Journal of the Psychiatric Association of Thailand

Psychological Well-being and Behavioral Effect of Siblings of Children with Autism Spectrum Disorder

2024-05-12T12:39:27+07:00

Objective: To investigate on the psychological well-being of the siblings of children with autism spectrum disorder and the correlations between depression and anxiety in the primary caregivers, behavior problems in children with ASD, social support and psychological well-being and behavior problems in siblings of children with ASD.

Methods: The current study used a quantitative approach and in-depth interview method to collect data from the sample group. The target populations were the caregivers of children with ASD and siblings of children with ASD between the age of 7 – 16 years old. Purposive sampling was done and 80 people participated in the study. The research instruments were applied as follows: 1) assessment forms for primary caregivers, which are, depression assessment form (PHQ9), anxiety assessment form (GAD7), The Scales of Independent Behavior–Revised (SIB–R), and The Strengths and Difficulties Questionnaire (SDQ), 2) assessment forms for the siblings of the children with ASD, which are Social Support Questionnaire and psychological well-being assessment form (MHI). The data was analyzed by using descriptive statistics, Inferential statistic and content analysis.

Result: It is found that 52.5% of the siblings of the children with ASD have healthy psychological well-being and they had normal behavior (92.5%). The result also reveals that the siblings of the children with ASD aged 7 – 12 are more likely to receive anxiety compared with the siblings of the children with ASD aged 13 – 16. Furthermore, from the correlation analysis, the study shows that the primary caregiver’s depression and the violent behavior of children with ASD were significantly positively correlated with the behavioral problems of siblings of children with ASD. Additionally, receiving social support was significantly positively correlated with the pro-social behavior of the siblings of the children with ASD. The result of the in–depth interview reveals that siblings of children with ASD experience both positive and negative feelings.

Conclusion: Most of the siblings of children with ASD had good mental health and typical behavior. Additionally, the primary caregiver’s depression and the violent behavior of children with ASD were significantly correlated with behavioral problems of siblings of children with ASD. Also, receiving social support was significantly correlated with the pro-social behavior of the siblings of the children with ASD.

Association Between Adverse Childhood Experiences and Efficacy of ECT in Adults with Unipolar and Bipolar Depression

2024-02-01T09:41:59+07:00

Objective: This study aimed to examine the association between adverse childhood experiences (ACEs) and response to electroconvulsive therapy (ECT) in adult patients with unipolar and bipolar depression at Ramathibodi hospital.

Methods: A retrospective-observational study was conducted on patients with unipolar and bipolar depression (≥18 years) who received inpatient ECT at Ramathibodi Hospital, Thailand, from January 2015 to June 2023. ACEs were assessed using the Adverse Childhood Experiences (ACE) Questionnaire - Thai version. The data were analyzed using Chi-square test, Fisher’s Exact test, independent t-test, and binary logistic regression.

Results: The study involved 38 patients diagnosed with major depressive disorder, persistent depressive disorder, or bipolar depression, with a mean age of 45.0 ± 17.4 years. Most of the patients were female (71.1%). This study found that the most prevalent ACE categories were emotional neglect (31.6 %), household mental illness (31.6 %), and physical neglect (26.3 %). After 6 sessions of ECT, 20 patients (52.6%) achieved response. Binary logistic regression showed that no significant association was found between ACE and ECT response (OR = 0.42, 95% CI = 0.05-3.21, p = 0.40). However, younger age (Odds ratio = 0.91, B = -0.09, 95%CI = 0.84-0.96, p = 0.02). and higher stimulus intensity (Odds ratio = 1.01, B = 0.01, 95%CI = 1.00-1.03, p = 0.05) were significant predictors of ECT response.

Conclusion: This study did not find a correlation between ACE and the response to ECT in patients with major depressive disorder. Therefore, ECT may be an effective treatment option for patients with depression, regardless of their history of childhood trauma. However, further research is necessary to understand how adverse childhood experiences affect treatment decisions.

The Effect of Resilience and Coping Intervention to Reduce Depression in Senior High School Students

2024-05-21T06:08:07+07:00

Objective: To study the effect of a Resilience and Coping Intervention (RCI) on reducing depression in senior high school students.

