Journal of the Psychiatric Association of Thailand

School Bullying and Family Function in Children and Adolescents with Attention Deficit/ Hyperactivity Disorder in a Tertiary Care Hospital

2025-02-18T15:10:41+07:00

Objective: To examine the prevalence of school bullying and the association between family function and school bullying in children and adolescents with attention deficit/ hyperactivity disorder at psychiatric clinic, Sunpasitthiprasong hospital.

Methods: This study was a cross-sectional descriptive study. Participants were 90 children aged 7 - 15 with attention deficit/ hyperactivity disorder treated at psychiatric clinic, Sunpasitthiprasong hospital during 4 November 2024 to 2 January 2025 and 90 guardians. Guardians answered the questionnaires including general information, Swanson, Nolan, and Pelham IV Scale Thai version and Chulalongkorn Family Inventory. Children and adolescents answered The Revised Olweus Bully/Victim Questionnaire Thai version. Descriptive statistics were used to explore descriptive data. Analytic statistics including Pearson Chi-Square, Independent t-test and Logistic regression were used to explore the association. Significant level was p < 0.05.

Results: Most of the participants (81.1%) were boy. More than half (57.8%) were bullied at school. SNAP-IV inattention and SNAP-IV hyperactivity/impulsivity were higher in bullied group compared with non-bullied group. Using multiple logistic regression, this study found that poor family communication was a risk factor for victimization compared with moderate to good family communication. Guardians with widow status was a protective factor for victimization compared with guardians with single status.

Conclusion: More than half of the participants were bullied at school. For victimization, poor family communication was a risk factor compared with moderate to good family communication while guardians with widow status was a protective factor compared with guardians with single status. Awareness and promotion of family communication may reduce the risk of victimization.

Factors Associated with Psychological Flexibility of Caregiver of Children with Attention Deficit Hyperactivity Disorder in the Northeast Region of Thailand

2025-03-04T11:46:36+07:00

Objective: This descriptive correlational research design aims to examine the relationships between knowledge, attitude, Thum-jai (acceptance), mental health problems (depression, anxiety, and stress), and psychological flexibility of family caregivers of children with ADHD.

Methods: The family caregivers of children with ADHD (n = 250) responded to the following research instruments: Sociodemographic data questionnaire, Knowledge about ADHD questionnaire, Attitude about ADHD questionnaire, The Thum-jai (acceptance) Scale, Depression Anxiety Stress Scale (DASS-21), and Acceptance and Action Questionnaire (AAQ-ll) measuring psychological flexibility. Descriptive statistics and Pearson's correlation coefficients were used to analyze the normally distributed data (n = 235).

Results: Knowledge (r = .015, p = .821) and attitude (r = -.057, p = .382) of family caregivers of children with ADHD were not statistically correlated with psychological flexibility. Thum-jai (acceptance) (r = .156, p = .016) was positively and significantly correlated with psychological flexibility whereas mental health problems by focusing on depression (r = -.483, p ≤.001), anxiety (r = -.574, p ≤.001), and stress (r = -.434, p ≤.001) were negatively and significantly correlated with psychological flexibility of family caregivers of children with ADHD.

Conclusion: The results reflect the expected relationships between variables for family caregivers of children with ADHD based on Acceptance and Commitment Therapy (ACT).

A Pilot Study on the Correlation between Draw-A-Story Test and The Beck Depression Inventory Version II in Adolescence

2025-05-14T15:26:29+07:00

Objective: This study examines the correlation between the Draw-A-Story test (DAS), which focuses on emotional content and self-image, and the Beck Depression Inventory version II (BDI-II) for screening depression in adolescents.

