Shuang Zhao BM, Longfei Ren MS, Qiong Wang MS, Meijun Long BA, Hui Wu PhD, Yang Wang PhD
Introduction
Parents who have lost their only child and over the age of 60 are known as elderly shidu parents. This study aimed to investigate predictors of prolonged grief disorder (PGD) among Chinese elderly shidu parents.
Methods
Two hundred and ninety-eight elderly shidu parents from Shenyang were included in this cross-sectional study. Participants completed a questionnaire including the Prolonged Grief questionnaire-13 (PG-13), the PTSD (post-traumatic stress disorder) Checklist for DSM-5 (PCL-5), the Center for Epidemiologic Studies Depression Scales (CES-D), the Self-Rating Anxiety Scale (SAS), and the Perceived Stress Scale-10 (PSS-10). Multiple linear regression was used to examine socio-demographic, bereavement-related and perceived stress associated with PGD symptoms.
Results
The prevalence of PGD among Chinese elderly shidu parents was 13.8%. Among the 41 PGD patients, 29, 39, 36 patients had comorbidity of PTSD, depressive symptoms and anxiety, respectively. Perceived stress, higher educational level, lower annual household income, perceived stigma, violent death of the child, and being in debt were associated with severer PGD symptoms.
Discussion
The present study revealed the prevalence of PGD and the important role of PGD in diagnosing other mental disorders in Chinese elderly shidu parents. Providing financial help, eliminating social stigma, and stress should be included in PGD prevention among Chinese elderly shidu parents.
{"title":"Predictors of prolonged grief disorder in Chinese elderly shidu parents: The role of perceived stigma and perceived stress","authors":"Shuang Zhao BM, Longfei Ren MS, Qiong Wang MS, Meijun Long BA, Hui Wu PhD, Yang Wang PhD","doi":"10.1111/appy.12489","DOIUrl":"10.1111/appy.12489","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Parents who have lost their only child and over the age of 60 are known as elderly shidu parents. This study aimed to investigate predictors of prolonged grief disorder (PGD) among Chinese elderly shidu parents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two hundred and ninety-eight elderly shidu parents from Shenyang were included in this cross-sectional study. Participants completed a questionnaire including the Prolonged Grief questionnaire-13 (PG-13), the PTSD (post-traumatic stress disorder) Checklist for DSM-5 (PCL-5), the Center for Epidemiologic Studies Depression Scales (CES-D), the Self-Rating Anxiety Scale (SAS), and the Perceived Stress Scale-10 (PSS-10). Multiple linear regression was used to examine socio-demographic, bereavement-related and perceived stress associated with PGD symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of PGD among Chinese elderly shidu parents was 13.8%. Among the 41 PGD patients, 29, 39, 36 patients had comorbidity of PTSD, depressive symptoms and anxiety, respectively. Perceived stress, higher educational level, lower annual household income, perceived stigma, violent death of the child, and being in debt were associated with severer PGD symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The present study revealed the prevalence of PGD and the important role of PGD in diagnosing other mental disorders in Chinese elderly shidu parents. Providing financial help, eliminating social stigma, and stress should be included in PGD prevention among Chinese elderly shidu parents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"14 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39495915","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}
After extensive research, this study explored whether high-dose prescriptions and polypharmacy remain more frequent in Japan than elsewhere. If confirmed, we aimed to identify the factors that contributed to this unique trend.
Methods
The psychotropic drug prescription patterns for patients with schizophrenia in Japan were reviewed. This was based on a large sample collected from surveys of the Research on Asian Psychotropic Prescription Patterns, an international collaborative research project conducted by Asian psychiatrists to monitor prescriptions of psychotropic drugs for people with mental disorders, in 2001, 2004, 2008, and 2016.
Results
The 2016 Research on Asian Psychotropic Prescription Patterns survey revealed that Japan continued to demonstrate the highest rate of polypharmacy and the highest dosages of psychotropic prescription drugs for patients with schizophrenia among the 15 countries and areas that participated in the survey.
Discussion
The Research on Asian Psychotropic Prescription Patterns surveys demonstrated that science plays a limited role in the decision-making process for prescriptions of psychotropic medications. Such prescriptions are influenced by a wide range of factors, such as the national mental health policy, prescription-financing systems, the history of psychiatry in each country, and the prevailing culture. Hospital-based national mental health policies and mental health financing systems have been the primary obstacles to reducing polypharmacy in Japan.
