Publisher: RMIT Publishing   (Total: 387 journals)

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Showing 1 - 200 of 387 Journals sorted alphabetically
40 [degrees] South     Full-text available via subscription   (Followers: 4)
Aboriginal and Islander Health Worker J.     Full-text available via subscription   (Followers: 16)
Aboriginal Child at School     Full-text available via subscription   (Followers: 7)
About Performance     Full-text available via subscription   (Followers: 13)
Access     Full-text available via subscription   (Followers: 28)
ACCESS: Critical Perspectives on Communication, Cultural & Policy Studies     Full-text available via subscription   (Followers: 15)
Accounting, Accountability & Performance     Full-text available via subscription   (Followers: 18)
ACORN : The J. of Perioperative Nursing in Australia     Full-text available via subscription   (Followers: 19, SJR: 0.198, CiteScore: 0)
Adelaide Law Review     Full-text available via subscription   (Followers: 26, SJR: 0.122, CiteScore: 0)
Advocate: Newsletter of the National Tertiary Education Union     Full-text available via subscription   (Followers: 1)
Agenda: A J. of Policy Analysis and Reform     Full-text available via subscription   (Followers: 2)
Agora     Full-text available via subscription   (Followers: 6)
Agricultural Commodities     Full-text available via subscription   (SJR: 0.123, CiteScore: 0)
Agricultural Science     Full-text available via subscription   (Followers: 2)
AIMA Bulletin     Full-text available via subscription   (Followers: 4)
AJP : The Australian J. of Pharmacy     Full-text available via subscription   (Followers: 15, SJR: 0.142, CiteScore: 0)
Analysis     Full-text available via subscription   (Followers: 3)
Ancient History : Resources for Teachers     Full-text available via subscription   (Followers: 9)
Anglican Historical Society J.     Full-text available via subscription   (Followers: 4)
Annals of the Royal Australasian College of Dental Surgeons     Full-text available via subscription   (Followers: 5)
ANZSLA Commentator, The     Full-text available via subscription   (Followers: 4)
Appita J.: J. of the Technical Association of the Australian and New Zealand Pulp and Paper Industry     Full-text available via subscription   (Followers: 16, SJR: 0.168, CiteScore: 0)
AQ - Australian Quarterly     Full-text available via subscription  
Arena J.     Full-text available via subscription  
Around the Globe     Full-text available via subscription   (Followers: 1)
Art + Law     Full-text available via subscription   (Followers: 12)
Art Monthly Australia     Full-text available via subscription   (Followers: 11)
Artefact : the journal of the Archaeological and Anthropological Society of Victoria     Full-text available via subscription   (Followers: 3)
Artlink     Full-text available via subscription   (Followers: 5)
Asia Pacific J. of Clinical Nutrition     Full-text available via subscription   (Followers: 13, SJR: 0.697, CiteScore: 2)
Asia Pacific J. of Health Management     Full-text available via subscription   (Followers: 4)
Aurora J.     Full-text available via subscription  
Australasian Biotechnology     Full-text available via subscription   (Followers: 1, SJR: 0.1, CiteScore: 0)
Australasian Catholic Record, The     Full-text available via subscription   (Followers: 6)
Australasian Drama Studies     Full-text available via subscription   (Followers: 2)
Australasian Epidemiologist     Full-text available via subscription  
Australasian Historical Archaeology     Full-text available via subscription   (Followers: 7, SJR: 0.212, CiteScore: 0)
Australasian J. of Early Childhood     Full-text available via subscription   (Followers: 6, SJR: 0.535, CiteScore: 1)
Australasian J. of Gifted Education     Full-text available via subscription   (Followers: 7, SJR: 0.123, CiteScore: 0)
Australasian J. of Human Security     Full-text available via subscription   (Followers: 1, SJR: 0.144, CiteScore: 0)
Australasian J. of Irish Studies, The     Full-text available via subscription   (Followers: 9)
Australasian J. of Regional Studies, The     Full-text available via subscription   (Followers: 1, SJR: 0.118, CiteScore: 0)
Australasian Law Management J.     Full-text available via subscription   (Followers: 7)
Australasian Leisure Management     Full-text available via subscription   (Followers: 3)
Australasian Musculoskeletal Medicine     Full-text available via subscription   (Followers: 4)
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)
Australasian Policing     Full-text available via subscription   (Followers: 6)
Australasian Public Libraries and Information Services     Full-text available via subscription   (Followers: 34)
Australasian Review of African Studies, The     Full-text available via subscription   (Followers: 2)
Australian Aboriginal Studies     Full-text available via subscription   (Followers: 9, SJR: 0.13, CiteScore: 0)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Ageing Agenda     Full-text available via subscription   (Followers: 7)
Australian and Aotearoa New Zealand Psychodrama Association J.     Full-text available via subscription   (Followers: 2)
Australian and New Zealand Continence J.     Full-text available via subscription   (Followers: 4)
Australian and New Zealand Sports Law J.     Full-text available via subscription   (Followers: 10)
Australian Art Education     Full-text available via subscription   (Followers: 8)
Australian Bookseller & Publisher     Full-text available via subscription   (Followers: 1)
Australian Bulletin of Labour     Full-text available via subscription   (Followers: 2)
Australian Canegrower     Full-text available via subscription   (Followers: 2)
Australian Coeliac     Full-text available via subscription   (Followers: 2)
Australian Cottongrower, The     Full-text available via subscription   (Followers: 1)
Australian Family Physician     Full-text available via subscription   (Followers: 3, SJR: 0.317, CiteScore: 1)
Australian Field Ornithology     Full-text available via subscription   (Followers: 4, SJR: 0.209, CiteScore: 0)
Australian Forest Grower     Full-text available via subscription   (Followers: 4)
Australian Grain     Full-text available via subscription   (Followers: 2)
Australian Holstein J.     Full-text available via subscription   (Followers: 1)
