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Introduction: Mental disorders during young adulthood can significantly impair functioning in daily activities. Non‐clinical support services aim to improve functioning by helping people to build social and life skills, participate in education and employment and improve physical health. This study aims to examine and synthesise the evidence for non‐clinical services on improving functional outcomes for young adults with mental disorders. Methods: A systematic search was undertaken to identify quantitative and qualitative studies reporting on a non‐clinical service component (vocational support, peer support, youth development, lifestyle interventions, family and network support) and examining functional outcomes (e.g., outcomes focussed on work and education, life skills, relationships and healthy behaviours). Results: Seventeen studies met inclusion criteria. Identified studies focussed on vocational support services (n = 9), lifestyle interventions (n = 6) and family and network support services (n = 2). No studies on peer‐support services or youth development services were found. More than half of the vocational support service studies reported increased employment rates among young adults (n = 6). Studies focussing on lifestyle interventions included a combination of physical activity, nutrition education, health coaching and motivation and behaviour change. However, the measures of functioning used across studies were too varied to determine whether lifestyle interventions may be useful in improving functional outcomes for young adults. Conclusion: Further research is needed to understand the impact of non‐clinical services on functioning. This evidence will provide pragmatic guidance for service planners to invest in supports and interventions that make a meaningful difference to the lives of young adults living with mental disorders. [ABSTRACT FROM AUTHOR]

Corporal punishment is associated with adverse outcomes; however, little empirical data exists about the state of corporal punishment in Australia. This paper presents the first national prevalence estimates of experiences of corporal punishment during childhood among Australians and its use as adults by Australian parents and caregivers. We also report community beliefs about the necessity of corporal punishment. Results show corporal punishment remains common in Australia. A high proportion of Australians (62.5%) experienced corporal punishment in childhood, including almost 6 in 10 (58.4%) young people aged 16–24. Approximately half of all parents surveyed (53.7%) had used corporal punishment. A quarter of Australians (26.4%) believe corporal punishment is necessary to raise children, 73.6% do not view it as necessaryThe use of corporal punishment and belief in its necessity are lower among younger people. Findings indicate the experience of corporal punishment remains unacceptably high in Australia but that the use of corporal punishment and beliefs about its necessity may be changing. These findings have significant implications for policy and practice in Australia. Changes in legislation could reduce this form of violence toward children. Relatively low rates of endorsement of the necessity of corporal punishment suggest the Australian community may be receptive to attempts for law reform in this area. [ABSTRACT FROM AUTHOR]

Objective: Suicide is a leading cause of death in children and adolescents worldwide and a major public health concern. While suicidal behaviours place a significant demand on mental health and emergency services, data regarding suicide‐related contacts with police and paramedics are an underutilised resource. The aim of the present study was to identify the demographic profile of young individuals (aged 5–17) and had a suicide‐related contact with police or paramedics in Queensland (Australia). Methods: The present study utilised a population‐wide linked dataset, including data from police and paramedics and health administrative data, between 1 February 2013 and 31 January 2018. Results: The identified cohort of 7929 children had a median age of 15 years and mainly comprised females (63.2%). Over the study period, 64 children died, most by suicide (76.6%). Less than a third of the cohort were responsible for almost two‐thirds of the total number of contacts with police or paramedics. Conclusion: Findings provide a comprehensive profile of children and adolescents in suicidal crisis and highlight the substantial number of interactions that occur with police and paramedics. Due to the way the linked dataset was constructed, it must be assumed that the number of young persons in suicidal crisis is higher. Findings highlight the value of considering pre‐hospital alternatives to presenting to emergency departments (EDs) for this cohort, to reduce impost on EDs and improve outcomes. Further examination of re‐presentations by young persons is warranted to inform prevention and intervention strategies. [ABSTRACT FROM AUTHOR]

Background: Externalizing symptoms are associated with risk of future substance use disorder (SUD). Few longitudinal studies exist using general population‐based samples which assess the spectrum of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms. Aims/Objectives: We aimed to study the associations between adolescent ADHD symptoms and subsequent SUD and additionally examine whether the risk of SUD is influenced by comorbid oppositional defiant disorder (ODD) symptoms. Methods: The Northern Finland Birth Cohort 1986 was linked to nationwide health care register data for incident SUD diagnoses until age 33 years (n = 6278, 49.5% male). ADHD/ODD‐case status at age 16 years was defined using parent‐rated ADHD indicated by Strengths and Weaknesses of ADHD symptoms and Normal Behaviors (SWAN) questionnaire with 95% percentile cut‐off. To assess the impact of ODD comorbidity on SUD risk, participants were categorized into four groups based on their ADHD/ODD case status. Cox‐regression analysis with hazard ratios (HRs) and 95% confidence intervals (CIs) were used to study associations between adolescent ADHD/ODD case statuses and subsequent SUD. Results: In all, 552 participants (8.8%) presented with ADHD case status at the age of 16 years, and 154/6278 (2.5%) were diagnosed with SUD during the follow‐up. ADHD case status was associated with SUD during the follow‐up (HR = 3.84, 95% CI 2.69–5.50). After adjustments for sex, family structure, and parental psychiatric disorder and early substance use the association with ADHD case status and SUD remained statistically significant (HR = 2.60, 95% CI 1.70–3.98). The risk of SUD remained elevated in individuals with ADHD case status irrespective of ODD symptoms. Conclusions: ADHD in adolescence was associated with incident SUD in those with and without symptoms of ODD. The association of ADHD and SUD persisted even after adjustment for a wide range of potential confounds. This emphasizes the need to identify preventative strategies for adolescents with ADHD so as to improve health outcomes. [ABSTRACT FROM AUTHOR]

