Kay A Wilhelm

The University of Notre Dame Australia

This educational article was written in the context of GPs, but we hope supports any clinician who is writing a complex health and/ or mental health referral. The article is: https://medicinetoday.com.au/.../making-time-count... NOTE: The Medicine Today Group now offers free online subscriptions to all health and medical practitioners registered w...

Background Olfactory deficits have a diverse etiology and can be detected with simple olfactory tests. Key olfactory pathways are located within the frontal and temporal lobes where they are vulnerable to damage due to head trauma. Orbitofrontal cortex (OFC) integrity is important for olfaction and aspects of behavioral regulation. We measured olfa...

and Keywords Expressive writing (EW) was developed in the 1980s by Pennebaker and colleagues, who defined it as "writing focusing on traumatic, stressful or emotional events, and the feelings inspired by these." There have been developments in terms of process, covering a range of instructions, target groups, and writing conditions and, more recent...

Background Traumatic brain injury (TBI) is a major public health problem that may be associated with numerous behavioral problems, including impulsivity, aggression and violence. Rates of self-reported TBI are high within offender populations, but the extent to which TBI is causally implicated in causing illegal behavior is unclear. This study exam...

Background : Frailty is associated with adverse outcomes in advanced heart failure. We studied the impact of frailty on post-operative outcomes in bridge to transplant (BTT) durable mechanical circulatory support (MCS) recipients. Methods : Patients undergoing left ventricular assist device (LVAD, n=96) or biventricular support (BiV, n=11) as BTT...

Objective This study evaluated the effectiveness of a short-term outpatient DBT (DBT-S) skills group for individuals experiencing pervasive emotion dysregulation (PED). Method Pre-and post-group outcome data consisted of self-report measures and six-month Mental Health admissions and Emergency Department presentations. Results Group completers re...

Introduction: Considerable evidence supports an association between poor impulse control (impulsivity) and violent crime. Furthermore, impulsivity and aggression has been associated with reduced levels of serotonergic activity in the brain. Selective serotonin reuptake inhibitors (SSRIs) are a class of anti-depressants that aim to regulate brain s...

Objectives To characterise cognitive performance and olfaction in recovered COVID-19 patients. Methods Patients underwent cognitive, olfaction and mental health assessments 2 months after initial SARS-CoV-2 infection as part of the Sydney St. Vincent’s Hospital ADAPT study, a prospective cohort study. Cognition was assessed with the Cogstate compu...

Background: The study aimed to determine whether the addition of cognitive impairment, depression, or both, to the assessment of physical frailty (PF) is associated with the risk of lung transplant (LTX) waitlist mortality. Methods: Since March 2013, all patients referred for LTX evaluation underwent PF assessment. Cognition was assessed using t...

BACKGROUND The internet is increasingly seen as an important source of health information for consumers and their families. Accessing information related to their illness and treatment enables consumers to more confidently discuss their health and treatments with their doctors, but the abundance of readily available information also means can be co...

Background: Clinicians need to be able to assess the quality of the available information to aid clinical decision-making. The internet has become an important source of health information for consumers and their families. Objective: This study aimed to rate the quality of websites with psychosis-related information (to provide clinicians with a...

Background: The aim of this study was to validate our previous finding that frailty predicts early mortality in patients with advanced heart failure (AHF) and that including cognition in the frailty assessment enhances the prediction of mortality. Methods: Patients with AHF referred to our Transplant Unit between November 2015 and April 2020 und...

Objectives The impact of psychiatric emergency care centres (PECCs) on ED mental health (MH) presentations has not been presented. We aim to compare demographics, diagnosis and admission frequency of patients presenting to an inner‐city ED with MH complaints, before and for several years after the opening of a PECC. Methods We collected ED patient...

Background Despite increasing awareness of high rates of physical illness and poor lifestyle behaviours among patients with a history of repeated deliberate self-harm (DSH), there is little research on specific lifestyle factors that are potentially problematic for this group. This paper aims to explore the relationship between lifetime repeated DS...

BACKGROUND Frailty is prevalent in the patients with advanced heart failure; however, its impact on clinical outcomes after heart transplantation (HTx) is unclear. The aim of this study was to assess the impact of pre-transplant frailty on mortality and the duration of hospitalization after HTx. METHODS We retrospectively reviewed the post-transpl...

Este artículo establece un marco para considerar los aspectos éticos relacionados con el tratamiento involuntario en personas con: a) una discapacidad intelectual o del desarrollo; b) un impedimento neurológico progresivo, y c) un estado mental comprometido desde el punto de vista del cuidador. Los diferentes momentos de decision de los tres grupos...

Background Mental disorders are overrepresented in prisoners, placing them at an increased risk of suicide. Advancing our understanding of how different mental disorders relate to distinct stages of the suicidal process—the transition from ideation to action—would provide valuable information for clinical risk assessment in this high-risk populatio...

Background: Frailty contributes to increased morbidity and mortality in patients referred for and undergoing lung transplantation (LTX). The study aim was to determine if frailty is reversible after LTX in those classified as frail at LTX evaluation. Methods: Consecutive LTX recipients were included. All patients underwent modified physical frai...

