East Asian Archives of Psychiatry最新文献

Objective: The COVID-19 pandemic has affected the mental health of children, adolescents, and their parents. This study aimed to assess the emotional and behavioural changes in children and adolescents and their association with parental depression during the COVID-19 pandemic in Bangladesh.

Methods: On 7 May 2020 during COVID-19 lockdown, an online questionnaire was distributed through social media and made available for 10 days. Data were collected from parents of children aged 4 to 17 years. The Bangla version of the parent-rated version of the Strengths and Difficulties Questionnaire (SDQ) was used to determine the behavioural and emotional disturbances of the children and adolescents. The Bangla version of the Patient Health Questionnaire (PHQ-9) was used to assess the depression status of parents.

Results: There were 512 participants. 21.5% of children and adolescents had emotional and behavioural problems. More boys than girls had abnormal peer relationship problems (21.1% vs 15.4%, p = 0.03). Of the parents, 16.2% had moderate depression, 5.5% moderately severe depression, and 2.9% severe depression. 8.2% and 2.9% of parents reported that it was very difficult and extremely difficult, respectively, to do work, take care of things at home, or get along with other people; the proportion was higher in mothers than fathers (χ² = 11.4, df = 3, p = 0.01). The PHQ-9 total score of parents mildly correlated with the SDQ score of children and adolescents (r = 0.51, p = 0.01). In multiple linear regression, a combination of parent sex (β = 0.08, p < 0.001), child's history of developmental/psychiatric problems (β = 0.02, p = 0.67), and the SDQ total score of children and adolescents (β = 0.52, p = 0.03) accounted for 27% of the variability in PHQ total score of parents.

Conclusion: During lockdown, the prevalence of psychiatric disorder among children and adolescents and their parents increased. The depression status of parents mildly correlated with the behavioural and emotional disturbances of children and adolescents. We recommend opening the schools as soon as the situation improves and developing interventions such as virtual mental health assessment for children and adolescents and their parents.

Objective: This study aimed to determine the prevalence of depression and the level of perceived social support among occupational therapists during the pandemic, and to identify any associations between depression and perceived social support.

Methods: Using convenience and snowball sampling, occupational therapists aged ≥18 years who were working in Hong Kong and able to read and understand Chinese were invited to participate in a survey between January 2021 and April 2021 (during the fourth wave of COVID-19 pandemic). Data collected included age, sex, education level, employment status, marital status, living status, level of perceived social support (measured by the Multidimensional Scale of Perceived Social Support [MSPSS-C]) and level of depression (measured by the Patient Health Questionnaire-9 [PHQ-9]).

Results: 87 occupational therapists completed the survey. The mean MSPSS-C score was 67.87; 88.5% of participants had a high level of perceived social support. The mean PHQ-9 score was 4.67; 59.8% of participants had no or minimal depression and 11.5% of participants had clinical depression. The MSPSS-C score negatively correlated with the PHQ-9 score (r_s = -0.401, p < 0.001). In regression analysis, the MSPSS-C score was associated with the PHQ-9 score (F(1, 85) = 44.846, r = 0.588, p < 0.001). About 34.5% of the variance of the PHQ-9 score was accounted for by the MSPSS-C score.

Conclusion: Higher level of perceived social support is associated with lower level of depression. Social support might serve as a protective factor for depression among occupational therapists in Hong Kong during the pandemic.

Objectives: To investigate the association between alcohol use and depression among university students in Hong Kong, their stress-coping methods, and their knowledge and perception of the effects of alcohol on health.

Methods: 345 full-time undergraduate students from The University of Hong Kong were invited to complete a questionnaire to assess their alcohol consumption (Alcohol Use Disorders Identification Test, CAGE questionnaire), depressive symptoms (Patient Health Questionnaire-9), and stress-coping methods (Coping Orientation to Problems Experienced Inventory), as well as knowledge and perception of alcohol consumption on health. Multiple linear regression was used to determine significant variables associated with depressive symptoms. Multinominal logistic regression was used to determine the effect of such variables on depressive symptom caseness and AUDIT drinking risk groups.

