Positive effects of anthocyanin-rich mulberry milk on mental health problems in the working population: an open-label study.

BACKGROUND/OBJECTIVES: Depression and anxiety are common mental health problems. Anthocyanins from berries might have an inhibitory effect on monoamine oxidase (MAO) enzymes and alleviate various mood and anxiety symptoms. This study examined the effects of a daily supplement of an anthocyanin-rich product on mental health problems. SUBJECTS/METHODS: This study was a secondary analysis from a randomized, 6-week, open-label trial in 300 healthy participants aged 18-60 years who consumed 1 or 2 servings of anthocyanin-rich mulberry milk daily. The General Health Questionnaire-28 (GHQ-28) and Hospital Anxiety and Depression Scale (HADS) were used to monitor mental health problems. In addition, the saliva activity levels of MAO-A, MAO-B, and cortisol were examined at the baseline and after 6 weeks. RESULTS: The total scores of the GHQ-28 and HADS and all their subscales decreased in both groups (all P < 0.05). The cortisol, MAO-A, and MAO-B activities decreased significantly (all P <0.05), but there were no significant differences between the groups (all P > 0.05). Significant correlations were noted between the decreased activity level of MAO-A enzyme and decreased scores from the GHQ-28 somatic subscale and the HADS depression subscale (all P < 0.05). CONCLUSIONS: Daily consumption of anthocyanin-rich mulberry milk possibly improves mental health problems by reducing depressive and anxiety symptoms in the working population. The suppression of MAO-A activity is a possible underlying mechanism. Trial Registration: Thai Clinical Trial Registration: #TCTR20201031002.

Mobile application for monitoring behavioral and psychological symptoms of dementia in patients with moderate to severe dementia.

AIM: Behavioral and psychological symptoms of dementia (BPSD) are common in patients with moderate-severe dementia and have negative impacts on both patients and caregivers. There is a lack of a tool for caregivers to monitor patients' BPSD by themselves. This study aimed to develop and validate a mobile application for caregivers to use in monitoring BPSD. METHODS: A total of 104 pairs of patients with moderate-severe dementia and their caregivers completed the study. The Neuropsychiatric Inventory (NPI) was modified and digitally transformed to a caregiver-rating mobile application to quantify nine domains of BPSD for their frequency and impact on the emotion of the caregivers. Data collected from the application were compared with the paper-and-pencil NPI for prevalence, concurrent validity (Spearman's rho) and internal consistency (Cronbach's alpha). RESULTS: The application was able to detect 93% of BPSD compared with the NPI. Concurrent validity was good-very good when compared with the Frequency × Severity score (ρ = 0.77, P < 0.001) and the burden score (ρ = 0.85, P < 0.001) from the NPI. Levels of internal consistency were acceptable for both frequency (α = 0.73) and impact (α = 0.79) scores. 80% of the caregivers reported that the application was "very likely to be helpful in caregiving". CONCLUSIONS: The mobile application for monitoring BPSD in patients with moderate-severe dementia had an excellent sensitivity, and good-very good validity and consistency. The caregivers had a positive perception of the application as an aid in caregiving. Geriatr Gerontol Int 2021; 21: 472-477.

Quality of Life, Mental Health and Educational Stress of High School Students in the Northeast of Thailand.

INTRODUCTION: Majority of high school students in Thailand aim to study at universities. Therefore, they spend a lot of time studying in both classrooms and tutorial classes, that could cause stress, health problems and deteriorate their Quality Of Life (QOL). However, there has been no study on these issues in Thai context. AIM: To describe the status of QOL, mental health, educational stress, well-being and determine factors associated with QOL among high school students in the Northeast of Thailand. MATERIALS AND METHODS: This cross-sectional study was conducted in the Northeast of Thailand among 1,112 students of grade 10th, 11th and 12th. Multistage random sampling was used to select high schools in 5 provinces. A self-administered questionnaire was used to assess QOL, educational stress, anxiety, depression and well-being. The association between the covariates was observed by using Generalized Linear Mixed (logistic regression) Model (GLMM). RESULTS: The prevalence of high level of QOL was 36% (95%CI: 32.30 to 41.69); whereas, 26.18% (95% CI: 16.72 to 35.63) had high level of educational stress and 16.41% (95% CI: 2.20 to 30.71) had severe anxiety. Prevalence of depression was 18.55% (95%CI: 9.86 to 27.23) and low level of well-being was 13.41% (95% CI: 0.18 to 27.14). The factors significantly associated with high QOL were; not having depression (Adj. OR= 3.07; 95%CI: (2.23 to 4.22); p<0.001), had high level of general well-being (Adj. OR=3.19; 95% CI:1.99 to 5.09; p<0.001) and had low to moderate level of anxiety (OR=1.60; 95%CI:1.01 to 2.67). CONCLUSION: Most of the high school students had low to moderate levels of QOL, educational stress and anxiety. Depression, anxiety and general well-being had influences on QOL of high school students.

