The development of the Pictorial Thai Quality of Life.

BACKGROUND: "Quality of life" has become a main focus of interest in medicine. The Pictorial Thai Quality of Life (PTQL) was developed in order to measure the Thai mental illness both in a clinical setting and community. OBJECTIVES: The purpose of this study was to develop the Pictorial Thai Quality of Life (PTQL), having adequate and sufficient construct validity, discriminant power, concurrent validity, and reliability. MATERIAL AND METHOD: To develop the Pictorial Thai Quality of Life Test, two samples groups were used in the present study: (1) pilot study samples: 30 samples and (2) survey samples were 672 samples consisting of normal, and psychiatric patients. The developing tests items were collected from a review of the literature in which all the items were based on the WHO definition of Quality of Life. Then, experts judgment by the Delphi technique was used in the first stage. After that a pilot study was used to evaluate the testing administration, and wording of the tests items. The final stage was collected data from the survey samples. RESULTS: The results of the present study showed that the final test was composed 25 items. The construct validity of this test consists of six domains: Physical, Cognitive, Affective, Social Function, Economic and Self-Esteem. All the PTQL items have sufficient discriminant power It was found to be statistically significant different at the. 001 level between those people with mental disorders and normal people. There was a high level of concurrent validity association with WHOQOL-BREF, Pearson correlation coefficient and Area under ROC curve were 0.92 and 0.97 respectively. The reliability coefficients for the Alpha coefficients of the PTQL total test was 0.88. The values of the six scales were from 0.81 to 0:91. CONCLUSIONS: The present study was directed at developing an effective psychometric properties pictorial quality of life questionnaire. The result will be a more direct and meaningful application of an instrument to detect the mental health illness poor quality of life in Thai communities.

The development of the Thai Psychiatric Satisfaction Scale.

BACKGROUND: Satisfaction with mental services is an important quality and outcome variable. The Thai Psychiatric Satisfaction Scale (TPSS) is developed in order to measure service satisfaction. OBJECTIVE: The purpose of the present study was to develop the Thai Psychiatric Satisfaction Scale (TPSS), having adequate and sufficient validity and reliability. MATERIAL AND METHOD: A sample of people with mental illness in the Department of Psychiatry, Siriraj Hospital was assessed. The TPSS was administered. Then factor analysis, internal consistency and test-retest reliability were analized. RESULTS: The Thai Psychiatric Satisfaction Scale (TPSS) contains seven domains: Professionals' Skills and Behavior, Information, Access, Efficacy, Type of Intervention, Relative's Involvement, and Environment and Setting. The infinity coefficient for the TPSS was 0.97 (95% CI 0.94-0.97) and ranged from 0.70 (95% CI 0.68-0.76) to 0.96 (95% CI 0.94-0.97). Test-retest for TPSS was 0.82. (95% CI 0.78-0.85). CONCLUSION: This TPSS is a validated and reliable multi-dimensional scale which measures the satisfaction of patients with mental health services for routine clinical practice in mental health service.

Validity and reliability of the Thai mental health questionnaire in psychiatric patients in the community.

The Thai Mental Health Questionnaire (TMHQ) has been developed for assessing the effectiveness of mental health services. The purpose of this study was to investigate the validity and reliability of the TMHQ in patients in contact with mental services. Subjects (age 12-74) came from out-patient and acute in-patient units in general practice. We obtained the opinions of experienced professionals, advocacy groups and patient groups to evaluate consensual and content validity. The results of this study showed that 1,205 patients were assessed using the TMHQ scale. Test-retest, Odd-even, and Cronbach's Alpha reliability were good for some items and poor for others. The TMHQ had good criterion validity: acute in-patients had higher scores than out-patients. TMHQ also had good concurrent validity, correlating well with other scales. Comments suggested the TMHQ was a useful and suitable scale for this population although social factors were not sufficiently covered.

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

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

Prevalence and incidence of depression in the Thai elderly.

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

General Health Questionnaire (GHQ) Thai version and the Thai Mental Health Questionnaire (TMHQ).

The purpose of this study was to validate the association between the all forms of Thai version of General Health Questionnaire (GHQ-60, GHQ-30, GHQ-28, GHQ-12) with the Thai Mental Health Questionnaire (TMHQ). Methods: The survey samples were 770 Thai policemen from 12 police stations under the Fifth Organization force Bureau Data collected from the Thai version of General Health Questionnaire and the Thai Mental Health Questionnaire. Results: There was a association between the GHQ Thai version and TMHQ. The effectiveness was found by the prevalence rate of mental illness, Cronbach Alpha reliability coefficient, and the similar construct validity between GHQ-28 and TMHQ. Conclusion: Forms of the GHQ, TMHQ can be compared in term of construct validity with GHQ-28.

The development of psychometric test “The Thai mental health questionnaire".

The purpose of this study was to develop the Thai Mental Health Questionnaire, having sufficient discriminate power, adequate construct validity, and reliability. The subject were two groups; (1) pilot study samples: 60 samples and (2) survey samples were 700 samples consisted of normals, psychiatric outpatients, and psychiatric inpatients. Data collected from the Thai Mental health Questionnaire was developed from criteria based on the DSM-IV. The results of this study showed that the final test composed of 70 items - was found to be significantly different at the .001 level between those people with mental disorders and normal people. The construct validity of this test consists of five factors: somatic, depression, anxiety, psychotic, and social function. The reliability coefficients for the Alpha were range from 0.82 to 0.94.

Efficacy and safety of olanzapine in the treatment of Thai schizophrenic patients.

Olanzapine is a thienobenzodiazepine derivative which displays efficacy in patients with schizophrenia and related psychoses. It has structural and pharmacological properties resembling those of atypical antipsychotic (clozapine) and an improved tolerability profile compared with the classical antipsychotic drugs. The purpose of this study was to evaluate the efficacy, tolerability and safety of olanzapine in chronic schizophrenic patients. In an open label study, 10 patients with schizophrenia (DSM-IV), who met the inclusion criteria (CGI score of at least 3, 18 to 65 years of age, no serious unstable medical illnesses), were assigned to receive olanzapine for six weeks after a wash-out period of at least these drugs. Dosages were started at 10 mg/day for at least five days and then adjusted according to each patient’s response, but not increased to no more than 20 mg/day. Treatment efficacy, safety and tolerabi-lity were evaluated with several well-known rating scales and blood chemistry. Olanzapine significantly reduced the severity of psychotic symptoms (score on clinical global improvement, brief psychiatric rating scale, and positive and negative syndrome scales) from baseline. At the end point, all the subjects were found to have clinically improved (a reduction in total positive and negative syndrome scale and reduction of 40.38 - 76.22 percent in Clinical global improvement). The only side-effects of Olanzapine appeared to be weight gain and drowsiness that was mild in severity with no reports of extrapyramidal side- effects. It was concluded that Olanzapine was well tolerated and effective in treating either positive or negative symptoms in patients with schizophrenia.