The moderating effect of employment status on the relationship between lifetime major depressive disorder and positive mental health

INTRODUCTION@#This paper aims to examine the (1) level of positive mental health (PMH), (2) identify the socio-demographic correlates of the PMH domains in the general population, and (3) establish if employment status moderates the relationship between major depressive disorder (MDD) and PMH among those with a lifetime prevalence of MDD.@*METHODS@#The Singapore Mental Health Study conducted between 2016 and 2018 included Singapore residents aged ≥18 years. The World Health Organization Composite International Diagnostic Interview version 3.0 was utilised to establish lifetime prevalence of MDD. Moderation analysis was conducted using SPSS PROCESS macro (Hayes, 2017) to assess if employment status moderated the relationship between MDD and PMH.@*RESULTS@#Significantly lower PMH total and domain scores were reported by respondents (n=2,270) who endorsed lifetime MDD compared to those who did not. Moderation analysis demonstrated that the effect of MDD on PMH total and domain scores varied considerably across employment status. Based on the interaction plots, the effect of MDD on both PMH total and domain scores was minimal among those employed than unemployed.@*CONCLUSION@#Healthcare professionals should support the employment needs of those who report lifetime MDD to provide care for an individual's mental well-being in a holistic manner. Acquiring or remaining in employment would be a priority depending on the PMH of the individual. Reducing barriers to employment for those with health issues or creating employment opportunities for this group are concerns that need to be addressed at a societal level.

Accuracy of self-reported height, weight and BMI in a multiethnic Asian population

INTRODUCTION@#The study assessed whether self-reported height, weight and derived body mass index (BMI) can provide an accurate measure of anthropometric data in a multiethnic adult population in Singapore.@*METHODS@#Standardised anthropometric measurements were compared against the self-reported values from 5,132 adult residents in a cross-sectional, epidemiological survey. Discrepancies in self-reports from measurements were examined by comparing overall mean differences. Intraclass correlations, Cohen's kappa and Bland-Altman plots with limits of agreement, and sub-analysis by sex and ethnicity were also explored.@*RESULTS@#Data were obtained from 5,132 respondents. The mean age of respondents was 43.9 years. Overall, the height was overestimated (0.2cm), while there was an underestimation of weight (0.8kg) and derived BMI (0.4kg/m2). Women had a larger discrepancy in height (0.35cm, 95% confidence interval [CI] 0.22 to 0.49), weight (-0.95kg, 95% CI -1.11 to -0.79) and BMI (-0.49kg/m2, 95% CI -0.57 to -0.41) compared with men. Height reporting bias was highest among Indians (0.28cm, 95% CI 0.12 to 0.44) compared with Chinese and Malays, while weight (-1.32kg, 95% CI -1.53 to -1.11) and derived BMI (-0.57kg/m2, 95% CI -0.67 to -0.47) showed higher degrees of underreporting among Malays compared with Chinese and Indians. Substantially high self-reported versus measured values were obtained for intraclass correlations (0.96-0.99, @*CONCLUSION@#Self-reported anthropometric estimates can be used, particularly in large epidemiological studies. However, sufficient care is needed when evaluating data from Indians, Malays and women as there is likely an underestimation of obesity prevalence.

General Practitioner's Attitudes and Confidence in Managing Patients with Dementia in Singapore

The number of people living with dementia is increasing globally as a result of an ageing population. General practitioners (GPs), as the front-line care providers in communities, are important stakeholders in the system of care for people with dementia. This commentary describes a study conducted to understand GPs' attitudes and self-perceived competencies when dealing with patients with dementia and their caregivers in Singapore. A set of study information sheet and survey questionnaires were mailed to selected GP clinics in Singapore. The survey, comprising the "GP Attitudes and Competencies Towards Dementia" questionnaire, was administered. A total of 400 GPs returned the survey, giving the study a response rate of 52.3%. About 74% of the GPs (n=296) were seeing dementia patients in their clinics. Almost all the GPs strongly agreed that early recognition of dementia served the welfare of the patients (n=385; 96%) and their relatives (n=387; 97%). About half (51.5%) of the respondents strongly agreed or agreed that they felt confident carrying out an early diagnosis of dementia. Factor analysis of questionnaire revealed 4 factors representing "benefits of early diagnosis and treatment of patients with dementia", "confidence in dealing with patients and caregiver of dementia", "negative perceptions towards dementia care" and "training needs". GPs in Singapore held a generally positive attitude towards the need for early dementia diagnosis but were not equally confident or comfortable about making the diagnosis themselves and communicating with and managing patients with dementia in the primary care setting. Dementia education and training should therefore be a critical step in equipping GPs for dementia care in Singapore. Shared care teams could further help build up GPs' knowledge, confidence and comfort in managing patients with dementia.

