Biomedical subjects

Helen Christensen

Publications and source records attributed to Helen Christensen.

66 records · Page 4Linked to original sources

PubMed2002

The prevention of depression using the Internet.

Efficacy trials suggest that depression is preventable in children and adults. However, current depression prevention interventions are not deliverable to the community en masse. The Internet offers an opportunity to deliver tailored prevention interventions such as those based on cognitive behavioural therapy (CBT) to a large audience, cost-effectively, while preserving intervention fidelity and anonymity. The Internet offers distinct advantages for data collection, which can be used to help refine intervention programs. There are no published randomised controlled trials of the effectiveness of the Internet in delivering depression prevention programs. The feasibility and potential effectiveness of the Internet is indicated by research demonstrating the successful delivery of CBT by computer, the use of the Internet in the delivery of CBT treatment, and the effective prevention of obesity and the promotion of exercise using Internet technologies. Possible limitations to public health interventions using the Internet include selective access, the inability to promote the sites to potential users and the issue of uptake once users access the sites. Randomised controlled trials of CBT delivered by the Internet are required.

Cognitive Behavioral Therapy↗

PubMed2002

Effectiveness of complementary and self-help treatments for depression.

OBJECTIVES: To review the evidence for the effectiveness of complementary and self-help treatments for depression. DATA SOURCES: Systematic literature search using PubMed, PsycLit, the Cochrane Library and previous review papers. DATA SYNTHESIS: Thirty-seven treatments were identified and grouped under the categories of medicines, physical treatments, lifestyle, and dietary changes. We give a description of each treatment, the rationale behind the treatment, a review of studies on effectiveness, and the level of evidence for the effectiveness studies. RESULTS: The treatments with the best evidence of effectiveness are St John's wort, exercise, bibliotherapy involving cognitive behaviour therapy and light therapy (for winter depression). There is some limited evidence to support the effectiveness of acupuncture, light therapy (for non-seasonal depression), massage therapy, negative air ionisation (for winter depression), relaxation therapy, S-adenosylmethionine, folate and yoga breathing exercises. CONCLUSION: Although none of the treatments reviewed is as well supported by evidence as standard treatments such as antidepressants and cognitive behaviour therapy, many warrant further research.

Acupuncture Therapy↗

PubMed2002

The quality and accessibility of Australian depression sites on the World Wide Web.

OBJECTIVES: To provide information about Australian depression sites and the quality of their content; to identify possible indicators of the quality of site content; and determine the accessibility of Australian depression web sites. DESIGN: Cross-sectional survey of 15 Australian depression web sites. MAIN OUTCOME MEASURES: (i) Quality of treatment content (concordance of site information with evidence-based guidelines, number of evidence-based treatments recommended, discussion of other relevant issues, subjective rating of treatment content); (ii) potential quality indicators (conformity with DISCERN criteria, citation of scientific evidence); (iii) accessibility (search engine rank). RESULTS: Mean content quality scores were not high and site accessibility was poor. There was a consistent association between the quality-of-content measures and the DISCERN and scientific accountability scores. Search engine rank was not associated with content quality. CONCLUSIONS: The quality of information about depression on Australian websites could be improved. DISCERN may be a useful indicator of website quality, as may scientific accountability. The sites that received the highest quality-of-content ratings were beyondblue, BluePages, CRUfAD and InfraPsych.

Australia↗

PubMed2002

Predictors of refusal to participate: a longitudinal health survey of the elderly in Australia.

BACKGROUND: The loss of participants in longitudinal studies due to non-contact, refusal or death can introduce bias into the results of such studies. The study described here examines reasons for refusal over three waves of a survey of persons aged >or=70 years. METHODS: In a longitudinal study involving three waves, participants were compared to those who refused to participate but allowed an informant to be interviewed and to those who refused any participation. RESULTS: At Wave 1 both groups of Wave 2 non-participants had reported lower occupational status and fewer years of education, had achieved lower verbal IQ scores and cognitive performance scores and experienced some distress from the interview. Those with an informant interview only were in poorer physical health than those who participated and those who refused. Depression and anxiety symptoms were not associated with non-participation. Multivariate analyses found that verbal IQ and cognitive impairment predicted refusal. Results were very similar for refusers at both Waves 2 and 3. CONCLUSIONS: Longitudinal studies of the elderly may over estimate cognitive performance because of the greater refusal rate of those with poorer performance. However, there is no evidence of bias with respect to anxiety or depression.

Activities of Daily Living↗

PubMed2002

Research priorities in mental health, Part 2: an evaluationof the current research effort against stakeholders' priorities.

