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Coping strategies of adolescents with leukemia at the outpatient department of the UPPGH Cancer Institute

The Philippine Journal of Psychiatry.2009;31(1):10-13.

Introduction: The American Cancer Society and the National Cancer Institute estimate that approximately 9,000 to 12,400 children and adolescents in the United States are diagnosed with cancer each year. Although childhood cancer is rare, it is the leading cause of death from disease among children 1-14 years. Most studies on health related quality of life in children with cancer have focused on survivors. Only few studies have evaluated patients during ongoing oncological treatment. Objective: To describe the most common coping strategies of adolescent with leukemia at PGH Cancer Institute. Methods: A prospective cross sectional study of coping behavior of adolescent patients with leukemia was done using convenient sampling of patients seen from October 21 to November 25 at the Philippine General Hospital Cancer Institute. Results: A total of 16 patients with leukemia ages 11 to 17 years old are described as follows: majority are males, Roman Catholics, all attending school (elementary, high school and college). The most common coping strategies used by the adolescents were using drugs prescribed by doctors, watching televisions, listening to music, being close with someone, eating, praying, trying to think of the good things in life, sleeping and going to church. Conclusions: Coping strategies most commonly used were self reliance, seeking diversion, relaxing and seeing spiritual support. Recommendation: A prospective study using a larger sample size is should be done.
Human ; Male ; Female ; Young Adult ; Adolescent ; Child ; ADAPTATION, PSYCHOLOGICAL ; LEUKEMIA

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A meta-analysis on the utility of the Structured Clinical Interview for the Diagnostic Statistical Manual (SCID) for a Mental Health Case Registry

Esguerra Maria Rita G. ; Querijero Margaret B.

The Philippine Journal of Psychiatry.2009;31(1):34-44.

A meta-analysis of studies was conducted on the validity of the Structured Clinical Interview for DSM (SCID) as diagnostic tools for the detection of psychiatric disorders: Schizophrenia, Bipolar disorder, major depressive disorder and Substance-related disorders. Looking at sensitivity and specificity, the SCID is seen to perform well, with to high values for all four diagnosis included in the study. In general, SCID was better used in detecting thrue negatives or the non-cases, as shown in higher specificities as compared to sensitivities.
MENTAL HEALTH ; DIAGNOSTIC EQUIPMENT

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Metabolic syndrome among Filipino schizophrenic patients maintained on typical & atypical antipsychotics at the UP-PGH Psychiatry Outpatient Department

Chua Wilma Anthea M. ; Querijero Margaret B.

The Philippine Journal of Psychiatry.2009;31(1):20-25.

Objective: This study identified the prevalence of metabolic syndrome among patients diagnosed with schizophrenia who were maintained on typical and atypical anti-psychotics and have been consulting at the UP-PGH Out-Patient Department by reviewing the values of the laboratory parameters included in the criteria for metabolic abnormalities within a period of 6 months. The prevalence of metabolic syndrome in patients maintained on typical and atypical anti-psychotics was described. Methodology: Patients consulting at the UP-PGH Out-Patient Department who have been diagnosed with schizooophrenia and maintained on typical and atypical anti-psychotics were screened. Only the values of laboratory exams which were reviewed and no new laboratory exams were performed. Parameters used to define the presence of metabolic syndrome as proposed by the International Diabetes Foundation were applied. Results: Fifty-two subjects had a mean age and duration of antipsychotic treatment of 38 and 12.6 years, respectively. Half were taking typical antipsychotics and the other half were maintained on atypical antipsychotics. Of the 52 subjects, 42.3% were noted to have central obesity, 23% had high blood pressure, 9.6% had high fasting glucose, 7.7% had low HDL cholesterol levels and 3.8% were noted to be obese. Four (7.49%) of the 52 subjects were noted to have metabolic syndrome, all of them maintained on atypical antipsychotics. Conclusion: Filipino patients diagnosed with schizophrenia on long-term antipsychotic underscores the need for regular assessment and monitoring of metabolic parameters.
Human ; Male ; Female ; Aged 80 and over ; Aged ; Middle Aged ; Adult ; SCHIZOPHRENIA ; METABOLIC SYNDROME X ; ANTIPSYCHOTIC AGENTS

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Olanzapine IM versus haloperidol IM for acute agitation in schizophrenia

Leynes Cynthia R. ; Bautista Tomas D.

