Asian journal of psychiatry最新文献

英文中文

Advancing suicide prevention through legislative action in Indonesia: The 2024 Presidential Decree on mental health and suicide

IF 3.8 4区医学 Q1 PSYCHIATRY

Asian journal of psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.ajp.2024.104353

Sandersan Onie, Irmansyah, Juneman Abraham, Anna Surti Ariani, Jiemi Ardian, Nurul F. Praharso, Byron J. Good

引用次数: 0

A nose for trouble: Tapentadol nasal spray use disorder associated nasal cartilage atrophy in a young male 一个麻烦的鼻子：他他多鼻喷雾剂使用障碍相关的鼻软骨萎缩的年轻男性。

IF 3.8 4区医学 Q1 PSYCHIATRY

Asian journal of psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.ajp.2024.104346

Pattath Narayanan Suresh Kumar , Greata Edwin , Rohith Suresh , Vikas Menon

引用次数: 0

The research gap in evaluating community-based mental health interventions in Korea: A comparative analysis with the United Kingdom 评价韩国社区精神卫生干预措施的研究差距：与英国的比较分析。

IF 3.8 4区医学 Q1 PSYCHIATRY

Asian journal of psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.ajp.2024.104348

Jongtae Kim

South Korea has historically relied on inpatient psychiatric care. Although the 1995 Mental Health Act aimed to promote community mental health services, progress in developing community-based interventions has been limited. This review aims to provide a concise analysis of the current state of research on evaluating community mental health care in Korea, employing a comparative perspective with the United Kingdom (UK), where community-based mental health approaches have been more extensively studied and implemented. On November 19, 2024, a literature search was conducted using PubMed. The search strategy combined keywords related to mental illness and community intervention with the terms “Korea” or “United Kingdom.” The review focused on randomized controlled trials from both countries that assessed patient-level outcomes of community-based mental health interventions. The findings reveal a striking contrast: in Korea, only one randomized pilot trial focused on depression in older adults was found. In contrast, 69 studies were identified in the UK, including 13 pilot/feasibility studies and 56 main studies, with 38 of these addressing severe mental illness. This clear difference underscores the limited research and evaluation of community-based mental health interventions in Korea. The results indicate a pressing need for research to assess these interventions. Such research could guide policy reforms toward deinstitutionalization and help Korea strengthen its community-based mental health system in line with global trends.

韩国历来依赖住院精神病治疗。虽然1995年的《精神卫生法》旨在促进社区精神卫生服务，但在制定基于社区的干预措施方面进展有限。本综述旨在对评估韩国社区精神卫生保健的研究现状进行简要分析，采用与英国（英国）的比较观点，在英国，社区精神卫生方法得到了更广泛的研究和实施。2024年11月19日，通过PubMed进行文献检索。该搜索策略将与精神疾病和社区干预相关的关键词与“韩国”或“英国”相结合。这篇综述的重点是两国的随机对照试验，这些试验评估了以社区为基础的精神卫生干预的患者水平的结果。研究结果揭示了一个惊人的对比：在韩国，只发现了一个针对老年人抑郁症的随机试点试验。相比之下，英国确定了69项研究，包括13项试点/可行性研究和56项主要研究，其中38项研究涉及严重精神疾病。这一明显差异凸显了韩国对社区精神卫生干预措施的研究和评估有限。结果表明，迫切需要进行研究来评估这些干预措施。这样的研究可以指导政策改革走向去机构化，并帮助韩国根据全球趋势加强以社区为基础的精神卫生系统。

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引用次数: 0

Examining barriers to access mental health services among patients with mental health issues in SAARC nations: A systematic review and meta-synthesis of qualitative studies 检查南盟国家精神健康问题患者获得精神卫生服务的障碍：定性研究的系统审查和综合。

IF 3.8 4区医学 Q1 PSYCHIATRY

Asian journal of psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.ajp.2024.104331

Gayatri Khanal , Y. Selvamani , Sushmita Ghimire , Suman Thapa , Rolina Dhital

Background

Inspite of high prevalence of mental illness in developing countries, access to health care for addressing mental health issues has several existing barriers at different levels leading to disproportionate adverse health outcomes, summarised as the three Ds of death, disability, and health-economic deficit. This study aims at examining the perspectives of patients with mental illness on barriers to access mental care.

Methods

In this study, we searched EMBASE, PubMed, Scopus and PsycNet databases. Database search examined qualitative articles on barriers to access mental health care published from January, 2013 to January, 2023. Papers appropriate for inclusion were selected in the South Asian Association for Regional Cooperation (SAARC) nations, employed qualitative methodologies, and focused on patients, caregiver, or healthcare practitioners’ perspective on challenges to access care. The Mixed Methods Appraisal Tool (MMAT) - Version 2018 was used to assess quality.

