Yuan Zhang MD, Min Jiang MD, Xiying Xiang MD, Wenwen He MD, Juan Du MD, Mingyan Hei MD, PhD
Aim
To compare the effect of family integrated care (FICare) on maternal stress in preterm infants with traditional non-parent neonatal intensive care unit (NICU) care.
Methods
We continuously enrolled mothers and their preterm infants from two NICUs between August 2014 and April 2017; while one NICU applied the FICare model (FICare group) and the other performed standard non-parent care model (control group). Maternal stress was evaluated by the Parental Stress Scale: NICU (PSS: NICU) on admission and right before the discharge. A generalized linear model to adjust for potential confounders. Subgroup analysis was also performed for comparisons between two groups.
Results
A total of 215 mothers with preterm infants were included in this study, among whom 118 (54.88%) were in FICare group and 97 (45.12%) were in control group. The mean PSS: NICU score was 117.36 ± 26.27 on admission with no difference between two groups. Before being discharged home, the PSS: NICU score of parents in both groups was significantly reduced, with the score of FICare group was significantly lower than that of control group. In all sub-domains of PSS: NICU score as sights and sounds, baby looks and behavior score, and parental role, the scores of FICare group were significantly lower than control group.
Conclusions
There was a simultaneous decrease of maternal stress for NICU preterm infants. FICare further facilitates reducing the maternal stress. It shall be encouraged to apply FICare model in NICUs.
{"title":"Effect of Family Integrated Care on maternal stress in preterm infants in the Neonatal Intensive Care Unit: A bi-center experience","authors":"Yuan Zhang MD, Min Jiang MD, Xiying Xiang MD, Wenwen He MD, Juan Du MD, Mingyan Hei MD, PhD","doi":"10.1111/appy.12521","DOIUrl":"10.1111/appy.12521","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To compare the effect of family integrated care (FICare) on maternal stress in preterm infants with traditional non-parent neonatal intensive care unit (NICU) care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We continuously enrolled mothers and their preterm infants from two NICUs between August 2014 and April 2017; while one NICU applied the FICare model (FICare group) and the other performed standard non-parent care model (control group). Maternal stress was evaluated by the Parental Stress Scale: NICU (PSS: NICU) on admission and right before the discharge. A generalized linear model to adjust for potential confounders. Subgroup analysis was also performed for comparisons between two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 215 mothers with preterm infants were included in this study, among whom 118 (54.88%) were in FICare group and 97 (45.12%) were in control group. The mean PSS: NICU score was 117.36 ± 26.27 on admission with no difference between two groups. Before being discharged home, the PSS: NICU score of parents in both groups was significantly reduced, with the score of FICare group was significantly lower than that of control group. In all sub-domains of PSS: NICU score as sights and sounds, baby looks and behavior score, and parental role, the scores of FICare group were significantly lower than control group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There was a simultaneous decrease of maternal stress for NICU preterm infants. FICare further facilitates reducing the maternal stress. It shall be encouraged to apply FICare model in NICUs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"15 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2022-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10658063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Suicidal deaths among physicians have been on a steady rise in the past few decades, despite being a part of the healthcare system, training for early identification and easy access to treatment services. While there is no doubt that this warrants concern at individual, institutional, and community levels, physician suicide remains an under-researched topic. We examine the correlates of suicidal deaths among physicians along with risks and protective factors conferred to physicians as a population and emphasize the need for preventive and risk-reduction initiatives that are specifically tailored for physicians and the healthcare provider community.
{"title":"The silent epidemic: Death by suicide among physicians","authors":"Gayatri Bhatia MD, DM, Pawan Sharma MD, Arghya Pal MD, Arpit Parmar MD, DM","doi":"10.1111/appy.12522","DOIUrl":"10.1111/appy.12522","url":null,"abstract":"<p>Suicidal deaths among physicians have been on a steady rise in the past few decades, despite being a part of the healthcare system, training for early identification and easy access to treatment services. While there is no doubt that this warrants concern at individual, institutional, and community levels, physician suicide remains an under-researched topic. We examine the correlates of suicidal deaths among physicians along with risks and protective factors conferred to physicians as a population and emphasize the need for preventive and risk-reduction initiatives that are specifically tailored for physicians and the healthcare provider community.</p>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"15 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9219795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kai-Rong Ding MSc, Shi-Bin Wang PhD, Wen-Qi Xu MSc, Li-Hua Lin MSc, Dan-Dan Liao MSc, Hong-Bei Chen MSc, Wen-Yan Tan MSc, Jia-Hao Huang MSc, Cai-Lan Hou PhD, Fu-Jun Jia PhD
Background
Mental health literacy (MHL) is rarely reported in the Chinese elderly. This study explored the pattern of MHL in the Chinese elderly in relation to depression, anxiety and poor sleep quality.