The Philippine Journal of Psychiatry.2009;31(1):26-33.

Patients with schizophrenia presenting with agitated or violent behavior require pharmacological tranquilization. Olanzapine is the first atypical antipsychotic to have a short acting intramuscular preparation for control of agitation. There is a need to review the efficacy and safety of olanzapine intramuscular compared to intramuscular haloperidol. Objectives: To compare the efficacy of olanzapine intramuscular with haloperidol intramuscular in controlling acute agitation among patients with schizophrenia. Methodology: The authors searched the Cochrane Schizophrenia Group Register (November 2004), Cochrane Database for studies, Cochrane Controlled Trials Register (Issue 1, 2002), MEDLINE (1992 to the present), Clinical Trials.gov, Lilly Trial Registry and ClinicalTrialresults.org. Authors also hand-searched references of journal articles and contacted pharmaceuticals for relevant literature. Articles included in the meta analysis were randomized clinical trials comparing the efficacy of intramuscular olanzapine to intramuscular haloperidol for controlling agitation among patients with schizophrenia. Included studies had participants 18 years old and above who had schizophrenia and were acutely agitated. Intervention included olanzapine intramuscular 10-20 mgs compared with haloperidol 5-10 mgs. Outcomes included were decreased in agitation as measured by time to tranquility, change in PANSS scale or other appropriate scale and mean dose to achieve tranquility. Secondary outcomes measures were occurrence of adverse events, patient and care giver satisfaction and economic costs. Analysis: Two authors independently assessed the quality of the studies. Data were extracted using the Cochrane Data Extraction Form. Missing data from the studies furnished by ClinicalTrialresults.org. Data that were continuous were sing mean change. Difference in mean change was analyzed using inverse variance, fixed effects method at 95% confidence interval. Data that were dichotomous were analyzed using odds or risk ratio using Mantel-Haenszel method at 95% confidence interval. Results: Pooled data from the studies did not show that olanzapine intramuscular was not equal to haloperidol intramuscular in decreasing acute agitation among patients with schizophrenia. In terms of treatment emergent adverse events, the risk for treatment emergent adverse events was more for haloperidol IM compared olanzapine IM. Conclusions: It cannot be said that olanzapine IM and haloperidol IM are not equal in decreasing agitation among patients with schizophrenia. In terms of treatment emergent adverse events, the risk for extrapyramidal side effects and dystonia was more for haloperidal IM compared to olanzapine IM while the risk for abnormal blood pressure was more for olanzapine IM compared to haloperidol IM. There is need to assess other factors like economic cost, patient and caregiver satisfaction which the studies in this meta-analysis did not include.
Human ; Aged 80 and over ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; SCHIZOPHRENIA ; PSYCHOMOTOR AGITATION ; OLANZAPINE ; HALOPERIDOL

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Suicidality among Filipino children and adolescents: a cross-sectional study on substance use among Filipino suicidal and parasuicidal child and adolescent patients

Nepomuceno Aileen M. ; Leynes Cynthia R. ; Pascual Joselito

The Philippine Journal of Psychiatry.2009;31(1):2-9.

