Asian journal of psychiatry最新文献

The mental health burden in India is increasing at unprecedented rates. The increased demand for mental health care and the undersupply of services has widened the treatment gap. Due to several factors, such as increasing service costs and the circumstances surrounding the COVID-19 pandemic, India has witnessed an inclination toward using digital mental health solutions to overcome the treatment gap. Drawing from the collective evidence and experience in implementing mental health solutions using digital phenotyping and smartphone app-based care delivery in India, we define the scope, potential, and challenges of implementing synchronous and asynchronous digital mental health solutions that can serve as a template for improving global mental health.

The tripartite classification of mental faculties into cognition, affect, and conation (motivation and action) continues to be the edifice on which the mind and the methods to address mental afflictions are studied. Eastern spiritual traditions offer insights into mental health as it pertains to each of these domains. Following up on our previous paper on the cognition path to psychotherapy (Knowing oneself, or Jnana Yoga), we herein focus on the path of selfless action (Karma Yoga). We review eastern concepts on the nature of karma and the approaches to optimal action (the will to do things, doing the right things, and doing them well). We then place these eastern insights in the context of emerging concepts in psychology on motivation and action. Current psychological concepts such as autonomy and intrinsic motivation, mastery, flow and growth mindset, higher purpose and value driven self-less action, equanimity and balance are convergent with ancient eastern concepts. We also review current neuroscientific underpinnings (such as neural circuitries, neurotransmitter systems and epigenetics and how these facilitate neural plasticity) relevant to karma, including free will, focused action, prosocial behaviors, extrinsic and intrinsic and motivation. These concepts have significant implications for psychotherapeutic models, especially in the areas of positive psychology and preventive psychiatry.

Lithium and mood stabilizers are considered effective augmentation agents of antidepressants for treatment-resistant depression. Thus, this study aimed to estimate the network structure of depression symptom criteria among unipolar depression patients with mood stabilizers, using data from the Research on Asian Psychotropic Prescription Patterns for mood stabilizers (REAP-MS). We estimated a network of the 9 depression symptom criteria among 411 unipolar depression patients in Asia. Each of the depression symptom criteria was considered to be a dichotomous categorical variable. Suicidality (suicidal ideation or attempt) was the most centrally situated within the network of depression symptoms, followed by depressed mood, loss of energy, anhedonia and weight loss or gain. Contrastingly, concentration problem was the least interconnected. The depression symptom criteria were organized into 4 clusters by the community detection method. The findings suggest that suicidality may be one of the significant therapeutic target symptoms in unipolar depression patients with mood stabilizers.

Objectives

Suicide is a serious mental health problem among university students. The current study aimed to examine the effectiveness of a novel intervention that targets suicide risk by enhancing self-esteem and self-compassion.

Methods

Participants were recruited from the healthcare center at a Japanese University. Measurements of suicidal risk, self-compassion, self-esteem, and other psychological variables were collected at baseline, post-intervention, four-week follow-up, eight-week follow-up, and twelve-week follow-up. Participants also provided feedback on the program's acceptability.

Results

A total of 17 participants consented to participate in the intervention, 14 completed post-treatment assessment, 10 completed the four-week follow-up assessment, and 8 completed the eight-week and twelve-week follow-up assessment. Following the intervention, the study observed moderate to large improvements in self-esteem, self-compassion, hopelessness, depression, and suicide risk. The participants also reported reliable changes in clinical outcomes and positive perceptions of the program.

Conclusions

The psychoeducation program exhibited high acceptability and feasibility and promising early outcomes. Despite the small sample size and lack of a control group, these findings suggest potential benefits of the program. Further studies for examining the efficacy of the program are highly warranted.

The Philippines are at the forefront of climate change impacts, including those related to health and well-being, but information on mental health and well-being are typically underreported. To help address this research lacuna, we conducted a systematic literature review. We aimed to provide an overview of current research knowledge and research gaps regarding the impacts of climate change outcomes on Filipinos’ mental health and well-being. Consulting 8 databases, we identified 951 records. The final analysis included 32 studies: 16 quantitative, 11 qualitative, 2 longitudinal, 2 experimental, and 1 published report. A narrative synthesis has been performed to synthesize the findings from included studies. Studies were presented in four sections: 1) Risks to mental health following a natural disaster, 2) Determinants of post-traumatic stress disorder risks, 3) Resilience and post-traumatic growth following natural disasters, and 4) Personal experiences and other mental health outcomes. Reviewed data show that climate change outcomes strongly and negatively impact Filippino’s mental health and well-being. Climate change outcomes also, negatively affect mental health through indirect (e.g., sleep disorders) and long-term pathways for example by being exposed to stressors such as migration, conflict, and violence. A set of coping strategies was identified which include banding together, mobilizing health experts, and expanding the local relationships with health workers. Future prospective studies should assess the effects of rising sea levels and vector-borne diseases among frontline communities. More interventional studies assessing preventive interventions and health promotion initiatives should be carried out to mitigate mental health disorders and improve well-being, thus contributing to improved health outcomes.

