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Biomedical subjects

Anthony F Jorm

Publications and source records attributed to Anthony F Jorm.

At least 37 records · Page 2Linked to original sources
PubMed2006

Examining geographical and household variation in mental health in Australia.

OBJECTIVE: International research has failed to demonstrate area effects in the distribution of common mental disorders. In contrast, strong and robust household effects are evident, though relatively rarely examined. This study investigated household and area effects in the distribution of mental health scores using Australian data. METHOD: Analysis of data from the first wave of the Household, Income and Labour Dynamics in Australia Survey: a large representative survey of 13 969 Australian adults. Multilevel regression methods were used to model variance in the mental health scale and mental component summary scale of the Short-Form 36 at the individual, household and area (Census Collection District) levels. A number of risk factors at various levels of the model were also examined. RESULTS: Very little variance in mental health scores occurred at the area level (1.5%), whereas significant and substantial variance occurred at the household level (23.0%). The variance at the household level remained highly significant following the inclusion of a range of risk factors at the individual, household and area levels. CONCLUSIONS: The results confirm the absence of substantial area-level variation in mental health using Australian data. The findings highlight the importance of focusing on household-level characteristics in future research.

Adolescent↗
PubMed2006

Influence of gender on mental health literacy in young Australians.

OBJECTIVES: To determine the effects of gender on mental health literacy in young people between 12 and 25 years of age. DESIGN: Computer-Assisted Telephone Interviewing was employed to conduct a cross-sectional structured interview focusing on young people's awareness of depression and psychosis. PARTICIPANTS: The sample comprised 1207 young Australians (539 males and 668 females) between the ages of 12-25 recruited from two metropolitan and two regional areas within Victoria. Six hundred and six respondents were presented a depression vignette and 601 were presented a psychosis vignette. RESULTS: Female respondents (60.7%) were significantly more likely to correctly identify depression in the vignette as compared to male respondents (34.5%). No significant gender differences were noted for the psychosis vignette. Males were less significantly likely to endorse seeing a doctor or psychologist/counsellor for the treatment of psychosis. Males were also significantly more likely than females to endorse alcohol as a way of dealing with depression and antibiotics as useful for dealing with psychosis. CONCLUSION: Gender differences in mental health literacy are striking. Males showed significantly lower recognition of symptoms associated with mental illness and were more likely endorse the use alcohol to deal with mental health problems. Such factors may contribute to the delays in help seeking seen in young males. Further research is needed to delineate how these gender differences in young people may obstruct help seeking, early intervention and other aspects of mental health service delivery.

Adolescent↗
PubMed2006

Measuring physical and mental health using the SF-12: implications for community surveys of mental health.

OBJECTIVE: The effects of using different approaches to scoring the SF-12 summary scales of physical and mental health were examined with a view to informing the design and interpretation of community-based survey research. METHOD: Data from a population-based study of 7485 participants in three cohorts aged 20-24, 40-44 and 60-64 years were used to examine relationships among measures of physical and mental health calculated from the same items using the SF-12 and RAND-12 approaches to scoring, and other measures of chronic physical conditions and psychological distress. RESULTS: A measure of physical health constructed using the RAND-12 scoring showed a monotonic negative association with psychological distress as measured by the Goldberg depression and anxiety scales. However, a non-monotonic association was evident in the relationship between SF-12 physical health scores and distress, with very high SF-12 physical health scores corresponding with high levels of distress. These relationships highlight difficulties in interpretation that can arise when using the SF-12 summary scales in some analytical contexts. CONCLUSIONS: It is recommended that community surveys that measure physical and mental functioning using the SF-12 items generate summary scores using the RAND-12 protocol in addition to the SF-12 approach. In general, researchers should be wary of using factor scores based on orthogonal rotation, which assumes that measures are uncorrelated, to represent constructs that have an actual association.

Adult↗
PubMed2006

Tobacco use after experiencing a major natural disaster: analysis of a longitudinal study of 2063 young adults.

