Australian and New Zealand Journal of Psychiatry最新文献

{"title":"Structure-function decoupling of the cerebello-thalamo-cortical circuit in schizophrenia and its clinical correlates.","authors":"Neelabja Roy, Dhruva Ithal, Urvakhsh Meherwan Mehta, Rakshathi Basavaraju, Ganesan Venkatasubramanian, Jagadisha Thirthalli","doi":"10.1177/00048674251370468","DOIUrl":"https://doi.org/10.1177/00048674251370468","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674251370468"},"PeriodicalIF":3.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013824","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":"Psychotropic pharmacogenetics in adult populations: From basic science to clinical trials and health economics - An evidence-based overview for decision makers.","authors":"Trang Tt Truong, Juliana Lago, Jennifer Neil, Fiona A Wilkes, Russell Barnes, Malcolm Hopwood, Ajeet B Singh","doi":"10.1177/00048674251369625","DOIUrl":"https://doi.org/10.1177/00048674251369625","url":null,"abstract":"<p><p>Psychotropic pharmacogenetics (PGx) offers significant potential advancements in psychiatric care by optimising medication selection and dosing based on genetic factors. This perspective article highlights the clinical utility, health economic implications and implementation challenges of psychotropic PGx, proposing that its broader implementation could enhance patient outcomes and reduce healthcare costs. Landmark studies show that PGx-guided care results in fewer adverse drug reactions and improved medication efficacy, with substantial cost savings compared to traditional prescribing methods. However, implementation barriers persist, particularly in Australia, where knowledge gaps, limited clinical guidelines and funding constraints hinder adoption. Despite challenges such as industry bias and limited data on non-antidepressant psychotropics, robust clinical and economic evidence supports the expanded use of psychotropic PGx, with emerging combinatorial approaches offering promise for future psychiatric treatment.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674251369625"},"PeriodicalIF":3.7,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008111","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":"Recommendations for a gold-standard pathway of care for young-onset dementia.","authors":"Priscilla Tjokrowijoto, Clare Beard, Bronwyn Morkham, Debbie Stange, Monica Cations, Samantha M Loi","doi":"10.1177/00048674251369967","DOIUrl":"https://doi.org/10.1177/00048674251369967","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674251369967"},"PeriodicalIF":3.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940415","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":"Screening for perinatal depression in Australia: Validation of the Edinburgh Postnatal Depression Scale in pregnancy and the postpartum.","authors":"Kelsey Perrykkad, Isobel Nicholls, Andrew Lewis, Philip Boyce, Karen Wynter, Irene Bobevski, Megan Galbally","doi":"10.1177/00048674251361756","DOIUrl":"10.1177/00048674251361756","url":null,"abstract":"<p><strong>Background: </strong>Universal screening of all perinatal women using the Edinburgh Postnatal Depression Scale is currently recommended in Australian National Guidelines, yet Australian validation studies of this measure are limited and with mixed findings. This study aims to address a current gap using the largest Australian sample to include both antenatal and postpartum periods to evaluate the performance screening for Major Depression.</p><p><strong>Method: </strong>Data from 887 women is drawn from the Mercy Pregnancy and Emotional Wellbeing Study, a prospective cohort, in Melbourne, Perth and regional and rural Western Australia. Participants completed an Edinburgh Postnatal Depression Scale and Structured Clinical Interview for <i>DSM</i> diagnostic interview between weeks 12 and 20 of pregnancy and then again at 6 months postpartum. Data are compared to report internal validity and receiver operator characteristics including area under the curve, sensitivity, specificity, positive predictive value, negative predictive value and optimal cutoffs for the Edinburgh Postnatal Depression Scale.</p><p><strong>Results: </strong>Internal consistency was good. With recommended Edinburgh Postnatal Depression Scale cutoffs of 13 or above in the postpartum and 15 and above antenatally the Edinburgh Postnatal Depression Scale was found to have a positive predictive value of 52% and 58%, respectively. Overall, the receiver operator characteristic analysis suggests fair to poor performance of the Edinburgh Postnatal Depression Scale for detecting Major Depression in both the antenatal and postpartum periods.</p><p><strong>Conclusions: </strong>Clinicians and researchers using recommended Edinburgh Postnatal Depression Scale cutoffs may expect to have one in two of those women screening positive later receive a diagnosis of Major Depression, and one in five who screen negative representing missed cases. Clinical implications and recommendations are discussed.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674251361756"},"PeriodicalIF":3.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940461","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":"Through the looking glass: Resetting the Royal Australian and New Zealand College of Psychiatry's approach to gender equity.","authors":"Megan Galbally, Beth Kotze, Sue Mackersey, Ryan Barber, Nimalee Kannakkahewa, Susanna Every-Palmer","doi":"10.1177/00048674251366796","DOIUrl":"10.1177/00048674251366796","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674251366796"},"PeriodicalIF":3.