East Asian Archives of Psychiatry最新文献

Objectives: This study aimed to investigate the adjuvant treatment effect of Ajwa dates (Phoenix dactylifera L) on quality of life (QoL) and serum tumour necrosis factor-alpha (TNF-α) levels in patients with schizophrenia treated with risperidone.

Methods: Consecutive hospitalised patients aged 20 to 45 years who were diagnosed with schizophrenia, treated with risperidone at 4 to 6 mg/day, with a disease onset of ≤5 years, and had passed the acute phase were invited to participate. Participants were randomly and equally assigned to either the treatment or control group. The treatment group received risperidone as prescribed and seven Ajwa dates per day (ie, 60-80 g), whereas the control group received risperidone alone. Patient QoL was assessed by a psychiatrist in face-to-face interviews using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) at baseline, week 4, and week 8. Serum TNF-α levels were assessed using the enzyme-linked immunosorbent assay at baseline and week 8.

Results: In total, 44 participants were included in the analysis. The treatment and control groups were comparable in terms of baseline characteristics, except for education level (p = 0.037) and WHOQOLBREF physical domain score (p = 0.002). At week 8, compared with the control group, the treatment group had higher total WHOQOL-BREF scores (69.3 vs 66.8, p = 0.015) and a greater percentage increase in scores (283.6% vs 243.4%), as well as lower TNF-α levels (86.8 vs 134.5 pg/mL, p = 0.046) and a greater percentage decrease in levels (-25.5% vs -8.6%). The WHOQOL-BREF scores were negatively correlated with serum TNF-α levels in both the treatment (r = -0.988, p < 0.001) and control (r = -0.918, p < 0.001) groups.

Conclusion: Ajwa dates have an adjuvant effect on improving QoL and reducing serum TNF-α levels in patients with schizophrenia treated with risperidone.

Objectives: To investigate the relationships among loneliness, maladaptive coping, and depressive symptoms in Chinese older patients with major depressive disorder (MDD), and to compare differences in loneliness and coping between Chinese older individuals with and without depression.

Methods: Chinese patients aged ≥60 years who were diagnosed with MDD were approached in a randomised sequence during follow-up appointments at psychiatric outpatient clinics. Attendees of general outpatient clinics and elderly community centres matched for age, sex, and education level were recruited by convenience sampling as controls. Both groups completed a questionnaire that included the six-item De Jong Gierveld Loneliness Scale, the Brief Coping Orientation to Problem Experiences Inventory, the Social Readjustment Rating Scale, the Hamilton Depression Rating Scale, the Hong Kong version of the Montreal Cognitive Assessment, the Cumulative Illness Rating Scale-Geriatric, and the Lawton Instrumental Activities of Daily Living scale. Hierarchical multiple linear regression was performed to examine relationships among coping, loneliness, and depressive symptoms, followed by correlation and mediation analyses.

Results: In total, 100 cases and 100 matched controls were included in the analysis. Cases reported significantly greater overall, emotional, and social loneliness relative to controls. Among patients with MDD, emotional loneliness and avoidant coping were associated with depressive symptoms. Among controls, only emotional loneliness was associated with depressive symptoms. Among all participants, avoidant coping partially mediated the relationship between emotional loneliness and depressive symptoms. Depressive symptoms were positively correlated with overall, emotional, and social loneliness, and avoidant coping and negatively correlated with problem-focused coping.

Conclusion: Loneliness and coping should be considered in comprehensive clinical assessments, psychiatric formulations, and individualised treatment plans for older patients with MDD. Targeted interventions addressing emotional loneliness and maladaptive coping strategies are warranted in MDD management.

Objectives: Mass murder is associated with a lifetime history of substance use. We aimed to examine cannabis involvement among those who committed mass shootings in the United States from 1900 to 2019.

Methods: We identified mass shooting events in the United States from 1900 to 2019 using publicly available English-language media reports and court/police records. People who perpetrated mass murders using methods other than firearms (eg, knives, automobiles) were used as a comparison group. Events were dichotomised into either prior to 1996 or from 1996 onward (first legalisation for medical use by California). Post-1960 data were used for additional analyses of a more modern era.