{"title":"Analysis of the trends of polypharmacy and high-dose prescriptions in Japan","authors":"Naotaka Shinfuku M.D. Ph.D.","doi":"10.1111/appy.12488","DOIUrl":"10.1111/appy.12488","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>After extensive research, this study explored whether high-dose prescriptions and polypharmacy remain more frequent in Japan than elsewhere. If confirmed, we aimed to identify the factors that contributed to this unique trend.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The psychotropic drug prescription patterns for patients with schizophrenia in Japan were reviewed. This was based on a large sample collected from surveys of the Research on Asian Psychotropic Prescription Patterns, an international collaborative research project conducted by Asian psychiatrists to monitor prescriptions of psychotropic drugs for people with mental disorders, in 2001, 2004, 2008, and 2016.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 2016 Research on Asian Psychotropic Prescription Patterns survey revealed that Japan continued to demonstrate the highest rate of polypharmacy and the highest dosages of psychotropic prescription drugs for patients with schizophrenia among the 15 countries and areas that participated in the survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The Research on Asian Psychotropic Prescription Patterns surveys demonstrated that science plays a limited role in the decision-making process for prescriptions of psychotropic medications. Such prescriptions are influenced by a wide range of factors, such as the national mental health policy, prescription-financing systems, the history of psychiatry in each country, and the prevailing culture. Hospital-based national mental health policies and mental health financing systems have been the primary obstacles to reducing polypharmacy in Japan.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"14 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2021-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/appy.12488","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39414346","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}
Wen-Hao Chen MD, Ming H. Hsieh MD, PhD, Shih-Cheng Liao MD, PhD, Chen-Chung Liu MD, PhD, Chih-Min Liu MD, PhD, Chi-Shin Wu MD, PhD, Yi-Ting Lin MD, Tzung-Jeng Hwang MD, PhD, Yi-Ling Chien MD, PhD
Introduction
Previous studies demonstrated a trend of increasing common mental disorders among the Emergency Department (ED) visitors in Western countries. Little is known about the current conditions of the emergency psychiatric services in Asian countries. This study aims to survey the current epidemiology and the changing ecology of emergency psychiatry services in Taiwan.
Methods
A total of 804 psychiatry consultations were initiated at the ED during the 1-year period from July 1, 2014 to June 30, 2015 in a medical center in northern Taiwan. Clinical data of gender, age, chief complaints, tentative diagnoses, dispositions, and ED staying hours were compared to a previous report in the same hospital in 1988.
Results
Psychiatry consultation was initiated in 0.72% of all ED visits (804/111,923). Among these visits, females were 1.73 times of the males. The most common chief complaints were psychosis/mania (33.5%) and suicide/self-harm (33.2%), followed by homicide/violence (12.8%) and anxiety/depression (10.3%). Top tentative diagnoses were schizophrenia spectrum and other psychotic disorders (31.3%), trauma- and stressor-related disorders (17.5%), bipolar disorders (15.9%), and depressive disorders (14.2%). Compared to 1988, there are three major changes: (1) over-representation of female patients, (2) an increase of “neurosis” patients, and (3) an increase of suicide/self-harm as chief problem.
Discussion
This study portrays the current epidemiology and changing ecology of psychiatric emergency in Taiwan. The increase of neurotic and suicide/self-harm patients requires more services and clinical training in managing common mental disorders and suicide in the ED.
{"title":"A quarter of century after: The changing ecology of psychiatric emergency services","authors":"Wen-Hao Chen MD, Ming H. Hsieh MD, PhD, Shih-Cheng Liao MD, PhD, Chen-Chung Liu MD, PhD, Chih-Min Liu MD, PhD, Chi-Shin Wu MD, PhD, Yi-Ting Lin MD, Tzung-Jeng Hwang MD, PhD, Yi-Ling Chien MD, PhD","doi":"10.1111/appy.12487","DOIUrl":"10.1111/appy.12487","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Previous studies demonstrated a trend of increasing common mental disorders among the Emergency Department (ED) visitors in Western countries. Little is known about the current conditions of the emergency psychiatric services in Asian countries. This study aims to survey the current epidemiology and the changing ecology of emergency psychiatry services in Taiwan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 804 psychiatry consultations were initiated at the ED during the 1-year period from July 1, 2014 to June 30, 2015 in a medical center in northern Taiwan. Clinical data of gender, age, chief complaints, tentative diagnoses, dispositions, and ED staying hours were compared to a previous report in the same hospital in 1988.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Psychiatry consultation was initiated in 0.72% of all ED visits (804/111,923). Among these visits, females were 1.73 times of the males. The most common chief complaints were psychosis/mania (33.5%) and suicide/self-harm (33.2%), followed by homicide/violence (12.8%) and anxiety/depression (10.3%). Top tentative diagnoses were schizophrenia spectrum and other psychotic disorders (31.3%), trauma- and stressor-related disorders (17.5%), bipolar disorders (15.9%), and depressive disorders (14.2%). Compared to 1988, there are three major changes: (1) over-representation of female patients, (2) an increase of “neurosis” patients, and (3) an increase of suicide/self-harm as chief problem.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This study portrays the current epidemiology and changing ecology of psychiatric emergency in Taiwan. The increase of neurotic and suicide/self-harm patients requires more services and clinical training in managing common mental disorders and suicide in the ED.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"14 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2021-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/appy.12487","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39407503","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}
Jerry Jay Yeo MBBS Candidate, Qian Hui Chew B.Soc.Sci (Hons), Kang Sim MBBS, MMed (Psychiatry), Grad Dip Psychotherapy (Distinction), MS-HPEd, FAMS
Background
Schizophrenia is a major psychiatric disorder which poses substantial illness burden on affected individuals. In view of the need to better understand the growing literature on resilience (adaptation in the face of adversity) and its clinical correlates to inform and optimize clinical management in schizophrenia, we sought to summarize the extant literature which examined the inter-relationships between resilience and demographic features, phenomenology, illness course, psychosocial functioning, and its mediational role among relevant factors.
