A retrospective database study on 2-year weight trajectories in first-episode psychosis

IntroductionIt is critical to focus on individual weight profiles in line with efforts to tailor treatment, given the heterogeneous nature of the clinical population. This study aims to identify and describe possible two-year weight trajectories among patients accepted to the Early Psychosis Intervention Programme (EPIP) in Singapore.MethodsDe-identified data was extracted from EPIP’s standing database for patients accepted from 2014 to 2018 with a schizophrenia spectrum disorder. Data collected at fixed time-points (baseline, 1-year, and 2-year) included anthropometric measures (height and weight), and sociodemographic (age, sex, highest education level, and vocational status) and clinical (duration of untreated psychosis, number of inpatient admissions, and scores on the Positive and Negative Syndrome Scale and Global Assessment of Functioning) information.ResultsA total of 391 complete data sets were included for main analyses. Those with missing weight data were more likely to be males, older at baseline, have a highest education level of tertiary and above at baseline, and have a longer duration of untreated psychosis. The weight change across two years resulted in the following membership breakdown: 151 (38.6%) in super high risk; 133 (34.0%) in high risk mitigated; 17 (4.3%) in at risk; 34 (8.8%) in delayed risk; and 56 (14.4%) in low risk.DiscussionThe lack of pharmacological, dietary, and physical activity data is a significant limitation in this study; however, the results reinforce the justification for future studies to prospectively capture and examine the influence of these data, with the aim of early detection and weight intervention for high risk groups

Triphasic Computed Tomography Enterography with Polyethylene Glycol to Detect Renal Cell Carcinoma Metastases to the Small Bowel

Enteroclysis was first used to diagnose small bowel obstruction in 1996. However, nasojejunal intubation required during enteroclysis causes discomfort to the patient. Triphasic computed tomography (CT) enterography, a noninvasive procedure that does not require intubation, was found to be an efficient method to diagnose small bowel lesions. We describe our experience of using triphasic CT enterography with polyethylene glycol (PEG) for diagnosing renal cell carcinoma (RCC) metastases to the small intestine. RCC can metastasize to many organs and can cause variable clinical presentations. We report the case of a 56-year-old man with RCC who had psoas muscle involvement and lung metastasis. The patient presented with melena and intermittent abdominal pain. Two conventional CT and small bowel series examinations had shown no obstructive lesion in the small intestine. However, triphasic CT enterography with PEG detected two enhanced masses suggestive of small bowel metastasis. The patient underwent laparotomy and segmental resection of the jejunum with primary anastomosis. Histologic examination was compatible with RCC. This is the first report where RCC metastasis to the small bowel was diagnosed using triphasic CT enterography. Our study emphasizes the importance of triphasic CT enterography in cases of obscure gastrointestinal bleeding, especially in patients suspected of having small bowel metastasis

The Implementation and Review of Cognitive Remediation Training for First Episode Psychosis in Singapore

10.3389/fpsyt.2021.784935Frontiers in Psychiatry1278493

A qualitative study on negative experiences of social media use and harm reduction strategies among youths in a multi-ethnic Asian society

PURPOSE: This study aimed to expand and inform the emerging body of research on the negative experiences of social media use among youths and how youths deal with them, in an Asian setting, using a qualitative approach. METHODS: Data were collected using 11 focus group discussions (FGDs) and 25 semi-structured interviews (SIs) among youths aged 15 to 24 years residing in Singapore who were recruited via purposive sampling. Data were analysed using thematic analysis. RESULTS: The salient negative effects mentioned by participants include the development of negative reactions and feelings from upward comparisons with others (e.g., others\u27 achievements and lifestyle), receiving hurtful comments, exposure to controversial content (e.g., political events and social movements), as well as the perpetuation of negative feelings, behaviours, and sentiments (e.g., rumination, unhealthy eating behaviour, and self-harm). Participants also described strategies which they have employed or deemed to be useful in mitigating the negative effects of social media use. These include filtering content and users, taking breaks from social media, cognitive reframing, and self-affirmation, where they identify and change stress-inducing patterns of thinking by setting realistic social, physical, and lifestyle expectations for themselves, and focusing on self-development. CONCLUSION: The current results highlight that while youths experience negative effects of social media use, they have high media literacy and have employed strategies that appear to mitigate the negative effects of social media use. The findings can inform various stakeholders involved in helping youths navigate the harms of social media use or provide directions for intervention studies aimed at reducing the harms of social media use

Efficacy of Solution-Focused Brief Therapy versus case management for psychological distress in help-seeking adolescents and young adults in Singapore: protocol for a randomised controlled trial

Introduction: There are insufficient scalable, evidence-based treatments to meet the increasing mental health needs of young persons in Singapore. Offering interim, brief interventions for distressed treatment-seekers can improve care access and mitigate adverse effects of long waiting times. This study proposes to test the efficacy of Solution-Focused Brief Therapy (SFBT), a strengths-based, goal-directed intervention, for psychological distress in help-seeking adolescents and young adults. Methods: We will conduct a fully-powered, randomised, single-centre, two-armed, parallel, superiority, controlled trial. From September 2023 to March 2025, the study will recruit 124 participants (ages 16-30) presenting at a national youth mental health service in Singapore (CHAT, Centre of Excellence for Youth Mental Health) with clinically-assessed non-specific psychological distress, subthreshold or prodromal symptoms, or a first episode of a mood disorder. Participants will be excluded if they have high suicidal risk, psychosis, cognitive impairments, or current psychological treatments. Participants will be randomised in a 1:1 ratio to receive six-session, case manager-delivered SFBT or treatment as usual (TAU), case management. Participants receiving SFBT are hypothesized to have greater improvements in self-reported psychological distress, from baseline to eight weeks, compared to the control group. Secondary outcomes are self-reported depression and anxiety symptoms, and functional impairment. The study will additionally explore if SFBT is associated with: 1) increased self-efficacy and decreased hopelessness; 2) decreased downstream referrals at post-intervention; and 3) sustained clinical gains at three months post-intervention, compared to TAU. Significance: Results have implications for expanding capacity of mental health services and enhancing capabilities of frontline case managers to provide timely and low-intensity evidence-based interventions to improve the mental health of young persons in Singapore

Interview guide to examine the harms of social media and strategies youth adopt to mitigate those harms.

Interview guide to examine the harms of social media and strategies youth adopt to mitigate those harms.</p

Sociodemographic characteristics of the study population.

Sociodemographic characteristics of the study population.</p