Background: Childhood maltreatment (CM) is associated with both dietary fat intake and obesity in later life. There is less information on associations with metabolic risk factors and specific types of CM such as physical, sexual and emotional abuse, as well as neglect. Aims: To assess the association between five types of self‐reported CM and a range of obesity and metabolic indicators in a subsample of a birth cohort. Methods: This was a study of 1689 adults born in a major metropolitan maternity hospital in Australia and followed up 30 years later. Body mass index, bioimpedance and fasting lipid levels/insulin resistance were measured. Details on self‐reported CM were collected using the Child Trauma Questionnaire. We adjusted for birth weight, parental income and relationship at participants' birth, as well as maternal age and alcohol or tobacco use. We also adjusted for participants' smoking, depression, educational level, marital and employment status at follow up. Results: One‐fifth reported maltreatment (n = 362), most commonly emotional neglect (n = 175), followed by emotional abuse (n = 128), physical neglect (n = 123), sexual (n = 121) and physical abuse (n = 116). On adjusted analyses, there were significant associations for CM, particularly neglect or emotional abuse, and one or more of the following outcomes: obesity, the total cholesterol/high‐density lipoprotein cholesterol (TC/HDL‐C) ratio and HDL levels. Results for other outcomes were more equivocal. Conclusions: Of child maltreatment types, emotional abuse and neglect show the strongest associations with obesity and several cardiometabolic risk factors, therefore highlighting the public health importance of early intervention to reduce childhood adversity. [ABSTRACT FROM AUTHOR]

Objectives: To examine associations between child maltreatment and health service use, both overall, by type and by the number of types of maltreatment reported. Design, setting: Cross‐sectional, retrospective survey using the Juvenile Victimization Questionnaire‐R2: Adapted Version (Australian Child Maltreatment Study); computer‐assisted mobile telephone interviews using random digit dialling, Australia, 9 April – 11 October 2021. Participants: Australians aged 16 years or more. The target sample size was 8500 respondents: 3500 people aged 16–24 years and 1000 respondents each from the five age groups (25–34, 35–44, 45–54, 55–64, 65 years or more). Main outcome measures: Self‐reported health service use during the past twelve months: hospital admissions, length of stay, and reasons for admission; and numbers of consultations with health care professionals, overall and by type. Associations between maltreatment and health service use are reported as odds ratios adjusted for age group, gender, socio‐economic status, financial hardship (childhood and current), and geographic remoteness. Results: A total of 8503 participants completed the survey. Respondents who had experienced child maltreatment were significantly more likely than those who had not to report a hospital admission during the preceding twelve months (adjusted odds ratio [aOR], 1.39; 95% confidence interval [CI], 1.16–1.66), particularly admission with a mental disorder (aOR, 2.4; 95% CI, 1.03–5.6). The likelihood of six or more visits to general practitioners (aOR, 2.37; 95% CI, 1.87–3.02) or of a consultation with a mental health nurse (aOR, 2.67; 95% CI, 1.75–4.06), psychologist (aOR, 2.40; 95% CI, 2.00–2.88), or psychiatrist (aOR, 3.02; 95% CI, 2.25–4.04) were each higher for people who reported maltreatment during childhood. People who reported three or more maltreatment types were generally most likely to report greater health service use. Conclusions: Child maltreatment has a major impact on health service use. Early, targeted interventions are vital, not only for supporting children directly, but also for their longer term wellbeing and reducing their health system use throughout life. [ABSTRACT FROM AUTHOR]

Objectives: To estimate the prevalence in Australia of each type of child maltreatment; to identify gender‐ and age group‐related differences in prevalence. Design, setting: Cross‐sectional national survey; mobile telephone interviews using random digit dialling (computer‐generated), Australia, 9 April – 11 October 2021. Retrospective self‐report data using validated questionnaire (Juvenile Victimisation Questionnaire‐R2 Adapted Version (Australian Child Maltreatment Study). Participants: People aged 16 years or more. The target sample size was 8500 respondents: 3500 people aged 16–24 years and 1000 respondents each from five further age groups (25–34, 35–44, 45–54, 55–64, 65 years or more). Main outcome measures: Proportions of respondents reporting physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence to age 18 years, assessed with the Juvenile Victimization Questionnaire‐R2 Adapted Version (Australian Child Maltreatment Study), overall and by gender and age group, and weighted to reflect characteristics of the Australian population aged 16 years or more in 2016. Results: Complete survey data were available for 8503 eligible participants (14% response rate). Physical abuse was reported by 32.0% of respondents (95% confidence interval [CI], 30.7–33.3%), sexual abuse by 28.5% (95% CI, 27.3–29.8%), emotional abuse by 30.9% (95% CI, 29.7–32.2%), neglect by 8.9% (95% CI, 8.1–9.7%), and exposure to domestic violence by 39.6% (95% CI, 38.3–40.9%). The proportions of respondents who reported sexual abuse, emotional abuse, or neglect were each statistically significantly larger for women than men. The reported prevalence of physical abuse by respondents aged 16–24 years was lower than for those aged 25–34 years, and that of sexual abuse was lower than for those aged 35–44 years, suggesting recent declines in the prevalence of these maltreatment types. Conclusions: Child maltreatment is common in Australia, and larger proportions of women than men report having experienced sexual abuse, emotional abuse, and neglect during childhood. As physical and sexual abuse may have declined recently, public health policy and practice may have positive effects, justifying continued monitoring and prevention activities. [ABSTRACT FROM AUTHOR]

Objective: To estimate associations between all five types of child maltreatment (emotional abuse, neglect, physical abuse, sexual abuse, and exposure to domestic violence) and health risk behaviours and conditions. Design, setting, participants: Nationally representative survey of Australian residents aged 16 years and older conducted by computer‐assisted telephone interviewing. Main outcome measures: Associations between child maltreatment and the following health risk behaviours and conditions: current smoker, binge drinking (at least weekly in past 12 months), cannabis dependence (according to the Cannabis Severity of Dependence Scale), obesity (based on body mass index), self‐harm in past 12 months, and suicide attempt in past 12 months. Results: A total of 8503 participants completed the survey. All five types of child maltreatment were associated with increased rates of all of the health risk behaviours and conditions that we considered. The strongest associations were in the youngest age group (16–24‐year‐olds). Sexual abuse and emotional abuse were associated with the highest odds of health risk behaviours and conditions. Cannabis dependence, self‐harm and suicide attempts were most strongly associated with child maltreatment. Experiencing more than one type of child maltreatment was associated with higher rates of health risk behaviours and conditions than experiencing one type of child maltreatment. Conclusions: Child maltreatment is associated with substantially increased rates of health risk behaviours and conditions. Prevention and intervention efforts should be informed by trauma histories, and holistic psychosocial care should be incorporated into programs focusing on behaviour change. [ABSTRACT FROM AUTHOR]

