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Publisher: RMIT Publishing   (Total: 400 journals)

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Showing 1 - 200 of 400 Journals sorted alphabetically
40 [degrees] South     Full-text available via subscription   (Followers: 2)
Aboriginal and Islander Health Worker J.     Full-text available via subscription   (Followers: 14)
Aboriginal Child at School     Full-text available via subscription   (Followers: 5)
About Performance     Full-text available via subscription   (Followers: 11)
Access     Full-text available via subscription   (Followers: 25)
ACCESS: Critical Perspectives on Communication, Cultural & Policy Studies     Full-text available via subscription   (Followers: 9)
Accounting, Accountability & Performance     Full-text available via subscription   (Followers: 16)
ACORN : The J. of Perioperative Nursing in Australia     Full-text available via subscription   (Followers: 17, SJR: 0.103, h-index: 4)
Adelaide Law Review     Full-text available via subscription   (Followers: 19)
Advocate: Newsletter of the National Tertiary Education Union     Full-text available via subscription   (Followers: 1)
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AIMA Bulletin     Full-text available via subscription   (Followers: 4)
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Analysis     Full-text available via subscription   (Followers: 3)
Ancient History : Resources for Teachers     Full-text available via subscription   (Followers: 4)
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Annals of the Royal Australasian College of Dental Surgeons     Full-text available via subscription   (Followers: 4, SJR: 0.101, h-index: 11)
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Appita J.: J. of the Technical Association of the Australian and New Zealand Pulp and Paper Industry     Full-text available via subscription   (Followers: 12, SJR: 0.18, h-index: 27)
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)
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Artlink     Full-text available via subscription   (Followers: 5)
Asia Pacific J. of Clinical Nutrition     Full-text available via subscription   (Followers: 10, SJR: 0.672, h-index: 51)
Asia Pacific J. of Health Management     Full-text available via subscription   (Followers: 3)
Aurora J.     Full-text available via subscription  
Australasian Biotechnology     Full-text available via subscription   (Followers: 1, SJR: 0.1, h-index: 8)
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Australasian Epidemiologist     Full-text available via subscription  
Australasian Historical Archaeology     Full-text available via subscription   (Followers: 7)
Australasian J. of Early Childhood     Full-text available via subscription   (Followers: 4, SJR: 0.174, h-index: 1)
Australasian J. of Gifted Education     Full-text available via subscription   (Followers: 5, SJR: 0.115, h-index: 3)
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Australasian J. of Irish Studies, The     Full-text available via subscription   (Followers: 8)
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Australasian Music Research     Full-text available via subscription   (Followers: 4)
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)
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Australasian Public Libraries and Information Services     Full-text available via subscription   (Followers: 32)
Australasian Review of African Studies, The     Full-text available via subscription   (Followers: 2)
Australian Aboriginal Studies     Full-text available via subscription   (Followers: 10, SJR: 0.109, h-index: 6)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Ageing Agenda     Full-text available via subscription   (Followers: 6)
Australian and Aotearoa New Zealand Psychodrama Association J.     Full-text available via subscription  
Australian and New Zealand Continence J.     Full-text available via subscription   (Followers: 3)
Australian and New Zealand Sports Law J.     Full-text available via subscription   (Followers: 8)
Australian Art Education     Full-text available via subscription   (Followers: 7)
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)
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Australian Educational and Developmental Psychologist, The     Full-text available via subscription   (Followers: 8, SJR: 0.143, h-index: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3, SJR: 0.364, h-index: 31)
Australian Field Ornithology     Full-text available via subscription   (Followers: 4, SJR: 0.141, h-index: 6)
Australian Forest Grower     Full-text available via subscription   (Followers: 4)
Australian Forestry     Full-text available via subscription   (Followers: 2, SJR: 0.252, h-index: 24)
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: 3)
Australian Indigenous Law Review     Full-text available via subscription   (Followers: 19)
Australian Intl. Law J.     Full-text available via subscription   (Followers: 23)
Australian J. of Acupuncture and Chinese Medicine     Full-text available via subscription   (Followers: 3, SJR: 0.106, h-index: 3)
Australian J. of Adult Learning     Full-text available via subscription   (Followers: 14, SJR: 0.159, h-index: 7)
Australian J. of Advanced Nursing     Full-text available via subscription   (Followers: 11, SJR: 0.225, h-index: 26)
Australian J. of Asian Law     Full-text available via subscription   (Followers: 4)
Australian J. of Cancer Nursing     Full-text available via subscription   (Followers: 8)
Australian J. of Civil Engineering     Full-text available via subscription   (Followers: 5, SJR: 0.17, h-index: 3)
Australian J. of Dyslexia and Learning Difficulties     Full-text available via subscription   (Followers: 8)
Australian J. of Emergency Management     Full-text available via subscription   (Followers: 10, SJR: 0.401, h-index: 18)
Australian J. of French Studies     Full-text available via subscription   (Followers: 7, SJR: 0.1, h-index: 5)
Australian J. of Herbal Medicine     Full-text available via subscription   (Followers: 3, SJR: 0.109, h-index: 7)
Australian J. of Language and Literacy, The     Full-text available via subscription   (Followers: 2, SJR: 0.399, h-index: 9)
Australian J. of Legal History     Full-text available via subscription   (Followers: 14)
Australian J. of Mechanical Engineering     Full-text available via subscription   (Followers: 3, SJR: 0.129, h-index: 4)
Australian J. of Medical Science     Full-text available via subscription   (Followers: 1, SJR: 0.122, h-index: 5)
Australian J. of Multi-Disciplinary Engineering     Full-text available via subscription   (Followers: 2)
Australian J. of Music Education     Full-text available via subscription   (Followers: 3)
Australian J. of Music Therapy     Full-text available via subscription   (Followers: 8)
Australian J. of Parapsychology     Full-text available via subscription   (Followers: 2)
Australian J. of Social Issues     Full-text available via subscription   (Followers: 5, SJR: 0.178, h-index: 20)
Australian J. of Structural Engineering     Full-text available via subscription   (Followers: 6, SJR: 0.296, h-index: 8)
Australian J. of Water Resources     Full-text available via subscription   (Followers: 6, SJR: 0.226, h-index: 9)
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, SJR: 0.1, h-index: 2)
Australian Literary Studies     Full-text available via subscription   (Followers: 5, SJR: 0.1, h-index: 6)
Australian Mathematics Teacher, The     Full-text available via subscription   (Followers: 6)
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: 4)
Australian Screen Education Online     Full-text available via subscription   (Followers: 2)
Australian Senior Mathematics J.     Full-text available via subscription   (Followers: 1)
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: 5)
Bioethics Research Notes     Full-text available via subscription   (Followers: 13)
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Bookseller + Publisher Magazine     Full-text available via subscription   (Followers: 5)
Breastfeeding Review     Full-text available via subscription   (Followers: 17, SJR: 0.31, h-index: 19)
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: 1)
Cancer Forum     Full-text available via subscription   (SJR: 0.143, h-index: 10)
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: 0.107, h-index: 3)
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: 4)
Communicable Diseases Intelligence Quarterly Report     Full-text available via subscription   (Followers: 2, SJR: 0.567, h-index: 27)
Communication, Politics & Culture     Open Access   (Followers: 12)
Communities, Children and Families Australia     Full-text available via subscription   (Followers: 2)
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: 17, SJR: 1.737, h-index: 24)
Cultural Studies Review     Full-text available via subscription   (Followers: 15)
Culture Scope     Full-text available via subscription   (Followers: 4)
Current Issues in Criminal Justice     Full-text available via subscription   (Followers: 10)
Dance Forum     Full-text available via subscription   (Followers: 2)
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: 14)
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: 2, SJR: 0.331, h-index: 7)
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: 17)
Education in Rural Australia     Full-text available via subscription   (Followers: 1)
Education, Research and Perspectives     Full-text available via subscription   (Followers: 10)
Educational Research J.     Full-text available via subscription   (Followers: 17)
Electronic J. of Radical Organisation Theory     Full-text available via subscription   (Followers: 3)
Employment Relations Record     Full-text available via subscription   (Followers: 2)
English in Aotearoa     Full-text available via subscription   (Followers: 1)
English in Australia     Full-text available via subscription   (Followers: 2, SJR: 0.19, h-index: 6)
Essays in French Literature and Culture     Full-text available via subscription   (Followers: 6)
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: 0.259, h-index: 8)
Federal Law Review     Full-text available via subscription   (Followers: 21)
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: 2)
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: 1)
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)
Globe, The     Full-text available via subscription   (Followers: 3)
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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)
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Journal Cover East Asian Archives of Psychiatry
  [SJR: 0.331]   [H-I: 7]   [2 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 2078-9947
   Published by RMIT Publishing Homepage  [400 journals]
  • 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
       
