Parenting stress and resilience in parents of children with autism spectrum disorder (ASD) in Southeast Asia: a systematic review

Background: This paper aimed to review the literature on the factors associated with parenting stress and resilience among parents of children with autism spectrum disorder (ASD) in the South East Asia (SEA) region. Methods: An extensive search of articles in multiple online databases (PsycNET, ProQuest, PudMed, EMBASE, CINAHL, Web of Science, and Google Scholar) resulted in 28 papers that met the inclusion criteria (i.e., conducted in the SEA region, specific to ASD only, published in a peer-reviewed journal, full text in English). Studies found were conducted in the following countries: Brunei, n = 1; Indonesia, n = 2; Malaysia, n = 12; Philippines, n = 5; Singapore, n = 5, Thailand, n = 2; and Vietnam, n = 1, but none from Cambodia, East Timor, Laos, and Myanmar were identified. Results: Across the studies, six main factors were found to be associated with parenting stress: social support, severity of autism symptoms, financial difficulty, parents' perception and understanding toward ASD, parents' anxiety and worries about their child's future, and religious beliefs. These six factors could also be categorized as either a source of parenting stress or a coping strategy/resilience mechanism that may attenuate parenting stress. Conclusion: The findings suggest that greater support services in Western countries may underlie the cultural differences observed in the SEA region. Limitations in the current review were identified. The limited number of studies yielded from the search suggests a need for expanded research on ASD and parenting stress, coping, and resilience in the SEA region especially in Cambodia, East Timor, Laos, and Myanmar. The identified stress and resilience factors may serve as sociocultural markers for clinicians, psychologists, and other professionals to consider when supporting parents of children with ASD

Prevalence Of Thyroid Dysfunction And Its Relationship With The Severity Of Major Depressive Disorder (MDD)

Objective: The objective of this study is to determine the prevalence of thyroid dysfunction in Major Depressive Disorder and the factors that were associated with the severity of MDD. Methods: A total of 140 major depressive disorder patients researched are subjected for blood sampling to determine the blood thyroid abnormalities. The severity of illness of MDD was determined by the duration of illness, frequency of admission/ suicidal attempts, and the Hamilton rating scale for depression (HAM-D). Results: Thirty-one of the 140 patients had thyroid dysfunction. There was no significant difference in the severity of illness among patients with MDD between thyroid dysfunction and normal function group (p=0.024). Conclusion: Patients with MDD had high prevalence of thyroid dysfunction; however, the former had no correlation with later.Please click PDF below to download the full paper...Â

Twelve-month, prospective, open-label study of repetitive transcranial magnetic stimulation for major depressive disorder in partial remission

Chawanun Charnsil, Sirijit Suttajit, Vudhichai Boonyanaruthee, Samornsri LeelarphatDepartment of Psychiatry, Chiang Mai University, Sriphum, Amphur Muang, Chiang Mai, ThailandBackground: The purpose of this study was to evaluate the long-term effect of repetitive transcranial magnetic stimulation (rTMS) as adjunctive treatment in patients with partial remission of major depressive disorder.Methods: This was a 12-month, prospective, open-label study in patients meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria for nonpsychotic major depressive disorder who responded to 8 weeks of medication treatment but did not reach remission. All patients were assigned to receive 10 sessions of rTMS applied at the left dorsolateral prefrontal cortex. During the course of rTMS, the patients were still taking their usual medication. Patients were followed up for 12 months to determine the long-term antidepressant effect.Results: There were nine patients (seven women and two men) who met the inclusion criteria and agreed to receive rTMS. The mean Hamilton rating scale for depression (HAM-D) score prior to treatment with rTMS was 12.89 ± 2.15. At 12 months after treatment, the mean HAM-D score was 6.45 ± 1.67 using a Friedman test, and in patients with partial remission of major depressive disorder, the HAM-D score significantly decreased after treatment with rTMS at 12 months (P = 0.001). Seven patients (77.78%) had reached the stage of remission (HAM-D < 8) after treating with rTMS at 12 months. There were no serious adverse events. One patient had vertigo after the first session of treatment and one patient felt scalp contractions during treatment, and both fully recovered within half an hour with no medical intervention.Conclusion: For patients with major depressive disorder in partial remission, high frequency rTMS at the left dorsolateral prefrontal cortex may provide benefits in adjunctive treatment with well tolerability. Also, follow-up findings show a long duration of benefit.Keywords: depression, remission, magnetic stimulation, adjunctive, long ter

Screen viewing time and externalising problems in pre-school children in Northern Thailand

Objectives: There are increasing reports of younger children accessing media and screen. This study aims to describe screen use in pre-school children and its  association with externalising problems.Methods: A cross-sectional study of pre-schoolers aged two to five years was  conducted. Their caregivers were asked to provide data regarding screen use by their children and themselves. The Child Behaviour Checklist (CBCL) was  completed by caregivers to assess their child’s behaviour.Results: Participants included 200 caregivers of pre-school children. There were 47% of pre-schoolers who had used at least three types of media. When comparing the 0–1, >1 to 2, and >2 hours per day of screen viewing time groups, the children who had experienced more screen time also had significantly more background media and their caregivers had more screen time (p < 0.001). The externalising problem scores increased with more screen viewing time, although the relationship was not statistically significant. However, age and gender of the child were factors associated with externalising problems from the multiple linear regression analysis (p = 0.03).Conclusion: Pre-schoolers with more screen viewing time did not have a significantly greater externalising problem score than those with less screen time. A longitudinal study with a larger sample size would provide more information

