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Chan W, Cao Y, Lu EY, Cheung WM, Tsang HWH. Types of Community Support Services and Self-Efficacy for Continuous Community Living among Individuals with Disabilities and Caregivers. Int J Environ Res Public Health 2022; 19:12976. [PMID: 36232276 PMCID: PMC9566762 DOI: 10.3390/ijerph191912976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/28/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023] [Imported: 06/21/2023]
Abstract
UNLABELLED This study explored the impacts of five types of community support services (i.e., center-based care, home-based care, respite care, caregiver assistance, and financial subsidies) on self-efficacy for continuous community living among individuals with disabilities and caregivers. DESIGN Cross-sectional. METHOD The sample consisted of a group of individuals with disabilities (n = 948) and a group of caregivers (n = 522). A mixed ANOVA was applied to explore the differences in the perceived importance of improvements to community support services between the groups. Logistic regression analyses were conducted to examine the perceived importance of improvements to types of community support services for self-efficacy for continuous community living. RESULTS Caregivers perceived higher levels of importance for improvements to community support services than individuals with disabilities. Both groups reported that financial subsidies were the most important area for improvement. The greater importance of improvements to financial subsidies reported by caregivers predicted greater odds for self-efficacy for continuous community living. The greater importance of improvements to center-based services reported by individuals with disabilities predicted greater odds for self-efficacy for continuous community living. CONCLUSIONS The findings suggested that financial subsidies for caregivers and center-based services for individuals with disabilities could improve self-efficacy for continuous community living.
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Affiliation(s)
- Wai Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Yuan Cao
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Erin Yiqing Lu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Wai Ming Cheung
- Faculty of Education, University of Hong Kong, Pokfulam, Hong Kong
| | - Hector Wing Hong Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Weng Y, Lin J, Ahorsu DK, Tsang HWH. Neuropathways of theory of mind in schizophrenia: A systematic review and meta-analysis. Neurosci Biobehav Rev 2022; 137:104625. [PMID: 35339482 DOI: 10.1016/j.neubiorev.2022.104625] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Social cognition is significantly associated with daily functioning in patients with schizophrenia. Its neural basis remains unknown. METHODS A systematic literature search was performed. Studies using imaging to measure theory of mind (ToM) in schizophrenia were identified. Imaging data were synthesized using the seed-based d mapping approach. Potential neuropathways were hypothesized based on the identified brain regions activated during ToM tasks. RESULTS A total of 25 studies were included in the present study. Compared with healthy people, patients with schizophrenia showed hyperactivations in superior longitudinal fasciculus II and hypoactivations in superior frontal gyrus, precuneus and cuneus, and precentral gyrus during ToM tasks. The primary brain regions involved in the potential neuropathways in schizophrenia were the middle temporal gyrus, superior and inferior frontal gyrus, and supplementary motor areas. CONCLUSION Deactivated brain regions in schizophrenia overlapped with the default mode and salience networks. Our findings shed light on how to develop a diagnostic tool for deficits in social cognition using neuroimaging techniques and effective therapeutic interventions to rectify dysfunction in schizophrenia.
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Affiliation(s)
- Yiting Weng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, People's Republic of China
| | - Jingxia Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, People's Republic of China; Mental Health Research Centre, The Hong Kong Polytechnic University, Hung Hom, Kowloon, People's Republic of China
| | - Daniel Kwasi Ahorsu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, People's Republic of China
| | - Hector W H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, People's Republic of China; Mental Health Research Centre, The Hong Kong Polytechnic University, Hung Hom, Kowloon, People's Republic of China.
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Guo Y, Yeung CY, Chan GCH, Chang Q, Tsang HWH, Yip PSF. Mobility Based on GPS Trajectory Data and Interviews: A Pilot Study to Understand the Differences between Lower- and Higher-Income Older Adults in Hong Kong. Int J Environ Res Public Health 2022; 19:5536. [PMID: 35564931 PMCID: PMC9101281 DOI: 10.3390/ijerph19095536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 02/05/2023]
Abstract
Few studies have examined mobility from a social exclusion perspective. Limited mobility can restrict opportunities to interact with others and therefore may lead to social exclusion. This pilot study was designed to test the feasibility of integrating Global Positioning System (GPS) trajectory data and interview data to understand the different mobility patterns between lower- and higher-income older adults in Hong Kong and the potential reasons for and impacts of these differences. Lower- (n = 21) and higher- (n = 24) income adults aged 60 years of age or older in Hong Kong were recruited based on purposive sampling. They were asked to wear a GPS device for 7 days. Seven measures of mobility (four dimensions) were created based on GPS data and compared between lower- and higher-income older adults, including extensity (standard deviation ellipse, standard distance between all locations), intensity (time spent out of home, doing activities), diversity (number of locations), and non-exclusivity (time spent in public open spaces and places with higher public service provisions). It then administered semi-structured interviews to understand the determined differences. The activity spaces for lower-income older adults were, on average, smaller than those for higher-income older adults, but lower-income older adults spent significantly more time participating in out-of-home activities. They were more likely to be exposed to environments with similar socioeconomic characteristics as their own. The interviews showed that limited social networks and expenditure on transport were the two main factors associated with lower-income older adults having relatively fewer activity spaces, which may lead to further social exclusion. We recommend using GPS in daily life as a feasible way to capture the mobility patterns and using interviews to deeply understand the different patterns between lower- and higher-income older adults. Policy strategies aiming to improve the mobility of older might be helpful for further improving the social inclusion of lower-income older adults.
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Affiliation(s)
- Yingqi Guo
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China; (Y.G.); (H.W.H.T.)
- Mental Health Research Centre, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China
| | - Cheuk-Yui Yeung
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China;
| | - Geoff C. H. Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China;
| | - Qingsong Chang
- School of Sociology and Anthropology, Xiamen University, Xiamen 361005, China;
| | - Hector W. H. Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China; (Y.G.); (H.W.H.T.)
- Mental Health Research Centre, The Hong Kong Polytechnic University, 11 Yuk Choi Road, Hung Hom, Hong Kong SAR, China
| | - Paul S. F. Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China;
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, 5 Sassoon Road, Pokfulam, Hong Kong SAR, China
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He J, Tang Y, Lin J, Faulkner G, Tsang HWH, Chan SHW. Non-invasive brain stimulation combined with psychosocial intervention for depression: a systematic review and meta-analysis. BMC Psychiatry 2022; 22:273. [PMID: 35439977 PMCID: PMC9016381 DOI: 10.1186/s12888-022-03843-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 03/07/2022] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES This review investigates the efficacy and safety of non-invasive brain stimulation (NIBS) combined with psychosocial intervention on depressive symptoms. MATERIALS AND METHODS We systematically searched five electronic databases from their inception to June 2021: PubMed, Embase, PsycINFO, Web of Science, and Medline. Randomized or non-randomized clinical trials in which NIBS plus psychosocial intervention was compared to control conditions in people with depressive symptoms were included. RESULTS A total of 17 eligible studies with 660 participants were included. The meta-analysis results showed that NIBS combined with psychosocial therapy had a positive effect on moderate to severe depression ([SMD = - 0.46, 95%CI (- 0.90, - 0.02), I2 = 73%, p < .01]), but did not significantly improve minimal to mild depression ([SMD = - 0.12, 95%CI (- 0.42, 0.18), I2 = 0%, p = .63]). Compared with NIBS alone, the combination treatment had a significantly greater effect in alleviating depressive symptoms ([SMD = - 0.84, 95%CI (- 1.25, - 0.42), I2 = 0%, p = .93]). However, our results suggested that the pooled effect size of ameliorating depression of NIBS plus psychosocial intervention had no significant difference compared with the combination of sham NIBS [SMD = - 0.12, 95%CI (- 0.31, 0.07), I2 = 0%, p = .60] and psychosocial intervention alone [SMD = - 0.97, 95%CI (- 2.32, 0.38), I2 = 72%, p = .01]. CONCLUSION NIBS when combined with psychosocial intervention has a significant positive effect in alleviating moderately to severely depressive symptoms. Further well-designed studies of NIBS combined with psychosocial intervention on depression should be carried out to consolidate the conclusions and explore the in-depth underlying mechanism.
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Affiliation(s)
- Jiali He
- grid.16890.360000 0004 1764 6123Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Yiling Tang
- grid.17091.3e0000 0001 2288 9830School of Kinesiology, University of British Columbia, Vancouver, British Columbia Canada
| | - Jingxia Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong. .,Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong, SAR, China.
