Anxiety, Depression and Cognitive Emotion Regulation Strategies in Psychiatric Patients during the COVID-19 Pandemic

Objective: The coronavirus disease 2019 (COVID-19) pandemic likely impacted emotional regulation and mood states. The present study aimed to investigate the perceived risk, stigma, and emotional regulation strategies of psychiatric patients, as well as the association between these characteristics, cognitive emotion regulation strategies (emotional suppression and cognitive reappraisal), and anxiety and depressive symptoms during the COVID-19 pandemic. Materials and Methods: The present cross-sectional study of 282 patients with anxiety and mood disorders was conducted during the COVID-19 pandemic in 2020. Participants completed questionnaires that investigated anxiety (hospital anxiety and depression scale [HADS]), depression (patient health questionnaire [PHQ-9]), and cognitive emotion regulation strategies (emotion regulation questionnaire [ERQ]). Descriptive statistics were used to assess the data. The t-test, chi-square test, and Mann-Whitney U test were used to compare the differences between the two groups, with cut-off scores of 11 in the HADS and nine in the PHQ-9. Results: Most participants were female (78.4%), and the median age was 31 years. A total of 23.8% of participants reported having anxiety symptoms, and 24.8% and 54.3% of participants reported having depression on the HADS-D and PHQ-9, respectively. HADS-A, HADS-D, and PHQ-9 were found to be significantly associated with emotional regulation style (P=0.002, P=0.005, P=0.006) but not with perceived risk and stigma. Patients with anxiety or depression tended to use expressive suppression more often than cognitive reappraisal. Conclusion: This study found that mood states were associated with cognitive emotional regulation strategies during the COVID-19 pandemic. Patients with anxiety or depression tended to use expressive suppression more often than cognitive reappraisal.

Cytoprotective effect of genistein against dexamethasone-induced pancreatic β-cell apoptosis

Steroid-induced diabetes is a well-known metabolic side effect of long-term use of glucocorticoid (GC). Our group recently demonstrated dexamethasone-induced pancreatic β-cell apoptosis via upregulation of TRAIL and TRAIL death receptor (DR5). Genistein protects against pancreatic β-cell apoptosis induced by toxic agents. This study aimed to investigate the cytoprotective effect of genistein against dexamethasone-induced pancreatic β-cell apoptosis in cultured rat insulinoma (INS-1) cell line and in isolated mouse islets. In the absence of genistein, dexamethasone-induced pancreatic β-cell apoptosis was associated with upregulation of TRAIL, DR5, and superoxide production, but downregulation of TRAIL decoy receptor (DcR1). Dexamethasone also activated the expression of extrinsic and intrinsic apoptotic proteins, including Bax, NF-κB, caspase-8, and caspase-3, but suppressed the expression of the anti-apoptotic Bcl-2 protein. Combination treatment with dexamethasone and genistein protected against pancreatic β-cell apoptosis, and reduced the effects of dexamethasone on the expressions of TRAIL, DR5, DcR1, superoxide production, Bax, Bcl-2, NF-κB, caspase-8, and caspase-3. Moreover, combination treatment with dexamethasone and genistein reduced the expressions of TRAIL and DR5 in isolated mouse islets. The results of this study demonstrate the cytoprotective effect of genistein against dexamethasone-induced pancreatic β-cell apoptosis in both cell line and islets via reduced TRAIL and DR5 protein expression.

Premenstrual syndrome in Thai nurses

OBJECTIVE

To investigate prevalence of premenstrual syndrome (PMS) and its associated factors among Thai nurses.

METHODS

The study was conducted in 423 nurses in a university hospital during October 2005 to March 2006. Prevalence of PMS was determined using a validated Thai version of Premenstrual Symptoms Screening Tool (PSST). Factors associated with PMS were analyzed using Student t-test and Chi-square test.

RESULTS

The prevalence of PMS in Thai nurses was 25.1%. Nurses with younger age, nulligravida, lower income, more coffee consumption, dysmenorrhea, and negative attitude toward menstruation had higher prevalence of PMS. After multiple logistic regression analysis, the significant factors associated with PMS were coffee consumption > 1 cups/day and negative attitude toward menstruation; odds ratios (95% confidence interval) were 2.322 (1.257 to 4.288) and 5.768 (2.096 to 15.872), respectively.

CONCLUSION

According to the Thai PSST, 25.1% of Thai nurses are suffering from PMS. The significant associated factors were more coffee consumption and negative attitude toward menstruation.

Research on development of the manual for self detection of depression in the Thai elderly

The purposes of this study were to develop an effective manual for the early self detection of depression in the Thai elderly, to detect the comorbidity of depression (pattern of drug and alcohol abuse, suicidal idea) and to ascertain the quality of life. A quasi experimental field research methodology (Randomized Control Group Pretest-Posttest Design) was implemented. The sample consisted of 1,390 elderly people in 35 communities from 4 districts surrounding Siriraj Hospital-Bangkok Noi, Bangkok Yai, Taling Chan and Bang Phlat. These areas are the peripheral parts of Bangkok and most of them have extended families. The result showed that: 1. The internal consistency reliability of the nine criteria of the manual for the self detection of depression in the Thai elderly ranged from 0.84 to 0.94. The validity tested by epidemiological methods, disclosed that the sensitivity was 82.14 per cent and the specificity was 97.56 per cent. 2. There was a statistically significant difference in the incidence of depression between the study and the control group (p<0.000); self referred cases = 86.7 per cent and 9.8 per cent respectively. The study group was able to detect depression in 42 days, while the control group did so in 122 days. In addition, in the associated comorbidity, there were differences in the patterns of drug and alcohol abuse, suicidal ideas and quality of life after the experiment. These findings showed a decreasing pattern of self medication for depression, and suicidal ideas and an improvement in the quality of life in the study group.

Prevalence and incidence of depression in the Thai elderly

The purposes of this study were to study the prevalence and incidence of depression in elderly Thais. A field survey study was implemented. The sample consisted of 1,713 elderly people in 35 communities from 4 districts surrounding Siriraj Hospital Bangkok Noi, Bangkok Yai, Taling Chun and Bang Plud. These areas are the peripheral part of Bangkok and most of them have extended family. The Thai Geriatric Depression Scale (TGDS) and the Thai Mini Mental State Examination (TMSE) were used as screening tests, for data collection. The prevalence of depression was 12.78 per cent, of which 8.23 per cent had only depressive symptomatology (male 5.43%, female 9.63%) while 4.55 per cent had both depression and cognitive impairment (male 2.8%, female 5.54%). The point incidence (one year) of depression was 7.27 (male 1.58%, female 5.68%). The major contributing factors in depression were financial, poor family relationships and physical illness. The prevention and management of these factors may bring about a better quality of life for the elderly in Thailand.

Improvement of tardive dyskinesia with risperidone: a case report

This case report illustrates the improvement of tardive dyskinesia (TD) and psychotic symptoms in an elderly Thai female with chronic schizophrenia with a long history of conventional antipsychotic exposure following the treatment with risperidone 2 mg/day. TD disappeared in 9 months and continued to be in remission at her 5-month follow-up visit recently.