  • 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 GMT
       
  • Volume 26 Issue 4 - The forgotten child
    • Abstract: Tang, Chun-Pan
      PubDate: Thu, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 GMT
       
  • Volume 26 Issue 2 - Drug addiction: A global challenge
    • PubDate: Thu, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 GMT
       
  • Volume 25 Issue 4 - Psychiatry's social control and patients' rights
    • Abstract: Ventriglio, Antonio; Bhugra, Dinesh
      PubDate: Thu, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 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, 2 Nov 2017 11:47:26 GMT
       
  • Volume 25 Issue 3 - Classic tower of Hanoi, planning skills, and the
           Indian elderly
    • Abstract: Balachandar, Rakesh; Tripathi, Ravikesh; Bharath, Srikala; Kumar, Keshav
      Objective: Elderly populations are vulnerable to age-related cognitive decline. Planning, a frontal lobe function, is reported to be affected in the elderly population. There is a paucity of studies which assessed planning skills in the elderly Indian population. The present study aimed to examine the utility of the classic Tower of Hanoi in the assessment of planning skills of elderly Indian subjects.

      Methods: A total of 215 (60 of whom were females, all aged 55-80 years) cognitively normal elders and 24 patients with mild Alzheimer's disease were recruited. All subjects provided informed consent and their planning skills were assessed using the classic Tower of Hanoi. Performance at each level was measured by the total time taken to solve, number of moves to solve, and the number of rule violations. Receiver operating characteristic curve analysis was exploratively performed to test the utility of the Tower of Hanoi in differentiating patients with mild Alzheimer's disease from those who were cognitively normal. Results: Performance measures of cognitively normal group steeply worsened with increasing complexity. With receiver operating characteristic curve analysis, patients with mild Alzheimer's disease were poorly differentiated from cognitively normal group according to their Tower of Hanoi performance.

      Conclusion: The Tower of Hanoi test is of limited value for the assessment of planning skills in the Indian elderly population. There is a need to modify and develop a suitable neuropsychology tool to assess the planning skills of elderly Indian subjects and further validate it.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 25 Issue 3 - Frequency and correlates of distant visual impairment
           in patients with schizophrenia, bipolar disorder, and major depressive
           disorder
    • Abstract: Zheng, Wei; Tang, Li-Rong; Correll, Christoph U; Ungvari, Gabor S; Chiu, Helen FK; Xiang, Ying-Qiang; Xiang, Yu-Tao
      Objective: Distant visual impairment in the severely mentally ill is under-researched. This study aimed to assess the frequency and correlates of distant visual impairment in a cohort of Chinese psychiatric patients, including its effect on their quality of life.

      Methods: Adult psychiatric inpatients with schizophrenia, bipolar disorder, and major depressive disorder consecutively admitted to a psychiatric hospital in Beijing, China underwent assessments of psychopathology (Brief Psychiatric Rating Scale, 16-item Quick Inventory of Depressive Symptomatology [Self-Report]), quality of life (12-item Short-Form Medical Outcomes Study [SF-12], 25-item National Eye Institute Visual Function Questionnaire [NEI-VFQ25]), adverse effects (Udvalg for Kliniske Unders gelser Side Effect Rating Scale), and presenting (as opposed to uncorrected) distant visual acuity (Logarithm of the Minimum Angle of Resolution [LogMAR] chart with patients wearing spectacles, if they owned them). Distant visual impairment was defined as binocular distant visual acuity of a LogMAR score of = 0.5 (< 6/18 Snellen acuity).

