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Background: Digitally accessible prescription claims have potential utility in timely identification and active follow up interventions for unsupervised medication discontinuation in consumers with schizophrenia and bipolar disorder, that may prevent relapse and other adverse outcomes. We conducted a systematic review in order to identify and understand definitions of non-adherence from prescription claims records to serve as decision points for interventions. Methods: Electronic searches were conducted using Ovid MEDLINE, PubMed, the Cochrane Central Register of Controlled Trials and PsycINFO on 12 January 2020 to identify studies published in English. Data extraction was done by two reviewers independently. A narrative synthesis and tabulation of outcomes was performed. PROSPERO (CRD42020201708). Results: Thirty-one studies were eligible for analysis. Three common computing parameters were used to calculate non-adherence over 12 months, the Medication Possession Ratio (MPR) was used most frequently (21 studies - 68%) with a non-adherence threshold Discussion: Computing non-adherence from prescription claim records is a potential decision point for interventions. Better utilisation of this widely available data should be used to improve clinical practice and ensure targeted access to services. Conclusion: While there was variation in methods used to compute non-adherence parameters from prescription claims records, all approaches demonstrated that non-adherence was associated with adverse outcomes, the foremost of which was rehospitalisation and increased costs of care. Prospero Registration: PROSPERO CRD42020201708

Background: Digitally accessible prescription claims have potential utility in timely identification and active follow up interventions for unsupervised medication discontinuation in consumers with schizophrenia and bipolar disorder, that may prevent relapse and other adverse outcomes. We conducted a systematic review in order to identify and understand definitions of non-adherence from prescription claims records to serve as decision points for interventions. Methods: Electronic searches were conducted using Ovid MEDLINE, PubMed, the Cochrane Central Register of Controlled Trials and PsycINFO on 12 January 2020 to identify studies published in English. Data extraction was done by two reviewers independently. A narrative synthesis and tabulation of outcomes was performed. PROSPERO (CRD42020201708). Findings: Thirty-one studies were eligible for analysis. Three common computing parameters were used to calculate non-adherence over 12 months, the Medication Possession Ratio (MPR) was used most frequently (21 studies - 68%) with a non-adherence threshold Interpretation: Computing non-adherence from prescription claim records is a potential decision point for interventions. While there was variation in methods used to compute non-adherence parameters from prescription claims records, all approaches demonstrated that non-adherence was associated with adverse outcomes, the foremost of which was rehospitalisation and increased costs of care.

BACKGROUND During COVID-19, the psychological distress and well-being of the general population has been precarious, increasing the need to determine the impact of complementary internet-based psychological interventions on both positive mental health as well as distress states. Psychological distress and mental well-being represent distinct dimensions of our mental health, and congruent changes in outcomes of distress and well-being do not necessarily co-occur within individuals. When testing intervention impact, it is therefore important to assess change in both outcomes at the individual level, rather than solely testing group differences in average scores at the group level. OBJECTIVE This study set out to investigate the differential impact of an internet-based group mental health intervention on outcomes of positive mental health (ie, well-being, life satisfaction, resilience) and indicators of psychological distress (ie, depression, anxiety, stress). METHODS A 5-week mental health intervention was delivered to 89 participants using the Zoom platform during 2020. Impact on outcomes of distress, well-being, and resilience was assessed at the start and end of the program with multiple analysis of variance (MANOVA) and reliable change indices (RCIs) being used to determine program impact at the group and individual levels, respectively. RESULTS The intervention significantly improved all mental health outcomes measured, (F6,83=5.60, P2=.29) showing small to moderate effect sizes on individual outcomes. The largest effect sizes were observed for life satisfaction and overall well-being (η2=.22 and η2=.2, respectively). Larger effect sizes were noted for those with problematic mental health scores at baseline. A total of 92% (82/89) of participants demonstrated reliable change in at least one mental health outcome. Differential response patterns using RCI revealed that more than one-half of the participants showed improvement in both mental well-being and psychological distress, over one-quarter in outcomes of well-being only, and almost one-fifth in distress only. CONCLUSIONS The results provide evidence for the significant impact of an internet-based mental health intervention during COVID-19 and indicate the importance of assessing dimensions of both well-being and distress when determining mental health intervention effectiveness.

