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.

Impact of unemployment on mental disorders, physical health and quality of life: Findings from the Singapore Mental Health Study

INTRODUCTION@#Nutritional psychiatry is an emerging field of study that investigates the role of diet and nutrition in mental health. Studies conducted in the general population have linked depressive symptoms with poor dietary patterns. The aim of this study was to characterise the dietary intake and analyse the dietary pattern using the Dietary Approach to Stop Hypertension (DASH) in a sample of psychiatric patients in a multiethnic Asian nation.@*METHODS@#Participants were recruited from an outpatient clinic and an inpatient unit at the Institute of Mental Health in Singapore. Self-reported dietary habits of a sample of psychiatric patients (N=380) were analysed using DASH. To examine the variables associated with DASH scores, a linear regression was conducted with the full sample and sociodemographic variables.@*RESULTS@#Persons with depressive disorders had a mean DASH score of 21.3 (±4.2), while persons with psychotic disorders had a mean DASH score of 21.2 (±4.9). Respondents who were older (B=1.94, 95% confidence interval [CI] 0.91-2.96, @*CONCLUSION@#Dietary patterns of persons with mental disorders were characterised. A host of sociodemographic factors, and not diagnosis of mental disorders, influenced the dietary quality of people with depressive and psychotic disorders. Clinicians treating psychiatric patients need to be aware of the nuanced reasons behind poor dietary choices and provide targeted psychoeducation to specific subgroups within the patient population.

Validation of the World Health Organization Disability Assessment Schedule 2.0 among older adults in an Asian country

INTRODUCTION@#As populations age globally and the burden of chronic illnesses increases, valid measures of disability are needed for assessment in the older adult population. The aim of the current analysis was to explore the psychometric properties and validity of the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in an epidemiological survey of older adults in Singapore.@*METHODS@#The study comprised secondary data analysis of the Well-being of the Singapore Elderly study. Inclusion criteria for the study were Singapore residents (Singapore citizens and permanent residents) aged 60 years and above. The 12-item interviewer-administered version of the WHODAS 2.0 was used to assess disability in the study. Data on cognition, health status and sociodemographic information were collected. Depression was assessed using the Automated Geriatric Examination for Computer Assisted Taxonomy.@*RESULTS@#The study found a one-factor model solution for WHODAS 2.0 with a high internal consistency of all items. The internal consistency for the overall scale was 0.92. The WHODAS 2.0 score positively correlated with multimorbidity, perceived overall health status, depression and subsyndromal depression. There was a significant inverse association between the WHODAS 2.0 score and the cognitive status. After adjustment for all sociodemographic variables in the multiple linear regression analysis, these measures remained significantly associated with the WHODAS 2.0 score.@*CONCLUSION@#WHODAS 2.0 was found to be a valid measure of disability among older adults. However, further research is required to determine its usefulness as a responsive instrument that can detect change following interventions.

A Qualitative Study Of Perceptions Of E-Cigarettes Among Youth Smokers And Parents Of Youth In Singapore

@#Objective: Electronic cigarettes (e-cigarettes) are increasingly used globally and the implications of their smoking are being debated. The aim of this study is to identify awareness, use and perceptions of e-cigarettes among young smokers and parents of youths in Singapore. Methods: A total of 12 focus group discussions (FGDs) were conducted among youths (aged 15-29 years) who smoke and parents of youths, from diverse social contexts. Participants were recruited using a mix of network and purposive sampling. Youth FGDs were conducted in English language while the parent FGDs were conducted in Chinese and English language. FGDs were audio recorded and transcribed verbatim. The data were analysed using qualitative content analysis. Results: Awareness about e-cigarettes was perceived more among youth as compared to parents in terms of structure, mechanism and use of the device. Parents considered e-cigarettes to be a healthy substitute for conventional smoking. However, youth expressed the failure of e-cigarettes to provide satiety level same as conventional cigarette smoking. Participants endorsed e-cigarettes as a tool for smoking cessation. Conclusion: It was evident from the study that though there was knowledge of e-cigarettes, both parents and youths were ill- informed about them, owing to varied and inconsistent information on e-cigarettes along with its legal implications in Singapore. Future research is required to assess safety and efficacy of e-cigarettes as well as the association of their use with smoking cessation.

Deliberate Self-Harm in Psychiatric Outpatients Aged 14-35 Years in Singapore

<p><b>INTRODUCTION</b>The main aim of the study was to identify the prevalence of deliberate self-harm (DSH) in a sample of youth outpatients attending the state psychiatric hospital in Singapore and to identify the sociodemographic and psychological/clinical risk factors associated with DSH. The secondary aim of  the study was to examine if different forms of DSH had distinguishing risk factors.</p><p><b>MATERIALS AND METHODS</b>A total of 400 outpatients at the Institute of Mental Health completed a self-report survey comprising sociodemographic questions, the Functional Assessment of  Self-Mutilation, Childhood Trauma Questionnaire, Parental Bonding Instrument and the Patient Health Questionnaire Depression Scale. Logistic regression models were used to test the associations.</p><p><b>RESULTS</b>The overall prevalence of DSH in our clinical population was 58.8%. Cutting/carving (25.4%) and hitting (20.4%) were the most common forms of DSH in the past 12 months. DSH acts were performed primarily for emotion regulation purposes. The risk factors for DSH in general were younger age group, female gender, abuse history and higher depression scores. Gender and age group were the factors that were differentially associated with cutting and hitting one's self.</p><p><b>CONCLUSION</b>There was a high prevalence of DSH in the psychiatric outpatient population. The risk factors identified in this study are consistent with those of international studies which point to their stability across cultures.</p>