      Results: Among 356 patients who met the study criteria, the frequency of distant visual impairment was 12.6% (15.2% with schizophrenia, 11.9% with bipolar disorder, 8.8% with major depressive disorder). In multiple logistic regression analysis, distant visual impairment was significantly associated with ocular disease only (p = 0.002, odds ratio = 3.2, 95% confidence interval = 1.5-6.7). Controlling for the confounding effect of ocular disease, patients with distant visual impairment had a lower quality of life in the general vision domain of the NEI-VFQ25 (F[2, 353] = 9.5, p = 0.002) compared with those without. No differences in the physical and mental domains of the SF-12 and in other domains of the NEI-VFQ25 were noted in these 2 groups.

      Conclusion: One-eighth of middle-aged severely mentally ill patients had distant visual impairment. Considering the impact of distant visual impairment on daily functioning, severely mentally ill patients need to be screened for impaired eyesight as part of their comprehensive health assessment.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 25 Issue 3 - Antidepressant prescription pattern in the presence of
           medical co-morbidity: REAP-AD 2013 study
    • Abstract: Grover, Sandeep; Avasthi, Ajit; Tripathi, Adarsh; Tanra, Andi J; Chee, Kok-Yoon; He, Yang-Lin; Chiu, Helen FK; Kuga, Hironori; Lee, Min-Soo; Chong, Mian-Yoon; Udormatn, Pichet; Kanba, Shigenobu; Yang, Shu-Yu; Si, Tian-Mei; Sim, Kang; Tan, Chay-Hoon; Shen, Winston W; Xiang, Yu-Tao; Sartorius, Norman; Shinfuku, Naotaka
      Objective: To evaluate the prescription pattern of antidepressants in patients with medical co-morbidity from major psychiatric centres in Asia.

      Methods: The Research on Asian Psychotropic Prescription Pattern for Antidepressants (REAP-AD 2013) collected data from 42 psychiatric centres in 10 Asian countries and regions. Antidepressant prescriptions of 2320 patients with various psychiatric disorders were evaluated. Of these, 370 patients who had specified medical co-morbidities formed the study cohort.

      Results: Escitalopram (20%) and mirtazapine (20%) were the most commonly prescribed antidepressants in patients with medical co-morbidity followed by sertraline (16%), trazodone (15%), and paroxetine (12%). Overall, more than half (52%; 247/476) of prescriptions comprised selective serotonin reuptake inhibitors. Slightly less than two-thirds (63%; n = 233) of patients received at least 1 selective serotonin reuptake inhibitor. In addition, 79% of patients were prescribed only 1 antidepressant. The mean number of antidepressants used per patient was 1.25 (standard deviation, 0.56). There were subtle differences in the most preferred antidepressant across medical illnesses such as diabetes mellitus, liver dysfunction, acid peptic disease, and cerebrovascular disease. Differences were also seen in prescription patterns across different countries.

      Conclusion: Although selective serotonin reuptake inhibitors formed the bulk of antidepressant prescriptions in the presence of medical co-morbidity, mirtazapine was also commonly used in the presence of medical co-morbidities. Specified medical morbidities do influence the selection of antidepressants.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 25 Issue 3 - Letters to the editor
    • PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 25 Issue 2 - Co-morbidity of obsessive-compulsive disorder and
           other anxiety disorders with child and adolescent mood disorders
    • Abstract: Paul, Imon; Sinha, Vinod Kumar; Sarkhel, Sujit; Praharaj, Samir Kumar
      Objective: To assess the co-morbidity of obsessive-compulsive disorder (OCD) and other anxiety disorders in child and adolescent mood disorders.

      Methods: A total of 100 patients aged < 18 years with mood disorders according to the DSM-IV-TR were screened for OCD and other anxiety disorders using Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version.

      Results: The prevalence of co-morbid anxiety disorders was 22%; OCD was present in 4%, and subthreshold obsessive-compulsive symptoms were present in 2%. Among others, 8% had panic disorder, 7% had generalised anxiety disorder, 3% had separation anxiety disorder, and 1% had social phobia; multiple anxiety disorders were present in 3% of patients.

      Conclusion: Co-morbid anxiety disorder was found in one-fifth of children and adolescents with mood disorder.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 25 Issue 2 - Psychosocial correlates of patients being physically
           restrained within the first 7 days in an acute psychiatric admission ward:
           Retrospective case record review
    • Abstract: Wu, William Wai-Kin
      Objective: Clinically, patients' characteristics may predict the use of physical restraint in a psychiatric ward. This study aimed to explore significant psychosocial variables in predicting the risk for application of physical restraint with intention of identifying patients at high risk for physical restraint at the time of admission to an acute psychiatric setting.

      Methods: The case records of 335 adult patients aged > 18 years, who were treated in 4 acute psychiatric admission wards of a public hospital in Hong Kong from 1 November 2013 to 28 February 2014, were retrospectively reviewed.

      Results: Results of statistical analysis indicated involuntary admission, current use of psychiatric medications, no history of violent behaviour, age, and depression as significant predictors of use of physical restraint. The model accounted for 28.5% to 38.5% of the variance in the use of physical restraint. Overall, this model had a success rate of 77.6%.

      Conclusion: It was concluded that 39.7% of inpatients admitted to the acute psychiatric admission ward had been restrained at least once in the first 7 days. Significant predictors of restraint included involuntary admission, current use of psychiatric medications, no history of violent behaviour, age, and depression; all of which could be regarded as risk factors for restraint.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 25 Issue 2 - Interpersonal psychotherapy for postnatal anxiety
           disorder
    • Abstract: Chung, Joseph Pui-Yin
      Interpersonal psychotherapy is one of two evidence-based formal psychotherapies for perinatal mood disorders. It is a time-limited, non-transference / cognitive-based therapy that focuses on communication and social support and can be easily conducted in a perinatal clinic setting. There is limited patient access to interpersonal psychotherapy in Hong Kong because the therapy is not widely disseminated. This case report aimed to illustrate the principles and techniques of interpersonal psychotherapy in perinatal psychiatry, and to raise interest among mental health professionals in Hong Kong in this evidence-based treatment.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 25 Issue 2 - Maternal filicide among women admitted to forensic
           psychiatric institutions in Malaysia: Case series
    • Abstract: Razali, Salmi; Salleh, Raba'iah Mohd; Yahya, Badiah; Ahmad, S Hassan
      Objectives: To examine the characteristics of maternal filicide and describe the adverse life events experienced by women who have committed filicide and been hospitalised in forensic psychiatric institutions in Malaysia.