Rate of Serum Valproate Concentration Monitoring in Patients with Bipolar Disorder Type I at Srinagarind Hospital Outpatient Clinic.

Objective: Determine in the out-patient setting the rate and the purpose of serum valproate concentration monitoring during treatment with valproate, either single valproate or valproate in combination with other psychotropics in patients with bipolar disorder type I (BD-I), to determine the rate of recording valproate associated adverse effects, the rate of the follow-up and the length (days) that the patients were in the condition of full remission/recovery and symptomatic. Material and Method: The present study was a retrospective descriptive study done between January 1, 2007 and December 31, 2008. The data were from the medical records of DSM-IV-TR BD-I out-patients at Srinagarind Hospital, Khon Kaen who were treated either by single valproate or valproate in combination with other drugs for at least six weeks long. The studied variable included the annual rate and the reason that psychiatrist requested serum valproate concentration (SVC) monitoring per patient, the annual rate that psychiatrist recorded the valproate associated adverse effects, the annual rate that the patient returned to have a follow-up visit, and the length (days) that the patient was in full remission/recovery and symptomatic. Results: During the study period, of the 199 patients with BD-I, only 57 patients (28.6%) that were treated with valproate had complete records. The SVC monitoring occurred 17 times from 13 patients (22.8%). The mean SVC was 76.4 microgram/ml (SD = 31.8). The mean value +SD and range of SVC during the remission/recovery period were 75.1+17.5 µg/ml and 43.5-96.8 µg/ml, which was not significantly different from the symptomatic period, which was 77.1+39.9 µg/ml and 0.7 to 124.9 µg/ml. However, the oral dosage of valproate during the remission/recovery period (944.7+275.4 mg/day, median 1,000 mg/day) was significantly higher than during the symptomatic period (699.0+592.5 mg/day, 1,000 mg/day) (t = 2.7, df = 104 and p = 0.009). Of all the SVC monitoring, 58.8% occurred during the symptomatic period and most of the monitoring was due to the emergence of adverse effects. The causes for requesting the SVC determination were the emergence of adverse effects (29.4%), no reason specified (29.4%), and to monitor the clinical response (11.8%). The rate of valproate associated adverse effects recording was 1.1 times/person/year, which was 18.6% of the average rate of follow-up visits (6.6 times/person/year). The most frequent adverse effect was sedation. The treatment of BD-I by valproate or in combination with other psychotropics resulted in the remission/recovery period lasting 470.2 days (SD 256.8, median 517.0) while the symptomatic period lasted 176.1 days (SD 157.5, median 139.5). Conclusion: During treatment of BD-I, the rate of serum valproate concentration monitoring was very few. However, when determination was requested, the SVC was within the therapeutic range. In addition, rate of recording of valproate associated adverse effects was very low and the most frequent adverse effect was mild. The reason for monitoring the clinical response was rarely found. Valproate seems to be easily administered. The dosage can be adjusted using only clinical response and adverse effects. Therefore, valproate was effective and safe in treatment of BD-I.

Clinical outcome of valproate maintenance treatment in bipolar I disorder at Srinagarind Hospital.

