Australian and New Zealand Journal of Psychiatry最新文献

{"title":"Letter to the Editor regarding '<i>Australian and New Zealand Journal of Psychiatry</i> Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guidelines for the management of schizophrenia'.","authors":"Ben Beaglehole, Matthew Tennant, Julie Fitzjohn","doi":"10.1177/00048674261467617","DOIUrl":"https://doi.org/10.1177/00048674261467617","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674261467617"},"PeriodicalIF":4.1,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468699","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":"Diagnostic complexities of autism and psychosis: A commentary on the ANZJP GRADE guidelines for the management of schizophrenia.","authors":"Kirk Chalmers, Kirsty Laurie, Shuichi Suetani, Catherine Franklin, James G Scott, Stephen Parker","doi":"10.1177/00048674261461986","DOIUrl":"10.1177/00048674261461986","url":null,"abstract":"<p><p>The <i>Australian and New Zealand Journal of Psychiatry</i> GRADE Evidence Guidelines for Schizophrenia highlight the importance of considering psychiatric comorbidities, including autism spectrum disorder. These guidelines acknowledge that there is limited empirical research to guide the management of individuals with schizophrenia who also have these comorbid conditions. This lack of evidence poses challenges for clinicians, especially those working in early psychosis services, where the possibility of a missed diagnosis of autism spectrum disorder is increasingly being examined, and pre-existing diagnoses of autism spectrum disorder are not uncommon. This commentary explores the complex overlaps among shared histories, risk factors and symptomatology, as well as the difficulties stemming from the absence of validated assessment tools to aid in diagnostic clarification. Psychotic symptoms may complicate the recognition and differentiation of underlying neurodevelopmental characteristics of autism spectrum disorder. Considering the limited available evidence, practical guidance is offered to assist clinicians in their decision-making when a strong evidence base is lacking. In the context of early psychosis, diagnostic formulation should be considered provisional, with assessment of a possible a missed ASD diagnosis occurring after the stabilisation of psychotic symptoms wherever possible.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"48674261461986"},"PeriodicalIF":4.1,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148395693","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":"Improving access to novel treatments for treatment-resistant depression: The potential role of specialist clinics in Australia.","authors":"Yash Giri, Paul Furst, Colleen K Loo, Scott R Clark, Prashant Tibrewal","doi":"10.1177/00048674261450390","DOIUrl":"10.1177/00048674261450390","url":null,"abstract":"<p><p>Treatment-resistant depression is a condition with significant morbidity, despite the current standard of treatment, including traditional pharmacotherapy, psychotherapy, augmentation strategies and electroconvulsive therapy. While novel therapies have emerged, such as ketamine/esketamine, transcranial magnetic stimulation and psilocybin-assisted therapy, the uptake of these treatments is relatively low, particularly within public mental health services. Commercial clinics across Australia offer these treatments, but can only be accessed by those able to pay, leaving those unable to pay with limited or no access. We compare novel treatments for treatment-resistant depression and examine barriers to their implementation within the Australian mental health system. We also propose specialist treatment-resistant depression clinics as a potential model to improve access and build clinical expertise. We identified challenges in identifying treatment-resistant depression, lack of training and expertise, and regulatory and economic barriers. We propose that the lack of public access to these novel treatments be initially addressed by the establishment of specialist treatment-resistant depression clinics in Australia, including in the public sector, which will drive training and the development of expertise within public mental health.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"625-632"},"PeriodicalIF":4.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148026369","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 retrospective analysis of voluntary adverse event reports to the TGA with higher THC medicinal cannabis products.","authors":"Myfanwy Graham, Calvert Tisdale, Suzanne Nielsen","doi":"10.1177/00048674261445267","DOIUrl":"10.1177/00048674261445267","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"699-703"},"PeriodicalIF":4.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147810171","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":"Under-25s show the clearest post-2021 rebound in mental health: HILDA 2001-2024.","authors":"Sergey Alexeev, Nick Glozier","doi":"10.1177/00048674261439582","DOIUrl":"10.1177/00048674261439582","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"703-705"},"PeriodicalIF":4.