Longitudinal Brain Changes In First-episode Psychosis: A 10 Year Follow-up MRI Study
Funder
National Health and Medical Research Council
Funding Amount
$165,250.00
Summary
It is now widely accepted that schizophrenia is associated with changes in the structure of the brain. Until recently these structural changes were considered to predate the onset of illness and to remain static. However, our own work has suggested an alternative model, which relates schizophrenia to brain changes at specific life stages. In order to demonstrate this, we intend to acquire repeat brain images on 100 patients who were initially scanned 10 years ago at the start of their psychotic ....It is now widely accepted that schizophrenia is associated with changes in the structure of the brain. Until recently these structural changes were considered to predate the onset of illness and to remain static. However, our own work has suggested an alternative model, which relates schizophrenia to brain changes at specific life stages. In order to demonstrate this, we intend to acquire repeat brain images on 100 patients who were initially scanned 10 years ago at the start of their psychotic illness. This would be the largest follow-up study of first episode psychosis in the world, with the longest interval between the first and second brain scan. Further, for a proportion of patients we will have 3 MRI scans, at illness onset, 2-4 years post-onset, followed by a third scan at 10 years, thereby providing unique follow-up brain imaging data. Based on our own and other research, we intend to explore the relationship between progressive brain change over a ten year period and: (i) the diagnosis of the patient (schizophrenia or other disorder), (ii) the clinical and functional outcome of the patient (still chronically ill or with no further episode of psychosis), and (iii) the cognitive state of the patient (their ability to perform well on tests of memory, planning and so on). We are able to conduct this study because of the existence of an infrastructure developed to follow-up patients, with a recontact rate of 70% of those patients admitted in 1992 and 1993. In this study we seek to implement these strategies for the patients identified after 1994. The results of this study will test our ideas derived from our model of the major psychotic illnesses and may identify the structural brain changes which are associated with the development of chronic schizophrenia and other psychoses. A further novel outcome will be the inclusion of patients who have remained well and identiifying the structural correlates of a good prognosis.Read moreRead less
Structural And Diffusion Tensor Neuroimaging In Twins Concordant And Discordant For Psychosis.
Funder
National Health and Medical Research Council
Funding Amount
$477,375.00
Summary
Measures from specialised brain scans i.e. MRI's (Magnetic Resonance Imaging) have suggested that several areas in the brain are different in those individuals who suffer from psychosis compared to those who don't. Evaluations of these brain differences have helped us better understand the nature of these illnesses. For example, frontal lobe dysfunction has been linked with the loss of ability to plan and organize information, seen in those who have schizophrenia. These measures may also help cl ....Measures from specialised brain scans i.e. MRI's (Magnetic Resonance Imaging) have suggested that several areas in the brain are different in those individuals who suffer from psychosis compared to those who don't. Evaluations of these brain differences have helped us better understand the nature of these illnesses. For example, frontal lobe dysfunction has been linked with the loss of ability to plan and organize information, seen in those who have schizophrenia. These measures may also help clarify the relationship between the genetic and environmental factors contributing to the development of these disorders. One of the best ways to investigate this relationship is the use of a twin study design. The Australian study of twins with psychosis will recruit dizygotic (DZ) and monozygotic (MZ) twin pairs in which at least one twin is affected by a psychotic disorder, plus control twin pairs matched for age, sex and zygosity. Measures derived from MRI scans will be collected in an attempt to further define specific brain regions reported to be different in psychosis. In addition Diffusion Tensor Imaging (DTI) will be used to visualize white matter tracts in the brain. The twin study design will allow us to differentiate genetic and environmental factors associated with these brain measures and help evaluate the potential for these measures to genetically define sub-groups of individuals with psychotic disorders. The identification of these subgroups would facilitate the search for susceptibility genes. Additionally, this study will help clarify the possible clinical overlap between affective (i.e. bipolar affective disorder) and non-affective (i.e. schizophrenia) psychotic disorders. The information obtained from this study has the potential to greatly improve our understanding of caustive factors in psychosis, which may also lead to earlier diagnosis and treatment, thereby improving prognosis.Read moreRead less
Mental illness is the leading cause of disability in high income countries including Australia. This proposal aims to address youth mental illness through four initiatives 1. Improving the understanding of causes of mental illness in youth 2. Reducing traditional and cyber bullying in schools 3, Investigating immune abnormalities in patients with early psychosis. 4. Conducting clinical trials of novel agents in youth with early psychosis
Randomised Controlled Trial Of Cognitive Behaviour Therapy To Prevent Psychosis Among People With At-risk Mental States.
