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Background: Population-based studies have found that early language delays are associated with poorer long-term outcomes in adolescence and adulthood. Few studies have explored the influence of change in language ability over time on adult outcomes., Aim: To examine the educational, vocational and mental health outcomes for adults accounting for different vocabulary developmental profiles over a 16-year period., Methods & Procedures: A total of 1914 participants of the Mater-University of Queensland Study of Pregnancy (MUSP) were categorized into four groups based on their vocabulary skills at 5 and 21 years: (1) persistently good (n = 1679), (2) persistently poor (n = 33), (3) improved (n = 160), and (4) deteriorated (n = 42). The associations between vocabulary group and educational, vocational, and mental health outcomes at 21 years were investigated., Outcomes & Results: Adults with deteriorated and persistently poor vocabulary skills were less likely to have completed secondary school; with the improved, deteriorated and persistently poor groups being less likely to be engaged in education, employment or training at the 21-year follow-up, compared with the persistently good group. Adults with deteriorated performance were at an increased risk of affective disorders, as well as substance and alcohol abuse/misuse., Conclusions & Implications: These findings provide evidence that impaired vocabulary skills in adulthood, regardless of whether the deficit was acquired early or later, are associated with adverse outcomes. Clinicians and educators need to be aware of these adversities and ensure they are supporting children and adolescents in whom language difficulties exist or emerge so as to prevent poor long-term outcomes from occurring., (© 2016 Royal College of Speech and Language Therapists.)

Purpose: The use of prescription opioid analgesics has been increasing over the last few decades in Australia. In particular, oxycodone and fentanyl have increased substantially. We examined the gender and age trends in the prescribing of subsidised opioid analgesics in the Australian population for non-palliative care indications., Methods: We analysed the Medicare Australia and Drug Utilisation Sub-Committee databases for prescription data from 2002 to 2009 in 10-year age groups and by gender. Prescriptions were converted to Defined Daily Doses (DDD)/1000/day using Australian Bureau of Statistics population data., Results: Overall use increased progressively in 2002-2009 from 12.95 to 16.08 DDD/1000 population/day (average annual increase 3.4%). Codeine was the most widely used agent followed by tramadol then oxycodone. Dispensed use increased in those aged in their 20s and 30s to plateau between 30 and 59 years for the three most preferred analgesics. The peak use of higher dose formulations of oxycodone was seen in males from 40 years. The highest dose formulation of tramadol was preferred in those aged up to approximately 70 years., Conclusions: Reasons for increased use may include increased prevalence of people with cancer and use for acute pain. The overall benefit and risk in this escalation of opioid use are difficult to determine; however, the increasing risk of tolerance, dependence, overdose and drug diversion suggests to clinicians and policy makers that this escalation may not be in the best interest of all Australians., (Copyright © 2015 John Wiley & Sons, Ltd.)

Background: Prenatal maternal depressive, anxious, and stress symptoms have been found to be associated with child and adolescent behavior problems. In this paper, we investigate their impact on behavior problems and depressive symptoms in adulthood., Methods: Participants included 3,099 mother-offspring pairs from the Mater University Study of Pregnancy (MUSP), an Australian based, prebirth cohort study. We used latent class growth analysis (LCGA) with parallel processes to identify trajectories of maternal depressive, anxious, and stress symptoms over four time periods between the mothers' first clinic visit and 5 years postpregnancy. We fitted the estimates from the maternal trajectories in multivariate logistic regression models to predict internalizing and externalizing behavior at age 21. We adjusted for a wide range of prenatal and postnatal factors, including maternal life events, relationship quality, contact with the new born, as well as concurrent maternal depressive and anxious symptoms and father's history of mental health problem., Results: LCGA found seven groups of mothers; one group of mothers exhibited high levels of depressive, anxious, and stress symptoms during pregnancy but not at later time points. Their offspring experienced increased levels of behavior problems and depressive symptoms., Conclusions: This paper provides the first evidence that high levels of maternal subjective depressive, anxious, and stress symptoms experienced in early pregnancy may predict internalizing and externalizing behavior problems and depressive symptoms in young adults., (© 2014 Wiley Periodicals, Inc.)

Background: Studies have shown a link between maternal-prenatal mental health and offspring behavior problems. In this paper, we derived longitudinal trajectories of maternal depressive, anxious, and stress symptoms over early life to predict offspring behavior in adolescence., Methods: Participants included 3,925 mother-offspring pairs from the Mater University Study of Pregnancy (MUSP), an Australian-based, prebirth cohort study. Latent class growth analysis with parallel processes was used to identify trajectories of maternal depressive, anxious, and stress symptoms over four measurement periods between the mothers' first clinic visit and 5 years postpregnancy. The estimates from the maternal trajectories were used to fit multivariate logistic regression models and predict internalizing and externalizing behavior at age 14. We adjusted for a wide range of factors, including a number of prenatal confounders, concurrent maternal depressive and anxious symptoms, father's history of mental problems, and maternal life events relationship quality and contact with the new born., Results: Seven maternal trajectories were identified one of which isolated high levels of depressive, anxious, and stress symptoms during pregnancy. After adjustment for confounders, this was the only trajectory that predicted higher internalizing behavior in adolescence. No specific maternal trajectory predicted externalizing problems., Conclusions: We found evidence for a prenatal effect, whereby high levels of maternal depression, anxiety, and stress symptoms in early pregnancy uniquely increased the risk of internalizing behavior problems in adolescence., (© 2013 Wiley Periodicals, Inc.)

