The comparison of Montgomery and Asberg Depression Rating Scale (MADRS thai) to diagnostic and statistical manual of mental disorders (DSM) and to Hamilton Rating Scale for Depression (HRSD): validity and reliability.

OBJECTIVE: To assess the validity and reliability of the Montgomery and Asberg Depression Rating Scale (MADRS Thai) by comparing DSM-IV TR criteria and Hamilton Rating Scale for Depression (HRSD). MATERIAL AND METHOD: Descriptive study. Subjects were recruited from the psychiatric out-patient clinic Siriraj Hospital. Subjects were assessed by MADRS Thai version and clinical interview. VALIDITY: Opinion from psychiatric and social science experts, evaluating 13 study cases and 2 7 control cases, compared to the Global Assessment Scale (GAS) and to the changed scale of HRSD. RELIABILITY: Inter-rater and Intra-rater reliability and Internal consistency. RESULTS: Content validity is above 0.5 except the item oflnner tension, Lassitude and Inablilty to feel. Criterion validity when compared to DSM-IV TR or HRSD, the sensitivity, specificity, PPV and NPV were all 100%. Pearson correlation coefficients sensitive to change were -0. 49 (p -value = 0. 11) and 0. 679 (p-value = 0. 025) when compared to 1) DSM-IV TR and 2) HRSD, respectively. ICC oflnter-rater and Intra-rater reliability were both 0.99 when compared to either 1) DSM-IV TR or 2) HRSD. Cronbach 's alpha of Internal consistency was 0. 96 and 0. 92 when compared to 1) DSM-IV TR and 2) HRSD, respectively. CONCLUSION: The result suggested that the Thai version of the Montgomery and Asberg Depression Rating Scale had a very good validity and reliability. Therefore, it can be used as a diagnostic test in Thai depressed patients.

Risk factor of birth weight below 2,500 grams and attention deficit hyperactivity disorder in Thai children.

OBJECTIVES: To study the factor of birth weight below 2,500 grams and Attention Deficit Hyperactivity Disorder (ADHD) and to identify the factors that are associated with ADHD. MATERIAL AND METHOD: A retrospective, hospital-based, case control study was conducted with 122 ADHD cases from the child and adolescent psychiatric outpatient unit at Siriraj Hospital, 119 nonADHD from students who have been assessedfrom Child Behavior Checklist (CBCL) and Conners Teacher Rating Scale, they are identified as normal. Mothers of both groups have been asked to fill a self report questionnaire to evaluate demographic data, prenatal data, factors effected pregnancy both physical and mental illness, post natal period, birth weight, underlying disease, physical illness and family history of ADHD. Multiple logistic regression analysis was used to determine the adjust effect of all factors. RESULTS: The number of ADHD cases who had a birth weight below 2,500 grams was 3.6 times the number of control cases who had a birth weight below 2,500 grams. It was statistically significant (p = 0.03). Factors associated with ADHD were pregnancy complication (p value < 0.05, OR = 4.17, 95%CI [1.66, 14.02]), emotional distress during pregnancy (p value <0.05, OR = 2.99, 95%CI [1.43, 5.40]), postnatal complication (p value < 0.05, OR = 3.26, 95%CI[1.56, 6.41] and a family history of ADHD (p value < 0.05, OR = 3.6, 95%CI [1.65, 8.11]. CONCLUSION: From the present study, the birth weight below 2,500 grams, pregnancy complication, emotional distress during pregnancy, neonatal complication and a family history of ADHD may be the risk factors of ADHD.

Parents' common pitfalls of discipline.

BACKGROUND: Problems of discipline are common among parents. These may be the results of the parents' pitfalls in disciplining their children. OBJECTIVE: To find out common pitfalls of parents in disciplining their children. MATERIAL AND METHOD: Parents of students with ages ranged between 60-72 months old in Bangkok-Noi district, Bangkok, were selected by random sampling. Total number of 1947 children ages between 60-72 months were recruited. Parents of these children were interviewed with a questionnaire designed to probe into problems in child rearing. There hindered and fifty questionnaires were used for data analyses. RESULTS: Parents had high concerns about problems in discipline their children and needed support from professional personnel. They had limited knowledge and possessed lots of wrong attitude towards discipline. Common pitfalls on the topics were problems in, 1) limit setting 2) rewarding and punishment 3) supervision on children watching TV and bedtime routines. CONCLUSION: Parents of children with ages 60-72 months old in Bangkok-Noi district, Bangkok, had several common pitfalls in disciplining their children, including attitude, knowledge and practice.

