INTRODUCTIONPrevious research has shown single mothers to be at greater risk for both physical and mental health disorders as compared to married mothers. Psychiatric disorders, in particular depression, have been shown to be more prevalent in single mothers than married mothers. This study was aimed at comparing the prevalence of depression, other mood, and anxiety disorders in single and married mothers in a multiethnic Asian society.

MATERIALS AND METHODSThe Singapore Mental Health Study (SMHS) was a cross-sectional survey of the representative population of Singapore. The survey targeted Singapore residents aged 18 years and above. Trained interviewers established the diagnoses of mental disorders using the Composite International Diagnostic Interview version 3.0 (CIDI 3.0). Physical illnesses, social support and sociodemographic correlates were established using structured interviews. For the purpose of this study, single mothers were defined as unmarried, divorced/separated/widowed mothers who had children aged 21 years and below.

RESULTSFace-to-face interviews were completed with 6616 respondents from December 2009 to December 2010. After controlling for sociodemographic correlates in multiple logistic regression model, single mothers had significantly higher odds of having mood disorders (OR = 5.28) as compared to married mothers.

CONCLUSIONOur study found that single mothers in Singapore across ethnicities, experienced a higher risk for mood disorders as elsewhere in the world. Single motherhood was also associated with lower age and education. Our study identifies young, single mothers as a vulnerable group associated with mental illnesses that must be targeted with specific interventions to improve mental health and well-being.

Adolescent ; Adult ; Anxiety ; epidemiology ; Cross-Sectional Studies ; Depression ; epidemiology ; Humans ; Middle Aged ; Mood Disorders ; epidemiology ; Mothers ; psychology ; Prevalence ; Risk ; Risk Assessment ; Singapore ; Single Parent ; psychology ; Social Support ; Socioeconomic Factors ; Young Adult

Internet gaming disorder (IGD) involves the excessive use of Internet games that can cause negative consequences like sleep problems, psychological distress, depression and anxiety. It is widely assumed that IGD is closely related with sleep problems, but studies on the topic are scant. Our study aims to explore the association between IGD and sleep problems. Methods: A total of 1085 participants, aged 13-40 years old reported playing Internet games in this self-administered, web-based survey. The instruments used for the study were socio-demographic questions, IGD Questionnaire, Life Satisfaction Scale, General Health Questionnaire-12 and Insomnia Severity Index. The cut-off point of 10 and above was used to establish the prevalence of sleep problems in this study. Logistic regression analysis was used to explore the association between socio-demographic factors, IGD and sleep problems. Results: The prevalence of sleep problems among those with IGD was 28.2%. Female online gamers (adjusted odds ratio, OR=0.7, 95% confidence interval (CI) = 0.5-0.9) were more likely to have sleep problems than males. Participants with secondary education (adjusted OR=1.9, 95% CI=1.2-3.0) and post- secondary education (adjusted OR=2.7, 95% CI= 1.2-6.0) were more likely to have sleep problems than those who had completed university. Participants with DSM-5 IGD were more likely to have sleep problems. Psychological distress (adjusted OR 4.8, 95% CI=3.6-6.7) and life satisfaction (B = -3.1, 95% CI= -4.0 to -2.2) was associated with sleep problems. Conclusion: Prevalence of sleep problems with IGD is higher among female gamers and is associated with increased psychological distress and decreased life satisfaction. Integrated health management is needed to promote good sleep hygiene among those diagnosed with IGD. ASEAN Journal of Psychiatry, Vol. 17 (1): July – December 2016: XX XX.

INTRODUCTIONStudies examining mental health treatment dropout have primarily focused on Western populations and less so on Asian samples. The current study explored the prevalence and correlates of mental health treatment dropout across the various healthcare sectors in Singapore.

MATERIALS AND METHODSData was utilised from the Singapore Mental Health Study (SMHS), a cross-sectional epidemiological survey conducted among an adult population (n = 6616) aged 18 years and above. Statistical analyses were done on a subsample of respondents (n = 55) who had sought treatment from the various treatment providers (i.e. mental health, medical, social services and religious healers) in the past 12 months. The World Mental Health (WMH) Composite International Diagnostic Interview version 3.0 (CIDI 3.0) was used to determine diagnoses of mental disorders, chronic medical disorders and service utilisation.

