Posttraumatic stress disorder of the Tsunami survivors in Thailand.

BACKGROUND: The natural disaster known as "the Tsunami" occurred in the Andaman sea coast of Thailand in December 2004, and there had been questions whether it could cause PTSD amongst the population who lives in the affected area and how to avoid PTSD condition to occur. OBJECTIVE: Establish statistical results of psychosocial factors, and their correlation to PTSD and other mental disorders to generate the PTSD database. MATERIAL AND METHOD: A cross-sectional community surveys from 3,133 samples had been conducted in two phases from the same sampling group. The first phase was concerned with prevalence of PTSD, depression, and related factors. The second phase included 2,573 samples from the first phase and focused on chronic PTSD and other mental disorders. RESULTS: The 3,133 samples used in the first phase show that 33.6% suffered from PTSD, 14.27% with depression, and 11.27% suffered from both. The 2,573 samples from the first phase were followed, collected the blood, and interview data only 21.6% were diagnosed with chronic PTSD. CONCLUSION: The statistical analysis has identified risks factors that could cause PTSD, and protective actions that could help to prevent PTSD. The prevalence of PTSD was still higher in the affected region six months after the Tsunami.

The effect of cinnamon cassia powder in type 2 diabetes mellitus.

BACKGROUND: Type 2 diabetes is a chronic metabolic disorder and the incidence of cardiovascular is increased two- to fourfold in its complications. Cinnamon is expected to have some degree of anti-diabetic efficacy without troublesome side effects. The objective of the present study was to investigate the anti-diabetic effect of cinnamon cassia powder in type 2 diabetic patients MATERIAL AND METHOD: Sixty type 2 diabetic patients were randomized either 1.5 g/d of cinnamon cassia powder or placebo. Both groups were in combination with their current treatment (metformin or sulfonylurea) according to single blind randomized, placebo-control trial in a 12-week period. Efficacy was evaluated by HbA1c fasting plasma glucose, Lipid profile, BUN, creatinine, liver function test and adverse effects were recorded. RESULTS: After a 12-week period, HbA1c was decreased similarly in both groups from 8.14% to 7.76% in the cinnamon group and from 8.06% to 7.87% in the placebo group. This was not found statistically significantly different. However the proportion of patients achieving HbA1c < or = 7% was also greater in patients receiving cinnamon compared with patients receiving placebo, nevertheless, it was not found statistically significantly different (35% vs 15%, x2 = 3.14, p > 0.05). No significant intergroup differences were observed in lipid profile, fasting plasma glucose except in SGOT 27.1 (8.75) to 22.1 (5) in cinnamon group and 24.08 (8.5) to 23.63 (8.88) in the placebo group (p = 0.001). CONCLUSION: The cinnamon cassia powder 1.5 g/d did not have any significant difference in reducing fasting plasma glucose, HbA1c and serum lipid profile in type 2 diabetes patients who had mean fasting plasma glucose 154.40 +/- 24.72 mg/dl.

Personality profiles of suicidal depressed patients.

OBJECTIVE: To investigate the personality profiles of depressed patients who attempted suicide. MATERIAL AND METHOD: The sample consisted of 80 patients aged above 18 years who presented with suicidal attempt and had clinical depression and 80 depressed patients who had never attempted suicide. The subjects were clinically assessed for depression and measured severity objectively with the Hamilton Depression Rating Scale (HAM-D). Personality was assessed via the Sixteen Personality Factor Questionnaire (16PF). RESULTS: The personality profile showed that patients with suicidal attempt were easily affected by feelings, emotionally less stable, concrete thinking, relatively more uninhibited and imaginative compared to those without suicidal attempt. CONCLUSION: Depressed patients who attempted suicide appeared to have a distinctive personality profile. Exploration and intervention tailored to specific personality profile particularly emotional instability, and concrete thinking in individuals with depression should be included in management of depression for prevention and reducing risk of suicide.

Comorbidity of alcohol dependence in suicidal depressed patients.

OBJECTIVES: To study the characteristics of suicidal attempt patients who had depressive symptoms and to assess the comorbidity of alcohol problems in those patients. MATERIAL AND METHOD: One hundred and ten patients aged over 18 years who received psychiatric consultation for suicidal attempt and had clinical of depression without psychotic features were evaluated for clinical symptoms, details of self-harming, history of alcohol use disorder and family history of substance use or suicide. The severity of depression was measured objectively with Hamilton Depression Rating Scale. RESULTS: Most cases of suicidal depressed patients were female (81 cases). The mean score of severity of depression from HAM-D was 16.2 (SD 3.52) that indicated moderate degree. The method employed for suicidal attempt was ingestion of drug or chemical agents. About 33% of subjects had comorbid alcohol use disorder and in this group 12.7% was diagnosed as alcohol dependence. Factors associated with suicidal depressed patients who had comorbid alcohol use disorder were male, aged above 30 years and lower education and additionally, in those with alcohol dependence were associated with stressor about financial problems and less likely to attempt suicide by acetaminophen overdose or be precipitated by relationship problem. CONCLUSION: Comorbid alcohol use disorder is common among depressed patients who attempted suicide. More concern about recognition of these comorbidities particularly in those with associated factors and giving appropriate treatment for the comorbidity may be helpful for prevention of suicide.

Social support in depressed patients who attempted suicide.

OBJECTIVES: To identify the level of perceived social support in depressed patients who attempted suicide and to determine whether perceived social support is associated with suicidal attempt in depressed patients. MATERIAL AND METHOD: The sample consisted of 90 patients who presented with suicidal attempt and had clinical depression and 90 depressed patients who had never attempted suicide. The subjects were clinically assessed for depression, availability of social support and their satisfaction, number of friends and consultants and family history. Subjects were recruited at King Chulalongkorn Memorial Hospital from July 2000 to June 2002. RESULTS: The depressed patients who attempted suicide had lower mean scores in all areas of perceived social support and reported having fewer friends and consultants than those without suicidal attempt. They also had a higher rate of financial problems, substance abuse and family history of alcohol or substance use disorder. The scores for severity of depression and level of perceived social support were negatively correlated with statistical significance. CONCLUSION: Depressed patients who attempted suicide were more likely to report fewer of friends and a lower level of social support. Assessment of patient's support network as well as their perception of available social support should be included in the evaluation of depressed patients particularly in those with substance use disorder and intervention to prevent suicide should focus more on increasing their capacity to obtain social resources and modulating their perception.