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Helen Christensen

Publications and source records attributed to Helen Christensen.

At least 55 records · Page 3Linked to original sources
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

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

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↗
PubMed2004

Association of adverse childhood experiences, age of menarche, and adult reproductive behavior: does the androgen receptor gene play a role?

Previous research has reported associations between adverse childhood experiences, early menarche, and early sexual activity. One hypothesis to account for these findings is that an X-linked androgen receptor GGC-repeat polymorphism predisposes fathers to behaviors which include family abandonment and their daughters to earlier menarche and sexual activity and less stable relationships. Retrospective data relevant to this theory were examined from a community survey involving 3,702 women in the age groups 20-24, 40-44, and 60-64 years, and another involving 908 women aged 18-79 years. Earlier age of menarche was found to be associated with adverse childhood experiences and earlier sexual activity. However, the androgen receptor gene polymorphism was unrelated to adverse fathering behavior or to marital breakdown.

Adult↗
PubMed2004

Delivering interventions for depression by using the internet: randomised controlled trial.

OBJECTIVE: To evaluate the efficacy of two internet interventions for community-dwelling individuals with symptoms of depression--a psychoeducation website offering information about depression and an interactive website offering cognitive behaviour therapy. DESIGN: Randomised controlled trial. SETTING: Internet users in the community, in Canberra, Australia. PARTICIPANTS: 525 individuals with increased depressive symptoms recruited by survey and randomly allocated to a website offering information about depression (n = 166) or a cognitive behaviour therapy website (n = 182), or a control intervention using an attention placebo (n = 178). MAIN OUTCOME MEASURES: Change in depression, dysfunctional thoughts; knowledge of medical, psychological, and lifestyle treatments; and knowledge of cognitive behaviour therapy. RESULTS: Intention to treat analyses indicated that information about depression and interventions that used cognitive behaviour therapy and were delivered via the internet were more effective than a credible control intervention in reducing symptoms of depression in a community sample. For the intervention that delivered cognitive behaviour therapy the reduction in score on the depression scale of the Center for Epidemiologic Studies was 3.2 (95% confidence interval 0.9 to 5.4). For the "depression literacy" site (BluePages), the reduction was 3.0 (95% confidence interval 0.6 to 5.2). Cognitive behaviour therapy (MoodGYM) reduced dysfunctional thinking and increased knowledge of cognitive behaviour therapy. Depression literacy (BluePages) significantly improved participants' understanding of effective evidence based treatments for depression (P < 0.05). CONCLUSIONS: Both cognitive behaviour therapy and psychoeducation delivered via the internet are effective in reducing symptoms of depression.

Adolescent↗
PubMed2004

Homocysteine and the brain in midadult life: evidence for an increased risk of leukoaraiosis in men.

BACKGROUND: High serum homocysteine (HCY) levels have been associated with thromboembolic cerebrovascular disease, but their relationship to microvascular disease is uncertain. Homocysteine also has a direct neurotoxic effect and has been linked to brain atrophy and an increased risk of Alzheimer disease. OBJECTIVE: To examine the relationship of HCY levels to brain and cognitive measures in a healthy community sample. DESIGN: Cross-sectional study. SETTING: Individuals residing in Canberra and Queanbeyan, Australia, who were participating in the longitudinal PATH Through Life Project. PARTICIPANTS: Individuals aged 60 to 64 years selected randomly from the community, 196 men and 189 women. MAIN OUTCOME MEASURES: Regression coefficients with HCY level as the putative determinant and various magnetic resonance imaging measures (brain atrophy index, ventricle-brain ratios, volume of periventricular and deep white matter hyperintensities) and cognitive measures (information processing speed, verbal memory, fine motor speed) as dependent measures. RESULTS: Homocysteine levels did not have a significant relationship with brain atrophy index or ventricle-brain ratios. High HCY levels were related to increased deep white matter hyperintensities but not periventricular white matter hyperintensities, after correcting for levels of folate, vitamin B(12), creatinine, and thyrotropin; hypertension; smoking; and diabetes, the relationship being significant only in men. Homocysteine levels were related to impairment in verbal memory and fine motor speed but not after the previously mentioned correction. CONCLUSIONS: Total HCY level is independently related to leukoaraiosis in middle-aged men, and this may be functionally relevant in the form of mild cognitive impairment. The remediation of hyperhomocysteinemia should begin early in life if its deleterious effects on the brain are to be prevented.

Brain↗
PubMed2004

Use of medical services after participation in a community-based epidemiological health survey.

