Kirsten J. Hancock

The gap in life expectancy from preventable physical illness in psychiatric patients in Western Australia: Retrospective analysis of population based registers

Objective To examine the mortality experience of psychiatric patients in Western Australia compared with the general population. Design Population based study. Setting Western Australia, 1985-2005. Participants Psychiatric patients (292 585) registered with mental health services in Western Australia. Main outcome measures Trends in life expectancy for psychiatric patients compared with the Western Australian population and causes of excess mortality, including physical health conditions and unnatural causes of death. Results When using active prevalence of disorder (contact with services in previous five years), the life expectancy gap increased from 13.5 to 15.9 years for males and from 10.4 to 12.0 years for females between 1985 and 2005. Additionally, 77.7% of excess deaths were attributed to physical health conditions, including cardiovascular disease (29.9%) and cancer (13.5%). Suicide was the cause of 13.9% of excess deaths. Conclusions Despite knowledge about excess mortality in people with mental illness, the gap in their life expectancy compared with the general population has widened since 1985. With most excess deaths being due to physical health conditions, public efforts should be directed towards improving physical health to reduce mortality in people with mental illness, in addition to ongoing efforts to prevent suicide.

Contact, configural coding and the other-race effect in face recognition

The other-race effect (ORE) in face recognition describes a well-established finding of better recognition for own-race than other-race faces. Although widely thought to reflect differences in contact between own- and other-race faces, little is known about how different contact levels relate to changes in processing of those faces. This study investigated how contact affects the size of the ORE and the use of expert configural face-coding mechanisms. Using inversion decrements as an index of configural coding, we predicted that increased self-reported contact would be associated with greater use of configural-coding mechanisms. Chinese and Caucasian participants varying in contact with other-race faces were recruited. The Chinese participants also varied in their length of residence in a Western country. Results showed that higher levels of contact were associated with a reduction in the ORE in both face recognition and configural coding. Importantly, smaller cross-race differences in configural coding were also associated with a smaller ORE in face recognition.

Higher maternal protectiveness is associated with higher odds of child overweight and obesity: a longitudinal Australian study.

In recent years there has been an increasing interest in overprotective parenting and the potential role it plays in child development. While some have argued that a trend towards increased parental fear and reduced opportunity for independent mobility may be linked to increasing rates of child overweight and obesity, there is limited empirical information available to support this claim. Using data from the Longitudinal Study of Australian Children, this study aimed to examine the longitudinal relationships between maternal protectiveness and child overweight and obesity. A cohort of 4–5 year old children was followed up at 6–7, 8–9 and 10–11 years of age (n  =  2596). Measures included a protective parenting scale administered when children were 6–7 and 8–9 years of age, child body mass index (BMI), family characteristics including household income, neighbourhood disadvantage, childs position amongst siblings, and maternal BMI, education, employment, mental health and age at first birth. International Obesity Taskforce age- and sex-specific BMI cut points were used to determine if children were in the normal, overweight or obese BMI range. There was no association between maternal protectiveness and the odds of children being overweight or obese at age 4–5, 6–7 or 8–9 years. However at age 10–11 years, a 1 standard deviation increase in maternal protectiveness was associated with a 13% increase in the odds of children being overweight or obese. The results provide evidence of a relationship between maternal protectiveness and child overweight and obesity, however further research is required to understand the mechanism(s) that links the two concepts.

Playgroup Participation and Social Support Outcomes for Mothers of Young Children: A Longitudinal Cohort Study

Objective This study aimed to examine friendship networks and social support outcomes for mothers according to patterns of playgroup participation. Methods Data from the Longitudinal Study of Australian Children were used to examine the extent to which patterns of playgroup participation across the ages of 3–19 months (Wave 1) and 2–3 years (Wave 2) were associated with social support outcomes for mothers at Wave 3 (4–5 years) and four years later at Wave 5 (8–9 years). Analyses were adjusted for initial friendship attachments at Wave 1 and other socio-demographic characteristics. Results Log-binomial regression models estimating relative risks showed that mothers who never participated in a playgroup, or who participated at either Wave 1 or Wave 2 only, were 1.7 and 1.8 times as likely to report having no support from friends when the child was 4–5 years, and 2.0 times as likely to have no support at age 8–9 years, compared with mothers who persistently participated in playgroup at both Wave 1 and Wave 2. Conclusion These results provide evidence that persistent playgroup participation may acts as a protective factor against poor social support outcomes. Socially isolated parents may find playgroups a useful resource to build their social support networks.

Two methods for engaging with the community in setting priorities for child health research: who engages?

Objective The aims of this study were to assess participatory methods for obtaining community views on child health research. Background Community participation in research is recognised as an important part of the research process; however, there has been inconsistency in its implementation and application in Australia. The Western Australian Telethon Kids Institute Participation Program employs a range of methods for fostering active involvement of community members in its research. These include public discussion forums, called Community Conversations. While participation levels are good, the attendees represent only a sub-section of the Western Australian population. Therefore, we conducted a telephone survey of randomly selected households to evaluate its effectiveness in eliciting views from a broader cross-section of the community about our research agenda and community participation in research, and whether the participants would be representative of the general population. We also conducted two Conversations, comparing the survey as a recruitment tool and normal methods using the Participation Program. Results While the telephone survey was a good method for eliciting community views about research, there were marked differences in the profile of study participants compared to the general population (e.g. 78% vs 50% females). With a 26% response rate, the telephone survey was also more expensive than a Community Conversation. The cold calling approach proved an unsuccessful recruitment method, with only two out of a possible 816 telephone respondents attending a Conversation. Conclusion While the results showed that both of the methods produced useful input for our research program, we could not conclude that either method gained input that was representative of the entire community. The Conversations were relatively low-cost and provided more in-depth information about one subject, whereas the telephone survey provided information across a greater range of subjects, and allowed more quantitative analysis.

