Y. K. Wing

Validation of the Chinese-Cantonese version of the Hospital Anxiety and Depression Scale and comparison with the Hamilton Rating Scale of Depression

Objective

Knowledge and Compliance Towards Lithium Therapy Among Chinese Psychiatric Patients in Hong Kong

Although patient education is believed to promote medication compliance, the exact relationship between the acquisition of drug knowledge and compliance during lithium treatment is unclear. A survey of 50 Chinese patients on maintenance lithium therapy revealed that their medical knowledge about lithium treatment, as measured by a “Lithium Questionnaire,” was very limited. Nonetheless, 70% of these patients were found, by multiple criteria, to be good compliers, and lithium compliance was apparently not affected by the amount of drug knowledge that patients possessed. It is argued that in the process of conducting patient education to enhance lithium compliance, a sound therapeutic alliance is more important than sheer knowledge acquisition.

ACNE AS A RISK FACTOR FOR ANOREXIA NERVOSA IN CHINESE

Acne is a highly visible and common skin disorder which is potentially disfiguring and associated with adverse emotional responses in adolescents, who are markedly sensitive to body image changes. Two psychologically vulnerable Chinese girls are reported, in whom traditional health concepts reinforced dieting behaviour, led to weight loss, regression of acne and eventually anorexia nervosa. The intricate interactions of acne, health beliefs, dieting behaviour and eating disorders are discussed.

Factors Associated with Psychosis among Patients with Severe Acute Respiratory Syndrome: A Case-Control Study

Abstract We observed that a number of patients with severe acute respiratory syndrome (SARS) developed affective psychosis during the acute phase of their illness. We reviewed all SARS-related psychiatric consultations in Hong Kong and investigated the risk factors for psychosis among patients with SARS in a matched case-control study. Patients with SARS-related psychosis received higher total doses of steroids and had higher rates of family history of psychiatric illness. The findings of the present study suggest that steroid toxicity, personal vulnerability, and, probably, psychosocial stressors jointly contributed to the development of psychosis in patients with SARS.

REM sleep behaviour disorder in the elderly

REM sleep behaviour disorder is a recently described parasomnia characterized by a history of excessive motor activities during sleep and is associated with pathological absence of muscle atonia during REM sleep. There is very limited literature on the condition. Two out of 349 elderly patients referred to a psychogeriatric unit were identified to have REM sleep behaviour disorder. These two patients are presented to illustrate the clinical features of the condition. Both of them showed a good response to clonazepam treatment.

Neuroleptic prescription for Chinese schizophrenics in Hong Kong.

There are very few studies on the pattern of neuroleptic prescription for schizophrenics in Asia. 106 schizophrenic patients in a psychiatric unit of a general teaching hospital in Hong Kong were surveyed. The mean daily dose (in chlorpromazine equivalent) was low (568.5mg). The mean daily dose of high potency agents was four times that of low potency agents. A high frequency of use of anticholinergic drugs may indicate that Chinese are more susceptible to acute extrapyramidal side-effects.

Prevalence of tardive dyskinesia in samples of elderly people in Hong Kong

The prevalence of dyskinesia was studied in 4 samples of elderly Chinese people in Hong Kong – a psychogeriatric clinic, a mental hospital, a geriatric day hospital and a senior citizen centre. Research Diagnostic Criteria were used to identify cases of tardive dyskinesia. The overall prevalence of spontaneous dyskinesia was 2.4% and tardive dyskinesia was 25.9%. The rate of spontaneous dyskinesia differs across the study samples and is related to nervous system conditions associated with increased age. On the other hand, the rate of dyskinesia associated with antidepressants may not be significantly different from that of spontaneous dyskinesia.

Schizophrenia and hypocalcaemia: variable phenotype of deletion at chromosome 22q11

OBJECTIVE The aim of this paper is to report the diagnosis of velo-cardio-facial syndrome (VCFS) in a patient presenting with schizophrenia and hypocalcaemia. Screening of deletion 22q11 in patients with schizophrenia is discussed. CLINICAL PICTURE We report a schizophrenic patient presenting with hypocalcaemia as the only feature of VCFS. Deletion 22q11 was confirmed by fluorescent in situ hybridisation (FISH). TREATMENT The patient was treated with haloperidol 3 mg/day with resolution of psychotic symptoms. OUTCOME The patient harboured some residual psychotic symptoms probably related to her irregular compliance. CONCLUSIONS The wide range of phenotypic variability of VCFS makes screening of 22q11 deletion in schizophrenia difficult. It is proposed that screening of 22q11 deletion in schizophrenia should be selectively targeted only at patients with specific features of VCFS highly predictive of the presence of 22q11 deletion.