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Publisher: RMIT Publishing   (Total: 397 journals)

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Showing 1 - 200 of 397 Journals sorted alphabetically
40 [degrees] South     Full-text available via subscription   (Followers: 3)
Aboriginal and Islander Health Worker J.     Full-text available via subscription   (Followers: 15)
Aboriginal Child at School     Full-text available via subscription   (Followers: 6)
About Performance     Full-text available via subscription   (Followers: 13)
Access     Full-text available via subscription   (Followers: 26)
ACCESS: Critical Perspectives on Communication, Cultural & Policy Studies     Full-text available via subscription   (Followers: 12)
Accounting, Accountability & Performance     Full-text available via subscription   (Followers: 18)
ACORN : The J. of Perioperative Nursing in Australia     Full-text available via subscription   (Followers: 19, SJR: 0.198, CiteScore: 0)
Adelaide Law Review     Full-text available via subscription   (Followers: 23, SJR: 0.122, CiteScore: 0)
Advocate: Newsletter of the National Tertiary Education Union     Full-text available via subscription   (Followers: 1)
Agenda: A J. of Policy Analysis and Reform     Full-text available via subscription   (Followers: 1)
Agora     Full-text available via subscription   (Followers: 6)
Agricultural Commodities     Full-text available via subscription   (SJR: 0.123, CiteScore: 0)
Agricultural Science     Full-text available via subscription   (Followers: 2)
AIMA Bulletin     Full-text available via subscription   (Followers: 4)
AJP : The Australian J. of Pharmacy     Full-text available via subscription   (Followers: 13, SJR: 0.142, CiteScore: 0)
Analysis     Full-text available via subscription   (Followers: 3)
Ancient History : Resources for Teachers     Full-text available via subscription   (Followers: 6)
Anglican Historical Society J.     Full-text available via subscription   (Followers: 3)
Annals of the Royal Australasian College of Dental Surgeons     Full-text available via subscription   (Followers: 5)
ANZSLA Commentator, The     Full-text available via subscription   (Followers: 4)
Appita J.: J. of the Technical Association of the Australian and New Zealand Pulp and Paper Industry     Full-text available via subscription   (Followers: 14, SJR: 0.168, CiteScore: 0)
AQ - Australian Quarterly     Full-text available via subscription  
Arena J.     Full-text available via subscription   (Followers: 1)
Around the Globe     Full-text available via subscription   (Followers: 1)
Art + Law     Full-text available via subscription   (Followers: 12)
Art Monthly Australia     Full-text available via subscription   (Followers: 10)
Artefact : the journal of the Archaeological and Anthropological Society of Victoria     Full-text available via subscription   (Followers: 3)
Artlink     Full-text available via subscription   (Followers: 5)
Asia Pacific J. of Clinical Nutrition     Full-text available via subscription   (Followers: 11, SJR: 0.697, CiteScore: 2)
Asia Pacific J. of Health Management     Full-text available via subscription   (Followers: 4)
Aurora J.     Full-text available via subscription  
Australasian Biotechnology     Full-text available via subscription   (Followers: 1, SJR: 0.1, CiteScore: 0)
Australasian Catholic Record, The     Full-text available via subscription   (Followers: 5)
Australasian Drama Studies     Full-text available via subscription   (Followers: 1)
Australasian Epidemiologist     Full-text available via subscription  
Australasian Historical Archaeology     Full-text available via subscription   (Followers: 7, SJR: 0.212, CiteScore: 0)
Australasian J. of Early Childhood     Full-text available via subscription   (Followers: 5, SJR: 0.535, CiteScore: 1)
Australasian J. of Gifted Education     Full-text available via subscription   (Followers: 7, SJR: 0.123, CiteScore: 0)
Australasian J. of Human Security     Full-text available via subscription   (Followers: 1, SJR: 0.144, CiteScore: 0)
Australasian J. of Irish Studies, The     Full-text available via subscription   (Followers: 8)
Australasian J. of Regional Studies, The     Full-text available via subscription   (Followers: 1, SJR: 0.118, CiteScore: 0)
Australasian Law Management J.     Full-text available via subscription   (Followers: 7)
Australasian Leisure Management     Full-text available via subscription   (Followers: 2)
Australasian Musculoskeletal Medicine     Full-text available via subscription   (Followers: 3)
Australasian Music Research     Full-text available via subscription   (Followers: 5)
Australasian Parks and Leisure     Full-text available via subscription   (Followers: 2)
Australasian Plant Conservation: J. of the Australian Network for Plant Conservation     Full-text available via subscription   (Followers: 4)
Australasian Policing     Full-text available via subscription   (Followers: 6)
Australasian Public Libraries and Information Services     Full-text available via subscription   (Followers: 34)
Australasian Review of African Studies, The     Full-text available via subscription   (Followers: 2)
Australian Aboriginal Studies     Full-text available via subscription   (Followers: 9, SJR: 0.13, CiteScore: 0)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Ageing Agenda     Full-text available via subscription   (Followers: 7)
Australian and Aotearoa New Zealand Psychodrama Association J.     Full-text available via subscription   (Followers: 1)
Australian and New Zealand Continence J.     Full-text available via subscription   (Followers: 4)
Australian and New Zealand Sports Law J.     Full-text available via subscription   (Followers: 9)
Australian Art Education     Full-text available via subscription   (Followers: 8)
Australian Bookseller & Publisher     Full-text available via subscription   (Followers: 1)
Australian Bulletin of Labour     Full-text available via subscription   (Followers: 2)
Australian Canegrower     Full-text available via subscription   (Followers: 2)
Australian Coeliac     Full-text available via subscription   (Followers: 1)
Australian Cottongrower, The     Full-text available via subscription   (Followers: 1)
Australian Educational and Developmental Psychologist, The     Full-text available via subscription   (Followers: 9, SJR: 0.146, CiteScore: 0)
Australian Family Physician     Full-text available via subscription   (Followers: 3, SJR: 0.317, CiteScore: 1)
Australian Field Ornithology     Full-text available via subscription   (Followers: 4, SJR: 0.209, CiteScore: 0)
Australian Forest Grower     Full-text available via subscription   (Followers: 4)
Australian Grain     Full-text available via subscription   (Followers: 2)
Australian Holstein J.     Full-text available via subscription   (Followers: 1)
Australian Humanist, The     Full-text available via subscription   (Followers: 4)
Australian Indigenous Law Review     Full-text available via subscription   (Followers: 21)
Australian Intl. Law J.     Full-text available via subscription   (Followers: 22)
Australian J. of Acupuncture and Chinese Medicine     Full-text available via subscription   (Followers: 4, SJR: 0.116, CiteScore: 0)
Australian J. of Adult Learning     Full-text available via subscription   (Followers: 15, SJR: 0.297, CiteScore: 0)
Australian J. of Advanced Nursing     Full-text available via subscription   (Followers: 14, SJR: 0.299, CiteScore: 1)
Australian J. of Asian Law     Full-text available via subscription   (Followers: 4)
Australian J. of Cancer Nursing     Full-text available via subscription   (Followers: 9)
Australian J. of Civil Engineering     Full-text available via subscription   (Followers: 5, SJR: 0.158, CiteScore: 0)
Australian J. of Dyslexia and Learning Difficulties     Full-text available via subscription   (Followers: 8, SJR: 0.1, CiteScore: 0)
Australian J. of Emergency Management     Full-text available via subscription   (Followers: 23, SJR: 0.354, CiteScore: 0)
Australian J. of French Studies     Full-text available via subscription   (Followers: 7, SJR: 0.123, CiteScore: 0)
Australian J. of Herbal Medicine     Full-text available via subscription   (Followers: 5)
Australian J. of Language and Literacy, The     Full-text available via subscription   (Followers: 3, SJR: 0.282, CiteScore: 1)
Australian J. of Legal History     Full-text available via subscription   (Followers: 15)
Australian J. of Mechanical Engineering     Full-text available via subscription   (Followers: 5, SJR: 0.119, CiteScore: 0)
Australian J. of Medical Science     Full-text available via subscription   (Followers: 1)
Australian J. of Multi-Disciplinary Engineering     Full-text available via subscription   (Followers: 2)
Australian J. of Music Education     Full-text available via subscription   (Followers: 4)
Australian J. of Music Therapy     Full-text available via subscription   (Followers: 9, SJR: 0.549, CiteScore: 1)
Australian J. of Parapsychology     Full-text available via subscription   (Followers: 2, SJR: 0.511, CiteScore: 0)
Australian J. of Social Issues     Full-text available via subscription   (Followers: 6, SJR: 0.399, CiteScore: 1)
Australian J. of Structural Engineering     Full-text available via subscription   (Followers: 7, SJR: 0.281, CiteScore: 1)
Australian J. of Water Resources     Full-text available via subscription   (Followers: 6, SJR: 0.156, CiteScore: 0)
Australian J. on Volunteering     Full-text available via subscription   (Followers: 2)
Australian J.ism Review     Full-text available via subscription   (Followers: 8)
Australian Life Scientist     Full-text available via subscription   (Followers: 2)
Australian Literary Studies     Full-text available via subscription   (Followers: 5)
Australian Mathematics Teacher, The     Full-text available via subscription   (Followers: 7)
Australian Nursing J. : ANJ     Full-text available via subscription   (Followers: 6)
Australian Orthoptic J.     Full-text available via subscription  
Australian Primary Mathematics Classroom     Full-text available via subscription   (Followers: 5)
Australian Screen Education Online     Full-text available via subscription   (Followers: 3)
Australian Senior Mathematics J.     Full-text available via subscription   (Followers: 2)
Australian Sugarcane     Full-text available via subscription  
Australian TAFE Teacher     Full-text available via subscription   (Followers: 4)
Australian Tax Forum     Full-text available via subscription   (Followers: 3)
Australian Universities' Review, The     Full-text available via subscription   (Followers: 4)
Australian Voice     Full-text available via subscription   (Followers: 6)
Bar News: The J. of the NSW Bar Association     Full-text available via subscription   (Followers: 7)
Bioethics Research Notes     Full-text available via subscription   (Followers: 14)
BOCSAR NSW Alcohol Studies Bulletins     Full-text available via subscription   (Followers: 4)
Bookseller + Publisher Magazine     Full-text available via subscription   (Followers: 5)
Breastfeeding Review     Full-text available via subscription   (Followers: 18, SJR: 0.183, CiteScore: 0)
British Review of New Zealand Studies     Full-text available via subscription   (Followers: 4)
Brolga: An Australian J. about Dance     Full-text available via subscription   (Followers: 3)
Cancer Forum     Full-text available via subscription   (SJR: 0.115, CiteScore: 0)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Chain Reaction     Full-text available via subscription  
Childrenz Issues: J. of the Children's Issues Centre     Full-text available via subscription  
Chiropractic J. of Australia     Full-text available via subscription   (SJR: 0.111, CiteScore: 0)
Chisholm Health Ethics Bulletin     Full-text available via subscription   (Followers: 1)
Church Heritage     Full-text available via subscription   (Followers: 4)
Commercial Law Quarterly: The J. of the Commercial Law Association of Australia     Full-text available via subscription   (Followers: 5)
Communicable Diseases Intelligence Quarterly Report     Full-text available via subscription   (Followers: 2, SJR: 0.563, CiteScore: 1)
Communication, Politics & Culture     Open Access   (Followers: 13)
Communities, Children and Families Australia     Full-text available via subscription   (Followers: 3)
Connect     Full-text available via subscription   (Followers: 2)
Contemporary PNG Studies     Full-text available via subscription  
Context: J. of Music Research     Full-text available via subscription   (Followers: 8)
Corporate Governance Law Review, The     Full-text available via subscription   (Followers: 7)
Creative Approaches to Research     Full-text available via subscription   (Followers: 13)
Critical Care and Resuscitation     Full-text available via subscription   (Followers: 24, SJR: 1.032, CiteScore: 1)
Cultural Studies Review     Full-text available via subscription   (Followers: 16)
Culture Scope     Full-text available via subscription   (Followers: 4)
Current Issues in Criminal Justice     Full-text available via subscription   (Followers: 13)
Dance Forum     Full-text available via subscription   (Followers: 4)
DANZ Quarterly: New Zealand Dance     Full-text available via subscription   (Followers: 3)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Deakin Law Review     Full-text available via subscription   (Followers: 15)
Developing Practice : The Child, Youth and Family Work J.     Full-text available via subscription   (Followers: 19)
Early Days: J. of the Royal Western Australian Historical Society     Full-text available via subscription  
Early Education     Full-text available via subscription   (Followers: 8)
EarthSong J.: Perspectives in Ecology, Spirituality and Education     Full-text available via subscription   (Followers: 1)
East Asian Archives of Psychiatry     Full-text available via subscription   (Followers: 3, SJR: 0.36, CiteScore: 1)
Educare News: The National Newspaper for All Non-government Schools     Full-text available via subscription  
Educating Young Children: Learning and Teaching in the Early Childhood Years     Full-text available via subscription   (Followers: 20)
Education in Rural Australia     Full-text available via subscription   (Followers: 2)
Education, Research and Perspectives     Full-text available via subscription   (Followers: 14)
Educational Research J.     Full-text available via subscription   (Followers: 18)
Electronic J. of Radical Organisation Theory     Full-text available via subscription   (Followers: 3)
Employment Relations Record     Full-text available via subscription   (Followers: 3)
English in Aotearoa     Full-text available via subscription   (Followers: 2)
English in Australia     Full-text available via subscription   (Followers: 2, SJR: 0.18, CiteScore: 0)
Essays in French Literature and Culture     Full-text available via subscription   (Followers: 8)
Ethos: Official Publication of the Law Society of the Australian Capital Territory     Full-text available via subscription   (Followers: 5)
Eureka Street     Full-text available via subscription   (Followers: 5)
Extempore     Full-text available via subscription  
Family Matters     Full-text available via subscription   (Followers: 10, SJR: 0.228, CiteScore: 1)
Fijian Studies: A J. of Contemporary Fiji     Full-text available via subscription   (Followers: 1)
Focus on Health Professional Education : A Multi-disciplinary J.     Full-text available via subscription   (Followers: 7)
Food New Zealand     Full-text available via subscription   (Followers: 4)
Fourth World J.     Full-text available via subscription   (Followers: 1)
Frontline     Full-text available via subscription   (Followers: 18)
Future Times     Full-text available via subscription   (Followers: 4)
Gambling Research: J. of the National Association for Gambling Studies (Australia)     Full-text available via subscription   (Followers: 5)
Gay and Lesbian Law J.     Full-text available via subscription   (Followers: 2)
Gender Impact Assessment     Full-text available via subscription   (Followers: 3)
Geographical Education     Full-text available via subscription   (Followers: 2)
Geriatric Medicine in General Practice     Full-text available via subscription   (Followers: 8)
Gestalt J. of Australia and New Zealand     Full-text available via subscription   (Followers: 2, SJR: 0.1, CiteScore: 0)
Globe, The     Full-text available via subscription   (Followers: 4)
Government News     Full-text available via subscription   (Followers: 2)
Great Circle: J. of the Australian Association for Maritime History, The     Full-text available via subscription   (Followers: 7)
Grief Matters : The Australian J. of Grief and Bereavement     Full-text available via subscription   (Followers: 10)
He Puna Korero: J. of Maori and Pacific Development     Full-text available via subscription   (Followers: 4)
Headmark     Full-text available via subscription   (Followers: 2)
Health Inform     Full-text available via subscription  
Health Issues     Full-text available via subscription   (Followers: 2)
Health Promotion J. of Australia : Official J. of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 8, SJR: 0.531, CiteScore: 1)
Health Voices     Full-text available via subscription  
Heritage Matters : The Magazine for New Zealanders Restoring, Preserving and Enjoying Our Heritage     Full-text available via subscription   (Followers: 2)
High Court Quarterly Review, The     Full-text available via subscription   (Followers: 3)
History of Economics Review     Full-text available via subscription   (Followers: 9)
HIV Australia     Full-text available via subscription   (Followers: 3)
HLA News     Full-text available via subscription   (Followers: 3, SJR: 0.438, CiteScore: 1)
Hong Kong J. of Emergency Medicine     Full-text available via subscription   (Followers: 4, SJR: 0.19, CiteScore: 0)
Idiom     Full-text available via subscription   (Followers: 1)
Impact     Full-text available via subscription   (Followers: 2)
InCite     Full-text available via subscription   (Followers: 17)
Indigenous Law Bulletin     Full-text available via subscription   (Followers: 21)
InPsych : The Bulletin of the Australian Psychological Society Ltd     Full-text available via subscription   (Followers: 2)
Inside Film: If     Full-text available via subscription   (Followers: 6)
Institute of Public Affairs Review: A Quarterly Review of Politics and Public Affairs, The     Full-text available via subscription   (Followers: 12)
Instyle     Full-text available via subscription   (SJR: 0.116, CiteScore: 0)
Intellectual Disability Australasia     Full-text available via subscription   (Followers: 11)
Interaction     Full-text available via subscription   (Followers: 4)
Intl. Employment Relations Review     Full-text available via subscription   (Followers: 3)
Intl. J. of Disability Management Research     Full-text available via subscription   (Followers: 3)
Intl. J. of e-Business Management     Full-text available via subscription  
Intl. J. of Employment Studies     Full-text available via subscription   (Followers: 8)

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East Asian Archives of Psychiatry
Journal Prestige (SJR): 0.36
Citation Impact (citeScore): 1
Number of Followers: 3  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 2078-9947
Published by RMIT Publishing Homepage  [397 journals]
  • Volume 29 Issue 2 - Consultation-liaison psychiatry in Hong Kong: A 2019
           update
    • Abstract: Mak, Arthur Dun-Ping; Wong, Evelyn Kit-Yi
      PubDate: Thu, 4 Jul 2019 00:03:19 GMT
       
  • Volume 29 Issue 2 - Associations between gastro-oesophageal reflux
           disease, generalised anxiety disorder, major depressive episodes, and
           healthcare utilisation: A community-based study
    • Abstract: Mak, Arthur D P; Wu, Justin C Y; Chan, Yawen; Tse, YK; Lee, Sing
      Objective: To examine the prevalence and comorbidity of gastro-oesophageal reflux disease (GORD) with generalised anxiety disorder (GAD) and major depressive episodes (MDE) in a general population using DSM-IV, and to evaluate the associations between these conditions and healthcare utilisation.