Australian Humanist, The     Full-text available via subscription   (Followers: 4)
Australian Indigenous Law Review     Full-text available via subscription   (Followers: 21)
Australian Intl. Law J.     Full-text available via subscription   (Followers: 22)
Australian J. of Acupuncture and Chinese Medicine     Full-text available via subscription   (Followers: 4, SJR: 0.116, CiteScore: 0)
Australian J. of Adult Learning     Full-text available via subscription   (Followers: 15, SJR: 0.297, CiteScore: 0)
Australian J. of Advanced Nursing     Full-text available via subscription   (Followers: 16, SJR: 0.299, CiteScore: 1)
Australian J. of Asian Law     Full-text available via subscription   (Followers: 4)
Australian J. of Cancer Nursing     Full-text available via subscription   (Followers: 10)
Australian J. of Dyslexia and Learning Difficulties     Full-text available via subscription   (Followers: 8, SJR: 0.1, CiteScore: 0)
Australian J. of Emergency Management     Full-text available via subscription   (Followers: 31, SJR: 0.354, CiteScore: 0)
Australian J. of French Studies     Full-text available via subscription   (Followers: 7, SJR: 0.123, CiteScore: 0)
Australian J. of Herbal Medicine     Full-text available via subscription   (Followers: 6)
Australian J. of Language and Literacy, The     Full-text available via subscription   (Followers: 5, SJR: 0.282, CiteScore: 1)
Australian J. of Legal History     Full-text available via subscription   (Followers: 16)
Australian J. of Medical Science     Full-text available via subscription   (Followers: 3)
Australian J. of Music Education     Full-text available via subscription   (Followers: 4)
Australian J. of Music Therapy     Full-text available via subscription   (Followers: 10, SJR: 0.549, CiteScore: 1)
Australian J. of Parapsychology     Full-text available via subscription   (Followers: 2, SJR: 0.511, CiteScore: 0)
Australian J. on Volunteering     Full-text available via subscription   (Followers: 2)
Australian J.ism Review     Full-text available via subscription   (Followers: 8)
Australian Life Scientist     Full-text available via subscription   (Followers: 2)
Australian Literary Studies     Full-text available via subscription   (Followers: 7)
Australian Mathematics Teacher, The     Full-text available via subscription   (Followers: 7)
Australian Nursing J. : ANJ     Full-text available via subscription   (Followers: 6)
Australian Orthoptic J.     Full-text available via subscription  
Australian Primary Mathematics Classroom     Full-text available via subscription   (Followers: 5)
Australian Screen Education Online     Full-text available via subscription   (Followers: 3)
Australian Senior Mathematics J.     Full-text available via subscription   (Followers: 2)
Australian Sugarcane     Full-text available via subscription  
Australian TAFE Teacher     Full-text available via subscription   (Followers: 4)
Australian Tax Forum     Full-text available via subscription   (Followers: 3)
Australian Universities' Review, The     Full-text available via subscription   (Followers: 4)
Australian Voice     Full-text available via subscription   (Followers: 6)
Bar News: The J. of the NSW Bar Association     Full-text available via subscription   (Followers: 8)
Bioethics Research Notes     Full-text available via subscription   (Followers: 15)
BOCSAR NSW Alcohol Studies Bulletins     Full-text available via subscription   (Followers: 4)
Bookseller + Publisher Magazine     Full-text available via subscription   (Followers: 5)
Breastfeeding Review     Full-text available via subscription   (Followers: 19, SJR: 0.183, CiteScore: 0)
British Review of New Zealand Studies     Full-text available via subscription   (Followers: 4)
Brolga: An Australian J. about Dance     Full-text available via subscription   (Followers: 3)
Cancer Forum     Full-text available via subscription   (SJR: 0.115, CiteScore: 0)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Chain Reaction     Full-text available via subscription  
Childrenz Issues: J. of the Children's Issues Centre     Full-text available via subscription  
Chiropractic J. of Australia     Full-text available via subscription   (SJR: 0.111, CiteScore: 0)
Chisholm Health Ethics Bulletin     Full-text available via subscription   (Followers: 1)
Church Heritage     Full-text available via subscription   (Followers: 5)
Commercial Law Quarterly: The J. of the Commercial Law Association of Australia     Full-text available via subscription   (Followers: 5)
Communicable Diseases Intelligence Quarterly Report     Full-text available via subscription   (Followers: 2, SJR: 0.563, CiteScore: 1)
Communication, Politics & Culture     Open Access   (Followers: 14)
Communities, Children and Families Australia     Full-text available via subscription   (Followers: 3)
Connect     Full-text available via subscription   (Followers: 2)
Contemporary PNG Studies     Full-text available via subscription  
Context: J. of Music Research     Full-text available via subscription   (Followers: 8)
Corporate Governance Law Review, The     Full-text available via subscription   (Followers: 8)
Creative Approaches to Research     Full-text available via subscription   (Followers: 14)
Critical Care and Resuscitation     Full-text available via subscription   (Followers: 25, SJR: 1.032, CiteScore: 1)
Cultural Studies Review     Full-text available via subscription   (Followers: 16)
Culture Scope     Full-text available via subscription   (Followers: 4)
Dance Forum     Full-text available via subscription   (Followers: 6)
DANZ Quarterly: New Zealand Dance     Full-text available via subscription   (Followers: 4)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Deakin Law Review     Full-text available via subscription   (Followers: 15)
Developing Practice : The Child, Youth and Family Work J.     Full-text available via subscription   (Followers: 20)
Early Days: J. of the Royal Western Australian Historical Society     Full-text available via subscription  
Early Education     Full-text available via subscription   (Followers: 9)
EarthSong J.: Perspectives in Ecology, Spirituality and Education     Full-text available via subscription   (Followers: 1)
East Asian Archives of Psychiatry     Full-text available via subscription   (Followers: 3, SJR: 0.36, CiteScore: 1)