Funder
National Health and Medical Research Council
Funding Amount
$619,604.00
Summary
Recent advances in the accurate identification of individuals at high risk of developing a psychotic disorder, such as schizophrenia, have inspired the development of interventions designed to delay, ameliorate or even prevent the onset of such disorders. To date, the results of only three randomised controlled trials of such interventions have been published. Although these results have shown that interventions are able to delay the onset of psychosis, and may even prevent psychosis in some cas ....Recent advances in the accurate identification of individuals at high risk of developing a psychotic disorder, such as schizophrenia, have inspired the development of interventions designed to delay, ameliorate or even prevent the onset of such disorders. To date, the results of only three randomised controlled trials of such interventions have been published. Although these results have shown that interventions are able to delay the onset of psychosis, and may even prevent psychosis in some cases, it is unclear which treatment should be preferred for this population because the three trials have assessed, respectively, a combination of anti-psychotic medication and cognitive behaviour therapy (CBT), CBT alone, and anti-psychotic medication alone. Since the trial of CBT alone produced results that were at least as favourable as the two other trials, and since ethical and clinical objections have been raised concerning the use of anti-psychotic medications with young people who may never develop a psychotic disorder, CBT may be the preferred treatment. Far from posing unnecessary risks, CBT has the potential to provide important therapeutic benefits even to those not destined to develop a psychosis. The current study is significant in that it proposes a controlled trial of a form of CBT which has been specially adapted for preventing transition to psychosis among young high-risk individuals, to test whether the previous favourable results for CBT can be independently replicated. It will be compared with a control treatment. Since cannabis abuse is common among young people who are at risk, and is a known risk factor for psychosis, CBT will include elements of treatment for cannabis abuse. The trial will be run in both Newcastle and Orange, NSW, enabling us to compare the effectiveness of CBT in urban and rural settings. This study has the potential to have large impacts on the quality of life of young people at risk of psychosis.Read moreRead less
Connecting The Dots: Novel Social Media Technologies For Long-term Functional Recovery In First Episode Psychosis
Funder
National Health and Medical Research Council
Funding Amount
$432,528.00
Summary
The aim of this program of research is to evaluate the effectiveness of innovative online social media and mobile-based interventions purposely designed to improve long-term recovery in youth mental health (i.e., early psychosis and youth depression). These pioneering interventions have been designed by a large multidisciplinary team through the integration of cutting-edge social media technologies, new psychological models and strong consumer-youth participation.
Repetitive Transcranial Magnetic Stimulation Treatment Of Auditory Hallucinations In Psychotic Disorders: A Clinical And Neurobiological Investigation
Funder
National Health and Medical Research Council
Funding Amount
$314,644.00
Summary
This research will investigate a novel treatment, repetitive transcranial magnetic stimulation treatment, for auditory hallucinations of psychosis (e.g. schizophrenia). This work is novel as it will utilise an innovative and sophisticated method to optimise treatment at the individual level. Additionally, by identifying features of patients that predict response to treatment, this research will make major contributions to personalised treatment selection guidelines.
Studies On The Expression Of Muscarinic Receptors: Implications For The Pathology Of Schizophrenia
Funder
National Health and Medical Research Council
Funding Amount
$498,791.00
Summary
Schizophrenia is a severe psychiatric disorder that affects approximately 1% of the population. This project will help define changes in the molecules in the brain of subjects with schizophrenia which are likely to be involved in two symptoms of the disorder, the psychoses and cognitive deficits. Understanding the cause of the cognitive deficits of schizophrenia is a high priority because they are the most disabilitating symptom of the disorder and do not respond to current drug treatments.
Psychiatric disorders are associated with considerable social and economic burden which could be reduced if we understood mental health outcomes in high risk populations. This fellowship will use advanced brain imaging to understand the development of mental health disorders in those at high risk of bipolar disorder and dementia.
Kava For The Treatment Of Generalized Anxiety Disorder: A 16-Week Double-Blind RCT
Funder
National Health and Medical Research Council
Funding Amount
$680,489.00
Summary
Herbal medicines play a prominent role in traditional medicine to treat affective disorders (mood and anxiety disorders), however scientific studies are needed to truly assess their effectiveness. This clinical trial is examining the anxiolytic efficacy of Kava in treating chronic anxiety. As current response to antidepressant drugs can be inadequate, Kava may offer an additional affordable, safe, and effective option to reduce anxiety.