East Asian Archives of Psychiatry最新文献

Objective: To examine associations between severe mental illness (SMI), general health symptoms, mental wellbeing, and different activity levels in patients with SMI.

Method: Consecutive patients with SMI referred for occupational therapy were prospectively included. Their hours of activities per day during hospital stay were recorded as <1 hour, 1-3 hours, and >3 hours in three categories: basic self-care activities, interest-based activities, and role-specific activities. Patients were free to join or decline any activities. Patients' somatic and mental health were measured at admission, discharge, and 1 month after discharge using the Brief Psychiatric Rating Scale (BPRS), Patient Health Questionnaire-15 (PHQ-15), Pittsburgh Sleep Quality Index (PSQI), Chinese version of Short Warwick Edinburgh Mental Wellbeing Scale (C-SWEMWBS), and Chinese version of General Activity Motivation Measure (GAMM).

Results: 84 patients (35 men and 49 women) aged 16 to 63 years were assessed at the three timepoints. The mean length of hospital stay of current admission was 74.73 days. The most common diagnosis was schizophrenia (n=35), followed by depression (n=15), psychosis (n=14), bipolar affective disorder (n=10), others (n=8), and delusional disorder (n=2). The hours of activities per day was <1 hour in 32 (38.1%) patients, 1-3 hours in 34 (40%) patients, and >3 hours in 18 (21.2%) patients. Improvement in somatic and mental health was positively associated with hours of activities per day. Activities were associated with reduced psychiatric symptoms (measured by BPRS) at discharge (Z = 5.978, p < 0.01). Activities were associated with less somatic complaints (measured by PHQ-15) [χ² = 23.478, p < 0.01], better sleep quality (measured by PSQI) [χ² = 14.762, p < 0.01]. The BPRS score for psychiatric symptoms at discharge was inversely associated with C-SWEMWBS score for mental wellbeing (r = -0.233, p = 0.033) and C-GAMM score for activity motivation (r = -0.258, p = 0.018). Basic self-care activities were a predictor for psychiatric symptoms (measured by BPRS) at discharge (adjusted R² = 0.091, F = 8.496, p = 0.005), whereas a combined group of badminton and Tai Chi was a predictor for general activity motivation (measured by GAMM) at 1 month after discharge (adjusted R² = 0.047, F = 4.697, p < 0.05), and soccer alone was a predictor for somatic health (measured by PHQ-15) at 1 month after discharge (adjusted R² = 0.06, F = 5.784, p < 0.05).

Conclusion: Participating in activities of patients' own choice and interests is positively associated with patients' psychiatric and somatic health and subjective wellbeing. Outdoor soccer has added effect on patients' somatic health. The beneficial effects are maintained at 1 month after discharge. Daily participation of activity meaningful to patients can be a non

We describe a 58-year-old Chinese man with schizophrenia who presented with an elevated clozapine level suspected to be related to acute infection.

Objective: To validate the Social Media Disorder scale in Nigerian adolescents by determining its unidimensional structure, reliability, sensitivity, specificity, and criterion validity.

Methods: A total of 516 and 1213 pre-university students in two universities were randomly recruited and assessed using the 9-item Social Media Scale and the 12-item General Health Questionnaire (in the second survey only).

Results: 46.3% and 56.3% of respondents in the first and second surveys met the criteria for social media disorder, respectively. Factor loading of items on the latent factor (addiction) was moderate. The model yielded a fairly acceptable fit in both samples. The averaged measure for intra-class correlation was acceptable (0.612). The internal consistency (Cronbach's alpha) was good (0.713 for sample 1 and 0.724 for sample 2). The test-retest reliability among the 113 respondents was good (r=0.696, p<0.001). The item-total correlations were all significant. Sensitivity of each item ranged from 67.7% (tolerance) to 91.3% (escape); specificity of each item ranged from 41.2% (escape) to 87.6% (displacement). For criterion validity, the total Social Media Disorder scale score correlated with General Health Questionnaire items that assess self-esteem, depression, and mood, as well as the total score.

Conclusion: The 9-item Social Media Disorder scale is acceptable for screening social media disorder in pre-university students in Nigeria. The high prevalence of social media disorder should be of concern to counsellors, teachers, and mental health practitioners. Strategies for public health education on social media use are needed in Nigeria.

Objective: To explore caregivers' perspective on factors affecting the recovery of their family members diagnosed with schizophrenia.

Methods: A qualitative grounded theory approach was used. A convenience sample of seven male and eleven female family caregivers of patients with schizophrenia were invited from outpatient (n = 6), inpatient (n = 7), and psychiatric rehabilitation (n = 5) services in an Indian mental health institute to participate in semi-structured interviews. Interviews were recorded, transcribed, and analysed. Similar themes were grouped and the main themes identified.

