East Asian Archives of Psychiatry最新文献

Rates of self-harm and suicidal behaviour among young people in Hong Kong are increasing, highlighting the urgent need for effective support. This paper outlines the current landscape of mental health services and funding mechanisms for children and adolescents in Hong Kong, describing the roles of various organisations. A critical evaluation of the system's strengths and limitations is presented, with particular emphasis on the interconnectedness and efficacy of existing referral pathways and intervention programmes. Despite the relatively well-integrated nature of the system and its demonstrable potential, key challenges remain. Examples include dependence on short-term funding, fragmented service delivery, insufficient support for underserved populations, and limitations within the referral infrastructure. To address these gaps, this review recommends enhanced cross-sector communication; implementation of culturally sensitive, youth-centred interventions; and coordinated policy development, with an emphasis on continuous evaluation. These reforms are essential to establish a more coherent and resilient mental health framework for young people in Hong Kong.

Objectives: To explore barriers to seeking mental health services among young people in Chennai, South India, using a qualitative study.

Methods: Young people aged 18 to 24 years with a diagnosis of any mental disorder were purposively recruited from a tertiary mental health centre in Chennai, South India, between April 2022 and March 2023. Face-to-face in-depth interviews were conducted. Questions pertaining to barriers to help-seeking included personal and emotional, social and cultural, environmental, and financial barriers. Each interview was audio-recorded and transcribed verbatim or translated into English. Thematic analysis was performed.

Results: In total, eight male and seven female participants (mean age 21.2 years) were included in the analysis. Five major themes emerged: (1) stigma and discrimination (including feelings of isolation and neglect, societal labelling, and reduced employment opportunities due to mental illness), (2) religious and spiritual factors (characterised by ignorance and high levels of stigma), (3) mental health literacy (poor understanding of mental health), (4) logistical barriers (limited access to healthcare facilities and transportation difficulties), and (5) financial barriers (high treatment costs and difficulties accessing government medical schemes).

Conclusion: Young people with mental disorders in India face multiple barriers to accessing mental health services. These findings may inform researchers, clinicians, and policymakers in developing targeted interventions, strategic frameworks, and policy reforms to promote early help-seeking among this population.

This perspective examines the relevance of culture in youth mental health in terms of manifestations, aetiology, and implications for engagement and intervention.

Objectives: To identify factors associated with treatment non-adherence among patients with bipolar disorder in Vietnam.

Methods: Outpatients with bipolar disorder receiving treatment at the Bach Mai Hospital, Vietnam between November 2023 and August 2024 were recruited using convenience sampling. Medication adherence was measured using the eight-item Morisky Medication Adherence Scale (MMAS-8). The adherence and non-adherence groups were compared. Generalised multiple linear regression was conducted to assess the effects of relevant factors on the MMAS-8 score. Logistic regression analysis was conducted to identify factors associated with non-adherence.

Results: Of 121 patients with bipolar disorder included in the analysis, 53 (43.8%) were classified as treatment adherence and 68 (56.2%) as non-adherence. In the multivariable analysis, non-adherence status was positively associated with male sex (odds ratio [OR] = 5.837, p = 0.006), lower education level (OR = 3.587, p = 0.023), and receipt of >2 medications (OR = 6.832, p = 0.002), and negatively associated with married status (OR = 0.149, p = 0.002) and family encouragement (OR = 0.214, p = 0.024). In the non-adherence group, MMAS-8 scores were negatively correlated with male sex (β = -0.565, p = 0.001), distance to the clinic (β = -0.002, p = 0.038), and number of medications (β = -1.927, p = 0.030), and positively correlated with family companion during examinations (β = 0.598, p = 0.016), family reminders to take medication (β = 0.585, p = 0.019), and family management of medication (β = 0.636, p = 0.036).

Conclusion: Among patients with bipolar disorder, treatment non-adherence is associated with male sex and number of prescribed medications. Family support is important for treatment adherence; efforts to foster family involvement may improve treatment adherence.

Objectives: To review the literature regarding psychotherapeutic modalities for phantom limb pain (PLP).

Methods: The PubMed, ScienceDirect, and Scopus databases were searched to identify English-language studies, including review articles, related to psychotherapeutic modalities for PLP published before December 2024. Non-English-language studies, books, book chapters, or unpublished literature were excluded.

Results: In total, 55 studies were included in the analysis. There were 28 original studies (such as randomised controlled trials, clinical trials, observational studies, experimental studies, pilot studies, cohort studies, etc), 16 case reports or case series, nine systematic or narrative reviews, one case report with review, and one Delphi study. The most commonly used modality for PLP was mirror therapy, followed by virtual reality or augmented reality therapy, motor imagery, hypnotherapy, eye movement desensitisation and reprocessing, graded motor imagery, virtual feedback, biofeedback, imaginative resonance training, cognitive behavioural therapy, auditory feedback, neurofeedback, thermal biofeedback, illusory touch, mental imagery, group therapy, and phantom exercises.