Methods
A systematic review was conducted on published empirical studies examining the topic of resilience and clinical correlates within schizophrenia spectrum conditions up until December 2020.
Results
Higher level of resilience was associated with lower severity of specific symptomatology including positive, negative, depressive symptoms, suicidal ideation, cognitive deficits, and better insight. Moreover, higher resilience was significantly associated with different aspects of illness course (such as shorter duration of untreated psychosis, longer duration of illness, improved symptom remission and recovery), internal factors (such as lower stigma, better self-esteem), and psychosocial functioning (better overall, real-life, social and interpersonal functioning, better quality of life). Resilience also acts as a mediator in pathways leading to depression, functioning, and quality of life within schizophrenia spectrum conditions.
Discussion
Viewed within the context of various resiliency models (compensatory, challenge, protective factor models), suggestions were made to enhance resilience and balance risk versus protective factors in order to improve disease management. Future research should seek to better elucidate associated biomarkers, inter-relationships with carer resilience, and evaluate the efficacy of suitable resilience-targeted interventions in schizophrenia.
{"title":"Resilience and its inter-relationship with symptomatology, illness course, psychosocial functioning, and mediational roles in schizophrenia: A systematic review","authors":"Jerry Jay Yeo MBBS Candidate, Qian Hui Chew B.Soc.Sci (Hons), Kang Sim MBBS, MMed (Psychiatry), Grad Dip Psychotherapy (Distinction), MS-HPEd, FAMS","doi":"10.1111/appy.12486","DOIUrl":"10.1111/appy.12486","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Schizophrenia is a major psychiatric disorder which poses substantial illness burden on affected individuals. In view of the need to better understand the growing literature on resilience (adaptation in the face of adversity) and its clinical correlates to inform and optimize clinical management in schizophrenia, we sought to summarize the extant literature which examined the inter-relationships between resilience and demographic features, phenomenology, illness course, psychosocial functioning, and its mediational role among relevant factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was conducted on published empirical studies examining the topic of resilience and clinical correlates within schizophrenia spectrum conditions up until December 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher level of resilience was associated with lower severity of specific symptomatology including positive, negative, depressive symptoms, suicidal ideation, cognitive deficits, and better insight. Moreover, higher resilience was significantly associated with different aspects of illness course (such as shorter duration of untreated psychosis, longer duration of illness, improved symptom remission and recovery), internal factors (such as lower stigma, better self-esteem), and psychosocial functioning (better overall, real-life, social and interpersonal functioning, better quality of life). Resilience also acts as a mediator in pathways leading to depression, functioning, and quality of life within schizophrenia spectrum conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Viewed within the context of various resiliency models (compensatory, challenge, protective factor models), suggestions were made to enhance resilience and balance risk versus protective factors in order to improve disease management. Future research should seek to better elucidate associated biomarkers, inter-relationships with carer resilience, and evaluate the efficacy of suitable resilience-targeted interventions in schizophrenia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"14 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2021-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/appy.12486","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39342177","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}
Dhenni Hartopo MD, Royke Tony Kalalo MD, Sp.KJ(K), FISCM
A language disorder is a significant symptom of schizophrenia. A psychiatrist can find this disorder when interviews with a patient. Screening and diagnosis in patients with schizophrenia alone rely heavily on interviews conducted on patients and any instructions captured from patients both verbally and nonverbally. A psychiatrist can also analyze the language aspects in schizophrenia from a language level perspective ranging from phonetic to pragmatic. This analysis paves the way for the process of interference detection since the prodromal phase. Language disorder in schizophrenia is often associated with impaired thinking processes. However, with the development of science and technology today, there is an objective and quantitative method of computational analysis of language through the Natural Language Processing process with a semantic space model that allows a psychiatrist to learn aspects of the human language process, especially in semantic and pragmatic aspects. The review provides a groundbreaking proposal for biomarkers for schizophrenia that have not been available so far through the assessment of language disorders in patients with schizophrenia. Objective and accurate detection of language disorders in schizophrenia can be a modality for psychiatrists to screen, make diagnoses, determine prognosis, evaluate therapies, and monitor recurrence using existing technology media.
