Search

Objectives: To compare the prevalence of post-traumatic stress disorder (PTSD) symptoms and examine the associated factors between students who studied at campuses located within the areas affected by Southern Thailand’s insurgency, and those in a nearby province.Material and Methods: This study was of a cross-sectional designed, conducted by self-administered questionnaires; using the Thai version of the PTSD checklist. The subject groups were Prince of Songkla University students who studied at the Pattani Campuses, which are located within the restive areas of Southern Thailand’s insurgency, and Hat Yai Campus, which is in a nearby province. Results: Of all 897 university students, 454 university students studied in Pattani. The prevalence of PTSD symptoms was 30.8%; which is statistically significant, compared with 17.6% of those who studied in Hat Yai (p-value

This study examined the prevalence of COVID-19 vaccine hesitancy and its associated factors, including anxiety and optimism, surrounding the COVID-19 pandemic among Thai university students. An online observational cross-sectional study was conducted between November and December 2021. Descriptive analyses and logistic regression were performed using R. In total, 409 university students participated in the study. Most reported high anxiety levels (69.4%), while more than half also expressed high levels of optimism associated with the COVID-19 pandemic (51.1%). Only 4.4% were unvaccinated, among whom 50% were hesitant to receive vaccination (2.2%). Per statistical analysis, those who perceived the available vaccines as low safety were significantly associated with a higher risk of vaccine hesitancy (p = 0.03). In contrast, those who reported that they would likely to receive the COVID-19 vaccine if recommended to by their doctors or pharmacists were significantly associated with lower vaccine hesitancy (p = 0.048). However, both anxiety and optimism regarding the COVID-19 pandemic were not associated with vaccine hesitancy. Thus, healthcare workers play an important role in COVID-19 vaccination counseling to prevent transmission. Health education during the pandemic should focus on COVID-19 infection as well as COVID-19 vaccines, including their safety and their adverse effects.

Because use and dosing of mood stabilizers (MSs) to treat bipolar disorder (BD) patients in Asia are not well documented, we examined prevalence and clinical correlates of treatment of Asian BD patients with relatively high doses of MSs.We conducted a pharmacoepidemiological survey across 13 Asian countries and territory in the Research on Asian Psychotropic Prescription Patterns Consortium. Mood stabilizer doses were converted to lithium carbonate equivalents (Li-eq milligrams per day). We compared relatively high (900 Li-eq mg/day) versus lower MS doses by bivariate comparisons, followed by multivariable linear regression to identify factors associated with higher MS doses.Among 1647 participants, MS dose averaged 584 (confidence interval, 565-603 Li-eq mg/d). Preliminarily, the 13.1% of the subjects given greater than 900 mg/d versus those given lower doses were younger, male, currently hospitalized, not currently depressed, and reported lifetime suicidal ideation; they also received relatively high doses of antipsychotics, received electroconvulsive treatment within the previous 12 months, and had greater ratings of tremors and sedation. By linear regression modeling, the mean proportion given high doses of MS was associated significantly and independently with higher doses of antipsychotics, younger age, male sex, hospitalized, more years of illness, country, higher body mass index, recent electroconvulsive treatment, and being in illness remission.Relatively high doses of MSs for BD are prevalent, but vary markedly among Asian countries, and are particularly likely among young males, ill for many years, and given high doses of antipsychotics or ECT. These characteristics allow better identification of patient profiles that can guide treatment of BD patients.

Every health care system requires an adequate health care workforce, service delivery, financial support, and information technology. During the COVID-19 pandemic, global health systems were ill prepared to address the rising prevalence of mental health problems, especially in low- and middle-income countries (LMICs), thereby increasing treatment gaps. To close these gaps globally, task shifting and telepsychiatry should be made available and maximized, particularly in LMICs. Task shifting to nonspecialist health workers to improve essential mental health coverage and encourage efficient use of the available resources and technology has become the most viable strategy.