Methods
A cross-sectional study was conducted among older adults in Guangzhou, south China. Participants were investigated face-to-face using the Chinese National Mental Health Literacy Scale, the Patient Health Questionnaire-9 item (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7) and the Pittsburgh Sleep Quality Index (PSQI). Mental Health Literacy Scale contains three dimensions: mental health knowledge, mental health skills (such as social support, cognitive reappraisal and attentional distraction) and mental health awareness. Multivariate logistic regression was used for examining the association between MHL and mental health.
Results
A total of 506 older adults were recruited. The percentage of depression, anxiety, and poor sleep quality were 16.6%, 7.9% and 40.9%, respectively. MHL dimensions independently associated with depression included cognitive reappraisal (OR = 1.95, p < .001), attentional distraction (OR = 0.61, p = 0.044) and awareness (OR = 0.56, p = 0.027). MHL dimensions independently associated with anxiety symptoms included cognitive reappraisal (OR = 1.90, p = 0.011) and attentional distraction (OR = 0.44, p = 0.016). MHL dimensions independently associated with poor sleep quality included social support (OR = 0.75, p = 0.022), cognitive reappraisal (OR = 1.55, p = 0.003) and attentional distraction (OR = 0.65, p = 0.016).
Conclusion
Given the low MHL and its association with poor mental health in the Chinese elderly, policymakers and health professionals should improve the older adults' MHL, which could be conducive to the prevention and control of their mental health problems.
背景心理健康素养(MHL)在我国老年人中报道较少。本研究探讨中国老年人MHL与抑郁、焦虑和睡眠质量差的关系。方法对中国南方广州的老年人进行横断面研究。采用中国全国心理健康素养量表、患者健康问卷第9项(PHQ-9)、广泛性焦虑障碍量表第7项(GAD-7)和匹兹堡睡眠质量指数(PSQI)对参与者进行面对面调查。心理健康素养量表包含三个维度:心理健康知识、心理健康技能(如社会支持、认知重评和注意力分散)和心理健康意识。多因素logistic回归检验MHL与心理健康的关系。结果共招募了506名老年人。抑郁、焦虑和睡眠质量差的比例分别为16.6%、7.9%和40.9%。与抑郁独立相关的MHL维度包括认知重评(OR = 1.95, p < .001)、注意力分散(OR = 0.61, p = 0.044)和意识(OR = 0.56, p = 0.027)。与焦虑症状独立相关的MHL维度包括认知重评(OR = 1.90, p = 0.011)和注意力分散(OR = 0.44, p = 0.016)。与睡眠质量差独立相关的MHL维度包括社会支持(OR = 0.75, p = 0.022)、认知重评(OR = 1.55, p = 0.003)和注意力分散(OR = 0.65, p = 0.016)。结论考虑到中国老年人低MHL及其与不良心理健康的关系，决策者和卫生专业人员应提高老年人的MHL水平，从而有利于老年人心理健康问题的预防和控制。
{"title":"Low mental health literacy and its association with depression, anxiety and poor sleep quality in Chinese elderly","authors":"Kai-Rong Ding MSc, Shi-Bin Wang PhD, Wen-Qi Xu MSc, Li-Hua Lin MSc, Dan-Dan Liao MSc, Hong-Bei Chen MSc, Wen-Yan Tan MSc, Jia-Hao Huang MSc, Cai-Lan Hou PhD, Fu-Jun Jia PhD","doi":"10.1111/appy.12520","DOIUrl":"10.1111/appy.12520","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mental health literacy (MHL) is rarely reported in the Chinese elderly. This study explored the pattern of MHL in the Chinese elderly in relation to depression, anxiety and poor sleep quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted among older adults in Guangzhou, south China. Participants were investigated face-to-face using the Chinese National Mental Health Literacy Scale, the Patient Health Questionnaire-9 item (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7) and the Pittsburgh Sleep Quality Index (PSQI). Mental Health Literacy Scale contains three dimensions: mental health knowledge, mental health skills (such as social support, cognitive reappraisal and attentional distraction) and mental health awareness. Multivariate logistic regression was used for examining the association between MHL and mental health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 506 older adults were recruited. The percentage of depression, anxiety, and poor sleep quality were 16.6%, 7.9% and 40.9%, respectively. MHL dimensions independently associated with depression included cognitive reappraisal (OR = 1.95, <i>p</i> < .001), attentional distraction (OR = 0.61, <i>p</i> = 0.044) and awareness (OR = 0.56, <i>p</i> = 0.027). MHL dimensions independently associated with anxiety symptoms included cognitive reappraisal (OR = 1.90, <i>p</i> = 0.011) and attentional distraction (OR = 0.44, <i>p</i> = 0.016). MHL dimensions independently associated with poor sleep quality included social support (OR = 0.75, <i>p</i> = 0.022), cognitive reappraisal (OR = 1.55, <i>p</i> = 0.003) and attentional distraction (OR = 0.65, <i>p</i> = 0.016).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Given the low MHL and its association with poor mental health in the Chinese elderly, policymakers and health professionals should improve the older adults' MHL, which could be conducive to the prevention and control of their mental health problems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"14 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2022-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33514672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ted Kheng Siang Ng, Lei Feng, Ru Yuan Chua, Lee Gan Goh, Ee Heok Kua, Rathi Mahendran
