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Background: Hypertensive disorders of pregnancy are associated with longer term cardiovascular risk. Understanding if depression or antidepressant use in pregnancy is associated with HDP is important in identifying those potentially vulnerable to poorer health in later life. This study examines if depression and antidepressants are associated with HDP. Methods: In all, 815 pregnant women were recruited within an Australian pregnancy cohort study at less than 20 weeks of pregnancy, all undertook the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and were assigned to four groups for this paper: those with unmedicated depression meeting criteria for current depression (n = 97), those taking selective serotonin reuptake inhibitors in early pregnancy (n = 101), those taking serotonin and noradrenaline reuptake inhibitors in early pregnancy (n = 31), and those without depression or taking antidepressant medication (control; n = 586). Women were then assessed again following birth. Hypertensive disorders of pregnancy were diagnosed according to the Society of Obstetric Medicine in Australia and New Zealand Guidelines. Results: Use of serotonin and noradrenaline reuptake inhibitors (SNRIs) (adjusted risk ratio = 9.10, 95% confidence interval = [3.82, 21.67]) and unmedicated depression (adjusted risk ratio = 3.11, 95% confidence interval = [1.32, 7.35]) were independently associated with significantly higher risk for developing hypertensive disorders of pregnancy compared to controls. Selective serotonin reuptake inhibitors (SSRIs) use did not confer any increased risk. Higher doses of SNRIs, but not selective serotonin reuptake inhibitors, were associated with significantly higher risk for developing HDP (adjusted risk ratio = 4.83, 95% confidence interval = [1.50, 15.58]). Conclusions: Our findings suggest that those with depression in pregnancy and/or on an serotonin and noradrenaline reuptake inhibitor should have closer surveillance for the development of hypertensive disorders of pregnancy. These findings support treatment of depression in pregnancy, however, also the consideration of class of antidepressant. [ABSTRACT FROM AUTHOR]

Objective: To assess depression literacy, help-seeking and help-offering to others in members of the police force in the state of Victoria, Australia. Methods: All staff in police stations involved in a cluster randomised controlled trial of an integrated workplace mental health intervention were invited to participate. Survey questions covered sociodemographic and employment information, recognition of depression in a vignette, stigma, treatment beliefs, willingness to assist co-workers with mental health problems, help-giving and help-seeking behaviours, and intentions to seek help. Using the baseline dataset associated with the trial, the paper presents a descriptive analysis of mental health literacy and helping behaviours, comparing police station leaders and lower ranks. Results: Respondents were 806 staff, comprising 618 lower-ranked staff and 188 leaders. Almost 84% of respondents were able to correctly label the problem described in the vignette. Among those who had helped someone with a mental health problem, both lower ranks and leaders most commonly reported ‘talking to the person’ although leaders were more likely to facilitate professional help. Leaders’ willingness to assist the person and confidence in doing so was very high, and over 80% of leaders appropriately rated police psychologists, general practitioners, psychologists, talking to a peer and contacting welfare as helpful. However, among both leaders and lower ranks with mental health problems, the proportion of those unlikely to seek professional help was greater than those who were likely to seek it. Conclusion: Knowledge about evidence-based interventions for depression was lower in this police sample than surveys in the general population, pointing to the need for education and training to improve mental health literacy. Such education should also aim to overcome barriers to professional help-seeking. Interventions that aim to improve mental health literacy and help-seeking behaviour appear to be suitable targets for better protecting police member mental health. [ABSTRACT FROM AUTHOR]

Objective: The MindSpot Clinic provides online mental health services to Australian adults with anxiety and depression. This paper describes users of MindSpot between January 2013 and June 2015. Outcomes are considered against three key objectives: improving access to mental health services, improving public awareness of how to access services and providing evidence-based treatments. Method: Website traffic data were examined to determine patterns of use. Demographic characteristics, past service utilisation and reasons for contacting MindSpot were analysed. Outcomes for patients enrolled in a MindSpot treatment course were also analysed. Primary outcomes were scores on the 9-Item Patient Health Questionnaire, Generalised Anxiety Disorder 7-Item, Yale–Brown Obsessive Compulsive Scale and Post-Traumatic Stress Disorder Checklist–Civilian Version, administered at assessment, post-treatment and 3-month follow-up. Results: The website was visited by almost 500,000 Australians, of which 33,990 adults started assessments, and 25,469 people completed assessment and were eligible for analysis. Mean age was 36.4 years (standard deviation = 13.3 years; range = 18–94 years), and 72% were female. The proportion living in rural or remote regions and who identified as Aboriginal and Torres Strait Islander closely matched national statistics. The majority (82%) reported that they were not currently in contact with mental health services. Most patients sought an assessment, information about treatment options, or referral to another service, and only 24% of those completing an assessment commenced a MindSpot treatment course. Of these, large clinical effects (d: 0.7–2.4; average symptom reductions: 25.5% to 61.6%) were found from assessment to follow-up on all outcome measures. Deterioration ranged from 1.0% to 4.3%. Conclusion: Based on the number of website visits, completed assessments and treatment outcomes, MindSpot achieved its three programme objectives. This model of service provision has considerable value as a complement to existing services, and is proving particularly important for improving access for people not using existing services. [ABSTRACT FROM AUTHOR]

