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Biomedical subjects

Anthony F Jorm

Publications and source records attributed to Anthony F Jorm.

At least 55 records · Page 3Linked to original sources
PubMed2005

Belief in the harmfulness of antidepressants: results from a national survey of the Australian public.

BACKGROUND: Surveys of the public in several countries have found that negative attitudes towards antidepressants are common. However, there has been little research into the factors associated with these attitudes. METHODS: A national survey of 999 Australian adults assessed beliefs about the helpfulness or harmfulness of antidepressants for a person with depression and suicidal thoughts. Associated factors investigated were as follows: sociodemographic characteristics, exposure to depression, ability to recognize depression, beliefs about other depression interventions, beliefs about long-term outcomes with and without treatment, beliefs about causes, and stigmatizing attitudes. RESULTS: Around a quarter of Australian adults believe that antidepressants would be harmful for a person who is depressed and suicidal. This group was less educated, had less exposure to depression, showed poorer recognition of depression, was less favorable about other standard interventions including psychological ones, was less pessimistic about the long-term outcome if the person did not have treatment, and was more likely to see depression as due to weakness and to be under the individual's control. LIMITATIONS: The survey did not directly ask about reasons for believing that antidepressants would be harmful. CONCLUSIONS: Belief in the harmfulness of antidepressants is associated with a general lack of exposure to depression, leading to an underestimation of its seriousness and of the necessity for intervention.

Adult↗
PubMed2005

Relationship of homocysteine, folic acid and vitamin B12 with depression in a middle-aged community sample.

BACKGROUND: Case control studies have supported a relationship between low folic acid and vitamin B112 and high homocysteine levels as possible predictors of depression. The results from epidemiological studies are mixed and largely from elderly populations. METHOD: A random subsample of 412 persons aged 60-64 years from a larger community sample underwent psychiatric and physical assessments, and brain MRI scans. Subjects were assessed using the PRIME-MD Patient Health Questionnaire for syndromal depression and severity of depressive symptoms. Blood measures included serum folic acid, vitamin B12, homocysteine and creatinine levels, and total antioxidant capacity. MRI scans were quantified for brain atrophy, subcortical atrophy, and periventricular and deep white-matter hyperintensity on T2-weighted imaging. RESULTS: Being in the lowest quartile of homocysteine was associated with fewer depressive symptoms, after adjusting for sex, physical health, smoking, creatinine, folic acid and B12 levels. Being in the lowest quartile of folic acid was associated with increased depressive symptoms, after adjusting for confounding factors, but adjustment for homocysteine reduced the incidence rate ratio for folic acid to a marginal level. Vitamin B12 levels did not have a significant association with depressive symptoms. While white-matter hyperintensities had significant correlations with both homocysteine and depressive symptoms, the brain measures and total antioxidant capacity did not emerge as significant mediating variables. CONCLUSIONS: Low folic acid and high homocysteine, but not low vitamin B12 levels, are correlates of depressive symptoms in community-dwelling middle-aged individuals. The effects of folic acid and homocysteine are overlapping but distinct.

Aged↗
PubMed2005

Within-occasion intraindividual variability and preclinical diagnostic status: is intraindividual variability an indicator of mild cognitive impairment?

Intraindividual variability in cognitive test performance has the potential to be a good marker of preclinical Alzheimer's disease status (S. C. Li & U. Lindenberger, 1999). Using cross-sectional community data from 2,317 individuals aged 60-64 years, the authors of this study found that variability was greater in individuals who met criteria for mild cognitive impairment or aging-associated cognitive decline but not for age-associated memory impairment. Higher variability was associated with lower education and a non-English-speaking background. In contrast to previous findings, variability in this study did not contribute uniquely to meeting criteria for mild cognitive impairment. The reasons for the differences may reside in the authors' method of estimating mean independent variability, the use of an occasion-specific measure, or the relatively younger age of the participants. Follow-up of the cohort in 4 years will yield data on the prospective validity of variability as a risk factor for impairment.

Adult↗
PubMed2005

Biomarkers, health, lifestyle, and demographic variables as correlates of reaction time performance in early, middle, and late adulthood.