Introduction
There is a scarcity of naturalistic follow-up studies on cognitive stimulating activities (CSAs), particularly in a real-world setting and over long-term. We thus investigated a pooled novel CSA intervention to prevent cognitive decline amongst community-dwelling older adults without dementia.
Methods
Nested within a community-based longitudinal follow-up cohort study of community-dwelling and multi-ethnic older adults (N = 991), a subset of the cohort (n = 264) underwent four single-blinded randomized controlled trials involving four novel CSAs, including mindfulness, horticulture, art therapy, and choral singing. At the cohort's 5-year follow-up, we examined if involvements in the CSAs improved cognition, compared to controls (n = 727). The primary outcomes were changes in global cognition and specific cognitive domain scores measured by the mini-mental state examination (MMSE). Exploratory subgroup analyses stratified by baseline cognitive status and the number of CSAs were also conducted.
Results
Compared to the control group, there was a small improvement in the CSA group on the total MMSE score (d = 0.108) and MMSE-immediate recall score (d = 0.199). Furthermore, subgroup analyses revealed medium effect sizes of improvements (d = 0.420) in cognitive domains in mild cognitive impairment (MCI) (vs. cognitively healthy) and those involved in two CSAs (vs. one CSA).
Discussion
In summary, a CSA intervention improved cognition. MCI and those involved in two CSAs gained greater benefits from the CSAs. These sustained improvements in cognitive functions could have a significant impact on delaying or preventing dementia.
{"title":"A 5-year community program in Singapore to prevent cognitive decline","authors":"Ted Kheng Siang Ng, Lei Feng, Ru Yuan Chua, Lee Gan Goh, Ee Heok Kua, Rathi Mahendran","doi":"10.1111/appy.12518","DOIUrl":"10.1111/appy.12518","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>There is a scarcity of naturalistic follow-up studies on cognitive stimulating activities (CSAs), particularly in a real-world setting and over long-term. We thus investigated a pooled novel CSA intervention to prevent cognitive decline amongst community-dwelling older adults without dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nested within a community-based longitudinal follow-up cohort study of community-dwelling and multi-ethnic older adults (<i>N</i> = 991), a subset of the cohort (<i>n</i> = 264) underwent four single-blinded randomized controlled trials involving four novel CSAs, including mindfulness, horticulture, art therapy, and choral singing. At the cohort's 5-year follow-up, we examined if involvements in the CSAs improved cognition, compared to controls (<i>n</i> = 727). The primary outcomes were changes in global cognition and specific cognitive domain scores measured by the mini-mental state examination (MMSE). Exploratory subgroup analyses stratified by baseline cognitive status and the number of CSAs were also conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to the control group, there was a small improvement in the CSA group on the total MMSE score (<i>d</i> = 0.108) and MMSE-immediate recall score (<i>d</i> = 0.199). Furthermore, subgroup analyses revealed medium effect sizes of improvements (<i>d</i> = 0.420) in cognitive domains in mild cognitive impairment (MCI) (vs. cognitively healthy) and those involved in two CSAs (vs. one CSA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>In summary, a CSA intervention improved cognition. MCI and those involved in two CSAs gained greater benefits from the CSAs. These sustained improvements in cognitive functions could have a significant impact on delaying or preventing dementia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"14 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40580490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Women with mental illness experience unique challenges during their motherhood. However, little is known about their own perceptions and unmet needs in the process of childbearing. A qualitative study design with a social constructivist paradigm was used to explore lived experiences of mothers with severe mental illness (SMI) during the childbearing period.
