1
|
Roystonn K, Koh YS, Shafie S, Sambasivam R, Vaingankar JA, Chong SA, Subramaniam M. Understanding Major Depressive Disorder in Singapore: Insights from the second Singapore Mental Health Study (SMHS 2016). J Affect Disord 2024; 364:295-304. [PMID: 39142576 DOI: 10.1016/j.jad.2024.08.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 07/21/2024] [Accepted: 08/11/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Major Depressive Disorder (MDD) poses significant public health challenges globally and in Southeast Asia, with substantial impairment and disease burden. Understanding its prevalence and associated risk factors is crucial for effective intervention. METHODS This study aims to describe the prevalence shifts, correlates, and comorbidities of MDD in Singapore. Data were collected from the second Singapore Mental Health Study (SMHS 2016), a national cross-sectional survey comprising 6126 adult residents. The WHO Composite International Diagnostic Interview assessed MDD and comorbidities. Statistical analyses, including logistic regression, were conducted to examine the associations and trends. RESULTS The lifetime weighted prevalence of MDD in SMHS 2016 was 6.2 %, with an overall increase from 5.8 % in 2010. Significant associations were found between MDD and age, marital status, and comorbid physical disorders. Young adults and divorced/separated individuals exhibited higher MDD prevalence. Chronic pain was significantly associated with MDD. LIMITATIONS The study's cross-sectional design limits causal inference, and selective non-response might affect prevalence estimates. However, the study benefits from a large, nationally representative sample and standardized methodologies. CONCLUSIONS Young and middle-aged adults, and divorced/separated individuals demonstrate elevated MDD prevalence, warranting targeted interventions. Individuals with comorbidities, particularly chronic pain, constitute a high-risk and vulnerable population. Comprehensive assessment and treatment plans should involve multidisciplinary teams and integrated care approaches to better address the complex needs of these individuals. Our study also highlights specific interventions for schools, families, communities, and workplaces. Despite Singapore's relatively low prevalence compared to Western nations, MDD remains cross-culturally valid emphasizing the need for early intervention and preventive public health measures.
Collapse
Affiliation(s)
| | - Yen Sin Koh
- Research Division, Institute of Mental Health, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore
| | | | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| |
Collapse
|
2
|
Kazi AA, Osuch EA, Wammes M, John-Baptiste A. Health-related quality of life among adolescents and young adults with mood and anxiety concerns. Clin Child Psychol Psychiatry 2024; 29:550-563. [PMID: 37978940 PMCID: PMC10945981 DOI: 10.1177/13591045231214286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVES To characterize health related quality of life (HRQOL) for Canadians aged 16 to 25 (adolescents and young adults, AYAs) seeking care for mood and anxiety concerns at the First Episode Mood and Anxiety Program, in London, Ontario and to identify factors associated with HRQOL in this population. METHODS AYAs completed demographic, psychometric, and HRQOL questionnaires. We calculated 36-Item Short-Form Health Survey (SF-36) scores standardized to Canadian and US population norms. We computed Short Form 6 Dimension (SF-6D) utilities conducting multivariable linear regression analysis, adjusting for age, sex, ethnoracial minority status, parental marital/cohabitation status, parental education, the Anxiety Sensitivity Index (ASI-R), Montgomery-Åsberg Depression Rating Scale Self-Report (MADRS-S), Sheehan Disability Scale (SDS), and a modified Inventory of College Students' Recent Life Experiences (ICSRLE-M). RESULTS Amongst 182 AYAs who completed questionnaires, mean physical component summary (PCS), mental component summary (MCS) and SF-6D utility scores were low, 43.8 (SD = 16.6), 19.0 (SD = 11.9) and .576 (SD = .074), respectively. Maternal post-secondary education, depression (MADRS-S) and functional impairment (SDS) were significantly associated with SF-6D utility. CONCLUSION This cohort of mental healthcare-seeking AYAs had significantly impaired psychometric and utility-based measures of quality of life, underscoring the importance of timely access to healthcare services for this population.