Introduction: The year 2000 World Health Organization reports that the age didtribution of suicide has changed such that the rates for those aged 5-44 years old have increased from 40% to 55%, while those aged 45 and above have decreasing suicide rates of 60% to 45%. In the Philippine General Hospital (PGH), the proportion of child and adolescent suicide cases has increased from 35.8% and 26% in 2003-2004 to 41.7% and 58.4% 2005-2006. To date, local studies on risk factors affecting adolescent suicide have not been done and the number of adolescent attempting to kill themselves in a country known for its close family ties and catholic practices continue to rise. Objectives: To describe the profile of Filipino children who committed suicide or parasuicide and characterize them in terms of history of substance use versus patients without a history of substance use in terms of the following variables: demographics, nature of suicide, and risk factors for suicide. Methods: A retrospective cross-sectional chart review of all Filipino charity patients aged 18 years and below, seen at the PGH Department of Emergency Services (DEMS) from the period January 1, 2006 to October 31, 2007 was done. Data was analyzed using frequency count distribution and ratio and proportion. Results and Conclusions: A total of 56 charts were reviewed for the study. The profile of the Filipino child who attempted suicide in this study can be described as: majority is female, single aged 14-18 years, RC, high school students, and unemployed. Most common method of suicide attempt was through ingestion of silver jewelry cleaner following family conflict. No mortality was reported. Suicide risk factors which appear to be significant in this population are substance use, domestic situation, and involvement in a relationship. Further characterization of the group into those with and without a history of substance use also suggests that increasing age, a lower educational attainment, employment status, family history of suicide, marital status of parents, domestic situation, and involvement in a relationship are factors that may influence substance use among this vulnerable population. Recommendations: Early psychiatric evaluation of alcoholic drinkers among adolescents and parental psycho-education in school should be done to curb the rising incidence of suicide attempts in this vulnerable population. Further, prospective and multicenter studies involving more subjects are needed to validate findings in this study.
Human ; Female ; Adolescent ; SUBSTANCE-RELATED DISORDERS ; SUICIDE ; SUICIDE, ATTEMPTED

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Is there a stigma of psychiatrists among medical colleagues in Tarlac?

Mallari Ma. Cecilia C. ; Conde Bernardo Jorge L. ; Navarro Jose C.

The Philippine Journal of Psychiatry.1998;22(2):9-11.

Psychiatrists are numerous in urban areas, but are lacking in the provinces. Could there be a discrimination of psychiatrists by physicians in the rural areas? Is there a stigma attached to being a psychiatrist in the province? In an attempt to answer the above questions, a questionnaire survey of physicians in the province of Tarlac was conducted. Internal validity of the questionnaire was tested using Cronbach Alpha. Two pretests were conducted; the actual test consisted of 25 items with 92 points. Stigma was defined in terms of a cutoff value above 50% from the total number of points. In 75% of the respondents, there was a stigma attached to being a psychiatrist in Tarlac. The following were cited as disadvantages if being a psychiatrist in the said province: few patients, inadequate facilities and poor income. Some thought that psychiatrists might identify with their patients and acquire the same symptoms. The presence of stigma caries a negative implication as to the delivery of mental health care. There is a need to re-orient and re-educate physicians in Tarlac and reintegrate psychiatry into general medical practice.
Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; PSYCHIATRY ; PHYSICIANS ; ATTITUDE ;

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Zolpidem in insomnia 3-year post-marketing surveillance study in the Philippines

Bautista Albert Hans P. ; Buenaventura Robert D.

The Philippine Journal of Psychiatry.1998;22(2):12-18.

A post-marketing surveillance study was conducted in the Philippines in routine practice and involved 1482 patients treated with zolpidem (Stilnox R), an imidazopyridine hypnotic agent. The patient population was 53.24 percent women and 45.28 percent men with a mean age of 47 years old (18.42 percent were over 65 years old). Of the patients, 44.26 percent were treated with a zolpidem dosage of 10 mg/day and 35.96 percent, 5mg/day. The treatment duration range from 2 to 35 days and a mean of 8 days. All adverse events were collected through spontaneous reporting. Thirty-nine patients (2.6 percent) reported 79 adverse events 20 (1.3 percent) of them discontinued treatment. CNS (central nervous system) related adverse events accounted for 70 percent of the total events. The most common events were headache and drowsiness the next day in 0.88 percent and 0.81 percent of the total cases respectivelv. Dizziness, lack of concentration, restlessness, hallucinations, nightmares, incoherence and disorientation were observed in a lower proportion, with one episode of twitching of the lower extremities. No serious adverse event was reported and no new risk factors or at-risk populations were identified. The safety profile of zolpidem is thus consistent with its known pharmacological properties, the results of previous clinical trials, and the cumulative international experience gained with this short-acting hypnotic drug.
Human ; Male ; Female ; Middle Aged ; Adult ; Young Adult ; Adolescent ; SLEEP INITIATION AND MAINTENANCE DISORDERS ; ZOLPIDEM ;