We aimed to identify demographic, health, and biomarker correlates of reaction time performance and to determine whether biomarkers explained age differences in reaction time performance. TIhe sample comprised three representative cohorts aged 20-24, 40-44, and 60-64 years, including a total of 7,485 participants. Reaction time measures of intraindividual variability and latency were used. The measure of intraindividual variability used was independent of mean reaction time. Older adults were more variable than younger adults in choice reaction time performance but not simple reaction time performance. The most important correlates of reaction time performance after gender and education were biological markers such as forced expiratory volume at one second, grip strength, and vision. Few measures of physical or mental health or lifestyle were associated with poorer performance on reaction time measures. Biomarkers explained the majority of age-related variance in simple reaction time and a large proportion of variance in choice reaction time. We conclude that for the ages studied, biomarkers are more important than health factors for explaining age differences in reaction time performance.

Adult↗
PubMed2005

The impact of beyondblue: the national depression initiative on the Australian public's recognition of depression and beliefs about treatments.

OBJECTIVE: To evaluate whether a campaign to increase public knowledge about depression (beyondblue: the national depression initiative) has influenced the Australian public's ability to recognize depression and their beliefs about treatments. METHOD: Data from national surveys of mental health literacy in 1995 and 2003-04 were analysed to see if states and territories which funded beyondblue (the high exposure states) had greater change than those that did not (the low exposure states). In both surveys, participants were asked what was wrong with a person in a depression case vignette and to give opinions about the likely helpfulness for this person of a range of treatments. In the 2003-04 survey participants were also asked questions to assess awareness of beyondblue. RESULTS: Awareness of beyondblue in the states that provided funding was found to be around twice the level of those that did not. Using the low-exposure states as a control, the high-exposure states had greater change in beliefs about some treatments, particularly counselling and medication, and about the benefits of help-seeking in general. Recognition of depression improved greatly at a national level, but slightly more so in the high-exposure states. CONCLUSIONS: The data are consistent with beyondblue having had a positive effect on some beliefs about depression treatment.

Attitude to Health↗
PubMed2005

Non-linear relationships between cognitive function and alcohol consumption in young, middle-aged and older adults: the PATH Through Life Project.

AIMS: To investigate associations, including non-linear relationships, between cognitive function and alcohol consumption, testing for moderating effects of age and gender and for differences across outcome measures. Design Cross-sectional general population samples of three age cohorts. Setting Canberra and Queanbeyan, Australia. PARTICIPANTS: The total sample of 7485 consisted of 2404 men and women aged 20-24 years, 2530 aged 40-44 years, and 2551 aged 60-64 years, selected from the electoral rolls. Measurements Self-report data using hand-held computers provided weekly alcohol consumption from the Alcohol Use Disorders Identification Test (AUDIT) frequency, quantity and binge-drinking items, and socio-demographic factors. Spot-the-Word, digits backwards, the Symbol-Digit Modalities Test (SDMT), immediate recall and reaction-time tests were conducted by trained interviewers. FINDINGS: Findings varied across dependent variables, but there was a general tendency for light drinkers (up to 20/10 g alcohol per day in men/women, respectively) to perform better than abstainers, occasional drinkers or those drinking at hazardous/harmful levels (>40/20 g per day in men/women). Poorer performance of hazardous/harmful drinkers was seen only in men, whereas that of abstainers was evident in both sexes but was stronger in women. After adjustment for education and race, male hazardous/harmful drinkers no longer performed significantly less well than light drinkers, whereas male and female abstainers and occasional drinkers still did so. CONCLUSIONS: Abstainers have poorer cognitive function than light drinkers and further investigation is needed to determine what factors contribute to this.

Adult↗
PubMed2005

Lower cognitive test scores observed in alcohol abstainers are associated with demographic, personality, and biological factors: the PATH Through Life Project.

AIMS: To identify variables that explain the association between alcohol abstention and cognitive performance. We hypothesized that demographic and personality variables would be important for explaining the association in all age cohorts, but that health variables would be more important in the older age-cohorts. DESIGN: Three age cohorts (20-24, 40-44, 60-64 years) were sampled randomly, yielding a total of 7485 participants, with data from 602 alcohol abstainers and 4158 light or moderate drinkers used in this study. Setting The sample was drawn from the cities of Canberra and Queanbeyan, Australia. MEASUREMENTS: Scales measuring demographic, health and personality variables and cognitive and physical tests were administered. Participants drinking at hazardous or harmful levels were excluded from the analysis. FINDINGS: A range of demographic and physical function measures were found to explain partially the finding of abstainers having lower cognitive test scores. The effects of independent variables were largest in the 60-64-year-old age group with a trend for physical variables such as lung function and grip strength to become more important in the older age groups. In the 20-24-year-olds, the majority of the effect remained unexplained. CONCLUSION: There is evidence that poorer cognitive test performance by abstainers reflects in part selection effects and poorer physical functioning, but does not appear to be due to mental or physical health conditions or personality.