OBJECTIVE: To determine-in a clinical setting-the rate and time to recurrence of any mood episode during valproate maintenance treatment for bipolar I disorder. MATERIAL AND METHOD: A retrospective cohort based on medical records of both in- and out-patient with bipolar I disorder (DSM-IV-TR) seen at Srinagarind Hospital between January 1, 2009 and December 31, 2010 was done. A recurrence was observed if the patient had fulfilled the remission criteria and valproate was the maintenance drug. Survival analysis and Cox regression analysis were used to analyze the data. RESULTS: Eighty-five patients with 124 remitted mood episodes met the inclusion criteria. Of the 85 patients, the average age was 41.4 +/- 17.1 years (range, 18-89); 49.4% were males; 48.2% married; 42.4% completed secondary school, 30.6% completed a bachelor degree; 35.3% were unemployed, and 34.1% were government employees. Twenty remitted mood episodes (16.1%) were in maintenance treatment with valproate only. The remaining 104 (83.9%) were in maintenance treatment with valproate in combination with other agents. There were 50 recurrences from 36 patients during the two years of study, the recurrence per a patient ranged from 1 to 3 times. The rate of recurrence was 21%/year or 2.2/100 person-months (95% CI = 1.65-2.93). The average time to recurrence to any mood episode was 33 months (95% CI = 15.06-50.94). With multivariable Cox regression, a statistically significant greater risk for a recurrence was associated with: (a) the previous episode being hospitalized (adjusted hazard ratio = 5.88, 95% CI = 2.76-12.36, p < 0.001); (b) blood valproate concentration during maintenance treatment < 50 microg/mL (adjusted hazard ratio = 3.07, 95% CI = 1.11-8.53, p = 0.03); and (c) time duration (month) of valproate maintenance treatment (adjusted hazard ratio = 0.98, 95% CI = 0.96-0.99, p = 0.001). With the adjusted hazard ratio 0.98, it could be interpreted in the other way that each additional month of taking valproate was associated with a statistically significant protective factor that decreased the risk of recurrence by 2% from the previous month. CONCLUSION: In the authors'clinical setting, valproate both singly and in combination with other psychotropic agents used for maintenance treatment of bipolar I disorder yielded a recurrence rate of 21% per year or 2.2 per 100 person-months and time to any mood episode recurrence of 33 months. The present result has importance for both clinical treatment decision-making and patient economic status.

Rivastigmine patch for treatment of Alzheimer's disease in clinical practice in Thailand.

BACKGROUND: Rivastigmine is a cholinesterase inhibitor for treatment of mild to moderate Alzheimer's disease (AD) and dementia associated with Parkinson's disease. The new patch formulation was recently made available. We assessed the safety, tolerability, and cognitive outcome of rivastigmine patch in treatment of mild to moderate AD in clinical practice in Thailand. METHODS: A multicentre, hospital-based, prospective observational study was conducted in nine hospitals across Thailand. Patients with probable mild to moderate AD who received the rivastigmine patch were enrolled. Data were collected data at baseline, weeks 4-8 and after week16. RESULTS: A total of 116 AD patients were screened, and three were excluded. Of 113 patients, 62.8% were women with a mean age of 73.3 ± 9.2 years; 79.7% were newly diagnosed. One-third of all patients had been using antipsychotic or antidepressant medication. Common comorbidities were hypertension and dyslipidemia. The Thai Mental State Examination score significantly increased from 18.6 to 20.3 (weeks 4-8) and 20.4 (week 16+) (P < 0.001). Scores based on physicians' (Clinical Global Impression) and caregivers' (Patients' Caregiver Global Impression of Change) impressions of improvement suggested minimal improvement. Because of adverse events, seven patients's dosages were reduced 10 cm(2) to 5 cm(2) or from 5 cm(2) to nothing. Itching was the most common adverse symptom. CONCLUSIONS: During the first 16 weeks after initiation of rivastigmine patch therapy, patients with probable mild to moderate AD had statistically significant improvement in cognitive function, but clinically marginal benefit. Rivastigmine was safe and well tolerated.

Characteristics, treatments and outcome of psychosis in Thai SLE patients.