| | - Guy Faulkner
- grid.17091.3e0000 0001 2288 9830School of Kinesiology, University of British Columbia, Vancouver, British Columbia Canada
| | - Hector W. H. Tsang
- grid.16890.360000 0004 1764 6123Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong ,grid.16890.360000 0004 1764 6123Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong, SAR China
| | - Sunny H. W. Chan
- grid.6518.a0000 0001 2034 5266School of Health and Social Wellbeing, University of the West of England, England, UK
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Huang WY, Tsang HW, Wang SM, Huang YC, Chen YC, Cheng CH, Chen CY, Chen JS, Chang YL, Huang RY, Lin CY, Potenza MN, Pakpour AH. Effectiveness of using calligraphic activity to treat people with schizophrenia: a randomized controlled trial in Southern Taiwan. Ther Adv Chronic Dis 2022; 13:20406223221080646. [PMID: 35295614 PMCID: PMC8918751 DOI: 10.1177/20406223221080646] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/28/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Prior research has shown preliminary evidence that calligraphy activity improves various body functions and decreases severity of psychotic symptoms in individuals with schizophrenia. However, major limitations of earlier studies include small and heterogeneous samples. The current large-scale randomized controlled trial examined effects of calligraphy activity on cognition (including attention), emotions, psychotic symptoms, quality of life, and mood in people with schizophrenia. Methods: One-hundred-and-fifty patients with schizophrenia were randomly allocated to the treatment group (receiving calligraphy activity) or the control group (receiving general activity), both of which lasted for 24 weeks (70 minutes per session; one session per week). Assessments were conducted at pretest, posttest, and three-month follow-up. The Montreal Cognitive Assessment, Chu’s Attention Test, Depression, Anxiety, and Stress Scale, Positive and Negative Syndrome Scale, World Health Questionnaire on the Quality of Life-Brief Form, and Visual Analogue Scale were used. Results: Improved cognition and attention were found in both groups, although no group effects were shown. The treatment group appeared to show lower severity of positive symptoms at follow-up than posttest, whereas the control group appeared to show the opposite pattern. Improved mood was found in the treatment group. Conclusion: This study provides evidence regarding effects of calligraphy activity on increasing cognition and potentially decreasing severity of positive symptoms in patients with schizophrenia. Calligraphy activity can be incorporated in clinical occupational therapy and may be provided to supplement medication treatment. Trial Registration: ClinicalTrials.gov NCT03882619; https://clinicaltrials.gov/ct2/show/NCT03882619
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Affiliation(s)
- Wen-Yi Huang
- Department of Family and Community Medicine, E-DA Hospital, No. 1, Yida Road, Yanchao District, Kaohsiung 82445
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung
- Chih-Yin Chen Department of Occupational Therapy, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan
| | - Hector W.H. Tsang
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong
| | - Shu-Mei Wang
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Yu-Chen Huang
- Chih-Yin Chen Department of Occupational Therapy, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan
| | - Yi-Chun Chen
- Chih-Yin Chen Department of Occupational Therapy, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan
| | - Chih-Heng Cheng
- Chih-Yin Chen Department of Occupational Therapy, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan
| | | | | | - Yen-Ling Chang
- Department of Family Medicine, Cardinal Tien Hospital, New Taipei
| | | | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, 1 University Rd., Tainan 701, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, 1 University Rd., Tainan 701, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, 1 University Rd., Tainan 701, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Marc N. Potenza
- Departments of Psychiatry and Neuroscience, Child Study Center, School of Medicine, Yale University, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USAConnecticut Mental Health Center, New Haven, CT, USA
| | - Amir H. Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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6
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Alimoradi Z, Majd NR, Broström A, Tsang HWH, Singh P, Ohayon MM, Lin CY, Pakpour AH. Is alexithymia associated with sleep problems? A systematic review and meta-analysis. Neurosci Biobehav Rev 2021; 133:104513. [PMID: 34958823 DOI: 10.1016/j.neubiorev.2021.12.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 12/03/2021] [Accepted: 12/21/2021] [Indexed: 02/08/2023]
Abstract
Alexithymia, a difficulty identifying and expressing emotions experienced by oneself or others, measurably harms quality of sleep. Research has observed the association between alexithymia and sleep problems; however, the cumulative effect of this association is still unknown. Therefore, this systematic review and meta-analysis was conducted to present scientific evidence regarding the relationship between alexithymia and sleep quality. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, and using relevant keywords, we searched six databases: Scopus, PubMed Central, ProQuest, ISI Web of Knowledge, EMBASE, and Science Direct. We selected observational studies on the association between alexithymia and sleep. We conducted meta-analysis using a random-effect model to calculate the effect size (ES) with Fisher's z transformation. Eligible studies (N = 26) in 24 papers included 7546 participants from 12 countries. The entire ES for the association between alexithymia and sleep was 0.44 (95 % CI: 0.31, 0.56). Additionally, patient populations had a larger ES (ES = 0.55; 95 % CI: 0.30, 0.79) than healthy populations (ES = 0.30; 95 % CI: 0.20, 0.41). The results of the present systematic review and meta-analysis revealed a significant association between alexithymia and sleep problems, especially among people with any medical condition.
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Affiliation(s)
- Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin 3419759811, Iran.
| | - Nilofar Rajabi Majd
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin 3419759811, Iran
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jönköping University, 55111 Jönköping, Sweden; Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
| | - Hector W H Tsang
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong; Graduate Research Assistant at the Pennsylvania State University, USA.
| | - Parmveer Singh
- P. G. Department of Agriculture, Khalsa College Amritsar, Punjab, India.
| | - Maurice M Ohayon
- Stanford Sleep Epidemiology Research Center (SSERC), School of Medicine, Stanford University, CA, USA.
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin 3419759811, Iran; Department of Nursing, School of Health and Welfare, Jönköping University, 55111 Jönköping, Sweden.
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Yen CF, Huang YT, Potenza MN, Tsai TT, Lin CY, Tsang HWH. Measure of Internalized Sexual Stigma for Lesbians and Gay Men (MISS-LG) in Taiwan: Psychometric Evidence from Rasch and Confirmatory Factor Analysis. Int J Environ Res Public Health 2021; 18:13352. [PMID: 34948970 DOI: 10.3390/ijerph182413352] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/11/2021] [Accepted: 12/13/2021] [Indexed: 02/05/2023]
Abstract
Internalized sexual stigma may hamper the development of self-identity, social interaction, and intimate relationship in lesbian, gay, and bisexual (LGB) individuals. The Measure of Internalized Sexual Stigma for Lesbians and Gay Men (MISS-LG) is an important instrument assessing internalized sexual stigma for LGB individuals. However, its psychometric properties have not been examined in LGB populations outside the Italian community. The present study used advanced psychometric testing to evaluate the traditional Chinese version (the MISS-LG) among LGB individuals in Taiwan. LGB individuals (500 male, 500 female) participated in this study and completed the MISS-LG, HIV and Homosexuality Related Stigma (HHRS), and Acceptance and Action Questionnaire-II (AAQ). Confirmatory factor analysis results confirmed the three-factor structure of the MISS-LG; however, two items for males and one item for females had somewhat low factor loadings on the sexuality factor. Each MISS-LG factor was found to be unidimensional in Rasch results, except for the slight misfit in Item 3 and concurrent validity of the MISS-LG was supported by the positive correlations with HHRS and the AAQ. The Chinese MISS-LG has relatively satisfactory psychometric properties. However, further research is needed to investigate the reasons for problematic fitting of several items.
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Ma H, Lin J, He J, Lo DHT, Tsang HWH. Effectiveness of TES and rTMS for the Treatment of Insomnia: Meta-Analysis and Meta-Regression of Randomized Sham-Controlled Trials. Front Psychiatry 2021; 12:744475. [PMID: 34744835 PMCID: PMC8569107 DOI: 10.3389/fpsyt.2021.744475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/03/2021] [Indexed: 02/05/2023] Open
Abstract
Objectives: Transcranial electric stimulation (TES) and repetitive transcranial magnetic stimulation (rTMS) have experienced significant development in treating insomnia. This review aims to examine the effectiveness of randomized sham-controlled trials of TES and rTMS in improving insomnia and examine potential moderators associated with the effect of the treatment. Methods: Nine electronic databases were searched for studies comparing the effects of TES/rTMS with sham group on insomnia from the inception of these databases to June 25, 2021, namely, Medline, Embase, PsycINFO, CINAHL, Cochrane Library, Web of Science, PubMed, ProQuest Dissertation and Thesis, and CNKI. Meta-analyses were conducted to examine the effect of TES and rTMS in treating insomnia. Univariate meta-regression was performed to explore potential treatment moderators that may influence the pooled results. Risk of bias was assessed by using the Cochrane Risk of Bias Tool. Results: A total of 16 TES studies and 27 rTMS studies were included in this review. The pooled results indicated that there was no significant difference between the TES group and the sham group in improving objective measures of sleep. rTMS was superior to its sham group in improving sleep efficiency, total sleep time, sleep onset latency, wake up after sleep onset, and number of awakenings (all p < 0.05). Both TES and rTMS were superior to their sham counterparts in improving sleep quality as measured by the Pittsburgh Sleep Quality Index at post-intervention. The weighted mean difference for TES and rTMS were -1.17 (95% CI: -1.98, -0.36) and -4.08 (95% CI: -4.86, -3.30), respectively. Gender, total treatment sessions, number of pulses per session, and length of treatment per session were associated with rTMS efficacy. No significant relationship was observed between TES efficacy and the stimulation parameters. Conclusions: It seems that TES and rTMS have a chance to play a decisive role in the therapy of insomnia. Possible dose-dependent and gender difference effects of rTMS are suggested.
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Affiliation(s)
- Haixia Ma
- Department of Rehabilitation, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR China
- Mental Health Research Centre, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR China
| | - Jingxia Lin
- Department of Rehabilitation, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR China
- Mental Health Research Centre, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR China
| | - Jiali He
- Department of Rehabilitation, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR China
| | - Dilys Hoi Ting Lo
- Department of Rehabilitation, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR China
| | - Hector W. H. Tsang
- Department of Rehabilitation, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR China
- Mental Health Research Centre, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR China
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9
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Poon LYJ, Tsang HWH, Chan TYJ, Man SWT, Ng LY, Wong YLE, Lin CY, Chien CW, Griffiths MD, Pontes HM, Pakpour AH. Psychometric Properties of the Internet Gaming Disorder Scale-Short-Form (IGDS9-SF): Systematic Review. J Med Internet Res 2021; 23:e26821. [PMID: 34661543 PMCID: PMC8561410 DOI: 10.2196/26821] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/24/2021] [Accepted: 09/16/2021] [Indexed: 02/05/2023] Open
Abstract
Background The Internet Gaming Disorder Scale–Short-Form (IGDS9-SF) is among the best with regard to its psychometric properties. Therefore, clinical psychologists are likely guided to use the IGDS9-SF if they want to assess or screen the disordered gaming in their practice. However, the information, especially psychometric evidence, concerning the IGDS9-SF has not been fully examined and summarized. Objective This systematic review evaluated the psychometric properties of different language versions of the IGDS9-SF and assessed its methodological quality in order to improve the clinicians’ understanding of the IGDS9-SF and facilitate its use. Methods Systematic literature searches were carried out using Embase, MEDLINE, PsycINFO, PubMed, ScienceDirect, Scopus, and Web of Science. The review included English-language studies of any research design that have reported at least one psychometric property of the IGDS9-SF, as defined by the COnsensus-based Standards for the selection of health status Measurement INstrument (COSMIN), and have aimed at testing the psychometric properties of the IGDS9-SF. Results In total, 21 studies comprising 15 language versions of the IGDS9-SF were included. Overall, the IGDS9-SF showed adequate internal consistency (although some items did not have satisfactory item-total correlation [IT]), excellent criterion validity, and the ability to distinguish different subgroups with measurement invariance being supported across gender and age. In terms of factor structure, the IGDS9-SF was shown to have a unidimensional factor structure across all 21 studies. Conclusions Although there is insufficient evidence regarding the responsiveness and properties of the IGDS9-SF using item response theory, the existing evidence supports its use in assessing disordered gaming among individuals.
