Australian and New Zealand Journal of Psychiatry最新文献

{"title":"The safety of psilocybin-assisted psychotherapy: A systematic review.","authors":"Rosana R Freitas, Efstathia S Gotsis, Alexander T Gallo, Bernadette M Fitzgibbon, Neil W Bailey, Paul B Fitzgerald","doi":"10.1177/00048674241289024","DOIUrl":"10.1177/00048674241289024","url":null,"abstract":"<p><strong>Introduction: </strong>Psilocybin, a classical psychedelic, has been rescheduled for use in psilocybin-assisted psychotherapy for treatment-resistant depression in Australia. While evidence for its use is promising, understanding the associated risks is crucial. Accordingly, this review aims to collate adverse event data from psilocybin-assisted psychotherapy clinical trials and evaluate its definition, way of measurement and reporting.</p><p><strong>Methods: </strong>A systematic method was employed to identify clinical trials related to the use of psilocybin-assisted psychotherapy in clinical populations that reported on adverse events. The quality assessment focused on relevant criteria related to adverse event definition, monitoring and reporting methods.</p><p><strong>Results: </strong>A total of 24 articles were included. The studies reported heterogeneous psilocybin doses, study designs and indications. Physical and psychological adverse events during and after psilocybin sessions were examined, revealing variations in measuring, reporting methods and occurrences. The most common adverse events during and after sessions included elevated blood pressure, headaches, nausea, vomiting, fatigue and anxiety. In addition, both suicidal ideation and behaviour were observed infrequently and mainly in participants with a history of suicidal ideation or suicide attempt(s).</p><p><strong>Conclusion: </strong>The review highlights the need to standardise the defintion of an adverse event, including how they are measured and reported, in psychedelic clinical trials to ensure consistent reporting across studies. In addition, screening participants for suicidality history and ongoing monitoring remains important, given the potential risk identified in the literature. However, based on the available data, the safety of psilocybin-assisted psychotherapy is generally supported, and no deaths were attributed to psilocybin. Nevertheless, cautious optimism is needed due to the preliminary nature and heterogeneity of the safety data.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"128-151"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816911","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: Cumulative incidence of psychotropic drug prescriptions among children and adolescents in an Australian population cohort.","authors":"Oliver J Watkeys, Kirstie O'Hare, Kimberlie Dean, Kristin R Laurens, Stacy Tzoumakis, Felicity Harris, Vaughan J Carr, Melissa J Green","doi":"10.1177/00048674241307152","DOIUrl":"10.1177/00048674241307152","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"180-183"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920508","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 impact of childhood abuse on future military sexual assault and PTSD symptomology in Australian veterans.","authors":"Katelyn Kerr, Rebecca Mellor, Darcy Bennett, Richard Wellauer, Violette McGaw","doi":"10.1177/00048674241289027","DOIUrl":"10.1177/00048674241289027","url":null,"abstract":"<p><strong>Introduction: </strong>The trauma most commonly associated with the military is combat-related trauma. It is increasingly recognised that childhood sexual and physical abuse and military sexual assault may influence or exacerbate posttraumatic stress disorder (PTSD) when military members are exposed to combat.</p><p><strong>Aims: </strong>The study aimed to determine whether a history of childhood sexual and physical abuse would increase the likelihood of military sexual assault (MSA) and determine whether a history of sexual abuse (childhood or military) impacted the incidence and severity of post-trauma sequelae compared to veterans without this history.</p><p><strong>Method: </strong>A retrospective correlational analysis was performed on baseline data collected from clinical case records of a cohort of 134 Australian veterans with PTSD who had attended an outpatient Military Service Trauma Recovery Day Programme between October 2020 and May 2022.</p><p><strong>Results: </strong>Almost half (48.5%) of veterans reported a history of abuse. Prevalence rates of military sexual abuse, child sexual abuse and child physical abuse were 14.9%, 13.4% and 23.1% respectively. The relationship between those who experienced childhood abuse and those who experienced military sexual abuse was not significant. No significant differences were observed between those who experienced any sexual abuse and those who did not on intake scores of psychological symptoms.