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Abdin E, Seet V, Jeyagurunathan A, Tan SC, Mohmad Khalid MIS, Mok YM, Verma S, Subramaniam M. Equipercentile linking of the Sheehan Disability Scale and the World Health Organization Assessment Schedule 2.0 scales in people with mental disorders. J Affect Disord 2024; 350:539-543. [PMID: 38218260 DOI: 10.1016/j.jad.2024.01.046] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 12/19/2023] [Accepted: 01/03/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND The Sheehan Disability Scale (SDS) and the World Health Organization Disability Assessment Scale (WHODAS 2.0) have been widely used to measure functional impairment and disability. To ensure that the scores from these two scales are practically exchangeable across diseases, therapies, and care programmes, the current study aimed to examine the linkage of the WHODAS 2.0 with the SDS and develop a simple and reliable conversion table for the two scales in people with mental disorders. METHODS A total of 798 patients (mean age = 36.1, SD = 12.7) were recruited from outpatient clinics of the Institute of Mental Health, and the Community Wellness Clinic in Singapore. Using a single-group design, an equipercentile equating method with log-linear smoothing was used to establish a conversion table from the SDS to the WHODAS 2.0 and vice versa. RESULTS The conversion table showed that the scores were consistent for the entire range of scores when the scores were converted either from the SDS to the WHODAS 2.0 or from the WHODAS 2.0 to the SDS. The agreement between the WHODAS 2.0's raw and converted scores and SDS's raw and converted scores were interpreted as good with intraclass correlation coefficient of 0.711 and 0.725, respectively. CONCLUSION This study presents a simple and reliable method for converting the SDS scores to the WHODAS 2.0 scores and vice versa, enabling interchangeable use of data across these two disability measures.
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Affiliation(s)
| | - Vanessa Seet
- Research Division, Institute of Mental Health, Singapore
| | | | - Sin Chik Tan
- Research Division, Institute of Mental Health, Singapore
| | | | - Yee Ming Mok
- Department of Mood and Anxiety, Institute of Mental Health, Singapore
| | - Swapna Verma
- Department of Psychosis, 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
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Samari E, Yuan Q, Zhang Y, Jeyagurunathan A, Subramaniam M. Barriers to using eHealth/mHealth platforms and perceived beneficial eHealth/mHealth platform features among informal carers of persons living with dementia: a qualitative study. BMC Geriatr 2024; 24:30. [PMID: 38184551 PMCID: PMC10771641 DOI: 10.1186/s12877-023-04628-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/20/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND New technologies have brought about a new age of technology-enabled aids that can equip informal carers with the relevant resources for better care. These include but are not limited to facilitating access to healthcare providers, knowledge of caring for persons living with dementia, and sources of support for carers' well-being. This qualitative study explores barriers to using eHealth/mHealth platforms and perceived beneficial eHealth/mHealth platform features among informal carers of persons living with dementia. METHODS An exploratory qualitative study design was employed. Semi-structured interviews were conducted among 29 informal carers of persons living with dementia in Singapore recruited via convenience and snowball sampling. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the data. RESULTS The participants in this study identified several barriers to using eHealth/mHealth platforms, including personal preference, apprehension, poor user experience and lack of skills. On the other hand, knowledge of dementia, caring for persons living with dementia and self-care, a list of resources, social support, location monitoring and alert systems, and the ability to manage appointments and transactions were valuable features for eHealth/mHealth platforms. CONCLUSIONS Despite the underutilisation of eHealth/mHealth platforms, carers expressed a keen interest in using them if they are functional and capable of reducing their care burden. The findings from this study can contribute to developing content and features for eHealth/mHealth interventions aimed at lightening carers' burden in their day-to-day caring routine.
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Affiliation(s)
- Ellaisha Samari
- Institute of Mental Health, Research Division, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Qi Yuan
- Institute of Mental Health, Research Division, 10 Buangkok View, Singapore, 539747, Singapore
| | - YunJue Zhang
- Institute of Mental Health, Research Division, 10 Buangkok View, Singapore, 539747, Singapore
| | - Anitha Jeyagurunathan
- Institute of Mental Health, Research Division, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Institute of Mental Health, Research Division, 10 Buangkok View, Singapore, 539747, Singapore
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Abdin E, Seet V, Jeyagurunathan A, Tan SC, Mok YM, Verma S, Lee ES, Subramaniam M. Validation of the 12-item World Health Organization Disability Assessment Schedule 2.0 in individuals with schizophrenia, depression, anxiety, and diabetes in Singapore. PLoS One 2023; 18:e0294908. [PMID: 38033104 PMCID: PMC10688897 DOI: 10.1371/journal.pone.0294908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/11/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND There is limited evidence on the reliability and validity of the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in an Asian patient population with mental and physical disorders. The current study aimed to examine the psychometric properties of the WHODAS 2.0 among patients with schizophrenia, depression, anxiety, and diabetes. METHODS A total of 1076 patients (M = 40.9 years, SD = 14.7) were recruited from the outpatient clinics of a tertiary psychiatric hospital and a primary care clinic. Internal consistency and test-retest reliability, structural validity, convergent validity, agreement, and floor and ceiling effects were examined. RESULTS Our confirmatory factor analysis (CFA) showed that the 1-factor model fits our data. Multigroup CFA demonstrated metric and scalar invariance, indicating the scores can be compared across the four conditions. The WHODAS 2.0 scale had excellent reliability in the overall sample and good to excellent reliability across conditions. The test-retest reliability and agreement between self-administered and interviewer-administered modes were good. The WHODAS 2.0 scores had moderate to strong correlations with the Social and Occupational Functioning Scale and the Sheehan Disability Scale scores in the overall sample and across four conditions. CONCLUSION Findings suggest that the WHODAS 2.0 is a valid tool to measure functioning and disability in those with schizophrenia, anxiety, depression, and diabetes in an Asian patient population.
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Affiliation(s)
- Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Vanessa Seet
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Sing Chik Tan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Yee Ming Mok
- Department of Mood and Anxiety, Institute of Mental Health, Singapore, Singapore
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - Eng Sing Lee
- Clinical Research Unit, National Healthcare Group Polyclinics, 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
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Sagayadevan V, Satghare P, Jeyagurunathan A, Koh YS, Shafie S, Chang S, Samari E, Subramaniam M. Mediating effect of symptom severity on the relationship between aggression, impulsivity and quality of life outcomes among patients with schizophrenia and related psychoses. Front Psychiatry 2023; 14:1154083. [PMID: 37810606 PMCID: PMC10556254 DOI: 10.3389/fpsyt.2023.1154083] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Aims Aggression and impulsivity among individuals with schizophrenia have been associated with poor clinical outcomes including worsening of symptoms and substance abuse which have been linked to a lower quality of life (QoL). The current study aimed to look at the mediating effect of symptom severity on the relationship between aggression, impulsivity and QoL among outpatients with schizophrenia and related psychoses in a multi-ethnic Asian population. Methods Data (n = 397) were collected from outpatients seeking treatment at the Institute of Mental Health. The World Health Organization quality of life-BREF (WHOQOL-BREF) scale, the symptoms checklist-90 revised (SCL-90-R), Buss Perry aggression questionnaire (BPAQ), and the Barratt impulsiveness scales (BIS) were used to assess subjective well-being, symptom severity, aggression, and impulsivity, respectively. Mediation analysis was performed using the PROCESS macro to understand the mediating effect of symptom severity. Results Motor impulsivity (MI) was indirectly associated with both the physical and psychological health domains of QoL while self-control was indirectly associated with the physical, psychological, and environmental health QoL domains through increased symptom severity. Conclusion The significant indirect effect of symptom severity in our study highlights one potential pathway through which impulsivity impacts the QoL of individuals with schizophrenia and related psychoses. Elucidating other factors besides symptom severity that have an indirect effect on the QoL of individuals provides alternative approaches for treatment through which better clinical outcomes can be achieved.
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Roystonn K, AshaRani PV, Devi F, Wang P, Zhang Y, Jeyagurunathan A, Abdin E, Car LT, Chong SA, Subramaniam M. Exploring views and experiences of the general public's adoption of digital technologies for healthy lifestyle in Singapore: a qualitative study. Front Public Health 2023; 11:1227146. [PMID: 37794896 PMCID: PMC10545896 DOI: 10.3389/fpubh.2023.1227146] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/04/2023] [Indexed: 10/06/2023] Open
Abstract
Objective Little is known about the general adult population's adoption of digital technology to support healthy lifestyle, especially when they are expected to take greater personal responsibility for managing their health and well-being today. The current qualitative study intended to gain an in-depth understanding of determinants of digital technology adoption for healthy lifestyle among community-dwelling adults in Singapore. Design A qualitative study design, with thematic framework analysis was applied to develop themes from the data. Setting Semi-structured individual interviews were conducted with participants either face-to-face or online through a videoconferencing platform. Participants 14 women and 16 men from the general population who were between the ages of 22 and 71 years. Results Three major themes were developed: (1) digitally disempowered (2) safety and perceived risks and harm; (3) cultural values and drives. Adoption of technology among the general population is needs-driven, and contingent on individual, technological and other cross-cultural contextual factors. Conclusion Our findings highlight there is no one solution which fits all individuals, emphasizing the challenges of catering to diverse groups to reduce barriers to adoption of digital technologies for healthy lifestyle. Digital guidance and training, as well as social influences, can motivate technological adoption in the population. However, technical problems as well as data security and privacy concerns should first be adequately addressed. This study provides rich cross-cultural insights and informs policy-making due to its alignment with government public health initiatives to promote healthy lifestyle.
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Affiliation(s)
| | - P. V. AshaRani
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Fiona Devi
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Peizhi Wang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Yunjue Zhang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Lorainne Tudor Car
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
- Lee Kong Chian School of Medicine, Nanyang Technological University, 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
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Koh YS, Shahwan S, Jeyagurunathan A, Abdin E, Vaingankar JA, Chow WL, Chong SA, Subramaniam M. Prevalence and correlates of suicide planning and attempt among individuals with suicidal ideation: Results from a nationwide cross-sectional survey. J Affect Disord 2023; 328:87-94. [PMID: 36791970 DOI: 10.1016/j.jad.2023.02.033] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Suicidality spans from having suicidal ideation to planning and making an attempt. However, not all individuals with suicidal thoughts will proceed to plan or attempt suicide. Our study investigated (i) the prevalence of suicide planning and attempt among those with suicidal ideation and (ii) their associations with sociodemographic characteristics, mental disorders, adverse childhood events and prior suicidal behaviour. METHOD This cross-sectional analysis utilised data from Singapore Mental Health Study 2016. Only respondents with suicidal ideation were included. A total of 411 and 365 individuals were examined to establish the prevalence of suicide planning and attempt respectively. Multivariable logistic regressions were performed to determine associations. RESULTS The prevalence of suicide planning and attempt were 17.7 % and 10.6 % respectively, with >80.0 % occurring within a year of suicidal ideation. Suicide planning was more likely among those who had mood disorders. Suicide attempt was more likely for those were currently married, had lower educational qualifications, history of anxiety disorders, history of emotional neglect and parental separation. LIMITATIONS Recall bias may be present because the age of onset for various mental disorders and suicidal behaviours were self-reported. As suicide was criminalised when the study was conducted, the prevalence of suicidal behaviours may have been underestimated. CONCLUSION Individuals at risk of suicide planning and attempt should be identified early since most of them progressed within a year. Findings suggest the importance of including prior suicide behaviour and history of dysfunctional family and emotional abuse in suicide risk assessment and intervention.
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Affiliation(s)
- Yen Sin Koh
- Research Division, Institute of Mental Health, Singapore, Singapore.