Collapse
Affiliation(s)
- Ayman A Kazi
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
- Michael DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Elizabeth A Osuch
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- London Health Sciences Centre, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
| | - Michael Wammes
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- London Health Sciences Centre, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
| | - Ava John-Baptiste
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
- London Health Sciences Centre, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
- Schulich Interfaculty Program in Public Health, Western University, London, ON, Canada
- Department of Anesthesia and Perioperative Medicine, Western University, London, ON, Canada
- Centre for Medical Evidence, Decision Integrity and Clinical Impact, London, ON, Canada
| |
Collapse
|
3
|
Aghababaie-Babaki P, Malekpour MR, Mohammadi E, Saeedi Moghaddam S, Rashidi MM, Ghanbari A, Heidari-Foroozan M, Esfahani Z, Mohammadi Fateh S, Hajebi A, Haghshenas R, Foroutan Mehr E, Rezaei N, Larijani B, Farzadfar F. Global, regional, and national burden and quality of care index (QCI) of bipolar disorder: A systematic analysis of the Global Burden of Disease Study 1990 to 2019. Int J Soc Psychiatry 2023; 69:1958-1970. [PMID: 37353952 DOI: 10.1177/00207640231182358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
BACKGROUND Bipolar disorders (BD) are significant debilitating mental problems. Here, we introduced a novel index as a representative of the quality of care delivered to BD patients worldwide. METHODS The Global Burden of Disease (GBD) 2019 study was the primary data source on BD, including prevalence, incidence, and years lived with disability (YLDs). Secondary indices were created and transformed into a single component that accounted for most of the variation, using the Principal Component Analysis (PCA) method. This component, reported on a scale of 0 to 100, was presented as the quality of care index (QCI). The QCI was estimated in different age groups and areas within a 30-year time frame. Gender disparity ratio (GDR), as the female-to-male ratio of the QCI, was reported. RESULTS The Global QCI slightly increased from 50.4 in 1990 to 53.1 in 2019. The GDR value was 0.95 in 2019. The high-middle SDI quintile had the highest QCI estimate of 63.0, and the lowest QCI value of 36.9 was regarding the low SDI quintile. Western-Pacific Region and South-East Asia had the highest and lowest QCI among WHO regions, with estimates of 70.7 and 31.2, respectively. The age group of 20 to 24 years old patients reported the lowest QCI estimate of 30.2, and the highest QCI of 59.8 was regarding 40 to 44 years old patients. CONCLUSION The QCI in BD had only a subtle increase from 1990 to 2019 and is in need of further improvement. Inequalities between different regions and age groups are considerable and require proper attention.
Collapse
Affiliation(s)
- Paria Aghababaie-Babaki
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Malekpour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mohammadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurological Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Kiel Institute for the World Economy, Kiel, Germany
| | - Mohammad-Mahdi Rashidi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ghanbari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Heidari-Foroozan
- Student Research Center Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Esfahani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Sahar Mohammadi Fateh
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirali Hajebi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Rosa Haghshenas
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elmira Foroutan Mehr
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
4
|
Steuber ER, McGuire JF. A Meta-analysis of Transcranial Magnetic Stimulation in Obsessive-Compulsive Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:1145-1155. [PMID: 37343662 DOI: 10.1016/j.bpsc.2023.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/04/2023] [Accepted: 06/07/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a debilitating illness with substantial morbidity. Although pharmacological and behavioral evidence-based treatments have shown efficacy, many patients remain unresponsive to this first-line care. Repetitive transcranial magnetic stimulation (rTMS) has shown significant promise for patients with treatment-refractory affective disorders. Therefore, we conducted a meta-analysis of randomized controlled trials to examine the therapeutic benefit of rTMS in patients with OCD and explore moderators of its treatment effects. METHODS PubMed (1997-Dec 31, 2022) and PsycINFO were searched for randomized sham-controlled trials of rTMS to treat OCD using the following terms: "obsessive-compulsive disorder," "transcranial magnetic stimulation," and "randomized controlled trial." Clinical characteristics and effect sizes were extracted from 25 randomized controlled trials (860 participants). A random effects model calculated the effect sizes for treatment efficacy and treatment response using the clinician-rated Yale-Brown Obsessive Compulsive Scale. RESULTS Across randomized controlled trials, rTMS exhibited a moderate therapeutic effect (g = 0.65) on OCD symptom severity and a 3-fold increased likelihood of treatment response (relative risk = 3.15) compared with sham conditions. Greater improvement in comorbid depression severity corresponded with greater treatment effects of rTMS on OCD symptom severity. In addition, longer rTMS sessions and fewer overall sessions predicted greater clinical improvement. CONCLUSIONS rTMS is moderately effective for reducing OCD symptom severity. It holds potential to serve as a therapeutic intervention, particularly for patients with OCD who have failed standard treatments and those with comorbid depression. Further research is needed to optimize rTMS protocols and evaluate the long-term efficacy of rTMS for OCD.