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Affiliation(s)
- Lok Y J Poon
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Hector W H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.,Mental Health Research Centre, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Tsan Y J Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Sze W T Man
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Lok Y Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Yi L E Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chi-Wen Chien
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Mark D Griffiths
- International Gaming Research Unit, Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | - Halley M Pontes
- Department of Organizational Psychology, Birkbeck, University of London, London, United Kingdom
| | - Amir H Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Alimoradi Z, Gozal D, Tsang HWH, Lin CY, Broström A, Ohayon MM, Pakpour AH. Gender-specific estimates of sleep problems during the COVID-19 pandemic: Systematic review and meta-analysis. J Sleep Res 2021; 31:e13432. [PMID: 34245055 PMCID: PMC8420603 DOI: 10.1111/jsr.13432] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/13/2021] [Accepted: 06/16/2021] [Indexed: 02/05/2023]
Abstract
The outbreak of the novel coronavirus disease 2019 (COVID‐19) changed lifestyles worldwide and subsequently induced individuals’ sleep problems. Sleep problems have been demonstrated by scattered evidence among the current literature on COVID‐19; however, little is known regarding the synthesised prevalence of sleep problems (i.e. insomnia symptoms and poor sleep quality) for males and females separately. The present systematic review and meta‐analysis aimed to answer the important question regarding prevalence of sleep problems during the COVID‐19 outbreak period between genders. Using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guideline and Newcastle–Ottawa Scale checklist, relevant studies with satisfactory methodological quality searched for in five academic databases (Scopus, PubMed Central, ProQuest, Web of Science , and EMBASE) were included and analysed. The protocol of the project was registered in the International Prospective Register of Systematic Reviews (PROSPERO; identification code CRD42020181644). A total of 54 papers (N = 67,722) in the female subgroup and 45 papers (N = 45,718) in the male subgroup were pooled in the meta‐analysis. The corrected pooled estimated prevalence of sleep problems was 24% (95% confidence interval [CI] 19%–29%) for female participants and 27% (95% CI 24%–30%) for male participants. Although in both gender subgroups, patients with COVID‐19, health professionals and general population showed the highest prevalence of sleep problems, it did not reach statistical significance. Based on multivariable meta‐regression, both gender groups had higher prevalence of sleep problems during the lockdown period. Therefore, healthcare providers should pay attention to the sleep problems and take appropriate preventive action.
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Affiliation(s)
- Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - David Gozal
- Department of Child Health and the Child Health Research Institute, The University of Missouri School of Medicine, Columbia, MO, USA
| | - Hector W H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Maurice M Ohayon
- Stanford Sleep Epidemiology Research Center (SSERC), School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Alimoradi Z, Broström A, Tsang HW, Griffiths MD, Haghayegh S, Ohayon MM, Lin CY, Pakpour AH. Sleep problems during COVID-19 pandemic and its' association to psychological distress: A systematic review and meta-analysis. EClinicalMedicine 2021; 36:100916. [PMID: 34131640 PMCID: PMC8192091 DOI: 10.1016/j.eclinm.2021.100916] [Citation(s) in RCA: 177] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/29/2021] [Accepted: 05/05/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The emerging novel coronavirus disease 2019 (COVID-19) has become one of the leading cause of deaths worldwide in 2020. The present systematic review and meta-analysis estimated the magnitude of sleep problems during the COVID-19 pandemic and its relationship with psychological distress. METHODS Five academic databases (Scopus, PubMed Central, ProQuest, ISI Web of Knowledge, and Embase) were searched. Observational studies including case-control studies and cross-sectional studies were included if relevant data relationships were reported (i.e., sleep assessed utilizing the Pittsburgh Sleep Quality Index or Insomnia Severity Index). All the studies were English, peer-reviewed papers published between December 2019 and February 2021. PROSPERO registration number: CRD42020181644. FINDINGS 168 cross-sectional, four case-control, and five longitudinal design papers comprising 345,270 participants from 39 countries were identified. The corrected pooled estimated prevalence of sleep problems were 31% among healthcare professionals, 18% among the general population, and 57% among COVID-19 patients (all p-values < 0.05). Sleep problems were associated with depression among healthcare professionals, the general population, and COVID-19 patients, with Fisher's Z scores of -0.28, -0.30, and -0.36, respectively. Sleep problems were positively (and moderately) associated with anxiety among healthcare professionals, the general population, and COVID-19 patients, with Fisher's z scores of 0.55, 0.48, and 0.49, respectively. INTERPRETATION Sleep problems appear to have been common during the ongoing COVID-19 pandemic. Moreover, sleep problems were found to be associated with higher levels of psychological distress. With the use of effective programs treating sleep problems, psychological distress may be reduced. Vice versa, the use of effective programs treating psychological distress, sleep problems may be reduced. FUNDING The present study received no funding.
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Affiliation(s)
- Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
| | - Hector W.H. Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Shahab Haghayegh
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Maurice M. Ohayon
- Stanford Sleep Epidemiology Research Center (SSERC), School of Medicine, Stanford University, CA, USA
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University
| | - Amir H. Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Fung TKH, Lau BWM, Ngai SPC, Tsang HWH. Therapeutic Effect and Mechanisms of Essential Oils in Mood Disorders: Interaction between the Nervous and Respiratory Systems. Int J Mol Sci 2021; 22:ijms22094844. [PMID: 34063646 PMCID: PMC8125361 DOI: 10.3390/ijms22094844] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 02/05/2023] Open
Abstract
Essential oils (EOs) are extracted from plants and contain active components with therapeutic effects. Evidence shows that various types of EOs have a wide range of health benefits. In our previous studies, the potential of lavender EO for prevention and even treatment of depression and anxiety symptoms was demonstrated. The favourable outcomes may be due to multiple mechanisms, including the regulation of monoamine level, the induction of neurotrophic factor expression, the regulation of the endocrine system and the promotion of neurogenesis. The molecules of EOs may reach the brain and exert an effect through two distinctive pathways, namely, the olfactory system and the respiratory system. After inhalation, the molecules of the EOs would either act directly on the olfactory mucosa or pass into the respiratory tract. These two delivery pathways suggest different underlying mechanisms of action. Different sets of responses would be triggered, such as increased neurogenesis, regulation of hormonal levels, activation of different brain regions, and alteration in blood biochemistry, which would ultimately affect both mood and emotion. In this review, we will discuss the clinical effects of EOs on mood regulation and emotional disturbances as well as the cellular and molecular mechanisms of action. Emphasis will be put on the interaction between the respiratory and central nervous system and the involved potential mechanisms. Further evidence is needed to support the use of EOs in the clinical treatment of mood disturbances. Exploration of the underlying mechanisms may provide insight into the future therapeutic use of EO components treatment of psychiatric and physical symptoms.
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Chen IH, Chen CY, Pakpour AH, Griffiths MD, Lin CY, Li XD, Tsang HWH. Problematic internet-related behaviors mediate the associations between levels of internet engagement and distress among schoolchildren during COVID-19 lockdown: A longitudinal structural equation modeling study. J Behav Addict 2021; 10:135-148. [PMID: 33570506 PMCID: PMC8969851 DOI: 10.1556/2006.2021.00006] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/03/2020] [Accepted: 01/10/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND AIMS Due to the rapid spread of the novel coronavirus disease 2019 (COVID-19), policies based on the nature of "spatial distancing" have been implemented and have resulted in school suspensions and online learning among schoolchildren. In order to examine the impact of such policies on schoolchildren, the aims of the present study were to (i) assess changes in the level of engagement in three internet-related activities (smartphone use, social media use, and gaming) before and during the COVID-19 outbreak, including prolonged and problematic engagement in these activities; (ii) investigate the differences of psychological distress before and after COVID-19 outbreak; and (iii) to use structural equation modeling to investigate the mediating roles of problematic internet-related behaviors in the causal relationships of psychological distress and time spent on internet-related activities. METHODS Self-report measures were used to assess internet-related activities and psychological distress. Time spent on internet-related activities, problematic use of internet-related activities, and psychological distress were collected from primary school students (N = 535; 265 boys; M age = 10.32 years [SD = 0.84]). The data were first collected before the COVID-19 outbreak (i.e., early November 2019) and then collected again during the school suspension due to COVID-19 outbreak (i.e., end of March 2020) for comparisons of changes. RESULTS Schoolchildren spent significantly more time on the smartphone (increased 1.02 h daily; P < 0.001) and social media (increased 0.73 h daily; P < 0.001) but not gaming (increased 0.14 h daily; P = 0.07) during the school suspension compared to the baseline. Schoolchildren who increased by 15 or 30 min daily on internet-related activities showed an increased level of psychological distress. The association between problematic use of social media and psychological distress was stronger during the school suspension (β = 0.584) than at the baseline (β = 0.451; P < 0.001). CONCLUSION Increased problematic use of internet-related activities among schoolchildren was associated with greater psychological distress. Parents should therefore monitor internet-related activities and psychological distress of their children to support their mental health.