Results: 43.2% of respondents were moderate- to high-risk drinkers, but only 23.2% were self-reported as moderate- to high-level drinkers. 57.9% of respondents had mild to severe depressive symptoms. Probable depression was more likely to occur in female students, those with higher general stress, those who do not use social support for stress-coping, and those who smoke. High-risk drinkers were more likely to occur in older students, smokers, those with higher household income, and those with higher general stress levels. Students with higher levels of depressive symptoms and higher risk of alcohol consumption were more likely to use avoidance for stress-coping. 89.5% of students considered alcohol consumption moderately to very harmful to health, but students demonstrated only moderate knowledge levels of alcohol consumption on health.

Conclusion: Alcohol consumption and depressive symptoms are prevalent among university students in Hong Kong. The use of avoidance for stress-coping is common in those with higher levels of depressive symptoms and higher-risk drinkers. Students tend to avoid seeking help for depressive symptoms and potentially take up drinking as a coping strategy. Context-specific approaches should be used when providing counselling services for student wellbeing in university settings. Further education of university students on knowledge and perception of alcohol consumption on health should be provided.

Objectives: To determine the psychometric properties of the Chinese version of the work and social adjustment scale (CWSAS) in outpatients with common mental disorders, and to evaluate the correlations of CWSAS with Physical Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), World Health Organization Five Well-being Index (WHO-5), and Chinese version of the Perceived Stress Scale-10 (CPSS-10).

Methods: Forward and backward translations of the CWSAS was performed. Between October 2018 and March 2020, 252 outpatients with a common mental disorder who had a job or a job plan were recruited from two psychiatric centres in Hong Kong. Participants were asked to complete the CWSAS, PHQ-9, GAD-7, WHO-5, and CPSS-10. Classical test theory and Rasch analysis were undertaken to determine the psychometric properties of the CWSAS and its correlations with other tools.

Results: Principal component analysis revealed that the CWSAS was a one-factor structure and showed adequate convergent and discriminant validities, internal consistency, item-total correlation, and inter-item correlation. There was a significant group difference in terms of employment status. CPSS-10 and PHQ-9 were predictors for CWSAS score. The CWSAS was a distinct factor among other outcome measures. Rasch analysis indicated that the CWSAS was well-targeted and unidimensional. The CWSAS had an adequate person separation index, item separation index, person reliability, and item reliability. No categorical disordering was found, whereas inadequate adjacent threshold distance was reported. The item of ability to work indicated a noticeable differential item functioning in employment status and main source of finance.

Conclusion: The CWSAS is psychometrically appropriate to measure functional outcomes in outpatients with common mental disorders.

Objectives: To assess the psychometric properties of the Persian version of the short Schema Mode Inventory (SMI).

Methods: The short SMI was translated into Persian by three clinical psychology professors and then back-translated into English by two professors in English language. Between 2017 and 2018, patients from Iran Psychiatric Hospital and Rasoul Akram Hospital who were diagnosed with personality disorder in Axis II by a psychiatrist and had minimum education of middle school were included. Controls included students and staff of the Iran Medical Sciences University who had minimum education of middle school. All participants were asked to complete the short SMI and the Young Schema Questionnaire - Short Form (YSQ-SF). Internal consistency (Cronbach's alpha), test-retest reliability, confirmatory factor analysis, internal correlation of schema mode subscales, and correlation between short SMI and YSQ-SF were assessed.

Results: Of 406 participants, 205 (50.7%) were patients and 201 (49.3%) were controls. The fitness indices indicated that the 14-factor model was reliable, with χ² = 12917.97, p < 0.001, df = 5795, χ²/df = 2.23, CFI = 0.96, NNFI = 0.96 SRMR = 0.08, and RMSEA = 0.05. The internal consistency of the short SMI was satisfactory (M = 0.94). Among 34 participants in the control group who completed the short SMI again after 2 weeks, test-retest reliability was high (Pearson correlation coefficient = 0.88, p < 0.001). The short SMI and YSQ-SF correlated strongly in terms of the overall scale and most subscales. The patient and control groups differed significantly in most subscales.

Conclusions: Psychometric properties of the Persian version of the short SMI showed good validity and reliability. It can be used in clinical and research settings.

Objective: This study aims to determine the association between single-nucleotide polymorphisms (SNPs) of the RELN gene and schizophrenia.