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 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
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Teh WL, Abdin E, P V A, Siva Kumar FD, Roystonn K, Wang P, Shafie S, Chang S, Jeyagurunathan A, Vaingankar JA, Sum CF, Lee ES, van Dam RM, Subramaniam M. Measuring social desirability bias in a multi-ethnic cohort sample: its relationship with self-reported physical activity, dietary habits, and factor structure. BMC Public Health 2023; 23:415. [PMID: 36859251 PMCID: PMC9979418 DOI: 10.1186/s12889-023-15309-3] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Social desirability bias is one of the oldest forms of response bias studied in social sciences. While individuals may feel the need to fake good or bad answers in response to sensitive or intrusive questions, it remains unclear how rampant such a bias is in epidemiological research pertaining to self-reported lifestyle indicators in a multicultural Asian context. The main purpose of the current study is, therefore, to examine the sociodemographic correlates and impact of social desirability responding on self-reported physical activity and dietary habits at an epidemiological scale in a non-western multi-cultural Asian setting. METHODS Prior to the main analyses, confirmatory and exploratory factor analyses were conducted to determine the factorial validity of a western derived concept of social desirability. Multiple regression analyses were conducted on cross-sectional data (n = 2995) extracted from a nationwide survey conducted between 2019 and 2020. RESULTS A unique factor structure of social desirability was found and was therefore used for subsequent analyses. Multiple regression analyses revealed older age groups, the Indian ethnic group, those with past or present marriages, and having no income, had a significantly greater tendency to act on the bias. CONCLUSION The construct of social desirability bias was fundamentally different in a multicultural context than previously understood. Only a small proportion of variance of self-report lifestyle scores was explained by social desirability, thus providing support for data integrity.
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Affiliation(s)
- Wen Lin Teh
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, Singapore.
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, Singapore
| | - Asharani P V
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, Singapore
| | - Fiona Devi Siva Kumar
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, Singapore
| | - Kumarasan Roystonn
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, Singapore
| | - Peizhi Wang
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, Singapore
| | | | - Chee Fang Sum
- Admiralty Medical Centre, Khoo Teck Puat Hospital, 676 Woodlands Drive 71, Singapore, Singapore
| | - Eng Sing Lee
- National Healthcare Group Polyclinics, 3 Fusionopolis Link. Nexus@One-North, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore, Singapore.,Departments of Exercise and Nutrition Sciences and Epidemiology, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW, Washington, DC, United States
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, Singapore
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Yuan Q, Zhang Y, Samari E, Jeyagurunathan A, Goveas R, Ng LL, Subramaniam M. Positive aspects of caregiving among informal caregivers of persons with dementia in the Asian context: a qualitative study. BMC Geriatr 2023; 23:51. [PMID: 36707781 PMCID: PMC9883086 DOI: 10.1186/s12877-023-03767-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 07/21/2022] [Accepted: 01/23/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Positive aspects of caregiving are important coping resources for informal caregivers of persons with dementia (PWD). However, existing studies mostly focused on caregivers from western societies and less attention was paid to the potential cultural differences. This study aims to explore positive aspects of caregiving in the Asian context. METHODS A qualitative methodology with semi-structured interviews was adopted. A total of 29 informal caregivers of PWD in Singapore were interviewed from Apr 2019 to Dec 2020. All the interviews were audio-recorded and transcribed verbatim for the analysis. Inductive thematic analysis was conducted. RESULTS The results revealed a total of three major themes with 11 sub-themes including: 1) positive aspects within self (i.e., better understanding of dementia and caregiving, personal growth, role satisfaction, and improved awareness of self-care); 2) positive aspects between caregiver and PWD (i.e., chance to demonstrate filial piety towards PWD, happiness and positive attitudes of PWD, positive interactions with PWD, and closer relationships with PWD); and 3) positive aspects between caregiver and others (i.e., empathy towards other caregivers, befriending peers, and sharing dementia and caregiving knowledge with others). DISCUSSION Findings from this study improved our understanding on positive aspects of caregiving among informal caregivers of PWD in the Asian context. In addition to similar themes across cultures such as personal growth, our study identified a few unique themes like improved awareness of self-care and chances to demonstrate filial piety. For future studies targeting Asian caregivers, it is necessary to include these cultural-specific positive aspects of caregiving.
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Affiliation(s)
- Qi Yuan
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Yunjue Zhang
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Ellaisha Samari
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Anitha Jeyagurunathan
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Richard Goveas
- grid.414752.10000 0004 0469 9592Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Li Ling Ng
- grid.413815.a0000 0004 0469 9373Department of Psychological Medicine, Changi General Hospital, Singapore, Singapore
| | - Mythily Subramaniam
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
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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. Int J Environ Res 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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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10
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Subramaniam M, Devi F, AshaRani PV, Zhang Y, Wang P, Jeyagurunathan A, Roystonn K, Vaingankar JA, Chong SA. Barriers and facilitators for adopting a healthy lifestyle in a multi-ethnic population: A qualitative study. PLoS One 2022; 17:e0277106. [PMID: 36322596 PMCID: PMC9629631 DOI: 10.1371/journal.pone.0277106] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
A healthy lifestyle is defined as ‘a way of living that lowers the risk of being seriously ill or dying early.’ Although barriers and facilitators of healthy lifestyles have been well-studied among populations like those with chronic non-communicable diseases, adolescents, and older adults in Asia, less information is available on barriers and facilitators perceived by the general adult population. Using a qualitative methodology and leveraging the socio-ecological model, the current study aimed to understand the barriers and facilitators of a healthy lifestyle in a sample of Singapore residents. Overall, 30 semi-structured interviews were conducted in English and other local languages from August 2020 to March 2021. Transcripts were analysed using framework analysis. Five main themes pertaining to personal, interpersonal, environmental, socio-cultural, and policy-level factors were classified under the two overarching categories of barriers and facilitators of healthy lifestyles. The results of this study offer important insights into understanding the barriers and facilitators to the adoption of a healthy lifestyle among people in Singapore. Furthermore, our findings illustrate the complex interplay between individuals, social relationships, environment, and policy that can act as either a barrier or a facilitator to adopting a healthy lifestyle.
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Affiliation(s)
- Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- * E-mail:
| | - Fiona Devi
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - P. V. AshaRani
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Yunjue Zhang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Peizhi Wang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | | | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
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Cetty L, Jeyagurunathan A, Roystonn K, Devi F, Abdin E, Tang C, Verma S, Chong SA, Ramsay J, Subramaniam M. Religiosity, Religious Coping and Distress Among Outpatients with Psychosis in Singapore. J Relig Health 2022; 61:3677-3697. [PMID: 35752728 PMCID: PMC9509299 DOI: 10.1007/s10943-022-01596-4] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 06/15/2023]
Abstract
This study aimed to investigate the prevalence of religious coping and explore the association between religious coping, religiosity, and distress symptoms amongst 364 outpatients diagnosed with psychosis in Singapore. Positive and Negative Religious Coping (PRC and NRC), religiosity (measuring the constructs of Organised Religious Activity (ORA), Non-Organised Religious Activity (NORA), and Intrinsic Religiosity (IR)) and severity of distress symptoms (depression, anxiety and stress) were self-reported by the participants. The majority of participants (68.9%) reported religion to be important in coping with their illness. Additionally, multiple linear regression analyses found that NRC was significantly associated with higher symptoms of distress. In contrast, ORA was significantly associated with lower anxiety symptom scores. Overall, the study indicates the importance of religion in coping with psychosis and the potential value in incorporating religious interventions in mental health care.
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Affiliation(s)
- Laxman Cetty
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Kumarasan Roystonn
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Fiona Devi
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Charmaine Tang
- Department of Psychosis, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Jonathan Ramsay
- College of Healthcare Sciences, James Cook University, 149 Sims Drive, Singapore, 387380, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308232, Singapore
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12
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AshaRani PV, Devi F, Wang P, Abdin E, Zhang Y, Roystonn K, Jeyagurunathan A, Subramaniam M. Factors influencing uptake of diabetes health screening: a mixed methods study in Asian population. BMC Public Health 2022; 22:1511. [PMID: 35941579 PMCID: PMC9360713 DOI: 10.1186/s12889-022-13914-2] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health screens are the cornerstones for health promotion and preventive interventions at a community level. This study investigated the barriers and facilitators to the uptake of diabetes health screening in the general population of Singapore. METHODS In this mixed methods study, participants without diabetes were recruited from the general population. The quantitative phase (n = 2459) included face to face survey of participants selected through disproportionate stratified random sampling. Those who participated in the quantitative survey were then randomly chosen for a one-to-one semi-structured interview (n = 30). RESULTS Among the survey respondents, 73.09% (n = 1777) had attended a diabetes health screening in their lifetime whilst 42.36% (n = 1090) and 57.64% (n = 1328, p < 0.0001) attended the health screens regularly (every 12 months) and irregularly, respectively. A significantly higher proportion of older adults (≥ 40 years) attended regular diabetes health screening compared to younger adults (less than 40 years; 55.59% vs 24.90%, p < 0.001). The top 3 reasons for attending regular health screens were to detect diabetes early, to make lifestyle changes in case of a diagnosis and being health conscious. Qualitative interviews identified similar issues and complex nuances that influenced the uptake of regular diabetes health screening. Several personal factors (laziness, self-reliance, psychological factors, etc.), competing priorities, fatalistic beliefs, affordability, misconceptions about the screens, and appointment related factors (inconvenient location, time, etc.) were identified as barriers, while affordable screens, sense of personal responsibility, perception of susceptibility /risk, role of healthcare team (e.g. reminders and prescheduled appointments) and personal factors (e.g. age, family, etc.) were facilitators. Age, household income, ethnicity and educational level were associated with the uptake of regular diabetes health screening. CONCLUSION The uptake of regular diabetes health screening can be improved. Several barriers and enablers to the uptake of diabetes health screening were identified which should be addressed by the policy makers to alleviate misconceptions and create greater awareness of the importance of the programme that will improve participation.
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Affiliation(s)
- P V AshaRani
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Fiona Devi
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Peizhi Wang
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Yunjue Zhang
- 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
| | - Anitha Jeyagurunathan
- Research Division, 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 and Department of Medicine, National University of Singapore, Singapore, 117549, Singapore
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13
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Yuan Q, Zhang Y, Samari E, Jeyagurunathan A, Tan GTH, Devi F, Wang P, Magadi H, Goveas R, Ng LL, Subramaniam M. The impact of having foreign domestic workers on informal caregivers of persons with dementia - findings from a multi-method research in Singapore. BMC Geriatr 2022; 22:305. [PMID: 35395748 PMCID: PMC8993210 DOI: 10.1186/s12877-022-03002-w] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 03/29/2022] [Indexed: 11/16/2022] Open
Abstract
Background Informal caregivers of persons with dementia (PWDs) sometimes engage foreign domestic workers (FDWs) to support their caregiving journey. However, there has not been much research to establish if this is really beneficial. The current study aims to investigate whether engaging FDWs specifically for caregiving of PWDs truly moderates caregiver stress and to explore caregivers’ experiences of engaging FDWs. Methods A multi-method study design with a quantitative and qualitative sub-study was adopted. For the quantitative sub-study, 282 informal caregivers of PWDs were recruited. Propensity score matching analysis was used. For the qualitative sub-study, 15 informal caregivers with FDWs were interviewed. Inductive thematic analysis was conducted. Results The quantitative sub-study confirmed that engaging FDWs did moderate the depressive symptoms of informal dementia caregivers (marginal effect = -3.35, p = 0.0497). However, such support did not affect their caregiving burden, self-efficacy, and perceived positive aspects of caregiving. The qualitative sub-study suggested that engaging FDWs is an ambivalent experience, which entails both support and challenges. Conclusions The current study confirmed previous research findings, that engaging FDWs moderated depressive symptoms among caregivers of PWDs, and it could be through their physical support such as in daily caregiving activities. Policy-makers may consider providing more subsidies to caregivers caring for PWDs with mobility issues to hire FDWs. They may also consider providing training to FDWs on dementia caregiving skills and improving the intake of such training as this might be helpful for both FDWs and caregivers during this journey.