Objective The objective of the review is to evaluate circulating levels of leptin in people diagnosed with myalgic encephalomyelitis chronic fatigue syndrome or fibromyalgia syndrome and to investigate the differences compared with healthy controls. Introduction Myalgic encephalomyelitis chronic fatigue syndrome is a condition that has major symptoms, including self-reported fatigue, post-exertional malaise, and unexplained pain across the body. The widespread pain is measured in a systematic way and is often referred to as fibromyalgia. The two disorders have many similarities, but their association with leptin has indicated that leptin may affect the role of pro-inflammatory cytokines and symptom severity. Inclusion criteria This review will consider observational studies of varying study designs including prospective and retrospective cohort studies, case-control studies, time-series, and analytical cross-sectional studies that include both cases and healthy comparators. Cases will include a diagnosis of myalgic encephalomyelitis, chronic fatigue syndrome, and/or fibromyalgia. Controls are people without this diagnosis, usually healthy participants. Only studies published in English will be included due to limited resources for translation. Methods This protocol will be reported based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) checklist and will follow the JBI methodology for systematic reviews of etiology and risk. A comprehensive search strategy will include PubMed, Embase, Scopus, Science Direct, and PsycINFO. Two reviewers will screen, critically appraise eligible articles, and extract data using a standardized data extraction tool informed by JBI SUMARI. The authors will complete a quantitative analysis that synthesizes findings across studies using pooled effect sizes and confidence intervals of the measures provided. Systematic review registration number PROSPERO [CRD42020169903].

Background Depression and obesity are significant global health concerns that commonly occur together. An integrated group cognitive behavioural therapy program was therefore developed to simultaneously address comorbid depression and obesity. Methods Twenty-four participants (63% women, mean age 46 years) who screened positively for depression with a body mass index ≥25 were recruited from a self-referred general population sample. The group therapy program (10 two-hour weekly sessions) was examined in a single-arm, before-after pilot trial, conducted in a behavioural health clinic in Adelaide, Australia. Primary outcomes included survey and assessment-based analyses of depression, anxiety, body image, self-esteem, and weight (kg), assessed at four time-points: baseline, post-intervention, three-months and 12-months post program. Eighteen participants (75%) completed the program and all assessments. Results Significant improvements in depression, anxiety, self-esteem and body shape concern scores, several quality of life domains, eating behaviours and total physical activity (among others) – but not weight – were observed over the course of the trial. Conclusions Results from this pilot trial suggest that combining interventions for depression and obesity may be useful. Further development of the program, particularly regarding the potential for physical health benefits, and a randomised controlled trial, are warranted. Trial registration Trial registration: ANZCTR, ACTRN12617001079336, 13 July 2017. Retrospectively registered after date of the first consent (6 July 2017), but before the date of the first intervention session (20 July 2017).

Recruitment in mental health research is challenging, as some disorders such as depression or schizophrenia may involve vulnerable participants that lack motivation as part of their illness. A mental health diagnosis can be stigmatising, so privacy and access to hospital-based patient cohorts is carefully controlled. Our team describe a pragmatic portal recruitment process for facilitating timely recruitment into multiple research studies focusing on mental health. Three factors were analysed; evaluating the success and impact of this novel recruitment process; identification of patterns in recruitment to better target participants; and provision of metrics of the different media formats engaged. A web-based recruitment portal was developed by the research team in collaboration with the South Australian Health and Medical Research Institute (SAHMRI) Consumer & Carer Research Advisory Group. A comprehensive marketing campaign was then undertaken to direct participants towards the portal. Recruitment insights from the dates and times of registration across a two-year period is provided. In total, 933 potential participants registered with the recruitment portal across a two-year period at a cost of approximately $10,000. The advertisement campaign linked to the portal page enabled 506 participants to register in just one week. The area of research was self-selected by the potential participants, then eligibility was followed up with telephone and face to face interviews. Of the total 933 people who registered 706 (76%) expressed an interest in the target clinical depression study, 119 (13%) opted to be clinical controls, and the remainder chose one of the alternative studies. 240 (26%) of those who registered were excluded through telephone interviews because they fell outside of the strict eligibility criterion. We learnt that 77% (n = 723/933) of participants were recruited within seven days of promotional events, providing an interesting pattern of recruitment that may assist future recruitment design. Refereed/Peer-reviewed

