1.Assessing for Mood and Anxiety Disorders in Parents of Clinically-Referred Children: Laying the Foundation for a Family-Based Approach to Mental Health in Singapore.
Sharon C SUNG ; Han Ying TNG ; Zi Jun WONG ; Yan Lin TAN ; Yi Ren TAN ; Siew Foong CHOONG ; Chee Hon CHIN ; Leong Yeok JANG ; Clare Hm KWAN ; Say How ONG ; James J HUDZIAK ; Michael J MEANEY ; Daniel Ss FUNG
Annals of the Academy of Medicine, Singapore 2019;48(2):55-62
INTRODUCTION:
Family history of psychopathology is a risk factor for mood and anxiety disorders in children, but little is known about rates of parental psychopathology among treatment-seeking youth with affective disorders in the Asia Pacific region. This study examined patterns of emotional and behavioural problems in parents of clinically-referred youth in Singapore. We hypothesised that parents would have higher rates of affective disorders compared to the Singapore national prevalence rate of 12%.
MATERIALS AND METHODS:
In this cross-sectional study, 47 families were recruited from affective disorders and community-based psychiatry programmes run by a tertiary child psychiatry clinic. All children had a confirmed primary clinical diagnosis of depression or an anxiety disorder. Parents completed the Mini International Neuropsychiatric Interview (MINI) to assess for lifetime mood and anxiety disorders. They also completed the Adult Self Report (ASR) and Adult Behavior Checklist (ABCL) to assess current internalising and externalising symptoms.
RESULTS:
Consistent with our hypothesis, 38.5% of mothers and 10.5% of fathers reported a lifetime mood and anxiety disorder. Nearly 1/3 of mothers had clinical/subclinical scores on current internalising and externalising problems. A similar pattern was found for internalising problems among fathers, with a slightly lower rate of clinical/subclinical externalising problems.
CONCLUSION
Our findings are consistent with previous overseas studies showing elevated rates of affective disorders among parents - particularly mothers - of children seeking outpatient psychiatric care. Routine screening in this population may help to close the current treatment gap for adults with mood and anxiety disorders.
Adult
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Anxiety Disorders
;
diagnosis
;
epidemiology
;
psychology
;
Child
;
Cross-Sectional Studies
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Family Health
;
statistics & numerical data
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Female
;
Humans
;
Male
;
Mood Disorders
;
diagnosis
;
epidemiology
;
psychology
;
Parent-Child Relations
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Parenting
;
psychology
;
Parents
;
psychology
;
Psychiatric Status Rating Scales
;
Psychopathology
;
Singapore
;
epidemiology
2.The Effect of Psychopathology on the Quality of Lifein Female Dermatological Outpatients
Young LEE ; So Hyun AHN ; Kwang Yeon CHOI ; Ik Seung CHEE
Journal of the Korean Society of Biological Therapies in Psychiatry 2019;25(2):109-116
OBJECTIVES: The purpose of this study was to investigate the effect of psychopathology on the quality of life in dermatological outpatients.METHODS: A sample of 151 female dermatological outpatients was compared with a control group of 200 females. Symptom Check List-90-R(SCL-90-R) was used to screen for psychopathology and Skindex-29 for quality of life. We compared the scores of SCL-90-R and Skindex-29 between the two groups and examined the correlation between SCL-90-R and Skindex-29 in the patient group. We analysed the subscales of SCL-90-R that affect Skindex-29.RESULTS: There was statistically significant higher in the score of SCL-90-R in patient group than control group. In high score group of Skindex-29, the score of SCL-90-R was significantly higher than in low score group of Skindex-29. The correlation between SCL-90-R and Skindex-29 was positively correlated with moderate relationship on all subscales except paranoid ideation. Somatization and psychoticism of SCL-90-R were the factors affecting on the total score of Skindex-29.CONCLUSION: The results of this study suggest that psychological distress of the dermatological outpatients is more severe than control group, and somatization and psychoticism are suggested as predictors of the quality of life of dermatologic patients.
