Clw Chan

Gender Differences of Persons with Schizophrenia in Rural China

This journal suppl. entitled: Abstracts for the 12th International Congress on Schizophrenia Research (ICOSR)

Impact of treatment decisions and significance of cultural beliefs in predicting quality of life of Chinese infertile women

This journal suppl. entitled: Abstracts of the 32nd Annual Meeting of the European Society of Human Reproduction and Embryology, Helsinki, Finland, 3 to 6 July 2016

Aerobic exercise and yoga hold promises for improving neurocognition and symptom in early psychosis

Background: Cardiovascular and metabolic problems combined with a bad lifestyle are a major cause of a shortened life expectancy in chronic psychotic disorders. While the incidence of cannabis use is twice as high in psychosis compared to the general population, use of cannabis has been associated with better outcomes on cardiometabolic risk factors. This study investigates whether this effect is mediated by the AKT1 gene, as activation of the related enzyme by cannabis may cause changes in metabolism. Methods: Patients with a recent onset psychosis (n=623) were included from a cohort study (GROUP). Cannabis use, based on self-report and urine screening, was related to Body Mass index (BMI). Next the mediating effects of six AKT1 polymorphisms (rs1130214, rs1130233, rs2494732, rs2498784, rs3730358 and rs3803300) were investigated. Results: There was a strong, negative association between BMI and cannabis use. Moreover, two SNPs (rs1130233 and rs2494732) showed an association with cannabis use, but did not mediate the effect of cannabis on BMI. Conclusion: In conclusion, cannabis use results in a lower body weight in patients with a psychosis. While AKT1 is related to cannabis use, it does not affect body mass via AKT1. Instead, AKT1 risk alleles may increase the incidence of cannabis use. Future studies may investigate whether other genes mediate the effect between cannabis and metabolic risk factors.

Spiritual Beliefs and Religious Practices among Persons with Schizophrenia in Rural Community.

This study aims to identify correlates of vocational functioning in a first episode psychosis (FEP) sample 7.5 years after presentation at a specialized early psychosis treatment service. The study involved a prospective, naturalistic follow-up of FEP patients commencing treatment with the Early Psychosis Prevention & Intervention Centre (EPPIC) in Melbourne, Australia, between 1995 and 1997. At treatment entry the Royal Park Multidiagnostic Instrument for Psychosis was used to assess duration of untreated psychosis (DUP), age at onset of psychotic disorder, and premorbid work/social functioning. At 7.5-year follow-up measures included the Brief Psychiatric Rating Scale (Thinking Disturbance subscale), Scale for the Assessment of Negative Symptoms (Alogia subscale), WHO Life Chart Schedule (to assess course of illness, treatment history, and duration of receipt of a disability support pension (DSP)), and the Structured Clinical Interview for DSM-IV (to derive Axis I diagnoses). Analyses involved 180 participants. Univariate and multivariate logistic regression analyses were used to estimate the effects of demographic, clinical and treatment variables on two outcomes: current employment; and durable employment (employment for more than 6 months in the past 2 years). The sample was primarily male (72%), with a mean age at follow-up of 29 years (sd=3.4). 45% reported current participation in competitive employment at 7.5 year follow-up (28% full-time, 17% part-time), and 53% reported recent durable employment. Multivariate analyses showed that, after controlling for other variables (including positive and negative thought disorder, premorbid functioning, and recent psychiatric treatment), current employment was negatively associated with continuous or episodic illness course characterized by worsening trajectory or incomplete remissions, disrupted education, and receiving a DSP for longer than 2 years. Lifetime diagnosis of schizophrenia, receipt of a DSP (regardless of duration) and disrupted education were negatively associated with durable employment. Educational attainment appears to be an important predictor of vocational outcome in the Australian labor market, although its relationship with premorbid functioning requires further investigation. The inverse relationship between DSP and employment, after controlling for symptom levels and course of illness, supports evidence from US studies that such payments may act as a disincentive to employment.The purpose of this study is to examine the long-term clinical and functional outcome of first-episode psychosis (FEP). The study was a naturalistic, prospective follow-up of a large epidemiologically representative sample of 765 FEP patients, mean 7.4-years after initial presentation to a specialist early psychosis service (EPPIC) in Melbourne, Australia. Standardised assessments were used at the followup to assess participants’ demographic characteristics, axis I diagnosis, psychopathology and level of work and social functioning. Follow-up interviews were conducted on 511 participants; 133 refused; 39 were deceased and 82 were un-contactable. No participant bias due to study attrition was found. Some 230 (45.0%) of the interviewed group, met DSM-IV criteria of a current psychotic disorder; 281 (55.0%) individuals received a lifetime diagnosis of psychotic disorder. Numbers of individuals diagnosed with schizophrenia, schizoaffective disorder, affective psychosis and other psychosis, were 306 (59.6%), 48 (9.4%), 110 (21.5%) and 47 (9.2%), respectively. Comparisons between the diagnostic groups found the schizophrenia group to have significantly higher BPRS (total, psychotic subscale) and SANS (total) mean scores and significantly lower GAF, SOFAS and QLS mean scores than the other diagnostic groups at follow-up. The prevalence of current psychotic disorder was significantly higher in the schizophrenia group (60.1%) as compared to the other diagnostic groups (χ2=78.4, df=3, p<0.001). Considering the course of the psychotic disorder over the most recent two years, the majority (49.1%) reported that they have never been actively psychotic, 31.6% reported a continuous course, 17.1% reported an episodic course and 2.2% individuals neither episodic nor continuous course of illness. In contrast to previous medium and longer term follow-up studies of first episode schizophrenia where 19-37% were reported to be occupationally engaged,(and 10-15% of those with established schizophrenia in Australia) the proportion of individuals observed in this study with some level of employment in the last two years was substantially higher (schizophrenia, 52%; affective psychosis, 74.5%; schizoaffective, 60.4%; and other psychotic group, 72.3%). Findings from the EPPIC long term follow-up study emphasis that a specialised early intervention service program might result in better functional outcomes in contrast to previous assumptions, especially for those with schizophrenia.