Background: The success of integrated prevention initiatives for eating disorders and obesity is hampered by a lack of shared risk factor research. Bullying and sexual abuse are potentially potent shared risk factors for the spectrum of eating and weight disorders. Methods: A representative sample of N = 3005 South Australian males and females ≥15 years was interviewed about their height, weight, eating disorder symptoms, lifetime experiences of bullying and sexual abuse and mental and physical health-related quality of life. Results: Participants who were currently obese (25.2%) or underweight (2.7%) or who reported current eating disorder symptoms (32.7%) were between 10% and 27% more likely to have experienced bullying, and obese and eating disordered participants were also 47% and 56% more likely to have experienced sexual abuse, respectively. In regard to specific symptoms, a lifetime history of bullying was associated with increased risk of obesity, extreme dieting, purging and overvaluation of body weight and/or shape, whereas a lifetime history of sexual abuse was associated with increased risk of obesity, binge eating and extreme dieting and decreased risk of underweight. Lifetime histories of bullying and sexual abuse were associated with health-related quality of life impairment; however, lifetime bullying was associated with a greater adverse impact among participants with current eating disorder symptoms. Conclusion: Self-reported bullying and sexual abuse victimisation have shared associations with eating and weight spectrum problems. Differences in the symptoms associated with bullying versus sexual abuse are discussed, as well as the clinical and public health implications.

Background During COVID-19, the psychological distress and well-being of the general population has been precarious, increasing the need to determine the impact of complementary internet-based psychological interventions on both positive mental health as well as distress states. Psychological distress and mental well-being represent distinct dimensions of our mental health, and congruent changes in outcomes of distress and well-being do not necessarily co-occur within individuals. When testing intervention impact, it is therefore important to assess change in both outcomes at the individual level, rather than solely testing group differences in average scores at the group level. Objective This study set out to investigate the differential impact of an internet-based group mental health intervention on outcomes of positive mental health (ie, well-being, life satisfaction, resilience) and indicators of psychological distress (ie, depression, anxiety, stress). Methods A 5-week mental health intervention was delivered to 89 participants using the Zoom platform during 2020. Impact on outcomes of distress, well-being, and resilience was assessed at the start and end of the program with multiple analysis of variance (MANOVA) and reliable change indices (RCIs) being used to determine program impact at the group and individual levels, respectively. Results The intervention significantly improved all mental health outcomes measured, (F6,83=5.60, P Conclusions The results provide evidence for the significant impact of an internet-based mental health intervention during COVID-19 and indicate the importance of assessing dimensions of both well-being and distress when determining mental health intervention effectiveness.

Background Few representative sample studies have reported estimates of bullying and sexual abuse in Australia. By using face-to-face interviews and self-labelling questions, we investigated the prevalence of these forms of abuse and their relationship with current harmful behaviours (smoking dependence, excessive alcohol intake, binge eating), antidepressant use, and the physical (PCS) and mental (MCS) components of health-related quality of life. Methods This study was a population-based survey that investigated 2873 South Australians in 2015 (48.8 ± 18.1 years; 49.3% males). Bullying and sexual abuse (age of onset and duration) and their outcomes were investigated through household interviews. Associations were adjusted for sociodemographic variables by using regression models. Results 45.6% (95% CI 43.3–47.9) of the participants were bullied, and 10.4% (95% CI 9.1–11.9) sexually abused; 7.3% (95% CI 6.2–8.5) reported experiencing both forms of abuse. Moreover, 15.8% of those bullied and 15.0% of those sexually abused suffered from these forms of abuse for > 24 months. Smoking dependence (7.8%) was twice as frequent among those who experienced bullying for > 24 months or when sexual abuse occurred in childhood ( 24 months. Binge eating (8.1%) was more frequent among those bullied or sexually abused in adulthood, but duration did not show a clear pattern. Antidepressant use was up to four times more likely, and PCS or MCS lower among those who were bullied or sexually abused, independent of when these forms of abuse started or their duration. The cumulative adverse relationship of bullying and sexual abuse with the investigated outcomes was more evident for smoking dependence, binge eating, PCS, and MCS than for antidepressant use, but no association was observed with alcohol intake. Conclusions The use of self-labelling questions to investigate sensitive areas such as bullying and sexual abuse in a survey is feasible. Such questions provided estimates that are consistent with findings from studies using more detailed instruments. Bullying and sexual abuse have an additive adverse association with various outcomes. Identifying survivors of both forms of abuse is important to avoid more serious consequences. Electronic supplementary material The online version of this article (10.1186/s12889-018-6367-8) contains supplementary material, which is available to authorized users.