AIM: To identify the extent to which tobacco use is affected by experience of a natural disaster and resulting symptoms of post-traumatic stress disorder (PTSD). DESIGN: Longitudinal community survey. SETTING: Canberra, the national capital of Australia. PARTICIPATION: A random selection of 2063 young adults participating in this project lived in a region affected by a major bushfire in 2003. They were first interviewed in 1999-2000 and re-interviewed in 2003-4 after the bushfire had occurred. MEASUREMENTS: Changes in participants' level of consumption of tobacco over a 4-year period were calculated. When interviewed after the disaster, participants answered questions concerning their experience of traumatic events, their immediate emotional response during the disaster and their fire-related PTSD symptoms of re-experiencing and hyperarousal. FINDINGS: Experience of traumatic events experienced during the disaster was associated with an increase in consumption of tobacco (OR: 1.12, 95% CI: 1.03-1.21). PTSD symptoms did not contribute independently to increased tobacco use after controlling for trauma experiences. CONCLUSIONS: These findings indicate that trauma experiences can trigger increased tobacco use in young adults regardless of whether such experiences result in PTSD symptoms. Public health information provided to communities and health-care providers should note that increases in this preventable health risk may occur as a result of individuals experiencing trauma.

Adult↗
PubMed2006

An instrument to measure engagement in life: factor analysis and associations with sociodemographic, health and cognition measures.

BACKGROUND: It has been proposed that active engagement with life may protect against cognitive decline. However, existing instruments for measuring life engagement have covered limited domains. OBJECTIVE: To present a new instrument to measure engagement with life; the RIASEC Activities List draws on activities categorised according to interest categories previously developed by Holland: Realistic, Investigative, Artistic, Social, Enterprising and Conventional (RIASEC). METHODS: Participants in a longitudinal, community-based survey were drawn from 3 age groups: 2,404 participants aged 20-24; 2,530 aged 40-44, and 2,551 aged 60-64 years. They provided information on which of 54 selected activities they had performed in the 6 months prior to their survey interview. Other information obtained from participants included measures of sociodemographic characteristics, personality attributes and mental and physical health. Two measures of cognition were also examined. Analyses were conducted separately for men and women in each of the 3 age groups. RESULTS: Confirmatory factor analyses identified six scales of activity types corresponding to Holland's six interest categories. The number of activities of any type undertaken in the past 6 months was significantly associated with cognitive measures, better physical health, and better mental health although these findings varied for men and women across the 3 age groups. Further, for both men and women in all age groups, performing activities of any type was associated with having higher extraversion and mastery scores, and lower levels of neuroticism. Associations were also found between performing specific types of activities and cognitive measures. CONCLUSIONS: This instrument has the potential to identify more clearly types of activities that may offer cognitive benefits and warrants further testing in longitudinal studies.

Adult↗
PubMed2006

Search for a common cause factor amongst cognitive, speed and biological variables using narrow age cohorts.

BACKGROUND: Cross-sectional studies have demonstrated that age-related effects on many cognitive and biological functioning variables are shared. A number of theories postulate that these associations arise from a common causal mechanism responsible for change across a wide range of functions. However, it has been claimed that the finding of shared variance among variables in these studies may be spurious because most studies have been cross-sectional and based on age-heterogeneous samples. OBJECTIVE: To examine evidence for changes with age in variance shared by cognitive variables using a narrow-age cohort design. METHODS: Three samples of adults with age ranges 20-24 years (n = 2,404), 40-44 years (n = 2,530) and 60-64 years (n = 2,510) were drawn from a population-based study. These groups were supplemented by data from an older sample of individuals (77 years and over) from a second population-based study (n = 374). Four models of the structure of a range of cognitive, speed and biological variables derived from previous cross-sectional research were fitted to data. These models were complete independence of variables within a cohort, a single common factor, multiple independent factors, and a second order factor model. RESULTS: Model fit and the magnitude of loadings from multiple-group confirmatory factor analyses was compared between age groups. The fit for all four models was worse in the 60-64 year age group. Factor loadings on the common factor specified in these models varied between the groups, but the speed factor rather than the biological factor showed increased loadings as a function of age. CONCLUSIONS: This narrow age-cohort study did not support the existence of developmental changes in the structure of cognitive and biological variables across the lifespan. Shared variation between measures of cognition and biological function may be an artifact of the research designs that have generated these findings. This casts doubt of the existence of a common causal mechanism. However, it may be that such changes manifest only in later old age.

