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
		                        			;
		                        		
		                        			Anxiety Disorders
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			epidemiology
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Cross-Sectional Studies
		                        			;
		                        		
		                        			Family Health
		                        			;
		                        		
		                        			statistics & numerical data
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Mood Disorders
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			epidemiology
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Parent-Child Relations
		                        			;
		                        		
		                        			Parenting
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Parents
		                        			;
		                        		
		                        			psychology
		                        			;
		                        		
		                        			Psychiatric Status Rating Scales
		                        			;
		                        		
		                        			Psychopathology
		                        			;
		                        		
		                        			Singapore
		                        			;
		                        		
		                        			epidemiology
		                        			
		                        		
		                        	
2.Quality of Life across Mental Disorders in Psychiatric Outpatients.
Vathsala SAGAYADEVAN ; Siau Pheng LEE ; Clarissa ONG ; Edimansyah ABDIN ; Siow Ann CHONG ; Mythily SUBRAMANIAM
Annals of the Academy of Medicine, Singapore 2018;47(7):243-252
INTRODUCTIONLiterature has shown that individuals with various psychiatric disorders experience a lower quality of life (QoL). However, few have examined QoL across disorders. The current study explored differences in QoL and symptom severity across 4 psychiatric diagnostic groups: anxiety disorders (including obsessive compulsive disorder [OCD]), depressive disorders, schizophrenia, and pathological gambling.
MATERIALS AND METHODSData analysed was from a previous study that examined the prevalence of hoarding symptoms among outpatients (n = 500) in a tertiary psychiatric hospital in Singapore. Measures utilised included the Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II) and Quality of Life Enjoyment and Satisfaction QuestionnaireShort Form (Q-LES-Q-SF). Sociodemographic information and details on type and number of comorbidities were also collected.
RESULTSThe depressive disorder group had the highest level of depressive and anxiety symptoms and the lowest QoL whereas; the schizophrenia group had the lowest level of depressive symptoms and the highest QoL. Age and employment status were the only sociodemographic correlates which were significantly associated with QoL. After controlling for sociodemographic factors, only the type of mental disorder was found to have a significant effect in explaining BAI, BDI-II and Q-LES-Q-SF.
CONCLUSIONFindings offer insight in terms of the burden associated with the various disorders.
Adult ; Anxiety Disorders ; epidemiology ; psychology ; Comorbidity ; Cost of Illness ; Demography ; Depressive Disorder ; epidemiology ; psychology ; Female ; Gambling ; epidemiology ; psychology ; Humans ; Male ; Middle Aged ; Outpatients ; psychology ; statistics & numerical data ; Psychiatric Status Rating Scales ; Quality of Life ; Schizophrenia ; diagnosis ; epidemiology ; Singapore ; epidemiology ; Socioeconomic Factors
