Australian and New Zealand Journal of Psychiatry最新文献

{"title":"Employment trajectories following the diagnosis and after long-acting injectable antipsychotic treatment in patients with schizophrenia: A nationwide study.","authors":"Chi-Shin Wu, Shi-Heng Wang, Wei-Lieh Huang, Ming-Shiang Wu, Wei J Chen","doi":"10.1177/00048674261483942","DOIUrl":"https://doi.org/10.1177/00048674261483942","url":null,"abstract":"<p><strong>Objective: </strong>This study examined employment trajectories following the diagnosis and antipsychotic treatment of schizophrenia, with particular focus on transitions to long-acting injectable antipsychotic treatment.</p><p><strong>Methods: </strong>We conducted a nationwide matched cohort study using Taiwan's National Health Insurance Research Database (2001-2021). Individuals aged 18-64 years with newly diagnosed schizophrenia spectrum disorders were matched 1:1 with individuals without schizophrenia by birth year, sex, and index date. Employment trajectories were analyzed using controlled interrupted time-series models. To evaluate treatment-related transitions, individuals initiating long-acting injectable antipsychotics were compared with matched oral antipsychotic users. Subgroup analyses were conducted by illness duration and baseline medication adherence.</p><p><strong>Results: </strong>The schizophrenia cohort (n = 93,041) showed substantially lower employment odds than matched comparisons (OR = 0.31), with a marked decline around diagnosis (OR = 0.90) and only modest recovery thereafter (post-diagnosis trend OR = 1.09 per year). In the treatment analysis (18,488 matched pairs), long-acting injectable users had lower baseline employment odds than oral antipsychotic users (OR = 0.85) and an immediate decline around long-acting injectable initiation (OR = 0.92), followed by a modestly more favorable post-initiation employment trend (OR = 1.03). More favorable post-initiation trends were observed among individuals with longer illness duration and lower baseline adherence. No meaningful differences in employment trajectories were observed across different long-acting injectable formulations, including flupentixol, risperidone, haloperidol, paliperidone, and fluphenazine.</p><p><strong>Conclusions: </strong>Employment outcomes in schizophrenia appear shaped by diagnostic and treatment-related transitions rather than static disease status. Stabilization after long-acting injectable initiation may be linked to incremental improvements in employment trajectories for some subgroups, but optimizing long-term vocational outcomes likely requires integrated psychosocial and vocational support.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674261483942"},"PeriodicalIF":4.1,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954646","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":"Psychiatrists' and psychiatry trainees' perspectives of treatment priorities and the role of cognitive symptoms in supporting people with psychotic disorders.","authors":"James P Kesby, Shuichi Suetani, Isabella Sleight, Jessica C Wood, Mike Trott, Gemma McKeon, Frances Dark, Stephen Parker","doi":"10.1177/00048674261480588","DOIUrl":"https://doi.org/10.1177/00048674261480588","url":null,"abstract":"<p><p>The treatment focus in psychotic disorders, like schizophrenia, is often the remission of positive symptoms despite neurocognitive impairments better predicting long-term outcomes. Cognitive remediation has substantial evidence for supporting reliable improvements in cognition in people affected by schizophrenia, but it remains underutilised. Understanding the barriers for cognitive remediation and cognitive testing implementation is critical to improving treatment outcomes in psychotic disorders. To address this, an online survey of psychiatrists and psychiatry trainees in Australia was undertaken to explore treatment priorities, referral practices, and confidence in treating people diagnosed with psychotic disorders. Statistical analyses were conducted using chi-square analyses, logistic regression and analysis of variance. Clinicians (<i>n</i> = 96) expressed confidence in their ability to treat those with psychotic disorders but were not as confident with regard to their ability to identify/treat cognitive symptoms in people with psychotic disorders. Despite acknowledging that cognitive symptoms were most predictive of functional outcomes (>75%), clinicians believed that patient concerns were primarily positive symptoms (>60%). Accordingly, treating positive symptoms was the highest priority in managing early psychosis (~90%), with cognitive symptoms rated as the lowest. Referral rates for cognitive testing or cognitive remediation were low (both < 30%). Despite the acknowledged relationship between cognitive symptoms and functional outcomes, and the evidence base for cognitive remediation efficacy, access to cognitive testing and cognitive remediation referral rates appear far from optimal. These findings should motivate mental health services to better incorporate cognitive screening to support the identification and prioritisation of cognitive symptoms.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674261480588"},"PeriodicalIF":4.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148928960","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":"Commentary on the ANZJP Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guidelines for the management of schizophrenia - Where are the recommendations for methamphetamine-related psychoses?","authors":"Cherrie Galletly, Shalini Arunogiri, Edward Hall, Stephen Parker, Grant Sara, Julia Lappin","doi":"10.1177/00048674261475184","DOIUrl":"https://doi.org/10.1177/00048674261475184","url":null,"abstract":"<p><p>The ANZJP Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guidelines for the management of schizophrenia provide strong recommendations when high-level evidence is available. For many clinical scenarios, however, there is insufficient evidence meaning that only weak recommendations can be made using the GRADE process. Concurrent methamphetamine use in people experiencing psychosis is one such scenario. The ANZJP GRADE guidelines offer only one weak recommendation, that people with comorbid schizophrenia and substance misuse be offered psychosocial interventions. Many clinicians would value additional recommendations for this common challenge in Australian mental health services. We consider the extent of the problem of methamphetamine-related psychosis in Australia and the heterogeneity of presentations that may be managed in clinical services. We summarise the existing evidence on treatment and highlight why research in this area remains scarce. Finally, we propose the development of a consensus framework to guide treatment of methamphetamine-related psychosis and, in so doing, to enable development of high(er)-level evidence with utility in real-world clinical settings.