Research Interests:
Research Interests:
Mental disorders are highly prevalent for the people who are aged between 16 and 25 years and can permanently disrupt the development of these individuals. Easily available mobile health (mHealth) apps for mobile phones have great... more
Mental disorders are highly prevalent for the people who are aged between 16 and 25 years and can permanently disrupt the development of these individuals. Easily available mobile health (mHealth) apps for mobile phones have great potential for the prevention and early intervention of mental disorders in young adults, but interventions are required that can help individuals to both identify high-quality mobile apps and use them to change health and lifestyle behavior. The study aimed to assess the efficacy of a Web-based self-guided app recommendation service ("The Toolbox") in improving the well-being of young Australians aged between 16 and 25 years. The intervention was developed in collaboration with young adults and consists of a curated list of 46 readily available health and well-being apps, assessed and rated by professionals and young people. Participants are guided by an interactive quiz and subsequently receive recommendations for particular apps to download and...
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We aimed to determine characteristics of patients receiving Medicare-funded face-to-face consultations by psychiatrists in a rural service with an established telemedicine service. For this study, 55 case-managed patients from four rural... more
We aimed to determine characteristics of patients receiving Medicare-funded face-to-face consultations by psychiatrists in a rural service with an established telemedicine service. For this study, 55 case-managed patients from four rural community mental health teams in South Australia provided information through questionnaires regarding psychological symptoms, quality of life, body mass index (BMI) and gave access to their Medicare data. In a logistic regression, it was found that being younger was more likely associated with a Medicare psychiatric consultation ( p<0.05). Participants with at least one recorded visit to a Medicare psychiatrist consultation also tended to have lower levels of psychological distress at the end of the 4-year period, have a higher BMI, and more general practitioner consultations. The study provides clinicians and policy makers with preliminary information on the subtle differences in clinical profile of patients seen by Medicare-funded psychiatrist...
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There is a growing need to identify new and innovative approaches to recruit representative samples of young adults in health intervention research. The current study used a data set of screening information from an online well-being... more
There is a growing need to identify new and innovative approaches to recruit representative samples of young adults in health intervention research. The current study used a data set of screening information from an online well-being intervention trial of young adults, to investigate cost-effectiveness of different recruitment strategies and whether the clinical and demographic characteristics of participants differed depending on paid or unpaid online recruitment sources. Data were collected from 334 18- to 25-year-old Australians. The study was advertised through a variety of paid and unpaid online recruitment channels (e.g., Google, Facebook, Twitter, YouTube, recruitment agency), with response rates to different recruitment channels tracked using unique Web links. Well-being of participants was measured using the Mental Health Continuum Short Form. Analyses consisted of independent t tests and χ(2) tests. Overall, unpaid recruitment channels had a considerably higher yield than paid recruitment channels. Of paid recruitment channels, a recruitment agency and paid Facebook advertisements attracted the largest number of individuals. This study also found differences between paid and unpaid online recruitment channels with regard to the well-being and mood of participants. Although the success of online recruitment channels is likely subject to a complex interplay between the number of exposures, the targeted sample, the wording, and placement of the advertisement, as well as study characteristics, our study demonstrated that unpaid recruitment channels are more effective than paid channels and that paid and unpaid channels may result in samples with different characteristics.
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Research Interests: Medical Informatics, Mental Health, Mental Health nursing, Focus Groups, User Centred Design, and 15 moreUser Experience Design, Adolescent, Library and Information Studies, Humans, Female, Male, South Australia, Young Adult, Mental health services, Adult, Rural Health Services, Health Personnel, Health Care Surveys, Delivery of Health Care, and Interviews as topic
Long chain Omega-3 polyunsaturated fatty acids (LCn3PUFAs) may improve cardiovascular health and depression. This study investigated the relationships between erythrocyte membrane LCn3PUFA status, depression and angina symptoms in... more
Long chain Omega-3 polyunsaturated fatty acids (LCn3PUFAs) may improve cardiovascular health and depression. This study investigated the relationships between erythrocyte membrane LCn3PUFA status, depression and angina symptoms in patients with heart disease. We recruited 91 patients (65 males and 26 females, mean age 59.2±10.3 years) with heart disease and depressive symptoms (Center for Epidemiological Studies Depression Scale, CES-D ≥ 16) and low fish/fish oil intakes. The Omega-3 Index (EPA+DHA) of erythrocyte membranes (as a percentage of total fatty acids) was assessed by gas chromatography. Depression status was measured by both self-report and clinician-report scales; CES-D and the Hamilton depression scale (HAM-D). Angina symptoms were measured using the Seattle Angina Questionnaire and the Canadian Cardiovascular Society Classification for Angina Pectoris. The mean Omega-3 Index was 4.8±1.0% (±SD). Depression scores measured by CES-D and HAM-D were 29.2±8.8 (moderate to se...