OBJECTIVES: To study the clinical characteristics and outcomes of psychosis and its clinical correlation with disease activity in Thai systemic lupus erythematosus (SLE) patients. METHODS: From 750 SLE patients, 36 episodes of psychosis or psychotic depression in SLE patients were retrospectively identified between June 1999 and June 2009 at Srinagarind Hospital, Khon Kaen University. The clinical characteristics, laboratory analyses, disease activity, treatments and outcomes were studied. RESULTS: A total of 35 SLE patients had 36 psychotic episodes that consisted of 29 psychotic episodes and 7 psychotic depressive episodes. Eleven episodes (30.6%) occurred during the first manifestation of lupus. Psychotic symptoms included persecutory delusion (50%), bizarre delusion (44.4%), third person auditory hallucinations (44.4%) and visual hallucinations (36.1%). Twenty four episodes (67%) were associated with active lupus in CNS and other organs. All patients received immunotherapy and psychotropic treatments. Psychosis and depressive psychosis were treated with antipsychotics and antidepressants for a mean duration of 71 and 410 days. One death resulted from suicide, and one of thirty four cases (2.9%) had a reoccurrence within a mean follow-up period of 44 months. CONCLUSION: About one-third of the psychotic episodes occurred during the first manifestation of lupus. Persecutory delusion, bizarre delusion, third person auditory hallucination, and visual hallucination were common. During psychotic episodes, lupus activity was active in other parts of CNS and organs in 67% of patients. Depressive psychosis required psychotropic treatment longer than psychosis alone. The psychiatric outcome was very favorable. Most of psychotic episodes (97.1%) were fully remitted and rarely showing recurrences.

Characteristics and burden of hospitalization because of intentional self-harm: Thai national, hospital-based data for 2010.

BACKGROUND: There is a paucity of data on intentional self-harm and suicide in Thailand. It is crucial to re-evaluate the burden and health outcomes. OBJECTIVE: To measure the character and burden of acts of intentional self-harm in the Thai hospitalized population. MATERIAL AND METHOD: Acts of intentional-self harm were categorized using ICD 10 classification. All of inpatient-related data were analyzed using SPSS 17. RESULTS: Overall intentional self-harm in 2010 led to 24,924 hospitalizations and 854 deaths; an incidence of 35.6/100,000 people with the highest level in two age groups: 18-25 and 26-40 year-olds. Self-poisoning (89%) was the most common method and pesticide was the leading used chemical agents. The total cost of treatment was 149,672,190 baht and the mean length of stay was 2.9 +/- 6.7 days. The mortality rate increased as the population got older with the highest rate being 10.6% for 70-79 year-olds. In 33.8% of cases, psychiatric co-diagnosis were found with anxiety disorders was the leading comorbidity. CONCLUSION: The incidence of intentional self-harm was medium to high, compared to other East Asians countries. Self-poisoning by exposure to pesticides was the most common self-harm method. Age over 60 had the highest mortality rate. Having a psychiatric co-diagnosis was common.

Epidemiology of assault-related hospitalizations in Thailand in the fiscal year 2010: comparison between with and without psychiatric disorder.