Methods: This study presents a descriptive cross-sectional analysis conducted among high school students from grades 10 to 12. A total of 20 participants were selected through a two-step sampling process. Initially, 63 volunteers were recruited and assessed using the BDI-II, allowing for categorization based on depression severity into four levels: 1) minimal (scores 0 - 13), 2) mild (scores 14 - 19), 3) moderate (scores 20 - 28), and 4) severe (scores 29 - 63). In the second step, participants were randomly selected from each severity level to ensure equal representation, with five participants chosen from each group. Ultimately, the final sample consisted of 20 students who completed the DAS, with evaluations by a psychologist, an art therapist, and an art teacher. The analysis revealed that drawings indicating negative emotional content and a self-image of victimhood received lower evaluative scores. The data analysis employed descriptive statistics, alongside Krippendorff’s alpha coefficient, to assess inter-rater agreement, and Spearman’s rank correlation coefficient was used to examine the variables (p < 0.05).

Results: The sample group consisted of 20 participants, with a gender distribution of 90% female and 10% male, and an average age of 16.55 years. The mean score on the BDI-II was 20.05 (SD = 9.85). The average scores for the DAS in the domains of emotional content and self-image were 3.17 (SD = 1.99) and 3.16 (SD = 1.15), respectively. The correlations observed between the DAS scores and the BDI-II, as assessed by three evaluators (the psychologist, the art therapist, and the art teacher), are detailed as follows. The correlations on emotional content were -0.83, -0.84, and -0.86 (p < 0.001), respectively. For self-image, the correlations were -0.83, -0.83, and -0.86 (p < 0.001), respectively.

Conclusion: The DAS test correlates statistically significantly negatively with the BDI-II. Psychologists, art therapists, or art teachers may use the DAS test on emotional content and self-image in screening for depression in late adolescence.

A Systematic Literature Review and Meta-Analysis on the Effectiveness of Parent-Mediated Intervention in Child with Autism Spectrum Disorder

2025-08-05T17:37:36+07:00

Objective: This study aimed to investigate the characteristics and effectiveness of parent-mediated intervention programs for children with Autism Spectrum Disorder (ASD).

Methods: A comprehensive search was conducted across major databases, including PubMed, Embase, CENTRAL, and Thai Journals Online (ThaiJO), as well as thesis collection databases such as ProQuest, EBSCO, and ThaiLIS. The search covered the period from January 1946 to December 2024. The PICO framework (Population: ASD children; Intervention: parent-mediated; Comparison: randomized controlled trial; Outcome: in children OR in parents) guided the systematic literature review. Inclusion criteria were English or Thai randomized controlled trials (RCTs) evaluating the effects of programs for autistic children with parental involvement (comprising therapists, parents, and children) in children under 18 years old diagnosed with ASD. The quality of the included studies was assessed by two independent researchers using the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2); disagreements were resolved by a third researcher. Data were analyzed using descriptive statistics (percentage, frequency, mean) to characterize the programs. Meta-analysis was performed for outcomes within the same groups, with results displayed using forest plots and effect sizes calculated as standardized mean differences (SMD).

Results: Out of 1,866 initial studies, 18 met the inclusion criteria. Of these, 11 had a high risk of bias, 4 had a medium risk of bias, and 3 had a low risk of bias. A total of 12 distinct program characteristics were identified. Most programs involved 12 sessions, with each session lasting 90 minutes. For children, parent-mediated interventions showed effectiveness in improving behavior (SMD 1.33; 95% CI [0.84, 1.83]) and social skills (SMD 0.68; 95% CI [0.50, 0.87]). However, these interventions were not effective for general development (SMD 0.19; 95% CI [-0.16, 0.55]) or language and communication (SMD 0.09; 95% CI [-0.10, 0.27]). For parents, effectiveness was observed in terms of knowledge and ability (SMD 0.54; 95% CI [0.02, 1.06]; p=0.04), but not for mental health (SMD 0.21; 95% CI [-0.10, 0.52]) or parent-child interaction (SMD -0.09; 95% CI [-0.59, 0.42]).

Conclusion: This study indicates that parent-mediated programs for children with ASD are effective in improving children’s behavior and social skills. Furthermore, these programs enhance parents’ knowledge and abilities.

Trends and Associated Factors in the Transition from Substance-Induced Psychotic Disorder to Schizophrenia: A Retrospective Study in Samutprakarn Hospital

2025-04-21T21:41:21+07:00

Objective: To study the trends and factors associated with diagnostic changes from substance-induced psychosis to schizophrenia among patients treated at Samutprakarn hospital.