The affective pathway to psychosis implicates affective symptoms and neuroticism as mediating steps between childhood trauma and symptoms of schizophrenia. Prior research seldom examined the interplay between childhood trauma, resilience, personality, social functioning and symptoms in schizophrenia patients. This study recruited 290 schizophrenia patients, and constructed a regularized partial correlation network of childhood trauma, resilience, big-five personality traits, symptoms and social functioning. We further applied flow diagram and shortest path analysis to clarify how different childhood trauma types would contribute to and reach different symptoms. In the network, emotional and physical abuse showed the highest expected influence, and resilience showed the highest strength. In flow diagrams, all nodes together contributed two-thirds of variance of social functioning (which had highest predictability). Among childhood trauma types, emotional abuse contributed most to positive symptoms; physical neglect contributed most to negative, depressive and disorganized symptoms. Childhood abuse reached positive symptoms via neuroticism and depressive symptoms, yet it reached negative symptoms via physical neglect and social functioning. Childhood neglect reached positive symptoms via resilience, conscientiousness, neuroticism and depressive symptoms, yet it reached negative symptoms via social functioning. Our findings support that different childhood trauma types contribute to different symptoms, and interacts with resilience, personality and social functioning.

Background

Several assessments have been developed to assess school-aged children’s emotional and behavioral problems (EBPs), but none based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision. This study aimed to develop the Assessment for Emotional and Behavioral Problems in School-aged children (AEBPS) fitting current knowledge of mental health disorders.

Materials and methods

This study included 2 phases. In Phase I, the assessment construct and its corresponding items were developed. In Phase II, the reliability and validity of the AEBPS were examined.

Results

The AEBPS contains 120 items in five subscales. The psychometric results showed that the AEBPS subscales had high internal consistency (Cronbach’s alpha = 0.83–0.97) and acceptable to good test–retest reliability (intra-class correlation coefficient = 0.65–0.93). The results of exploratory factor analysis showed that most items within each subscale of the AEBPS significantly contributed to their respective concepts. The AEBPS subscales had small to high correlations with the subscales of the Child Behavior Checklist (r = 0.37–0.87). The AEBPS had good discriminant validity to differentiate children with and without EBPs.

Conclusions

The newly-developed AEBPS fits the current knowledge of mental health diagnoses for assessing school-aged children’s EBPs and has sound psychometric evidence. The AEBPS can be reliably and validly used in a variety of settings.

Background

Since its creation, the Mental Health Literacy Scale (MHLS) has been used worldwide in mental health literacy studies.

Objective

This study aimed to systematically evaluate, summarize, and compare the measurement properties of MHLS validation studies.

Methods

PsycINFO, CINAHL, ERIC, Scopus, Embase, MEDLINE, and PubMed databases were searched from May 30, 2015, to December 31, 2023. Peer-reviewed studies validating the MHLS and its measurement properties were included, irrespective of language, study population, and setting. Studies using the MHLS as an outcome measure, as a comparative instrument to validate another instrument, or using other MHL measures and grey literature was excluded.

Results

Of the 685 search results, 16 studies were deemed eligible. The COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) RoB criteria showed 15/15 studies exhibited ‘Very Good’ or ‘Adequate’ internal consistency, 3/6 reliability, 1/8 content validity, 14/14 structural validity, 6/7 hypothesis testing for convergent validity, 2/7 hypothesis testing for known-group validity, and 0/1 error measurement. The Cronbach’s alpha ranged from 0.720 to 0.890, and the Intra-class Correlation Coefficient ranged from 0.741 to 0.99, while content validity was limited regarding the quality of evidence rating. The four-factor and unidimensional structures were 35.7 % and 28.6 %, respectively, the most common models.

Conclusion

The MHLS exhibited strong evidence of construct validity and reliability, ensuring consistent and accurate evaluation of MHL and improving research credibility and generalizability. However, the low number of identical language versions of MHLS studies prohibited statistical pooling and quantitative summaries.

Trichobezoars or hairballs in the gastrointestinal tract occur as a complication of trichotillomania or compulsive hair pulling, and trichophagia, or compulsive eating of hair. The DSM-5 classifies trichotillomania as an obsessive-compulsive spectrum disorder. In this case series of four children with trichobezoar, we present the varied psychopathology that led to the same and discuss the current literature on complex issues underlying trichotillomania.