Principal Investigator: Austin
The impact of antidepressants in pregnancy has been of great concern to both women and clinicians. There is now evidence that mild and short-lived withdrawal symptoms can arise in a small proportion of infants. However the degree of exposure in pregnancy and the impact on longer-term neurobehavioural outcomes is not so well documented. This study based at the Royal Hospital for Women in Sydney is examining these questions and a multicentre study is now being planned to increase recruitment capacity.
Principal Investigator: Breakspear
The overarching goal for this project is to develop video and audio-based technology for the analysis of facial expression and speech content, in order to advance the diagnosis and treatment of major depression. Despite the disorder’s high prevalence and associated disability, existing diagnosis and management relies heavily on self-report and the judgement of clinicians with no current laboratory-based techniques allowing the measurement of illness expression, course or recovery. These limitations compromise optional patient management and have hampered the development of objective markers of end-points for intervention within both clinical and research settings. This project will address such limitations by developing an objective means of identifying emotional expression in a cohort of healthy controls, as a suitable match to participants with mood disorders.Furthermore this project will add to a better understanding of emotional expression as a function of speech content, cognitive load and interpersonal context. Ultimately we hope that the development of these automated laboratory-base indices can be implemented in a format suitable for portable laptop and webcam use, so that clinicians and patients can employ this technology in an effort to better identify and monitor illness severity and clinical response. The present project will develop a normative database for comparison with mood disordered groups.
Principal Investigator: Brodaty, Lee-Fay Low, Lynn Chenoweth, Richard Fleming, Peter Spitzer
The Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE) is a randomised controlled trial of humour therapy. About 400 residents from 36 hostels and nursing homes will be randomly assigned to receive the SMILE treatment or usual care. ElderClowns will visit weekly for 12 weeks, and staff volunteers will be trained to be LaughterBosses and bring humour to daily care routines. SMILE will evaluate whether humour therapy improves resident quality-of-life and mood, and reduces staff turnover. The Clowns-in-Residence: Cases Under Study (CIRCUS) substudy will additionally train four low care residents to co-administer humour.
Principal Investigator: Loo
Neural plasticity describes the brain’s ability to change, to adapt to injury or other environmental factors. These changes are known to take place during growth and maturation and may further develop through learning and use. We hope to learn whether this ability to change is impaired when someone is depressed, and whether recovery from depression is accompanied by a return to normal levels of brain 'plasticity'. In this study, we will test brain plasticity in the motor cortex, using Transcranial Magnetic Stimulation. This involves the use of brief magnetic pulses to activate the brain. Each testing sessions takes about 2.5 hours. Both depressed people and those who are healthy with no history of depression are sought for this study.
Principal Investigator: Loo
Mild brain stimulation (also known as direct current stimulation, DCS) is a potential alternative to medication and electroconvulsive therapy for depressed patients. Very weak currents are used to stimulate the brain through the scalp. The stimulation is painless with no known serious side effects. Subjects will be fully awake and alert during the 30 minute treatment. tDCS is currently being offered as a treatment in research studies by the University of NSW, at the Black Dog Institute building, on site of Prince of Wales Hospital, Sydney. The study is particularly suitable for those seeking an alternative to medication or who are unable to tolerate medications or ECT.
Principal Investigator: Loo
Recent studies overseas have reported dramatic improvement from depression within hours of a single treatment with ketamine. In these studies, the effect of ketamine appeared stronger and much more rapid in onset than conventional antidepressant medications. Ketamine is a medical drug used for anaesthesia, sedation and pain relief. The study is approved by the University of New South Wales and will be conducted at Wesley Hospital in Kogarah.
Principal Investigator: Manicavasagar
An innovative maintenance treatment for bipolar disorder is now being offered that aims to reduce relapse of bipolar episodes as well as reduce levels of stress and anxiety. Mindfulness meditation has been shown to reduce rates of relapse in unipolar depression but this has yet to be investigated in bipolar disorder.
The program involves random allocation to either mindfulness-based cognitive therapy or treatment as usual (with the addition of bipolar education material). The therapy will be conducted in a group run by psychologists and is held on a weekly basis for 8 weeks in Randwick.
Principal Investigator: Manicavasagar
Mindfulness is a way of being in the present, non-judgementally. We are hoping to compare mindfulness scores between people with bipolar disorder, depression and those who have not been diagnosed with these conditions.
Principal Investigator: Mitchell
A common cause of relapse in the management of bipolar disorder is
poor medication adherence – which correlates with low levels of acceptance
of illness and high levels of denial. While several psychosocial treatments
have been developed for bipolar disorder, they do not focus upon the difficulties
in acceptance of, and adaptation to illness. We have developed a novel psychological
intervention for bipolar disorder, modified from schema-focused cognitive therapy,
and commenced a pilot evaluation (funded by Rotary) of its efficacy, using a
randomised controlled trial (comparing to treatment as usual). Once this trial
is completed, further interventions will be tested, after determining the predictors
of optimal response and identifying the critical components of therapy.
Principal Investigator: Multiple studies with differing Principal
Investigators
Most researchers are involved in undertaking Randomised Controlled
Trials (RCTs) of antidepressant and mood stabiliser medications designed and
sponsored by various pharmaceutical companies. A number of the researchers are
on Australian and International advisory bodies for the development of new drugs.