Educare News: The National Newspaper for All Non-government Schools     Full-text available via subscription  
Educating Young Children: Learning and Teaching in the Early Childhood Years     Full-text available via subscription   (Followers: 19)
Education in Rural Australia     Full-text available via subscription   (Followers: 3)
Education, Research and Perspectives     Full-text available via subscription   (Followers: 14)
Educational Research J.     Full-text available via subscription   (Followers: 18)
Electronic J. of Radical Organisation Theory     Full-text available via subscription   (Followers: 3)
Employment Relations Record     Full-text available via subscription   (Followers: 3)
English in Aotearoa     Full-text available via subscription   (Followers: 2)
English in Australia     Full-text available via subscription   (Followers: 3, SJR: 0.18, CiteScore: 0)
Essays in French Literature and Culture     Full-text available via subscription   (Followers: 9)
Ethos: Official Publication of the Law Society of the Australian Capital Territory     Full-text available via subscription   (Followers: 5)
Eureka Street     Full-text available via subscription   (Followers: 5)
Extempore     Full-text available via subscription  
Family Matters     Full-text available via subscription   (Followers: 10, SJR: 0.228, CiteScore: 1)
Fijian Studies: A J. of Contemporary Fiji     Full-text available via subscription   (Followers: 1)
Focus on Health Professional Education : A Multi-disciplinary J.     Full-text available via subscription   (Followers: 7)
Food New Zealand     Full-text available via subscription   (Followers: 4)
Fourth World J.     Full-text available via subscription   (Followers: 1)
Frontline     Full-text available via subscription   (Followers: 18)
Future Times     Full-text available via subscription   (Followers: 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: 3)
Geographical Education     Full-text available via subscription   (Followers: 2)
Geriatric Medicine in General Practice     Full-text available via subscription   (Followers: 8)
Gestalt J. of Australia and New Zealand     Full-text available via subscription   (Followers: 2, SJR: 0.1, CiteScore: 0)
Globe, The     Full-text available via subscription   (Followers: 4)
Government News     Full-text available via subscription   (Followers: 2)
Great Circle: J. of the Australian Association for Maritime History, The     Full-text available via subscription   (Followers: 7)
Grief Matters : The Australian J. of Grief and Bereavement     Full-text available via subscription   (Followers: 11)
He Puna Korero: J. of Maori and Pacific Development     Full-text available via subscription   (Followers: 3)
Headmark     Full-text available via subscription   (Followers: 2)
Health Inform     Full-text available via subscription  
Health Issues     Full-text available via subscription   (Followers: 2)
Health Promotion J. of Australia : Official J. of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 8, SJR: 0.531, CiteScore: 1)
Health Voices     Full-text available via subscription  
Heritage Matters : The Magazine for New Zealanders Restoring, Preserving and Enjoying Our Heritage     Full-text available via subscription   (Followers: 2)
High Court Quarterly Review, The     Full-text available via subscription   (Followers: 3)
HIV Australia     Full-text available via subscription   (Followers: 3)
HLA News     Full-text available via subscription   (Followers: 3, SJR: 0.438, CiteScore: 1)
Hong Kong J. of Emergency Medicine     Full-text available via subscription   (Followers: 5, SJR: 0.19, CiteScore: 0)
Idiom     Full-text available via subscription   (Followers: 1)
Impact     Full-text available via subscription   (Followers: 2)
InCite     Full-text available via subscription   (Followers: 17)
Indigenous Law Bulletin     Full-text available via subscription   (Followers: 20)
InPsych : The Bulletin of the Australian Psychological Society Ltd     Full-text available via subscription   (Followers: 2)
Inside Film: If     Full-text available via subscription   (Followers: 6)
Institute of Public Affairs Review: A Quarterly Review of Politics and Public Affairs, The     Full-text available via subscription   (Followers: 12)
Instyle     Full-text available via subscription   (SJR: 0.116, CiteScore: 0)
Intellectual Disability Australasia     Full-text available via subscription   (Followers: 12)
Interaction     Full-text available via subscription   (Followers: 4)
Intl. Employment Relations Review     Full-text available via subscription   (Followers: 3)
Intl. J. of Disability Management Research     Full-text available via subscription   (Followers: 3)
Intl. J. of e-Business Management     Full-text available via subscription  
Intl. J. of Employment Studies     Full-text available via subscription   (Followers: 8)
Intl. J. of Home Economics     Full-text available via subscription   (Followers: 2)
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Intl. J. of Punishment and Sentencing, The     Full-text available via subscription   (Followers: 9)
Irrigation Australia: The Official J. of Irrigation Australia     Full-text available via subscription   (Followers: 3)
ISAA Review     Full-text available via subscription   (Followers: 1)
J. (Australian Native Plants Society. Canberra Region)     Full-text available via subscription   (Followers: 1)
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J. of Australian Colonial History     Full-text available via subscription   (Followers: 8)
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East Asian Archives of Psychiatry
Journal Prestige (SJR): 0.36
Citation Impact (citeScore): 1
Number of Followers: 3  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 2078-9947
Published by RMIT Publishing Homepage  [387 journals]
  • Volume 30 Issue 1 - Multi-disciplinary psychiatric case management model
           in Hong Kong: Service coverage and risk stratification
    • Abstract: Lee, CC; Chui, WWH; Wong, SL; Wong, TCB; Lau, SPF; Kwong, PK; Hung, SF; Yau, SSW
      Introduction: Community mental health services in Hong Kong follow a multi-disciplinary case management model. We investigated whether at-risk patients received higher intensity care and whether risk stratification concorded between personalised care programmes and integrated community centres of mental wellness.