3.Increased Risk of Psychiatric Disorders in Women with Polycystic Ovary Syndrome in Southwest China.
Jing TAN ; Qiu-Yi WANG ; Gui-Mei FENG ; Xue-Ying LI ; Wei HUANG ;
Chinese Medical Journal 2017;130(3):262-266
BACKGROUNDPolycystic ovary syndrome (PCOS) and its characteristic symptoms have been associated with physical and psychological issues in women of reproductive age. The current study was conducted in response to the dearth of systematic research related to psychological functioning and quality of life in patients with PCOS in Southwest China, and to determine whether patients with PCOS exhibit poorer mental health (MH) compared to healthy women of the same age and living in the same region, without a PCOS diagnosis.
METHODSWe enrolled 120 outpatients with PCOS and 100 healthy controls in this study. Standardized questionnaires were administered to assess general MH conditions (General Health Questionnaire-12-item version), anxiety (State-Trait Anxiety Inventory), depression (Beck Depression Inventory), as well as health-related quality of life (HRQoL) measured using the 36-item short-form health survey. The independent samples t-test was conducted for continuous study variables. For categorical variables, the Pearson Chi-square test, Fisher's exact test, and logistic regression were performed.
RESULTSThe prevalence of anxiety (13.3% vs. 2.0%) and depression (27.5% vs. 3.0%) was higher in patients with PCOS compared to the controls (both P< 0.05). Patients with PCOS had decreased HRQoL. Patients with PCOS who had fertility requirements were more likely to be anxious and depressed than those without fertility requirements (anxiety: 22.6% [12/53] vs. 5.9% [4/67], χ2 = 7.117, P = 0.008; depression: 37.7% (20/53) vs.19.4% (13/67), χ2 = 4.988, P = 0.026).
CONCLUSIONSPCOS and related symptoms may be risk factors for depression and anxiety. Professionals should be concerned with the MH of women with PCOS, and psychological therapy should be considered.
Adult ; Anxiety ; diagnosis ; etiology ; China ; Depression ; diagnosis ; etiology ; Female ; Humans ; Mental Disorders ; diagnosis ; etiology ; Polycystic Ovary Syndrome ; complications ; physiopathology ; psychology ; Psychiatric Status Rating Scales ; Quality of Life ; Surveys and Questionnaires ; Young Adult
4.Screening for Drinking Problems in the Elderly in Singapore Using the CAGE Questionnaire.
Clarissa Wy ONG ; Vathsala SAGAYADEVAN ; Edimansyah ABDIN ; Saleha Binte SHAFIE ; Anitha JEYAGURUNATHAN ; Goi Khia ENG ; Louisa PICCO ; Janhavi VAINGANKAR ; Siow Ann CHONG ; Mythily SUBRAMANIAM
Annals of the Academy of Medicine, Singapore 2016;45(10):456-465
INTRODUCTIONGiven that past research on drinking problems has focused primarily on younger samples, the present study sought to examine the prevalence and correlates of alcohol use among the elderly in Singapore.
MATERIALS AND METHODSData were extracted from the Well-being of the Singapore Elderly (WiSE) study, a cross-sectional, epidemiological survey conducted among a nationally representative sample of Singapore residents (n = 2565) aged 60 years and above. Variables assessed include drinking problems, depression and anxiety symptoms, obesity, smoking status, chronic physical disorders and disability.
RESULTSThe weighted prevalence of drinking problems (CAGE score ≥2) in our sample was 4.2%. Male sex, Indian ethnicity, and being divorced or separated were associated with a significantly higher likelihood of drinking problems. Participants with drinking problems were also more likely to have subthreshold depression. There were no significant differences in disability among those with drinking problems, those without drinking problems and non-drinkers, after adjusting for demographic variables.
