Dennis Liu | University of California, Irvine (original) (raw)
Papers by Dennis Liu
Schizophrenia Research, Jul 1, 2019
It has previously been shown in short-term interventions that kernel-based whole grain (WG) rye p... more It has previously been shown in short-term interventions that kernel-based whole grain (WG) rye products have beneficial effects on test markers related to obesity and type 2 diabetes (T2D). T2D increases the risk of several severe health issues, including declined cognitive functions. The protein brain-derived neurotrophic factor (BDNF) is suggested to be a potential biomarker for neuronal integrity. The aim of this study was to investigate the effect on plasma BDNF concentrations, 10.5 h after the intake of WG rye. Healthy young adults were provided late evening meals consisting of WG rye kernel-based bread (RKB) or a white wheat flour-based bread (reference product (WWB)), in a randomized cross-over design. The BDNF concentrations were investigated at fasting in the morning 10.5 h after single evening meals with RKB and WWB, and also after three consecutive evening meals with RKB and WWB, respectively. No difference was observed in the BDNF concentrations depending on the priming setting (p > 0.05). The RKB evening meals increased the BDNF concentrations by 27% at fasting (p = 0.001), compared to WWB. The increase of BDNF after the RKB indicate that, in addition to anti-diabetic properties, the dietary fiber in WG rye may support neuronal integrity.
Pathology, 1996
ABSTRACT This study examined whether the effects of protein restriction and angiotensin convertin... more ABSTRACT This study examined whether the effects of protein restriction and angiotensin converting enzyme (ACE) inhibition on the progression of renal failure are common or additive. Male Sprague Dawley rats (12 wks of age) underwent 5/6 nephrectomy and were randomized to 20% protein diet (PD) (n = 9), 20% PD+enalapril (5 mg/kg/day) (n = 10), 20% PD+felodipine (30 mg/kg/day) (n = 9), 6% PD (n = 9), 6% PD+enalapril (n = 9) or 6% PD+felodipine (n = 10). Protein restriction, enalapril or felodipine treatment all retarded progression of renal failure and development of glomerular lesions. Protein restriction and enalapril appeared to have additive effects in preventing glomerular sclerosis.
Translational Psychiatry, 2021
Autoimmune processes are suspected to play a role in the pathophysiology of psychotic disorders. ... more Autoimmune processes are suspected to play a role in the pathophysiology of psychotic disorders. Better understanding of the associations between auto-immunoglobulin G (IgG) repertoires and clinical features of mental illness could yield novel models of the pathophysiology of psychosis, and markers for biological patient stratification. We undertook cross-sectional detection and quantification of auto-IgGs in peripheral blood plasma of 461 people (39% females) with established psychotic disorder diagnoses. Broad screening of 24 individuals was carried out on group level in eight clinically defined groups using planar protein microarrays containing 42,100 human antigens representing 18,914 proteins. Autoantibodies indicated by broad screening and in the previous literature were measured using a 380-plex bead-based array for autoantibody profiling of all 461 individuals. Associations between autoantibody profiles and dichotomized clinical characteristics were assessed using a stepwise...
Australian & New Zealand Journal of Psychiatry, 2020
Australasian Psychiatry, 2020
Objectives: The COVID-19 pandemic poses significant risks to the vulnerable patient population su... more Objectives: The COVID-19 pandemic poses significant risks to the vulnerable patient population supported by community mental health (CMH) teams in South Australia. This paper describes a plan developed to understand and mitigate these risks. Methods: Public health and psychiatric literature was reviewed and clinicians in CMH teams and infectious disease were consulted. Key risks posed by COVID-19 to CMH patients were identified and mitigation plans were prepared. Results: A public health response plan for CMH teams was developed to support vulnerable individuals and respond to the COVID-19 pandemic. This plan will be reviewed regularly to respond to changes in public health recommendations, research findings and feedback from patients and clinicians. Conclusions: The strategic response plan developed to address risks to vulnerable patients from COVID-19 can assist other CMH services in managing the COVID-19 pandemic.
Psychoneuroendocrinology, 2021
While high levels of glucocorticoids are generally neuro-damaging, a related adrenal steroid, deh... more While high levels of glucocorticoids are generally neuro-damaging, a related adrenal steroid, dehydroepiandrosterone (DHEA), has anti-glucocorticoid and neuroprotective properties. Previous work has shown increased circulating levels of DHEA and abnormal cortisol/DHEA ratios in people with schizophrenia, however reports are limited and their relationship to neuropathology is unclear. We performed the largest study to date to compare levels of serum DHEA and cortisol/DHEA ratios in people with schizophrenia and healthy controls, and investigated the extent to which cortisol/DHEA ratios predict brain volume. Serum cortisol and DHEA were assayed in 94 people with schizophrenia and 81 healthy controls. T1-weighted high-resolution anatomical scans were obtained using a 3 T Achieva scanner on a subset of 59 people with schizophrenia and 60 healthy controls. Imaging data were preprocessed and analyzed using SPM12. People with schizophrenia had significantly increased serum DHEA levels (p = 0.002), decreased cortisol/DHEA ratios (p = 0.02) and no difference in cortisol levels compared to healthy controls. Cortisol/DHEA ratios were inversely correlated with hippocampal (r =-0.33 p = 0.01) and dorsolateral prefrontal cortex (r =-0.30, p = 0.02) volumes in patients. Our findings suggest that the cortisol/DHEA ratio may be a molecular blood signature of hippocampal and cortical damage. These results further implicate the role of DHEA and hypothalamic-pituitary-adrenal axis dysfunction in the pathophysiology of schizophrenia.