Introduction Varying public views on cannabis use across countries may explain the variation in the prevalence of use, policies, and research in individual countries, and global regulation of cannabis. This paper aims to describe the current state of cannabis use, policies, and research across sixteen countries. Methods PubMed and Google Scholar were searched for studies published from 2010 to 2020. Searches were conducted using the relevant country of interest as a search term (e.g., “Iran”), as well as relevant predefined keywords such as “cannabis,” “marijuana,” “hashish,” “bhang “dual diagnosis,” “use,” “addiction,” “prevalence,” “co-morbidity,” “substance use disorder,” “legalization” or “policy” (in English and non-English languages). These keywords were used in multiple combinations to create the search string for studies’ titles and abstracts. Official websites of respective governments and international organizations were also searched in English and non-English languages (using countries national languages) to identify the current state of cannabis use, policies, and research in each of those countries. Results The main findings were inconsistent and heterogeneous reporting of cannabis use, variation in policies (e.g., legalization), and variation in intervention strategies across the countries reviewed. European countries dominate the cannabis research output indexed on PubMed, in contrast to Asian countries (Thailand, Malaysia, India, Iran, and Nepal). Conclusions Although global cannabis regulation is ongoing, the existing heterogeneities across countries in terms of policies and epidemiology can increase the burden of cannabis use disorders disproportionately and unpredictably. There is an urgent need to develop global strategies to address these cross-country barriers to improve early detection, prevention, and interventions for cannabis use and related disorders.

This letter to the editor continues the discussion about the similarities and differences between secondary psychosis and schizophrenia, which was initiated by the authors of the article Substance-induced psychosis and schizophrenia: the interaction point (Fedotov I.A., Quattrone D., Shustov D.I. Substance-induced psychosis and schizophrenia: the interaction point. I.P. Pavlov Russian Medical Biological Herald. 2020;28(4):593-604. doi:10.238 88/PAVLOVJ2020284593-604).

Healthcare workers have faced an unprecedented workload in overstretched health facilities during the COVID-19 pandemic, and we describe various initiatives to support them. Psychological, financial and peer support, accommodation and meal services, proper personal protective equipment, applause and gratitude in the community, spiritual and religious life, child care and volunteering were identified. The potential effects of the COVID-19 pandemic – permanent stress, burnout and other mental health problems among healthcare professionals – can be expected to grow. Continued monitoring is essential to bolster resilience among healthcare workers and prevent the possible consequences for their mental health.

The Prince of Songkla University, Pattani campus is located within the restive areas of Southern Thailand’s insurgency. The violent situations have been continuingly deteriorating since 2004, whilst local civilians; including young people, have undergone different forms of mental distress. Hence, this cross-sectional survey aimed to compare levels, characteristics and associated factors of resilience among university students at the Pattani campus, located in the restive area of Southern Thailand’s insurgency, and a nearby province (Hatyai campus). The study was conducted between 8th August, 2018 and 8th October, 2018, at both Prince of Sonkla University, Pattani and Hatyai campuses. All of the participants completed the personal information, and Thai resilience questionnaires (Thai-RQ) by themselves. The data were analysed using the R program, for both descriptive statistics and logistic regression. Most of the 443 students, who studied at Prince of Songkla University, Pattani campus were females (80.3%) and Muslims (76.3%). Most of them were at a normal level (55.7%), within the domain of resilience, with the highest prevalence, being coping strategy (75.9%). No significantly statistical difference of levels, or characteristics of resilience were found between the two campuses. Satisfaction towards: university teaching, age, religion and birth order were also significantly associated to resilience among university students in the restive area. However, only gender and satisfaction towards university teaching were found in the non-restive campus.

Digital mental health interventions and digital psychiatry have been rapidly implemented over the past decade, particularly with the intent to offer a cost-effective solution in those circumstances in which the current mental health services and infrastructure are not able to properly accommodate the patients' needs. However, mental health workforce is often poorly theoretical/practical trained in digital psychiatry and in delivering remote consultations safely and effectively, not being common to own curricula-specific training requirements in digital psychiatry and skills.A web-based international cross-sectional survey was carried out by a working group constituted by one or two national representative(s) of each WHO South-East Asia and Western Pacific Regions (APAC), with the aim to evaluate the level of training, knowledge, experience, and perception regarding the topic of digital psychiatry in a sample constituted by medical students, psychiatry trainees, and early career psychiatrists from APAC.An overall lack of theoretical and/or practical training on new digital tools and digital health interventions in psychiatry was observed. The level of training influences knowledge background, which, in turns, influences young professionals' perceptions and opinions regarding digital psychiatry and interventions in mental health.Implementing psychiatry training programs may significantly improve the level of knowledge and use of digital tools in mental healthcare. Moreover, mental health services and infrastructures should be properly adapted to the digital era, considering the overall weak and heterogeneous technical support and equipment, issues of internet connectivity, and other administrative-related challenges observed in APAC.