</p><p><strong>Conclusion: </strong>This is the first Australian study to investigate the prevalence of childhood abuse and military sexual abuse and its impact on PTSD and associated psychopathology in a sample of veterans seeking mental health treatment. No additional risks of experiencing military sexual assault were found for those who had survived childhood sexual abuse.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"40-47"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493733","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":"Development of a framework of the skills and attributes needed by mental health professionals to provide optimal clinical care to people experiencing complex psychosis: A Delphi consensus study.","authors":"Sarah Grattan, Kimberley Davies, Janelle Weise, Nicholas Burns, Robyn Murray, Jennifer Weldon, Robin Ellis, Julia M Lappin","doi":"10.1177/00048674241289032","DOIUrl":"10.1177/00048674241289032","url":null,"abstract":"<p><strong>Background: </strong>Complex psychosis is associated with high social and economic costs. The key skills and attributes needed by mental health professionals to provide optimal clinical care to people experiencing complex psychosis have not previously been defined. A framework detailing these skills and attributes is needed to support the identification of training needs for those working with this population.</p><p><strong>Methods: </strong>A modified online Delphi method was used to reach consensus on the skills and attributes essential for mental health professionals to deliver optimal clinical care to people experiencing complex psychosis. Participants were international healthcare professionals and academic researchers who self-identified as experts in complex psychosis. Participants were asked to rate their level of agreement with each item on a five-point Likert-type scale and to provide comments. Qualitative feedback was used to modify existing, or create new, items for subsequent rounds.</p><p><strong>Results: </strong>64 responses were received across three Delphi rounds. 167 items reached consensus and were endorsed (132 in Round 1, 31 in Round 2 and 4 in Round 3). Median score range for endorsed items was 4.5/5, with 88.6% scoring 5/5. All 167 endorsed items were included in the framework, categorised into 14 overarching domains.</p><p><strong>Conclusion: </strong>Multiple skills and attributes were identified as being core components required in the delivery of optimal care by mental health professionals to people experiencing complex psychosis. The resulting framework provides a benchmark for training and skill development of mental health clinicians at both individual and team levels to optimise effective working with this high-needs population.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"60-73"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493730","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: Differential effects of access restriction to a highway bridge on suicide numbers by jumping.","authors":"Eberhard A Deisenhammer, Manuel Pitschieler, Timo Schurr","doi":"10.1177/00048674241297544","DOIUrl":"10.1177/00048674241297544","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"89-91"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613872","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":"Trauma, resilience and significant relationships: Sex differences in protective factors for military mental health.","authors":"Lisa Dell, Kelsey Madden, Jenelle Baur, Alyssa Sbisa, Alexander McFarlane, Miranda VanHooff, Richard Bryant, Ellie Lawrence-Wood","doi":"10.1177/00048674241286818","DOIUrl":"10.1177/00048674241286818","url":null,"abstract":"<p><strong>Background: </strong>Military service is historically a male-dominated occupation, as such, the majority of research examining the development of mental disorder in Australian Defence Force members has had primarily male samples. While there have been mixed findings internationally regarding sex differences in rates of mental disorder and subthreshold symptoms among military personnel, across studies, the evidence tends to suggest that female military members are at least as likely as males to experience subthreshold mental health symptoms and have similar or higher rates of posttraumatic stress disorder despite the differences in roles during service. What is less understood is the impact of sex differences in symptom emergence over time and in predictors of clinical disorder.</p><p><strong>Method: </strong>The sample included a longitudinal cohort of Australian Defence Force members (<i>N</i> = 8497) surveyed at Time 1 (2010) and followed up at Time 2 (2015) on measures of anger, self-perceived resilience, trauma exposure, deployment exposure, suicidality, help-seeking, relationship satisfaction and mental health disorder symptoms. Outcomes included Subthreshold Disorder (above the optimal screening cut-off on the 10-item Kessler distress scale or posttraumatic stress disorder checklist) and Probable Disorder (above the epidemiological cut-off on the 10-item Kessler distress scale or posttraumatic stress disorder checklist).