Frontiers in Immunology, 2018
Schizophrenia Bulletin, 2019
Methods: This was a post hoc analysis of a 17-wk, open-label (OL) treatment period from a large, ... more Methods: This was a post hoc analysis of a 17-wk, open-label (OL) treatment period from a large, multicenter, phase 3 noninferiority study (NCT01515423) that compared the efficacy and safety of paliperidone palmitate once-every-3-months and PP1M in patients with schizophrenia. During the 17-wk OL period, patients received flexibly dosed PP1M (day 1 [234 mg]; day 8 [156 mg]; wks 5, 9, and 13 [78, 117, 156, or 234 mg]). Patients were grouped according to the number of hospital admissions for psychosis that occurred 24 months before study entry: no prior hospitalizations (low activity), 1 prior hospitalization (moderate activity), and ≥2 prior hospitalizations (high activity). Assessments included change in Positive and Negative Syndrome Scale (PANSS) total scores, change in Clinical Global Impression-Severity (CGI-S) scores, and the percentage of patients who attained symptomatic remission (defined as a score ≤3 on the following PANSS symptom score items: P1 [delusions], P2 [conceptual disorganization], P3 [hallucinatory behavior], N1 [blunted affect], N4 [social withdrawal], N6 [lack of spontaneity], G5 [mannerisms/posturing], and G9 [unusual thought content]) at OL end point (wk 17). Subgroup differences were examined using ANCOVA models for continuous end points and by the Cochran-Mantel-Haenszel test for categorical variables. No adjustments were made for multiplicity as the OL period was used to determine acceptability for entry to the double-blind period. Results: Of 1,146 patients, 450 (39.3%) had no prior hospitalizations, 426 (37.2%) had 1 prior hospitalization, and 270 (23.6%) had ≥2 prior hospitalizations within the previous 24 months. BL demographics and disease characteristics were similar between groups. Mean age ranged from 37.6 to 41.0 years, patients were predominantly male (range, 51.6%-58.9%), and most were from non-European Union/non-United States regions (range, 51.5%-60.6%). For low, moderate, and high disease activity groups, mean [SD] total PANSS scores were 85.8 (10.51), 85.6 (10.74), and 86.0 (11.3), respectively; mean (SD) CGI-S scores were 4.5 (0.67), 4.4 (0.70), and 4.4 (0.67), respectively. In each disease activity group, statistically and clinically meaningful improvements from BL were observed in all efficacy measures at all time points during the 17-wk treatment period. At OL end point, mean changes from BL in PANSS total scores were-20.5,-20.1, and-18.3 in the low, moderate, and high disease activity groups, and mean changes from BL in CGI-S scores were-1.1,-1.0, and-0.9, respectively; there was no statistically significant difference in PANSS total scores or CGI-S scores between disease activity groups. The percentages of patients who attained symptomatic remission at the OL end point were 49.4%, 53.1%, and 49.1%, respectively. The most common adverse events (≥5% in any group) were insomnia, anxiety, akathisia, injection site pain, nasopharyngitis, and weight increase. Discussion: Findings from the 17-wk OL period demonstrated that treatment with PP1M produced a rapid, beneficial effect in patient symptom scores that was significant from week 1 onward. PP1M was rapidly effective in patients with schizophrenia regardless of BL disease activity. Safety was consistent with previous acute trials evaluating PP1M.
JMIR Mental Health, 2020
Background Web-based information and interventions for mental illness are increasingly being prov... more Background Web-based information and interventions for mental illness are increasingly being provided. There is an expectation that citizens have access to the internet and are competent in using technology. People with schizophrenia are often excluded from social engagement, have cognitive impairment, and have very limited income, all of which may reduce their use of technology. Objective This study aimed to investigate technology access, use of digital technology, and confidence in using technology among people with schizophrenia living in the community. Methods Face-to-face structured interviews with 50 people with schizophrenia (aged 18-65 years) living in the northern suburbs of Adelaide, South Australia, were conducted using an instrument designed to assess technology access and utilization. Results Most participants (42/50, 84%) owned a mobile phone, but only 58% (29/50) owned a smartphone. Two-thirds of participants (33/50, 66%) had access to the internet at home, using a sm...
The Journal of Neuroscience, 1992
Previous culture studies have demonstrated that muscle cells autonomously express and cluster ACh... more Previous culture studies have demonstrated that muscle cells autonomously express and cluster ACh receptors (AChRs) and that contact by neurites induces a reorganization of these clusters. We studied these phenomena in zebrafish embryos where the same cells could be examined in vivo and in vitro, and where contacts between cells could be viewed repeatedly. Receptor clusters first appeared when the pioneer growth cones emerged from the spinal cord, were always associated with labeled branches, and developed normally in the presence of neuromuscular transmission blockers. When motoneurons were removed, the muscles failed to cluster receptors. In contrast, muscle cells grown in cell culture uncontacted by nerves clustered AChRs. Our results suggest that clustering of AChRs in living embryos is induced by the presence of neurites and does not occur in the absence of neuronal contact. We suggest that conditions in cell culture, which differ from those in the intact embryo, induce cluster...
Schizophrenia Research: Cognition, 2019
Previous studies have shown that people with schizophrenia have high rates of Obstructive Sleep A... more Previous studies have shown that people with schizophrenia have high rates of Obstructive Sleep Apnoea (OSA). Despite this, intervention studies to treat OSA in this population have not been undertaken. The ASSET (Assessing Sleep in Schizophrenia and Evaluating Treatment) pilot study investigated Continuous Positive Airway Pressure (CPAP) treatment of severe OSA in participants recruited from a clozapine clinic in Adelaide. Participants with severe untreated OSA (Apnoea-Hypopnoea Index (AHI) > 30), were provided with CPAP treatment, and assessed at baseline and six months across the following domains: physical health, quality of sleep, sleepiness, cognition, psychiatric symptoms and CPAP adherence. Six of the eight ASSET participants with severe OSA accepted CPAP. At baseline, half of the cohort had hypertension, all were obese with a mean BMI of 45, and they scored on average 1.47 standard deviations below the normal population in cognitive testing. The mean AHI was 76.8 and sleep architecture was markedly impaired with mean rapid eye movement (REM) sleep 4.1% and mean slow wave sleep (SWS) 4.8%. After six months of treatment there were improvements in cognition (BACS Z score improved by an average of 0.59) and weight loss (mean weight loss 7.3 ± 9 kg). Half of the participants no longer had hypertension and sleep architecture improved with mean REM sleep 31.4% of the night and mean SWS 24% of the night. Our data suggests CPAP may offer novel benefits to address cognitive impairment and sleep disturbance in people with schizophrenia.
