Academic Psychiatry and Psychology Journal

Development of Bite Guards for Use in Electroconvulsive Therapy in Psychiatric Patients at Suanprung Psychiatric Hospital, Chiang Mai Province

2026-04-03T21:02:31+07:00

Electroconvulsive therapy (ECT) is an effective treatment modality for patients with severe psychiatric disorders or those who are refractory to other therapeutic approaches. However, muscle contractions during the procedure may lead to oral complications, including tooth fracture, tooth displacement, and tongue lacerations, particularly when the bite guard is not well adapted to the patient’s oral anatomy. The author therefore developed bite guards for use during ECT to reduce oral complications. This article outlines the conceptual framework and development process from 2017 to the present. Two models were developed: Suanprung Model 1, which was designed to be suitable for both unmodified ECT and modified ECT, and Model 2, which specifically aimed to resolve the persistent issue of tongue lacerations. Follow-up results demonstrated that the use of these bite guards significantly reduced both the incidence and severity of oral complications. Notably, no complications were observed with Suanprung Model 2. In addition, the production cost was lower compared to commercially available alternatives, resulting in reduced overall expenditure. User satisfaction was reported to be high, supporting the feasibility and appropriateness of implementation within the Suanprung Hospital context. The findings suggest that the developed bite guards have potential for broader application in other psychiatric settings and evaluate long-term outcomes.

Development and Effectiveness of a Community-Participatory Depression Surveillance and Suicide Prevention Model for Older Adults, Phu sang District, Phayao Province.

2025-11-16T09:10:10+07:00

Objective: To develop a community-participatory model for depression surveillance and suicide prevention among older adults in Phu Sang District, Phayao Province, Thailand.

Materials and methods: This mixed-methods study was conducted in three phases: (1) situation analysis, (2) model development, trial implementation, and revision, and (3) expansion through a quasi-experimental one-group pretest–posttest design. The participants included community leaders, public health personnel, and older adults, purposively selected for a total of 110 participants. Data were collected using focus group interviews, questionnaires, semi-structured interviews, and the Mental Health Check-in program. The study was conducted from May 2024 to July 2025. Data were analyzed using content analysis, descriptive statistics and paired t-test.

Results: The community-participatory model for depression surveillance and suicide prevention among older adults comprised four key activities:1) “3S Mind Scan” the service access rate for depression care increased from 19% to 33%; 2) “Friendly Community Saves Lives” all 13 individuals with suicidal behavior were successfully helped; 3) “Empower the Elderly: No One Left Behind” the mental strength of older adults improved from low to moderate levels; 4) “Phu Sang District Health Board: Co-Creation and Evaluation Initiative” Participation and satisfaction scores increased, and suicide deaths among older adults showed a declining trend.

Conclusion: A community-participatory model for depression surveillance and suicide prevention among older adults can effectively enhance mental health literacy, strengthen positive attitudes and psychological resilience, improve access to appropriate care for depression, and has the potential to reduce the suicide mortality rate among older adults.

Depression, Anxiety, Stress and Disability after Ischemic Stroke at Maharaj Nakorn Chiang Mai Hospital

2025-12-12T18:54:38+07:00

Objective: To examine the levels of depression, anxiety, stress, disability, and factors associated with mental health among patients with ischemic stroke.

Materials and methods: Survey research was conducted among 100 patients at the Outpatient Department (OPD 21) of Maharaj Nakorn Chiang Mai Hospital between October 2024 and September 2025. Data were collected using a general information questionnaire, the Depression Anxiety Stress Scales–21 (DASS-21), and the Modified Rankin Scale. Descriptive statistics and binary logistic regression were used for data analysis, with statistical significance set at p < .05.

Results: Most participants were male (55%) with a median age of 64 years. The prevalence of mental health problems included anxiety (45%), stress (21%), and depression (19%). Forty-eight percent of patients had no or slight disability. Female patients had 13.59 times higher odds of developing depression compared with males (p < .05), and patients with moderate to severe disability had 23.19 times higher odds of experiencing stress than those with no or slight disability (p < .05).

Conclusion: Stroke patients have a high prevalence of anxiety, particularly among women. The level of disability is associated with mental health status. Mental health screening is recommended.

Prevalence and Association of Somatic Symptoms with Depression Severity in Major Depressive Disorder Patients at Suanprung Psychiatric Hospital

2026-01-26T22:10:32+07:00

Objective: To determine the prevalence of somatic symptoms among patients with major depressive disorders and the association between somatic symptoms and the severity of major depressive disorder among outpatients receiving care at Suanprung Psychiatric Hospital, Chiangmai province.

Materials and methods: This analytical cross-sectional study was conducted among newly diagnosed outpatients with major depressive disorder aged ≥20 years, diagnosed according to ICD-10 criteria between January and May 2025. Somatic symptoms were assessed using the Thai version of PHQ-15. Data were analyzed using the chi-square test and multivariate logistic regression.

Results: A total of 230 participants were included. The prevalence of somatic symptoms was 96.96%. The most common symptoms were sleep problems (92.17%), fatigue or low energy (81.74%), and headache (76.96%) respectively. Most participants had a medium level of somatic symptom severity (38.26%). Regarding depression severity, most patients were classified as having a severe depressive episode without psychotic symptoms (68.26%). Factors predicting severe depression included age ≤40 years (OR 1.85, p=0.05), duration of illness <4 months (OR 2.35, p=0.01), and medium-to-high somatic symptom severity (OR 1.92, p=0.04).

Conclusion: Patients with major depressive disorder receiving care have a high prevalence of somatic symptoms, which are significantly associated with depression severity.
A systematic assessment of somatic symptoms using the PHQ-15 alongside clinical evaluation may facilitate earlier identification and screening of patients at risk for severe depression.

Development of an Empowerment Program for Patients with Depression and Suicidal Ideation

2026-03-29T08:29:48+07:00

Objective: To develop a self-empowerment program (Empowerment Program: EMPRO) and to evaluate its effectiveness in reducing depression, suicidal ideation, and increasing the level of self-empowerment among patients with depression and suicidal ideation.

Materials and methods: This study included 100 patients with depression and suicidal ideation, aged 18–60 years, who received services at Suan Prung Psychiatric Hospital, Chiang Mai. Participants were selected using purposive sampling. Research instruments included a personal information questionnaire, the Beck Depression Inventory-II (BDI-II Thai version), the Beck Scale for Suicide Ideation (BSS), and the EMPRO empowerment scale. The program consisted of six small-group sessions, each lasting 60 minutes, and a 4-week telephone follow-up. Data were analyzed using descriptive statistics and paired t-test or Wilcoxon signed-rank test.

Results: After participating in the EMPRO program, the depression score decreased from a mean of 27.50 to 16.30, and the suicidal ideation score decreased from 14.20 to 7.80
(p < .001). The level of self-empowerment increased from 82.50 to 112.80 significantly. Qualitative findings reflected that participants had increased self-awareness, mindfulness, positive thinking, and hope for the future.

Conclusion: The EMPRO program has the potential to reduce depression and suicidal ideation, while promoting self-empowerment, and can be used as a guideline to support patient rehabilitation in mental health service systems.