Conclusion: PLP is a complex condition encompassing physiological, psychological, and social factors. Due to its biopsychosocial nature, pharmacological treatments alone provide limited relief. Psychotherapeutic modalities have demonstrated effectiveness in treating PLP. Mirror therapy and virtual/augmented reality therapy are among the most commonly used modalities. The combined use of multiple psychotherapeutic modalities is more beneficial than standalone approaches.

Objectives: This study aimed to determine the mental health status and help-seeking barriers and to identify predictors of help-seeking barriers among South Asians in Hong Kong at the end of the COVID-19 pandemic.

Methods: This cross-sectional study was conducted between January and August 2023. Using convenience sampling, South and Southeast Asian Hong Kong residents aged ≥18 years were invited to complete an online questionnaire in English. Anxiety in the prior 2 weeks was assessed using the Generalised Anxiety Disorder-7. Depression in the prior 2 weeks was assessed using the Patient Health Questionnaire-9. Insomnia in the prior 2 weeks was assessed using the Insomnia Severity Index. Perceived barriers to help-seeking were measured using eight statements; responses were either 'agree' or 'disagree'. Additionally, quality of life and quality of health were assessed using a visual analogue scale ranging from 0 to 100.

Results: Of 474 respondents, 273 were verified to be South or Southeast Asians and were included in the analysis. Of these, 13.6%, 22.8%, and 12.1% were at risk of developing anxiety, depression, and insomnia, respectively. Self-report quality of life and quality of health scores were 70.3 and 67.9, respectively. Compared with those not at risk, those at risk of developing mental health disorders (anxiety, depression, or insomnia) were younger (34.0 vs 29.6 years, p = 0.003), not married (27.7% vs 43.6%, p = 0.02), and had lower quality of life score (77.3 vs 52.6, p < 0.001) and quality of health score (75.4 vs 49.1, p < 0.001). They also more frequently reported having cultural/language barriers (50.2% vs 70.5%, p = 0.004), having cost concerns (64.1% vs 80.8%, p = 0.011), being too busy to seek help (41.5% vs 66.7%, p < 0.001), and that their family considered having mental health disorders to be shameful (25.1% vs 51.3%, p < 0.001). The predictors of perceived barriers to help-seeking were full-time employment (p = 0.02), having a lower education level (p = 0.02), and being at risk of developing mental health disorders (p = 0.02).

Conclusion: Among South Asians in Hong Kong, those who were younger and not married were more likely to be at risk of developing mental health disorders, whereas males, full-time workers, those with a lower education level, and those at risk of developing mental health disorders were more likely to report having help-seeking barriers. The predictors of perceived barriers to help-seeking were full-time employment, a lower education level, and being at risk of developing mental health disorders.

Objectives: The efficacy of current schizophrenia treatments on cognitive symptoms remains limited owing to constrained data around the aetiopathogenesis of such symptoms. Complete blood cell counts have been used to identify variations in inflammatory responses among individuals with schizophrenia. This study aimed to determine associations between inflammatory markers and cognitive impairment in patients with schizophrenia.

Methods: Patients with schizophrenia aged 20 to 40 years were recruited from Prof Dr M Ildrem Hospital, Medan, Indonesia. Diagnoses were made by psychiatrists based on the DSM-5 criteria. Healthy controls matched for age, sex, and body mass index were recruited from the local community. The severity of schizophrenia was assessed by a psychiatrist using the Positive and Negative Syndrome Scale. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA). Complete blood cell counts were performed. Absolute neutrophil, lymphocyte, monocyte, and white blood cell (WBC) counts were quantified, and the neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) were calculated.

Results: In total, 64 men and 38 women were included in the analysis. Patients with schizophrenia (n = 52) and healthy controls (n = 50) were comparable in terms of all baseline characteristics, except that patients with schizophrenia were older (33.4 vs 27.9 years, p < 0.001) and had lower MoCA scores (16.79 vs 27.60, p < 0.001). For patients, the mean illness duration was 3.5 years, and the mean Positive and Negative Syndrome Scale score was 74.15. Patients with schizophrenia had higher WBC counts (8.89 vs 7.53 10³/μL, p = 0.002), neutrophil counts (6.77 vs 5.05 10³/μL, p < 0.001), and NLR (3.96 vs 2.68, p < 0.001). Neutrophil counts (r = -0.293, p = 0.035), NLR (r = -0.393, p = 0.004), and MLR (r = -0.351, p = 0.011) were negatively correlated with MoCA scores.

Conclusion: Patients with schizophrenia show signs of cognitive impairment and elevated WBC counts, neutrophil counts, and NLR. These peripheral inflammatory markers may be used to enhance understanding of the complex inflammatory theory of psychotic disorders.