Journal of Neuroinflammation, 2017
Background: Increases in pro-inflammatory cytokines are found in the brain and blood of people wi... more Background: Increases in pro-inflammatory cytokines are found in the brain and blood of people with schizophrenia. However, increased cytokines are not evident in all people with schizophrenia, but are found in a subset. The cytokine changes that best define this subset, termed the "elevated inflammatory biotype", are still being identified. Methods: Using quantitative RT-PCR, we measured five cytokine mRNAs (IL-1β, IL-2 IL-6, IL-8 and IL-18) from peripheral blood of healthy controls and of people with schizophrenia or schizoaffective disorder (n = 165). We used a cluster analysis of the transcript levels to define those with low and those with elevated levels of cytokine expression. From the same cohort, eight cytokine proteins (IL-1β, IL-2, IL-6, IL-8, IL-10, IL-12, IFNγ and TNFα) were measured in serum and plasma using a Luminex Magpix-based assay. We compared peripheral mRNA and protein levels across diagnostic groups and between those with low and elevated levels of cytokine expression according to our transcription-based cluster analysis. Results: We found an overall decrease in the anti-inflammatory IL-2 mRNA (p = 0.006) and an increase in three serum cytokines, IL-6 (p = 0.010), IL-8 (p = 0.024) and TNFα (p < 0.001) in people with schizophrenia compared to healthy controls. A greater percentage of people with schizophrenia (48%) were categorised into the elevated inflammatory biotype compared to healthy controls (33%). The magnitude of increase in IL-1β, IL-6, IL-8 and IL-10 mRNAs in people in the elevated inflammation biotype ranged from 100 to 220% of those in the non-elevated inflammatory biotype and was comparable between control and schizophrenia groups. Blood cytokine protein levels did not correlate with cytokine mRNA levels, and plasma levels of only two cytokines distinguished the elevated and low inflammatory biotypes, with IL-1β significantly increased in the elevated cytokine control group and IL-8 significantly increased in the elevated cytokine schizophrenia group. Conclusions: Our results confirm that individuals with schizophrenia are more likely to have elevated levels of inflammation compared to controls. We suggest that efforts to define inflammatory status based on peripheral measures need to consider both mRNA and protein measures as each have distinct advantages and disadvantages and can yield different results.
Schizophrenia Bulletin, 2017
proteomic approach was used to confirm this finding in a second ALSPAC age 11 cohort who did (n =... more proteomic approach was used to confirm this finding in a second ALSPAC age 11 cohort who did (n = 38) or did not (n = 66) report psychotic experiences, at age 18. Conclusion: We found that proteins involved in the Complement and Coagulation system are dysregulated in the blood during childhood long before the development of psychotic disorder. Although these findings need to be confirmed in independent and larger studies, future therapeutic strategies that target these processes in those at risk of developing psychotic disorder should be considered.
Schizophrenia Bulletin, 2017
Background: Cognitive deficits, a highly disabling feature of schizophrenia (SZ), are the stronge... more Background: Cognitive deficits, a highly disabling feature of schizophrenia (SZ), are the strongest predictor of functional outcome. Recent evidence points to thalamocortical circuitry as the culprit in SZ risk and cognitive deficits. Patients with SZ have reduced sleep spindles (bursts of 12-15 Hz electroencephalogram activity during non-rapid eye movement sleep), which are initiated by the thalamic reticular nucleus and propagated to and synchronized in the cortex via thalamocortical feedback loops. Sleep spindles mediate memory consolidation and are associated with impaired sleep-dependent memory consolidation and symptom severity in SZ. Here we used resting state functional magnetic resonance imaging (fMRI) to investigate whether spindle deficits in SZ are associated with changes in the connectivity of thalamocortical networks. Methods: Participants were chronic, medicated SZ patients (n = 26) and demographically matched healthy controls (HC, n = 29). The scanning protocol included resting-state fMRI (two 6-minute scans) and diffusion-weighted imaging on a 3T Siemens Trio scanner. We performed a seed-based functional connectivity analysis based on the FSL-Oxford thalamic connectivity atlas (7 thalamic seeds: prefrontal, premotor, primary motor, sensory, temporal, posterior parietal, and occipital). Following standard preprocessing, motion artifacts and physiological noise were regressed out, and functional connectivity was computed. All reported clusters survived a multiple comparison correction of pFDR <.05. Nocturnal sleep was monitored with polysomnography in a separate session. Sleep was scored according to standard criteria, and sleep spindles during N2 were identified using an automated wavelet spindle detector. Results: Connectivity between the thalamus and prefrontal cortices was reduced in SZ (MNI coordinates: x = 22, y = 46, z = −6; cluster size: 442 voxels; pFDR = .04). In contrast, connectivity between the thalamus and sensory motor cortices was increased in SZ (−38, −14, 48; cluster size: 4989 voxels; pFDR = .001). Patients showed consistent, widespread reductions in sleep spindle density that reached significance in a centroparietal cluster (pFDR = .042). Reduced spindle density predicted abnormal hyperconnectivity of the thalamus with sensory motor cortex in SZ (−32, −34, 52; cluster size: 257 voxels; pFDR = .007). Conclusion: This is the first demonstration that a prominent biomarker of SZ, sleep spindles, correlates with a regionally specific abnormality in sensory motor thalamocortical functional connectivity suggesting TRNmediated thalamocortical circuit dysfunction. This relationship between spindle density and sensory motor thalamocortical connectivity is in line with recent animal work showing that the firing of sensory projecting TRN neurons correlate with sleep spindles (Halassa et al., 2014). Future plans include complementing functional connectivity analysis with measurements of thalamocortical white matter integrity.
The Journal of Physiology, 1988
1. The activity of the two classes of motoneurones, primary and secondary, which innervate myotom... more 1. The activity of the two classes of motoneurones, primary and secondary, which innervate myotomal muscle fibres in the zebra fish, was monitored with electromyographic and intracellular techniques. 2. Simultaneous EMG and intracellular recordings from muscle fibres showed that the activity of the two motor systems and of individual primary motoneurones can be distinguished by recording EMG spikes during swimming. 3. Measurements of EMG spikes demonstrated that primary and secondary motoneurones are co‐ordinately activated over a wide range of conditions during normal swimming. 4. During swimming the primary motoneurones within a given segment are usually co‐activated although they sometimes fire independently. 5. When different primary motoneurones within a given segment are co‐activated, they fire nearly synchronously. 6. We conclude that the primary motoneurones are used principally, although not exclusively, during fast swimming, struggling and the startle response, whereas sec...
Early intervention in psychiatry, Jan 17, 2016
This study examined the prevalence of risk factors for cardiovascular (CV)-related morbidity and ... more This study examined the prevalence of risk factors for cardiovascular (CV)-related morbidity and mortality in young people with psychosis aged 18 to 24 years. The study included 132 people aged 18 to 24 years who participated in the 2010 second Australian national survey of people living with psychosis. The 2009 World Health Organisation (WHO) Global Health Risks report was used as a framework to determine which specific risk factors were present in each in these young people. The risk factors assessed in this study were smoking, alcohol use, hypertension, overweight/obesity, physical inactivity, high blood glucose, high cholesterol and poor diet. Each risk factor was defined according to WHO criteria. A count of the total number of risk factors present for each participant was determined. Data for male and female participants were compared. Young men had an average of 2.9 (SD 1.2) risk factors. Young women had an average of 2.4 (SD 1.2) risk factors. The most common risk factors we...
