Biomedical subjects

Kathleen M Griffiths

Publications and source records attributed to Kathleen M Griffiths.

27 records · Page 2Linked to original sources

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↗

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

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

A five year follow-up study of the use of clozapine in community practice.

OBJECTIVE: To present information about the value of clozapine in treatment-resistant schizophrenia. Data is reported on the use of clozapine in an entire cohort of (42) patients in a community, the Australian Capital Territory. It extends a 3-year study of clinical and financial outcomes to 5 years. METHOD: Experiences during the 2 years before clozapine was prescribed and those of the 5 years following prescription were compared by a records review, including hospital and hostel bed use and estimated treatment costs. Changes in dose levels, living circumstances and employment status were assessed, and treating psychiatrists reported on side-effects and their impression of clinical change since clozapine was prescribed. RESULTS: Ten subjects were excluded. The remaining cohort (32 subjects) demonstrated continuing clinical improvement and cost savings during follow-up. Those (22) remaining on clozapine after the five year period showed continuing clinical improvement, reduced hospital admissions and hospital bed usage and significantly large cost savings, and were moderately to markedly improved after 3 years. Only one patient (of 22) showed a slight deterioration in the next two years while 14 showed further improvement. After 5 years, the clinical status of four of the 10 subjects who discontinued clozapine was unchanged or deteriorated compared with their preclozapine status. There were no suicides. CONCLUSION: The findings of continuing clinical improvement and decreased costs after long-term (5 years) use of clozapine supports the selective use of clozapine in community practice.

Adult↗

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↗