Psychiatry - Research Publications

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    Psychosis and Hopelessness Mediate the Relationship Between Reduced Sleep and Suicidal Ideation in Schizophrenia Spectrum Disorders
    Carruthers, SP ; Lee, SJ ; Sankaranarayanan, A ; Sumner, PJ ; Toh, WL ; Tan, EJ ; Neill, E ; Van Rheenen, TE ; Gurvich, C ; Rossell, SL (ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2022-01-01)
    OBJECTIVE: Suicide is a major cause of death amongst individuals with schizophrenia spectrum disorders (SSD). Despite numerous risk factors being identified, accurate prediction of suicidality and provision of tailored and effective treatment is difficult. One factor that may warrant particular attention as a contributor to increased psychopathology and suicidality in SSD is disturbed sleep. Sleep disturbances have been reliably linked to greater levels of suicidal ideation and are highly prevalent amongst individuals with SSD. This study aimed to examine if reduced sleep duration and psychopathology are associated with increased suicidal ideation. METHOD: One-hundred and eighteen adults with chronic SSD living within the community participated in this cross-sectional study. Psychosis symptoms were assessed using the Positive and Negative Syndrome Scale. Items 4 and 10 from the Montgomery-Asperg Depression Rating Scale and Item 2 from the Calgary Depression Scale for Schizophrenia were used to assess reduced sleep duration, current suicidal ideation, and hopelessness, respectively. All measures were rated concurrently. RESULTS: A hierarchical logistic regression revealed that greater acute sleep disturbances were associated with increased suicidal ideation and this relationship was found to be uniquely mediated by both positive symptom severity and hopelessness. CONCLUSION: These results suggest that individuals with SSD who exhibited disrupted or disordered sleep, positive symptoms and/or hopelessness should be routinely screened for suicidal thinking. Furthermore, interventions that effectively target sleep disruptions may provide much-needed action against suicidal ideation.HIGHLIGHTSReduced sleep found to be associated with increased suicidal ideationThis was uniquely mediated by both hopelessness and positive symptomsMore regular screening of sleep problems in schizophrenia is needed.
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    Evidence that a working memory cognitive phenotype within schizophrenia has a unique underlying biology
    Dean, B ; Thomas, EHX ; Bozaoglu, K ; Tan, EJ ; Rheenen, TEV ; Neill, E ; Sumner, PJ ; Carruthers, SP ; Scarr, E ; Rossell, SL ; Gurvich, C (ELSEVIER IRELAND LTD, 2022-11)
    It is suggested studying phenotypes within the syndrome of schizophrenia will accelerate understanding the complex molecular pathology of the disorder. Supporting this hypothesis, we have identified a sub-group within schizophrenia with impaired working memory (WM) and have used Affymetrix™ Human Exon 1.0 ST Arrays to compare their blood RNA levels (n=16) to a group of with intact WM (n=18). Levels of 72 RNAs were higher in blood from patients with impaired WM, 11 of which have proven links to the maintenance of different aspects of working memory (cognition). Overall, changed gene expression in those with impaired WM could be linked to cognition through glutamatergic activity, olfaction, immunity, inflammation as well as energy and metabolism. Our data gives preliminary support to the hypotheses that there is a working memory deficit phenotype within the syndrome of schizophrenia with has a biological underpinning. In addition, our data raises the possibility that a larger study could show that the specific changes in gene expression we have identified could prove to be the biomarkers needed to develop a blood test to identify those with impaired WM; a significant step toward allowing the use of personalised medicine directed toward improving their impaired working memory.
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    Psychological-health correlates of physical activity and sedentary behaviour during the COVID pandemic
    Ringin, E ; Meyer, D ; Neill, E ; Phillipou, A ; Tan, EJ ; Toh, WL ; Sumner, PJ ; Owen, N ; Hallgren, M ; Dunstan, DW ; Rossell, SL ; Van Rheenen, TE (ELSEVIER SCI LTD, 2022-10)
    BACKGROUND: While physical inactivity is associated with adverse psychological outcomes, less is known about the psychological outcomes associated with sedentary behaviour, and specifically, its mentally active and passive forms. The COVID-19 pandemic represents a unique opportunity to study associations between these variables in light of widespread stay-at-home mandates and restrictions on outdoor exercise/social activities. Using a cross-sectional dataset acquired during the COVID-19 pandemic in Australia, we examined whether physical activity and sedentary behaviour were associated with subjective quality of life (sQoL) and subjective cognitive dysfunction, and whether these associations were mediated by depressive symptoms. METHODS: 658 participants (males = 169, females = 489) self-reported data on physical activity and sedentary behaviour in an online survey during May 2020-May 2021. Data on physical activity and sedentary behaviour (both mentally active and passive types) was compared according to whether it was collected during or out of a lockdown period. Regression models were used to test associations of physical activity and sedentary behaviour with sQoL and subjective cognitive dysfunction, and whether these associations were mediated by depression severity. RESULTS: Physical activity was beneficially associated with sQoL, whereas sedentary behaviour (both total hours and the reduction of mentally active/increase in mentally passive behaviour) was detrimentally associated with sQoL. These associations were mediated by depression severity. Physical activity and sedentary behaviour were also indirectly associated with subjective cognitive dysfunction by virtue of their associations with depression severity. CONCLUSIONS: There are important differences in the psychological correlates of mentally passive and active sedentary behaviours. Our findings suggest that health promotion strategies should focus on not only increasing physical activity but also reducing passive sedentary behaviours as a means of maintaining good psychological health.
