Research Higher Degree Projects
We are currently offering research higher degree projects in the following areas:
- heart disease and psychosis
- trauma and psychosis
- stress and psychosis
- ultra high risk for psychosis
- anxiety and schizophrenia
- depression in young people
- metabolic monitoring and psychosis
Explaining the elevated risk for heart disease in young people with psychosis
This is a treatment study of young people with psychosis. The project is currently funded by the Heart Foundation and focuses on risk factors for heart disease in 16-25 year olds at entry to a psychosis treatment centre and tracks change in those risk factors after initiation of treatment with antipsychotic drugs. The psychosis service is based in Dandenong in south eastern Melbourne. Potential students would need to be able to travel to Dandenong. Skills acquired could include work within a specialised psychosis treatment centre, assessment of psychiatric symptoms, side effects of psychotropic drugs, drug use histories, demographics and collection of biospecimens including DNA and serum. An opportunity exists for a highly motivated student who is interested in youth mental health and its relationship to physical health outcomes to work on a project under the supervision of Dr Debra Foley from the Biostatistics Unit at Orygen Youth Health Research Centre and Centre for Youth Mental Health, University of Melbourne. Other investigators associated with project include Professor Andrew Mackinnon, Professor Stephen Harrap, Associate Professor Brendan Murphy and Dr Kate Morley.
Contact for more information: Dr Debra Foley, dfoley@unimelb.edu.au
The prevalence of childhood trauma in an ultra high risk for psychosis population
In recent years there has been a significant amount of research interest in the relationship between childhood trauma and psychotic symptoms, such as hallucinations and delusions. High levels of childhood trauma have been reported in first episode and chronic psychotic populations. However, the issue of prevalence of childhood trauma in young people identified as being at “ultra high risk” (UHR) of psychosis (i.e., in the putatively prodromal phase) has not been widely researched. A recent file audit conducted at the PACE clinic, Orygen Youth Health indicated high levels of childhood trauma (about 70%) in an ultra high risk cohort. The UHR population is a valuable group in which to investigate the relationship between trauma and psychosis because it may shed light on the etiological relationship between trauma and psychosis in a prospective cohort. To date, the relationship between trauma and psychosis has generally been investigated retrospectively, which introduces a number of contaminating and biasing factors. The current study will be a cross-sectional study of the prevalence of childhood trauma in a UHR cohort involved in a clinical trial at the PACE clinic, Orygen Youth Health. Prevalence of trauma in this group will be compared with prevalence of trauma in a matched non-clinical control group.
Contact for more information: Dr Barnaby Nelson, nelsonb@unimelb.edu.au
Longitudinal study of childhood trauma and development of psychotic disorder
In recent years there has been a significant amount of research interest in the relationship between childhood trauma and development of psychosis. Some authors hypothesise that previous trauma is a significant aetiological factor in the development of a psychotic disorder. To date, the relationship between trauma and psychosis has generally been investigated retrospectively, which introduces a number of contaminating and biasing factors. Young people identified as being at “ultra high risk” (UHR) of psychosis (i.e., in the putatively prodromal phase) are a valuable group in which to investigate the relationship between trauma and psychosis because they report a high rate of trauma but are not all destined to develop a psychotic disorder and generally do not have some of the same confounding issues inherent in retrospective studies of psychotic populations. The study would use data regarding previous trauma collected from a large clinical multi-site trial and examine whether particular trauma is related to development of a psychotic disorder. The study could also include investigation of psychological styles (also collected in the trial) that might act as a mediating factor in the relationship between previous trauma and development of psychosis. The project could additionally recruit a control group from within Orygen Youth Health and compare types of trauma and psychological styles between the groups to determine whether this influences the types of psychiatric symptoms experienced.
Contact for more information: Dr Barnaby Nelson, nelsonb@unimelb.edu.au
The relationship between biological and subjective measures of stress and psychiatric symptoms in an ultra high risk for psychosis cohort
Researchers have hypothesised that stress plays an important role in the onset and maintenance of psychotic disorders. The ultra high risk (UHR) for psychosis population is a valuable population in which to investigate the relationship between these variables. The current study is a cross-sectional investigation of the relationship between biological measures of stress (salivary cortisol measures), subjective experience of stressful events, and psychiatric symptoms in a UHR cohort at the PACE clinic, Orygen Youth Health. It is hypothesized that there will be a positive relationship between biological and subjective measures of stress and that both of these variables will be positively correlated with general psychiatric symptoms.
Contact for more information: Dr Barnaby Nelson, nelsonb@unimelb.edu.au
Does daily stress and coping affect clinical outcome in the ultra high risk for psychosis population?
