East Asian Archives of Psychiatry最新文献

Objectives: This study aimed to assess the factor structure, internal consistency, and convergent validity of the Perceived Psychosocial Stressor Questionnaire among Thai university students.

Methods: The Perceived Psychosocial Stressor Questionnaire items were derived from prior research on stressors in Thai and Asian university students. Content validity was evaluated by a panel of two psychologists and two psychiatrists through a single discussion. The validated questionnaire assessed the frequency of difficulties over 3 months in the following nine items: health: underlying disease, health: substance addiction, intrafamilial relationship, extrafamilial relationship, academic, achievement, financial, social support, and self-coping. Responses were measured using a five-point Likert scale from 0 (never) to 5 (always); higher scores indicated greater extent of perceived stressors. Internal consistency was analysed using Cronbach's alpha and inter-item correlation. Convergence was evaluated using the Thai adaptation of the Positive and Negative Affect Schedule. Exploratory factor analysis was performed.

Results: In total, 359 Thai university students were included in the analysis. The Perceived Psychosocial Stressor Questionnaire had a two-factor structure; factor 1 had loadings from six items (health: substance addiction, intrafamilial relationship, extrafamilial relationship, financial, academic, and achievement) and factor 2 had loadings from two items (social support and self-coping). Correlation between these two factors was weak (r = 0.17), hence the limited internal consistency (Cronbach's alpha = 0.60). Convergence analysis showed significant associations between the Perceived Psychosocial Stressor Questionnaire and the Positive and Negative Affect Schedule; factor 1 was more strongly associated with anxious and negative affects, whereas factor 2 was more strongly associated with positive affects. Posthoc analysis showed that freshmen reported significantly lower levels of perceived psychosocial stressors compared with seniors.

Conclusion: The Perceived Psychosocial Stressor Questionnaire can be used to assess psychosocial stressors among Thai university students, with potential applications in clinical, administrative, and research settings.

The increasing prevalence of neurodevelopmental disorders highlights the need for a paradigm shift from a deficit-based model to a strength-based model. This perspective provides a conceptual discussion of the neurodiversity paradigm. The traditional medical model views the neurodevelopmental disorders as impairments, which often leads to stigma and social exclusion. In contrast, the neurodiversity paradigm, such as the strength-based model of neurodiversity, values the cognitive differences and leverages the unique strengths of individuals with neurodiversity, hence promoting inclusion. Applying this model in clinical, educational, and workplace settings enhances well-being, self-determination, and productivity. However, in Asia cultural emphasis on conformity, stigma surrounding mental health, and limited awareness hinder the adoption of neurodiversity-affirming practices. Promoting neurodiversity in Asia requires anti-stigma initiatives, policy reforms, and increased public education to foster inclusion. Future research should focus on identifying strengths, evaluating neurodiversity strategies, and assessing their impact on mental health. Early adoption of the neurodiversity approach can mitigate psychosocial challenges and support the development of individuals with neurodiversity, ultimately fostering a more inclusive society.

Objective: To investigate changes in child and adolescent psychiatric admissions during the first year of the pandemic, compared with the preceding 2 years.

Methods: Electronic medical records of all child and adolescent psychiatric admissions to Tuen Mun Hospital and Castle Peak Hospital, Hong Kong across 3 years (1 February 2018 to 31 January 2021) were retrospectively reviewed.

Results: In total, 376 admissions from 1 February 2018 to 31 January 2021 were included in the analysis (131 from 1 February 2018 to 31 January 2019, 127 from 1 February 2019 to 31 January 2020, and 118 from 1 February 2020 to 31 January 2021). Annual admissions decreased by 7.1% during the first year of the pandemic compared with the preceding year, and by 9.9% compared with 2 years prior. The admission rate for anxious mood was lower in the first year of the pandemic, compared with 2 years earlier (6.1% in 2018 vs 1.6% in 2019 vs 0% in 2020, adjusted p = 0.036). Suspension of face-to-face teaching was a negative predictor for the monthly admission incidence rate (b = -0.425, standard error = 0.1372, p = 0.002).

