OBJECTIVES: This study was conducted to estimate the prevalence of psychosocial problems among residents of four flood-prone barangays in Manila located along the Maricaban-Malibay creek in Pasay City and were reported to have experienced 10-15 feet-deep flood waters simultaneously caused by Typhoon Maring and the southwest monsoon in August 2013.
METHODOLOGY: A stratified two-stage random cluster sampling method, adapted from the Community Assessment for Public Health Emergency Response (CASPER) Toolkit, was employed in the syudy. The first stage of sampling used street clusters, with more or less of the same size, as the primary sampling unites (PSU) and households as secondary sampling units (SSU) to select the households that will be included in the survey. Since the clusters were more or less of the same size, they ahd equal chances of being selected in the study if the probability of selection is proportionate to size (PPS). Seven houses were then randomly chosen from the 30 selected clusters. All of the househol heads from the 210 selected households were given several copies of the self-administered questionnairescalled the Self-Reporting Questionnaire-20 (SRQ-20), a screening tool developed by WHO, to determine the psychosocial condition of the household members 12-65 years.
RESULTS: The prevalence of psychosocial distress in this population was estimated at 17% (95%CI=13.7-20.3%). The residents of the study barangays were in their rehabilitation phase i.e., three months post disaster when data was collected for this study. The study also characterized the households in the sample according to socio-economic status, presence of members with special needs, and presence of children 0-5 years ol. In the aftermath of the disaster, 46.84% of the respondents had positive answer on the group of questions about decreased energy, 49.8% on somatic symptoms,25.89% on depressive thoughts and 40.91% on depressive moods.There was a higher prevalence of these 4 factors among females, those separated, with low socioeconomic status and low educational attainment.
CONCLUSION: The estimated prevalence of psychosocial distress was 17% (95%CI=13.7%-20.3%), In the aftermath of the disaster, 46.8% of the respondents had positive answer on the group of questions about decreased energy, 49.8% on somatic symptoms, 25.9% on depressive thoughts and 40.9% on depressive moods.

Human ; Male ; Female ; Depression ; Anxiety ; Stress Disorders, Post-traumatic ; Cyclonic Storms ; Floods

OBJECTIVES: This study evaluated the prevalence of anxiety, depression, and posttraumatic growth (positive psychological change as a result of the struggle with highly challenging life circumstances) among patients with HIV/AIDS as well as determine the correlation between these variables alongside select sociodemographic variables.
METHODOLOGY: Fifty eight patients enrolled in an HIV/AIDS clinic at a tertiary hospital were selected via convenience sampling and asked to complete a sociodemographic questionnaire, the Posttraumatic Growth Inventory (PTGI) and the Hospital Anxiety and Depression Scale (HADS) from July to October 2015.
RESULTS: Ninety three percent of the participants reported moderate to high levels of posttraumatic growth, with a mean score of 4.70 (SD = 0.86). 20.7% (11.2 - 33.4, CL=95%) of patients screened positive for depression while 55.2% (41.5 - 68.3, CL=95%) of patients screened positive for anxiety. A statistically significant negative corellation was demonstrated between posttraumatic growth and depression (r=-0.29, p-value= 0.027) but not for anxiety (r=.027, p-value= 0.118).
CONCLUSION: There is a high prevalence of patients in the sample that exhibit depression and anxiety symptoms. Despite this, most patients report a capacity to experience positive changes in the aftermath of a life-threatening, chronic, and stigmatizing illness, correlating with a decrease in depressive symptomatology. As such, initiatives promoting posttraumatic growth are valuable in the comprehensive care for patients afflicted with HIV/AIDS.