Objectives: To examine the associations between experiences of child maltreatment and mental disorders in the Australian population. Design: Population‐representative survey conducted by computer‐assisted telephone interviewing. Setting, participants: Australian residents aged 16 years and older. Main outcome measures: Mental disorder diagnoses of lifetime major depressive disorder, current alcohol use disorder (mild, moderate and severe), current generalised anxiety disorder and current post‐traumatic stress disorder. Results: More than one in three Australians (3606/8503 surveyed participants; 38.0%; 95% CI, 36.7–39.3%) met the diagnostic criteria for a mental disorder. The prevalence of mental disorders in non‐maltreated participants was 21.6% (95% CI, 19.9–23.3%; n = 851). This increased to 36.2% (95% CI, 33.5–38.9%; n = 764) for those who experienced a single type of maltreatment and 54.8% (95% CI, 52.6–56.9%; n = 1991) for participants who experienced multi‐type maltreatment. Compared with non‐maltreated Australians, maltreated participants had about three times the odds of any mental disorder (odds ratio [OR], 2.82; 95% CI, 2.47–3.22), generalised anxiety disorder (OR, 3.14; 95% CI, 2.48–3.97), major depressive disorder (OR, 3.19; 95% CI, 2.68–3.80) and severe alcohol use disorder (OR, 2.62; 95% CI, 1.83–3.76), and almost five times the odds of post‐traumatic stress disorder (OR, 4.60; 95% CI, 3.00–7.07). Associations between experiences of child maltreatment and mental disorders were strongest for sexual abuse, emotional abuse and multi‐type maltreatment. The strength of the associations did not differ by gender. Adjustment for childhood and current financial hardship and for current socio‐economic status did not significantly attenuate the associations. Conclusions: Mental disorders are significantly more likely to occur in individuals who experience child maltreatment, particularly multi‐type maltreatment. Prevention of child maltreatment provides an opportunity to substantially reduce the prevalence of mental illness and improve the health of the Australian population. [ABSTRACT FROM AUTHOR]

[7] B Child maltreatment produces substantial health risk behaviours. b Participants who experienced child maltreatment were four times more likely to have self-harmed in the previous year, four times more likely to have attempted suicide in the previous year, and six times as likely to be dependent on cannabis. B Child maltreatment is endemic. b Sample-wide prevalence rates were: physical abuse, 32.0%; sexual abuse, 28.5%; emotional abuse, 30.9%; neglect, 8.9%; and exposure to domestic violence, 39.6%. Keywords: Child welfare; Child abuse; Mental health policy; Adolescence EN Child welfare Child abuse Mental health policy Adolescence S47 S51 5 04/04/23 20230403 NES 230403 The Australian Child Maltreatment Study provides evidence demanding generational public health reform for national benefit Some 60 years have passed since scientific awareness of child maltreatment in Australia first stirred.[1], [2], [3], [4] Since then, in various domains, progress has been made in responding to child maltreatment. [6] B Child maltreatment is associated with a massive mental health burden. b Using diagnostic criteria, we found significantly higher prevalence of mental health disorders in participants who experienced child maltreatment (48.0% I v i 21.6%). [Extracted from the article]

Objectives: To describe the aims, design, methodology, and respondent sample representativeness of the Australian Child Maltreatment Study (ACMS). Design, setting: Cross‐sectional, retrospective survey; computer‐assisted mobile telephone interviewing using random digit dialling (computer‐generated), Australia, 9 April – 11 October 2021. Participants: People aged 16 years or more. The target sample size was 8500 respondents: 3500 people aged 16–24 years and 1000 respondents each from five further age groups (25–34, 35–44, 45–54, 55–64, 65 years or more). Main outcome measures: Primary outcomes: Emotional abuse, neglect, physical abuse, sexual abuse, exposure to domestic violence during childhood, assessed with the Juvenile Victimization Questionnaire‐R2 Adapted Version (Australian Child Maltreatment Study). Secondary outcomes: selected mental disorder diagnoses (Mini International Neuropsychiatric Interview, MINI), selected physical health conditions, health risk behaviours, health service use. Results: The demographic characteristics of the ACMS sample were similar to those of the Australian population in 2016 with respect to gender, Indigenous status, region and remoteness category of residence, and marital status, but larger proportions of participants were born in Australia, lived in areas of higher socio‐economic status, had tertiary qualifications, and had income greater than $1250 per week. Population weights were derived to adjust for these differences. Associations between the number of calls required to recruit participants and maltreatment rates and health outcomes were not statistically significant. Conclusions: The ACMS provides the first reliable estimates of the prevalence of each type of child maltreatment in Australia. These estimates, and those of associated mental health and health risk behaviours reported in this supplement can inform policy and practice initiatives for reducing the prevalence of child maltreatment and its consequences. Our benchmark study also provides baseline data for repeated waves of the ACMS that will assess the effectiveness of these initiatives. [ABSTRACT FROM AUTHOR]