CONCLUSIONOur findings contribute to the body of research that indicates an association between drinking problems and depressive symptoms among the elderly. Thus, screening for depressive symptoms in the elderly with drinking problems may be useful in identifying such comorbidities in order to aid treatment planning.
Aged ; Aged, 80 and over ; Alcohol-Related Disorders ; diagnosis ; epidemiology ; psychology ; Alcoholism ; diagnosis ; epidemiology ; psychology ; Anxiety ; epidemiology ; psychology ; Chronic Disease ; Cross-Sectional Studies ; Depression ; epidemiology ; psychology ; Divorce ; statistics & numerical data ; Ethnic Groups ; Female ; Humans ; India ; Male ; Marital Status ; Mass Screening ; Middle Aged ; Obesity ; epidemiology ; Prevalence ; Risk Factors ; Sex Factors ; Singapore ; epidemiology ; Smoking ; epidemiology ; Surveys and Questionnaires
5.Comprehensive psychological intervention to improve outcome in functional gastrointestinal disorder: a cohort study.
Yu Tien WANG ; Kah Foo Victor KWOK ; Shian Ming TAN ; Ming Hwei YEK ; Wai Choung ONG ; Sylvaine BARBIER ; Beng Yeong NG
Singapore medical journal 2015;56(7):385-392
INTRODUCTIONPatients with functional gastrointestinal disorders (FGIDs) have a decreased quality of life (QoL). Psychological illnesses are strongly associated with FGIDs. This study examined the effect of a comprehensive psychological intervention programme designed for refractory FGID patients.
METHODSRefractory FGID patients at a tertiary gastroenterology unit were encouraged to participate in a psychological intervention programme, which included screening for anxiety and depression in patients, educating patients and physicians on FGIDs, and providing early access to psychiatric consultation for patients with significant psychological illnesses. The duration of follow-up was six months. Outcomes were measured using the Irritable Bowel Syndrome-QoL (IBS-QoL) instrument and the EuroQol five dimensions (EQ-5D) questionnaire.
RESULTSA total of 1,189 patients (68% female, 80% Chinese, mean age 48.6 years) participated in the programme. Among these participants, 51% had a significant psychological disorder (Hospital Anxiety and Depression Scale [HADS] anxiety or depression score > 7). These participants had a significantly poorer QoL (IBS-QoL and EQ-5D, both p < 0.0001), and were more likely to be single or English-speaking, as compared to the participants without psychological disorders. Participants who completed ≥ 3 months of follow-up (n = 906) showed significant and durable improvement. High baseline HADS anxiety score predicted improvement (p < 0.001), with participant IBS-QoL and EQ-5D scores decreasing over time.
CONCLUSIONThe intervention programme was associated with a clinically meaningful improvement in the QoL of patients with refractory FGIDs. High baseline anxiety was predictive of improvement.
Adult ; Anxiety ; complications ; diagnosis ; therapy ; Depression ; complications ; diagnosis ; therapy ; Female ; Follow-Up Studies ; Gastrointestinal Diseases ; complications ; psychology ; therapy ; Humans ; Male ; Mental Disorders ; complications ; therapy ; Middle Aged ; Quality of Life ; Severity of Illness Index ; Singapore ; Surveys and Questionnaires ; Treatment Outcome
6.The Korean Version of the Trauma Symptom Checklist for Children: Psychometric Properties and the Connection to Trauma among Korean Children and Adolescents.
Journal of Korean Medical Science 2014;29(6):837-845
		                        		