Adult↗
PubMed2006

Modified Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as a screening test for dementia for Thai elderly.

A potential test for early detection of dementia in the elderly is the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), which is based on information from the informant for the elderly about the changes of the elderly in everyday cognitive functioning associated with dementia. The present study aimed to modify and assess the reliability and validity of the modified IQCODE consisting of 32 items. The study consisted of two methods of assessing dementia: DSMIV diagnosis carried out by clinicians, and informants responding to the IQCODE. The subjects were 200 pairs of elderly subjects and their informants who visited the Geriatric Clinic, Ramathibodi Hospital. The optimal cutoff score on the modified IQCODE was 3.42, with 90% sensitivity and 95% specificity. The positive predictive values, negative predictive values, and accuracy were 0.94, 0.90, and 0.92, respectively. The IQCODE items had high internal consistency. The IQCODE associated with the elderly person's age, but not with their gender and educational level; nor were they associated with the demographic characteristics of the informant. Therefore, the IQCODE could be used as an alternative screening test for dementia in Thailand with acceptable sensitivity and specificity. This tool may be useful for dementia screening in the community and the geriatric clinic for early detection of disease.

Adult↗
PubMed2005

Experiences in applying skills learned in a Mental Health First Aid training course: a qualitative study of participants' stories.

BACKGROUND: Given the high prevalence of mental disorders and the comparatively low rate of professional help-seeking, it is useful for members of the public to have some skills in how to assist people developing mental disorders. A Mental Health First Aid course has been developed to provide these skills. Two randomized controlled trials of this course have shown positive effects on participants' knowledge, attitudes and behavior. However, these trials have provided limited data on participants' subsequent experiences in providing first aid. To remedy this, a study was carried out gathering stories from participants in one of the trials, 19-21 months post-training. METHODS: Former course participants were contacted and sent a questionnaire either by post or via the internet. Responses were received from 94 out of the 131 trainees who were contacted. The questionnaire asked about whether the participant had experienced a post-training situation where someone appeared to have a mental health problem and, if so, asked questions about that experience. RESULTS: Post-training experiences were reported by 78% of respondents. Five key points emerged from the qualitative data: (1) the majority of respondents had had some direct experience of a situation where mental health issues were salient and the course enabled them to take steps that led to better effects than otherwise might have been the case; (2) positive effects were experienced in terms of increased empathy and confidence, as well as being better able to handle crises; (3) the positive effects were experienced by a wide range of people with varied expectations and needs; (4) there was no evidence of people over-reaching themselves because of over-confidence and (5) those who attended were able to identify quite specific benefits and many thought the course not only very useful, but were keen to see it repeated and extended. CONCLUSION: The qualitative data confirm that most members of the public who receive Mental Health First Aid training subsequently provide support to people with mental health problems and that this support generally has positive effects.

Adult↗
PubMed2005

Associations of pre-trauma attributes and trauma exposure with screening positive for PTSD: analysis of a community-based study of 2,085 young adults.

BACKGROUND: While pre-trauma personality and mental health measures are risk factors for post-traumatic stress disorder (PTSD), such information is usually obtained following the trauma and can be influenced by post-trauma distress. We used data collected from a community-based survey of young adults before and after a major natural disaster to examine the extent to which participants' traumatic experiences, demographic and pre-trauma risk factors were associated with their screening positive for PTSD when re-interviewed. METHOD: A representative selection of 2,085 young adults from the Australian Capital Territory and environs, interviewed in 1999 as part of a longitudinal community-based survey, were re-interviewed 3-18 months after a major bushfire had occurred in the region. When re-interviewed, they were asked about their experiences of trauma threat, uncontrollable and controllable traumatic experiences and their reaction to the fire. They were also screened for symptoms of fire-related PTSD experienced in the week prior to interview. RESULTS: Four-fifths of participants were exposed to the trauma with around 50% reporting having experienced uncontrollable traumatic events. Reporting PTSD symptoms was associated with being female, having less education, poorer mental health and higher levels of neuroticism prior to the trauma. Particular fire experiences, including being evacuated and feeling very distressed during the disaster, were more strongly associated with PTSD symptoms compared with pre-trauma measures. CONCLUSIONS: While demographic and pre-trauma mental health increased the likelihood of reporting PTSD symptoms, exposure to trauma threat and reaction to the trauma made greater contributions in explaining such symptoms as a result of this disaster.