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Affiliation(s)
- I-Hua Chen
- School of Education Science, Minnan Normal University, Zhangzhou, China
| | - Chao-Ying Chen
- School of Physical Therapy, Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Amir H. Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Mark D. Griffiths
- Psychology Department, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Xu-Dong Li
- Gaogeng Nine-year School, Qionglai, China
| | - Hector W. H. Tsang
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Tsang HH, Ahorsu D, Chung K, Wong H, Yiu MC, Mok Y, Lei K. Neuropsychological correlates of community function among major depressive disorder outpatients without comorbidity in Hong Kong: An exploratory cross-Sectional study. Asian J Soc Health Behav 2021. [DOI: 10.4103/shb.shb_66_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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15
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Chen J, Chen X, Leung SS, Tsang HW. Potential impacts, alleviating factors, and interventions for children of a parent with schizophrenia: A scoping review. Children and Youth Services Review 2021. [DOI: 10.1016/j.childyouth.2020.105751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Ahorsu DK, Chung K, Wong HH, Yiu MGC, Mok YF, Lei KS, Tsang HWH. The Effects of Major Depressive Disorder on the Sequential Organization of Information Processing Stages: An Event-Related Potential Study. Brain Sci 2020; 10:E935. [PMID: 33291661 DOI: 10.3390/brainsci10120935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/28/2020] [Accepted: 12/01/2020] [Indexed: 02/05/2023] Open
Abstract
The adverse effects of depression on patients’ life have been reported but information about its effects on the sequential organization of the information processing stages remains poorly understood as previous studies focused only on distinct stages. This study adds to existing knowledge by examining the effect of major depressive disorder (MDD) on the sequential organization of information processing, executive and community functioning. Fifty-seven participants with 19 participants each for first episode depression (FMDD), recurrent episodes depression (RMDD), and healthy controls (HCs) participated in this study. They completed assessments on executive and community functioning measures, and choice reaction time task (CRTT) for the event-related potential (ERP) data. Findings revealed no significant between-group difference in executive functioning but participants with depression (FMDD and RMDD) were found to be more depressed, with FMDD participants having worse community functioning skills compared with HCs. There was no significant between-group main effect on behavioral data. ERP data showed significantly less positive-going P3b among RMDD participants compared with HCs. FMDD participants used a different information processing strategy at P1, while HCs and RMDD participants used a different processing strategy at N2b compared with the other group(s), respectively. The results suggest the use of multifaceted assessment to get a holistic view of the health status of people with MDD in order to inform clinicians on the appropriate interventional strategies needed for the patient.
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So WWY, Lu EY, Cheung WM, Tsang HWH. Comparing Mindful and Non-Mindful Exercises on Alleviating Anxiety Symptoms: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2020; 17:E8692. [PMID: 33238594 DOI: 10.3390/ijerph17228692] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/17/2020] [Accepted: 11/17/2020] [Indexed: 02/05/2023]
Abstract
Background: In recent years, studies and reviews have reported the therapeutic benefits of both mindful and non-mindful exercises in reducing anxiety. However, there have not been any systematic reviews to compare their relative effectiveness for therapeutic application, especially among the non-clinical population. Thus, the aim of this review is to compare the effectiveness between mindful and non-mindful exercise on treating anxiety among non-clinical samples. Methods: Potential articles were retrieved from PubMed, Embase, Academic Search Premier, and PsycInfo. Randomized controlled trials, which involved both mindful and non-mindful exercises as intervention, and the use of anxiety outcome measures were included. Results: Twenty-four studies fulfilled the inclusion criteria and were included in our systematic review. In addition, 14 studies provided sufficient data to be included in the meta-analysis. For studies that reported significant group differences at post-assessment, results showed that mindful exercise was more beneficial in reducing anxiety than non-mindful exercise. The meta-analysis reported that yoga was more effective in reducing anxiety than non-mindful exercise. Conclusions: Compared to non-mindful exercise, yoga is shown to be more effective in alleviating anxiety symptoms. It is recommended that yoga could be used as a primary healthcare intervention to help the public reduce anxiety.
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Lu EY, Lee P, Cai S, So WWY, Ng BFL, Jensen MP, Cheung WM, Tsang HWH. Qigong for the treatment of depressive symptoms: Preliminary evidence of neurobiological mechanisms. Int J Geriatr Psychiatry 2020; 35:1393-1401. [PMID: 32662069 DOI: 10.1002/gps.5380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/21/2020] [Accepted: 07/06/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Qigong has been shown to effectively reduce depressive symptoms in older adults with chronic physical illness. Here, we sought to evaluate the effects of qigong on serotonin, cortisol, and Brain-derived Neurotropic Factors (BDNF) levels and test their roles as potential mediators of the effects of qigong on depressive symptoms. METHODS Thirty older adults with chronic physical illness participated in a randomized clinical trial. They were randomly assigned to a qigong group (n = 14) or a control group for cognitive training of executive function and memory (n = 16). The participants provided blood and saliva samples at baseline and post-intervention. Levels of cortisol were measured from the salvia samples, and serotonin and BDNF were measured from the blood samples. RESULTS Consistent with the study findings presented in the primary outcome paper, a significant Group × Time interaction effect emerged on depressive symptoms, explained by greater reductions in the qigong group than the control group. Qigong participants had significantly larger increases in serotonin and BDNF, and decreases in cortisol levels, compared with control group participants. Moreover, treatment-related changes in cortisol levels (but not serotonin or BDNF) fully mediated the beneficial effects of qigong on depressive symptoms. CONCLUSION The findings provide preliminary evidence that treatment-related changes in cortisol may mediate the benefits of qigong on depressive symptoms. Given the limitation of small sample size of the present study, future studies with larger sample sizes and more extended follow-up assessment are warranted to determine the reliability of these findings.
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Affiliation(s)
- Erin Yiqing Lu
- Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Posen Lee
- Department of Occupational Therapy, I-Shou University, Kaohsiung City, Taiwan
| | - Shuhe Cai
- Department of Orthopedic Rehabilitation, Fujian University of Traditional Chinese Medicine Subsidiary Rehabilitation Hospital, Fuzhou, Fujian, China
| | - Wendy Wing Yan So
- Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | | | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
| | - Wai Ming Cheung
- Faculty of Education, The University of Hong Kong, Pokfulam Road, Hong Kong SAR
| | - Hector W H Tsang
- Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
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Abstract
In order to understand the phenomenon of stigma in different populations (e.g., different ethnicities, different diseases, and different conditions), this Special Issue collects papers from around the world to illustrate the stigma phenomenon. After a rigorous process of peer review, a total of 24 papers were published and included in the Special Issue. These papers were contributed from different continents and countries, including the Americas (e.g., United States), Europe (e.g., Finland), and Asia (e.g., Saudi Arabia). Therefore, the diversity of ethnicity was ensured in the Special Issue. Moreover, these papers address different stigmatized populations/conditions (e.g., mental illness, obesity, public housing, homosexuality, and transgender). The most discussed populations were those with mental illness and those with obesity/overweight. However, additional evidence on the stigma topic is still needed. Specifically, future studies could consider the following directions to explore in depth the issues of stigma in different populations: (1) using longitudinal designs to understand the temporal or causal relationship between stigma and other related psychosocial factors; (2) designing treatment programs to fight stigma-this could be carried out in healthcare providers, healthcare trainees, the public, caregivers, and the stigmatized populations.
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Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Correspondence: ; Tel.: +886-235-3535 (ext. 5106)
| | - Hector W. H. Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China;
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Leung JWH, Cheung KK, Ngai SPC, Tsang HWH, Lau BWM. Protective Effects of Melatonin on Neurogenesis Impairment in Neurological Disorders and Its Relevant Molecular Mechanisms. Int J Mol Sci 2020; 21:ijms21165645. [PMID: 32781737 PMCID: PMC7460604 DOI: 10.3390/ijms21165645] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/30/2020] [Accepted: 08/01/2020] [Indexed: 02/05/2023] Open
Abstract
Neurogenesis is the process by which functional new neurons are generated from the neural stem cells (NSCs) or neural progenitor cells (NPCs). Increasing lines of evidence show that neurogenesis impairment is involved in different neurological illnesses, including mood disorders, neurogenerative diseases, and central nervous system (CNS) injuries. Since reversing neurogenesis impairment was found to improve neurological outcomes in the pathological conditions, it is speculated that modulating neurogenesis is a potential therapeutic strategy for neurological diseases. Among different modulators of neurogenesis, melatonin is a particularly interesting one. In traditional understanding, melatonin controls the circadian rhythm and sleep-wake cycle, although it is not directly involved in the proliferation and survival of neurons. In the last decade, it was reported that melatonin plays an important role in the regulation of neurogenesis, and thus it may be a potential treatment for neurogenesis-related disorders. The present review aims to summarize and discuss the recent findings regarding the protective effects of melatonin on the neurogenesis impairment in different neurological conditions. We also address the molecular mechanisms involved in the actions of melatonin in neurogenesis modulation.
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Affiliation(s)
- Joseph Wai-Hin Leung
- Department of Biology, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
- Regenerative Medicine Program, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada
| | - Kwok-Kuen Cheung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China; (K.-K.C.); (S.P.-C.N.)
| | - Shirley Pui-Ching Ngai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China; (K.-K.C.); (S.P.-C.N.)
| | - Hector Wing-Hong Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China; (K.-K.C.); (S.P.-C.N.)
- Correspondence: (H.W.-H.T.); (B.W.-M.L.)
| | - Benson Wui-Man Lau
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China; (K.-K.C.); (S.P.-C.N.)
- Correspondence: (H.W.-H.T.); (B.W.-M.L.)
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Li CT, Hung GK, Fong KN, Gonzalez PC, Wah SH, Tsang HW. Effects of a home-based occupational therapy telerehabilitation via smartphone for outpatients after hip fracture surgery: A feasibility randomised controlled study. J Telemed Telecare 2020; 28:239-247. [PMID: 32594832 DOI: 10.1177/1357633x20932434] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION This study aimed to investigate the effects of a home-based occupational therapy telerehabilitation (TR) via smartphone in enhancing functional and motor performance and fall efficacy for outpatients receiving day hospital rehabilitation after hip fracture surgery in Hong Kong. METHODS This was a feasibility randomised controlled trial with two groups - an experimental group and a comparison group - and a sample of 31 older adults attending a geriatric day hospital who had undergone hip fracture surgery within 12 weeks of diagnosis. Patients were assessed at baseline, immediately after a three-week intervention and at three-week post-intervention follow-up for motor performance, activities of daily living (ADL) functioning and fall efficacy. The experimental group received a home programme using the Caspar Health e-system and a mobile app for smartphones, while the comparison group received paper-and-pencil instructions for the home programme on a weekly basis for three weeks. RESULTS Compared to the comparison group, significant improvements in fall efficacy and instrumental ADL performance at post intervention and follow-up were found in the experimental group. However, in the comparison group, inadequate social support was a factor contributing to better muscle strength testing in both the affected and non-affected legs. There were no significant differences between the two groups in regard to the other variables. DISCUSSION This study supports the potential use of TR via smartphone as an alternative home programme for use in occupational therapy practice with older adults after hip fracture surgery.