Conclusion: The admission rate for anxious mood was significantly lower in the first year of the pandemic than in 2 years earlier. However, there were no significant differences in sociodemographic and clinical factors or psychiatric diagnoses.

Objectives: This study aimed to explore the associations between stressors, disillusionment, and affective symptoms (including depressive symptoms and positive, anxious, and negative affects) among Thai medical students.

Methods: Fourth-year medical students from rural and urban campuses of Srinakharinwirot University were purposively recruited to complete a self-administered online questionnaire. Perceived distress was assessed across different domains of stressors including intrafamilial and extrafamilial relationship difficulties, academic pressure and time mismatch, and achievement-related difficulties. Disillusionment related to medical training was assessed using a three-item scale. Affective symptoms were measured using the Thai version of the Patient Health Questionnaire-9 and the Thai adaptation of the Positive and Negative Affect Schedule.

Results: In total, 49 male and 66 female fourth-year medical students completed the questionnaire. Of these, 14 reported remitted or stable mental illnesses. Eight students scored in the moderate-to-severe range on the Patient Health Questionnaire-9; three of these reported remitted or stable mental illnesses and five reported no prior diagnosis. From structural equation modelling, disillusionment was associated with intrafamilial relationship difficulties (β = 0.41, p < 0.001), academic pressure and time mismatch (β = 0.15, p < 0.001), as well as depressive symptoms (β = 0.31, p = 0.029) and positive affects (β = -0.89, p < 0.001). Through disillusionment, intrafamilial relationship difficulties was indirectly associated with depressive symptoms (β = 0.13, p = 0.048) and positive affects (β = -0.36, p = 0.005), whereas academic pressure and time mismatch was indirectly associated with positive affects (β = -0.13, p = 0.013). Achievement-related difficulties was associated with depressive symptoms (β = 0.25, p = 0.030) and anxious affects (β = 0.31, p < 0.001) without mediation by disillusionment.

Conclusion: Preliminary evidence shows that disillusionment mediates the associations between various stressors and affective symptoms, with differential effects, in Thai fourth-year medical students.

Objectives: To identify factors associated with internet addiction (IA) among medical students in Indonesia during the COVID-19 pandemic.

Methods: Medical students from three faculties of medicine (one private university and two public universities) in Jakarta, Indonesia were recruited between January and December 2021 to complete an online questionnaire via Google Forms. Participants' sociodemographic data and patterns of internet use were collected. They subsequently completed the Internet Addiction Diagnostic Questionnaire for IA, the Indonesian version of the Self-Reporting Questionnaire-20 for emotional problems, and the Indonesian version of the Rosenberg Self-Esteem Scale for self-esteem.

Results: In total, 400 male and 746 female participants completed the survey. Of the participants, 287 (25.0%) had IA. IA was associated with pre-clinical stage of training (adjusted odds ratio [AOR] = 1.469, p = 0.042), age at first internet use of ≤8 years (AOR = 1.625, p = 0.010), weekend internet use duration of >11 hours per day (AOR = 1.569, p = 0.025), internet use for social media / online gaming / entertainment (AOR = 2.207, p < 0.001), presence of emotional problems (AOR = 2.503, p < 0.001), and low self-esteem (AOR = 1.880, p < 0.001).

Conclusion: During the COVID-19 pandemic, IA is prevalent among Indonesian medical students, particularly among those with emotional problems and low self-esteem. Routine screening for emotional problems and IA, peer support programmes, and access to psychosocial support services are essential for their well-being.

Objectives: To assess the relationship and psychiatric morbidities in siblings of children with intellectual disability (ID) and to identify themes related to positive and negative effects on the quality of sibling relationships.