Methods: A retrospective descriptive study of patients initially diagnosed with substance-induced psychosis between 2014 and 2023. Data were collected from medical records, then continue to monitor data until the diagnosis is changed to schizophrenia or the patient discontinued treatment or the data collection period ends in December 2024. Data were analyzed using descriptive statistics, multiple logistic regression, and Kaplan-Meier method. To help provide an overview or trend in the change in psychiatric diagnosis from substance abuse to schizophrenia.

Results: Of all 193 patients with substance-induced psychosis, 80.3 percent were male, with a mean age of 30.4 years, and 53.9 percent were single. The main types of drugs that caused psychotic symptoms were amphetamine, alcohol, cannabis, and multiple drug use. The percentages were 47.2, 21.8, 20.7 and 9.3 percent, respectively. There were 55 cases (28.5%) that changed their diagnostic to schizophrenia, with a cumulative risk of 26.6% at 2 years. Significant factors associated with diagnostic conversion included single marital status, disorganized speech (disorganized thought), antipsychotic medication dosage (equivalent to haloperidol 5 - 15 mg/day), and persistent psychiatric symptoms or were referred.

Conclusion: The transition from substance-induced psychosis to schizophrenia occurred in 28.5% of patients. Continuous follow-up treatment during the first 2 years is crucial, especially in those with risk factors, for appropriate treatment planning and to reduce the chance of relapse of psychotic symptoms in the long term.

Prevalence and Associated Factors of Alcohol Withdrawal Delirium in Trauma Patients at a Tertiary Care Hospital in Lower Northeastern Thailand

2025-07-30T09:02:48+07:00

Objective: To determine the prevalence and associated factors of alcohol withdrawal delirium among trauma patients with a history of alcohol consumption.

Methods: This study was a retrospective cross-sectional descriptive study conducted among 365 trauma patients with a history of alcohol consumption who were admitted to Sunpasitthiprasong Hospital, Ubon Ratchathani, between June 1, 2021 and June 1, 2024. Purposive sampling was employed. Data were obtained from medical records and analyzed using descriptive statistics and inferential statistics, including Pearson’s chi-square test or Fisher’s exact test, Independent Samples t-test, and the Mann–Whitney U test. In addition, a two-step logistic regression analysis and multivariate logistic regression (bivariate and multivariate analyses) were performed. A p-value < 0.05 was considered statistically significant.

Results: A total of 365 patients were included in the study, with a mean age of 48.8 ± 13.15 years; 95.1% were male. The majority had single-system injuries (67.7%), while 32.3% sustained multiple injuries. The prevalence of alcohol withdrawal delirium (Delirium tremens; F10.4) among trauma patients with a history of alcohol consumption was 41.1%. Risk factors significantly associated with this condition included a history of prior alcohol withdrawal delirium (aOR = 6.04, 95% CI 3.06 – 11.91) and a hospital stay of ≥7 days (aOR = 3.59, 95% CI 1.91 – 6.75). In contrast, protective factors included a history of alcohol withdrawal seizures (aOR = 0.34, 95% CI 0.19 – 0.62) and prior use of psychotropic medications (aOR = 0.28, 95% CI 0.12 – 0.63). Furthermore, patients with alcohol withdrawal delirium had more laboratory abnormalities compared to those with alcohol withdrawal without delirium (F10.3), including higher levels of Blood Urea Nitrogen (BUN) (p-value = 0.039), Creatinine (p-value = 0.037), and Potassium (p-value = 0.041), along with lower Bicarbonate (HCO₃) levels (p-value = 0.041). In addition, this group experienced longer hospital stays (median = 11 days, IQR 7 – 17).

Conclusions: Alcohol withdrawal delirium is a frequent complication in trauma patients with a history of alcohol use and is associated with multiple clinical and laboratory risk factors. Early screening and close monitoring of high-risk patients are essential for reducing complications and mitigating the healthcare burden.

Geopsychiatry: The New Emerging Discipline Which Thai Psychiatrists Should Know

2025-07-28T12:48:34+07:00