Objective: It is well established that socio-economic position is associated with depression. The experience of financial hardship, having to go without the essentials of daily living due to limited financial resources, may explain the effect. However, there are few studies examining the link between financial hardship and diagnosable depression at a population level. The current paper addresses this gap and also evaluates the moderating effect of age.Method: Data were from 8841 participants aged 16–85 years in Australia’s 2007 National Survey of Mental Health and Wellbeing. The 12-month prevalence of depressive episode was assessed using the Composite International Diagnostic Interview. Measures of socio-economic position included: financial hardship, education, labour-force status, occupational skill, household income, main source of income, and area-level disadvantage.Results: Financial hardship was more strongly associated with depression than other socio-economic variables. Hardship was more strongly associated with current depression than with prior history of depression. The relative effect of hardship was strongest in late adulthood but the absolute effect of hardship was greatest in middle age.Conclusions: The results demonstrate the critical role of financial hardship in the association between socio-economic disadvantage and 12-month depressive episode, and suggest that social and economic policies that address inequalities in living standards may be an appropriate way to reduce the burden attributable to depression. [ABSTRACT FROM PUBLISHER]

Objective: Self-efficacy can be conceptualised as a person’s perception of their own ability to produce a desired outcome. Low self-efficacy has been reported to be a mediating variable in developing depression. The Self-Efficacy Questionnaire for Depressed Adolescents (SEQ-DA) is a 12-item inventory, designed to measure self-perceived ability of the young person to cope with depressive symptoms. This paper presents further information on the psychometric properties of the SEQ-DA in a clinical sample of depressed adolescents.Method: The SEQ-DA was administered to a clinical sample of 130 adolescents with a depressive disorder at baseline, at the end of 3 months of therapy and 6 months following therapy. A diagnosis of depression was made using the Schedule for Affective Disorders and Schizophrenia for School Aged Children. The ability of the SEQ-DA to identify those adolescents who had a diagnosis of major depressive disorder at baseline, following treatment and at 6-month follow-up was evaluated. Receiver operating characteristic (ROC) analysis of the SEQ-DA in this clinical sample of depressed adolescents was undertaken to establish cut-off scores of the SEQ-DA.Results: The SEQ-DA score at baseline of < 36 and following treatment of < 43 were predictive of a depressive disorder.Conclusions: The SEQ-DA is a very simple self-report measure that can be used to predict which adolescents treated for depression are likely to remain depressed, thus prompting more intensive treatment and follow-up. [ABSTRACT FROM PUBLISHER]

To examine the likely utility of the recently published Australian and New Zealand clinical practice guidelines for the treatment of depression.The guidelines are critiqued for their intrinsic logic and their success in extracting potentially valid and useful management templates.This paper provides examples of key limitations to many specific interpretations and conclusions.It is argued that these guidelines are far less precise and informative for clinical practice than they appear and with a disturbing lack of rigour for a document promulgated by a professional college. [ABSTRACT FROM AUTHOR]

Objective: The main objective of this paper was to investigate and compare mental health nurses’ beliefs about interventions for schizophrenia and depression with those of psychiatrists and the public. Factors affecting nurses’ beliefs were also investigated. Method: This research used methods employed in previous surveys of professional and public beliefs. A postal survey of 673 Australian mental health nurses was carried out. The survey was comprised of a vignette describing a person with either depression or schizophrenia. Participants rated whether particular medical, psychological and lifestyle interventions were helpful, harmful or neither. Factors examined included: nurses’ age, sex, degree of contact with similar problems, work setting, level of highest qualification and whether their education was hospital-based or completed within the tertiary sector. Results: The nurses agreed with psychiatrists (but not the public) about the interventions most likely to be helpful, such as antidepressants for depression and antipsychotic medication for schizophrenia. However, there were many differences between nurses, psychiatrists and the public. Nurses were more likely than psychiatrists to believe that certain non-standard interventions such as vitamins, minerals and visiting a naturopath would be helpful. Nurses’ beliefs tended to form a bridge between the attitudes of psychiatrists and the public for some of these non-standard interventions. Age, work setting and qualifications were related to nurses’ intervention beliefs. Conclusions: Mental health practitioners need to be aware of a range of beliefs within mental health services. The acknowledgement of differing belief systems is important for high quality, integrated care. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper was to compare the Australian public’s attitudes towards people who have been treated for a mental disorder with the attitudes of general practitioners, psychiatrists and clinical psychologists. Method: The study involved a household survey of 2031 members of the Australian public and a postal survey of 872 general practitioners, 1128 psychiatrists and 454 clinical psychologists. Survey participants were presented with a vignette describing a person with schizophrenia or one with depression. They were asked opinions about the person’s long-term outcome in various areas of life after receiving treatment. Participants were also asked whether they thought the person described would be discriminated against by others. Results: Both the public and professionals rated outcomes as poorer and discrimination as more likely for the person with schizophrenia than for the one with depression. The professionals made more negative ratings than the public, although the clinical psychologists had similar attitudes to the public about depression. Conclusions: Compared to the public, health professionals rate long-term outcomes more negatively and discrimination as more likely. It is possible that these more negative attitudes are realistic, being based on greater knowledge of mental disorders. However, professional attitudes may be biased by greater contact with patients who have chronic or recurrent disorders. Either way, health professionals need to be aware of the effects that their negative attitudes might have on patients and the public. [ABSTRACT FROM AUTHOR]