The relationship between attachment style and adjustment to bereavement among Hong Kong Chinese

The hepatitis C virus (HCV) is the leading notifiable disease in Australia.It is described as a stigmatised disease, as the majority of new infections are associated with intravenous drug use.The current qualitative study explored the lived experiences of those diagnosed with HCV.Fifteen participants (10 women & 5 men) who were HCV positive and not current drug users were interviewed about the impact of their diagnosis and how they have adjusted to it.The data were analysed using open and closed coding methods.Diagnosis was found to be a traumatic experience with considerable emotional impact that could be exacerbated by stigma, discrimination and a lack of information.Support is provided for a selfmanagement construct encompassing medical, emotional and life role facets.It was concluded that positive reactions to disclosure contribute to adjustment, whereas perceptions of stigma and negative reactions to disclosure may create barriers to self-management and personal growth.Much of the research into attendance to psychological services has investigated the predictors after the initiation of an appointment or following prior attendance. The aim of this study was to assess why some patients that are referred for treatment do not make contact for a first appointment. By investigating the factors that result in a patient not contacting it would assist referrers and psychological services to save time and money, to know whether they should be followed up, and to identify ways to support and increase the likelihood that they will contact and attend a service. The Sunshine Coast GP Allied Health Service, established by the Sunshine Coast Division of General Practice and funded by the Commonwealth Governments Better Outcomes in Mental Health Initiative, was chosen for investigation. Patients referred during a three month period were followed up whether they had contacted or not. The Health Behaviour Model and Transtheoretical Model were applied to understanding the internal and external factors that might be involved in predicting contact following referral. This study produced some interesting findings and recommendations have been made for referrers and psychological services.This retrospective study used archival data to gain a better understanding of potential and determined deficits in the practise of Psychology in Queensland. Using thematic coding in a grounded theory approach, 134 complaints received by the Psychologists Board of Queensland between 1998 and 2004 were analysed to identify what factors or themes health consumers had complained about. Additionally, 186 cases of determined unsatisfactory professional conduct (as defined by the Health Practitioners Professional Standards Act 1999) for the same period were quantitatively analysed to identify potential predictive factors of those psychologists found to have engaged in professional misconduct. Within the limitations of the data, this study identified that 4 year graduates were found to have engaged in unsatisfactory professional conduct more than their professional peers with post-graduate qualifications and that health consumer complaints covered many areas of psychological practice notably that of poor communication.Age-related cognitive decline and dementia are major health issues in developed countries. Risk factors associated with these conditions include the presence of the apolipoprotein E isoform e4 (ApoE), premorbid IQ, cardiovascular disease, and lifestyle factors including level of physical activity and degree of involvement in intellectually stimulating activities. Evidence from several large-scale observational studies shows that regular engagement in these activities is associated with better cognitive function, less cognitive decline in later life and a lower incidence of dementia. In addition, intervention studies have demonstrated that the cognitive performance of older persons (with and without cognitive impairment) can be improved through brief training programs involving educational, physical and cognitive interventions. To date, however, there has been little investigation of the capacity of these interventions to slow the rate of deterioration among people with identified risk. To address this gap, we have developed a program of research to assess the efficacy and viability of interventions involving physical exercise and cognitive stimulation to arrest or slow cognitive decline in a group of at-risk women. The research evidence in relation to physical exercise, intellectual stimulation and cognitive decline and dementia will be summarised in this presentation and the proposed body of research outlined.The aim of this study was to investigate dissociation, measured as a continuous dimension from normal experiences through to the severe symptoms characteristic of dissociative identity disorder, by modelling dissociation as an outcome of childhood trauma, adult personality and adjustment.A questionnaire package was completed by a sample of 279 adults (M = 27.80 years, SD = 12.77), 47 males and 231 females.Participants completed the Dissociative Experiences Scale II (DES-II), the NEO Five-Factor Inventory (NEOFFI), the Resilience Scale (RS), the Childhood Trauma Questionnaire (CTQ), and the Creative Experiences Questionnaire (CEQ).Structural equation analyses using AMOS generated a model that fit the data well (χ/df = 1.87).Inspection of significant paths in the model found, consistent with theory and existing research, that childhood trauma had a direct link to dissociation (regression weight = .13).A benefit of the modelling approach was the capacity to identify a complex pattern of relationships by which personality (neuroticism and agreeableness) and adjustment (fantasy proneness and resilience) mediated the relationship between childhood trauma and dissociation.

