Australian and New Zealand Journal of Psychiatry最新文献

{"title":"Evidence-based interventions for vocational recovery in first-episode psychosis: A meta-analysis of employment and education rates.","authors":"Oscar Gonzalo, Juan Luis Sánchez-González, Alba Sánchez-Gil, Lorena Carrascal-Laso, María Isidoro-García, Javier Martín-Vallejo, Jesus Perez","doi":"10.1177/00048674261471316","DOIUrl":"https://doi.org/10.1177/00048674261471316","url":null,"abstract":"<p><strong>Background: </strong>Young people with first-episode psychosis experience high rates of disruption in work and education and consistently describe vocational participation as a core priority of recovery. This meta-analysis aimed to evaluate the effectiveness of evidence-based interventions in improving employment and education rates after a first-episode psychosis.</p><p><strong>Method: </strong>A PROSPERO-registered meta-analysis was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three endpoints were analysed: (a) employment, (b) education, and (c) combined vocational rates. Both meta-analyses of proportions and comparative meta-analyses (intervention vs control) were performed under random-effects models. Risk of bias (RoB2), Risk of Bias in Non-randomised Studies - of Exposure and certainty of evidence Grading of Recommendations, Assessment, Development and Evaluation were assessed.</p><p><strong>Results: </strong>Thirty-one studies (<i>n</i> = 8651) were included. Vocational interventions - particularly Individual Placement and Support (odds ratio = 2.86, 95% CI 1.81-4.54) - were consistently associated with improved competitive employment compared with control conditions (odds ratio = 2.35, 95% CI 1.88-2.94). No intervention showed a consistent advantage for education rates (odds ratio = 1.19, 95% CI 0.80-1.76). The combined endpoint showed substantial heterogeneity (<i>I</i>² = 69.6%, <i>τ</i>² = 0.296, <i>p</i> < 0.001) and possible publication bias, limiting interpretability (odds ratio = 2.02, 95% CI 1.29-3.17).</p><p><strong>Conclusions: </strong>Our findings support integrating structured, evidence-based vocational support - particularly Individual Placement and Support - as a routine component of services for early psychosis, specifically for patients with employment goals.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674261471316"},"PeriodicalIF":4.1,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683196","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":"Growing chasms: Australian psychiatrist workforce distribution across local government areas by socioeconomic status.","authors":"Luke Sy-Cherng Woon, Stephen Allison, Tarun Bastiampillai, Steve Kisely, Wai-Man Liu, Jeffrey C L Looi","doi":"10.1177/00048674261471314","DOIUrl":"https://doi.org/10.1177/00048674261471314","url":null,"abstract":"<p><strong>Objective: </strong>Local socioeconomic status may influence psychiatrist distribution, yet this remains systematically unexamined in Australia. We aimed to assess how psychiatrist availability varies across regions with differing socioeconomic advantage.</p><p><strong>Methods: </strong>Psychiatrist workforce data from the Health Workforce Data Tool (2013-2023) were linked to local government areas-level quintiles of the Index of Relative Socioeconomic Advantage and Disadvantage. We calculated and compared the proportion of local government areas with psychiatrists, psychiatrist counts per local government area, and psychiatrists per 10,000 population by Socio-Economic Indexes for Areas quintile. Panel regression analyses examined per capita variations, adjusting for state/territory and year effects in the same analyses.</p><p><strong>Results: </strong>Outer regional/remote/very remote areas had relatively low access to psychiatrists compared to metropolitan/inner regional areas. Disparities widened over time between the highest socioeconomic status quintile and all others. The average psychiatrist count per 10,000 population for top-quintile local government areas was 2.8 (standard deviation: ±4.8; from 0.6 (standard deviation: ±1.0, Northern Territory) to 5.5 (standard deviation: ±7.0, South Australia)), compared with 0.2-0.5 per 10,000 population for all lower socioeconomic status quintiles. In panel regression with interaction between Socio-Economic Indexes for Areas and remoteness, psychiatrist counts (adjusted for state/territory and year) in non-top-quintile local government areas were 2.6 (95% confidence interval: -4.1 to -1.1) to 3.0 (95% confidence interval: -4.4- to -1.7) per 10,000 population lower than top-quintile metropolitan and inner regional local government areas.