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Affiliation(s)
- Qi Yuan
- Research Division, Institute of Mental Health, Buangkok Green, Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Yunjue Zhang
- Research Division, Institute of Mental Health, Buangkok Green, Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Ellaisha Samari
- Research Division, Institute of Mental Health, Buangkok Green, Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Buangkok Green, Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Gregory Tee Hng Tan
- School of Social Sciences, Singapore Management University, Singapore, Singapore
| | - Fiona Devi
- Research Division, Institute of Mental Health, Buangkok Green, Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Peizhi Wang
- Research Division, Institute of Mental Health, Buangkok Green, Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Harish Magadi
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Richard Goveas
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Li Ling Ng
- Department of Psychological Medicine, Changi General Hospital, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green, Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
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14
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Lau JH, Jeyagurunathan A, Shafie S, Chang S, Samari E, Cetty L, Verma S, Tang C, Subramaniam M. The factor structure of the Barratt Impulsiveness Scale (BIS-11) and correlates of impulsivity among outpatients with schizophrenia and other psychotic disorders in Singapore. BMC Psychiatry 2022; 22:226. [PMID: 35361174 PMCID: PMC8968701 DOI: 10.1186/s12888-022-03870-x] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 03/21/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Impulsivity has been linked to risky behaviours amongst patients with schizophrenia or other psychotic disorders. However, there is a dearth of studies examining impulsivity amongst this population in Singapore. Moreover, to date, scales to measure impulsivity have not been validated in this population. The present study seeks to examine the underlying factor structure of the Barratt Impulsiveness Scale (BIS-11) and explore sociodemographic and clinical correlates of impulsivity within this group. METHODS Confirmatory factor analyses (CFA) were conducted to test factor structures of the BIS-11 proposed in extant literature. However, due to poor fit statistics, the sample (n = 397) was split into two groups, with Exploratory Factor Analyses (EFA) conducted in the first subgroup (n = 200). The final model of the EFA was then tested within the second subgroup (n = 197) with CFA. Multivariable linear regressions were conducted to examine sociodemographic and clinical correlates of each underlying factor. RESULTS CFA indicated a three-factor structure amongst 16-items of the BIS-11 with acceptable fit: i) Non-planning impulsivity (5-items; α = 0.94), ii) Motor impulsiveness (6-items α = 0.84), and iii) Lack of self-control (5-items, α = 0.85). Lower education was associated with higher non-planning impulsivity. While age, ethnicity, marital status, and general psychiatric symptom severity were significant correlates of motor impulsiveness, problematic alcohol use and general psychiatric symptom severity were related to a greater lack of self-control. CONCLUSION Factor structures of the BIS-11 suggested by extant literature were not applicable, and we propose an alternative factor structure for BIS-11. Significant correlates of impulsivity are highlighted, and avenues for future research are suggested.
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Affiliation(s)
- Jue Hua Lau
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Saleha Shafie
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Sherilyn Chang
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Ellaisha Samari
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Laxman Cetty
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Swapna Verma
- grid.414752.10000 0004 0469 9592Medical Board, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Charmaine Tang
- grid.414752.10000 0004 0469 9592Department of Early Psychosis Intervention, Institute of Mental Health Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Mythily Subramaniam
- grid.414752.10000 0004 0469 9592Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
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15
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Tan YWB, Lau JH, AshaRani PV, Roystonn K, Devi F, Lee YY, Whitton C, Wang P, Shafie S, Chang S, Jeyagurunathan A, Chua BY, Abdin E, Sum CF, Lee ES, Subramaniam M. Dietary patterns of persons with chronic conditions within a multi-ethnic population: results from the nationwide Knowledge, Attitudes and Practices survey on diabetes in Singapore. Arch Public Health 2022; 80:62. [PMID: 35189947 PMCID: PMC8862351 DOI: 10.1186/s13690-022-00817-2] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/05/2022] [Indexed: 11/17/2022] Open
Abstract
Background Chronic conditions are a leading cause of death and disability worldwide and respective data on dietary patterns remain scant. The present study aimed to investigate dietary patterns and identify sociodemographic factors associated with Dietary Approaches to Stop Hypertension (DASH) scores within a multi-ethnic population with various chronic conditions. Methods The present study utilised data from the 2019-2020 Knowledge, Attitudes, and Practices study on diabetes in Singapore – a nationwide survey conducted to track the knowledge, attitudes, and practices pertaining to diabetes. The study analysed data collected from a sample of 2,895 Singapore residents, with information from the sociodemographic section, DASH diet screener, and the modified version of the World Mental Health Composite International Diagnostic Interview (CIDI) version 3.0 checklist of chronic physical conditions. Results Respondents with no chronic condition had a mean DASH score of 18.5 (±4.6), those with one chronic condition had a mean DASH score of 19.2 (±4.8), and those with two or more chronic conditions had a mean DASH score of 19.8 (±5.2). Overall, the older age groups [35– 49 years (B = 1.78, 95% CI: 1.23 – 2.33, p <0.001), 50–64 years (B = 2.86, 95% CI: 22.24 – 3.47, p <0.001) and 65 years and above (B = 3.45, 95% CI: 2.73 – 4.17, p <0.001)], Indians (B = 2.54, 95% CI: 2.09 – 2.98, p <0.001) reported better diet quality, while males (B = -1.50, 95% CI: -1.87 – -1.14, p <0.001) reported poorer diet quality versus females. Conclusion Overall, respondents with two or more chronic conditions reported better quality of diet while the sociodemographic factors of age, gender and ethnicity demonstrated a consistent pattern in correlating with diet quality, consistent with the extant literature. Results provide further insights for policymakers to refine ongoing efforts in relation to healthy dietary practices for Singapore.
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Affiliation(s)
- Yeow Wee Brian Tan
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore.
| | - Jue Hua Lau
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - P V AshaRani
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Kumarasan Roystonn
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Fiona Devi
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Ying Ying Lee
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Clare Whitton
- School of Public Health, Faculty of Health Sciences, Curtin University, Kent Street, Western Australia, 6102, Bentley, Australia
| | - Peizhi Wang
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Boon Yiang Chua
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
| | - Chee Fang Sum
- Admiralty Medical Centre, Khoo Teck Puat Hospital, 676 Woodlands Drive 71, Singapore, Singapore
| | - Eng Sing Lee
- National Healthcare Group Polyclinics, Fusionopolis Link. Nexus@One-North, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore, Singapore
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16
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Chang S, Jeyagurunathan A, Abdin E, Shafie S, Samari E, Verma S, Wei KC, Chong SA, Subramaniam M. Mapping the steps to reach psychiatric care in Singapore: An examination of services utilized and reasons for seeking help. Gen Hosp Psychiatry 2021; 73:38-45. [PMID: 34564051 DOI: 10.1016/j.genhosppsych.2021.09.007] [Citation(s) in RCA: 3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study is to shed light on the types of services utilized and map the steps taken by patients in their pathways to receiving psychiatric care in Singapore. METHODS Participants were outpatients who were recruited from a psychiatric tertiary hospital (n = 323). Pathways to psychiatric care form was administered to collect information on sources of care utilized, reasons for seeking help and the time point of each contact made. Pathways taken by patients to reach psychiatric care were mapped, and reasons for seeking help were reviewed and analyzed. Quantile regression was conducted to explore association between sociodemographic and clinical factors with duration between onset of problem and receiving psychiatric care. RESULTS The need to manage symptoms was most commonly endorsed by participants as the reason that first prompted them to seek help. Prior to receiving psychiatric care, participants on average obtained services from 1.2 other care providers and the main pathway to psychiatric services was via primary care and community services (37.2%). The median duration between onset of problem and receiving psychiatric care was 6 months, and age was found to be significantly associated with shorter median duration (β = -0.172, p = 0.009). CONCLUSIONS Patients often consult different care providers prior to obtaining psychiatric services and contact was made more frequently via primary care and community care providers. Findings from this study reiterate the need for engaging community partners to render timely and relevant support for individuals with mental health issues.
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Affiliation(s)
- Sherilyn Chang
- Research Department, Institute of Mental Health, Singapore.
| | | | | | - Saleha Shafie
- Research Department, Institute of Mental Health, Singapore
| | | | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, Singapore
| | - Ker-Chiah Wei
- Department of Community Psychiatry, Institute of Mental Health, Singapore
| | - Siow Ann Chong
- Research Department, Institute of Mental Health, Singapore
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17
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Jeyagurunathan A, Abdin E, Shafie S, Sambasivam R, Yunjue Z, Chua BY, Vaingankar JA, Verma S, Ee TW, Chong SA, Subramaniam M. Asthma Prevalence and its Risk Factors Among a Multi-Ethnic Adult Population. Yale J Biol Med 2021; 94:417-427. [PMID: 34602881 PMCID: PMC8461573] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Asthma is a substantial global health problem characterized by chronic airway inflammation, leading to intermittent symptoms. This study aims to establish the prevalence and risk factors of asthma in a multi-ethnic adult population. Data for the study were extracted from the Singapore Mental Health Study 2016, a population-based, cross-sectional, epidemiological study of Singapore residents aged 18 years and above. The data relating to asthma prevalence was captured using the modified World Mental Health Composite International Diagnostic Interview (CIDI) version 3.0 chronic conditions checklist. The prevalence of lifetime asthma in this population was 11.9% (95% CI, 10.83-13.12). Those of Malay and Indian ethnicity (versus Chinese), ex-smokers (versus never smoked) and those who were overweight and obese (versus normal weight) were more likely to be associated with asthma. Participants belonging to the age group of 35 years and above (versus 18-34 years of age), male gender (versus female) were less likely to be associated with lifetime asthma. Asthma was also more likely to be associated with bipolar disorder. Those with current asthma (ie, those who had received treatment during the past 12 months) were significantly associated with lower health-related quality of life in the physical component score (PCS) than those without asthma. The high prevalence and association with lowered health-related quality of life makes asthma a significant public health concern. Our study's findings can help create awareness and encourage integrated approaches for managing asthma in the health sector.
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Affiliation(s)
- Anitha Jeyagurunathan
- Research Division, Institute of Mental Health (IMH),
Singapore,To whom all correspondence should be addressed:
Anitha Jeyagurunathan, MSW, Mphil, Principal Research Officer, Research
Division, Institute of Mental Health, Buangkok Green Medical Park, Singapore;
| | | | - Saleha Shafie
- Research Division, Institute of Mental Health (IMH),
Singapore
| | | | - Zhang Yunjue
- Research Division, Institute of Mental Health (IMH),
Singapore
| | - Boon Yiang Chua
- Research Division, Institute of Mental Health (IMH),
Singapore
| | | | - Swapna Verma
- Department of Psychosis and East Region, IMH,
Singapore
| | - Tang Wern Ee
- National Healthcare Group Polyclinics, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health (IMH),
Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health (IMH),
Singapore,Saw Swee Hock School of Public Health, Singapore
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18
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Asharani PV, Lau JH, Roystonn K, Devi F, Peizhi W, Shafie S, Chang S, Jeyagurunathan A, Yiang CB, Abdin E, Vaingankar JA, Sum CF, Lee ES, Dam RV, Chong SA, Subramaniam M. Health Literacy and Diabetes Knowledge: A Nationwide Survey in a Multi-Ethnic Population. Int J Environ Res Public Health 2021; 18:9316. [PMID: 34501905 PMCID: PMC8431510 DOI: 10.3390/ijerph18179316] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022]
Abstract
Health literacy is a key determinant of the public health and health climate of the nation. This study examined the functional health literacy of the nation, factors associated with health literacy, and its relationship with diabetes recognition. This cross-sectional survey recruited participants (N = 2895) who were 18 years and above from a population registry through disproportionate stratified sampling. The Brief Health Literacy Screen and other questionnaires were administered through face-to-face interviews, in one of the four national languages (English, Chinese, Malay or Tamil). The majority (80.5%) had adequate functional health literacy and were able to recognise symptoms of diabetes correctly (83.5% overall; 83.7% and 82.2% in those with adequate and inadequate health literacy, respectively). Those with inadequate health literacy had a higher incidence of chronic conditions (p < 0.001) compared to those with adequate health literacy in bivariate analysis. The majority of the sample had sufficient levels of physical activity (83.3%), and more than half reported an unhealthy lifestyle (57.4%). Older age, Chinese ethnicity, those who were employed, with lower education (secondary or below), and were married had significantly higher odds of inadequate health literacy. Health literacy was not associated with lifestyle, physical activity, chronic conditions and diabetes recognition. Health literacy interventions should focus on the disadvantaged social groups for improving their health literacy.
