Biomedical subjects

Kathleen M Griffiths

Publications and source records attributed to Kathleen M Griffiths.

At least 19 recordsLinked to original sources

PubMed2006

Stigma in response to mental disorders: a comparison of Australia and Japan.

BACKGROUND: There are few national or cross-cultural studies of the stigma associated with mental disorders. Australia and Japan have different systems of psychiatric health care, and distinct differences in cultural values, but enjoy similar standards of living. This study seeks to compare the nature and extent of stigma among the public in the two countries. METHODS: A household survey of the public was conducted in each country using similar methodologies. The Australian study comprised a national survey of 3998 adults aged over 18 years. The Japanese survey involved 2000 adults aged 20 to 69 from 25 regional sites distributed across the country. Interviewees reported their personal attitudes (personal stigma, social distance) and perceptions of the attitudes of others (perceived stigma, perceived discrimination) in the community with respect to four case vignettes. These vignettes described a person with: depression; depression with suicidal ideation; early schizophrenia; and chronic schizophrenia. RESULTS: Personal stigma and social distance were typically greater among the Japanese than the Australian public whereas the reverse was true with respect to the perception of the attitudes and discriminatory behaviour of others. In both countries, personal stigma was significantly greater than perceived stigma. The public in both countries showed evidence of greater social distance, greater personal stigma and greater perceived stigma for schizophrenia (particularly in its chronic form) than for depression. There was little evidence of a difference in stigma for depression with and without suicide for either country. However, social distance was greater for chronic compared to early schizophrenia for the Australian public. CONCLUSION: Stigmatising attitudes were common in both countries, but negative attitudes were greater among the Japanese than the Australian public. The results suggest that there is a need to implement national public awareness interventions tailored to the needs of each country. The current results provide a baseline for future tracking of national stigma levels in each country.

Adult↗

PubMed2006

Population promotion of informal self-help strategies for early intervention against depression and anxiety.

Much of the burden of depression and anxiety in the population is attributable to subclinical symptoms. Broadening formal health-care systems to treat subclinical depression and anxiety is not the answer to reducing this burden, because health-care systems lack the resources even to provide optimal care to clinical cases. The solution proposed is the population-wide dissemination of informal self-help strategies that have evidence for effectiveness. These are highly acceptable to the public, easily applied, inexpensive and may avert the development of many clinical cases.

Anxiety↗

PubMed2006

The public's ability to recognize mental disorders and their beliefs about treatment: changes in Australia over 8 years.

OBJECTIVE: A national survey of Australian adults in 1995 showed a low level of recognition of mental disorders and beliefs about treatment that were often discordant with those of professionals. The present study aimed to find out whether recognition and treatment beliefs have changed over 8 years. METHOD: A national survey of 2001 adults in 2003-2004 included the same questions as the 1995 survey. These interview questions were based on a vignette of a person with either depression or schizophrenia. RESULTS: Over the 8 years, the public showed better recognition of depression and schizophrenia and gave more positive ratings to a range of interventions, including help from mental health professionals, medications, psychotherapy and psychiatric ward admission. CONCLUSIONS: The Australian public's beliefs have changed over 8 years to be more like those of mental health professionals. This change may have positive implications for help-seeking and treatment concordance.

Adolescent↗

PubMed2006

Changes in depression awareness and attitudes in Australia: the impact of beyondblue: the national depression initiative.

OBJECTIVE: To assess changes in depression awareness and attitudes in Australia and the effect that beyondblue: the national depression initiative has had on these. METHOD: Data from national surveys of mental health literacy in 1995 and 2003-2004 were analysed to see if states and territories that funded beyondblue (the high-exposure states) had greater changes than those that did not (the low-exposure states). In both surveys, participants were shown a depression vignette and asked whether they themselves or family or friends had ever had a similar problem, whether they thought the person would be discriminated against, and questions about the likelihood of long-term positive and negative outcomes for the person. Participants were also assessed for symptoms of psychological distress in the past month. RESULTS: There was an increase in the percentage of people who said that they or their family or friends had a problem like the person in the vignette. This increase was greater in the high-exposure states. However, there was no change in reports of current psychological distress, suggesting that there is greater depression awareness or openness rather than a real increase in symptoms. People in the high-exposure states also showed an increase in the belief that discrimination would occur. There was little change in beliefs about long-term outcomes, apart from people in high-exposure states believing that a depressed person would be more understanding of other people's feelings. CONCLUSIONS: The data are consistent with beyondblue having had an effect on awareness of depression and of discrimination against depressed people.