Objectives: To determine the prevalence in Australia of multi‐type child maltreatment, defined as two or more maltreatment types (physical abuse, sexual abuse, emotional abuse, neglect, or exposure to domestic violence) and to examine its nature, family risk factors, and gender and age cohort differences. Design: Retrospective cross‐sectional survey using a validated questionnaire. Setting and participants: Mobile phone random digit‐dial sample of the Australian population aged 16 years and older. Main outcome measures: National estimates of multi‐type child maltreatment up to age 18 years using the Juvenile Victimisation Questionnaire‐R2: Adapted Version (Australian Child Maltreatment Study). Results: Of 8503 participants, 62.2% (95% CI, 60.9–63.6%) experienced one or more types of child maltreatment. Prevalence of single‐type maltreatment was 22.8% (95% CI, 21.7–24.0%), whereas 39.4% (95% CI, 38.1–40.7%) of participants reported multi‐type maltreatment and 3.5% (95% CI, 3.0–4.0%) reported all five types. Multi‐type maltreatment was more common for gender diverse participants (66.1% [95% CI, 53.7–78.7%]) and women (43.2% [95% CI, 41.3–45.1%]) than for men (34.9% [95% CI, 33.0–36.7%]). Multi‐type maltreatment prevalence was highest for those aged 25–44 years. Family‐related adverse childhood experiences — especially mental illness and alcohol or substance misuse — increased risk. Exposure to domestic violence was the maltreatment type most often present in multi‐type maltreatment patterns. Conclusions: Multi‐type child maltreatment is prevalent in Australia and more common in women and gender diverse individuals. Child protection services, health practitioners, and prevention and intervention services must assess and manage multi‐type maltreatment in children and address its health consequences across the lifespan. Public health policy should consider prevention services or strategies that target multi‐type child maltreatment. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether vitamin D supplementation reduces depressive symptoms and incidence of antidepressant use.Methods: We used data from the D-Health Trial (N = 21,315), a randomized double-blind placebo-controlled trial of monthly vitamin D3 for the prevention of all-cause mortality. Participants were Australians aged 60-84 years. Participants completed the Patient Health Questionnaire (PHQ-9) at 1, 2 and 5 years after randomization to measure depressive symptoms; national prescribing records were used to capture antidepressant use. We used mixed models and survival models.Results: Analyses of PHQ-9 scores included 20,487 participants (mean age 69·3 years, 46% women); the mean difference (MD) in PHQ-9 score (vitamin D vs. placebo) was 0·02 (95% CI -0·06, 0·11). There was negligible difference in the prevalence of clinically relevant depression (PHQ-9 score ≥10) (odds ratio 0·99; 95% CI 0·90, 1·08). We included 16,670 participants in the analyses of incident antidepressant use (mean age 69·4 years, 43% women). Incidence of antidepressant use was similar between the groups (hazard ratio [HR] 1·04; 95% CI 0·96, 1·12). In subgroup analyses, vitamin D improved PHQ-9 scores in those taking antidepressants at baseline (MD -0·25; 95% CI -0·49, -0·01; p-interaction = 0·02). It decreased risk of antidepressant use in participants with predicted 25(OH)D concentration <50 nmol/L (HR 0·88; 95% CI 0·75, 1·02; p-interaction = 0·01) and increased risk in those with predicted 25(OH)D ≥ 50 nmol/L (HR 1·10; 95% CI 1·01, 1·20).Conclusion: Monthly supplementation with high-dose vitamin D3 was not of benefit for measures of depression overall, but there was some evidence of benefit in subgroup analyses.Clinical Trial Registration: The trial is registered on the Australian New Zealand Clinical Trials Registry: ACTRN12613000743763. https://www.anzctr.org.au/. [ABSTRACT FROM AUTHOR]

Background: Adverse childhood experiences (ACEs) are associated with many health problems in women during pregnancy, including depression/anxiety, gestational diabetes and adverse birth outcomes. However, unlike other health risk factors, screening for ACEs has not been widely implemented in antenatal care settings. Aims: The aim of the scoping review was to explore the challenges in screening for ACEs in antenatal care settings and to provide the lessons learnt and evidence that guide the practice of ACE screening for both healthcare providers and pregnant women. Methods: A five‐stage process for conducting the scoping review was utilised. Searches of four key databases (PubMed, PsycINFO, CINAHL and SCOPUS) and reference lists from relevant studies were conducted. Results: Seven publications met the inclusion criteria. Challenges identified for healthcare providers in screening for ACEs include lack of knowledge and confidence in ACE tool and shortage of time and resources to undertake screening. Impediments for pregnant women include concerns about privacy. However, there were examples of effective practice for ACE screening in antenatal care settings that could apply widely. Conclusion: Addressing impediments to ACE screening is critical in implementing trauma‐informed practices that can identify women at risk of adverse health outcomes during pregnancy. A study on screening for ACEs in antenatal care in both public and private settings is needed to examine its feasibility and acceptability in the Australian context before being included in the National Perinatal Data Collection. [ABSTRACT FROM AUTHOR]

Aim: To identify and describe key service components that should be incorporated into age‐appropriate integrated mental health care for young adults aged 18–24 years. Methods: Key service components were identified through a mixed‐methods approach including targeted examinations of the literature and structured discussions with experts in youth mental health. Results: Seven key components were identified as important for providing age‐appropriate mental health care to young adults. Two were classified as clinical service components (structured psychological therapies; care coordination and liaison), three were classified as non‐clinical service components (vocational support; youth development; peer support) and two as integrated non‐clinical and clinical service components (lifestyle interventions and family and network support). Example service models for each of these key service components were identified and described. Conclusions: This is the first study to identify and describe key service components for age‐appropriate mental health care for young adults. The findings provide mental health service planners with a framework of services that should be considered when planning and resourcing services for this age range. [ABSTRACT FROM AUTHOR]