Adult↗
PubMed2005

Clinical and neuroimaging correlates of mild cognitive impairment in a middle-aged community sample: the personality and total health through life 60+ study.

This cross-sectional study aimed at determining the clinical and structural brain magnetic resonance imaging correlates of mild cognitive impairment (MCI). The data presented here are from the first wave of the longitudinal Personality and Total Health through Life 60+ project. 2,551 community-dwelling individuals in the age range of 60-64 years were recruited randomly through the electoral roll. They were screened using Mini-Mental State Examination and a short cognitive battery. Those who screened positive underwent detailed medical and neuropsychological assessments. Of the 224 subjects who screened positive, 117 underwent a detailed assessment. Twenty-nine subjects fulfilled the Mayo Clinic criteria for MCI. Magnetic resonance imaging scans were analyzed for 26 subjects with MCI as well as normal controls. Subjects were clinically evaluated for depressive symptoms and major and minor depression syndromes. Logistic regression analysis was performed predicting MCI from anterior and mid-ventricular brain ratios, cortical atrophy measures, hippocampal volumes, volumes of amygdala and white matter hyperintensities after adjusting for age, gender, years of education, depression and physical disability. None of the neuroanatomical substrates appeared as predictors of MCI. The only predictors were higher depression scores and fewer years of education. Structural neuroimaging may not have an added advantage in the detection of MCI in middle-aged community-dwelling subjects. It may be that this age group is too young for such brain changes to be identified.

Amygdala↗
PubMed2005

Structure of beliefs about the helpfulness of interventions for depression and schizophrenia. Results from a national survey of the Australian public.

BACKGROUND: The public tends to have different views from professionals about the treatment of mental disorders. It has been proposed that these differences do not simply reflect a lack of knowledge about treatments, but also the operation of pre-existing general belief systems about health interventions. The present study uses factor analysis to examine the structure of public beliefs about interventions for depression and schizophrenia, using case vignettes that vary in severity or stage of illness. METHODS: In a national survey of 3,998 Australian adults, respondents were presented with one of four vignettes: depression, depression with suicidal thoughts, early schizophrenia and chronic schizophrenia. Respondents were asked about the likely helpfulness or harmfulness of a wide range of interventions for the person in the vignette. Methods suitable for ordinal data were used to explore a range of factor analytic solutions. Once identified, the location of participants on each factor was estimated by calculating a mean score for items loading highly on that factor. These scale means were compared between subgroups of participants. RESULTS: Four factors were found. Three of these-Lifestyle, Psychological and Medical-corresponded to previously found factors. An additional factor named Information-seeking was defined by items that had not been included in earlier research. These items concerned obtaining information or advice from a variety of sources including the internet, books and health educators. Differences on the factors were a function of socio-demographic factors and ability to identify the condition portrayed in the vignette. However, the magnitude of these differences was small. Differences between factors were more pronounced, with mean ratings on the Medical factor falling between harmful and neutral, while mean ratings on other factors lay between neutral and helpful. CONCLUSION: The public tends to favour psychological and lifestyle interventions over medical ones. These beliefs do not reflect specific knowledge about the effectiveness of particular treatments, but rather general commitments to broad classes of treatment that are applied irrespective of the type of mental disorder. Educational campaigns to improve public knowledge about treatments will need to take account of these pre-existing belief systems.

Adult↗
PubMed2005

Hormone replacement therapy and cognition in an Australian representative sample aged 60-64 years.