Collapse
Affiliation(s)
- Elizabeth R Steuber
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Joseph F McGuire
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
| |
Collapse
|
5
|
Subramaniam M, Abdin E, Kong AMC, Vaingankar JA, Jeyagurunathan A, Shafie S, Sambasivam R, Fung DSS, Verma S, Chong SA. Differences in the Prevalence and Profile of DSM-IV and DSM-5 Alcohol Use Disorders-Results from the Singapore Mental Health Study 2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:285. [PMID: 36612604 PMCID: PMC9819399 DOI: 10.3390/ijerph20010285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria for alcohol use disorders (AUD) was a significant shift from the historical DSM-IV Text Revised version. Following this shift in diagnostic criteria, a difference in the prevalence of AUD was expected. The current study aimed to evaluate the consequences of the modification of the diagnostic criteria from DSM-IV to DSM-5 AUD using lifetime diagnosis in Singapore's multi-ethnic population using data from a nationwide epidemiological study. METHODS Respondents were assessed for lifetime mental disorders using the Composite International Diagnostic Interview (CIDI) administered through face-to-face interviews. Lifetime DSM-IV AUD diagnoses were compared with DSM-5 AUD diagnoses generated by modifying the criteria and the addition of the craving criterion. Sociodemographic correlates of lifetime DSM-IV/DSM-5 AUD were examined using multiple logistic regression analysis. Associations between DSM-IV/DSM-5 AUD, chronic conditions, and the HRQOL summary scores were examined using logistic and linear regression after controlling for significant sociodemographic factors. RESULTS The lifetime prevalence of DSM-IV AUD was 4.6% (0.5% for dependence and 4.1% for abuse) in the adult population, while the lifetime prevalence of DSM-5 AUD was 2.2%. Younger age, male gender, and lower education were associated with higher odds of both DSM-IV and DSM-5 AUD. However, those who were economically inactive (versus employed) (AOR, 0.4; 95% CI 0.2-0.9) and had a higher monthly household income (SGD 4000-5999 versus below SGD 2000) had lower odds of DSM-IV AUD (AOR, 0.4; 95% CI 0.2-0.7), but this was not observed among those with DSM-5 AUD. Both DSM-IV and DSM-5 AUD were associated with significant comorbidities in terms of other mental disorders; however, those diagnosed with lifetime GAD had significantly higher odds of having DSM-5 AUD (AOR, 5; 95% CI 1.9-13.2) but not DSM-IV AUD. CONCLUSIONS While using the DSM-5 criteria would result in a lower prevalence of AUD in Singapore, it remains a highly comorbid condition associated with a poor health-related quality of life that is largely untreated, which makes it a significant public health concern.