Methods: The study used a quasi-experimental, pre-post-intervention design. The research population was high school students aged 15 - 18 years in one northeastern province in Thailand. The sample of 84 students was assigned to either an experimental group (n = 42) in the RCI program for three weeks or a control group (n = 42) for the school’s regular support program. Instruments used to measure the variables included a demographic characteristics form, the Thai versions of the Patient Health Questionnaire for Adolescents (PHQ-A) for depression, and the Connor-Davidson Resilience Scale (10-Item CD-RISC). Data were collected pre-intervention (baseline), immediately upon the program’s completion, and one-month post-intervention. Descriptive statistics, independent t-test, one-way repeated measures ANOVA, and multiple comparisons of Bonferroni were used for data analysis.

Results: Immediately after program completion, the RCI significantly reduced depression scores in the experimental group (p =.004) and were significantly lower than those in the control group (p =.020). Similarly, the experimental group showed a significant increase in resilience scores over baseline (p =.013) and were significantly higher than those in the control group (p =.013). However, these positive effects were not sustained one month after program completion.

Conclusion: Although the three-week RCI program demonstrated effectiveness by reducing depression and increasing resilience, it did not provide lasting relief for the high school students.

Effects of Mindful Self-Compassion Enhancing Program on Depression in Junior High School Students

2024-06-12T07:46:02+07:00

Objective: To study the effects of the Mindful Self-Compassion Enhancing Program on Depression in Junior High School Students in a district school of Nakhon Ratchasima Province.

Methods: Quasi-experimental research. The sample was 40 junior high school students who met the inclusion criteria. They were matched and randomly assigned equally to an experimental and a control group. The experimental group received four weeks of the Mindful Self-Compassion Enhancing Program. The control group received a routine provided care by their school. The research tools consisted of 1) a personal data recording form, 2) the Thai version of The Patient Health Questionnaire for Adolescents (PHQ-A), and 3) the Mindful Self-Compassion Enhancing Program. Data were analyzed using descriptive statistic, repeated measures ANOVA, and the paired sample t-test. The statistical significance level was set at .01 level.

Results: Within-experimental group comparison: Immediately after the program’s completion, the junior high school students’ mean depression score was lower than prior to beginning the program (p ≤ .01). Six weeks after the program’s completion, the mean depression score remained lower compared to their mean score both when beginning the program and also at the program’s immediate completion (p ≤ .01). Between-group comparison: The experimental group's mean depression score after the program’s completion was lower than the control group’s score (p ≤ .01). After six weeks, the average depression score of the experimental group remained significantly lower than that of the control group (p ≤ .01).

Conclusion: The results of this study suggest that the Mindful Self-Compassion Enhancing Program is a suitable intervention for junior high school students. The program’s effectiveness in reducing depression, as evidenced by the significant decrease in mean depression scores, makes a compelling case for its use in this age group.

Exploring Sleep Problems in School-Age Children: A Cross-Sectional Analysis and Association with Children’s Psychiatric Diagnoses, Caregivers' Sleep Quality, and Stress

2024-04-29T11:05:37+07:00

Objective: This study aimed to investigate the differences in sleep disturbance between children with psychiatric disorders and a control group and to explore the relationship between children's sleep disturbances and psychiatric diagnoses, as well as caregivers’ sleep problems and stress.

Methods: In this cross-sectional analytic study, the data were recruited from Thai children aged 6 - 10 years with any psychiatric diagnosis and compared with a control group consisting of students in grades 1 - 4 from a public school. Children’s sleep disturbances were examined using the Children’s Sleep Habits Questionnaire (CSHQ) - Thai version. The Pittsburgh Sleep Quality Index (PSQI) – Thai version and the Thai Perceived Stress Scale-10 (T-PSS-10) were used to evaluate caregivers’ sleep problems and stress. The binary logistic regression was employed to examine factors related to children's sleep disturbances. Additionally, a stepwise multiple regression analysis was conducted to pinpoint the significant factors relating to children's total CSHQ scores.

Results: Among 202 participants, 87 had psychiatric disorders, and 115 were controls. Those with psychiatric disorders had higher mean CSHQ scores (49.99 vs. 47.82) and a significantly higher percentage of sleep disturbances (57.47% vs. 45.22%) compared to controls. The significant associated factors with sleep disturbance in children were psychiatric disorders, medication use, caregivers' sleep quality, and stress levels. Adjusting for confounding variables with stepwise multiple regression analysis revealed that psychiatric diagnosis, consuming caffeine after 5 PM, caregiver stress levels, and monthly income were significant predictors of total CSHQ scores.

