East Asian Archives of Psychiatry最新文献

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.

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.