East Asian Archives of Psychiatry最新文献

Objectives: To evaluate the level of social distance towards people with mental illness among pharmacy students in a Nigerian university and to explore its associated factors.

Methods: A cross-sectional survey was conducted among 433 pharmacy students in University of Nigeria, Nsukka. The 8-item Social Distance Scale was used to assess an individuals' avoidance reaction directed towards people with mental disorder. Descriptive statistics, Student's t test, and multivariate logistic regression were used for data analysis.

Results: Overall, the students demonstrated a low social distance towards people with mental illness. Lower social distance towards people with mental disorder was associated with younger students (p = 0.006) and students who have had contact with a person with mental illness (p = 0.026), who have visited a mental hospital (p = 0.019), who have experienced mental illness (p = 0.028), and who know a family member or friend with mental illness (p = 0.015). Independent predictors for high social distance towards people with mental illness were age of ≥25 years (odds ratio = 1.488, p = 0.046) and no prior visit to a mental hospital (odds ratio = 2.676, p = 0.016).

Conclusion: Our pharmacy students had a low social distance towards people with mental illness. Predictors for the low social distance were younger age and previous visits to a mental hospital. We recommend more robust educational and training programme, and increased exposure to clinical clerkship in psychiatry to improve social distance towards people with mental illness among pharmacy students.

Background: Generalised anxiety disorder (GAD) has harmful effects on physical and mental health and quality of life. Mindfulness-based cognitive therapy (MBCT) is a treatment option for GAD. This meta-analysis was conducted to determine the effectiveness of MBCT on GAD.

Methods: Two authors independently performed the eligibility, quality assessment, and data extraction processes, and consensus was reached in case of discrepancies. Electronic databases were searched for eligible studies (randomised controlled trials, randomised trials, cluster randomised controlled trials, and clinical trials) up to November 2018 using keywords: mindfulness-based cognitive therapy OR mindfulness based cognitive therapy OR MBCT AND general anxiety disorder OR GAD*. The methodological quality of studies was assessed using the revised Jadad scale. Cohen's formula was used to determine the effect size based on the mean and standard deviation of the changes in the study groups before and after the intervention.

Results: Six studies that compared the effectiveness between MBCT and controls were included for analysis. The mean revised Jadad score of the six studies was 4.3 (range, 3-6). The overall mean effect size was -0.65. The funnel plot of effect sizes in relation to the effect size standard error showed a symmetrical distribution. Compared with controls, MBCT significantly improved the treatment outcome of GAD in all studies, except one.

Conclusion: MBCT was effective for treating GAD.

Objectives: The aim of the present study was to assess the reliability and validity of the Persian version of the State-Trait Anxiety Inventory Form Y (STAI-Y) among high school students.

Methods: A sample of 492 high school students in Kermanshah city, Iran were randomly selected via multistage sampling. They were asked to complete the STAI-Y and Beck Anxiety Inventory (BAI) to determine the correlation coefficients. Data analysis was performed via descriptive statistics, factor analysis, Cronbach's coefficient alpha, and Pearson correlation coefficient.

Results: In the Persian version of STAI-Y, the Cronbach's alpha for internal consistency was 0.886 for trait anxiety and 0.846 for state anxiety. The convergent validity between STAI-Y and BAI was 0.612 for trait anxiety and 0.643 for state anxiety (p < 0.001).

Conclusion: The reliability, internal consistency, and validity of the Persian version of the STAI-Y is good among high school students in Kermanshah.

Background: The DSM-IV and the DSM-5 eliminated the importance of the syndromal identity of melancholic depression in favour of a dimensional model within the domain of major depressive disorders. Melancholic depression was excluded from DSM as a distinct disorder owing to the impact of ageing, genetics, and course of illness. We challenge these assertions using retrospective data collected from patients with depression.

Method: Electronic medical records of 1073 patients with depressive-spectrum disorders in 12 centres across Germany spanning from January 2010 to June 2013 were retrospectively reviewed. The diagnosis of melancholia was made using the Hamilton Depression Rating Scale 21 items (HAMD-21). Patients were followed up every 2 weeks and yearly until discharge from inpatient units. The final dataset consisted of 1014 patients; each had received a minimum of two complete observations.

Results: At baseline, patients with melancholic depression had higher HAMD-21 score than did patients with non-melancholic depression (32.6 vs 23.13, p < 0.001). At the final visit, patients with melancholic depression responded to treatment more often than did patients with non-melancholic depression (81.3% vs 69.04%, p = 0.0156), whereas the two groups were comparable in terms of remission status (50.55 vs 48.68%, p = 0.1943). The relapse rate was higher in patients with melancholic depression than in patients with non-melancholic depression after 1 year (60% vs 45.01%, p = 0.0599), 2 years (77.78% vs 60.36%, p = 0.0233), and 4 years (80% vs 64.45%, p = 0.0452).

