Post-traumatic stress disorder in the Australian Defence Force: estimating prevalence from defence electronic health system records.

Objective: To estimate the prevalence of post-traumatic stress disorder (PTSD) in serving members of the Australian Defence Force (ADF) in the year 2015-2016.

Methods: The electronic health records of serving members of the ADF were screened for the term PTSD over a 12-month period. A 10% sample of these records were examined alongside a randomised matched sample of records.

CowMesh: a data-mesh architecture to unify dairy industry data for prediction and monitoring.

Dairy is an economically significant industry that caters to the huge demand for food products in people's lives. To remain profitable, farmers need to manage their farms and the health of the dairy cows in their herds. There are, however, many risks to cow health that can lead to significant challenges to dairy farm management and have the potential to lead to significant losses.

An exploration of actigraphy in the context of ketamine and treatment-resistant depression.

Objectives: This study explored the potential of non-parametric and complexity analysis metrics to detect changes in activity post-ketamine and their association with depressive symptomatology.

Methods: Individuals with treatment-resistant depression (TRD: n = 27, 16F, 35.9 ± 10.

Australian Defence Force Centre for Mental Health Second Opinion Clinic - first ten years of operation.

Objectives: The aim is to report the operation of the Australian Defence Force Centre for Mental Health (ADFCMH) Second Opinion Clinic (SOC) after its first 10 years of operation.

Method: Demographic data and clinical data were recorded and analysed for all Australian Defence Force (ADF) personnel (=209) seen at the clinic from 2011 to 2021.

Results: Assessment at the clinic led to a change in diagnosis from that given at the time of referral in 40.

Veteran homelessness in Australia: What do we know? What has been done? What do we need to do?

Objective: We report on the extent of veteran homelessness in Australia, what has already been done to address it and what actions are recommended to further improve the response.

Conclusions: Work conducted by not-for-profit organisations and the Department of Veterans' Affairs are outlined with positive prospects for significant coordinated action to further address the situation reported.

Effect of massed v. standard prolonged exposure therapy on PTSD in military personnel and veterans: a non-inferiority randomised controlled trial.

Background: A short, effective therapy for posttraumatic stress disorder (PTSD) could decrease barriers to implementation and uptake, reduce dropout, and ameliorate distressing symptoms in military personnel and veterans. This non-inferiority RCT evaluated the efficacy of 2-week massed prolonged exposure (MPE) therapy compared to standard 10-week prolonged exposure (SPE), the current gold standard treatment, in reducing PTSD severity in both active serving and veterans in a real-world health service system.

Methods: This single-blinded multi-site non-inferiority RCT took place in 12 health clinics across Australia.

The relationship between the HDRS insomnia items and polysomnographic (PSG) measures in individuals with treatment-resistant depression.

The Hamilton Depression Rating Scale (HDRS), which includes several insomnia-related items, is potentially valuable in evaluating both depressive and sleep symptoms. However, the HDRS insomnia items have not been fully assessed by objective measures. This study compared the three HDRS insomnia items (Early, Middle, and Late) with the corresponding objective polysomnography (PSG) measures of Sleep Latency (SL), middle wakefulness, and late wakefulness.

Australian military and veterans' mental health care: improving assessment of military personnel and veterans.

Objective: To describe key practical knowledge and skill components required for clinicians involved with the assessment of military personnel and veterans.

Conclusions: Assessment of military and veterans' mental health issues involves a tailored history-taking process that includes specific aspects of service, transition and reporting requirements. Recommendations for the detailed assessment of military personnel and veterans are provided.

Keeping military in mind: The Royal Australian & New Zealand College of Psychiatrists' Military and Veterans' Mental Health Network.

Objective: The objective of this study is to introduce The Royal Australian & New Zealand College of Psychiatrists (RANZCP) Military and Veterans' Mental Health Network (The Network) and profile its inaugural members.

Methods: We implemented an online survey of demographic, professional and practice characteristics of network members; self-rated knowledge of military and veterans' mental health; reasons for joining The Network; and suggestions as to how The Network could best support members' needs. Quantitative survey responses were analysed descriptively.