BACKGROUND: Assault is a leading cause of injury and death; however little is known regarding the psychiatric epidemiology of assault-related hospitalizations (ARH) in Thailand. OBJECTIVE: To analyze the epidemiological data of ARH in Thailand for the fiscal year 2010 and to compare the epidemiology of ARH between with and without psychiatric disorder MATERIAL AND METHOD: The data analyzed were from the annual reports for the fiscal year 2010 (October 1, 2009-September 30, 2010), on every kind of hospitalization reimbursed by the Universal Health Coverage System, the Social Welfare System, and the Civil Servant Medical Benefits Scheme, altogether provided medical coverage for more than 96% of the Thai population. The information on ARH (X85-Y09: ICD-10 version for 2010) and comorbid psychiatric disorder(s) (F00-F99) were extracted. Number of in-patient hospitalizations by sex, age, geographical region, month, hospital charges, length of hospital stay (LOS) and mortality rate (MR) were analyzed. Frequencies (percentages) of ARH and subgroups were reported. RESULTS: The national ARH care cost was 0.98% of the overall national in-patient care expenses (88,964 million Baht). The rate of ARH was 0.72 of every 100 hospitalizations or 7.74 incidents/100,000 general population. Assaults leading to hospitalizations frequently occurred among males (80.86%); in 25-39 year-olds (35.60%), 40-59 year-olds (22.85%); by sharp object (29.44%), blunt object (24.40%) and bodily force (23.71%); in the Central (39.48%) and Northeast region (31.16%). There was a tri-modal monthly peak distribution: April (11.12%), December (9.45%) and October (8.90%). A minority i.e. 0.4% (male to female ratio of 4.22:1) of ARH had a concomitant psychiatric disorder(s): the most frequent being 'mental and behavioral disorders due to psychoactive substance use' (66.54%) followed by 'schizophrenia, schizotypal and delusional disorders' (14.230%). The MR of ARH with and without concomitant psychiatric disorder was 1.03% and 0.30%, respectively. The LOS of overall ARH was 5.15 +/- 12.41 days, min-max was 1-568 days and the mode was 1 day. The LOS of ARH with/without psychiatric disorder was 5.2 +/- 12.4 vs. 3.7 +/- 7.5 days. The expenses paid for ARH with/without psychiatric disorder was 75,811,383.40 Baht vs. 791,214,659.90 Baht. CONCLUSION: Assault accounted for 0.72 hospitalization of every 100 hospitalizations and 7.74 times/100,000 population. A fraction (0.04%) of ARH had concomitant psychiatric disorder(s): most frequently psychoactive substance use disorders followed by schizophrenia and related psychosis.

Epidemiology of mental and behavioral disorders among the elderly: based on data of hospitalized patients in Thailand 2010.

BACKGROUND: To date, only small, selected groups of elderly hospitalized with mental and behavioral disorders (EHMBD) have been studied. Since no national epidemiological studies have been published, the recent advent of universal healthcare in Thailand makes doing such a study timely for improving the medical curricula and service provision. OBJECTIVE: To analyze the epidemiology of the EHMBD in the year 2010 of Thailand. MATERIAL AND METHOD: The data analyzed were gathered from Medical Expense Reimbursement forms submitted for the fiscal year 2010. The particular focus of this research was on elderly inpatient aged 60 years and over with ICD-10 (for 2010) diagnosis: F00-F99 Mental and Behavioral Disorders. The authors extracted and analyzed the number of in-patient department (IPD) admissions, psychiatric diagnoses, length of hospital stays, hospital charges and mortality rate. Data were analyzed using SPSS 17 for Windows. RESULTS: In 2010, EHMBD accounted for 11,418 admissions which was 1.56 admission per 1000 elderly people or 13.9% of overall admission (19 years and over). Of the 11,418 admission, 44 died (0.39%). The mean in-patient charges/admission in Thai Baht (SD) for the EHMBD with any F00-F99 diagnosis was 12,896 (51,659). The average range of stay was 8.3 +/- 22.2 days. The leading diagnosed clusters of behavioral and mental disorders were organic mental disorders (F00-F09: 23.8%), neurotic, stress-related and somatoform disorders (F40-F48: 21.1%); and mental and behavioral disorders due to use of alcohol (F10: 20.3%). Alcohol use disorders among the elderly resulted in four times more men being hospitalized than women. Regarding the F30-F39 cluster mood (affective) disorders, the prevalence of depressive episodes increased with age and bipolar affective disorder decreased with age. CONCLUSION: The prevalence of hospitalization among the elderly with mental and behavioral disorders was about one-eighth that of all admission of adult from 19 years old. Death was an uncommon result. The most common psychiatric diagnoses were organic mental disorders, neurotic, stress-related and somatoform disorders and mental and behavioral disorders due to use of alcohol.

Interpersonal problems among psychiatric outpatients and non-clinical samples.