BACKGROUND: Personally relevant health information is an important factor that can change individuals' perceptions of their health needs. Health information can be delivered through various mechanisms, including health promotion campaigns and the general media. Another means by which individuals may receive personal health information is by participating in an epidemiological health survey. This study investigated effects of such participation on numbers of health services used by a representative sample of 7485 Australians. METHODS: Participants in the PATH Through Life Project lived in Canberra and environs, Australia, and were drawn from three age groups: 20-24 years, 40-44 years and 60-64 years. Information obtained included socio-demographic variables, mental and physical health as measured by the 12-item Short Form Health Survey Questionnaire, and national insurance data on numbers of general practitioner (GP) services used before and after survey participation. RESULTS: Both men and women in the youngest age group, men aged 40-44 years and women aged 60-64 years obtained more GP services for 3 months after interview. After this 3-month period, levels of service use by these participants returned to pre-interview levels. Increased service use related primarily to participants reporting poorer mental or physical health and to their being given information on potential health risks as part of the survey process. CONCLUSIONS: These findings suggest that participating in such surveys may increase self-awareness of current physical and mental health status, potential health risks and health care needs.

Adult↗
PubMed2004

A population survey found an association between self-reports of traumatic brain injury and increased psychiatric symptoms.

OBJECTIVE: This study determined whether self-reported Traumatic Brain Injury (TBI), identified in a community sample and occurring up to 60 years previously, is associated with current psychiatric symptoms, suicidality, and psychologic well-being. STUDY DESIGN AND SETTING: Three age cohorts (20-24, 40-44, 60-64) were randomly sampled from the cities of Canberra and Queanbeyan, Australia, yielding a total of 7,485 participants. The samples were administered scales measuring anxiety, depression, suicidality, positive and negative affect, personality traits, and physical health status. RESULTS: Of the total sample, 5.7% reported history of TBI involving loss of consciousness for at least 15 min, occurring an average of 22 years previously. History of TBI was associated with increased symptoms of depression, anxiety, negative affect, and suicidal ideation. CONCLUSION: History of TBI is a risk factor for psychiatric morbidity. The effect is greatest in young adults, and occurs up to several decades subsequent to the occurrence of TBI.

Adult↗
PubMed2004

Gender differences in factors affecting use of health services: an analysis of a community study of middle-aged and older Australians.

Research on patterns of self-rated health and health service use suggests that women report having poorer health than men, and that, after controlling for health measures, women are more likely to obtain formal health care. Proposed reasons for these differences have included that women's self-rated health is more strongly influenced by psychosocial factors or negative affect and that women are likely to obtain services when at better levels of self-rated health, compared with men. Our study explored gender differences in the effects of non-health attributes on decisions to obtain primary medical services for an Australian community-based sample of 4140 adults from two age groups: 40-44 years and 60-64 years. Participants provided information on measures of physical and mental health, and on predisposing and enabling factors that could affect their levels of health service use. Information on visits made to general practitioners (GPs) in a 6-month period was obtained from the national insurer. We found that men and women who obtained no GP services reported comparable levels of physical and mental health and that, for both men and women, measures of health needs were most strongly associated with their obtaining care. After controlling for measures of mental and physical health and enabling factors, we found that non-health factors that could predispose an individual to obtain care had greater impact on men's but not women's decisions to obtain any GP services. Our findings do not support the hypothesis that in choosing to obtain medical care, women are more strongly influenced by non-health factors compared with men.

Adult↗
PubMed2004

Use of medications to enhance memory in a large community sample of 60-64 year olds.

BACKGROUND: There are no existing epidemiological data on use of medications to enhance memory. METHOD: A community survey was carried out in Canberra and Queanbeyan, Australia, of an electoral roll sample of 2551 adults aged 60-64 years. Data collected included self-reports of using medications to enhance memory, tests of memory and other cognitive functions, anxiety, depression, physical health and use of other medications. RESULTS: 2.8% of the sample reported using medications to enhance memory, the main ones being gingko biloba, vitamin E, bacopa (brahmi), and folic acid/B vitamins. Users were more likely to be female, to have subjective memory problems and to use other psychotropic medications. However, they did not differ in memory performance, anxiety, depression or physical health. DISCUSSION: Some older people are using complementary medications to improve their memory or prevent memory loss, despite the lack of strong evidence for their effectiveness. These people show no objective evidence of memory impairment.

Aged↗
PubMed2004

Academic consumer researchers: a bridge between consumers and researchers.