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Given the prevalence of cardiovascular disease and the high rates of depression among cardiac patients, there is a need to develop practical ways to identify this population and provide pragmatic general-practitioner-based interventions... more
Given the prevalence of cardiovascular disease and the high rates of depression among cardiac patients, there is a need to develop practical ways to identify this population and provide pragmatic general-practitioner-based interventions for managing depression as a comorbid condition. The Identifying Depression As a Comorbid Condition (IDACC) study employed a hybrid design, incorporating a randomized controlled trial nested within a prospective cohort study. IDACC screened for depression in patients hospitalized in South Australia for a range of cardiac conditions, with outcome measures monitored for 12 months after discharge. The subgroup identified as depressed was entered into the nested IDACC trial, which tests the hypothesis that identifying depression and offering an evidence-based intervention to general practitioners, incorporating multidisciplinary telephone case conferencing, will reduce levels of depression, improve quality of life, and reduce associated economic costs. At baseline, 46.3% of 1455 participants screened were classified as depression cases on the basis of their score on the Center for Epidemiological Studies Depression Scale (&amp;amp;amp;amp;amp;amp;amp;amp;gt; or =16) or the Hospital Anxiety and Depression Scale (&amp;amp;amp;amp;amp;amp;amp;amp;gt; or =8). Elevated scores were associated with being younger, female, divorced or separated, not employed, living alone, having a lower level of education, and having poorer health and quality of life. Nearly one fifth (19.4%) of participants had Center for Epidemiological Studies Depression Scale scores &amp;amp;amp;amp;amp;amp;amp;amp;gt;27, which is indicative of major depression. This project confirms, in an Australian setting, the high prevalence of depressive symptoms among hospitalized cardiac patients. Follow-up over 12 months will enhance understanding of the natural history of depression in cardiac patients, while the nested trial will inform on effectiveness of an intervention involving tailored advice and support to general practitioners.
Research Interests: Algorithms, Depression, Quality of life, Cardiovascular disease, Family Practice, and 15 moreProspective studies, Humans, Hospitalization, Female, Male, Health Status, Aged, Middle Aged, Adult, Coronary heart disease, Public health systems and services research, General practitioner, Cohort Studies, Statistics as Topic, and Cardiovascular medicine and haematology
Research Interests: Ophthalmology, Primary Care, Depression, Behavior, Hospitals, and 15 moreHumans, Low vision, Cues, Orthoptics, Nursing Care, Randomised Controlled Trial, Patients, Heart Disease, Prevalence, Public health systems and services research, Communication barriers, Delivery of Health Care, Interviews as topic, Medical and Health Sciences, and Cardiovascular medicine and haematology
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... Abstract. The definitive version is available at www.blackwell-synergy.com. Geoffrey Schrader, Rima Al Atrash-Najar, Rohan Dhillon, Tarun Bastiampillai. Details der Publikation. Download, http://hdl.handle.net/2440/33034. Herausgeber,... more
... Abstract. The definitive version is available at www.blackwell-synergy.com. Geoffrey Schrader, Rima Al Atrash-Najar, Rohan Dhillon, Tarun Bastiampillai. Details der Publikation. Download, http://hdl.handle.net/2440/33034. Herausgeber, Blackwell. ...
Research Interests:
A review of case notes of patients attending a general hospital psychiatric outpatient clinic revealed that 75% of patients with depressive disorders and 38% of patients with neurotic disorders were prescribed antidepressants.... more
A review of case notes of patients attending a general hospital psychiatric outpatient clinic revealed that 75% of patients with depressive disorders and 38% of patients with neurotic disorders were prescribed antidepressants. Antidepressants were often prescribed for long periods in low doses and in combination with benzodiazepines. There was less polypharmacy, however, with more sedating antidepressants. The results indicate that clinical prescription habits for antidepressants may still be at some variance with recommendations from the literature.