Comorbid Diabetes and Depression among Older Adults - Prevalence, Correlates, Disability and Healthcare Utilisation

<p><b>INTRODUCTION</b>The objectives of this current study were to: 1) examine the prevalence and correlates of diabetes mellitus (DM) among older adults (aged 60 years and above) in a multi-ethnic population; 2) examine the prevalence and correlates of comorbid DM and depression among them; and 3) assess the effect of comorbid depression on disability, cognition and healthcare utilisation.</p><p><b>MATERIALS AND METHODS</b>Data for the current study came from the Well-being of the Singapore Elderly (WiSE) study; a single phase, cross-sectional survey conducted among Singapore residents aged 60 years and above. A total of 2565 respondents completed the survey; depression was assessed using the Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT) while a diagnosis of DM was considered if respondents stated that a doctor had diagnosed them with DM.</p><p><b>RESULTS</b>DM was reported by 25.5% of the population. The prevalence of depression was significantly higher in those diagnosed with DM than those without DM (6% vs 3%). After adjusting for sociodemographic correlates, smoking and other chronic conditions, DM remained significantly associated with depression and subsyndromal depression. However, after including measures of functioning and cognitive impairment as covariates, DM was not significantly related to depression and subsyndromal depression. Those with comorbid DM and depression were more likely to be of Indian and Malay ethnicity, aged 75 to 84 years (versus 60 to 74 years) and widowed.</p><p><b>CONCLUSION</b>Given the significant association of certain sociodemographic groups with comorbid depression among those with DM, targeted interventions for prevention and early diagnosis in these groups should be considered.</p>

Prevalence of Depression among Older Adults-Results from the Well-being of the Singapore Elderly Study

<p><b>INTRODUCTION</b>Depression is a significant public health issue across all sociodemographic groups and is identified as a common and serious mental health problem particularly among the older adult population. The aims of the current study were to determine the prevalence of depression and subsyndromal depression among older adults in Singapore.</p><p><b>MATERIALS AND METHODS</b>The Well-being of the Singapore Elderly (WiSE) study was a comprehensive single phase, cross-sectional survey. Stage 1 Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy (GMS-AGECAT) depression syndrome was used for this analysis. Association of depression and subsyndromal depression with sociodemographic characteristics, social support as well as comorbidity with chronic physical illnesses and quality of life was assessed.</p><p><b>RESULTS</b>The prevalence of GMS-AGECAT depression and subsyndromal depression was 3.7% and 13.4%, respectively. The odds of depression were significantly higher among those aged 75 to 84 (2.1) as compared to those aged 60 to 74 years and in those who had a history of depression diagnosis by a doctor (4.1). The odds of depression were higher among those of Indian and Malay ethnicities (5.2 and 3.2 times, respectively) as compared to those of Chinese ethnicity. Those with depression and subsyndromal depression were associated with more disability, poorer life satisfaction, and medical comorbidities.</p><p><b>CONCLUSION</b>Our study suggests that the prevalence of depression seems to have decreased as compared to a decade ago wherein the prevalence of depression was estimated to be 5.5%. This positive trend can be ascribed to concerted efforts across various disciplines and sectors, which need to be continually strengthened, monitored and evaluated.</p>

Prevalence and Correlates of Internet Gaming Problem among Internet Users: Results from an Internet Survey