Methods
Semi-structured in-depth interviews were conducted with 30 mothers recruited through purposive sampling. This was followed by inductive thematic analysis. Rigor was established through triangulation and respondent validation. This paper focuses on the perceptions during the pre-conception and pregnancy period.
Results
Emergent categories (themes) were thoughts/feelings about childbearing (ambivalence about being a mother/having a baby, fantasies about childbearing/rearing, guilt about pregnancy), the impact of mental illness (stigma, effect of symptoms on their self-care including healthcare, concerns about effect of medications on fetus), unmet needs (lack of emotional support, unanswered doubts about effects of illness on pregnancy, child and motherhood, wanting to be considered as “potential mothers”), and caregivers' reactions (discrimination, anger/abuse, selective support). The centrality of motherhood and balancing the “dual role” of a patient and mother were the overarching categories after analysis.
Conclusion
Mothers with SMI prize motherhood but navigate through it with various adverse experiences. The results of this study, grounded in their voices, provide critical insights for service and policy provisions in perinatal psychiatry.
{"title":"“It seemed like my fault for wanting to become a mother …”—Experiences and perceptions related to motherhood in women with severe mental illness","authors":"Debanjan Banerjee MD, DM, Rashmi Arasappa MD, Prabha S. Chandra MD, FRCPsych, Geetha Desai MD, DNB, PhD","doi":"10.1111/appy.12519","DOIUrl":"10.1111/appy.12519","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Women with mental illness experience unique challenges during their motherhood. However, little is known about their own perceptions and unmet needs in the process of childbearing. A qualitative study design with a social constructivist paradigm was used to explore lived experiences of mothers with severe mental illness (SMI) during the childbearing period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured in-depth interviews were conducted with 30 mothers recruited through purposive sampling. This was followed by inductive thematic analysis. Rigor was established through triangulation and respondent validation. This paper focuses on the perceptions during the pre-conception and pregnancy period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Emergent categories (themes) were thoughts/feelings about childbearing (ambivalence about being a mother/having a baby, fantasies about childbearing/rearing, guilt about pregnancy), the impact of mental illness (stigma, effect of symptoms on their self-care including healthcare, concerns about effect of medications on fetus), unmet needs (lack of emotional support, unanswered doubts about effects of illness on pregnancy, child and motherhood, wanting to be considered as “potential mothers”), and caregivers' reactions (discrimination, anger/abuse, selective support). The centrality of motherhood and balancing the “dual role” of a patient and mother were the overarching categories after analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Mothers with SMI prize motherhood but navigate through it with various adverse experiences. The results of this study, grounded in their voices, provide critical insights for service and policy provisions in perinatal psychiatry.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"14 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2022-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40569246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mental illness and substance use disorders have been increasing worldwide. Mental illness has a significant impact upon the lives of the individual as well as their loved ones. Mental disorders are known to result in a high level of disability. This article provides a comparative review of the epidemiology of mental disorders in Australia and India, summarizing and comparing prevalence rates in both countries based upon available data. Overall, it is evident that Australia has higher prevalence rates of mental disorders than India, across most diagnostic groups. Australia has the highest prevalence of anxiety disorders whereas India has the highest prevalence of substance use disorders; including tobacco use disorders. The next most prevalent mental disorders in India are depressive disorders. However, there are demographic parameters such as gender and age as well as service-provision differences across the countries that need to be factored into any interpretation of the data. There are also problems associated with different diagnostic instruments with language and cultural nuances that may impact comparisons. We suggest that a joint epidemiological survey between the two countries would help better understand and delineate the key similarities pertaining to the epidemiology of mental disorders in Australia and India. This will in turn assist with the development of policy and treatment of mental disorders.