OBJECTIVE: To describe the contributions that consumers, and academic consumer researchers in particular, can make to mental health research. METHOD: A literature survey and a systematic consideration of the potential advantages of consumer and academic consumer researcher involvement in health research. RESULTS: Consumer researchers may contribute to better health outcomes, but there are significant barriers to their participation in the research process. To date, discussion has focused on the role of nonacademic consumers in the health research process. There has been little recognition of the particular contributions that consumers with formal academic qualifications and research experience can offer. Academic consumer researchers (ACRs) offer many of the advantages associated with lay consumer participation, as well as some unique advantages. These advantages include acceptance by other researchers as equal partners in the research process; skills in research; access to research funding; training in disseminating research findings within the scientific community; potential to influence research funding and research policy; capacity to influence the research culture; and potential to facilitate the involvement of lay consumers in the research process. In recognition of the value of a critical mass of ACRs in mental health, a new ACR unit (the Depression and Anxiety Consumer Research Unit [CRU]) has been established at the Centre for Mental Health Research at the Australian National University. CONCLUSIONS: Academic consumer researchers have the potential to increase the relevance of mental health research to consumers, to bridge the gap between the academic and consumer communities and to contribute to the process of destigmatizing mental disorders.

Academic Medical Centers↗
PubMed2004

Effect of web-based depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression: randomised controlled trial.

BACKGROUND: Little is known about the efficacy of educational interventions for reducing the stigma associated with depression. AIMS: To investigate the effects on stigma of two internet depression sites. METHOD: A sample of 525 individuals with elevated scores on a depression assessment scale were randomly allocated to a depression information website (BluePages), a cognitive-behavioural skills training website (MoodGYM) or an attention control condition. Personal stigma (personal stigmatising attitudes to depression) and perceived stigma (perception of what most other people believe) were assessed before and after the intervention. RESULTS: Relative to the control, the internet sites significantly reduced personal stigma, although the effects were small. BluePages had no effect on perceived stigma and MoodGYM was associated with an increase in perceived stigma relative to the control. Changes in stigma were not mediated by changes in depression, depression literacy or cognitive-behavioural therapy literacy. CONCLUSIONS: The internet warrants further investigation as a means of delivering stigma reduction programmes for depression.

Adult↗
PubMed2003

Improving screening accuracy for dementia in a community sample by augmenting cognitive testing with informant report.

This study sought to determine whether the augmentation of cognitive testing with an informant report questionnaire could improve accuracy in screening for dementia in a community setting. The sample consisted of 646 subjects aged 70-93 years. Cognitive state was assessed using the Mini-Mental State Examination (MMSE). Informants completed the 16-item short form of the Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE). Dementia was diagnosed according to DSM-III-R criteria. Combination of the IQCODE with the MMSE resulted in more accurate prediction of caseness than either test alone. Receiver Operating Characteristic analysis demonstrated the superior screening performance of a logical "or" rule and a weighted sum of scores on the two tests over other methods of combination, replicating previous clinically based research. The findings also suggest that the appropriate combination of existing tests may be a fruitful method of improving screening accuracy in a variety of situations.

Aged↗
PubMed2003

Association of obesity with anxiety, depression and emotional well-being: a community survey.

OBJECTIVE: To investigate the association of obesity with anxiety, depression and emotional well-being (positive and negative affect) in three age groups. METHODS: A cross-sectional survey was carried out in Canberra and the neighbouring town of Queanbeyan, Australia, with a random sample from the electoral roll of 2,280 persons aged 20-24, 2,334 aged 40-44, and 2,305 aged 60-64. RESULTS: Self-reported height and weight were used to classify participants as underweight (body mass index of less than 18.5), acceptable weight (18.5 to less than 25), overweight (25 to less than 30) or obese (30 and over). Obesity in women was associated with more anxiety and depression symptoms and less positive affect, but there were only weak and inconsistent associations in men. When factors that might mediate any association were controlled (physical ill health, lack of physical activity, poorer social support, less education and financial problems), a different picture emerged, with the underweight women having more depression and negative affect and the obese and overweight women tending to have better mental health than the acceptable weight group. Controlling for physical ill health alone accounted for the association of obesity with anxiety and depression in women. CONCLUSIONS: Obesity has an association with anxiety, depression and lower well-being in women, but not in men. The results are consistent with physical ill health playing a mediating role. IMPLICATION: Reducing obesity in the population is unlikely to have any direct effect on mental health or emotional well-being.

Adult↗