Previous studies have shown that females are at an increased risk of developing posttraumatic stress disorder (PTSD) in response to physical assault compared with males. Our aims were to (a) test if this gender-specific risk generalised to subclinical levels of PTSD, (b) observe how this relationship was affected by including possible confounding factors, and (c) estimate how this trauma contributed to the overall prevalence of PTSD in females. Data came from an Australian birth cohort study (n = 2,547) based in Brisbane, Australia that commenced in 1981. Using ordinal logistic regression adjusted for a wide range of confounding factors, including polyvictimisation and internalising and externalising symptoms, we found females were at a significantly greater risk compared to males of developing either partial or full PTSD, odds ratio (OR) = 7.68; 95% confidence interval (CI) = [2.94, 20.08], as well as full PTSD only, OR = 9.23; 95% CI = [2.77, 30.79], following the experience of assaultive violence (p value for test of interaction = .004). In addition to the high prevalence of sexual assault (12.9%), attributable risk analysis suggested that due to the strong risk of PTSD in females exposed to physical assault, physical assault is possibly a contributor to the overall female increased prevalence of PTSD., (Copyright © 2013 International Society for Traumatic Stress Studies.)

Background: Investigations of gene-environment interaction (GxE) in depression have implicated a polymorphism in the promoter region of the serotonin transporter gene (5-HTTLPR) as a moderator of the stress-depression relationship. However, recent evidence for 5-HTTLPR GxE in depression has been inconsistent. This study examined the moderating effect of the val158met polymorphism in the catechol-O-methyltransferase (COMT) gene on the strength of 5-HTTLPR GxE., Methods: A community sample of youth (n=384) was genotyped for 5-HTTLPR and COMT. A multi-method, multi-informant index of chronic family stress was derived from interviews and questionnaires administered at youth age 15. GxGxE was examined in relation to depression diagnoses between ages 15 and 20 and depressive symptoms at age 20., Results: Significant three-way interactions were observed for both depressive symptoms and diagnoses, such that 5-HTTLPR GxE occurred only in the context of COMT val158 allele homozygosity. For val158 homozygotes, the 5-HTTLPR LL genotype exerted a protective effect in the face of stress. No genetic main effect or two-way GxE was found for 5-HTTLPR., Conclusions: Inconsistent 5-HTTLPR GxE findings to date may be partly attributable to unmeasured epistatic effects between 5-HTTLPR and COMT val158met. Identifying the conditions under which 5-HTTLPR GxE is most likely to operate may allow depression prevention and treatment efforts to target youth at highest risk., (2010 Wiley-Liss, Inc.)

Objective: To examine the prospective association between symptoms commonly experienced during pregnancy and the mental and general health status of women 14 years post partum., Methods: Data used were from the Mater-University of Queensland Study of Pregnancy, a community-based prospective birth cohort study begun in Brisbane, Australia, in 1981. Logistic regression analyses were conducted., Results: Data were available for 5118 women. Women who experienced a higher burden of symptoms during pregnancy were at greater risk of becoming depressed and reporting poorer health status 14 years post partum. Women who experienced major problems during pregnancy were 4 times more likely to be depressed and nearly 8 times more likely to report poorer health status 14 years after the index pregnancy compared with women who experienced few problems., Conclusions: Findings suggest that pregnant women who experience common symptoms during pregnancy are likely to experience poorer mental and self-reported general health 14 years after the pregnancy.

Patients with advanced cancer frequently express positive attitudes and can be unduly optimistic about the potential benefits of treatment. In order to evaluate an illusory domain in the context of advanced cancer, we developed a scale of will to live and characterized the beliefs that patients held about the curability of their cancer, and how committed they were to using alternative treatments. A measure of quality of life was used as the dependent variable in order to assess the association between these attributes. After a preliminary exploration confirmed the presence of an illusory domain, these concepts were prospectively tested in 149 ambulant patients with advanced cancer who attended for palliative systemic treatment, radiation treatment or supportive care. The scale of global quality of life was reliable (Cronbach's alpha coefficient 0.72). The distribution of the scores of will to live was skewed, with no respondent scoring poorly, and the scale was reliable (Cronbach's alpha coefficient 0.82). The scale of belief in curability showed diverse beliefs. In some cases, there was a discrepancy between respondents' beliefs in curability and what they believed to be the report by their doctors. There was also an association between a committed use of alternative treatments and a belief in the curability of the cancer (p<0.001). In a multiple regression analysis, both will to live and performance status remained associated with better quality of life scores after adjustment for other relevant variables (p<0.05 and <0.001, respectively). These results suggest that positive illusory beliefs can be measured and are an important component of adaption for some patients with advanced cancer. Furthermore, this illusory domain may influence the perception and measurement of quality of life., (Copyright 2003 John Wiley & Sons, Ltd.)