Human ; Male ; Female ; Depression ; Anxiety ; Hiv ; Prevalence ; Posttraumatic Growth, Psychological ; Depressive Disorder ; Anxiety Disorders ; Tertiary Healthcare

The case presented multifactorial facets of depression and diabetes leading to noncompliance to both medical and psychiatric treatment resulting in suicide. A biopsychosocial approach was done to elucidate the complexity of the case, factoring in the adolescent storm, vicious cycle of diabetes and depression and effect of enmeshed attachments. Management involved short-term and long-term goals, focusing on psychoeducation about the nature and course of depression, psychiatric impact of depression leading to noncompliance, suicide precaution and treatment plans through psychopharmacology and psychoterapy, family therapy, liaison with the Pediatric Endocrinology and Nutrition service and support group involvement.

Human ; Female ; Depression ; Insulin--administration & Dosage ; Family Therapy ; Psychopharmacology ; Suicide ; Depressive Disorder ; Psychotherapy ; Patient Compliance ; Diabetes Mellitus ; Self-help Groups

In this paper, the researcher proposed to search for current research data on ADHD and play therapy. To achieve this, the researcher look into ADHD - it's definition, manifestation children, the "metaphors" used in relation to ADHD, the neurobiology of ADHD, and treatment interventions for ADHD. The researcher conducted a review of research publications for the past 10 years on ADHD and play therapy and share her clinical experience in the use of play therapy for children with ADHD. The researcher also presented the quantitative data from gathered research to assess the quality of life od several children with ADHD pre- and post-play therapy.

Human ; Play Therapy ; Attention Deficit Disorder With Hyperactivity

This paper is presented at the 27th Midyear Convention of the Philippine Psychiatric Association, Inc. in Iloilo City on 22 July 2016. 

Content:

What are the individuals we meet as psychiatrists Ways of relating with our patientsThe fourfold human beingSacred & SacrednessRole of psychiatristPsychiatry in MedicineParting shot
Human ; Psychiatry ; Patients

OBJECTIVES: This study aims to describe the demographic profile of the both the victims and perpetrators of incest as well as the circumstances surrounding the abuse.
METHODOLOGY: This was a descriptive retrospective study of incest cases seen at the WCPU of VSMMC after getting permission from the WCPU Head and Medical Records Section of the said hospital while maintaining anonymity and after gaining the Ethics & Research Committee approval. The charts with incomplete data were excluded.
RESULTS: Ninety six charts were reviewed. Fifty one (53.13%) were in the age range of 11 - 15 years old with the youngest victim being only 3 years old and the eldest was 27 years old at the time of referral though the incest began when she was 10 years old. All the victims referred were female and 94 (97.92%) were children at the time of referral to the WCPU thus 53.13% had only attained an elementary education. Seventy one (73.95%) of the victims were not residents of Cebu City. Sixty one (63.54%) of the incest cases occured during the day between 12 noon till 559 PM. Two thirds (64 or 66.67%) of the incest cases occured within the victim's household and 72 or 75% of the abuse was done repeatedly. The abuse was usually reported after 72 hours in 69 of the cases (71.88%). There were 101 perpetrators wherein 99% were males. Forty nine (48.51%) were in the age range of 28-47 years old while there were 11 (10.89%) were in the 13-17 years age range. Majority (53 or 52.48%) had blue collar jobs while 43 (42.57%) were unemployed. All of the perpetrators were known to the victim with the ff distribution: almost half (47 or 46.53%) were fathers or stepfathers and the other half  (46 or 45.54%) were extended family members such as uncles (22 or 21.78%), first cousins (16 or 15.84%) and grandfathers (8 or 7.92%). There were 7 (6.9%) brothers and 1 (0.99%) sister who were also perpetrators of incest.
CONCLUSION: The demographic profile and circumstances surrounding the abuse were as expected with many coming from remote communities outside the city of Cebu that could possibly be the cause of delayed consultation at the WCPU despite laws that require reporting to the Department of Social Welfare within 24 hours.

