Schizophrenia Research Unit

Liverpool, Australia

Schizophrenia Research Unit

Liverpool, Australia
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Teasdale S.B.,Bondi Community Center | Teasdale S.B.,University of New South Wales | Ward P.B.,University of New South Wales | Ward P.B.,Schizophrenia Research Unit | And 5 more authors.
British Journal of Psychiatry | Year: 2017

Background Nutrition interventions would appear fundamental for weight management and cardiometabolic risk reduction in people experiencing severe mental illness (SMI). Comprehensive evaluation of nutrition interventions is lacking. Aims To subject randomised controlled trials of nutrition interventions in people with SMI to systematic review and meta-analysis, and to measure anthropometric and biochemical parameters and nutritional intake. Method An electronic database search identified trials with nutrition intervention components. Trials were pooled for meta-analysis. Meta-regression analyses were performed on anthropometric moderators. Results Interventions led to significant weight loss (19 studies), reduced body mass index (17 studies), decreased waist circumference (10 studies) and lower blood glucose levels (5 studies). Dietitian-led interventions (6 studies) and studies delivered at antipsychotic initiation (4 studies) had larger effect sizes. Conclusions Evidence supports nutrition interventions as standard care in preventing and treating weight gain among people experiencing SMI. © The Royal College of Psychiatrists 2017.

Rosenbaum S.,University of New South Wales | Rosenbaum S.,The Bondi Center | Rosenbaum S.,University of Sydney | Vancampfort D.,Catholic University of Leuven | And 7 more authors.
Psychiatry Research | Year: 2015

People with PTSD experience high levels of cardiovascular disease and comorbid mental health problems. Physical activity (PA) is an effective intervention in the general population. We conducted the first systematic review and meta-analysis to determine the effect of PA on PTSD. We searched major electronic databases from inception till 03/2015 for RCTs of PA interventions among people with PTSD. A random effects meta-analysis calculating hedges g was conducted. From a potential of 812 hits, four unique RCTs met the inclusion criteria (n=200, mean age of participants 34-52 years). The methodological quality of included trials was satisfactory, and no major adverse events were reported. PA was significantly more effective compared to control conditions at decreasing PTSD and depressive symptoms among people with PTSD. There was insufficient data to investigate the effect on anthropometric or cardiometabolic outcomes. Results suggest that PA may be a useful adjunct to usual care to improve the health of people with PTSD. Although there is a relative paucity of data, there is reason to be optimistic for including PA as an intervention for people with PTSD, particularly given the overwhelming evidence of the benefits of PA in the general population. Robust effectiveness and implementation studies are required. © 2015 Elsevier Ireland Ltd.

Langdon R.,Macquarie University | Langdon R.,Schizophrenia Research Unit | Langdon R.,Connectivity | Ward P.B.,Schizophrenia Research Unit | And 2 more authors.
Schizophrenia Bulletin | Year: 2010

Deluded people differ from nondeluded controls on attributional style questionnaires and probabilistic-reasoning and theory-of-mind (ToM) tasks. No study to date has examined the relations between these 3 reasoning anomalies in the same individuals so as to evaluate their functional independence and potentially inform theories of delusion formation. We did so in 35 schizophrenic patients with a history of delusions, 30 of whom were currently deluded, and 34 healthy controls. Compared with healthy controls, patients showed (a) a jumping-to-conclusions bias and a bias to overadjust when confronted with a change of evidence on probabilistic-reasoning tasks, (b) an excessive externalizing attributional bias, and (c) performance deficits on 3 ToM tasks. Probabilistic-reasoning and ToM measures correlated, while attributional-bias scores were independent of other task measures. A general proneness to delusional ideation correlated with probabilistic-reasoning and ToM measures, while externalizing bias was unrelated to the study measures of delusional ideation. Personalizing bias associated specifically with paranoia across the clinical and nonclinical participants. Findings are consistent with a common underlying mechanism in schizophrenia which contributes to the anomalies on probabilistic-reasoning and ToM tasks associated with delusions. We speculate that this mechanism is impairment of the normal capacity to inhibit "perceived reality" (the evidence of our senses), a capacity that evolved as part of the "social brain" to facilitate intersubjective communication within a shared reality.