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674261475184"},"PeriodicalIF":4.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918316","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":"Academic performance in children of mothers with perinatal depressive disorder.","authors":"Biruk Shalmeno Tusa, Rosa Alati, Getinet Ayano, Berihun Dachew","doi":"10.1177/00048674261457299","DOIUrl":"10.1177/00048674261457299","url":null,"abstract":"<p><strong>Background: </strong>Maternal perinatal depression is a well-established risk factor for adverse child developmental outcomes; however, its long-term association with academic achievement remains unclear. This study examined its association with children's academic performance across multiple stages of schooling.</p><p><strong>Methods: </strong>Data were drawn from the New South Wales Perinatal Data Collection, linked with the New South Wales Admitted Patient Data Collection and the New South Wales National Assessment Program - Literacy and Numeracy. Maternal perinatal depressive disorders were identified from hospital admission records using the International Classification of Diseases, 10th Revision, Australian Modification codes. Academic performance was assessed using the National Assessment Program - Literacy and Numeracy results in Grades 3, 5 and 7. Outcomes were classified as meeting or not meeting the national minimum standards in reading, spelling, writing, grammar and numeracy. Generalised estimating equations and propensity score matching were applied to examine associations.</p><p><strong>Results: </strong>After adjustment and matching, maternal perinatal depressive disorders were associated with increased odds of children not meeting the national minimum standards in reading (odds ratio = 1.24, 95% confidence interval = [1.10, 1.41]), spelling (odds ratio = 1.28, 95% confidence interval = [1.13, 1.46]), writing (odds ratio = 1.32, 95% confidence interval = [1.19, 1.47]) and grammar (odds ratio = 1.18, 95% confidence interval = [1.06, 1.33]), but not numeracy (odds ratio = 1.10, 95% confidence interval = [0.96, 1.27]). Associations were more consistent for antenatal depression, while postnatal depression was associated with reading and writing only.</p><p><strong>Conclusions: </strong>Children of mothers with perinatal depressive disorders showed an association with suboptimal academic performance, particularly in literacy-related domains. The stronger associations observed for antenatal depression suggest that early gestational exposure may affect foundational cognitive and socio-emotional development, highlighting the importance of timely identification and treatment of maternal depression during pregnancy to support long-term educational outcomes.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"870-881"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148306812","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 role of psychological resilience in the relationship between complex post-traumatic stress disorder symptom severity and functioning impairment in mental health support-seeking Australian defence force veterans: A cross-sectional study.","authors":"Wachira Suriyawong, Thanos Karatzias, Hannah Steele, Grace Wk Ho, Mitchell K Byrne, Noppamas Pipatpiboon, David A Mitchell, Mark Shevlin, Bróna Ng Easpaig, Xianliang Liu, Jianxia Zhai, Janina Murta, Daniel Bressington","doi":"10.1177/00048674261465559","DOIUrl":"10.1177/00048674261465559","url":null,"abstract":"<p><strong>Objective: </strong>Military veterans have high rates of mental health conditions; complex post-traumatic stress disorder may be the most functionally impaired trauma diagnosis in this patient group. Psychological resilience acts as a protective factor for mental health. Still, it is unclear how this may influence relationships between the two main symptom clusters of complex post-traumatic stress disorder and functioning impairment in veterans. Therefore, we investigated the relationships between psychological resilience, trauma symptom severity, trauma exposure and work/social functional impairment among Australian Defence Force veterans.</p><p><strong>Methods: </strong>Cross-sectional survey including 148 mental health support-seeking former-serving Australian Defence Force veterans in primary care. Relationships between variables were explored using correlations, mean difference tests and mediation analysis to examine the role of resilience in the relationship between complex post-traumatic stress disorder symptoms and functional impairment.</p><p><strong>Results: </strong>Resilience showed significant negative correlations with functioning impairment. The number of traumas showed weak positive correlations with disturbances in self-organisation symptoms, post-traumatic stress disorder symptoms and functional impairment. The complex post-traumatic stress disorder group had significantly lower resilience and functioning than those with no diagnosis. After controlling for the number of trauma exposures, resilience partially mediated the association between post-traumatic stress disorder symptoms and functioning (indirect effect = 0.141, <i>p</i> < 0.05), and partially mediated the association between disturbances in self-organisation symptoms and functioning (indirect effect = 0.157, <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Psychological resilience was associated with better functioning in veterans regardless of trauma diagnosis. Resilience also partially mediates the relationship between disturbances in self-organisation/post-traumatic stress disorder symptoms and functioning in those with International Classification of Diseases, 11th Revision, complex post-traumatic stress disorder, indicating it is an important intervention target in Australian Defence Force veterans with polytrauma.