      Methods: Registration records from 2000 through 2012 of female patients from 2 main forensic psychiatric institutions in Malaysia were reviewed. The medical records of patients who had committed maternal filicide were selected and descriptively evaluated.

      Results: A total of 18 cases of maternal filicide were identified. Family dysfunction that presented with marital discord, domestic violence, or husband with substance abuse was the main stress experienced by the women. Three social circumstances, including an adolescent who became a victim of date rape; immigrants who experienced sexual abuse; and filicide-suicide precipitated by financial difficulties were highlighted.

      Conclusion: Women who committed filicide had experienced various difficulties in their life. The presence of such life events might alert mental health professionals to investigate the possibility of filicide among their patients.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 25 Issue 2 - Association of clozapine with seizures: A brief report
           involving 222 patients prescribed clozapine
    • Abstract: Grover, Sandeep; Hazari, Nandita; Chakrabarti, Subho; Avasthi, Ajit
      Objective: To study the prevalence and incidence of seizures in patients prescribed clozapine. Methods: The treatment records of 222 patients commenced on clozapine were retrospectively reviewed during the period of January 2007 to June 2014 to evaluate the prevalence of seizures before and after starting clozapine.

      Results: The majority of patients commenced on clozapine were male (65%), single (65%), and unemployed (57%). The mean (+/- standard deviation) dose of clozapine was 277.9 +/- 102.5 mg/day. A history of seizure was present in 6 patients who were also prescribed antiepileptic medication; of these 6 patients, only 1 case had recurrence of seizure while taking clozapine due to poor compliance with ongoing antiepileptic medication. The incidence rate of new-onset seizure with clozapine was 6% (12/216). Most patients who developed seizures were male, aged between 24 and 41 years, and had a long duration of illness (= 10 years). The risk of seizure was associated with the dose of clozapine used: 3% (5/159) with dose up to 300 mg/day, 8% (4/49) with 325 to 500 mg/day, and 38% (3/8) in those receiving > 500 mg/day. More than half of the patients (7/12) who developed seizures while prescribed clozapine were managed with reduction in the dose of clozapine. In one-third of cases (4/12) an antiepileptic medication was added and in 1 case, clozapine was stopped. All patients who continued on clozapine remained seizure-free at follow-up that ranged from 6 months to 4 years.

      Conclusion: The incidence of seizures with clozapine was 6% and the risk of seizures increased with higher doses.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 25 Issue 2 - Comparative study of neurological soft signs in
           patients with schizophrenia or obsessive-compulsive disorder, and healthy
           controls
    • Abstract: Tripathi, Richa; Soni, Ajitabh; Tyagi, Alok; Mehta, Shubham; Gupta, Suresh
      Objective: The primary objective of this study was to examine neurological soft signs in patients with obsessive-compulsive disorder compared with patients with schizophrenia and a control group in the Indian setting. The secondary objective was to find any correlation between age at onset and neurological soft signs scores, as well as that between severity of obsessive-compulsive disorder symptoms (total Yale-Brown Obsessive Compulsive Scale score) and neurological soft signs scores.

      Methods: This was a cross-sectional hospital-based study of 135 individuals (45 patients with schizophrenia, 45 patients with obsessive-compulsive disorder who were attending the psychiatric outpatient department of Sawai Man Singh Medical College, Jaipur, India, and 45 matched healthy controls) from 20 June 2013 to 22 December 2014. After applying strict inclusion and exclusion criteria, the participants completed the study instruments (Cambridge Neurological Inventory [Part 2] and Yale- Brown Obsessive Compulsive Scale). Their socio-demographic data were also recorded.

      Results: The neurological soft signs total score and domain scores (motor coordination, sensory integration, and disinhibition) were significantly higher in patients with schizophrenia (p < 0.05) than in the obsessive-compulsive disorder group or the control group. The obsessive-compulsive disorder group did not significantly differ from the control group in terms of neurological soft signs scores. No correlation was found between neurological soft signs scores and age at onset as well as that between neurological soft signs scores and total Yale-Brown Obsessive Compulsive Scale score.

      Conclusion: Neurological soft signs assessed by the Cambridge Neurological Inventory and Yale-Brown Obsessive Compulsive Scale, which discriminate patients with schizophrenia from controls, appear to be relatively specific to schizophrenia. Further studies are required to explore neurological soft signs in patients with obsessive-compulsive disorder.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 25 Issue 1 - CBT for adults: A practical guide for clinicians [Book
           Review]
    • Abstract: Wong, William Wai-Wai
      Review(s) of: CBT for adults: A practical guide for clinicians, by Lynne M Drummond, The Royal College of Psychiatrists, USD 52; pp304; ISBN: 978-1909726277.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 25 Issue 1 - Prodromal psychosis: A case series of ten symptomatic
           patients
    • Abstract: Ching, Elaine Yee-Ning; Lee, Edwin Ho-Ming; Hui, Christy Lai-Ming; Lin, Jing-Xia; Chang, Wing-Chung; Chan, Sherry Kit-Wa; Chen, Eric Yu-Hai
      This case series provides an account of 10 patients with prodromal psychosis in Hong Kong over the course of 12 months between 2012 and 2014. Patterns of symptoms and functioning levels were noted each month and overall presentation was classified into 4 categories. Four patients' conditions were classified as fluctuating, 3 patients as improved, 2 patients as no change, and 1 patient as transition into psychosis. The noted observations were compared to the current conceptualisation of prodromal psychosis according to the clinical staging model of McGorry and colleagues. This case series provides insights into the condition in an Asian population and provides background data to inform future clinical research and mental health services.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 25 Issue 1 - Concurrent validation of a neurocognitive assessment
           protocol for clients with mental illness in job matching as shop sales in
           supported employment
    • Abstract: Ng, Serena SW; Lak, Davis CC; Lee, Sharon CK; Ng, Peggie PK
      Objectives: Occupational therapists play a major role in the assessment and referral of clients with severe mental illness for supported employment. Nonetheless, there is scarce literature about the content and predictive validity of the process. In addition, the criteria of successful job matching have not been analysed and job supervisors have relied on experience rather than objective standards in recruitment. This study aimed to explore the profile of successful clients working in 'shop sales' in a supportive environment using a neurocognitive assessment protocol, and to validate the protocol against 'internal standards' of the job supervisors.