Collapse
Affiliation(s)
- Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore 539747, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore 539747, Singapore
| | | | | | | | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore 539747, Singapore
| | | | | | - Swapna Verma
- Medical Board, Institute of Mental Health, Singapore 539747, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore 539747, Singapore
| |
Collapse
|
6
|
Sleep quality of Singapore residents: findings from the 2016 Singapore mental health study. Sleep Med X 2022; 4:100043. [PMID: 35243325 PMCID: PMC8861160 DOI: 10.1016/j.sleepx.2022.100043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 12/21/2021] [Accepted: 01/17/2022] [Indexed: 12/04/2022] Open
Abstract
Given the importance of sleep for physical and mental wellbeing, it is crucial to understand the extent of insomnia among community dwellers. However, there is a paucity of population wide epidemiological studies to estimate the prevalence of poor sleep quality. This present study aimed to 1) characterize the sleep quality of a nationally representative sample (n = 6126) of Singapore residents using Pittsburg Sleep Quality Index (PSQI) and 2) identify the sociodemographic correlates of poor sleep in this population. A total of 27.6% of respondents reported poor sleep quality (PSQI score ≥5). Sociodemographic correlates of poor sleep quality in the Singapore population included, but were not limited to, females (AOR = 1.44, 95% CI = 1.17 to 1.77, p-value = 0.001), Malays (vs Chinese) (AOR = 1.53, 95% CI = 1.23 to 1.9, p-value < 0.001), Indians (vs Chinese) (AOR = 1.22, 95% CI = 1.02 to 1.47, p-value = 0.03), ex-smokers (vs non-smokers) (AOR = 1.43, 95% CI = 1.07 to 1.92, p-value = 0.02), persons with comorbid mental health conditions (vs no mental health conditions) (AOR = 14.11, 95% CI = 6.52 to 30.54, p-value < 0.01), and persons with physical multimorbidity (vs no physical conditions) (AOR = 1.63, 95% CI = 1.24 to 2.15, p-value < 0.001). The prevalence of poor sleep in Singapore is comparable to that of other countries in the Asian region. Targeted public health campaigns to psycho-educate vulnerable groups on the importance of good sleep hygiene may improve the overall wellbeing of residents in Singapore. Sleep is important for physical and mental health, however data on population wide prevalence of insomnia is scarce. Using the Pittsburgh Sleep Quality Index, we found that 27.6% of this nationally representative sample had poor sleep. Sociodemographic correlates of poor sleep quality in our population included females, Malays, Indians, and ex-smokers. Persons with comorbid mental health conditions and physical multimorbidity were found to have poor sleep quality. Targeted psychoeducation to the relevant subgroups could improve sleep quality of Singapore residents.
Collapse
|
7
|
Self-compassion, mental health shame and work motivation in German and Japanese employees. Int Rev Psychiatry 2022; 35:113-124. [PMID: 37101367 DOI: 10.1080/09540261.2022.2148829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In Germany, more than two-thirds of employees report mental health issues, while in Japan, more than half of the country's workforce are mentally distressed. Although both countries are socio-economically developed in similar ways, their cultures differ strongly. This article investigates mental health constructs among German and Japanese employees. A cross-sectional design was employed in which 257 German and 165 Japanese employees completed self-report scales regarding mental health problems, mental health shame, self-compassion and work motivation. T-tests, correlation and regression analyses were conducted. Results show that German employees have significantly higher levels of mental health problems, mental health shame, self-compassion and work motivation than Japanese employees. While many correlations were similar, mental health problems were associated with intrinsic motivation in Germans, but not in Japanese. Shame was associated with both intrinsic and extrinsic motivation in Japanese, but not in Germans. Self-compassion - defined as a complex of compassion, humanity, care and unconditional, compassionate love - was associated with gender and age in Japanese, but not in German employees. Lastly, regression analysis uncovered that self-compassion was the strongest predictor of mental health problems in Germans. In Japanese employees, mental health shame is the strongest predictor of mental health problems. Results can guide managers and psychologists in internationalised organisations to effectively approach employee mental health.
Collapse
|
8
|
Kotera Y, Asano K, Kotera H, Ohshima R, Rushforth A. Mental Health of Japanese Workers: Amotivation Mediates Self-Compassion on Mental Health Problems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710497. [PMID: 36078213 PMCID: PMC9517843 DOI: 10.3390/ijerph191710497] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/17/2022] [Accepted: 08/20/2022] [Indexed: 05/23/2023]
Abstract
Workplace mental health is a cause for concern in many countries. Globally, 78% of the workforce experienced impairment of their mental health in 2020. In Japan, more than half of employees are mentally distressed. Previously, research has identified that self-compassion (i.e., being kind and understanding towards oneself) and work motivation were important to their mental health. However, how these three components relate to each other remains to be elucidated. Accordingly, this study aimed to examine the relationship between mental health problems, self-compassion and work motivation (i.e., intrinsic motivation, extrinsic motivation and amotivation). A cross-sectional design was employed, where 165 Japanese workers completed self-report scales regarding those three components. A correlation and path analyses were conducted. Mental health problems were positively associated with amotivation and negatively associated with age and self-compassion. While intrinsic motivation and extrinsic motivation did not mediate the impact of self-compassion on mental health problems, amotivation did. The findings can help managers and organizational psychologists help identify effective approaches to improving work mental health.
