International review of psychiatry (Abingdon, England), Jan 13, 2015
Australia has been implementing routine outcome measurement in its specialized public sector ment... more Australia has been implementing routine outcome measurement in its specialized public sector mental health services for over a decade. It uses a range of clinician-rated and consumer-rated measures that are administered at set times during episodes of inpatient, ambulatory and community residential episodes of care. Routine outcome measurement is now embedded in service delivery, and data are made available in a variety of ways to different audiences. These data are used by policy-makers and planners to inform decisions about system-wide reforms, by service managers to monitor quality and effectiveness, and by clinicians to guide clinical decision-making and to promote dialogue with consumers. Consumers, carers and the general community can use these data to ensure that services are accountable for the care they deliver. This paper describes the status quo in Australia with respect to routine outcome measurement, discusses the factors that led to its successful implementation, and c...
The Australian and New Zealand journal of psychiatry, 2014
To inform decisions about mental health resource allocation, planners require reliable estimates ... more To inform decisions about mental health resource allocation, planners require reliable estimates of people who report service demand (i.e. people who use or want mental health services) according to their level of possible need. Using data on 6915 adults aged 16-64 years in Australia's 2007 National Survey of Mental Health and Wellbeing, we examined past-year service demand among respondents grouped into four levels of possible need: (a) 12-month mental disorder; (b) lifetime but no 12-month mental disorder; (c) any other indicator of possible need (12-month symptoms or reaction to stressful event, or lifetime hospitalisation); (d) no indicator of possible need. Multivariate logistic regression analyses examined correlates of service demand, separately for respondents in each of levels 1-3. Sixteen per cent of Australian adults reported service demand, of whom one-third did not meet criteria for a 12-month mental disorder (equivalent to 5.7% of the adult population). Treatment p...
The British journal of psychiatry : the journal of mental science, 2014
Few studies have examined the impact of stimulant use on outcome in early psychosis. Ceasing subs... more Few studies have examined the impact of stimulant use on outcome in early psychosis. Ceasing substance use may lead to positive outcomes in psychosis. To examine whether baseline cannabis or stimulant disorders and ongoing drug use predict readmission within 2 years of a first psychosis admission. Predictors of readmission were examined with Cox regression in 7269 people aged 15-29 years with a first psychosis admission. Baseline cannabis and stimulant disorders did not predict readmission. A stimulant disorder diagnosis prior to index psychosis admission predicted readmission, but a prior cannabis disorder diagnosis did not. Ongoing problem drug use predicted readmission. The lowest rate of readmission occurred in people whose baseline drug problems were discontinued. Prior admissions with stimulant disorder may be a negative prognostic sign in first-episode psychosis. Drug use diagnoses at baseline may be a good prognostic sign if they are identified and controlled.
The Australian and New Zealand journal of psychiatry, 2014
Stimulants may worsen psychotic symptoms but there is limited evidence about the impact of stimul... more Stimulants may worsen psychotic symptoms but there is limited evidence about the impact of stimulant abuse in people with schizophrenia. This study examined the prevalence and correlates of stimulant and other drug disorders in a population-based sample of people with schizophrenia, examining associations with frequent service use, physical health comorbidities and accommodation instability. New South Wales (NSW) hospital, community mental health and emergency department data were used to examine health service contact over 5 years in 13,624 people with a diagnosis of schizophrenia. Associations of stimulant disorders were examined with multinomial logistic regression, comparing people with no substance disorders to those with cannabis disorders, stimulant disorders or both. Of people with schizophrenia, 51% had substance disorders, including 14% with stimulant disorders. Stimulant disorders were more common in young adults and in urban areas, less common in migrants, and unrelated ...