Vancampfort D.,Catholic University of Leuven | De Hert M.,Catholic University of Leuven | Stubbs B.,University of Greenwich | Ward P.B.,University of New South Wales | And 4 more authors.
Comprehensive Psychiatry | Year: 2015

Objective This cross-sectional study examined the association between psychiatric symptoms and motivation for physical activity within the self-determination theory (SDT) framework in people with schizophrenia. Method Over a 4-month period, 55 (17♀) inpatients with a DSM-V diagnosis of schizophrenia were assessed with the Psychosis Evaluation tool for Common use by Caregivers (PECC) and the Behavioural Regulation in Exercise Questionnaire (BREQ-2), that provided separate scores for amotivation, external, introjected and autonomous regulation. Spearman correlation coefficients were examined between these motivation scores and symptom ratings. Results The BREQ-2 score for autonomous regulations (2.6 ± 1.1) was significantly correlated with the PECC negative symptoms score (10.3 ± 4.1) (r = -0.34, p = 0.011). No other significant correlations between BREQ-2 and PECC scores were found. The BREQ-2 score for external regulations (0.7 ± 0.9) was associated with older age (35.2 ± 11.3 years) (r = -0.30, p = 0.024). Conclusions These findings provide evidence that negative symptoms are associated with lower autonomous motivation towards physical activity in inpatients with schizophrenia. Future longitudinal research should confirm the current findings. Such research will guide physical activity approaches aimed at facilitating enhanced physical and mental health outcomes in individuals with schizophrenia. © 2014 Elsevier Inc. All rights reserved.

Shine J.M.,University of Sydney | Ward P.B.,University of New South Wales | Ward P.B.,Schizophrenia Research Unit | Naismith S.L.,University of Sydney | And 2 more authors.
Journal of Clinical Neuroscience | Year: 2011

Despite being common, the pathophysiological mechanisms underlying the phenomenon of freezing in patients with Parkinson's disease (PD) remain poorly understood. Recent work has shown that freezing behaviour can be provoked through the use of a computer-based virtual reality task, allowing for the exploration of freezing with functional MRI (fMRI). This article describes a single patient with PD who performed a virtual-reality walking task, both "On" and "Off" dopaminergic medication, while fMRI data were obtained. The results showed distinct BOLD patterns during "walking", "dual-task walking" and during episodes of freezing. The results of this single study highlight the potential utility of this approach in elucidating the underlying neural correlate of freezing behaviour in PD. Crown Copyright © 2011 Published by Elsevier Ltd. All rights reserved.

Shine J.M.,University of Sydney | Matar E.,University of Sydney | Ward P.B.,University of New South Wales | Ward P.B.,Schizophrenia Research Unit | And 4 more authors.
PLoS ONE | Year: 2013

Freezing of gait is a devastating symptom of Parkinson's disease (PD) that is exacerbated by the processing of cognitive information whilst walking. To date, no studies have explored the neural correlates associated with increases in cognitive load whilst performing a motor task in patients with freezing. In this experiment, 14 PD patients with and 15 PD patients without freezing of gait underwent 3T fMRI while performing a virtual reality gait task. Directions to walk and stop were presented on the viewing screen as either direct cues or as more cognitively indirect pre-learned cues. Both groups showed a consistent pattern of BOLD response within the Cognitive Control Network during performance of the paradigm. However, a between group comparison revealed that those PD patients with freezing of gait were less able to recruit the bilateral anterior insula, ventral striatum and the pre-supplementary motor area, as well as the left subthalamic nucleus when responding to indirect cognitive cues whilst maintaining a motor output. These results suggest that PD patients with freezing of gait are unable to properly recruit specific cortical and subcortical regions within the Cognitive Control Network during the performance of simultaneous motor and cognitive functions. © 2013 Shine et al.

Shine J.M.,University of Sydney | Matar E.,University of Sydney | Ward P.B.,University of New South Wales | Ward P.B.,Schizophrenia Research Unit | And 5 more authors.
Brain | Year: 2013

Freezing of gait is a devastating symptom of advanced Parkinson's disease yet the neural correlates of this phenomenon remain poorly understood. In this study, severity of freezing of gait was assessed in 18 patients with Parkinson's disease on a series of timed 'up and go' tasks, in which all patients suffered from episodes of clinical freezing of gait. The same patients also underwent functional magnetic resonance imaging with a virtual reality gait paradigm, performance on which has recently been shown to correlate with actual episodes of freezing of gait. Statistical parametric maps were created that compared the blood oxygen level-dependent response associated with paroxysmal motor arrests (freezing) to periods of normal motor output. The results of a random effects analysis revealed that these events were associated with a decreased blood oxygen level-dependent response in sensorimotor regions and an increased response within frontoparietal cortical regions. These signal changes were inversely correlated with the severity of clinical freezing of gait. Motor arrests were also associated with decreased blood oxygen level-dependent signal bilaterally in the head of caudate nucleus, the thalamus and the globus pallidus internus. Utilizing a mixed event-related/block design, we found that the decreased blood oxygen level-dependent response in the globus pallidus and the subthalamic nucleus persisted even after controlling for the effects of cognitive load, a finding which supports the notion that paroxysmal increases in basal ganglia outflow are associated with the freezing phenomenon. This method also revealed a decrease in the blood oxygen level-dependent response within the mesencephalic locomotor region during motor arrests, the magnitude of which was positively correlated with the severity of clinical freezing of gait. These results provide novel insights into the pathophysiology underlying freezing of gait and lend support to models of freezing of gait that implicate dysfunction across coordinated neural networks. © 2013 The Author (2013).