<p><b>INTRODUCTION</b>The current study aimed to establish the prevalence of internet gaming disorder (IGD) and its association with demographic characteristics, game genre, game use (time spent on gaming), as well as psychological distress, social phobia and well-being among current online gamers in Singapore.</p><p><b>MATERIALS AND METHODS</b>A total of 1251 participants aged 13 to 40 years completed the study which was administered as a web survey. The online questionnaire was designed using QuestionPro, and consisted of 8 sections and 105 questions. The 9-item Internet Gaming Disorder Questionnaire was used to establish the prevalence of IGD in the study. A series of logistic regression models were used to examine the associations between IGD, demographic characteristics and game genre, as well as IGD and psychological distress, social phobia and well-being.</p><p><b>RESULTS</b>The prevalence of IGD established using a cutoff of 5 among those who were current online gamers was 17.7%. Multiple logistic regressions revealed that those meeting criteria of IGD were more likely to be older, reported an earlier age of onset of playing online games, had primary and secondary education versus tertiary education, were currently students versus being currently employed and played massively multiplayer online role-playing games. Distress and social anxiety were higher while satisfaction with life was significantly lower among those who met criteria for IGD than those who did not meet the criteria.</p><p><b>CONCLUSION</b>The prevalence of IGD and its negative consequences in our sample of current online gamers was significant and point towards the need for further clinical studies and innovative interventions to address the problem.</p>

Prevalence Of Sleep Problems Among Those With Internet Gaming Disorder In Singapore

Internet gaming disorder (IGD) involves the excessive use of Internet games that can cause negative consequences like sleep problems, psychological distress, depression and anxiety. It is widely assumed that IGD is closely related with sleep problems, but studies on the topic are scant. Our study aims to explore the association between IGD and sleep problems. Methods: A total of 1085 participants, aged 13-40 years old reported playing Internet games in this self-administered, web-based survey. The instruments used for the study were socio-demographic questions, IGD Questionnaire, Life Satisfaction Scale, General Health Questionnaire-12 and Insomnia Severity Index. The cut-off point of 10 and above was used to establish the prevalence of sleep problems in this study. Logistic regression analysis was used to explore the association between socio-demographic factors, IGD and sleep problems. Results: The prevalence of sleep problems among those with IGD was 28.2%. Female online gamers (adjusted odds ratio, OR=0.7, 95% confidence interval (CI) = 0.5-0.9) were more likely to have sleep problems than males. Participants with secondary education (adjusted OR=1.9, 95% CI=1.2-3.0) and post- secondary education (adjusted OR=2.7, 95% CI= 1.2-6.0) were more likely to have sleep problems than those who had completed university. Participants with DSM-5 IGD were more likely to have sleep problems. Psychological distress (adjusted OR 4.8, 95% CI=3.6-6.7) and life satisfaction (B = -3.1, 95% CI= -4.0 to -2.2) was associated with sleep problems. Conclusion: Prevalence of sleep problems with IGD is higher among female gamers and is associated with increased psychological distress and decreased life satisfaction. Integrated health management is needed to promote good sleep hygiene among those diagnosed with IGD. ASEAN Journal of Psychiatry, Vol. 17 (1): July – December 2016: XX XX.

Socio-demographic Correlates of Positive Mental Health and Differences by Depression and Anxiety in an Asian Community Sample

<p><b>INTRODUCTION</b>Positive Mental Health (PMH) instrument is a self-administered multidimensional measure that is validated in the adult multi-ethnic Asian population in Singapore and comprises General Coping (GC), Emotional Support (ES), Spirituality, Interpersonal Skills (IS), Personal Growth and Autonomy (PGA) and Global Affect (GA) domains. This paper aimed to (i) examine socio-demographic differences and identify correlates for the total PMH and domain-specific scores in the sample, and (ii) compare the PMH total score for respondents with and without depression or anxiety.</p><p><b>MATERIALS AND METHODS</b>Singapore residents aged 21 to 65 years, of Chinese, Malay or Indian ethnicity and residing in households across Singapore (n = 404) completed the 47-item PMH instrument in an anonymous survey. Socio-demographic information was obtained during the survey and respondents also completed the Patient Health Questionnaire (PHQ)-8 and Generalised Anxiety Disorder (GAD)-7 scale to establish depression and anxiety. Descriptive analyses were conducted to examine for differences in PMH scores by socio-demographic groups and between those with and without depression and anxiety.</p><p><b>RESULTS</b>The total PMH score was significantly different across ethnicity and marital status in the bivariate analysis. After multivariate analysis, ethnicity remained a significant correlate for total PMH and the 6 domain-specific PMH scores, marital status correlated with Spirituality, educational level was associated with IS; while gender was associated with ES and PGA. Significantly lower PMH total scores were observed for those with depression and anxiety as compared to those without.</p><p><b>CONCLUSION</b>Socio-demographic correlates of PMH were identified in an Asian community sample. PMH scores were significantly lower among those with depression and anxiety.</p>