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Affiliation(s)
- Cabbee Tl Li
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.,Geriatric Day Hospital, Haven of Hope Hospital, Hong Kong
| | - Goris Kn Hung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Kenneth Nk Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Pablo Cruz Gonzalez
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Shu-Hong Wah
- Geriatric Day Hospital, Haven of Hope Hospital, Hong Kong
| | - Hector Wh Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
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Lee P, Cai S, Lu EY, Ng BFL, Jensen MP, Tsang HWH. Qigong Reduces Depressive Symptoms of Taiwanese Elderly with Chronic Physical Illness: A Randomized Controlled Trial. J Altern Complement Med 2019; 26:76-78. [PMID: 31855445 DOI: 10.1089/acm.2019.0354] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Posen Lee
- Department of Occupational Therapy, I-Shou University, Kaohsiung City, Taiwan
| | - Shuhe Cai
- Department of Orthopedic Rehabilitation, Fujian University of Traditional Chinese Medicine Subsidiary Rehabilitation Hospital, Fuzhou, China
| | - Erin Yiqing Lu
- Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | | | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Hector W H Tsang
- Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
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Fung XCC, Pakpour AH, Wu YK, Fan CW, Lin CY, Tsang HWH. Psychosocial Variables Related to Weight-Related Self-Stigma in Physical Activity among Young Adults across Weight Status. Int J Environ Res Public Health 2019; 17:E64. [PMID: 31861769 DOI: 10.3390/ijerph17010064] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 02/05/2023]
Abstract
A healthy lifestyle with sufficient physical activity (PA) can contribute to weight management. Yet, many people do not maintain a healthy lifestyle. To explain PA, we propose a model that incorporates the Theory of Planned Behavior (TPB) with weight-related self-stigma. We recruited 325 young adults to complete questionnaires regarding their physical activities, weight-related self-stigma, and TPB factors. We used structural equation modeling to examine the model fit and the path invariance across weight groups. The model showed excellent model fit, but path invariance was not supported. Weight-related self-stigma significantly explained the perceived behavioral control, behavioral intention, and engagement of PA. People without overweight and people with overweight have different considerations for PA. Weight-related self-stigma is important for PA as well. To promote a healthy lifestyle, healthcare providers should provide different suggestions or interventions that suit their patients' weight-related concerns.
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Man DWK, Tsang WSF, Lu EY, Tsang HWH. Bibliometric study of research productivity in occupational therapy and physical therapy/physiotherapy in four Western countries and five Asian countries/regions. Aust Occup Ther J 2019; 66:690-699. [PMID: 31595529 DOI: 10.1111/1440-1630.12608] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2019] [Indexed: 02/05/2023]
Abstract
INTRODUCTION High-quality research is the foundation of occupational therapy and physical therapy/physiotherapy. A bibliometric study on the research productivity of occupational therapy and physical therapy/physiotherapy scholars in different Western and Asian countries/regions could provide a snapshot of current research achievement in rehabilitation science. METHOD On the basis of an understanding of the leading role of rehabilitation research in Western countries and a recognition of achievements made by Asian occupational therapy and physical therapy/physiotherapy scholars, the current bibliometric study examined the research productivity of occupational therapy and physical therapy/physiotherapy professors and associate professors from four Western countries (Australia, Canada, the United States and the United Kingdom) and five Asian countries/regions (Hong Kong, Japan, Taiwan, Singapore and South Korea). The h-indices of these scholars were retrieved online and aggregated to quantify the research productivity of institutions and countries/regions. RESULTS Australia, Canada, Hong Kong and the United States were identified as countries/regions with higher research productivity in occupational therapy and physical therapy/physiotherapy. The institutions were ranked on the basis of the median h-indices of their professors and associate professors; the top 20 productive institutions with occupational therapy programmes had a median h-index of 17.5 or higher, whereas the benchmark of the top 20 institutions with physical therapy/physiotherapy programmes was 25. CONCLUSION Professors and associate professors in Australia, Canada, Hong Kong and the United States are productive in occupational therapy and physical therapy/physiotherapy research. The number of faculty members and university connections are regarded as important for research achievement. Recommendations for various levels of collaboration are provided.
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Affiliation(s)
- David W K Man
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Walter S F Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Erin Yiqing Lu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Hector W H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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Ye J, Cheung WM, Tsang HWH. The Neuroscience of Nonpharmacological Traditional Chinese Therapy (NTCT) for Major Depressive Disorder: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med 2019; 2019:2183403. [PMID: 31223326 DOI: 10.1155/2019/2183403] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 04/18/2019] [Accepted: 05/05/2019] [Indexed: 02/05/2023]
Abstract
Background Depression is a common disease affecting a large number of people across the world. Many researchers have focused on treatment for depression based on Western scientific approaches, but research based on traditional Chinese medicine (TCM) interventions, studying its clinical effectiveness and the underlying mechanisms involved, has been limited. The aim of this review is to conduct a pioneering systematic review with meta-analysis of existing studies that investigate the neuroscience basis of nonpharmacological traditional Chinese therapy (NTCT). Methods Both English (Pubmed, Embase, Scopus, SPORTDiscus, PsycINFO) and Chinese (China National Knowledge Infrastructure (CNKI)) databases were searched from inception to October 2018. The effects of NTCT on major depressive disorder, brain activity, and neurophysiological biomarker related outcomes were extracted. Study quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. The effect size of each study was reported by the mean difference of change scores. Results Six of twelve eligible studies showed that there was a significant improvement in favor of acupuncture in depressive symptoms (SMD -0.69, 95% CI -1.09 to -0.28, p=0.002, I 2 = 73%, p< 0.0008). Based on the available evidence, NTCT including acupuncture, Qigong, and Tai Chi was found to possibly improve brain metabolites, brain activity, and immune and endocrine systems in patients with major depressive disorder. Conclusions Acupuncture could effectively relieve depressive syndromes. The clinical effects of acupuncture might be attributable to their influence on three proposed pathways, namely, the hypothalamic-pituitary-adrenal (HPA) axis, the locus coeruleus (LC)-immunity pathway, and the negative feedback loop of the hippocampus. Nevertheless, conclusions are limited due to the small number of studies included and the low-quality of the study designs. In the future, a cross-sectional study is needed to test the proposed plausible pathways. PROSPERO registration number is CRD42017080937.
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Pakpour AH, Tsai MC, Lin YC, Strong C, Latner JD, Fung XCC, Lin CY, Tsang HWH. Psychometric properties and measurement invariance of the Weight Self-Stigma Questionnaire and Weight Bias Internalization Scale in children and adolescents. Int J Clin Health Psychol 2019; 19:150-9. [PMID: 31193103 DOI: 10.1016/j.ijchp.2019.03.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 03/13/2019] [Indexed: 02/05/2023] Open
Abstract
Given the negative consequences of weight bias, including internalized weight stigma, on health outcomes, two instruments—the Weight Self-Stigma Questionnaire (WSSQ) and Weight Bias Internalization Scale (WBIS)—have been developed. However, their psychometric properties are yet to be tested for Asian pediatric populations. Method:Participants aged 8 to 12 years (N = 287; 153 boys) completed the WSSQ and the WBIS, and they were classified into either a group with overweight or a group without overweight based on self-reported weight and height. Results:Both WSSQ and WBIS had their factor structures supported by confirmatory factor analyses (CFAs). The measurement invariance of two-factor structure was further supported for WSSQ across gender and weight status. The measurement invariance of single-factor structure was supported for WBIS across gender but not across weight status. Conclusions:WSSQ and WBIS were both valid to assess the internalization of weight bias. However, the two instruments demonstrated different properties and should be applied in different situations.
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Ye J, Cai S, Cheung WM, Tsang HWH. An East Meets West Approach to the Understanding of Emotion Dysregulation in Depression: From Perspective to Scientific Evidence. Front Psychol 2019; 10:574. [PMID: 30984060 PMCID: PMC6447656 DOI: 10.3389/fpsyg.2019.00574] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 02/28/2019] [Indexed: 02/05/2023] Open
Abstract
Depression, an emotion regulation disorder, is a prevalent mental illness in the world. Meanwhile, traditional Chinese medicine (TCM) has been increasingly regarded as a promising and effective alternative therapy approach for patients with depression. Despite many years of research on depression, the current understanding of the pathological mechanism of depression based on TCM theories is still in its infancy. Due to the lack of scientific evidence in the past, TCM is not fully recognized by researchers around the world. This review firstly summarizes the pathogenesis and etiology of depression in terms of both Eastern and Western medical systems. Secondly, it adopts an integrated Eastern and Western approach to propose some plausible neurophysiological pathways linking the liver, spleen, and heart functions explicated in TCM theory. The aim of this theoretical review is to bridge the knowledge gap between Eastern and Western medicine, which may better explain the pathology of depression.