{"title":"Language disorder as a marker for schizophrenia","authors":"Dhenni Hartopo MD, Royke Tony Kalalo MD, Sp.KJ(K), FISCM","doi":"10.1111/appy.12485","DOIUrl":"10.1111/appy.12485","url":null,"abstract":"<p>A language disorder is a significant symptom of schizophrenia. A psychiatrist can find this disorder when interviews with a patient. Screening and diagnosis in patients with schizophrenia alone rely heavily on interviews conducted on patients and any instructions captured from patients both verbally and nonverbally. A psychiatrist can also analyze the language aspects in schizophrenia from a language level perspective ranging from phonetic to pragmatic. This analysis paves the way for the process of interference detection since the prodromal phase. Language disorder in schizophrenia is often associated with impaired thinking processes. However, with the development of science and technology today, there is an objective and quantitative method of computational analysis of language through the Natural Language Processing process with a semantic space model that allows a psychiatrist to learn aspects of the human language process, especially in semantic and pragmatic aspects. The review provides a groundbreaking proposal for biomarkers for schizophrenia that have not been available so far through the assessment of language disorders in patients with schizophrenia. Objective and accurate detection of language disorders in schizophrenia can be a modality for psychiatrists to screen, make diagnoses, determine prognosis, evaluate therapies, and monitor recurrence using existing technology media.</p>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"14 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/appy.12485","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39260041","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}
Gabriel Ivbijaro MBE, MBBS, MA, MMedSci, PhD, FRCGP, FWACPsych, IDFAPA
There have been many suicide prevention initiatives, some focused on the individual, some on the environment, some on systems and some on carers and caregivers, with each contributing to reducing suicide risk. Suicide is preventable and prevention should be everybody's business. We are grateful to Wiley, the Asia-Pacific Psychiatry and the Editor in Chief, Professor Allan Tasman for commissioning this special issue of the journal focused on suicide prevention. I am also grateful to Michelle Riba, Lakshmi Vijayakumar, Tsuyoshi Akiyama, Soumitra Pathare, Danuta Wasserman, Norman Sartorius and David Goldberg for the support that they have provided in preparing this special issue, and to all our peer reviewers for their contribution. Suicide prevention in childhood and adolescence (Wasserman et al., 2021) highlights some of the key papers in the field providing the building blocks for understanding what is required to prevent suicide in this age group noting that many countries have achieved reductions in rates of suicide. This reduction is not universal, and those countries that have increased rates need to look at what interventions have been successful in other parts of the world to reduce rates of suicide in childhood and adolescence further. Adopting the concept that suicide prevention is everybody's business is likely to be helpful because it will enable a holistic approach to addressing this problem. Suicide prevention in psychiatric patients (Wasserman, Carli, et al., 2021) highlights that the provision of cognitive behavior therapy and other brief interventions, including psychoeducation to people with a diagnosis of schizophrenia can decrease the risk of suicide and provides a summary of interventions that reduce risk of suicide in a range of mental disorders recommending a comprehensive suicide risk assessment as the first step in providing effective suicide prevention in psychiatric patients. Suicide prevention in older adults (de Mendoça Lima et al., 2021) in this special issue brings together the dynamic interaction of community, systems and individuals and its importance in reducing rates of suicide in older adults, noting that a public health approach is essential. Reducing access to methods of suicide is also important. In his review, McInnis et al. (2021) examine the issue of access to firearms suggesting self-exclusion agreements as a potential way forward. This is innovative, non-stigmatizing and gives the power to an individual with a known mood disorder to protect themselves and society and is especially important for countries where issues of gun control can be divisive and political. Families and carers matter and should not be forgotten as part of a of protective network that can support an individual during periods when they are at increased risk of suicide. Edwards et al. (2021) propose a practical way of history taking, including emotional engagement, that enables the family member who is feeling suicidal to feel respected
