Problematic drug use among outpatients with schizophrenia and related psychoses.

Problematic drug use is common among psychiatric patients and is linked with poorer course and outcomes of illness. The aim of this study is to assess the prevalence of problematic drug use, and to explore its sociodemographic correlates and associations with health behaviors and outcomes among outpatients with schizophrenia and related psychoses in Singapore. Data from 397 individuals who were aged 21-65 years and were seeking treatment for schizophrenia and related psychoses in the outpatient clinics of a tertiary psychiatric hospital were analyzed. The Drug Abuse Screening Test (DAST-10) was used to assess problematic drug use. Information on sociodemographics, smoking status, alcohol use, symptoms severity and quality of life were collected. Multivariable logistic regressions were conducted to explore correlates and associations of problematic drug use. The prevalence of problematic drug use was 5.8% ( = 23) in the sample, and 10.6% ( = 42) of the participants reported having problematic drug use and/or problematic alcohol use. More males than females reported having problematic drug use ( = 0.021), and also problematic drug and/or alcohol use ( = 0.004). Significant associations were observed between problematic drug use and smokers with nicotine dependence, and with physical health domain of quality of life. Individuals with greater symptom severity were approximately twice as likely to have problematic drug use and/or alcohol use. While the prevalence of problematic drug use in this sample population is relatively lower compared to other countries, there is a considerable number who might be at risk. Routine screening and close monitoring of drug use is recommended as part of psychiatric assessment, particularly among males and patients with nicotine dependence

Recognition of diabetes and sociodemographic predictors: results of a cross-sectional nationwide population-based survey in Singapore

10.1136/bmjopen-2021-050425BMJ OPEN12

Prevalence and patterns of physical activity, sedentary behaviour, and their association with health-related quality of life within a multi-ethnic Asian population

10.1186/s12889-021-11902-6BMC Public Health211193

Advancing research to eliminate mental illness stigma: an interventional study to improve community attitudes towards depression among university students in Singapore

Background: After decades of anti-stigma initiatives, the Advancing Research To Eliminate Mental Illness Stigma (ARTEMIS) intervention study is one of the first in Singapore to evaluate the effects of an anti-stigma intervention on attitudes towards depression in university students. Methods: 390 university students from a local university in Singapore were voluntarily recruited for the study. The ARTEMIS intervention comprises an educational and social contact component, as well as a question and answer (Q&A) session with experts in the area of mental health. The Community Attitudes towards Mental Illness (CAMI) scale was administered at baseline, post-intervention and at 3-months follow-up. A confirmatory factor analysis (CFA) was conducted. Results: The CFA identified a 3-factor model for the CAMI with a decent fit (RMSEA = 0.06, CFI = 0.93, TLI = 0.93, SRMR = 0.06). Favourable shifts in attitudes across the factors were observed immediately after the intervention (p < 0.001). Gender (β = − 1.19, 95% CI: − 2.10, − 0.27, p = 0.01) and nationality (β = − 1.23, 95% CI: − 2.35, − 0.11, p = 0.03) were identified as significant correlates for the community mental health ideology (CMHI) factor. Linear effects indicated that having a close social contact with mental illness observed a smaller decrease in authoritarianism scores from pre- to post-intervention (β = 0.85, 95% CI: 0.18, 1.53, p = 0.01); whereas quadratic effects found a greater decrease in scores from post-intervention to after 3-months for benevolence (β = − 0.34, 95% CI: − 0.52, − 0.16, p < 0.001) and CMHI (β = − 0.22, 95% CI: − 0.45, − 0.002, p = 0.048). Conclusion: The anti-stigma intervention shows promising short-term results across the CAMI dimensions even after adjusting for sociodemographic correlates. However, the intervention did not observe the sustained attitude shifts after 3-months. Recommendations for future anti-stigma interventions were also considered.Published versionThis study was supported by Tote Board (Grant No. 2016/11/051)

Recognition of depression and help-seeking preference among university students in Singapore : an evaluation of the impact of advancing research to eliminate mental illness stigma an education and contact intervention

