East Asian Archives of Psychiatry最新文献

Background: Endophenotypes aid in studying the complex genetic basis of bipolar disorder. We aimed to compare first-degree relatives of patients with bipolar I disorder in a hospital in India with unrelated healthy controls in terms of neurocognition and affective temperament METHODS. This cross-sectional study was conducted between August and November 2012 at a tertiary hospital in India. First-degree relatives (parents, siblings, and children) of patients with bipolar I disorder were included; they were aged 18 to 50 years and had education level of at least eighth grade. Additionally, matched healthy controls were recruited from the general population. Sociodemographic data were collected using a semi-structured proforma. Participants were assessed for verbal and visual working memory, executive function (including cognitive flexibility, response inhibition, as well as concept formation, abstract reasoning, and set-shifting abilities), and affective temperament by a single investigator.

Results: Of the 52 first-degree relatives of patients diagnosed with bipolar I disorder, 30 were included in the analysis. Additionally, 30 matched healthy controls from the general population were included for comparison. Compared with healthy controls, first-degree relatives performed significantly poorer in all tests and had significantly higher scores for cyclothymic, hyperthymic, and anxious temperaments.

Conclusion: Impairments in working memory, executive function, and certain affective temperaments are potential endophenotypes for bipolar I disorder. Working memory and executive function are most important cognitive domains for social, occupational, and interpersonal functioning. These potential markers could be used to trace susceptible genes for bipolar disorder and thus enhance our understanding of the complex genetics of mood disorders.

Background: Attention deficit hyperactivity disorder (ADHD) often coexists with substance use disorders (SUDs). This study aimed to determine factors associated with ADHD symptoms among adults with SUDs in Malaysia.

Methods: Patients aged ≥18 years with a ≥1-year history of substance use who were admitted to any of the three drug rehabilitation centres in urban Malaysia for >1 month were invited to participate. Participants were interviewed using the Malay version of the Alcohol, Smoking and Substance Involvement Screening Test to assess substance use and the Malay version of the Adult ADHD Self-Reporting Scale to assess ADHD symptoms.

Results: The prevalence of adult ADHD symptoms among participants with SUDs was 47.2%. Compared with participants without ADHD, a lower proportion of participants with ADHD had medical comorbidities (84.9% vs 93.3%, p = 0.018), whereas a higher proportion of participants with ADHD symptoms had a history of imprisonment (80.8% vs 65.6%, adjusted p = 0.018) and first imprisonment before the age of 18 years (24.6% vs 16.8%, adjusted p = 0.048).

Conclusion: A high proportion of adults undergoing rehabilitation for SUDs have ADHD symptoms. Screening and interventions for ADHD should be integrated into SUD rehabilitation programmes.

Background: House officers are susceptible to internet addiction and psychological distress. This study aimed to investigate factors associated with internet addiction among house officers in a Malaysian hospital.

Methods: This is a cross-sectional study of house officers at Hospital Selayang in Selangor, Malaysia. They were randomly selected to complete a survey between May and June 2023. Internet addiction was assessed using the validated Malay version of the Internet Addiction Test. Levels of depression, anxiety, and stress were assessed using the self-report Depression, Anxiety and Stress Scale 21.

Results: Of 62 male and 81 female house officers included, 27 (18.9%) had internet addiction. In the simple logistic regression analysis, internet addiction was associated with a family history of mental illness (p = 0.043) and anxiety (p = 0.002). In the multiple logistic regression analysis, only anxiety remained to be associated with internet addiction (adjusted odds ratio = 6.34, p = 0.005), whereas a family history of mental illness became slightly not significant (adjusted odds ratio = 3.03, p = 0.051).

Conclusion: Given the bidirectional relationship between psychological distress and internet addiction, it is crucial to implement comprehensive intervention strategies that integrate mental health support with measures to manage excessive internet use.

Background: Severe acute respiratory syndrome (SARS) and COVID-19 are both highly infectious diseases that cause severe respiratory illness. This study aimed to compare survivors of SARS and COVID-19 and identify factors associated with long-term psychiatric comorbidities.

Methods: This was a retrospective cohort study of adult Chinese survivors of SARS and COVID-19 who had been admitted to the United Christian Hospital, Hong Kong. In total, 90 SARS survivors and 60 COVID-19 survivors agreed to participate, and their data at 30 months post-infection were retrieved.

Results: Compared with SARS survivors, COVID-19 survivors had a lower prevalence of psychiatric disorder at 30 months post-infection (6.7% vs 33.3%, p < 0.001). Higher levels of anxiety and depression were independently associated with greater perceived functional impairment, higher average pain intensity level in the past month, and less use of rational problem solving.

Conclusion: Experience of SARS might be a protective factor to combat COVID-19 in the Hong Kong population. Potential treatment strategies include optimisation of pain management, physical rehabilitation, and enhancing effective coping strategies.

This review aims to determine the role of S-adenosylmethionine (SAMe) supplementation as an alternative therapeutic option, particularly for individuals with inadequate responses to conventional antidepressive treatments. The effects of SAMe on depression are analysed through its role in modulating neurotransmitter metabolism, reducing neuroinflammation, enhancing neuroplasticity, and regulating gene expression. These mechanisms may contribute to the efficacy of SAMe in treating depression, particularly in treatment-resistant cases. The review also addresses SAMe's potential use in managing other psychiatric disorders and neurological diseases.

Background: Pakistani television dramas often depict scenes involving suicide that may affect the psychological wellbeing of viewers. We aimed to examine the effects of suicide depiction in Pakistani television dramas on their viewers.