To describe the frequency, type and quality of mental health treatment among Australian adults wi... more To describe the frequency, type and quality of mental health treatment among Australian adults with past-year affective and/or anxiety disorders. Retrospective analysis of data for 8831 adults aged 16-85 years interviewed for the 2007 National Survey of Mental Health and Wellbeing, of whom 17% (n = 1517) met International Classification of Diseases, 10th revision (ICD-10) criteria for a past-year affective and/or anxiety disorder. Three levels of mental health treatment received in the past year: (1) any consultation with a health professional for mental health; (2) any evidence-based intervention (antidepressant medication, mood stabiliser medication, cognitive behaviour therapy and/or psychotherapy); and (3) minimally adequate treatment (a "dose" of an evidence-based intervention above a minimum threshold, consistent with treatment guidelines). Of participants with past-year affective and/or anxiety disorders, 39% sought professional help for mental health, 26% received an evidence-based treatment, and 16% received minimally adequate treatment. After controlling for clinical factors including type and severity of disorder, the odds of all levels of treatment were lower among younger adults (16-29 years) compared with middle-aged adults, and the odds of receiving an evidence-based treatment or minimally adequate treatment were lower among people who consulted a general practitioner only compared with a mental health professional. Closing the gap in treatment quality requires strategies to increase the use of evidence-based interventions, and to ensure these are delivered in sufficient doses. Research to elucidate why some patients are at increased risk of inadequate treatment, and the aspects of treatment that contribute to inadequate care, is indicated.
The Health of the Nation Outcome Scales was developed to routinely measure outcomes for adults wi... more The Health of the Nation Outcome Scales was developed to routinely measure outcomes for adults with mental illness. Comparable instruments were also developed for children and adolescents (the Health of the Nation Outcome Scales for Children and Adolescents) and older people (the Health of the Nation Outcome Scales 65+). All three are being widely used as outcome measures in the United Kingdom, Australia and New Zealand. There is, however, no comprehensive review of these instruments. This paper fills this gap by reviewing the psychometric properties of each. Articles and reports relating to the instruments were retrieved, and their findings synthesised to assess the instruments' validity (content, construct, concurrent, predictive), reliability (test-retest, inter-rater), sensitivity to change, and feasibility/utility. Mostly, the instruments perform adequately or better on most dimensions, although some of their psychometric properties warrant closer examination. Collectively,...
... Interim evaluation report of a trial of telephone-based cognitive behaviour therapy Bridget B... more ... Interim evaluation report of a trial of telephone-based cognitive behaviour therapy Bridget Bassilios,Valeria Zoteyeva, Kylie King, Justine Fletcher, Fay Kohn, Grant Blashki, Philip Burgess, Jane Pirkis August 2009 CENTRE for HEALTH POLICY, PROGRAMS and ECONOMICS ...
Objective: To examine whether there was a reduction in demand for psychological services provided... more Objective: To examine whether there was a reduction in demand for psychological services provided through the Access to Allied Psychological Services (ATAPS) projects after the introduction of the Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule (Better Access) program, and whether any such reduction was greater in urban than rural areas. Design and setting: A
The Australian and New Zealand journal of psychiatry, 2015
Stimulant abuse and dependence often complicate the care of people with psychotic disorders. This... more Stimulant abuse and dependence often complicate the care of people with psychotic disorders. This study systematically reviews the prevalence estimates reported for stimulant abuse and dependence in people with psychotic disorders, and examines personal, clinical, regional and methodological factors which explain variation in these rates. PsychINFO, EMBASE and MEDLINE (1946-2013) were searched systematically for studies reporting on stimulant drug use disorders in representative samples of people with psychotic disorders. Random effects models estimated the pooled rate of a stimulant use disorder, defined to include stimulant abuse and stimulant dependence. Study characteristics associated with heterogeneity in rates of stimulant use disorder were examined by subgroup analyses for categorical variables, by meta-regression for continuous independent variables and by multiple meta-regression. Sixty-four studies provided 68 estimates of lifetime or recent stimulant use disorders in 22,...