We are at the dawn of a new era of treatment for major depressive disorder involving precision medicine. Research is using big data, genome-wide association studies, and pharmacogenomics to create a combinatorial biological and environmental model of depression. Biomarkers have already been used to indicate causative pathways and the effectiveness of treatment responses in other areas of medicine. As technology advances, psychiatric practice will be able to use new tools and technology to assist with diagnosis and drug treatment options. The complex interaction of the inherited genome, epigenetic responses, pharmacokinetics, and environmental factors combine to produce endophenotypic outcomes that are predictable. The prevalence and cost burden of depression are so great that improved diagnostic tools are needed. The role of pharmacogenomics and related sciences pharmacokinetics and pharmacodynamics are discussed. Refereed/Peer-reviewed

Objective: Although polycystic ovary syndrome (PCOS) is considered a lifelong disorder, very little is understood about the diagnosis and impact of this condition in women outside of the peak reproductive years. We examined the frequency of diagnosed PCOS and concurrent health conditions in women across the lifespan. Methods: Data were analysed from 1509 women aged 15–95 years participating in a cross-sectional, face-to-face population survey in South Australia, 2015. We assessed the prevalence of PCOS in 10-year age groups and the frequency of comorbidities in women with and without PCOS subgrouped by age (< 45, [Formula: see text] 45 years). The main outcome measures were Diagnosed PCOS and other chronic conditions; lifestyle factors. Logistic regression analyses determined the risk of comorbidities in women with PCOS adjusting for age and BMI. Results: Overall prevalence of PCOS was 5.6% (95% confidence interval (CI) 4.6–6.9%), peaking in the 35–44 year age group (9.1%), and lowest in those aged 15–24 (4.1%) or [Formula: see text] 65 (3.7%) years. Women with PCOS and aged Conclusion: PCOS is underdiagnosed in young and post-menopausal women. Diabetes and cardiovascular disease are key comorbidities requiring greater attention in younger women with PCOS.

Evidence indicates that inflammatory mediators play a role in the development of major depressive disorder (MDD). MDD is thought to be a multigenic disorder in that many genes are implicated in its development. Genetics has enabled researchers to identify the effects of single-nucleotide polymorphisms in specific inflammatory pathways. The link between these genes and biochemical expression of inflammatory mediators is explored. The advance in genomics is rapidly growing as technology enables us to examine large sections of the human genome in a short period of time. At the same time, laboratories across the world are creating genetic databases, mapping samples on a grand scale, and providing the opportunity to access anonymized MDD clinical and genetic data with relative ease. In the last decade, a combination of candidate gene studies, linkage studies, and genome-wide association studies have started to reveal the inheritance of MDD and the genes responsible. Refereed/Peer-reviewed

This study investigated the achievement of lifestyle recommendations and use of preventive medication in people who 1) are obese, 2) or have metabolic risk factors (hypertension, dyslipidaemia, and/or diabetes), 3) or have cardiovascular disease (CVD), 4) or are healthy, and the impact this preventive health care had on their 'Health-Related Quality of Life' (HRQoL). Cross-sectional survey conducted in 2015 with 2379 South Australian adults (57.1 +/- 14 years; 51.7% females). Physical (PCS) and mental components scores (MCS) of HRQoL were assessed using the SF-12 questionnaire. Although adequate fruit/vegetable intake was lower among individuals with CVD (29.8%; p=0.049), this behaviour was associated with a better MCS. Adequate physical activity level was lower among those with metabolic risk factors (29.5%) or CVD (31.0%; p=0.008), but independent of their clinical condition, this behaviour was associated with a higher PCS. Individuals with CVD were less likely to have adequate alcohol consumption (63.4%; p=0.026), but those achieving this recommendation had poorer PCS. Nonsmoking was similar in all groups (85%; p=0.768) and was associated with a better MCS only among healthy individuals and those with CVD. In all the groups, individuals achieving all the lifestyle recommendations had a better PCS. Only 48.2% of individuals with CVD reported combined use of antithrombotic, antihypertensive, and antilipidemic drugs, but the use of these medications was not associated with HRQoL. In conclusion, the vast majority of individuals at risk of or with CVD did not achieve preventive recommendations, and only the adequacy of uptake of all recommended lifestyle behaviours showed consistent benefits for PCS and MCS. (C) 2017 Elsevier Inc. All rights reserved. Refereed/Peer-reviewed

The concept of empowerment has been widely discussed and its psychological and political meaning explored. However, it is rarely described in the context of nursing practice. This article focuses on the practice of empowering individuals with learning difficulties, within a secure setting. The ideas may be applied to any healthcare setting.