Neil A.L.,Menzies Research Institute | Carr V.J.,University of New South Wales | Carr V.J.,Schizophrenia Research Unit | Mihalopoulos C.,Deakin University | And 5 more authors.
Australian and New Zealand Journal of Psychiatry | Year: 2014

Objectives: To assess differences in costs of psychosis between the first and second Australian national surveys of psychosis and examine them in light of policy developments. Method: Cost differences due to changes in resource use and/or real price rises were assessed by minimizing differences in recruitment and costing methodologies between the two surveys. For each survey, average annual societal costs of persons recruited through public specialized mental health services in the census month were assessed through prevalence-based, bottom-up cost-of-illness analyses. The first survey costing methodology was employed as the reference approach. Unit costs were specific to each time period (2000, 2010) and expressed in 2010 Australian dollars. Results: There was minimal change in the average annual costs of psychosis between the surveys, although newly included resources in the second survey's analysis cost AUD$3183 per person. Among resources common to each analysis were significant increases in the average annual cost per person for ambulatory care of AUD$7380, nongovernment services AUD$2488 and pharmaceuticals AUD$1892, and an upward trend in supported accommodation costs. These increases were offset by over a halving of mental health inpatient costs of AUD$11,790 per person and a 84.6% (AUD$604) decrease in crisis accommodation costs. Productivity losses, the greatest component cost, changed minimally, reflecting the magnitude and constancy of reduced employment levels of individuals with psychosis across the surveys. Conclusions: Between 2000 and 2010 there was little change in total average annual costs of psychosis for individuals receiving treatment at public specialized mental health services. However, there was a significant redistribution of costs within and away from the health sector in line with government initiatives arising from the Second and Third National Mental Health Plans. Non-health sector costs are now a critical component of cost-of-illness analyses of mental illnesses reflecting, at least in part, a whole-of-government approach to care. © The Royal Australian and New Zealand College of Psychiatrists 2013.

Rosenbaum S.,University of New South Wales | Newby J.M.,University of New South Wales | Steel Z.,University of New South Wales | Steel Z.,St John of God Health Care Richmond Hospital | And 3 more authors.
Internet Interventions | Year: 2015

Background: Accumulating evidence indicates that face-to-face physical activity interventions improve the physical and mental health of people with mental disorders. However, it is unclear whether internet-delivered physical activity interventions are also efficacious. Objective: Our aim was to determine the effect of online physical activity interventions on the severity of symptoms of mental illness among people experiencing mental disorders. Methods: A systematic review of major electronic databases was conducted from inception to January 2015. Randomised controlled trials of internet-delivered interventions to increase physical activity participation in adults (>. 18. years) with a DSM, ICD, clinician-confirmed diagnosis, and/or those receiving specialist mental health treatment were eligible for inclusion. Outcome data for symptom severity (depression) and physical activity participation was extracted. Results: Two trials (N= 95 participants) met the inclusion criteria, which investigated online clinician-guided interventions of 9-10. week duration. Results were discrepant across studies. One study found a moderate between-groups effect size compared to wait-list control on depression outcomes (d= .67) but no differences in physical activity participation. In the other study, there were no significant differences between an online physical activity intervention versus treatment-as-usual in a university counselling service. Conclusion: The preliminary findings suggest that online physical activity interventions may have positive effects on depression symptoms, but the size of the effects and mechanism of change remain unclear. Further research is critically needed to explore the efficacy and acceptability of online physical interventions for people with mental disorders. © 2015 The Authors.

Todd J.,University of Newcastle | Todd J.,Schizophrenia Research Institute | Whitson L.,University of Newcastle | Smith E.,University of Newcastle | And 6 more authors.
Psychophysiology | Year: 2014

Repetitive patterning facilitates inferences about likely properties of sound to follow. Mismatch negativity (MMN) occurs when sound fails to match an inference. Smaller MMN in schizophrenia indexes deficient gain control (difference in utilizing a limited dynamic range). Although it is clear that this group has a lower limit to MMN size, this study addressed whether smaller MMN indicates impaired perceptual inference. MMN was elicited to four deviants in two sequences: one in which occurrence was random and one in which it was paired. Despite smaller MMN, persons with schizophrenia are equally able to reduce MMN size evoked by a deviant when its occurrence is cued. Results also expose alterations in the evoked response to repeated sounds that appear to be exacerbations of age-related amplitude decline. Since these anomalies impact the computed MMN, they highlight the need to identify all contributions to limits in gain control in schizophrenia. © 2014 Society for Psychophysiological Research.

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