Chinese cancer quality of life measure: a translation and initial validation of the fact-G (CH) scale

In a state-funded or state-subsidised system all three of these should be regarded as “social” decisions, although conventionally (a) and (b) are often regarded as “clinical” decisions, i.e. purely technical matters for doctors to decide. But they are all priority-setting decisions, in which some citizens are winners and others are losers. And they concern the use of limited resources that taxpayers have provided. As a matter of justice, therefore, the views of citizentaxpayers should influence the outcomes.The 1999 Annual Conference of the International Society for Quality of Life Research (ISOQOL), Barcelona, Spain, 3-6 November 1999. In Quality of Life Research, 1999, v. 8 n. 7, p. 562, abstract no. 23Background: The 22-item Well-being Questionnaire (W-BQ22) (Bradley, 1994) includes Anxiety, Depression, Energy and Positive Well-being subscales. However, the constructs of anxiety and depression could not be easily distinguished from each other. Consequently, the W-BQ12 was designed to include just three subscales, Negative Well-being (including only negatively-worded anxiety and depression items), Energy (2 positively- and 2 negativelyworded items) and Positive Well-being (all positively-worded items). The SF-36 (Ware & Sherbourne, 1983), a widely used health status measure, includes a 4-item vitality subscale (2 positively- and 2 negatively-worded items) and a 5-item mental health scale (2 positively worded and 3 negatively-worded items). Method: Factor structures of W-BQ22, W-BQ12 and SF-36 were compared using data from 789 outpatients with diabetes. Results: W-BQ22 factor analysis showed negatively-worded anxiety and depression items loading together, while positively-worded depression items loaded with positive well-being items and separately from positively-worded anxiety items. W-BQ12 loaded as intended on 3 factors, with negatively-worded anxiety and depression items loading together on one factor: negative well-being. The four energy items (2 positively- and 2 negatively-worded) loaded together (factor 3) and the four positive well-being items loaded together (factor 1). Unforced factor analysis of the SF-36 produced 5 factors and split the mental health and vitality items into two components, which could only be defined in terms of positive and negative wording. A forced 8-factor solution produced similar results, with the mental health and vitality items being split into two components according to their positive or negative wording. A forced 2-factor solution brought mental health/vitality items together, separate from physical health items. Conclusion: The previously unrecognised influence of positive and negative wording on factor structure is clearly shown here to be of importance in conceptualising and designing measures of psychological well-being to be used with people with diabetes and may be of relevance for other populations.