{"title":"Suicide prevention is everybody's business","authors":"Gabriel Ivbijaro MBE, MBBS, MA, MMedSci, PhD, FRCGP, FWACPsych, IDFAPA","doi":"10.1111/appy.12483","DOIUrl":"10.1111/appy.12483","url":null,"abstract":"There have been many suicide prevention initiatives, some focused on the individual, some on the environment, some on systems and some on carers and caregivers, with each contributing to reducing suicide risk. Suicide is preventable and prevention should be everybody's business. We are grateful to Wiley, the Asia-Pacific Psychiatry and the Editor in Chief, Professor Allan Tasman for commissioning this special issue of the journal focused on suicide prevention. I am also grateful to Michelle Riba, Lakshmi Vijayakumar, Tsuyoshi Akiyama, Soumitra Pathare, Danuta Wasserman, Norman Sartorius and David Goldberg for the support that they have provided in preparing this special issue, and to all our peer reviewers for their contribution. Suicide prevention in childhood and adolescence (Wasserman et al., 2021) highlights some of the key papers in the field providing the building blocks for understanding what is required to prevent suicide in this age group noting that many countries have achieved reductions in rates of suicide. This reduction is not universal, and those countries that have increased rates need to look at what interventions have been successful in other parts of the world to reduce rates of suicide in childhood and adolescence further. Adopting the concept that suicide prevention is everybody's business is likely to be helpful because it will enable a holistic approach to addressing this problem. Suicide prevention in psychiatric patients (Wasserman, Carli, et al., 2021) highlights that the provision of cognitive behavior therapy and other brief interventions, including psychoeducation to people with a diagnosis of schizophrenia can decrease the risk of suicide and provides a summary of interventions that reduce risk of suicide in a range of mental disorders recommending a comprehensive suicide risk assessment as the first step in providing effective suicide prevention in psychiatric patients. Suicide prevention in older adults (de Mendoça Lima et al., 2021) in this special issue brings together the dynamic interaction of community, systems and individuals and its importance in reducing rates of suicide in older adults, noting that a public health approach is essential. Reducing access to methods of suicide is also important. In his review, McInnis et al. (2021) examine the issue of access to firearms suggesting self-exclusion agreements as a potential way forward. This is innovative, non-stigmatizing and gives the power to an individual with a known mood disorder to protect themselves and society and is especially important for countries where issues of gun control can be divisive and political. Families and carers matter and should not be forgotten as part of a of protective network that can support an individual during periods when they are at increased risk of suicide. Edwards et al. (2021) propose a practical way of history taking, including emotional engagement, that enables the family member who is feeling suicidal to feel respected","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"13 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/appy.12483","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39156798","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}
This issue of the Asia-Pacific Psychiatry dedicated to suicide prevention contains three articles that present a road map for more robust and systematic approaches to addressing the scourge of suicide among children, adolescents, and young adults. As has been previously reported. More than 60 000 children and adolescents aged 10– 19 across the world died from suicide in 2016, and suicide represents the third leading cause of death in 15–19-year-olds, after road injury and interpersonal violence (causes that can often overlap with suicide; World Health Organization, 2019). Additionally, the prevalence of child and adolescent suicide has been on a persistent upward trend since the 1990s, seeming to stabilize during the late 2010's but later aggravated during the COVID pandemic. For example, in addition to articles referenced in this issue, the U.S. Center for Disease Control and Prevention (Yard et al., 2021) reported an estimated increase in emergency room visits by youth ages 12 to 17 for suicide attempts of 22.3% higher during summer 2020 and 39.1% higher during winter 2021 than during the corresponding periods in 2019 in the United States, with the majority of the increase in adolescent girls. Though suicide at any age is a tragic outcome, it is even more tragic when it has become a growing epidemic which prematurely ends promising lives. It behooves all of us in pediatric mental health to mount all possible efforts toward reversing this trend, particularly using a public health model with clear universal, secondary, and tertiary levels of prevention. The article by Wasserman et al. (2021) directly touches on the topic of suicide prevention in this age group, presenting a narrative review of current knowledge on risk and protective factors and effectiveness of interventions. Although the comprehensive review of risk factors in this article is quite impressive, its core lies in the sections addressing preventive interventions. The authors identify the existence of various evidence-based awareness and skills training programs aimed at universal prevention with youth populations, particularly in school-based settings. They cite programs such as Signs of Suicide (SOS), Youth Aware of Mental Health (YAM), and the Good Behavior Game (GBG) ask promising, but also site the SEHER trial in India as well as other work supporting the implementation of school based mental health promotion interventions in low-and-middle income countries. The latter are quite important, especially given an anticipated increase in risk for suicidality in developing nations as their youth face the various social and developmental pressures encountered in developed nations. An example of this is Turkey, for which studies such as Dalkilic et al. (2013) suggest an increasing risk of suicidality among adolescents, accompanied by increasing substance use, depression, and pressures resulting with urbanization. Wasserman et al. (2021) cited the use of Gatekeeper programs and screenin