Female
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Humans
;
Outpatients
;
Psychopathology
;
Quality of Life
3.Clinical Correlates of Alcohol Use Disorder in Depressed Patients with Unipolar and Bipolar Disorder
Minseok HONG ; Tae Hyon HA ; Suyeon LEE ; Sunghee OH ; Woojae MYUNG
Psychiatry Investigation 2019;16(12):926-932
OBJECTIVE: Alcohol use disorder (AUD) is one of the most frequent comorbid conditions in mood disorders. We aimed to examine the relationships between clinical phenotypes of acutely depressed subjects and co-occurring AUD.METHODS: Clinical assessment including diagnosis of mood disorder and co-occurring AUD, the severity of depressive or manic symptoms, and affective temperaments were conducted in 137 subjects suffering from a major depressive episode. According to the presence of AUD, clinical variables were compared between the two groups. Using binary logistic regression models, the effects of mood symptoms and affective temperaments on the risk of AUD were determined.RESULTS: Severity of manic symptoms, suicidal ideation, and childhood trauma were higher in the AUD group than in the non-AUD group. Scores for irritable and hyperthymic temperament were higher and the score for anxious temperament was lower in the AUD group. In regression models adjusting confounders, anxious temperament was an independent protector against AUD. On the other hand, the diagnosis of bipolar disorder and the irritable manic symptom dimension increased the risk of AUD.CONCLUSION: Anxious temperament decreased the AUD risk, whereas irritable manic symptoms increased the risk during depression. AUD in mood disorders may be an expression of manic psychopathology.
Bipolar Disorder
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Depression
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Diagnosis
;
Hand
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Humans
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Logistic Models
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Mood Disorders
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Phenotype
;
Psychopathology
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Suicidal Ideation
;
Temperament
4.Temperament and Character Profiles Associated with Internalizing and Externalizing Problems in Children with Attention Deficit Hyperactivity Disorder
Psychiatry Investigation 2019;16(3):206-212
OBJECTIVE: This study aimed to identify temperament and character profiles associated with internalizing and externalizing problems in children with attention deficit hyperactivity disorder (ADHD). METHODS: Children with ADHD (n=114, 8.51±1.87 years) were selected from the Department of Child and Adolescent Psychiatry at Jeju National University Hospital. They were diagnosed by Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version and evaluated using the Advanced Test of Attention and Korean Wechsler Intelligence Scale for Children-Fourth Edition. Their parents completed the ADHD Rating Scale, Korean-Child Behavioral Checklist, and Junior Temperament and Character Inventory. RESULTS: The participants with both internalizing and externalizing problem had more severe ADHD symptoms and significantly higher novelty seeking, harm avoidance, and self-transcendence, as well as lower self-directedness and cooperativeness than those who had not comorbid problems. Harm avoidance was correlated with their level of internalizing problems regardless of severity of ADHD symptoms. In addition, novelty seeking and sex (male) were being associated with the level of externalizing problems. CONCLUSION: Differences were observed in the temperament and character profiles of children with ADHD according to their comorbid psychopathology. Results suggested that temperament and character profiles may affect the comorbid psychopathology in children with ADHD regardless of ADHD symptom severity.
Adolescent
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Adolescent Psychiatry
;
Attention Deficit Disorder with Hyperactivity
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Checklist
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Child
;
Humans
;
Intelligence
;
Mood Disorders
;
Parents
;
Psychopathology
;
Temperament
5.Assessment and Understanding of Chronotype
Sleep Medicine and Psychophysiology 2019;26(1):5-15
Chronotype (CT) is defined as an inter-individual difference in sleep-wake cycles and daily activities. Previous studies have suggested that this individual difference can influence our biological and psychological functioning. Literature regarding the psychometric properties and validity of CT measures are reviewed. We provide an overview of biological indicators (sleep-wake cycle, body temperature, cortisol, and melatonin) that are used for distinguishing two chronotypes: morningness (MT) and eveningness (ET). We also review the differences between CT in relation to personality traits and the occurrence of psychopathology. In addition, the methodological limitations of studies on CT are discussed. Finally, future research directions in terms of CT are proposed.
Body Temperature
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Hydrocortisone
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Individuality
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Psychometrics
;
Psychopathology
6.Protocol and Rationale: A 24-week Double-blind, Randomized, Placebo Controlled Trial of the Efficacy of Adjunctive Garcinia mangostana Linn. (Mangosteen) Pericarp for Schizophrenia
Alyna TURNER ; John J MCGRATH ; Olivia M DEAN ; Seetal DODD ; Andrea BAKER ; Susan M COTTON ; James G SCOTT ; Bianca E KAVANAGH ; Melanie M ASHTON ; Adam J WALKER ; Ellie BROWN ; Michael BERK
Clinical Psychopharmacology and Neuroscience 2019;17(2):297-307
OBJECTIVE: Garcinia mangostana Linn., commonly known as mangosteen, is a tropical fruit with a thick pericarp rind containing bioactive compounds that may be beneficial as an adjunctive treatment for schizophrenia. The biological underpinnings of schizophrenia are believed to involve altered neurotransmission, inflammation, redox systems, mitochondrial dysfunction, and neurogenesis. Mangosteen pericarp contains xanthones which may target these biological pathways and improve symptoms; this is supported by preclinical evidence. Here we outline the protocol for a double-blind randomized placebo-controlled trial evaluating the efficacy of adjunctive mangosteen pericarp (1,000 mg/day), compared to placebo, in the treatment of schizophrenia. METHODS: We aim to recruit 150 participants across two sites (Geelong and Brisbane). Participants diagnosed with schizophrenia or schizoaffective disorder will be randomized to receive 24 weeks of either adjunctive 1,000 mg/day of mangosteen pericarp or matched placebo, in addition to their usual treatment. The primary outcome measure is mean change in the Positive and Negative Symptom Scale (total score) over the 24 weeks. Secondary outcomes include positive and negative symptoms, general psychopathology, clinical global severity and improvement, depressive symptoms, life satisfaction, functioning, participants reported overall improvement, substance use, cognition, safety and biological data. A 4-week post treatment interview at week 28 will explore post-discontinuations effects. RESULTS: Ethical and governance approvals were gained and the trial commenced. CONCLUSION: A positive finding in this study has the potential to provide a new adjunctive treatment option for people with schizophrenia and schizoaffective disorder. It may also lead to a greater understanding of the pathophysiology of the disorder.