      Methods: Records of all patients in North Lantau and Mongkok districts who received case management services (from personalised care programmes and/or integrated community centres of mental wellness) between 1 April 2014 and 30 June 2015 were reviewed. Patients' levels of risk, demographic data, and clinical characteristics were analysed.

      Results: Identified at-risk patients received high-intensity care from personalised care programmes and integrated community centres of mental wellness. Case management was coordinated between the Hospital Authority and non-government organisations. However, risk stratification did not correlate with assessment rating scores of psychopathology or psychosocial functioning. Assessment rating scales appear unsuitable to provide any optimal cut-off scores for risk stratification.

      Conclusions: Risk stratification should be a structured clinical judgement based on comprehensive and accurate information of protective and risk factors, rather than relying on cut-off scores of assessment rating scales.

      PubDate: Wed, 6 May 2020 01:50:13 GMT
       
  • Volume 30 Issue 1 - Patients' reports of traumatic experience and
           posttraumatic stress in psychiatric settings
    • Abstract: Wu, KK; Cheng, JP; Leung, J; Chow, LP; Lee, CC
      Objective: To determine the prevalence of traumatic experience (TE) among patients in psychiatric settings in Hong Kong and the associations between TE, levels of distress, and anxiety and depressive symptoms.

      Methods: 129 patients who have received inpatient psychiatric services were recruited. Their lifetime TE was assessed using the Life Event Checklist (LEC), and TE in psychiatric settings using the Psychiatric Experiences Questionnaire (PEQ). Their level of distress symptoms was assessed using the Impact of Event Scale-Revised (IES-R), and the level of anxiety and depressive symptoms using the Hospital Anxiety and Depression Scale (HADS).

      Results: The prevalence of direct and indirect TE was 84.5%, as was the prevalence of TE in psychiatric settings. Common TE in psychiatric settings included witnessing another patient being taken down (61.2%), being put in restraints of any kind (41.1%), and witnessing another patient being physically assaulted by another patient (36.4%). TE in psychiatric settings associated with high prevalence of severe or extreme distress 1 week after the event included being forced to take medication against their will (52.2%), being threatened with physical violence (52.2%), and experiencing a physical assault (50.0%). Lifetime TE (the total number of LEC items reported) was associated with severity of distress, and anxiety and depressive symptoms, whereas TE in psychiatric settings (the total number of PEQ items reported) was associated with severity of distress only. The total number of LEC items reported is the only predictor of levels of distress, and anxiety and depressive symptoms.

      Conclusions: Lifetime TE and TE in psychiatric settings are common among patients with SMI. Trauma-informed care is suggested for mental health services.

      PubDate: Wed, 6 May 2020 01:50:13 GMT
       
  • Volume 30 Issue 1 - Melancholic versus non-melancholic depression: A
           prospective study
    • Abstract: Munoli, RN; Sharma, PSVN; Kongasseri, S; Bhandary, RP; Praharaj, SK
      Background: The binarian model views melancholia as a distinct depressive class, whereas the unitarian model views it as a more severe expression of depression. This study aims to investigate the sociodemographic, clinical, and course differences between melancholic and non-melancholic depression.

      Methods: This prospective observational study was carried out at Kasturba Hospital, Manipal, India from November 2010 to September 2011. We recruited consecutive inpatients aged 18 to 60 years who have a diagnosis of depressive disorder (based on ICD-10), with or without any psychiatric or physical comorbidities. Patients were categorised into melancholia and non-melancholia using the CORE questionnaire, with scores of >=8 indicating the presence of melancholic depression. In addition, patients were evaluated using the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Somatoform Symptom Checklist, Columbia Suicide Severity Rating Scale, Clinical Global Impression, and Presumptive Stressful Life Events Scale at baseline and at 1, 3, and 6 months.

      Results: Of 87 inpatients with a diagnosis of depression, 50 met the inclusion criteria and 37 were excluded. Compared with patients with non-melancholic depression, patients with melancholic depression had higher depression score (30.8 vs 23.8, p < 0.001), had higher number of patients with psychotic depression (39.1% vs 7.4%, p = 0.007), had higher overall illness severity score (5.9 vs 4.8, p < 0.001), and had higher number of patients with suicidal ideation and suicidal behaviour. Regarding the course of melancholia, the number of melancholic patients decreased from 23 at baseline to eight at 1 month, three at 3 months, and three at 6 months. Scores of non-interactiveness, retardation, and agitation decrease significantly over 3 months.

      Conclusions: The construct and course of melancholia may be viewed as a part of depression, more in line with severe depression. Melancholia increases the risk for suicidal ideation and suicidal behaviour.

      PubDate: Wed, 6 May 2020 01:50:13 GMT
       
  • Volume 30 Issue 1 - Prevalence and correlates of depressive symptoms among
           medical students: A cross-sectional single-centre study
    • Abstract: Al-Maashani, M; Al-Balushi, N; Al-Alawi, M; Mirza, H; Al-Huseini, S; Al-Balushi, M; Obeid, Y; Jose, S; Al-Sibani, N; Al-Adawi, S
      Background: Depressive symptoms are common among medical students. The aim of the present study was to determine the prevalence and risk factors of depressive symptoms among medical students in Sultan Qaboos University in Oman.