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PPA: Programs, policies and action - taking on the challenge of the future

Jimenez Alma L.

The Philippine Journal of Psychiatry.1998;12(2):19-23.

For 1998, the PPA Board adopted a comprehensive program to empower psychiatrists to respond to the increasing demands on and broadening concerns of psychiatrists. All activities were tailored to fit the theme "Taking on the Challenge of the Future." Goals and strategies were articulated and functioned as guidelines for the relevance and coherence of activities to the overall theme. The PPA Board notes that its program was implemented as designed. For making this possible, special mention goes to PPA members, the pharmaceuticals and our secretariat. The incoming PPA Board can continue the gains made this year, improve attention areas and implement the plans designed this year Moving into the next millenium, anticipating the next twenty-five years, the PPA faces the critical task of facilitating change for itself and its community. Hopefully, this years program has empowered him to take on the challenge of the future.
PSYCHIATRY ; POLICY ; CONSTITUTION AND BYLAWS

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A correlation between ovulatory phase and cytohormonal maturation index of women with affected disorders: a preliminary study

Ang Maria S. ; Delgado Dennis ; Cabrera Mary ann ; Conde Bernardo J.L. ; Navarro Jose C.

The Philippine Journal of Psychiatry.1998;22(2):4-8.

Difference in endocrine features between men and women supports a biological hypothesis in affective disorders among women. Studies done showed high probability that mood changes in associated with hormonal alterations, particularly that of estrogen and progesterone. There are cyclic morphological changes occurring in the female reproductive system in response to these hormones. The cytohormonal maturation index (CHMI) is used to evaluate the female hormonal milieu. A differential of the three types of cells is expressed as percentages of the parabasal (P), the intermediate (I), and the superficial (S) cells, in that order. Predominance of the intermediate cells reflect high levels of progesterone, and the superficial cells that of estrogen. This study aims to compare the correlation of CHMI with ovulatory phase between women of reproductive age with affective disorder and normal control; and to compare the CHMI of the two groups. Eight women of reproductive age (mean age = 29.62 +/- 7.95), diagnosed to have affective disorders and having an episode of mania/hypomania or depression, underwent Paps smear. Written consents were obtained. LMP and PMP were obtained to determine the current ovulatory phase. The control group is composed of seven women of same age group (mean age = 29.29 +/- 6.65) having no manifestations of any psychiatric illnesses. Paps smear was performed by a Gynecology Resident. A Pathology Resident blinded to the study reviewed the slides for CHMI. Fishers exact I test and Mann-Whitney U test were utilized. A p value of 0.05 was considered as statistically significant. There is a significant difference in the proportion of agreement between the ovulatory phase and the CHMI between the two groups (p=0.045). However, there is no difference in the percentages of progesterone and estrogen between the two groups (p=0.247 and 0.452, respectively).
Human ; Female ; Adult ; WOMEN ; FOLLICULAR PHASE ; MOOD DISORDERS ; ;

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Psychosocial aspect of disaster: psychiatric morbidity

Bautista Tomas D.

The Philippine Journal of Psychiatry.1999;23(1):24-34.

To determine the prevalence of psychiatric syndromes among the disaster victims in CABCOM, Pampanga who underwent psychosocial processing.
Human ; Male ; Female ; Adult ; PSYCHOLOGY ; PSYCHIATRY ; DISASTERS

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