Cognition
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Depression
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Fruit
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Garcinia mangostana
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Garcinia
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Inflammation
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Neurogenesis
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Outcome Assessment (Health Care)
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Oxidation-Reduction
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Oxidative Stress
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Psychopathology
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Psychotic Disorders
;
Schizophrenia
;
Synaptic Transmission
;
Xanthones
7.Effects of Amisulpride Adjunctive Therapy on Working Memory and Brain Metabolism in the Frontal Cortex of Patients with Schizophrenia: A Preliminary Positron Emission Tomography/Computerized Tomography Investigation
Jeong Ha PARK ; Ji Son HONG ; Sun Mi KIM ; Kyung Joon MIN ; Un Sun CHUNG ; Doug Hyun HAN
Clinical Psychopharmacology and Neuroscience 2019;17(2):250-260
OBJECTIVE: Dopamine plays a significant role in working memory by acting as a key neuromodulator between brain networks. Additionally, treatment of patients with schizophrenia using amisulpride, a pure dopamine class 2/3 receptor antagonist, improves their clinical symptoms with fewer side effects. We hypothesized that patients with schizophrenia treated with amisulpride and aripiprazole show increased working memory and glucose metabolism compared with those treated with cognitive behavioral therapy (CBT) and aripiprazole instead. METHODS: Sixteen patients with schizophrenia (eight in the amisulpride group [aripiprazole+amisulpride] and eight in the CBT group [aripiprazole+CBT]) and 15 age- and sex-matched healthy control subjects were recruited for a 12-week-long prospective trial. An [18F]-fluorodeoxyglucose-positron emission tomography/computerized tomography scanner was used to acquire the images. RESULTS: After 12 weeks of treatment, the amisulpride group showed greater improvement in the Letter-Number Span scores than the CBT group. Additionally, although brain metabolism in the left middle frontal gyrus, left occipital lingual gyrus, and right inferior parietal lobe was increased in all patients with schizophrenia, the amisulpride group exhibited a greater increase in metabolism in both the right superior frontal gyrus and right frontal precentral gyrus than the CBT group. CONCLUSION: This study suggests that a small dose of amisulpride improves the general psychopathology, working memory performance, and brain glucose metabolism of patients with schizophrenia treated with aripiprazole.
Aripiprazole
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Brain
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Cognition
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Cognitive Therapy
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Dopamine
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Electrons
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Frontal Lobe
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Glucose
;
Humans
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Memory, Short-Term
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Metabolism
;
Neurotransmitter Agents
;
Occipital Lobe
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Parietal Lobe
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Positron-Emission Tomography
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Prefrontal Cortex
;
Prospective Studies
;
Psychopathology
;
Schizophrenia
;
Sulpiride
8.Schizophrenia and Corollary Discharge: A Neuroscientific Overview and Translational Implications
Rujuta PARLIKAR ; Anushree BOSE ; Ganesan VENKATASUBRAMANIAN
Clinical Psychopharmacology and Neuroscience 2019;17(2):170-182
Corollary discharge mechanism refers to the suppression of sensory consequences of self-generated actions; a process that serves to distinguish between self and non-self based on discrimination of origination of action. It explains, say for example, why we cannot tickle ourselves. This review discusses how corollary discharge model is an essential neural integration mechanism central to the motor functioning of animal kingdom. In this article, research conducted in the field of corollary discharge has been reviewed to understand the neuroanatomical and neurophysiological basis of corollary discharge and gain insight into the biochemical basis of its dysfunction. This review article also explores the role of corollary discharge and its dysfunction in the presentation of symptoms of schizophrenia, discussing the findings from corollary discharge studies on schizophrenia population. Lastly, the link between schizophrenia psychopathology and corollary discharge dysfunction has been highlighted, and an attempt has been made to establish a case for correction of corollary discharge deficit in schizophrenia through neuromodulation.
