Adrienne O’Neil

Professor Adrienne O’Neil is supported by an NHMRC Emerging Leader (2) Fellowship. Her research focuses on understanding shared pathways, pathophysiology, risk factors and treatment of mental and physical disorders with a focus on lifestyle interventions.  She is a behavioural scientist who specialises in promoting the use and quality of evidence-based lifestyle medicine and rehabilitation in mental health and cardiac settings.

Prof O’Neil is leading 4 key projects:

Is lifestyle-based care as good as conventional psychological care for psychological distress?

Despite the evidence that lifestyle-based mental health care is efficacious, we are often asked by clinicians if we know whether it is a suitable alternative to established approaches like psychotherapy.  The need to answer this question has been exacerbated by Covid-19 which has seen an increase in depression and anxiety in Victorians and thus put a greater burden on these existing services.

This 18 month trial was funded by a Medical Research Future Fund grant in partnership with our local public mental health drug & alcohol service in Geelong (Barwon Health), Diabetes Victoria, GMHBA and Australasian Society of Lifestyle Medicine.

The main aim to is determine whether a group-based, Zoom delivered lifestyle program targeting two pillars (diet and exercise) is non-inferior to a psychotherapy program over 8 weeks for adults with elevated distress.

This will be the first trial to determine whether this new approach to mental health care is as good as those existing and may provide support for an additional care pathway For Australians with mental health concerns in the future.

https://foodandmoodcentre.com.au/projects/the-calm-trial/

Is lifestyle-based care as good as conventional psychological care for unipolar and bipolar depression?

Lifestyle-based mental care has enormous potential to alleviate the burden on GPs and psychological service providers. Yet there is no evidence that it works in real world settings like primary care as a much-needed alternative to psychological care for patients with clinical mood disorders.

This 5-year trial forms part of the Mental Health Australia General Clinical Trials Network (MAGNET). MAGNET was established as part of a NHMRC Centre of Research Excellence (1153607) led by Director of IMPACT Institute at Deakin University, Prof Michael Berk. It is a cooperative mental health clinical research alliance designed to be a vehicle that enables practice change for mental health in Australia. It comprises researchers, consumer and carer groups who represent diverse needs, practitioner Colleges, peak bodies, health systems and industry partners. https://www.deakin.edu.au/about-deakin/news-and-media-releases/articles/deakin-to-lead-new-national-network-in-mental-health-research

The main aim of the trial is to test the effectiveness of a GP-referred, group-based lifestyle program targeting four pillars (diet, exercise, sleep & substance/tobacco cessation) for reducing depressive symptoms compared to group-based psychotherapy in 600 adults with unipolar or bipolar depression.

This project has real potential to identify a critical, additional care pathway for Australians with bipolar or unipolar depression to help alleviate the current system burden.

Clinical guidelines for Lifestyle-based Mental Health Care

In 2020, our team established an international taskforce to lead the development of the World Federations for the Society of Biological Psychiatry & Australasian Society of Lifestyle Medicine guidelines for lifestyle-based mental health care. Led by Prof O’Neil (Co-Chair), it comprises international experts Prof Jim Blumenthal (Co-Chair) (USA); Dr Anu Ruusunen (Finland), Dr Wolf Marx (AU), Prof Brendon Stubbs (UK); A/Prof Felipe Schuch (Sth America), Dr Fiona Ho (Hong Kong), and Dr Sam Manger (AU) (see link for full list https://www.wfsbp.org/educational-activities/wfsbp-task-forces/ ). These guidelines were compiled based on a series of 8 systematic review processes centred on both established (e.g diet) and emerging (e.g mindfulness) lifestyle pillars. They are designed to provide mental health specialists and non-specialists (e.g. allied health professionals, practice nurses) comprehensive guidance when delivering this care in any setting. Depression is the first indication in our suite of guidelines to be published in mid 2022.

How much of the population burden of mental disorders could be eliminated by targeting lifestyle behaviours?

In Australia as elsewhere, there is no funding mechanism to support a shift from the status quo towards lifestyle targets for the prevention of mental disorders. Policy makers need evidence to show the cost and health benefits to the population if lifestyle factors were a target for mental disorder prevention.

The main aim is to establish how much of the mental disorder burden would be avoided if lifestyle-based mental health care was adopted nationally and globally.  This project draws on the renowned Global Burden of Disease (GBD) Study the most comprehensive epidemiological study conducted worldwide to address this critical gap. Since 1990, GBD investigators have assessed incidence and prevalence for 354 causes in 195 countries, including Australia. It provides high quality morbidity data for major diseases and risk factors. Population attributable risks (PARs)-the proportion of an illness averted if a specific exposure was eliminated- are available for many lifestyle risk factors in relation to physical disorders (e.g diabetes), but not for common mental disorders. This study address this key gap.   This project will generate critical evidence that policy makers need to show if this approach represents a good return on investment at a national and international level.

Research areas and skills: common mental disorders, cardiovascular disease, lifestyle, social determinants, behavioural science, epidemiology, translation