      Methods: A random population-based telephone survey was conducted to record frequency of GORD symptoms, symptoms of GAD and MDE based on DSM-IV, and healthcare utilisation.

      Results: Of 2011 respondents, 4.2% had weekly GORD and 13.9% had monthly GORD, whereas 3.8% reported GAD and 12.4% reported MDE. Those with monthly GORD had higher risk of GAD (p = 0.01) and MDE (p < 0.001). GORD symptom frequency was independently correlated with MDE and GAD in a dose-response manner. The number of psychiatric diagnoses was independently correlated with GORD. GORD symptom frequency, GAD, and MDE were correlated with consultation frequency. GORD symptom frequency was corelated with high investigation expenditure.

      Conclusion: GORD had a strong dose-response relationship with GAD and MDE in a Hong Kong population. Excessive healthcare utilisation should alert clinicians to the risk of psychiatric comorbidity.

      PubDate: Thu, 4 Jul 2019 00:03:19 GMT
       
  • Volume 29 Issue 2 - Neurocognitive characteristics of individuals with
           irritable bowel syndrome
    • Abstract: Wong, Kenneth Man-fung; Yuen, Snowy Suet-Ying; Mak, Arthur Dun-Ping
      Irritable bowel syndrome (IBS) is a systems-based brain-gut axis disorder. Cognitive functions reflect central affective and attentional processes that are driven by genetic and epigenetic influences and effect complex brain-gut interactions. These interactions include stress-induced changes in hypothalamicpituitary- adrenal axis and autonomic nervous system, remodelling of the immune system, and alterations in microbiota composition. This review summarises current neurocognitive findings on patients with IBS. 13 studies of neurocognition in IBS patients were identified from PubMed, Ovid MEDLINE, EMBASE, and PsycINFO. The methodology and relevant findings were systematically analysed. There are alterations in both hot and cold cognitions in IBS patients. Consistently, attentional bias towards negative emotionally valenced and gastrointestinal symptom-related stimuli is found in hot cognition tasks, with other cold cognition differences including frontal executive dysfunction and stress-related hippocampal-mediated cognitive alterations. The effect of psychiatric comorbidity on a disorder level, as well as illness chronicity, on cognitive alterations requires further examination. Attentional bias and executive dysfunction in IBS gave support to its neural network alterations accounting for visceral hypersensitivity. Further prospective neuropsychological studies should examine the effect of chronicity, current symptom severity, and psychiatric comorbidity on the cognition in different IBS subtypes.

      PubDate: Thu, 4 Jul 2019 00:03:19 GMT
       
  • Volume 29 Issue 2 - Clinical toxicology and overdose of psychiatric
           medications
    • Abstract: Chan, Yiu Cheung
      This article reviews the poisoning epidemiology in Hong Kong, assessment and treatment of acute poisoning, and management of acute psychiatric medication overdose. In 2016, nearly 4000 poisoning cases involving approximately 6000 poisons were reported to Hong Kong Poison Information Centre. About 25% of the poisons involved were psychiatric-related medications. The initial medical assessment on poisoning includes history taking, vital signs monitoring, and focused physical examination. Approaches in managing acute poisoning include supportive measures, decontamination, antidote use, and enhanced elimination. Management on overdose of psychiatric medications (zopiclone, tricyclic antidepressants, selective serotonin reuptake inhibitor, antipsychotics, valproic acid, lithium, and methylphenidate) are discussed with practical tips highlighted.

      PubDate: Thu, 4 Jul 2019 00:03:19 GMT
       
  • Volume 29 Issue 2 - Compulsory mental health treatment in Hong Kong: Which
           way forward'
    • Abstract: Cheung, Daisy
      On 25 to 26 August 2017, the 'Compulsory Mental Health Treatment in Hong Kong: Which Way Forward'' conference was held in Hong Kong. Academics and practitioners from the United Kingdom, United States, New Zealand, and Hong Kong came together to discuss such important topics as the philosophical justifications for compulsory treatment, constitutional and human rights, and how compulsory powers are and should be used in practice. Speakers and conference participants then engaged in roundtable discussions on various issues that arose, in particular how reform of the law regulating compulsory mental health treatment in Hong Kong should proceed.

      PubDate: Thu, 4 Jul 2019 00:03:19 GMT
       
  • Volume 29 Issue 2 - Depression and quality of life in patients with
           neurological disorder in a Malaysian hospital
    • Abstract: Das, Priscilla; Naing, Nyi Nyi; Wan-Arfah, Nadiah; Jan, K O Naing Noor; Kueh, Yee Cheng; Rasalingam, Kantha
      Objective: To investigate association between major depressive disorder (MDD) and quality of life in patients with neurological disorder.

      Methods: This cross-sectional study was carried out at a Malaysian hospital between April 2016 and December 2016 using convenience sampling. Patients aged >=18 years with intracranial tumour or other brain disorders were invited to participate. Quality of life was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life questionnaire version 3.0; diagnosis of MDD was made using Mini International Neuropsychiatric Interview.

      Results: Of 122 patients approached, 100 (66 women and 34 men) were included (response rate, 93.5%), with a mean age of 45.3 years. The prevalence of MDD in patients with neurological disorder was 30%. Compared with non-depressed patients, patients with MDD had poorer global health status / quality of life (p = 0.003), and reduced physical (p = 0.003), role (p = 0.021), emotional (p < 0.001), cognitive (p = 0.004), and social (p = 0.007) functioning, as well as more symptoms of fatigue (p = 0.004), pain (p < 0.001), dyspnoea (p = 0.033), insomnia (p < 0.001), appetite loss (p = 0.002), constipation (p = 0.034), diarrhoea (p = 0.021), and financial difficulties (p = 0.039).

      Conclusion: Patients with MDD had reduced quality of life. Fatigue, pain, dyspnoea, insomnia, appetite loss, constipation, diarrhoea, and financial difficulties were prevalent among patients with MDD.

      PubDate: Thu, 4 Jul 2019 00:03:19 GMT
       
  • Volume 27 Issue 3 - Distress related to individual depressive symptoms: A
           cross-sectional study in Thai patients with major depression
    • Abstract: Rungpetchwong, Tinarom; Likhitsathian, Surinporn; Jaranai, Siripan; Srisurapanont, Manit
      Objective: To examine the distress related to individual depressive symptoms, the correlation between symptom distress and disability, and the gender difference in distress levels in patients with major depressive disorder.

      Methods: This was a cross-sectional, observational study carried out at a university hospital providing tertiary care in northern Thailand. Participants were patients with major depressive disorder aged between 18 and 65 years. Depression severity was self-rated using the 9-item Patient Health Questionnaire (PHQ- 9). We expanded the 9 symptom items of the PHQ-9 into 13 individual symptoms. The participants rated their distress for each symptom on a scale of 0 to 4, from 0 indicating 'not at all' to 4 indicating 'extremely'.

      Results: A total of 130 (92 female and 38 male) patients with major depressive disorder participated in this study. Of the 13 symptoms, the distress level of overeating was lowest. Compared with overeating, the distress levels of feeling depressed / hopeless, feeling guilty, poor concentration, anhedonia, initial insomnia, middle / terminal insomnia, and fatigue were significantly higher and had a large effect size of differences (p < 0.001, Cohen's dz >= 0.8). The distress levels related to feeling depressed / hopeless, feeling guilty, poor concentration, anhedonia, fatigue, suicidal ideation, and moving / speaking slowly were moderately and significantly correlated with overall functional impairment (Pearson's r = 0.31-0.48, p < 0.001). Analysis of covariance, adjusted by the PHQ-9 total score, indicated no significant difference between men and women on any symptom.

      Conclusions: Depressive symptoms related to high distress levels and moderately correlated with functional impairment were feeling depressed / hopeless, feeling guilty, poor concentration, and anhedonia.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 27 Issue 3 - Psychiatric and behavioural problems in children and
           adolescents with epilepsy
    • Abstract: Salayev, Kamran Ali; Sanne, Bjarte; Salayev, Rustam
      Objective: To investigate the psychiatric and behavioural symptoms in children and adolescents with epilepsy.

      Methods: Patients with epilepsy and aged 4 to 16 years were recruited from a medical centre in Azerbaijan during January 2012 to December 2013. A community sample was drawn from 3 schools as the comparison group. The Strengths and Difficulties Questionnaire (SDQ) was administered to parents of both patients with epilepsy and children in the comparison group. The total difficulties score and the scores for each subscale were compared between the 2 groups. Additionally, scores between different groups of epileptic patients were compared.

      Results: A total of 409 patients with epilepsy and 515 children in the comparison group were recruited. Those with epilepsy had a significantly higher mean total difficulties score and mean difficulties subscale scores (p < 0.001). In epileptic children with severe mental or physical disabilities, prosocial behaviour scores were significantly lower than those in the comparison group. The proportion of children with a total difficulties score in the abnormal range was higher in the epilepsy group than in the comparison group (53.1% vs. 15.7%; p < 0.001). Children with symptomatic epilepsy showed a higher total difficulties score than those with idiopathic epilepsy (p < 0.05).

      Conclusion: Children with epilepsy have a higher rate of psychiatric and behavioural symptoms. These rates are even higher in children with symptomatic epilepsy.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 27 Issue 3 - Community perceptions of mental illness in Jharkhand,
           India
    • Abstract: Sangeeta, Sanku Jalla; Mathew, KJ
      Introduction: Understanding and perceptions about mental illness vary among individuals based on their experience with the illness or their contact with the people affected by it. These may be further influenced by the individuals' sociocultural background. This study aimed to understand the differences in the beliefs about, understanding of, and explanations for mental illness between different population groups of Jharkhand, India.

      Methods: During July 2014 to February 2016, we recruited the following 3 groups of individuals aged between 18 and 60 years: individuals with mental illness (group 1, n = 240), relatives of individuals with mental illness (group 2, n = 240), and the general public (group 3, n = 240). Qualitative and quantitative findings were combined in this study, and participants were asked about their beliefs about, understanding of, and explanations about mental illness.

      Results: Individuals with mental illness and their relatives shared similar beliefs whereas the general public held a different opinion in various domains. There were significant differences among all groups in their understanding of various aspects of mental illnesses including the definition, causes, signs and symptoms, treatment, and outcomes.

      Conclusion: Individuals' perception towards different aspects of mental illness varies, despite they are sharing the same sociocultural milieu. Differences in beliefs, understanding, and explanations may lead to conflicts in treatment goals and expectations, and hamper the intervention strategies that promote mental health and patient care. Focused strategies to develop uniformity in beliefs and explanations about various aspects of mental illness may help to develop collaboration with different community groups that may in turn help in developing effective interventions and treatment.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 27 Issue 3 - Psychiatrists' attitude and use of secondgeneration
           antipsychotics for the treatment of schizophrenia in Taiwan
    • Abstract: Chen, Chih-Kang; Su, Hsu-Han; Sun, I-Wen
      Objectives: This survey aimed to understand the attitude of psychiatrists and their use of commonly prescribed second-generation antipsychotics (SGAs) for the treatment of schizophrenia in Taiwan. It also attempted to identify the factors that might influence their preference for selecting SGAs.

      Methods: Psychiatrists were interviewed face-to-face using a structured questionnaire. The questionnaire addressed various issues involved in the treatment of patients with schizophrenia, including the reasons for selecting SGAs, psychiatrists' level of satisfaction with commonly prescribed SGAs, and their current use of SGAs in clinical practice.

      Results: Gender and age of the psychiatrists, and practice setting were not related to SGA selection. The selection of a SGA might be influenced by characteristics of the psychiatrist, properties of the drugs, and the healthcare insurance system. Most psychiatrists agreed that the performance of brand-name drugs was superior to that of generic drugs. Better symptom control, improvement in cognition, and higher tolerability were among the major factors considered by psychiatrists in Taiwan when prescribing antipsychotics.

      Conclusion: Selection of a SGA in Taiwan is potentially influenced by the characteristics of the psychiatrist, properties of the drug, and the healthcare insurance system. Efficacy and tolerability were among the major determining factors when prescribing antipsychotics for the treatment of patients with schizophrenia.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 27 Issue 3 - Psychiatric interview of children and adolescents
           [Book Review]
    • Abstract: Chan, Kwok-Ling
      Review(s) of: Psychiatric interview of children and adolescents, by Claudio Cepeda, Lucille Gotanco, American Psychiatric Association Publishing, US$79.00, pp514, ISBN: 978-1-61537-048-1.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 27 Issue 3 - Folie a deux by proxy in a father, after physical
           abuse by a mentally ill daughter
    • Abstract: Tay, Jing-Ling; Li, Ziqiang
      This is the first case report in a country predominated by Chinese that describes the physical abuse of a recipient by the inducer in shared delusional disorder. The report describes a 42-year-old patient who physically abused her father until he submitted to her delusions. Subsequently and for years, both sustained persecutory delusions against their neighbours. While the patient was undergoing treatment, the father continued reinforcing her delusions. There is a need to explore the possibility of any forms of abuse of the recipient by the inducer in shared psychotic disorder. This report discusses the development of such delusions in a specific case and makes recommendations for the management of similar cases.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 27 Issue 3 - OPD-CA-2 operationalized psychodynamic diagnosis in
           childhood and adolescence: Theoretical basis and user manual [Book Review]
           
    • Abstract: Chow, Lai-Yin
      Review(s) of: OPD-CA-2 operationalized psychodynamic diagnosis in childhood and adolescence: Theoretical basis and user manual, by Franz Resch, Georg Romer, Klaus Schmeck, Inge Seiffge-Krenke, Hogrefe Publishing Group, US$79.00, pp334, ISBN: 978-0-88937-489-8.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 27 Issue 2 - Prevalence and correlates of psychological distress in
           adolescent students from India
    • Abstract: Jaisoorya, TS; Desai, G; Beena, KV; Beena, M; Ellangovan, K; Thennarasu, K
      Objective: There are limited data on the prevalence and correlates of psychological distress among adolescents in India. This study assessed psychological distress among adolescents who attended school in Kerala, India.

      Methods: A total of 7560 students from 73 schools, aged 12 to 19 years completed a self-administered questionnaire that included Kessler Psychological Distress Scale and other standardised instruments to assess various domains.

      Results: Mild psychological distress was reported by 10.5%, moderate distress by 5.4%, and severe distress by 4.9% of students. Older age, not living with both parents, and urban residence were significantly associated with psychological distress (p < 0.05). Students who experienced psychological distress had a higher risk of reporting academic failure, alcohol and tobacco use, suicidality, and sexual abuse. Increasing severity of psychological distress was associated with higher odds of these correlates.

      Conclusions: Psychological distress is common among adolescents and its correlates with negative outcomes suggest the need for early recognition and treatment.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 27 Issue 2 - A cross-sectional cohort study of prevalence,
           co-morbidities, and correlates of attentiondeficit hyperactivity disorder
           among adult patients admitted to the Li Ka Shing psychiatric outpatient
           clinic, Hong Kong
    • Abstract: Leung, Vincent MC; Chan, LF
      Objectives: To examine the prevalence, co-morbidities, and correlates of attention-deficit hyperactivity disorder (ADHD) among adult patients who attended the Li Ka Shing psychiatric outpatient clinic (LKSPC), Hong Kong.

      Methods: This study was a cross-sectional cohort study of patients consecutively referred to LKSPC over a 3-month period for evaluation of adult ADHD in 2 phases. In the screening phase, the Adult ADHD Self-Report Scale-v1.1 (ASRS-v1.1) Screener and Symptom Checklist and Sheehan Disability Scale (SDS) were used in the evaluation. In the interview phase, ADHD diagnosis was ascertained using the Diagnostic Interview for ADHD in Adults, version 2.0 (DIVA 2.0), with the DSM-5 criteria, in patients who exceeded the cut-off point of either the ASRS-v1.1 Screener or Symptom Checklist.

      Results: The study included 254 patients of whom 49 were diagnosed with ADHD. Patients with ADHD were aged 18 to 60 (mean, 40.1) years, and 63.3% were women. The estimated prevalence of ADHD in adult psychiatric patients, by sensitivity analysis, was 13% to 19.3% with a higher prevalence in men than women (24.7% vs. 17.1%). Adult ADHD was highly co-morbid with substance / alcohol use disorders and forensic record, and associated with functional impairment. In the ADHD combined presentation group, there was additional co-morbidities of bipolar disorder, active substance use and chronic alcohol use, and a higher associated risk of suicidal attempt.