Background: The SMHS 2016 revealed that young adults in Singapore had the highest 12-month prevalence of mental disorders, with depression being the most prevalent condition. Additionally, the study found that those with higher education were less likely to seek treatment. The recognition of mental illness and knowledge of where to seek help has been found to influence one's ability to seek timely psychological help. This study thus aims to evaluate the effects of ARTEMIS, an education and contact intervention on university students' recognition of depression and help-seeking preference. Methods: A total of 390 university students were recruited over a period of 6-months (October 2018 to April 2019). Students had to attend a one-off intervention which comprised a lecture on depression and personal contact with a person with lived experience of mental illness. Recognition of depression and help-seeking preference were assessed using a vignette approach, at pre- and post-intervention as well as at 3-month follow-up. Results: The intervention was effective at improving student's recognition of depression and this effect was sustained at 3-months follow-up. The intervention was also effective in shifting student's help-seeking preference, although the effects were not sustained at 3-month follow-up. Having a close friend or family with mental illness was associated with better recognition, and being able to correctly recognize depression was linked to a preference to seek psychiatric over non-psychiatric help. Conclusion: This study elucidated the efficacy of a knowledge-contact-based intervention in improving university students' recognition of depression and help-seeking preference. However, while the benefits on recognition of depression is more enduring, it is more transient for help-seeking beliefs, and booster sessions may be needed to improve the long-term effectiveness of the intervention on help-seeking preference. Lastly, to investigate the generalizability of this study's findings, future studies could replicate the current one across other non-self-selected samples, such as by integrating the intervention as part of student's orientation.Singapore Totalisator Board (SingTOTE)Published versionThis research was supported by Tote Board, Singapore

Preliminary development of a bystander intervention scale for depression and the examination of socio-demographic correlates amongst Singapore university students

Background: Despite peer involvement having a positive impact on help-seeking behavior, there is a lack of a scale quantifying the possibility of an individual intervening upon noticing peers who show signs of depression. The aims of this study were to (1) develop a bystander intervention scale for depression that assesses the likelihood of university students intervening when a peer shows signs of depression based on the theory of bystander intervention, (2) identify the underlying factors contributing to the behavior, and (3) explore the socio-demographic correlates of the scale. Methods: The proposed scale, the Bystander Intervention Scale for Depression (BISD), is a 17-item self-reported questionnaire that was developed based on existing bystander intervention theory and inputs from mental health experts. Data was collected as part of a larger study to evaluate the effectiveness of an anti-stigma intervention amongst university students from a local university. A total of 392 participants were recruited. Exploratory factor analyses were performed to identify the underlying factor structure. Multiple linear regressions were conducted to explore the socio-demographic correlates of the scale. Result: Four key factors were identified for the proposed scale: (1) Awareness of depression among peers; (2) Vigilance towards possible symptoms of depression; (3) Knowledge on how to intervene; (4) Acceptance of responsibility to intervene. Having experience in the mental health field was associated with all factors while having family members or friends with mental illness was associated with all factors except for knowledge on how to intervene. Students of older age were associated with higher vigilance towards possible symptoms of depression and knowledge on how to intervene. Those of non-Chinese ethnicity were associated with acceptance of responsibility to intervene. Conclusion: This study provides a preliminary tool to assess bystander intervention in depression amongst university students. This study identifies sub-groups of the student population that require more education to intervene with depressed peers and also informs the development of future strategies.Singapore Totalisator Board (SingTOTE)Published versionThe study was funded by Tote Board, Singapore. The funding body had no role in the design of the study, data collection and analysis, interpretation of data and in writing the manuscript

Smoking-Related Health Beliefs in a Sample of Psychiatric Patients: Factors Associated with the Health Beliefs and Validation of the Health Belief Questionnaire