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Affiliation(s)
- P. V. Asharani
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Jue Hua Lau
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Kumarasan Roystonn
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Fiona Devi
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Wang Peizhi
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Chua Boon Yiang
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Chee Fang Sum
- Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore 730676, Singapore;
| | - Eng Sing Lee
- Clinical Research Unit, National Healthcare Group Polyclinics 3 Fusionopolis Link, Singapore 138543, Singapore;
| | - Rob Van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore;
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore;
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Sambasivam R, Jeyagurunathan A, Abdin E, Shafie S, Chang S, Vaingankar JA, Chong SA, Subramaniam M. Occupational groups and its physical and mental health correlates: results from the Singapore Mental Health Study 2016. Int Arch Occup Environ Health 2021; 95:753-764. [PMID: 34302531 PMCID: PMC8938346 DOI: 10.1007/s00420-021-01741-8] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/23/2021] [Indexed: 11/21/2022]
Abstract
Purpose The physical and mental wellbeing of an individual is impacted by the type occupation one does. This study aims to establish the prevalence of mental and physical disorders, the association of occupational groups and health-related quality of life, and the extent of work-loss and work-cut back in past 30 days among the employed in the Singapore resident population. Methods Data from a population-based, epidemiological survey of a representative sample of Singapore citizens and permanent residents aged 18 years and above were used. Lifetime diagnosis of select mental disorders was established using the World Health Organization’s Composite International Diagnostic Interview version 3.0 (WHO-CIDI 3.0). Data on nicotine dependence, work productivity, quality of life and socio-demographics were obtained via self-report. Ten major occupational groups based on the Singapore Standard Occupational Classification were included in the analysis. Results The sample comprised 4021 employed individuals who were predominantly males (54.7%) and aged 35–49 years (35.4%). ‘Service and sales workers’ (22.6%), ‘Professionals’ (17.3%) and ‘Legislators, senior officials and managers’ (16.4%) were the three largest occupational groups. Socio-demographic characteristics differed significantly (p < 0.001) across all occupational groups. Lifetime prevalence of mood disorders among the employed was 8.4% and the most prevalent physical disorder was chronic pain (18.9%). No significant differences were observed in work productivity loss across the occupational groups. Conclusions The disparities in the socio-demographic characteristics and prevalence of mental and physical disorders across occupational categories provide policymakers with vital information to pilot effective interventions that can improve the psychosocial and physical conditions at work.
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Affiliation(s)
- Rajeswari Sambasivam
- Research Division, Institute of Mental Health, Singapore, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Singapore, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, Singapore, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
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Roystonn K, Cetty L, Jeyagurunathan A, Devi F, Abdin E, Tan ST, Tang C, Verma S, Subramaniam M. Quality of Life and Its Associations with Religiosity and Religious Coping among Outpatients with Psychosis in Singapore. Int J Environ Res Public Health 2021; 18:ijerph18137200. [PMID: 34281137 PMCID: PMC8296895 DOI: 10.3390/ijerph18137200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/28/2021] [Accepted: 07/02/2021] [Indexed: 11/26/2022]
Abstract
This cross-sectional study investigated the relationship of religiosity, the use of positive and negative religious coping methods, and quality of life (QOL) among 364 outpatients with psychosis in Singapore. Positive religious coping was significantly associated with better scores on physical (β = 0.51, p = 0.02) and psychological (β = 0.64, p = 0.01) QOL domains in the regression model. Negative religious coping was related to worse QOL in all four domains: physical (β = −0.44, p = 0.03), psychological (β = −0.76, p < 0.01), social (β = −0.54, p = 0.03), and environment (β = −0.65, p < 0.01). Increased participation in organizational religious activities was positively associated with higher QOL for psychological (β = 2.47, p < 0.01), social relationships (β = 2.66, p = 0.01), and environment (β = 2.09, p = 0.01) domains. Interestingly, those with no religious affiliation were found with higher scores in the QOL domain for social relationships (β = 4.59, p = 0.02). Religious coping plays an important role for the QOL of outpatients with psychosis. Greater awareness of the importance of religion in this population may improve cultural competence in treatment. Individuals with psychosis may benefit from greater community support and collaboration between clinical and religious community-based organizations to improve social integration and QOL.
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Shafie S, Subramaniam M, Abdin E, Vaingankar JA, Sambasivam R, Zhang Y, Shahwan S, Chang S, Jeyagurunathan A, Chong SA. Help-Seeking Patterns Among the General Population in Singapore: Results from the Singapore Mental Health Study 2016. Adm Policy Ment Health 2021; 48:586-596. [PMID: 33057931 PMCID: PMC8192323 DOI: 10.1007/s10488-020-01092-5] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2020] [Indexed: 11/05/2022]
Abstract
This study aimed to establish lifetime mental health service utilisation among the general population of Singapore. The sociodemographic correlates of those seeking help from different service provider groups and changes in lifetime mental health service utilisation between 2010 and 2016 among those with mental disorders were also explored. A population-based cross-sectional epidemiological household survey of the Singapore resident population aged 18 years and above was conducted from 2016 to 2018, using the World Mental Health Composite International Diagnostic Interview (CIDI) version 3.0. Data from two cross-sectional population-based studies were used for comparison of lifetime mental health service utilisation in 2010 (n = 6616) and 2016 (n = 6126). Chi square test and multiple logistic regression were used to analyse the data. A total of 6126 respondents completed the study in 2016. Overall 9.3% of the total sample, 32.0% of those with mental disorders, and 5.7% of those not meeting criteria for mental disorders, ever sought help for their mental health issues in their lifetime, from any treatment service sectors. Several sociodemographic characteristics were found to be correlated with different service provider groups. There was no change in mental health service utilisation between 2010 and 2016 for all mental disorders included in this study, with the exception of a significant increase in help sought from professionals in social services, among those with alcohol abuse. Even though the overall help-seeking rates are low, it is encouraging that those seeking help did so from mental health professionals and professionals working in the social services.
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Affiliation(s)
- Saleha Shafie
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Rajeswari Sambasivam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Yunjue Zhang
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
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Subramaniam M, Abdin E, Vaingankar JA, Chang S, Sambasivam R, Jeyagurunathan A, Seow LSE, Van Dam R, Chow WL, Chong SA. Association of adverse childhood experiences with diabetes in adulthood: results of a cross-sectional epidemiological survey in Singapore. BMJ Open 2021; 11:e045167. [PMID: 33722874 PMCID: PMC7959232 DOI: 10.1136/bmjopen-2020-045167] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 02/08/2021] [Accepted: 02/21/2021] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES Several studies have linked diabetes mellitus to adverse childhood experiences (ACEs). While a number of studies have examined the association between ACEs and diabetes in Western populations, few have done it in Asian populations. The current study aimed to examine (1) the association between ACEs and diabetes, including the association after age stratification, and (2) the association of comorbid depression, resource use and health-related quality of life (HRQoL) among those with diabetes and ACEs in Singapore. SETTINGS Participants were surveyed in their homes or any other preferred venue of their choice. PARTICIPANTS 6126 individuals aged 18 years and above were randomly selected among Singapore residents. DESIGN Cross-sectional nationwide epidemiological study. RESULTS Exposure to any ACE was not associated with increased odds of diabetes; however, those who had experienced parental separation, death or divorce of a parent had higher odds of diabetes. In addition, we observed significant interaction between age and ACEs in relation to odds of diabetes. ACEs were significantly associated with higher odds of diabetes mainly in the younger age group. The prevalence of major depressive disorder was significantly higher among those with diabetes and ACEs than those with diabetes alone (3.7% and 0.3% respectively). CONCLUSIONS Efforts to promote regular exercise and healthy lifestyles both in the population and among those with diabetes must continue for the prevention and management of diabetes. The findings emphasise the need to create more awareness of both the prevalence and impact of ACEs among those treating chronic diseases.
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Affiliation(s)
- Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore
- Epidemiology Domain, Saw Swee Hock School of Public Health, Singapore
| | | | | | - Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore
| | | | | | | | - Rob Van Dam
- Epidemiology Domain, Saw Swee Hock School of Public Health, Singapore
| | - Wai Leng Chow
- Epidemiology and Communicable Diseases Division, Ministry of Health, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
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Teh WL, Abdin E, Vaingankar JA, Shafie S, Jeyagurunathan A, Yunjue Z, Subramaniam M. Prevalence, Lifestyle Correlates, and Psychosocial Functioning Among Multi-Ethnic Older Adults with Mild Cognitive Impairment in Singapore: Preliminary Findings from a 10/66 Population Study. Yale J Biol Med 2021; 94:73-83. [PMID: 33795984 PMCID: PMC7995946] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Asia, which has the highest increase in dementia prevalence, is unfortunately lacking recent up-to-date research, with regions of Southeast Asia being the most inadequate. Preventive approaches, such as the understanding of Mild Cognitive Impairment (MCI), are currently the most effective approach in reducing the risk or delaying the onset of dementia but are not adequately understood. Additionally, there is a paucity of research examining lifestyle and sociodemographic correlates of MCI that are relevant to the local population of Singapore. To address these gaps, this study aimed to explore: 1) the prevalence of MCI and Amnestic Mild Cognitive Impairment (aMCI), 2) the psychosocial and lifestyle correlates of MCI and aMCI. Data were drawn from the Well-being of the Singapore Elderly (WiSE) population study, which is a single-phase cross-sectional household survey conducted among older adult residents aged 60 years and above. Analyses revealed that the weighted MCI prevalence (1.2%) was lower than global figures. Few sociodemographic and lifestyle habits were related to MCI prevalence, as only age and physical activeness emerged as significant correlates. Despite the low prevalence of MCI, individuals with MCI experienced marked disability, clinical levels of depression and anxiety, which are all concerning finds. Due to the exploratory and cross-sectional nature of the study, future longitudinal research could further refine our understanding of MCI and confirm the present findings.
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Affiliation(s)
- Wen Lin Teh
- Research Division, Institute of Mental Health, Singapore
| | | | | | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore
| | | | - Zhang Yunjue
- Research Division, Institute of Mental Health, Singapore
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Vaingankar JA, Abdin E, Chong SA, Sambasivam R, Shafie S, Ong HL, Jeyagurunathan A, Wen Lau Y, Samari E, Chua YC, Pang S, Subramaniam M. Development of the Chinese, Malay and Tamil translations of the Positive Mental Health Instrument: Cross-cultural adaptation, validity and internal consistency. Transcult Psychiatry 2021; 58:76-95. [PMID: 33297859 DOI: 10.1177/1363461520976045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Indexed: 01/07/2023]
Abstract
This study describes the development and validation of Chinese, Malay and Tamil translations of the Positive Mental Health Instrument (PMHI) in a general population sample in Singapore. Translations were performed using two independent forward translations followed by expert panel discussions and tested for content, construct and language appropriateness using focus group discussions. The final translated tools were field-tested among 220 residents per language using self-administered questionnaires comprising the translated PMHI and other validity measures. Missing data, floor and ceiling effects, confirmatory factor analysis (CFA), internal consistency, item response theory differential item functioning (IRT-DIF) and criterion validity were assessed. A total of 10 PMHI-Chinese items, 26 PMHI-Malay items and six response categories and six PMHI-Tamil items were modified based on expert panel and focus group discussions. PMHI had low missing data and showed negative but acceptable skewness (<2) and kurtosis (<7) for all translations, except for the PMHI-Malay "spirituality" subscale (skewness: -2.8; kurtosis: 12.5). CFA showed that all three PMHI translations fulfilled the original six-factor-higher-order structure (RMSEA = 0.05, CFI = 0.962, TLI = 0.96). Cronbach's alpha coefficients for total PMHI were 0.958, 0.954, 0.945 and 0.949 in the overall sample and the Chinese, Malay and Tamil translations, respectively. The three translations of the PMHI showed expected and significant positive (r = 0.116 to 0.663) and negative correlations (r = -0.137 to -0.574) with established measures. The findings show that the Chinese, Malay and Tamil translations of the PMHI have high internal consistency and validity in this multi-ethnic population.
