East Asian Archives of Psychiatry最新文献

英文中文

Anti-Voltage-gated Potassium Channel Limbic Encephalitis with Psychiatric Features: a Case Report. 具有精神特征的抗电压门控钾通道边缘脑炎1例报告。

Q3 Medicine

East Asian Archives of Psychiatry

Pub Date : 2019-09-01 DOI: 10.12809/eaap1820

J. Hee, S. H. Low, S. Tan

We report a case of anti-voltage-gated potassium channel (VGKC) limbic encephalitis in a 47-year-old 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.

我们报告一例抗电压门控钾通道(VGKC)边缘脑炎在一个47岁的男子提出了2年的精神病史特征。患者有认知障碍，言语不清，步态轻度不稳，但无其他神经功能障碍或癫痫发作。血、尿、脑脊液检查和脑磁共振成像结果正常。然而，脑电图显示双侧颞区有癫痫灶，伴轻度至中度弥漫性脑病。自身免疫小组结果证实了抗VGKC边缘脑炎的诊断，血清VGKC浓度为6730 pmol/L。患者给予Keppra和脉冲静脉注射甲基强的松龙3天，行为得到改善。

引用次数: 1

Prevalence of Aggressive or Violent Behaviour in Thai Patients with Schizophrenia: a Cross-Sectional Study. 泰国精神分裂症患者攻击性或暴力行为的流行:一项横断面研究。

Q3 Medicine

East Asian Archives of Psychiatry

Pub Date : 2019-09-01 DOI: 10.12809/eaap1775

N. Maneeton, B. Maneeton, N. Jaiyen, P. Woottiluk, W. Khemawichanurat

OBJECTIVEThis study aimed to determine the prevalence of violence and factors associated with aggressive or violent behaviour in Thai patients with schizophrenia.METHODSThis 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.RESULTSOf 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.CONCLUSIONSPatients 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.

目的:本研究旨在确定泰国精神分裂症患者的暴力发生率以及与攻击或暴力行为相关的因素。方法本横断面研究纳入2014年1月至11月在泰国Suan Prung精神病院住院的所有年龄≥18岁的精神分裂症患者。基线访谈由一名精神科医生和精神科护士进行。对武器和有毒化学品的获取情况进行了评价。结果在筛查的230例精神分裂症患者中，包括207例(162男45女)。其中，只有16例(7.7%)患者有攻击性或暴力行为，包括言语攻击(n = 7)、身体攻击(n = 5)和财物攻击(n = 4)。然而，只有2例(12.5%)患者被警方起诉。暴力患者武器得分高于非暴力患者(p < 0.05)。二元逻辑回归分析显示，武器得分是暴力的唯一显著预测因子。结论更易获得武器的精神分裂症患者更易出现攻击性或暴力行为。对在临床环境中获取武器的常规筛查和对精神病症状的适当治疗可减少攻击性或暴力行为和暴力犯罪的发生率。

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引用次数: 3

Mental Health Literacy in Cancer Outpatients in Singapore. 新加坡癌症门诊患者的心理健康素养

Q3 Medicine

East Asian Archives of Psychiatry

Pub Date : 2019-09-01 DOI: 10.12809/eaap1813

S. Poon, F. Wang, J. Goh, Y. Chan, L. Lim

OBJECTIVEWe aimed to evaluate the prevalence of depressive and anxiety symptoms and mental health literacy (MHL) in outpatients with or without cancer in Singapore.METHODSOncology 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.RESULTSA 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).CONCLUSIONSMHL is comparable between oncology outpatients and controls and is positively associated with education level.

目的:我们旨在评估新加坡有或无癌症门诊患者抑郁和焦虑症状的患病率以及心理健康素养(MHL)。方法采用医院焦虑抑郁量表(Hospital anxiety and Depression Scale)对妇科门诊患者和非癌症门诊患者(对照)进行焦虑和抑郁症状的严重程度评估，并对重度抑郁症和广泛性焦虑症的MHL进行诊断、病因、治疗和对精神卫生服务的态度评估。结果共纳入肿瘤门诊患者89例，对照组61例。初等和中等教育程度者的MHL评分显著低于大学教育程度者(p = 0.001)。肿瘤科门诊患者和对照组在焦虑(13.5% vs 9.8%， p = 0.5)、抑郁(2.2% vs 1.6%， p > 0.99)和MHL总评分(7.94 vs 9.13, p = 0.102)方面具有可比性。结论smhl在肿瘤门诊患者和对照组之间具有可比性，且与文化程度呈正相关。