BMC Psychiatry, 2016
Background: Clozapine is an effective treatment for a proportion of people with schizophrenia (SZ... more Background: Clozapine is an effective treatment for a proportion of people with schizophrenia (SZ) who are resistant to the beneficial effects of other antipsychotic drugs. However, anything from 40-60 % of people on clozapine experience residual symptoms even on adequate doses of the medication, and thus could be considered 'clozapine resistant'. Agents that could work alongside clozapine to improve efficacy whilst not increasing the adverse effect burden are both desired and necessary to improve the lives of individuals with clozapine-resistant SZ. N-Acetylcysteine (NAC) is one such possible agent. Previous research from our research group provided promising pilot data suggesting the efficacy of NAC in this patient population. The aim of the study reported here is to expand this work by conducting a large scale clinical trial of NAC in the treatment of clozapine-resistant SZ. Methods: This study is an investigator initiated, multi-site, randomised, placebo-controlled trial. It aims to include 168 patients with clozapine-resistant SZ, divided into an intervention group (NAC) and a control group (placebo). Participants in the intervention group will receive 2 g daily of NAC. The primary outcome measures will be the negative symptom scores of the Positive and Negative Syndrome Scale (PANSS). Secondary outcome measures will include: changes in quality of life (QoL) as measured by the Lancashire Quality of Life Profile (LQoLP) and cognitive functioning as measured by the total score on the MATRICS. Additionally we will examine peripheral and cortical glutathione (GSH) concentrations as process outcomes. Discussion: This large scale clinical trial will investigate the efficacy of NAC as an adjunctive medication to clozapine. This trial, if successful, will establish a cheap, safe and easy-to-use agent (NAC) as a 'go to' adjunct in patients that are only partly responsive to clozapine. Trial registration: Australian and New Zealand Clinical Trials Registration Number: Current Randomised Controlled Trial ACTRN12615001273572. The date of registration 23 November 2015.
Frontiers in Psychiatry, 2016
Background: Obstructive sleep apnea (OSA) in the general community is associated with obesity, sm... more Background: Obstructive sleep apnea (OSA) in the general community is associated with obesity, smoking, alcohol, and sedative medication use and contributes to depressed mood, daytime sedation, and sudden cardiovascular deaths. Poor cardiovascular health, impaired social functioning, and negative and cognitive symptoms are also among the common clinical features of psychotic disorders. People with psychosis have higher rates of sleep disturbance; however, OSA has not been extensively investigated in this population. aims: This study aimed to determine the prevalence of OSA and general sleep disruption symptoms in a representative Australian sample of people with psychosis. We investigated the prevalence of potential risk factors for OSA, including obesity, psychotropic medications, and substance abuse in this population. Finally, we evaluated associations between symptoms of OSA, symptoms of general sleep disruption, and various clinical features in people with psychosis. Methods: Participants took part in the Second National Australian Survey of Psychosis, a population-based survey of Australians with a psychotic disorder aged 18-64 years. Symptoms associated with OSA (snoring and breathing pauses during sleep) in the past year were assessed using questions from the University of Maryland Medical Centre Questionnaire and symptoms associated with general sleep disruption in the past week using the Assessment of Quality of Life Questionnaire. Data collected included psychiatric diagnosis and symptoms, education, employment, medications, smoking status, physical activity, drug and alcohol use, and cognitive function. Physical health measures Demographics and social Participation Gender, age, marital status, formal study educational level, and current employment were recorded. Item to assess the participant's involvement in meaningful activity was extracted from the main interview schedule to assess: 0 = employed in any job in last 12 months; 1 = home duties/caring for own children; 2 = caring included body mass index, waist circumference, blood pressure, fasting blood glucose, and lipids. results: Snoring was reported by 41.9%; 7% stating they frequently stopped breathing (pauses) during sleep. Univariate logistic regressions show OSA symptoms (pauses and snoring) were associated with older age, female gender, lower levels of social participation or employment, cardiovascular risk factors, sedentary lifestyle, and poorer quality of life, while symptoms of general sleep disruption were more likely in people with depressive symptoms. conclusion: Australians with psychosis have high levels of sleep disturbance, including OSA. OSA symptoms were associated with cardiovascular disease risk factors, reduced social participation and employment, and poorer quality of life. Whether correction of OSA can improve these factors in people with psychosis remains to be determined.
Schizophrenia Research, 2015
To explore the diets of people living with psychotic disorders, and to compare their dietary comp... more To explore the diets of people living with psychotic disorders, and to compare their dietary composition to the general population. Method: 184 people with psychotic disorders in Adelaide, South Australia completed a food frequency questionnaire. Physical information and mental health status were collected. Outcome measures included energy and macronutrient intake; fish, sodium, fruit and vegetable intake; micro-nutrient intake; body mass index; waist circumference; and diagnoses of diabetes and hypertension. The RDI of nutrients was derived from Australian Government publications. Comparison dietary data was obtained from surveys carried out by the Australian Bureau of Statistics. Results: The majority of participants were overweight or obese (78%) and 77.5% met the criteria for at-risk waist circumference; and 58% of participants consumed salt and saturated fat in excess of the RDI. Most did not achieve the RDI for fruits and vegetables (97.8%), fibre (88.6%), fish (61.4%), magnesium (73.4%) or folate (86.4%). Women with psychosis had significantly higher intakes of vitamins and minerals compared to women in the general population. Men and women with psychosis consumed more daily total fat, saturated fat and sodium compared to adults in the Australian population, but lower fibre and vitamin E than their male and female counterparts. Conclusion: People with psychosis, especially women, report poor dietary choices including increased energy and fat intake, heightening their risk for cardiovascular disease. Women with psychosis report higher intake of vitamins and minerals than women in the general population. Whilst dietary intake contributes to obesity in psychosis, other factors including antipsychotic agents, decreased physical activity and smoking add to the cardiovascular risk.
Australian health review : a publication of the Australian Hospital Association, Jan 10, 2015
Objectives The aim of the present study was to document Australian policies on the physical healt... more Objectives The aim of the present study was to document Australian policies on the physical health of people with mental illness and evaluate the capacity of policy to support health needs. Methods A search of state and federal policies on mental and physical illness was conducted, as well as detailed analysis of policy content and the relationships between policies, by applying the World Health Organization Mental Health Action Plan 2013-2020 as an evaluative framework. Results National policy attention to the physical health of people with mental illness has grown, but there is little interconnection at the national and state levels. State policies across the country are inconsistent, and there is little evidence of consistent policy implementation. Conclusions A coherent national health policy framework on addressing co-occurring physical and mental illnesses that includes healthcare system reforms and ensuring the interconnectedness of other relevant services should be prioritis...