RESULTSOf those who had received treatment, 37.6% had ended treatment prematurely, 23.2% had completed treatment and 39.2% were still in treatment. The religious and spiritual sector (83.1%) had the highest dropout, followed by the general medical sector (34.6%), mental health services sector (33.9%) and the social services sector (30%). Marital status emerged as the only sociodemographic factor that significantly predicted treatment dropout-with those who were married being significantly less likely to drop out than those who were single.

CONCLUSIONThe overall dropout rate across the various healthcare sectors was comparable to past studies. While the small sample size limits the generalisability of findings, the current study provides useful insight into treatment dropout in an Asian population.

Adolescent ; Adult ; Age Factors ; Asian Continental Ancestry Group ; statistics & numerical data ; Cross-Sectional Studies ; Educational Status ; Employment ; statistics & numerical data ; Female ; Health Services ; utilization ; Humans ; Income ; statistics & numerical data ; Male ; Marital Status ; statistics & numerical data ; Mental Disorders ; epidemiology ; therapy ; Mental Health Services ; utilization ; Middle Aged ; Patient Dropouts ; statistics & numerical data ; Prevalence ; Sex Factors ; Singapore ; epidemiology ; Social Work ; statistics & numerical data ; Spiritual Therapies ; utilization ; Surveys and Questionnaires ; Young Adult

INTRODUCTIONHoarding is defined as the acquisition of, and inability to discard items even though they appear to others to have no value. The objectives of the study were to establish the prevalence of hoarding behaviour among the general population and among individuals with obsessive-compulsive disorder (OCD) in a cross-sectional study conducted in Singapore.

MATERIALS AND METHODSThe Singapore Mental Health Study was a cross-sectional epidemiological survey of a nationally representative sample of residents aged 18 years or older, living in households. The diagnoses of mental disorders were established using Version 3.0 of Composite International Diagnostic Interview (CIDI 3.0). Differences between 3 groups i.e. those diagnosed with lifetime/12-month Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) OCD with hoarding, those diagnosed with lifetime/12-month DSM-IV OCD without hoarding and those with lifetime hoarding behaviour without diagnosis of DSM-IV OCD were determined.

RESULTSThe weighted prevalence of lifetime hoarding behaviour was 2% and that of hoarding among those with OCD was 22.6%. Those who met the criteria for hoarding behaviour alone were associated with lower odds of having obsessions of contamination, harming, ordering as well as compulsions of ordering and other compulsions than those who met criteria for both OCD and hoarding.

CONCLUSIONHoarders without OCD were less impaired, in terms of comorbid psychopathology, than those with OCD with and without hoarding, and had a higher quality of life versus those with both OCD and hoarding, though still lower than that of the general population.

Adolescent ; Adult ; Aged ; Cross-Sectional Studies ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Hoarding Disorder ; complications ; diagnosis ; epidemiology ; etiology ; Humans ; Male ; Middle Aged ; Obsessive-Compulsive Disorder ; complications ; diagnosis ; Prevalence ; Quality of Life ; Singapore ; epidemiology ; Young Adult

INTRODUCTIONThis study assessed occupational differences in the prevalence of mental and physical disorders in an employed general population sample in Singapore and investigated the impact of these disorders on work productivity losses in terms of work-loss days and work-cutback days. The association of occupation with alcohol use disorders (AUD) and nicotine dependence (ND) was also investigated.

MATERIALS AND METHODSData from a population-based mental health survey of a representative sample of multi-ethnic residents aged 18 years and above were used. The World Health Organization's (WHO) Composite International Diagnostic Interview (CIDI) was administered to establish the lifetime diagnosis of key mental disorders. Self-report on sociodemographic characteristics, productivity loss, ND, and lifetime physical conditions were obtained. Nine occupational groups were included in this analysis.

RESULTSThe sample comprised 4361 participants with a mean (SD) age of 42.2 (11.9) years, ranging between 19 to 80 years. 'Associate professionals and technicians' (26.2%), 'Services and sales workers' (17.7%) and 'Professionals' (15.4%) were the 3 predominant occupational categories. Sociodemographic characteristics differed significantly across occupations (P <0.001). The lifetime prevalences of having 'any mental disorder' and 'any physical disorder' were 13.0% and 37.9%, respectively; major depressive disorder was the most prevalent mental disorder (5.9%) and hypertension was the most common physical disorder (15.6%). There were no significant differences in work productivity loss across occupations. Sociodemographic and occupational correlates for AUD and ND were identified.

CONCLUSIONSociodemographic and health disparities exist in the major occupational categories in Singapore. The strength of the associations between occupation and AUD and ND are significant, indicating the need for preventative measures in select occupations.