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959401","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":"Evolving approaches to mood disorders.","authors":"Steve Kisely","doi":"10.1177/00048674261457005","DOIUrl":"10.1177/00048674261457005","url":null,"abstract":"","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"613-614"},"PeriodicalIF":4.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148209899","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":"Developing policy and regulation for the safer use of artificial intelligence technologies for mental health in Australia.","authors":"Kylie Maidment, Helen Christensen, Jack Lattimore, Jill M Newby, Alexis E Whitton","doi":"10.1177/00048674261434403","DOIUrl":"10.1177/00048674261434403","url":null,"abstract":"<p><p>Artificial intelligence is emerging as a powerful tool for improving mental health research and care, offering opportunities for early intervention, personalised treatment, ongoing monitoring and enhanced capacity for the mental health workforce. In Australia, however, the integration of artificial intelligence into mental health systems is hindered by substantial knowledge, policy and regulatory gaps. This paper outlines two urgent priorities for the safe and effective use of artificial intelligence in mental health: (1) closing knowledge gaps and (2) developing robust policy and regulatory frameworks. We outline emerging opportunities, including artificial intelligence-driven technologies that could improve affordability, accessibility and treatment outcomes, as well as tools to strengthen the mental health workforce, alongside key risks such as inadequate regulation, insufficient monitoring or reporting of adverse events, perpetuation of bias in research, data privacy and security concerns, and lack of human oversight. We provide 10 recommendations to guide the safer adoption of artificial intelligence for mental health in Australia. These include the creation of a National AI in Mental Health Expert Advisory Group, evidence-based national guidelines, expanded data collection on artificial intelligence use in mental health, Australian-led research that considers priority populations, development of Australian databases for training artificial intelligence models, targeted investment in artificial intelligence technologies that can support an under-resourced mental health workforce, creation of artificial intelligence mental health literacy resources for the Australian public, and regulations that hold developers and providers accountable for the safety of their technologies.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"618-624"},"PeriodicalIF":4.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580319","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":"Predictors of benefits and safety events from participation in a lifestyle therapy trial for adults with depression: A secondary analysis of the CALM randomised controlled trial.","authors":"Lara K Radovic, Madeleine L Connolly, Lauren M Young, Marita Bryan, Wolfgang Marx, Megan Turner, Dean Saunders, Sophie Mahoney, Rachel Fiddes, Tayla John, Amelia McGuinness, Tetyana Rocks, Deborah N Ashtree, Adrienne O'Neil","doi":"10.1177/00048674261440324","DOIUrl":"10.1177/00048674261440324","url":null,"abstract":"<p><strong>Objective: </strong>Lifestyle-based interventions are increasingly popular for treating depression, yet a comprehensive evaluation of who benefits or may be harmed is limited. This study examined predictors of benefits and safety events, and the types of these events experienced by participants in the CALM trial, which compared lifestyle therapy with psychotherapy for depression.</p><p><strong>Methods: </strong>'Benefit' was defined as a ⩾ 50% reduction in Patient Health Questionnaire-9 scores, along with self-reported or staff-observed safety events. Generalised estimating equations identified predictors of benefit and safety events, reporting risk ratios and beta coefficients. Exploratory subgroup analyses were conducted by treatment arm (lifestyle vs psychotherapy).</p><p><strong>Results: </strong>Of 132 completers, 38% met criteria for benefit and 78% reported at least one safety event. Older age (RR = 1.14, 95% CI [1.01, 1.30]) and being born overseas (RR = 1.59, 95% CI [1.06, 2.38]) predicted benefit. Older age (β = 0.16, 95% CI [0.05, 0.26]) and higher baseline glucose (β = 0.16, 95% CI [0.10, 0.23]) were associated with more safety events. Subgroup analyses indicated that age predicted benefit in the psychotherapy arm, while place of birth predicted benefit in the lifestyle arm. Safety events were more common in the lifestyle arm among participants who were older or had elevated glucose.</p><p><strong>Conclusion: </strong>In the CALM trial, older age and being born overseas predicted benefit, while older age and higher glucose levels were associated with greater safety events. These findings provide clinicians and consumers with a clearer risk-benefit profile of behavioural therapies and support personalised treatment based on consumer characteristics.</p><p><strong>Registration: </strong>Australian and New Zealand Clinical Trials Registry (https://www.anzctr.org.au/; ACTRN12621000387820).</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"677-686"},"PeriodicalIF":4.