      Conclusions: Efforts are needed to increase the detection and treatment of adult ADHD that affects a relevant proportion of our adult psychiatric outpatient population, and was associated with adverse social outcomes and functional impairment.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 27 Issue 2 - Positive aspects of caregiving experience among
           caregivers of patients with dementia
    • Abstract: Grover, Sandeep; Nehra, Ritu; Malhotra, Rama; Kate, Natasha
      Objective: To assess the positive aspects of caregiving and its correlates among caregivers of patients with dementia.

      Methods: A total of 55 primary caregivers of patients with dementia were invited to complete the Scale for Positive Aspects of Caregiving Experience (SPACE), Coping Checklist, Social Support Questionnaire, and World Health Organization Quality of Life-BREF version. Caregivers were also assessed by a clinician using the Burden Interview Schedule. Patients were assessed using the Hindi Mental State Examination and Instrumental Activities of Daily Living Scale.

      Results: The mean SPACE domain score was highest for motivation for caregiving role (2.63) followed by caregiver satisfaction (2.54), caregiving personal gains (2.4), and self-esteem and social aspect of caring (2.23). More educated caregivers scored significantly lower in the self-esteem and social aspect of caring. Married caregivers had a higher mean score in the motivation for caregiving role. There were some correlations between subjective burden and various SPACE domains, but the total objective burden score had no correlation with the SPACE. Higher use of avoidance coping was associated with a positive caregiving experience. Stronger social support was associated with higher score in the motivation for caregiving role. Higher level of caregiver burden in various domains was associated with lower motivation for caregiving. Caregiver satisfaction was associated with better quality of life for caregivers in terms of the environment.

      Conclusion: A positive caregiving experience for primary caregivers of patients with dementia is associated with both objective and subjective burdens, avoidance coping, and perceived social support.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 27 Issue 2 - Serum levels of neuroactive steroids in firstepisode
           antipsychotic-naive schizophrenic patients and its correlation with
           aggression: A case-control study
    • Abstract: Solanki, Ram K; Sharma, Parag; Tyagi, Alok; Singh, Chitra
      Background: The evidence of hypothalamic-pituitary-adrenal axis dysfunction in schizophrenia has been reviewed in the context of the stress-diathesis model. Overactivation of this axis leads to altered blood levels of cortisol and dehydroepiandrosterone sulfate (DHEA-S). These neurosteroids in turn act on the hippocampus and interact with gamma-aminobutyric acid and N-methyl-D-aspartate receptors leading to neurotoxicity and may be involved in the neurobiology of aggression. This study aimed to explore the blood level of these neurosteroids and ascertain its correlation with state aggression and psychopathology in first-episode antipsychotic-na ve schizophrenic patients.

      Methods: A total of 30 patients with first-episode schizophrenia along with 20 age- and gender-matched healthy controls participated in the study. Both groups were subjected to serum cortisol and DHEA-S measurement after assessment of psychopathology and aggression on a standardised psychometric scale.

      Results: Serum DHEA-S level was significantly higher in the patient group (p = 0.001). No difference was noted between males and females in the patient group (p = 0.93) but female controls had a significantly lower serum DHEA-S level than male controls (p < 0.01). Serum DHEA-S inversely correlated with scores on Modified Overt Aggression Scale (p = 0.01) but not with Positive and Negative Syndrome Scale (p = 0.39) or Clinical Global Impression Scale (p = 0.28).

      Conclusion: The first-episode antipsychotic-na ve schizophrenic patients showed a significantly higher blood level of DHEA-S compared with healthy controls. Serum DHEA-S level has an inverse relationship with aggression and may serve as a biological adaptive mechanism to antagonise the neuronal damage caused by cortisol.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 27 Issue 2 - Global prevalence of elder abuse: A metaanalysis and
           meta-regression
    • Abstract: Ho, Cyrus SH; Wong, Siow-Yi; Chiu, Marcus M; Ho, Roger CM
      Objective: Elder abuse is increasingly recognised as a global public health and social problem. There has been limited inter-study comparison of the prevalence and risk factors for elder abuse. This study aimed to estimate the pooled and subtype prevalence of elder abuse worldwide and identify significant associated risk factors.

      Methods: We conducted a meta-analysis and meta-regression of 34 population-based and 17 non- population-based studies.

      Results: The pooled prevalences of elder abuse were 10.0% (95% confidence interval, 5.2%-18.6%) and 34.3% (95% confidence interval, 22.9%-47.8%) in population-based studies and third party- or caregiver-reported studies, respectively. Being in a marital relationship was found to be a significant moderator using random-effects model.

      Conclusions: This meta-analysis revealed that third parties or caregivers were more likely to report abuse than older abused adults. Subgroup analyses showed that females and those resident in non-western countries were more likely to be abused. Emotional abuse was the most prevalent elder abuse subtype and financial abuse was less commonly reported by third parties or caregivers. Heterogeneity in the prevalence was due to the high proportion of married older adults in the sample. Subgroup analysis showed that cultural factors, subtypes of abuse, and gender also contributed to heterogeneity in the pooled prevalence of elder abuse.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 27 Issue 2 - Stormy lives: A journey through personality disorder
           [Book Review]
    • Abstract: Kam, Irene WK
      Review(s) of: Stormy lives: A journey through personality disorder, Tennyson Lee, Muswell Hill Press, US$20.00; pp234; ISBN: 978-1-908995-16-2.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 27 Issue 1 - Validation of the Chinese version of the revised
           clinical interview schedule: Findings from Hong Kong mental morbidity
           survey
    • Abstract: Chan, Wai-Chi; Wong, Corine Sau-Man; Chen, Eric Yu-Hai; Ng, Roger Man-Kin; Hung, Se-Fong; Cheung, Eric Fuk-Chi; Sham, Pak-Chung; Chiu, Helen Fung-Kum; Lam, Ming; Chang, Wing-Chung; Lee, Edwin Ho-Ming; Chiang, Tin-Po; Lau, Joseph Tak-Fai; van Os, Jim; Lewis, Glyn; Bebbington, Paul; Lam, Linda Chiu-Wa
      This study aimed to assess the psychometric properties of the Chinese version of the Revised Clinical Interview Schedule (C-CIS-R), and explore its applicability as a diagnostic instrument for common mental disorders (CMDs) in Hong Kong. Its psychometric properties were evaluated among 140 patients and 161 healthy controls. In comparison to the diagnoses made by the Structured Clinical Interview for the DSM-IV, the C-CIS-R showed good criterion validity in diagnosing CMDs. The correlation of the total score of C-CIS-R with the 12-item General Health Questionnaire and Hospital Anxiety and Depression Scale was satisfactory, indicating favourable convergent validity as well. The inter-rater and test-retest reliability were also satisfactory. Receiver operating characteristic analyses suggested an optimal cut-off point of 11/12 for detecting diagnosable CMDs (sensitivity: 0.69; specificity: 0.93) and 17/18 for identifying a need for treatment (sensitivity: 0.70; specificity: 0.95). In conclusion, C-CIS-R is a valid diagnostic instrument for CMDs in a Chinese community. Its cut-off points for clinically significant symptoms and treatment needs among Chinese are identical to those adopted in the original English version.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 27 Issue 1 - Validation of an instrument to assess the mental
           capacity to sign an enduring power of attorney
    • Abstract: Ko, Rachel Shuk-Fun; Lui, Victor Wing-Cheong; Lai, Ken C; Chiu, Charles CY; Lam, Linda Chiu-Wa
      Objective: To describe the validation of an instrument to assess the mental capacity of an individual to sign an enduring power of attorney.

      Methods: An instrument named Capacity Assessment to Sign an Enduring Power of Attorney (CASEPA) was developed following a literature review, focus group discussions, expert reviews, and pilot testing. Chinese persons aged >= 60 years who had a range of cognitive abilities were recruited from elderly care centres in Hong Kong to explore its psychometric properties.

      Results: A total of 85 participants were included. For inter-rater reliability, the intraclass correlation coefficient was 0.93 for understanding, 0.87 for appreciation, and 0.84 for reasoning. For internal consistency, the Cronbach's alpha was 0.75 for understanding, 0.74 for appreciation, and 0.86 for reasoning. The content validity was examined by an international expert in mental capacity and psychiatry and by 5 local experts in the fields of mental health, law, psychiatry, psychology, and geriatrics. The clinician ratings correlated with the ability score for understanding (r = 0.74, p < 0.001), appreciation (r = 0.73, p < 0.001) and reasoning (r = 0.73, p < 0.001).

      Conclusion: The CASEPA is a potentially useful tool to assess the mental capacity of an individual to sign an enduring power of attorney.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 27 Issue 1 - College binge drinking and its association with
           depression and anxiety: A prospective observational study
    • Abstract: Nourse, Rosemary; Adamshick, Pamela; Stoltzfus, Jill
      Objective: Binge drinking is a significant public health problem across college campuses in the United States. Despite substantial research and the use of evidence-based methods, the binge drinking culture remains an obstinate health crisis on campuses. This study examined the current binge drinking rate on a selected college campus, the association between binge drinking and anxiety and depression as well as the associated consequences of students' alcohol use.

      Methods: A sample of 201 students from a small, private Mid-Atlantic college completed validated scales as well as demographics and questionnaires. Primary outcome measures were the 9-item Patient Health Questionnaire, 7-item Generalised Anxiety Questionnaire, and Alcohol Use Disorders Identification Test (AUDIT). Secondary measures were the Brief Young Adult Alcohol Consequences Questionnaire, questionnaires, and demographics. Descriptive outcomes, frequencies and percentages, and separate Chisquare tests methodologies were utilised for analyses.

      Results: According to the AUDIT, 93% of students engaged in hazardous drinking, with a binge drinking rate of 38.8%. No significant associations were found between hazardous drinking and depression (p = 0.20) or anxiety (p = 0.68) levels in students. A significant relationship was found between their amount of drinking and negative consequences (p < 0.001). A substantial number of students reported moderate and severe levels of anxiety and depression.

      Conclusions: Our student sample engaged in binge drinking, suffered negative consequences, and presented with anxiety and depression issues along with gender implications as females had higher rates of depression and anxiety. Males drank significantly more and binged more often than females. The majority of students who binged experienced memory loss. Both females and males reported taking foolish risks and being impulsive when drinking. Students are vulnerable to harmful consequences when binging and have poor insight regarding binge drinking.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 27 Issue 1 - Impact of cognition and clinical factors on functional
           outcome in patients with bipolar disorder
    • Abstract: Soni, Ajitabh; Singh, Paramjeet; Shah, Raghav; Bagotia, Sunil
      Objective: To examine the role of different clinical variables and cognition on functional outcome in patients with bipolar disorder.

      Methods: A total of 61 euthymic patients with bipolar disorder and 30 healthy individuals were included in the study. The patients were divided into low functioning (n = 30) or high functioning (n = 31) subgroups based on functioning level measured by Global Assessment of Functioning Scale score. Groups were subjected to neurocognitive and clinical assessment.

      Results: Clinical variables differed significantly between low and high functioning patient groups, namely total number of episodes, depressive episodes, and time since the last episode. These variables were also correlated significantly with Global Assessment of Functioning Scale score. All 3 groups differed significantly for digit span backward test, verbal learning and memory test, Trail Making Test, and Stroop Colour Test. Digit span backward test, Trail Making Test, and Stroop Colour Test were significantly correlated with Global Assessment of Functioning Scale score.

      Conclusions: Total episodes, depressive episodes, time since the last episode, and cognitive dysfunction correlated with poor functioning. Executive dysfunction was the strongest predictor of psychosocial outcome in euthymic bipolar patients. Long-term therapeutic interventions should target relapse prevention with special consideration given to depressive episodes and cognitive rehabilitation.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 27 Issue 1 - Olanzapine-induced pancytopenia: A rare but worrying
           complication
    • Abstract: Pang, Nicholas; Thrichelvam, Nathisha; Naing, Noor Jan Khin Ohnmar
      Unlike clozapine, and despite its structural similarities, olanzapine is not usually associated with haematological suppression. Nonetheless this case report highlights an incident of olanzapine-induced thrombocytopenia and neutropenia in a first-contact patient. We report on a 50-year-old male who presented with 7 years of delusions and hallucinations. A diagnosis of schizophrenia was made in the absence of any suggestive features of mood disorders, substance abuse or organicity, and olanzapine as second-line treatment. Within a week of starting treatment he developed biochemical neutropenia and thrombocytopenia without any clinical symptoms that resolved after cessation of the offending drug. An organic workup for infective, inflammatory, and neoplastic causes was unremarkable. Comparison with other case reports and 3 postulated mechanisms are discussed. Despite its comparative rarity, the addition of this case report to a growing corpus suggests that clinicians should maintain heightened surveillance of patients prescribed olanzapine, to identify any untoward iatrogenic haematological abnormalities or immunosuppression.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 27 Issue 1 - Wetting in children and adolescents: A practical guide
           for parents, teachers, and caregivers;
    • Abstract: Lam, SM
      Wetting in children and adolescents: A practical guide for parents, teachers, and caregivers; by Alexander von Gontard Hogrefe Publishing US$12.80; pp82; ISBN: 978-0-88937-487-4; Soiling in children and adolescents: A practical guide for parents, teachers, and caregivers, by Alexander von Gontard, Hogrefe Publishing, US$12.80; pp82; ISBN: 978-0-88937-487-4.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 4 - Co-morbidity in attention-deficit hyperactivity
           disorder: A clinical study from India
    • Abstract: Jacob, Preeti; Srinath, Shoba; Girimaji, Satish; Seshadri, Shekhar; Sagar, John Vijay
      Objective: To assess the prevalence of neurodevelopmental and psychiatric co-morbidities in children and adolescents diagnosed with attention-deficit hyperactivity disorder at a tertiary care child and adolescent psychiatry centre.

      Methods: A total of 63 children and adolescents who were diagnosed with attention-deficit hyperactivity disorder and fulfilled the inclusion criteria were comprehensively assessed for neurodevelopmental and psychiatric co-morbidities. The tools used included the Mini-International Neuropsychiatric Interview for Children and Adolescents, Attention Deficit Hyperactivity Disorder Rating Scale IV (ADHD-RS), Children's Global Assessment Scale, Clinical Global Impression Scale, Vineland Social Maturity Scale, and Childhood Autism Rating Scale.

      Results: All except 1 subject had neurodevelopmental and / or psychiatric disorder co-morbid with attention-deficit hyperactivity disorder; 66.7% had both neurodevelopmental and psychiatric disorders. Specific learning disability was the most common co-existing neurodevelopmental disorder and oppositional defiant disorder was the most common psychiatric co-morbidity. The mean baseline ADHD-RS scores were significantly higher in the group with psychiatric co-morbidities, especially in the group with oppositional defiant disorder.

      Conclusion: Co-morbidity is present at a very high frequency in clinic-referred children diagnosed with attention-deficit hyperactivity disorder. Psychiatric co-morbidity, specifically oppositional defiant disorder, has an impact on the severity of attention-deficit hyperactivity disorder. Co-morbidity needs to be explicitly looked for during evaluation and managed appropriately.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 4 - The forgotten child
    • Abstract: Tang, Chun-Pan
      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 4 - Substance use problems, a volume in advances in
           psychotherapy: Evidence based practice series (second edition) [Book
           Review]
    • Abstract: Chiang, Tin-Po
      Review(s) of: Substance use problems, a volume in advances in psychotherapy: Evidence based practice series (second edition), by Mitch Earleywine, Hogrefe Publishing Group, US$29.80; pp104; ISBN: 978-0-88937-416-4.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 4 - Prevalence of maternal affective disorders in Chinese
           mothers of preschool children with autism spectrum disorders
    • Abstract: Yu, Yee-Wah; Chung, Kwok-Hang; Lee, Yiu-Ki; Lam, Wai-Chung; Yiu, Michael Gar-Chung
      Objectives: To evaluate the prevalence of affective disorders and identify their associated factors among Chinese mothers of preschool children diagnosed with autism spectrum disorders.

      Methods: This cross-sectional study was conducted at the Autism Spectrum Disorders Multidisciplinary Clinic of the United Christian Hospital from August 2012 to June 2013. All mothers of a consecutive series of preschool children diagnosed with autism spectrum disorders at their first visit to the clinic were recruited. Information regarding the child-related, maternal, and environmental factors was collected. Psychiatric diagnoses were made according to the Chinese-Bilingual Structured Clinical Interview for DSM-IV Axis I Disorders. Independent factors associated with maternal affective disorders were determined by univariate and multivariate analyses.

      Results: Of the 121 subjects, the point prevalence of affective disorders as a group was 29.8%. The point prevalence of major depressive disorders, adjustment disorders, anxiety disorders, and bipolar affective disorders was 14.9%, 10.7%, 3.3% and 0.8%, respectively. A higher level of disruptive and self-absorbed behaviours in the children (as assessed by the Developmental Behaviour Checklist), a higher level of affiliate stigma (as assessed by 22-item Affiliate Stigma Scale), and a history of psychiatric disorders were independently associated with current affective disorders.