{"title":"Comprehensive approaches to youth suicide prevention","authors":"Andres J. Pumariega M.D.","doi":"10.1111/appy.12484","DOIUrl":"10.1111/appy.12484","url":null,"abstract":"This issue of the Asia-Pacific Psychiatry dedicated to suicide prevention contains three articles that present a road map for more robust and systematic approaches to addressing the scourge of suicide among children, adolescents, and young adults. As has been previously reported. More than 60 000 children and adolescents aged 10– 19 across the world died from suicide in 2016, and suicide represents the third leading cause of death in 15–19-year-olds, after road injury and interpersonal violence (causes that can often overlap with suicide; World Health Organization, 2019). Additionally, the prevalence of child and adolescent suicide has been on a persistent upward trend since the 1990s, seeming to stabilize during the late 2010's but later aggravated during the COVID pandemic. For example, in addition to articles referenced in this issue, the U.S. Center for Disease Control and Prevention (Yard et al., 2021) reported an estimated increase in emergency room visits by youth ages 12 to 17 for suicide attempts of 22.3% higher during summer 2020 and 39.1% higher during winter 2021 than during the corresponding periods in 2019 in the United States, with the majority of the increase in adolescent girls. Though suicide at any age is a tragic outcome, it is even more tragic when it has become a growing epidemic which prematurely ends promising lives. It behooves all of us in pediatric mental health to mount all possible efforts toward reversing this trend, particularly using a public health model with clear universal, secondary, and tertiary levels of prevention. The article by Wasserman et al. (2021) directly touches on the topic of suicide prevention in this age group, presenting a narrative review of current knowledge on risk and protective factors and effectiveness of interventions. Although the comprehensive review of risk factors in this article is quite impressive, its core lies in the sections addressing preventive interventions. The authors identify the existence of various evidence-based awareness and skills training programs aimed at universal prevention with youth populations, particularly in school-based settings. They cite programs such as Signs of Suicide (SOS), Youth Aware of Mental Health (YAM), and the Good Behavior Game (GBG) ask promising, but also site the SEHER trial in India as well as other work supporting the implementation of school based mental health promotion interventions in low-and-middle income countries. The latter are quite important, especially given an anticipated increase in risk for suicidality in developing nations as their youth face the various social and developmental pressures encountered in developed nations. An example of this is Turkey, for which studies such as Dalkilic et al. (2013) suggest an increasing risk of suicidality among adolescents, accompanied by increasing substance use, depression, and pressures resulting with urbanization. Wasserman et al. (2021) cited the use of Gatekeeper programs and screenin","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"13 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/appy.12484","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39156796","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}
Gabriel Ivbijaro MBE, MBBS, MA, MMedSci, PhD, FRCGP FWACPsych, IDFAPA, Lucja Kolkiewicz MBBS, MRCPsych, IFAPA, David Goldberg KBE, Isatou N. S. N'jie BA Hons, DPS, MCLIP, MInstLM, Todd Edwards BA, MA, PhD, Michelle B. Riba MD, MS, Igor Švab MD, PhD, Jeffrey Geller MD, MPH, Yaccub Enum BSc, MSc, DLSHTM
<div> <section> <h3> Introduction</h3> <p>Suicide prevention during Covid 19 has become a global priority because the current pandemic has led to societal difficulties threatening the fabric of our lifestyle with increased morbidity and mortality. Modelling studies published since the COVID 19 pandemic was declared in March 2020 estimate that suicide rates will increase by anywhere between 1% to 145% globally in response to the pandemic and action needs to be taken.</p> </section> <section> <h3> Methods</h3> <p>A narrative literature review on high quality evidence sources limited to human studies and publications written in English language only has been used to examine the relationship of COVID 19 and existing mental illness or history of mental illness, suicide prevention strategies and changes in overall suicide rates.</p> </section> <section> <h3> Results</h3> <p>A total of 39 papers are summarised and grouped using the headings aetiological factors, proposed interventions to increase access and national policies to provide a framework for suicide prevention during pandemics such as COVID 19. This review indicates that 1) investing in active labour market programmes will result in a decreased suicide rate during times of high unemployment 2) People in low paid and casual jobs require specific support because they are most financially vulnerable during a pandemic related crisis 3) Women require specific support during a pandemic because of the type of employment they have and because they often carry a greater proportion of the domestic burden and are at increased risk of domestic violence during lockdown and crisis 4) Mental health and substance misuse services need to be appropriately funded and prioritised during and post pandemic, due to the associated increase in substance misuse during a pandemic causing worsening mental health and increased risk of suicide 5) National Suicide Prevention Strategies should be developed by all countries and should anticipate response to a range of disasters, including a pandemic 6) Suicide prevention is everybody's business and National Suicide Prevention Strategies should adopt a whole-systems approach including mental health services, primary care, social care, NGO's and other community stakeholders 7) Suicide is preventable 8) It is essential to prioritise suicide prevention strategies in the COVID and post-COVID period to ensure that lives are saved.</p> </section> <section> <h3> Discussion</h3> <p>Increase in suicide is not inevitable and suicide prevention during pandemics and post COVID 19 pandemics