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    Investigating predictors contributing to the expression of schizotypy during the COVID-19 pandemic
    Toh, WL ; Sumner, PJ ; Meyer, D ; Neill, E ; Phillipou, A ; Tan, EJ ; Van Rheenen, TE ; Rossell, SL (PERGAMON-ELSEVIER SCIENCE LTD, 2022-06)
    The coronavirus (COVID-19) pandemic has caused major disruptions to social and other forms of functioning, which may influence schizotypy expression. The current study aimed to explore possible distal and proximal predictors contributing to schizotypy in a sample of the Australian general population during the COVID-19 pandemic. The COvid-19 and you: mentaL heaLth in AusTralia now survEy (COLLATE) project is an online mental health study aimed at tracking key mental health indicators over the progression of the pandemic. Adults residing in Australia were invited to take part using non-discriminative snowball sampling. Demographic-clinical information was collected for 850 participants in either October 2020 or January 2021. To assess schizotypy facets, the Launay-Slade Hallucinations Scale-Extended (LSHS-E) and Peters Delusions Inventory (PDI-21) were used to measure hallucination and delusion proneness respectively. Generalised linear models (with gamma and negative binomial distributions) were employed. Age, negative emotions and loneliness significantly contributed to both hallucination and delusion proneness; gender, education and religiosity also significantly contributed to delusion proneness, in the final regression models. Our study corroborated the specific contribution of loneliness, amongst other factors, in the prediction of schizotypy facets. Tackling loneliness represents a public health challenge that needs to be urgently addressed, especially in the face of the ongoing COVID-19 pandemic.
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    No influence of sex on the relationship between schizotypy factors and executive control across the schizophrenia spectrum
    Gaillard, A ; Tan, EJ ; Carruthers, SP ; Gurvich, C ; Hughes, ME ; Neill, E ; Sumner, PJ ; Van Rheenen, TE ; Rossell, SL (PERGAMON-ELSEVIER SCIENCE LTD, 2022-04)
    Sex differences in symptoms and executive control across schizophrenia spectrum disorders (SSD) are consistently reported. Similarly, these findings of sex differences are also observed in schizotypy, that is, schizophrenia-like features occurring in healthy individuals in the absence of a clinical diagnosis. This study aimed to examine the relationships between performance on three major domains of executive control: performance monitoring, response inhibition, and cognitive set-shifting, and schizotypy factor scores in both SSD patients and healthy controls (HCs), and whether sex moderated any relationships observed. A total of 111 (67 males and 44 females) patients with SSD and 258 (129 males and 129 females) HCs were included in this study. Schizotypal personality traits (in both SSD and HC) was assessed using the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE). Executive control performance was assessed using seven tasks. Stepwise linear regressions revealed that performance on cognitive set-shifting tasks was significantly associated with the introvertive anhedonia, cognitive disorganisation, and unusual experiences subscales of the O-LIFE. When sex was examined as a moderator, it was not a significant moderator of any of the relationships between cognitive set-shifting tasks and schizotypy factors. The results suggest that independent of sex, cognitive set-shifting ability is associated to an increased vulnerability to schizotypal personality traits, although performance monitoring and response inhibition did not.
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    Surviving the COVID-19 pandemic: An examination of adaptive coping strategies
    Meyer, D ; Van Rheenen, TE ; Neill, E ; Phillipou, A ; Tan, EJ ; Toh, WL ; Sumner, PJ ; Rossell, SL (ELSEVIER SCI LTD, 2022-05)
    The mental health consequences of the COVID-19 pandemic have been significant in Australia. The aim of this study was to investigate coping strategies that individuals have adopted to assist them through this stressful period. Survey data collected in September and December 2020 as part of a larger study (the COLLATE project) were analysed. The number of adaptive coping strategies endorsed by respondents had a significant negative relationship with depression and a significant positive relationship with resilience. Females tended to use more of these strategies than men, as did people who said their mental health had improved rather than deteriorated because of the COVID-19 restrictions imposed by government. Specific adaptive coping strategies differed for those with and without a mental illness. People with a mental illness were more likely to seek professional and online help, while people without a mental illness were more likely to use self-help. Focusing on what one is grateful for and keeping oneself productively occupied ("using the time to do things around the house") were the most beneficial coping strategies in terms of alleviating depression, anxiety and stress. Public health messaging promoting adaptive coping strategies may be useful in bolstering the mental health of individuals during lockdown periods. In particular, the promotion of coping flexibility should be recommended rather than the frequent use of the same coping strategies.