INTRODUCTION: The aims of this study were two-fold; to investigate the validity and reliability of the Thai version of the Inventory of Interpersonal Problems (IIP) and to compare the characteristics of the interpersonal problems experienced in a non-clinical sample and psychiatric outpatients. METHODS: A total of 689 subjects (452 non-clinical sample and 237 psychiatric outpatients) completed the IIP-32 and IIP-64, Symptom checklist-90 (SCL-90) and 16 Personality Factor (16 PF) Questionnaire, after which a four-week retest was carried out. Cronbach's alpha was used for internal consistency and the intra-class correlation coefficient was used to determine test-retest reliability. Factor analysis of the IIP sub-scales and Pearson's correlation were used for construct and concurrent validity. RESULTS: Both versions of the IIP showed good internal consistency. Factor analysis revealed two factors that corresponded to the circumplex property. The expected correlation between the SCL-90 and 16 PF subscales reflected the level of concurrent validity. There was a significant difference in the cold, socially-inhibited and self-sacrificing subscales between the non-clinical and clinical samples, while major depressive disorder was found to have a significantly higher score in the subscales of the control dimension, i.e. the non-assertive, socially inhibited and self-sacrificing subscales, than the neurotic and non-clinical groups, whereas, the neurotic group differed from the normative sample in terms of the affiliation axis. CONCLUSION: The IIP-64 and IIP-32 demonstrated their reliability and are suitable for use in either clinical or non-clinical setting.

Breathing meditation by medical students at Khon Kaen University: effect on psychiatric symptoms, memory, intelligence and academic achievement.

OBJECTIVE: To examine the short-term effects on fifth-year medical students of a 4-week, breathing meditation-based, stress reduction intervention on psychiatric symptoms, memory function, intelligence, and academic achievement. MATERIALS AND METHOD: Using a randomized control trial, the meditation group practiced every 8.00 to 8.20 a.m. before beginning daily learning schedule. Meditation emphasized mindful awareness of the breath during inhaling and exhaling. The control group went about their normal activities in the other room. The psychiatric symptoms were measured using the Symptom Checklist-90 (SCL-90), the memory used the Wechsler Memory Scale-I (WMS-I), the intelligence used the Raven's Advanced Progressive Matrices (APM), and the academic achievement used psychiatry course MCQ examination score. Analysis was done using Ancova statistic. RESULTS: Fifty-eight volunteer medical students during their psychiatry rotation between June 2008 and May 2009, were randomized into either in the meditation (n = 30) or the control (non-meditation) (n = 28) group. There was no significant difference between the groups in their respective SCL-90, WMS-I, APM, and psychiatry course MCQ examination score. CONCLUSION: Among normal, intelligent, mentally healthy persons, short-term breathing meditation practice will not likely change psychiatric symptoms, memory function, intellectual performance, and academic achievement.

Remission rate of atypical antipsychotic treatment of bipolar depression: experience at Srinagarind Hospital, northeast Thailand.

OBJECTIVE: To determine the remission rate when using atypical antipsychotic treatment for bipolar depression at Srinagarind Hospital, Khon Kaen, Thailand. MATERIAL AND METHOD: The authors reviewed the patient records for 18 persons, both in- and out-patients, with DSM-IV-TR bipolar depression, treated with atypical antipsychotic(s), at the Department of Psychiatry, Srinagarind Hospital, between May 2005 and April 2008. The remission rate using atypical antipsychotic treatment was assessed using survival analysis while the patterns of prescribing atypical antipsychotics were delineated using percentages. RESULTS: Of the 18 patients, 15 fulfilled the remission criteria. The mean time to remission was 10.3 weeks (SD 8.4). The incidence-density of the remission rate for bipolar depression treated with atypical antipsychotics was 8.1 per 100 person-weeks (SD 2.4, 95% CI 4.5-13.4). One patient achieved remission using only atypical antipsychotic monotherapy while 17 received a combination of atypical antipsychotics plus one or more of the following: antidepressants, anticonvulsants, anxiolytics and/or lithium. The present study revealed that remission was 1.4 times higher among females than males and 13 times higher among married than singles. CONCLUSION: The incidence-density of the remission rate using atypical antipsychotics for treatment of bipolar depression was 8.1 per 100 person-weeks. Almost all of the patients were treated with a combination of atypical antipsychotics plus other groups of medications. Higher remission was associated with females and married persons.

Effects of 12-Week Bacopa monnieri Consumption on Attention, Cognitive Processing, Working Memory, and Functions of Both Cholinergic and Monoaminergic Systems in Healthy Elderly Volunteers.