</p><p><strong>Results: </strong>Results found that while lifetime trauma exposure remained the strongest predictor of later probable disorder emergence among both males and females, for females specifically, self-reported resilience was also a significant protective factor. In contrast, being in a significant relationship at Time 1 was a protective factor against the development of subthreshold disorder in males.</p><p><strong>Conclusion: </strong>For the first time, sex differences in mental health symptom emergence over time have been explored in a large Australian cohort of military members. The capacity to adapt and bounce back after adversity emerged as a proactive factor against poor mental health for females in the military and could be addressed as part of routine skills training. Social support from significant relationship was particularly important for males' mental health, suggesting that maintaining positive relationships and supporting military spouses and partners are critical for males' mental health.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48-59"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399149","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":"Research Letter: Exploring the utility of ketamine in child and adolescent mental health: Perspectives of psychiatrists.","authors":"Sarthak Gandhi, Simon Craig, Michael Gordon","doi":"10.1177/00048674241268229","DOIUrl":"10.1177/00048674241268229","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"86-88"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141892772","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":"Exploring the reliability and profile of frequent mental health presentations using different methods: An observational study using statewide ambulance data over a 4-year period.","authors":"Anthony Hew, Jesse T Young, Bosco Rowland, Debbie Scott, Ziad Nehme, Shalini Arunogiri, Dan I Lubman","doi":"10.1177/00048674241289016","DOIUrl":"10.1177/00048674241289016","url":null,"abstract":"<p><strong>Introduction: </strong>A disproportionate number of mental health presentations to emergency services are made by frequent presenters. No current consensus definition of a frequent presenter exists. Using a statewide population-based ambulance database, this study (i) applied previous statistical methods to determine thresholds for frequent presenters, (ii) explored characteristics of the identified frequent presenter groups compared to non-frequent presenters and (iii) assessed the reliability of these methods in predicting continued frequent presenter status over time.</p><p><strong>Methods: </strong>Statistical methods utilised in previous studies to identify frequent presenters were applied to all ambulance attendances for mental health symptoms, self-harm and alcohol and other drug issues between 1 January 2017 and 31 December 2020 in Victoria, Australia. Differences in characteristics between identified frequent and non-frequent presenter groups were determined by logistic regression analysis. The consistency of agreement of frequent presenter status over time was assessed using intraclass correlation coefficients.</p><p><strong>Results: </strong>Thresholds for frequent presenters ranged from a mean of 5 to 39 attendances per calendar year, with groups differing in size, service use and characteristics. Compared to non-frequent presenters, frequent presenters had greater odds of being female, presenting with self-harm, experiencing social disadvantage or housing issues, involving police co-attendance and being transported to hospital. All frequent presenter definitions had poor reliability in predicting ongoing frequent presentations over time.</p><p><strong>Conclusion: </strong>A range of methods can define frequent presenters according to thresholds of yearly service use. Reasons for identifying frequent presenters may influence the method chosen. Future studies should explore definitions that capture the dynamic nature of presentations by this group.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"74-85"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493731","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":"Youth suicidality risk relative to ambient temperature and heatwaves across climate zones: A time series analysis of emergency department presentations in New South Wales, Australia.","authors":"Cybele Dey, Jianyun Wu, John Uesi, Grant Sara, Michael Dudley, Katherine Knight, James G Scott, Ollie Jay, Michael Bowden, Iain E Perkes","doi":"10.1177/00048674241290449","DOIUrl":"10.1177/00048674241290449","url":null,"abstract":"<p><strong>Objective: </strong>Youth suicidality prevalence continues to rise alongside hot weather severity. Links between these two variables are underexplored. We examined associations between daily temperature and emergency department suicidality presentations by young people. We assessed these associations for five regions covering New South Wales as determined by 'climate zone' and analysed for heatwave effects as well as based on demographic subgroups.