Conclusion: Children with psychiatric disorders have a high risk of sleep disturbances. However, other factors such as caffeine intake, caregiver stress, and caregiver’s monthly income also play a role. Early identification and intervention for sleep problems in all children, along with promoting sleep hygiene and stress management for both caregivers and children, are crucial for overall well-being.

Prevalence of Not in Education, Employment, or Training (NEET), Associated Factors, and the Relationship with Game Addiction Among Youth Aged 15 - 25 Years in Thailand

2024-06-18T14:24:56+07:00

Objectives: This study aimed to investigate the prevalence and associated factors of NEET, examine psychiatric disorders in youth with NEET, and explore the association between NEET and game addiction among youth in Thailand.

Methods: This questionnaire-based cross-sectional study was conducted among youth aged 15 - 25 years from July to November 2023. Participants were recruited from communities across 15 provinces in Thailand using a stratified and multi-stage sampling method. The questionnaire included demographic data, NEET status and related characteristics, gaming behavior, and positive parenting. Furthermore, game addiction was assessed using Gaming Disorder Scale: GAME-S, while other psychiatric disorders were evaluated using the Mini Neuropsychiatric Interview (M.I.N.I.). The data analysis employed descriptive statistics and inferential statistics, including Chi-square, T-test, and Analysis of Variance (ANOVA).

Results: The participants included 668 youths and their parents with equal proportions of males and females, with a mean age of 19.92 years. The prevalence of NEET was 4.5%. Factors associated with NEET were older age and playing video games with strangers or online friends (OR=3.39; 95%CI [1.01, 11.42]), and playing alone (OR=3.30; 95%CI [1.15, 9.46]). In contrast, gender, main caregiver, screen time, game addiction, and positive parenting were not associated with NEET. Additionally, psychiatric diseases found in youth with NEET were alcohol abuse (3.3%) and major depressive disorder (3.3%).

Conclusion: The prevalence of youth with NEET is 4.5%, and comorbid psychiatric diseases of those youth include alcohol abuse and major depressive disorder. The interpretation of the association between studied factors and NEET is limited due to the limited number of youth identified as NEET.

The Thai-version of the Online Gambling Disorder Questionnaire: Development and Psychometric Properties in Youth

2024-02-09T14:57:15+07:00

Objective: to develop The Thai version Online Gambling Disorder Questionnaire and explore the psychometric properties among Thai youth.

Method: A cross-sectional study was conducted among Thai youth aged 15 - 24, who reported engaging in online gambling at least once in the past 12 months. The sample size consisted of 200 individuals, selected through online questionnaire distribution using snowball sampling. The research tools included an online questionnaire (Google Form) comprising three parts: 1) general information section 2) The Thai version Online Gambling Disorder Questionnaire for youth with 11 items, and 3) The Problem Gambling Severity Index (PGSI) with 9 items. Internal consistency reliability was analyzed using Cronbach's Alpha coefficient, Structural validity was analyzed using confirmatory factor analysis, and convergent validity were examined through correlation with PGSI.

Results: The sample comprised predominantly females (55%), with an average age of 20 years, and the majority were pursuing undergraduate education (81%). The top three online gambling experiences included mixed betting (21.89%), followed by baccarat/hi-lo (20.12%), and sports betting (14.50%). The Thai version Online Gambling Disorder Questionnaire for youth demonstrated a single-factor structure with good fit indices (χ2 = 67.01; df = 39; relative chi-square = 1.72; p=.003; RMSEA = .06; RMR = .03; GFI = .95; AGFI = .91; TLI=.96; CFI = .97; PGFI = .56). The questionnaire exhibited high internal consistency (Cronbach's alpha = .90) and a statistically significant positive relationship with The Problem Gambling Severity Index (p<.01, rxy=.84).

Conclusion: This study showed a structurally sound one-dimensional model, aligning with the original study's model. The questionnaire exhibited high reliability and convergent validity, indicating its suitability for use among Thai youth in assessing online gambling behavior.

Psychosocial Factors and Emotional Intelligence of Attempted Suicide Patients in Lampang Hospital

2024-05-03T19:53:04+07:00

Objective: To study and compare psychosocial factors and emotional intelligence between attempted suicide patients treated at Lampang Hospital and individuals with no history of suicide attempts.