Schizophrenia Research, Jul 1, 2019
It has previously been shown in short-term interventions that kernel-based whole grain (WG) rye p... more It has previously been shown in short-term interventions that kernel-based whole grain (WG) rye products have beneficial effects on test markers related to obesity and type 2 diabetes (T2D). T2D increases the risk of several severe health issues, including declined cognitive functions. The protein brain-derived neurotrophic factor (BDNF) is suggested to be a potential biomarker for neuronal integrity. The aim of this study was to investigate the effect on plasma BDNF concentrations, 10.5 h after the intake of WG rye. Healthy young adults were provided late evening meals consisting of WG rye kernel-based bread (RKB) or a white wheat flour-based bread (reference product (WWB)), in a randomized cross-over design. The BDNF concentrations were investigated at fasting in the morning 10.5 h after single evening meals with RKB and WWB, and also after three consecutive evening meals with RKB and WWB, respectively. No difference was observed in the BDNF concentrations depending on the priming setting (p > 0.05). The RKB evening meals increased the BDNF concentrations by 27% at fasting (p = 0.001), compared to WWB. The increase of BDNF after the RKB indicate that, in addition to anti-diabetic properties, the dietary fiber in WG rye may support neuronal integrity.
Pathology, 1996
ABSTRACT This study examined whether the effects of protein restriction and angiotensin convertin... more ABSTRACT This study examined whether the effects of protein restriction and angiotensin converting enzyme (ACE) inhibition on the progression of renal failure are common or additive. Male Sprague Dawley rats (12 wks of age) underwent 5/6 nephrectomy and were randomized to 20% protein diet (PD) (n = 9), 20% PD+enalapril (5 mg/kg/day) (n = 10), 20% PD+felodipine (30 mg/kg/day) (n = 9), 6% PD (n = 9), 6% PD+enalapril (n = 9) or 6% PD+felodipine (n = 10). Protein restriction, enalapril or felodipine treatment all retarded progression of renal failure and development of glomerular lesions. Protein restriction and enalapril appeared to have additive effects in preventing glomerular sclerosis.
Translational Psychiatry, 2021
Autoimmune processes are suspected to play a role in the pathophysiology of psychotic disorders. ... more Autoimmune processes are suspected to play a role in the pathophysiology of psychotic disorders. Better understanding of the associations between auto-immunoglobulin G (IgG) repertoires and clinical features of mental illness could yield novel models of the pathophysiology of psychosis, and markers for biological patient stratification. We undertook cross-sectional detection and quantification of auto-IgGs in peripheral blood plasma of 461 people (39% females) with established psychotic disorder diagnoses. Broad screening of 24 individuals was carried out on group level in eight clinically defined groups using planar protein microarrays containing 42,100 human antigens representing 18,914 proteins. Autoantibodies indicated by broad screening and in the previous literature were measured using a 380-plex bead-based array for autoantibody profiling of all 461 individuals. Associations between autoantibody profiles and dichotomized clinical characteristics were assessed using a stepwise...
Australian & New Zealand Journal of Psychiatry, 2020
Australasian Psychiatry, 2020
Objectives: The COVID-19 pandemic poses significant risks to the vulnerable patient population su... more Objectives: The COVID-19 pandemic poses significant risks to the vulnerable patient population supported by community mental health (CMH) teams in South Australia. This paper describes a plan developed to understand and mitigate these risks. Methods: Public health and psychiatric literature was reviewed and clinicians in CMH teams and infectious disease were consulted. Key risks posed by COVID-19 to CMH patients were identified and mitigation plans were prepared. Results: A public health response plan for CMH teams was developed to support vulnerable individuals and respond to the COVID-19 pandemic. This plan will be reviewed regularly to respond to changes in public health recommendations, research findings and feedback from patients and clinicians. Conclusions: The strategic response plan developed to address risks to vulnerable patients from COVID-19 can assist other CMH services in managing the COVID-19 pandemic.
Psychoneuroendocrinology, 2021
While high levels of glucocorticoids are generally neuro-damaging, a related adrenal steroid, deh... more While high levels of glucocorticoids are generally neuro-damaging, a related adrenal steroid, dehydroepiandrosterone (DHEA), has anti-glucocorticoid and neuroprotective properties. Previous work has shown increased circulating levels of DHEA and abnormal cortisol/DHEA ratios in people with schizophrenia, however reports are limited and their relationship to neuropathology is unclear. We performed the largest study to date to compare levels of serum DHEA and cortisol/DHEA ratios in people with schizophrenia and healthy controls, and investigated the extent to which cortisol/DHEA ratios predict brain volume. Serum cortisol and DHEA were assayed in 94 people with schizophrenia and 81 healthy controls. T1-weighted high-resolution anatomical scans were obtained using a 3 T Achieva scanner on a subset of 59 people with schizophrenia and 60 healthy controls. Imaging data were preprocessed and analyzed using SPM12. People with schizophrenia had significantly increased serum DHEA levels (p = 0.002), decreased cortisol/DHEA ratios (p = 0.02) and no difference in cortisol levels compared to healthy controls. Cortisol/DHEA ratios were inversely correlated with hippocampal (r =-0.33 p = 0.01) and dorsolateral prefrontal cortex (r =-0.30, p = 0.02) volumes in patients. Our findings suggest that the cortisol/DHEA ratio may be a molecular blood signature of hippocampal and cortical damage. These results further implicate the role of DHEA and hypothalamic-pituitary-adrenal axis dysfunction in the pathophysiology of schizophrenia.