Background and aims: There are few longitudinal studies assessing the association of cannabis use and subsequent onset of bipolar disorder. We aimed to measure the association between early cannabis exposure and subsequent bipolar disorder. Design, Setting and Participants: Observational study linking a sample from the northern Finland birth cohort 1986 (n = 6325) to nation‐wide register data to examine the association of life‐time cannabis exposure at age 15/16 years and subsequent bipolar disorder until age 33 (until the end of 2018); 6325 individuals (48.8% males) were included in the analysis. Measurements: Cannabis exposure was measured via self‐report. Bipolar disorder was measured via bipolar disorder‐related diagnostic codes (ICD‐10: F30.xx, F31.xx) collected from the Care Register for Health Care 2001–18, the Register of Primary Health Care Visits 2011–18, the medication reimbursement register of the Social Insurance Institution of Finland 2001–05 and the disability pensions of the Finnish Center for Pensions 2001–16. Potential confounders included demographic characteristics, parental psychiatric disorders, emotional and behavioral problems and other substance use. Findings Three hundred and fifty‐two adolescents (5.6%) reported any cannabis use until the age of 15–16 years. Of the whole sample, 66 (1.0%) were diagnosed with bipolar disorder. Adolescent cannabis use was associated with bipolar disorder [hazard ratio (HR) = 3.46; 95% confidence interval (CI) = 1.81–6.61]. This association remained statistically significant after adjusting for sex, family structure and parental psychiatric disorders (HR = 3.00; 95% CI = 1.47–6.13) and after further adjusting for adolescent emotional and behavioral problems (HR = 2.34; 95% CI = 1.11–4.94). Further adjustments for frequent alcohol intoxications, daily smoking and lifetime illicit drug use attenuated the associations to statistically non‐significant. Conclusions: In Finland, the positive association between early cannabis exposure and subsequent development of bipolar disorder appears to be confounded by other substance use. [ABSTRACT FROM AUTHOR]

Aim: This study examines 3 years of child and adolescent health data from Australian onshore and offshore immigration detention centres from 2014 to 2017, quantifying the health presentation data of children and adolescents in Australian immigration detention and comparing rates between onshore and offshore detention. Methods: This study utilised the Quarterly Immigration Detention Health Reports over a period of 3 years. To compare onshore and offshore datasets, we calculated the rate of health events per quarter against the estimated quarterly onshore and offshore detention population of children. We ran a series of two‐proportion z‐tests for each matched quarter to calculate median z and P values for all quarters. These were used as an indicator as to whether the observed differences between onshore and offshore events were statistically significant. Results: The estimated number of children detained per quarter onshore ranged from 700 in 2014 (quarter 3) to 13 in 2016 (quarters 3 and 4); the estimated quarterly population of children in offshore detention ranged from 186 in 2014 (quarter 3) to 42 in 2017 (quarter 2). Children offshore had significantly higher rates of consultations with a mental health nurse (z = −1.96; P = 0.002), psychologist (z = −2.32; P = 0.01) and counsellor (z = −3.41; P < 0.001). As for reasons for presentation to general practitioners and psychiatrists, complaints related to skin (z = −1.97; P = 0.05), respiratory issues (z = −1.96; P = 0.05) and urological issues (z = −2.21; P = 0.03) were significantly higher amongst children detained offshore. Conclusions: Compared to children in the Australian community, children detained both onshore and offshore had greater health needs. Children offshore also presented more frequently with a range of complaints and accessed health services at higher rates than children detained onshore; this adds to growing evidence about the harms of offshore detention and detention more generally. [ABSTRACT FROM AUTHOR]

Background: Caesarean section (CS) is associated with an increased risk of adverse health outcomes for both mothers and offspring. The evidence for an association between CS and reduced offspring cognitive and academic performance has been inconsistent, with considerable limitations. Aim: The aim of this study is to compare cognitive and academic performance in childhood and early adulthood in offspring delivered by CS with those delivered vaginally at term. Materials and methods: Data on 4327 mothers and offspring from a longitudinal birth cohort study were analysed. Offspring cognitive performance was measured by the Picture Peabody Vocabulary Test‐Revised (PPVT‐R) at ages five and 21 and the Raven's Standard Progressive Matrices at age 14. Academic achievement was assessed using the Wide Range Achievement Test at age 14. Results: After adjustment for confounding factors, there was no statistically significant association between cognitive performance and offspring birth mode at age five (P = 0.11). The adjusted difference of mean scores at five years on the PPVT‐R for elective CS birth compared to those born by vaginal delivery was −2.2 (95% confidence interval (CI) −4.3 to −0.2), whereas for emergency CS it was 0.0 (95% CI −2.0 to 2.0). There were no differences in cognitive or academic performance at ages 14 and 21. Conclusion: Birth mode was not significantly associated with offspring cognitive or academic performance. Our study does not support concerns that CS is associated with a reduction in cognitive performance. [ABSTRACT FROM AUTHOR]

Background: No biological treatment has been firmly established for the at‐risk stage of psychotic disorder. In this study we aim to test if subthreshold psychotic symptoms can be effectively treated with cannabidiol (CBD), a non‐psychoactive compound of the plant Cannabis sativa. The question has taken on increased importance in the wake of evidence questioning both the need and efficacy of specific pharmacological interventions in the ultra‐high risk (UHR) for psychosis group. Methods: Three‐arm randomized controlled trial of 405 patients (135 per arm) aged 12–25 years who meet UHR for psychosis criteria. The study includes a 6‐week lead‐in phase during which 10% of UHR individuals are expected to experience symptom remission. Participants will receive CBD (per oral) at doses 600 or 1000 mg per day (fixed schedule) for 12 weeks. Participants in the third arm of the trial will receive matching placebo capsules. Primary outcome is severity of positive psychotic symptoms as measured by the Comprehensive Assessment of At‐Risk Mental States at 12 weeks. We hypothesize that CBD will be significantly more effective than placebo in improving positive psychotic symptoms in UHR patients. All participants will also be followed up 6 months post baseline to evaluate if treatment effects are sustained. Conclusion: This paper reports on the rationale and protocol of the Cannabidiol for At Risk for psychosis Youth (CanARY) study. This study will test CBD for the first time in the UHR phase of psychotic disorder. [ABSTRACT FROM AUTHOR]