      Method: A cross-sectional study was conducted among a random sample selected from 1041 medical students at Sultan Qaboos University, Oman. The Patient Health Questionnaire-9 (PHQ-9) was used to screen for depressive symptoms. A logistic regression model was used to determine risk factors for depressive symptoms.

      Results: Of 197 medical students selected, 189 (61 men and 128 women) responded. The PHQ-9 results showed that the prevalence of depressive symptoms was 41.3%. In multivariate analysis, female students were more likely than male students to develop depression (adjusted odds ratio = 2.866, p = 0.004). Medical students with a family history of depression were more likely to develop depression than those without a family history of depression (adjusted odds ratio = 4.150, p = 0.014).

      Conclusion: Depressive symptoms are common among medical students in Sultan Qaboos University. Risk factors for depressive symptoms are female sex and family history of depression.

      PubDate: Wed, 6 May 2020 01:50:13 GMT
       
  • Volume 30 Issue 1 - Staff mental health self-assessment during the
           COVID-19 outbreak
    • Abstract: Chung, Joseph PY; Yeung, Wai-Song
      With the COVID-19 outbreak, vigilance in infection control has increased in both general public and hospital levels, and its psychological impact on hospital staff is expected to increase. In a survey in Canada about the psychosocial effects of Severe Acute Respiratory Syndrome on hospital staff, 29% of the respondents scored above the threshold point on the 12-item General Health Questionnaire, indicating probable emotional distress. Frontline healthcare workers may experience fear of being infected and spreading the virus to their families, particularly those working in isolation wards and accident and emergency departments. There is a need for timely mental health care for patients and health workers during the COVID-19 outbreak.

      PubDate: Wed, 6 May 2020 01:50:13 GMT
       
  • Volume 30 Issue 1 - Cognitive functioning of ageing patients with severe
           mental illness: A pilot study
    • Abstract: Wong, Mimi MC; Pang, Pui-Fai
      There are concerns about adequacy of care for older people with severe mental illness in terms of health and social care aspects. An increasing number of patients with severe mental illness are expected to survive into old age. They are likely to develop neurodegenerative disorders such as dementia in addition to psychiatric morbidities. Up to 60% of such patients have clinically relevant cognitive impairment.

      PubDate: Wed, 6 May 2020 01:50:13 GMT
       
  • Volume 29 Issue 4 - Association of childhood attention deficit
           hyperactivity disorder symptoms with academic and psychopathological
           outcomes in Indian College students: A retrospective survey
    • Abstract: Jaisoorya, TS; Desai, Geetha; Nair, BSivasankaran; Rani, Anjana; Menon, Priya G; Thennarasu, K
      "Objective: To survey the prevalence of retrospectively recalled clinically significant symptoms of attention deficit hyperactivity disorder (ADHD) in childhood and determine the association of ADHD symptoms in childhood with current academic achievement and psychopathological outcomes among college students in the state of Kerala, India.

      Methods: A self-administered questionnaire was distributed to 5784 students from 58 colleges selected by cluster random sampling. The Barkley Adult ADHD Rating Scale-IV was used for recollection of childhood ADHD symptoms; a total score of >=60 (indicating the 99 percentile) was taken as the cut-off for clinically significant ADHD symptoms in childhood. The Alcohol, Smoking and Substance Involvement Screening Test was used to assess lifetime use of alcohol and tobacco. The Kessler Psychological Distress Scale was used to assess non-specific psychological distress. Lifetime suicidality and exposure to sexual abuse were assessed by asking relevant questions. Students who recalled having clinically significant ADHD symptoms in childhood were compared with those who did not.

      Results: Of 5784 students, 639 (11.5%) did not complete the questionnaire. Of the remaining 5145 students, 1750 (34.8%) were men and 3395 (65.2%) were women, with a mean age of 19.4 years. 143 (2.8%) students reported clinically significant ADHD symptoms in childhood. Childhood ADHD symptoms were significantly more common in men and in those living in urban areas. In the bivariate analysis, those with clinically significant ADHD symptoms in childhood had significantly higher odds of poorer academic performance, alcohol use, tobacco use, psychological distress, suicidal thoughts, suicidal attempts, and contact and non-contact sexual abuse, after adjusting for sex and residence.

      Conclusions: Clinical evaluation and appropriate management may be warranted for adults who retrospectively recall clinically significant ADHD symptoms in childhood."

      PubDate: Fri, 31 Jan 2020 17:43:05 GMT
       
  • Volume 29 Issue 4 - Adult attention deficit hyperactivity disorder in a
           Malaysian Forensic Mental Hospital: A cross-sectional study
    • Abstract: Woon, Luke Sy-Cherng; Zakaria, Hazli
      "Objective: To determine the prevalence of adult attention deficit hyperactivity disorder (ADHD) and comorbid mental disorders in a Malaysian forensic mental hospital.

      Methods: All adult patients admitted to the forensic wards who were able to understand Malay or English language and give written informed consent were included. Participants were assessed using the Conners Adult Attention-Deficit Diagnostic Interview for DSM-IV (for presence of adult ADHD and a history of childhood ADHD) and the Mini International Neuropsychiatric Interview (for psychiatric comorbidities). Sociodemographic and offence-related data were also collected.