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Affiliation(s)
- Jiajia Ye
- Department of Rehabilitation Assessment, Fujian University of Traditional Chinese Medicine Subsidiary Rehabilitation Hospital, Fuzhou, China
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Shuhe Cai
- Department of Orthopaedic Rehabilitation, Fujian University of Traditional Chinese Medicine Subsidiary Rehabilitation Hospital, Fuzhou, China
| | - Wai Ming Cheung
- Faculty of Education, The University of Hong Kong, Hong Kong, China
| | - Hector W. H. Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
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Sánchez-Vidaña DI, Po KKT, Fung TKH, Chow JKW, Lau WKW, So PK, Lau BWM, Tsang HWH. Lavender essential oil ameliorates depression-like behavior and increases neurogenesis and dendritic complexity in rats. Neurosci Lett 2019; 701:180-192. [PMID: 30825591 DOI: 10.1016/j.neulet.2019.02.042] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 02/11/2019] [Accepted: 02/26/2019] [Indexed: 02/05/2023]
Abstract
Depression is a major health issue that causes severe societal economic and health burden. Aromatherapy, a practice that uses essential oils for preventive and therapeutic purposes, represents a promising therapeutic alternative for the alleviation of depressive symptoms. Lavender essential oil (LEO) has been the focus of clinical studies due to its positive effect on mood. An animal model of chronic administration of high dose corticosterone to induce depression- and anxiety-like behavior and reduced neurogenesis was used to explore the biological changes brought by aromatherapy. Twenty-four adult male Sprague Dawley rats were randomly assigned into four groups: Control, corticosterone (Cort) group with high dose of corticosterone, LEO group with daily exposure to LEO by inhalation, and LEO + Cort. At the end of the 14-day treatment period, behavioral tests were carried out. Serum samples were collected 2-3 days after the 14-day period treatment and before perfusion to carry out biochemical analyses to measure BDNF, corticosterone and oxytocin. After perfusion, brains were collected for immunohistochemical analysis to detect BrdU and DCX positive cells in the hippocampus and subventricular zone. Results showed that treatment with LEO ameliorated the depression-like behavior induced by the chronic administration of corticosterone as observed in the LEO + Cort group. Cort treatment reduced the number of BrdU positive cells in the hippocampus and the subventricular zone. Treatment with LEO prevented the corticosterone-induced reduction in the number of BrdU positive cells (LEO + Cort group) demonstrating the neurogenic effect of LEO under high corticosterone conditions. Chronic administration of high dose of corticosterone significantly reduced the dendritic complexity of immature neurons. On the contrary, treatment with LEO increased dendritic complexity of immature neurons under high corticosterone conditions (LEO + Cort group). The improved neurogenesis and dendritic complexity observed in the LEO + Cort group demonstrated a clear restorative effect of LEO under high corticosterone conditions. However, 2-3 days after the treatment, the levels of BDNF were upregulated in the LEO and LEO + Cort groups. Furthermore, the concentration of oxytocin in serum, 2-3 days after the treatment, showed to be upregulated in the LEO group alone. The present study has provided evidence of the biological effect of LEO on neuroplasticity and neurogenesis. Also, this study contributes to the understanding of the mechanism of action of LEO in an animal model where depression- and anxiety-like behavior and reduced neurogenesis were induced by high corticosterone administration.
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Affiliation(s)
| | - Kevin Kai-Ting Po
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Timothy Kai-Hang Fung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jason Ka-Wing Chow
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Way Kwok-Wai Lau
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong, China
| | - Pui-Kin So
- University Research Facility in Life Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Benson Wui-Man Lau
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Hector Wing-Hong Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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So WWY, Cai S, Yau SY, Tsang HWH. The Neurophysiological and Psychological Mechanisms of Qigong as a Treatment for Depression: A Systematic Review and Meta-Analysis. Front Psychiatry 2019; 10:820. [PMID: 31824346 PMCID: PMC6880657 DOI: 10.3389/fpsyt.2019.00820] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 10/17/2019] [Indexed: 02/05/2023] Open
Abstract
Objective: An increasing number of studies have shown the anti-depressive effect of qigong. However, its underlying mechanism remains poorly understood. This study aims to systematically review and meta-analyze existing literature on the mechanism of qigong in reducing depression. Method: The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials of qigong were searched from PsycINFO, PubMed, Embase, ScienceDirect, and Academic Search Premier from inception to December 2018. Studies which involved depression and any neurophysiological or psychological mechanisms as outcomes were included. Publication bias was tested before conducting meta-analysis. Two independent raters were involved for the entire review process. Results: A total of nine studies were identified which covered both neurophysiological and psychological mechanisms. Among these selected studies, seven were involved in meta-analysis, which suggested that qigong was effective in alleviating depression (standardized mean difference, SMD = -0.27, p < 0.05, I 2 = 27%). A significant effect was also found for diastolic blood pressure (SMD = -1.64, p < 0.05, I 2 = 31%). However, no significant effect was found for cortisol level and systolic blood pressure. Conclusions: This review shows that qigong is effective in reducing depression through activating the parasympathetic nervous system. Future studies with higher quality of research methodology with less selection and attrition bias should be conducted to unravel the possible anti-depressive effect of qigong.
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Affiliation(s)
- Wendy Wing Yan So
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Shuhe Cai
- Department of Orthopaedic Rehabilitation, Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Suk Yu Yau
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Hector Wing Hong Tsang
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, Hong Kong
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Fan CW, Keponen R, Piikki S, Tsang HWH, Popova ES, Taylor R. Psychometric evaluation of the Finnish translation of the assessment of communication and interaction skills (ACIS-FI). Scand J Occup Ther 2018; 27:112-121. [PMID: 29952677 DOI: 10.1080/11038128.2018.1483425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Background: The Model of Human Occupation (MOHO) is a widely used conceptual practice model in Finland. Therefore, Finnish translations of valid and reliable MOHO assessments are needed.Objective: The primary objective of this study was to examine the psychometric properties of the Finnish translation of the Assessment of Communication and Interaction Skills (ACIS-FI) using the many-facet Rasch model approach.Methods and Materials: Twenty-eight occupational therapists completed an in-person training workshop on the ACIS-FI and participated as raters in this study. One hundred and forty-eight clients were rated using the ACIS-FI. Rating scale functioning, unidimensionality, person validity and rater severity, item targeting, and item and person separation statistics were examined.Results: The rating scales demonstrated adequate functioning; the rating category 'deficit' was infrequently adopted by the raters. The ACIS-FI had satisfactory construct validity, as confirmed by all items exhibiting unidimensionality within a single construct (i.e. communication and interaction skills), and appropriate item fit. Validity was further confirmed through low person misfit (6%) and low rater misfit (3.6%). No ceiling or floor effects were found. The ACIS-FI was able to separate clients into four levels of communication and interaction skills.Conclusions: This study offers evidence for the validity of the ACIS-FI as a measure of communication and interaction skills in occupational therapy.Significance: The ACIS-FI offers Finnish practitioners and researchers a valid tool to measure communication and interactions skills that is theoretically grounded in the MOHO.
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Affiliation(s)
- Chia-Wei Fan
- Department of Occupational Therapy, Adventist University of Health Sciences, Orlando, USA
| | - Riitta Keponen
- Department of Participation and Human Functioning, Metropolia University of Applied Sciences, Helsinki, Finland
| | - Sanna Piikki
- Department of Participation and Human Functioning, Metropolia University of Applied Sciences, Helsinki, Finland
| | - Hector W H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Evguenia S Popova
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, USA
| | - Renee Taylor
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, USA
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Fung JKKM, Tsang HWH. Management of behavioural and psychological symptoms of dementia by an aroma-massage with acupressure treatment protocol: A randomised clinical trial. J Clin Nurs 2017; 27:1812-1825. [PMID: 28986942 DOI: 10.1111/jocn.14101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2017] [Indexed: 02/05/2023]
Abstract
AIMS AND OBJECTIVES This study evaluates the clinical effectiveness of a multicomponent aroma-massage with an acupressure treatment protocol and compared it to cognitive training for the management of behavioural and psychological symptoms of dementia. BACKGROUND Pharmacological interventions have been unsatisfactory in managing behavioural and psychological symptoms of dementia; thus, complementary and alternative medicine has been extensively researched to identify an adjunct safe and cost-effective intervention. DESIGN This randomised clinical trial utilised a three-arm parallel group design. Cognitive training was used as a conventional intervention to manage behavioural and psychological symptoms of dementia, whereas exercise was considered "treatment as usual" in this study; both were used as comparisons with the experimental protocol. There were three treatment groups: Group 1: aroma-massage with acupressure + exercise, Group 2: cognitive training + exercise and Group 3: aroma-massage with acupressure + cognitive training. METHOD Sixty older adults were recruited and randomly assigned to the three groups (20 each). Using the 29-item Chinese Version of the Cohen-Mansfield Agitation Inventory, Neuropsychiatric Inventory, Mini-mental State Examination and Barthel Index-20, the outcome measures were assessed at preintervention, postintervention and the 3-month follow-up to assess behaviour, Activities of Daily Living, cognition, and behavioural and psychological symptoms of dementia severity and distress. Multiple comparisons performed through repeated measures were analysed to detect between-group differences and within-subject differences, as well as the interaction effects between groups and times. RESULTS The Group 1 and 3 participants showed a significant reduction in the severity and distress caused by behavioural and psychological symptoms of dementia, whereas Group 2 did not demonstrate similar effects. CONCLUSIONS This clinical study suggests that aroma-massage with acupressure is as effective as cognitive training and can enhance cognitive training in reducing the severity and distress of behavioural and psychological symptoms of dementia. RELEVANCE TO CLINICAL PRACTICE Aroma-massage with acupressure may serve as an adjunct therapy to reduce behavioural and psychological symptoms of dementia. This therapy is safe, cost-effective and can be implemented by caregivers and family members who are not professionally trained.
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Affiliation(s)
- Jo Kamen Ka-Man Fung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Hector Wing-Hong Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
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Tsui MCM, Tsang HWH. Views of people with schizophrenia and their caregivers towards the needs for psychiatric rehabilitation in urban and rural areas of mainland China. Psychiatry Res 2017; 258:72-77. [PMID: 28988122 DOI: 10.1016/j.psychres.2017.09.052] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 09/15/2017] [Accepted: 09/22/2017] [Indexed: 02/08/2023]
Abstract
This qualitative study explores and compares the views of the individuals with schizophrenia and their caregivers in the urban and rural areas of Wuxi towards the needs for psychiatric rehabilitation. The results may more precisely guide the government and policy makers to tailor the corresponding strategies and services. With interview guides, individual face-to-face semi-structured interviews were conducted among a total of 16 participants (four people with schizophrenia and their caregivers in the urban areas and in the rural areas, respectively). All interviews were audio-recorded, transcribed, and analyzed using an inductive approach. The findings revealed commonalities and discrepancies on their views about the needs of rehabilitation interventions and community care, the healthcare resources for medication, the major factors of employment, and the support to caregivers for facilitating recovery. Some policy and service implications to promote psychiatric rehabilitation of the people with schizophrenia and their caregivers in Wuxi are discussed. With careful consideration of the possible socio-cultural differences, the findings may also serve as references for the related researchers and clinicians in other regions in China.
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Affiliation(s)
- Man C M Tsui
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, China
| | - Hector W H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, China.
