1.New requirements for Psychiatry Residency Training Programs (PRTPs) in the Philippines
Ruth T. Villanueva ; Myra Dee Dee Lopez-Roces ; Constantine D. Della ; Jannel Gatlabayan-Cleto ; Georgina M. Gozo-Oliver
The Philippine Journal of Psychiatry 2023;4(2):1-15
It has been more than a decade since the Committee
on Standardization and Accreditation of
Residency Training was renamed Board of
Accreditation of the Specialty Board of
Philippine Psychiatry (SBPP). The SBPP is
composed of two bodies namely the Boards of
Accreditation and Certification. These bodies are
mandated to uphold the highest standards of
accrediting psychiatry residency training
programs (Board of Accreditation) and granting
diplomate status to graduates of these programs
(Board of Certification). Guided by the
biopsychosocial and spiritual model of health,
the Board of Accreditation remains steadfast in
ensuring that psychiatry residency training
programs continue to be relevant to current
demands of mental health and psychiatric care
in the country. In addition, it sees to it that these
programs are in harmony with global standards.
As psychiatry faces new challenges in the third
millennium, certain innovations and iterations in
the manner by which mental illnesses are
diagnosed, treated, and prevented must be set
in place. Through its Millennium Developmental
Goals, the United Nations has declared that the
achievement of gender equality is an effective
way of combating disease. Mental health
problems and psychiatric disorders are closely
linked with gender-related issues. Yet, many
residency training programs in the Philippines
have not formally and systematically integrated
gender sensitivity into their curricula. The same
can be said of the concepts of religion and
spirituality. Numerous researches have established
the positive link between religion and
spirituality and mental health.
Psychiatry
;
Internship and Residency
2.Supporting medical educators to ensure wellness of medical students
The Philippine Journal of Psychiatry 2023;4(2):16-20
Most medical faculty members assume various
roles such as educator, administrator, clinician,
and researcher. (1) Furthermore, they act as role
models for students and instruments to improve
student wellness. Strategies geared towards the
faculty can therefore promote a top-down
approach to enhancing student wellness. (2)
Unfortunately, there is a dearth of data about
this. If we expect the faculty to take care of
students’ wellness, then we must ascertain the
faculty’s wellness as well.
Faculty, Medical
;
Students
3.Practice and perceptions of pediatric residents in a Tertiary Government Hospital on mental healthcare as part of general practice
Constantine L. Yu Chua ; Lorelei Melanie K. Elma
The Philippine Journal of Psychiatry 2023;4(2):21-32
Objective:
This study aimed to describe mental health practice patterns, perceptions,
perceived responsibility, confidence, barriers, and supports of pediatric residents in a tertiary
government hospital to arrive at recommendations in enhancing their mental health
competencies.
Methodology:
As part of needs and baseline assessment within an existing collaboration,
written self-administered questionnaires were distributed among pediatric residents of the
hospital. Frequency of answers were tallied to see clustering and trends. RESULTS: Most of the
37 Pediatric residents had positive perceptions i.e. 78.83% - 83.78% and planned to incorporate
all aspects mental healthcare in their future practice as consultants i.e. 89.19 %- 97.29 %.
However, they did not get to practice or apply it as much during training. All respondents
perceived that diagnosing the neurodevelopmental disorders of Autism Spectrum, Attention
Deficit and Hyperactivity, Intellectual Disability and Learning was their responsibility. When it
came to confidence in diagnosing other psychiatric disorders less than half to 3/5 (45.9%-
64/9%) were confident or very confident in doing so. Approximately three fifths (56.75%
-67.56%) of them were confident in managing neurodevelopmental disorders. There was an even
lower proportion i.e. one fourth (16.21% - 32.43%) of pediatric residents who were confident in
managing other psychiatric disorders. Time was the most often perceived barrier while more
exposure and training were the supportive factors for integrating mental healthcare into
practice.