Frontiers in Immunology, 2018
Schizophrenia Bulletin, 2019
Methods: This was a post hoc analysis of a 17-wk, open-label (OL) treatment period from a large, ... more Methods: This was a post hoc analysis of a 17-wk, open-label (OL) treatment period from a large, multicenter, phase 3 noninferiority study (NCT01515423) that compared the efficacy and safety of paliperidone palmitate once-every-3-months and PP1M in patients with schizophrenia. During the 17-wk OL period, patients received flexibly dosed PP1M (day 1 [234 mg]; day 8 [156 mg]; wks 5, 9, and 13 [78, 117, 156, or 234 mg]). Patients were grouped according to the number of hospital admissions for psychosis that occurred 24 months before study entry: no prior hospitalizations (low activity), 1 prior hospitalization (moderate activity), and ≥2 prior hospitalizations (high activity). Assessments included change in Positive and Negative Syndrome Scale (PANSS) total scores, change in Clinical Global Impression-Severity (CGI-S) scores, and the percentage of patients who attained symptomatic remission (defined as a score ≤3 on the following PANSS symptom score items: P1 [delusions], P2 [conceptual disorganization], P3 [hallucinatory behavior], N1 [blunted affect], N4 [social withdrawal], N6 [lack of spontaneity], G5 [mannerisms/posturing], and G9 [unusual thought content]) at OL end point (wk 17). Subgroup differences were examined using ANCOVA models for continuous end points and by the Cochran-Mantel-Haenszel test for categorical variables. No adjustments were made for multiplicity as the OL period was used to determine acceptability for entry to the double-blind period. Results: Of 1,146 patients, 450 (39.3%) had no prior hospitalizations, 426 (37.2%) had 1 prior hospitalization, and 270 (23.6%) had ≥2 prior hospitalizations within the previous 24 months. BL demographics and disease characteristics were similar between groups. Mean age ranged from 37.6 to 41.0 years, patients were predominantly male (range, 51.6%-58.9%), and most were from non-European Union/non-United States regions (range, 51.5%-60.6%). For low, moderate, and high disease activity groups, mean [SD] total PANSS scores were 85.8 (10.51), 85.6 (10.74), and 86.0 (11.3), respectively; mean (SD) CGI-S scores were 4.5 (0.67), 4.4 (0.70), and 4.4 (0.67), respectively. In each disease activity group, statistically and clinically meaningful improvements from BL were observed in all efficacy measures at all time points during the 17-wk treatment period. At OL end point, mean changes from BL in PANSS total scores were-20.5,-20.1, and-18.3 in the low, moderate, and high disease activity groups, and mean changes from BL in CGI-S scores were-1.1,-1.0, and-0.9, respectively; there was no statistically significant difference in PANSS total scores or CGI-S scores between disease activity groups. The percentages of patients who attained symptomatic remission at the OL end point were 49.4%, 53.1%, and 49.1%, respectively. The most common adverse events (≥5% in any group) were insomnia, anxiety, akathisia, injection site pain, nasopharyngitis, and weight increase. Discussion: Findings from the 17-wk OL period demonstrated that treatment with PP1M produced a rapid, beneficial effect in patient symptom scores that was significant from week 1 onward. PP1M was rapidly effective in patients with schizophrenia regardless of BL disease activity. Safety was consistent with previous acute trials evaluating PP1M.
JMIR Mental Health, 2020
Background Web-based information and interventions for mental illness are increasingly being prov... more Background Web-based information and interventions for mental illness are increasingly being provided. There is an expectation that citizens have access to the internet and are competent in using technology. People with schizophrenia are often excluded from social engagement, have cognitive impairment, and have very limited income, all of which may reduce their use of technology. Objective This study aimed to investigate technology access, use of digital technology, and confidence in using technology among people with schizophrenia living in the community. Methods Face-to-face structured interviews with 50 people with schizophrenia (aged 18-65 years) living in the northern suburbs of Adelaide, South Australia, were conducted using an instrument designed to assess technology access and utilization. Results Most participants (42/50, 84%) owned a mobile phone, but only 58% (29/50) owned a smartphone. Two-thirds of participants (33/50, 66%) had access to the internet at home, using a sm...
The Journal of Neuroscience, 1992
Previous culture studies have demonstrated that muscle cells autonomously express and cluster ACh... more Previous culture studies have demonstrated that muscle cells autonomously express and cluster ACh receptors (AChRs) and that contact by neurites induces a reorganization of these clusters. We studied these phenomena in zebrafish embryos where the same cells could be examined in vivo and in vitro, and where contacts between cells could be viewed repeatedly. Receptor clusters first appeared when the pioneer growth cones emerged from the spinal cord, were always associated with labeled branches, and developed normally in the presence of neuromuscular transmission blockers. When motoneurons were removed, the muscles failed to cluster receptors. In contrast, muscle cells grown in cell culture uncontacted by nerves clustered AChRs. Our results suggest that clustering of AChRs in living embryos is induced by the presence of neurites and does not occur in the absence of neuronal contact. We suggest that conditions in cell culture, which differ from those in the intact embryo, induce cluster...
Schizophrenia Research: Cognition, 2019
Previous studies have shown that people with schizophrenia have high rates of Obstructive Sleep A... more Previous studies have shown that people with schizophrenia have high rates of Obstructive Sleep Apnoea (OSA). Despite this, intervention studies to treat OSA in this population have not been undertaken. The ASSET (Assessing Sleep in Schizophrenia and Evaluating Treatment) pilot study investigated Continuous Positive Airway Pressure (CPAP) treatment of severe OSA in participants recruited from a clozapine clinic in Adelaide. Participants with severe untreated OSA (Apnoea-Hypopnoea Index (AHI) > 30), were provided with CPAP treatment, and assessed at baseline and six months across the following domains: physical health, quality of sleep, sleepiness, cognition, psychiatric symptoms and CPAP adherence. Six of the eight ASSET participants with severe OSA accepted CPAP. At baseline, half of the cohort had hypertension, all were obese with a mean BMI of 45, and they scored on average 1.47 standard deviations below the normal population in cognitive testing. The mean AHI was 76.8 and sleep architecture was markedly impaired with mean rapid eye movement (REM) sleep 4.1% and mean slow wave sleep (SWS) 4.8%. After six months of treatment there were improvements in cognition (BACS Z score improved by an average of 0.59) and weight loss (mean weight loss 7.3 ± 9 kg). Half of the participants no longer had hypertension and sleep architecture improved with mean REM sleep 31.4% of the night and mean SWS 24% of the night. Our data suggests CPAP may offer novel benefits to address cognitive impairment and sleep disturbance in people with schizophrenia.