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Affiliation(s)
| | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
| | | | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore
| | - Hui Lin Ong
- Research Division, Institute of Mental Health, Singapore
| | | | - Ying Wen Lau
- Research Division, Institute of Mental Health, Singapore
| | | | - Yi Chian Chua
- Department of Early Psychosis, Institute of Mental Health, Singapore
| | - Shirlene Pang
- Research Division, Institute of Mental Health, Singapore
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Shafie S, Samari E, Jeyagurunathan A, Abdin E, Chang S, Chong SA, Subramaniam M. Gender difference in quality of life (QoL) among outpatients with schizophrenia in a tertiary care setting. BMC Psychiatry 2021; 21:61. [PMID: 33509142 PMCID: PMC7842069 DOI: 10.1186/s12888-021-03051-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 01/13/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Patients with mental illness report lower quality of life (QoL) compared to the general population. Prior research has found several differences in clinical features and experiences of male and female patients with schizophrenia. Given these differences, it is also important to explore if there are any gender differences in terms of their QoL. This study aimed to investigate differences in QoL between and within each gender among outpatients with schizophrenia in Singapore. METHODS A total of 140 outpatients were recruited through convenience sampling at the Institute of Mental Health, Singapore. QoL was measured using the brief version of World Health Organization Quality of Life (WHOQOL-BREF) which consists of four domains: physical health, psychological health, social relationships, and environment. QoL scores of males and females were compared using independent t-tests, and multiple linear regressions were used to examine sociodemographic correlates of QoL in the overall sample and within each gender. RESULTS There was no significant difference in QoL domain scores between genders. Among males, Indian ethnicity (versus Chinese ethnicity) was positively associated with physical health (β=3.03, p=0.018) while males having Technical Education/ Diploma/ A level education (versus Degree and above) were positively associated with social relationships domain (β=2.46, p=0.047). Among females, Malay ethnicity (versus Chinese ethnicity) was positively associated with physical health (β=1.95, p=0.026) psychological health (β=3.21, p=0.001) social relationships (β=2.17, p=0.048) and environment (β=2.69, p=0.006) domains, while females who were separated/divorced (versus single) were inversely associated with psychological health (β=- 2.80, p=0.044) and social relationships domains (β=- 4.33, p=0.011). Females who had Secondary and below education (versus Degree and above) were inversely associated with social relationships (β=- 2.29, p=0.028) and environment domains (β=- 1.79, p=0.048). CONCLUSIONS The findings show the importance of treatments targeting QoL to attend to both the clinical features of the illness as well patient's sociodemographic characteristics.
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Affiliation(s)
- Saleha Shafie
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Ellaisha Samari
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
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Vaingankar JA, Chang S, Chong SA, Samari E, Jeyagurunathan A, Devi F, Wei KC, Tan WM, Chong R, Ye P, Lim LL, Babjee R, Mythily S. Service providers' perspectives on hoarding management in the community in Singapore. Singapore Med J 2021; 63:409-414. [PMID: 33472339 PMCID: PMC9578118 DOI: 10.11622/smedj.2021005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
| | | | | | - Fiona Devi
- Research Division, Institute of Mental Health, Singapore
| | - Ker-Chiah Wei
- Department of Developmental Psychiatry, Institute of Mental Health, Singapore
| | - Weng Mooi Tan
- Community Mental Health Division, Agency for Integrated Care, Singapore
| | - Rebecca Chong
- Community Mental Health Division, Agency for Integrated Care, Singapore
| | - Peishan Ye
- Community Mental Health Division, Agency for Integrated Care, Singapore
| | - Lea Lea Lim
- Housing Management Group, Housing and Development Board, Singapore
| | - Ramzi Babjee
- Municipal Services Office, Ministry of National Development, Singapore
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Lau JH, Abdin E, Jeyagurunathan A, Seow E, Ng LL, Vaingankar JA, Chong SA, Subramaniam M. The association between caregiver burden, distress, psychiatric morbidity and healthcare utilization among persons with dementia in Singapore. BMC Geriatr 2021; 21:67. [PMID: 33468059 PMCID: PMC7816438 DOI: 10.1186/s12877-021-02014-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 01/06/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Caregivers of persons with dementia (PWD) face high caregiving burden, distress related to responsive behaviours, and psychiatric morbidity. The present paper examines how these are associated with healthcare utilization of the PWD in Singapore. METHODS The data of 399 caregiver-PWD dyads were extracted from a national cross-sectional survey. PWD completed the Client Service Receipt Inventory, which provided information on their healthcare utilization (i.e. emergency service use, hospital admission, length of stay in hospital, and number of outpatient visits) within a frame of 3 months. The Zarit Burden Interview (ZBI), Neuropsychiatric Inventory Questionnaire (NPI-Q), and Self Reporting Questionnaire (SRQ-20) were administered to caregivers. Information on severity of dementia, physical multimorbidity of the PWD, household composition, and caregivers' sociodemographic characteristics such as age, gender, and education were collected. Variables significantly associated with healthcare utilization in the univariate analyses were selected and included in the final regression models. Emergency service use and hospital admission were investigated using logistic regression analyses, whilst negative binomial models were utilized for length of stay in hospital and number of outpatient visits. RESULTS After adjusting for significant correlates such as dementia severity and multimorbidity, only caregiver distress from responsive behaviours was positively associated with emergency room utilization, while caregiver burden was positively associated with length of hospital stay in the final regression model. Psychiatric morbidity was associated with healthcare utilization outcomes at the univariate level but did not reach statistical significance in final models. CONCLUSION The study identifies caregiver variables associated with the healthcare utilization of PWD. Policy makers and healthcare professionals should provide interventions to ease burden and distress amongst caregivers of PWD.
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Affiliation(s)
- Jue Hua Lau
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, Singapore.
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, Singapore
| | - Esmond Seow
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, Singapore
| | - Li Ling Ng
- Department of Rheumatology & Immunology, Singapore General Hospital, SingHealth, Singapore, Singapore
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, Singapore
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Jeyagurunathan A, Lau JH, Abdin E, Shafie S, Chang S, Samari E, Cetty L, Wei KC, Mok YM, Tang C, Verma S, Chong SA, Subramaniam M. Aggression Amongst Outpatients With Schizophrenia and Related Psychoses in a Tertiary Mental Health Institution. Front Psychiatry 2021; 12:777388. [PMID: 35046853 PMCID: PMC8761620 DOI: 10.3389/fpsyt.2021.777388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/23/2021] [Indexed: 12/02/2022] Open
Abstract
Aims: Aggression is defined as "any behavior intended to cause physical, emotional, or psychological harm to another." The aims of the current study were to (i) examine underlying factor structure of the Buss-Perry Aggression Questionnaire (BPAQ) and (ii) explore socio-demographic and clinical correlates (symptom severity, substance use and alcohol use) among patients with schizophrenia and related psychoses in a multi-ethnic Asian population. Methods: Data collected from 397 participants who were seeking outpatient treatment for schizophrenia and related psychoses at a tertiary psychiatric hospital were included in the analyses. BPAQ, a 29-item, four-factor instrument that measures physical aggression, verbal aggression, anger and hostility was used to assess aggression. Data on socio-demographic variables, age of onset of illness, drug use, alcohol use and symptom severity were also collected. Confirmatory factor analysis (CFA) was performed to establish the underlying factor structure of the BPAQ. Multiple regression analyses were utilized to examine socio-demographic and clinical correlates of the BPAQ factors. Results: The mean age of the participants was 36.2 years (SD = 10.9, range: 21-65). Factor structure obtained from the CFA indicated that a higher order four-factor solution had an acceptable fit to the observed data (WLSMV χ2 = 1,025.35, df = 320, RMSEA = 0.07, CFI = 0.94, TLI = 0.93, SRMR = 0.05). Females had lower physical aggression and hostility scores as compared to males. Those with lower education had higher physical aggression scores as compared to those with higher education. Participants who received a diagnosis after the age of 30 years had higher physical aggression and anger scores as compared to those who received a diagnosis at or before 20 years of age. Symptom severity was positively associated with higher BPAQ scores. Conclusion: The study findings demonstrated high internal consistency and applicable measurement factor structure of BPAQ in this study sample, making it an appropriate questionnaire for assessing aggressive behavior in this population. We also identified socio-demographic and clinical factors that were associated with aggression in patients with schizophrenia and related psychoses.
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Affiliation(s)
| | - Jue Hua Lau
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Edimansyah Abdin
- 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
| | - Ellaisha Samari
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Laxman Cetty
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Ker-Chiah Wei
- Department of Developmental Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Yee Ming Mok
- Department of Mood and Anxiety, Institute of Mental Health, Singapore, Singapore
| | - Charmaine Tang
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
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Chang S, Jeyagurunathan A, Lau JH, Shafie S, Samari E, Cetty L, Mok YM, Verma S, Subramaniam M. Problematic Drug Use Among Outpatients With Schizophrenia and Related Psychoses. Front Psychiatry 2021; 12:762988. [PMID: 34744843 PMCID: PMC8569375 DOI: 10.3389/fpsyt.2021.762988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 09/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Problematic drug use is common among psychiatric patients and is linked with poorer course and outcomes of illness. The aim of this study is to assess the prevalence of problematic drug use, and to explore its sociodemographic correlates and associations with health behaviors and outcomes among outpatients with schizophrenia and related psychoses in Singapore. Methods: Data from 397 individuals who were aged 21-65 years and were seeking treatment for schizophrenia and related psychoses in the outpatient clinics of a tertiary psychiatric hospital were analyzed. The Drug Abuse Screening Test (DAST-10) was used to assess problematic drug use. Information on sociodemographics, smoking status, alcohol use, symptoms severity and quality of life were collected. Multivariable logistic regressions were conducted to explore correlates and associations of problematic drug use. Results: The prevalence of problematic drug use was 5.8% (n = 23) in the sample, and 10.6% (n = 42) of the participants reported having problematic drug use and/or problematic alcohol use. More males than females reported having problematic drug use (p = 0.021), and also problematic drug and/or alcohol use (p = 0.004). Significant associations were observed between problematic drug use and smokers with nicotine dependence, and with physical health domain of quality of life. Individuals with greater symptom severity were approximately twice as likely to have problematic drug use and/or alcohol use. Conclusion: While the prevalence of problematic drug use in this sample population is relatively lower compared to other countries, there is a considerable number who might be at risk. Routine screening and close monitoring of drug use is recommended as part of psychiatric assessment, particularly among males and patients with nicotine dependence.
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Affiliation(s)
- Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Jue Hua Lau
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Ellaisha Samari
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Laxman Cetty
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Yee Ming Mok
- Department of Mood and Anxiety, Institute of Mental Health, Singapore, Singapore
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
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Vaingankar JA, Abdin E, Chong SA, Shafie S, Sambasivam R, Zhang YJ, Chang S, Chua BY, Shahwan S, Jeyagurunathan A, Kwok KW, Subramaniam M. The association of mental disorders with perceived social support, and the role of marital status: results from a national cross-sectional survey. ACTA ACUST UNITED AC 2020; 78:108. [PMID: 33133595 PMCID: PMC7592592 DOI: 10.1186/s13690-020-00476-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 03/12/2020] [Accepted: 09/22/2020] [Indexed: 12/03/2022]
Abstract
Background This study investigated whether (i) mental disorders were associated with perceived social support and its subcomponents, (ii) current marital status was related to perceived social support, and (iii) ‘Married’ status influenced the relationship between mental state and perceived social support. Methods Data from a cross-sectional national survey comprising 6126 respondents were used. Lifetime diagnosis for five mental disorders was assessed with a structured questionnaire. Perceived social support was measured with the Multidimensional Scale of Perceived Social Support (MSPSS) that provides Global and subscale scores for Significant Other, Family and Friends. Multiple linear regression analyses were conducted to address the research questions with MSPSS score as the dependent variable. Structural equation modeling (SEM) was performed to test mediation by marital status. Results All mental disorders included in the study, except alcohol use disorder (AUD), were significantly and negatively associated with Global MSPSS scores. After controlling for sociodemographic factors and chronic physical illness, major depressive disorder (β = - 0.299, 95% CI: -0.484 – -0.113, p = 002) and having any of the five mental disorders (β = - 0.133, 95% CI: -0.254 – -0.012, p = 032) were negatively associated with support from Significant Other, while support from Family and Friends was lower among all disorders, except AUD. Being married was positively associated with perceived social support in people with and without mental disorders. Results of the SEM partially support mediation by mental state - perceived social support relationship by ‘Married’ status. Conclusion Having mental disorders was associated with lower perceived social support. Being married has potential to influence this relationship.