Animals
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Discrimination (Psychology)
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Hallucinations
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Motor Activity
;
Psychopathology
;
Schizophrenia
;
Transcranial Direct Current Stimulation
9.Reliability and Validity of the Korean Version of the Birchwood Insight Scale
Jin Hyeok JANG ; Nam Young LEE ; Yong Sik KIM ; Sang Won PARK
Journal of Korean Neuropsychiatric Association 2019;58(1):55-63
OBJECTIVES: In the treatment of schizophrenia, treatment compliance is an important prognostic factor. As insight has a significant impact on treatment compliance, an appropriate assessment of insight is essential in the treatment of schizophrenia. This study examined the reliability and validity of the Korean version of Birchwood Insight Scale (BIS). METHODS: Fifty seven adult patients diagnosed with schizophrenia according to DSM-5 were recruited from a university hospital. They were evaluated using the Positive and Negative Syndrome Scale (PANSS), The Scale to Assessment Unawareness of Mental Disorder (SUMD) and BIS. Explorative factor analysis was performed to examine the construct validity of the Korean version of BIS. Concurrent validity was evaluated by a comparison with the PANSS G12 item and SUMD. The test-retest correlation was evaluated to examine the test-retest reliability. Multiple regression analysis was performed to examine the variables affecting insight. RESULTS: Explorative factor analysis showed that the Korean version of BIS was composed of 2 factors, which are ‘Awareness of symptoms’ and ‘Awareness of illness and need for treatment.’ The Korean version of BIS was reliable in terms of the internal consistency. Concurrent validity with the PANSS G 12 item and SUMD was statistically significant. The test-retest reliability was also statistically significant. Multiple regression analysis showed that the PANSS negative factor affects the BIS score, indicating that negative symptoms of schizophrenia may impair insight of the illness. CONCLUSION: This study suggests that the Korean version of BIS is a valid and reliable tool for assessing the insight of patients with schizophrenia.
Adult
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Compliance
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Humans
;
Mental Disorders
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Psychopathology
;
Reproducibility of Results
;
Schizophrenia
10.Functional Disabilities Evaluated using World Health Organization Disability Assessment Schedule 2.0 in Patients with Chronic Schizophrenia and Its Related Factors
Kyeongwoo PARK ; Dong Kyun LEE ; Hyeongrae LEE ; Chul Eung KIM ; Seunghyong RYU
Journal of Korean Neuropsychiatric Association 2019;58(1):47-54
OBJECTIVES: This study examined the functional disabilities of patients with chronic schizophrenia using WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) and its related factors. METHODS: The subjects consisted of 86 patients with schizophrenia with more than 10 years' duration of illness and 40 healthy volunteers. The functional disabilities and psychopathology were evaluated using the WHODAS 2.0 and 18-items Brief Psychiatric Rating Scale (BPRS-18), respectively. This study analyzed the six sub-domains ('cognition', 'mobility', 'self-care', 'getting along', 'life activities', and 'participation') of WHODAS 2.0 and the four sub-scales ('positive symptoms', 'negative symptoms', 'affect', and 'resistance') of BPRS-18. RESULTS: Patients with chronic schizophrenia experienced severe functional disabilities across all six sub-domains of WHODAS 2.0 compared to healthy people. Hierarchical regression showed that 'negative symptoms' explained the disabilities in the WHODAS 2.0 sub-domains of 'cognition' (p<0.05), 'self-care' (p<0.05), 'getting along' (p<0.01), and 'life activities' (p<0.05). 'Positive symptoms' and 'affect' explained the disabilities in 'cognition' (p<0.01 and p<0.05, respectively) and 'participation' (p<0.05 and p<0.01, respectively). 'Resistance' was found to be a predictor of 'getting along' disabilities (p<0.01). CONCLUSION: Negative symptoms mainly accounted for the multiple domains of functional disabilities in the WHODAS 2.0 but residual positive and affective symptoms could also deteriorate the cognition and social participation of patients with chronic schizophrenia.
Affective Symptoms
;
Appointments and Schedules
;
Brief Psychiatric Rating Scale
;
Cognition
;
Disability Evaluation
;
Global Health
;
Healthy Volunteers
;
Humans
;
Psychopathology
;
Schizophrenia
;
Social Participation
;
World Health Organization

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