      Conclusion: Psychiatric disorders, predominantly affective disorders, are common among Chinese mothers of preschool children with autism spectrum disorders. Identification of independent factors associated with maternal affective disorders can aid in the early detection of cases and planning of early intervention programmes to address both child and maternal psychological needs.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 4 - Outcome of a knowledge contact-based antistigma
           programme in adolescents and adults in the Chinese population
    • Abstract: Fung, Esther; Lo, Tak-Lam; Chan, Raymond WS; Woo, Francis CC; Ma, Clara WL; Mak, Bill SM
      A lack of knowledge about mental health and stigma of the mentally ill are barriers to the treatment of mental disorders. To reduce these barriers, anti-stigma campaigns using a knowledge contact approach were launched to raise public mental health knowledge by education and to reduce stigma by encouraging contact with individuals with mental disorders. The current study attempted to investigate the outcome of a knowledge contact-based programme in adolescents and adults in the Hong Kong Chinese population. Matched background individuals served as controls. Results from the 149 adolescents and 98 adults who participated in our programme showed that they had superior mental health literacy to the control group. Although both adolescents and adults showed a positive outcome on most measures of stigma, the former showed positive outcome on more measures of stigma than the latter. Our results support the initiative of using a knowledge contact-based anti-stigma campaign in Chinese societies. The results of this study provide preliminary data that will help inform and guide future research and development of effective mental health awareness programmes specific to people of various age-groups in the Chinese community.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 4 - Psychological adjustment of siblings of children with
           autism spectrum disorder in Hong Kong
    • Abstract: Chan, Janice YN; Lai, Kelly YC
      Objectives: Findings about the psychological adjustment of siblings of children with autism spectrum disorder have been inconsistent in western literature and little is known among non-western societies. This study explored the psychological adjustment of siblings of children with autism spectrum disorder in Hong Kong.

      Methods: A total of 116 families with siblings of children with autism spectrum disorders co-morbid with learning disability were included in the study. Parents completed questionnaires about sibling emotional and behavioural adjustment, and their own mental well-being, quality of life, and family functioning. Siblings completed a questionnaire on their relationship with the autistic proband.

      Results: Parent ratings did not reveal any significant negative impact on the emotional and behavioural adjustment of the typically developing siblings of children with autism spectrum disorder, but there were concerns about their peer relationships and weak prosocial behaviours. When cut-off scores were used to screen for risk of mental health problems, a quarter of the siblings warranted further assessment. Parents' quality of life and family functioning were significant predictors of sibling adjustment.

      Conclusions: In managing children with autism spectrum disorder, it is necessary to bear in mind the adjustment of their siblings, especially their peer relationships and prosocial behaviour. Adopting a holistic approach to address the psychosocial needs of the parents can facilitate sibling adjustment.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 4 - Recurrent psychotic episodes with a nearmonthly cycle
    • Abstract: Che, Kit-I
      A 12-year-old girl presented to the mental health service for an abrupt onset of mental changes characterised by hearing voices and being paranoid. She appeared preoccupied and her mood was labile. There was no family history of mental illness, and no organic causes were identified. These symptoms subsided spontaneously in a week. However, she experienced 3 other similar psychotic episodes afterwards which happened in a near-monthly cycle. Her level of functioning was normal between these episodes. Throughout the course of the illness, it was noted that these mental state changes might be related to the menstrual cycle. In this case we discuss the recurrent periodic psychoses in adolescents and the important differential diagnoses to be considered, including menstrual psychosis, a rare and less well-understood clinical entity.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 3 - Wuling capsule for major depressive disorder: A
           meta-analysis of randomised controlled trials
    • Abstract: Zheng, Wei; Zhang, Yan-Fang; Zhong, Hua-Qing; Mai, Si-Ming; Yang, Xin-Hu; Xiang, Yu-Tao
      Introduction: In China, Wuling capsule, a traditional Chinese medicine consisting of Wuling mycelia of Xylaria nigripes (Kl.) Sacc (a rare type of fungus), is used to treat major depressive disorders. A metaanalysis of randomised controlled trials was performed to compare the efficacy and safety of Wuling capsule alone with Wuling capsule-antidepressant combination in the treatment of major depressive disorders.

      Methods: Two assessors independently selected studies, extracted data, and conducted quality assessment and data synthesis. Standard mean difference, risk ratio (RR) +- 95% confidence interval (CI), the number needed to treat, and the number needed to harm were analysed.

      Results: A total of 12 randomised controlled trials (880 patients; mean age +- standard deviation, 39.7 +- 12.5 years; male patients, 41%) were identified, including 4 trials with Wuling capsule alone (n = 340) and 8 with Wuling capsule-antidepressant (sertraline, mianserin, mirtazapine, and paroxetine) combination (n = 540). The mean length of trial was 5.7 +- 1.3 weeks. Meta-analysis of symptomatic improvement at last-observation endpoint and study-defined response and remission revealed no significant differences between the Wuling capsule alone and antidepressant monotherapy. The Wuling capsule-antidepressant cotreatment was superior to antidepressant monotherapy in symptomatic improvement at last-observation endpoint (standard mean difference: -0.46, p = 0.001) as well as study-defined response (68.4% vs. 56.0%, RR = 1.23; p = 0.03) and remission (46.5% vs. 34.5%, RR = 1.35; p = 0.05). Wuling capsule was associated with fewer adverse drug reactions than antidepressant monotherapy.

      Conclusions: Adjunctive Wuling capsule may augment the effects of antidepressants and may be associated with fewer adverse drug reactions. More large-scale and rigorously designed randomised controlled trials with large sample size are warranted to clarify the effectiveness of Wuling capsule for major depressive disorders.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 3 - Null hypothesis testing (I) - 5% significance level
    • Abstract: Wong, Kai-Choi
      In early 2015, the psychology journal Basic and Applied Social Psychology announced its ban on the use of "Null Hypothesis Significance Testing Procedure" (NHSTP), because of its invalidity.1
      Authors are now required to remove all vestiges of NHSTP, and any statement of "significant" differences. It is the first academic journal to take action against NHSTP, but the challenge of NHSTP began about 50 years ago.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 3 - Antiepileptic-induced psychosis as a possible
           predictor of post-temporal lobectomy alternative psychosis
    • Abstract: Benedict, Francis; Lim, Kheng-Seang; Jambunathan, Stephen Thevananthan; Hashim, Aili Hanim
      We present a patient with topiramate-induced psychosis who developed alternative psychosis following temporal lobectomy. The number of surgical candidates for temporal lobectomy is increasing as is the frequency of psychiatric co-morbidities. Preoperative planning should take account of these psychiatric co-morbidities. In particular, precautions should be taken when antiepileptic drug-induced psychosis occurs, as this could predict the occurrence of alternative psychosis following lobectomy.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 3 - Cognitive dysfunction and associated behaviour
           problems in postpartum women: A study from North India
    • Abstract: Meena, Parth Singh; Soni, Ruchi; Jain, Mahendra; Jilowa, Charan Singh
      Objectives: During and after childbirth women undergo tremendous psychological and biological changes. These biological changes, along with the stress of assuming the new role of mother, make postpartum women vulnerable to various psychiatric disorders including cognitive dysfunction, depression, and anxiety. Such problems are under-reported as they are difficult to identify, especially by caregivers who are more focused on the newborn. The present study aimed to evaluate the prevalence of behaviour problems and cognitive dysfunction during the postpartum period.

      Methods: A cross-sectional study was carried out at the Department of Obstetrics and Gynaecology, Jawahar Lal Nehru Medical College, Ajmer, India. The study sample included 200 consecutive women who came for their first follow-up after childbirth, and 100 healthy and non-pregnant women who served as controls. Cognitive function was assessed using the Standard Mini-Mental State Examination Scale (SMMSE), Brief Cognitive Rating Scale (BCRS), and Trail Making Test Part B (TMT-B). 21-Item Depression Anxiety and Stress Scale was administered to assess depressive and anxiety symptoms.

      Results: Postpartum women scored poorly on SMMSE, BCRS, and TMT-B compared with non-pregnant women (p < 0.001), whereas subscores of depression, anxiety, and stress were significantly higher (p < 0.001).

      Conclusions: Women had significantly more cognitive deficits during the postpartum period than their non-pregnant counterparts. The former also had a higher prevalence of depression, anxiety, and stress.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 3 - Socio-demographic and clinical characteristics of
           patients who attempt suicide: A hospital-based study from Eastern India
    • Abstract: Halder, Susmita; Mahato, Akash Kumar
      Introduction: Suicide has become an important public health concern with a high number of deaths and increasing number of attempted suicides every year. There are multiple factors that underlie a suicide attempt. Although mental illness and severe stress have long been known to be associated with suicide, socio-demographic and clinical characteristics of those attempting suicide can also provide indications of suicidal intent. The present study aimed to explore the socio-demographic and clinical characteristics of patients in Kolkata, India who attempted suicide.

      Methods: Consecutive patients (n = 100) with failed suicide attempt who were referred to the psychiatry department of 2 multispecialty hospitals in Kolkata were included in the study. Their socio-demographic details and clinical characteristics were recorded. Suicidal intent and depressive symptoms were assessed and psychosocial risk factors were identified following detailed clinical interview.

      Results: Suicide attempt was more frequent among younger female patients. Reaction to stress was the most common risk factor. The majority of attempts were impulsive in nature rather than planned.

      Conclusion: Young adults under stress are more vulnerable. Early identification of such individuals and psychosocial support to prevent suicidal ideation is vital.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 3 - Core skills for the CASC [Book Review]
    • Abstract: Cheng, Kin-Shing
      Review(s) of: Core skills for the CASC, by James Woollard, Josie Jenkinson, RCPsych Publications, 15.00 pounds, pp80, ISBN: 978-1909726543.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 2 - Permissive attitude towards drug use, life
           satisfaction, and continuous drug use among psychoactive drug users in
           Hong Kong
    • Abstract: Cheung, Nicole WT; Cheung, Yuet-Wah; Chen, Xi
      Objectives: To examine the effects of a permissive attitude towards regular and occasional drug use, life satisfaction, self-esteem, depression, and other psychosocial variables in the drug use of psychoactive drug users. Psychosocial factors that might affect a permissive attitude towards regular / occasional drug use and life satisfaction were further explored.

      Methods: We analysed data of a sample of psychoactive drug users from a longitudinal survey of psychoactive drug abusers in Hong Kong who were interviewed at 6 time points at 6-month intervals between January 2009 and December 2011. Data of the second to the sixth time points were stacked into an individual time point structure. Random-effects probit regression analysis was performed to estimate the relative contribution of the independent variables to the binary dependent variable of drug use in the last 30 days.

      Results: A permissive attitude towards drug use, life satisfaction, and depression at the concurrent time point, and self-esteem at the previous time point had direct effects on drug use in the last 30 days. Interestingly, permissiveness to occasional drug use was a stronger predictor of drug use than permissiveness to regular drug use. These 2 permissive attitude variables were affected by the belief that doing extreme things shows the vitality of young people (at concurrent time point), life satisfaction (at concurrent time point), and self-esteem (at concurrent and previous time points). Life satisfaction was affected by sense of uncertainty about the future (at concurrent time point), self-esteem (at concurrent time point), depression (at both concurrent and previous time points), and being stricken by stressful events (at previous time point).

      Conclusions: A number of psychosocial factors could affect the continuation or discontinuation of drug use, as well as the permissive attitude towards regular and occasional drug use, and life satisfaction. Implications of the findings for prevention and intervention work targeted at psychoactive drug users are discussed.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 2 - Developing treatments for stimulant abuse: A brief
           overview
    • Abstract: Davidson, Colin
      The abuse of stimulants such as cocaine, amphetamine, and methamphetamine is a huge problem in many parts of the world. Abuse of these drugs does not ruin just the user's life, but also adversely affects those around them. Despite many years of research, there are no approved medications for stimulant dependence, and treatment is focused on psychotherapy and abstinence. Over the last 10 to 20 years, there have been some major changes in approach to medication development for stimulant dependence. These include assessing ligands for non-dopaminergic sites, atypical dopamine transporter ligands, blocking long-term potentiation and / or memory reconsolidation, vaccines against the stimulant, and molecular approaches including pharmacogenomics and gene silencing. Also included in this overview are non-drug treatments such as deep brain stimulation and psychosurgery. This overview highlights recent preclinical and clinical studies of treatment development for stimulant dependence.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 2 - Current status of substance abuse in East Asia and
           therapeutic prospects
    • Abstract: Ren, Qian; Ma, Min; Hashimoto, Kenji
      The abuse of drugs, including opioids and stimulants, is a major public health problem worldwide, including in East Asia. Nonetheless, there are no pharmacological treatments for many psychiatric or neurological symptoms associated with that abuse. Abused drugs exert several detrimental effects on structural plasticity in brain regions associated with reward circuits. Understanding the molecular mechanisms that underlie this structural plasticity in brain neurons will aid in the development of novel therapeutic drugs for substance abuse. In this review, we discuss recent topics in substance abuse in East Asia and the therapeutic drugs available. Finally, we discuss potential therapeutic signalling pathways involved in long-term changes to structural plasticity in the brain after repeated administration of opioids and stimulants.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 2 - Drug addiction: A global challenge
    • PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 2 - Depression and associated factors in patients with
           type 2 diabetes mellitus
    • Abstract: Hashim, Nurul Azreen; Ariaratnam, Suthahar; Salleh, Mohd Razali; Said, Mas Ayu; Sulaiman, Ahmad Hatim
      Objectives: To determine the prevalence of major depressive disorder and its association with sociodemographic and clinical factors in patients with type 2 diabetes mellitus.

      Methods: This was a cross-sectional study of patients with type 2 diabetes mellitus who attended the hospital-based primary care clinics at the University Malaya Medical Centre, Kuala Lumpur, Malaysia. The patients were interviewed using the Mini-International Neuropsychiatric Interview to diagnose depression based on the DSM-IV criteria. The socio-demographic and clinical data were obtained by interviewing the patients and subsequently verified against their respective case notes.

      Results: A total of 204 patients were recruited. The prevalence of major depressive disorder was 15.7%. Major depressive disorder was significantly associated with younger age of patients (mean +- standard deviation, 57.8 +- 15.1 years, p = 0.04), younger age at diagnosis of diabetes mellitus (46.2 +- 13.0 years, p = 0.01), having secondary education (p = 0.02), and having a history of depression (p = 0.002). Multivariate analysis showed that current age (p = 0.04), duration of diabetes mellitus (p = 0.04), age at diagnosis of diabetes mellitus (p = 0.01), and secondary education (p = 0.01) were significant factors.

      Conclusions: The prevalence of major depressive disorder was high among patients with type 2 diabetes mellitus. Screening of patients with type 2 diabetes mellitus for depression should be performed periodically or routinely, especially in the primary care setting.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 2 - Acupuncture for detoxification in treatment of opioid
           addiction
    • Abstract: Wu, Sharon LY; Leung, Albert Wing-Nang; Yew, David Tai-Wai
      Opioid is a popular drug of abuse and addiction. We evaluated acupuncture as a non-pharmacological treatment with a focus on managing withdrawal symptoms. Electrical stimulation at a low frequency (2 Hz) accelerates endorphin and encephalin production. High-frequency stimulation (100 Hz) upregulates the dynorphin level that in turn suppresses withdrawal at the spinal level. The effect of 100-Hz electroacupuncture may be associated with brain-derived neurotrophic factor activation at the ventral tegmental area, down-regulation of cAMP response element-binding protein, and enhanced dynorphin synthesis in the spinal cord, periaqueductal grey, and hypothalamus. Clinical trials of acupuncture for the management of different withdrawal symptoms were reviewed. The potential of acupuncture to allay opioid-associated depression and anxiety, and its possible use as an adjuvant treatment were evident. A lack of effect was indicated for opioid craving. Most studies were hampered by inadequate reporting details and heterogeneity, thus future well-designed studies are needed to confirm the efficacy of acupuncture in opioid addiction treatment.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 1 - Gender differences in perceived social support and
           stressful life events in depressed patients
    • Abstract: Soman, Savitha; Bhat, Shripathy M; Latha, KS; Praharaj, Samir Kumar
      Objective: To study the gender differences in perceived social support and life events in patients with depression.

      Methods: A total of 118 patients aged 18 to 60 years, with depressive disorder according to the DSMIV- TR, were evaluated using the Multidimensional Scale of Perceived Social Support and Presumptive Stressful Life Events Scale.

      Results: The perceived social support score was significantly higher in males than females (p < 0.001). Males perceived significantly higher social support from friends than females (p < 0.001), whereas support from significant others was higher in females. There was a higher mean number of total life events as well as specific type of life events in males that became apparent after controlling for education (p < 0.05). Financial loss or problems was the most commonly reported life event in both males and females. Work-related problems were more commonly reported by males, whereas family and marital conflict were more frequently reported by females.

      Conclusion: Perceived social support and stressful life events were higher in males with depression than females.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 1 - Validation of the Hong Kong Cantonese version of World
           Health Organization five well-being index for people with severe mental
           illness
    • Abstract: Kong, Chung-Lung; Lee, Chi-Chiu; Ip, Yee-Chiu; Chow, Lai-Ping; Leung, Chi-Hoi; Lam, Yiu-Chau
      Objective: The World Health Organization Five Well-Being Index (WHO-5) has been developed to measure psychological wellbeing. Translation and linguistic validation of the WHO-5 into a Cantonese version has been accomplished for local use but it is not yet validated in people with severe mental illness in Hong Kong. This study aimed to examine the applicability of WHO-5 in measuring the psychological wellbeing dimension of people with severe mental illness. A brief and easily administrated tool to measure psychological wellbeing of people with severe mental illness can be used to provide an outcome measure in research studies and clinical trials.