</p><p><strong>Methods: </strong>Daily emergency department presentations for suicidality by people aged 12-24 years across New South Wales, Australia, during warmer months (November to March) from 2012 to 2019 were examined in relation to daily mean temperature and heatwaves (⩾3 consecutive days ⩾ 95th percentile of long-term daily mean temperature) and by climate zone, using a generalised additive model with negative binomial distribution. Risks for age- and sex-based subgroups were also calculated.</p><p><strong>Results: </strong>New South Wales youth suicidality presentation rates were significantly higher on hotter days. For every 1°C rise above average daily mean temperature, youth suicidality presentations to New South Wales emergency departments increased by 1.3%. Heatwaves did not increase presentation rates beyond single-day daily mean temperature effects. These findings were predominantly replicated across climate zones and demographic subgroups, though the association between suicidality and ambient temperature was weaker in coastal regions including Eastern Sydney.</p><p><strong>Conclusion: </strong>There is a positive linear association between ambient temperature and youth suicidality presentations to emergency departments. Risks are increased on single hot days, not only during heatwaves. Public health, broader societal approaches to heat and health system planning should consider impacts on youth suicidality of predicted increases in hot weather severity and frequency.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"18-28"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493734","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":"Self-poisoning in young Australians: The impact of COVID-19 and recent trends following easing of restrictions.","authors":"Nicholas A Buckley, Firouzeh Noghrehchi, Rohan A Elliott, Carol Wylie, Nick Merwood, Lauren Benger, Jared Brown, Rose Cairns","doi":"10.1177/00048674241291321","DOIUrl":"10.1177/00048674241291321","url":null,"abstract":"<p><strong>Introduction: </strong>Self-poisoning is the most common form of hospitalised self-harm in young people and has been increasing over the last decade. The COVID-19 pandemic was associated with further increases in self-harm in adolescents. There are limited data on changes after pandemic restrictions ended. This study aimed to describe recent trends in self-poisoning in young people.</p><p><strong>Setting: </strong>Australia 2018-2023.</p><p><strong>Methods: </strong>A retrospective analysis of self-poisoning calls to Australia's poisons information centres. Intentional poisoning exposures in people aged 5-19 years were included in the main analysis. We also examined intentional poisonings in people aged 20 and over for comparison. We used interrupted time-series analysis to estimate the impact of COVID-19 (March 2020) and 're-opening' (December 2021), when many restrictions were lifted in Australia. We compared effects in the jurisdictions with most disruptions and lockdowns with other jurisdictions.</p><p><strong>Results: </strong>There were 201,755 self-poisonings documented, 64% female, with 19,946 children (aged 5-14, 9.9%) and 44,388 adolescents (aged 15-19, 22.0%). There was a steep increase in the rate of poisoning in female children and adolescents - with the annual increase being 1.361 (95% confidence interval = [1.074, 1.735]) and 1.154 (95% confidence interval = [1.049, 1.283]) times faster than pre-pandemic trends in these two groups between March 2020 and December 2021. Following relaxation of restrictions, there was a sudden drop and then slow decline in self-poisonings (despite rising COVID-19 infection rates). There was an overall 29.6% increase in intentional poisonings in young people over the study period. This is markedly more pronounced among young females (37.0%) vs males (11.2%). There were substantial jurisdictional variations, with larger increases in Victoria, Tasmania and the Australian Capital Territory.</p><p><strong>Conclusion: </strong>There has been a marked increase in child and adolescent female self-poisonings over the last 6 years, with increases strongly associated with COVID-19 pandemic restrictions but persisting after their removal.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"29-39"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646254","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}