Research Interests:
Eckert, Kerena, Schrader, Geoffrey, Wilkinson, David, Askew, Deborah, Dick, Marie-Louise, Wade, Tony, Marwick, Thomas H., Scuffham, Paul A., Jackson, Claire L., Schluter, Philip J., Goldney, Robert, Jansen, Else, Stewart, Tania and... more
Eckert, Kerena, Schrader, Geoffrey, Wilkinson, David, Askew, Deborah, Dick, Marie-Louise, Wade, Tony, Marwick, Thomas H., Scuffham, Paul A., Jackson, Claire L., Schluter, Philip J., Goldney, Robert, Jansen, Else, Stewart, Tania and Stewart, Simon S (2009). Prevalent ...
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To examine how the rates of the use of particular face-to-face primary mental health care services changed in the first 4 years (2006-2010) of the Better Access initiative in both urban and rural regions of South Australia. Time-series... more
To examine how the rates of the use of particular face-to-face primary mental health care services changed in the first 4 years (2006-2010) of the Better Access initiative in both urban and rural regions of South Australia. Time-series analysis of the number of psychology session, psychiatry assessment and general practitioner care plan services recorded in Medicare Australia data. South Australia. Pre-existing data set of South Australian residents who accessed Medicare between 2006 and 2010 MAIN OBJECTIVE MEASURE: Number of services per 100 000 population (service rate). Psychology session service rates increased in all regions, but continued to follow a &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;location gradient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;, being higher in areas closer to Adelaide and lower in areas more distant from Adelaide. Psychiatry assessment service rates increased in Adelaide but did not change in other regions. Rates in remote areas were subject to substantial variation over time. General practitioner care plan service rates increased in Adelaide and in the Riverland, but declined in the Murray Mallee region. Overall, service rates increased in Adelaide and nearby regions, but the results for rural and remote regions were mixed. Possible explanations for the geographical variability include population characteristics (such as socio-economic status), methods of service delivery (visiting practitioners, telepsych), the relative proportion of total health services provided by general practitioners versus other practitioners, or real variations in the need for primary mental health services.
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Research Interests:
Research Interests:
To evaluate the impact of psychiatric inpatient bed closures, accompanied by a training program aimed at enhancing team effectiveness and incorporating data-driven practices, in a mental health service. Retrospective comparison of the... more
To evaluate the impact of psychiatric inpatient bed closures, accompanied by a training program aimed at enhancing team effectiveness and incorporating data-driven practices, in a mental health service. Retrospective comparison of the changes in services within three consecutive financial years: baseline period - before bed reduction (2006-07); observation period - after bed reduction (2007-08); and intervention period - second year after bed reduction (2008-09). The study was conducted at Cramond Clinic, Queen Elizabeth Hospital, Adelaide. Length of stay, 28-day readmission rates, discharges, bed occupancy rates, emergency department (ED) presentations, ED waiting time, seclusions, locality of treatment, and follow-up in the community within 7days. Reduced bed numbers were associated with reduced length of stay, fewer referrals from the community and subsequently shorter waiting times in the ED, without significant change in readmission rates. A higher proportion of patients was tr...
Research Interests:
The Identifying Depression as a Comorbid Condition (IDACC) study aimed to identify depressive symptoms in hospitalised cardiac patients and support management of depression in general practice. This post hoc analysis of the IDACC trial... more
The Identifying Depression as a Comorbid Condition (IDACC) study aimed to identify depressive symptoms in hospitalised cardiac patients and support management of depression in general practice. This post hoc analysis of the IDACC trial examines the effectiveness and practicality of different forms of communication between hospital psychiatric services and general practitioners. We randomised 669 cardiac inpatients with depressive symptoms, identified with the Center for Epidemiological Studies Depression Scale (CES-D), to an intervention or usual care control group. Individual depression scores and depression management guidelines were sent to GPs of all intervention patients. Where possible, psychiatric advice was provided to the GP either by multidisciplinary enhanced primary care case conference or one-to-one telephone advice. Multidisciplinary case conferences were implemented for only 24% of intervention patients. General practitioners received individual telephone advice in 40...