      Methods: Subjects were randomly recruited from the Extended-Care Patient Intensive Treatment, Early Diversion and Rehabilitation Stepping-Stone Project (EXITERS) and the Rehabilitation Activity Centre (RAC) of Kwai Chung Hospital in Hong Kong. They were invited to complete the abbreviated version of Hong Kong Chinese World Health Organization Quality of Life (WHOQOL-BREF [HK]) and WHO-5 (Cantonese version) separately and concurrent validity was examined.

      Results: A total of 84 subjects were recruited, 42 each from EXITERS and RAC. In all, 49 (58%) were male and 35 (42%) were female. The mean +- standard deviation age was 43.2 +- 9.7 years. Their mean duration of mental illness was 16.4 +- 10.5 years and the mean years of education was 10.17 +- 2.5 years, i.e. about junior secondary school level in Hong Kong. The internal consistency of the WHO-5 was satisfactory (0.86) and was comparable with previous reports. Regarding validity, 1-factor structure with an eigenvalue of 3.24 explained 64.8% of total variance of WHO-5 for people with severe mental illness. Concurrent validity was established with moderate correlation (0.41-0.51) between WHO-5 and 4 domains of the WHOQOL-BREF (HK).

      Conclusion: The WHO-5 (Cantonese version) is a reliable and valid tool to assess the psychological wellbeing of people with severe mental illness in Hong Kong. It can be used to monitor the effectiveness of psychological intervention aimed at improving the wellbeing of such patients.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 1 - Prescribing pattern of antidepressants in children and
           adolescents: Findings from the research on Asia psychotropic prescription
           pattern
    • Abstract: Chee, Kok-Yoon; Tripathi, Adarshn; Avasthi, Ajit; Chong, Mian-Yoong; Xiang, Yu-Tao; Sim, Kang; Kanba, Shigenobu; He, Yan-Ling; Lee, Min-Soo; Chiu, Helen Fung-Kum; Yang, Shu-Yu; Kuga, Hironori; Udomratn, Pichet; Tanra, Andi Jayalangkara; Maramis, Margarita Maria; Grover, Sandeep; Mahendran, Rathi; Kallivayalil, Roy A; Shen, Winston W; Shinfuku, Naotaka; Tan, Chay-Hoon; Sartorius, Norman
      Objective: Pharmacotherapy of depression in children and adolescents is complex. In the absence of research into the efficacy and safety of antidepressants in this group of patients, their off-label prescription is common. This paper aimed to illustrate the prescription pattern of antidepressants in children and adolescents from major psychiatric centres in Asia.

      Methods: The Research on Asia Psychotropic Prescription Pattern on Antidepressants worked collaboratively in 2013 to study the prescription pattern of antidepressants in Asia using a unified research protocol and questionnaire. Forty psychiatric centres from 10 Asian countries / regions participated and 2321 antidepressant prescriptions were analysed.

      Results: A total of 4.7% antidepressant prescriptions were for children and adolescents. Fluoxetine, sertraline, and escitalopram were the most common antidepressants prescribed for children and adolescents. Almost one-third (30.3%) of prescriptions were for diagnoses other than depressive and anxiety disorders. There was less antidepressant polypharmacy and concomitant use of benzodiazepine, but more concomitant use of antipsychotics in children and adolescents compared with adults.

      Conclusion: Off-label use of antidepressants in children and adolescents was reported by 40 Asian psychiatric institutions that participated in the study. In-service education and regulatory mechanisms should be reinforced to ensure efficacy and safety of antidepressants in children and adolescents.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 1 - Relationship between traditional Chinese beliefs about
           aetiology of mental disorders and help seeking: A survey of the elderly in
           Macao
    • Abstract: Found, Andrew
      Objective: A wide range of factors can influence help-seeking attitudes when individuals experience a mental disorder. The current study investigated the relationship between traditional Chinese beliefs related to the aetiology of mental disorders and help-seeking attitudes among elderly participants in Macao.

      Methods: In order to ensure the suitability of participants for inclusion in this study, the participants were required to complete an initial screening test using the Short Portable Mental Status Questionnaire (SPMSQ). Participants who successfully passed the test (n = 183) completed a questionnaire that included the Inventory of Attitudes Toward Seeking Mental Health Services (IASMHS), a set of 9 items related to traditional Chinese beliefs about aetiology of mental disorders and demographic items.

      Results: The IASMHS scores were higher for female participants and for participants who had completed high school compared with those who had never attended school or who had only completed primary education. Endorsement of traditional Chinese beliefs about the aetiology of mental disorders was higher for male participants. There was a negative correlation between traditional Chinese aetiology beliefs related to mental disorders and help-seeking attitudes.

      Conclusion: Traditional Chinese beliefs related to the aetiology of mental disorders are a negative factor that inhibits help seeking. Implications for efforts to increase the utilisation of mental health services by the elderly are discussed.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 26 Issue 1 - Psychiatric disorders among prisoners: A national
           study in Egypt
    • Abstract: El-Gilany, Abdel-Hady; Khater, Mohamed; Gomaa, Zeinab; Hussein, Elsayed; Hamdy, Ibrahem
      Objectives: To estimate the overall prevalence of psychiatric disorders among prisoners and its associated factors, and to estimate the prevalence of different mental and personality disorders.

      Methods: This was a cross-sectional descriptive study carried out in 16 randomly selected prisons in Egypt. A stratified proportional random sample of 1350 adult prisoners was included in the study. Data were collected by a psychiatrist by direct interview with prisoners. The study questionnaire obtained information about socio-demographics, prisoner circumstances, medical history, psychological factors, legal history of the prisoner as well as the Arabic version of the Structured Clinical Interview for the DSM-IV Axis I and Axis II disorders. Bivariate and logistic regression analyses were performed to determine the significant factors associated with presence of psychiatric disorder.

      Results: The overall point prevalence of psychiatric disorders was 22%, excluding substance abuse and alcohol intake. The independent predictors for psychiatric disorders were work in prison (adjusted odds ratio = 0.6), family visits (0.5), substance abuse outside prison (2.7), history of psychiatric disorders outside prison (2.0), and repeated admission to the prison (2.5). The prevalence of mood disorders and psychosis was 3.3% and 1.3%, respectively. The overall prevalence of personality disorders was 13.6%.

      Conclusions: Psychiatric disorders are prevalent among prisoners; the most common being personality and antisocial disorders. There is a need for psychiatric assessment of prisoners when first imprisoned and for subsequent regular monitoring and treatment.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 25 Issue 4 - Psychiatry's social control and patients' rights
    • Abstract: Ventriglio, Antonio; Bhugra, Dinesh
      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 25 Issue 4 - A 17-month review of the care model, service
           structure, and design of THRIVE, a community mental health initiative in
           Northern Singapore
    • Abstract: Cheang, Ka-Man; Cheok, Christopher CS
      Effective delivery of psychiatric care requires the development of a range of services. The existing Singapore health care system provides a comprehensive range of psychiatric services based in restructured hospitals. The Ministry of Health Community Mental Health Masterplan (2012-2017) aims to build novel services for the community. This Masterplan envisions the development of ASCATs (Assessment Shared Care Teams) and COMITs (Community Intervention Teams) to build the capacity and capability for psychiatric care to be delivered outside the hospital in the community. A community mental health plan comprising a fast access clinic, internet-delivered self-help and building a community network of providers was devised for the North of Singapore through the THRIVE (Total Health Rich In Vitality and Energy) programme. This article provides an introduction to the care model, service structure and design of the THRIVE, and reviews its milestones and achievements from its inception in August 2012 until December 2013.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 25 Issue 4 - Prevalence of psychiatric morbidity in Chinese
           subjects with knee osteoarthritis in a Hong Kong orthopaedic clinic
    • Abstract: Wong, Lai-Yi; Lo, Ramon Yiu; Chiu, Chi-Kit; Lee, Wing-King; Lee, Yuen-Lun; Kwong, Po-Keung; Lo, William Tak-Lam
      Objectives: To identify the prevalence and associated factors of psychiatric morbidities and to evaluate the effectiveness of the Hospital Anxiety and Depression Scale (HADS) in screening for psychiatric morbidity in patients with knee osteoarthritis in a local orthopaedic clinic.

      Methods: A cross-sectional study was conducted from October 2013 to June 2014 to examine patients with knee osteoarthritis at a specialist orthopaedic clinic. They were evaluated for psychiatric diagnoses using the Structured Clinical Interview for the DSM-IV Axis I Disorders (SCID-I). Socio-demographic and clinical characteristics were compared between patients with and without psychiatric morbidity. Patients were also assessed using the HADS with accuracy compared with the psychiatric diagnoses made by the SCID-I.

      Results: Of the 115 patients, 39% had current psychiatric disorders. Logistic regression analysis revealed that limitation of physical activity, perceived absence of confidant, a history of psychiatric illness, and follow-up in orthopaedic clinic for = 5 years were independent factors associated with psychiatric disorders.

      Conclusions: The prevalence of psychiatric morbidity in patients with knee osteoarthritis was significant. Recognition of independent associated factors can aid in early identification and intervention in patients who are at risk of developing psychiatric morbidity. The HADS is a useful means to screen for psychiatric morbidity in these patients.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 25 Issue 4 - Six-month follow-up of cognitive impairment and
           depressive symptoms in late-onset depression
    • Abstract: Wong, Mimi MC; Chan, CF; Li, SW; Lau, YM
      Objective: To assess cognitive performance in elderly depressed patients following treatment for 6 months. Remission rate of depression after 6 months of treatment was calculated.

      Methods: The study was performed in a consecutive group of patients aged >/= 65 years with late-onset depression. Severity of depression was assessed by the Hamilton Depression Scale, cognitive performance by the Hong Kong Montreal Cognitive Assessment, and functional level by the Instrumental Activities of Daily Living Scale.

      Results: A total of 52 patients were recruited. In all, 28 (53.8%) were found to have cognitive impairment at baseline and 8 (28.6%) of them had improvement after 6 months. This cognitively impaired group was older and had a lower Instrumental Activities of Daily Living Scale score. The remission rate of depression was 61.5%.

      Conclusions: Cognitive impairment constituted a stable feature in a considerable number of elderly patients with depression. About two-thirds of patients achieved remission of depression after 6 months of treatment.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 25 Issue 4 - Neutropenia and agranulocytosis in Chinese patients
           prescribed clozapine
    • Abstract: Lau, Kit-Ling; Yim, Patty Heung-Wah
      Objectives: To examine the rate of neutropenia and agranulocytosis, and the pattern of development of these 2 disorders among Chinese patients prescribed clozapine treatment in a local psychiatric unit.

      Methods: Patients who were receiving clozapine when they were under the care of Pamela Youde Nethersole Eastern Hospital Psychiatric Unit, Hong Kong, from 1 January 1997 to 31 December 2012 and who developed neutropenia and agranulocytosis from 1 January 1997 to 30 June 2013 were retrospectively reviewed.

      Results: A total of 13 patients out of 980 clozapine recipients developed neutropenia and 3 developed agranulocytosis during treatment. Half of them were aged > 50 years and three quarters were female. The majority of patients who developed neutropenia and agranulocytosis were prescribed > 1 psychotropic medication in addition to clozapine. Half of the incidents occurred in the first 18 weeks of clozapine treatment.

      Conclusion: Long-term monitoring of white cell count is necessary during clozapine treatment. The concurrent use of clozapine with other potentially leukopenic psychotropic drugs should be limited.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 25 Issue 4 - Burden assessment, psychiatric morbidity, and their
           correlates in caregivers of patients with intellectual disability
    • Abstract: Bhatia, MS; Bhatia, Shruti; Gautam, Priyanka; Saha, Rashmita; Kaur, Jaswinder
      Objective: Intellectual disability in a child places great stress on a family and caregiver and this leads to significant socio-occupational dysfunction and impaired quality of life for caregivers. This study aimed to assess socio-demographic characteristics, burden, and psychiatric morbidity of the caregivers of persons with intellectual disability, as well as to determine the variables that correlated with burden and psychiatric morbidity.

      Methods: An observational study was carried out in an outpatient psychiatric unit of a tertiary care teaching hospital in India from October 2014 to April 2015. A total of 100 caregivers of intellectually impaired individuals were assessed for burden and psychiatric morbidity.

      Results: In all, 39% of the caregivers had a high burden score, 46% perceived mild-to-moderate burden severity, and 15% perceived no to mild burden. Mild-to-moderate depressive symptoms were present in 23% and 16% had severe-to-extremely severe depressive symptoms. Mild-to-moderate anxiety symptoms were evident in 19% of caregivers and a further 19% had severe-to-extremely severe anxiety symptoms.

      Conclusion: Routine assessment of burden and psychiatric morbidity in the caregiver will help to reduce their burden and thus help them care for their children more appropriately and efficiently.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 25 Issue 3 - Homelessness and cognitive impairment: An exploratory
           study in Tokyo, Japan
    • Abstract: Pluck, Graham; Nakakarumai, Maho; Sato, Yuko
      Objective: Homelessness has frequently been associated with neuropsychological impairment. This has been observed using general screening tests for dementia as well as tests of more focal abilities, particularly executive function. Most studies have been of homeless individuals from North America with none reported from Japan.

      Methods: In this exploratory study we interviewed a sample of 16 homeless adults from Tokyo, Japan, and performed tests of cognitive function, assessed head injury, addictive behaviours (drug use, gambling, alcohol abuse), and recorded details of homelessness history. The cognitive examination involved the Japanese Adult Reading Test to estimate premorbid intelligence quotient, the Wisconsin Card Sorting Test to measure frontal lobe-related cognitive function, and the Mini-Mental State Examination to measure global cognitive impairment associated with dementia.

      Results: Among the 16 homeless individuals, 7 (44%) displayed global cognitive impairment. In addition, executive function tended to be poor. In contrast, estimated premorbid intelligence quotient was within the normal range. Substance abuse in general was not at a level to cause clinical concern, although a high level of pathological gambling was observed. There were no associations between cognitive function and clinical and addictive behaviour variables, although associations were noted between cognitive scores and time spent homeless.

      Conclusion: The results suggest high levels of neuropsychological impairment in this sample of homeless adults in Japan. Furthermore, cognitive impairment is acquired rather than developmental in origin, and is proportional to the length of time spent homeless.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 25 Issue 3 - Psychiatric morbidity in Chinese adults with type 1
           diabetes in Hong Kong
    • Abstract: Tung, Ka-Yee; Cheng, Kin-Shing; Lee, Wing-King; Kwong, Po-Keung; Chan, Kin-Wah; Law, Alexander Chun-Bon; Lo, William Tak-Lam
      Objectives: To determine the prevalence of psychiatric morbidity and identify the correlates, as well as to evaluate the effectiveness of the Hospital Anxiety and Depression Scale and the 12-item General Health Questionnaire to screen for psychiatric morbidity in Chinese adults with type 1 diabetes.

      Methods: Subjects were recruited from a local public diabetes specialist outpatient clinic from August 2013 to January 2014. Demographic and clinical factors were recorded. Psychiatric diagnosis was established using the Chinese-bilingual version of the Structured Clinical Interview for the DSM-IV Axis I disorders. Scores for the Hospital Anxiety and Depression Scale and the 12-item General Health Questionnaire were compared with the psychiatric diagnosis.

      Results: Of the 136 patients, the point prevalence of overall psychiatric, depressive, and anxiety disorders was 39.7%, 23.5%, and 25.7%, respectively. Family history of mental illness, smoking status, history of mental illness, presence of social problems, perceived absence of confidant, presence of neuropathy and hyperlipidaemia, as well as higher level of glycosylated haemoglobin were found to be the associated factors.

      Conclusion: Psychiatric disorders were common in Chinese adults with type 1 diabetes. Finding out associated factors and using the Hospital Anxiety and Depression Scale and the 12-item General Health Questionnaire as a screening tool helped to identify patients in a diabetes clinic with psychiatric disorders.

      PubDate: Thu, 13 Jun 2019 16:08:59 GMT
       
  • Volume 29 Issue 1 - Attentional bias modification training for patients
           with generalised anxiety disorder: A randomised controlled study
    • Abstract: Chau, SW H; Tse, CY; So, SH W; Chan, SS M
      Background: Hypervigilance to threat is a mechanism contributing to generalised anxiety disorder (GAD). Although attentional bias modification training (ABMT) is designed to reduce attention to threat, its use as a mechanistically focused psychological intervention for GAD has not been examined. We aimed to investigate the effect of a brief ABMT on reducing anxiety, worry, and attentional bias in outpatients with GAD, and to determine the association between change in attentional bias and changes in anxiety and worry.

      Methods: This was a parallel-group, double-blind, randomised controlled trial. Patients with GAD who had no changes after medication treatment for the past 8 weeks were randomly allocated to either the treatment or control group to receive 4 weekly sessions of ABMT or sham ABMT, respectively, in addition to standard care. Anxiety was measured using the Hamilton Anxiety Rating Scale and the State- Trait Anxiety Inventory - trait anxiety subscale. Pathological worry was measured using the Penn State Worry Questionnaire. Attentional bias was measured using the bias score.