Methods: This cross-sectional comparative study included two groups: 1) patients aged 18-60 years who had attempted suicide and were treated at the psychiatric outpatient department of Lampang Hospital, and 2) a comparison group of individuals without a history of suicide attempts, selected from the general population aged 18 - 60 years, matched by gender and age within 5 years to the patient group. Each group comprised 42 participants, totaling 84 individuals. Data were collected between November 2023 and January 2024 using a general information questionnaire and the Thai Emotional Intelligence Assessment developed by the Department of Mental Health, Ministry of Public Health. Statistical analyses included 1) descriptive statistics 2) Fisher’s exact test, and 3) Independent t-test.

Results: Among the attempted suicide group, 36 (85.7%) were female and 6 (14.3%) were male, with a mean age of 24.2 ± 6.3 years (ranging from 18 to 45 years). Similarly, the group without suicide attempts comprised 36 (85.7%) females and 6 (14.3%) males, with a mean age of 24.7 ± 5.7 years (ranging from 18 to 47 years). The study found that the attempted suicide group had lower educational levels, poorer family relationships, lower socioeconomic status, higher prevalence of psychiatric disorders, and higher substance use compared to the non-attempted suicide group. Regarding emotional intelligence, significant differences were found across all aspects except responsibility which showed no statistical significant difference. The non-attempted suicide group demonstrated higher self-control than normal range whereas level of empathy, responsibility, motivation, problem-solving, decision-making, relationships, self-esteem, life satisfaction, and emotional tranquility were within normal ranges. While the attempted suicide group showed significantly lower in emotional intelligence levels in all aspects except the empathy and responsibility levels which remained within normal ranges

Conclusion: Individuals who attempted suicide exhibited lower emotional intelligence levels than those who had not attempted suicide in almost all aspects. Therefore, specific emotional intelligence enhancement programs tailored to each aspect and further studies on the effectiveness or outcome of such programs may be beneficial for future suicide prevention efforts.

Work Stress, Occupational Burnout and Quality of Life among Dental Assistants in Private Dental Clinics, Bangkok, Thailand

2024-05-21T05:56:31+07:00

Objective: This study aimed to investigate the prevalence and factors associated with work-related stress, burnout, and quality of life among dental assistants working in private dental clinics in Bangkok.

Methods: This cross-sectional study used an online survey to collect data from 370 dental assistants in Bangkok. Self-administered questionnaires consisting of a personal information survey, the Suanprung Stress Test (SPST-20), the Maslach Burnout Inventory-General Survey (MBI-GS), and the World Health Organization Quality of Life-BREF Thai version (WHOQOL-BREF-THAI) were employed as the research instruments. Data were analyzed using multiple linear regression, stepwise method with a significance level of 0.05.

Results: Majority of dental assistant samples experienced moderate stress levels (41.3%), reported good quality of life (66.2%), and showed no signs of burnout (96.8%). Linear regression analysis revealed a positive correlation between increased working hours and stress (B=4.531, p=0.009) as well as quality of life (B=8.298, p<0.001). Conversely, increased work experience showed a negative correlation with both stress (B=-9.945, p=0.012) and quality of life (B=-10.758, p=0.006)

Conclusion: Most dental assistants had moderate stress levels and no burnout, with a good quality of life, Nevertheless, it remains crucial to emphasize appropriate working hours and provide support for other welfare measures to prevent high levels of stress and improve the quality of life for dental assistants.

Perspective and Adaptive Behavior Toward acting Role, Peer Relationship, Fan Club and Mentality among Thai “Y” Genre Actors

2024-06-18T08:03:51+07:00

Objective: This research was therefore undertaken to study the perspectives and factors related to adapting behavior to acting roles, peer relationships, fan clubs, and mentality of Thai Y genre actors for benefit the adaptive behavior methods of the actors to positive and negative situations for good mental health.

Methods: This qualitative research was conducted in 18 Thai Y genre actors using a semi-structured in-depth interview, based on literature reviews which can separated in 5 domains which leaded to the actors’ adaptive behavior to positive and negative situations. The collected data were analyzed via content analysis.

