Electrocardiographic Monitoring of Psychiatric In-patients Taking Antipsychotic Medications.

OBJECTIVE: To assess the adherence to guidelines for electrocardiographic (ECG) monitoring in Hong Kong psychiatric in-patients who have been prescribed antipsychotic medications. METHODS: In-patients who had been prescribed antipsychotic drugs on hospital admission during the baseline audit period of 15 April 2015 to 16 July 2015 and the re-audit period of 28 January 2016 to 30 April 2016 were included. Quality improvement interventions were delivered after the baseline audit. ECG monitoring adherence was categorised as full adherence (ECG before taking antipsychotics), partial adherence (ECG after taking antipsychotics), or non-adherence (no ECG during hospital stay). Overall compliance was defined as full adherence plus partial adherence. RESULTS: The baseline audit and re-audit included 378 and 422 patients, respectively. Overall compliance with ECG monitoring increased significantly from the baseline audit to re-audit (40.2% vs. 69.9%; p < 0.001). Case-doctors having the grade of resident was associated with stronger adherence to ECG monitoring in both audits. CONCLUSION: Adherence to ECG monitoring guidelines for in-patients who are prescribed antipsychotic drugs is low in Hong Kong, and junior doctors (residents) demonstrate stronger adherence than moresenior doctors.

Validation of the Chinese Version of the Revised Clinical Interview Schedule: Findings from Hong Kong Mental Morbidity Survey.

This study aimed to assess the psychometric properties of the Chinese version of the Revised Clinical Interview Schedule (C-CIS-R), and explore its applicability as a diagnostic instrument for common mental disorders (CMDs) in Hong Kong. Its psychometric properties were evaluated among 140 patients and 161 healthy controls. In comparison to the diagnoses made by the Structured Clinical Interview for the DSM-IV, the C-CIS-R showed good criterion validity in diagnosing CMDs. The correlation of the total score of C-CIS-R with the 12-item General Health Questionnaire and Hospital Anxiety and Depression Scale was satisfactory, indicating favourable convergent validity as well. The inter-rater and test-retest reliability were also satisfactory. Receiver operating characteristic analyses suggested an optimal cut-off point of 11/12 for detecting diagnosable CMDs (sensitivity: 0.69; specificity: 0.93) and 17/18 for identifying a need for treatment (sensitivity: 0.70; specificity: 0.95). In conclusion, C-CIS-R is a valid diagnostic instrument for CMDs in a Chinese community. Its cut-off points for clinically significant symptoms and treatment needs among Chinese are identical to those adopted in the original English version.