      Results: A total of 33 participants were allocated to the treatment (n = 17) or control (n = 16) groups. Both groups reported a significant reduction in levels of anxiety and worry after intervention, but the reduction was not greater after ABMT than sham ABMT. There was no significant change in attentional bias after ABMT; change in attentional bias was not correlated to changes in anxiety and worry.

      Conclusion: The efficacy of the brief ABMT as a mechanistically focused treatment for GAD was not supported. The small sample size and short duration of treatment may have rendered the results inconclusive.

      PubDate: Thu, 28 Mar 2019 20:01:34 GMT
       
  • Volume 29 Issue 1 - Factors associated with falls in psychogeriatric
           inpatients and comparison of two fall risk assessment tools
    • Abstract: Wong, MM C; Pang, PF
      Objectives: Development of a fall prevention programme for psychogeriatric inpatients is required. Therefore, the present study aimed to investigate factors associated with falls in psychogeriatric inpatients and compare two fall risk assessment tools.

      Methods: This study had two parts. First, all fall reports involving psychogeriatric inpatients in United Christian Hospital in 2016 were retrospectively reviewed. Factors associated with the falls were identified by comparing patients who had a fall incident and those who did not. Second, in a pilot study, 30 consecutive psychogeriatric inpatients were assessed for fall risk using the Morse Fall Scale (MFS) and the Wilson Sims Fall Risk Assessment Tool (WSFRAT), and outcomes were then compared with the modified Functional Ambulation Classification (MFAC).

      Results: In 2016, 46 women and 47 men aged 65 to 94 years were admitted to the psychiatric wards (two women and two men were admitted twice). A total of 12 falls involving nine women and two men were reported. Over 66% of falls involved patients with dementia, 75% involved women, and over 50% occurred on the way to the bathroom, mostly during the night shift when the staffing level was low. In the pilot study, of 30 consecutive psychogeriatric inpatients, 20 were classified as high risk by the WSFRAT and 10 of them were also classified as high risk by the MFS. Those classified as high risk by WSFRAT matched perfectly with those classified as high risk by MFAC. However, 30% of those classified as high risk by MFAC were not classified as high risk by MFS.

      Conclusions: Patients with dementia and women had higher risk of fall. Extra proportion of at-risk patients are able to benefit from additional fall risk interventions when WSFRAT is used instead of MFS. Further studies are needed to calculate the psychometric properties of WSFRAT.

      PubDate: Thu, 28 Mar 2019 20:01:34 GMT
       
  • Volume 29 Issue 1 - Prevalence, factors, and outcome of physical violence
           against mental health professionals at a Nigerian psychiatric hospital
    • Abstract: Akanni, OO; Osundina, AF; Olotu, SO; Agbonile, IO; Otakpor, AN; Fela-Thomas, AL
      Objectives: This cross-sectional study aimed to assess the prevalence, factors, and consequences of physical violence by mentally ill patients against mental health professionals.

      Methods: 124 of 145 mental health professionals at a Nigerian neuropsychiatric hospital satisfactorily completed a questionnaire on their experiences with physical assault.

      Results: 77 (62.1%) staff had been assaulted during their whole career; 38 (30.6%) of them were assaulted in the past 12 months. The most common type of assault was pushing (32.9%). The most common antecedent event to assault was calming an aggressive patient (44.1%). In their whole career, 22.1% of assaulted staff sustained injuries that required medical attention; 42.4% of assaulted staff sometimes or frequently/always experienced posttraumatic stress disorder symptoms. Physical assault in the whole career was associated with older age (p = 0.04), longer years of practice (p = 0.01), and job dissatisfaction (p = 0.05).

      Conclusions: Physical violence encountered by mental health professionals at a Nigerian neuropsychiatric hospital is substantial. Policy review of staff safety, training, and support is recommended.

      PubDate: Thu, 28 Mar 2019 20:01:34 GMT
       
  • Volume 29 Issue 1 - Instructions for authors
    • PubDate: Thu, 28 Mar 2019 20:01:34 GMT
       
  • Volume 29 Issue 1 - Sexuality in the 21st century: Sexual fluidity
    • Abstract: Ventriglio, A; Bhugra, D
      Sexuality is a vital component of human life. Sexuality deals with procreation and pleasure. Sexual behaviours and orientations vary and may be related to mental health. Some sexual orientations may be discriminated or censored by religious or political beliefs, and this has a big impact on sexual variations. Frequently, sexual variations are considered to be pathological and need to be medically treated. However, it should be accepted that sexuality includes a continuum of behaviours, thoughts, fantasies, acts, and attractions that are beyond procreation. Modern sexology introduced the concept of gender identity and sexual fluidity to describe how gender and sexual orientation vary and are flexible over time. Healthcare professionals and policy makers should be aware of these new definitions in order to meet health needs of sexually variant people and prevent sexuality discrimination.

      PubDate: Thu, 28 Mar 2019 20:01:34 GMT
       
  • Volume 29 Issue 1 - Religion, psychiatry, and alternate sexuality
    • Abstract: Darmansjah, D; Kalra, G; Ventriglio, A
      Religious institutions tend to display a conservative view towards individuals with alternate sexuality or identity. For managing patients with alternate sexuality, it is imperative that clinicians understand and take into account religious views and its effects on a person's mental health. We review the literature on religion, alternate sexuality, and psychiatry to ascertain their interaction and impact on the mental health of individuals with alternate sexuality or identity. Differing but overlapping perspectives on alternate sexuality persist across world religions. Individuals with conflict between religious and sexual identities are prone to have adverse mental health outcomes; adequate social supports result in more positive mental health outcomes. Education on lesbian, gay, bisexual, transgender, queer, and intersex-related topics in mental health professionals leads to better recognition of the issue and provision of respectful, effective mental health care within the context of socio-religious identity and background.

      PubDate: Thu, 28 Mar 2019 20:01:34 GMT
       
  • Volume 29 Issue 1 - Association of temporomandibular joint osseous changes
           with anxiety, depression, and limitation of mandibular function in elderly
           Vietnamese
    • Abstract: Nguyen, MS; Reemann, P; Loorits, D; Ilves, P; Jagomagi, T; Nguyen, T; Saag, M; Voog-Oras, U
      Objectives: This study aimed (1) to determine the prevalence of anxiety, depression, and TMJ osseous changes in elderly Vietnamese according to sex and residence, and (2) to investigate the association of temporomandibular joint (TMJ) osseous changes with anxiety, depression, and limitation of mandibular function.

      Methods: Elderly people living in Danang, Vietnam were recruited. Participants were screened for anxiety and depression using the self-reported 7-item Generalized Anxiety Disorder Scale (GAD-7) and 9-item Patient Health Questionnaire (PHQ-9), respectively. Participants then self-rated the limitation of their mandibular function using the 20-item Jaw Functional Limitation Scale (JFLS-20) questionnaire. TMJ osseous changes (erosion, flattening, osteophytes, and sclerosis) were evaluated using digital orthopantomography.

      Results: Of 179 participants aged 65 to 74 years, 17.9% and 35.8% had anxiety and depression symptoms, respectively. Compared with urban residents, rural residents had higher prevalence of anxiety (23.3% vs 12.4%, p = 0.009) and depression (46.62% vs 24.7%, p = 0.019). The prevalence of TMJ osseous changes was 58.1%. The most common TMJ osseous change was flattening (41.3%), followed by erosion (34.6%), sclerosis (16.2%), and osteophytes (7.8%). Participants with or without TMJ osseous changes were comparable in terms of GAD-7 score, PHQ-9 score, and JFLS-20 score and sub-scores.

      Conclusions: Anxiety and depression and TMJ osseous changes were prevalent in elderly Vietnamese. Rural residents had higher prevalence of anxiety and depression than urban residents. TMJ osseous changes were not associated with anxiety, depression, or limitation of mandibular function.

      PubDate: Thu, 28 Mar 2019 20:01:34 GMT
       
  • Volume 28 Issue 4 - Forensic psychiatric services in Hong Kong
    • Abstract: Siu, Bonnie Wei-Man; Lam, M
      PubDate: Thu, 31 Jan 2019 13:51:35 GMT
       
  • Volume 28 Issue 4 - Profiling mentally ill offenders in Hong Kong: A
           5-year retrospective review study
    • Abstract: Siu, BWM; Chan, O; Au-Yeung, CCY; Chow, KKW; Liu, ACY; Tang, DYY; Lui, SH; Cheung, EFC; Lam, M
      Objectives: This study aimed to determine the prevalence of mental illness in offenders referred to psychiatrists from January 2011 to March 2016 and any associations between crime and mental illness in these offenders.

      Methods: Case notes of offenders referred to psychiatrists at the Siu Lam Psychiatric Centre from 1 January 2011 to 31 March 2016 were reviewed. Data on sex, age on admission, educational level, principal psychiatric diagnosis, index offence, source and reason of referral, and outcome were collected.

      Results: Case notes were reviewed for 4492 offenders (75% males) aged 14 to 93 (mean, 40.6) years. Of these, 68% were referred by the courts for psychiatric report and 32% were referred by correctional institutions for psychiatric assessment and treatment. Approximately 73% of them had a diagnosable mental disorder. The most common principal psychiatric diagnoses were schizophrenia and related disorders (25%), mental and behavioural disorders due to psychoactive substance use (20%), and mood disorders (9%). The most common index offences were theft and related offences (22%), acts intended to cause injury (20%), and illicit drug offences (11%). Offences involving violence were more prevalent in males than in females (p < 0.001). In terms of the three most common principal psychiatric diagnoses, 'acts intended to cause injury' was most prevalent in those with 'schizophrenia and other related disorders' than in those with the other two diagnoses (31% vs 19% vs 17%, p < 0.001). 'Theft and related offences' was most prevalent in those with mood disorders than in those with other two diagnoses (38% vs 20% vs 18%, p < 0.001). 'Illicit drug offences' was most prevalent in those with 'mental and behavioural disorders due to psychoactive substance' than those with other two diagnoses (22% vs 8% vs 6%, p < 0.001).

      Conclusions: The prevalence of mental disorders among offenders referred to psychiatrists is high. The pattern of associations between crime and mental disorders in these offenders is comparable with that reported in overseas studies. As Siu Lam Psychiatric Centre is the only facility in Hong Kong for mentally ill offenders, our sample is representative, and our results provide cross-sectional pattern of forensic psychiatric service utilisation in Hong Kong.

      PubDate: Thu, 31 Jan 2019 13:51:35 GMT
       
  • Volume 28 Issue 4 - Compulsory admission in Hong Kong: Balance between
           paternalism and patient liberty
    • Abstract: Siu, B; Fistein, EC; Leung, HW; Chan, L; Yan, CK; Lai, A; Yuen, KK; Ng, KK
      In Hong Kong, compulsory admission is governed by the Mental Health Ordinance Section 31 (detention of a patient under observation), Section 32 (extension of period of detention for such a patient), Section 36 (detention of certified patients), and the sections in Part IV for hospital order, transfer order, and removal order. Mental health professionals adopt both legal criteria and practice criteria for compulsory admission. The present study discusses the harm principle, the patient's decision-making capacity, the multi-axial framework for compulsory admission, and the balance between paternalism and patient liberty.

      PubDate: Thu, 31 Jan 2019 13:51:35 GMT
       
  • Volume 28 Issue 4 - Combination of psychiatric and psychological
           approaches in the assessment and treatment of sexual offenders
    • Abstract: Chan, O; Lam, S
      This review discusses the association between mental disorders and sexual offending, and provides an overview of the combination of psychiatric and psychological approaches to assess and treat sexual offenders at the Sex Offender Evaluation and Treatment Unit in Siu Lam Psychiatric Centre in Hong Kong.

      PubDate: Thu, 31 Jan 2019 13:51:35 GMT
       
  • Volume 28 Issue 4 - Prevalence and screening of mental illness among
           remand prisoners in Hong Kong
    • Abstract: Chow, KKW; Chan, O; Yu, MWM; Lo, CSL; Tang, DYY; Chow, DLY; Siu, BWM; Cheung, EFC
      Objectives: This study aimed to validate the Correctional Mental Health Screen (CMHS) in the Hong Kong prison population and determine the prevalence of psychiatric disorders among remand prisoners in Hong Kong and the associated factors of mental illness.

      Methods: This cohort study was conducted at the Lai Chi Kok Reception Centre and the Tai Lam Centre for Women in Hong Kong. Remand prisoners aged >=21 years were recruited between May and August 2014. Sociodemographic and clinical data were collected. Each remand prisoner was assessed using the appropriate CMHS for males or for females, then interviewed by a specialist psychiatrist using the Structured Clinical Interview for DSM-IV for current affective disorder and psychotic disorder for crossvalidation.

      Results: A total of 245 remand prisoners were recruited (150 males and 95 females; mean age, 25.8 years). Of them, 51% (55% males and 44% females) had a lifetime history of psychiatric disorder, whereas 39.6% (46% males and 29.5% females) had a current psychiatric disorder. The most common psychiatric disorder was substance use disorder (>36%), followed by mood disorder (>20%), psychotic disorder (5.3%), and lifetime neurotic disorder (3.7%). Living in a public housing estate (odds ratio [OR] = 1.99), a history of childhood conduct problem (OR = 2.40), and a forensic history (OR = 1.97) were associated with an increased risk of having a psychiatric disorder. The CMHS had good diagnostic efficiency after cross-validation with the Structured Clinical Interview for DSM-IV.

      Conclusion: Psychiatric disorders are prevalent in remand prisoners in Hong Kong. The CMHS is an effective tool to screen remand prisoners for timely treatment of prisoners with mental health needs.

      PubDate: Thu, 31 Jan 2019 13:51:35 GMT
       
  • Volume 28 Issue 4 - People with intellectual and developmental disorders
           in the United Kingdom criminal justice system
    • Abstract: Chester, V
      This review aims to describe the way in which people with intellectual and/or developmental disabilities (IDD) are treated within the criminal justice system (CJS) in the United Kingdom (UK). The relevant empirical literature and national reports are reviewed, and the current care model for offenders with IDD described. The care of people with IDD within the CJS is relatively advanced in UK; however, offenders with IDD experience difficulties at all stages. This includes engagement with police and the courts, accessing adapted therapies, and after discharge from inpatient care or release from custody. This review highlights a number of strengths of the existing model of care, as well as ongoing challenges. Care of people with IDD within the CJS is highly political, and many aspects of the current model operate according to government policy, based upon charitable or independent review evidence, rather than empirical research. Further research on people with IDD in the CJS is urgently needed, to fully understand the factors related to treatment outcomes.

      PubDate: Thu, 31 Jan 2019 13:51:35 GMT
       
  • Volume 28 Issue 4 - Diminished responsibility: Law reform in the United
           Kingdom and personal perspective on forensic psychiatric practice in Hong
           Kong
    • Abstract: Liu, ACY
      This commentary discusses law reform on diminished responsibility in the United Kingdom and provides a personal perspective on forensic psychiatric practice relating to diminished responsibility in Hong Kong.

      PubDate: Thu, 31 Jan 2019 13:51:35 GMT
       
  • Volume 28 Issue 4 - Maternal infanticide and filicide in a psychiatric
           custodial institution in Hong Kong
    • Abstract: Tang, D; Siu, B
      Objective: The aim of this study was to review the history, legislation, and psychiatric perspective of filicide, to compare the characteristics of mothers who committed neonaticide versus infanticide, and to discuss the infanticide law in Hong Kong.

      Methods: Data of mothers remanded to the Siu Lam Psychiatric Centre from 2008 to 2016 for filicide were reviewed, as were data of filicide from the Child Fatality Review Reports published by the Social Welfare Department.

      Results: From 2008 to 2016, eight mothers were remanded to Siu Lam Psychiatric Centre for filicide. Four were convicted of infanticide; the other four were convicted of manslaughter. Those convicted of infanticide were single and aged
      PubDate: Thu, 31 Jan 2019 13:51:35 GMT
       
  • Volume 28 Issue 4 - Sexually violent predator law in the United States
    • Abstract: Felthous, AR; Ko, J
      Sexually violent predator (SVP) laws in the United States are controversial. They tend to be opposed by academics, libertarians, and professional organisations but are supported by states and the Supreme Court. This study reviews the history of SVP legislation, compares features of SVP laws among states, and summarise requirements by the Supreme Court that shaped these laws. Features of SVP laws include identification of sexual offenders with mental abnormality that predisposes them to sexually offending behaviours in the future, and standards of proof for conditional or unconditional release. A comprehensive understanding of all statutes can inform policymakers about SVP laws, whether supportive or restrictive of such legislation.

      PubDate: Thu, 31 Jan 2019 13:51:35 GMT
       
  • Volume 28 Issue 3 - Premorbid adjustment in predicting symptom severity
           and social cognitive deficits in schizophrenia
    • Abstract: Dewangan, RL; Singh, P
      Objective: Schizophrenia patients have deficits in premorbid adjustment (PMA) and social cognition (SC); both deficits are associated with symptom severity, neuro-cognitive deficits, and prognosis. This study aimed to determine symptom severity and two domains of SC deficit by assessing specific areas of PMA in schizophrenia patients.

      Methods: This cross-sectional study included 60 male and 60 female patients with paranoid schizophrenia aged 20 to 35 years from two psychiatric inpatient departments of Chhattisgarh state of India. They were assessed using the Scale for Assessment of Positive Symptoms, Scale for Assessment of Negative Symptoms, Premorbid Adjustment Scale, Recognition of Facial Expression Task, and Picture Arrangement Test.