      Results: Of 199 patients admitted, 120 were included for analysis. The mean age of participants was 36.3 years. 94.2% were men. 81.7% were single, divorced, or separated. 25% had a history of childhood ADHD. The prevalence of adult ADHD was 15.8%. The persistence rate was 63%. Among the 19 participants with adult ADHD, the most common psychiatric comorbidities were substance dependence (68.4%), lifetime depression (63.2%), and generalised anxiety disorder (47.4%). Compared with participants without ADHD, participants with adult ADHD were less likely to be married (0% vs 21.8%, p = 0.022) and more likely to have alcohol abuse (15.8% vs 2%, p = 0.028), lifetime manic/hypomanic episodes (42.1% vs 7.9%, p = 0.001), and generalised anxiety disorder (47.4% vs 19.8%, p = 0.017), and were of younger age at first offence (21.8 years vs 26.9 years, p = 0.021).

      Conclusions: Adult ADHD is common in a Malaysian forensic mental hospital and is associated with unmarried status, alcohol abuse, lifetime manic/hypomanic episodes, generalised anxiety disorder, and younger age at first offence."

      PubDate: Fri, 31 Jan 2020 17:43:05 GMT
       
  • Volume 29 Issue 4 - Early maladaptive schemas, depression severity, and
           risk factors for persistent depressive disorder: A cross-sectional study
    • Abstract: Chen, Kai-Hung; Tam, Carl Wai-Cheong; Chang, Kelly
      "Objective: To investigate associations of the five early maladaptive schemas (EMS) domains with depression severity by comparing patients with persistent depressive disorder (PDD), patients with major depressive disorder (MDD), and controls with no psychiatric disorders.

      Methods: Patients with PDD (n = 30), patients with MDD (n = 24), and controls with no psychiatric disorders (n = 30) were recruited. Participants were assessed using the Mini-International Neuropsychiatric Interview 5.0 version (MINI), the Beck Depression Inventory-Second Edition (BDI-II), and the Young Schema Questionnaire-3rd Edition Short Form (YSQ-S3).

      Results: The five EMS domains (YSQ-S3 score) significantly correlated with depression severity (BDI-II score), with correlation coefficients ranging from 0.583 to 0.788. After controlling for age, education, and sex, the two best predictors of depression severity were domains 'over-vigilance and inhibition' and 'disconnection and rejection'. For domains of disconnection and rejection, impaired autonomy and performance, and over-vigilance and inhibition, the total YSQ-S3 score was significantly higher in the PDD group than both the MDD and control groups. For the domain of impaired limits, the total YSQ-S3 score was significantly higher in both the PDD and MDD groups than the control group.

      Conclusion: All five EMS domains correlated significantly with depression severity. PDD and MDD differed in psychopathology. The EMS domains of disconnection and rejection, impaired autonomy and performance, and over-vigilance and inhibition may be specific risk factors for PDD."

      PubDate: Fri, 31 Jan 2020 17:43:05 GMT
       
  • Volume 29 Issue 4 - Validation of the Chinese version of
           obsessive-compulsive inventory-revised
    • Abstract: Hon, KHSimon; Siu, Bonnie WM; Cheng, CW; Wong, Wilson CW; Foa, Edna B
      "Background: The Obsessive-Compulsive Inventory-Revised (OCI-R) is a psychometrically sound and valid self-report measure for evaluating the severity of six dimensions of obsessive-compulsive symptoms: washing, obsessing, hoarding, ordering, checking, and neutralising. We aimed to validate the Chinese version of the OCI-R (C-OCI-R) in patients with obsessive-compulsive disorder (OCD) in Hong Kong.

      Methods: The C-OCI-R was forward and backward translated and reviewed by an expert panel and a focus group. The internal consistency and test-retest reliability (2-week interval) were examined. Confirmatory factor analysis was used to examine the construct validity of the C-OCI-R. Concurrent validity was examined by the correlation between the C-OCI-R and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), whereas divergent validity was examined by the correlation of the C-OCI-R with the Beck Depression Inventory-Second Edition and the Hamilton Depression Rating Scale.

      Results: 130 OCD patients were recruited. The C-OCI-R showed excellent internal consistency (Cronbach's alpha = 0.92) and test-retest reliability (Spearman's rho correlation coefficient = 0.96). The original six-factor model was supported by confirmatory factor analysis. Concurrent validity and divergent validity were established. However, the neutralising subscale may need further development, and the divergent validity of the obsessing subscale was unsatisfactory. The structure of OCD symptoms was similar in Chinese and western patients.

      Conclusion: The C-OCI-R is a valid and reliable measure for assessing the severity of obsessive-compulsive symptoms in local Chinese patients with OCD."

      PubDate: Fri, 31 Jan 2020 17:43:05 GMT
       
  • Volume 29 Issue 4 - Pulmonary embolism as a cause of death in psychiatric
           inpatients: A case series
    • Abstract: Lee, CC; Fung, Regina; Pang, SW; Lo, TL
      We report four cases of fatal pulmonary embolism confirmed by autopsy among inpatients in a Hong Kong psychiatric hospital from 2010 to 2014. None of the four patients had a medical or premorbid condition associated with vascular thromboembolism or causing prolonged immobilisation. Only two patients were taking long-term antipsychotic medication, but all were physically restrained shortly before the event.

      PubDate: Fri, 31 Jan 2020 17:43:05 GMT
       
  • Volume 29 Issue 4 - Reducing injury during restraint by crisis
           intervention in psychiatric wards in Singapore
    • Abstract: Poremski, Daniel; Loo, Elayne; Chan, Christopher Yi Wen; Li, Liu Dong; Fung, Daniel
      "Objective: The application of restraints during psychiatric crises is a serious adverse event. We aimed to reduce the number of injuries sustained by patients during the application of restraints.

