East Asian Archives of Psychiatry最新文献

Background: This study aimed to investigate factors associated with burnout among healthcare workers (HCWs) in a tertiary hospital in Singapore.

Methods: All HCWs from the Singapore General Hospital were invited to participate in a survey using a secure online platform. Participant demographic data were collected. Instruments used included the Oldenburg Burnout Inventory (OLBI), the Connor-Davidson Resilience Scale, the Patient Health Questionnaire-4, a brief form of the Perceived Social Support Questionnaire, the Demand-Control-Support Questionnaire, and the Leisure Time Satisfaction Scale.

Results: Of 9888 staff, 742 (7.5%) responded. The mean OLBI score was 43.7, whereas the mean exhaustion subscale score was 22.5 and the mean disengagement subscale score was 21.2. Of the participants, 53.6% and 50.0% met the cut-off values for disengagement and exhaustion, respectively. In the linear regression analysis, those aged 20 to 29 years had higher OLBI scores than those aged ≥40 years (ß = 1.88, p = 0.001). Higher OLBI scores were associated with higher Patient Health Questionnaire-4 scores (ß = 0.52, p < 0.001), including the subscales of anxiety (ß = 0.30, p = 0.038) and depression (ß = 0.70, p < 0.001), lower scores for resilience (ß = -0.20, p < 0.001), particularly in the subscales of self-efficacy (ß = -0.37, p = 0.018) and cognitive focus (ß = -1.02, p < 0.001), higher psychological demand subscale scores (ß = 0.62, p < 0.001) and lower decision latitude subscale scores (ß = -0.33, p < 0.001) and lower social support subscale scores (ß = -0.47, p < 0.001), and lower Leisure Time Satisfaction Scale score (ß = -0.55, p < 0.001).

Conclusion: Among HCWs in a Singaporean hospital, burnout was associated with age <40 years, the presence of anxiety and depressive symptoms, low resilience, high psychological demands and low decision latitude and social support, and low leisure time satisfaction.

Objectives: To determine the rate and predictive factors of malnutrition in people with dementia in Khon Kaen, Thailand.

Methods: Patients aged ≥60 years with a diagnosis of major neurocognitive disorder (according to DSM-5 criteria) and their primary caregivers were invited to participate. Nutritional status was assessed using the Thai version of the Mini-Nutritional Assessment. Cognitive function was assessed using the Thai version of the Mini-Mental State Examination. Functional status was assessed using the Barthel Index for activities of daily living and Lawton Instrumental Activities of Daily Living Scale. Overall dementia symptom severity was assessed using the Clinical Global Impression - severity scale. The profile of behavioural and psychological symptoms of dementia was assessed using the Neuropsychiatric Inventory.

Results: In total, 61 pairs of older adults with dementia and their caregivers were included. Of the 61 patients with dementia, 4.9% had malnutrition and 34.4% were at risk of malnutrition. Regarding caregivers, 6.6% were at risk of malnutrition. Predictors for the nutritional status of patients with dementia were caregiver Mini-Nutritional Assessment score (odds ratio = 0.72, p = 0.03) and patient Neuropsychiatric Inventory apathy subscale score (odds ratio = 1.26, p = 0.05).

Conclusion: Apathy level of patients and nutritional status of caregivers were predictors of nutritional status in patients with dementia. Regular monitoring of behavioural and psychological symptoms of dementia in older adults with dementia and the nutritional status of their caregivers should be included in comprehensive nutritional assessment.

Background: Physical activity (PA) can improve the clinical symptoms, physical health, and functional outcomes of patients with psychosis. This study aimed to investigate the moderating effects of age on the associations between exercise self-efficacy (ESE) and PA in women with psychosis.

Methods: Data from 38 women with psychosis (mean age, 37.5±13.2 years) who participated in a community mental health project in Hong Kong were analysed. Psychotic symptoms were evaluated using the Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms. Levels of PA were determined using the self-report International Physical Activity Questionnaire-Long Form. ESE was assessed using a self-report instrument. The moderating effects of age on associations between ESE domains and physical activity levels were assessed.

Results: Age was correlated with moderate-intensity PA (r = 0.51, p = 0.007) and total PA (r = 0.52, p = 0.002). The ESE 'must exercise alone' domain was correlated with moderate-intensity PA (r = 0.17, p = 0.009) and total PA (r = 0.15, p = 0.04). The ESE 'resistance from others' domain was correlated with moderate-intensity PA (r = 0.0003, p = 0.03). No significant correlations were observed between other PA variables and other ESE domains. Among women with psychosis, age was a moderating factor in the association between moderate-intensity PA and ESE, particularly in domains of 'must exercise alone', 'inconvenience to exercise', and 'resistance from others'.

Conclusion: Among women with psychosis, ESE domains of 'must exercise alone', 'inconvenience to exercise', and 'resistance from others' as well as overall ESE were significantly associated with moderate-intensity PA in older age group only. Age-specific strategies should be applied when designing interventions to increase PA levels in this population.