Introduction In Australia, an estimated 90% of those entering prison are current tobacco smokers and three-quarters of current prisoners are tobacco smokers. Aims To identify factors and their relative contributions to smoking cessation among male prisoners. Methods A total of 425 male tobacco smokers with a median age of 32 years in Australian p...

BACKGROUND People with type 2 diabetes often experience mental health symptoms that impair functioning, exacerbate illness and increase mortality risk. Access to psychological support is typically low in people with type 2 diabetes. Detection of depression is variable in the primary care setting and can be further impacted by the stigma attached to...

Background People with type 2 diabetes mellitus (T2DM) often experience mental health symptoms that exacerbate illness and increase mortality risk. Access to psychological support is low in people with T2DM. Detection of depression is variable in primary care and can be further hampered by mental health stigma. Electronic mental health (eMH) progra...

Purpose Despite increasing awareness of high rates of physical illness and poor lifestyle behaviours among patients with a history of suicidality (suicidal ideation and behaviours), there is little research on specific lifestyle factors that are potentially problematic for this group. This paper aims to explore the relationship between frequency of...

Identification of mental health risk is important for optimising diabetes care in type 2 diabetes mellitus (T2DM). Personality is linked to diabetes health and may assist detection of individuals with T2DM most at risk of chronic mental health difficulties. This study examined the moderator effect of personality factors on changes in psychological...

Background: E-mental health (eMH) interventions are now widely available and they have the potential to revolutionize the way that health care is delivered. As most health care is currently delivered by primary care, there is enormous potential for eMH interventions to support, or in some cases substitute, services currently delivered face to face...

Intentional drug overdoses with antidepressant and antipsychotic medications are an increasingly common problem. Currently, there is little guidance with regard to reintroduction of these medications after intentional overdoses. We have used published toxicological and pharmacokinetic data to obtain factors which control the recovery from overdoses...

Background: The high prevalence of diabetes distress and subclinical depression in adults with type 1 and type 2 diabetes mellitus (T1DM and T2DM, respectively) indicates the need for low-intensity self-help interventions that can be used in a stepped care approach to address some of their psychological needs. However, people with diabetes can be...

BACKGROUND The high prevalence of diabetes distress and subclinical depression in adults with type 1 and type 2 diabetes mellitus (T1DM and T2DM, respectively) indicates the need for low-intensity self-help interventions that can be used in a stepped care approach to address some of their psychological needs. However, people with diabetes can be re...

BACKGROUND e-mental health (eMH) interventions are now widely available and they have the potential to revolutionise the way that health care is delivered. As most health care is currently delivered by primary care, there is enormous potential for eMH interventions to support, or in some cases substitute, for services currently delivered face to fa...

BACKGROUND Depressive symptoms are common in people with type 2 diabetes and exacerbate disease burden through increased social and occupational impairment and greater morbidity and mortality. Effective depression treatments exist, however rates of depression screening in type 2 diabetes are variable, access to psychological support is characterist...

Background: Depressive symptoms are common in people with type 2 diabetes mellitus (T2DM). Effective depression treatments exist; however, access to psychological support is characteristically low. Web-based cognitive behavioral therapy (CBT) is accessible, nonstigmatizing, and may help address substantial personal and public health impact of como...

This handbook provides a comprehensive, up-to-date overview of the science of stress and mental health. Topics covered include assessment issues, the role of stress in various mental disorders, developmental influences and individual difference factors that predict reactivity to stress, and treatment of stress-related mental health problems. Decade...

Objectives: The aim of this study was to identify mental health and lifestyle factors predicting smoking among people at high risk of suicidal behaviour. Methods: Participants ( n = 363) completed self-report mental health and lifestyle measures at first appointment in a hospital clinic following presentation to the emergency department for deli...

Background: Young people with type 1 diabetes are at increased risk of mental disorders. Whereas treatment need is high, difficulty recruiting young people with type 1 diabetes into psychosocial studies complicates development, testing and dissemination of these interventions. Objective: Interviews with young adults with type 1 diabetes were con...

Background: Men generally have higher rates of suicide, despite fewer overt indicators of risk. Differences in presentation and response suggest a need to better understand why suicide prevention is less effective for men. Objective: To explore the views of at-risk men, friends and family about the tensions inherent in suicide prevention and to...

Background: Previous research has identified that men experiencing depression do not always access appropriate health services. Web-based interventions represent an alternative treatment option for men, are effective in reducing anxiety and depression, and have potential for wide dissemination. However, men do not access Web-based programs at the...

Background: Depressive symptoms are common in people with type 2 diabetes and contribute to adverse health consequences that substantially impact social and vocational function. Despite the existence of effective depression treatments, the majority of people with type 2 diabetes do not access these when needed. Web-based alternatives to more tradi...

Interpersonal therapy is a useful tool for the treatment of patients with depression and other mental disorders. A shorter version is available for GPS, which offers a more tailored intervention and greater treatment options.