Adult↗
PubMed2005

Cognitive deficits 3 to 6 years before dementia onset in a population sample: the Honolulu-Asia aging study.

OBJECTIVE: To determine the type of cognitive deficits occurring 3 to 6 years before onset of dementia in a population sample. DESIGN: A prospective study in which cognitive deficits in participants who had incident dementia at the 6-year follow-up were examined at baseline and 3 years. SETTING: Honolulu, Hawaii. PARTICIPANTS: Three thousand seven hundred thirty-four Japanese-American men aged 71 to 93 at baseline. At the 6-year follow-up, there were 52 incident cases of dementia, and 1,559 controls. MEASUREMENTS: The Cognitive Abilities Screening Instrument (CASI) and a questionnaire on subjective memory problems were administered at baseline. Dementia was assessed at baseline and at 3-year and 6-year follow-ups. RESULTS: Subjects who had incident dementia at 6-year follow-up, had showed deficits 3 to 6 years earlier in the CASI domain of episodic memory and in the questionnaire covering subjective memory problems. Up to 3 years before onset, there was worsening of the episodic memory deficit from baseline and new deficits in language, verbal fluency, and orientation. CONCLUSION: Cognitive deficits and awareness of memory problems are frequently present several years before dementia onset. The predictive value of these deficits is not large enough to allow earlier diagnosis of dementia, but information about such deficits may be useful as criteria for mild cognitive impairment.

Aged↗
PubMed2005

MRI hyperintensities and depressive symptoms in a community sample of individuals 60-64 years old.

OBJECTIVE: Previous studies have found associations of magnetic resonance imaging (MRI) signal hyperintensities with depression in the elderly. The present study investigates the association in a younger community sample (age 60-64 years) of depressed subjects and comparison groups for potential mediating and confounding variables. METHOD: A subsample of 475 persons 60-64 years of age from a larger community survey underwent brain MRI scans. White matter hyperintensities were quantified by using an automated procedure, and basal ganglia hyperintensities were quantified by using semiquantitative visual ratings. The study also assessed depressive symptoms and use of antidepressant medication. Potential mediating or confounding variables assessed included physical disability, hypertension, stroke, diabetes, head injury, cortisol, thyroid-stimulating hormone, cognitive functioning, smoking, and alcohol use. RESULTS: Depressive symptoms were found to be related to total brain white matter hyperintensities but not to basal ganglia hyperintensities. However, associations disappeared when statistical adjustment was made for physical disability and smoking. CONCLUSIONS: Depressive symptoms are related to white matter hyperintensities in mid-adult life in a community sample. Physical disability appears to play an important role in this association.

Age Factors↗
PubMed2004

Hippocampal and amygdalar volumes in relation to handedness in adults aged 60-64.

We evaluated the association between handedness and manual tracings of hippocampal and amygdalar volumes. Brain MRI and handedness data were obtained for 441 community dwelling participants aged 60-64 years of whom 31 were left-handed. Both absolute and normalized hippocampal volumes were larger in left-handed women than right-handed women. Hippocampal volume was not associated with handedness in men, and amygdalar volume was not associated with handedness in men or women. There was no right-left asymmetry in hippocampal or amygdalar volumes in either gender. We conclude that volumetric differences by handedness must be taken into account where hippocampal volumes are of clinical importance. Our results may also explain reports of lower rates of dementia in left-handed individuals.

Adult↗
PubMed2004

Prevalence of mild cognitive impairment in 60- to 64-year-old community-dwelling individuals: The Personality and Total Health through Life 60+ Study.

This epidemiological study aimed at determining the prevalence of mild cognitive impairment (MCI) in 60- to 64-year-old individuals using different diagnostic criteria. Community dwelling individuals (n = 2,551) in the age range of 60-64 years were recruited randomly through the electoral roll. They were screened using the MMSE and a short cognitive battery, and those who screened positive underwent detailed medical and cognitive assessments. Extant MCI-related diagnoses were established by consensus. Predictive regression models on the sub-sample were used to determine population prevalence for the diagnoses. Of the 224 subjects who screened positive for MCI, 112 underwent a detailed assessment and 74% met the criteria for at least one recognised diagnosis of mild cognitive deficit (MCI and related diagnoses). By predictive regression modelling, the prevalence of any MCI diagnosis was 13.7% (95% CI 9.1-30.2) in the population of 60- to 64-year-olds. The estimated prevalence rates for specific diagnoses were: MCI 3.7%, ageing-associated cognitive decline 3.1%, Clinical Dementia Rating score (0.5) 2.8%, age-associated memory impairment 1%, other cognitive disorders 0.9%, and mild neurocognitive disorder 0.6%. Agreement on 'caseness' between various proposed diagnoses was at best fair and generally poor. Memory and other cognitive problems not meeting the threshold for dementia are relatively common in 60- to 64-year-old individuals living in the community. The prevalence rate varies up to six-fold according to the diagnostic criteria applied, with limited overlap between diagnoses. There is an urgent need for standardization of the criteria.

