Psychiatric services in primary care settings: a survey of general practitioners in Thailand

BACKGROUND: General Practitioners (GPs) in Thailand play an important role in treating psychiatric disorders since there is a shortage of psychiatrists in the country. Our aim was to examine GP's perception of psychiatric problems, drug treatment and service problems encountered in primary care settings. METHODS: We distributed 1,193 postal questionnaires inquiring about psychiatric practices and service problems to doctors in primary care settings throughout Thailand. RESULTS: Four hundred and thirty-four questionnaires (36.4%) were returned. Sixty-seven of the respondents (15.4%) who had taken further special training in various fields were excluded from the analysis, giving a total of 367 GPs in this study. Fifty-six per cent of respondents were males and they had worked for 4.6 years on average (median = 3 years). 65.6% (SD = 19.3) of the total patients examined had physical problems, 10.7% (SD = 7.9) had psychiatric problems and 23.9% (SD = 16.0) had both problems. The most common psychiatric diagnoses were anxiety disorders (37.5%), alcohol and drugs abuse (28.1%), and depressive disorders (29.2%). Commonly prescribed psychotropic drugs were anxiolytics and antidepressants. The psychotropic drugs most frequently prescribed were diazepam among anti-anxiety drugs, amitriptyline among antidepressant drugs, and haloperidol among antipsychotic drugs. CONCLUSION: Most drugs available through primary care were the same as what existed 3 decades ago. There should be adequate supply of new and appropriate psychotropic drugs in primary care. Case-finding instruments for common mental disorders might be helpful for GPs whose quality of practice was limited by large numbers of patients. However, the service delivery system should be modified in order to maintain successful care for a large number of psychiatric patients

The Development and Validation of the Thai-Translated Irrational Performance Beliefs Inventory (T-iPBI)

© 2018, Springer Science+Business Media, LLC, part of Springer Nature. One of the most commonly employed cognitive-behavioural approaches to psychotherapy is rational-emotive behaviour therapy, but researchers have been troubled by some of the limitations of irrational beliefs psychometrics. As a result, Turner et al. (Eur J Psychol Assess 34:174–180, 2018a. https://doi.org/10.1027/1015-5759/a000314) developed the Irrational Performance Beliefs Inventory (iPBI), a novel measure of irrational beliefs for use within performance domains. However, the linguistic and cross-cultural adaptation of the iPBI into other languages is necessary for its multinational and multicultural use. The purpose of this paper is to develop the Thai-translated version of the iPBI (T-iPBI) and examine the validity and reliability of the T-iPBI. Data retrieved from 166 participants were analysed using SPSS and AMOS software packages. Thirty-three participants completed two follow-up T-iPBI measurements (1- and 3-week repeat assessment). After the linguistic and cross-cultural adaptation processes, the T-iPBI demonstrated excellent levels of reliability, with internal consistency and test–retest reliability, as well as construct, concurrent, and predictive validity. The current findings indicate that the 20-item T-iPBI can be used as a self-assessment instrument to evaluate individual’s irrational performance beliefs in a Thai population. We also highlight the implications of this study and suggest a variety of future research directions that stem from the results

Anxiety and depression symptoms following smoking cessation and/or brief alcohol treatment among moderate risk smokers and drinkers

The goal of this study was to examine the change in anxiety and depression symptoms following a smoking cessation and brief alcohol intervention. Participants were 620 hospital out-patients (males = 97.7%; 33.6 years of age, SD = 11.6), in Nakhon Pathom province, Thailand, who screened positive for moderate risk for tobacco and alcohol use. The patients were involved in a randomised controlled trial comparing smoking cessation treatment that integrated a brief alcohol intervention consisting of smoking cessation treatment only or brief alcohol intervention only. Alcohol use and smoking, and anxiety and depressive symptoms were assessed at baseline, and 3 and 6-month following treatment. Findings from generalised estimation equations (GEE) analysis suggested that overall anxiety and depression scores to be significantly reduced following treatment. The tobacco only intervention significantly reduced anxiety and depression symptoms, while the alcohol only intervention significantly reduced depression symptoms. Smoking abstinence significantly reduced anxiety and depression symptoms and low risk alcohol use significantly reduced anxiety symptoms but not depression symptoms. Smoking cessation and/or brief alcohol treatment may be accompanied by improved psychological well-being.