      Results: Deficits in premorbid sociability and in scholastic performance were the best predictors of severity of positive symptoms, social knowledge, and negative emotion recognition deficit in schizophrenia patients.

      Conclusion: Given the important role of SC and PMA, assessing premorbid functioning can help in deciding early and appropriate intervention for schizophrenia.

      PubDate: Fri, 23 Nov 2018 22:11:44 GMT
       
  • Volume 28 Issue 3 - Aripiprazole versus lithium in management of acute
           mania: A randomized clinical trial
    • Abstract: Shafti, SS
      Objective: This study aimed to compare aripiprazole with lithium for the effectiveness of treating Iranian male patients with acute mania.

      Methods: A total of 30 male in-patients with bipolar I disorder who presented with relapse or new emergence of an episode of acute mania were equally randomised to receive 4 weeks of aripiprazole (5 mg uncoated tablets) or lithium carbonate (300 mg uncoated tablets) according to standard practice guidelines and titration protocols. The Manic State Rating Scale (MSRS) was used to determine the severity of manic symptoms at baseline (week 0) and up to week 4. The Bech-Rafaelsen Mania Scale (BRMS), Schedule for Assessment of Insight (SAI), and Clinical Global Impressions-Global Improvement scale (CGI-G) were used to determine the severity of manic symptoms, insight, and overall illness severity, respectively. All outcome measures were recorded by a single experienced psychiatrist.

      Results: The frequency and intensity of manic symptoms (MSRS score) in both groups decreased significantly from baseline to week 4. In the aripiprazole and lithium groups, the intensity of manic symptoms decreased by >/= 25% in 5 and 7 patients and by >50% in 1 and 5 patients, respectively. Between-group analysis showed that lithium was more effective at weeks 3 and 4 in decreasing the frequency and intensity of manic symptoms. The lithium group achieved greater improvement in symptoms than the aripiprazole group in terms of BRMS score, SAI score, and CGI-G.

      Conclusion: Lithium is more effective than aripiprazole in improving manic symptoms.

      PubDate: Fri, 23 Nov 2018 22:11:44 GMT
       
  • Volume 28 Issue 3 - Association of suicidal ideation with demographic,
           lifestyle and health factors in Malaysians
    • Abstract: Cheah, YK; Azahadi, M; Phang, SN; Abd Manaf, N H
      Objective: To determine the association of suicidal ideation with demographic, lifestyle, and health factors, using data from National Health and Morbidity Survey 2011 (NHMS 2011) of Malaysia.

      Methods: The NHMS 2011 included 10,141 respondents. Independent variables of suicidal ideation were income, age, household size, sex, ethnicity, education, marital status, smoking, physical activity, and self-rated health. The risk factors of suicidal ideation were determined using logistic regression analysis.

      Results: In the pooled sample, suicidal ideation was associated with age, sex, ethnicity, and self-rated health, but not associated with income, household size, education, physical activity, or smoking.

      Conclusion: The likelihood of having suicidal ideation is positively associated with young adults, women, Indians, and those with poor self-rated health.

      PubDate: Fri, 23 Nov 2018 22:11:44 GMT
       
  • Volume 28 Issue 3 - Audit of mental capacity assessment by primary care
           physicians versus consultation-liaison psychiatrists
    • Abstract: Chan, CYW; Yong, SWL; Mhaisalkar, AS; Sin, G L; Poon, S H; Tan, S M
      Objective: To review the mental capacity assessment of in-patients referred to consultation-liaison psychiatrists and to compare the assessment first made by primary care physicians.

      Methods: Medical records of in-patients who were referred to consultation-liaison psychiatrists for mental capacity assessment between May and October 2015 were retrospectively reviewed. Assessment was first made by a primary care physician; complex cases were referred to a consultation-liaison psychiatrist. Audit of each case note was conducted independently by at least two of the authors.

      Results: Medical records of 37 female and 26 male in-patients aged 24 to 91 (mean, 68.2) years were audited. Only 33.3% of these patients had no psychiatric diagnosis. Overall, assessments by primary care physicians were suboptimal. Assessments by consultation-liaison psychiatrists were more detailed, with documentation of mental capacity (93.7%) and psychiatric diagnosis (88.9%). Nonetheless, patient wishes and beliefs were poorly documented (19.0%), as were whether the patient had a lasting power of attorney or a court-appointed deputy (6.3%) and whether the patient had made advance care planning (0%).

      Conclusion: Overall, mental capacity assessment was inadequately performed by primary care physicians and consultation-liaison psychiatrists. More work needs to be done to engage, educate, and empower all stakeholders involved.

      PubDate: Fri, 23 Nov 2018 22:11:44 GMT
       
  • Volume 28 Issue 3 - Attitude of medical students in Paraguay towards
           homosexuality
    • Abstract: Torales, J; Barrios, I; Torres, A; Dunjo, N; Benitez, M G; Villalba, J; Ventriglio, A; Bhugra, D
      Introduction: The attitude of medical students towards homosexuality may affect the quality of care for homosexual patients. This study aimed to describe the attitude of medical students at the National University of Asuncion, Paraguay towards homosexuality.

      Methods: This observational, cross-sectional study was conducted in June 2016 in consecutive medical students from the National University of Asuncion (Santa Rosa del Aguaray branch), Paraguay. The 10-item attitude towards homosexuality scale (EAH-10) was used to assess participants' acceptance/ rejection of homosexuals as individuals, homosexuality as a sexual orientation, and public manifestations of homosexuality.

      Results: A total of 48 female and 29 male participants (mean age, 21 +- 2 years) were included. Most were Catholic (71.4%), followed by non-Catholic Christian (10.4%), agnostic (9.1%), atheist (2.6%), and other (6.5%). 71.4% reported having at least one homosexual friend. The mean EAH-10 score was 27.23 +- 9.379. 42.9% of participants were indifferent or undecided in their attitude towards homosexuality and 28.6% were discriminatory. Having homosexual friends was associated with a lower EAH-10 score (t = -3.447 [75], p = 0.001).

      Conclusion: Education about health issues of homosexuals is needed for medical students in Paraguay.

      PubDate: Fri, 23 Nov 2018 22:11:44 GMT
       
  • Volume 28 Issue 3 - Postvention in action: The international handbook of
           suicide bereavement support [Book Review]
    • Abstract: Wu, Kitty K
      Review(s) of: Postvention in Action: The international handbook of suicide bereavement support, Edited by Karl Andriessen, Karolina Krysinska, Onja T Grad, Hogrefe Publishing, ISBN 0889374937.

      PubDate: Fri, 23 Nov 2018 22:11:44 GMT
       
  • Volume 28 Issue 3 - Video feedback on mother-child interactions in
           perinatal psychiatric service in Hong Kong
    • PubDate: Fri, 23 Nov 2018 22:11:44 GMT
       
  • Volume 28 Issue 2 - Posttraumatic stress after treatment in an intensive
           care unit
    • Abstract: Wu, KK; Cho, VW; Chow, FL; Tsang, AP Y; Tse, DM
      Objective: To study posttraumatic stress in patients after treatment in an intensive care unit (ICU).

      Methods: This prospective cohort study included 136 adult patients with critical medical and surgical problems who were discharged from the ICU of the Caritas Medical Centre, Hong Kong. Their occurrence of posttraumatic stress disorder (PTSD), anxiety, and depression after ICU treatment were measured using the Impact of Event Scale - Revised and Hospital Anxiety and Depression Scale. Patient ICU experience was measured using the ICU Memory Tool. Multivariable analyses were conducted to examine the predictors of PTSD symptoms, anxiety, and depression.

      Results: Symptoms of PTSD, anxiety, and depression were reported in 10% to 17% of patients. Symptom severity was associated with less factual memory, more vivid memory of feelings about and more delusional memory of the ICU experience, low emotional support, and high perceived life threat.

      Conclusions: Symptoms of posttraumatic stress, anxiety, and depression may occur after ICU treatment. Early identification and appropriate intervention for PTSD are important for rehabilitation.

      PubDate: Fri, 13 Jul 2018 22:42:46 GMT
       
  • Volume 28 Issue 2 - Association between N-methyl-d-aspartate receptor
           subunit 2B gene polymorphisms and personality traits in a young Japanese
           population
    • Abstract: Narita, S; Onozawa, Y; Yoshihara, E; Nishizawa, D; Numajiri, M; Ikeda, K; K, Iwahashi
      Objective: The N-methyl-d-aspartate receptor subunit 2B (GluN2B) is involved in regulation of anxiety and depression and nervous activity in the brain. Single nucleotide polymorphisms of the GluN2B gene (GRIN2B) are associated with human mental function and behaviour. We investigated whether four GRIN2B polymorphisms (rs7301328, rs1806201, rs1805247, and rs1805502) affect characterisation of personality traits.

      Methods: In 248 young people, GRIN2B polymorphisms were analysed, and personality traits were assessed using the Neuroticism Extraversion Openness-Five Factor Inventory (NEO-FFI) and State-Trait Anxiety Inventory (STAI).

      Results: There was no main effect of the GRIN2B polymorphisms on the NEO-FFI and STAI dimension scores. Interaction between polymorphism and sex was found in rs1805247 (p = 0.034) and rs1805502 (p = 0.040) in terms of the conscientiousness score of the NEO-FFI. However, post hoc simple main effect analysis showed no significant effect. The preliminary haplotype analysis indicated that haplotype CTT (rs1806201-rs1805247-rs1805502) in the haplotype block was associated with the extraversion score of the NEO-FFI in female participants (p = 0.044), but the significance was lost on correction for multiple testing.

      Conclusion: There was no significant association between selected GRIN2B polymorphisms and personality traits, but this may be due to low statistical power. Further studies involving a larger study population are needed to clarify this.

      PubDate: Fri, 13 Jul 2018 22:42:46 GMT
       
  • Volume 28 Issue 2 - Clozapine-related paroxysmal supraventricular
           tachycardia: A case report
    • Abstract: Kim, SJ; Gim, MS
      Clozapine is considered to be more effective than other antipsychotic drugs for treating treatmentresistant schizophrenia. However, side effects of clozapine include agranulocytosis and, less commonly, cardiovascular disease, which is occasionally fatal. We describe a 56-year-old woman who developed clozapine-related paroxysmal supraventricular tachycardia during clozapine dose titration and had a recurrence despite being treated with verapamil. For treatment-resistant schizophrenia, a slow titration of the clozapine dose is necessary, and potential cardiac side-effects should be monitored.

      PubDate: Fri, 13 Jul 2018 22:42:46 GMT
       
  • Volume 28 Issue 2 - Neutrophil-lymphocyte ratio and C-reactive protein
           level in patients with major depressive disorder before and after
           pharmacotherapy
    • Abstract: Adhikari, A; Dikshit, R; Karia, S; Sonavane, S; Shah, N; De Sousa, A
      Background: Neutrophil-lymphocyte ratio (NLR) and C-reactive protein (CRP) level are useful biomarkers of inflammation. This study aimed to assess NLR and CRP level in patients with major depressive disorder before and after pharmacotherapy to determine whether NLR or CRP could be used as biomarkers of severity of major depression and whether there was any sex difference.

      Methodology: Patients with major depression who received no pharmacotherapy 1 month prior to the study were included. Their haemoglobin, total white blood cell count, neutrophil and lymphocyte counts, NLR, and CRP levels were evaluated at baseline and 12 weeks post pharmacotherapy, as were the Montgomery Asberg Rating Scale for Depression, the Scale for Impact of Suicidality Management and Assessment and Planning of Care (SIS-MAP), and the Clinical Global Impression Scale - Severity.

      Results: 24 male and 26 female patients were included. At 12 weeks after pharmacotherapy, males had a higher haemoglobin level (p = 0.025), higher total white blood cell count (p = 0.018), and lower percentage of neutrophils (p = 0.019) than females. There was no sex difference in NLR or CRP. From baseline to 12 weeks, males had no significant change in any blood parameter, but females had a significantly greater increase in the percentage of neutrophils (p = 0.0001) and decrease in the percentage of lymphocytes (p = 0.012), resulting in a significantly increased NLR (p = 0.001). Both males and females had significant improvement on all 3 scales (p < 0.001). At 12 weeks, in males, the increase in NLR positively correlated with CRP as well as the Montgomery-Asberg Depression Rating Scale and the SIS-MAP, but not the Clinical Global Impression - Severity Scale. In females, the increase in NLR did not correlate with CRP or any of the scales.

      Conclusion: In female patients, the NLR increased in response to antidepressant therapy while CRP remained unchanged. This indicated that inflammation has a role in the pathogenesis of major depression.

      PubDate: Fri, 13 Jul 2018 22:42:46 GMT
       
  • Volume 28 Issue 2 - Attitude of Indian medical students towards
           homosexuality
    • Abstract: Kar, A; Mukherjee, S; Ventriglio, A; Bhugra, D
      Introduction: It is important to understand the attitude of medical students towards homosexuality, as this may affect patient care.

      Methods: Year 2 and 3 students at Calcutta National Medical College, Kolkata, India were asked to selfadminister an 18-item questionnaire anonymously. Internal consistency of the questionnaire statements was high (Cronbach's alpha of 0.91). There were five responses for each statement: strongly agree, generally agree, unsure, generally disagree, and strongly disagree.

      Results: Of 290 students, 270 (93.1%) [148 males and 122 females] completed the questionnaire and were included in the analysis. Overall, 55.6% strongly disagreed that homosexuality was an illness; 70.8% agreed that homosexuals were capable of forming stable relationships. Only 31.1% believed that homosexual doctors would better understand homosexual patients. About 71.8% reported that talking about homosexuality did not embarrass them, and 81.8% believed that problems associated with homosexuality could be reduced if society was more liberal. Nonetheless, negative attitudes were reflected in the stereotypical image of homosexuality. About 15.9% of respondents believed that homosexuality was an illness; 24.8% considered homosexuals neurotic, 28.1% considered homosexuals promiscuous; and 8.2% thought that they posed a danger to children.

      Conclusion: Although the overall attitude of Indian medical students towards homosexuality is positive, the percentage of students with negative attitudes remains quite high. Further work on the medical curriculum is needed to change these negative attitudes so that patients receive appropriate care.

      PubDate: Fri, 13 Jul 2018 22:42:46 GMT
       
  • Volume 28 Issue 2 - Arachnoid cyst causing depression and neuropsychiatric
           symptoms: A case report
    • Abstract: Shettar, M; Karkal, R; Misra, R; Kakunje, A; Chandran, V V Mohan; Mendonsa, RD
      Arachnoid cysts are benign space-occupying brain lesions that contain cerebrospinal fluid. Most cases are congenital in origin, caused by failed fusion of the arachnoid membrane early in fetal development. Cases are often incidentally detected on neuroimaging; however, rarely patients present with neuropsychiatric manifestations when cysts expand and cause a midline shift, compression of nearby brain tissue or cerebrospinal fluid compartments or both. We report a case of a 56-year-old woman with no past history or family history of psychiatric illness who developed acute-onset right-sided weakness, depressive symptoms, and other neuropsychiatric deficits. A diagnosis of organic mood disorder caused by an arachnoid cyst was made. Her symptoms and neuropsychiatric deficits remitted after cyst marsupialisation by open craniotomy. Therefore, it is important to investigate the organic aetiology in elderly patients who present with simultaneous mood disorder and cognitive dysfunction.

      PubDate: Fri, 13 Jul 2018 22:42:46 GMT
       
  • Volume 28 Issue 1 - Sexual dysfunction in patients with
           antidepressant-treated anxiety or depressive disorders: A pragmatic
           multivariablelongitudinal study
    • Abstract: Preeti, S; Jayaram, SD; Chittaranjan, A
      Objective: To investigate early evolution, tolerability, and predictors of antidepressant-emergent sexual dysfunction in patients with anxiety or depressive disorder. Methods: Patients with anxiety or depressive disorders who were prescribed antidepressant monotherapy (mirtazapine, sertraline, desvenlafaxine, escitalopram, or fluoxetine) at the discretion of the treating clinician were recruited from July 2012 to June 2014 from a hospital outpatient service. All were free of psychotropic medication for least 1 month. Sexual function was assessed at baseline, week 2, and week 6 using the Psychotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ). A PRSexDQ score of ≥2 was considered to indicate sexual dysfunction. Sexual function was dichotomised to 'favourable' or 'impaired'. Results: Of 230 patients recruited, 209 were assessed at baseline of whom 184 were assessed at week 2; of these, 154 were also assessed at week 6. At baseline, 138 (66%) of the 209 patients were diagnosed with depressive disorder and 71 (34%) with anxiety disorder; 29% of patients had sexual dysfunction (in any domain of PRSexDQ). By week 6, the percentage had increased to 41%, although the change in the mean PRSexDQ score was only marginal (from 1.04 at baseline to 1.55 at week 6). With regard to individual questionnaire items, by week 6, sexual desire improved, but erectile and ejaculatory function in men and orgasmic function in women worsened. Fluoxetine and sertraline were associated with impaired sexual function, whereas mirtazapine was associated with favourable sexual function. In a logistic regression analysis, at week 2, mirtazapine and desvenlafaxine were predictors of favourable sexual outcome, whereas fluoxetine and higher baseline PRSexDQ score were predictors of impaired sexual outcome. At week 6, mirtazapine remained a predictor of favourable sexual outcome, whereas fluoxetine, higher 2-week PRSexDQ score, and adequate dose were predictors of impaired sexual outcome. Conclusions: In patients with anxiety or depressive disorder, the risk of antidepressant-emergent sexual dysfunction at 6 weeks is low when drug doses are initially low with gradual up-titration. Baseline sexual dysfunction was independently associated with impaired sexual outcome. Men may be more likely than women to experience impaired sexual outcome. In patients with baseline sexual dysfunction, prescription of mirtazapine might be preferable to fluoxetine.