Journal of Neuroinflammation, 2017
Background: Increases in pro-inflammatory cytokines are found in the brain and blood of people wi... more Background: Increases in pro-inflammatory cytokines are found in the brain and blood of people with schizophrenia. However, increased cytokines are not evident in all people with schizophrenia, but are found in a subset. The cytokine changes that best define this subset, termed the "elevated inflammatory biotype", are still being identified. Methods: Using quantitative RT-PCR, we measured five cytokine mRNAs (IL-1β, IL-2 IL-6, IL-8 and IL-18) from peripheral blood of healthy controls and of people with schizophrenia or schizoaffective disorder (n = 165). We used a cluster analysis of the transcript levels to define those with low and those with elevated levels of cytokine expression. From the same cohort, eight cytokine proteins (IL-1β, IL-2, IL-6, IL-8, IL-10, IL-12, IFNγ and TNFα) were measured in serum and plasma using a Luminex Magpix-based assay. We compared peripheral mRNA and protein levels across diagnostic groups and between those with low and elevated levels of cytokine expression according to our transcription-based cluster analysis. Results: We found an overall decrease in the anti-inflammatory IL-2 mRNA (p = 0.006) and an increase in three serum cytokines, IL-6 (p = 0.010), IL-8 (p = 0.024) and TNFα (p < 0.001) in people with schizophrenia compared to healthy controls. A greater percentage of people with schizophrenia (48%) were categorised into the elevated inflammatory biotype compared to healthy controls (33%). The magnitude of increase in IL-1β, IL-6, IL-8 and IL-10 mRNAs in people in the elevated inflammation biotype ranged from 100 to 220% of those in the non-elevated inflammatory biotype and was comparable between control and schizophrenia groups. Blood cytokine protein levels did not correlate with cytokine mRNA levels, and plasma levels of only two cytokines distinguished the elevated and low inflammatory biotypes, with IL-1β significantly increased in the elevated cytokine control group and IL-8 significantly increased in the elevated cytokine schizophrenia group. Conclusions: Our results confirm that individuals with schizophrenia are more likely to have elevated levels of inflammation compared to controls. We suggest that efforts to define inflammatory status based on peripheral measures need to consider both mRNA and protein measures as each have distinct advantages and disadvantages and can yield different results.
Schizophrenia Bulletin, 2017
proteomic approach was used to confirm this finding in a second ALSPAC age 11 cohort who did (n =... more proteomic approach was used to confirm this finding in a second ALSPAC age 11 cohort who did (n = 38) or did not (n = 66) report psychotic experiences, at age 18. Conclusion: We found that proteins involved in the Complement and Coagulation system are dysregulated in the blood during childhood long before the development of psychotic disorder. Although these findings need to be confirmed in independent and larger studies, future therapeutic strategies that target these processes in those at risk of developing psychotic disorder should be considered.
Schizophrenia Bulletin, 2017
Background: Cognitive deficits, a highly disabling feature of schizophrenia (SZ), are the stronge... more Background: Cognitive deficits, a highly disabling feature of schizophrenia (SZ), are the strongest predictor of functional outcome. Recent evidence points to thalamocortical circuitry as the culprit in SZ risk and cognitive deficits. Patients with SZ have reduced sleep spindles (bursts of 12-15 Hz electroencephalogram activity during non-rapid eye movement sleep), which are initiated by the thalamic reticular nucleus and propagated to and synchronized in the cortex via thalamocortical feedback loops. Sleep spindles mediate memory consolidation and are associated with impaired sleep-dependent memory consolidation and symptom severity in SZ. Here we used resting state functional magnetic resonance imaging (fMRI) to investigate whether spindle deficits in SZ are associated with changes in the connectivity of thalamocortical networks. Methods: Participants were chronic, medicated SZ patients (n = 26) and demographically matched healthy controls (HC, n = 29). The scanning protocol included resting-state fMRI (two 6-minute scans) and diffusion-weighted imaging on a 3T Siemens Trio scanner. We performed a seed-based functional connectivity analysis based on the FSL-Oxford thalamic connectivity atlas (7 thalamic seeds: prefrontal, premotor, primary motor, sensory, temporal, posterior parietal, and occipital). Following standard preprocessing, motion artifacts and physiological noise were regressed out, and functional connectivity was computed. All reported clusters survived a multiple comparison correction of pFDR <.05. Nocturnal sleep was monitored with polysomnography in a separate session. Sleep was scored according to standard criteria, and sleep spindles during N2 were identified using an automated wavelet spindle detector. Results: Connectivity between the thalamus and prefrontal cortices was reduced in SZ (MNI coordinates: x = 22, y = 46, z = −6; cluster size: 442 voxels; pFDR = .04). In contrast, connectivity between the thalamus and sensory motor cortices was increased in SZ (−38, −14, 48; cluster size: 4989 voxels; pFDR = .001). Patients showed consistent, widespread reductions in sleep spindle density that reached significance in a centroparietal cluster (pFDR = .042). Reduced spindle density predicted abnormal hyperconnectivity of the thalamus with sensory motor cortex in SZ (−32, −34, 52; cluster size: 257 voxels; pFDR = .007). Conclusion: This is the first demonstration that a prominent biomarker of SZ, sleep spindles, correlates with a regionally specific abnormality in sensory motor thalamocortical functional connectivity suggesting TRNmediated thalamocortical circuit dysfunction. This relationship between spindle density and sensory motor thalamocortical connectivity is in line with recent animal work showing that the firing of sensory projecting TRN neurons correlate with sleep spindles (Halassa et al., 2014). Future plans include complementing functional connectivity analysis with measurements of thalamocortical white matter integrity.
The Journal of Physiology, 1988
1. The activity of the two classes of motoneurones, primary and secondary, which innervate myotom... more 1. The activity of the two classes of motoneurones, primary and secondary, which innervate myotomal muscle fibres in the zebra fish, was monitored with electromyographic and intracellular techniques. 2. Simultaneous EMG and intracellular recordings from muscle fibres showed that the activity of the two motor systems and of individual primary motoneurones can be distinguished by recording EMG spikes during swimming. 3. Measurements of EMG spikes demonstrated that primary and secondary motoneurones are co‐ordinately activated over a wide range of conditions during normal swimming. 4. During swimming the primary motoneurones within a given segment are usually co‐activated although they sometimes fire independently. 5. When different primary motoneurones within a given segment are co‐activated, they fire nearly synchronously. 6. We conclude that the primary motoneurones are used principally, although not exclusively, during fast swimming, struggling and the startle response, whereas sec...
Early intervention in psychiatry, Jan 17, 2016
This study examined the prevalence of risk factors for cardiovascular (CV)-related morbidity and ... more This study examined the prevalence of risk factors for cardiovascular (CV)-related morbidity and mortality in young people with psychosis aged 18 to 24 years. The study included 132 people aged 18 to 24 years who participated in the 2010 second Australian national survey of people living with psychosis. The 2009 World Health Organisation (WHO) Global Health Risks report was used as a framework to determine which specific risk factors were present in each in these young people. The risk factors assessed in this study were smoking, alcohol use, hypertension, overweight/obesity, physical inactivity, high blood glucose, high cholesterol and poor diet. Each risk factor was defined according to WHO criteria. A count of the total number of risk factors present for each participant was determined. Data for male and female participants were compared. Young men had an average of 2.9 (SD 1.2) risk factors. Young women had an average of 2.4 (SD 1.2) risk factors. The most common risk factors we...