Results: Perspective of become a Y-series actor is mainly positive, mostly think it as an opportunity to be in this industry. For acting roles, 72% said this job made them felt value from fame and being part of successful series globally. Peer relationships, 28% been mistreated by co-actors or crew because they’re in lower ranking. In fan clubs’ aspect, 50% scared of being eyes on, must pretend being nice to match fans' expectation. In Perspective of mentality, 44% have family dispute, have avoid any argument personality and start to plan their future in other occupation.

Conclusion: The correlation of Thai Y-genre actors’ perception towards self, adaptive behavior from role transition from ordinary person to famous person, the gender identity confusion from Y-genre acting role and peer relationship and actors’ mentality such as fear of negative evaluation, stress management, family supportive system and their future was discovered in this research. The research participants have experiences both positive and negative which impact on their mental health in the Y-genre industry environment.

Comparison of Benzodiazepines and Antidepressants Prescribing Pattern among New Psychiatric Outpatients before and after the COVID-19 Pandemic in Suanprung Psychiatric Hospital

2024-03-04T07:56:48+07:00

Objective: To compare medication prescribing patterns of benzodiazepines and antidepressants among new psychiatric outpatients at Suanprung Psychiatric Hospital before and after the COVID-19 pandemic, and to investigate factors that influenced medication prescribing patterns.

Methods: A retrospective cohort study was conducted using the electronic database and medical record form between March 2018 and February 2022. The population was new psychiatric outpatients receiving services at Suanprung Psychiatric Hospital. The logistic regression, independent T-test, and Fisher's exact test were used for statistical analysis.

Results: The participants consisted of 15,596 people with 8,663 classified as "Pre-COVID-19" group and 6,933 as "Post-COVID-19" group. Prevalence of benzodiazepines and/or antidepressants prescribed were at a higher rate in the "Post-COVID-19 Pandemic" group than in the "Pre-COVID-19" group (OR, 1.15 [95% CI, 1.03-1.29]; P=0.010). When adjusting the covariates factors, it was found, the prevalence of benzodiazepines prescribing increased significantly (OR, 1.21 [95% CI, 1.12-1.30]; P<0.001), while the prevalence of benzodiazepines prescribing increased significantly of antidepressants prescribing increased non-significantly (OR, 1.04 [95% CI, 0.95-1.13]; P=0.397).

Conclusion: Prescriptions for benzodiazepines and/or antidepressants was increasing in prevalence in the "Post- COVID-19" compared to "Pre-COVID-19", particularly for benzodiazepines. This may be a result of the proportion of patients diagnosed with anxiety disorders increasing after the COVID-19 pandemic. In contrast, the dose per day decreased in the "Post-COVID-19". In the case of a pandemic, drug prescribing patterns will be useful in designing the drug management system in psychiatric hospitals to meet emergency services and pharmaceutical care needs.

Comparison of the Montreal Cognitive Assessment (MoCA) between Patients with Parkinson’s Disease and Parkinson’s Disease Dementia

2024-03-31T10:15:50+07:00

Objective: This study is aimed to compare the characteristics of scores from the Montreal Cognitive Assessment (MoCA) between Parkinson's disease patients (PD) and patients with Parkinson's disease with dementia (PDD), in order to determine the sensitivity, specificity, and appropriate cutoff scores of the MoCA for distinguishing dementia in PD patients.

Methods: This retrospective study utilized data from the medical records of PD patients who were receiving treatments at the outpatient department of the Neurological Institute of Thailand from January 2017 to December 2021. There is a total of 98 patients, where 56 patients had PD and 42 had PDD. All patients were assessed using the measurements of Thai Mental State Examination (TMSE) and the Montreal Cognitive Assessment (MoCA).

Results: Significant differences were found between the two groups when comparing the total MoCA scores. Differences in average scores were found in almost all cognitive domains, with the PD group scoring higher in visuospatial, immediate memory, delayed memory, attention, language, and orientation domains compared to the PDD group. However, no significant differences between the two groups were found in naming and abstraction domains. As a result, MoCA was found to be an effective tool for differentiating PD from PDD groups, with an appropriate cutoff score of ≤ 16 points (sensitivity 74%, specificity 82%).

Conclusion: These cognitive domains, such as, complex attention, executive and visuo-spatial functions, and delayed memory, could potentially serve as pivotal components in evaluating cognitive impairment among patients with PDD.