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DSM-III multiaxial diagnoses were given to 257 patients. Analysis of axis I diagnoses and axis IV and axis V assessments generally revealed the expected associations between particular psychiatric disorders and levels of psychosocial... more
DSM-III multiaxial diagnoses were given to 257 patients. Analysis of axis I diagnoses and axis IV and axis V assessments generally revealed the expected associations between particular psychiatric disorders and levels of psychosocial stress and social and occupational functioning. However, a major difficulty affecting the usefulness of axis IV and axis V data when they are routinely gathered according to the current DSM-III instructions is the stipulation that the clinician judge the etiological significance of a stressor before it is coded.
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Research Interests:
This study was undertaken to determine whether psychosocial factors determined during a pre-operative semi-structured psychiatric interview were associated either with the amount of weight loss following obesity surgery or with dropping... more
This study was undertaken to determine whether psychosocial factors determined during a pre-operative semi-structured psychiatric interview were associated either with the amount of weight loss following obesity surgery or with dropping out from follow-up after surgery. Multiple regression and discriminant function analysis of weight loss at six, twelve, twenty four and thirty six months showed no correlation between psychosocial variables and the amount of weight lost or with dropping out from follow-up. It is concluded that the type of psychiatric interview performed in this study does not yield information which reliably predicts weight loss after surgery for obesity.
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SynopsisBased on the Nevid & Morrison Libertarian Mental Health Ideology Scale, the present study shows a conceptual/ideological shift in medical students' attitudes towards psychiatry after a 6-week psychiatry course. The resultant... more
SynopsisBased on the Nevid & Morrison Libertarian Mental Health Ideology Scale, the present study shows a conceptual/ideological shift in medical students' attitudes towards psychiatry after a 6-week psychiatry course. The resultant attitudes were more in line with those of teaching staff than those of the clinical team. Overall, the students developed a more positive view of psychiatry.
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Features of depressive personality as defined by Schneider (1958) were associated with high levels of depression severity in a cohort of 87 outpatients with chronic depression. Depres sive personality was associated with higher levels of... more
Features of depressive personality as defined by Schneider (1958) were associated with high levels of depression severity in a cohort of 87 outpatients with chronic depression. Depres sive personality was associated with higher levels of introver sion and an earlier age of onset ...
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In order to test the hypothesis that patients who are predisposed to depression have an enduring cognitive style, dysfunctional attitudes (Dysfunctional Attitudes Schedule), neuroticism and extraversion (Maudsley Personality Inventory),... more
In order to test the hypothesis that patients who are predisposed to depression have an enduring cognitive style, dysfunctional attitudes (Dysfunctional Attitudes Schedule), neuroticism and extraversion (Maudsley Personality Inventory), and severity of depression (Levine-Pilowsky Depression Questionnaire) were measured in a survey of former patients with previous diagnoses of either depressive or nondepressive psychiatric conditions. We found that there were no significant differences in dysfunctional attitudes between these groups of patients and that their scores were similar to those reported for normal populations. There was, however, a correlation between introversion and high dysfunctional attitude scores. Possible implications regarding interactions between cognitive style, personality, and predisposition toward depression are discussed as well as a suggestion that a history of a suicide attempt may predict a poor response to cognitive psychotherapy.
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This report describes a man with narcolepsy, paranoid psychosis, major depression, and tardive dyskinesia. The case illustrates the treatment difficulties such a patient presents and also raises questions about interactions between the... more
This report describes a man with narcolepsy, paranoid psychosis, major depression, and tardive dyskinesia. The case illustrates the treatment difficulties such a patient presents and also raises questions about interactions between the putative neurotransmitters involved in each of these conditions. It is suggested that the presence of narcolepsy may facilitate the appearance of unwanted effects of antidepressants and neuroleptics such as psychosis and depression.
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A cohort of patients with chronic depression was followed prospectively. While depression severity scores differed significantly over time, there was less change in measures of personality and negative cognitions. The findings support the... more
A cohort of patients with chronic depression was followed prospectively. While depression severity scores differed significantly over time, there was less change in measures of personality and negative cognitions. The findings support the contention that some aspects of chronic depression are most helpfully viewed in terms of personality rather than affective disorder.
Research Interests: Psychology, Cognitive Science, Personality, Personality Disorders, Comorbidity, and 15 moreProspective studies, Humans, Chronic Disease, Female, Male, Depressive Disorder, Clinical Sciences, Middle Aged, Adult, Age Factors, Ambulatory Care, Cohort Studies, Severity of Illness Index, Psychiatric Status Rating Scales, and Personality Inventory
In a prospective study of patients with chronic depression, none of a series of variables reported to be predictive of outcome in episodic depression emerged as significant predictors of change in depression scores over time. It is... more
In a prospective study of patients with chronic depression, none of a series of variables reported to be predictive of outcome in episodic depression emerged as significant predictors of change in depression scores over time. It is concluded that either greater changes in depression severity than those observed may be required to detect predictors of outcome in chronic depression, or that other variables, perhaps related to the social context of the patient rather than to the depression itself, may determine the course of chronic depression.