Results: Caregivers' perspectives on factors affecting recovery from schizophrenia were categorised to two themes: facilitators and barriers. The nine facilitators were (1) getting into a precise treatment regimen and sticking to it, (2) developing some personal attributes, (3) exercising family's role diametrically, (4) paying attention to basic needs, (5) sharing with the Almighty, (6) adapting to a supportive lifestyle, (7) not being idle… engage in something, (8) coming out, being and sharing with others, and (9) having adequate resources with a good support system. The ten barriers were (1) detrimental treatment practices, (2) hampering illness impacts, (3) off-putting personality elements, (4) unaccommodating family circumstances, (5) caregivers' limitation, (6) flaccid support system and scarce resources, (7) ambiguous treatment outcome or prognosis, (8) futile religious, health, and social belief systems, (9) situational factors, and (10) presence of troubling physical or psychological stressors.

Conclusion: The recovery process is facilitated through family involvement and support by mental health professionals. Thus, giving a pre-treatment counselling to the caregivers and repeating the same content to the patients after regaining insight can be helpful.

Objectives: To examine perceived stigma and its correlates in remitted patients with mental illnesses and their caregivers.

Methods: In patients with mental illnesses, their perceived stigma (Perceived Devaluation Discrimination Scale), endorsed secrecy (Secrecy scale), self-esteem (Rosenberg Self-Esteem Scale), functioning (Work Social Adjustment Scale), and emotional wellbeing (Well Being Index) were assessed. In caregivers, their perceived stigma towards patients (Devaluation of Consumer Scale) and families (Devaluation of Consumer Families Scale), emotional wellbeing (Well Being Index), and depressive symptoms (Centre for Epidemiological Studies-Depression scale) were assessed. Differences between diagnoses were examined using ANOVA. Correlation between perceived stigma among patients and caregivers was studied.

Results: Of 152 patients with mental illnesses, 76.3% and 85.53 % reported moderate-to-high levels of perceived stigma and endorsed secrecy, respectively. Of 152 caregivers, 40.13% and 25.65% reported moderate-to-high levels of perceived stigma towards patients and families, respectively. Overall, patients had high levels of perceived stigma and endorsed secrecy, low self-esteem, moderate functional impairment, and extremely poor emotional wellbeing. There were significant differences across different diagnostic categories with respect to self-esteem, functioning, perceived stigma, secrecy, and emotional wellbeing. Patients with substance use disorders reported highest perceived stigma, lowest self-esteem, and most severe functional impairment, and their caregivers reported highest perceived stigma towards patients and families, most-reduced emotional wellbeing, and highest rates of depressive symptoms. Patients' perceived stigma was not associated with caregivers' perceived stigma.

Conclusion: Perceived stigma is prevalent among patients and caregivers and affects their quality of life. The stigma associated with substance use disorder merits special attention.

Objective: This study aimed to compare the emotional/behavioural problems and functional impairment between early school-age children with attention-deficit/hyperactivity disorder (ADHD) and non-ADHD controls. Factors associated with behavioural problem scores were also evaluated.

Methods: Children aged 6 to 10 years who were diagnosed with ADHD based on the Swanson, Nolan and Pelham version IV Scale (SNAP-IV) and the DSM-5 criteria for ADHD were compared with age-and sex-matched controls with negative SNAP-IV results in terms of emotional/behavioural problems (as assessed by the Child Behavioural Checklist) and functional impairment (as assessed by the Strength and Difficulties Questionnaire).

Results: 40 children with ADHD and 40 non-ADHD controls with a mean age of 8.40 ± 1.44 years were included. The ADHD group scored significantly higher than controls in terms of all eight subscales of emotional/behavioural problems (p<0.001 to p<0.01). Regarding functional impairment, the ADHD group reported significantly higher scores than controls in terms of total difficulties, conduct problems, and hyperactivity (all p<0.01); and significantly lower prosocial scores (p<0.03). In the multiple linear regression analysis, among the ADHD group, comorbid medical disorders were associated with higher total problem score, internalising behaviour problems score, and externalising behaviour problems score; whereas combined subtype ADHD was associated with higher total difficulties score.

Conclusions: Early school-age children with ADHD have more emotional/behavioural problems and functional impairment than non-ADHD controls, and they need further evaluation and intervention for psychosocial functioning, particularly those with comorbid medical disorder or combined subtype ADHD.

Objectives: To determine the validity and reliability of the Persian version of the Food Thought Suppression Inventory (FTSI) in overweight university students in Iran.