Methods: 134 patients aged 16 to 58 (mean, 38.0) years who were diagnosed with acute or chronic schizophrenia at the Zhongshan Third People's Hospital between January 2018 and April 2020 were recruited, as were 64 healthy controls aged 22 to 59 (mean, 45.6) years who matched with the age and sex of the patients. MassARRAY mass spectrometry genotyping technology was used to determine the genotypes of four SNPs of RELN (rs2073559, rs2229864, rs362691, and rs736707).

Results: There were no significant between-group or between-sex differences in terms of genotype, allele frequency, or haplotype frequency of the SNPs (all p > 0.05). In the association analysis between genotypes and quantitative traits in the Positive and Negative Syndrome Scale, rs2229864 and rs736707 were associated with the scores for items P3 (hallucinatory behaviour) and G11 (attention disorder), and rs362691 was associated with G10 (disorientation). However, the associations did not remain significant after Bonferroni correction.

Conclusion: Multiple pathogenic polymorphisms of RELN might be associated with hallucinatory behaviour and attention disorder in Chinese patients with schizophrenia.

Lurasidone is used for treatment of bipolar depression in adults and adolescents. Lurasidone-associated manic switch has been reported in adults but not yet in adolescents. We report a case of lurasidone-induced manic switch in a male adolescent treated for bipolar I depression. Five days after adding lurasidone to his regimen (sodium valproate and olanzapine), our patient became manic with psychotic features. After discontinuation of lurasidone, he was stabilised with electroconvulsive therapy, and the medication was switched to a lithium-quetiapine combination. This case highlights the potential risk of lurasidone-induced manic switch in adolescents with bipolar depression.

Objectives: To investigate the effectiveness of eight 45-minute sessions of computer-assisted cognitive training programme (CCTP) on improving the cognitive and functional performance of patients with Severe Mental Illness (SMI).

Methods: Medical records of 16 women and 13 men aged 26 to 62 (mean, 46.34) years who participated a CCTP were reviewed. The CCTP lasted a total of 6 hours in eight sessions over 8 weeks and comprised a series of mobile applications customised to patients' specific impaired cognitive domains. Pre- and post-test performance of cognition and functioning were assessed using the Montreal Cognitive Assessment Hong Kong version (HK-MoCA) and the Brief Assessment of Prospective Memory (BAPM), respectively.

Results: After the CCTP, the mean HK-MoCA score increased significantly (23.62 ± 5.34 vs 25.48 ± 3.75, d = 0.403, p = 0.001), with a significant increase in delayed recall (3.14 ± 1.75 vs 3.93 ± 1.44, d = 0.493, p = 0.003), and the mean BAPM score decreased significantly (1.44 ± 0.47 vs 1.26 ± 0.23, d = 0.486, p = 0.012). The improvement was greater in participants with primary-level education than in participants with secondary- or tertiary-level education in terms of the HK-MoCA score (3.83 ± 3.06 vs 1.35 ± 2.12, d = 0.942, p = 0.046) and the BAPM scores (-0.49 ± 0.43 vs -0.10 ± 0.29, d = 1.063, p = 0.035).

Conclusion: Our shortened CCTP effectively enhanced the cognitive performance and daily functioning of patients with SMI. Verbal episodic memory showed the most improvement. The improvement was greater in those with primary-level education than in those with secondary- or tertiary-level education.

Objective: We aim to provide an up-to-date systematic review and meta-analysis of the effects of cognitive stimulation (CS) on cognition, depressive symptoms, and quality of life in persons with dementia. Factors affecting the treatment effect were examined.

Methods: A literature search was performed on databases of MEDLINE, EMBASE, PsycINFO, CINAHL Plus, and Cochrane Library up to 7 March 2019. Only randomised controlled trials investigating the effects of CS in persons with dementia were included. The outcome measures were cognitive function, depressive symptoms, and quality of life.

Results: 20 randomised controlled trials with a total of 1251 participants (intervention group: 674; control group: 577) were included for meta-analysis. Most participants had mild to moderate dementia. CS had a significant positive small-to-moderate effect on cognition (Hedges's g = 0.313, p < 0.001). Heterogeneity of CS was low to moderate (Q=30.5854, df=19, p < 0.05, I2 = 37.877%). Inconclusive results were found for depressive symptoms and quality of life.

Conclusion: CS has a significant positive effect on cognitive function, but its effect on depressive symptoms and quality of life was inconclusive. Future studies with more robust methodology establishing evidence of its efficacy are required.