{"title":"A comparative review of the epidemiology of mental disorders in Australia and India","authors":"Nagesh Pai, Shae-Leigh Vella, David Castle","doi":"10.1111/appy.12517","DOIUrl":"10.1111/appy.12517","url":null,"abstract":"<p>Mental illness and substance use disorders have been increasing worldwide. Mental illness has a significant impact upon the lives of the individual as well as their loved ones. Mental disorders are known to result in a high level of disability. This article provides a comparative review of the epidemiology of mental disorders in Australia and India, summarizing and comparing prevalence rates in both countries based upon available data. Overall, it is evident that Australia has higher prevalence rates of mental disorders than India, across most diagnostic groups. Australia has the highest prevalence of anxiety disorders whereas India has the highest prevalence of substance use disorders; including tobacco use disorders. The next most prevalent mental disorders in India are depressive disorders. However, there are demographic parameters such as gender and age as well as service-provision differences across the countries that need to be factored into any interpretation of the data. There are also problems associated with different diagnostic instruments with language and cultural nuances that may impact comparisons. We suggest that a joint epidemiological survey between the two countries would help better understand and delineate the key similarities pertaining to the epidemiology of mental disorders in Australia and India. This will in turn assist with the development of policy and treatment of mental disorders.</p>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"14 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2022-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82105674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
RanPiao Gan MD, YuanQiao Zhao MD, GuiSen Wu MD, JiaHui Zeng MD, YeGang Hu PhD, LiHua Xu MD, PhD, YanYan Wei PhD, XiaoChen Tang PhD, XiaoHua Liu MD, PhD, HaiChun Liu PhD, Tao Chen PhD, JiJun Wang MD, PhD, TianHong Zhang MD, PhD
Introduction
Impaired sensitivity of the skin flush response to niacin is found in approximately 30% of patients with schizophrenia. Although the niacin response abnormality (NRA) may serve as a useful endophenotype for schizophrenia, few studies have directly replicated NRA in patients with first-episode psychosis (FEP).
Methods
In total, 204 patients with FEP, 16 with psychotic mood disorder (PMD), and 68 healthy controls (HC) were included. The log10(EC50) values represent the concentration of methyl nicotinate required to elicit a half-maximal blood flow (MBF) response, and the MBF value was calculated. The NRA was defined as having log10(EC50) molar value above the 90% and an MBF value below the 60% of those in the HC group.
Results
In total, 13.7% of the FEP, 12.5% of the PMD, and 7.4% of the HC group met the definition of NRA. Significant differences were found in the log10(EC50) values between the FEP and HC groups (p = .014) and in the MBF between the FEP and PMD groups (p = .011). Patients with FEP and NRA had more severe negative symptoms than those with a normal niacin response.
Discussion
These data represent the NRA in patients with FEP, defining a small subgroup of patients with early-phase psychosis possessing a clinically significant phospholipid-signaling defect.
{"title":"Replication of the abnormal niacin response in first episode psychosis measured using laser Doppler flowmeter","authors":"RanPiao Gan MD, YuanQiao Zhao MD, GuiSen Wu MD, JiaHui Zeng MD, YeGang Hu PhD, LiHua Xu MD, PhD, YanYan Wei PhD, XiaoChen Tang PhD, XiaoHua Liu MD, PhD, HaiChun Liu PhD, Tao Chen PhD, JiJun Wang MD, PhD, TianHong Zhang MD, PhD","doi":"10.1111/appy.12516","DOIUrl":"10.1111/appy.12516","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Impaired sensitivity of the skin flush response to niacin is found in approximately 30% of patients with schizophrenia. Although the niacin response abnormality (NRA) may serve as a useful endophenotype for schizophrenia, few studies have directly replicated NRA in patients with first-episode psychosis (FEP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In total, 204 patients with FEP, 16 with psychotic mood disorder (PMD), and 68 healthy controls (HC) were included. The log<sub>10</sub>(EC<sub>50</sub>) values represent the concentration of methyl nicotinate required to elicit a half-maximal blood flow (MBF) response, and the MBF value was calculated. The NRA was defined as having log<sub>10</sub>(EC<sub>50</sub>) molar value above the 90% and an MBF value below the 60% of those in the HC group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 13.7% of the FEP, 12.5% of the PMD, and 7.4% of the HC group met the definition of NRA. Significant differences were found in the log<sub>10</sub>(EC<sub>50</sub>) values between the FEP and HC groups (<i>p</i> = .014) and in the MBF between the FEP and PMD groups (<i>p</i> = .011). Patients with FEP and NRA had more severe negative symptoms than those with a normal niacin response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>These data represent the NRA in patients with FEP, defining a small subgroup of patients with early-phase psychosis possessing a clinically significant phospholipid-signaling defect.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"14 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2022-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79407410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We review the history of Morita therapy (MT), which has existed for over 100 years, and examine what has changed over that period and what has not. Classic MT, which was dependent on a highly strict therapeutic approach, gradually lost its pre-eminence, but at the same time, the fundamental theory of MT was refined. This theory came to be applied to current outpatient MT and adapted to inpatient MT. As MT was refined, a standard training system for therapists was established, adaptations to modern conditions were made and expanded, and comparisons to and dialogs with other psychotherapeutic concepts such as mindfulness became possible. To better evaluate MT, further work should be conducted on its effectiveness of from a clinical epidemiological perspective.