Methods: Siblings of children with ID were purposively recruited from the psychiatry department of the Vardhman Mahavir Medical College, Delhi, India. Both siblings and children with ID were assessed on the Indian adaptation of the Vineland Social Maturity Scale. Additionally, siblings were assessed using the Sibling Relationship Questionnaire-Revised (SRQ-R) and the Kiddie Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version. In-depth interviews with siblings were conducted using an interview guide to explore their responses across five domains. Data were analysed thematically.

Results: In total, 90 unaffected siblings (mean age, 12.1 years) of children with ID (mean age, 12.8 years) were included in the analysis. Of the four dimensions of the SRQ-R, the mean score was highest for warmth/closeness (2.47) and lowest for rivalry (0.73). Of the 16 individual subscales, the mean score was highest for affection (3.41), followed by nurturance of siblings (3.1), and companionship (2.89). Social quotient scores of children with ID were negatively correlated with SRQ-R scores in maternal partiality (r = -0.229, p = 0.030) and positively correlated with SRQ-R scores in companionship (r = 0.276, p = 0.009), intimacy (r = 0.270, p = 0.010), competition (r = 0.277, p = 0.008), quarrelling (r = 0.345, p = 0.001), dominance by sibling (r = 0.38, p < 0.001), and dominance of sibling (r = 0.239, p = 0.023). Only a few siblings had subthreshold conduct disorder (5.6%), oppositional defiant disorder (8.9%), and attention deficit hyperactivity disorder (12.2%). Twenty siblings participated in in-depth interviews. The main themes identified were 'impact on social life', 'impact on relationships with other siblings', 'impact on relationships with parents', 'impact on personal life', and 'positive aspects'.

Conclusion: In India, the relationship between children with ID and their unaffected siblings is mainly characterised by warmth and closeness, intimacy, prosocial behaviour, companionship, similarity, admiration, and affection. Siblings of children with ID may experience a range of internalising and externalising symptoms, although most did not reach the threshold level for diagnosis.

Objectives: To investigate the psychometric properties of the Chinese version of the Connor-Davidson Resilience Scale-10 (CD-RISC-10) in a representative sample of young people in Hong Kong. Measurement invariance across age and sex was assessed to ensure valid subgroup comparisons.

Methods: Participants were recruited between May 2019 and April 2022 using stratified multistage cluster sampling. They were asked to complete a battery of self-report measures to collect data related to sociodemographics, childhood adversities, personality traits, and various psychological constructs. Each participant also underwent a structured diagnostic screening for lifetime and current psychiatric disorders, which was repeated 1 year later during longitudinal follow-up. Resilience was measured using the Chinese version of the CD-RISC-10. Depressive and anxiety symptoms were assessed using the Chinese versions of the nine-item Patient Health Questionnaire and the seven-item Generalised Anxiety Disorder Scale, respectively. Exploratory and confirmatory factor analyses were conducted. Reliability was assessed using McDonald's omega (ω). Measurement invariance and discriminant validity were tested. Predictive validity for the 12-month onset of major depressive episode and generalised anxiety disorder was evaluated using receiver operating characteristic analysis.

Results: In total, 3175 participants (41.9% male) aged 15 to 24 years completed the diagnostic interview. At the 1-year follow-up, 1766 (55.6%) participants completed reassessment. Only those without a lifetime history of depression or anxiety at baseline were included in the predictive validity analysis. Exploratory and confirmatory factor analyses supported a two-factor structure (comparative fit index = 0.962, root mean square error of approximation = 0.058). Internal consistency was acceptable to excellent (ω = 0.767-0.873). Metric invariance was supported across age and sex; scalar and strict invariance were not fully established. Discriminant validity analyses confirmed that resilience was empirically distinct from depression and anxiety. Predictive validity was low; the area under the curve was 0.626 for major depressive episode and 0.632 for generalised anxiety disorder. The Youden index values were modest, indicating limited predictive utility of the CD-RISC-10.

Conclusions: The Chinese version of the CD-RISC-10 is reliable and valid for resilience assessment among adolescents and young adults in Hong Kong. However, it has limited capacity to predict future psychiatric diagnoses. These findings highlight the importance of a broader assessment framework and tailored interventions based on sex and developmental stage.