At present, the scientific evidence concerning the effect of Bacopa monnieri on brain activity together with working memory is less available. Therefore, we aimed to determine the effect of B. monnieri on attention, cognitive processing, working memory, and cholinergic and monoaminergic functions in healthy elderly. A randomized double-blind placebo-controlled design was utilized. Sixty healthy elderly subjects (mean age 62.62 years; SD 6.46), consisting of 23 males and 37 females, received either a standardized extract of B. monnieri (300 and 600 mg) or placebo once daily for 12 weeks. The cholinergic and monoaminergic systems functions were determined using AChE and MAO activities. Working memory was assessed using percent accuracy and reaction time of various memory tests as indices, whereas attention and cognitive processing were assessed using latencies and amplitude of N100 and P300 components of event-related potential. All assessments were performed before treatment, every four weeks throughout study period, and at four weeks after the cessation of intervention. B. monnieri-treated group showed improved working memory together with a decrease in both N100 and P300 latencies. The suppression of plasma AChE activity was also observed. These results suggest that B. monnieri can improve attention, cognitive processing, and working memory partly via the suppression of AChE activity.

Validity and reliability study of the Thai version of WHO Schedules for Clinical Assessment in Neuropsychiatry version 2.1.

OBJECTIVE: To determine the validity and reliability of the Thai version of WHO Schedule for Clinical Assessment in Neuropsychiatry (SCAN) version 2.1. MATERIAL AND METHOD: The SCAN interview book version 2.1 was translated from English into Thai. The content validity of the translation was verified by examining the back-translation. Whenever inconsistencies were encountered, the Thai version was adapted to convey the meaning of the original. The revised Thai version was then field-tested in 4 regions of Thailand for comprehensibility of the relatively technical language. Re-edition of the Thai version was made in accordance with suggestions from the field trial. The complete SCAN Thai version was put into the computerized I-Shell program for inter and intra-rater reliability study. RESULTS: Based on the response from Thai subjects and consultations with competent and well SCAN-trained psychiatrists, content validity was established. The inter- and intra-rater agreement of somatoform and dissociative symptoms module were 0.77, 0.85; anxiety: 0.79, 0.84; mood: 0.80, 0.86; eating disorders: 0.73, 0.76; use of alcohol: 0.66, 0.82; stress and adjustment disorders: 0.90, 0.94; psychosis: 0.68, 0.76; cognitive impairment: 0 72, 0.78 and observed behavior, affect and speech module were 0.45 and, 0.51 respectively. CONCLUSION: The SCAN version 2.1 Thai version proved to be a reliable tool for assessing psychiatric illness among Thais.

The validity and reliability of the WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN Thai Version): anxiety disorders section.

BACKGROUND: Anxiety disorders are some of the most prevalent psychiatric disorders, have early onset, are chronic and can cause functional impairment. It is, therefore, crucial to establish an accurate diagnosis for treatment and research purposes. OBJECTIVE: To test the validity and reliability of the W.H.O. Schedules for Clinical Assessment in Neuropsychiatry (SCAN Thai Version): Anxiety Disorders Section. MATERIAL AND METHOD: The linguistic clarity of the psychiatric schedules for Thais was tested by psychiatrists from the country's four regions. The psychiatrists were competent in the use of the schedules and their underlying objectives. Then between October 2004 and August 2005, Reliability of SCAN: anxiety disorder section was tested among 30 participants, including patients with anxiety disorders and normal volunteers. RESULTS: Based on reactions from Thais and consultations from competent psychiatrists, content validity was established. The duration of interviews for anxiety disorders section averaged 45.1 min (SD = 13.5). The reliability determined by Cohen's kappa coefficient for the 83 items that related to anxiety disorders in the SCAN were in Section 3, 4, 5. This overall inter-rater reliability was 0.79 (SD = 0.22), which were in substantial level of agreement. The overall intra-rater reliability was rated by the same psychiatrist 2 weeks apart. The result was 0.84 (SD = 0.21), which was near perfect agreement. There were three items (3.6%) of fair agreement and five items (6%) of moderate agreement that were caused from discrepancy of item definitions and the subjectivity of raters. CONCLUSION: The Anxiety Disorders Sections of the WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN Thai Version) were an effective tool for assessing symptoms of anxiety disorders among Thais.