by jurisdiction and by health district within jurisdictions. Higher rates were associated with districts having more individuals aged 25-44 years, males (in South Australia), metropolitan residents, and those born outside Oceania. These associations persisted after adjustment. There was no statistically significant association between workforce levels and compulsory community treatment use in New South Wales.</p><p><strong>Conclusion: </strong>Our findings suggest that sociodemographic factors such as age, sex and place of residence or birth may explain some of the variation in compulsory community treatment use between health districts. The influence of sociodemographic variables and geographical location in influencing compulsory community treatment use at the health district level needs further investigation.</p><p><strong>Registration: </strong>Australian and New Zealand Clinical Trials Registry (https://www.anzctr.org.au/; ACTRN12624000153516).</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674261489461"},"PeriodicalIF":4.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079491","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":"Why population-based longitudinal studies are vital for mental health prevention and policy.","authors":"James A Foulds, Craig A Olsson, Reremoana Theodore, Rebecca Glauert","doi":"10.1177/00048674261490060","DOIUrl":"https://doi.org/10.1177/00048674261490060","url":null,"abstract":"<p><p>There has been an increase in the prevalence of mental health problems in young people worldwide for over a decade. Population-based longitudinal studies can help show why this has occurred and whether it will continue throughout life for the present cohort of young people. This in turn will guide the policy response. We discuss two recent articles published in <i>Australian and New Zealand Journal of Psychiatry</i> which highlight the value of longitudinal studies in understanding the causal structure of mental health problems. Australia and New Zealand have a rich tradition of longitudinal studies dating to the 1970s, with some studies now enrolling offspring of the original cohorts. Advances in methods, computing technology and the availability of linked administrative data will make these studies even more valuable in future. The studies will need to evolve to capture shifting environmental factors, such as the digital environment. To get the most value from these studies, there needs to be secure long-term investment by central funding agencies and support for vibrant collaboration networks between the studies.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674261490060"},"PeriodicalIF":4.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073514","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":"Psychosocial treatment with or without antipsychotic medication in first-episode psychosis: What have we learned from the STAGES trial about the risks and benefits?","authors":"Kelly Allott, Sidhant Chopra, Brian O'Donoghue, Barnaby Nelson, Aswin Ratheesh, Mario Alvarez-Jimenez, Alex Fornito, Susy Harrigan, Andrew Thompson, Stephen J Wood, Christos Pantelis, Michael Berk, Patrick D McGorry, Shona Francey","doi":"10.1177/00048674261490058","DOIUrl":"https://doi.org/10.1177/00048674261490058","url":null,"abstract":"<p><p>STAGES trial was a triple-blind noninferiority trial that investigated intensive psychosocial treatment with or without low-dose antipsychotics in young people with first-episode psychosis with a short duration of untreated psychosis, who were low-risk and had stable family support. Participants received cognitive behavioural case management combined with either low-dose risperidone/paliperidone or placebo. Only 7% of the screened individuals were included (<i>N</i> = 90), with just 30% completing the protocol, reflecting trial challenges. Both groups showed significant improvements in social and occupational functioning (primary outcome) and symptoms at 6 months, with placebo demonstrating noninferior outcomes. At 24 months, the groups did not significantly differ, though noninferiority could not be confirmed. Neuroimaging findings revealed that placebo recipients showed reduced basal ganglia volume and widespread cortical thinning relative to healthy controls, while antipsychotics increased basal ganglia volume and attenuated cortical thinning. This demonstrates that antipsychotics do not cause tissue loss early in treatment, and delaying medication may hasten illness-related brain volume loss. Metabolic analyses showed that antipsychotics contributed to greater weight gain and metabolic changes, though some risk existed without medication. Cognitive analyses revealed baseline illness-associated cognitive impairment, with verbal learning/memory decline over 6 months in the medication group only, suggesting early cognitive side effects. STAGES trial findings demonstrate that carefully selected low-risk first-episode psychosis patients can achieve clinical improvement through psychosocial interventions alone while minimising potential negative metabolic and cognitive effects. However, delaying medication may result in adverse structural brain changes. The results support integrated treatment and shared decision-making approaches that balance symptom management, functional recovery and preservation of physical, cognitive and brain health.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674261490058"},"PeriodicalIF":4.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073534","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":"A multidisciplinary perspective on digital health interventions in schizophrenia care: Expanding the 2026 Grading of Recommendations, Assessment, Development and Evaluations guidelines.","authors":"Urska Arnautovska, Ellie Brown, Nicole Korman, Mike Trott, Sharon Lawn, Joseph Firth, Agata Bialkowski, Frances Dark, Dan Siskind, Alyssa Milton","doi":"10.1177/00048674261484723","DOIUrl":"https://doi.org/10.1177/00048674261484723","url":null,"abstract":"<p><p>In this paper, we aim to provide a multidisciplinary and lived-experience-informed perspective on existing evidence for the utilisation of digital health interventions in schizophrenia care. We have integrated the findings from the most recent meta-analysis of digital health interventions for people with schizophrenia, and latest available evidence on the feasibility and efficacy of digital health interventions as a potential adjunct treatment. We found that there is growing evidence from randomised controlled trials on the efficacy of digital health interventions in improving specific aspects of psychotic symptoms, cognition and reducing the risk of relapse. To date, however, there have been no randomised controlled trials evaluating digital health interventions that target physical health comorbidity, although promising co-designed interventions are emerging. Overall, the quantity and quality of evidence regarding the efficacy of digital health interventions for schizophrenia care is rapidly increasing. Given the established acceptability and feasibility of such treatment approaches, along with potential benefits and low adverse risk profile, digital health interventions with established evidence of efficacy should be considered as an adjunctive part of core treatment and overall clinical care, with dedicated attention to ensuring their safety, accessibility and sustainable implementation. Further high-quality randomised controlled trials establishing the efficacy of digital health interventions targeting physical health aspects, and rigorous implementation studies informing optimal and sustainable integration within routine care in mental health services, are required. Integration of lived experience, clinician and lived experience (peer) support input across all stages of the research process, including subsequent implementation in real-life services, is needed to ensure high acceptability of these innovative, adjunctive treatment approaches for people with schizophrenia.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674261484723"},"PeriodicalIF":4.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149068898","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":"Author reply to Letter to the Editor regarding 'Improving access to novel treatments for treatment-resistant depression: The potential role of specialist clinics in Australia'.","authors":"Prashant Tibrewal, Paul Furst, Colleen Loo, Scott R Clark","doi":"10.1177/00048674261489126","DOIUrl":"https://doi.org/10.1177/00048674261489126","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674261489126"},"PeriodicalIF":4.1,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023774","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":"Letter to the Editor regarding 'Improving access to novel treatments for treatment-resistant depression: The potential role of specialist clinics in Australia'.","authors":"Gin S Malhi, Erica Bell, Kinga Szymaniak, Gurubhaskar Shivakumar","doi":"10.1177/00048674261488611","DOIUrl":"https://doi.org/10.1177/00048674261488611","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674261488611"},"PeriodicalIF":4.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987688","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}