Steve Kisely | The University of Queensland, Australia (original) (raw)

Papers by Steve Kisely

Australian & New Zealand Journal of Psychiatry, 2022

Background: Perinatal depression is often underdiagnosed; consequently, many women suffer perinat... more Background: Perinatal depression is often underdiagnosed; consequently, many women suffer perinatal depression without follow-up care. Screening for depressive symptoms during the perinatal period has been recommended in Australia to increase detection and follow-up of women suffering from depressive symptoms. Screening rates have gradually increased over the last decades in Australia. Objective: To explore trends in referrals of women to community mental health services during the perinatal period, and prenatal and postnatal admissions to psychiatric units, among those who gave birth in Queensland between 2009 and 2015. Method: Retrospective analyses of data from three linked state-wide administrative data collections. Trend analyses using adjusted Poisson regression models examined 426,242 births. Outcome variables included referrals to specialised mental health services; women admitted with a mood disorder during the second half of their pregnancy and during the first 3 months of...

Evidence Based Mental Health, 2016

Evidence-based mental health, 2015

ABSTRACT FROM: Kayama M, Kido Y, Setoya N, et al . Community outreach for patients who have diffi... more ABSTRACT FROM: Kayama M, Kido Y, Setoya N, et al . Community outreach for patients who have difficulties in maintaining contact with mental health services: longitudinal retrospective study of the Japanese Outreach Model Project. BMC Psychiatry 2014;14:311. Intensive forms of community treatment for people with severe mental illness include Assertive Community Treatment (ACT) and Assertive Outreach (AO). They are characterised by caseloads of <20 patients per clinician. These interventions can reduce admissions to hospital, increase retention in care and improve social functioning, but the effect on mental state and quality of life is less clear.1 Any benefit is greatest for patients with high rates of hospital admission.1 There is less evidence when comparing less intensive forms of case management with standard care.1 Japan has not had a nationwide implementation of ACT and there are many patients who lose contact with mainstream services.2 Kayama and colleagues evaluated the effectiveness of the nationwide Japanese Outreach Model Project (JOMP), established in 2011 …

Australian Health Review, 2016

Objective The aim of the present study was to assess the effects of a community intervention aime... more Objective The aim of the present study was to assess the effects of a community intervention aimed at general practitioners (GPs) by comparing Medicare claims data from patients with severe mental illness (SMI) of GPs exposed to the intervention and controls that were not. Methods A comparison was made of primary care consultation and pathology data of people with SMI from intervention and control areas. Negative binomial regression models were used to compare the frequency and length of GP consultations, as well as the number and type of pathology examinations. Results Records of 103 people from intervention area and 98 controls were obtained. Intervention and control areas were not different at baseline in terms of age and claims data, but females had higher consultation rates. After adjusting for gender, people from intervention areas had more GP consultations, especially long consultations (adjusted incidence rate ratio 1.56; 95% confidence interval 1.28–1.91). They also had mor...

Journal of Psychiatric Research, 2020

International journal of mental health nursing, 2017

Improving the input of people with mental illness into their recovery plans can potentially lead ... more Improving the input of people with mental illness into their recovery plans can potentially lead to better outcomes. In the present study, we evaluated the introduction of motivational aftercare planning (MAP) into the discharge planning of psychiatric inpatients. MAP is a manualized intervention combining motivational interviewing with advance directives. We measured changes in the level of patient input into discharge planning following training staff in the use of MAP. This included the following: (i) documentation of early relapse signs along with successful past responses; (ii) evidence of aftercare planning; and (iii) the use of the patients' own words in the plan. We used a ward-level controlled before-and-after design comparing one intervention ward with two control wards. We used anonymized recovery plans, with a goal of 50 plans per ward before and after the intervention, to look for evidence of patient input into care planning with a standardized checklist. There were...

The Australian and New Zealand journal of psychiatry, Jan 11, 2015

People with chronic schizophrenia have high rates of physical ill-health such as heart disease. H... more People with chronic schizophrenia have high rates of physical ill-health such as heart disease. However, there has been less attention to the issue of poor oral health including dental caries (tooth decay) and periodontal (gum) disease, although both have consequences for quality of life and systemic physical health. We therefore measured tooth decay and gum disease in Malaysians with schizophrenia. We recruited long-stay inpatients with schizophrenia from June to October 2014. Four dental specialists assessed oral health using the decayed-missing-filled teeth index, the Community Periodontal Index of Treatment Needs and the Debris Index of the Simplified Oral Hygiene Index. Results were compared with the 2010 Oral Health survey of the general Malaysian population. A total of 543 patients participated (66.7% males, 33.3% females; mean age = 54.8 years [standard deviation = 16.0]) with a mean illness duration of 18.4 years (standard deviation = 17.1). The mean decayed-missing-filled ...

British Journal of Psychiatry Open, 2015

BackgroundClozapine causes significant metabolic disturbances including obesity and type 2 diabet... more BackgroundClozapine causes significant metabolic disturbances including obesity and type 2 diabetes. Recent evidence that reduced glucagon-like-peptide-1 (GLP-1) may contribute to aetiology of clozapine-associated metabolic dysregulation suggests a potential therapeutic role for GLP-1 agonists.MethodThis open-label, pilot randomised controlled trial evaluates the effect of exenatide in clozapine-treated obese adults who have schizophrenia, with or without poorly controlled diabetes. Sixty out-patients will be randomised to once weekly extended release exenatide or treatment as usual for 24 weeks.AimsTo evaluate the feasibility of larger studies regarding methodology, acceptability, tolerability and estimate efficacy for glycaemic control or weight loss. Secondary outcomes are psychosis severity and metabolic parameters.ConclusionsThis is the first trial investigating GLP-1 agonists for glycaemic control and weight loss in clozapine-treated patients with either diabetes or obesity. C...