Activities of Daily Living↗
PubMed2004

Mental health first aid training of the public in a rural area: a cluster randomized trial [ISRCTN53887541].

BACKGROUND: A Mental Health First Aid course has been developed which trains members of the public in how to give initial help in mental health crisis situations and to support people developing mental health problems. This course has previously been evaluated in a randomized controlled trial in a workplace setting and found to produce a number of positive effects. However, this was an efficacy trial under relatively ideal conditions. Here we report the results of an effectiveness trial in which the course is given under more typical conditions. METHODS: The course was taught to members of the public in a large rural area in Australia by staff of an area health service. The 16 Local Government Areas that made up the area were grouped into pairs matched for size, geography and socio-economic level. One of each Local Government Area pair was randomised to receive immediate training while one served as a wait-list control. There were 753 participants in the trial: 416 in the 8 trained areas and 337 in the 8 control areas. Outcomes measured before the course started and 4 months after it ended were knowledge of mental disorders, confidence in providing help, actual help provided, and social distance towards people with mental disorders. The data were analysed taking account of the clustered design and using an intention-to-treat approach. RESULTS: Training was found to produce significantly greater recognition of the disorders, increased agreement with health professionals about which interventions are likely to be helpful, decreased social distance, increased confidence in providing help to others, and an increase in help actually provided. There was no change in the number of people with mental health problems that trainees had contact with nor in the percentage advising someone to seek professional help. CONCLUSIONS: Mental Health First Aid training produces positive changes in knowledge, attitudes and behaviour when the course is given to members of the public by instructors from the local health service.

Adolescent↗
PubMed2004

Suicide and mental health in rural, remote and metropolitan areas in Australia.

OBJECTIVES: To compare the prevalence of mental health disorders and the use of professional help by area of residence, age and sex; and to determine whether the differences parallel differences in suicide rates. DESIGN: Retrospective cross-sectional analysis of Australian national mortality data (1997-2000) and the National Survey of Mental Health and Wellbeing (1997), using broad area-of-residence classifications based on the Rural, Remote and Metropolitan Area (RRMA) index. MAIN OUTCOME MEASURES: (a) Suicide rates; (b) prevalence of depression, anxiety and substance-use disorders; and (c) use of health professionals for mental health problems - by age, sex and area of residence. RESULTS: Higher suicide rates were evident for men, particularly young men in rural (40.4 per 100 000; z, 3.2) and remote (51.7 per 100 000; z, 7.2) populations compared with metropolitan (31.8 per 100 000) populations. Although the proportion of young men reporting mental health disorders did not differ significantly between rural (23.5%; z, -0.5) and remote (18.8%; z, -1.6) areas compared with metropolitan (25.6%) areas, young men with a mental health disorder from non-metropolitan areas were significantly less likely than those from metropolitan areas to seek professional help for a mental health disorder (11.4% v 25.2%; z, -2.2). CONCLUSIONS: There is a need to investigate why young men in non-metropolitan areas, the population with the greatest suicide risk, do and do not engage with mental health services.

Adult↗
PubMed2004

Effectiveness of complementary and self-help treatments for anxiety disorders.

OBJECTIVES: To review the evidence for the effectiveness of complementary and self-help treatments for anxiety disorders. DATA SOURCES: Systematic literature search using PubMed, PsycLit, and the Cochrane Library. DATA SYNTHESIS: 108 treatments were identified and grouped under the categories of medicines and homoeopathic remedies, physical treatments, lifestyle, and dietary changes. We give a description of the 34 treatments (for which evidence was found in the literature searched), the rationale behind the treatments, a review of studies on effectiveness, and the level of evidence for the effectiveness studies. CONCLUSIONS: The treatments with the best evidence of effectiveness are kava (for generalised anxiety), exercise (for generalised anxiety), relaxation training (for generalised anxiety, panic disorder, dental phobia and test anxiety) and bibliotherapy (for specific phobias). There is more limited evidence to support the effectiveness of acupuncture, music, autogenic training and meditation for generalised anxiety; for inositol in the treatment of panic disorder and obsessive-compulsive disorder; and for alcohol avoidance by people with alcohol-use disorders to reduce a range of anxiety disorders.