引用次数: 4

Five Personality Traits in Late-onset Depression in Hong Kong. 香港晚发性抑郁症的五种人格特征。

Q3 Medicine

East Asian Archives of Psychiatry

Pub Date : 2019-09-01 DOI: 10.12809/eaap1761

J. Chik, T. K. Poon, R. Ng

OBJECTIVEThis study aimed to examine the association between five personality traits and late-onset depression in Hong Kong older people.METHODSThis 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).RESULTThe 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 (β = 0.581, p = 0.003).CONCLUSIONSThe 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.

目的探讨香港老年人五种人格特征与晚发性抑郁症的关系。方法本横断面研究包括40例老年迟发性抑郁症(LOD)患者和54例非抑郁老年对照。采用NEO五因素量表(人格)、汉密尔顿抑郁评定量表(抑郁严重程度)、迷你精神状态检查(认知功能)、劳顿日常生活工具活动(功能)和累积疾病评定量表(身体疾病数量)对患者进行评估。结果LOD组汉密尔顿抑郁评定量表得分较高(18.9比3.7,p < 0.001)，迷你精神状态检查得分较低(24.9比26.4,p = 0.004)，日常生活工具活动量表得分较低(21.9比23.7,p = 0.013)。在NEO五因素量表上，LOD组神经质得分较高(30.7比17.5,p < 0.001)，外向性得分较低(19.0比26.4,p < 0.001)，开放性得分较低(18.9比21.5,p = 0.026)，尽责性得分较低(29.1比33.8,p < 0.001)。神经质是LOD的唯一显著预测因子(比值比= 2.325,p = 0.001)，也是与抑郁严重程度相关的唯一显著因素(β = 0.581, p = 0.003)。结论神经质人格特征与LOD及其严重程度相关。对抑郁症患者的评估应包括人格特征的评估。

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引用次数: 0

Clinical Toxicology and Overdose of Psychiatric Medications. 临床毒理学和精神药物过量。

Q3 Medicine

East Asian Archives of Psychiatry

Pub Date : 2019-06-01

Y C Chan

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.

本文综述了香港的中毒流行病学、急性中毒的评估和治疗，以及急性精神科药物过量的处理。2016年，香港毒物信息中心共接获近4000宗中毒个案，涉及约6000种毒药。大约25%的中毒是与精神有关的药物。中毒的初步医学评估包括病史记录、生命体征监测和重点体格检查。处理急性中毒的方法包括支持性措施、净化、使用解毒剂和加强消除。讨论了精神药物(唑匹克隆、三环抗抑郁药、选择性血清素再摄取抑制剂、抗精神病药、丙戊酸、锂和哌醋甲酯)过量使用的管理，并强调了实用技巧。

引用次数: 0

Associations between Gastro-oesophageal Reflux Disease, Generalised Anxiety Disorder, Major Depressive Episodes, and Healthcare Utilisation: a Community-based Study. 胃食管反流病、广泛性焦虑障碍、重度抑郁发作和医疗保健利用之间的关系:一项基于社区的研究

Q3 Medicine

East Asian Archives of Psychiatry

Pub Date : 2019-06-01 DOI: 10.12809/EAAP1808

Arthur DP Mak, Justin CY Wu, Yawen Chan, YK Tse, Sing Lee

OBJECTIVETo 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.METHODSA 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.RESULTSOf 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.CONCLUSIONGORD 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.

目的利用DSM-IV研究胃食管反流病(GORD)与广泛性焦虑障碍(GAD)和重度抑郁发作(MDE)在普通人群中的患病率和合并症，并评估这些疾病与医疗保健利用之间的关系。方法采用随机电话调查方法，记录GORD症状、GAD和MDE症状(基于DSM-IV)的发生频率以及医疗保健利用情况。结果在2011年的调查对象中，4.2%的人有每周GORD, 13.9%的人有每月GORD，而3.8%的人有GAD, 12.4%的人有MDE。每月GORD患者发生GAD (p = 0.01)和MDE (p < 0.001)的风险较高。GORD症状频次与MDE、GAD呈剂量-效应独立相关。精神科诊断数与GORD独立相关。GORD症状频次、GAD、MDE与就诊频次相关。GORD症状出现频率与调查费用高相关。结论:在香港人群中，GAD与MDE之间存在较强的剂量反应关系。过度的医疗保健利用应提醒临床医生精神合并症的风险。

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引用次数: 1

Compulsory Mental Health Treatment in Hong Kong: Which Way Forward? 香港的强制性精神健康治疗:未来路向?