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Affiliation(s)
- Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747 Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747 Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747 Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747 Singapore
| | - Rajeswari Sambasivam
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747 Singapore
| | - Yun Jue Zhang
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747 Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747 Singapore
| | - Boon Yiang Chua
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747 Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747 Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747 Singapore
| | - Kian Woon Kwok
- School of Social Sciences, Nanyang Technological University, 50, Nanyang Drive, Singapore, 639798 Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10, Buangkok View, Singapore, 539747 Singapore
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Roystonn K, Vaingankar JA, Chua BY, Sambasivam R, Shafie S, Jeyagurunathan A, Verma S, Abdin E, Chong SA, Subramaniam M. The Public Health Impact and Policy Implications of Online Support Group Use for Mental Health in Singapore: Cross-Sectional Survey. JMIR Ment Health 2020; 7:e18114. [PMID: 32749231 PMCID: PMC7435627 DOI: 10.2196/18114] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 02/04/2020] [Revised: 05/13/2020] [Accepted: 06/06/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The wide mental health treatment gap continues to pose a global and local public health challenge. Online support groups are on the rise and could be used to complement formal treatment services for mental health. OBJECTIVE This study aimed to examine the prevalence of online support group use and explore factors associated with the use in the general population using data from a national cross-sectional mental health survey in Singapore. METHODS Singapore residents aged 18 years and above participated in a nationally representative household survey in which the World Health Organization Composite International Diagnostic Interview 3.0 was administered by trained interviewers to examine the use of online support groups for mental health. Multiple logistic regressions were used to analyze the association of online support group use with various sociodemographic and health factors. RESULTS A total of 6110 respondents with complete data were included in this study. Overall, 10 individuals per 1000 adults (1%) reported seeking help from online support groups for their mental health problems. Compared to younger adults (those aged 18 to 34 years) and those with university education, individuals aged 50 to 64 years (P<.001; OR 0.1, 95% CI 0.0-0.3) and those with preuniversity qualifications (P=.02; OR 0.1, 95% CI 0.0-0.8) were less likely to use online support groups for mental health, respectively. Participants with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorder were 6.8 times more likely (P<.001; 95% CI 3.0-15.4) to use an online support group; in particular, individuals with major depressive disorder (P<.001; OR 5.4, 95% CI 2.1-13.8) and obsessive compulsive disorder (P=.01; OR 3.5, 95% CI 1.3-9.7) were more likely to use an online support group for their mental health. CONCLUSIONS Online support groups could be used to complement formal treatment services, especially for mood and anxiety-related disorders. As online support group use for mental health issues may be more prevalent among younger people, early detection and accurate information in online support groups may guide individuals toward seeking professional help for their mental health problems.
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Affiliation(s)
| | | | - Boon Yiang Chua
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Swapna Verma
- Clinical Education, Office of Education, Duke-NUS Medical School, Singapore, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technology University, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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AshaRani PV, Abdin E, Kumarasan R, Siva Kumar FD, Shafie S, Jeyagurunathan A, Chua BY, Vaingankar JA, Fang SC, Lee ES, Van Dam R, Chong SA, Subramaniam M. Study protocol for a nationwide Knowledge, Attitudes and Practices (KAP) survey on diabetes in Singapore's general population. BMJ Open 2020; 10:e037125. [PMID: 32540891 PMCID: PMC7299045 DOI: 10.1136/bmjopen-2020-037125] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION This study aims to establish the Knowledge, Attitudes and Practices (KAP) of the general population (people with and without diabetes) towards diabetes. The study will examine (a) recognition and understanding of causes, prevention and treatment strategies of diabetes; (b) identify the knowledge gaps and behavioural patterns that may hamper diabetes prevention and control; (c) stigma towards and stigma perceived by people with diabetes and (d) awareness of anti-diabetes campaigns. METHODS AND ANALYSIS The study is a nationwide, cross-sectional study of Singapore's general population aged 18 years and above (n=3000), comprising Chinese, Malay, Indian and other ethnic groups, who can understand English, Chinese, Malay or Tamil language. The sample was derived using a disproportionate stratified sampling using age and ethnicity. The proportion of respondents in each ethnic group (Chinese, Malay and Indian) was set to approximately 30%, while the proportion of respondents in each age group was set around 20% in order to ensure a sufficient sample size. The respondents will be administered questionnaires on diabetes KAP, stigma towards diabetes, lifestyle, diet and awareness of local anti-diabetes campaigns. The analysis will include descriptive statistics and multiple logistic and linear regression analyses to determine the socio-demographic correlates of correct recognition of diabetes, help-seeking preferences, as well as overall knowledge and attitudes among those with and without diabetes. We will consider a p value ≤0.05 as significant. ETHICS AND DISSEMINATION This study protocol has been reviewed by the Institutional Research Review Committee and the National Healthcare Group Domain Specific Review Board (NHG DSRB Ref 2018/00430). The results of the study will be shared with policymakers and other stakeholders. There will be a local mass media briefing to disseminate the findings online, in print and on television and radio. The results will be published in peer-reviewed journals and presented in scientific meetings.
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Affiliation(s)
- P V AshaRani
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore
| | - Roystonn Kumarasan
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore
| | | | - Saleha Shafie
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore
| | | | - Boon Yiang Chua
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore
| | | | - Sum Chee Fang
- Admiralty Medical Centre, Khoo Teck Puat Hospital, 676 Woodlands Drive 71, Singapore
| | - Eng Sing Lee
- National Healthcare Group Polyclinics, 3 Fusionopolis Link. Nexus@One-North, Singapore
| | - Rob Van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore
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Sagayadevan V, Lau YW, Zhang Y, Jeyagurunathan A, Shafie S, Chang S, Chong SA, Subramaniam M. Caregivers' causal attributions of their relatives' mental illness and the association with stigma. Transcult Psychiatry 2020; 57:421-431. [PMID: 31674286 DOI: 10.1177/1363461519884384] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Causal attributions of mental illness have received substantial attention given their influence on help-seeking patterns of individuals and the level of engagement with health services. Few studies, however, have examined caregivers' perspectives of their relatives' illness. The current study aimed to examine caregivers' causal attributions of their relatives' mental illness and its association with perceived stigma in a multi-ethnic Asian sample. Primary caregivers (N = 350) of psychiatric outpatients were recruited from a psychiatric hospital. The attribution and stigma sections of the Family Interview Schedule (FIS) were utilized to obtain caregivers' causal report of their relatives' illness and stigma perception. Logistic regressions were performed to examine the socio-demographic and diagnostic correlates of the four categories of causal attributions (psychosocial, biological, drug-/substance use-related, supernatural). The majority of caregivers identified psychosocial causes, followed by biological, supernatural, and lastly drug-/substance use-related causes for their relatives' illness. Marital status, religion, employment status and the diagnosis of depressive disorders were significant correlates of biological attributions. Ethnicity and not knowing their relatives' diagnosis were significantly associated with psychosocial attributions. For drug-/substance use-related attributions, ethnicity was the only significant correlate. Supernatural attributions did not yield any significant associations. Caregivers who endorsed drug-/substance use-related reasons also reported significantly higher stigma than caregivers who did not endorse these attributions. A tendency to endorse biological and psychosocial causes for their relative's illness was noted among caregivers. Further research on caregivers' causal attributions is warranted to account for and replicate current study findings.
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Vaingankar JA, Chong SA, Abdin E, Siva Kumar FD, Chua BY, Sambasivam R, Shafie S, Jeyagurunathan A, Seow E, Subramaniam M. Understanding the relationships between mental disorders, self-reported health outcomes and positive mental health: findings from a national survey. Health Qual Life Outcomes 2020; 18:55. [PMID: 32131837 PMCID: PMC7057535 DOI: 10.1186/s12955-020-01308-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 02/26/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The link between mental illness and mental health is gaining focus in research and practice. This study aimed to investigate the association of mental disorders with positive mental health (PMH), overall health and quality of life. In addition, the role of PMH in mediating the relationships between mental disorders and health outcomes was assessed. METHODS The study sample comprised 2270 residents aged 18 years and above who participated in a nationally representative, cross-sectional survey estimating the lifetime prevalence of mood, anxiety and alcohol use disorders, and health outcomes (self-reported overall health, quality of life and PMH) in Singapore. The Positive Mental Health Instrument was used to estimate the level of Total PMH among the respondents with and without mental disorders. Associations between mental disorders and health outcomes were assessed through regression models. Path analyses were conducted to investigate mediating role of PMH. RESULTS Total PMH (Mean ± SD) was significantly lower among individuals having any of the studied lifetime mental disorders (4.23 ± 0.64 versus 4.50 ± 0.67 among those without these disorders). Although having a mood or anxiety disorder was associated with significantly lower Total PMH even after controlling for socio-demographic characteristics, similar relationship was not observed for alcohol use disorders. History of any mental disorders was also associated with lower overall health and quality of life. Total PMH mediated the relationships between mental disorders and overall health and quality of life by reducing the effect sizes for the associations between mental disorders and these health outcomes. CONCLUSIONS Mental disorders were associated with poor health outcomes in affected individuals. This study showed that PMH can mediate the relationships between mental disorders and health outcomes, and act as an underlying mechanism to improve overall health and quality of life in individuals with mental disorders. Findings thus highlight the significance of incorporating mental health promotion and interventions in clinical populations.
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Affiliation(s)
- Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Fiona Devi Siva Kumar
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Boon Yiang Chua
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Rajeswari Sambasivam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Esmond Seow
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
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Subramaniam M, Jeyagurunathan A, Devi F, Chang SHS, Samari E, Verma SK, Ng WLJ, Tan WM, Chong R, Ye P, Lim LL, Babjee R, Vaingankar JA, Chong SA. An exploratory study on the lived experiences of hoarding in Singapore. Health Soc Care Community 2020; 28:456-466. [PMID: 31680365 PMCID: PMC7027790 DOI: 10.1111/hsc.12878] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 09/23/2019] [Accepted: 10/05/2019] [Indexed: 06/10/2023]
Abstract
Research studies have revealed that people with hoarding typically collect and keep items due to their aesthetic appeal, utility and strong emotional attachment to the items resulting in clutter and limiting living spaces. This study aims to explore the experiences of individuals with hoarding disorder to understand and describe-the patterns and reasons for hoarding, experiences with decluttering and the impact of hoarding disorder on significant others and society in the context of a multi-ethnic urban Asian country. A total of 12 participants with hoarding disorder were recruited and interviewed using a simple semi-structured interview guide designed for the study. The resulting transcribed interviews were analysed using thematic analysis. The mean age of the participants was 56.7 years (SD = 14.5). Nine super-ordinate and discrete but interconnecting themes emerged from the qualitative interviews: types of hoarded items, sources of hoarded items, ways of storing/arranging hoarded items, help-seeking/treatment contact, reasons for hoarding, experiences with decluttering, impact upon family, community and self, restricting hoarding behaviours and insight. Key themes identified in the study are consistent with the literature on studies on hoarding which have been done in other populations. Hoarding in the community has serious consequences for individuals with hoarding disorder and others living in the community, which is compounded by the lack of insight among these individuals. There is a pressing need to increase public awareness and recognition of hoarding behaviours to aid efforts in bringing timely and appropriate services to the affected individuals.
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Affiliation(s)
| | | | - Fiona Devi
- Research DivisionInstitute of Mental HealthSingaporeSingapore
| | | | - Ellaisha Samari
- Research DivisionInstitute of Mental HealthSingaporeSingapore
| | - Swapna Kamal Verma
- Clinical DepartmentsEast Region & Department of PsychosisInstitute of Mental HealthSingaporeSingapore
- Duke‐NUS Medical SchoolSingaporeSingapore
| | - Wei Lik Jared Ng
- Clinical DepartmentsNorth RegionInstitute of Mental HealthSingaporeSingapore
| | - Weng Mooi Tan
- Community Mental Health DivisionAgency for Integrated CareSingaporeSingapore
| | - Rebecca Chong
- Community Mental Health DivisionAgency for Integrated CareSingaporeSingapore
| | - Peishan Ye
- Community Mental Health DivisionAgency for Integrated CareSingaporeSingapore
| | - Lea Lea Lim
- Housing Management GroupHousing & Development BoardSingaporeSingapore
| | - Ramzi Babjee
- Municipal Service OfficeMinistry of National DevelopmentSingaporeSingapore
| | | | - Siow Ann Chong
- Research DivisionInstitute of Mental HealthSingaporeSingapore
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Subramaniam M, Abdin E, Vaingankar J, Shafie S, Chang S, Seow E, Chua BY, Jeyagurunathan A, Heng D, Kwok KW, Chong SA. Obsessive-Compulsive Disorder in Singapore: Prevalence, Comorbidity, Quality of Life and Social Support. Ann Acad Med Singap 2020. [DOI: 10.47102/annals-acadmedsg.2019185] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: Using data from Singapore Mental Health Study 2016 (SMHS 2016), we
examined the prevalence of lifetime and 12-month obsessive-compulsive disorder (OCD),its sociodemographics correlates and association with comorbid psychiatric disorders and physical conditions, perceived social support and quality of life. Materials and Methods: The World Mental Health Composite International Diagnostic Interview (version 3.0) was administered by trained interviewers to 6126 residents aged ≥18 years old to assess OCD prevalence and that of other select psychiatric disorders. Details on sociodemographics, perceived social support and health-related quality of life were obtained. Results: Lifetimeand 12-month prevalence of OCD was 3.6% and 2.9%, respectively. Adjusted regression analysis showed that those with OCD had significantly higher odds of major depressive disorder (odds ratio [OR], 5.4), bipolar disorder (OR, 8.9), generalised anxiety disorder (OR, 7.3) and alcohol abuse (OR, 2.7). OCD was significantly associated with suicidal ideation and suicidality (OR, 5.1). OCD subjects also had higher odds of chronic pain (OR, 2.4) and diabetes (OR, 3.1). Finally, OCD subjects had lower mean mental composite summary scores than controls (respondents without any of the psychiatric disorders and physical conditions included in SMHS 2016) and those with other lifetime psychiatric disorders and physical conditions. Conclusion: OCD prevalence in Singapore is high. Most people with OCD do not seek treatment despite experiencing significant comorbidity and loss of quality of life.