Adolescent↗
PubMed2004

A National Depression Index for Australia.

OBJECTIVE: To develop a National Depression Index for measuring the depression status of the Australian population. DESIGN: Cross-sectional data were analysed from two random samples of the Australian adult population - the National Survey of Mental Health and Wellbeing (2000) and the National Health Survey (2001). PARTICIPANTS: The National Survey of Mental Health and Wellbeing (2000) - 10 641 participants; and the National Health Survey (2001) - 17 918 participants. MAIN OUTCOME MEASURES: Selected items from the Kessler Psychological Distress Scale (K10); and diagnoses of a major depressive episode according to DSM-IV criteria using a computerised interview. RESULTS: Six items from the K10 that were most closely related to the DSM-IV diagnosis of "major depressive episode" were identified. Scores on an index calculated from these items were rescaled to form an index reflecting relative risk of depression and having a value of 100 for the Australian adult population. Taking into account sex, employment status and income, index values were higher in younger people, females, unemployed people and those socioeconomically disadvantaged. This pattern provides additional support for the validity of the index, as well as establishing benchmark levels to which index values from future surveys and in other groups may be compared. CONCLUSIONS: The proposed National Depression Index is a valid indicator of depression and level of depressive symptoms. It is suitable for monitoring depression at the population level. The scaling characteristics of the measure ensure that it can be interpreted by members of the general public.

Adolescent↗
PubMed2004

Use of prescription medications and complementary and alternative medicines to treat depressive and anxiety symptoms: results from a community sample.

BACKGROUND: Individuals prescribed antidepressants or anxiolytics may replace or augment such medications with complementary and alternative medicines (CAMs). Little is known about the extent to which individuals in the community use CAMs instead of, or in addition to, medications they have been prescribed, for anxiety and depressive symptoms. METHOD: Information on use of CAMs, antidepressants and anxiolytics was obtained from a community sample of 7485 survey participants from Canberra and environs, Australia. Participants aged 20-24, 40-44, or 60-64 were also provided information on sociodemographic attributes, physical and mental health. RESULTS: 6.29% of participants used only prescription medications to treat their depression or anxiety. 2.28% used only CAMs for this purpose while a further 0.59% reported using both types of treatments. Those using CAMs and those who took prescription medications had comparable levels of mental health problems while CAM users had fewer physical health problems and lower neuroticism. Compared with those taking neither CAMs nor prescribed medication, however, CAM users had more depressive and anxiety symptoms, worse mental health, higher neuroticism and lower levels of mastery. LIMITATIONS: Information on use of prescribed and CAMs is self-reported and is subject to the inaccuracies and omissions associated with this method of data collection. CONCLUSION: We found survey participants used CAMs less frequently than prescription medications to treat their depressive or anxiety symptoms. Nonetheless, medical practitioners should be aware that their patients may use CAMs and seek information about such use to reduce the likelihood of adverse interactions between prescribed medication and CAMs.

Adult↗
PubMed2004

The impact of employee level and work stress on mental health and GP service use: an analysis of a sample of Australian government employees.

BACKGROUND: This study sought to identify the extent to which employee level and work stressors were associated with mental health problems experienced by Australian government employees, and with their use of primary care services. METHODS: 806 government employees aged between 40 and 44 years were surveyed as part of an epidemiological study conducted in Australia. Data collected from participants included sociodemographic attributes, physical health, psychological measures and work stressors relating to job control, job demands, job security and skills discretion at work. For 88% of these participants, information on visits made to general practitioners (GPs) for the six months before and after their survey interview was obtained from health insurance records. RESULTS: When work stress and personal factors were taken into account, men at more junior levels reported better mental health, more positive affect and used fewer GP services. Women at middle-management levels obtained less GP care than their more senior counterparts. Both men and women who reported higher levels of work stress were found to have poorer mental health and well-being. The impact of such stressors on GP service use, however, differed for men and women. CONCLUSION: Measures of work stress and not employee level affect the mental health and well-being of government employees. For governments with responsibility for funding health care services, reducing work stress experienced by their own employees offers potential benefits by improving the health of their workforce and reducing outlays for such services.

Administrative Personnel↗