Psychiatrists’ Perceptions Of What Determines Outcomes For People Diagnosed With Schizophrenia In Vietnam

Objectives: Research about the outcomes of schizophrenia and the factors that determine them in developing countries is still limited. In this study, we interviewed experienced Vietnamese psychiatrists to examine their perspectives on outcome determinants in their country. The qualitative approach aimed to complement existing epidemiological knowledge and contribute to debate around the hypothesis that recovery is better in developing countries. Methods: Fifteen Vietnamese psychiatrists working in five leading psychiatric facilities participated in semi-structured interviews. Thematic content analysis of their expressed views identified three themes related to important outcome determinants in Vietnam: access to contemporary treatment, established patientlevel prognostic indicators, and sociocultural variables. Results: The improving accessibility of modern treatment (including new medications, specialist staff and facilities) and increasing community adoption of a medical perspective on mental illness were seen as factors leading to improved outcomes, particularly in urban areas. However, some psychiatrists also identified the potentially beneficial nature of some aspects of Vietnamese society and culture being eroded by modernization, including traditional family structures, forms of employment and lifestyles. Conclusions: The perspectives of psychiatrists in this study suggest that socioeconomic change may be exerting conflicting influences on the outcomes of schizophrenia in Vietnam and other developing countries. Their views have implications in terms of how adequate treatment and support for people with severe mental illness can be provided in the context of limited resources, staffing and formal treatment options. Further research is needed to establish current recovery rates and prospectively explore the impact of modernization on outcomes.

A retrospective survey of childhood corporal punishment by school teachers in students / 中华儿科杂志

<p><b>OBJECTIVE</b>To ascertain the prevalence of childhood corporal punishment by teachers in students, to explore the influencing factors and associations between childhood corporal punishment and psychological problems.</p><p><b>METHODS</b>Five hundred and twenty-eight students from a college and a technical secondary school in Hebei province were surveyed by self-administered questionnaire anonymously in Dec. 2004. The questionnaire used for this survey mainly included (1) general demographic information; (2) 5 forms of childhood corporal punishments, in this study, cases of teachers' corporal punishments were defined as those who answered positively one or more of the 5 questions relating to childhood corporal punishment by school teachers occurring before the age of 16 years; (3) Symptom Checklist-90 (SCL-90); (4) Youth Risk Behaviours.</p><p><b>RESULTS</b>Overall, 57.6% of students reported having been corporally punished at least one time, one of four forms of corporal punishment by teachers before age of 16 years, the four forms corporal punishment were non-contact corporal punishment, e.g., running for punishment, repeat-doing homework many times for punishment, standing for punishment, kneel down for punishment, not allowing to eat, sending outside in winter, etc. (53.4%), hitting/kicking/pushing very hard with open hands/fist/feet/other part of body (16.1%), beating with an object (10.2%), and locking in a small compartment/tying with rope (0.2%). No students reported having been choked, or burned/scalded, or stabbed with a sharp object by the teachers. Males had a significantly higher overall prevalence rate than females (66.4% vs. 46.6%, chi(2) = 21.01, P = 0.000). There was no statistically significant association between a history of childhood corporal punishment and the three other demographic indicators, which included residence region (rural and non-rural area) prior to 16 years of age, parental education level, and whether the respondent lived in a single or multiple children family. Compared with their peers who had not experienced childhood corporal punishment by teachers, the students with two or more forms of corporal punishments by teachers showed significantly higher scores (punished group vs. unpunished group) of psychological symptoms of somatization (0.78 vs. 0.42), obsessiveness (1.22 vs. 0.98), interpersonal sensitivity (1.24 vs. 0.89), depression (1.06 vs. 0.76), anxiety (0.90 vs. 0.64), hostility (1.11 vs. 0.68), paranoid ideation (1.11 vs. 0.71) and psychoticism (0.84 vs. 0.56), and showed significantly higher rates in sadness (54.7% vs. 26.3%), drunk (37.2% vs. 20.1%), involving in physical fighting (15.1% vs. 3.6%) in the past year and current smoking (36.0% vs. 14.5%).</p><p><b>CONCLUSIONS</b>The problem of corporal punishment by teachers is common in schools, and the problem has a significant correlation with youth mental health problems. The results highlighted urgent needs to increase public awareness on children rights, creating learning-friendly environment in school.</p>

