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Dive into the research topics where Hannah Newall is active.

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Featured researches published by Hannah Newall.


The Journal of Clinical Psychiatry | 2012

Tobacco use before, at, and after first-episode psychosis: a systematic meta-analysis.

Nicholas Myles; Hannah Newall; Jackie Curtis; Olav Nielssen; David Shiers; Matthew Large

OBJECTIVE Patients with first-episode psychosis have a high prevalence of tobacco use. We aimed to examine the prevalence and course of tobacco use during early psychosis using meta-analysis. DATA SOURCES Systematic search of MEDLINE (1948-2011), Embase (1947-2011), CINAHL (1984-2011), PsycINFO (1967-2011), and ISI Web of Science (1900-2011) using the search terms [psychosis OR schizophrenia] AND [tobacco OR smoking OR nicotine]. STUDY SELECTION We located 10 studies reporting the age at initiation of daily tobacco use and the age at onset of psychosis, 31 studies reporting prevalence of tobacco use in patients with first-episode psychosis, 10 studies comparing smoking to age-/gender-matched controls, and 7 studies reporting prevalence of tobacco use at intervals after treatment. DATA EXTRACTION The following data were extracted: age at initiation of daily tobacco use and at onset of psychosis, the proportion of patients with first-episode psychosis who used tobacco, the proportion of the general population who used tobacco, and the proportion of patients with psychosis who used tobacco at various intervals after initiation of antipsychotic treatment. RESULTS The pooled estimate for the interval between initiation of tobacco use and the onset of psychosis was 5.3 years (standardized mean difference = 0.85). The estimated prevalence of tobacco users in first episode of psychosis is 58.9% (95% CI, 54.3%-63.4%). There is a strong association between first-episode psychosis and tobacco use (OR = 6.04; 95% CI, 3.03-12.02) compared with healthy controls. The prevalence of tobacco use at intervals between 6 and 120 months after treatment remained unchanged (OR = 0.996; 95% CI, 0.907-1.094). CONCLUSIONS Patients with first-episode psychosis tend to have smoked for some years prior to the onset of psychosis, have high prevalence of tobacco use at the time of presenting for treatment, and are much more likely to smoke than aged-matched controls. Their apparent difficulty in quitting has implications for tobacco cessation programs and efforts to reduce cardiovascular disease among people with mental illness.


Australian and New Zealand Journal of Psychiatry | 2013

Systematic meta-analysis of individual selective serotonin reuptake inhibitor medications and congenital malformations

Nicholas Myles; Hannah Newall; Harvey Ward; Matthew Large

Context: It has been suggested that the commonly prescribed class of antidepressants selective serotonin reuptake inhibitors (SSRIs) are associated with birth defects. However, the teratogenic effect of individual SSRIs has not been previously compared using meta-analysis. Objective: To determine the strength of the association between individual SSRIs and major, minor, and cardiac malformation among infants born to women taking these medications. Data sources: Electronic search of CINAHL, EMBASE, Medline, PsycINFO, and ISI Web of Science using the search terms (SSRI OR antidepressant) AND (obstetric outcome OR malformation OR birth outcome OR teratogen), supplemented by manual searching of published references and requests of primary researchers for unpublished data. Study selection: There were 115 studies identified by electronic search and reviewed in full text, which yielded 16 papers reporting 36 data samples for major malformations, nine papers reporting 26 data samples for cardiac malformations, and four papers reporting seven data samples for minor malformations. Data synthesis: Fluoxetine (OR 1.14, 95% CI 1.01–1.30) and paroxetine (OR 1.29, 95% CI 1.11–1.49) were associated with increased risk of major malformations. Paroxetine was associated with increased risk of cardiac malformations (OR 1.44, 95% CI 1.12–1.86). Sertraline and citalopram were not significantly associated with congenital malformation. Between-sample heterogeneity was low and a range of methodological considerations had no significant impact on effect size. There was little evidence of publication bias. Conclusions: Fluoxetine and paroxetine should be avoided in the first trimester and among those at risk of an unplanned pregnancy.


Early Intervention in Psychiatry | 2012

The heart of the matter: cardiometabolic care in youth with psychosis

Jackie Curtis; Hannah Newall; Katherine Samaras

Aim: Weight gain, obesity and metabolic disturbances in youth with psychosis are significant contributors to the health burden of people with psychosis, with a two‐ to threefold increase in rates compared with the general population and a 20% reduction in life expectancy. Several studies have now described cardiometabolic benefits of a range of interventions, including a structured diet and exercise programmes and metformin for patients receiving antipsychotic medications. Despite the development of Australian consensus guidelines and screening algorithms to detect such metabolic abnormalities, there is a lack of guidelines for clinicians to determine appropriate, timely, targeted prevention and intervention to manage these complications in the youth population.


Early Intervention in Psychiatry | 2011

Metabolic abnormalities in an early psychosis service: a retrospective, naturalistic cross-sectional study

Jackie Curtis; Catherine Henry; Andrew Watkins; Hannah Newall; Katherine Samaras; Philip B. Ward

Aim: There is an increasing recognition of the impact of weight gain on the development of metabolic abnormalities in young people receiving atypical antipsychotic drugs for first‐episode psychosis. This study examined the prevalence of such abnormalities in a specialist early‐intervention community mental health team.


