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Picco L, Seow E, Chua BY, Mahendran R, Verma S, Xie H, Wang J, Chong SA, Subramaniam M. Help-seeking beliefs for mental disorders among medical and nursing students. Early Interv Psychiatry 2019; 13:823-831. [PMID: 29740952 PMCID: PMC6635751 DOI: 10.1111/eip.12673] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 02/05/2018] [Accepted: 03/13/2018] [Indexed: 12/01/2022]
Abstract
AIM The current study aimed to investigate beliefs about help-seeking, treatment options and expected outcomes for people with alcohol abuse, dementia, depression, obsessive-compulsive disorder and schizophrenia, using a vignette-based approach, among a sample of nursing and medical students. METHODS This was a cross-sectional online study among medical and nursing students (n = 1002) who were randomly assigned 1 of 5 vignettes. Questions were asked about whom could best help the person in the vignette, the likely helpfulness of a broad range of interventions, and the likely outcome for the person in the vignette with and without appropriate help. RESULTS A total of 45.1% of students recommended seeing a psychiatrist, which was the most common source of help reported for all 5 vignettes. Help-seeking preferences were significantly associated with age, academic year and vignette type. Respondents rated seeing a psychiatrist as the most helpful intervention (92.4%) and dealing with the problem on their own as the most harmful (68.1%). Then, 81.5% of students indicated that the condition of the person in the vignette would worsen if appropriate help was not sought. CONCLUSION Medical and nursing students most commonly recommended seeking help from a psychiatrist for mental health-related problems, where help-seeking preferences were associated with various age, academic year and vignette type. As these students will be the future medical and nursing workforce, they need to be equipped with the skills and ability to recognize signs and symptoms of mental illness, to aid timely and appropriate treatment for people with mental illness.
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Affiliation(s)
- Louisa Picco
- Research DivisionInstitute of Mental HealthSingapore
| | - Esmond Seow
- Research DivisionInstitute of Mental HealthSingapore
| | | | - Rathi Mahendran
- Psychological MedicineNational University HospitalSingapore
- Clinical, Academic and Faculty AffairsDuke‐NUS Graduate Medical SchoolSingapore
| | - Swapna Verma
- Clinical, Academic and Faculty AffairsDuke‐NUS Graduate Medical SchoolSingapore
- Department of General Psychiatry and Early Psychosis Intervention ProgrammeInstitute of Mental HealthSingapore
| | - Huiting Xie
- Nursing AdministrationInstitute of Mental HealthSingapore
| | - Jia Wang
- Nursing AdministrationInstitute of Mental HealthSingapore
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Tor PC, Gálvez V, Ang A, Fam J, Chan HN, Tan SN, Loo CK. Electroconvulsive practice in Singapore: a cross-sectional national survey. Singapore Med J 2019; 60:590-595. [PMID: 31197378 DOI: 10.11622/smedj.2019064] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION The use of electroconvulsive therapy (ECT) in Singapore dates back to 1947. However, there is little local information on the clinical practice of ECT and its standards. We aimed to conduct a comprehensive national survey of ECT practice in Singapore. METHODS A cross-sectional structured questionnaire assessing the types of ECT (e.g. electrode placement, stimulus parameters), indications, anaesthetic technique, dosing methods, monitoring of outcomes and credentialing was sent in 2015 to all ECT centres in Singapore via email to collect qualitative and quantitative data regarding ECT. RESULTS Data was obtained from all ECT centres (n = 6), which represented that ECT was available in 23.1% of all hospitals and 50.0% of all psychiatric specialist centres. The rate of ECT was 5.89 treatments per 10,000 residents per year, and each patient received an average of 5.4 ECT per course. Only 7.0% of ECT was administered for continuation/maintenance ECT. The most common indication for ECT was depression in 5 (83.3%) out of six centres, with schizophrenia being the second most common. In 5 (83.3%) out of six centres, ECT was brief (0.5 ms) bitemporal ECT with age-based dosing, and 93.0% of the sessions were conducted in an inpatient setting. All ECT was conducted under general anaesthesia, with propofol (66.7%) being the most common type of anaesthetic used. CONCLUSION The practice of ECT in Singapore was highly uniform. The rates and indications for ECT were consistent with those of other developed countries, with greater use of ECT for schizophrenia. Future advances for ECT in Singapore include the use of individualised dosing based on empirical seizure threshold titration, expanded electrode placements and increased utilisation of continuation/maintenance ECT.