Methods: In April 2023, we searched the YouTube website for Urdu-language television dramas released between 2011 and 2022 that contained scenes of suicidal behaviours (both attempts and completed suicides) using the keywords 'suicide in Pakistani dramas'. Data extracted included details of the characters involved including age group, sex, role, occupation, religion, and marital status, as well as details of the suicidal behaviours including method, reason/trigger, and place of suicide.

Results: In total, 49 incidents of suicidal behaviours from 46 characters in 40 Urdu-language television dramas were included in the analysis. Of the 40 dramas, 42.5% were released in 2021 and 2022, and 57.5% were released between 2011 and 2020. Among the 46 characters with suicidal behaviour, 50.0% were male, 54.3% were young adults, 52.2% were married, 26.1% were housewives, 100% were Muslim, and 34.8% were in a leading role. Of the 49 incidents of suicidal behaviour, 29 were suicide, 19 were suicide attempts, and one was homicide-suicide. Common methods of suicidal behaviour depicted were gun shooting (30.6%), wrist cutting (18.3%), self-poisoning (12.2%), and jumping from height (12.2%). Common reasons for suicidal behaviour were failure in love (24.4%), familial issues (24.4%), and others (26.5%); 69.4% of suicidal behaviour occurred in home.

Conclusion: Television dramas with scenes involving suicidal behaviours may negatively affect the general population, particularly adolescents. These scenes should be censored to prevent imitation or identification among vulnerable young people. Television dramas should provide psychoeducational messages to promote help-seeking rather than suicide for emotional problems.

Background: Anxiety is common among house officers. Psychological inflexibility increases the risk of anxiety. This study aimed to determine the associations between anxiety and sociodemographic factors, work-related variables, and psychological inflexibility, and to identify predictors for anxiety among house officers in a hospital in Malaysia.

Methods: This cross-sectional study was conducted at Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia. House officers were recruited from seven departments (general surgery, obstetrics and gynaecology, paediatrics, orthopaedics, emergency, anaesthesiology, and psychiatry) between December 2023 and March 2024 using convenience sampling. Participants were asked to rate their levels of psychological flexibility (using the seven-item Acceptance and Action Questionnaire-II) and anxiety (using the seven-item Generalised Anxiety Disorder scale [AAQ-II]), as well as their perceived factors for anxiety.

Results: In total, 43 male and 95 female participants (mean age, 27.5 years) were included in the analysis. Of the 138 participants, 75 (54.3%) were classified as having anxiety. Participants with anxiety were more likely to have a psychiatric condition (10.7% vs 1.6%, p=0.031), work more hours per week (73.95 vs 67.84, p=0.017), and have higher AAQ-II scores (31.61 vs 19.63, p<0.001). Common factors that the house officers perceived to be associated with anxiety included poor work-life balance (85.5%), hospital bureaucracy (77.5%), and performance pressure (73.9%). Predictors for anxiety were the AAQ-II score (adjusted odds ratio=1.19, p<0.001) and working hours per week (adjusted odds ratio=1.04, p=0.034).

Conclusion: Psychological inflexibility and excessive working hours are predictors for anxiety among house officers in a hospital in Malaysia.

Background: Anxiety disorders are among the most common mental health problems in childhood. Early detection and treatment are essential. We aimed to determine the psychometric properties of the Spence Children's Anxiety Scale - parent version (SCAS-P) in children with various psychiatric disorders in Hong Kong.

Methods: Children aged 6 to 12 years and their parents or guardians were recruited by convenience sampling from the child and adolescent psychiatry specialist out-patient clinic at Queen Mary Hospital. The parents or guardians were asked to complete the SCAS-P, the Diagnostic Interview Schedule for Children version IV (DISC-IV) anxiety module, the Screen for Child Anxiety Related Emotional Disorders parent version (SCARED-P), and the Child Behavior Checklist (CBCL).

Results: In total, 135 child-parent pairs were included. The median age of the children (78 male and 57 female) was 10 (range, 8-11) years. The children had various psychiatric diagnoses; 43.7% had attention deficit hyperactivity disorder and 41.4% had autism spectrum disorder. In addition, 57 (42.2%) children were diagnosed by a psychiatrist with at least one anxiety disorder (based on the DISC-IV anxiety module). The median SCAS-P score was 36.0; it was higher in children with anxiety disorder (n = 57) than in children without anxiety disorder (n = 78) [46.0 vs 28.5, p < 0.001]. The internal consistency of the SCAS-P was high (Cronbach's alpha = 0.938). Convergent validity of the SCAS-P was confirmed with the SCARED-P and CBCL subscales of internalising and anxiety, whereas divergent validity of the SCAS-P was confirmed with the CBCL subscales of externalising, aggression, and delinquency. Test-retest reliability of the SCAS-P was good (intraclass correlation coefficient = 0.90). The SCAS-P had satisfactory criterion validity for any anxiety disorder (area under the curve [AUC] = 0.77), obsessive compulsive disorder (AUC = 0.76), social anxiety disorder (AUC = 0.70), separation anxiety disorder (AUC = 0.81), generalised anxiety disorder (AUC = 0.82), and physical injury fears (AUC = 0.86).

Conclusion: The SCAS-P has satisfactory validity and reliability in screening anxiety disorders among children with various psychiatric disorders. In a busy clinic setting, we recommend using the total SCAS-P score to screen anxiety among children with psychiatric disorders.