Continuous performance test for measuring sustained attention in Thai hyperactive children.

A computerized Continuous Performance Test with visual vigilance test was performed on Thai hyperactive children who were diagnosed by both Conners' rating scale and by DSM-IV criteria and this was compared before and during treatment with methylphenidate. The results showed a definite improvement in cognitive function and sustained attention in Thai hyperactive children during treatment.

Normal values of computerized continuous performance test for measuring the sustained attention in Thai students.

The values of a computerized continuous performance test for measuring sustained attention was performed on 127 Thai students, 63 boys and 64 girls. The measured values were reaction time in milli-seconds, commission (correct and incorrect) and omission (correct and incorrect). These values could be used as a baseline standard for sustained attention in normal Thai children.

A survey for nocturnal enuresis in Thai students and their families.

This survey of nocturnal enuresis in Thail students was performed in five elementary schools in Bangkok, comprising 1,804 students and their 1,356 siblings aged 6 to 12 years old, to evaluate the prevalence rate and other associated factos of enuresis in Thai students and their families. Among these 3,160 children, there were 9.34% of male enuretics and 7.78% of female enuretics who were wet at least twice weekly.

Alarm conditioning and traditional method for enuresis treatment in Thai children: Randomized controlled trial.

Compared to traditional methods, Pad and Bell method had more advantages not only for its effectiveness in higher remission rate and less relapse rate, but also for the number of days readed to reach remission. This was not more than the traditional method. Even though Pad and Bell is a new method and unfamiliar to Thai physicians and patients, it has many advantages in both effectiveness and safety, so it should be considered as a new curative method and used more widely in Thailand. If Thai physicians use this new method, enuresis treatment in Thai children can be changed and improved comparably to the western countries.

Brief conners’ teacher rating scale for assessing attention deficit hyperactivity disorder in Thai children.

As the modified Brief Conners’ Teacher Rating Scale in the Thai version possessed high reliability and validity, we can expect it to be a useful assessing tool for ADHD in Thai children. Because the diagnosis of ADHD is usually based on clinical interview and observation that are time-consuming it might be impossible for the physician to make a decision in the clinical setting. The behavioral problems in ADHD are normally prominent in the classroom setting. Therefore if this rating scale can be apply to Thai children, it will be helpful for the physicians to use it as an adjuvant tool for assessing ADHD.

An analysis of the cost-effectiveness of enuresis treatment in Thai children, comparing the traditional method with alarm conditioning: Randomized controlled trial.

The cost-effectiveness of different treatments of primary nocturnal enuresis in Thai children were analysed. The traditional method and alarm conditioning were compared from both a provider’s and a patient’s perspective. The alarm conditioning had slightly more direct cost per treated case but had much lower cost per successful case.

A survey of eating attitudes and behaviors among Thai female teenage students.

A survey with selected follow-up interviews was conducted on 226 female students aged 12-19 by using Fating Attitudes test, 223 usable questionnaires were returned, twenty respondents (8.96%) produces EAT scores of 30 or more. Interviews of high EAT scoring and low BMI subjects revealed several subjects with partial syndromes which failed to fulfil diagnostic criteria for clinical eating disorder.

Anaclitic depression: A case report.

One case report developed the distinguished symptoms of anaclitic depression at the age of four months, the symptoms aggravated and needed for emergency treatment. The patients had dramatic response to the proper management and also be capable for developing the attachment with primary caregiver. The author has demonstrated the developmental process of attachment with its results.

Ultrasonography in New Born Hip.

One-hundred hips of the newborns, male 58 and female 42, were examined clinically be static and dynamic ultrasound examination for congenital dysplasia of the hip. The following finding were found Graf’s type I mature hip = 24%, Graf’s type IIA physiologic immature hip = 76%, average  angle = 55.1o and average  angle = 51.0o. Both clinical and dynamic examination revealed normal findings. From the result of this study, we would recommend the ultrasound examination as the primary imaging technique when congenital hip dysplasia or instability is suspected.