      Methods: This was a concurrent validation study of criterion-related scales for a single job type. The subjective ratings from the supervisors were concurrently validated against the results of neurocognitive assessment of intellectual function and work-related cognitive behaviour.

      Results: A regression model was established for clients who succeeded and failed in employment using supervisor's ratings and a cutoff value of 10.5 for the Performance Fitness Rating Scale (R2 = 0.918, F[41] = 3.794, p = 0.003). Classification And Regression Tree was also plotted to identify the profile of cases, with an overall accuracy of 0.861 (relative error, 0.26).

      Conclusion: Use of both inference statistics and data mining techniques enables the decision tree of neurocognitive assessments to be more readily applied by therapists in vocational rehabilitation, and thus directly improve the efficiency and efficacy of the process.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 25 Issue 1 - Transformation of a metaphor: Semantic shift in a
           Cantonese term 'Chi Sin' denoting insanity
    • Abstract: Ng, Joanne Yui-Wing; Chen, Eric Yu-Hai
      Objectives: The historical evolution of the existing terms used to describe insanity may be able to shed light on the formation of stigma towards psychosis patients. In Hong Kong, a widely used Cantonese term for insanity 'Chi Sin' provides a unique example because of its neutral original sense, as it literally means misconnection in a network circuit. We attempt to trace the origin and subsequent evolution of the term 'Chi Sin' from its early use to the present day to understand how local Hong Kong people have attached increasingly negative connotations to this scientific term since the mid-20th century.

      Methods: We sampled as many newspapers and magazines published in Hong Kong from 1939 to June 2014 as possible, and sampled 7 popular local movies from the 1950s and 1960s. We also searched all the newspapers published in Hong Kong, Macau, Taiwan, and Mainland China from January 1998 to June 2014, and searched several other local historical resources.

      Results: In one early use of 'Chi Sin' in 1939, the term was only used in a technical sense to describe 'short circuiting'. We found that the development of the telephone system, the Strowger system, in Hong Kong is closely related to the evolution of the semantics of the term 'Chi Sin'.

      Conclusions: The original meaning of short circuitry of the term 'Chi Sin' is no longer used, and it has become a dead metaphor through repeated use with negative emotional connotations. This illustrates some of the factors facilitating the emergence of a metaphor with subsequent semantic drift.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 25 Issue 1 - Effect of co-morbid depression on neurocognitive
           functioning in patients with obsessive-compulsive isorder: A study from
           India
    • Abstract: Singh, Dharmendra; Mattoo, Surendra K; Grover, Sandeep; Kohli, Adarsh
      Objective: To study neuropsychological function in subjects with obsessive-compulsive disorder (OCD) with and without co-morbid depression in comparison with healthy controls (HC).

      Methods: The 3 sample groups included subjects with OCD without depression (OCD group, n = 30); subjects with OCD and depression (OCDD group, n = 20); and HC (n = 25). All 3 groups were matched for age, gender, and years of education, and they were assessed on the following: Trail Making Tests A and B, Verbal Fluency Test, PGI Memory Scale, Stroop test, Tower of London Test, Raven's Standard Progressive Matrices, Wisconsin Card Sorting Test, and the Object Alternation Test.

      Results: Both OCD and OCDD groups performed more poorly than HC, whereas the OCDD group performed worse than OCD group. Besides, OCD and OCDD groups had significantly poorer performance on tests of attention, memory, executive functions, verbal fluency, and intelligence. The OCDD group performed worse than the OCD group notably on Verbal Fluency Test, PGI memory test, and Object Alternation Test.

      Conclusion: On tests of neurocognitive functioning, the performance of the OCDD group was poorer than the OCD group, and both performed poorer than HC, suggesting that OCD is associated with neurocognitive dysfunction and that this is exacerbated in the presence of depression.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 25 Issue 1 - Effectiveness of psycho-educational intervention in
           improving outcome of unipolar depression: Results from a randomised
           clinical trial
    • Abstract: Kumar, Kuldip; Gupta, Manushree
      Objectives: Depressive disorders are one of the leading components of the global burden of disease with a prevalence of up to 14% in the general population. Numerous studies have demonstrated that pharmacotherapy combined with non-pharmacological measures offer the best treatment approach. Psycho-education as an intervention has been studied mostly in disorders such as schizophrenia and dementia, less so in depressive disorders. The present study aimed to assess the impact of psychoeducation of patients and their caregivers on the outcome of depression.

      Methods: A total of 80 eligible depressed subjects were recruited and randomised into 2 groups. The study group involved an eligible family member and all were offered individual structured psychoeducational modules. Another group (controls) received routine counselling. The subjects in both groups also received routine pharmacotherapy and counselling from the treating clinician and were assessed at baseline, 2, 4, 8, and 12 weeks using the Hamilton Depression Rating Scale (HDRS), Global Assessment of Functioning (GAF), and Psychological General Well-Being Index (PGWBI). Results from both groups were compared using statistical methods including Chi-square test, Fisher's exact test, Student's t test, Pearson's correlation coefficient, as well as univariate and multiple regression analyses.

      Results: Baseline socio-demographic and assessment measures were similar in both groups. The study group had consistent improvement in terms of outcome measures with HDRS, GAF, and PGWBI scores showing respective mean change of -15.08, 22, and 60 over 12 weeks. The comparable respective changes in the controls were -8.77, 18.1, and 43.25.