OBJECTIVE: To examine the current distribution of mental health research in Australia and compare this with the priorities of various stakeholder groups. METHOD: A content analysis was carried out on a year's worth of published articles and a year's worth of competitive research grants. A questionnaire for stakeholders was developed in which respondents were asked to rate priorities for research using the same categories. Questionnaires were sent to mental health researchers,members of panels that evaluate mental health research grant applications,general practitioners, psychiatrists, clinical psychologists, mental health nurses, mental health consumer and carer advocates, and members of the National Mental Health Working Group. RESULTS: Different groups of stakeholders tended to have differing perspectives on research priorities, with some major differences between committees that evaluate research grants and consumer and carer groups. Different stakeholder groups also tended to obtain their information about research from different sources. However, there were also a number of areas of agreement. When different research topics are considered,the following tended to be under-researched: affective disorders,suicide, primary care and community settings, prevention and promotion,evaluation of services, Aboriginal and Torres Strait Islander peoples,and socially and economically disadvantaged people. CONCLUSIONS: It is of concern that committees that evaluate research are guided by different values from consumers and carers in setting priorities. Nevertheless, there is consensus across stakeholder groups that a number of areas should be a high priority.

Analysis of Variance↗

PubMed2002

Research priorities in mental health, part 1: an evaluation of the current research effort against the criteria of disease burden and health system costs.

OBJECTIVE: To examine the amount of research that various mental disorders are currently receiving in Australia and compare this with the disease burden and health system costs attributable to these disorders. METHOD: A content analysis was carried out on a year's worth of published articles and a year's worth of competitive research grants. Abstracts of articles and grants were coded for a number of attributes, including the type of mental disorder covered. The percentage of articles and grant funding for various mental disorders was compared against published data on the disease burden and health system costs attributable to these disorders. RESULTS: Mental disorders contribute 19.1% of disease burden and 9.8% of health system costs, but receive only 8.9% of National Health and Medical Research Council funding. An examination of the distribution of research within the mental health area showed that substance use disorders are by far the most researched in terms of both publications and grant funding, followed by affective disorders. By contrast, affective disorders account for the most burden, followed by dementia, substance use and anxiety disorders. The biggest consumers of health system costs are dementia, affective disorders, and schizophrenia and other psychoses. CONCLUSIONS: While all mental disorders merit more research attention than they are currently receiving, affective disorders and dementia appear to be particularly under-researched given their contribution to disease burden and health system costs.

Australia↗

PubMed2002

Factors associated with young adults' obtaining general practitioner services.

This paper explores factors associated with the use of general practitioner services by young adults aged 20 to 24 years. The analyses examined sociodemographic and health data obtained for a community survey of respondents who lived in Canberra or Queanbeyan in 1999 and 2000 and linked this information to Medicare records of general practitioner visits over the following six months. In line with the Andersen model of health behaviour, predictor variables were classified as measures of physical and mental health needs for such services or as factors that predispose or enable the individual to obtain those services. Those who obtained general practitioner care were more likely to be female, to have been or be undertaking higher education and to be living with children. They were also identified by their having poorer physical health, more chronic diseases, higher levels of suicidal ideation and by their regularly using marijuana. General practitioners need to be aware of the potential mental health and substance use problems experienced by consumers in this age group. Strategies are also needed to encourage young men to seek general practitioner services when they are ill.

Adult↗

PubMed2002

Sexual orientation and mental health: results from a community survey of young and middle-aged adults.

BACKGROUND: Community surveys have reported a higher rate of mental health problems in combined groups of homosexual and bisexual participants, but have not separated these two groups. AIMS: To assess separately the mental health of homosexual and bisexual groups compared with heterosexuals. METHOD: A community survey of 4824 adults was carried out in Canberra, Australia. Measures covered anxiety, depression, suicidality, alcohol misuse, positive and negative affect and a range of risk factors for poorer mental health. RESULTS: The bisexual group was highest on measures of anxiety, depression and negative affect, with the homosexual group falling between the other two groups. Both the bisexual and homosexual groups were high on suicidality. Bisexuals also had more current adverse life events, greater childhood adversity, less positive support from family, more negative support from friends and a higher frequency of financial problems. Homosexuals reported greater childhood adversity and less positive support from family. CONCLUSIONS: The bisexual group had the worst mental health, although homosexual participants also tended to report more distress.

Adult↗

PubMed2002

Change in cognitive functioning associated with apoE genotype in a community sample of older adults.

The influence of a genetic risk factor, apolipoprotein E (apoE) epsilon4 variant, was assessed in older adults aged 70 to 94 on 3 occasions over 7 years. The results of latent growth curve analyses are reported for individuals genotyped for apoE at the 2nd measurement occasion (n = 601) and for a subsample of individuals without probable or definite dementia during the 1st or 2nd occasion (n = 434). ApoE-epsilon4 status was a significant predictor of level and change in memory performance and change in speed performance in the full sample, and of initial level and change in memory performance in the nondemented subsample. These results support previous findings that apoE-epsilon4 is associated with accelerated memory deterioration in individuals without clinical dementia.