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687762","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":"Among key social determinants, connection associated with lowest odds of non-suicidal self-injury and suicidal ideation among Australian youth.","authors":"Alysia M Robertson, Veronica Sheanoda, Paul Campbell, Emma Knight, Tegan Cruwys, Jason DE Proulx, Joanne A Rathbone, Katherine J Reynolds","doi":"10.1177/00048674261438055","DOIUrl":"10.1177/00048674261438055","url":null,"abstract":"<p><strong>Objective: </strong>To test the relative importance of key social determinants (as specified in the Australian <i>National Suicide Prevention Strategy 2025-2035</i>) associated with suicidal ideation and non-suicidal self-injury in Australian youth.</p><p><strong>Methods: </strong>Representative data from the cross-sectional National Study of Mental Health and Wellbeing 2020-2022 were analysed for Australian youth aged 16-24 years. We used population-weighted multivariable logistic regression analyses to predict 12-month suicidal ideation and non-suicidal self-injury from several social determinants: household income, receipt of government pension/allowance payments, study/work engagement, experience of homelessness, household financial stress, urban residence and social connectedness.</p><p><strong>Results: </strong>Social connectedness was a statistically significant predictor in both models, such that a one-unit increase reduced the odds of 12-month suicidal ideation by 52% and non-suicidal self-injury by 55%. Other significant predictors were having ever experienced homelessness, which increased the odds of suicidal ideation by 116%, while each household financial stressor (e.g. not being able to pay bills on time) increased the odds of non-suicidal self-injury by 34%. No other social determinant was statistically significant in the multivariable models.</p><p><strong>Conclusion: </strong>Social connectedness was the only social determinant associated with lower odds of both suicidal ideation and non-suicidal self-injury in youth. Although further longitudinal studies are needed to confirm these benefits, our cross-sectional findings provide initial support for the National Suicide Prevention Strategy's emphasis on strengthening social inclusion and economic security as key prevention strategies. Our findings highlight the importance of implementing and evaluating connectedness interventions for youth as a priority next step in suicide and NSSI prevention efforts.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"666-676"},"PeriodicalIF":4.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147643801","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":"Middle childhood profiles of social-emotional competencies and difficulties differentiate risk of health service presentations with adolescent mental disorders.","authors":"Emma J Carpendale, Melissa J Green, Oliver J Watkeys, Stacy Tzoumakis, Vaughan J Carr, Kristin R Laurens","doi":"10.1177/00048674261426776","DOIUrl":"10.1177/00048674261426776","url":null,"abstract":"<p><strong>Objective: </strong>The dual-factor model of mental health postulates a role for positive mental health, alongside mental illness, in determining mental health care needs. Informed by this model, the present study delineated profiles of social-emotional competencies and difficulties during middle childhood in a population-based sample of girls and boys and determined their association with adolescent mental disorder diagnoses.</p><p><strong>Method: </strong>Latent profile analyses were conducted across five indices of social-emotional competency and four indices of psychopathology that were measured by questionnaire self-report among 13,349 girls and 13,488 boys at age ~11 years. The association of the profiles with adolescent presentations to hospital or ambulatory services (ages ~12-17 years) were determined using logistic regression.</p><p><strong>Results: </strong>Analyses yielded five profiles in each sex: <i>complete mental health</i> (44% girls; 42% boys), <i>average mental health</i> (30%; 33%), <i>internalising symptoms with poor relationship skills</i> (9%; 7%), <i>externalising symptoms with poor self-management</i> (12%; 9%) and <i>low mental health</i> (5%; 10%). Profiles associated differentially with adolescent presentations with any mental disorder, externalising disorders, internalising disorders and self-harm/suicidal ideation, identified in linked health records. Greater odds of any and specific mental disorder diagnoses were characteristic of all profiles relative to <i>average mental health</i> (adjusted odds ratios [aOR]: 1.7-3.3) except <i>complete mental health</i> (aOR: 0.7-0.9), with different strengths of association according to profile.</p><p><strong>Conclusion: </strong>Combining information on social-emotional competencies and psychopathology in middle childhood may help refine the provision of mental health promotion and early intervention to alleviate adolescent mental disorder.</p>","PeriodicalId":8589,"journal":{"name":"Australian and New Zealand Journal of Psychiatry","volume":" ","pages":"653-665"},"PeriodicalIF":4.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147509098","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}