      Conclusion: Structured psycho-education combined with pharmacotherapy is an effective intervention for people with depressive disorders. Psycho-education optimises the pharmacological treatment of depression in terms of faster recovery, reduction in severity of depression, and improvement in subjective wellbeing and social functioning.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 4 - Use and Interpretation of statistical tests
    • PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 4 - Premenstrual dysphoric disorder in the diagnostic and
           statistical manual of mental disorders, fifth edition: Contributions from
           Asia
    • Abstract: Mehta, Nidhi; Mehta, Shubham
      Premenstrual dysphoric disorder has been included as a separate diagnostic entity in the chapter of 'Depressive Disorders' of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM- 5). The antecedent, concurrent, and predictive diagnostic validators of premenstrual dysphoric disorder have been reviewed by a sub-workgroup of the DSM-5 Mood Disorders Work Group, which includes a panel of experts on women's mental health. Contributions from the Asian continent have been mainly in the form of prevalence studies. Genetic and neurobiological domains of premenstrual dysphoric disorder largely remain untouched in Asia and offer a potential area for investigation.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 4 - Functional recovery of consumers discharged from
           mental hospital and participating in a community-based psychosocial
           programme provided by a non-governmental organisation
    • Abstract: Young, Kim-Wan; Ng, Petrus; Pan, Jiayan
      Objective: To explore the 1-year functional recovery rate and identify factors predicting functional recovery of consumers in the Hong Kong context. Methods: By adopting a prospective longitudinal follow-up research design, a cohort of Chinese people discharged from the mental hospital and participating in a community-based psychosocial programme provided by a non-governmental organisation were followed up for 1 year. These individuals were assessed on their social functioning, psychiatric symptoms, self-efficacy, and quality of life using standardised assessment scales at baseline, 6 months, and 12 months of follow-up. Results: Of 87 participants, about one quarter (23.0%, n = 20) achieved functional recovery and about three quarters (79.3%, n = 69) achieved symptom remission at 12 months of follow-up. Also, the group showing functional recovery achieved better quality of life than those not showing recovery. Logistic regression analysis indicated that current functioning, current psychiatric symptoms, and achieving open employment at 12 months were significant predictors of functional recovery. These 3 predicting factors altogether accounted for half (54.4%) of the variance of functional recovery. Conclusions: It is more difficult to achieve functional recovery than symptom remission for consumers. Helping consumers to improve social skills, achieve open employment, and reduce psychiatric symptoms is recommended as important elements in facilitating functional recovery in the local context.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 4 - The Chinese first-episode schizophrenia trial:
           Background and study design
    • Abstract: Han, Xue; Yuan, Yan-Bo; Yu, Xin; Zhao, Jing-Ping; Wang, Chuan-Yue; Lu, Zheng; Yang, Fu-De; Deng, Hong; Wu, Yang-Feng; Ungvari, Gabor S; Xiang, Yu-Tao; Chiu, Helen Fung-Kum
      Schizophrenia is a complex illness with unknown aetiology and pathogenesis. Currently, a considerable number of patients with schizophrenia do not receive standardised and systematic treatment in China. In the past years, many controlled trials have been conducted in chronic schizophrenia. In contrast, research on first-episode schizophrenia is lacking. This paper describes the background and design of the Chinese First-Episode Schizophrenia Trial project - a multicentre, randomised, open-label clinical trial. A total of 600 first-episode schizophrenia patients were randomly divided into 3 groups and treated with risperidone, aripiprazole, and olanzapine for 1 year. During the study period, only 1 medication change of the 3 antipsychotic medications was allowed.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 4 - Anticipation with phenotypic variation in three
           father-son pairs with affective disorder: A case series
    • Abstract: Rajkumar, Ravi Philip
      Anticipation is a phenomenon in which successive generations within a family experience an earlier age of onset and a more severe form of a given illness. It has been observed in various neurological and psychiatric conditions, including bipolar disorder. The molecular basis of anticipation involves trinucleotide repeat expansions in genes, but this has not been conclusively demonstrated in bipolar disorder. The histories of 3 father-son pairs are presented. In each pair, the son presented with an earlyonset bipolar disorder, and the father developed severe depression after the age of 50 years. No female relatives were affected. The implications of these observations are discussed. Genetic, epigenetic, and environmental mechanisms that may have contributed to this phenomenon are briefly described. The study of such patients may throw light on the "extended phenotype" of mood disorders, as well as the genetic and epigenetic mechanisms involved in the phenomena of anticipation and phenotypic variation.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 4 - Reliability and validity of the severity of dependence
           scale in a Chinese sample of treatment-seeking Ketamine users
    • Abstract: Tung, Chi-Kwong; Yeung, Sze-Wing; Chiang, Tin-Po; Xu, KE; Lam, Ming
      Objective: Despite growing popularity of ketamine misuse in Asia, there is a lack of a validated instrument to measure the severity of ketamine dependence. Psychometric properties of Chinese Severity of Dependence Scale for ketamine (C-SDS-K) were examined in a sample of treatment-seeking ketamine users in Hong Kong. Methods: A total of 80 treatment-seeking ketamine users were recruited from 3 treatment centres. The C-SDS-K was administered to assess their severity of dependence on ketamine in the previous month. The diagnosis of their ketamine misuse as per the DSM-IV criteria, and the count of dependence criteria fulfilled in the previous month were determined by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Results: The C-SDS-K showed high internal consistency (a = 0.74) and test-retest reliability (intraclass correlation coefficient = 0.95). Total score of C-SDS-K correlated positively with frequency (rs = 0.73, p < 0.001) and dose (rs = 0.89, p < 0.001) of ketamine use per week in the previous month, duration of regular ketamine use (rs = 0.28, p = 0.01), and the count of DSM-IV ketamine dependence criteria met in the previous month (rs = 0.84, p < 0.001). All items loaded strongly on a single factor (factor loading = 0.60) in principal component analysis. Conclusion: The findings support SDS as a reliable and valid tool for measuring the severity of dependence in the treatment-seeking population of Chinese ketamine users.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 4 - Association of psychiatric co-morbidities and quality
           of life with severity of chronic obstructive pulmonary disease
    • Abstract: Mehta, Jilan Rameshchandra; Ratnani, Imran Jahangirali; Dave, Jigna Dinkarbhai; Panchal, Bharat Navinchandra; Patel, Amit Khimjibhai; Vala, Ashok Ukabhai