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    Mental health of individuals with and without eating disorders across six months and two waves of COVID-19
    Phillipou, A ; Tan, EJ ; Toh, WL ; Van Rheenen, TE ; Meyer, D ; Neill, E ; Sumner, P ; Rossell, SL (ELSEVIER, 2021-12)
    PURPOSE: The COVID-19 global pandemic has resulted in a significant mental health toll, and recent findings suggest that individuals with an eating disorder (ED) history may be particularly vulnerable. The current study aimed to: (1) identify changes in the pattern of mental health symptoms over the first six months of the pandemic between individuals with an ED history, compared to a community sample without an ED history (non-ED); and (2) identify differences in mental health symptoms and concerns between two waves of the virus and associated lockdowns. METHOD: Data from 4915 respondents - 231 with an ED history - were compared across monthly time points from April to September 2020 on psychological symptoms including negative mood, quality of life, coping and hopefulness, as well as changes to eating and exercise behaviours. RESULTS: Mental health symptoms were increased in the ED group, but generally did not differ from non-ED in the pattern of symptoms reported over time. Increased depressive symptoms and restrictive eating behaviours were found across both groups in relation to the second wave/lockdown, as well as decreased hopefulness and quality of life. Respondents in both groups also reported coping worse during the second wave of the virus compared to the first wave. CONCLUSION: Although non-ED and ED groups tended to generally show the same pattern of symptoms, the mental health status of the ED group was significantly poorer than the non-ED group throughout the pandemic, and exacerbations in some symptoms (i.e. increased food restriction and depressive symptoms) is cause for concern.
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    Obsessive-compulsive disorder and related symptoms amidst the COVID-19 outbreak: Results from the COLLATE project
    Toh, WL ; Neill, E ; Phillipou, A ; Tan, EJ ; Van Rheenen, TE ; Meyer, D ; Rossell, SL (WILEY, 2021-04)
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    Identifying the cognitive underpinnings of voice-hearing by comparing never, past and current voice-hearers
    Toh, WL ; Tan, EJ ; Neill, E ; Van Rheenen, TE ; Gurvich, C ; Sumner, PJ ; Carruthers, SP ; Thomas, EHX ; Rossell, SL (WILEY, 2020-06)
    OBJECTIVE: The current study aimed to compare specific cognitive profiles corresponding to auditory verbal hallucinations (AVH) status and elucidate which pattern of cognitive deficits may predict voice-hearing status. METHOD: Clinical participants with schizophrenia spectrum disorders were partitioned into: (i) current voice-hearers (n = 46), (ii) past voice-hearers (n = 37) and (iii) never voice-hearers (n = 40), and compared with 319 non-clinical controls. Cognitive assessment employed the MATRICS Consensus Cognitive Battery (MCCB), supplemented by the Delis-Kaplan Executive Function System (D-KEFS) Colour-Word Interference Test (Stroop) as a robust measure of executive function. RESULTS: On the Visual Learning domain, current and past voice-hearers had significantly poorer performance relative to never voice-hearers, who in turn had significantly poorer performance than non-clinical controls. Current and never voice-hearers had significantly poorer performance on the Social Cognition domain relative to non-clinical controls. Current voice-hearers also had significantly poorer performance on the Inhibition domain relative to non-clinical controls. Binary logistic regression revealed that Visual Learning was the only significant cognitive predictor of AVH presence. CONCLUSION: Visual learning, and potentially inhibition, may be viable therapeutic targets when addressing cognitive mechanisms associated with AVHs. Future research should focus on investigating additional cognitive mechanisms, employing diverse voice-hearing populations and embarking on related longitudinal studies.
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    Mental health status of healthcare versus other essential workers in Australia amidst the COVID-19 pandemic: Initial results from the collate project
    Toh, WL ; Meyer, D ; Phillipou, A ; Tan, EJ ; Van Rheenen, TE ; Neill, E ; Rossell, SL (ELSEVIER IRELAND LTD, 2021-04)
    The novel coronavirus (COVID-19) has necessitated many healthcare workers operating on the frontlines. Another segment of the population whose mental well-being is being tested are the 'other essential workers' (e.g. supermarket workers). The current study aimed to compare the mental health of healthcare versus other essential workers in the early stages of the COVID-19 outbreak. The COVID-19 and you: mentaL heaLth in AusTralia now survEy (COLLATE) project is a nationwide online mental health survey launched on 1 April 2020, aimed at identifying key mental health concerns. Adults currently living in Australia were invited to take part, and non-discriminative snowball sampling was employed. Participants were partitioned into healthcare workers (HCW; n=905), other essential workers (OEW; n=810), and the general population (GNP; n=3443). Across all groups, top COVID-19 related concerns were primarily associated with the health and well-being of loved ones. In terms of current levels of depression, anxiety, stress and quality of life, HCWs fared the best, and OEWs fared the worst (with the GNP falling in between). In the face of this medical crisis, Australian HCWs seem to be managing their mental health relatively well, but more supports need to be devoted to OEWs to safeguard their mental well-being.