Quetiapine monotherapy versus placebo in the treatment of children and adolescents with bipolar depression: a systematic review and meta-analysis

Benchalak Maneeton,1 Suwannee Putthisri,2 Narong Maneeton,1 Pakapan Woottiluk,3 Sirijit Suttajit,1 Chawanun Charnsil,1 Manit Srisurapanont1 1Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, 2Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 3Psychiatric Nursing Division, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand Background: Some studies have indicated the efficacy of quetiapine in the treatment of bipolar depression in adult patients. However, its efficacy has been not shown in child and adolescent patients.Objective: This systematic review purposefully determined the efficacy and acceptability of quetiapine in the treatment of children and adolescents with bipolar depression.Data sources: A database search of EMBASE, PubMed, CINAHL, and Cochrane Controlled Trials Register was carried out in March 2016. All randomized controlled trials (RCTs) of bipolar depression in children and adolescents were considered for inclusion in this review.Study eligibility criteria, participants, and interventions: RCTs of quetiapine in the treatment of child and adolescent patients with bipolar depression with end point outcomes were included in this study. Languages were not limited.Study appraisal and synthesis methods: The full-text versions of relevant clinical studies were thoroughly examined and extracted. The primary efficacy of outcome was measured by using the pooled mean-changed scores of the rating scales for bipolar depression. However, the response and remission rates were also measured.Results: A total of 251 randomized patients in the three RCTs of quetiapine versus placebo in the treatment of bipolar depression for children and adolescents were eligible in this review. The pooled mean-changed score of the quetiapine-treated group was not greater than that of the placebo-treated group. Similarly, the pooled response and remission rates were not different between the two groups. The pooled overall discontinuation rate and the discontinuation rate due to adverse events were not different between the two groups.Limitations: Limited studies were eligible in this review.Conclusion: According to the findings in this review, quetiapine may not be efficacious in the treatment of bipolar depression in children and adolescents. Its acceptability, however, was comparable to a placebo. Therefore, the use of quetiapine in children and adolescents with bipolar depression is not recommended. Further well-defined clinical studies should be performed to confirm these outcomes. Keywords: monotherapy, depressive episodes, pharmacological treatment, Children’s Depression Rating Scale–Revised, CDRS-

Comparative efficacy, acceptability, and tolerability of dexmethylphenidate versus placebo in child and adolescent ADHD: a meta-analysis of randomized controlled trials

Narong Maneeton,1,* Benchalak Maneeton,1,* Pakapan Woottiluk,2 Sirijit Suttajit,1 Surinporn Likhitsathian,1 Chawanun Charnsil,1 Manit Srisurapanont1 1Department of Psychiatry, Faculty of Medicine, 2Division of Psychiatric Nursing, Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand *These authors contributed equally to this work Background: The efficacy of dexmethylphenidate (d-MPH) has been proven in the treatment of children and adolescents with attention-deficit hyperactivity disorder (ADHD).Objective: The aim of this systematic review is to determine the efficacy, acceptability, and tolerability of d-MPH in child and adolescent ADHD.Methods: The searches of SCOPUS, MEDLINE, CINAHL, and Cochrane Controlled Trials Register were performed in February 2015. All randomized controlled trials of d-MPH versus placebo that were performed in children and adolescents with ADHD up to 18 years of age were included in the study. The efficacy was measured by using the pooled mean-endpoint or mean-changed scores of ADHD rating scales and the response rate. Acceptability and tolerability were measured by using the pooled rates of overall discontinuation and discontinuation due to adverse events, respectively.Results: A total of 1,124 children and adolescents diagnosed as having ADHD were included in this review. In a laboratory school setting, the pooled mean-change and mean-endpoint scores in the d-MPH-treated group were significantly greater than those of the placebo-treated group with standardized mean difference (95% confidence interval [CI]) of -1.20 (-1.73, -0.67), I2=95%. Additionally, the pooled mean-changed scores of the ADHD rating scales for teachers and parents in the d-MPH-treated group were significantly greater than that of the placebo-treated group with weighted mean difference (95% CI) of -13.01 (-15.97, -10.05), I2=0% and (95% CI) of -12.99 (-15.57, -10.42), I2=0%, respectively. The pooled response rate in the d-MPH-treated groups had a significance higher than that of the placebo-treated group. The rates of pooled overall discontinuation and discontinuation due to adverse events between the two groups were not significantly different.Conclusion: Based on the findings in this review, it can be concluded that d-MPH medication is efficacious and tolerable in child and adolescent ADHD. However, the acceptability of d-MPH is no greater than that of the placebo. Further systematic studies may confirm these findings. Keywords: dexmethylphenidate, child and adolescent ADHD, meta-analysi