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Despite the existence of effective interventions for anxiety disorders, relapse - or the return of fear - presents a significant problem for patients and clinicians in the longer term. The present paper draws on the experimental and clinical behavioural literature, reviewing the mechanisms by which the return of fear can occur. The aim of the paper was to generate a list of treatment recommendations for clinicians aimed at reducing relapse in successfully treated anxiety disorders. Clinical and experimental literature on the mechanisms of renewal, reinstatement, spontaneous recovery and reacquisition are reviewed. These are linked with the clinical and experimental literature on the return of fear in successfully treated anxiety. A list of recommendations to assist in reducing the probability of relapse in successfully treated anxiety is presented. This list includes methods for use in behavioural (exposure) treatment of anxiety disorders that aim to enhance clinical outcomes. Despite the significant problem of relapse in successfully treated anxiety, there are methods available to reduce the probability of relapse through return of fear. Clinicians engaging in treatment of anxiety disorders should be mindful of these methods to ensure optimal patient outcome. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this paper is to examine whether Australian young people’s awareness of beyondblue is associated with better recognition of depression and anxiety disorders, and better quality of beliefs about possible interventions and first-aid actions for these problems.Method: In 2011, a telephone interview was conducted with a national sample of 3021 Australians aged between 15 and 25 years. Participants were presented with a vignette portraying depression, depression with suicidal thoughts, social phobia, post-traumatic stress disorder or psychosis in a young person. They were then asked about recognition of the disorder portrayed, their beliefs about the helpfulness or harmfulness of various interventions and first-aid actions, and their awareness of beyondblue. The quality of youths’ beliefs was scored against health professionals’ ratings of the same list of interventions and first-aid actions.Results:Beyondblue awareness was associated with more accurate recognition of the disorder portrayed in all vignettes except social phobia. It was also associated with beliefs about the helpfulness of first-aid actions that were more closely aligned with professional ratings for the depression, psychosis and social phobia vignettes. However, it was associated with beliefs about interventions for the psychosis vignette only.Conclusions: Overall, the associations of beyondblue awareness with better mental health literacy were not specific to depression and anxiety disorders, which are their main focus. Beyondblue awareness is mostly unrelated to treatment beliefs, but seems to have non-specific associations with recognition of disorders and first-aid beliefs. [ABSTRACT FROM PUBLISHER]

Objective: This paper reports findings from a national survey on stigmatizing attitudes towards people with depression, anxiety disorders and schizophrenia/psychosis. Method: In 2011 telephone interviews were carried out with 6019 Australians aged 15 or over. Participants were presented with a case vignette describing either depression, depression with suicidal thoughts, early schizophrenia, chronic schizophrenia, social phobia or post-traumatic stress disorder. Questions were asked about stigmatizing attitudes, including perceptions of discrimination, personal and perceived stigma and desire for social distance. Results: Chronic schizophrenia was most likely to be associated with dangerousness, unpredictability and a preference for not employing someone with the problem, while social phobia was most likely to be seen as due to personal weakness. Attitudes concerning dangerousness and social distance were greater in relation to men with mental disorders compared to women. Other people were perceived as more likely to hold stigmatizing attitudes than the respondents reported for themselves. Conclusions: Anti-stigma interventions are more likely to be successful if they focus on individual disorders rather than on 'mental illness' in general. Such interventions may need to address perceptions of social phobia as being due to weakness and those of dangerousness in people with more severe disorders. Such interventions should also focus on bringing beliefs about public perceptions in line with personal beliefs. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to report the prevalence and patterns of 12 month comorbidity in the 2007 National Survey of Mental Health and Wellbeing (2007 NSMHWB). In this paper the comorbidity between common mental disorders (affective, substance use and anxiety) and between physical and mental disorders is examined. Method: The 2007 NSMHWB was a nationally representative household survey of 8841 Australian adults (16-85 years) that assessed participants for symptoms of the most prevalent ICD-10 mental disorders. Results: The common mental disorder classes (affective, anxiety and substance use disorders) often occur together and 25.4% of persons with an anxiety, affective or substance use disorder had at least one other class of mental disorder. A small proportion (3.5%, 95% confidence interval (CI) = 2.3-4.7%) had all three classes of disorder. Mental disorder and physical disorder comorbidity was also common, with 28% (95%CI = 25.1-30.9%) of those with a chronic physical disorder also having a mental disorder. Comorbidity was associated with greater severity and greater health service use. Conclusions: Comorbidity is widespread and remains a significant challenge for the delivery of effective health-care services and treatment. [ABSTRACT FROM AUTHOR]

This paper reviews 30 years of longitudinal research, initially undertaken to examine gender differences in rates of major depression and psychosocial risk factors for depression. The research focus has broadened to include the impact of anxiety on depression onset, coping styles for stress and depression, genetic and environmental influences on depression onset, and more recently, a shift towards examining positive mental health. The original cohort consisted of a socially homogenous group of postgraduate teacher trainees and does not attempt to represent the normal variability in an adult population. However, the issues raised by this research provide many insights about real and artefactual factors that contribute to the rate and experience of depression. The study findings are supplemented by data from other studies undertaken by this research team that are pertinent to the topic and add weight to some of the observations from the Teachers' Study. [ABSTRACT FROM AUTHOR]

Objective: This paper aims to assess the utility of six measures of consumer outcomes: the Behaviour and Symptom Identification Scale, the Mental Health Inventory (MHI), the Medical Outcomes Study 36-Item Short-Form Survey, the Health of the Nation Outcome Scales, the Life Skills Profile (LSP) and the Role Functioning Scale previously recommended for the routine assessment in Australian mental health services. Method: Consumers and service providers were invited through focus group discussions and surveys to describe the perceived utility of these selected measures. Results: All six measures were rated favourably. The qualitative and quantitative findings suggest that the MHI elicited the most positive results of the consumer measures. No observer-rated scale was clearly preferred. Conclusion: The qualitative feedback obtained indicated that process and context issues may be as important to the successful use of routine instruments for the measurement of consumer outcomes in clinical practice as the choice of instrument. [ABSTRACT FROM AUTHOR]