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Gomez IN, Lai CYY, Morato-Espino PG, Chan CCH, Tsang HWH. Behavioural and Autonomic Regulation of Response to Sensory Stimuli among Children: A Systematic Review of Relationship and Methodology. Biomed Res Int 2017; 2017:2629310. [PMID: 29333436 DOI: 10.1155/2017/2629310] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 08/28/2017] [Accepted: 10/09/2017] [Indexed: 02/05/2023]
Abstract
Background Previous studies have explored the correlates of behavioural and autonomic regulation of response to sensory stimuli in children; however, a comprehensive review of such relationship is lacking. This systematic review was performed to critically appraise the current evidence on such relationship and describe the methods used in these studies. Methods Online databases were systematically searched for peer-reviewed, full-text articles in the English language between 1999 and 2016, initially screened by title and abstract, and appraised and synthesized by two independent review authors. Results Fourteen Level III-3 cross-sectional studies were included for systematic review, among which six studies explored the relationship between behaviour and physiological regulation of responses to sensory stimuli. Three studies reported significant positive weak correlations among ASD children; however, no correlations were found in typically developing children. Methodological differences related to individual differences among participants, measures used, and varied laboratory experimental setting were noted. Conclusion This review suggests inconclusive evidence supporting the relationship between behavioural and physiological regulation of responses to sensory stimuli among children. Methodological differences may likely have confounded the results of the current evidence. We present methodological recommendations to address this matter for future researches. This trial is registered with PROSPERO registration number CRD42016043887.
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Cheung WM, Lam JWI, Au DWH, So WWY, Huang Y, Tsang HWH. Explaining student and home variance of Chinese reading achievement of the PIRLS 2011 Hong Kong. Psychol Schs 2017. [DOI: 10.1002/pits.22041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Zhang GF, Tsui CM, Lu AJB, Yu LB, Tsang HWH, Li D. Integrated Supported Employment for People With Schizophrenia in Mainland China: A Randomized Controlled Trial. Am J Occup Ther 2017; 71:7106165020p1-7106165020p8. [PMID: 29135426 DOI: 10.5014/ajot.2017.024802] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Guo Fu Zhang
- Guo Fu Zhang, MMSc, is Psychiatrist, Wuxi Mental Health Center, Wuxi Tongren International Rehabilitation Hospital, Nanjing Medical University, Nanjing, China
| | - Chi Man Tsui
- Chi Man Tsui, MMedSc, is Occupational Therapist, Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Aisia Jiang Bo Lu
- Aisia Jiang Bo Lu, BN, is Nurse, Wuxi Mental Health Center, Wuxi Tongren International Rehabilitation Hospital, Nanjing Medical University, Nanjing, China
| | - Li Bo Yu
- Li Bo Yu, BN, is Nurse, Wuxi Mental Health Center, Wuxi Tongren International Rehabilitation Hospital, Nanjing Medical University, Nanjing, China
| | - Hector Wing Hong Tsang
- Hector Wing Hong Tsang, PhD, is Professor and Head, Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Da Li
- Da Li, MD, is Psychiatrist, Wuxi Mental Health Center, Wuxi Tongren International Rehabilitation Hospital, Nanjing Medical University, Nanjing, China;
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Sánchez-Vidaña DI, Ngai SP, He W, Chow JK, Lau BW, Tsang HW. The Effectiveness of Aromatherapy for Depressive Symptoms: A Systematic Review. Evid Based Complement Alternat Med 2017; 2017:5869315. [PMID: 28133489 DOI: 10.1155/2017/5869315] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/25/2016] [Accepted: 11/14/2016] [Indexed: 02/05/2023]
Abstract
Background. Depression is one of the greatest health concerns affecting 350 million people globally. Aromatherapy is a popular CAM intervention chosen by people with depression. Due to the growing popularity of aromatherapy for alleviating depressive symptoms, in-depth evaluation of the evidence-based clinical efficacy of aromatherapy is urgently needed. Purpose. This systematic review aims to provide an analysis of the clinical evidence on the efficacy of aromatherapy for depressive symptoms on any type of patients. Methods. A systematic database search was carried out using predefined search terms in 5 databases: AMED, CINHAL, CCRCT, MEDLINE, and PsycINFO. Outcome measures included scales measuring depressive symptoms levels. Results. Twelve randomized controlled trials were included and two administration methods for the aromatherapy intervention including inhaled aromatherapy (5 studies) and massage aromatherapy (7 studies) were identified. Seven studies showed improvement in depressive symptoms. Limitations. The quality of half of the studies included is low, and the administration protocols among the studies varied considerably. Different assessment tools were also employed among the studies. Conclusions. Aromatherapy showed potential to be used as an effective therapeutic option for the relief of depressive symptoms in a wide variety of subjects. Particularly, aromatherapy massage showed to have more beneficial effects than inhalation aromatherapy.
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Da Li, Tsui MCM, Yuan G, Zhang G, Tsang HWH. Measuring perceived rehabilitation needs of people with schizophrenia in mainland China. Adm Policy Ment Health 2016; 41:636-46. [PMID: 23873038 DOI: 10.1007/s10488-013-0510-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This paper reports the development and validation of the Wuxi version of the Rehabilitation Needs Questionnaire for People with Schizophrenia (PRNQ-S-WX) based on the original Hong Kong version. PRNQ-S-WX was validated by exploratory factor analysis (EFA) using a convenience sample of 250 people with schizophrenia. EFA yielded a 17-factor solution accounting for 81.3 % of the total variance which resulted in a 75-item PRNQ-S-WX. The questionnaire has sound internal consistencies. Its factor structure is similar to the Hong Kong version. Some suggestions for policy, service and research development in mental health in mainland China are made.
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Affiliation(s)
- Da Li
- Wuxi Mental Health Center, Nanjing, China
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Au DW, Tsang HW, Lee JL, Leung CH, Lo JY, Ngai SP, Cheung W. Psychosomatic and physical responses to a multi-component stress management program among teaching professionals: A randomized study of cognitive behavioral intervention (CB) with complementary and alternative medicine (CAM) approach. Behav Res Ther 2016; 80:10-6. [PMID: 26974559 DOI: 10.1016/j.brat.2016.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 12/22/2015] [Accepted: 02/18/2016] [Indexed: 02/08/2023]
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Tsang HWH, Ching SC, Tang KH, Lam HT, Law PYY, Wan CN. Therapeutic intervention for internalized stigma of severe mental illness: A systematic review and meta-analysis. Schizophr Res 2016; 173:45-53. [PMID: 26969450 DOI: 10.1016/j.schres.2016.02.013] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 02/05/2016] [Accepted: 02/05/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Internalized stigma can lead to pervasive negative effects among people with severe mental illness (SMI). Although prevalence of internalized stigma is high, there is a dearth of interventions and meanwhile a lack of evidence as to their effectiveness. This study aims at unraveling the existence of different therapeutic interventions and the effectiveness internalized stigma reduction in people with SMI via a systematic review and meta-analysis. METHODS Five electronic databases were searched. Studies were included if they (1) involved community or hospital based interventions on internalized stigma, (2) included participants who were given a diagnosis of SMI>50%, and (3) were empirical and quantitative in nature. RESULTS Fourteen articles were selected for extensive review and five for meta-analysis. Nine studies showed significant decrease in internalized stigma and two showed sustainable effects. Meta-analysis showed that there was a small to moderate significant effect in therapeutic interventions (SMD=-0.43; p=0.003). Among the intervention elements, four studies suggested a favorable effect of psychoeducation. Meta-analysis showed that there was small to moderate significant effect (SMD=-0.40; p=0.001). CONCLUSION Most internalized stigma reduction programs appear to be effective. This systematic review cannot make any recommendation on which intervention is more effective although psychoeducation seems most promising. More Randomized Controlled Trials (RCT) on particular intervention components using standard outcome measures are recommended in future studies.
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Affiliation(s)
- Hector W H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
| | - S C Ching
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - K H Tang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - H T Lam
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Peggy Y Y Law
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - C N Wan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
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Tsang HWH, Bell MD, Cheung V, Tam KL, Yeung WS. Integrated supported employment plus cognitive remediation training for people with schizophrenia. Hong Kong Med J 2016; 22 Suppl 2:S15-8. [PMID: 26908337 DOI: pmid/26908337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- H W H Tsang
- Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - M D Bell
- Department of Psychiatry, School of Medicine, Yale University, USA
| | - V Cheung
- Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - K L Tam
- Department of Psychiatry, United Christian Hospital, Hong Kong
| | - W S Yeung
- Pamela Youde Nethersole Eastern Hospital, Hong Kong
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Abstract
OBJECTIVE To evaluate the evidence from randomised controlled trials (RCTs) and quantify the effects of acupressure on anxiety among adults. METHODOLOGY RCTs published between January 1997 and February 2014, comparing acupressure with sham control, were identified from the databases Science Citation Index/Social Sciences Citation Index, Scopus, PubMed and PsycINFO. Meta-analysis of eligible studies was performed and the magnitude of the overall effect size was calculated for the anxiety outcome. Revised STRICTA (the Standards for Reporting Interventions in Clinical Trials of Acupuncture) criteria were used to appraise the acupressure procedures, and the Cochrane risk of bias tool was used to assess the methodological quality of the studies. RESULTS Of 39 potentially relevant studies, seven RCTs met the inclusion criteria for review while five studies met the criteria for meta-analysis. All studies reported the positive effect of acupressure on relieving anxiety from the anticipation of surgery or treatment. EX-HN3 (Yintang), HT7 (Shenmen) were the commonest points selected and two studies used bilateral points. The acupressure procedure was generally well reported and studies had a low risk of bias. The combined results of the five trials showed a greater overall reduction in anxiety in the acupressure group than in the sham controls (standardised mean differences (SMD)=-1.11; 95% CI -1.61 to -0.61; p<0.0001 heterogeneity: I(2)=75%; χ(2)=16.17; p=0.003; r=0.485). CONCLUSIONS Acupressure seems to be effective in providing immediate relief of pretreatment anxiety among adults, and has a medium effect size. However, conflicting results were found for the improvements on physiological indicators. More rigorous reporting, including allocation concealment procedure, is needed to strengthen the results.