Schizophrenia Research, 2015

The Australian and New Zealand journal of psychiatry, Jan 31, 2015

Studies of overall cancer incidence and mortality in psychiatric patients have had mixed results.... more Studies of overall cancer incidence and mortality in psychiatric patients have had mixed results. Some have reported lower than expected cancer incidence or mortality, while others have found no association or an increased risk depending on sample, psychiatric diagnosis, cancer site and methodology. Few studies have compared cancer incidence and mortality using the same population and methodology. A population-based record-linkage analysis to compare cancer incidence and mortality in psychiatric patients with that for the general Queensland population, using an historical cohort to calculate age- and sex-standardised rate ratios and hazard ratios. Mental health records were linked with cancer registrations and death records from 2002 to 2007. There were 89,992 new cancer cases, of which 3349 occurred in people with mental illness. Cancer incidence was the same as the general population for most psychiatric disorders. Rates were actually lower for dementia (hazard ratio = 0.77; 95% c...

Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2010

to investigate the burden of excess mortality among people with mental illness in developed count... more to investigate the burden of excess mortality among people with mental illness in developed countries, how it is distributed, and whether it has changed over time. we conducted a systematic search of MEDLINE, restricting our attention to peer-reviewed studies and reviews published in English relating to mortality and mental illness. Because of the large number of studies that have been undertaken during the last 30 years, we have selected a representative cross-section of studies for inclusion in our review. there is substantial excess mortality in people with mental illness for almost all psychiatric disorders and all main causes of death. Consistently elevated rates have been observed across settings and over time. The highest numbers of excess deaths are due to cardiovascular and respiratory diseases. With life expectancy increasing in the general population, the disparity in mortality outcomes for people with mental illness is increasing. without the development of alternative a...

BMJ (Clinical research ed.), Jan 21, 2013

To examine the mortality experience of psychiatric patients in Western Australia compared with th... more To examine the mortality experience of psychiatric patients in Western Australia compared with the general population. Population based study. Western Australia, 1985-2005. Psychiatric patients (292,585) registered with mental health services in Western Australia. Trends in life expectancy for psychiatric patients compared with the Western Australian population and causes of excess mortality, including physical health conditions and unnatural causes of death. When using active prevalence of disorder (contact with services in previous five years), the life expectancy gap increased from 13.5 to 15.9 years for males and from 10.4 to 12.0 years for females between 1985 and 2005. Additionally, 77.7% of excess deaths were attributed to physical health conditions, including cardiovascular disease (29.9%) and cancer (13.5%). Suicide was the cause of 13.9% of excess deaths. Despite knowledge about excess mortality in people with mental illness, the gap in their life expectancy compared with ...

Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2008

There are conflicting data on cancer incidence and mortality in psychiatric patients, although mo... more There are conflicting data on cancer incidence and mortality in psychiatric patients, although most studies suggest that while cancer mortality is higher, incidence is no different from that in the general population. Different methodologies and outcomes may account for some of the conflicting results. We investigated the association between mental illness and cancer incidence, first admission rates, and mortality in Nova Scotia using a standard methodology. A population-based record-linkage study of 247,344 patients in contact with primary care or specialist mental health services during 1995 to 2001 was used. Records were linked with cancer registrations and death records. Cancer mortality was 72% higher in males (95%CI, 63% to 82%) and 59% higher in females (95%CI, 49% to 69%) among patients in contact with mental health services. This was reflected in similarly elevated first admission rates. However, there was weaker and less consistent evidence for increased incidence. For sev...

Australian & New Zealand Journal of Psychiatry, 2013

ABSTRACT We present an argument for revival of the ethos of scientific research in psychiatry in ... more ABSTRACT We present an argument for revival of the ethos of scientific research in psychiatry in the form of practical wisdom, known in ancient Greek philosophy as phronesis. In his Nicomachean Ethics, Aristotle describes several states of knowledge. These include: craft expertise (techne) or the knowledge derived from skilful practice; science (episteme) or the knowledge derived from deduction; intuition (nous) or the knowledge derived from experience; theoretical wisdom (sophia) or the understanding of universals; and practical wisdom (phronesis) or the understanding of particulars (Aristotle, 1934). While each of these modes of knowledge can be observed within psychiatry to some extent, it is phronesis in the guise of sound clinical judgement that defines not just competence (enkrateia), but excellence (arete), in the practice of psychiatry.

Conclusions: Les TUS sont très fréquemment co-occurrents dans les cas de TDM. Les cliniciens et l... more Conclusions: Les TUS sont très fréquemment co-occurrents dans les cas de TDM. Les cliniciens et les services de santé mentale devraient envisager une évaluation de routine des troubles liés à l&amp;#x27;utilisation d&amp;#x27;une substance chez les patients souffrant de dépression.

Conclusions: Il ya presque une double différence dans le type de service utilisé pour des raisons... more Conclusions: Il ya presque une double différence dans le type de service utilisé pour des raisons de SM dans les provinces. Le système médical général des soins primaires est le service le plus largement utilisé pour la SM. Le besoin demeure le prédicteur le plus fort ...