Mental disorders and their impact on academic performance in Australia: a matched population-based cohort study.

Objectives To compare scholastic performance and high school completion of young people hospitalised with a mental disorder compared to young people not hospitalised for a mental disorder by sex. Approach A population-based matched case-comparison cohort study of young people aged ≤18 years hospitalised for a mental disorder during 2005-2018 in New South Wales, Australia using linked birth, health, education and mortality records. The comparison cohort was matched on age, sex and residential postcode. Generalised linear mixed modelling examined risk of school performance below the national minimum standard (NMS) and generalised linear regression examined risk of not completing high school for young people with a mental disorder compared to matched peers. Results Young males with a mental disorder had over a 1.7 times higher risk of not achieving the NMS for numeracy (ARR: 1.71; 95%CI 1.35-2.15) and reading (ARR: 1.99; 95%CI 1.80-2.20) compared to matched peers. Young females with a mental disorder had around 1.5 times higher risk of not achieving the NMS for numeracy (ARR: 1.50; 95%CI 1.14-1.96) compared to matched peers. Both young males and females with a disorder had around a three times higher risk of not completing high school compared to peers. Young males with multiple disorders had up to a six-fold increased risk and young females with multiple disorders had up to an eight-fold increased risk of not completing high school compared to peers. Conclusions Early recognition and support could improve school performance and educational outcomes for young people who were hospitalised with a mental disorder. This support should be provided in conjunction with access to mental health services and school involvement and assistance

Impact of chronic health conditions and injury on school performance and health outcomes in New South Wales, Australia : a retrospective record linkage study protocol

Introduction: Children who have sustained a serious injury or who have a chronic health condition, such as diabetes or epilepsy, may have their school performance adversely impacted by the condition, treatment of the condition and/or time away from school. Examining the potential adverse impact requires the identification of children most likely to be affected and the use of objective measures of education performance. This may highlight educational disparities that could be addressed with learning support. This study aims to examine education performance, school completion and health outcomes of children in New South Wales (NSW), Australia, who were hospitalised with an injury or a chronic health condition compared with children who have not been hospitalised for these conditions. Method and analysis This research will be a retrospective population-level case-comparison study of hospitalised injured or chronically ill children (ie, diabetes, epilepsy, asthma or mental health conditions) aged ≤18 years in NSW, Australia, using linked health and education administrative data collections. It will examine the education performance, school completion and health outcomes of children who have been hospitalised in NSW with an injury or a chronic health condition compared with children randomly drawn from the NSW population (matched on gender, age and residential postcode) who have not been hospitalised for these conditions. Ethics and dissemination The study received ethics approval from the NSW Population Health Services Research Ethics Committee (2018HRE0904). Findings from the research will be published in peer-reviewed journals and presented at scientific conferences

Homicide during psychotic illness in New South Wales between 1993 and 2002

This paper analyses people charged with homicide offences committed during the acute phase of mental illness. High rates of drug misuse, especially of drugs known to induce psychotic illness and brain injury, were reported. Evolving auditory hallucinations and delusional beliefs that led the person to believe they were in danger were the symptoms strongly associated with lethal assault. The victims were mostly family members or close associates. Only nine of the victims were strangers, including three fellow patients. Most lethal assaults (69%) occurred during the first year of illness, and the first episode of psychotic illness was found to carry the greatest risk of committing homicide

Folie à deux homicide and the two-factor model of delusions

Introduction. Cases of folie à deux resulting in homicide challenge traditional definitions of delusions. Secondaries who abandon their beliefs soon after separation from a primary raise doubts about the status of their delusional beliefs at the time of the offence. In this paper, we apply the "two-factor" model of delusions to a series of cases of folie à deux resulting in homicide. Method. A retrospective analysis of five cases. Results. The primary affected person appeared to be the source of the delusional content in each of the cases. Impairment of belief evaluation was evident to some degree in all patients. There appeared to be a range of underlying causes of impaired belief evaluation. The transitory nature of the reported beliefs in some secondary cases suggested that they were due to motivational rather than neuropathological mechanisms. Social isolation contributed to the inability to critically appraise beliefs in most cases. Conclusion. The two-factor model is a useful method to contrast the emergence of a shared delusional belief in primary and secondary patients with folie à deux. Folie à deux demonstrates the need to consider the exogenous source of delusional content in many patients.19 page(s

Suicide in Australia: meta-analysis of rates and methods of suicide between 1988 and 2007

In 1997, there was a peak in the number of suicides in Australia, when 2720 deaths were classified as suicide. This study looks at some of the reasons why. In 1997, there was a peak in the number of suicides in Australia, when 2720 deaths were classified as suicide, giving an overall non-age-adjusted rate of 14.7 per 100 000. Over the next 10 years, the total number of suicides fell so that in 2007, 1880 deaths were classified as suicide, an overall non-age-adjusted rate of 8.9 per 100 000. Although the number of deaths from suicide fell, this does not appear to be the result of a decline in suicidal ideation or rates of attempted suicide. Objective: To examine the changes in rates of methods of suicide in Australian states and territories between 1988 and 2007. Design and setting: Meta-analysis of suicide mortality rates and suicide methods (hanging, shooting, gassing, poisoning, jumping from a height, drowning, use of a sharp implement) for males and females in Australian states and territories in the decades 1988–1997 and 1998–2007. Main outcome measures: Changes in use of suicide methods from 1988 to 2007; changes in the overall suicide rates and in rates for each method of suicide in Australian states and territories between 1988–1997 and 1998–2007. Results: There was a decline in rates of shooting, gassing, poisoning and drowning in males and a decline in shooting, gassing, jumping from a heiight and drowning among females, but an increase in hanging by both males and females in the decade 1998–2007 when the compared to 1988–1997. There was significant variation in the rates of and trends in methods of suicide between the states and territories of Australia between 1988–1997 and 1998–2007. Conclusions: The decline in rates of suicide in most parts of Australia coincides with a reduction in the availability of lethal methods. Consideration should be given to further measures to limit the availability of lethal methods of suicide