Objective: Longitudinal studies examining the association between adolescent cannabis use and self‐harm are rare, heterogeneous and mixed in their conclusions. We study this association utilizing a large general population‐based sample with prospective data. Methods: The Northern Finland Birth Cohort 1986 (n = 6582) with linkage to nationwide register data was used to study the association of self‐reported cannabis use at age 15–16 years and self‐harm and suicide death until age 33 (until year 2018), based on register information. Cox regression analysis with Hazard Ratios (HR) and 95% confidence intervals (CI) was used. Psychiatric disorders, parental psychiatric disorders and other substance use were considered as confounders. Results: In all, 6582 (49.2% male) were included in the analysis, and 377 adolescents (5.7%) reported any cannabis use until the age of 15–16 years. Based on register information, 79 (55.7% male) had visited in health care services due to self‐harm, and 22 (90.1% male) had died by suicide. In crude analyses, adolescent cannabis use was associated with self‐harm (HR = 3.93; 95% CI 2.24–6.90). The association between cannabis use and self‐harm remained statistically significant after adjusting for sex, psychiatric disorders at baseline, frequent alcohol intoxications, other illicit drug use, and parental psychiatric disorders (HR 2.06; 95% CI 1.07–3.95). In contrast, the association of cannabis use with suicide did not reach statistical significance even in crude analysis (HR 2.60; 95% CI 0.77–8.78). Conclusion: Cannabis use in adolescence may increase risk of self‐harm independent of adolescent psychopathology and other substance use. [ABSTRACT FROM AUTHOR]

Background: Deficits in social cognition are common in people with schizophrenia and are associated with impaired functioning. Finding effective interventions to address these deficits is a priority. Social Cognition Interaction Training (SCIT) is a psychosocial intervention that has demonstrated acceptability and feasibility in various health care settings. Larger, well‐designed randomized controlled trials are needed to examine the effectiveness of this intervention. Design: A randomized controlled trial. Methods: One hundred and twenty adults diagnosed with schizophrenia spectrum disorder were randomized to receive SCIT (n = 61) or Befriending Therapy (BT) (n = 59). Both intervention groups were delivered weekly for 2 hr over 12 weeks. Neurocognitive assessment was completed at baseline. Participants completed assessments of social cognition, social functioning, and meta‐cognition at baseline, post‐intervention, and 3‐month follow‐up. Results: There were no clinically significant differences between group outcomes on any measure of social cognition or social functioning. There was a trend for both groups to improve over time but not at a level of statistical significance. Conclusions: SCIT did not show any additional benefits on measures of social cognition compared to Befriending Therapy for people with schizophrenia spectrum disorder. The findings are discussed in terms of potential improvements to the programme. Practitioner points: Effective interventions for the social cognitive deficits of schizophrenia spectrum disorders are still being refined.Social Cognition Interaction Training is a promising therapy but requires further modifications to improve its effectiveness. [ABSTRACT FROM AUTHOR]

Information is lacking on the prevalence of child maltreatment, trends over time, patterns of exposure to multiple forms of maltreatment, and associated health risk behaviours and health outcomes through life. Keywords: Child welfare; Child abuse; Child health; Mental disorders EN Child welfare Child abuse Child health Mental disorders S3 S4 2 04/04/23 20230403 NES 230403 Public health initiatives are needed urgently to prevent the maltreatment of Australian children Child maltreatment, comprising physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence, is a serious public health concern. Associations between experiences of child maltreatment and mental disorders were strongest for sexual abuse, emotional abuse, and multi-type maltreatment. [Extracted from the article]

Background: Intervention on adolescent bullying is reliant on valid and reliable measurement of victimization and perpetration experiences across different behavioural expressions. Aims: This study developed and validated a survey tool that integrates measurement of both traditional and cyber bullying to test a theoretically driven multi‐dimensional model. Sample: Adolescents from 10 mainstream secondary schools completed a baseline and follow‐up survey (N = 1,217; Mage = 14 years; 66.2% male). Methods: The Bullying and cyberbullying Scale for Adolescents (BCS‐A) developed for this study comprised parallel victimization and perpetration subscales, each with 20 items. Additional measures of bullying (Olweus Global Bullying and the Forms of Bullying Scale [FBS]), as well as measures of internalizing and externalizing problems, school connectedness, social support, and personality, were used to further assess validity. Results: Factor structure was determined, and then, the suitability of items was assessed according to the following criteria: (1) factor interpretability, (2) item correlations, (3) model parsimony, and (4) measurement equivalence across victimization and perpetration experiences. The final models comprised four factors: physical, verbal, relational, and cyber. The final scale was revised to two 13‐item subscales. The BCS‐A demonstrated acceptable concurrent and convergent validity (internalizing and externalizing problems, school connectedness, social support, and personality), as well as predictive validity over 6 months. Conclusions: The BCS‐A has sound psychometric properties. This tool establishes measurement equivalence across types of involvement and behavioural forms common among adolescents. An improved measurement method could add greater rigour to the evaluation of intervention programmes and also enable interventions to be tailored to subscale profiles. [ABSTRACT FROM AUTHOR]

The article presents two case study related to 21-year-old fashion design student who engages in musical theatre part time to fund her studies and 66-year-old retired plumber has diagnosed with cardiomyopathy following his second myocardial infarction. Topics include the clinical research and technological innovation have greatly improved survival after admission to intensive care units.

Aggression in children is a common transdiagnostic symptom associated with a wide range of developmental and mental health problems. It emerges early and without intervention, may increase in severity as the child grows stronger. Aggressive children are more likely to experience physical and mental illness, unemployment, poverty and forensic problems as adults. Strategies to prevent aggression must address risk factors: low maternal education, adolescent pregnancy, in utero exposure to tobacco and alcohol, poverty, coercive parenting, childhood maltreatment and bullying victimisation. The aggressive child requires a comprehensive assessment to identify and manage underlying or comorbid problems, to understand the reasons for the aggressive behaviour and to detect modifiable factors that exacerbate or perpetuate the aggression. Psychosocial interventions include parenting skills training and child-directed cognitive behavioural therapy, whereas pharmacotherapy may be used to treat underlying developmental or mental health problems or to manage the aggression. [ABSTRACT FROM AUTHOR]