</p><p><strong>Conclusions: </strong>Psychiatrists are densely concentrated in high socioeconomic status and metropolitan/inner regional areas. Lower socioeconomic status local government areas shared similar, limited psychiatrist distributions. Targeted strategies are required to improve the equitable distribution of mental health resources across socioeconomic gradients.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674261471314"},"PeriodicalIF":4.1,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663371","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":"Socioeconomic deprivation and dementia risk in New Zealand: A modelling study.","authors":"Etuini Ma'u, Nicholas Rush, Jade Tamatea, Malakai 'Ofanoa, Sebastian Walsh, Gill Livingston, Naaheed Mukadam, Gary Cheung, Sarah Cullum","doi":"10.1177/00048674261470616","DOIUrl":"https://doi.org/10.1177/00048674261470616","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to estimate the population attributable fraction for dementia associated with neighbourhood deprivation and the potential impact of reducing deprivation on dementia prevalence over time.</p><p><strong>Methods: </strong>We calculated the population attributable fraction across Aotearoa New Zealand for 13 risks (less education, hypertension, obesity, smoking, depression, physical inactivity, social isolation, diabetes, excessive alcohol, air pollution, hearing loss, vision loss, high low-density lipoprotein cholesterol) stratified by deprivation and ethnicity. We modelled the impact of reducing deprivation on dementia prevalence over 30 years.</p><p><strong>Results: </strong>Population attributable fraction increased with deprivation, from 36.0% in the least deprived to 45.8% in the most deprived quintile. Modelled reductions in deprivation were predicted to produce greater dementia prevalence reductions at all time points for Māori and Pacific peoples compared to Europeans.</p><p><strong>Discussion: </strong>Dementia prevention potential increases as deprivation increases. The impact of reducing deprivation increases over 30 years. Projected benefits are disproportionately greater in populations in areas of higher deprivation.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674261470616"},"PeriodicalIF":4.1,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663423","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 scoping review of programmes that address the daily living functioning of people diagnosed with borderline personality disorder.","authors":"Dillon Tepper, Ben Sellar, Sheryl Shipley, Rachel Smith, Carolyn M Murray","doi":"10.1177/00048674251393159","DOIUrl":"10.1177/00048674251393159","url":null,"abstract":"<p><strong>Introduction: </strong>People diagnosed with borderline personality disorder experience persistent functional impairment despite current evidence-based treatment. Domains of daily living functioning, such as establishing a routine, household management and self-care, can be important goals for rehabilitation. This review aimed to scope and synthesise programmes that address the daily living functioning of people diagnosed with borderline personality disorder.</p><p><strong>Methods: </strong>This review followed the PRISMA Extension for Scoping Reviews Checklist and the Joanna Briggs Institute scoping review methodological guidance. Eight databases (Medline, PsycINFO, ASSIA, CINAHL, Embase, Emcare, ProQuest Dissertations & Theses Global and Scopus) and grey literature were searched.</p><p><strong>Results: </strong>Forty-four records were found spanning 12 countries, from 1987 to 2025, comprising research studies, educational materials and programme summaries. Programmes included independent living skills development, residential facilities, outpatient treatment and occupational therapy, with rehabilitation and recovery the most frequently used approaches. The domains of daily living functioning were health (<i>n</i> = 189), relational (<i>n</i> = 84), responsibility (<i>n</i> = 67), personal (<i>n</i> = 61), leisure (<i>n</i> = 53), routine (<i>n</i> = 42) and household (<i>n</i> = 30). Measures used to describe changes in functioning varied considerably.</p><p><strong>Conclusions: </strong>Programmes supporting the daily living functioning of people diagnosed with borderline personality disorder exist. However, the evidence base is currently disparate. No single programme addressed all identified domains of daily living functioning. Comprehensive, evidence-based rehabilitation programmes addressing all domains of daily living functioning are needed to enable functional recovery for people diagnosed with borderline personality disorder.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"747-764"},"PeriodicalIF":4.