{"title":"Suicide prevention and COVID-19","authors":"Gabriel Ivbijaro MBE, MBBS, MA, MMedSci, PhD, FRCGP FWACPsych, IDFAPA, Lucja Kolkiewicz MBBS, MRCPsych, IFAPA, David Goldberg KBE, Isatou N. S. N'jie BA Hons, DPS, MCLIP, MInstLM, Todd Edwards BA, MA, PhD, Michelle B. Riba MD, MS, Igor Švab MD, PhD, Jeffrey Geller MD, MPH, Yaccub Enum BSc, MSc, DLSHTM","doi":"10.1111/appy.12482","DOIUrl":"10.1111/appy.12482","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Suicide prevention during Covid 19 has become a global priority because the current pandemic has led to societal difficulties threatening the fabric of our lifestyle with increased morbidity and mortality. Modelling studies published since the COVID 19 pandemic was declared in March 2020 estimate that suicide rates will increase by anywhere between 1% to 145% globally in response to the pandemic and action needs to be taken.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A narrative literature review on high quality evidence sources limited to human studies and publications written in English language only has been used to examine the relationship of COVID 19 and existing mental illness or history of mental illness, suicide prevention strategies and changes in overall suicide rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 39 papers are summarised and grouped using the headings aetiological factors, proposed interventions to increase access and national policies to provide a framework for suicide prevention during pandemics such as COVID 19. This review indicates that 1) investing in active labour market programmes will result in a decreased suicide rate during times of high unemployment 2) People in low paid and casual jobs require specific support because they are most financially vulnerable during a pandemic related crisis 3) Women require specific support during a pandemic because of the type of employment they have and because they often carry a greater proportion of the domestic burden and are at increased risk of domestic violence during lockdown and crisis 4) Mental health and substance misuse services need to be appropriately funded and prioritised during and post pandemic, due to the associated increase in substance misuse during a pandemic causing worsening mental health and increased risk of suicide 5) National Suicide Prevention Strategies should be developed by all countries and should anticipate response to a range of disasters, including a pandemic 6) Suicide prevention is everybody's business and National Suicide Prevention Strategies should adopt a whole-systems approach including mental health services, primary care, social care, NGO's and other community stakeholders 7) Suicide is preventable 8) It is essential to prioritise suicide prevention strategies in the COVID and post-COVID period to ensure that lives are saved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Increase in suicide is not inevitable and suicide prevention during pandemics and post COVID 19 pandemics ","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"13 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2021-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/appy.12482","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39084143","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}
Carlos Augusto de Mendonça Lima, Diego De Leo, Gabriel Ivbijaro, Igor Svab
Background
Suicide among older adults is a multifactorial problem with several interrelated factors involved that vary with age, gender and culture. The number of suicides is highest in those aged 70 years or older in almost all regions of the world. With the increase in life expectancy, and the decrease in mortality due to other causes of death, we could expect the absolute number of older adults' suicide continue increasing.
Methods
Review of the literature on suicide protective factors of suicide among older adults.
Results
Improvements on social determinants of health and the timely detection and early treatment of affective disorders are key interventions. Prevention based on community actions and training of gatekeepers may have positive impact. Community programs that promote a sense of usefulness, belonging and that contribute to preserve social integration should be encouraged. Governments should develop the improvement of retirement programs and the development of support systems. The access to general health and mental health services should be facilitated and Primary Care professionals should receive proper training to detect and manage older persons at risk. Actively promoting a culture of coping to different stages of life and to the changes imposed by the advancing of age should form the essential part of a process bringing to better successful aging avenues.
Conclusions
Suicide prevention in older adults should broaden its focus and pay attention to the many socio-environmental conditions that may be relevant in older age, especially social isolation, financial security and physical health.
