Objectives: To assess the public's recognition of mental disorders and their beliefs about the effectiveness of various treatments (“mental health literacy”). Design: A cross‐sectional survey, in 1995, with structured interviews using vignettes of a person with either depression or schizophrenia. Participants: A representative national sample of 2031 individuals aged 18–74 years; 1010 participants were questioned about the depression vignette and 1021 about the schizophrenia vignette. Results: Most of the participants recognised the presence of some sort of mental disorder: 72% for the depression vignette (correctly labelled as depression by 39%) and 84% for the schizophrenia vignette (correctly labelled by 27%). When various people were rated as likely to be helpful or harmful for the person described in the vignette for depression, general practitioners (83%) and counsellors (74%) were most often rated as helpful, with psychiatrists (51%) and psychologists (49%) less so. Corresponding data for the schizophrenia vignette were: counsellors (81%), GPs (74%), psychiatrists (71%) and psychologists (62%). Many standard psychiatric treatments (antidepressants, antipsychotics, electroconvulsive therapy, admission to a psychiatric ward) were more often rated as harmful than helpful, and some nonstandard treatments were rated highly (increased physical or social activity, relaxation and stress management, reading about people with similar problems). Vitamins and special diets were more often rated as helpful than were antidepressants and antipsychotics. Conclusion: If mental disorders are to be recognised early in the community and appropriate intervention sought, the level of mental health literacy needs to be raised. Further, public understanding of psychiatric treatments can be considerably improved.
SYNOPSISThe IQCODE is a questionnaire which asks an informant about changes in an elderly person's everyday cognitive function. The questionnaire aims to assess cognitive decline independent of pre-morbid ability. In the present study, the IQCODE was administered to a sample of 613 informants from the general population. In addition, the questionnaire was administered to informants of 309 dementing subjects who had filled it out one year previously. A principal components analysis, using the general population sample, confirmed that the IQCODE measures a general factor of cognitive decline. The questionnaire was found to have high internal reliability in the general population sample (alpha = 0-95) and reasonably high test-retest reliability over one year in the dementing sample (r = 0-75). The total IQCODE score, as well as each of the 26-items, was found to discriminate well between the general population and dementing samples. The correlation with education was quite small (r = -0-13), indicating that contamination by premorbid ability is not a problem.
Objective To evaluate the efficacy of two internet interventions for community-dwelling individuals with symptoms of depression-a psychoeducation website offering information about depression and an interactive website offering cognitive behaviour therapy. Design Randomised controlled trial. Setting Internet users in the community, in Canberra, Australia. Participants 525 individuals with increased depressive symptoms recruited by survey and randomly allocated to a website offering information about depression (n = 166) or a cognitive behaviour therapy website (n = 182), or a control intervention using an attention placebo (n = 178). Main outcome measures Change in depression, dysfunctional thoughts; knowledge of medical, psychological, and lifestyle treatments; and knowledge of cognitive behaviour therapy. Results Intention to treat analyses indicated that information about depression and interventions that used cognitive behaviour therapy and were delivered via the internet were more effective than a credible control intervention in reducing symptoms of depression in a community sample. For the intervention that delivered cognitive behaviour therapy the reduction in score on the depression scale of the Center for Epidemiologic Studies was 3.2 (95% confidence interval 0.9 to 5.4). For the "depression literacy" site (BluePages), the reduction was 3.0 (95% confidence interval 0.6 to 5.2). Cognitive behaviour therapy (MoodGYM) reduced dysfunctional thinking and increased knowledge of cognitive behaviour therapy. Depression literacy (BluePages) significantly improved participants' understanding of effective evidence based treatments for depression (P < 0.05). Conclusions Both cognitive behaviour therapy and psychoeducation delivered via the internet are effective in reducing symptoms of depression.
Objective: The article gives an introductory overview of the use of the Delphi expert consensus method in mental health research. It explains the rationale for using the method, examines the range of uses to which it has been put in mental health research, and describes the stages of carrying out a Delphi study using examples from the literature. Method:To ascertain the range of uses, a systematic search was carried out in PubMed. The article also examines the implications of 'wisdom of crowds' research for how to conduct Delphi studies. Results:The Delphi method is a systematic way of determining expert consensus that is useful for answering questions that are not amenable to experimental and epidemiological methods. The validity of the approach is supported by 'wisdom of crowds' research showing that groups can make good judgements under certain conditions. In mental health research, the Delphi method has been used for making estimations where there is incomplete evidence (e.g. What is the global prevalence of dementia?), making predictions (e.g. What types of interactions with a person who is suicidal will reduce their chance of suicide?), determining collective values (e.g. What areas of research should be given greatest priority?) and defining foundational concepts (e.g. How should we define 'relapse'?). A range of experts have been used in Delphi research, including clinicians, researchers, consumers and caregivers. Conclusion:The Delphi method has a wide range of potential uses in mental health research.
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