Human ; Female ; Adolescent ; Child ; Incest ; Family Characteristics ; Child Abuse ; Social Welfare ; Medical Records ; Referral And Consultation

OBJECTIVE: This study aims to describe the knowledge and attitude of parents toward their mentally retarded child enrolled for special education in an elementary in Manila.
METHODOLOGY: Using a Tagalog version of the 25 item Index of Parent Attitude (IPA) was used to measure the parents' relationship problems with and their attitude towards their special child. A score below 30 meant that there was no clinically significant problem in tghe parent child relationship, while a score above 30 meant there was a problem and a score above 70 meant parents experienced severe stress with the potential to becoming violent towards their children. A 10 item Knowledge Questionnaire Regarding Mental Retardation (KQMR) answerable by True or False, was also drafted in Taglog. A linguist was consulted to translate and back translate both questionnaires. A score of 1-4 was considered as having poor knowledge, 5-7 good and 8-10 as having excellent knowledge. Consent from the principal of Sta. Ana Elementary School and from parents of mentally retarded children was requested to conduct the study. Parents who had accompanied their children to school and were present at the tiem of study was conducted were included in the study once they agreed to participate. Those who were found to have low scores in th KQMR were invited for 2 Focused Group Discussions (FGD) that lasted for 2 hours each; during with the psychiatrist in training explored their difficulties in managing their mentally retarded children.
RESULTS: Sixty parents agreed to participate in answering the questionnaires and only 18 parents joined the FGD sessions. Based on the IPA 41 (68.33%) were identified as having a significantly problematic attitude towards their child; 16 (26.67%) had no significant problems and 3 (5.0%) had the tendency to become violent towards their child. Forty six (76.67%) were considered to have poor level of knowledge regarding Mental Retardation while 14 (23.33%) had good fund of knowledge and no one had excellent scores. It was mostly the mothers (55 or 91.67%)  who were in school to respond to the questionnaire, most of whom were married (55 or 91.67%) and all of them were more than 30 years old; 43 (71.67%) were unemployed. Fifty percent had a monthly income less than 5000.00 PhP, 40% had 5-10 thousand PhP and 10% had 10,000.00 PhP or more monthly income. Fifty five (91.67%) were high school graduates while 18 or 30% had reached college level. Fifty six (93.33%) were Roman Catholics. From the KQMR many (68%) considered that all mentally retarded children are similar in characteristics and behavior, 70% didn't think that medications could control behavioral changes and 80% didn't think psychiatrist could help in dealing with behavioral or maladaptive changes of such children, while 60% believed that all  types of mental retardation are hereditary. On the other hand 87% were correct in disagreeing with the statement that mentally retarded children become Schizophrenic and 83% considered that the behaviorial changes among mentally retarded children are similar to those of other children.
CONCLUSION: Although some had an accurate understanding about mental retardation most were misinformed, thus the urgent need to educate all parents i.e. both fathers and mothers and perhaps even other members of the family about mental retardation- its causes, complications and how their children could be better managed at home and in school.

Human ; Male ; Female ; Intellectual Disability ; Mentally Disabled Persons ; Parent-child Relations ; Attitude ; Education, Special ; Psychiatry

INTRODUCTION: Prevalence of mental disorders is high worldwide. In Low-and-Lower-Middle-income countries (LALMICs) mental illnesses are already the second cause of burden in DALYs. As psychiatrists are extremely rare in LALMICs, addressing this issue calls for shifting mental health to primary care and consequently, training first line health care providers would be the next challenge. Via the FAST program, the World Asssociation of Social Psychiatry (WASP), Sanofi, Ministries of Health, academics, patients/families association and NGOs have joined forces to improve access to mental health care in LALMICs. The program is based on 3 pillars: (1) Mental health literacy, (2) health care professionals (HCP) training and (3) affordable quality medicines.
OBJECTIVE: This study aims to develop a training curriculum and a set of materials to train HCP that is easily adaptable to the singularity of the local environment.
METHODOLOGY: (1) A master-2 public health student conducted the project; (2) two domains were selected in priority: schizophrenia and unipolar mood disorders; (3) two main targets were identified: general practitioners and nurses / community healthcare workers; (4) professional's needs were assessed through a phone questionnaire; (5) WASP experts were in charge of drafting slides kits and other technical documents (6) to avoid any risk of conflict of interest, it was decided that training on medications will be based on the WHO mhGAP guide.
RESULTS: For each disease and each category of HCP (1) a training of trainers manual; (2) a training curriculum; (3) a slide kit; (4) a training brochure; (5) videos of patients; (6) role-play scenarios; (7) clinical cases (8) pre and post assessment questionnaires, were made available.
CONCLUSION: First feed-back indicated that these tools were of great added value for countries with limited human resources, even though, as anticipated, they will have to be adapted locally, especially role-play scenarios, clinical cases and patient's videos.