Collapse
Affiliation(s)
- Yasuhiro Kotera
- School of Health Sciences, University of Nottingham, Nottingham NG7 2RD, UK
| | - Kenichi Asano
- Department of Psychological Counseling, Faculty of Psychology, Mejiro University, Tokyo 161-0032, Japan
| | - Hiromasa Kotera
- Department Linguistics, University of Potsdam, 14469 Potsdam, Germany
| | - Remi Ohshima
- Department of Psychological Counseling, Faculty of Psychology, Mejiro University, Tokyo 161-0032, Japan
| | - Annabel Rushforth
- College of Health, Psychology and Social Care, University of Derby, Derby DE22 1GB, UK
| |
Collapse
|
9
|
Strategies to Reduce Mental Illness Stigma: Perspectives of People with Lived Experience and Caregivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031632. [PMID: 35162655 PMCID: PMC8835394 DOI: 10.3390/ijerph19031632] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Reducing the stigma surrounding mental illness is a global public health priority. Traditionally, anti-stigma campaigns were led by mental health professionals/organisations and had an emphasis on increasing mental health literacy. More recently, it has been argued that people with lived experience have much to contribute in terms of extending and strengthening these efforts. The purpose of this paper was to elicit views and suggestions from people with lived experience (PWLE) as well as from informal caregivers of people with mental health conditions, on effective strategies to combat the stigma surrounding mental illness. METHODS Six focus group discussions (FGDs) were carried out with PWLE recruited at outpatient services at the Institute of Mental Health, Singapore, and five FGDs were carried out with informal caregivers who responded to advertisements for the study between March and November 2018. In all, the sample comprised 42 PWLE and 31 caregivers. All the FGDs were transcribed verbatim and were analysed using thematic analysis. A pragmatic approach was adopted for the study, and the researchers did not assume any particular philosophical orientation. RESULTS Four overarching themes depicting strategies to combat stigma were identified through thematic analysis. They were (1) raising mental health awareness, (2) social contact, (3) advocacy by influential figures or groups, and (4) the legislation of anti-discriminatory laws. CONCLUSIONS These strategies were in line with approaches that have been used internationally to disrupt the process of stigma. Our study has further identified nuanced details on how these strategies can be carried out as well as possible areas of priority in the Singapore landscape.
Collapse
|
10
|
AshaRani PV, Karuvetil MZ, Brian TYW, Satghare P, Roystonn K, Peizhi W, Cetty L, Zainuldin NA, Subramaniam M. Prevalence and Correlates of Physical Comorbidities in Alcohol Use Disorder (AUD): a Pilot Study in Treatment-Seeking Population. Int J Ment Health Addict 2022; 21:1-18. [PMID: 35095353 PMCID: PMC8783789 DOI: 10.1007/s11469-021-00734-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2021] [Indexed: 12/17/2022] Open
Abstract
This study aimed to understand the prevalence of physical comorbidities, undiagnosed and inadequately controlled chronic physical conditions and correlates of high cholesterol, hypertension and liver enzyme abnormalities in those with alcohol use disorder (AUD). Participants (n = 101) with AUD were recruited from a tertiary care centre through convenient sampling. The prevalence of physical and psychiatric comorbidities in the sample was 83.17% and 51.49%, respectively. Around 53.47% had two or more chronic physical conditions (multimorbidity). Hypertension (44.55%), asthma (23.76%), high cholesterol (22.77%) and liver enzyme abnormalities (21.78%) were the top four physical comorbidities. The prevalence of undiagnosed and inadequately controlled chronic physical conditions was 61.4% and 32.7%, respectively. Gender, education and body mass index (BMI) were associated with hyperlipidaemia while age and education were associated with hypertension. Higher waist-hip ratio was associated with liver enzyme abnormalities. Routine clinical care must include regular screening and follow-up of the risk groups to monitor their physical and mental health.