This cross-sectional survey assessed the association between post-traumatic stress disorder symptoms and perceived self-sufficiency, reflecting the Sufficiency Economy Philosophy (SEP), conceived by H.M. King Bhumibol Adulyadej (King Rama IX). It was conducted among university students on one campus located within the area affected by the Southern Thailand insurgency and another campus located in a nearby province outside of the restive area. All self-administered questionnaires consisted of questions related to personal information, the Thai version of the PTSD checklist, and a questionnaire aimed at measuring the perceived self-sufficiency according to H.M. King Bhumibol Adulyadej’s SEP. The study found that most university students in the restive area affected by the Southern Thailand insurgency perceived to live sufficiently according to H.M. King Bhumibol Adulyadej’s SEP. The rate of perceived self-sufficiency was also higher than reported by the students from the other campus in a nearby province. Moreover, self-sufficiency exhibited a significant inverse association with PTSD symptoms.

General psychiatric training is one of the essential requirements for all Thai medical doctors, as declared by the Medical Council of Thailand in 2012. Hence, psychiatric training for medical students must be fulfilled to achieve these requirements. This study was designed to examine the change of subjects and the self-perceived incompetence in psychiatric practice of a cohort of medical doctors who graduated in the academic year of 2017, in concerns to their practices one year after graduation. Most participants were female doctors, with an average age of 25.7 years, and were working in Southern Thailand. Compared with 1 year prior, they showed a statistically significant frequency of physical disorders and increasing stress from their work. The largest topic of psychiatric practice, for which they were statistically more concerned with, concerned child and adolescent psychiatry. Self-perceived incompetence in both diagnosis and treatment significantly increased from graduation, with the exceptions of diagnoses of mental retardation, attention deficit hyperactivity, and tics/Tourette’s disorder. Substance-related disorders in adults, along with basic psychological support, were found to be general practice self-perceived incompetence, at both outpatient clinics and inpatient units. However, practice in adult outpatients at psychiatric clinics mostly demonstrated significantly more self-perceived competence. Moreover, emergency care, especially concerning patient suicide and multi-disciplinary practice, was shown to have increasing self-perceived competence among general practitioners having worked for a year following graduation. This information should be used as feedback for stakeholders in both medical education and mental health care. HIGHLIGHTS Medical doctors who graduated in southern Thailand the previous year mostly worked in the same part of Thailand and significantly increased stress and physical illness Basic psychological support in both outpatient and inpatient unit’s practices, were statistically significantly increased, compared with when the doctors graduated one year earlier The general practitioners stated that they had been most concerned with children and adolescent psychiatric practice since they graduated Emergency care and multi-disciplinary practice in psychiatric practice were shown to have increasing self-perceived competence among those who graduated M.D. a year before

Background With the uncertainties of COVID-19, people infected by coronavirus present with diverse psychiatric presentations. Some centers have had to manage their patients with existing protocols, others have had to come up with innovations. We aim to report the challenges and good practices recorded in the management of psychiatric conditions and delirium coexisting with COVID-19 and during the COVID-19 era across continents. Material and Methods Early Career Psychiatrists (ECPs) from across five continents were approached to provide their perspective on the management of psychiatric conditions in patients with COVID-19 and during the current pandemic. Results We collected information about the experiences from ten countries. Commonalities were similar psychiatric presentations and poor preparedness across countries. Differences were varying innovations and adjustments made in the management of psychiatric conditions coexisting with COVID-19. Good practices which can be adopted by other countries are novel approaches such as telepsychiatry, proactive consultation-liaison units and enhanced community services targeted at circumventing challenges faced yet providing mental health services. Conclusions This publication highlights the need for global preparedness in the mental health sector during outbreaks of infectious diseases. With our results we can conclude that there is the need for concerted efforts targeted at global and locally sensitive adaptation of existing protocols and the development of new guidelines for the management of psychiatric conditions for the present pandemic and subsequent occurrences., Highlights • Twenty-one Early Career Psychiatrists (ECPs) from thirteen countries across five continents, provided their perspective on the management of psychiatric conditions in patients with COVID-19. • We found commonalities such as similar psychiatric presentations, poor preparedness and alterations in the management of psychiatric conditions coexisting with COVID-19. • There are shared similarities and differences, likewise modifications in pre-existing protocols in the management of delirium and other psychiatric conditions in patients with COVID-19 and during the current era across continents. • A common factor is the need for preparedness in the mental health sector; the need for concerted efforts targeted at globally and locally sensitive adaptation of guidelines and protocols for the management of psychiatric conditions for the present pandemic and subsequent occurrences.