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940440","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 Letters: Increasing access to psychological therapies for psychosis in Australia: The need to upskill the private practice psychology workforce.","authors":"Rachel M Brand, Tahlia Wilson, Karina Rune","doi":"10.1177/00048674251348380","DOIUrl":"10.1177/00048674251348380","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"835-837"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332404","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":"Consultation with health professionals for mental health in Australia in 2020-2022 and changes since 2007: Findings from the 2020-2022 National Study of Mental Health and Wellbeing.","authors":"Meredith G Harris, Caley Tapp, Joshua J Vescovi, Matthew Sunderland, Sandra Diminic, Cath Chapman, Tim N Slade, Maree Teesson, Jane Pirkis, Philip M Burgess","doi":"10.1177/00048674241307919","DOIUrl":"10.1177/00048674241307919","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to estimate the proportions of Australians aged 16-85 years who consulted health professionals for mental health in 2020-2022, and changes since 2007.</p><p><strong>Methods: </strong>Secondary analysis of merged data from the National Study of Mental Health and Wellbeing in 2020-2022 (<i>N</i> = 15,893) and its 2007 predecessor (<i>N</i> = 8841).</p><p><strong>Results: </strong>In 2020-2022, 17.4% of Australians aged 16-85 years had consulted a health professional (including overnight hospital admission) for their mental health in the past year (vs 11.9% in 2007). The largest increases between the surveys were in use of psychologists (123%), other (non-medical) mental health professionals (64%), and general practitioners (53%). Of adults with a 12-month mental disorder, 46.6% consulted a health professional in 2020-2022 (vs 37.5% in 2007), increasing with severity (mild 22.9%, moderate 48.4% and severe 68.8%). Multivariate regression models showed that consulting a health professional was positively associated with age < 65 years, female sex, being unmarried, disorder severity, and affective or anxiety disorder; these patterns held for consultations with most types of professionals. Socioeconomic and geographical characteristics were associated with consulting particular professionals: lower income (consulting a psychiatrist), high income and living in a major city (psychologist), living in a less disadvantaged area (general practitioner). Increases in consulting were not experienced by all groups (e.g. the likelihood of consulting increased for people aged 16-45 years, but not for older age groups).</p><p><strong>Conclusion: </strong>Consultation with health professionals for mental health improved between 2007 and 2020-2022 but remains below national targets. Some changes may reflect recent service reforms; however, gaps in access persist.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"810-823"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636059","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":"Attitudes toward psychedelics and psychedelic-assisted psychotherapy among Australian mental healthcare providers.","authors":"Zohaib Nadeem, Stephen Parker, Hugh McGovern, Bianca Sebben, Lena Kl Oestreich","doi":"10.1177/00048674251346679","DOIUrl":"10.1177/00048674251346679","url":null,"abstract":"<p><strong>Background: </strong>Recent regulatory changes in Australia have approved 3,4-methylenedioxymethamphetamine for treating post-traumatic stress disorder and psilocybin for treatment-resistant depression. However, limited data exists on Australian mental healthcare providers' attitudes, knowledge and readiness to implement with psychedelic-assisted psychotherapy.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted between December 2023 and March 2024, targeting Australian general practitioners, psychiatrists and psychologists. Participants completed online questionnaires developed based on the Knowledge, Attitude and Practices framework to explore mental healthcare providers' knowledge, attitudes and practices toward psychedelics.</p><p><strong>Results: </strong>The survey was completed by 109 clinicians (21% psychiatrists, 56% psychologists, 23% general practitioners). Attitudes toward psychedelic-assisted therapy were positive. However, safety and efficacy concerns persisted, particularly among psychiatrists, who were significantly more likely than psychologists to perceive psychedelic use as unsafe under medical supervision and question the scientific rigor of current research. Self-rated knowledge positively predicted actual knowledge, though many clinicians relied on informal sources such as podcasts and Internet-based media, highlighting gaps in evidence-based education. Clinicians with personal experience of psychedelic use expressed higher levels of agreement with statements relating to psychedelics improving outcomes in conjunction with psychotherapy and showing promise in treating psychiatric disorders.