Key words: Composite International Diagnostic Interview, Epidemiology, Multi-ethnic,
Psychiatric disorder, Survey
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Affiliation(s)
- Mythily Subramaniam
- Institute of Mental Health, Singapore, Nanyang Technological University, Singapore
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Samari E, Chang S, Vaingankar J, Chong SA, Jeyagurunathan A, Siva Kumar FD, Goveas RR, Ng K, Tan WM, Chong R, Ye P, Lim LL, Babjee R, Subramaniam M. A Qualitative Study on Perspectives and Lived Experiences of Caregivers of Individuals With Hoarding Behaviour in an Asian Population. Ann Acad Med Singap 2020; 49:41-45. [PMID: 32200396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Subramaniam M, Abdin E, Vaingankar J, Shafie S, Chang S, Seow E, Chua BY, Jeyagurunathan A, Heng D, Kwok KW, Chong SA. Obsessive-Compulsive Disorder in Singapore: Prevalence, Comorbidity, Quality of Life and Social Support. Ann Acad Med Singap 2020; 49:15-25. [PMID: 32200393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Using data from Singapore Mental Health Study 2016 (SMHS 2016), we examined the prevalence of lifetime and 12-month obsessive-compulsive disorder (OCD), its sociodemographic correlates and association with comorbid psychiatric disorders and physical conditions, perceived social support and quality of life. MATERIALS AND METHODS The World Mental Health Composite International Diagnostic Interview (version 3.0) was administered by trained interviewers to 6126 residents aged ≥18 years old to assess OCD prevalence and that of other select psychiatric disorders. Details on sociodemographics, perceived social support and health-related quality of life were obtained. RESULTS Lifetime and 12-month prevalence of OCD was 3.6% and 2.9%, respectively. Adjusted regression analysis showed that those with OCD had significantly higher odds of major depressive disorder (odds ratio [OR], 5.4), bipolar disorder (OR, 8.9), generalised anxiety disorder (OR, 7.3) and alcohol abuse (OR, 2.7). OCD was significantly associated with suicidal ideation and suicidality (OR, 5.1). OCD subjects also had higher odds of chronic pain (OR, 2.4) and diabetes (OR, 3.1). Finally, OCD subjects had lower mean mental composite summary scores than controls (respondents without any of the psychiatric disorders and physical conditions included in SMHS 2016) and those with other lifetime psychiatric disorders and physical conditions. CONCLUSION OCD prevalence in Singapore is high. Most people with OCD do not seek treatment despite experiencing significant comorbidity and loss of quality of life.
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Jeyagurunathan A, Abdin E, Vaingankar JA, Chua BY, Shafie S, Chang SHS, James L, Tan KB, Basu S, Chong SA, Subramaniam M. Prevalence and comorbidity of migraine headache: results from the Singapore Mental Health Study 2016. Soc Psychiatry Psychiatr Epidemiol 2020; 55:33-43. [PMID: 31456029 DOI: 10.1007/s00127-019-01755-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 02/06/2019] [Accepted: 08/20/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIM Migraine is a highly prevalent and disabling neurological disorder associated with a wide range of psychiatric comorbidities. Studies have revealed that those with migraine headache and coexisting psychiatric disorders have poorer treatment outcomes and increased disability. The study aims to establish the prevalence, correlates, and comorbidities of migraine headache among the multi-ethnic Asian population in Singapore. METHOD Data were extracted from the Singapore Mental Health Study 2016 (SMHS 2016), a cross-sectional epidemiological survey of a nationally representative sample. Face-to-face interviews were completed with 6126 participants between 2016 and 2017. The data relating to chronic medical conditions, psychiatric conditions, and 30-day functioning and disability were captured using the World Mental Health Composite International Diagnostic Interview (CIDI) version 3.0. RESULTS The lifetime prevalence for migraine headache in the Singapore general population was 8.2%. Malay ethnicity (versus Chinese), female gender (versus male), and diploma holders (versus university) were significantly more likely to experience migraine headache. Participants belonging to the older age group (65 years and above versus 18-34 years of age), and those who were economically inactive (versus employed) were less likely to experience migraine headache. The mean age of onset for migraine was 26.4 years (SD = 11.1). Poisson regression analyses showed that migraine headache was also significantly associated with psychiatric conditions such as major depressive disorder (MDD) (prevalence ratio (PR), 1.80; 95% CI, 1.25-2.58), bipolar disorder (BD) (PR, 3.55; 95% CI, 2.29-5.51), generalized anxiety disorder (GAD) (PR, 2.04; 95% CI, 1.12-3.69), obsessive compulsive disorder (OCD) (PR, 2.20; 95% CI, 1.49-3.26), and alcohol use disorder (AUD) (PR, 1.93; 95% CI, 1.20-3.08). Those with migraine headache were significantly associated with poor functioning and disability compared to those without migraine headache. CONCLUSIONS AND DISCUSSION Our study showed significant associations between migraine headache and psychiatric disorders, as well as with role functioning and disability. The findings of our study emphasise the need for screening for psychiatric comorbidity among those with migraine and the development of appropriate interventions for this group.
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Affiliation(s)
- Anitha Jeyagurunathan
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Boon Yiang Chua
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Shi Hui Sherilyn Chang
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Lyn James
- Ministry of Health (MOH), Singapore, Singapore
| | | | - Sutapa Basu
- Early Psychosis Intervention Programme (EPIP), Department of Psychosis, IMH, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health (IMH), Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
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Siva Kumar FD, Vaingankar JA, Sambasivam R, Abdin E, Jeyagurunathan A, Seow E, Picco L, Chong SA, Subramaniam M. Marital Status and Positive Mental Health of Psychiatric Outpatients. Ann Acad Med Singap 2019. [DOI: 10.47102/annals-acadmedsg.v48n12p429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
| | | | | | | | | | - Esmond Seow
- Research Division, Institute of Mental Health, Singapore
| | - Louisa Picco
- Research Division, Institute of Mental Health, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
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Siva Kumar FD, Vaingankar JA, Sambasivam R, Abdin E, Jeyagurunathan A, Seow E, Picco L, Chong SA, Subramaniam M. Marital Status and Positive Mental Health of Psychiatric Outpatients. Ann Acad Med Singap 2019; 48:429-434. [PMID: 32112067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Sagayadevan V, Jeyagurunathan A, Lau YW, Shafie S, Chang S, Ong HL, Samari E, Verma SK, Chong SA, Subramaniam M. Cognitive insight and quality of life among psychiatric outpatients. BMC Psychiatry 2019; 19:201. [PMID: 31253121 PMCID: PMC6599343 DOI: 10.1186/s12888-019-2163-y] [Citation(s) in RCA: 5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 05/27/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Past studies have focused primarily on clinical insight and less on cognitive insight among individuals with mental illness. METHODS This study examined the level of cognitive insight (CI) and its association with quality of life (QoL) among psychiatric outpatients (N = 400) in Singapore. The Beck Cognitive Insight Scale (BCIS) consisting of two subscales (self-reflectiveness (SR) and self-certainty (SC)) was used to measure CI while the brief version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire was used to assess the subjective well-being of the individual. RESULTS Socio-demographic correlates of CI, differences in SR, SC, and CI scores across diagnostic groups, and the association between insight and QoL were examined. Significant differences across diagnostic groups were found only for SR scores. Higher SR and overall CI scores were significantly associated with higher QoL in the environmental domain whereas higher SC scores were associated with lower QoL in the social relationships domain. CONCLUSIONS An understanding of cognitive insight is necessary to produce a significant change in the underlying belief system of an individual. Together with clinical insight, these two forms of insight can be used to inform therapeutic approaches to increase awareness and improve the QoL of those with mental illnesses.
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Affiliation(s)
- Vathsala Sagayadevan
- 0000 0004 0469 9592grid.414752.1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10, Buangkok View, Singapore, 539747 Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10, Buangkok View, Singapore, 539747, Singapore.
| | - Ying Wen Lau
- 0000 0004 0469 9592grid.414752.1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10, Buangkok View, Singapore, 539747 Singapore
| | - Saleha Shafie
- 0000 0004 0469 9592grid.414752.1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10, Buangkok View, Singapore, 539747 Singapore
| | - Sherilyn Chang
- 0000 0004 0469 9592grid.414752.1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10, Buangkok View, Singapore, 539747 Singapore
| | - Hui Lin Ong
- 0000 0004 0469 9592grid.414752.1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10, Buangkok View, Singapore, 539747 Singapore
| | - Ellaisha Samari
- 0000 0004 0469 9592grid.414752.1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10, Buangkok View, Singapore, 539747 Singapore
| | - Swapna Kamal Verma
- 0000 0004 0469 9592grid.414752.1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10, Buangkok View, Singapore, 539747 Singapore ,0000 0004 0469 9592grid.414752.1Early Psychosis Intervention Programme (EPIP) & General Psychiatry (GP1), Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747 Singapore
| | - Siow Ann Chong
- 0000 0004 0469 9592grid.414752.1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10, Buangkok View, Singapore, 539747 Singapore
| | - Mythily Subramaniam
- 0000 0004 0469 9592grid.414752.1Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10, Buangkok View, Singapore, 539747 Singapore
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Goh CMJ, Abdin E, Jeyagurunathan A, Shafie S, Sambasivam R, Zhang YJ, Vaingankar JA, Chong SA, Subramaniam M. Exploring Singapore's consumption of local fish, vegetables and fruits, meat and problematic alcohol use as risk factors of depression and subsyndromal depression in older adults. BMC Geriatr 2019; 19:161. [PMID: 31182040 PMCID: PMC6558709 DOI: 10.1186/s12877-019-1178-z] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 05/31/2019] [Indexed: 11/10/2022] Open
Abstract
Background Depression is a chronic mental disorder that severely impacts the older adult population globally. Nutritional psychiatry is an approach that has gained traction over the years. Exploring locally relevant consumption of common types of fish, vegetables and fruits (V&F), meat and problematic alcohol use (PAU) as risk factors associated with depression and subsyndromal depression (SSD) could reveal modifiable factors that could be targeted in the local older adult population in Singapore. Methods Data collected from the Well-being of the Singapore Elderly (WiSE) study, a cross-sectional population-based epidemiological study of Singapore’s older adult population was analysed for the purposes of this study. Two thousand five hundred sixty-five participants were recruited and comprised of Singapore citizens and permanent residents aged ≥60 years. Data on fish, meat, and V&F consumption were collected using the sociodemographic and risk factor questionnaire. The CAGE (Cut, Annoyed, Guilt, and Eye-opener) questionnaire was used to determine PAU. The Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy (GMS-AGECAT) was used to obtain participants’ diagnosis of depression or SSD. A multinomial logistic regression was used to explore the relationship between depression and dietary factors. Results Consumption of V&F in the last 3 days was less likely to be associated with depression and SSD. Frequent consumption of specific species of fish was associated with depression and SSD. PAU and the frequent consumption of Himantura gerrardi (stingray) were more likely to be associated with SSD. Finally, meat consumption was more likely to be associated with depression and SSD. Conclusions The preliminary findings of the study support a need for healthy eating for the older adult population in Singapore. Further directions include a more thorough health and nutrition survey to capture accurate diets among the older adults in Singapore.