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145628196","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":"Psychiatrists' role in disaster situations: A narrative review of empirical evidence.","authors":"Ruta Karaliuniene, Renato de Filippis, Rodrigo Ramalho, Victor Pereira-Sanchez, Sachin Nagendrappa, Helen Herrman","doi":"10.1177/00048674261445764","DOIUrl":"10.1177/00048674261445764","url":null,"abstract":"<p><p>Disaster exposure is widespread, and a significant portion of those who experience severe impacts may develop mental health distress and clinical conditions. Psychiatrists may play crucial roles in multidisciplinary emergency response teams supporting both survivors and other responders. However, no previous study has yet explored the evidence discussing and supporting these roles. We aimed to synthesize available evidence featuring the roles of psychiatrists in disaster response in order to guide future research, training and public policy. We conducted a narrative review applying a Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)-guided search of four databases: MEDLINE, Embase, PsycINFO and the Cochrane Library, using a strategy combining disaster-related terms with those related to psychiatric and psychological crisis interventions. We included in this review original quantitative, qualitative and mixed-methods studies reporting interventions during or after disasters in which psychiatrists played an active role. After removing duplicates, 2318 titles and abstracts were screened, 125 articles underwent full-text review and 14 studies ultimately met the criteria for inclusion. Psychiatrists played a multifaceted and crucial role in diverse disaster settings worldwide, providing direct clinical care, leading and coordinating mental health responses, generating research, building local capacity and offering expert supervision. Psychiatrists have been shown to serve important roles in disaster settings, but more research is needed to better understand their specific contributions and plan their most appropriate integration as essential and unique members of multidisciplinary response teams.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"720-728"},"PeriodicalIF":4.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148026302","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":"Body dysmorphic symptoms in autism and attention-deficit hyperactivity disorder: A comorbidity study.","authors":"Janelle Janus, Denny Meyer, Ella Byrne, Katrina Holmes À Court, David J Castle, Susan L Rossell","doi":"10.1177/00048674261418840","DOIUrl":"10.1177/00048674261418840","url":null,"abstract":"<p><p>Body dysmorphic disorder (BDD) is a persistently under-recognised psychiatric condition. Evidence suggests a degree of shared cognitive dysfunction and clinical presentation of BDD with autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). The current study is the first to investigate the co-occurrence of BDD, ASD and ADHD in a large online community sample. Utilising data from an online survey, we investigated the comorbidity frequency of BDD, ASD and ADHD, as well as the presence of possible undiagnosed BDD in these neurodevelopmental populations (<i>N</i> = 6844). Individuals with BDD did not report a higher frequency of ASD or ADHD comorbidity than those without BDD. However, individuals with neurodevelopmental diagnoses were significantly more likely to have possible undiagnosed BDD than those without a neurodevelopmental diagnosis (ASD adjusted odds ratio [AOR] = 3.55, ADHD AOR = 2.45). These preliminary findings cautiously suggest that elevated body image concern and possible BDD in ASD and ADHD are potentially missed or misattributed to individuals' neurodevelopmental diagnoses without further investigation.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"780-791"},"PeriodicalIF":4.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177690","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":"Student wellbeing supports in Australian and New Zealand medical schools: A post-guidance snapshot from a 14-institution survey.","authors":"Andri Burger, Chanaka Wijeratne, Minh Thu Nguyen, Megan Kalucy, Kimberlie Dean","doi":"10.1177/00048674261455737","DOIUrl":"10.1177/00048674261455737","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"803-805"},"PeriodicalIF":4.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148300660","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":"Differences in dementia diagnosis based on clinical setting: Data from the ASPREE clinical trial.","authors":"Xiaoping Lin, Swarna Vishwanath, Jane Banaszak-Holl, Delphine Allan, Susannah Ahern, John J McNeil, Henry Brodaty, Robyn L Woods, Suzanne G Orchard, Stephanie A Ward","doi":"10.1177/00048674261431638","DOIUrl":"10.1177/00048674261431638","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"715-719"},"PeriodicalIF":4.