Objective: Social Cognition and Interaction Training (SCIT) has demonstrated effectiveness in improving social cognition and functioning of people with schizophrenia. This pilot study examines the acceptability, feasibility, and effectiveness of SCIT with individuals who have schizophrenia‐spectrum disorders and are receiving care through a public mental health service. Method: In a pragmatic randomized waitlist controlled trial, 36 participants (aged 19–55 years) with a schizophrenia spectrum disorder were randomly allocated to SCIT or treatment as usual (TAU). Measures of theory of mind, emotion perception, attributional bias, social skills, quality of life, life skills, depression, anxiety, and stress were administered pre‐ and post‐intervention with follow‐up conducted 4 months later. All wait‐list controls subsequently received the intervention and a secondary within‐group analysis was conducted including these participants. Results: While no significant differences were found between groups on any outcomes, there was strong engagement with the SCIT intervention. Of the 21 participants in the intervention group, the completion rate was 85.71% with a median attendance rate of 17 sessions. Within subject analyses of SCIT participants over time showed significant improvements in quality of life, emotion recognition, social skills, and a trend towards better life skills from pre‐ to post‐intervention. These gains were sustained at the 4‐month follow‐up time. Conclusions and implications for practice: Although this study showed limited benefits in outcomes associated with SCIT compared with TAU, it demonstrated the acceptability of SCIT to participants in a real world public health setting shown by high retention, attendance, and positive feedback. This pilot shows SCIT can be implemented in routine clinical practice and lays the foundation for a larger pragmatic study. Practitioner points: SCIT can be implemented successfully in a real‐world community mental health setting. SCIT had high levels of acceptability to these participants.Limitations The small sample size meant there was insufficient power to detect differences between groups on outcome measures. The study did not include measures of psychiatric symptoms or neuropsychological functioning which may have influenced participants’ capacity to benefit from SCIT. [ABSTRACT FROM AUTHOR]

Aim Psychotic-like experiences ( PLEs) are common in young people and are associated with both distress and adverse outcomes. The Community Assessment of Psychic Experiences-Positive Scale ( CAPE-P) provides a 20-item measure of lifetime PLEs. A 15-item revision of this scale was recently published ( CAPE-P15). Although the CAPE-P has been used to assess PLEs in the last 12 months, there is no version of the CAPE for assessing more recent PLEs (e.g. 3 months). This study aimed to determine the reliability and validity of the current CAPE-P15 and assess its relationship with current distress. Method A cross-sectional online survey of 489 university students (17-25 years) assessed lifetime and current substance use, current distress, and lifetime and 3-month PLEs on the CAPE-P15. Results Confirmatory factor analysis indicated that the current CAPE-P15 retained the same three-factor structure as the lifetime version consisting of persecutory ideation, bizarre experiences and perceptual abnormalities. The total score of the current version was lower than the lifetime version, but the two were strongly correlated ( r = .64). The current version was highly predictive of generalized distress ( r = .52) and indices that combined symptom frequency with associated distress did not confer greater predictive power than frequency alone. Conclusion This study provided preliminary data that the current CAPE-P15 provides a valid and reliable measure of current PLEs. The current CAPE-P15 is likely to have substantial practical utility if it is later shown to be sensitive to change, especially in prevention and early intervention for mental disorders in young people. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Bullying is defined as repeated negative actions involving a power differential, and intention to harm. There is limited research on harmful intention as a definitional component. This study explored the role of the perpetrator's harmful intention and the target's perception of harmful intention. Some 209 students (M = 14.5 years; 66.5% female) and 447 parents (M = 46.4 years; 86.4% female) were randomly assigned in an online survey. Participants assessed the likelihood of bullying in five hypothetical scenarios (physical, verbal, rumor, exclusion, and cyber) across five intention conditions, that also involved repetition and a power differential. The five intention conditions were: 1) harm intended by perpetrator (I) and perceived as intended to harm by target (I) [II condition]; 2) harm not intended by perpetrator (N) but perceived as intended to harm by target (I) [NI condition]; 3) harm intended by perpetrator (I) but not perceived as intended to harm by target (N) [IN condition]; 4) harm not intended by perpetrator (N) and not perceived as intended to harm by target N [NN condition]; and 5) a control which did not state any actual or perceived harmful intention [C condition]. For students and parents, the perpetrator's harmful intention and the target's perception of harmful intention were important when considering whether a peer interaction constituted bullying. These findings confirm the applicability of the three-part definition of bullying, and highlight the importance of assessing these two dimensions of harmful intention when determining whether a problematic peer interaction should be regarded as bullying. Aggr. Behav. 43:352-363, 2017. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

This study used prospective birth cohort data to analyse the relationship between peer aggression at 14 years of age and educational and employment outcomes at 17 years ( N = 1091) and 20 years ( N = 1003). Participants from the Western Australian Pregnancy Cohort (Raine) study were divided into mutually exclusive categories of peer aggression. Involvement in peer aggression was reported by 40.2% (10.1% victims; 21.4% perpetrators; 8.7% victim–perpetrators) of participants. Participants involved in any form of peer aggression were less likely to complete secondary school. Perpetrators and victim–perpetrators of peer aggression were more likely to be in the ‘No Education, Employment or Training’ group at 20 years of age. This association was explained by non-completion of secondary school. These findings demonstrate a robust association between involvement in peer aggression and non-completion of secondary school, which in turn was associated with an increased risk of poor educational and employment outcomes in early adulthood. [ABSTRACT FROM AUTHOR]

Objective The Global Burden of Disease Study 2010 (GBD 2010) is the first to include conduct disorder (CD) and attention-deficit/hyperactivity disorder (ADHD) for burden quantification. Method A previous systematic review pooled the available epidemiological data for CD and ADHD, and predicted prevalence by country, region, age and sex for each disorder. Prevalence was then multiplied by a disability weight to calculate years lived with disability (YLDs). As no evidence of deaths resulting directly from either CD or ADHD was found, no years of life lost (YLLs) were calculated. Therefore, the number of disability-adjusted life years (DALYs) was equal to that of YLDs. Results Globally, CD was responsible for 5.75 million YLDs/DALYs with ADHD responsible for a further 491,500. Collectively, CD and ADHD accounted for 0.80% of total global YLDs and 0.25% of total global DALYs. In terms of global DALYs, CD was the 72nd leading contributor and among the 15 leading causes in children aged 5-19 years. Between 1990 and 2010, global DALYs attributable to CD and ADHD remained stable after accounting for population growth and ageing. Conclusions The global burden of CD and ADHD is significant, particularly in male children. Appropriate allocation of resources to address the high morbidity associated with CD and ADHD is necessary to reduce global burden. However, burden estimation was limited by data lacking for all four epidemiological parameters and by methodological challenges in quantifying disability. Future studies need to address these limitations in order to increase the accuracy of burden quantification. [ABSTRACT FROM AUTHOR]