International Clinical Psychopharmacology | 2012

Efficacy of metformin for prevention of weight gain in psychiatric populations: a review

Hannah Newall; Nicholas Myles; Philip B. Ward; Katherine Samaras; David Shiers; Jackie Curtis

There is uncertainty with regard to the appropriate use of metformin for the prevention and management of second-generation antipsychotic-induced weight gain and metabolic abnormalities. We aim to systematically review the primary literature and to provide recommendations with regard to the use of metformin in psychiatric populations prescribed second-generation antipsychotics. The authors undertook a literature search of Medline, EMBASE, and PsycINFO using the search terms; antipsychotic OR atypical antipsychotic AND weight AND metformin. Narrative review was undertaken without additional statistical analysis. The search provided 198 results from which 10 original research papers were identified: six randomized controlled trials and one open-label study for adults and two randomized controlled trials and one open-label study for children and adolescents. Four meta-analyses were also identified. We concluded that if weight gain occurs after second-generation antipsychotic initiation, despite lifestyle intervention, metformin should be considered. Further studies with adequate statistical power are required to determine the efficacy of metformin in those with chronic psychotic illness.


Current Pharmaceutical Design | 2012

The Association between Cannabis Use and Earlier Age at Onset of Schizophrenia and other Psychoses: Meta-analysis of Possible Confounding Factors

Nicholas Myles; Hannah Newall; Olav Nielssen; Matthew Large

A recent meta-analysis showed that the mean age of onset of psychosis among cannabis users was almost three years earlier than that of non-cannabis users. However, because cannabis users usually smoke tobacco, the use of tobacco might independently contribute to the earlier onset of psychosis. We aimed to use meta-analysis to compare the extent to which cannabis and tobacco use are each associated with an earlier age at onset of schizophrenia and other psychoses. We also examined other factors that might have contributed to the finding of an earlier age of onset among cannabis users, including the proportion of males in the samples, the diagnostic inclusion criteria and aspects of study quality. The electronic databases MEDLINE, EMBASE, PsycINFO and ISI Web of Science, were searched for English-language peer-reviewed publications that reported age at onset of schizophrenia and other psychoses separately for cannabis users and non-users, or for tobaccosmokers and non-smokers. Meta-analysis showed that the age at onset of psychosis for cannabis users was 32 months earlier than for cannabis non-users (SMD=- 0.399, 95%CI -0.493 - -0.306, z=-8.34, p < 0.001), and was two weeks later in tobacco smokers compared with non-smokers (SMD=0.002, 95%CI -0.094 - 0.097, z=0.03, p=0.974). The main results were not affected by subgroup analyses examining studies of a single sex, the methods for making psychiatric diagnoses and measures of study quality. The results suggest that the association between cannabis use and earlier onset of psychosis is robust and is not the result either of tobacco smoking by cannabis using patients or the other potentially confounding factors we examined. This supports the hypothesis that, in some patients, cannabis use plays a causal role in the development of schizophrenia and raises the possibility of treating schizophrenia with new pharmacological treatments that have an affinity for endo-cannabinoid receptors.


Acta Psychiatrica Scandinavica | 2012

Considering metformin in cardiometabolic protection in psychosis.