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Affiliation(s)
- Chong Min Janrius Goh
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Rajeswari Sambasivam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Yun Jue Zhang
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
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Lau YW, Vaingankar JA, Abdin E, Shafie S, Jeyagurunathan A, Zhang Y, Magadi H, Ng LL, Chong SA, Subramaniam M. Social support network typologies and their association with dementia and depression among older adults in Singapore: a cross-sectional analysis. BMJ Open 2019; 9:e025303. [PMID: 31154300 PMCID: PMC6549623 DOI: 10.1136/bmjopen-2018-025303] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To examine the social support network type and its associations with depression and dementia among older adults in Singapore. DESIGN This study is a cross-sectional analysis of data from the Well-being of the Singapore Elderly study. The Practitioner Assessment of Network Type was used to identify five social support network types. Odds Ratios (OR) of dementia and depression were estimated with logistic regression and multinomial logistic regression, respectively, adjusted for sociodemographic variables. SETTING Singapore. OUTCOME MEASURES 10/66 criteria and Automated Geriatric Examination for Computer Assisted Taxonomy computer algorithm. PARTICIPANTS 2421 older adults aged 60 years and above, and their informants. RESULTS Logistic regression revealed that as compared with participants in the family dependent social support network type, those in the locally integrated social support network type were negatively associated with dementia. It was observed that it is the older adults' perception of the quality of social interaction that influences the likelihood of depression. CONCLUSION The social support network typology presents knowledge about the older adults' social network profile and their cognitive functioning-ability which would help stakeholders better identify older adults who might be at risk of cognitive decline or experiencing delay in diagnosis of dementia.
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Affiliation(s)
- Ying Wen Lau
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Yunjue Zhang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Harish Magadi
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Li Ling Ng
- Psychological Medicine, Changi General Hospital, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
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Subramaniam M, Abdin E, Jeyagurunathan A, Chang S, Samari E, Shafie S, Wei KC, Verma S, Chong SA. Exploration of illness perception among patients with mental illness in a multi-ethnic Asian sample. Psychiatry Res 2018; 267:516-527. [PMID: 29980132 DOI: 10.1016/j.psychres.2018.06.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 09/26/2017] [Revised: 06/12/2018] [Accepted: 06/12/2018] [Indexed: 01/12/2023]
Abstract
Illness perceptions are beliefs that patients have about their illness. These beliefs play an important role in influencing their behaviour and outcomes. This study examined the factor structure and correlates of the Illness Perception Questionnaire Mental Health (IPQ-MH) among patients with mental illness in a multi-ethnic Asian sample. 400 participants with schizophrenia and other psychotic disorders, mood or anxiety disorder were recruited from a tertiary psychiatric institution and administered the IPQ-MH. Data on sociodemographic variables were also collected. A multi-factor structure was identified for the Identity, Structure and Cause subscale of the IPQ-MH. Age was consistently associated with a positive perception of illness across all three disorders; women had a more positive perception of schizophrenia and other psychotic disorders as compared to men while those of Indian ethnicity had a more negative perception of their mood disorder as compared to those of Chinese ethnicity. Those with lower education had a poorer understanding of their illness among those with mood disorder, and a poorer understanding of their illness and the effectiveness of treatment among those with anxiety disorder. The study identified specific groups which can be targeted through tailored and culturally relevant psychoeducational interventions to enhance their understanding and perception of mental illness.
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Affiliation(s)
- Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747 Singapore.
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747 Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747 Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747 Singapore
| | - Ellaisha Samari
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747 Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747 Singapore
| | - Ker Chiah Wei
- Department of Community Psychiatry, Institute of Mental Health, Singapore
| | - Swapna Verma
- Department of Early Psychosis Intervention, Institute of Mental Health, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747 Singapore
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Jeyagurunathan A, Abdin E, Shafie S, Wang P, Chang S, Ong HL, Abdul Rahman RF, Sagayadevan V, Samari E, Chua YC, Vaingankar JA, Verma SK, Wei KC, Chong SA, Subramaniam M. Pathways to care among psychiatric outpatients in a tertiary mental health institution in Singapore. Int J Soc Psychiatry 2018; 64:554-562. [PMID: 29947273 PMCID: PMC6116080 DOI: 10.1177/0020764018784632] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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] [Indexed: 11/18/2022]
Abstract
BACKGROUND Pathways to care studies in Singapore are of high interest given the cultural diversity and various sources of help available for those with mental illnesses, ranging from the more traditional to tertiary-level mental health care services. AIM The current study aimed to explore the associations of patients' socio-demographic characteristics with pathways to first contact and duration of untreated mental illness. METHOD A total of 402 participants were recruited through convenience sampling. A pathway to care form was used to gather systematic information about the sources of care utilized by participants before approaching a mental health professional. Data were analysed using multinomial logistic regression and multiple linear regression models to assess the associations. RESULTS Majority of participants reported primary care (36.0%) as their first point of contact, followed by non-formal sources of help (33.8%), specialist care (21.8%), police/court (4.0%), websites/media (3.3%) and religious/traditional treatment (1.3%). Those belonging to Malay and Indian ethnicity (vs Chinese) were more likely to make first contact with non-formal sources of help than primary care. Those who received a diagnosis of any mood or anxiety disorder (vs schizophrenia and related psychoses) were less likely to make first contact with specialist care or non-formal sources of help than primary care. Those who were separated/divorced/widowed were significantly associated with higher duration of untreated illness compared to those who were single. Participants whose family/relative initiated the first contact were significantly associated with a shorter duration of untreated illness compared to those who initiated first contact on their own. CONCLUSION Findings suggest the determinants of the pathways to first contact and duration of untreated illness included diagnosis, ethnicity, marital status and family initiating the first contact. The pathways adopted by these participants need to be kept in mind for planning mental health programmes.
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Affiliation(s)
| | | | - Saleha Shafie
- 1 Research Division, Institute of Mental Health, Singapore
| | - Peizhi Wang
- 1 Research Division, Institute of Mental Health, Singapore
| | - Sherilyn Chang
- 1 Research Division, Institute of Mental Health, Singapore
| | - Hui Lin Ong
- 1 Research Division, Institute of Mental Health, Singapore
| | | | | | | | - Yi Chian Chua
- 1 Research Division, Institute of Mental Health, Singapore
| | | | - Swapna Kamal Verma
- 2 Early Psychosis Intervention Programme (EPIP) & General Psychiatry (GP1), Institute of Mental Health, Singapore
| | - Ker-Chiah Wei
- 3 Community Psychiatry, Institute of Mental Health, Singapore
| | - Siow Ann Chong
- 1 Research Division, Institute of Mental Health, Singapore
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Zhang Y, Subramaniam M, Lee SP, Abdin E, Sagayadevan V, Jeyagurunathan A, Chang S, Shafie SB, Abdul Rahman RF, Vaingankar JA, Chong SA. Affiliate stigma and its association with quality of life among caregivers of relatives with mental illness in Singapore. Psychiatry Res 2018; 265:55-61. [PMID: 29684770 DOI: 10.1016/j.psychres.2018.04.044] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [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: 06/29/2017] [Revised: 04/05/2018] [Accepted: 04/12/2018] [Indexed: 12/01/2022]
Abstract
Affiliated stigma often refers to internalized stigma among family members of stigmatized individuals. This study aimed to investigate the relationship between affiliate stigma and quality of life (QOL) among primary caregivers of individuals with mental illness undergoing treatment at the Institute of Mental Health, Singapore. Three hundred and fifty caregivers were recruited for the study. The World Health Organization Quality of Life questionnaire (WHOQOL-BREF) and Family Stigma Scale (FSS) were administered to the primary caregivers of patients with mental illness. Multiple linear regression analyses were conducted to investigate the association of affiliate stigma with QOL. A high proportion of caregivers of individuals with mental illness experience affiliate stigma in Singapore. All four QOL domains were significantly associated with affiliate stigma. These findings entail that it is imperative to improve public's perception of those with mental illness to reduce stigmatization and thus improve caregiver's QOL.
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Affiliation(s)
- Yunjue Zhang
- Research Division, Institute of Mental Health, 10 Buangkok View Singapore 539747, Singapore.
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View Singapore 539747, Singapore
| | - Siau Pheng Lee
- Research Division, Institute of Mental Health, 10 Buangkok View Singapore 539747, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 10 Buangkok View Singapore 539747, Singapore
| | - Vathsala Sagayadevan
- Research Division, Institute of Mental Health, 10 Buangkok View Singapore 539747, Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, 10 Buangkok View Singapore 539747, Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, 10 Buangkok View Singapore 539747, Singapore
| | - Saleha Binte Shafie
- Research Division, Institute of Mental Health, 10 Buangkok View Singapore 539747, Singapore
| | | | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, 10 Buangkok View Singapore 539747, Singapore
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Picco L, Lau YW, Pang S, Jeyagurunathan A, Vaingankar JA, Abdin E, Chong SA, Subramaniam M. Predictors of General Functioning and Correlates of Quality of Life: A Cross-Sectional Study among Psychiatric Outpatients. Ann Acad Med Singap 2018; 47:3-12. [PMID: 29493706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Functioning and quality of life (QOL) are negatively impacted as a result of mental illness. This study aimed to determine the: i) socio-demographic and clinical correlates of functioning and; ii) associations between functioning and QOL in a multiethnic sample of psychiatric outpatients. MATERIALS AND METHODS This was a cross-sectional study of outpatients receiving treatment from a tertiary psychiatric hospital. Functioning was assessed using the Global Assessment of Functioning (GAF) scale, while QOL was measured using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) which comprises 4 domains: physical health, psychological health, social relationships and environment. RESULTS Various socio-demographic and clinical correlates were associated with functioning including employment and marital status, education and diagnosis. Depression was the only clinical characteristic which negatively correlated with functioning (P = 0.035). Amongst the whole sample, multiple linear regressions revealed that functioning was positively associated with all 4 QOL domains (physical health [P <0.001], psychological health [P <0.001], social relationships [P <0.001] and environment [P <0.001]). Further analysis of each diagnostic group revealed that functioning was positively associated with all 4 QOL domains in the anxiety, depression and obsessive compulsive disorder subsamples, while in the schizophrenia subsample, functioning was only significantly associated with all environment domain. CONCLUSION Functional impairments were associated with different socio-demographic and clinical characteristics, which should be addressed when planning tailored treatment and interventions. Given that functioning is significantly associated with QOL, it is crucial to regularly assess and monitor them (in addition to symptomatic outcomes and adopting a more holistic and biopsychosocial approach).
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Affiliation(s)
- Louisa Picco
- Research Division, Institute of Mental Health, Singapore
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Chang S, Ong HL, Abdin E, Vaingankar JA, Jeyagurunathan A, Shafie S, Mahendran R, Subramaniam M, Chong SA. Head circumference, leg length and its association with dementia among older adult population in Singapore. Int J Geriatr Psychiatry 2017; 32:e1-e9. [PMID: 28052429 DOI: 10.1002/gps.4643] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 10/27/2016] [Accepted: 11/16/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND Head circumference and leg length serve as reliable proxy indicators of early-life environment. Research studies have shown that these anthropometric measurements are associated with cognitive impairment and dementia among older adults. The aim of the present study was to assess the associations between dementia with head circumference and leg length among the older adult population in Singapore. This study also aimed to examine the sociodemographic correlates of these anthropometric measurements. METHODS Data were collected from 2565 older adults aged 60 years and above, in a population study on the Well-being of the Singapore Elderly. Head circumference and leg length measurements were obtained, and sociodemographic information was recorded. Dementia diagnosis was made using the 10/66 dementia algorithm. Anthropometric measurements were first stratified into quarters, and then logistic regression analysis was used to examine factors associated with head circumference and leg length, as well as to examine the association between dementia with these measurements. RESULTS Sociodemographic correlates of head circumference and leg length include age, gender, ethnicity and education level. Smaller head circumference was independently associated with higher odds of 10/66 dementia (OR = 2.173-2.709). When the regression analysis was stratified by gender, the association was found only in the male sample. Leg length was not significantly associated with dementia after controlling for sociodemographic variables. CONCLUSION Smaller head circumference is independently associated with dementia among older adults in Singapore. Findings from this study suggest that risk factors for dementia begin their influence in early life. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore
| | - Hui Lin Ong
- Research Division, Institute of Mental Health, Singapore
| | | | | | | | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, National University Hospital, Singapore
| | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
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