Objectives: This study aimed to compare mental healthcare services for older adults aged ≥65 years among countries in World Psychiatric Association (WPA) Zone 10.

Methods: A culturally sensitive questionnaire was developed and sent to the presidents of national psychiatric associations of the eight countries in WPA Zone 10 (Armenia, Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Uzbekistan).

Results: Psychiatric associations of six countries responded to the questionnaire (Armenia and Moldova did not respond). The prevalence of mental disorders among older adults (aged ≥65 years) varied from 2.6% in Russia (among those aged ≥60 years) to 3.5% in Azerbaijan, 4% in Uzbekistan, 12.1% in Kazakhstan, and 13.8% in Kyrgyzstan (no data were available for Belarus). Specialised gerontopsychiatric care is provided in all six countries, except for Kazakhstan.

Conclusion: The prevalence of mental disorders in older adults differed among countries in WPA Zone 10. Improving gerontopsychiatric care is a target for healthcare planners in WPA Zone 10.

Background: We investigated the prevalence of restless legs syndrome (RLS) among Jordanian medical students and its association with stress, anxiety, smoking, caffeine use, study habits, and academic performance.

Methods: A cross-sectional study was conducted between November 2023 and January 2024 among medical students in the Jordanian public universities. Participants were selected to complete a questionnaire (based on the DSM-5 diagnostic criteria for RLS) through convenience and snowball sampling.

Results: Among the 215 participants, 11 men and 13 women met the diagnostic criteria for RLS based on their questionnaire responses; the prevalence of RLS was 11.2%. Among these 24 participants, 66.7% reported worsened symptoms during examination periods; 79.1% reported worsened symptoms when experiencing daytime stress; 62.5% reported improved symptoms following physical activity; 66.7% reported that RLS symptoms affected sleep quality; and 45.8% reported having a concomitant anxiety disorder. Meeting the criteria for RLS was not associated with sex, academic stage (basic vs clinical), smoking status, or academic performance.

Conclusion: RLS is not uncommon among medical students in Jordan. Greater awareness of RLS is needed for prompt diagnosis and treatment to prevent associated negative impacts.

We conducted a systematic review evaluating the efficacy of rivastigmine augmentation for treatment-refractory posttraumatic stress disorder (PTSD). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The databases Ovid MEDLINE, PubMed, CINAHL, and EMBASE were searched using key words: 'rivastigmine' OR 'Exelon' OR 'rivastigmine augmentation' OR 'Exelon augmentation' AND 'posttraumatic stress disorder*' OR 'post-traumatic stress disorder*' OR 'PTSD' OR 'combat disorder*' OR 'post-traumatic symptoms'. The asterisk specified plural forms of the relevant word. Four papers were identified, comprising one double-blind randomised controlled trial, one non-controlled open trial, one case series (presenting three case studies), and one paper with two case studies. The randomised controlled trial found no statistically significant difference in efficacy, using the PTSD CheckList-Military Version as the relevant outcomes measure, between the active add-on rivastigmine interventions and placebo or treatment as usual. The open trial, although reporting relatively positive outcomes, had a weak study design and lacked reporting of key information, including participant sex and age and pre-rivastigmine PTSD measures. The assessment of efficacy was based on participants' reporting of subjective benefits, and clinician-rating using a Clinical Global Impression, rather than established PTSD assessments scales. Although the five case studies reported improvement in PTSD symptoms, there were confounding factors and limitations in clinical and demographic data, warranting caution regarding attributed benefits. There is a lack of methodologically robust evidence supporting the efficacy of add-on rivastigmine for the treatment of refractory PTSD. Additional research may help in further evaluating its possible clinical efficacy.

Background: There is evidence suggesting that autistic traits are associated with schizotypal traits. This study examined the factor structure of the Autism Spectrum Quotient 10 (AQ-10) and its associations with schizotypal traits (measured by the Schizotypal Personality Questionnaire-Brief [SPQ-B]) in a cohort of Chinese adolescents and young adults.

Methods: Invitation letters, stratified by locations and housing types, were randomly sent to individuals aged 15 to 24 years for participation. Assessments were made using face-to-face or online interviews. Autistic traits were assessed using the Chinese version of the AQ-10. Schizotypal personality traits were assessed using the Chinese version of the 22-item SPQ-B.

Results: In total, 395 male and 536 female participants (mean age, 19.93 years) were recruited between July 2020 and May 2021. Exploratory factor analysis of the AQ-10 yielded three factors (theory of mind, task switching, and attention deficits) explaining 55.11% of the total variance. Autistic traits were positively correlated with schizotypal traits of disorganised features (r = 0.21, p < 0.001), interpersonal relationship deficits (r = 0.19, p < 0.001), and cognitive-perceptual deficits (r = 0.11, p = 0.001).

Conclusion: In Chinese adolescents and young adults, autistic traits, especially task switching and attention deficits (compared with theory of mind) are more closely correlated with schizotypal personality traits. Disentangling the overlapping and diametrical structure of autistic traits and schizotypal traits may help understand their aetiologies, assessment, and interventions.