East Asian Archives of Psychiatry最新文献

Background: Anxiety is common among house officers. Psychological inflexibility increases the risk of anxiety. This study aimed to determine the associations between anxiety and sociodemographic factors, work-related variables, and psychological inflexibility, and to identify predictors for anxiety among house officers in a hospital in Malaysia.

Methods: This cross-sectional study was conducted at Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia. House officers were recruited from seven departments (general surgery, obstetrics and gynaecology, paediatrics, orthopaedics, emergency, anaesthesiology, and psychiatry) between December 2023 and March 2024 using convenience sampling. Participants were asked to rate their levels of psychological flexibility (using the seven-item Acceptance and Action Questionnaire-II) and anxiety (using the seven-item Generalised Anxiety Disorder scale [AAQ-II]), as well as their perceived factors for anxiety.

Results: In total, 43 male and 95 female participants (mean age, 27.5 years) were included in the analysis. Of the 138 participants, 75 (54.3%) were classified as having anxiety. Participants with anxiety were more likely to have a psychiatric condition (10.7% vs 1.6%, p=0.031), work more hours per week (73.95 vs 67.84, p=0.017), and have higher AAQ-II scores (31.61 vs 19.63, p<0.001). Common factors that the house officers perceived to be associated with anxiety included poor work-life balance (85.5%), hospital bureaucracy (77.5%), and performance pressure (73.9%). Predictors for anxiety were the AAQ-II score (adjusted odds ratio=1.19, p<0.001) and working hours per week (adjusted odds ratio=1.04, p=0.034).

Conclusion: Psychological inflexibility and excessive working hours are predictors for anxiety among house officers in a hospital in Malaysia.

Background: Anxiety disorders are among the most common mental health problems in childhood. Early detection and treatment are essential. We aimed to determine the psychometric properties of the Spence Children's Anxiety Scale - parent version (SCAS-P) in children with various psychiatric disorders in Hong Kong.

Methods: Children aged 6 to 12 years and their parents or guardians were recruited by convenience sampling from the child and adolescent psychiatry specialist out-patient clinic at Queen Mary Hospital. The parents or guardians were asked to complete the SCAS-P, the Diagnostic Interview Schedule for Children version IV (DISC-IV) anxiety module, the Screen for Child Anxiety Related Emotional Disorders parent version (SCARED-P), and the Child Behavior Checklist (CBCL).

Results: In total, 135 child-parent pairs were included. The median age of the children (78 male and 57 female) was 10 (range, 8-11) years. The children had various psychiatric diagnoses; 43.7% had attention deficit hyperactivity disorder and 41.4% had autism spectrum disorder. In addition, 57 (42.2%) children were diagnosed by a psychiatrist with at least one anxiety disorder (based on the DISC-IV anxiety module). The median SCAS-P score was 36.0; it was higher in children with anxiety disorder (n = 57) than in children without anxiety disorder (n = 78) [46.0 vs 28.5, p < 0.001]. The internal consistency of the SCAS-P was high (Cronbach's alpha = 0.938). Convergent validity of the SCAS-P was confirmed with the SCARED-P and CBCL subscales of internalising and anxiety, whereas divergent validity of the SCAS-P was confirmed with the CBCL subscales of externalising, aggression, and delinquency. Test-retest reliability of the SCAS-P was good (intraclass correlation coefficient = 0.90). The SCAS-P had satisfactory criterion validity for any anxiety disorder (area under the curve [AUC] = 0.77), obsessive compulsive disorder (AUC = 0.76), social anxiety disorder (AUC = 0.70), separation anxiety disorder (AUC = 0.81), generalised anxiety disorder (AUC = 0.82), and physical injury fears (AUC = 0.86).

Conclusion: The SCAS-P has satisfactory validity and reliability in screening anxiety disorders among children with various psychiatric disorders. In a busy clinic setting, we recommend using the total SCAS-P score to screen anxiety among children with psychiatric disorders.

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.