Q3 Medicine

East Asian Archives of Psychiatry

Pub Date : 2019-06-01 DOI: 10.12809/EAAP1818

D. Cheung

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.

2017年8月25日至26日，“香港的强制性精神健康治疗:未来路向?”的会议在香港举行。来自英国、美国、新西兰和香港的学者和实践者齐聚一堂，讨论强制治疗的哲学理据、宪制和人权，以及在实践中如何使用和应该如何使用强制性权力等重要议题。发言者和与会者随后就出现的各种问题进行圆桌讨论，特别是应如何进行香港规管强制性精神健康治疗的法律改革。

引用次数: 1

Depression and Quality of Life in Patients with Neurological Disorder in a Malaysian Hospital. 马来西亚一家医院神经障碍患者的抑郁和生活质量

Q3 Medicine

East Asian Archives of Psychiatry

Pub Date : 2019-06-01

P Das, N N Naing, N Wan-Arfah, K O Naing Noor Jan, Y C Kueh, K Rasalingam

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.

目的:探讨重度抑郁障碍(MDD)与神经障碍患者生活质量的关系。方法:本横断面研究于2016年4月至2016年12月在马来西亚一家医院进行，采用方便抽样。年龄≥18岁的颅内肿瘤或其他脑部疾病患者被邀请参加。使用欧洲癌症研究和治疗组织生活质量问卷3.0版评估生活质量;MDD的诊断采用迷你国际神经精神病学访谈。结果:122例患者中，纳入100例(女性66例，男性34例)(有效率93.5%)，平均年龄45.3岁。神经障碍患者中重度抑郁症的患病率为30%。患者与非抑郁患者相比,MDD全球健康状况/生活质量较差(p = 0.003)和物理(p = 0.003),减少角色(p = 0.021),情感(p < 0.001),认知(p = 0.004),和社会功能(p = 0.007),以及更多的症状疲劳(p = 0.004),疼痛(p < 0.001),呼吸困难(p = 0.033),失眠(p < 0.001),食欲不振(p = 0.002)、便秘(p = 0.034),腹泻(p = 0.021),和金融困难(p = 0.039)。结论:重度抑郁症患者生活质量下降。疲劳、疼痛、呼吸困难、失眠、食欲不振、便秘、腹泻和经济困难在重度抑郁症患者中普遍存在。

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引用次数: 0

Consultation-Liaison Psychiatry in Hong Kong: a 2019 Update. 香港咨询联络精神病学:2019年最新进展。

Q3 Medicine

East Asian Archives of Psychiatry

Pub Date : 2019-06-01

A D P Mak, E K Y Wong

引用次数: 0

Neurocognitive Characteristics of Individuals with Irritable Bowel Syndrome. 肠易激综合征患者的神经认知特征。

Q3 Medicine

East Asian Archives of Psychiatry

Pub Date : 2019-06-01 DOI: 10.12809/EAAP1877

K. Wong, S. Yuen, A. Mak

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 hypothalamic-pituitary-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.

肠易激综合征(IBS)是一种基于系统的脑-肠轴疾病。认知功能反映了由遗传和表观遗传影响驱动的中心情感和注意过程，并影响复杂的脑-肠相互作用。这些相互作用包括应激引起的下丘脑-垂体-肾上腺轴和自主神经系统的变化，免疫系统的重塑和微生物群组成的改变。本文综述了目前肠易激综合征患者的神经认知研究结果。从PubMed、Ovid MEDLINE、EMBASE和PsycINFO中确定了13项IBS患者神经认知的研究。系统分析了研究方法和相关发现。肠易激综合征患者的冷热认知都有改变。与此一致的是，在热认知任务中发现了对负面情绪价值和胃肠道症状相关刺激的注意偏倚，而其他冷认知差异包括额叶执行功能障碍和压力相关海马介导的认知改变。精神合并症在障碍水平上的影响，以及疾病的慢性，对认知改变需要进一步的检查。肠易激综合征的注意偏差和执行功能障碍支持其神经网络改变，说明内脏超敏反应。进一步的前瞻性神经心理学研究应检查慢性、当前症状严重程度和精神共病对不同IBS亚型认知的影响。

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