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Objective: Little is known about the predictors of symptom change or the methods that might increase user ‘compliance’ on websites designed to improve mental health outcomes. The present paper: (i) examines predictors of expected final depression and anxiety scores on the MoodGYM website as a function of user characteristics; and (ii) compares the compliance rates of the original site with the new public version of the site (MoodGYM Mark II). The latter site requires compulsory completion of ‘core’ online assessments and may increase completion of site questionnaires. Method: MoodGYM Mark I participants were 19 607 visitors (public registrants) between April 2001 and September 2003 plus 182 participants who had been randomly assigned to MoodGYM in an earlier trial (The BlueMood Trial). MoodGYM Mark II participants were 38 791 public registrants of the MoodGYM Mark II site collected between September 2003 and October 2004. Symptom assessments are repeated within the website intervention to allow the examination of change in symptoms. Outcome variables were gender, initial depression severity scores, number of assessments completed and final anxiety and depression scores. Results: Men are predicted to be 0.19 units (SE = 0.095) higher than women on depression, controlling for the initial depression level and number of modules completed. For initial depression scores above 2, it is predicted that the final score will indicate improvement relative to the initial score, the magnitude of the improvement increasing as a function of the number of modules attempted. For initial anxiety scores above 2, it is predicted that the final score will indicate improvement relative to the initial score, the magnitude of the improvement increasing as a function of the number of modules attempted. Mark II registrants were more likely than to Mark I registrants to complete onsite assessments. Conclusions: Visitors to the MoodGYM site are likely to have better psychological outcomes if they complete more of the site material. Compulsory completion of core sections increases assessment completion. There is a need to examine further the significance of attrition from online interventions, to develop methods of handling missing data, and to investigate strategies to improve visitor dropout. [ABSTRACT FROM AUTHOR]

Background The National Survey of Mental Health and Well-being in Australia has provided a rare opportunity to investigate not only the sociodemographic distribution of well-being, but also how it is related to impaired mental or physical health, to specific groups of psychiatric disorders and disability in daily life. Methods A national household sample of 10,641 individuals (response rate 78%) representative of the adult population was interviewed with the Composite International Diagnostic Interview and completed scales measuring recent symptoms, disablement and well-being. The latter was measured by the single item Life Satisfaction Scale of Andrews and Withey (1976) expressed as percentage, with 100% being "delighted". Results The mean score for the Australian adult population was 70.4 % (95 % CI 70.0, 70.8), which matches the proposed universal norm. Men and women had very similar mean scores. Well-being was higher in persons with tertiary education and in those owning or purchasing their homes. It was lower in persons with physical or mental disorders, particularly depression. For alcohol use, a U-shaped relationship was found, whereby wellbeing was lower both in abstainers and in heavy users. Multiple regression analysis showed that when adjustment is made for confounders, women had higher life satisfaction than men and that high life satisfaction became less common with age in men,but even more so in women. Life satisfaction was impaired for respondents with high psychological distress, especially in the unemployed, the divorced and those with tertiary education, whether or not their symptoms led to a CIDI-A diagnosis of depression. Conclusion The correlates of well-being are essentially in the expected direction. Depressive disorder has a stronger association with low well-being than other psychiatric diagnoses. Of particular interest is the existence of a small number of persons with current anxiety or depressive disorders who report having high life... [ABSTRACT FROM AUTHOR]

Objective: To determine whether people’s attitudes towards a person who has experienced depression influence them in (i) the types of actions they take to help themselves if they experience common psychiatric symptoms, and (ii) the degree to which their symptoms improve. Method: A postal survey was carried out with 3109 adults to assess attitudes and symptoms of anxiety and depression. Attitudes were assessed by questions on a depressed person’s likely long-term outcome in various areas of life and whether the respondents thought the depressed person was likely to experience discrimination. A follow-up survey was carried out 6 months later with 422 persons who had a high level of symptoms at baseline. These individuals were asked about whether they had taken various actions to relieve their symptoms. Results: The attitude measures did not predict use of actions which involved someone else having to know that the person had psychiatric symptoms, nor use of actions which did not. The attitude measures also did not predict change in anxiety and depression symptoms. Conclusions: The attitude measures did not predict patterns of help-seeking or outcome for people with common psychiatric symptoms. However, attitudes towards depression were quite benign and the situation could be different for people with severe mental disorders. [ABSTRACT FROM AUTHOR]

Objective: Previous research has shown that the public have different beliefs to mental health professionals about the helpfulness of interventions for mental disorders. However, it is not known whether the public’s beliefs actually influence their behaviour when they develop psychiatric symptoms. Method: A postal survey of 3109 Australian adults was used to assess beliefs about the helpfulness of a broad range of interventions for depression, as well as respondents’ current level of anxiety and depression symptoms and any history of treated depression. A follow-up survey of 422 persons who had a high level of symptoms at baseline was conducted 6 months later. These people were asked which interventions they had used to reduce their symptoms. An analysis was carried out to see whether beliefs and other factors at baseline predicted subsequent use of interventions. Results: There were some major discrepancies between the ranking of interventions as likely to be helpful and the ranking of how frequently they were actually used. Interventions involving mental health professionals were often rated as likely to be helpful, but were rarely used in practice. Other simple, cheap and readily available interventions were used the most frequently, but were not the most likely to be rated as helpful. The most consistent predictors across all interventions used were gender, history of treatment, current symptoms and belief in a particular intervention. Of particular interest was the finding that beliefs in the helpfulness of antidepressants predicted their use. However, beliefs were not predictors of use for all interventions. Conclusions: Beliefs about the helpfulness of an intervention did not always predict actual use of that intervention, although beliefs did predict use of antidepressants. Therefore, campaigns that change public beliefs about effective treatments may also influence actual use of treatments. Interventions preferred by professionals are not... [ABSTRACT FROM AUTHOR]

Background: Understanding the relevance of biological and social factors to sex differences in the prevalence and detection of depressive and anxiety disorders has been impaired by the lack of standardized research methods across cultures. Method: Prevalence rates of depressive and anxiety disorders were assessed using a 2-stage design from 26969 patients attending for primary care in 15 centers from 4 continents. Logistic regression analysis was used to examine sex differences in prevalence and detection across centers. Results: Odds ratios for women compared with men of current depression (1.60; 95% confidence interval [CI], 1.37-1.86) and agoraphobia or panic (1.63; 95% CI, 1.18-2.20) were consistent across centers. The odds ratio for generalized anxiety varied among centers: 3 groups of centers were identified with odds ratios of 0.46 (95% CI, 0.27-0.78), 1.34 (95% CI, 1.08-1.66), and 3.09 (95% CI, 1.60-5.89). There was no sex difference in the detection of depressive and anxiety disorders by physicians across centers. Conclusions: The absence of a sex-by-center effect for current depression and agoraphobia or panic disorder is consistent with biological and psychosocial factors, either interacting or working alone, that have a similar final effect across cultures. It does not support the idea that sex differences in prevalence are caused by local psychosocial factors that vary from country to country. The variation in the odds ratio for generalized anxiety disorder offers some support to the idea that there are local differences between the centers contributing to the sex difference in rates. Patients' sex does not appear to affect the likelihood of current depression and anxiety being detected by primary care physicians. [ABSTRACT FROM AUTHOR]