{"title":"A century of Morita therapy: What has and has not changed","authors":"Mitsuhiro Nakamura MD, MPH, Hidehito Niimura MD, PhD, Kenji Kitanishi MD, PhD","doi":"10.1111/appy.12511","DOIUrl":"10.1111/appy.12511","url":null,"abstract":"<p>We review the history of Morita therapy (MT), which has existed for over 100 years, and examine what has changed over that period and what has not. Classic MT, which was dependent on a highly strict therapeutic approach, gradually lost its pre-eminence, but at the same time, the fundamental theory of MT was refined. This theory came to be applied to current outpatient MT and adapted to inpatient MT. As MT was refined, a standard training system for therapists was established, adaptations to modern conditions were made and expanded, and comparisons to and dialogs with other psychotherapeutic concepts such as mindfulness became possible. To better evaluate MT, further work should be conducted on its effectiveness of from a clinical epidemiological perspective.</p>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"15 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2022-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/appy.12511","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9319541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Martine Stecher Nielsen and colleagues' article ( 2021) in the Asia Pacific Psychiatry, which is the official journal of the Pacific Rim College of Psychiatrists and the Asian Federation of Psychiatric Associations, compared the status of child and adolescent psychiatry training programs and the workforce in child and adolescent mental health services in three geographical regions, namely South East Europe, the Middle East, and the Far East, to identify similar problems, highlight success stories, and to make recommendations for future regional studies. The study (Stecher-Nielsen et al., 2021) used data from the World Psychiatric Association, Child and Adolescent Psychiatry Section's regional projects including data from 44 countries. The study (Stecher-Nielsen et al., 2021) is extremely important, because it shows there is an urgent need for more qualified child and adolescent psychiatrists and allied professionals in a very large group of countries in South East Europe, the Middle East, and the Far East, with great differences in religion, culture, and economy. The aforementioned lack of qualified child and adolescent psychiatrists and allied professionals may result in various problems, which, in turn can lead to delayed identification, diagnosis, and treatment of child and adolescent mental disorders that can have lifelong consequences, due to the temporally regulated modifications brain undergoes during this neurodevelopmental period (Kieling et al., 2011). This (Skokauskas et al., 2019) is in line with the United Nations' Sustainable Development Goals (United Nations, 2015), adopted in 2015, which contributed to the greater recognition of both the current global mental health epidemic, and the urgent need for countries to allocate more resources. Martine Stecher Nielsen and colleagues (2021) in their article suggested, among other things that the future increase of the child and adolescent mental health workforce size, would inevitably mandate the implementation of other strategies such as advocating for child and adolescent psychiatry or child and adolescent mental health as a focus for both undergraduate and postgraduate trainees to ensure the long term expansion of training positions. This is very salient observation considering recent advances in genetics of childhood neurodevelopmental disorders, such as attention deficit hyperactivity disorder, autism spectrum disorder and intellectual disability (Parenti et al., 2020). Specifically, rare variants frequently affect protein function directly, providing a promising chance to discover the molecular mechanisms of neurodevelopmental disorders, such as autism spectrum disorder (Sanders et al., 2019). Various functional studies, using disease models such as induced pluripotent stem cells and genome-edited animals, with deleterious rare variants have been done to clarify the mechanism of pathogenesis and facilitate novel drug discovery. The aforementioned is conceptually in line with the Rese