Jackie Curtis; Hannah Newall; Nicholas Myles; David Shiers; Katherine Samaras

A 20% reduction in life expectancy is testament to the disproportionate burden of cardiovascular morbidity and mortality in psychiatric populations. Cardiovascular disease largely explains the mortality gap between those with schizophrenia and the general population, a gap that continues to widen (1). Lifestyle factors such as poor nutrition, obesity, cigarette smoking, substance abuse and sedentariness contribute to a complex set of cardiovascular risks. However, cardiometabolic disturbances and weight gain occur within weeks of first exposure to antipsychotic medications (2), a particular concern as psychotic disorders typically commence in youth at a vulnerable developmental phase and with a lifetime ahead. By the time this population reach their late 30s, rates of diabetes (10.2%) and prediabetes (37%) indicate that early weight gain and its attendant insulin resistance effect a biological path from normal glucose metabolism to disease (3). For young people with early psychosis, this means that not only can early weight gain influence a path towards obesity-related medical disorders, but it may limit ability to engage in healthy physical activities as basic as walking, as well as damaging self-worth and confidence to participate in active physical pursuits (4). In tackling or preventing cardiometabolic risk, a lifestyle programme to prevent weight gain at initiation of antipsychotic treatment is primary and fundamental. A multipronged approach is required, including healthy eating strategies, supervised caloric restriction for those gaining weight and sedentariness-reducing strategies. Another potential tool in our armamentarium is metformin, first line in treating type 2 diabetes mellitus and with established efficacy in euglycaemic disorders such as polycystic ovary syndrome. Twelve RCTs and three meta-analyses demonstrate that metformin alone or with lifestyle intervention can attenuate weight gain in normoglycaemic patients with psychosis commencing or receiving antipsychotic medications (5). The weight benefit translated to clinically meaningful improvements in cardiometabolic risk factors. The utility of these studies to influence practice is limited by low statistical power and relatively short study length. Nevertheless, in four adequately powered studies, metformin consistently improved weight and metabolic parameters for a variety of antipsychotics applicable to general psychiatric practice (5). These benefits were evident in the critical early phase following antipsychotic initiation in drugnaı̈ve, first-episode psychosis patients, regardless of the antipsychotic used. The review also observed that metformin plus lifestyle intervention was significantly more effective than metformin or lifestyle intervention alone: compared with placebo, metformin plus lifestyle gave a net weight reduction of 7.8 kg in as short a period as 12 weeks. The utility of metformin as a safe and cheap treatment for preventing diabetes in at-risk obese populations without psychiatric disease is established. In our view, patients with psychosis constitute another important at-risk group, similar to those with prediabetes: in particular, those on antipsychotic medications with significant weight gain and acquisition of cardiometabolic risk factors. Just as in the non-psychiatric atrisk population, metformin is not a solitary panacea. Early lifestyle intervention is an opportunity to modify the long-term health trajectory of a generation of at-risk psychiatric patients and should be primary. However, metformin addition increases the effectiveness of lifestyle intervention, at least in the short term. We suggest that metformin in concert with a structured, supervised lifestyle programme could be considered in the severely mentally ill when antipsychotic agents are initiated or in antipsychotic recipients who are overweight, obese or have elevated cardiometabolic risk factors. A precipitous rise in body weight, waist circumference or fasting glucose can be viewed similarly to an obese non-psychiatric patient with impaired glucose tolerance, where lifestyle and metformin intervention are considered acceptable. Furthermore, obesity has a disproportionately greater impact on the psychiatric patient s ability to exercise and their self-confidence to participate in physical activities (4). Taken alongside their greater likelihood of co-occurring hyperlipidaemia and tobacco smoking, then perhaps this psychiatric population should be considered at even greater cardiovascular risk and hence with a stronger justification for early intervention, than their equivalent obese non-psychiatric population. We believe the opportunity exists for medical practitioners to actively engage in cardiometabolic protection of people with schizophrenia, perhaps some of our most vulnerable patients. Early, pro-active intervention with lifestyle strategies and, where necessary, metformin may offer a primary preventative strategy in antipsychotic recipients. Actively protecting cardiometabolic health could be an efficient way to reduce clinical, social and economic burden in the psychiatric population. Is it time to extend the early intervention paradigm for treating first-episode psychosis to encompass the body as well as the mind?


Australian and New Zealand Journal of Psychiatry | 2014

Observation to action: progressive implementation of lifestyle interventions to improve physical health outcomes in a community-based early psychosis treatment program.

Simon Rosenbaum; Li Xian Lim; Hannah Newall; Jackie Curtis; Andrew Watkins; Katherine Samaras; Philip B. Ward

1 Early Psychosis Programme, The Bondi Centre, South Eastern Sydney Local Health District, Bondi Junction, Australia 2 School of Psychiatry, University of New South Wales, Randwick, Australia 3 Faculty of Medicine, University of New South Wales, Randwick, Australia 4 Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, Australia 5 Faculty of Health, University of Technology, Sydney, Sydney, Australia 6 Department of Endocrinology, St Vincent’s Hospital, Darlinghurst, Australia 7 Diabetes and Obesity Program, Garvan Institute of Medical Research, Darlinghurst, Australia 8 Schizophrenia Research Unit, South Western Sydney Local Health District, Liverpool, Australia


Acta Psychiatrica Scandinavica | 2013

Antipsychotic drug-treated patients best suited for metformin therapy. Reply.

Jackie Curtis; Hannah Newall; Nicholas Myles; David Shiers; Katherine Samaras

atypical antipsychotic-induced weight gain and glucose metabolism dysregulation: review of the literature and clinical suggestions. CNS Drugs 2010;24:193–206. 4. Hasnain M, Fredrickson SK, Vieweg WV. Metformin for obesity and glucose dysregulation in patients with schizophrenia receiving antipsychotic drugs. J Psychopharmacol 2011;25:715–721. 5. Wang M, Tong JH, Zhu G, Liang GM, Yan HF, Wang XZ. Metformin for treatment of antipsychotic-induced weight gain: a randomized, placebo-controlled study. Schizophr Res 2012;138:54–57. 6. Nathan DM, Davidson MB, Defronzo RA et al. Impaired fasting glucose and impaired glucose tolerance: implications for care. Diabetes Care 2007;30:753–759.


Social Psychiatry and Psychiatric Epidemiology | 2012

The age at onset of psychosis and tobacco use: a systematic meta-analysis

Nicholas Myles; Hannah Newall; Michael T. Compton; Jackie Curtis; Olav Nielssen; Matthew Large

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Jackie Curtis

University of New South Wales

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Katherine Samaras

St. Vincent's Health System

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Nicholas Myles

Institute of Medical and Veterinary Science

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Matthew Large

University of New South Wales

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Philip B. Ward

University of New South Wales

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Simon Rosenbaum

University of New South Wales

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