Research Interests:
Eckert, Kerena, Schrader, Geoffrey, Wilkinson, David, Askew, Deborah, Dick, Marie-Louise, Wade, Tony, Marwick, Thomas H., Scuffham, Paul A., Jackson, Claire L., Schluter, Philip J., Goldney, Robert, Jansen, Else, Stewart, Tania and... more
Eckert, Kerena, Schrader, Geoffrey, Wilkinson, David, Askew, Deborah, Dick, Marie-Louise, Wade, Tony, Marwick, Thomas H., Scuffham, Paul A., Jackson, Claire L., Schluter, Philip J., Goldney, Robert, Jansen, Else, Stewart, Tania and Stewart, Simon S (2009). Prevalent ...
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To define the clinical and demographic characteristics of frequent attenders with mental disorders at a general hospital ED; to determine whether those persons had additional attendances at other ED in the same city; and to assess the... more
To define the clinical and demographic characteristics of frequent attenders with mental disorders at a general hospital ED; to determine whether those persons had additional attendances at other ED in the same city; and to assess the documented care of those frequent attenders. A retrospective descriptive study of those who attended the Queen Elizabeth Hospital, Woodville South, Australia ED on average at least once per month between 1 July 2006 and 15 March 2007. Of 11,594 attenders, 54 (0.47%) at the ED were frequent attenders with mental disorders. Their 735 attendances represented 4.5% of the total of 16,345 attendances. Of those frequent attenders, 34 (63%) also visited other Adelaide hospital ED on an additional 410 occasions. Presentations peaked on the weekends and between 18.00 h and midnight. Although 43% of frequent attenders had specific mental health-care plans, only two-thirds of those had been assigned to a mental health team. The documented management of frequent attenders with mental disorders at a general hospital ED appeared to be less than optimal. Furthermore, the majority of those frequent attenders also attended other general hospital ED in the same city, and this did not appear to be recognized.
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Research Interests: Adolescent, Family history, Multivariate Analysis, Numerical Taxonomy, Humans, and 15 morePersonality Development, Chronic Disease, Female, Male, Cluster Analysis, Depressive Disorder, Clinical Sciences, Aged, Middle Aged, Alcohol dependence, Spectrum, Longitudinal Studies, Adult, Cohort Studies, and Psychiatric Status Rating Scales
Research Interests:
A review of case notes of patients attending a general hospital psychiatric outpatient clinic revealed that 75% of patients with depressive disorders and 38% of patients with neurotic disorders were prescribed antidepressants.... more
A review of case notes of patients attending a general hospital psychiatric outpatient clinic revealed that 75% of patients with depressive disorders and 38% of patients with neurotic disorders were prescribed antidepressants. Antidepressants were often prescribed for long periods in low doses and in combination with benzodiazepines. There was less polypharmacy, however, with more sedating antidepressants. The results indicate that clinical prescription habits for antidepressants may still be at some variance with recommendations from the literature.
Research Interests:
This study was undertaken to determine whether psychosocial factors determined during a pre-operative semi-structured psychiatric interview were associated either with the amount of weight loss following obesity surgery or with dropping... more
This study was undertaken to determine whether psychosocial factors determined during a pre-operative semi-structured psychiatric interview were associated either with the amount of weight loss following obesity surgery or with dropping out from follow-up after surgery. Multiple regression and discriminant function analysis of weight loss at six, twelve, twenty four and thirty six months showed no correlation between psychosocial variables and the amount of weight lost or with dropping out from follow-up. It is concluded that the type of psychiatric interview performed in this study does not yield information which reliably predicts weight loss after surgery for obesity.
Research Interests:
... Abstract. The definitive version is available at www.blackwell-synergy.com. Geoffrey Schrader, Rima Al Atrash-Najar, Rohan Dhillon, Tarun Bastiampillai. Details der Publikation. Download, http://hdl.handle.net/2440/33034. Herausgeber,... more
... Abstract. The definitive version is available at www.blackwell-synergy.com. Geoffrey Schrader, Rima Al Atrash-Najar, Rohan Dhillon, Tarun Bastiampillai. Details der Publikation. Download, http://hdl.handle.net/2440/33034. Herausgeber, Blackwell. ...