Adolescent↗

PubMed2006

Stigma about depression and its impact on help-seeking intentions.

OBJECTIVE: Research has shown that people are reluctant to seek professional help for depression, especially from mental health professionals. This may be because of the impact of stigma which can involve people's own responses to depression and help-seeking (self stigma) as well as their perceptions of others' negative responses (perceived stigma). The aim of this article was to examine community help-seeking intentions and stigmatizing beliefs associated with depression. METHOD: A total of 1,312 adults randomly sampled from the Australian community completed a questionnaire providing a depression vignette and measures of self- and perceived-stigmatizing responses, source-specific help-seeking intentions, current depressive symptoms and depression experience, and demographics. RESULTS: Many people reported they would feel embarrassed about seeking help from professionals, and believed that other people would have a negative reaction to them if they sought such help. Some expected professionals to respond negatively to them. Responses varied according to the sources of professional help. Self-embarrassment and expectations that others would respond negatively predicted the likelihood of help-seeking from professional sources. CONCLUSION: Self- and perceived-stigmatizing responses to help-seeking for depression are prevalent in the community and are associated with reluctance to seek professional help. Interventions should focus on minimizing expectations of negative responses from others and negative self-responses to help-seeking, and should target younger people.

Adolescent↗

PubMed2005

Automated assessment of the quality of depression websites.

BACKGROUND: Since health information on the World Wide Web is of variable quality, methods are needed to assist consumers to identify health websites containing evidence-based information. Manual assessment tools may assist consumers to evaluate the quality of sites. However, these tools are poorly validated and often impractical. There is a need to develop better consumer tools, and in particular to explore the potential of automated procedures for evaluating the quality of health information on the web. OBJECTIVE: This study (1) describes the development of an automated quality assessment procedure (AQA) designed to automatically rank depression websites according to their evidence-based quality; (2) evaluates the validity of the AQA relative to human rated evidence-based quality scores; and (3) compares the validity of Google PageRank and the AQA as indicators of evidence-based quality. METHOD: The AQA was developed using a quality feedback technique and a set of training websites previously rated manually according to their concordance with statements in the Oxford University Centre for Evidence-Based Mental Health's guidelines for treating depression. The validation phase involved 30 websites compiled from the DMOZ, Yahoo! and LookSmart Depression Directories by randomly selecting six sites from each of the Google PageRank bands of 0, 1-2, 3-4, 5-6 and 7-8. Evidence-based ratings from two independent raters (based on concordance with the Oxford guidelines) were then compared with scores derived from the automated AQA and Google algorithms. There was no overlap in the websites used in the training and validation phases of the study. RESULTS: The correlation between the AQA score and the evidence-based ratings was high and significant (r=0.85, P<.001). Addition of a quadratic component improved the fit, the combined linear and quadratic model explaining 82 percent of the variance. The correlation between Google PageRank and the evidence-based score was lower than that for the AQA. When sites with zero PageRanks were included the association was weak and non-significant (r=0.23, P=.22). When sites with zero PageRanks were excluded, the correlation was moderate (r=.61, P=.002). CONCLUSIONS: Depression websites of different evidence-based quality can be differentiated using an automated system. If replicable, generalizable to other health conditions and deployed in a consumer-friendly form, the automated procedure described here could represent an important advance for consumers of Internet medical information.

Australia↗

PubMed2005

Website quality indicators for consumers.