      Methods: Structured interviews were conducted with 10 staff to determine six root causes of patient injury during restraint. Three plan-do-study-act cycles were implemented: (1) reorganising shift rosters to pair trained staff with inexperienced staff, (2) holding monthly session for practising de-escalation and restraint techniques as a team in a supervised setting, and (3) rotating the responsibility for leading the de-escalation in real crises.

      Results: Pre-intervention period was from January 2014 to December 2014 (28 251 inpatient bed days). Intervention period was from January 2015 to March 2015 (7121 inpatient bed days). Post-intervention period was from April 2015 to December 2016 (51 735 inpatient bed days). Data extracted included the dates and numbers of crises, activation of the crisis team, use of restraints, and injuries. During pre-intervention and intervention periods, only two minor and three moderate injuries were recorded. During post-intervention period, no injury was recorded and the number of restraints decreased gradually although the number of crisis team activations increased in the early phase. Eventually restraints were used only upon arrival of the crisis team.

      Conclusion: Our quality improvement project identified six root causes and implemented three plan-do-study- act cycles to successfully eliminated patient injuries during the use of restraints."

      PubDate: Fri, 31 Jan 2020 17:43:05 GMT
       
  • Volume 29 Issue 3 - New service model for common mental disorders in Hong
           Kong: A retrospective outcome study
    • Abstract: Lee, WK; Lo, A; Chong, G; Chang, SYS; Lu, V; Yip, PLI; Liu, CMK; Leung, M; Chung, CM; Wong, KY; Yeung, YYE; Chan, SMA; Ngai, YS; Wong, PS; Lo, TL
      Objective: To review the first 8-month outcome of the Common Mental Disorder Clinic model in Hong Kong in terms of patient exit status and improvement in depressive and anxiety symptoms.

      Methods: During the first appointment, patients were interviewed by a multidisciplinary team comprising a psychiatrist, a psychiatric nurse, and an occupational therapist. A multidisciplinary case conference was conducted to discuss clinical observations, diagnosis, issues of concern, and the optimal individualised treatment plan. Low-intensity interventions by nurses and/or occupational therapists were provided, as were optional, time-limited, protocol-based interventions by clinical psychologists for those with mild to moderate depressive and anxiety symptoms. Pharmacological intervention may be used when indicated. Upon completion of the treatment plan, patients were reassessed by the treating psychiatrist. Discharge options included discharge without psychiatric follow-up, step-up to psychiatric outpatient clinics, and step-down services. The self-administered Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder 7-item scale (GAD-7) were used to assess the past 2 weeks' depressive and anxiety symptoms, respectively, at baseline and at each session.

      Results: From July 2015 to February 2016, 1325 Chinese patients received the new service. Of them, 170 men and 363 women (mean age, 52.6 years) completed the treatment plan. After treatment, their mean PHQ-9 score decreased from 11.06 to 7.55 (p < 0.001), and the mean GAD-7 score decreased from 9.94 to 6.54 (p < 0.001). After treatment, 42.4% and 48.2% of the patients were within the normal range of PHQ-9 and GAD-7 scores, respectively, compared with 16.9% and 20.8% before treatment. The mean time to implementation of the individualised treatment plan was 82.33 days. Of the patients, 54.4% were discharged without any need for medical or psychiatric follow-up; 28% were stepped up to psychiatric outpatient clinics; and 17.3% were stepped down. The predictors of exit status were whether psychiatric medication was prescribed during initial intake (p = 0.011), whether psychiatric medication was prescribed at last follow-up (p < 0.001), the service period (p = 0.010), and the GAD-7 final score (p = 0.005).

      Conclusions: The first 8-month outcome of the new service model was encouraging, with shortened waiting time, reduced severity of symptoms, and better exit status (high recovery and step-down rates).

      PubDate: Tue, 29 Oct 2019 23:23:16 GMT
       
  • Volume 29 Issue 3 - Anti-voltage-gated potassium channel limbic
           encephalitis with psychiatric features: A case report
    • Abstract: Hee, JM; Low, SHK; Tan, S M
      We report a case of anti-voltage-gated potassium channel (VGKC) limbic encephalitis in a 47-yearold man presenting with a 2-year history of psychiatric features. The patient had cognitive impairment, slurred speech, and a mildly unsteady gait but no other neurological deficits or seizures. Results of blood, urine, and cerebrospinal fluid tests and magnetic resonance imaging of the brain were normal. However, electroencephalography showed an epileptogenic focus in the bilateral temporal regions with mild to moderate diffuse encephalopathy. Autoimmune panel results confirmed the diagnosis of anti-VGKC limbic encephalitis, with a serum VGKC concentration of 6730 pmol/L. The patient was treated with Keppra and pulsed intravenous methylprednisolone for 3 days, and his behaviour improved.

      PubDate: Tue, 29 Oct 2019 23:23:16 GMT
       
  • Volume 29 Issue 3 - Mental health literacy in cancer outpatients in
           Singapore
    • Abstract: Poon, S H; Wang, FQ; Goh, J; Chan, YH; Lim, L
      Objective: We aimed to evaluate the prevalence of depressive and anxiety symptoms and mental health literacy (MHL) in outpatients with or without cancer in Singapore.

      Methods: Oncology outpatients and outpatients without cancer (controls) were assessed for severity of anxiety and depressive symptoms (using the Hospital Anxiety and Depression Scale) and MHL regarding major depressive disorder and generalised anxiety disorder in terms of diagnosis, aetiology, treatment, and attitudes toward mental health services.