Australian and New Zealand Journal of Psychiatry, 2001
Objective: In Australia, mental health services are delivered by a complex web of publicand priva... more Objective: In Australia, mental health services are delivered by a complex web of publicand private-sector providers. There is a growing recognition that linkages between these groups are not optimal, and a concern that this may lead to poor outcomes. This paper illustrates a conceptual framework for developing, implementing and evaluating programmes concerned with linkages.Method: Drawing on theoretical and practical literature,
This article describes three recently established community-based crisis services for people with... more This article describes three recently established community-based crisis services for people with acute psychiatric illness. Data were obtained from local information systems developed in the early phase of service operation. Patterns of service were found to vary among the teams in terms of the frequency of contact with the client, the period of contact with the client and the overall numbers of contacts. Such diversification of services reflects, at least in part, the differences in the service networks within which the new services were set. Such diversification of services is inevitable and creative, and the evaluation of these services must consider not only the short-term impact of crisis services, but also the impact of the network of care services on longer term outcomes for the client. (Aust J Public Health 1991; 15: 122-9) rograms that offer an alternative to hospitalisation for people with serious mental illness Correspondence to Dr
Australian and New Zealand Journal of Psychiatry, 2001
Objective: This study aimed to examine access to mental health care for people from non-English-s... more Objective: This study aimed to examine access to mental health care for people from non-English-speaking backgrounds relative to that of people from English-speaking backgrounds, in the context of the mental health status of both groups; and to consider whether, if they perceive that they have needs for care, these needs are met.Method: The study used data from the population-based Australian
INFORMAL CAREGIVERS 21. 22. 23. 24. 25. 26. 27. 28. 29. Stenhouse NS, McCall MG. Differential mor... more INFORMAL CAREGIVERS 21. 22. 23. 24. 25. 26. 27. 28. 29. Stenhouse NS, McCall MG. Differential mortality from cardiovascular disease in migrants from England and Wales, Scotland and Italy, and native-born Australians. J Chronic Dis Ulman R, Abernethy JD. Blood pressure and length of stay in Australia of Italian immigrants in the Australian National Blood Pressure Study. Znt J Epidemiol 1975; 4: 213-5. Armstrong BK, Margetts BM, Masarei JRL, Hopkins SM. Coronary risk factors in Italian migrants to Australia. Am J Epidnniol 1983; 118: 651-8. English RM, Bennett SA. Overweight and obesity in the Australian community. J Food Nutr 1985; 42: 2-7. Keys A, Menotti A, Karvonen MJ et al. The diet and 15-year death rate in the seven countries study. Am J Ep'demiol1986; Carleton RA, Dwyer J, Finberg L, et al. Mueller WH, Wear ML, Hank CL, Emerson JB, et al. Which measurement of body fat is best for epidemiological research? AmJ Epidemiol 1991; 133: 858-69. Salonen JT, Slater JS, Tuomilehto J, Rauramaa R. Leisure time and occupational physical activity: risk of death from ischemic heart disease. Am J Epidemiol 1988; 127: 87-94. Zimmet PZ, Collins VR, Dowse GK, Alberti KGMM, et al. for the Mauritius Noncommunicable Disease Study Group. The relation of physical activity to cardiovascular disease risk factors in Mauritians. Am J Epidemiol 1991; 134: 862-75. Blair SN, Kohl HW, Paffenbarger RS, Clark DG. Physical fit-
Background: In recent times, increasing emphasis has been placed on quality of health services. T... more Background: In recent times, increasing emphasis has been placed on quality of health services. This movement began in the general health sector. It has now been embraced by the mental health sector, with the focus spanning acute inpatient, non-acute inpatient and ...