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"848-858"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148560603","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":"Early identification, trauma and stigma in mental health.","authors":"Steve Kisely","doi":"10.1177/00048674261474784","DOIUrl":"10.1177/00048674261474784","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"813-814"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705377","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 'Middle childhood profiles of social-emotional competencies and difficulties differentiate risk of health service presentations with adolescent mental disorders'.","authors":"Kristin R Laurens, Emma J Carpendale","doi":"10.1177/00048674261462751","DOIUrl":"10.1177/00048674261462751","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"906-907"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381387","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":"Reported exposure to news portrayals about mental health problems and their impact: Findings from the 2025 National Survey of Stigma and Discrimination.","authors":"Anna M Ross, Amy J Morgan, Gayle McNaught, Rachel Green, Nicola J Reavley","doi":"10.1177/00048674261462377","DOIUrl":"10.1177/00048674261462377","url":null,"abstract":"<p><strong>Objective: </strong>Media portrayals of people with mental illness have the power to mitigate or perpetuate stigma related to mental health. This study aimed to investigate reported real-world exposure to news media portrayals about people with mental health problems in the past 12 months and the impact of these.</p><p><strong>Methods: </strong>Data were from a nationally representative survey of 6032 Australians exploring attitudes towards people with mental health problems. Participants were asked about their exposure to positive news stories about a person with a mental health problem, as well as negative portrayals, in which someone was harmed by a person with a mental health problem. Further questions covered the sources (traditional or social media) and impact of these exposures.</p><p><strong>Results: </strong>Regression models were used to explore sociodemographic predictors of impact. Most participants reported exposure to negative news portrayals (68.4%, 95% confidence interval = [66.9, 69.8]), while fewer reported exposure to positive news stories (33.7%, 95% confidence interval = [32.3, 35.2]). Most people exposed to the negative news stories reported a negative impact (69.0%, 95% confidence interval = [67.2, 70.7]), and most exposed to positive news stories reported a positive impact (80.2%, 95% confidence interval = [77.6, 82.5]). Age and gender were associated with reported impact but not lived experience of mental illness.</p><p><strong>Conclusions: </strong>Exposure to negative news stories about mental health problems was prevalent. Given their impact on news audiences broadly, negative news stories need to be accurate and responsible to mitigate negative impacts. A renewed focus on generating and promoting positive and stigma-challenging news stories is needed to increase subsequent positive impacts.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"894-904"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418302","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":"Defining and measuring psychosocial disability in Australia: Assessment of national surveys and administrative datasets.","authors":"Firew Tekle Bobo, Joel Hollier, Kuo-Yi Jade Chang, George Disney, Bernie Mullin, Jennifer Smith-Merry","doi":"10.1177/00048674261450886","DOIUrl":"10.1177/00048674261450886","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to assess the alignment in defining and measuring psychosocial disability and/or mental health challenges across major Australian national mental health data sources.</p><p><strong>Methods: </strong>We reviewed the definition and measurement of psychosocial disability and mental health challenges in two stages. First, we examined the data items across five national data sources: the Survey of Disability, Ageing and Carers (SDAC), the National Health Survey (NHS), the National Study of Mental Health and Wellbeing (NSMHW), the Census and the National Disability Insurance Scheme (NDIS) administrative data. In the second stage, we analysed the prevalence of psychosocial disability and mental health challenges across the datasets.</p><p><strong>Results: </strong>The definition and measurement approaches for psychosocial disability and mental health challenges vary across data sources, reflecting differences in the conditions included and the purpose for which data were collected. Psychosocial disability is inconsistently defined: broad population surveys (SDAC, NHS) include neurodevelopmental and neurodegenerative conditions, whereas the NDIS captures only severe mental illnesses with substantial functional impairment. Prevalence across Australia varied widely from 42.9% for lifetime mental disorders (NSMHW) and 26.1% for long-term conditions (NHS), down to 6% when strictly defining psychosocial disability (SDAC).</p><p><strong>Conclusions: </strong>There are variations in definitions and measurement across major Australian mental health data sources with respect to conditions captured in the datasets and the definitions used. Researchers and policymakers should therefore critically appraise - and where possible adjust for - these variations when using these data to inform strategic decisions and resource allocation.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"859-869"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148337585","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: \"Psilocybin in the real world: Regulatory, ethical, and operational challenges in Australia's clinical landscape\".","authors":"","doi":"10.1177/00048674261450797","DOIUrl":"10.1177/00048674261450797","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"908"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147961889","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}