Adolescent ; Adult ; Aged ; Alcohol-Related Disorders ; epidemiology ; Chronic Disease ; epidemiology ; Depressive Disorder, Major ; epidemiology ; Female ; Health Surveys ; Humans ; Male ; Middle Aged ; Occupations ; Prevalence ; Singapore ; epidemiology ; Tobacco Use Disorder ; epidemiology ; Young Adult

INTRODUCTIONThe aims of the study were to identify the prevalence and sociodemographic and clinical correlates of suicidal behaviours using data from a cross-sectional survey among those with major depressive disorder (MDD) in Singapore.

MATERIALS AND METHODSThe Singapore Mental Health Study (SMHS) was a cross-sectional epidemiological study that surveyed Singapore residents (Singapore citizens and permanent residents) aged 18 years and above. The assessment of mental disorders was established using version 3.0 of the Composite International Diagnostic Interview (CIDI 3.0). For the purposes of this study, suicidal behaviour was assessed by questions which were asked to respondents who answered positively to the screening questions in the CIDI 3.0 "Depression" module.

RESULTSThe prevalence of suicidal ideation, plan and attempt among those with lifetime MDD was 43.6%, 13.7% and 12.3%, respectively. We found that suicidal ideation, plan and attempt were significantly associated with ethnicity, education and income. The rate of those who had sought some professional help was higher among those with suicidal plan (71.7%) and attempt (72.3%) as compared to those with suicidal ideation (48.7%) and those with MDD but no suicidal behaviour (29%).

CONCLUSIONIndividuals with MDD and suicidal behaviour do differ from their non-suicidal counterparts as they have a different sociodemographic and clinical profile. There is a need for more research and a better understanding of this population which in turn could lead to the development and implementation of relevant interventions.

Adolescent ; Adult ; Aged ; Cross-Sectional Studies ; Depressive Disorder, Major ; complications ; psychology ; Female ; Humans ; Male ; Middle Aged ; Singapore ; Socioeconomic Factors ; Suicidal Ideation ; Suicide, Attempted ; statistics & numerical data ; Young Adult

INTRODUCTIONMental illnesses are not only a growing public health concern but also a major social and economic issue affecting individuals and families throughout the world. The prevalence of mental disorders, the extent of disability caused by these disorders, and services utilisation of these patients has been well studied in developed countries. The aim of this study was to establish the prevalence of select mental disorders and their associated sociodemographic correlates in the adult Singapore resident population.

MATERIALS AND METHODSThis was a cross-sectional, populationbased, epidemiological study of adult Singapore residents aged 18 years and above. The subjects were randomly selected using a disproportionate stratified sampling method. The diagnoses of selected mental disorders including major depressive disorder (MDD), dysthymia, bipolar (bipolar I & II) disorders, generalised anxiety disorder (GAD), obsessive compulsive disorder (OCD), alcohol abuse and alcohol dependence were established using the Composite International Diagnostic Interview, which is a fully structured diagnostic instrument that assesses lifetime and 12-month prevalence of mental disorders.

RESULTSAmong the 6616 respondents (response rate of 75.9%), 12.0% had at least one lifetime affective, anxiety, or alcohol use disorders. The lifetime prevalence of MDD was 5.8% and that of bipolar disorder was 1.2%. The combined lifetime prevalence of the 2 anxiety disorders, GAD and OCD was 3.6%, with the latter being more common than GAD (0.9% and 3.0% respectively). The lifetime prevalence of alcohol abuse and dependence were found to be 3.1% and 0.5% respectively. Age, gender, ethnicity, marital status and chronic physical illnesses were all significant correlates of mental disorders.

CONCLUSIONThe identified associated factors would help guide resource allocation, policy formulation and programme development in Singapore.

Adolescent ; Adult ; Aged ; China ; ethnology ; Cross-Sectional Studies ; Female ; Health Surveys ; Humans ; India ; ethnology ; Malaysia ; ethnology ; Male ; Mental Disorders ; classification ; diagnosis ; epidemiology ; ethnology ; Middle Aged ; Risk Assessment ; Singapore ; epidemiology ; Young Adult

INTRODUCTIONDisability increases an individual's dependence and negatively impacts their physical, mental, and social functioning. The current study aims to establish the prevalence and risk factors of disability in Singapore's population.