Conclusion: Melancholic depression has an identifiable constellation of symptoms and it is not just a severe form of major depression. Melancholic depression is not the result of age-related or pathoplastic changes. We advocate including melancholia as its own illness entity in the next edition of the DSM.

Objective: To evaluate the validity and reliability of a Thai version of the Short Mood and Feelings Questionnaire (SMFQ).

Methods: The present study included 23 children with depressive disorders (diagnosis made by child psychiatrists) and 74 children with no depressive disorders. All children and their parents were asked to complete the Thai versions of the SMFQ, Children's Depression Inventory, and Mood and Feelings Questionnaire. Criterion validity, convergent validity, reliability, and parent-child agreement of the SMFQ were measured.

Results: With a cut-off score of 9, the child-rated SMFQ yielded a sensitivity of 87.0% and specificity of 86.5%, whereas the parent-rated SMFQ yielded a sensitivity of 82.6% and a specificity of 89.2%. The correlation coefficient between the child-rated and parent-rated versions was 0.75, and the correlation coefficients between the Thai Children's Depression Inventory and the child-rated and parent-rated versions were 0.86 and 0.74, respectively. Respectively for the child-rated and parent-rated versions, the Cronbach's alpha was 0.90 and 0.923, and the intra-class correlation coefficient was 0.61 and 0.75. The Bland-Altman plot showed that 92.9% and 85.7% of the child and parent test-retest answers were within limits of agreement.

Conclusion: The Thai version of SMFQ has a high degree of psychometric validity and reliability.

Introduction: Community mental health services in Hong Kong follow a multi-disciplinary case management model. We investigated whether at-risk patients received higher intensity care and whether risk stratification concorded between personalised care programmes and integrated community centres of mental wellness.

Methods: Records of all patients in North Lantau and Mongkok districts who received case management services (from personalised care programmes and/or integrated community centres of mental wellness) between 1 April 2014 and 30 June 2015 were reviewed. Patients' levels of risk, demographic data, and clinical characteristics were analysed.

Results: Identified at-risk patients received high-intensity care from personalised care programmes and integrated community centres of mental wellness. Case management was coordinated between the Hospital Authority and non-government organisations. However, risk stratification did not correlate with assessment rating scores of psychopathology or psychosocial functioning. Assessment rating scales appear unsuitable to provide any optimal cut-off scores for risk stratification.

Conclusions: Risk stratification should be a structured clinical judgement based on comprehensive and accurate information of protective and risk factors, rather than relying on cut-off scores of assessment rating scales.

Background: Depressive symptoms are common among medical students. The aim of the present study was to determine the prevalence and risk factors of depressive symptoms among medical students in Sultan Qaboos University in Oman.

Method: A cross-sectional study was conducted among a random sample selected from 1041 medical students at Sultan Qaboos University, Oman. The Patient Health Questionnaire-9 (PHQ-9) was used to screen for depressive symptoms. A logistic regression model was used to determine risk factors for depressive symptoms.

Results: Of 197 medical students selected, 189 (61 men and 128 women) responded. The PHQ-9 results showed that the prevalence of depressive symptoms was 41.3%. In multivariate analysis, female students were more likely than male students to develop depression (adjusted odds ratio = 2.866, p = 0.004). Medical students with a family history of depression were more likely to develop depression than those without a family history of depression (adjusted odds ratio = 4.150, p = 0.014).

Conclusions: Depressive symptoms are common among medical students in Sultan Qaboos University. Risk factors for depressive symptoms are female sex and family history of depression.

Objective: To determine the prevalence of traumatic experience (TE) among patients in psychiatric settings in Hong Kong and the associations between TE and levels of distress and anxiety and depressive symptoms.

Methods: 129 patients who have received inpatient psychiatric services were recruited. Their lifetime TE was assessed using the Life Event Checklist (LEC), and TE in psychiatric settings using the Psychiatric Experiences Questionnaire (PEQ). Their level of distress symptoms was assessed using the Impact of Event Scale-Revised (IES-R), and the level of anxiety and depressive symptoms using the Hospital Anxiety and Depression Scale (HADS).

Results: The prevalence of direct and indirect TE was 84.5%, as was the prevalence of TE in psychiatric settings. Common TE in psychiatric settings included witnessing another patient being taken down (61.2%), being put in restraints of any kind (41.1%), and witnessing another patient being physically assaulted by another patient (36.4%). TE in psychiatric settings associated with high prevalence of severe or extreme distress 1 week after the event included being forced to take medication against their will (52.2%), being threatened with physical violence (52.2%), and experiencing a physical assault (50.0%). Lifetime TE (the total number of LEC items reported) was associated with severity of distress and anxiety and depressive symptoms, whereas TE in psychiatric settings (the total number of PEQ items reported) was associated with severity of distress only. The total number of LEC items reported is the only predictor of levels of distress and anxiety and depressive symptoms.

Conclusions: Lifetime TE and TE in psychiatric settings are common among patients with SMI. Trauma-informed care is suggested for mental health services.