OBJECTIVE: To investigate the relationship between hormone replacement therapy (HRT) and level of cognitive performance intra-individual variability, and interactions with statin use, progesterone therapy and type of menopause. METHODS: A representative sample of 60-64 year olds was recruited from the Canberra and Queanbeyan regions in Australia. They were administered tests of verbal memory, working memory, speed of information processing, simple and complex reaction time, verbal intelligence and the Mini-Mental State Exam. Intra-individual variation (consistency) on performance on simple and complex reaction time tasks was calculated. Women provided information on HRT use and demographic, health and lifestyle variables. RESULTS: Four hundred and four (35.0%) current postmenopausal HRT users, 316 (27.4%) previous HRT users and 434 (37.6%) women who had never used HRT, were included in this study. There were significant overall differences between HRT current and previous users on age, prevalence of diabetes, alcohol use, body mass index, level of anxiety and lung function. After controlling for potentially confounding health and demographic variables, there were no significant main effects detected between HRT groups on any cognitive measure. Significant interactions were detected between HRT group and statin use on intra-individual variability on simple reaction time, and between HRT group and menopause type on intra-individual variability on choice reaction time. All other interactions were non-significant. CONCLUSIONS: HRT use had no effect on level of cognitive performance. Two interactions were detected between HRT use and statin use, and type of menopause on intra-individual variability. Given the large number of comparisons, little weight can be placed on these significant results.

Analysis of Variance↗
PubMed2005

Public beliefs about causes and risk factors for mental disorders: a comparison of Japan and Australia.

BACKGROUND: Surveys of the public in a range of Western countries have shown a predominant belief in social stressors as causes of mental disorders. However, there has been little direct cross-cultural comparison. Here we report a comparison of public beliefs about the causes of mental disorders in Japan and Australia. METHODS: Surveys of the public were carried out in each country using as similar a methodology as feasible. In both countries, household interviews were carried out concerning beliefs about causes and risk factors in relation to one of four case vignettes, describing either depression, depression with suicidal thoughts, early schizophrenia or chronic schizophrenia. In Japan, the survey involved 2000 adults aged between 20 and 69 from 25 regional sites spread across the country. In Australia, the survey involved a national sample of 3998 adults aged 18 years or over. RESULTS: In both countries, both social and personal vulnerability causes were commonly endorsed across all vignettes. The major differences in causal beliefs were that Australians were more likely to believe in infection, allergy and genetics, while Japanese were more likely to endorse "nervous person" and "weakness of character". For risk factors, Australians tended to believe that women, the young and the poor were more at risk of depression, but these were not seen as higher risk groups by Japanese. CONCLUSION: In both Japan and Australia, the public has a predominant belief in social causes and risk factors, with personal vulnerability factors also seen as important. However, there are also some major differences between the countries. The belief in weakness of character as a cause, which was stronger in Japan, is of particular concern because it may reduce the likelihood of seeking professional help and support from others.

Adolescent↗
PubMed2005

Public beliefs about causes and risk factors for mental disorders: changes in Australia over 8 years.

BACKGROUND: Surveys of the public in several countries have found a predominant belief in social environmental causes of mental disorders. The present study was conducted to determine whether this has changed over time in Australia. METHOD: Beliefs about causes and risk factors were assessed using questions based around case vignettes of a person with depression or schizophrenia. These questions were asked in a national survey of 2,031 Australians aged 18-74 carried out in 1995, and a second survey of 1,823 persons carried out in 2003-2004. RESULTS: The major changes were an increase in belief in genetic causes of both depression and schizophrenia, increases in beliefs about problems from childhood and the death of someone close as causes of depression, and a decrease in the belief that "weakness of character" is a cause of schizophrenia. CONCLUSION: There has been an increase in belief about genetic causes, which may be due to publicity about the human genome project and related scientific advances. This change has not been at the expense of belief in social causes, and it has been accompanied by a decrease in the belief that personal weakness is a cause.

Adolescent↗
PubMed2005

Public beliefs about treatment and outcome of mental disorders: a comparison of Australia and Japan.