Social Psychiatry and Psychiatric Epidemiology, 1996
The aim of this study was to develop a practical, comprehensive, and valid self-report measure of... more The aim of this study was to develop a practical, comprehensive, and valid self-report measure of the experience of caring for a relative with a serious mental illness. The notion of caregiver 'burden' was rejected; instead caregiving was conceptualised within a 'stressappraisal-coping' framework. A 66-item version of the Experience of Caregiving Inventory (ECI) was derived from analyses of responses from 6216 caregivers, and then tested on an independent sample of 63 relatives of patients with schizophrenia recently in acute care. The extent to which the ECI complied with the stress-coping model was tested, especially the degree to which it, in association with coping, predicted psychological morbidity in carers. Ten sub-scales with good internal consistency resulted from our analyses, eight negative (difficult behaviours; negative symptoms; stigma; problems with services; effects on the family; the need to provide backup; dependency; loss) and two positive (rewarding personal experiences; good aspects of the relationship with the patient). The ECI, in conjunction
This analysis examines the notion of progressive deterioration in schizophrenia, using long-term ... more This analysis examines the notion of progressive deterioration in schizophrenia, using long-term followup data on hospital episodes in defined cohorts from psychiatric case registers in Victoria, Australia; Denmark; and Salford, England. The analyses differentiate heterogeneity existing at the first hospitalization for schizophrenia, which produces a widely varying natural course, from heterogeneity that develops over time, as episodes of hospitalization occur. Episodes of hospitalization for schizophrenia tend to duster earlier rather than later in the treatment career, suggesting a progressive amelioration rather than deterioration. When overall chronidty is adjusted, each additional episode of hospitalization lowers the risk for a further hospitalization by about 10 percent.
There is a paucity of studies examining which suicides are considered newsworthy. By combining da... more There is a paucity of studies examining which suicides are considered newsworthy. By combining data on media reports of individuals' suicides with routinely collected suicide data, it was found that 1% of Australian suicides were reported over a 1-year period. There was evidence of over-reporting of suicides by older people and females, and those involving dramatic methods. Reported suicides fell into three groups: suicides reported in a broader context; suicides by celebrities; and suicides involving unusual circumstances/methods. The data suggest a need for media professionals and suicide experts to work together to balance newsworthiness against the risk of copycat behavior.
International review of psychiatry (Abingdon, England), Jan 13, 2015
Australia has been implementing routine outcome measurement in its specialized public sector ment... more Australia has been implementing routine outcome measurement in its specialized public sector mental health services for over a decade. It uses a range of clinician-rated and consumer-rated measures that are administered at set times during episodes of inpatient, ambulatory and community residential episodes of care. Routine outcome measurement is now embedded in service delivery, and data are made available in a variety of ways to different audiences. These data are used by policy-makers and planners to inform decisions about system-wide reforms, by service managers to monitor quality and effectiveness, and by clinicians to guide clinical decision-making and to promote dialogue with consumers. Consumers, carers and the general community can use these data to ensure that services are accountable for the care they deliver. This paper describes the status quo in Australia with respect to routine outcome measurement, discusses the factors that led to its successful implementation, and c...
The Australian and New Zealand journal of psychiatry, 2014
To inform decisions about mental health resource allocation, planners require reliable estimates ... more To inform decisions about mental health resource allocation, planners require reliable estimates of people who report service demand (i.e. people who use or want mental health services) according to their level of possible need. Using data on 6915 adults aged 16-64 years in Australia's 2007 National Survey of Mental Health and Wellbeing, we examined past-year service demand among respondents grouped into four levels of possible need: (a) 12-month mental disorder; (b) lifetime but no 12-month mental disorder; (c) any other indicator of possible need (12-month symptoms or reaction to stressful event, or lifetime hospitalisation); (d) no indicator of possible need. Multivariate logistic regression analyses examined correlates of service demand, separately for respondents in each of levels 1-3. Sixteen per cent of Australian adults reported service demand, of whom one-third did not meet criteria for a 12-month mental disorder (equivalent to 5.7% of the adult population). Treatment p...