{"title":"Suicide prevention in older adults","authors":"Carlos Augusto de Mendonça Lima, Diego De Leo, Gabriel Ivbijaro, Igor Svab","doi":"10.1111/appy.12473","DOIUrl":"10.1111/appy.12473","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Suicide among older adults is a multifactorial problem with several interrelated factors involved that vary with age, gender and culture. The number of suicides is highest in those aged 70 years or older in almost all regions of the world. With the increase in life expectancy, and the decrease in mortality due to other causes of death, we could expect the absolute number of older adults' suicide continue increasing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Review of the literature on suicide protective factors of suicide among older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Improvements on social determinants of health and the timely detection and early treatment of affective disorders are key interventions. Prevention based on community actions and training of gatekeepers may have positive impact. Community programs that promote a sense of usefulness, belonging and that contribute to preserve social integration should be encouraged. Governments should develop the improvement of retirement programs and the development of support systems. The access to general health and mental health services should be facilitated and Primary Care professionals should receive proper training to detect and manage older persons at risk. Actively promoting a culture of coping to different stages of life and to the changes imposed by the advancing of age should form the essential part of a process bringing to better successful aging avenues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Suicide prevention in older adults should broaden its focus and pay attention to the many socio-environmental conditions that may be relevant in older age, especially social isolation, financial security and physical health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"13 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/appy.12473","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39084142","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}
Vasileios Stavropoulos, Jeremy Vassallo, Tyrone Leonard Burleigh, Rapson Gomez, Michelle Colder Carras
Background
Disordered Internet gaming is thought to be perpetuated by one's need to escape their real-life distress or mental health symptoms, which may in turn generate depressive feelings. Nevertheless, moderate engagement with Internet games has also been suggested to provide relief, thus improving one's mood. This study aspires to clarify the contribution of Internet gaming and gender in the association between anxiety and depression.
Methods
A large sample of Internet gamers (N = 964) were recruited online. Disordered Internet gaming was assessed with the Internet Gaming Disorder Scale, 9 Items Short Form (IGD9S-SF). Anxiety and depression symptoms were assessed using the Depression, Anxiety and Stress Scale, 21 items (DASS-21).
Results
Regression, moderation and moderated moderation analyses accounting for the effects of gender on the relationship between disordered gaming, anxiety, and depression found a significant effect for anxiety symptoms on depression symptoms and a significant interaction between anxiety and Internet gaming disorder on depression symptoms. Findings support the theory that although anxious gamers bear a higher depression risk, this is buffered with lower and exacerbated with higher disordered gaming symptoms.
Conclusion
Findings suggest a dual role of Internet gaming in the association between anxiety and depression, depending on the intensity of one's disordered gaming symptoms. Depression prevention and intervention protocols should be optimized by considering the effects of Internet gaming among anxious gamers by focusing on the intensity of a gamer's involvement and any gaming disorder symptoms. Further research should include clinical samples to better understand this interaction.
{"title":"The role of internet gaming in the association between anxiety and depression: A preliminary cross-sectional study","authors":"Vasileios Stavropoulos, Jeremy Vassallo, Tyrone Leonard Burleigh, Rapson Gomez, Michelle Colder Carras","doi":"10.1111/appy.12474","DOIUrl":"10.1111/appy.12474","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Disordered Internet gaming is thought to be perpetuated by one's need to escape their real-life distress or mental health symptoms, which may in turn generate depressive feelings. Nevertheless, moderate engagement with Internet games has also been suggested to provide relief, thus improving one's mood. This study aspires to clarify the contribution of Internet gaming and gender in the association between anxiety and depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A large sample of Internet gamers (<i>N</i> = 964) were recruited online. Disordered Internet gaming was assessed with the Internet Gaming Disorder Scale, 9 Items Short Form (IGD9S-SF). Anxiety and depression symptoms were assessed using the Depression, Anxiety and Stress Scale, 21 items (DASS-21).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Regression, moderation and moderated moderation analyses accounting for the effects of gender on the relationship between disordered gaming, anxiety, and depression found a significant effect for anxiety symptoms on depression symptoms and a significant interaction between anxiety and Internet gaming disorder on depression symptoms. Findings support the theory that although anxious gamers bear a higher depression risk, this is buffered with lower and exacerbated with higher disordered gaming symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings suggest a dual role of Internet gaming in the association between anxiety and depression, depending on the intensity of one's disordered gaming symptoms. Depression prevention and intervention protocols should be optimized by considering the effects of Internet gaming among anxious gamers by focusing on the intensity of a gamer's involvement and any gaming disorder symptoms. Further research should include clinical samples to better understand this interaction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8618,"journal":{"name":"Asia‐Pacific Psychiatry","volume":"14 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2021-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/appy.12474","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39001449","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}
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