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Affiliation(s)
- Phern-Chern Tor
- Department of General Psychiatry, Institute of Mental Health, Singapore
| | - Verònica Gálvez
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Black Dog Institute, Sydney, Australia
| | - Aaron Ang
- Department of Psychological Medicine, Tan Tock Seng Hospital, Singapore
| | - Johnson Fam
- Department of Psychological Medicine, National University Hospital, Singapore
| | - Herng-Nieng Chan
- Department of Psychological Medicine, Singapore General Hospital, Singapore
| | - Sheng-Neng Tan
- Department of Psychological Medicine, Changi General Hospital, Singapore
| | - Colleen K Loo
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Black Dog Institute, Sydney, Australia.,Department of Psychiatry, St George Hospital, Sydney, Australia
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Abstract
Mental health is a major concern throughout the world. The lifetime prevalence of mental health problems in Singapore for those aged 18 years and above was reported to be 12%. However, studies on mental health literacy are relatively scarce in Singapore. The aim of this paper is to provide a topical review of local studies on mental health literacy, people's knowledge of, and attitude toward mental illness, and beliefs about mental health treatment. A narrative review of studies on mental health literacy in Singapore covering the period from 1995 to 2016 highlights the findings from various local studies about attitudes toward mental illness, belief about the causes, and help-seeking behavior. Findings revealed that many lay people are unable to recognize different types of mental disorders. Negative attitudes toward mental illness that hinders individuals from seeking professional treatment, and help-seeking, are the common themes that emerge from the findings. Health professionals have differing views about the causes and treatment of mental disorders. Findings also revealed that treatment seeking and attitudes and beliefs toward mental illness are related to mental health literacy. Implications for promoting mental health literacy are provided.
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Affiliation(s)
- Kareen N Tonsing
- a Department of Anthropology , Oakland University , Rochester , MI , USA
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Werner P. Family Physicians’ Recommendations for the Treatment of Alzheimer’s Disease. Am J Alzheimers Dis Other Demen 2016; 21:403-10. [PMID: 17267372 DOI: 10.1177/1533317506294844] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to examine family physicians’ recommendations for various pharmacological and nonpharmacological treatments for Alzheimer’s disease (AD) and its correlates. A phone survey was conducted with 395 family physicians using an experimental vignette methodology, varying in the severity of the disease. Information regarding participants’ recommendations about 10 interventions for the person described in the vignette was elicited. Sociodemographic and professional correlates were examined. Engagement in social activities and participation in support groups were the interventions most recommended by the physicians. Isolation and physical restraints were the least recommended. Recommendations about AD treatments were associated with the severity of the disease and the extent to which the person described in the vignette was perceived as dangerous. Physicians’ recommendations were very similar to those of the lay public, a fact that might contribute to the efficiency of the treatment plan.
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Affiliation(s)
- Perla Werner
- Department of Gerontology, University of Haifa, Israel.
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Dai Y, Zhang B, Sun H, Li Z, Shen L, Liu Y. Prevalence and Correlates of Psychological Symptoms in Chinese Doctors as Measured with the SCL-90-R: A Meta-Analysis. Res Nurs Health 2015; 38:369-83. [PMID: 26291179 DOI: 10.1002/nur.21673] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Yue Dai
- Department of Social Medicine and Healthcare Management, School of Public Health; Central South University; Changsha Hunan China
| | - Baoquan Zhang
- Department of Clinical Medicine, School of Union Medicine; Fujian Medical University; Fuzhou Fujian China
| | - Hong Sun
- Professor, Department of Social Medicine and Healthcare Management, School of Public Health; Central South University President, Xiangya Hospital Central South University; No.87 Xiangya Road, Kaifu District Changsha Hunan Province 410078 China
| | - Zhanzhan Li
- Department of Epidemiology and Health Statistics, School of Public Health; Central South University; Changsha Hunan China
| | - Liangfang Shen
- Department of Human Resource, Xiangya Hospital; Central South University; Changsha Hunan China
| | - Yuanyuan Liu
- Department of Human Resource, Xiangya Hospital; Central South University; Changsha Hunan China
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Ellison N, Mason O, Scior K. Bipolar disorder and stigma: a systematic review of the literature. J Affect Disord 2013; 151:805-20. [PMID: 24135506 DOI: 10.1016/j.jad.2013.08.014] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 08/17/2013] [Accepted: 08/19/2013] [Indexed: 01/24/2023]
Abstract
AIM The degree to which bipolar disorder is stigmatised by the public and the extent of internalised stigma for people with this disorder, their families, and carers has been a relatively neglected area of research. This review aimed to determine what is currently known about stigma and bipolar disorder. METHOD A systematic search of the literature was conducted to identify publications which investigated public attitudes and/or beliefs about bipolar disorder or explored internalised stigma in bipolar disorder. The electronic databases PsychINFO, Medline, Embase, and Web of Science were searched for articles published between 1992 and 2012. RESULTS Twenty five articles met the reviews inclusion criteria. There are inconsistent findings regarding public stigma, although there is some evidence that bipolar disorder is viewed more positively than schizophrenia and less positively than depression. There is a moderate to high degree of internalised stigma in bipolar disorder, although the literature raises questions regarding its ubiquity in this population. LIMITATIONS Limiting the search by year of publication and excluding studies where stigma was not the main focus could mean stigma has wider implications than were identified. CONCLUSIONS This review is the first systematic synthesis of research relating to stigma and bipolar disorder. In comparison to research on other mental health problems, there is a dearth of literature exploring stigma in bipolar disorder. The literature is largely inconclusive. Future research is needed to replicate tentative findings and address methodological limitations before the field can move on to the development of anti-stigma interventions.