Conclusion
With such positive perceptions already in place, programs to improve knowledge
and skills can be developed to increase confidence, focusing on diagnosing and managing
psychiatric conditions. Target areas as guided by this research can be on how to use screening
tools and psychotropics, diagnosing anxiety and behavioral addictions, and managing psychosis
and trauma. These should be incorporated in a time-efficient manner into usual patient
interviews. Training and added exposure can be utilized in the short-term as well as
institutionalization of collaboration, liaison, and feedback systems in the future.
Mental Health
4.A cross-sectional study on the prevalence and severity of suicidal ideations and behaviors of senior high school students using the Columbia-Suicide Severity Rating Scale (C-SSRS)
The Philippine Journal of Psychiatry 2023;4(2):33-41
Objectives:
In the light of increased suicide risk among adolescents, this research aimed at determining
the prevalence and severity of suicidal ideations and behaviors of senior high school students in a public
secondary school in Metro Manila using the Columbia-Suicide Severity Rating Scale (C-SSRS).
Methodology:
This is a descriptive cross-sectional school-based study, conducted on 236 senior high
school students, 18 years old and above, in San Juan National High School (SJNHS) in San Juan, Metro
Manila. The study employed convenience sampling. Upon selection, the C-SSRS was administered. Data
on four constructs of suicide were gathered: 1) suicidal ideation severity; 2) intensity, which was
quantified in terms of frequency, duration, control, deterrents and reasons for suicidal ideation; 3)
suicidal behavior rated on a nominal subscale as actual, aborted, interrupted, preparatory behavior and
non-suicidal injurious behavior; and lastly 4) lethality of actual suicide attempts on a 6-point ordinal scale,
and if actual lethality was zero, potential lethality was further rated on a 3-point ordinal scale.
Results:
The majority (67.8%) had mild suicidal ideations; 37.71% had active suicidal ideations with intent
but not necessarily a specific plan and only 13.98% had active suicidal ideation with intent to act and a
specific plan. The intensity of suicidal ideation was not that frequent in 35.59% of the respondents
i.e.18.64% 1x/ week and 16.95% less than 1x/ week. About a third (30.07%) had very short duration of
suicidal ideations i.e. fleetingly (19.92%) or less than an hour/ day (11.02%). A third (32.62%) were able to
easily control (18.64%) or control with minimal difficulty (13.98%). Reason for suicidal ideation were either
to get attention (10.59%) or to end the emotional pain (11.02%). A third (30.93%) had actual attempts
(15.25%) and Non -Suicidal Self Injury (NSSI) (15.68%); while another 35.06 % had interrupted (16.53%) or
aborted (19.07%) attempts. Those who had actual attempts, 41.67% had no physical injury while 50 %
incurred minor injuries. Thirty- two (88.89%) had suicidal attempt that was likely to result in injury but not
likely to cause death.
Conclusion
In light of these relatively high prevalence rates for suicidal ideation and behaviors, schoolwide
intervention on education or awareness programs, gatekeeper training, peer leadership, skills
training and screening or assessment may have to be instituted to curb the increased suicide risk of the
senior high school students and further prevent suicide attempts.
Prevalence
;
Suicidal Ideation
5.Examination of the right to confidentiality
Nina Kristy A. Osorio-Grapilon
The Philippine Journal of Psychiatry 2023;4(2):42-50
With the establishment of the Republic Act No. 11036, more popularly known as the
Mental Health Act, improvement in the mental, neurologic, and psychosocial health took a
step forward in the Philippines. This law, which was signed on June 2018, gave specific
provisions in different aspects of delivery of mental health services to Filipinos. This law
proved very useful in the dilemma faced in the following case where a potential problem
in confidentiality was encountered.
Mental Health Services
;
Confidentiality
;
Mental Health
;
Philippines
6.Major depressive disorder among patients receiving antiretroviral treatment in a social hygiene clinic: Prevalence, associated factors and effects on quality of life
Leonides E. Bumatay, Jr. ; Rodelen Paccial ; Joeffrey Cruzada ; Emmanuela Sevilleja
The Philippine Journal of Psychiatry 2023;4(2):51-
Objectives:
The current study aimed to determine the prevalence of depression among
patients who received antiretroviral treatment; describe the sociodemographic and
clinical factors associated with Major Depressive Disorder; as well as compare the quality
of life among those with and without the co morbid psychiatric illness.