The British journal of psychiatry : the journal of mental science, 2014
Few studies have examined the impact of stimulant use on outcome in early psychosis. Ceasing subs... more Few studies have examined the impact of stimulant use on outcome in early psychosis. Ceasing substance use may lead to positive outcomes in psychosis. To examine whether baseline cannabis or stimulant disorders and ongoing drug use predict readmission within 2 years of a first psychosis admission. Predictors of readmission were examined with Cox regression in 7269 people aged 15-29 years with a first psychosis admission. Baseline cannabis and stimulant disorders did not predict readmission. A stimulant disorder diagnosis prior to index psychosis admission predicted readmission, but a prior cannabis disorder diagnosis did not. Ongoing problem drug use predicted readmission. The lowest rate of readmission occurred in people whose baseline drug problems were discontinued. Prior admissions with stimulant disorder may be a negative prognostic sign in first-episode psychosis. Drug use diagnoses at baseline may be a good prognostic sign if they are identified and controlled.
The Australian and New Zealand journal of psychiatry, 2014
Stimulants may worsen psychotic symptoms but there is limited evidence about the impact of stimul... more Stimulants may worsen psychotic symptoms but there is limited evidence about the impact of stimulant abuse in people with schizophrenia. This study examined the prevalence and correlates of stimulant and other drug disorders in a population-based sample of people with schizophrenia, examining associations with frequent service use, physical health comorbidities and accommodation instability. New South Wales (NSW) hospital, community mental health and emergency department data were used to examine health service contact over 5 years in 13,624 people with a diagnosis of schizophrenia. Associations of stimulant disorders were examined with multinomial logistic regression, comparing people with no substance disorders to those with cannabis disorders, stimulant disorders or both. Of people with schizophrenia, 51% had substance disorders, including 14% with stimulant disorders. Stimulant disorders were more common in young adults and in urban areas, less common in migrants, and unrelated ...
To describe the frequency, type and quality of mental health treatment among Australian adults wi... more To describe the frequency, type and quality of mental health treatment among Australian adults with past-year affective and/or anxiety disorders. Retrospective analysis of data for 8831 adults aged 16-85 years interviewed for the 2007 National Survey of Mental Health and Wellbeing, of whom 17% (n = 1517) met International Classification of Diseases, 10th revision (ICD-10) criteria for a past-year affective and/or anxiety disorder. Three levels of mental health treatment received in the past year: (1) any consultation with a health professional for mental health; (2) any evidence-based intervention (antidepressant medication, mood stabiliser medication, cognitive behaviour therapy and/or psychotherapy); and (3) minimally adequate treatment (a "dose" of an evidence-based intervention above a minimum threshold, consistent with treatment guidelines). Of participants with past-year affective and/or anxiety disorders, 39% sought professional help for mental health, 26% received an evidence-based treatment, and 16% received minimally adequate treatment. After controlling for clinical factors including type and severity of disorder, the odds of all levels of treatment were lower among younger adults (16-29 years) compared with middle-aged adults, and the odds of receiving an evidence-based treatment or minimally adequate treatment were lower among people who consulted a general practitioner only compared with a mental health professional. Closing the gap in treatment quality requires strategies to increase the use of evidence-based interventions, and to ensure these are delivered in sufficient doses. Research to elucidate why some patients are at increased risk of inadequate treatment, and the aspects of treatment that contribute to inadequate care, is indicated.
The Health of the Nation Outcome Scales was developed to routinely measure outcomes for adults wi... more The Health of the Nation Outcome Scales was developed to routinely measure outcomes for adults with mental illness. Comparable instruments were also developed for children and adolescents (the Health of the Nation Outcome Scales for Children and Adolescents) and older people (the Health of the Nation Outcome Scales 65+). All three are being widely used as outcome measures in the United Kingdom, Australia and New Zealand. There is, however, no comprehensive review of these instruments. This paper fills this gap by reviewing the psychometric properties of each. Articles and reports relating to the instruments were retrieved, and their findings synthesised to assess the instruments' validity (content, construct, concurrent, predictive), reliability (test-retest, inter-rater), sensitivity to change, and feasibility/utility. Mostly, the instruments perform adequately or better on most dimensions, although some of their psychometric properties warrant closer examination. Collectively,...