Child sexual abuse: a study among 892 female students of a medical school / 中华儿科杂志

<p><b>OBJECTIVE</b>This study was designed to ascertain the prevalence of child sexual abuse (CSA) among female students of a medical school and to explore the impact of CSA on the mental health and health related risk behaviors of the victims being sexually abused and to provide useful reference for CSA prevention.</p><p><b>METHODS</b>A cross-sectional survey was carried out among 892 female students from a medical school by anonymous self-administered questionnaire during Oct. 2002. The questionnaire used for this study mainly included (1) general demographic information; (2) sexual experiences; (3) 12 forms of CSA. In this study, cases of CSA were defined as those who answered positively to one or more of the 12 questions relating to childhood sexual experiences (including non-physical contact CSA and physical contact CSA) occurring before age 16 with a person when a child did not want to. (4) Center for Epidemiologic Studies (CES)-Depression Scale; (5) Self Esteem Scale; (6) Risk Behaviors; (7) Health status' self-evaluation. Survey procedures were designed to protect students' privacy by allowing anonymous and voluntary participation. Students were seated separately, completed the self-administered questionnaire in their classrooms during a regular class period. Respondents were encouraged to participate in this survey, but given the sensitive nature of the subject, they could skip portion of the questionnaire if they were not comfortable with the questions. The completed questionnaires were sealed in envelopes by students themselves (the envelope was distributed with questionnaire at the same time), and then collected together. Data were analysed by using the Statistical Package for the Social Sciences software. Frequency, percentage, Chi-square test and t-test of statistics were used to analyze the CSA prevalence and explore the influence of CSA on mental health of students.</p><p><b>RESULTS</b>Among 892 female students, 25.6% reported having experienced CSA (any one of 12 forms non-physical contact and physical contact CSA) before the age of 16 years. The median age at first episode was 12 years. Comparing the rates of CSA of female students in different parents' education level, between one-child in a family and more than one-child in a family, among rural area, county and city, there were no significant differences. Compared to the students who had not experienced CSA, the students who had experienced CSA reported higher levels of depression (CES-D score 18.78 vs. 16.68, t = 2.81, P = 0.005), lower levels of health status self-evaluation (score 3.53 vs. 3.78, t = 2.94, P = 0.003); higher proportion of subjects who reported drinking alcohol and having ever smoked during the past 30 days (drinking 32.7% vs. 22.9%, chi(2) = 8.51, P = 0.004; smoking 8.8% vs. 4.4%, chi(2) = 6.17, P = 0.013); a higher percentage engaged in sexual intercourse (19.3% vs. 5.9%, chi(2) = 33.48, P = 0.000); ever seriously considered attempting suicide (23.7% vs. 15.4%, chi(2) = 8.09, P = 0.004), making a plan about how would attempt suicide (17.9% vs. 9.7%, chi(2) = 10.62, P = 0.001), being threatened or injured by someone with a weapon such as a knife, or club on school property (3.5% vs. 1.1%, chi(2) = 6.17, P = 0.013), being involved in physical fight (16.7% vs. 5.6%, chi(2) = 27.05, P = 0.000) during the 12 months preceding the survey.</p><p><b>CONCLUSIONS</b>The results further showed that the CSA of girls in our country is not uncommon, as reported before in our country and in the other countries and is associated with poor mental health and risky behaviors. The findings highlight the urgent need for the further research into CSA epidemiological characteristics, health services for the victims abused sexually, sexual abuse prevention programs in schools and the general community in China.</p>