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Affiliation(s)
- Nell Ellison
- Clinical, Educational and Health Psychology Research Department, University College London, London WC1E 7HB, United Kingdom.
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Liu W, Gerdtz MF, Liu TQ. A survey of psychiatrists' and registered nurses' levels of mental health literacy in a Chinese general hospital. Int Nurs Rev 2011; 58:361-9. [PMID: 21848784 DOI: 10.1111/j.1466-7657.2011.00883.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Mental health literacy (MHL) is the term used to describe people's knowledge and beliefs about mental disorders which aid in the recognition, management or the prevention of illness. Health professionals' levels of MHL will shape the therapeutic relationship in which they work in partnership with patients. Studies have been conducted in Australia and Singapore to determine levels of MHL among members of the general public and health professionals. To date, no such studies have been published in Chinese populations. AIM The study aims to compare levels of MHL between registered nurses and psychiatrists in a Chinese general hospital. The paper reports participants' diagnosis and beliefs about interventions used to manage depression and schizophrenia. METHODS A descriptive cross-sectional survey was undertaken among a group of psychiatrists and registered nurses in the psychiatric department of one large teaching hospital in China (n=70). Participants completed the survey by rating written vignettes related to depression and schizophrenia. RESULTS The psychiatrists were highly accurate in correctly diagnosing both depression and schizophrenia; the registered nurses were less so for diagnosing depression. In terms of treatment options, the two groups reached a broad agreement on beliefs about the use of mental health interventions, but differed significantly in the use of some specific mental health interventions. CONCLUSIONS This study provides preliminary information about levels of MHL among Chinese mental health professionals and describes their attitudes towards the helpfulness of interventions used to restore mental health and well-being. Future large-scale studies are required to identify factors that influence beliefs about the use of mental health interventions. The findings have implications for further education of registered nurses in the specialization of mental health nursing in China.
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Affiliation(s)
- W Liu
- Department of Nursing, Melbourne School of Health Sciences, The University of Melbourne, Carlton, Victoria, Australia.
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Depression literacy among older Chinese immigrants in Canada: a comparison with a population-based survey. Int Psychogeriatr 2010; 22:1318-26. [PMID: 20813076 DOI: 10.1017/s1041610210001511] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Investigations of mental health literacy are important because the recognition of a mental health problem is the first step in seeking appropriate mental health care. Lack of recognition is a significant barrier to accessing mental health resources. Older Chinese immigrants are at increased risk for depression; however, there is no research investigating their depression literacy, including their beliefs about treatment, etiology, and prognosis. METHODS This study investigated depression literacy among 53 older Chinese immigrants in Canada (aged 55-87 years) and compared their literacy to Canadian-born participants of the same age who were part of a larger population-based survey. Depression literacy was assessed through interviews using a case vignette and included the following indices: rates of correct identification of depression; perceived efficacy of various people, professions and treatments; and perceptions of etiology and prognosis. RESULTS In the Chinese sample, 11.3% correctly identified depression in the case vignette. In contrast, 74.0% of participants in the population-based survey correctly identified depression. Differences in the perceptions of helpful people and interventions, etiology, and prognosis were also noted between the samples. Both samples strongly endorsed physical activity as helpful in the treatment of depression. CONCLUSIONS In light of these results, it is clear that older Chinese immigrants would benefit from information regarding the symptoms, etiology, and treatment of depression, and that this information may begin to address the serious underutilization of mental health services among this group. Our discussion highlights practice implications and promising interventions.