Aged↗

PubMedDate not supplied

Association of pulmonary function with cognitive performance in early, middle and late adulthood.

BACKGROUND: Pulmonary function has been associated with some measures of cognitive performance, mostly in late adulthood. This study investigated whether this association is present for a range of cognitive measures, at three stages of adulthood, and whether it remains after controlling for demographic, health and lifestyle factors. METHOD: The relationship between forced expiratory volume at 1 s (FEV1), a measure of pulmonary function, and cognitive test performance was examined in three cohorts aged 20-24, 40-44 and 60-64. RESULTS: After controlling for demographic variables, smoking, physical activity, and respiratory disease, significant associations between FEV1 and cognitive test performance were evident in each age group for most cognitive measures. The association between FEV1 and measures of speed increased with age. CONCLUSION: FEV1 has a small but reliable positive association with cognitive test performance throughout adulthood, possibly reflecting a common physiological factor.

Adult↗

PubMedDate not supplied

Pet ownership and health in older adults: findings from a survey of 2,551 community-based Australians aged 60-64.

BACKGROUND: It is commonly assumed that owning a pet provides older residents in the community with health benefits including improved physical health and psychological well-being. It has also been reported that pet owners are lower on neuroticism and higher on extraversion compared with those without pets. However, findings of research on this topic have been mixed with a number of researchers reporting that, for older people, there is little or no health benefit associated with pet ownership. OBJECTIVE: To identify health benefits associated with pet ownership and pet caring responsibilities in a large sample of older community-based residents. METHODS: Using survey information provided by 2,551 individuals aged between 60 and 64 years, we compared the sociodemographic attributes, mental and physical health measures, and personality traits of pet owners and non-owners. For 78.8% of these participants, we were also able to compare the health services used, based on information obtained from the national insurer on the number of general practitioner (GP) visits they made over a 12-month period. RESULTS: Compared with non-owners, those with pets reported more depressive symptoms while female pet owners who were married also had poorer physical health. We found that caring for a pet was associated with negative health outcomes including more symptoms of depression, poorer physical health and higher rates of use of pain relief medication. No relationship was found between pet ownership and use of GP services. When we examined the personality traits of pet owners and carers, we found that men who cared for pets had higher extraversion scores. Our principal and unexpected finding, however, was that pet owners and carers reported higher levels of psychoticism as measured by the Revised Eysenck Personality Questionnaire. CONCLUSIONS: We conclude that pet ownership confers no health benefits for this age group. Instead, those with pets have poorer mental and physical health and use more pain relief medication. Further, our study suggests that those with pets are less conforming to social norms as indicated by their higher levels of psychoticism.

Animals↗

PubMedDate not supplied

Web-based cognitive behavior therapy: analysis of site usage and changes in depression and anxiety scores.

BACKGROUND: Cognitive behavior therapy is well recognized as an effective treatment and prevention for depression when delivered face-to-face, via self-help books (bibliotherapy), and through computer administration. The public health impact of cognitive behavior therapy has been limited by cost and the lack of trained practitioners. We have developed a free Internet-based cognitive behavior therapy intervention (MoodGYM, http://moodgym.anu.edu.au) designed to treat and prevent depression in young people, available to all Internet users, and targeted to those who may have no formal contact with professional help services. OBJECTIVE: To document site usage, visitor characteristics, and changes in depression and anxiety symptoms among users of MoodGYM, a Web site delivering a cognitive-behavioral-based preventive intervention to the general public. METHODS: All visitors to the MoodGYM site over about 6 months were investigated, including 2909 registrants of whom 1503 had completed at least one online assessment. Outcomes for 71 university students enrolled in an Abnormal Psychology course who visited the site for educational training were included and examined separately. The main outcome measures were (1) site-usage measures including number of sessions, hits and average time on the server, and number of page views; (2) visitor characteristics including age, gender, and initial Goldberg self-report anxiety and depression scores; and (3) symptom change measures based on Goldberg anxiety and depression scores recorded on up to 5 separate occasions. RESULTS: Over the first almost-6-month period of operation, the server recorded 817284 hits and 17646 separate sessions. Approximately 20% of sessions lasted more than 16 minutes. Registrants who completed at least one assessment reported initial symptoms of depression and anxiety that exceeded those found in population-based surveys and those characterizing a sample of University students. For the Web-based population, both anxiety and depression scores decreased significantly as individuals progressed through the modules. CONCLUSIONS Web sites are a practical and promising means of delivering cognitive behavioral interventions for preventing depression and anxiety to the general public. However, randomized controlled trials are required to establish the effectiveness of these interventions.

Adolescent↗