... Interim evaluation report of a trial of telephone-based cognitive behaviour therapy Bridget B... more ... Interim evaluation report of a trial of telephone-based cognitive behaviour therapy Bridget Bassilios,Valeria Zoteyeva, Kylie King, Justine Fletcher, Fay Kohn, Grant Blashki, Philip Burgess, Jane Pirkis August 2009 CENTRE for HEALTH POLICY, PROGRAMS and ECONOMICS ...
Objective: To examine whether there was a reduction in demand for psychological services provided... more Objective: To examine whether there was a reduction in demand for psychological services provided through the Access to Allied Psychological Services (ATAPS) projects after the introduction of the Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule (Better Access) program, and whether any such reduction was greater in urban than rural areas. Design and setting: A
The Australian and New Zealand journal of psychiatry, 2015
Stimulant abuse and dependence often complicate the care of people with psychotic disorders. This... more Stimulant abuse and dependence often complicate the care of people with psychotic disorders. This study systematically reviews the prevalence estimates reported for stimulant abuse and dependence in people with psychotic disorders, and examines personal, clinical, regional and methodological factors which explain variation in these rates. PsychINFO, EMBASE and MEDLINE (1946-2013) were searched systematically for studies reporting on stimulant drug use disorders in representative samples of people with psychotic disorders. Random effects models estimated the pooled rate of a stimulant use disorder, defined to include stimulant abuse and stimulant dependence. Study characteristics associated with heterogeneity in rates of stimulant use disorder were examined by subgroup analyses for categorical variables, by meta-regression for continuous independent variables and by multiple meta-regression. Sixty-four studies provided 68 estimates of lifetime or recent stimulant use disorders in 22,...
Australian and New Zealand Journal of Psychiatry, 2001
Objective: In Australia, mental health services are delivered by a complex web of publicand priva... more Objective: In Australia, mental health services are delivered by a complex web of publicand private-sector providers. There is a growing recognition that linkages between these groups are not optimal, and a concern that this may lead to poor outcomes. This paper illustrates a conceptual framework for developing, implementing and evaluating programmes concerned with linkages.Method: Drawing on theoretical and practical literature,
This article describes three recently established community-based crisis services for people with... more This article describes three recently established community-based crisis services for people with acute psychiatric illness. Data were obtained from local information systems developed in the early phase of service operation. Patterns of service were found to vary among the teams in terms of the frequency of contact with the client, the period of contact with the client and the overall numbers of contacts. Such diversification of services reflects, at least in part, the differences in the service networks within which the new services were set. Such diversification of services is inevitable and creative, and the evaluation of these services must consider not only the short-term impact of crisis services, but also the impact of the network of care services on longer term outcomes for the client. (Aust J Public Health 1991; 15: 122-9) rograms that offer an alternative to hospitalisation for people with serious mental illness Correspondence to Dr
Australian and New Zealand Journal of Psychiatry, 2001
Objective: This study aimed to examine access to mental health care for people from non-English-s... more Objective: This study aimed to examine access to mental health care for people from non-English-speaking backgrounds relative to that of people from English-speaking backgrounds, in the context of the mental health status of both groups; and to consider whether, if they perceive that they have needs for care, these needs are met.Method: The study used data from the population-based Australian