{"title":"An international medical education perspective on training in child and adolescent psychiatry","authors":"Branko Aleksic MD, PhD, Hideki Kasuya MD, PhD","doi":"10.1111/appy.12509","DOIUrl":"10.1111/appy.12509","url":null,"abstract":"Martine Stecher Nielsen and colleagues' article ( 2021) in the Asia Pacific Psychiatry, which is the official journal of the Pacific Rim College of Psychiatrists and the Asian Federation of Psychiatric Associations, compared the status of child and adolescent psychiatry training programs and the workforce in child and adolescent mental health services in three geographical regions, namely South East Europe, the Middle East, and the Far East, to identify similar problems, highlight success stories, and to make recommendations for future regional studies. The study (Stecher-Nielsen et al., 2021) used data from the World Psychiatric Association, Child and Adolescent Psychiatry Section's regional projects including data from 44 countries. The study (Stecher-Nielsen et al., 2021) is extremely important, because it shows there is an urgent need for more qualified child and adolescent psychiatrists and allied professionals in a very large group of countries in South East Europe, the Middle East, and the Far East, with great differences in religion, culture, and economy. The aforementioned lack of qualified child and adolescent psychiatrists and allied professionals may result in various problems, which, in turn can lead to delayed identification, diagnosis, and treatment of child and adolescent mental disorders that can have lifelong consequences, due to the temporally regulated modifications brain undergoes during this neurodevelopmental period (Kieling et al., 2011). This (Skokauskas et al., 2019) is in line with the United Nations' Sustainable Development Goals (United Nations, 2015), adopted in 2015, which contributed to the greater recognition of both the current global mental health epidemic, and the urgent need for countries to allocate more resources. Martine Stecher Nielsen and colleagues (2021) in their article suggested, among other things that the future increase of the child and adolescent mental health workforce size, would inevitably mandate the implementation of other strategies such as advocating for child and adolescent psychiatry or child and adolescent mental health as a focus for both undergraduate and postgraduate trainees to ensure the long term expansion of training positions. This is very salient observation considering recent advances in genetics of childhood neurodevelopmental disorders, such as attention deficit hyperactivity disorder, autism spectrum disorder and intellectual disability (Parenti et al., 2020). Specifically, rare variants frequently affect protein function directly, providing a promising chance to discover the molecular mechanisms of neurodevelopmental disorders, such as autism spectrum disorder (Sanders et al., 2019). Various functional studies, using disease models such as induced pluripotent stem cells and genome-edited animals, with deleterious rare variants have been done to clarify the mechanism of pathogenesis and facilitate novel drug discovery. The aforementioned is conceptually in line with the Rese","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"14 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2022-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39637847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>I write this commentary from Australia in the Asia-Pacific region. The work of the World Psychiatric Association (WPA) Consortium of Academic Child and Adolescent Psychiatrists (CAP) in undertaking such international comparison is immense. Collaboration allows us to learn from each other and find better ways of doing things. International comparison also supports CAP advocacy allowing benchmarking against comparable countries. An effective approach in Australia where CAP numbers are less than comparable European countries (RANZCP, <span>2019</span>).