</p><p><strong>Conclusion: </strong>While Australian mental healthcare providers generally support psychedelic-assisted psychotherapy, significant safety and efficacy concerns remain, particularly among psychiatrists. Targeted educational initiatives from professional bodies, emphasizing evidence-based training and accessible resources, are essential to support informed clinical decision-making and safe therapeutic practices in this emerging field.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"798-809"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635992","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":"Cardiometabolic monitoring in children and adolescents prescribed antipsychotics in Australian primary care, 2011 to 2017.","authors":"Julie Klau, David Gonzalez-Chica, Melissa Raven, Natalie Aboustate, Jon Jureidini","doi":"10.1177/00048674251361696","DOIUrl":"10.1177/00048674251361696","url":null,"abstract":"<p><strong>Objective: </strong>To determine the extent of cardiometabolic monitoring occurring in children/adolescents 18 years and under receiving antipsychotics in Australian general practice: study period 2011 to 2017.</p><p><strong>Methods: </strong>Retrospective cohort study using large primary care database, MedicineInsight. Rates of monitoring within 12 months of patients receiving an incident antipsychotic prescription were reported descriptively for weight, body mass index (BMI), waist circumference (WC), glucose, total cholesterol, triglycerides, high-density lipoproteins (HDL), blood pressure, liver function, prolactin, and metabolic syndrome (MetS) defined as weight, blood pressure and glucose. Target trial methodology was used to examine whether monitoring rates were higher in patients prescribed antipsychotics compared to patients not receiving antipsychotics.</p><p><strong>Results: </strong>55.9% of patients using antipsychotics were monitored at least once on at least one parameter. Weight was most frequently measured (39.1% patients measured at least once), followed by BMI (31.2%), blood pressure (29.0%), glucose (12.9%), liver function (9.1%), total cholesterol (8.1%), triglycerides (6.7%), HDL (3.1%), WC (1.6%) and prolactin (1.1%). Monitoring for MetS occurred at least once in 1.5% of patients. Antipsychotic users recorded a small but significantly higher rate of monitoring than non-users (1.157 vs 0.691 monitoring visits for any parameter within the 12 month measurement period, difference 0.461; 95% CI [0.271, 0.660], <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Rates of cardiometabolic monitoring were well below guideline recommendations. Our results suggest the need for education and training to increase awareness of adverse health impacts of antipsychotics and improve adherence to cardiometabolic guideline recommendations. Communication between primary and secondary health care providers also needs to be addressed.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"824-834"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833864","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":"Prevalence and impact of frailty among inpatients with schizophrenia: Evidence from the US Nationwide Inpatient Sample 2005-2020.","authors":"Yuan-Chang Hsu, Chih-Tsai Chen, Kuo-Ping Li, Pesus Chou","doi":"10.1177/00048674251349708","DOIUrl":"10.1177/00048674251349708","url":null,"abstract":"<p><strong>Objective: </strong>Frailty is more prevalent among individuals with schizophrenia, and could negatively affect their hospitalization outcomes. This study aimed to investigate if co-existing frailty is associated with worse in-hospital outcomes in patients with schizophrenia.</p><p><strong>Methods: </strong>Data of patients ⩾20 years admitted for schizophrenia from 2005 to 2020 were extracted from the from the US Nationwide Inpatient Sample database. Patients were classified by frailty status using the Hospital Frailty Risk Score into three categories: low, intermediate and high risk. Logistic regressions were used to determine the associations.</p><p><strong>Results: </strong>A total of 956,541 patients with schizophrenia were included, and 8%, 4% and 67% patients were in high, intermediate, and low frailty risk, respectively. Patients with intermediate and high risk significantly increased risk of in-hospital mortality (adjusted odds ratio = 1.89, 95% confidence interval: 1.39-2.57; adjusted odds ratio = 3.56, 95% confidence interval: 2.50-5.07), unfavorable discharge (odds ratio = 1.40, 95% confidence interval: 1.35-1.44; adjusted odds ratio = 1.78, 95% confidence interval: 1.68-1.88), prolonged length of stay (adjusted odds ratio = 1.25, 95% confidence interval: 1.22-1.28; adjusted odds ratio = 1.52, 95% confidence interval: 1.45-1.59) and major complications (adjusted odds ratio = 2.43, 95% confidence interval: 2.37-2.50; adjusted odds ratio = 2.69, 95% confidence interval: 2.60-2.79). Besides, intermediate and high risk patients had greater hospital costs (aBeta = 2.69, 95% confidence interval: 2.37-3.01; aBeta = 5.43, 95% confidence interval: 4.81-6.06, per 1000 dollars). Stratified analysis showed consistent associations between frailty and adverse outcomes across age groups.</p><p><strong>Conclusion: </strong>In hospitalized patients with schizophrenia, frailty assessed by the Hospital Frailty Risk Score is associated with worse in-hospital outcomes, independent of other demographic and clinical factors.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"786-797"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526299","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}