BMC Psychiatry, 2016
Background: Clozapine is an effective treatment for a proportion of people with schizophrenia (SZ... more Background: Clozapine is an effective treatment for a proportion of people with schizophrenia (SZ) who are resistant to the beneficial effects of other antipsychotic drugs. However, anything from 40-60 % of people on clozapine experience residual symptoms even on adequate doses of the medication, and thus could be considered 'clozapine resistant'. Agents that could work alongside clozapine to improve efficacy whilst not increasing the adverse effect burden are both desired and necessary to improve the lives of individuals with clozapine-resistant SZ. N-Acetylcysteine (NAC) is one such possible agent. Previous research from our research group provided promising pilot data suggesting the efficacy of NAC in this patient population. The aim of the study reported here is to expand this work by conducting a large scale clinical trial of NAC in the treatment of clozapine-resistant SZ. Methods: This study is an investigator initiated, multi-site, randomised, placebo-controlled trial. It aims to include 168 patients with clozapine-resistant SZ, divided into an intervention group (NAC) and a control group (placebo). Participants in the intervention group will receive 2 g daily of NAC. The primary outcome measures will be the negative symptom scores of the Positive and Negative Syndrome Scale (PANSS). Secondary outcome measures will include: changes in quality of life (QoL) as measured by the Lancashire Quality of Life Profile (LQoLP) and cognitive functioning as measured by the total score on the MATRICS. Additionally we will examine peripheral and cortical glutathione (GSH) concentrations as process outcomes. Discussion: This large scale clinical trial will investigate the efficacy of NAC as an adjunctive medication to clozapine. This trial, if successful, will establish a cheap, safe and easy-to-use agent (NAC) as a 'go to' adjunct in patients that are only partly responsive to clozapine. Trial registration: Australian and New Zealand Clinical Trials Registration Number: Current Randomised Controlled Trial ACTRN12615001273572. The date of registration 23 November 2015.
Frontiers in Psychiatry, 2016
Background: Obstructive sleep apnea (OSA) in the general community is associated with obesity, sm... more Background: Obstructive sleep apnea (OSA) in the general community is associated with obesity, smoking, alcohol, and sedative medication use and contributes to depressed mood, daytime sedation, and sudden cardiovascular deaths. Poor cardiovascular health, impaired social functioning, and negative and cognitive symptoms are also among the common clinical features of psychotic disorders. People with psychosis have higher rates of sleep disturbance; however, OSA has not been extensively investigated in this population. aims: This study aimed to determine the prevalence of OSA and general sleep disruption symptoms in a representative Australian sample of people with psychosis. We investigated the prevalence of potential risk factors for OSA, including obesity, psychotropic medications, and substance abuse in this population. Finally, we evaluated associations between symptoms of OSA, symptoms of general sleep disruption, and various clinical features in people with psychosis. Methods: Participants took part in the Second National Australian Survey of Psychosis, a population-based survey of Australians with a psychotic disorder aged 18-64 years. Symptoms associated with OSA (snoring and breathing pauses during sleep) in the past year were assessed using questions from the University of Maryland Medical Centre Questionnaire and symptoms associated with general sleep disruption in the past week using the Assessment of Quality of Life Questionnaire. Data collected included psychiatric diagnosis and symptoms, education, employment, medications, smoking status, physical activity, drug and alcohol use, and cognitive function. Physical health measures Demographics and social Participation Gender, age, marital status, formal study educational level, and current employment were recorded. Item to assess the participant's involvement in meaningful activity was extracted from the main interview schedule to assess: 0 = employed in any job in last 12 months; 1 = home duties/caring for own children; 2 = caring included body mass index, waist circumference, blood pressure, fasting blood glucose, and lipids. results: Snoring was reported by 41.9%; 7% stating they frequently stopped breathing (pauses) during sleep. Univariate logistic regressions show OSA symptoms (pauses and snoring) were associated with older age, female gender, lower levels of social participation or employment, cardiovascular risk factors, sedentary lifestyle, and poorer quality of life, while symptoms of general sleep disruption were more likely in people with depressive symptoms. conclusion: Australians with psychosis have high levels of sleep disturbance, including OSA. OSA symptoms were associated with cardiovascular disease risk factors, reduced social participation and employment, and poorer quality of life. Whether correction of OSA can improve these factors in people with psychosis remains to be determined.
Schizophrenia Research, 2015
To explore the diets of people living with psychotic disorders, and to compare their dietary comp... more To explore the diets of people living with psychotic disorders, and to compare their dietary composition to the general population. Method: 184 people with psychotic disorders in Adelaide, South Australia completed a food frequency questionnaire. Physical information and mental health status were collected. Outcome measures included energy and macronutrient intake; fish, sodium, fruit and vegetable intake; micro-nutrient intake; body mass index; waist circumference; and diagnoses of diabetes and hypertension. The RDI of nutrients was derived from Australian Government publications. Comparison dietary data was obtained from surveys carried out by the Australian Bureau of Statistics. Results: The majority of participants were overweight or obese (78%) and 77.5% met the criteria for at-risk waist circumference; and 58% of participants consumed salt and saturated fat in excess of the RDI. Most did not achieve the RDI for fruits and vegetables (97.8%), fibre (88.6%), fish (61.4%), magnesium (73.4%) or folate (86.4%). Women with psychosis had significantly higher intakes of vitamins and minerals compared to women in the general population. Men and women with psychosis consumed more daily total fat, saturated fat and sodium compared to adults in the Australian population, but lower fibre and vitamin E than their male and female counterparts. Conclusion: People with psychosis, especially women, report poor dietary choices including increased energy and fat intake, heightening their risk for cardiovascular disease. Women with psychosis report higher intake of vitamins and minerals than women in the general population. Whilst dietary intake contributes to obesity in psychosis, other factors including antipsychotic agents, decreased physical activity and smoking add to the cardiovascular risk.
Australian health review : a publication of the Australian Hospital Association, Jan 10, 2015
Objectives The aim of the present study was to document Australian policies on the physical healt... more Objectives The aim of the present study was to document Australian policies on the physical health of people with mental illness and evaluate the capacity of policy to support health needs. Methods A search of state and federal policies on mental and physical illness was conducted, as well as detailed analysis of policy content and the relationships between policies, by applying the World Health Organization Mental Health Action Plan 2013-2020 as an evaluative framework. Results National policy attention to the physical health of people with mental illness has grown, but there is little interconnection at the national and state levels. State policies across the country are inconsistent, and there is little evidence of consistent policy implementation. Conclusions A coherent national health policy framework on addressing co-occurring physical and mental illnesses that includes healthcare system reforms and ensuring the interconnectedness of other relevant services should be prioritis...