Principal Investigator: Parker
Cognitive Behavioural Therapy (CBT) involves teaching people skills and strategies to manage negative thoughts and behaviours that are associated with depression. CBT has been studied for over 20 years, and there is good evidence that it is effective as a treatment for depression. However, researchers are still not sure how CBT works in helping depression. Mindfulness Based Cognitive Therapy (MBCT) is a new variant of CBT, which involves teaching people to make simple shifts in their awareness of thoughts, feelings and bodily sensations. MBCT has been shown to be effective in preventing relapse, but has not yet been used as a treatment for depression. This study will compare group MBCT and CBT as treatments for depression, and examine how these treatments work.
Principal Investigator: Parker
This study explores cognitive and coping styles in different mood disorders. The way individuals think about stressful situations influences mood and coping behaviours, which in turn are influenced by personality, beliefs and attitudes. Psychological therapies target these aspects to assist with management of mood. Little is known about how these factors operate in different mood disorders, and research suggests such factors may be important predictors of relapse. Information from this study may provide insight into what specific aspects of psychological therapy work best in preventing relapse for different types of mood disorders.
Principal Investigator: Parker
The purpose of this study is to develop a standardised assessment measure
which might be used by general practitioners and other health practitioners
to develop a diagnostic and formulation template to assist management decisions.
Principal Investigator: Parker
A recent study of patients referred to the Black Dog Institute’s Depression Clinic indicated that of those diagnosed with a primary mood disorder, a sizeable proportion received a diagnosis of bipolar disorder for the first time. Since no formal research has been undertaken to determine the impact of a first-time diagnosis of bipolar disorder, including the direct and indirect outcomes and the benefits associated with receiving a diagnosis – this study is designed to address these questions.
Principal Investigator: Parker
In addition to involvement in large RCTs, three small studies will
pursue our clinical observations, examining
Principal Investigator: Parker
This research aims to determine whether changing the treatment paradigm from a drug to a non-drug (i.e. psychological) approach will result in improved outcomes for those with a unipolar, non-melancholic depression. By altering the primary treatment approach, we hypothesise that more positive outcomes will occur.
Principal Investigator: Parker
Identification of depression may be confounded in patients with a medical
illness by the presence of illness-related factors. The 10-item Depression in
the Medically Ill [DMI-10] instrument is a self-report measure designed for
use in this population. Numerous studies of its properties are being undertaken.
Principal Investigator: Proudfoot
As many as 65% of Australian adults with mental health problems do not access services for their problems. This study is evaluating an innovative program developed by the Black Dog Institute to help people monitor and manage stress, anxiety and depression. The program is delivered via the web on participants’ own mobile phones and computers. It is suitable for all mobile phones that are internet-enabled. The study involves use of the program for 7 weeks and the completion of 3 questionnaires over 19 weeks.
Principal Investigator: Sachdev
The vagus nerve connects the brain to visceral organs such as the heart,
lungs and the gastrointestinal tract. It carries a large amount of information
from the body organs to the brain that has an impact on limbic activity Stimulation
of the Vagus Nerve has been known for some time to control epilepsy. More recent
studies have shown that such stimulation can help depression as well. Two studies
of VNS for resistant depression have been conducted in the United Sates, and
a trial was recently started in Europe. The efficacy of this treatment remains
to be established, but if successful, it will be great advance in the management
of very treatment-resistant patients. We plan an open label, non-randomized,
single-arm, longitudinal study of up to 25 patients, following them for 18 weeks
in the first instance, and for a lengthier period for those who choose to remain
in the study.
Principal Investigator: Wilhelm
Depression is the second highest cause of medical morbidity (behind
heart disease) and most cases are seen in general practice. Undetected cases
of depression cause increased medical and psychiatric morbidity, use of unnecessary
investigations. We pursue several different case-finding strategies, including
use of the DMI-10 measure.
Principal Investigator: Wilhelm
Deliberate self harm (DSH) accounts for 1-5% of public hospital admissions
but follow-up is challenging. Causes are being studied.
Principal Investigator: Wilhelm
Patients with a mix of depression and multiple somatic complaints have
multiple attendances in general practice and hospital outpatient clinics and
generate multiple medical investigations. Previous studies have identified such
patients as more likely to have a depressive or anxiety disorder, often neither
recognised nor treated. We propose to test a particular intervention in an innovative
treatment comparison study.
Principal Investigator: Wilhelm
Our study of sex differences in the expression of depression led to
qualitative focus group studies and models for examining how men and women cope
with depression. We will study a novel intervention (the use of narrative) to
invoke mastery. If the writing technique proves effective, we will test other
techniques (eg problem solving and other self-mastery techniques), building
on work demonstrating the importance of patient choice.
Principal Investigator: Vijaya Manicavasagar
Research in bipolar disorder has suggested that recovery from the illness consists of a three-pronged approach involving medication, information/education about the disorder, and having a plan or strategy to remain well.
This research examines the latter two psychosocial approaches to recovery in bipolar disorder by way of an 8-session Wellbeing Group Program that combines psychoeducation with the development of an individualised comprehensive Wellbeing Plan across sessions, for adults (20 – 70 years) diagnosed with bipolar II disorder. The groups will be run at the Black Dog Institute in Randwick, NSW.
Depression and Bipolar Disorder Information Australia - Black Dog Institute.Copyright © 2012 Black Dog Institute
Page last updated: 2-Apr-2012