Background Depression is twice as common in diabetes mellitus (DM) as the general population and is associated with adverse health outcomes, but access to evidence-based therapies such as cognitive behavioral therapy (CBT) is limited in routine diabetes care. Past research has shown that generic Internet-based cognitive behavioral therapy (iCBT) is...

Background. We recently reported that frailty is independently predictive of increased mortality in patients with advanced heart failure referred for heart transplantation (HTx). The aim of this study was to assess the impact of frailty on short-term outcomes after bridge-to-transplant ventricular assist device (BTT-VAD) implantation and/or HTx and...

Background Diabetes mellitus is Australia’s fastest growing chronic disease, and has high comorbidity with depression. Both subthreshold depression and diabetes distress are common amongst people with type 1 or type 2 diabetes, and are associated with poorer diabetes self-care. A need exists for low-intensity self-help interventions for large numbe...

Aim: While the impact of major depression on diabetes has gained increasing attention, the role of minor depression is less well investigated. This observational study compared three groups of adults with Type 1 (T1DM) or Type 2 (T2DM) diabetes mellitus: with me) no depressive symptoms (NODEP), ii) mild depressive symptoms (MILD) and iii) moderate-...

Rates of self-harm in Australia are increasing and constitute a concerning public health issue. Although there are standard treatment pathways for physical complaints, such as headache, abdominal pain and chest pain, in Emergency Medicine, there is no national pathway for self-harm or other psychiatric conditions that present to the emergency depar...

Purpose: Early relationships formed between parent and child are thought to guide the child's feelings, thoughts and expectations in subsequent adult relationships. We examined the relationship between two four category models of perceptions of parenting and adult attachment style among a nonclinical cohort. Parenting style was assessed using the P...

Background: The aim of this study was to identify whether the addition of cognitive impairment, depression, or both, to the assessment of physical frailty provides better outcome prediction in patients with advanced heart failure referred for heart transplantation (HT). Methods: Beginning in March 2013, all patients with advanced heart failure r...

Purpose: Although patients demonstrate a range of problematic health-related lifestyle behaviours preceding suicidal behaviour, there is little research that routinely measure these behaviours. This paper seeks to establish the utility of health-related lifestyle measure (Fantastic Lifestyle Checklist) in people presenting to a major inner city Em...

Background: Men are at greater risk than women of dying by suicide. One in eight will experience depression - a leading contributor to suicide - in their lifetime and men often delay seeking treatment. Previous research has focused on men's use of unhelpful coping strategies, with little emphasis on men's productive responses. The present study ex...

Introduction: Depression substantially contributes to the personal burden and healthcare costs of living with diabetes mellitus (DM). Comorbid depression and DM are associated with poorer quality of life, poorer self-management and glycemic control, increased risk for DM complications and higher mortality rates, and higher health service utilizati...

Background: Frailty is a clinically recognized syndrome of decreased physiological reserve. The heightened state of vulnerability in these patients confers a greater risk of adverse outcomes after even minor stressors. Our aim was to assess the prevalence and prognostic significance of the frailty phenotype in patients referred for heart transplan...

Objectives Men are almost two times more likely to die by suicide than women, yet little research has focused on what is required to prevent suicide among men. This paper aims to investigate what factors interrupt suicidal behaviour in men, and to examine differences according to known suicide risk factors. Setting Australia. Participants 251 Austr...

Despite higher rates of suicide in men, there is a dearth of research examining the perspectives and experiences of males at risk of suicide, particularly in terms of understanding how interventions can be tailored to men's specific needs. The current study aimed to examine factors assisting, complicating or inhibiting interventions for men at risk...

Young people with type 1 diabetes experience elevated levels of emotional distress that impact negatively on their diabetes self-care, quality of life, and disease-related morbidity and mortality. While the need is great and clinically significant, a range of structural (eg, service availability), psychological (eg, perceived stigma), and practical...

Knowledge about proactive strategies that men use to cope with depression and suicide is limited. This narrative review aims to provide an overview and critical appraisal of qualitative studies investigating men’s accounts of strategies used to cope with depression and/or suicidal behavior. A search was conducted of relevant databases to identify...

The Internet is used to deliver information on many psychiatric disorders such as bipolar disorder. This paper reports on the results of a 12-months randomised controlled trial, which examined the efficacy of an Internet-based preventive program for bipolar disorder, adjunctive to usual pharmacological management. Participants were recruited by com...

Recent research has indicated that young people experiencing homelessness live with high rates of psychological distress and mental illness, yet often do not access mental health services due to a number of barriers. Access may be enhanced through greater interagency collaboration, adopting principles of early intervention, outreach and youth cultu...

Prisoners have extremely high rates of smoking with rates 3-4 times higher than the general community. Many prisoners have used heroin. The aims of this study were to investigate the impact of heroin use on smoking cessation and the social determinants of health among prisoners. Secondary analysis of data from a randomised controlled trial of a mul...

Helping smokers with current or past depression quit smoking can be challenging. A range of online resources and telephone services are available for clinicians to complement smoking cessation treatment for these patients.