Results

Out of 351 papers, only 24 met the inclusion requirements. A multilevel conceptual framework guided the reporting of emergent themes. Patient with mental disorder experienced four levels of barriers while receiving mental health services: 1. sociocultural (family support, community support networks, and cultural attitudes), 2. organizational (organizational characteristics, service access, and inadequacy of resources), 3. structural (poor implementation of existing policy) and 4. individual levels (knowledge, attitudes, and individual characteristics).

Conclusions

Complex, interlinked, multilevel barriers existed while accessing MHS for patient in SAARC nations. To improve access to MHS, multilevel solutions ought to tackle individual, organizational, societal, and structural barriers at various phases of the care pathway is imperative.

背景：尽管发展中国家的精神疾病发病率很高，但在不同程度上，获得解决精神健康问题的卫生保健存在一些现有障碍，导致不成比例的不良健康结果，总结为死亡、残疾和健康-经济赤字这三个d。本研究旨在探讨精神疾病患者对获得精神护理障碍的看法。方法：检索EMBASE、PubMed、Scopus、PsycNet等数据库。数据库检索检查了2013年1月至2023年1月发表的关于获得精神卫生保健障碍的定性文章。在南亚区域合作联盟（SAARC）国家中选择适合纳入的论文，采用定性方法，并侧重于患者、护理人员或医疗保健从业人员对获得护理的挑战的看法。使用混合方法评估工具(MMAT) - 2018版进行质量评估。结果：351篇论文中，只有24篇符合纳入要求。多层概念框架指导了紧急主题的报告。精神障碍患者在接受心理健康服务时遇到四个层次的障碍：1。社会文化（家庭支持、社区支持网络和文化态度）；2、组织性（组织特征、服务可及性、资源不足性）；3 .结构性（现有政策执行不力）；个人层面（知识、态度和个人特征）。结论：南盟国家患者获取MHS存在复杂、相互关联、多层次的障碍。为了改善卫生保健服务的可及性，多层次的解决方案必须解决护理途径各个阶段的个人、组织、社会和结构障碍。

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引用次数: 0

Affective temperaments: Effects on treatment response for major depression 情感气质：对重度抑郁症治疗反应的影响。

IF 3.8 4区医学 Q1 PSYCHIATRY

Asian journal of psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.ajp.2024.104335

Ross J. Baldessarini , Alessandro Miola , Leonardo Tondo

There is growing interest in assessing affective temperaments in relation to major depressive disorder (MDD) and bipolar disorder (BD). Needed is evaluation of the impact of temperament ratings on responses to treatment of depression in these disorders. We measured treatment response as %-improvement in HDRS₂₁ depression ratings and correlated this measure as well as response rate (≥50 % improvement) with TEMPS-A ratings of anxious, cyclothymic, dysthymic, hyperthymic, and irritable affective temperaments in 2264 mood-disorder patients (1165 BD, 1099 MDD; 62.3 % women, mean age 48.5 years). Higher dysthymic temperament score was associated with less improvement in depression ratings, greater hyperthymia scores with increased improvement. Both temperaments also were associated with increases (dysthymia) or decreases (hyperthymia) in initial HDRS₂₁ scores. However, higher initial HDRS₂₁ scores led to greater percent-improvement. Multivariable logistic regression sustained independent effects of temperament scores on treatment-response. Reported effects were similar with MDD and BD. Limitations include the observational design limiting causality and uncertain generalizability to other geographical locations or clinical settings. Ratings of dysthymic and hyperthymic temperaments, respectively, were associated with significantly lesser and greater improvement of depression ratings with both MDD and BD.

人们对评估情感气质与重度抑郁症（MDD）和双相情感障碍（BD）之间的关系越来越感兴趣。需要的是评估气质评分对这些疾病中抑郁症治疗反应的影响。我们以HDRS21抑郁评分的%改善来衡量治疗反应，并将该测量和反应率（≥50 %改善）与2264名情绪障碍患者(1165名BD， 1099名MDD；62.3 %女性，平均年龄48.5岁)。心境恶劣气质评分越高，抑郁评分改善越少，心境亢进评分越高，抑郁评分改善越少。这两种气质也与初始HDRS21评分的增加（心境恶劣）或减少（心境亢进）有关。然而，较高的初始HDRS21分数会导致更大的改善百分比。多变量逻辑回归支持气质评分对治疗反应的独立影响。报告的效果与重度抑郁症和双相障碍相似。局限性包括观察性设计限制了因果关系和不确定的其他地理位置或临床环境的普遍性。心境恶劣和心境亢进的评分分别与重度抑郁症和双相抑郁症评分的显著或显著改善相关。