      Objective: This was a single-centre, cross-sectional, observational study performed at a tertiary care hospital in India to study the association of psychiatric co-morbidities and quality of life with severity of chronic obstructive pulmonary disease (COPD). Methods: A total of 59 clinically stable patients with COPD were assessed for disease severity, as per the updated Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline (2013). Psychiatric co-morbidities like anxiety disorders and depression were diagnosed by clinician-administered interview (as per the DSM-V criteria). Insomnia, anxiety disorders and depression, as well as quality of life were also assessed by self-rating scales including Insomnia Severity Index (ISI), Hospital Anxiety and Depression Scale, and St. George's Respiratory Questionnaire, respectively. Results: Depression was the commonest psychiatric co-morbidity affecting 32.2% of individuals. Patients with depression and anxiety disorders had higher score in COPD assessment test (p = 0.02 and p = 0.004, respectively), ISI (p < 0.001 and p = 0.01, respectively), and poorer quality of life (p < 0.001 and p = 0.02, respectively) compared with those without these conditions. Patients with severe symptoms of COPD were more likely to suffer from anxiety (p = 0.001), depression (p = 0.01), insomnia (p = 0.01), and have poor quality of life (p < 0.001). Patients in the GOLD-D (i.e. those at high risk and with more symptoms) group had poorer quality of life (p = 0.004) when compared with GOLD-A (low risk and less symptoms) and GOLD-C (high risk and less symptoms) groups. Conclusions: Patients with psychiatric co-morbidities have severe symptoms of COPD and poor quality of life.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 3 - Recovery entails bridging the multiple realms of best
           practice: Towards a more integrated approach to evidence-based clinical
           treatment and psychosocial disability support for mental health recovery
    • Abstract: Rosen, Alan; O'Halloran, Paul
      While mental health recovery is a very personal process, the approach also offers possibilities as a metaframework for improving quality of services to support people with severe and enduring mental illness. This paper explores how a recovery paradigm offers opportunities to better understand how efforts within the personal, clinical, and psychosocial disability domains of well-being relate and need bridging and integration with an evidence-based framework of practice to optimise outcomes. Recovery from a severe and persisting mental illness such as schizophrenia is optimised by a holistic approach integrating the domains of clinical treatment and psychosocial rehabilitation with the personal efforts of individuals. For service providers, a monolithic or single paradigm approach with an exclusive or predominant biological, psychological, social, or cultural focus is unable to offer effective guidance on the treatment and rehabilitation support needed to enable community participation and ameliorate the impact which problems associated with mental illness have on individuals, their families, and their wider communities. Moreover, recovery-oriented services need to be effective, embracing evidence-based policy, practice and service delivery by providing treatment and support which actually work to improve outcomes for consumers and families.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 3 - What will it take for recovery to flourish in Hong
           Kong'
    • Abstract: Davidson, Larry; Tse, Samson
      The notion of mental health "recovery" is beginning to stimulate important changes in the mental health care provided to persons with serious mental illnesses in Hong Kong. However, the Chinese culture poses many challenges to implementing the types of recovery-oriented practices developed over the last 2 decades in the West. This article considers some of the challenges that policy makers, system leaders, practitioners, family members, and persons with mental illnesses themselves may face in attempting to transform care in Hong Kong. In addition to shifting from an individualistic to a more collectivist culture that emphasises the importance of family involvement, the primarily linear notion of mental stability that currently guides practice may need to be reconsidered in the face of evidence which suggests that recovery is a non-linear path that involves hard work both on the part of the individual as well as the family.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 3 - Beyond the clinical model of recovery: Recovery of a
           Chinese immigrant woman with bipolar disorder
    • Abstract: Kwok, Caroline Fei-Yeng
      Recovery from serious mental illness can be conceptualised in a number of ways, some more helpful to clients than others. This paper aimed to show that the clinical model of recovery, based on symptom relief, return to function, and freedom from hospitalisation, is a limited one and that a holistic approach is needed. The author has chosen to narrate her own story. She is a Chinese immigrant from Hong Kong to Canada suffering from bipolar illness, who was hospitalised several times and, eventually, achieved full recovery. The recovery of the author illustrates the limitations of the clinical model of recovery. Her story demonstrates the importance of the principles of empowerment, as achieved through self-management, social support, meaningful occupation, and spiritual fulfilment. The empowerment model of recovery is recommended for the use of mental health professionals, with special attention to individual client factors such as culture and gender.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 3 - Expected possible selves and coping skills among young
           and middle-aged adults with bipolar disorder
    • Abstract: Tse, Samson; Yuen, Yammi Man-Yan; Suto, Melinda
      Objectives: This qualitative study explored expected possible selves and coping skills among young and middle-aged adults with bipolar disorder in Hong Kong. Disruptive or positive experiences associated with bipolar disorder can shape the development of the sense of possible selves. Methods: Guided by narrative inquiry methodology, 14 Chinese participants (8 women; age range, 22-65 years), recruited from community mental health services and the public, were interviewed. Results: Young participants (18-40 years) elaborated on their expected possible selves as they related to health, work, and family, whereas middle-aged participants (41-65 years) talked about independent possible selves. The participants used problem-focused, emotion-focused, and cultural coping methods to deal with their bipolar disorder and achieve their expected possible selves. Furthermore, the young participants expressed ambivalence towards self-help strategies to manage high mood episodes. Conclusions: This study not only improves our understanding of possible selves among young and middleaged adults with bipolar disorder, but also provides information for designing self-help interventions. Limitations of the study along with directions for future research are discussed.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 3 - Positive psychology: An approach to supporting
           recovery in mental illness
    • Abstract: Schrank, Beate; Brownell, Tamsin; Tylee, Andre; Slade, Mike