Results: The proportion of those who committed mass shootings who had used, possessed, and/or distributed cannabis was significantly higher for events that occurred from 1996 onward, compared with prior to 1996 (11.2% vs 4.9%, p = 0.002). The proportion of those committed mass murders by other methods who had used, possessed, and/or distributed cannabis did not significantly differ for events that occurred from 1996 onward, compared with prior to 1996 (4.8% vs 5.7%, p = 0.76). When 58 mass shooting events and 31 mass murder events by other methods perpetrated before 1960 were excluded, results were similar when 1996 was used as a cutoff for the respective events (p = 0.02 and p = 0.40). Among those who committed mass shootings, those with cannabis involvement (n = 74) were younger than those without (n = 754) [28.7 vs 33.5 years, p < 0.001] and were of younger age group than older age group (11.9% vs 5.8%, p = 0.002).

Conclusion: Cannabis use may be harmful in subgroups of individuals (eg, those who committed mass shootings) who are vulnerable to cannabis use. This should be considered by policymakers, individuals with commercial interests, the public, and mental health and medical professionals when they debate related public health issues.

Background: Endophenotypes aid in studying the complex genetic basis of bipolar disorder. We aimed to compare first-degree relatives of patients with bipolar I disorder in a hospital in India with unrelated healthy controls in terms of neurocognition and affective temperament METHODS. This cross-sectional study was conducted between August and November 2012 at a tertiary hospital in India. First-degree relatives (parents, siblings, and children) of patients with bipolar I disorder were included; they were aged 18 to 50 years and had education level of at least eighth grade. Additionally, matched healthy controls were recruited from the general population. Sociodemographic data were collected using a semi-structured proforma. Participants were assessed for verbal and visual working memory, executive function (including cognitive flexibility, response inhibition, as well as concept formation, abstract reasoning, and set-shifting abilities), and affective temperament by a single investigator.

Results: Of the 52 first-degree relatives of patients diagnosed with bipolar I disorder, 30 were included in the analysis. Additionally, 30 matched healthy controls from the general population were included for comparison. Compared with healthy controls, first-degree relatives performed significantly poorer in all tests and had significantly higher scores for cyclothymic, hyperthymic, and anxious temperaments.

Conclusion: Impairments in working memory, executive function, and certain affective temperaments are potential endophenotypes for bipolar I disorder. Working memory and executive function are most important cognitive domains for social, occupational, and interpersonal functioning. These potential markers could be used to trace susceptible genes for bipolar disorder and thus enhance our understanding of the complex genetics of mood disorders.

Background: Attention deficit hyperactivity disorder (ADHD) often coexists with substance use disorders (SUDs). This study aimed to determine factors associated with ADHD symptoms among adults with SUDs in Malaysia.

Methods: Patients aged ≥18 years with a ≥1-year history of substance use who were admitted to any of the three drug rehabilitation centres in urban Malaysia for >1 month were invited to participate. Participants were interviewed using the Malay version of the Alcohol, Smoking and Substance Involvement Screening Test to assess substance use and the Malay version of the Adult ADHD Self-Reporting Scale to assess ADHD symptoms.

Results: The prevalence of adult ADHD symptoms among participants with SUDs was 47.2%. Compared with participants without ADHD, a lower proportion of participants with ADHD had medical comorbidities (84.9% vs 93.3%, p = 0.018), whereas a higher proportion of participants with ADHD symptoms had a history of imprisonment (80.8% vs 65.6%, adjusted p = 0.018) and first imprisonment before the age of 18 years (24.6% vs 16.8%, adjusted p = 0.048).

Conclusion: A high proportion of adults undergoing rehabilitation for SUDs have ADHD symptoms. Screening and interventions for ADHD should be integrated into SUD rehabilitation programmes.

Background: House officers are susceptible to internet addiction and psychological distress. This study aimed to investigate factors associated with internet addiction among house officers in a Malaysian hospital.