Mental Health ; General Practitioners ; Health Literacy ; Prevalence ; Students, Public Health ; Mood Disorders ; Community Psychiatry ; Primary Health Care ; Community Health Services ; Curriculum ; Schizophrenia

INTRODUCTION: According to WHO about 80% of people living with a severe mental disorder in Low-and-Middle-income countries (LAMICs) do not have access to appropriate healthcare. Low literacy regarding mental disorders is one of the main barriers that prevent access to mental healthcare, which leads to stigma, socio economic exclusion, suffering of people with mental disorders and forces families to hide their relatives rather than to direct them to the community healthcare centre. To address this issue mental health, stakeholders from more than 20 countries joined forces with the World Association of Social Psychiatry and Sanofi in the FAST program, based on 3 pillars: (1) Mental health literacy, (2) health care professionals training and (3) affordable quality medicines.
OBJECTIVE: This research aimed or develop Information-Education-Communication materials to improve mental health literacy in LAMICs.
METHODOLOGY: Workshops with participants from different sectors (public, academic, associative, private) were set up to develop generic documentsbased on the experienced derived from malaria awareness programs. Then, for each country, documents were revised and adapted by a local working group.
RESULTS: A flip chart, an educational comic book, a leaflet, a poster and a brochure on schizophrenia were made available with versions adapted to the local specificities of (a) Sub - Saharan Africa (b) North Africa (c) Eastern Europe and (d) Latin America. The main message of the educational materials was that: mental disorders are like any other disease i.e. they can be treated and people with mental disorders are like any other person. The following specific topics where covered: frequency of mental disorders, symptoms recognition, cause of disease, where to seek help, stigma. Recommendations on how to use these materials were also available.
CONCLUSION: Improving mental health literacy in developing countries calls for relevant materials. A rigorous evaluation of the impact of the FAST documents is now required.

Human ; Health Literacy ; Mental Health ; Developing Countries ; Social Stigma ; Community Psychiatry ; Schizophrenia ; Community Health Services ; Malaria

OBJECTIVE: This study aimed to determine the prevalence of Acute Stress Disorder and Post Traumatic Stress Disorder among residents of Barangay Tumana, Marikina exposed to Typhoon Ondoy in September 2009 and Habagat rains in August 2012.

METHODOLOGY: The Acute Stress Disorder Scale (ASDS) and Impact of Events Scale-Revised (IESR) were administered to 212 subjects. Trauma history was also obtained. When screened positive for Acute Stress Disorder (ASD) and/or Post Traumatic Stress Disorder (PTSD), a confirmatory diagnosis was done through psychiatric clinical interview.

RESULTS: The study showed a prevalence rate of 10% for ASD and 5% for PTSD. Co-morbid ASD and PTSD were seen in 4% of the subjects. Frequency and type of prior traumatic events were not significantly different among subjects who were positive or negative for ASD/PTSD diagnoses.

CONCLUSION: There was a significant prevalence of ASD/PTSD diagnoses among residents exposed to Typhoon Ondoy and Habagat, thus the need for developing a means of early detection and immediate therapeutic intervention in Filipino communities exposed to natural disasters.

Human ; Prevalence ; Stress Disorders, Traumatic, Acute ; Stress Disorders, Post-traumatic ; Cyclonic Storms