		                        			
		                        			The purpose of the present study was to develop a Korean version of the trauma symptom checklist for children (TSCC) and to examine its reliability and validity for screening posttraumatic stress symptoms. A normative group of 405 children and adolescents aged 8 to 16 yr participated in the study. A test-retest procedure was conducted with 76 participants from the normative group after 4 weeks. In the traumatized group, 73 children and adolescents of the same age from the Child Sexual Abuse Treatment Center were included. Good internal consistency (Cronbach's alpha) for the total scale (0.95, ranging 0.79-0.85 on the clinical scales) and test-retest reliability for the total scale (r=0.91, ranging 0.71-0.87 on the clinical scales) were found. Confirmatory 6-factor analysis explained 51.1% of the variance. Other measures such as concurrent or discriminative validity were also shown to be satisfactory. In conclusion, the Korean version of TSCC has been shown to be a screening instrument with satisfactory psychometric qualities that is capable of identifying trauma symptoms among children and adolescents who have self-reported experiencing trauma or for whom clinicians have identified traumatic experiences.
		                        		
		                        		
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Analysis of Variance
		                        			;
		                        		
		                        			Anxiety
		                        			;
		                        		
		                        			Asian Continental Ancestry Group
		                        			;
		                        		
		                        			Checklist/*methods
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Child Abuse, Sexual/psychology
		                        			;
		                        		
		                        			Depression/psychology
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Mental Disorders/diagnosis/psychology
		                        			;
		                        		
		                        			Observer Variation
		                        			;
		                        		
		                        			*Psychology, Adolescent
		                        			;
		                        		
		                        			Psychometrics
		                        			;
		                        		
		                        			Questionnaires
		                        			;
		                        		
		                        			Reproducibility of Results
		                        			;
		                        		
		                        			Republic of Korea
		                        			;
		                        		
		                        			Stress Disorders, Post-Traumatic/diagnosis/*psychology
		                        			
		                        		
		                        	
7.Psychological Problems and Clinical Outcomes of Children with Psychogenic Non-Epileptic Seizures.
Yoon Young YI ; Heung Dong KIM ; Joon Soo LEE ; Keun Ah CHEON ; Hoon Chul KANG
Yonsei Medical Journal 2014;55(6):1556-1561
		                        		
		                        			
		                        			PURPOSE: Our purpose was to investigate psychological problems and clinical outcomes in children with psychogenic non-epileptic seizures (PNES). MATERIALS AND METHODS: We retrospectively reviewed the data of 25 patients who were diagnosed with PNES between 2006 and 2012. RESULTS: Twenty-five children with PNES, aged 8 to 19 years (mean 13.82), were referred to psychiatrists for psychiatric assessment. On their initial visit, 72% of patients had comorbid psychological problems, including depression, anxiety, conduct disorder, adjustment disorder, Attention Deficit Hyperactivity Disorder, schizophrenia, and bipolar disorder. Among these, depression was the most frequent (36%). Predisposing and triggering factors included familial distress (40%), social distress (24%), and specific events (20%). The following treatment was advised based on the results of the initial psychological assessment: 3 patients regularly visited psychiatric clinic to assess their clinical status without treatment, nine underwent psychotherapy, and 13 received a combination of psychotherapy and psychopharmacological therapy. At the mean follow-up of 31.5 months after diagnosis, 20 patients (80%) were event-free at follow-up, three (12%) showed reduced frequency, and two (8%) experienced persistent symptoms. CONCLUSION: The outcomes of PNES in children are much better than those in adults, despite a high rate of psychological comorbidities.
		                        		
		                        		
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Anxiety/epidemiology
		                        			;
		                        		
		                        			Attention Deficit Disorder with Hyperactivity/epidemiology
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Child, Preschool
		                        			;
		                        		
		                        			Comorbidity
		                        			;
		                        		
		                        			Depression/epidemiology
		                        			;
		                        		
		                        			Depressive Disorder/epidemiology/psychology
		                        			;
		                        		
		                        			Electroencephalography
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Mental Disorders/*diagnosis/epidemiology/*psychology
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Psychophysiologic Disorders/*diagnosis/*psychology
		                        			;
		                        		
		                        			Psychotherapy
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Seizures/diagnosis/*psychology/*therapy
		                        			;
		                        		
		                        			Treatment Outcome
		                        			;
		                        		
		                        			Young Adult
		                        			
		                        		
		                        	
8.Psychosocial adjustment and quality of life of adolescents and adults with congenital heart disease.
Korean Journal of Pediatrics 2014;57(6):257-263
		                        		
		                        			
		                        			The incidence of people living with congenital heart disease (CHD) has been increasing every year owing to remarkable advances in surgical and catheter intervention techniques and devices, and improved knowledge of critical care for patients with CHD. However, these patients continue to face physical, psychosocial, and environmental challenges, and a number of studies have shown higher rates of depression and anxiety disorders than the general population. To improve psychosocial functioning and quality of life for adults with CHD, health care providers are recommended to inform CHD patients of an accurate diagnosis, and overall treatment process, beginning in adolescence to facilitate a smooth transition from adolescence to adulthood. Active cooperation with psychiatrists, psychologists, social workers, chaplains, and family members is highly recommended to help CHD patients feel normal and optimistic and to promote good social interactions, close family relationships, and a strong sense of coherence.
		                        		