Methodology:
A descriptive study was performed at a local hygiene clinic.
Sociodemographic and clinical data were gathered, using the Patient Health
Questionnaire 9 (PHQ-9) for screening depression and confirmed by Mental Status Exam
(MSE). Quality of life assessment was done through WHOQOL-HIV BREF questionnaire.
Results:
Of the 130 respondents, 31 (23.85%) subjects were assessed to have
depression. Among the different sociodemographic and clinical factors, younger age (p
value = .0174) was associated with depression. Though the quality of life of a Person Living
with HIV (PLHIV) fell in the acceptable category, those who had depression had poorer
quality of life in all subdomains especially in the psychological and social domains and
these were all highly statistically significant (p value <.0001).
Conclusion
The study revealed that Major Depressive Disorder (MDD) was prevalent in
almost one fourth (23.85%) of HIV patients who were mostly of a younger age i.e. less than
45 years old; with 90.32 % of the 31 noted to have MDD were less than 35 years old.
Patients with concomitant depression had a poorer quality of life not only psychologically
but in all subdomains compared to those who were not depressed.
Depression
;
HIV
;
Quality of Life
7.Determining the prevalence of depressive and anxiety symptoms among seleced pregnant patients in some parts of Luzon during the COVID-19 pandemic: A cross-sectional study
The Philippine Journal of Psychiatry 2023;4(2):52-
Objectives:
This study explored the prevalence of depressive and anxiety symptoms
during the COVID-19 pandemic as well as the relationship between certain
sociodemographic factors these depressive and anxiety symptoms among the
participants.
Methodology:
This research used a quantitative cross sectional study design. The
participants were selected through convenience and snowball sampling. They answered a
Sociodemographic Survey, Hamilton Anxiety Rating Scale and Hamilton Depression Rating
Scale. Frequency and Percentage were used to describe the sociodemographic
characteristics and to tabulate the prevalence of anxiety and depressive symptoms.
Ordinal Logistic Regression Analysis was used to determine the relationship between
certain sociodemographic factors and depressive and anxiety symptoms among the
participants.
Results:
Of the 212 women in this sample, 96.2% showed anxiety and 43.9% manifested
depressive symptoms during the COVID-19 Pandemic. Younger participants and those in
post- partum experienced higher levels of anxiety while those with lower educational
attainment had lower levels of anxiety as well as that of depression. Those with more
pregnancies were more likely to have higher levels of depression and those at 2nd and 3rd
Trimester of their pregnancy were less likely to develop higher levels of depression than
those during their postpartum period.
Conclusion
This study demonstrated that certain concerns during the pandemic
represented a significant risk factor for mental distress among pregnant women as well as
those who had just given birth. Screening of patients for possible psychiatric symptoms
and common concerns should be prioritized upon their routine ante-natal care. Support
measures must be considered for women during pregnancy or perinatal period to
safeguard this susceptible population.
Depression
;
Anxiety
;
Pregnancy
;
Covid 19
8.Resilience levels among Filipino non-medical personnel at a Tertiary Government Hospital in Metro Manial during the COVID-19 Pandemic - July 2021
Rafael Henry E. Legaspi ; Constantine D. Della
The Philippine Journal of Psychiatry 2023;4(2):53-
Objectives:
This study aimed to measure the resilience level of non-medical personnel
of the University of the Philippines Manila – Philippine General Hospital (UP-PGH) and
determine whether this was associated with sociodemographic factors such as gender,
length of service and job position.
Methodology:
A cross-sectional study that included non-medical personnel using
convenience sampling via email was done. Data was obtained through the 14-item
Resilience Scale (RS-14) as well as a sociodemographic factors questionnaire. Descriptive
and non-parametric correlational analysis of data was used.