MATERIALS AND METHODSData was extracted from the Well-being of the Singapore Elderly (WiSE) study. This cross-sectional study recruited participants aged 60 years and above (n = 2421) who were representative of Singapore's multiethnic population. We used the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 to assess the severity of disability in our sample while establishing its associations and correlations with cognitive levels, sociodemographic variables, and chronic illness.

RESULTSCognitive deficits, old age, female gender, Malay and Indian ethnicity, lack of education, retired or homemaker status, presence of chronic illness (specifically stroke, heart problems, depression, and dementia) were found to be significantly associated with disability in Singapore's elderly population. As hypothesised, participants with deficits in cognition were more likely to indicate higher WHODAS scores.

CONCLUSIONThe findings highlighted specific factors associated with disability in this multiethnic population. The identification of these factors would lead the way to the development of appropriate interventions.

Age Factors ; Aged ; Aged, 80 and over ; Chronic Disease ; Cognitive Dysfunction ; epidemiology ; Cross-Sectional Studies ; Dementia ; epidemiology ; Depression ; epidemiology ; Disabled Persons ; Educational Status ; Ethnic Groups ; statistics & numerical data ; Female ; Heart Diseases ; epidemiology ; Humans ; India ; Malassezia ; Male ; Middle Aged ; Occupations ; statistics & numerical data ; Prevalence ; Retirement ; statistics & numerical data ; Risk Factors ; Sex Factors ; Singapore ; epidemiology ; Stroke ; epidemiology

INTRODUCTION: This paper aims to examine the (1) level of positive mental health (PMH), (2) identify the socio-demographic correlates of the PMH domains in the general population, and (3) establish if employment status moderates the relationship between major depressive disorder (MDD) and PMH among those with a lifetime prevalence of MDD. METHODS: The Singapore Mental Health Study conducted between 2016 and 2018 included Singapore residents aged ≥18 years. The World Health Organization Composite International Diagnostic Interview version 3.0 was utilised to establish lifetime prevalence of MDD. Moderation analysis was conducted using SPSS PROCESS macro (Hayes, 2017) to assess if employment status moderated the relationship between MDD and PMH. RESULTS: Significantly lower PMH total and domain scores were reported by respondents (n=2,270) who endorsed lifetime MDD compared to those who did not. Moderation analysis demonstrated that the effect of MDD on PMH total and domain scores varied considerably across employment status. Based on the interaction plots, the effect of MDD on both PMH total and domain scores was minimal among those employed than unemployed. CONCLUSION Healthcare professionals should support the employment needs of those who report lifetime MDD to provide care for an individual's mental well-being in a holistic manner. Acquiring or remaining in employment would be a priority depending on the PMH of the individual. Reducing barriers to employment for those with health issues or creating employment opportunities for this group are concerns that need to be addressed at a societal level.
Adolescent ; Adult ; Depressive Disorder, Major/epidemiology* ; Employment ; Humans ; Mental Health ; Prevalence ; Unemployment

INTRODUCTION: The study assessed whether self-reported height, weight and derived body mass index (BMI) can provide an accurate measure of anthropometric data in a multiethnic adult population in Singapore. METHODS: Standardised anthropometric measurements were compared against the self-reported values from 5,132 adult residents in a cross-sectional, epidemiological survey. Discrepancies in self-reports from measurements were examined by comparing overall mean differences. Intraclass correlations, Cohen's kappa and Bland-Altman plots with limits of agreement, and sub-analysis by sex and ethnicity were also explored. RESULTS: Data were obtained from 5,132 respondents. The mean age of respondents was 43.9 years. Overall, the height was overestimated (0.2cm), while there was an underestimation of weight (0.8kg) and derived BMI (0.4kg/m2). Women had a larger discrepancy in height (0.35cm, 95% confidence interval [CI] 0.22 to 0.49), weight (-0.95kg, 95% CI -1.11 to -0.79) and BMI (-0.49kg/m2, 95% CI -0.57 to -0.41) compared with men. Height reporting bias was highest among Indians (0.28cm, 95% CI 0.12 to 0.44) compared with Chinese and Malays, while weight (-1.32kg, 95% CI -1.53 to -1.11) and derived BMI (-0.57kg/m2, 95% CI -0.67 to -0.47) showed higher degrees of underreporting among Malays compared with Chinese and Indians. Substantially high self-reported versus measured values were obtained for intraclass correlations (0.96-0.99, CONCLUSION Self-reported anthropometric estimates can be used, particularly in large epidemiological studies. However, sufficient care is needed when evaluating data from Indians, Malays and women as there is likely an underestimation of obesity prevalence.