		                        		
		                        		
		                        			Adolescent*
		                        			;
		                        		
		                        			Adult*
		                        			;
		                        		
		                        			Anxiety
		                        			;
		                        		
		                        			Anxiety Disorders
		                        			;
		                        		
		                        			Catheters
		                        			;
		                        		
		                        			Critical Care
		                        			;
		                        		
		                        			Depression
		                        			;
		                        		
		                        			Diagnosis
		                        			;
		                        		
		                        			Family Relations
		                        			;
		                        		
		                        			Health Personnel
		                        			;
		                        		
		                        			Heart Defects, Congenital*
		                        			;
		                        		
		                        			Heart Diseases
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Incidence
		                        			;
		                        		
		                        			Interpersonal Relations
		                        			;
		                        		
		                        			Psychiatry
		                        			;
		                        		
		                        			Psychology
		                        			;
		                        		
		                        			Quality of Life*
		                        			;
		                        		
		                        			Sense of Coherence
		                        			;
		                        		
		                        			Social Workers
		                        			
		                        		
		                        	
9.Psychosocial care for cancer patients--too little, too late?
Rathi MAHENDRAN ; Joanne CHUA ; Eugene WUAN ; Emily N K ANG ; Siew Eng LIM ; Ee Heok KUA
Annals of the Academy of Medicine, Singapore 2013;42(10):535-537
		                        		
		                        			
		                        			Assessment of psychosocial and psychiatric needs is an increasingly important component of cancer care. Clinical experience with patients indicate that distress, anxiety and depression are prevalent from early stages of the illness. Strategies to enhance psychosocial care are presented and these include early identification through screening, training for healthcare staff working with cancer patients and support not only for patients but their caregivers as well.
		                        		
		                        		
		                        		
		                        			Anxiety
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			Anxiety Disorders
		                        			;
		                        		
		                        			Caregivers
		                        			;
		                        		
		                        			Depression
		                        			;
		                        		
		                        			diagnosis
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Neoplasms
		                        			;
		                        		
		                        			psychology
		                        			
		                        		
		                        	
10.An Explanatory Model for Sleep Disorders in People with Cancer.
Journal of Korean Academy of Nursing 2011;41(4):460-470
		                        		
		                        			
		                        			PURPOSE: The aim of this study was to develop and test an explanatory model for sleep disorders in people with cancer. A hypothetical model was constructed on the basis of a review of previous studies, literature, and sleep models, and 10 latent variables were used to construct a hypothetical model. METHODS: Data were collected from April 19 to June 25, 2010, using self-report questionnaires. The sample was 291 outpatients with cancer who visited the oncology cancer center at a university hospital. Collected data were analyzed using SPSS Win 15.0 program for descriptive statistics and correlation analysis and AMOS 7.0 program for covariance structural analysis. RESULTS: It appeared that overall fit index was good as chi2/df=1.162, GFI=.969, AGFI=.944, SRMR=.052, NFI=.881, NNFI=.969, CFI=.980, RMSEA=.024, CN=337 in the modified model. The explanatory power of this model for sleep disorders in people with cancer was 62%. Further, sleep disorders were influenced directly by cancer symptom experience, dysfunctional beliefs and attitudes about sleep, and past sleep pattern. CONCLUSION: Findings suggest that nurses should assess past sleep pattern and consider the development of a comprehensive nursing intervention program to minimize the cancer symptom experience, dysfunctional beliefs and attitudes about sleep, and thus, reduce sleep disorders in people with cancer.
		                        		
		                        		
		                        		
		                        			Anxiety
		                        			;
		                        		
		                        			Depression
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Hospitals, University
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			*Models, Theoretical
		                        			;
		                        		
		                        			Neoplasms/*complications/*diagnosis/psychology
		                        			;
		                        		
		                        			Questionnaires
		                        			;
		                        		
		                        			Self Concept
		                        			;
		                        		
		                        			Sleep Disorders/epidemiology/*etiology/*psychology
		                        			;
		                        		
		                        			Social Support
		                        			
		                        		
		                        	
            
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