Executive dysfunction among mild traumatic brain injured patients in Northeastern Thailand.

Background: Mild traumatic brain injury (TBI) is a common neurological disorder. Cognitive impairment is a result of TBI, and executive function is impaired in various degree of injury. Few data are available for assessment of executive dysfunction in Thai patients. Objective: Examine prevalence and factors influencing executive dysfunction among mild TBI patients in Thailand. Materials and methods: A cross-sectional descriptive study was conducted to determine the prevalence of 60 mild TBI patients. The patients were selected from those who were admitted at Khon Kaen Hospital between September and December 2009. Patients with previously major psychiatric or neurological disorders and currently confused or depressed were excluded. The executive function was measured by the Wisconsin Card Sorting Test (WCST), and the data was analyzed statistically. Results: Prevalence of executive dysfunction among the patients was 21.7%. Primary education level and low monthly salary were two factors to be associated with dysfunction. Alcohol use was associated with WCST score, but not with the dysfunction. However, severity of injury had no significant association with both the dysfunction and WCST score. Conclusion: Executive dysfunction in mild TBI patients was high (21.7% prevalent in Northeastern Thailand). Primary education level and low monthly salary were associated with dysfunction.

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.

Effects of psycho-educational program on knowledge and attitude upon schizophrenia of schizophrenic patients' caregivers.

BACKGROUND: Schizophrenia is mainly characterized by chronic psychotic symptoms such as delusions, hallucinations, and negative symptoms such as social withdrawal. These symptoms cause behavior problems, i.e. aggressive behavior violence, or social isolation that affect the patients' lives, and the health status and daily routine of caregivers or family members. Psychological distress or burden of caregivers often results in poor care provided to these patients. Most studies showed that high expressed emotion in the family leads to high a relapse rate of schizophrenia. The psycho-educational program is aimed to provide education about this disorder help the caregivers to deal with the patients' problems more effectively, reduce psychological distress of caregivers, and provide social support for caregivers. OBJECTIVE: Study the effects of psycho-educational program on knowledge and attitude of schizophrenia on caregivers of schizophrenic patients. MATERIAL AND METHOD: The participants completed the one-day psycho-educational program run by a team of psychiatrists in the Department of Psychiatry, Chulalongkorn Memorial Hospital. The psycho-educational program was composed of didactic session on schizophrenia, group discussion, and communication skill building. The participants were evaluated for the knowledge and attitude, before and after the program. The mean scores of knowledge, attitude before and after the program were compared by using paired t-test. RESULTS: Ninety-one caregivers of schizophrenic patients participated into the present study. The results showed that the mean scores of knowledge and attitude before the program were 6.06 (SD = 1.86) and 37.57 (SD = 6.46) and after the program were 6.91 (SD = 3.35), and 29.37 (SD = 15.79), respectively. The scores of knowledge and attitude of caregivers, before and after the program were statistically different. The participants evaluated the program as an interesting and very useful program. CONCLUSION: Psycho-educational program on schizophrenia increase the knowledge and shape the attitude of caregivers. Therefore, interventions targeting caregivers of schizophrenic patients should result in the successful treatment and rehabilitation of schizophrenic patients.

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.