The Australian and New Zealand journal of psychiatry
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Aust N Z J Psychiatry · Aug 2019
Altered social cognition and connectivity of default mode networks in the co-occurrence of autistic spectrum disorder and attention deficit hyperactivity disorder.
As two common neurodevelopmental disorders, autistic spectrum disorder and attention deficit hyperactivity disorder frequently occur together. Until now, only a few studies have investigated the co-occurrence of attention deficit hyperactivity disorder and autistic spectrum disorder, this is due to restrictions associated with previous Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Most previous research has focused on the developmental trajectories for autistic spectrum disorder and attention deficit hyperactivity disorder separately, while the neural mechanisms underpinning the co-occurrence of autistic spectrum disorder and attention deficit hyperactivity disorder remain largely unknown. ⋯ Our results showed that dysfunction of the default mode network is a central feature in the co-occurrence of autistic spectrum disorder and attention deficit hyperactivity disorder, including connectivity within the default mode network as well as between the default mode network and the somatomotor networks, thus supporting the existence of a clinically combined phenotype (autistic spectrum disorder + attention deficit hyperactivity disorder).
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Aust N Z J Psychiatry · Jul 2019
The impact of strengthening mental health services to prevent suicidal behaviour.
Successive suicide prevention frameworks and action plans in Australia and internationally have called for improvements to mental health services and enhancement of workforce capacity. However, there is debate regarding the priorities for resource allocation and the optimal combination of mental health services to best prevent suicidal behaviour. This study investigates the potential impacts of service capacity improvements on the incidence of suicidal behaviour in the Australian context. ⋯ This study suggests that more than one-quarter of suicides and attempted suicides in the Greater Western Sydney population catchment could potentially be averted with a combination of increases to hospital staffing and non-secondary (non-acute) mental health care. Reductions in tertiary care services (e.g. psychiatric hospital beds) in combination with these increases would not adversely affect subsequent incidence of suicidal behaviour.
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Aust N Z J Psychiatry · Jun 2019
Functional dysconnectivity within the emotion-regulating system is associated with affective symptoms in major depressive disorder: A resting-state fMRI study.
Major depressive disorder (MDD) can be characterized as a multidimensional and system-level disorder. The neuropathophysiological abnormalities have been reported to be distributed in emotion regulation system, involving the prefrontal cortex (PFC), limbic and striatum in convergent studies. Decrease of positive affect and increase of negative affect are recognized as a hallmark of MDD. However, the dysfunctions in affective processing in MDD within the emotion regulation system remains largely unclear. In this study, our goals are to characterize the dysconnectivity pattern within this system and explore the relationships between this kind of dysconnectivity pattern and affective symptoms, which might help us better look into the neuropathophysiological mechanisms underlying MDD. ⋯ These findings demonstrated that MDD showed characteristic pathological alterations of the emotion regulation system. Dysconnectivity within prefrontal-limbic system might be more related to the dysregulation of negative affect, whereas dysconnectivity within prefrontal-striatum system might influence more on positive affect processing. The decrease in positive affect and increase in negative affect in MDD might have different pathological basis. These results could help better understand the dysconnectivity pattern in the emotion-regulating system underlying depression.
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Aust N Z J Psychiatry · Apr 2019
ReviewDementia with Lewy bodies: Challenges in the diagnosis and management.
Dementia with Lewy bodies is the second most common form of neurodegenerative dementia in older age yet is often under-recognised and misdiagnosed. This review aims to provide an overview of the clinical features of dementia with Lewy bodies, discussing the frequent challenges clinicians experience in diagnosing dementia with Lewy bodies, and outlines a practical approach to the clinical management, particularly in the Australian setting. ⋯ Dementia with Lewy bodies is a common form of dementia. It often presents as a diagnostic challenge to clinicians, particularly at early stages of disease, and in patients with mixed neuropathological changes, which occur in over 50% of people with dementia with Lewy bodies. Prompt diagnosis and comprehensive treatment strategies are important in improving patients' care.
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Aust N Z J Psychiatry · Feb 2019
Depression and poor outcome after an acute coronary event: Clarification of risk periods and mechanisms.
Lifetime depression and depression around the time of an acute coronary syndrome event have been associated with poor cardiac outcomes. Our study sought to examine the persistence of this association, especially given modern cardiac medicine's successes. ⋯ Lifetime depression may increase the risk of depression around the time of an acute coronary syndrome but not influence cardiac outcomes. We suggest that poor sleep quality may be causal or indicate high anxiety/neuroticism, which increases risk to depression and contributes to poor cardiac outcomes rather than depression being the primary causal factor.