Methods: This is a cross-sectional study of house officers at Hospital Selayang in Selangor, Malaysia. They were randomly selected to complete a survey between May and June 2023. Internet addiction was assessed using the validated Malay version of the Internet Addiction Test. Levels of depression, anxiety, and stress were assessed using the self-report Depression, Anxiety and Stress Scale 21.

Results: Of 62 male and 81 female house officers included, 27 (18.9%) had internet addiction. In the simple logistic regression analysis, internet addiction was associated with a family history of mental illness (p = 0.043) and anxiety (p = 0.002). In the multiple logistic regression analysis, only anxiety remained to be associated with internet addiction (adjusted odds ratio = 6.34, p = 0.005), whereas a family history of mental illness became slightly not significant (adjusted odds ratio = 3.03, p = 0.051).

Conclusion: Given the bidirectional relationship between psychological distress and internet addiction, it is crucial to implement comprehensive intervention strategies that integrate mental health support with measures to manage excessive internet use.

Background: Severe acute respiratory syndrome (SARS) and COVID-19 are both highly infectious diseases that cause severe respiratory illness. This study aimed to compare survivors of SARS and COVID-19 and identify factors associated with long-term psychiatric comorbidities.

Methods: This was a retrospective cohort study of adult Chinese survivors of SARS and COVID-19 who had been admitted to the United Christian Hospital, Hong Kong. In total, 90 SARS survivors and 60 COVID-19 survivors agreed to participate, and their data at 30 months post-infection were retrieved.

Results: Compared with SARS survivors, COVID-19 survivors had a lower prevalence of psychiatric disorder at 30 months post-infection (6.7% vs 33.3%, p < 0.001). Higher levels of anxiety and depression were independently associated with greater perceived functional impairment, higher average pain intensity level in the past month, and less use of rational problem solving.

Conclusion: Experience of SARS might be a protective factor to combat COVID-19 in the Hong Kong population. Potential treatment strategies include optimisation of pain management, physical rehabilitation, and enhancing effective coping strategies.

This review aims to determine the role of S-adenosylmethionine (SAMe) supplementation as an alternative therapeutic option, particularly for individuals with inadequate responses to conventional antidepressive treatments. The effects of SAMe on depression are analysed through its role in modulating neurotransmitter metabolism, reducing neuroinflammation, enhancing neuroplasticity, and regulating gene expression. These mechanisms may contribute to the efficacy of SAMe in treating depression, particularly in treatment-resistant cases. The review also addresses SAMe's potential use in managing other psychiatric disorders and neurological diseases.

Background: Pakistani television dramas often depict scenes involving suicide that may affect the psychological wellbeing of viewers. We aimed to examine the effects of suicide depiction in Pakistani television dramas on their viewers.

Methods: In April 2023, we searched the YouTube website for Urdu-language television dramas released between 2011 and 2022 that contained scenes of suicidal behaviours (both attempts and completed suicides) using the keywords 'suicide in Pakistani dramas'. Data extracted included details of the characters involved including age group, sex, role, occupation, religion, and marital status, as well as details of the suicidal behaviours including method, reason/trigger, and place of suicide.

Results: In total, 49 incidents of suicidal behaviours from 46 characters in 40 Urdu-language television dramas were included in the analysis. Of the 40 dramas, 42.5% were released in 2021 and 2022, and 57.5% were released between 2011 and 2020. Among the 46 characters with suicidal behaviour, 50.0% were male, 54.3% were young adults, 52.2% were married, 26.1% were housewives, 100% were Muslim, and 34.8% were in a leading role. Of the 49 incidents of suicidal behaviour, 29 were suicide, 19 were suicide attempts, and one was homicide-suicide. Common methods of suicidal behaviour depicted were gun shooting (30.6%), wrist cutting (18.3%), self-poisoning (12.2%), and jumping from height (12.2%). Common reasons for suicidal behaviour were failure in love (24.4%), familial issues (24.4%), and others (26.5%); 69.4% of suicidal behaviour occurred in home.

Conclusion: Television dramas with scenes involving suicidal behaviours may negatively affect the general population, particularly adolescents. These scenes should be censored to prevent imitation or identification among vulnerable young people. Television dramas should provide psychoeducational messages to promote help-seeking rather than suicide for emotional problems.