Research Interests:
A review of case notes before and after the introduction of the DST into clinical psychiatric practice revealed considerable changes in diagnosis and management. Specifically there were increases in the diagnosis of biological depression... more
A review of case notes before and after the introduction of the DST into clinical psychiatric practice revealed considerable changes in diagnosis and management. Specifically there were increases in the diagnosis of biological depression and treatment with somatic antidepressant therapy. There was no association between DST results and particular management plans. There was a strong association between requesting the DST and management with antidepressants. It is suggested that the introduction of laboratory tests for psychiatric disorders may firm the belief of psychiatrists in the biological basis of some forms of depression and thus alter their diagnostic and treatment practice.
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Aims: There is evidence that individuals with a mental illness are more likely to report a history of victimization and to be at an increased risk for future victimization. The aims of the current study are to determine lifetime rates of... more
Aims: There is evidence that individuals with a mental illness are more likely to report a history of victimization and to be at an increased risk for future victimization. The aims of the current study are to determine lifetime rates of different types of victimization in a population of psychiatric inpatients and to examine the associations between a history of victimization and measures of adverse outcome and rates of posttraumatic stress disorder (PTSD). Method: A total of 130 psychiatric inpatients with a range of psychiatric diagnoses were surveyed. Information collected included history of victimization, aggression and violence levels, suicidal ideation, PTSD symptomatology, rates of hospitalization and pension status. Results: A lifetime history of victimization was reported in 87.7% of patients with 46% having lifetime and 32% current PTSD. Most clinicians did not identify the high rates of comorbid PTSD in these patients. Victimization was associated significantly with rec...
Research Interests: Adolescent, Comorbidity, Mental Illness, Humans, Posttraumatic stress disorder, and 15 moreFemale, Male, South Australia, Crime Victims, Mathematical Computing, Mental Disorders, Aged, Prevalence, Middle Aged, Adult, Cross Sectional Studies, Life Change Events, Statistics as Topic, Psychology and Cognitive Sciences, and Medical and Health Sciences
Research Interests:
There is convincing evidence to suggest that depression significantly increases the risk of mortality following myocardial infarction. There are few data concerning depression as a risk factor for mortality following cardiac surgery. The... more
There is convincing evidence to suggest that depression significantly increases the risk of mortality following myocardial infarction. There are few data concerning depression as a risk factor for mortality following cardiac surgery. The aim of the present observational study was to determine if preoperative depressive symptoms resulted in an increased risk of late mortality following cardiac surgery. Preoperative assessments of depressive symptoms were performed on 158 patients undergoing coronary artery bypass surgery. Elevated preoperative depression symptoms were defined as a depression anxiety stress scale score of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 10. Twenty-four of the 158 patients ( 15.2%) were classified as having elevated preoperative depressive symptoms. Patients were followed for a median of 25 months (range: 4-38 months). Three of the 24 patients (12.5%) with preoperative depressive symptoms died within the follow-up period, compared with three of the 134 (2.2%) non-depressed patients (odds ratio: 6.24; 95% CI: 1.18-32.98; P = 0.046). There were no other group differences on variables including population demographics, medical risk factors, surgical parameters, and indices of postoperative morbidity. Elevated depressive symptoms before coronary bypass surgery may be a significant predictor of late death. Prospective studies evaluating the prevalence of depressive symptoms in cardiac surgical patients and their effect on long-term outcome must be undertaken.