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引用次数: 0

Comparative effectiveness of interventions for the prevention and treatment of perinatal depression: A systematic review and network meta-analysis 围产期抑郁症预防和治疗干预措施的比较效果：系统综述和网络荟萃分析。

IF 3.8 4区医学 Q1 PSYCHIATRY

Asian journal of psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.ajp.2024.104316

Robert David Smith , Wen Dang , Shuyuan Shen , Sze Chai Hung , Ip Hoi Lam , Jojo Y.Y. Kwok , Edmond P.H. Choi , Daniel Y.T. Fong , Shehzad Ali , Claire A. Wilson , Kris Y.W. Lok

Background

Several interventions have been investigated addressing perinatal depression; however, interventions have not been compared using both direct and indirect evidence. This study compared the relative effectiveness of all interventions that prevent depression (objective 1) or treat depression symptoms (objective 2) in perinatal women.

Methods

Eight databases searched from their inception to March 2024. Inclusion criteria were randomised controlled trials in perinatal women participants evaluating any interventions that addressed prevention or treatment of depression. Two random-effects Bayesian network meta-analyses were conducted using studies with perinatal women participants reporting frequency of depression or reporting depression severity. For objective 1 odds ratios (OR) and objective 2 standardised mean differences (SMD) were used.

Results

A total of 177 articles were included (n = 76 objective 1, n = 101 objective 2). For objective 1; mindfulness was the highest-ranking intervention (SCURA=88), with significant OR compared to treatment as usual (TAU) (OR=0.21; 0.06, 0.71 95 %CrI). Other interventions with significant OR, compared to TAU included: pharmacological treatments, CBT, physical activities, education, and collaborative care. For objective 2; interpersonal therapy plus massage was the highest-ranking intervention (SCURA=89) with significant SMD compared to TAU (SMD=-1.38; −2.54, −0.21). Other interventions with significant SMD compared to TAU: IPT, alternative therapies, physical activities, mindfulness, CBT, collaborative care, education, and enhanced TAU. Pharmacological treatments were effective compared to sham/placebo.

Conclusion

CBT, mindfulness, physical activity, collaborative care, education, and pharmacological interventions were effective in addressing prevention and treatment of perinatal depression symptoms compared to control arms. Healthcare providers may consider offering these interventions to perinatal women.

背景：一些干预措施已经研究解决围产期抑郁症；然而，还没有使用直接和间接证据对干预措施进行比较。本研究比较了围产期妇女预防抑郁（目标1）或治疗抑郁症状（目标2）的所有干预措施的相对有效性。方法：检索自建库至2024年3月的8个数据库。纳入标准是围产期妇女参与者的随机对照试验，评估任何预防或治疗抑郁症的干预措施。两项随机效应贝叶斯网络荟萃分析使用围产期妇女参与者报告抑郁频率或报告抑郁严重程度的研究进行。目标1采用优势比（OR），目标2采用标准化平均差异（SMD）。结果：共纳入177篇文献（n = 目标1 76篇，n = 目标2 101篇）。正念是排名最高的干预措施（SCURA=88），与常规治疗（TAU）相比具有显著的OR (OR=0.21；0.06, 0.71 95 %CrI)。与TAU相比，其他具有显著OR的干预措施包括：药物治疗、CBT、体育活动、教育和协作护理。对于目标2；人际治疗加按摩是最高级别的干预（SCURA=89），与TAU (SMD=-1.38；-2.54, -0.21)。与TAU相比，其他具有显著SMD的干预措施包括：IPT、替代疗法、体育活动、正念、CBT、协作护理、教育和增强TAU。与假药/安慰剂相比，药物治疗有效。结论：与对照组相比，CBT、正念、体育活动、协同护理、教育和药物干预在预防和治疗围产期抑郁症状方面是有效的。医疗保健提供者可考虑向围产期妇女提供这些干预措施。

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引用次数: 0

Implementing a collaborative care model for child and adolescent mental health in Qatar: Addressing workforce and access challenges 在卡塔尔实施儿童和青少年心理健康协作护理模式：应对劳动力和获取机会方面的挑战。

IF 3.8 4区医学 Q1 PSYCHIATRY

Asian journal of psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.ajp.2024.104347

Mohamed Adil Shah Khoodoruth , Muhammad Abdur Rahman Khoodoruth , Widaad Nuzhah Chut-Kai Khoodoruth

Child and adolescent mental health disorders in Qatar remain significantly underserved due to a critical shortage of specialists, stigma, and logistical barriers. This paper proposes implementing a Collaborative Care Model (CoCM) within Qatar’s primary care settings, leveraging existing infrastructure, such as the CERNER electronic health record system, and innovations like telepsychiatry and AI-driven tools. The model integrates task-sharing among interdisciplinary teams to enhance accessibility and continuity of care. This commentary explores the model’s feasibility, addressing challenges like workforce shortages and psychotropic prescribing processes. The proposed CoCM offers a sustainable solution to improve youth mental health outcomes and reduce systemic disparities.