      Results: A total of 89 oncology outpatients and 61 controls were recruited. Those with primary and secondary education had significantly lower MHL scores than those with university education (p = 0.001). Oncology outpatients and controls were comparable in terms of anxiety (13.5% vs 9.8%, p = 0.5), depression (2.2% vs 1.6%, p > 0.99), and total MHL score (7.94 vs 9.13, p = 0.102).

      Conclusions: MHL is comparable between oncology outpatients and controls and is positively associated with education level.

      PubDate: Tue, 29 Oct 2019 23:23:16 GMT
       
  • Volume 29 Issue 3 - Prevalence of aggressive or violent behaviour in Thai
           patients with schizophrenia: A cross-sectional study
    • Abstract: Maneeton, N; Maneeton, B; Jaiyen, N; Woottiluk, P; Khemawichanurat, W
      Objective: This study aimed to determine the prevalence of violence and factors associated with aggressive or violent behaviour in Thai patients with schizophrenia.

      Methods: This cross-sectional study was conducted in all patients with schizophrenia aged >=18 years admitted to Suan Prung Psychiatric Hospital, Thailand, between January and November 2014. Baseline interviews were conducted by a psychiatrist and psychiatric nurses. Accessibility to weapons and toxic chemicals was evaluated.

      Results: Of 230 patients with schizophrenia screened, 207 (162 men and 45 women) were included. Of them, only 16 (7.7%) patients had aggressive or violent behaviour, including verbal aggression (n = 7), physical aggression (n = 5), and aggression against property (n = 4). Nonetheless, only 2 (12.5%) of them had been charged by the police. The weapon score was higher in violent than non-violent patients (p < 0.05). Binary logistic regression analysis showed that the weapon score was the only significant predictor of violence.

      Conclusion: Patients with schizophrenia with greater access to weapons were more likely to have aggressive or violent behaviour. Routine screening for access to weapons in clinical settings and adequate treatment of psychotic symptoms may reduce the incidence of aggressive or violent behaviour and violent offences.

      PubDate: Tue, 29 Oct 2019 23:23:16 GMT
       
  • Volume 29 Issue 3 - Five personality traits in late-onset depression in
           Hong Kong
    • Abstract: Chik, JDW; Poon, TK; Ng, RMK
      Objective: This study aimed to examine the association between five personality traits and late-onset depression in Hong Kong older people.

      Methods: This cross-sectional study included a convenience sample of 40 older people with late-onset depression (LOD) and 54 non-depressed elderly controls. The patients were assessed using the NEO Five Factor Inventory (for personality), the Hamilton Depression Rating Scale (for depression severity), the Mini-Mental State Examination (for cognitive function), the Lawton Instrumental Activities of Daily Living (for functioning), and the Cumulative Illness Rating Scale (for number of physical illnesses).

      Result: The LOD group had a higher Hamilton Depression Rating Scale score (18.9 vs 3.7, p < 0.001), lower Mini Mental State Examination score (24.9 vs 26.4, p = 0.004), and lower Instrumental Activities of Daily Living scale score (21.9 vs 23.7, p = 0.013). On the NEO Five Factor Inventory, the LOD group had a higher neuroticism score (30.7 vs 17.5, p < 0.001) and lower scores on extraversion (19.0 vs 26.4, p < 0.001), openness (18.9 vs 21.5, p = 0.026), and conscientiousness (29.1 vs 33.8, p < 0.001). Neuroticism was the only significant predictor of LOD (odds ratio = 2.325, p = 0.001) and the only significant factor associated with depression severity (beta = 0.581, p = 0.003).

      Conclusions: The personality trait of neuroticism is associated with LOD and its severity. Assessment of personality traits should be included in the assessment of people with depression.

      PubDate: Tue, 29 Oct 2019 23:23:16 GMT
       
  • Volume 29 Issue 3 - 'Organic anxiety' in a middle-aged man presenting with
           dyspnoea: A case report
    • Abstract: Wong, MFK; Leung, MWM; Leung, CM
      We report a case of pulmonary embolism in a patient who presented with repeated anxiety attacks and psychotic symptoms and was misdiagnosed as having withdrawal seizure or anxiety disorder not otherwise specified. This case highlighted the nonspecific clinical features of pulmonary embolism and the principles in making psychiatric diagnosis. Careful history taking, thorough physical examination, appropriate investigation, and a high index of suspicion led to the correct diagnosis. The principle of hierarchy of psychiatric diagnosis (ie, organic over non-organic) and the possibility of comorbidities should always apply.

      PubDate: Tue, 29 Oct 2019 23:23:16 GMT
       
  • Volume 29 Issue 2 - Consultation-liaison psychiatry in Hong Kong: A 2019
           update
    • Abstract: Mak, Arthur Dun-Ping; Wong, Evelyn Kit-Yi
      PubDate: Thu, 4 Jul 2019 00:03:19 GMT
       
  • Volume 29 Issue 2 - Associations between gastro-oesophageal reflux
           disease, generalised anxiety disorder, major depressive episodes, and
           healthcare utilisation: A community-based study
    • Abstract: Mak, Arthur D P; Wu, Justin C Y; Chan, Yawen; Tse, YK; Lee, Sing
      Objective: To examine the prevalence and comorbidity of gastro-oesophageal reflux disease (GORD) with generalised anxiety disorder (GAD) and major depressive episodes (MDE) in a general population using DSM-IV, and to evaluate the associations between these conditions and healthcare utilisation.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

      PubDate: Thu, 31 Jan 2019 13:51:35 GMT
       
 
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