Asia‐Pacific Psychiatry最新文献

Families and carers can play an important role in helping prevent suicide. Unfortunately, silence and secrecy within the family environment have sometimes prevented family members from intervening to potentially change the course of suicide intent. This article describes a family-oriented assessment process that can facilitate family-involvement in care. Suicide risk assessment requires a skilled interview with the individual patient to determine accurately suicidal intent. However, family members provide a vital source of collateral information for assessing risk and the relational support needed to diminish risk. Strength-based strategies for intervening with patients and family members to help prevent suicide are described.

An increased risk of suicide has been reported for psychiatric patients. In several world regions, an underlying psychiatric disorder is reported in up to 90% of people who die from suicide, though this rate seems to be considerably lower in low- and middle-income countries. Major psychiatric conditions associated with suicidality are mood disorders, alcohol and substance use disorders, borderline personality disorder, and schizophrenia. Comorbidity between different disorders is frequently associated with a higher suicide risk. A history of suicide attempts, feelings of hopelessness, impulsivity and aggression, adverse childhood experiences, severe psychopathology, and somatic disorders are common risk factors for suicide among psychiatric patients. Stressful life events and interpersonal problems, including interpersonal violence, are often triggers. A comprehensive and repeated suicide risk assessment represents the first step for effective suicide prevention. Particular attention should be paid during and after hospitalization, with the first days and weeks after discharge representing the most critical period. Pharmacological treatment of mood disorders and schizophrenia has been shown to have an anti-suicidal effect. A significant reduction of suicidal thoughts and behavior has been reported for cognitive behavioral therapy and dialectical behavior therapy. Brief interventions, including psychoeducation and follow-ups, are associated with a decrease in suicide deaths. Further development of suicide prevention in psychiatric patients will require a better understanding of additional risk and protective factors, such as the role of a person's decision-making capacity and social support, the role of spiritual and religious interventions, and the reduction of the treatment gap in mental health care.

During the 2015 WPA International Congress, Taiwan Young Psychiatrist Organization (TYPO) together with the collaboration of over 100 young psychiatrists launched “The Future of World Psychiatry Program” to facilitate collaboration among young psychiatrists and mentors globally. The program consisted of two “Meet the Expert Workshops,” four “Young Psychiatrists Symposiums,” and pre- and post-WPAIC online social networking, where the mentors gave valuable advice and young psychiatrists shared their latest research findings. Future training programs may consider using this model and transform it into a virtual context to benefit more young psychiatrists globally.

The present study was designed to validate an English version of the mental health literacy scale into Persian, in Iran. Statistical population consisted of all residents of 22 municipal districts of Tehran, Iran, in 2018. Multistage sampling methods were used (sample size = 1026). All participants filled the Mental Health Literacy scale; 12-item General Health Questionnaire; Multidimensional Health Locus of Control scale and a demographic checklist. Exploratory and confirmatory factor analysis, the intra-class correlation coefficient was used for analysing data. All analyses were run with SPSS and AMOS Graphics version 18. Exploratory factor analysis revealed five components (24 items) explaining 21.68%, 20.24%, 8.97%, 6.48% and 5.36% of the variance respectively (totally explained variance = 62.74%). Confirmatory factor analysis showed an acceptable goodness-of-fit (CMIN/DF = 3.19, GFI = 0.887, CFI = 0.893, IFI = 0.894, TLI = 0.877, RMSEA = 0.065). The values of Cronbach's alpha showed satisfactory internal consistency. Two clinical correlates of mental health literacy were investigated. The structure of the mental health literacy scale was to some extent different from the one in O'Connor et al. study, but it was consistent with the definition of MHL presented by Jorm et al. This is the first Persian version of the MHL in the general population in Iran and undoubtedly needs to be checked on more studies.

Background: Borderline personality disorder (BPD) contributes to suicide-related morbidity and mortality and requires more intensive psychotherapeutic resources due to its high mental health service usage. Accessibility to an evidence-based treatment program is a cornerstone to support patients with BPD and part of broader suicide prevention efforts as well as improving their quality of life.

Aims: In this article, the authors aim to discuss and review available dialectical behavior therapy (DBT) and DBT-informed services of selected countries in the Asia-Pacific Rim, namely Singapore, Malaysia, and Mexico.

Materials & Methods: We contacted providers of different services and gathered information on the process of setting up the service and adapting the treatment, in addition to reviewing the available literature published in the countries.

Results: To date, there have been a pair of DBT-informed services in Singapore, four in Malaysia, and several in Mexico with a few of them offering standard DBT. Different efforts have been put in place to increase the accessibility to training and also the number of DBT practitioners.

Discussion: Important considerations during the process of setting up new services include the use of domestic examples and local language that are contextually appropriate for the local community. Selected challenges faced in common include shortage of workforce, affordability of training programs, and the need for language adaptation with or without translation.

Conclusion: Further long-term evaluation of locally adapted DBT-informed mental health services will help to elucidate the effectiveness and efficacy of the program which will potentially serve as a guide for other resource-scarce regions.

Gambling is a popular pastime in India and the number of problem gamblers is on the rise. Although the impact of gambling disorder on families is grossly under-researched in India, drawing on international evidence it is only reasonable to assume that this is an important area deserving further clinical and research attention. Of the several types of interventions possible with families of persons with gambling disorder, in our clinical experience, the 5-step intervention is a feasible and culturally adaptable psychotherapeutic intervention. In this paper we have looked at the theoretical aspects of this intervention and also raise some of the practical challenges of offering psychological interventions to families of persons with gambling disorder in India. Albeit limited, we discuss the evidence base to have emerged from India in this field. Finally, we suggest some intervention measures as the way forward.