由于专家严重短缺、耻辱感和后勤障碍，卡塔尔的儿童和青少年精神健康障碍仍然严重不足。本文建议在卡塔尔的初级保健环境中实施协作护理模式（CoCM），利用现有的基础设施，如CERNER电子健康记录系统，以及远程精神病学和人工智能驱动工具等创新。该模式整合了跨学科团队之间的任务分担，以提高护理的可及性和连续性。这篇评论探讨了该模型的可行性，解决了劳动力短缺和精神药物处方过程等挑战。拟议的CoCM为改善青少年心理健康结果和减少系统性差异提供了可持续的解决方案。

引用次数: 0

Safety and efficacy of early augmentation with Transcranial Direct Current Stimulation (tDCS) in adolescents with Major Depressive Disorder: A randomized controlled trial 早期增强经颅直流电刺激（tDCS）治疗青少年重度抑郁症的安全性和有效性：一项随机对照试验。

IF 3.8 4区医学 Q1 PSYCHIATRY

Asian journal of psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.ajp.2024.104349

Saumya Upadhyay, Vivek Agarwal, Amit Arya, Sujita Kumar Kar

Background

Transcranial Direct Current Stimulation (tDCS) is an emerging modality with demonstrated efficacy in Major Depressive Disorder (MDD), however, there is paucity of research in adolescent depression. This study attempts to evaluate the safety and efficacy of tDCS in adolescents with MDD as an early augmentation to drug therapy.

Methods

Adolescents with MDD aged 10–18 years were enrolled in the study and allocated to active or sham groups as per randomization. Sertraline was given in the range of 25–50 mg to each participant. After baseline assessments, 10 sessions of tDCS were given with 2 mA current for 20 minutes, keeping anode at left DLPFC and cathode at right DLPFC. Side effects were assessed and rating scales were reapplied at 2 weeks and then 6 weeks. Results were analyzed.

Results

A total of 32 patients were analysed (15-active, 17-sham). At 2 weeks, the BDI and BAI scores of the true group were significantly lower than the sham group, and the reduction in the scores of the former was statistically greater. This significance did not persist at 6 weeks, and the reduction in the scores of the two groups was significantly different from baseline to 2-weeks and 6-weeks. Response and remission rates were higher in the active group at 6 weeks. Adverse effects were comparable.

Conclusion

tDCS is safe and effective for early augmentation of drugs in adolescents with MDD. However, effects do not last long after termination of sessions. Further studies are needed with a larger sample size and longer follow-ups.

背景：经颅直流电刺激（Transcranial Direct Current Stimulation, tDCS）是一种新兴的治疗方式，在重度抑郁症（MDD）中已被证实有效，然而，对青少年抑郁症的研究却很缺乏。本研究试图评估tDCS在青少年重度抑郁症患者中作为药物治疗早期补充的安全性和有效性。方法：将10-18岁的MDD青少年纳入研究，并按随机分组分为活跃组和假组。每位参与者给予舍曲林25-50 毫克。基线评估后，给予10次tDCS，电流为2 mA，持续20 分钟，阳极位于左侧DLPFC，阴极位于右侧DLPFC。在第2周和第6周对副作用进行评估并重新应用评分量表。对结果进行分析。结果：共分析32例患者（主动15例，假手术17例）。2周时，真组BDI、BAI评分均显著低于假组，且假组下降幅度更大。这种显著性在6周后没有持续，两组的评分从基线到2周和6周的下降有显著差异。6周时，积极组的缓解率和缓解率更高。不良反应具有可比性。结论：tDCS对MDD青少年早期加药安全有效。然而，效果在会话结束后不会持续很长时间。进一步的研究需要更大的样本量和更长的随访时间。

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引用次数: 0

Improving acceptance of psychosis risk terminology through cultural sensitivity 通过文化敏感性提高对精神病风险术语的接受度。

IF 3.8 4区医学 Q1 PSYCHIATRY

Asian journal of psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.ajp.2024.104352

Isnaria Rizki Hayati, Elni Yakub, Rikas Saputra , Yenni Lidyawati, Rizky Andana Pohan, Erfan Ramadhani

引用次数: 0

Digital mental health interventions in India: Addressing challenges and expanding access 印度的数字心理健康干预措施：应对挑战并扩大获取途径。

IF 3.8 4区医学 Q1 PSYCHIATRY

Asian journal of psychiatry

Pub Date : 2025-01-01 DOI: 10.1016/j.ajp.2024.104339

Sonia Mathew, Ajay Jose, Rejikumar G

引用次数: 0

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