Researchers have hypothesised that stress plays an important role in the onset and maintenance of psychotic disorders. The ultra high risk (UHR) for psychosis population is a valuable population in which to investigate the relationship between these variables. The Experience Sampling Method (ESM) is an ecologically valid method of assessing daily stress and coping. The current study will involve assessing stress and coping using the ESM in a UHR population involved in a clinical trial of fish oil versus placebo. It is hypothesized that: i) higher stress and poorer coping will be associated with worse symptomatic and functional outcome and ii) UHR patients taking fish oil will show reduced stress-sensitivity over time than UHR patients on placebo.
Contact for more information: Dr Barnaby Nelson, nelsonb@unimelb.edu.au
Are antidepressant medications effective in reducing transition to full threshold psychosis in a UHR (putatively prodromal) population?
Individuals presenting with an “at risk mental state” (otherwise known as an Ultra High Risk (UHR) psychosis population) are at a greatly increased risk for developing a frank psychosis than the general population. This has led to efforts to investigate treatments that will stop or delay a “transition” to a fully psychotic state. Authors have suggested that antidepressants such as SSRI’s may be effective in the role, although there has not been a randomized controlled trial undertaken in this population as it could be seen as unethical to withhold antidepressant treatment from a group who have a particularly high rate of depression. One way of further investigating the effectiveness of these medications would be to conduct a naturalistic study comparing those prescribed antidepressants and those not controlling for potential confounders. The proposed study will collect data on antidepressant use from a larger multi-site trial comparing omega 3 fish oil fish to placebo. It will be possible to compare the outcome of those in the placebo group who were prescribed antidepressants compared to those who were not.
Contact for more information: Dr Andy Thompson, Andy.Thompson@mh.org.au
Anxiety symptoms and disorders in schizophrenia
Anxiety disorders such as generalized anxiety disorder, post-traumatic stress disorder, and social phobia are estimated to be prevalent in patients with schizophrenia. Further, it has been argued that anxiety symptoms may be an inherent characteristic of schizophrenia. However, the nature characteristics of anxiety in patients with first episode schizophrenia are poorly understood. Thus, the aim of this project will be to determine the prevalence, characteristics and stability of anxiety (symptoms and disorder) in patients with first episode schizophrenia. The psychometric properties of measures of anxiety will also be examined. The student will develop an understanding of the issue of comorbidity in schizophrenia as well as an appreciation of measurement issues in psychiatry.
Contact for more information: Dr Sue Cotton, smcotton@unimelb.edu.au
Pilot study of an intervention to reduce weight gain and metabolic disturbance in youth with a first episode of psychosis
Weight gain and metabolic disturbances have been shown to be a particular problem in individuals, especially those with first episode of psychosis taking new generation antipsychotic medications. However, a previous trial has demonstrated that a psychological intervention can be effective in reducing weight gain in those taking antipsychotics for established psychotic disorder. The proposed study would aim to adapt and pilot an intervention in a youth population experiencing their first episode of a psychotic illness at Orygen Youth Health. It would involve designing and delivering the intervention, including focus groups with young people to gain a consumer perspective of what would be helpful, and testing its effectiveness by using pre and post outcome measurement of weight and metabolic parameters.
Contact for more information: Dr Andy Thompson, Andy.Thompson@mh.org.au
Improving the management of depression in young people
While clinical practice guidelines exist for the management of depression in young people, it has been shown that the recommendations in such guidelines are often not incorporated into real world clinical practice. The proposed study would measure the effectiveness of new resources aimed at helping clinicians to manage and treat young people with a depressive disorder according to guideline recommendations, and seek to investigate the role of attitudes and beliefs in affecting any demonstrated change in practice. It would involve a clinical file audit at Orygen Youth Health to measure current practice, which would be compared to a previous audit already undertaken.
Contact for more information: Dr Sarah Hetrick, shetrick@unimelb.edu.au
Ensuring best practice for youth mental health disorders in a specialist setting
Significant research evidence exists for the use of specific psychological therapy with young people who have serious mental health disorders. This research evidence is reflected in clinic practice guidelines, yet, it is unclear whether this is what is delivered to young people in every day clinical practice at Orygen Youth Health. The proposed study would examine what interventions clinicians are delivering in each of the clinics at Orygen Youth Health, ascertain what the barriers are delivering evidence based psychological interventions, and designing a strategy to improve the rate at which evidence based psychological interventions are delivered. The effectiveness of this strategy would be investigated using a before and after design.
Contact for more information: Dr Andy Thompson, Andy.Thompson@mh.org.au