      This paper reviews the literature on positive psychology with a special focus on people with mental illness. It describes the characteristics, critiques, and roots of positive psychology and positive psychotherapy, and summarises the existing evidence on positive psychotherapy. Positive psychology aims to refocus psychological research and practice on the positive aspects of experience, strengths, and resources. Despite a number of conceptual and applied research challenges, the field has rapidly developed since its introduction at the turn of the century. Today positive psychology serves as an umbrella term to accommodate research investigating positive emotions and other positive aspects such as creativity, optimism, resilience, empathy, compassion, humour, and life satisfaction. Positive psychotherapy is a therapeutic intervention that evolved from this research. It shows promising results for reducing depression and increasing well-being in healthy people and those with depression. Positive psychology and positive psychotherapy are increasingly being applied in mental health settings, but research evidence involving people with severe mental illness is still scarce. The focus on strengths and resources in positive psychology and positive psychotherapy may be a promising way to support recovery in people with mental illness, such as depression, substance abuse disorders, and psychosis. More research is needed to adapt and establish these approaches and provide an evidence base for their application.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 3 - Rehabilitation and recovery
    • Abstract: Siu, Bonnie Wei-Man
      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 3 - Contemporary mental health rehabilitation
    • Abstract: Killaspy, Helen
      In the United Kingdom, contemporary mental health rehabilitation services evolved during the period of deinstitutionalisation. They focus on people with complex psychosis, a "low volume, high needs" group which is at risk of social exclusion. Without these specialist services, this group is at risk of becoming stuck in a hospital or in other facilities that do not enable them to achieve their optimal level of autonomy. When a "whole system" of rehabilitative care is provided, including specialist inpatient facilities and supported accommodation, the majority are able to progress in their recovery and live successfully in the community. Rehabilitation is a complex intervention; current and further research is needed to identify the specific aspects of treatment and support it delivers that are most effective in enabling recovery and social inclusion for those with the most complex and long-term mental health needs.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 3 - Green's Child and Adolescent Clinical
           Psychopharmacology (fifth edition) [Book Review]
    • Abstract: Poon, Yvonne Patricia Yuan-Ping
      Review(s) of: Green's child and adolescent clinical psychopharmacology (fifth edition), by William Klykylo, Rick Bowers, Julia Jackson, Christina Weston, Lippincott Williams and Wilkins, USD102.99; pp416; ISBN: 978-1451107142.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 3 - Beyond illness and treatment
    • Abstract: Chang, Tobata CS; Liu, Jennifer SY
      Peer support workers or peer experts are a new workforce in the mental health services of Hong Kong. As two of the few peer support workers in mental health services, we share our experience in working in a regional hospital. We share the amazing benefit of this new workforce to service users and service providers as well as the obstacles in the further development of this service. We hope our experience can help to examine the implementation of peer support services in Hong Kong. As this service is still in its preliminary stage in Hong Kong, we are looking forward to establish a win-win situation for both our peers and the service providers for the enhancement of mental health services in Hong Kong.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 3 - "Recovery" from the eye of a peer specialist
    • Abstract: Chan, Lei-Hung
      As a peer specialist in the Community Psychiatric Service of Castle Peak Hospital, I have opportunities to work with multidisciplinary case managers, people in recovery and their family, community partners, and the media. Through sharing of my personal recovery journey, I aim to emerge as a messenger of hope and healing to people in recovery and their family by conveying that recovery from mental illness is possible.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 2 - Quality of life in people with mental illness in
           non-residential community mental health services in Hong Kong
    • Abstract: Ng, Petrus; Pan, Jia-Yan; Lam, Paul; Leung, Alex
      Objective: To identify the subjective quality of life in people with chronic mental health problems who were in non-residential community mental health services, and to investigate factors affecting their quality of life after the illness. Methods: People with mental illness (n = 105) were recruited. They were assessed with the self-rated Hong Kong Chinese version of the World Health Organization Quality of Life Brief questionnaire. Results: The participants had lower total quality-of-life and the 4 domain scores of the questionnaire than the general population. They were particularly dissatisfied with their financial situation. Duration of illness was positively correlated with subjective quality-of-life variables while age at onset of the mental illness was negatively correlated with subjective quality of life, in particular the physical health, psychological health, and environmental domains. Conclusion: This study highlighted the significance of duration and age at onset of illness in subjective quality of life of people with mental illness. A longitudinal study to test the causal relationships between these factors and the quality of life in people with mental illness is recommended.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
  • Volume 24 Issue 2 - Relationship between first treatment contact and
           supernatural beliefs in caregivers of patients with Schizophrenia
    • Abstract: Grover, Sandeep; Nebhinani, Naresh; Chakrabarti, Subho; Shah, Ruchita; Avasthi, Ajit
      Objective: To explore the relationship between attribution of symptoms to supernatural beliefs and first treatment contact in caregivers of patients with schizophrenia attending a tertiary care hospital located in North India. Methods: A total of 122 caregivers (aged >= 18 years, staying with patient >= 1 year and involved in patients' care) of consecutive patients with diagnosis of schizophrenia (according to the ICD-10) were evaluated for their supernatural beliefs and first treatment contact. Results: The first treatment contact was a government or private psychiatrist in slightly more than half (53.3%) of the patients, while it was faith healers in 23.8% of the patients. Around three quarters (74.6%) of the caregivers attributed patients' symptoms to >= 1 supernatural belief (like sorcery / witchcraft, ghosts, spirit intrusion, divine wrath, planetary influences, evil spirits, and bad deeds in previous life) and more than half (57.4%) of the caregivers attributed patients' symptoms to > 1 supernatural belief. It was observed that those who contacted faith healers for their patients' treatment had significantly higher attribution of the symptoms to supernatural causes. Conclusions: Supernatural beliefs were common in caregivers of patients with schizophrenia and the majority attributed their patients' symptoms to these beliefs. It signifies an urgent need for mental health literacy in India.

      PubDate: Thu, 2 Nov 2017 11:47:26 GMT
       
 
 
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