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Affiliation(s)
- Doreen W H Au
- Faculty of Education, The University of Hong Kong, Hong Kong, Hong Kong
| | - Hector W H Tsang
- Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Paul P M Ling
- Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Christie H T Leung
- Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - P K Ip
- Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - W M Cheung
- Faculty of Education, The University of Hong Kong, Hong Kong, Hong Kong
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Au DWH, Tsang HWH, So WWY, Bell MD, Cheung V, Yiu MGC, Tam KL, Lee GTH. Effects of integrated supported employment plus cognitive remediation training for people with schizophrenia and schizoaffective disorders. Schizophr Res 2015; 166:297-303. [PMID: 26044114 DOI: 10.1016/j.schres.2015.05.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 04/29/2015] [Accepted: 05/04/2015] [Indexed: 02/08/2023]
Abstract
OBJECTIVES The present study aims to investigate the synergistic effects of cognitive remediation training (CRT) on Integrated Supported Employment (ISE). ISE blends individual placement support service with work-related social skills training for Chinese people suffering from schizophrenia or schizoaffective disorder. METHOD Ninety participants with schizophrenia or schizoaffective disorders were recruited from two psychiatric outpatient services in Hong Kong. They were randomly assigned into the ISE+CRT (n=45) and ISE (n=45) conditions. Blinded assessments on vocational, clinical, psychological, and neurocognitive outcomes were conducted by independent assessors. The two groups were followed up at 7 and 11months. RESULTS Both groups yielded similar improvements across several outcome domains assessed immediately after the interventions and at 7 and 11month follow-ups, but no significant group differences were found. Significant positive trends over time in vocational, clinical and cognitive outcomes consistently favored the ISE+CRT condition. CONCLUSION While both the ISE+CRT and ISE groups demonstrated improvement in vocational, clinical, psychological, and neurocognitive outcomes, there was no evidence to show that cognitive remediation facilitated further improvement in these domains beyond gains associated with ISE alone. Further investigation is needed to fully exploit the synergistic potential of ISE combined with CRT, and to better understand which individuals experience a maximal benefit from the specific rehabilitation program components.
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Affiliation(s)
- Doreen W H Au
- Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Hector W H Tsang
- Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
| | - Wendy W Y So
- Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Morris D Bell
- Department of Psychiatry, School of Medicine, Yale University, United States
| | - Vinci Cheung
- Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Michael G C Yiu
- Department of Psychiatry, United Christian Hospital, Hong Kong
| | - K L Tam
- Department of Psychiatry, United Christian Hospital, Hong Kong
| | - Gary Tin-ho Lee
- Department of Psychiatry, United Christian Hospital, Hong Kong
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Tsang HWH, Cheung WM, Chan AHL, Fung KMT, Leung AY, Au DWH. A pilot evaluation on a stress management programme using a combined approach of cognitive behavioural therapy (CBT) and complementary and alternative medicine (CAM) for elementary school teachers. Stress Health 2015; 31:35-43. [PMID: 24038798 DOI: 10.1002/smi.2522] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 07/21/2013] [Accepted: 07/26/2013] [Indexed: 02/05/2023]
Abstract
The aim of this study is to explore the efficacy of implementing a stress management programme based on a combined approach using cognitive behavioural therapy and complementary and alternative medicine for elementary school teachers who experienced mild level of stress, anxiety and/or depressive symptoms in Hong Kong. A 12-h programme involving cognitive behavioural therapy, self-management, relaxation techniques (diaphragmatic breathing and progressive muscle relaxation), mindful exercises (qigong and yoga), aromatherapy and acupressure was conducted. A quasi-experimental design was used to compare the intervention groups (n = 47) with the wait-list control groups (n = 46). The primary outcome measures were depression, anxiety and stress. Results indicated that the intervention group had significant reduction in depression [(F = 3.93; degrees of freedom (df) = 2.90; p = 0.023)], anxiety (F = 3.37; df = 2.90; p = 0.039) and stress (F = 3.63; df = 2.89; p = 0.031) when compared with the control group. Participants in both groups demonstrated lowered level of salivary cortisol at the post-assessment. The pilot results provided preliminary support to the multi-component stress management programme in relieving affective symptoms of teachers. The programme may be considered as an initial strategy to empower teachers with the abilities to cope with their affective symptoms. Further evaluation using a better designed randomized study with a larger sample size is warranted. (word: 198; max.: 200).
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Affiliation(s)
- Hector W H Tsang
- Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
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Li D, Tsui MCM, Tsang HWH. Measuring perceived rehabilitation needs of Caregivers of People with Schizophrenia in mainland China. Adm Policy Ment Health 2014; 41:325-33. [PMID: 23371057 DOI: 10.1007/s10488-013-0473-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This paper reports the development and validation of the Wuxi version of the Rehabilitation Needs Questionnaire for Caregivers of People with Schizophrenia (PRNQ-C-WX) based on the original Hong Kong version (PRNQ-C-HK). PRNQ-C-WX was validated by exploratory factor analysis (EFA) using a convenience sample consisting of 200 caregivers of people with schizophrenia. EFA yielded an eight-factor solution accounting for 63.8 % of the total variance which resulted in a 50-item PRNQ-C-WX. The questionnaire has excellent internal consistencies. Its factor structure is similar to the Hong Kong version. Some suggestions for policy, service and research development in mental health in mainland China are made.
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Affiliation(s)
- Da Li
- Wuxi Mental Health Center, Nanjing, China
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Tsang H, Chan CL, Chen K, Cho WC, Lee MS. Scientific basis of mind-body interventions. Evid Based Complement Alternat Med 2014; 2014:706892. [PMID: 24734112 DOI: 10.1155/2014/706892] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 01/16/2014] [Indexed: 02/05/2023]
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Tsang HWH. Stages of change, self-stigma, and treatment compliance among Chinese adults with severe mental illness. Hong Kong Med J 2013; 19 Suppl 9:4-8. [PMID: 24473581 DOI: pmid/24473581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
1. Individuals with higher global functioning, better readiness for action, and lower self-esteem decrement tend to have better psychosocial treatment participation. 2. Individuals with lesser psychiatric symptoms are more likely to have better treatment attendance. 3. Self-stigmatisation undermines treatment compliance. Its indirect effects can be mediated via stages of change and insight. 4. The self-stigma reduction programme may reduce self-esteem decrement, promote readiness for changing own problematic behaviours, and enhance psychosocial treatment compliance. However, its therapeutic effects were not maintained during the 6-month follow-up.
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Affiliation(s)
- H W H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University
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Li D, Li SMY, Tsang HWH, Wong AHH, Fung KMT, Tsui MCM, Chung RCK, Yiu MGC, Tam KL, Lee GTH. Development and validation of perceived rehabilitation require questionnaires for caregivers of people with schizophrenia. Int J Psychiatry Clin Pract 2013; 17:264-72. [PMID: 23578402 DOI: 10.3109/13651501.2013.794244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study aimed at developing and validating the Perceived Rehabilitation Needs Questionnaires for Caregivers (PRNQ-Cs) of people with schizophrenia. METHODS The items of PRNQ-C were generated based on focus group discussion and literature review. A validation study was conducted to examine its psychometric properties among 98 caregivers who were recruited via convenience sampling. RESULTS Through the use of direct oblique rotation, exploratory factor analysis yielded an eight-factor solution which accounted for 64.39% of the total variance. Its internal consistency and test-retest reliability were satisfactory. CONCLUSION Through cross-cultural validation, the PRNQ-C is applicable in other Chinese communities with huge population of schizophrenia.
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Affiliation(s)
- Da Li
- Wuxi Mental Health Center , Nanjing , China
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Tsang HWH, Tsang WWN, Jones AYM, Fung KMT, Chan AHL, Chan EP, Au DWH. Psycho-physical and neurophysiological effects of qigong on depressed elders with chronic illness. Aging Ment Health 2013; 17:336-48. [PMID: 23072658 DOI: 10.1080/13607863.2012.732035] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This randomized controlled trial examined the psychological, physical, and neurophysiological effects of a qigong exercise program on depressed elders with chronic medical illness. The experimental group (n = 21, 80 ± 7 years) was given a 12-week qigong exercise program, while the comparison group (n = 17, 81 ± 8 years) participated in a newspaper reading program with the same duration and frequency. Measurement of depression symptoms, psychosocial functioning, muscle strengths, salivary cortisol, and serum serotonin was conducted. At 12 weeks, the qigong group had significant reduction in depressive symptoms (F = 11.68; p < 0.025). Improvement in self-efficacy (F = 4.30; p < 0.050), self-concept of physical well-being (F = 6.82; p < 0.025), and right-hand grip strength (F = 5.25; p = 0.034) was also found when compared with the comparison group. A change in salivary cortisol level was found marginally insignificant between groups (F = 3.16; p = 0.087). However, a decreasing trend of cortisol level was observed. The results provided preliminary evidence for the hypotheses that the antidepressive effect of qigong exercise could be explained by improvement in psychosocial functioning and possibly down-regulation of hyperactivity of the hypothalamic-pituitary-adrenal axis.
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Affiliation(s)
- Hector W H Tsang
- Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
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Tsang HW, Lee JL, Au DW, Wong KK, Lai KW. Developing and testing the effectiveness of a novel health qigong for frail elders in Hong Kong: a preliminary study. Evid Based Complement Alternat Med 2013; 2013:827392. [PMID: 24109493 DOI: 10.1155/2013/827392] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 08/01/2013] [Accepted: 08/01/2013] [Indexed: 02/05/2023]
Abstract
Eight-Section Brocades and Yijin Jing consist of some routine movements that are too difficult for frail elders. A novel health qigong protocol was developed and its effectiveness for frail elders was examined using a randomized clinical trial (RCT). An expert panel performed functional anatomy analysis and safety field test prior to the RCT. The experimental group (n = 61, 83 ± 6 yr) was given a 12-week qigong exercise program, while the comparison group (n = 55, 84 ± 6 yr) participated in a newspaper reading program with the same duration and frequency. Pre-, mid-, post-, and follow-up assessments were conducted. At 12 weeks, the qigong group had significant improvements in thinking operations (F = 4.05, P = .02) and significant reduction of resting heart rate (F = 3.14, P = .045) as compared to the newspaper reading group. A trend of improvements in grip strength and a decreasing trend of depression levels were observed among the qigong group. Significant perceived improvements in physical health (F = 13.01, P = .001), activities of daily living (F = 5.32, P = .03), and overall health status (F = 15.26, P = .0001) were found. There are improvements in some aspects of psychosocial, cognitive, physical, and physiological domains. Clinical applications and possibilities for further research are discussed.
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