Background The most recent Global Burden of Disease Study ( GBD 2010) is the first to include attention-deficit/hyperactivity disorder ( ADHD) and conduct disorder ( CD) for burden quantification. We present the epidemiological profiles of ADHD and CD across three time periods for 21 world regions. Methods A systematic review of global epidemiology was conducted for each disorder (based on a literature search of the Medline, PsycInfo and EMBASE databases). A Bayesian metaregression tool was used to derive prevalence estimates by age and sex in three time periods (1990, 2005 and 2010) for 21 world regions including those with little or no data. Prior expert knowledge and covariates were applied to each model to adjust suboptimal data. Final prevalence output for ADHD were adjusted to reflect an equivalent value if studies had measured point prevalence using multiple informants while final prevalence output for CD were adjusted to reflect a value equivalent to CD only. Results Prevalence was pooled for males and females aged 5-19 years with no difference found in global prevalence between the three time periods. Male prevalence of ADHD in 2010 was 2.2% (2.0-2.3) while female prevalence was 0.7% (0.6-0.7). Male prevalence of CD in 2010 was 3.6% (3.3-4.0) while female prevalence was 1.5% (1.4-1.7). ADHD and CD were estimated to be present worldwide with ADHD prevalence showing some regional variation while CD prevalence remained relatively consistent worldwide. Conclusions We present the first prevalence estimates of both ADHD and CD globally and for all world regions. Data were sparse with large parts of the world having no estimates of either disorder. Epidemiological studies are urgently needed in certain parts of the world. Our findings directly informed burden quantification for GBD 2010. As mental disorders gained increased recognition after the first GBD study in 1990, the inclusion of ADHD and CD in GBD 2010 ensures their importance will be recognized alongside other childhood disorders. [ABSTRACT FROM AUTHOR]

Background While cytokines have been implicated in the pathophysiology of depression in adults, the potential role in younger age groups such as adolescents is less clear. This article therefore reviews the literature (a) to explore the relationship between cytokines and depression in adolescents, and (b) to examine how cytokines may be related to adolescent depression in the context of other neurobiological theories of depression. Method A systematic review of the scientific literature on the subject was conducted in February 2013, searching the Web of Knowledge, PubMed (Medline), PsycInfo and Cochrane electronic databases. Results Eighteen studies were identified measuring both depression or depressive symptoms and cytokines or immune markers in adolescents. Adolescents with depression show age-specific characteristics of the immune and inflammatory system, specifically in NK cell activity and in pro-inflammatory cytokines (such as IL-1β and TNF-α). In addition, the role of cytokines in adolescent depression is influenced by neurodevelopment, hormonal changes, stress and trauma. Conclusions There may be differences in the neurobiology of adolescent major depressive disorder ( MDD) compared with adult MDD. Increased understanding of the role of cytokines in adolescent MDD may lead to improved outcomes in the treatment of adolescent depression. [ABSTRACT FROM AUTHOR]

This study aims to review the evidence for the efficacy of risperidone in the treatment of disruptive behavioural disorders (DBDs) in children and adolescents. Established databases were searched using the terms ' Risperidone and efficacy and children' and ' Risperidone and efficacy and adolescents'. Randomised, double-blind controlled studies were retained for analysis. Janseen-Cilag was contacted to identify any unpublished studies. Quality of studies was measured using Jadad scores. Seven studies of 657 subjects with a mean age of 9.9 years ( SD= 2.0) (range 4-18 years) were identified. Only one study was judged to use the highest quality of methodology according to the Jadad score. Patients with DBD who were treated with risperidone showed clinical improvement compared with placebo. Weight gain, somnolence and gastrointestinal complaints were common. Risperidone was found to be efficacious in reducing symptoms in children and adolescents with DBD. However, studies were mostly of short duration and had deficiencies in the descriptions of blinding and randomisation. Research using rigorous methodology examining the long-term outcomes of efficacy and safety are required to inform clinicians and families of the therapeutic benefits and risks of risperidone in this clinical population. [ABSTRACT FROM AUTHOR]

BACKGROUND: Patients with apparent complete recovery from thrombotic thrombocytopenic purpura (TTP) often complain of problems with memory, concentration, and fatigue. STUDY DESIGN AND METHODS: Twenty-four patients who were enrolled in the Oklahoma TTP-HUS Registry for their initial episode of TTP, 1995-2006, and who had ADAMTS13 activity of less than 10 percent were evaluated for a broad range of cognitive functions 0.1 to 10.6 years (median, 4.0 years) after their most recent episode. At the time of their evaluation, they had normal physical and Mini-Mental State Examinations and no evidence of TTP. RESULTS: The patients, as a group, performed significantly worse on 4 of the 11 cognitive domains tested than standardized US data from neurologically normal individuals adjusted for age, sex, and education (p < 0.05). These four domains measured complex attention and concentration skills, information processing speed, rapid language generation, and rote memorization. Twenty-one (88%) patients performed below expectations on at least 1 of the 11 domains. No clear patterns were observed between cognitive test results and patients' characteristics or features of the preceding TTP, including age, occurrence of severe neurologic abnormalities, multiple episodes, and interval from an acute episode. CONCLUSION: Patients who have recovered from TTP may have persistent cognitive abnormalities. The abnormalities observed in these patients are characteristic of disorders associated with diffuse subcortical microvascular disease. Studies of larger patient groups will be required to confirm these preliminary observations and to determine patient characteristics that may contribute to persistent cognitive abnormalities. [ABSTRACT FROM AUTHOR]