BACKGROUND: Surveys of the public in a number of countries have shown poor recognition of mental disorders and beliefs about treatment that often diverge from those of health professionals. This lack of mental health literacy can limit the optimal use of treatment services. Australia and Japan are countries with very different mental health care systems, with Japan emphasising hospital care and Australia more oriented to community care. Japan is also more collectivist and Australia more individualist in values. These differences might influence recognition of disorders and beliefs about treatment in the two countries. METHODS: Surveys of the public were carried out in each country using as similar a methodology as feasible. In both countries, household interviews were carried out concerning beliefs in relation to one of four case vignettes, describing either depression, depression with suicidal thoughts, early schizophrenia or chronic schizophrenia. In Australia, the survey involved a national sample of 3998 adults aged 18 years or over. In Japan, the survey involved 2000 adults aged between 20 and 69 from 25 regional sites spread across the country. RESULTS: The Japanese public were found to be more reluctant to use psychiatric labels, particularly for the depression cases. The Japanese were also more reluctant to discuss mental disorders with others outside the family. They had a strong belief in counsellors, but not in GPs. They generally believe in the benefits of treatment, but are not optimistic about full recovery. By contrast, Australians used psychiatric labels more often, particularly "depression". They were also more positive about the benefits of seeking professional help, but had a strong preference for lifestyle interventions and tended to be negative about some psychiatric medications. Australians were positive about both counsellors and GPs. Psychiatric hospitalization and ECT were seen negatively in both countries. CONCLUSION: There are some major differences between Australia and Japan in recognition of disorders and beliefs about treatment. Some of these may relate to the different health care systems, but the increasing openness about mental health in Australia is also likely to be an explanatory factor.

Attitude to Health↗
PubMed2005

Recognition of depression and psychosis by young Australians and their beliefs about treatment.

OBJECTIVES: To assess young people's ability to recognise clinically defined depression and psychosis, the types of help they thought appropriate for these problems, their knowledge of appropriate treatments, and their perceptions regarding prognosis. DESIGN: A cross-sectional telephone survey using structured interviews. Vignettes of a person with either depression or psychosis were presented, followed by questions related to recognition of the disorder, best forms of treatment and the prognosis. PARTICIPANTS: A randomly selected sample of 1207 young people aged 12-25 years. SETTING: Melbourne, Victoria, and surrounding regional and rural areas. OUTCOME MEASURES: Responses to a mental health literacy questionnaire. RESULTS: Almost half the respondents were able to identify depression correctly, whereas only a quarter identified psychosis correctly. Counsellors and family or friends were the most commonly cited forms of best help, with family or friends preferred by the younger age group for depression. General practitioners were considered more helpful for depression, and psychiatrists and psychologists more helpful for psychosis. Most respondents considered counselling and psychotherapy to be helpful. However, more than half the respondents expressed negative or equivocal views regarding the helpfulness of recommended pharmacological treatments. CONCLUSIONS: The limitations we identified in youth mental health literacy may contribute to the low rates of treatment and the long duration of untreated illness reported in other studies. There is a need for initiatives to enhance mental health literacy among young people, and those close to them, if benefits of early treatment are to be realised.

Adolescent↗
PubMed2005

Mental health first aid responses of the public: results from an Australian national survey.

BACKGROUND: The prevalence of mental disorders is so high that members of the public will commonly have contact with someone affected. How they respond to that person (the mental health first aid response) may affect outcomes. However, there is no information on what members of the public might do in such circumstances. METHODS: In a national survey of 3998 Australian adults, respondents were presented with one of four case vignettes and asked what they would do if that person was someone they had known for a long time and cared about. There were four types of vignette: depression, depression with suicidal thoughts, early schizophrenia, and chronic schizophrenia. Verbatim responses to the open-ended question were coded into categories. RESULTS: The most common responses to all vignettes were to encourage professional help-seeking and to listen to and support the person. However, a significant minority did not give these responses. Much less common responses were to assess the problem or risk of harm, to give or seek information, to encourage self-help, or to support the family. Few respondents mentioned contacting a professional on the person's behalf or accompanying them to a professional. First aid responses were generally more appropriate in women, those with less stigmatizing attitudes, and those who correctly identified the disorder in the vignette. CONCLUSIONS: There is room for improving the range of mental health first aid responses in the community. Lack of knowledge of mental disorders and stigmatizing attitudes are important barriers to effective first aid.

Adolescent↗