Methods: A sample of 233 overweight students were recruited from five universities in Tehran. Participants were asked to complete the Persian versions of FTSI, Binge Eating Scale, Thought Control Questionnaire, Rumination Response Scale, and Dutch Eating Behaviour Questionnaire. Sociodemographic characteristics of participants were also collected.

Results: Validity of the Persian version of the FTSI was verified by the fitting indices of the proposed single-factor model of the main makers (χ2 = 112.75, df = 90, p = 0.052, χ2 / df = 1.25, goodness-of-fit index = 0.93, comparative fit index = 0.96, non-normed fitness index = 0.96, root mean score of error approximation = 0.032, and standardised root mean residual = 0.052). Internal consistency of the instrument was high, with a Cronbach's alpha of 0.88.

Conclusion: The Persian version of the FTSI is a valid and reliable tool for screening patients in obesity clinics and for evaluating treatment outcomes.

Objective: To determine associations between mindfulness meditation and mental health and health-related quality of life among Buddhist monastics.

Methods: This is a cross-sectional study of Chinese Buddhist monastics aged ≥18 years who practised mindfulness meditation daily. Mental health was assessed by the 12-item General Health Questionnaire (GHQ-12), whereas health-related quality of life was assessed by the 12-item Short Form Health Survey (SF-12). The number of years and the average daily amount of time spent in mindfulness meditation were collected.

Results: 47 monastics completed the interview. They practised mindfulness meditation for a mean of 7.3 years, 1.1 hours per day. Both the number of years (β = -0.48, p = 0.03) and amount of daily practice (β = -0.53, p < 0.001) of mindfulness meditation were associated with the GHQ-12 score, after adjusting for age, sex, education, and years of being a monastic. Only the amount of daily practice (β = 0.44, p = 0.004) was associated with the mental component summary of SF-12. Neither was associated with the physical component summary of SF-12.

Conclusions: Among Chinese Buddhist monastics who practise daily mindfulness meditation, spending more time each day and having longer years of practice were associated with better mental health.

Objective: This study aims to develop and validate the stigma assessment tool for family member caregivers of patients with mental illness (SAT-FAM).

Methods: This study was conducted in three phases: (1) explicate the concept of stigma towards family caregivers of patients with mental illness, (2) develop and iteratively optimise a preliminary version of the SAT-FAM, and (3) test the psychometric properties of the final version of the SAT-FAM. In phase 1, 14 family caregivers of patients with mental illness were interviewed for qualitative data collection and analysis. Four themes emerged: people's reaction and attitude, compassion with fear, rejection and loneliness, and confusion about mental illness. In phase 2, the first draft of the SAT-FAM with 38 items was developed. Based on the content validity index, each item was evaluated by 15 experts using a 4-point scale (1 = not relevant; 4 = very relevant). 15 family member caregivers of patients with mental illness were randomly selected to complete the face validity form on a Likert scale ranging from 1 (strongly disagree) to 4 (strongly agree). In phase 3, 286 family caregivers of people with mental illness were recruited for exploratory factor analysis. Internal consistency (Cronbach's coefficient) and test-retest reliability were measured.

Results: The final draft of the SAT-FAM comprised 30 items in four factors: shame and discrimination, social interaction, emotional reaction, and avoidance behaviours. The internal consistency (Cronbach's alpha) was >0.89 for all factors. The test-retest reliability among 30 family caregivers was good (0.76).

Conclusions: The SAT-FAM is a valid and reliable self-report instrument for assessing stigma towards family caregivers of patients with mental illness. It enables a practical way of evaluating interventions aimed at reducing stigma.

Objective: To determine the prevalence of attention-deficit/hyperactivity disorder (ADHD) among primary school children in Oforikrom, Kumasi, Ghana.

Methods: 10 of 35 primary schools in Oforikrom were readily available. Of 2000 children aged 5 to 13 years selected, 1540 (77%) of their parents/guardians consented to participate. Their parents/guardians and six teachers from each school were asked to complete the Disruptive Behavior Disorders Rating Scale to screen children for the presence of ADHD, oppositional defiant disorder, or conduct disorder. Children who displayed symptoms (pretty much or very much) in most related items as determined by parents and/or teachers were considered positive cases.

Results: The mean age of 1540 pupils was 9 ± 2.16 years. Most (31%) were primary 4 pupils. 5% of pupils displayed ADHD symptoms (attention deficit disorder subtype in 36%, hyperactivity disorder subtype in 27%, and combined subtype in 37%). Of them, 51% were male. Most (19%) of those who displayed the symptoms were in primary 5.

Conclusion: The prevalence of ADHD among primary school children in Oforikrom was 5%. 51% of those with ADHD symptoms were male. Most (19%) of those with ADHD symptoms were in primary 5.