BACKGROUND: The rating tool DISCERN was designed for use by consumers without content expertise to evaluate the quality of health information. There is some evidence that DISCERN may be a valid indicator of evidence-based website quality when applied by health professionals. However, it is not known if the tool is a valid measure of evidence-based quality when used by consumers. Since it is a lengthy instrument requiring training in its use, DISCERN may prove impractical for use by the typical consumer. It is therefore important to explore the validity of other simpler potential indicators of site quality such as Google PageRank. OBJECTIVE: This study aimed to determine (1) whether the instrument DISCERN is a valid indicator of evidence-based Web content quality for consumers without specific mental health training, and (2) whether Google PageRank is an indicator of website content quality as measured by an evidence-based gold standard. METHODS: This was a cross-sectional survey of depression websites using consumer and health professional raters. The main outcome measures were (1) site characteristics, (2) evidence-based quality of content as measured by evidence-based depression guidelines, (3) DISCERN scores, (4) Google PageRank, and (5) user satisfaction. RESULTS: There was a significant association between evidence-based quality ratings and average DISCERN ratings both for consumers (r = 0.62, P = .001) and health professionals (r = 0.80, P < .001). Consumer and health professional DISCERN ratings were significantly correlated (r = 0.77, P < .001). The evidence-based quality score correlated with Google PageRank (r = 0.59, P = .002). However, the correlation between DISCERN scores and user satisfaction was higher than the correlation between Google PageRank and user satisfaction. CONCLUSIONS: DISCERN has potential as an indicator of content quality when used either by experts or by consumers. Google PageRank shows some promise as an automatic indicator of quality.

Consumer Behavior↗

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

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

Effectiveness of treatments for depression in older people.

OBJECTIVE: To conduct a systematic review of the evidence for the effectiveness of a range of possible treatments for depression in older people. DATA SOURCES: Literature search using the PubMed, PsycInfo and Cochrane Library databases. DATA SYNTHESIS: Treatments that have been suggested to be effective for depression were grouped under three categories: medical treatments, psychological treatments, and lifestyle changes/alternative treatments. We describe each treatment, review the studies of its effectiveness in people aged > or = 60 years, and give a rating of the level of evidence. CONCLUSIONS: The treatments with the best evidence of effectiveness are antidepressants, electroconvulsive therapy, cognitive behaviour therapy, psychodynamic psychotherapy, reminiscence therapy, problem-solving therapy, bibliotherapy (for mild to moderate depression) and exercise. There is limited evidence to support the effectiveness of transcranial magnetic stimulation, dialectical behaviour therapy, interpersonal therapy, light therapy (for people in nursing homes or hospitals), St John's wort and folate in reducing depressive symptoms.

Aged↗

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↗

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

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↗

PubMed2004

A comparison of changes in anxiety and depression symptoms of spontaneous users and trial participants of a cognitive behavior therapy website.

BACKGROUND: In randomized controlled trials Internet sites have been shown to be effective in the treatment of depression and anxiety. However, it is unclear if the positive effects demonstrated in these trials transfer to community users of such sites. OBJECTIVE: To compare anxiety and depression outcomes for spontaneous visitors to a publicly accessible cognitive behavior therapy website (MoodGYM) (http://moodgym.anu.edu.au) with outcomes achieved through a randomized controlled efficacy trial of the same site. METHODS: All community visitors to the MoodGYM site between April 2001 and September 2003 were sampled: 182 participants in the BlueMood Trial who had been randomly assigned to the MoodGYM site as part of a large trial and 19607 visitors (public registrants) to the site. Symptom assessments (quizzes) were repeated within the website intervention to allow the examination of change in symptoms across modules. Outcome variables were (1) age, gender, initial depression severity scores, and number of assessments attempted, and (2) symptom change measures based on Goldberg anxiety and depression scores recorded on a least two occasions. RESULTS: Public registrants did not differ from trial participants in gender, age, or initial level of depression, which was high for both groups relative to previously published epidemiological data sets. Trial participants completed more assessments. No significant differences in anxiety or depression change scores were observed, with both public registrants and trial participants improving through the training program. CONCLUSIONS: Public registrants to a cognitive behavior therapy website show significant change in anxiety and depression symptoms. The extent of change does not differ from that exhibited by participants enrolled on the website for a randomized controlled trial.

Analysis of Variance↗

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

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↗