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502971","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":"Health characteristics and court diversion among adults with psychosis in the New South Wales Local Court: A data-linkage study.","authors":"Erin Spike, Tony Butler, Preeyaporn Srasuebkul, Julian Trollor, Grant Sara, David Greenberg, Azar Kariminia","doi":"10.1177/00048674251405145","DOIUrl":"10.1177/00048674251405145","url":null,"abstract":"<p><strong>Background: </strong>Diversionary approaches seek to address criminal legal system involvement among people with psychosis and other mental illness. There is limited evidence examining health characteristics of people with psychosis in Australian criminal legal systems and how these vary with court outcomes, including diversion.</p><p><strong>Methods: </strong>We conducted a data-linkage study of 21,229 adults hospitalised with psychosis in New South Wales (June 2001 to December 2019) with a subsequent offence finalised in the New South Wales Local Court. We described psychosis types, co-occurring conditions and prior health service use and examined their associations with court outcome (diversion vs conviction) using logistic regression, adjusting for sociodemographic and legal factors.</p><p><strong>Results: </strong>A total of 70.8% of participants had a schizophrenia spectrum disorder (substance-induced psychosis 22.6%; affective psychosis 6.6%). Co-occurring conditions were common (lifetime substance-related harm 84.8%; personality disorder 41.3%; neurodevelopmental disorder 17.5%; physical condition 25.6%), and 76.3% used mental health services in the year before the index offence. Affective and substance-induced psychoses were negatively associated with diversion vs schizophrenia spectrum disorders (adjusted odds ratios = 0.64 [95% confidence interval = 0.54-0.74] and 0.29 [95% confidence interval = 0.26-0.33], respectively). Duration of psychosis admissions and past-year mental health service use were positively associated with diversion, while in those with schizophrenia spectrum disorders, lifetime substance-related harm was negatively associated.</p><p><strong>Conclusion: </strong>Court defendants with psychosis have a complex health profile. Although people with schizophrenia spectrum disorders are more likely to be diverted than those with other psychosis types, substance use may inhibit diversion. Health and criminal legal system collaboration is needed to facilitate diversion and treatment for this group.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"765-779"},"PeriodicalIF":4.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910340","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":"Autism spectrum disorder in older people: A scoping review of the screening and diagnostic tools available for diagnosis.","authors":"Annabelle Chalk, Andre Bauer, Niall Higgins, Isaac Tranter, Megan Nitz","doi":"10.1177/00048674251374475","DOIUrl":"10.1177/00048674251374475","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis and management of autism spectrum disorder is an important clinical issue for psychiatrists. However, there is a lack of research and resources to recognise this condition in older people. This condition is important to detect and diagnose because it is associated with high incidence of psychiatric comorbidity. The diagnosis helps clinicians understand the additional needs of these patients and helps families understand their additional difficulties. This paper aims to identify the studies that have been conducted on autism in the eldest and the approaches to detect and diagnose this.</p><p><strong>Method: </strong>A scoping review was conducted in accordance with the PRISMA Extension for Scoping Reviews guidelines. Searches were performed on five databases where search terms were based on (1) Autism, (2) Aged/Elderly and (3) Diagnosis. Two authors independently assessed the results with discrepancies resolved by a third reviewer. Quality was assessed using Mixed Method Quality Assessment Tool in included systematic reviews, randomised control trials, case-control studies, cohort studies, case series and case reports.</p><p><strong>Results: </strong>The review identified 4 diagnostic tools, and 19 screening tools available for use in the elderly. However, most of these tools were not validated in studies focusing on older people and most included a small number of older people in their sample.</p><p><strong>Conclusion: </strong>Given Australia's ageing population, and resultant increasing demands on healthcare services, this is an important topic to inform future research and clinical practice. More research is required to validate or create diagnostic and screening tools specifically for older people.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"729-746"},"PeriodicalIF":4.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205353","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}