      PubDate: Fri, 13 Apr 2018 09:01:50 GMT
       
  • Volume 28 Issue 1 - Symptoms of anxiety and depression in obese
           Singaporeans: A preliminary study
    • Abstract: Lu, Y; Chew, MWP; Shabbir, A; So, JBY; Ho, RCM; Ndukwe, N
      Background: Obesity is a major component of metabolic syndrome and an independent risk factor for various chronic diseases. It is also closely associated with mental illness, and the interaction is complex and multifactorial. This study aimed to estimate the prevalence of anxiety and depressive symptoms among obese Singaporeans. Methods: Cross-sectional data of 36 male and 47 female obese Singaporeans who had been referred to the weight management clinic of National University Hospital, Singapore, between January 2010 and November 2011 were collected. Obesity was classified according to criteria of the World Health Organization. The extents of anxiety and depressive symptoms were measured using the Hospital Anxiety and Depression Scale. Results: In obese Singaporeans attending the weight management clinic, the prevalence of anxiety symptoms was higher than that of depressive symptoms (28% vs 11%). There was no major socioeconomic difference between obese patients with and without anxiety, or with and without depressive symptoms. Conclusion: In obese Singaporeans, anxiety symptoms may be more common than depressive symptoms. Weight management programmes should incorporate anxiety management as part of standard treatment. Early detection and pharmacological and psychological interventions should be implemented.

      PubDate: Fri, 13 Apr 2018 09:01:50 GMT
       
  • Volume 28 Issue 1 - Frontal theta asymmetry as a biomarker of depression
    • Abstract: Dharmadhikari, AS; Tandle, AL; Jaiswal, SV; Sawant, VA; Vahia, VN; Jog, N
      Introduction: Electroencephalography (EEG) has been used extensively to study affective disorders. Quantitative spectral analysis of an EEG scan has been used to assess the biological basis of emotional disorders such as depression as well as to investigate biomarkers of affective disorders. Inter-hemispheric asymmetries in both baseline and stimulus-evoked frequencies (alpha, beta, theta, and delta) are potential biomarkers of depression. The role of frontal alpha asymmetry has been established, but other spectral frequencies such as frontal theta remain elusive. We compared the hemispheric differences in frontal theta power in depressed patients and controls before and during listening to music to study the correlation of frontal theta asymmetry with depression. Methods: To determine whether stimulus-evoked frontal theta asymmetry is a biomarker of depression, we compared 23 patients with mild depression (based on the Hamilton Depression Rating Scale) with 17 age- and sex-matched controls by conducting EEG at rest and after listening to Indian classical music. Results: In controls without depression, the mean frontal theta power of the left hemisphere and frontal theta asymmetry increased significantly during music listening. In depressed patients, frontal theta asymmetry was reversed during music listening. Conclusion: Frontal theta asymmetry is a potential biomarker of depression.

      PubDate: Fri, 13 Apr 2018 09:01:50 GMT
       
  • Volume 28 Issue 1 - Self-harm and suicide attempts in a Japanese
           psychiatric hospital
    • Abstract: Tanimoto, C; Yayama, S; Suto, S; Matoba, K; Kajiwara, T; Inoue, M; Endo, Y; Yamakawa, M; Makimoto, K
      Objective: Self-harm and attempted suicide are risk factors for suicide in psychiatric hospital in-patients. This study aimed to analyse the circumstances of self-harm and suicide attempts in a Japanese psychiatric hospital so as to improve management and care. Methods: Incident reports of self-harm and suicide attempts during a 12.4-year period from November 2000 to March 2013 were reviewed. A descriptive analysis was conducted in terms of age, sex, and diagnosis of patients, as well as level, ward, situations, and causes of incidents. Results: During the study period, 90 cases of self-harm and attempted suicide involving 58 patients were reported. The rate of self-harm and suicide attempts was 0.05 per 1000 patient-days. The types of self harm and suicide attempts included hanging (n = 25), wrist cutting (n = 19), ingestion of foreign objects (n = 17), and others (n = 29). The single case of completed suicide involved hanging, in a patient with schizophrenia. Among 55 patients with relevant data, the most common clinical diagnosis was mood disorder (41.8%), followed by schizophrenia (36.4%). Mood disorder was 3.5 times as prevalent in females as in males (14 vs. 4). Fourteen patients with mood disorder (n = 8) or schizophrenia (n = 6) were repeatedly involved in 46 of 89 cases of self-harm or attempted suicide; 11 were female. One woman with mood disorder attempted suicide 9 times within the same year. The top 3 management and care factors related to self-harm and suicide attempts were failure to adhere to preventive procedures (28%), insufficient therapeutic communication (28%), and difficulty in predicting suicide (20%). Conclusion: Self-harm and suicide attempts at this psychiatric hospital occurred at a rate of 0.05 per 1000 patient-days between late 2000 and early 2013. Efforts are needed to increase compliance with suicide prevention procedures and therapeutic communication, so as to improve management and care of psychiatric in-patients and prevent them from committing suicide.

      PubDate: Fri, 13 Apr 2018 09:01:50 GMT
       
  • Volume 28 Issue 1 - Clinical handbook of psychotropic drugs (22nd edition)
           [Book Review]
    • Abstract: Chiang, TP
      Review(s) of: Clinical handbook of psychotropic drugs (22nd edition), by Ric M Procyshyn, Kalyna Z Bezchlibnyk-Butler, J Joel Jeffries, Hogrefe Publishing Group ISBN: 978-0-88937-496-6

      PubDate: Fri, 13 Apr 2018 09:01:50 GMT
       
  • Volume 28 Issue 1 - Mindfulness [Book Review]
    • Abstract: Tsang, Alfert WK
      Review(s) of: Mindfulness, by Katie Witkiewitz, Corey R Roos, Dana Dharmakaya Colgan, Sarah Bowen Hogrefe Publishing GroupUS$ 29.8; pp76; ISBN: 978-0-88937-414-0

      PubDate: Fri, 13 Apr 2018 09:01:50 GMT
       
  • Volume 28 Issue 1 - Electrocardiographic monitoring of psychiatric
           in-patients taking antipsychotic medications
    • Abstract: Kwan, MM; Nguyen, DGH; Ng, RMK
      Objective: To assess the adherence to guidelines for electrocardiographic (ECG) monitoring in Hong Kong psychiatric in-patients who have been prescribed antipsychotic medications. Methods: In-patients who had been prescribed antipsychotic drugs on hospital admission during the baseline audit period of 15 April 2015 to 16 July 2015 and the re-audit period of 28 January 2016 to 30 April 2016 were included. Quality improvement interventions were delivered after the baseline audit. ECG monitoring adherence was categorised as full adherence (ECG before taking antipsychotics), partial adherence (ECG after taking antipsychotics), or non-adherence (no ECG during hospital stay). Overall compliance was defined as full adherence plus partial adherence. Results: The baseline audit and re-audit included 378 and 422 patients, respectively. Overall compliance with ECG monitoring increased significantly from the baseline audit to re-audit (40.2% vs. 69.9%; p < 0.001). Case-doctors having the grade of resident was associated with stronger adherence to ECG monitoring in both audits. Conclusion: Adherence to ECG monitoring guidelines for in-patients who are prescribed antipsychotic drugs is low in Hong Kong, and junior doctors (residents) demonstrate stronger adherence than moresenior doctors.

      PubDate: Fri, 13 Apr 2018 09:01:50 GMT
       
  • Volume 27 Issue 4 - Management for psychiatrists, fourth edition [Book
           Review]
    • Abstract: Ng, Roger
      Review(s) of: Management for psychiatrists, fourth edition, edited by Dinesh Bhugra, Stuart Bell, Alistair Burns, RCPsych Publications, 90.00 pounds, pp544, ISBN: 978-1909726659.

      PubDate: Wed, 31 Jan 2018 17:14:46 GMT
       
  • Volume 27 Issue 4 - Bipolar disorder 2017 (Advances in psychotherapy:
           Evidence based practice) [Book Review]
    • Abstract: Tang, Wayne
      Review(s) of: Bipolar disorder 2017 (Advances in psychotherapy: Evidence based practice), by Robert P. Reiser, Larry W. Thompson, Sheri L. Johnson, Trisha Suppes, Hogrefe Publishing, 19.90 pounds, pp128, ISBN: 978-0-88937-410-2.

      PubDate: Wed, 31 Jan 2018 17:14:46 GMT
       
  • Volume 27 Issue 4 - Antidepressants for depression associated with
           traumatic brain injury: A meta-analytical study of randomised controlled
           trials
    • Abstract: Paraschakis, Antonios; Katsanos, Aristeidis H
      Introduction: Depression following traumatic brain injury is experienced by 16% to 60% of affected patients. The present study aimed to update the best evidence-based pharmacological treatments for tackling such chronic and debilitating disorders.

      Methods: We systematically reviewed and meta-analysed randomised controlled trials published from 1990 until August 2017 that compared the efficacy of antidepressants with placebo in the treatment of post-traumatic brain injury depression. We searched MEDLINE, SCOPUS, and the Cochrane Central Register of Controlled Trials (CENTRAL).

      Results: Four studies were eligible for the meta-analysis. The antidepressants studied were the selective serotonin reuptake inhibitors sertraline and citalopram. The rate of non-responders at the end of the followup period was lower in the treatment groups compared with placebo (odds ratio = 0.42, 95% confidence interval: 0.15-1.17); this difference was not statistically significant (p = 0.10). In subgroup analysis of the studies that reported mean Hamilton Depression Rating Scale score differences between treatment and control groups in both baseline and endpoint evaluations, the pooled mean difference was reduced from 2.11 (95% confidence interval: -1.25 to 5.46) to -2.36 (95% confidence interval: -5.59 to 0.87), in favour of the treatment group, though not statistically significant (p = 0.06). No evidence of heterogeneity was detected. In the subgroup analysis according to the antidepressant used in the included studies, there was a trend towards statistical significance for sertraline only (odds ratio = 0.28, 95% confidence interval: 0.08-1.03; p = 0.05); this was not evident in the study that reported the use of citalopram (odds ratio = 0.83; 95% confidence interval: 0.15-4.64; p = 0.84).

      Conclusions: Sertraline might be effective, though not statistically significant, in treating patients with post-traumatic brain injury depression. Adequately powered randomised controlled trials - extended to the plethora of newer antidepressants aiming to prove their non-inferiority to the selective serotonin reuptake inhibitors studied - are needed to confirm our results. The dearth of quality studies of this devastating problem of public health is rather impressive.

      PubDate: Wed, 31 Jan 2018 17:14:46 GMT
       
  • Volume 27 Issue 4 - Positive aspects of caregiving and its correlates
           among caregivers of bipolar affective disorder
    • Abstract: Grover, Sandeep; Kate, Natasha; Chakrabarti, Subho; Avasthi, Ajit
      Objective: To evaluate the positive aspects of caregiving and its correlates (socio-demographic and clinical variables, caregiver burden, coping, quality of life, psychological morbidity) in the primary caregivers of patients with bipolar affective disorder (BPAD).

      Methods: A total of 60 primary caregivers of patients with a diagnosis of BPAD were evaluated on the Scale for Positive Aspects of Caregiving Experience (SPACE) and the Hindi version of Involvement Evaluation Questionnaire, Family Burden Interview Schedule (FBIS), modified Hindi version of Coping Checklist, shorter Hindi version of the World Health Organization Quality of Life (WHOQOL-BREF), and Hindi translated version of 12-item General Health Questionnaire (GHQ-12).

      Results: Caregivers of patients with BPAD had the highest mean score in the SPACE domain of Motivation for caregiving role (2.45), followed by Caregiver satisfaction (2.38) and Caregiving personal gains (2.20). The mean score was the lowest for the domain of Self-esteem and social aspect of caring (2.01). In terms of correlations, age of onset of BPAD had a negative correlation with various domains of SPACE. The mean number of total lifetime affective and depressive episodes correlated positively with Self-esteem and social aspect of caring. Caregiver satisfaction correlated negatively with FBIS domains of Disruption of routine family activities, Effect on mental health of others, and subjective burden. Coercion as a coping mechanism correlated positively with domains of Caregiving personal gains, Caregiver satisfaction, and the total score on SPACE. Three (Physical health, Psychological health, Environment) out of 5 domains of the WHOQOL-BREF correlated positively with the total SPACE score. No association was noted between GHQ-12 and SPACE scores.

      Conclusion: Positive caregiving experience in primary caregivers of patients with BPAD is associated with better quality of life of the caregivers.

      PubDate: Wed, 31 Jan 2018 17:14:46 GMT
       
  • Volume 27 Issue 4 - Feasibility and clinical utility of high-definition
           transcranial direct current stimulation in the treatment of persistent
           hallucinations in Schizophrenia
    • Abstract: Bose, Anushree; Shivakumar, Venkataram; Chhabra, Harleen; Parlikar, Rujuta; Sreeraj, Vanteemar S; Dinakaran, Damodharan; Narayanaswamy, Janardhanan C; Venkatasubramanian, Ganesan
      Persistent auditory verbal hallucination is a clinically significant problem in schizophrenia. Recent studies suggest a promising role for add-on transcranial direct current stimulation (tDCS) in treatment. An optimised version of tDCS, namely high-definition tDCS (HD-tDCS), uses smaller electrodes arranged in a 4x1 ring configuration and may offer more focal and predictable neuromodulation than conventional tDCS. This case report illustrates the feasibility and clinical utility of add-on HD-tDCS over the left temporoparietal junction in a 4x1 ring configuration to treat persistent auditory verbal hallucination in schizophrenia.

      PubDate: Wed, 31 Jan 2018 17:14:46 GMT
       
  • Volume 27 Issue 4 - Increasing the continuity of care between primary care
           provider and a psychiatric hospital in Singapore
    • Abstract: Huang, Hannah; Poremski, Daniel; Goh, Yen-Li; Hendriks, Margaret; Fung, Daniel
      Introduction: People who have a mental illness and who are stable on their current treatment may be suitable for follow-up care with a community-based general practitioner. A general practitioner- partnership programme was designed in an institute in Singapore to facilitate the transition to community services. However, the rates of successful referrals were low.

      Methods: Our study followed the format of a quality improvement project, and used administrative data from April 2014 to June 2016 to gauge the impact of the interventions chosen to improve uptake of referrals. Three potential areas of improvement were found based on interviews with 25 service users.

      Results: During the 11 months of pre-intervention period (April 2014 to February 2015), 64% of potentially suitable service users (152 of 238 referrals) transitioned to community services. Low transition was linked to 3 identified causes and consequently, case managers developed personalised financial counselling for service users, assisted in the application for financial supports, and dispelled misconceptions about service provider inability to treat mental illness. Over the 16 months of intervention period (March 2015 to June 2016), the follow-up rate for referrals rose to 92% (260 / 283 referrals).

      Conclusion: Given that financial support entitlements change, it is important for case managers to remain aware of changing policy. Misconceptions of service provider qualifications may have a great impact on service user's willingness to seek services from primary care providers.

      PubDate: Wed, 31 Jan 2018 17:14:46 GMT
       
  • Volume 27 Issue 4 - Fear of fear and broad dimensions of psychopathology
           over the course of cognitive behavioural therapy for panic disorder with
           Agoraphobia in Japan
    • Abstract: Ogawa, Sei; Kondo, Masaki; Ino, Keiko; Ii, Toshitaka; Imai, Risa; Akechi, Tatsuo; Furukawa, Toshi A
      Objective: To examine the relationship of fear of fear and broad dimensions of psychopathology in panic disorder with agoraphobia over the course of cognitive behavioural therapy in Japan.

      Methods: A total of 177 Japanese patients with panic disorder with agoraphobia were treated with group cognitive behavioural therapy between 2001 and 2015. We examined associations between the change scores in Agoraphobic Cognitions Questionnaire or Body Sensations Questionnaire and the changes in subscales of Symptom Checklist-90 Revised during cognitive behavioural therapy controlling the change in panic disorder severity using multiple regression analysis.

      Results: Reduction in Agoraphobic Cognitions Questionnaire score was related to a decrease in all Symptom Checklist-90 Revised (SCL-90-R) subscale scores. Reduction in Body Sensations Questionnaire score was associated with a decrease in anxiety. Reduction in Panic Disorder Severity Scale score was not related to any SCL-90-R subscale changes.

      Conclusions: Changes in fear of fear, especially maladaptive cognitions, may predict broad dimensions of psychopathology reductions in patients of panic disorder with agoraphobia over the course of cognitive behavioural therapy. For the sake of improving a broader range of psychiatric symptoms in patients of panic disorder with agoraphobia, more attention to maladaptive cognition changes during cognitive behavioural therapy is warranted.

      PubDate: Wed, 31 Jan 2018 17:14:46 GMT
       
 
 
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