This study examined the (a) health beliefs and emotions (perception of risk, benefits, severity, and worry) about smoking among current and former smokers, (b) their awareness of health warnings, (c) factors associated with smoking-related health beliefs, and (d) the factor structure of the health belief questionnaire. Participants (n = 184) were recruited from a tertiary psychiatric care hospital. Current smokers showed a significantly higher risk perception and lower perceived benefits compared to former smokers. Younger age (&lt;40 years), nicotine dependence (ND), a history of smoking-related diseases (SRD), and intention to quit were significantly associated with a higher risk perception in current smokers. Younger age, a history of SRDs, and motivation to quit were positively associated with health beliefs, while the latter two were associated with worry. Motivation and younger age were associated with a better perception of benefits and severity. Information on the cigarette packets was the major source of awareness for the sample, and 69% reported that existing campaigns were not effective in discouraging their smoking. Personalized risk communication and educational initiatives must focus on improving the knowledge of risk, benefits, and increase motivation to promote health cognition and thus smoking cessation

Sources of information on diabetes and its demographic correlates: a nationwide survey among Singapore residents

Diabetes is a major public health concern in Singapore, and the Singapore Government declared a \u27War on Diabetes\u27, which included a nationwide public health campaign. It is important to identify what sources of diabetes information reach the general population, whether this differs by socio-demographic characteristics and if the sources of information influence knowledge of diabetes to aid the successful dissemination of health information. Two thousand eight hundred ninety-five respondents were part of a population-based cross-sectional study conducted from February 2019 to September 2020. Respondents rated on a five-point scale whether they had obtained information on diabetes from eight different information sources, and responses were dichotomized into \u27endorsed receiving information\u27 or \u27not endorsed receiving information\u27. Poisson regression models were conducted with the \u27endorsement of receiving information\u27 from each source as the outcome and socio-demographic variables as predictors. 95.9% of the study population had received information on diabetes from at least one source, and the mean number of sources was 4.2 ± 2.0. The leading source was media articles (82.1%), followed by health promotion videos/advertisements (77.9%), online websites (58.5%), books (56.5%), healthcare professionals (55.0%), radio (54.4%), public forums (27.7%) and support groups (15.5%). Endorsing a greater number of informational sources was associated with being younger, belonging to Malay or Indian instead of Chinese ethnicity, and having diabetes. An intensive nationwide diabetes awareness campaign successfully reached the public in Singapore with specific sources of information depending on socio-demographic characteristics. Findings suggest that diabetes information campaigns should utilize multiple channels for dissemination considering the different socio-demographic subgroups

The potential impact of an anti-stigma intervention on mental health help-seeking attitudes among university students

Background: The reluctance of young adults to seek mental health treatment has been attributed to poor mental health literacy, stigma, preference for self-reliance and concerns about confidentiality. The purpose of this study was to examine the potential impact of an anti-stigma intervention that includes education about depression, information about help-seeking as well as contact with a person with lived experience, on help seeking attitudes. Methods: A pre-post study design was employed. Changes in help-seeking attitudes were measured using the Inventory of Attitudes towards Seeking Mental Health Services (IASMHS) immediately post-intervention and after 3 months. Sociodemographic data, information on past experiences in the mental health field and contact with people with mental illness were collated. Three hundred ninety university students enrolled in the study. Linear mixed models were used to examine the effects of the intervention. Results: Scores on all subscales of the IASMHS, Psychological Openness (PO), Help-seeking Propensity (HP) and Indifference to Stigma improved significantly post-intervention and at 3-month follow-up compared to pre-intervention, with HP demonstrating the highest effect size. However, a significant decline was observed on all three scales at 3-month follow-up compared to post-intervention. Gender, having friends/family with mental illness, and previous experience in the mental health field moderated the intervention effects for the PO and HP subscales. Conclusions: The study showed that the brief anti-stigma intervention was associated with improvements in help-seeking attitudes among university students with differential effects among certain sub-groups. As the beneficial outcomes appeared to decrease over time, booster sessions or opportunities to participate in mental health-related activities post-intervention may be required to maintain the desired changes in help-seeking attitudes.Published versio