Results:
One hundred twenty five of the 153 respondents (81.70%) garnered a resilience
score of 74-98 or moderate to high resilience level, while 28 or 18.30% had a resilience
score corresponding to very low and on the low end. The mean resilience score was 81.8,
corresponding to a moderate resilience level. More women than men had a resilience level
of moderate to high. Respondents with greater than 5 years of work experience within the
hospital had higher resilience levels than those who were less experienced. Moderate to
high resilience levels were found in more administrative than non-administrative
personnel. No significant association was found between resilience level and the factors
analyzed. In terms of Resilience Core Characteristics, all comparisons between
demographic factors of interest and Self-reliance, Purpose, Equanimity, Perseverance and
Authenticity yielded insignificant results except for Self-reliance versus length of service,
which showed a weak but significant relationship. Exploratory factor analysis found that
the unidimensionality of the RS-14 Scale (US Version) still applied when administered to
Filipinos in this particular population.
Conclusion
Majority of the non- medical personnel of the UP -PGH had moderate level
of resilience. There was a lack of significant association between resilience level and
demographic characteristics like age, length of service, and position in the study sample.
In terms of Resilience Core Characteristics, comparison between length of service and
self -reliance showed a weak but significant relationship.
Resilience, Psychological
;
COVID -19
9.Comorbid sleep disorders among patients presenting with insomnia who underwent polysomnography
April Fatima Hernandez ; Roland dela Eva
The Philippine Journal of Psychiatry 2023;4(2):54-
Objective:
The aim of this study was to determine the comorbid sleep disorders on
Polysomnography (PSG) of patients complaining of insomnia symptoms.
Methodology:
This is a retrospective study among patients who underwent diagnostic
and split-night polysomnography from April 2014 to February 2019. Those who had at
least one of the following insomnia symptoms of difficulty initiating sleep, difficulty
maintaining sleep and early morning awakening with or without a history of sleep aide use
were identified as patients with insomnia. Polysomnography sleep parameters and
outcome were tabulated and statistical analysis was done using SPSS v 20.0.
Results:
Out of the 302 patients who were included in the study, 34.4% of subjects had a
family history of sleep disorder and 70.4% had a history of sleep aide use. Among the
medical comorbidities, 47.7% of the subjects were diagnosed with hypertension while
10.65% were diagnosed with psychiatric disorder. Most of the patients complained of
both difficulty initiating sleep and early morning awakening. PSG sleep parameters
showed that patients did not experience excessive daytime sleepiness or delayed sleep
latency. On the other hand, poor sleep efficiency could be due to increased arousal index.
Half of the patients turned out to have severe obstructive sleep apnea (52%) while 2.3% of
the patients had periodic limb movement disorder. Among those diagnosed with severe
OSA, 53.3% had a history of sleep aide use.
Conclusion
The study showed the importance of screening patients with insomnia for
underlying comorbid sleep disorders. The American Academy of Sleep Medicine (AASM)
treatment guidelines for chronic insomnia emphasized the need to have a high index of
suspicion for this population in order to recommend diagnostic procedures such as
polysomnography. Diagnosing a patient with insomnia to have an underlying sleep apnea
and/or periodic limb movement disorder would change the course of management among
patients with chronic insomnia and eventually avoid prescribing medications that could
actually worsen the patient’s condition.
Sleep Initiation and Maintenance Disorders
;
Sleep Wake Disorders
;
Polysomnography
;
Comorbidity
10.Psychiatry and spirituality: Relationships and importance in psychotherapy
The Philippine Journal of Psychiatry 2023;4(1-2):1-9
This paper summarizes a lecture on psychiatry and spirituality, which examined research onthe relationship between religion, spirituality and mental health, and discussed theimportance of addressing spiritual issues in psychotherapy. In this article, religion andspirituality are first differentiated from one another. Next, research on the relationshipbetween religion and mental health is examined. Third, a theoretical model is presentedexplaining how religious involvement may affect mental and social health. Fourth, a review of religious/spiritually-integrated psychotherapy is presented with a focus ondepression/anxiety, moral injury, and PTSD. Finally, further resources for more informationabout the topic is provided. Because many people in the Philippines are religious, and religionaffects mental health one way or the other, it cannot be ignored by psychiatrists who practicein this country.
Religion
;
Spirituality
;
Depression
;
Anxiety
;
Suicide
;
Substance-Related Disorders
;
Stress Disorders, Post-Traumatic
;
Psychotherapy

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