INFORMAL CAREGIVERS 21. 22. 23. 24. 25. 26. 27. 28. 29. Stenhouse NS, McCall MG. Differential mor... more INFORMAL CAREGIVERS 21. 22. 23. 24. 25. 26. 27. 28. 29. Stenhouse NS, McCall MG. Differential mortality from cardiovascular disease in migrants from England and Wales, Scotland and Italy, and native-born Australians. J Chronic Dis Ulman R, Abernethy JD. Blood pressure and length of stay in Australia of Italian immigrants in the Australian National Blood Pressure Study. Znt J Epidemiol 1975; 4: 213-5. Armstrong BK, Margetts BM, Masarei JRL, Hopkins SM. Coronary risk factors in Italian migrants to Australia. Am J Epidnniol 1983; 118: 651-8. English RM, Bennett SA. Overweight and obesity in the Australian community. J Food Nutr 1985; 42: 2-7. Keys A, Menotti A, Karvonen MJ et al. The diet and 15-year death rate in the seven countries study. Am J Ep'demiol1986; Carleton RA, Dwyer J, Finberg L, et al. Mueller WH, Wear ML, Hank CL, Emerson JB, et al. Which measurement of body fat is best for epidemiological research? AmJ Epidemiol 1991; 133: 858-69. Salonen JT, Slater JS, Tuomilehto J, Rauramaa R. Leisure time and occupational physical activity: risk of death from ischemic heart disease. Am J Epidemiol 1988; 127: 87-94. Zimmet PZ, Collins VR, Dowse GK, Alberti KGMM, et al. for the Mauritius Noncommunicable Disease Study Group. The relation of physical activity to cardiovascular disease risk factors in Mauritians. Am J Epidemiol 1991; 134: 862-75. Blair SN, Kohl HW, Paffenbarger RS, Clark DG. Physical fit-
Background: In recent times, increasing emphasis has been placed on quality of health services. T... more Background: In recent times, increasing emphasis has been placed on quality of health services. This movement began in the general health sector. It has now been embraced by the mental health sector, with the focus spanning acute inpatient, non-acute inpatient and ...
Social Psychiatry and Psychiatric Epidemiology, 1996
The aim of this study was to develop a practical, comprehensive, and valid self-report measure of... more The aim of this study was to develop a practical, comprehensive, and valid self-report measure of the experience of caring for a relative with a serious mental illness. The notion of caregiver 'burden' was rejected; instead caregiving was conceptualised within a 'stressappraisal-coping' framework. A 66-item version of the Experience of Caregiving Inventory (ECI) was derived from analyses of responses from 6216 caregivers, and then tested on an independent sample of 63 relatives of patients with schizophrenia recently in acute care. The extent to which the ECI complied with the stress-coping model was tested, especially the degree to which it, in association with coping, predicted psychological morbidity in carers. Ten sub-scales with good internal consistency resulted from our analyses, eight negative (difficult behaviours; negative symptoms; stigma; problems with services; effects on the family; the need to provide backup; dependency; loss) and two positive (rewarding personal experiences; good aspects of the relationship with the patient). The ECI, in conjunction
This analysis examines the notion of progressive deterioration in schizophrenia, using long-term ... more This analysis examines the notion of progressive deterioration in schizophrenia, using long-term followup data on hospital episodes in defined cohorts from psychiatric case registers in Victoria, Australia; Denmark; and Salford, England. The analyses differentiate heterogeneity existing at the first hospitalization for schizophrenia, which produces a widely varying natural course, from heterogeneity that develops over time, as episodes of hospitalization occur. Episodes of hospitalization for schizophrenia tend to duster earlier rather than later in the treatment career, suggesting a progressive amelioration rather than deterioration. When overall chronidty is adjusted, each additional episode of hospitalization lowers the risk for a further hospitalization by about 10 percent.
There is a paucity of studies examining which suicides are considered newsworthy. By combining da... more There is a paucity of studies examining which suicides are considered newsworthy. By combining data on media reports of individuals' suicides with routinely collected suicide data, it was found that 1% of Australian suicides were reported over a 1-year period. There was evidence of over-reporting of suicides by older people and females, and those involving dramatic methods. Reported suicides fell into three groups: suicides reported in a broader context; suicides by celebrities; and suicides involving unusual circumstances/methods. The data suggest a need for media professionals and suicide experts to work together to balance newsworthiness against the risk of copycat behavior.
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Papers by Philip Burgess