Early psychiatric intervention and youth mental health measures are crucial in Japan due to the declining birth rate and increasing levels of stress among young people. Although the need for such services is increasingly recognised, implementation in Japan is lagging. The Government of Japan is currently building the Community-based Integrated Care System That Also Addresses Mental Disorders. Although its main purpose was to move from hospitalisation to a care-in-the-community model, the need to incorporate early psychiatric intervention services for long-term sustainability is also recognised. The demographic and geographic characteristics of each region must be considered when designing early psychiatric services. In this perspective, four model regions were selected to reflect typical characteristics in Japan, namely Adachi City in Tokyo, Akita Prefecture, Tokorozawa City in Saitama Prefecture, and the Tokyo-Yokohama metropolitan region. To introduce early consultation and support services for young people, the Department of Psychiatry and Implementation Science was established in 2023, based on a joint research agreement with a leading company.

Objectives: To determine the effectiveness of a group acceptance and commitment therapy (ACT) programme on improving psychological flexibility, resilience, and other psychological outcomes in adolescents with subclinical mental health issues in secondary schools in Hong Kong.

Methods: This study used a single-group, pretest-posttest, quasi-experimental design. The group ACT programme comprised four 1.5-hour sessions delivered weekly by a psychologist and an assistant. Students with subclinical levels of anxiety symptoms, depressive symptoms, or perceived stress were recruited from seven schools. Participants were asked to complete a self-report questionnaire before and after intervention to evaluate the effectiveness of the group ACT programme. Psychological flexibility was assessed using the Chinese version of the Acceptance and Action Questionnaire II. Resilience was assessed using the Short Resilience Scale. Anxiety and depressive symptoms were assessed using the Patient Health Questionnaire-9 and Generalised Anxiety Disorder-7, respectively. Life satisfaction was assessed using the Satisfaction with Life Scale. Sleep quality over the previous month was assessed using the Pittsburgh Sleep Quality Index.

Results: In total, 61 students of grades 7 to 12 were included; 53 (86.9%) attended ≥3 sessions. No significant changes were observed in psychological flexibility or resilience. Participants reported significantly reduced stress (p = 0.003) and depressive symptoms (p = 0.036), with a small-to-moderate effect size (Cohen's d = 0.36 and 0.28, respectively).

Conclusion: This school-based ACT programme appeared feasible and could significantly reduce stress and depressive symptoms among secondary school students with subclinical mental health issues.

Objectives: To determine the prevalence of internet gaming disorder (IGD) among high school students in Ahmedabad, India and the associations between IGD and behavioural and emotional problems.

Methods: Students of grades 9 to 12 attending English-medium schools in Ahmedabad, India, who had ever engaged in gaming were recruited between February 2023 and June 2024. Participants were asked to complete a semi-structured proforma to collect data regarding demographics, time spent gaming per day, preferred time for gaming, gaming device, gaming type, gaming genre, and regular daily exercise. Participants were also asked to complete four self-report instruments including the Internet Gaming Disorder Scale Short Form, Insomnia Severity Index, Perceived Stress Scale, and 4-item Patient Health Questionnaire.

Results: In total, 2200 high school students were included in the analysis. The mean IGD score was 18.4; 15.8% of students were indicative of IGD. Compared with those without IGD, those with IGD were more likely to be in 11th grade (odds ratio [OR] = 2.073, p = 0.037), play >3 hours per day (OR = 3.232, p = 0.003), and have higher levels of perceived stress (OR = 5.793, p < 0.001), insomnia (OR = 0.866, p < 0.001), and anxiety and depression symptoms (OR = 0.923, p = 0.002).

Conclusion: Among Ahmedabad high school students, IGD was associated with those in 11th grade, play >3 hours per day, and with higher levels of perceived stress, insomnia severity, and anxiety and depressive symptoms.