Cancer and mental illness

Over many years, it has been shown that cancer represents a significant proportion of excess mortality for people with mental illness. In this chapter, we probe this relationship in more detail, and examine the progression of factors that play a role in this finding. Against expectations, people with mental illness are no more likely to develop cancer, even though they have higher exposure to major risk factors including smoking, drug and alcohol use, and obesity. However, even though people with mental illness are just as likely to be diagnosed with cancer, they are more likely to die from it. The reasons for this are multifactorial, including lower rates of routine cancer screening (either because it is not recommended or people with mental illness do not follow through on the recommendation to do so), the increased length of time it takes to be diagnosed after presenting with symptoms, more advanced stage at diagnosis including metastatic cancer at diagnosis, and reduced likelihood of surgical intervention. We discuss the complexities associated with providing medical care for people with comorbid psychiatric disorders and the difficulties faced both by people with mental illness and the people who provide them with medical care.

The Diverse Risk Profiles of Persistently Absent Primary Students: Implications for Attendance Policies in Australia

ABSTRACT The risk factors associated with absenteeism are well known. However, childrens exposure to combinations of risks and how these relate to absence patterns remains unclear. Understanding variations in risk profiles among persistently non-attending children will inform the development of absence interventions. Using a longitudinal sample of Australian children (6–11 years), a latent class analysis of 19 risks identified four classes of risk exposure. Most children (56%) were exposed to minimal risk, 20% were exposed to parenting, child development, and mental health risks only, 15% were exposed to a greater extent to financial risks only, and 9% had a higher probability of exposure to all risks. Persistently non-attending children were eight times more likely to be in the high-risk group than regular attenders. However, one-third of persistent non-attenders were classified as low-risk. The heterogeneity of risk profiles is discussed in relation to policies using financial penalties to motivate improved attendance.

Longitudinal trajectories of mental health in Australian children aged 4-5 to 14-15 years

Mental health can affect young people’s sense of wellbeing and life satisfaction, their ability to participate in employment and education, and their onward opportunities in life. This paper offers a rare opportunity to longitudinally examine mental health in a population-representative study of children aged 4–5 years to 14–15 years. Using data from the Longitudinal Study of Australian Children (LSAC), this study examined maternally-reported child mental health over a 10 year period, in order to understand their initial mental health status early in life and its change over time, as measured by the Strengths and Difficulties Questionnaire. Longitudinal models were fitted from ages 4–5 to 14–15 years. Results showed that child sex, maternal mental health, socio-economic status (family income, maternal education, neighbourhood disadvantage), maternal hostility, and child temperament (persistence, sociability, reactivity) are all independent contributors to child mental health at age 4. These effects largely persist over time, with the effects of maternal mental health increasing slightly over time. Persistence of these effects suggests the need for early intervention and supports. The independent contribution of these factors to child mental health suggests that multi-faceted approaches to child and maternal mental health are needed.

Mental health problems among 4–17-year-olds with hearing problems : results from a nationally representative study

Abstract Objective: This study aimed to characterize the risk of mental health problems among a representative sample of 6,310 4–17-year-olds, 147 of whom had parent-reported hearing problems. Methods: The study used data from the Young Minds Matter survey. The Diagnostic Interview Schedule for Children (DISC-IV) assessed prevalence of mood, anxiety and behavioural disorders. The Strengths and Difficulties Questionnaire (SDQ) assessed social and emotional problems. Logistic regression models were used to estimate odds of having mental health problems adjusting for child factors (speech and language problems, global health, age and gender), family factors (family structure, parent income, education, financial strain and psychological distress) and school-related factors (bullying, school liking, school absence). Results: In unadjusted analyses, children and young people with hearing problems had substantially higher odds of most mental health problems. Hearing problems were not associated with any mental health problem among 4–11-year-olds after adjusting for other child factors. After adjustments for child, family and school-related factors, 12–17-year-olds with a hearing problem remained at greater risk of social phobia and generalized anxiety (DISC-IV), and of peer and emotional problems (SDQ). Conclusions: Clinicians caring for children and young people with hearing problems should be alert for heightened risk of specific mental health problems based on age and the nature of hearing problems. Understanding a wider range of correlates associated with the higher prevalence of mental health problems may allow health professionals to be more informed about the nature of mental health problems that are comorbid to hearing problems.

School absence and its effect on school performance for children born with orofacial clefts

BACKGROUND School absence is associated with lower performance on standardized tests. Children born with orofacial clefts (OFC) are likely to have more absence than children without OFC; however, school absence for children with OFC has not been quantified. We aimed to describe school absence and its relationship with school performance for children with and without OFC. METHODS Population-based record-linked cohort study of children (402 with OFC, 1789 without OFC) enrolled in schools in Western Australia, 2008 to 2012. We compared median school absence rates using Wilcoxon rank tests, and investigated the impact of school absence on standardized scores from reading, numeracy, and writing tests, using multivariable models fitted by generalized estimating equations. RESULTS In Semester 1, at each primary school year level, children without OFC and children with cleft lip only or cleft palate only had similar median absence rates (approximately 1 week). Children with cleft lip and palate had significantly higher absence rates in Years 4 to 6 (between 1 and 2 weeks). During secondary school, median absence rates were higher (2 weeks) for all children, but not statistically different between children with and without OFC. Higher absence was significantly associated with lower standardized reading, numeracy, and writing scores. However, having a cleft of any type had little influence on the association between absence and test scores. CONCLUSION School absence affected school performance for all children. Absence did not differentially disadvantage children born with OFC, suggesting current practices to identify and support children with OFC are minimizing effects of their absence on school performance. Birth Defects Research 109:1048-1056, 2017.