</p><p>In this study the CAP profession almost universally reports a large ‘treatment gap’ between available CAP resources and community need, even in wealthy countries. Not surprisingly it shows wealthier countries have more CAP resources than less wealthy countries; not just number of CAP but also access to a CAP training program, national training guidelines, a broader range of training rotations and guidance from a National Child and Adolescent Mental Health Policy. But the connection between a countries wealth and CAP resources is far from universal. Collaborative approaches examining this variation will help us understand the enablers and barriers to greater CAP resources in all countries.</p><p>The study asks CAP about the perceived need for more CAP and CAMH professionals. Almost universally such a need is reported. Understandably it focuses on CAP. However, CAP do not work in isolation and what care they provide is determined by the system of care in which they work and how tasks are allocated between the various professions; both within specialist CAMH services (if available) and between primary and specialist care. The relative cost of training and employing various professionals is relevant with CAP being expensive to train and employ. A future challenge is looking at a broader multidisciplinary comparison of the CAMH workforce and the system of care they work in.</p><p>Modern CAMH place CAP in a role of clinical leadership, delivering direct and indirect consultation to other professionals, and oversight of care delivery by others. Defining the professional capabilities of the modern CAP guides what CAP training should include in curriculum and workplace training experiences provided.</p><p>The study asks about professional structures supporting CAP including the presence of a National Society, CAP Journal and availability of University CAP Academic Departments. It explores if CAP is a recognized specialty or subspecialty and the interface with general psychiatry. Such structures support the CAP profession, however distilling which and how such professional structures enable the profession requires further exploration. International collaboration is required to better understand what works best. The study demonstrates general psychiatrists deliver a lot of CAP care even in the presence of a CAP workforce. Clearly their training in CAP is important. In Australia debate exists on the bal
一群澳大利亚海外出生的CAP聚集在一起，为斯里兰卡(Rathnayaka等人，2016)和印度(www.pathwaysfoundationkovai.org)的项目开发和交付提供相互支持和帮助。在这种多元文化的劳动力中，在国际上支持CAP的潜力巨大。亚太地区正在采用更广泛的“国内”方式来开展共同农业计划的区域参与。澳大利亚和新西兰皇家精神病学院(RANZCP)，儿童和青少年精神病学学院(FCAP)与太平洋岛国合作开发了一种方法，使用ANZ CAP志愿者支持培训和劳动力发展(Kowalenko等，2020;Robertson, Hagali等，2019;Robertson, Paul等人，2019)。这样的努力也发生在其他地方。澳新银行对志愿者服务感兴趣，这代表了一个重要的志愿者队伍，以支持CAMH的区域发展。如何最好地组织和部署这样的志愿者队伍目前正在通过试点志愿者计划进行探索。“在国内”培训对接受者、志愿者和支持这种努力的组织有其风险，特别是在资源不平等、结构性种族主义以及殖民主义和文化剥夺对土著人民的持续影响等情况下。在与国际CAP同事发展关系时，我们需要深思熟虑，确保相互尊重、相互影响和相互学习;同时认识到资源的巨大差距。自2020年以来，COVID大流行带来了严重限制国际旅行的变化。海外学员在澳大利亚的培训机会更加有限，澳新银行提供“国内”项目的旅行已经停止。然而，大流行已使远程保健(视频会议)成为主流。远程保健促进国际参与的潜力是巨大的，尽管它的全部益处和局限性还有待发掘。2020年，斐济国立大学(FNU)、圣文森特精神卫生中心和斐济精神卫生中心(FCAP)建立了伙伴关系，重点通过远程医疗提供为期12周的CAMH午餐时间专业发展课程(OPHELIA培训:在线太平洋卫生交流;Chang et al. 2022)。两年一次的FCAP Pasifika研究小组(PSG) (Robertson, Hagali等，2019)于2021年9月首次在线举行。然而，远程保健依赖于充足的基础设施，有可能进一步扩大差距。不管怎样，远程医疗将改变我们未来的工作。最后，让我谈谈太平洋地区的共同农业政策。它不是WPA-CAP研究的一部分，但可能在未来。太平洋地区的共同农业政策与本研究的三个地区既有相似之处，也有显著差异。拥有900万人口的巴布亚新几内亚(PNG)有一名CAP和大约10名普通精神病医生。巴布亚新几内亚大学提供专科普通精神病学培训，包括为所罗门群岛和东帝汶等邻国提供培训。SI有两个普通精神病医生。在讲英语的西太平洋岛国斐济、瓦努阿图、萨摩亚、汤加、纽埃、基里巴斯和其他国家，斐济有一个单一的CAP，以及一系列在CAMH方面接受过一些培训的普通精神病医生和心理健康医生。FNU有望很快提供精神病学培训。另一方面，现代澳大利亚和新西兰都是英国殖民主义的产物，拥有重要的土著文化遗产，是富裕的国家，拥有完善的卫生系统，包括CAMH服务。CAP的培训遵循与英国和北美类似的传统。太平洋地区有一些国家对澳新货币政策不太熟悉，包括新喀里多尼亚和塔希提讲法语的岛屿领土，它们为澳新货币政策提供了充足的资源，并且与法国有关;菲律宾和夏威夷也在太平洋上。我们可以看到，西太平洋岛屿国家、巴布亚新几内亚和西太平洋岛国在CAP或CAMH方面资源不足，严重依赖初级保健。太平洋呈现出独特的差异，太平洋岛国是幅员辽阔的海洋中人口少(200万)的小陆地。PNG和SI地形崎岖，道路基础设施有限。旅行既昂贵又富有挑战性。远程保健正在发展并具有巨大潜力，但存在重大的基础设施挑战。太平洋也是世界上热带风暴和海啸频发的自然灾害多发地区之一，也是气候灾害的重灾区。扩大国际合作将使太平洋地区的儿童和青少年及其家庭受益。
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