Australian military and veteran's mental health care part 1: an introduction to cultural essentials for clinicians.

Objective: This article aims to define the cultural specificity of Australian military and veterans, and introduce some of the essential clinician knowledge, skills and attitudes required for effective cultural competence in the management of mental health (MH) conditions in this population.

Conclusion: Military culture has the defining characteristics of the military as an organisation with a formal structure, as a cultural group governed by norms and shared values, and as a social group that provides people with identities. Key requirements for cultural competence introduced here are basic knowledge of the military structure, norms and identity; clinical skills including basic assessment and awareness of the commonly occurring MH disorders; and an exploration of attitudes of both the clinician and the military or veteran patient.

Outlier Detection in Health Record Free-Text using Deep Learning.

In recent years, machine learning approaches have been successfully applied to analysis of patient symptom data in the context of disease diagnosis, at least where such data is well codified. However, much of the data present in Electronic Health Records (EHR) is unlikely to prove suitable for classic machine learning approaches. In particular, the use of free (or unstructured) text for clinical notes presents significant analytical opportunities, but also unique difficulties.

Twenty-four-hour motor activity and body temperature patterns suggest altered central circadian timekeeping in Smith-Magenis syndrome, a neurodevelopmental disorder.

Smith-Magenis syndrome (SMS) is a contiguous gene syndrome linked to interstitial microdeletion, or mutation of RAI1, within chromosome 17p11.2. Key behavioral features of SMS include intellectual disability, sleep-disturbances, maladaptive, aggressive and self-injurious behaviors, hyperactivity, and sudden changes in mood.

Are 24-hour motor activity patterns associated with continued rapid response to ketamine?

Purpose: This study examined the links between 24-hour activity patterns (specifically, amplitude and timing of wrist activity) and the persisting qualities of clinical antidepressant response to the glutamatergic modulator ketamine.

Methods: Twenty-four-hour activity patterns were compared across 5 days of 24-hour activity rhythms in patients with major depressive disorder who displayed either a brief antidepressant response (24-48 hours), a continued antidepressant response (>72 hours), or no antidepressant response to ketamine. These postinfusion-response profiles were then used retrospectively to examine cohort-specific fitted parameters at baseline, postinfusion day 1 (D1), and postinfusion D3.

Ketamine-Induced Glutamatergic Mechanisms of Sleep and Wakefulness: Insights for Developing Novel Treatments for Disturbed Sleep and Mood.

Ketamine, a drug with rapid antidepressant effects and well-described effects on slow wave sleep (SWS), is a useful intervention for investigating sleep-wake mechanisms involved in novel therapeutics. The drug rapidly (within minutes to hours) reduces depressive symptoms in individuals with major depressive disorder (MDD) or bipolar disorder (BD), including those with treatment-resistant depression. Ketamine treatment elevates extracellular glutamate in the prefrontal cortex.

The changing face of posttraumatic stress disorder in modern warfare.

Objectives: This study examined aspects of modern warfare and determined whether they have changed the clinical presentation of posttraumatic stress disorder (PTSD).

Conclusions: The relationship between PTSD, mild traumatic brain injury, unmanned aerial vehicle operations and women in combat examined. It was concluded that there are significant changes in how contemporary combat veterans may present with PTSD.

Motor-Activity Markers of Circadian Timekeeping Are Related to Ketamine's Rapid Antidepressant Properties.

Background: The rapid clinical antidepressant effects of the glutamatergic modulator ketamine may be due to its ability to restore synaptic plasticity and related effects on sleep-wake and circadian systems. Preclinical studies indicate that ketamine alters expression of circadian clock-associated molecules, and clinical studies of ketamine on plasticity-related biomarkers further suggest an association with sleep slow waves and sleep homeostasis.

Methods: Wrist-activity monitors were used to examine the pharmacologic and rapid antidepressant effects of ketamine on markers of circadian timekeeping (amplitude and timing) in mood disorders.