Research Interests: Depression, Nonparametric Statistics, Humans, Female, Male, and 11 moreRisk factors, Clinical Sciences, Prevalence, Middle Aged, Myocardial Infarction, Analysis of Variance, Chi Square Distribution, Risk Factors, Coronary artery bypass surgery, Neuropsychological Tests, and coronary artery bypass grafting (CABG)
Research Interests: Multivariate Analysis, Prospective studies, Humans, Female, Male, and 15 moreDepressive Disorder, Risk factors, Aged, Middle Aged, Coronary Angiography, Adult, Coronary heart disease, Age Factors, Risk Factors, Coronary Artery Disease, Chest Pain, Logistic Models, Case Control Studies, Cohort Studies, and Cardiovascular medicine and haematology
Multidisciplinary case conferences were implemented for only 24% of intervention patients. General practitioners received individual telephone advice in 40% of cases, and 36% received written information only. The psychiatrist telephone... more
Multidisciplinary case conferences were implemented for only 24% of intervention patients. General practitioners received individual telephone advice in 40% of cases, and 36% received written information only. The psychiatrist telephone advice resulted in a significant reduction in the proportion of patients with moderate to severe depression 12 months after cardiac hospitalisation (19% vs. 35%). DISCUSSION
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Objective: To evaluate the effect on depressive symptoms in cardiac patients of patient-specific advice to general practitioners regarding management of comorbid depression. Design and setting: A randomised controlled trial in four... more
Objective: To evaluate the effect on depressive symptoms in cardiac patients of patient-specific advice to general practitioners regarding management of comorbid depression. Design and setting: A randomised controlled trial in four general hospitals in Adelaide, South Australia. Participants: Patients (n = 669) admitted to cardiology units for a range of cardiovascular conditions who were screened and assessed as being depressed
Research Interests: Cardiology, Psychiatry, Depression, IT Management, Treatment Outcome, and 19 moreAdolescent, Family Practice, Humans, Hospitalization, Female, Male, South Australia, Randomised Controlled Trial, Health Status, Clinical Sciences, Aged, Middle Aged, Adult, Patient Care Team, Public health systems and services research, General practitioner, Depressive Symptoms, Epidemiologic Studies, and Relative Risk
eHealth facilitation of chronic disease management has potential to increase engagement and effectiveness and extend access to care in rural areas. The objective of this study was to demonstrate the feasibility and acceptability of an... more
eHealth facilitation of chronic disease management has potential to increase engagement and effectiveness and extend access to care in rural areas. The objective of this study was to demonstrate the feasibility and acceptability of an eHealth system for the management of chronic conditions in a rural setting. We developed an online management program which incorporated content from the Flinders Chronic Condition Management Program (Flinders Program) and used an existing software platform (goACT), which is accessible by patients and health care workers using either Web-enabled mobile phone or Internet, enabling communication between patients and clinicians. We analyzed the impact of this eHealth system using qualitative and simple quantitative methods. The eHealth system was piloted with 8 recently hospitalized patients from rural areas, average age 63 (SD 9) years, each with an average of 5 chronic conditions and high level of psychological distress with an average K10 score of 32.20 (SD 5.81). Study participants interacted with the eHealth system. The average number of logins to the eHealth system by the study participants was 26.4 (SD 23.5) over 29 weeks. The login activity was higher early in the week. The pilot demonstrated the feasibility of implementing and delivering a chronic disease management program using a Web-based patient-clinician application. A qualitative analysis revealed burden of illness and low levels of information technology literacy as barriers to patient engagement.
While the extent of medical comorbidity in depressive illness is widely recognised, there have been few studies where objective and subjective assessment of comorbidity in chronic depression have been made. The aim of this study was to... more
While the extent of medical comorbidity in depressive illness is widely recognised, there have been few studies where objective and subjective assessment of comorbidity in chronic depression have been made. The aim of this study was to determine the extent and nature of medical comorbidity, in terms of both physician and patient assessments, in a group of outpatients with chronic depressive symptoms. Eighty-seven outpatients with a history of depressed mood for at least 2 years were assessed using the SCID and the Hamilton Depression scale. Physician and patient assessment of any medical comorbidity were completed. Sixty percent of patients, and significantly more public general hospital outpatients than private outpatients, viewed themselves as suffering from a serious medical illness in addition to their depression. Only 8% were viewed objectively as having a serious medical condition. The discrepancy between patient and physician assessments of medical comorbidity in chronic depression is of note and may relate to depressed mood. Careful evaluation of chronically depressed patients&#39; perceptions of physical illness may help achieve a positive treatment outcome.
Research Interests:
A group of psychiatric in-patients significantly over-estimated the intensity of their depression when asked to recollect how depressed they had been one week earlier. The initial level of depression affected the accuracy of recall.... more
A group of psychiatric in-patients significantly over-estimated the intensity of their depression when asked to recollect how depressed they had been one week earlier. The initial level of depression affected the accuracy of recall. Unexpectedly, patients who were more depressed initially had more accurate recall, particularly for biological and symptomatically negative items of the Zung Self-Rating Depression Scale.