Objective: This study aims to compare burnout syndrome as well as the associated factors among doctors, who work at, secondary and tertiary-care hospitals either: in the restive areas of Thailand’s southern insurgency, and the nonrestive areas of nearby provinces.Material and Methods: This was a cross-sectional designed study, which was conducted in order to survey all doctors, who worked at hospitals, located in lower, southern Thailand from; January to April 2018. The questionnaire used; The Maslach Burnout Inventory (MBI) Thai version questionnaire. The data was analyzed by descriptive statistics. The factors associated with burnout syndrome were analyzed by using chi-square test and logistic regression.Results: The total number of participants were; 245 medical doctors. Fifty-eight percent of them were females, whilst 42.0% were males, and most of them were single (50.2%). The mean age of the participants was; 35.9 years, and 30.2% of them worked more than 40 hours per week. The total prevalence of Burnout syndrome among them was; 99.6%, with the highest score found to be in the emotional exhaustion section. There were no differences in burnout syndrome between, those who worked in restive areas and those who worked in non-restive areas of Thailand’s southern insurgency, grade point average (GPA), perceived sleep/rest quality and perceived work stress were related to emotional exhaustion, while types of specialty, work hour/week and family relationships were associated with depersonalization. The sample size was not adequate for the personal accomplishment part analysis.Conclusion: Almost all medical doctors, who worked at either secondary or tertiary-care hospitals in the lower, southern areas of Thailand, suffered from burnout, only 1 physician did not. The factors associated to burnout syndrome are; work hours per week, GPA, type of specialty, perception of sleeping/rest quality, perception of having stress from work and family relationships.

Objective: To study the primary clinical characteristics and prevalence of post-traumatic disorder (PTSD) symptom among patients with substance-related disorder living within the areas of Thailand, affected by insurgency.Material and Method: This study was a descriptive, cross-sectional survey based on self-administered questionnaireswhich included questions relating to: personal information, traumatic experiences and the Thai version of post-traumaticstress disorder check-list (Thai PCL.) The subjects were patients with substance-related disorders at Thanyarak Pattani Hospital. This information was gathered by psychiatric nurses during the period within the periods 1st of April through 30th of June, 2016. Descriptive statistics were used to analyze the demographic characteristics of the patientsResults: Ninety-two patients were enrolled in the study, all male with a mean age of 28.8±7.3 years. They were mostly single, Muslim and had graduated from elementary school. Most of them denied a family history of addiction, however, many indicated one or more male siblings had misused some illegal drug. No psychiatric disorder was diagnosed orrecorded by the hospital. The most common substances used among these substance-related disorders patients weremethamphetamines (36.9%) and opioids (30.4%) with “heavy use”. The prevalence of PTSD symptoms by the ThaiPCL screening test was 4.3% (n=4). The 4 patients with a positive PCL result, reported that they felt terrified wheneverviolent situations in the unrest areas were announced. Three of them also stated for always felt extreme panic in order to delay evacuation, as well as experiencing a direct threat to their own life, or that of their family, having seen serious injuries and/or death of their peers and neighbors.Conclusion: The most common substances used in the areas affected by the insurgency of southern Thailand weremethamphetamines and opioids. There was no dual diagnosis of psychiatric disorders recorded and the prevalence of PTSD symptoms among patients with substance related disorders was 4.3%. Most of those, who were suspected of having PTSD, had experienced threats to themselves or family, witnessed serious injuries or the death of peers and neighbors.

Gender is an important determining factor of mental health and psychological difficulties. There is a wide gap of knowledge in mental health as regards to gender and gender diversity. However, psychological support from family, friends, and health providers are protective factors for mental disorders in women and those of other genders. In addition, many women and diverse gender populations face violence, harassment, and discrimination. Therefore, health providers need a knowledge-based framework to practice holistically. This chapter aims to embody frequently occurring concerns among women and LGBTQ people, as well as to conceptualize models of mental health care regarding gender diversity.