Collapse
Affiliation(s)
- P. V. AshaRani
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Mohamed Zakir Karuvetil
- National Addictions Management Service, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Tan Yeow Wee Brian
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Pratika Satghare
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Kumarasan Roystonn
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Wang Peizhi
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Laxman Cetty
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Noor Azizah Zainuldin
- National Addictions Management Service, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, 117549 Singapore
| |
Collapse
|
11
|
AshaRani PV, Jue Hua L, Roystonn K, Siva Kumar FD, Peizhi W, Ying Jie S, Shafie S, Chang S, Jeyagurunathan A, Boon Yiang C, Abdin E, Ajit Vaingankar J, Sum CF, Lee ES, Chong SA, Subramaniam M. Readiness and Acceptance of eHealth Services for Diabetes Care in the General Population: Cross-sectional Study. J Med Internet Res 2021; 23:e26881. [PMID: 34473062 PMCID: PMC8446836 DOI: 10.2196/26881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 03/16/2021] [Accepted: 07/13/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Diabetes management is a growing health care challenge worldwide. eHealth can revolutionize diabetes care, the success of which depends on end user acceptance. OBJECTIVE This study aims to understand the readiness and acceptance of eHealth services for diabetes care among the general population, perceived advantages and disadvantages of eHealth, and factors associated with eHealth readiness and acceptance in a multiethnic Asian country. METHODS In this cross-sectional epidemiological study, participants (N=2895) were selected through disproportionate stratified random sampling from a population registry. Citizens or permanent residents of Singapore aged >18 years were recruited. The data were captured through computer-assisted personal interviews. An eHealth questionnaire was administered in one of four local languages (English, Chinese, Malay, or Tamil), as preferred by the participant. Bivariate chi-square analyses were performed to compare the sociodemographic characteristics and perception of advantages and disadvantages of eHealth services between the diabetes and nondiabetes groups. Multivariable logistic regression models were used to determine factors associated with eHealth readiness and acceptance. All analyses were weighted using survey weights to account for the complex survey design. RESULTS The sample comprised participants with (n=436) and without (n=2459) diabetes. eHealth readiness was low, with 47.3% of the overall sample and 75.7% of the diabetes group endorsing that they were not ready for eHealth (P<.001). The most acceptable eHealth service overall was booking appointments (67.4%). There was a significantly higher preference in the diabetes group for face-to-face sessions for consultation with the clinician (nondiabetes: 83.5% vs diabetes: 92.6%; P<.001), receiving prescriptions (61.9% vs 79.3%; P<.001), referrals to other doctors (51.4% vs 72.2%; P<.001), and receiving health information (34% vs 63.4%; P<.001). The majority of both groups felt that eHealth requires users to be computer literate (90.5% vs 94.3%), does not build clinician-patient rapport compared with face-to-face sessions (77.5% vs 81%), and might not be credible (56.8% vs 64.2%; P=.03). Age (≥35 years), ethnicity (Indian), and lower education status had lower odds of eHealth readiness. Age (≥35 years), ethnicity (Indian), lower education status (primary school), BMI (being underweight), and marital status (being single) were associated with a lower likelihood of eHealth acceptance. Among only those with diabetes, a longer duration of diabetes (4-18 years), higher education (degree or above), and younger age (23-49 years) were associated with eHealth readiness, whereas younger age and income (SGD 2000-3999 [US $1481-$2961]) were associated with acceptance. CONCLUSIONS Overall, an unfavorable attitude toward eHealth was observed, with a significantly higher number of participants with diabetes reporting their unwillingness to use these services for their diabetes care. Sociodemographic factors associated with acceptance and readiness identified a group of people who were unlikely to accept the technology and thus need to be targeted for eHealth literacy programs to avoid health care disparity. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2020-037125.
Collapse
Affiliation(s)
- P V AshaRani
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Lau Jue Hua
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | | | - Wang Peizhi
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Soo Ying Jie
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Chua Boon Yiang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Chee Fang Sum
- Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Eng Sing Lee
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| |
Collapse
|