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Liu CC, Chang LR, Tseng HH, Lai MC, Hwu HG. Differential propensity in recognition of prepsychotic phenomena among psychiatrists, clinical psychologists and school counsellors. Early Interv Psychiatry 2010; 4:275-82. [PMID: 20977683 DOI: 10.1111/j.1751-7893.2010.00182.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The prodromal symptoms of schizophrenia are difficult to differentiate from other common psychiatric illnesses or stress reactions. Despite the development of new diagnostic instruments, non-specificity and poor awareness of this clinical entity are still major barriers to early identification of individuals at risk for schizophrenia. This study was conducted to assess differences among three types of mental health professionals in the recognition of prepsychotic phenomena. METHODS A questionnaire was developed that presented 11 case vignettes. The vignettes represented a hypothetical gradient of clinical severity, including stress reactions; very early stage, intermediate-risk stage and very high-risk stage of the schizophrenia prodrome; and full-blown psychosis. The questionnaire was completed by 57 psychiatrists, 44 clinical psychologists and 50 school counsellors. For each vignette, respondents indicated their top three choices among nine different diagnostic considerations. RESULTS As a group, psychiatrists were most likely to consider schizophrenia for all stages of clinical severity, whereas school counsellors were least likely to. Still, only about half of psychiatrists selected schizophrenia as their first choice for very high-risk cases, and even fewer psychologists and counsellors did so. A proportion of school counsellors failed to recognize full-blown psychosis. Despite the differential propensity in recognition of prepsychotic phenomena, a gradient in considering schizophrenia as a possible diagnosis across the stages of clinical severity was obvious. CONCLUSIONS Psychiatrists, clinical psychologists and school counsellors all need further education, targeting their group-specific proclivities, to improve their sensitivity and specificity in early identification of individuals at risk for schizophrenia.
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Affiliation(s)
- Chen-Chung Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
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Ranahan P. Mental Health Literacy: A Conceptual Framework for Future Inquiry into Child and Youth Care Professionals’ Practice with Suicidal Adolescents. CHILD & YOUTH CARE FORUM 2009. [DOI: 10.1007/s10566-009-9087-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Dunn KI, Goldney RD, Grande ED, Taylor A. Quantification and examination of depression-related mental health literacy. J Eval Clin Pract 2009; 15:650-3. [PMID: 19522721 DOI: 10.1111/j.1365-2753.2008.01067.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of the study was to create an algorithm to measure depression-related mental health literacy. METHOD Participants were those recruited for the 1998 and 2004 South Australian Health Omnibus Surveys. Two unprompted questions were selected from a mental health literacy questionnaire and responses were quantified through allocation of scores agreed by a focus group of mental health professionals. RESULTS An application of the algorithm resulted in findings consistent with those of other research, providing face validity for the method developed. The application allowed for examination of overall levels of depression-related mental health literacy, with improvement found between 1998 and 2004. Similarly, differences in overall literacy according to demographics were also uncovered. CONCLUSIONS Tracking mental health literacy within populations is important as it has been shown to be related to individual help-seeking as well as provision of support for those with a mental disorder. The method devised in this study allows for comparisons of literacy levels to be made across populations and time. It also offers increased capacity for statistical application.
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Affiliation(s)
- Kirsten I Dunn
- Discipline of Psychiatry, University of Adelaide, Adelaide, South Australia, Australia.
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Magliano L, De Rosa C, Fiorillo A, Malangone C, Guarneri M, Marasco C, Maj M. Beliefs of psychiatric nurses about schizophrenia: a comparison with patients' relatives and psychiatrists. Int J Soc Psychiatry 2004; 50:319-30. [PMID: 15648745 DOI: 10.1177/0020764004046073] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND What patients' relatives and health professionals think about causes, treatments and psychosocial consequences of schizophrenia can influence its detection and outcome. AIMS To compare the beliefs about schizophrenia in 190 nurses, 110 psychiatrists and 709 relatives of patients with this mental disorder, recruited in 30 randomly selected mental health centres. METHODS In each centre, the key-relatives of the first consecutive 25 subjects with schizophrenia, and the nurses and psychiatrists who had been working in the service for at least one year, were asked to complete the Questionnaire on the Opinions about Mental Illness (QO). RESULTS The factors most frequently mentioned by psychiatrists and nurses among the causes of schizophrenia were heredity, stress and family conflicts, while those most frequently mentioned by relatives were stress, traumas and love breakdown. Nurses had opinions: (a) similar to those expressed by psychiatrists concerning patients' ability to work equally as other people, and patients' punishability in case of illegal acts; (b) similar to those expressed by relatives about patients' unpredictability and political rights; (c) significantly different from the other two samples as concerns recognition of patients' affective rights. CONCLUSIONS Family psychoeducational interventions and nurses' training should address not only clinical aspects but also disability and psychosocial consequences of schizophrenia.
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