Ching-Hua Lin MD, PhD, Hung-Yu Chan MD, PhD, Hsin-Yi Lin MD, Cheng-Chung Chen MD, PhD
Introduction
The management of pediatric bipolar disorder (PBD) requires pharmacotherapy to control acute symptoms, reduce relapse, prevent suicide, and improve psychosocial functioning. The purpose of this study was to investigate prescribing patterns among PBD patients discharged from two public mental hospitals in Taiwan, from 2006 to 2019.
Methods
PBD patients discharged from the two study hospitals, from 1 January 2006 to 31 December 2019 (n = 420), were included in the analysis. Prescribed drugs at discharge, including mood stabilizers (i.e., lithium, valproate, carbamazepine, and lamotrigine), antipsychotics (i.e., second- and first-generation antipsychotics, SGAs and FGAs), and antidepressants, were explored. Complex polypharmacy was defined as the use of 3 or more agents among the prescribed drugs. Time trends of each prescribing pattern were analyzed using the Cochran-Armitage Trend test.
Results
The most commonly prescribed psychotropic agents were SGAs (76.0%), followed by valproate (65.7%) and FGAs (24.8%). The prescription rates of SGAs, antidepressants, antidepressant plus antipsychotic, and antidepressant without mood stabilizer significantly increased over time, whereas the prescription rates of mood stabilizers, lithium, and FGAs significantly decreased.
Discussions
Prescribing patterns changed greatly for PBD patients over time. However, much more evidence supporting the effectiveness of psychotropic agents in PBD patients is required.
{"title":"Fourteen-year trends in the prescribing patterns of pediatric bipolar patients discharged from two public mental hospitals in Taiwan","authors":"Ching-Hua Lin MD, PhD, Hung-Yu Chan MD, PhD, Hsin-Yi Lin MD, Cheng-Chung Chen MD, PhD","doi":"10.1111/appy.12525","DOIUrl":"10.1111/appy.12525","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The management of pediatric bipolar disorder (PBD) requires pharmacotherapy to control acute symptoms, reduce relapse, prevent suicide, and improve psychosocial functioning. The purpose of this study was to investigate prescribing patterns among PBD patients discharged from two public mental hospitals in Taiwan, from 2006 to 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PBD patients discharged from the two study hospitals, from 1 January 2006 to 31 December 2019 (<i>n</i> = 420), were included in the analysis. Prescribed drugs at discharge, including mood stabilizers (i.e., lithium, valproate, carbamazepine, and lamotrigine), antipsychotics (i.e., second- and first-generation antipsychotics, SGAs and FGAs), and antidepressants, were explored. Complex polypharmacy was defined as the use of 3 or more agents among the prescribed drugs. Time trends of each prescribing pattern were analyzed using the Cochran-Armitage Trend test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The most commonly prescribed psychotropic agents were SGAs (76.0%), followed by valproate (65.7%) and FGAs (24.8%). The prescription rates of SGAs, <i>antidepressants,</i> antidepressant plus antipsychotic, and antidepressant without mood stabilizer <i>significantly increased over time,</i> whereas the prescription rates of mood stabilizers, lithium, and FGAs significantly decreased.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussions</h3>\u0000 \u0000 <p>Prescribing patterns changed greatly for PBD patients over time. However, much more evidence supporting the effectiveness of psychotropic agents in PBD patients is required.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"15 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10667538","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}
Wen Yi Huan MBBS, Wan Asyikin Wan Azlan MB BCh BAO, Dr. Psych, Yee Tieng Lee MBBS, MMed (Psych)
Cotard's syndrome is a rare neuropsychiatric disorder characterized by marked nihilistic delusions. This report describes an Indonesian woman from a small town in Malaysia who was diagnosed with depression and Cotard's delusion. The diagnosis was confirmed after thorough history-taking, clinical examination, and relevant laboratory tests. Herein, we highlight the unique psychopathology of a possible Cotard's syndrome subtype and efficacy of pharmacological combination strategies, rather than monotherapy and electroconvulsive therapy, for its treatment.
{"title":"Cotard delusion in a depressed patient: “My throat is missing!”","authors":"Wen Yi Huan MBBS, Wan Asyikin Wan Azlan MB BCh BAO, Dr. Psych, Yee Tieng Lee MBBS, MMed (Psych)","doi":"10.1111/appy.12524","DOIUrl":"10.1111/appy.12524","url":null,"abstract":"<p>Cotard's syndrome is a rare neuropsychiatric disorder characterized by marked nihilistic delusions. This report describes an Indonesian woman from a small town in Malaysia who was diagnosed with depression and Cotard's delusion. The diagnosis was confirmed after thorough history-taking, clinical examination, and relevant laboratory tests. Herein, we highlight the unique psychopathology of a possible Cotard's syndrome subtype and efficacy of pharmacological combination strategies, rather than monotherapy and electroconvulsive therapy, for its treatment.</p>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"15 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10664674","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}
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}
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