The COVID-19 pandemic has posed a serious threat to global mental health. Multiple lines of evidence suggest that there is a varying yet considerable increase in mental health issues among the general population and vulnerable groups.1 2 The aftermath is obscure and speculative from a social, economic, individual and public mental health perspective. Recently published studies support the existence of an emotional epidemic curve, describing a high probability of an increase in the burden of mental health issues in the postpandemic era.3 4 Furthermore, previous major public health emergencies showed that more than half of the population developed mental health problems and required mental health intervention.4 5 There is, therefore, an urgent need to reorganise existing mental health services to address the current unmet needs for mental health and to prepare for future challenges in the postpandemic era in terms of prevention and management. The current evidence and published literature related to previous epidemics suggest that mental health issues may arise after the peak of the pandemic, with increased prevalence among the vulnerable population and people with risk factors (box 1).4 The surge in mental health issues may remain untreated or undiagnosed due to interrupted mental health services and other challenges for mental health services in the post-COVID-19 pandemic era. Box 1 ### Mental health issues, vulnerable population and risk factors 1. Mental health issues : including grief reactions, substance use disorders, anxiety, sleep disorders, depression, suicides, post-traumatic stress disorders, panic disorders.4,25,26

Background: During the 2 months of February and March 2019, more than 10 Thai university students were official reported to have committed suicide, which may impact on others' suicidality. Aims: This study aims to examine media and other factors influenced suicidal ideation among Thai university students, during the crisis of suicidal height in March–April 2019. Methods: The study was of a retrospective and cross-sectional design. Patients, who were university students and accessed the psychiatric outpatient clinic in March–April 2019, were recruited. Data collected by the hospital's databased system included patient profiles, perceptions of media influencing suicidality, and the Thai version of the suicide screening test. Results: Of the 68 participants, most participants were female (75.0%). They mostly stated that they were at a high risk of suicide (35.0%); whereas those who reported that the media influenced them were shown to have 3.5 times, higher risk of suicide (P = 0.012). Moreover, the moderate risk of suicide was statistically significantly associated with media, while other variables did not associate with suicidal risk (P = 0.03). Conclusion: During the crisis of copycat suicides, among Thai university students; most of whom were psychiatric outpatients, were at high risk for suicide. In addition, those who reported that the media had influenced them demonstrated a higher risk of suicide. Moreover, those who were at moderate risk for suicide were significantly associated with media.

Objective: To determine the effectiveness of psychological interventions in depressive adolescents to prevent recurrent depressive episodes. Methods: English databases, including Embase, Medline, Global Health, and PsychINFO, were searched for studies that examined the effectiveness of psychological interventions in preventing recurrent depression. Eight articles were found in the electronic databases and 4 studies were found from a manual search. Methodological quality was assessed using the Cochrane Collaboration’s tool.Results: One quasi-randomized control trial and 11 randomized control trials met the inclusion criteria. A systematic review of the 12 studies was conducted. The studies involved 1,641 participants that represented different effects of recurrence prevention interventions at 6, 9, 12, 24, and 33 months following treatment completion. Cognitive behavioral therapy (CBT) group intervention showed effectiveness in recurrence prevention in depressive adolescents in 6-33 months. Supportive psychotherapy and family therapy also prevented recurrent depression at 24-month follow-up, while psychodynamic/psychoanalytic psychotherapy and interpersonal psychotherapy could prevent recurrence in depressive adolescents for 12 months following completion of the intervention.Conclusion: Among the psychological interventions studied in the included articles, CBT group intervention showed the greatest long-term effect since group CBT could prevent recurrent depression in adolescents up to 33 months.

This article aims to review the current practice of recurrence prevention and intervention of adolescent depressive disorder in Thailand. In particular, we assess the Clinical Practice Guideline of Major Depressive Disorder for General Practitioners (CPG-MDD-GP) for Thailand, which is now the official guideline for all depressive patients who are children, adolescents, and adults in Thailand. Although this current Thai clinical guideline was developed and derived from the National Institute for Health and Care Excellence (NICE) of the United Kingdom and the recommendations and the practice parameters of the American Academy of Child and Adolescent Psychiatry (AACAP), it differs from these guidelines in a number of ways. Specifically, the main tool for the primary assessment of the Thai CPG-MDD-GP is called 9Q which categorizes the severity and follow-up of depressive symptoms by health care providers in a hospital setting, whereas the NICE guideline for depression in children and adolescents is based mainly on the community setting, and the AACAP parameter assesses patients by a direct interview method. Additionally, the Thai CPG-MDD-GP has no premise intervention for recurrence prevention of depression and lacks details regarding the importance of treatment engagement by family and community.