Perceived attitudes toward LGBTQ + physicians among individuals with psychiatric illness in the religiously diverse Southern Region of Thailand: a multihospital-based survey.

OBJECTIVES: This study purposed to analyze perceived attitudes toward LGBTQ + physicians and related factors among individuals with psychiatric illnesses in southern Thailand. MATERIALS AND METHODS: From May to July 2023, a cross-sectional study was conducted at four psychiatric outpatient clinics in Southern Thailand. The questionnaires utilized were: 1) a demographic information questionnaire, 2) a questionnaire regarding attitudes toward LGBTQ + physicians, 3) a questionnaire evaluating individuals' attitudes toward LGBTQ + physicians while receiving medical attention, and 4) a patient-doctor relationship questionnaire. All data were analyzed using descriptive statistics, and the factors associated with perceived attitudes toward LGBTQ + physicians were analyzed using the Wilcoxon rank sum test, the Kruskal-Wallis test, and linear regressions. The analyses were conducted using the R Foundation for Statistical Computing software, version 4.3.1. Statistical significance was defined as a p-value of less than 0.05. RESULTS: Among our 542 participants, the mean age was 36.3 ± 14.1 years. The majority were female (64.6%), Buddhist (62.4%), and diagnosed with depression (46.3%). Approximately three-quarters showed a good doctor-patient relationship (74.0%). The median (IQR) score of the perceived attitudes toward LGBTQ + physicians was 75 (66, 88). Predominantly, the LGBTQ + physicians were perceived as normal (76.3%) and being a viable part of society (88.7%). Moreover, our participants disagreed with the view that being an LGBTQ + physician was a sin (70.6%) or immoral (68.2%). They felt comfortable during history taking (79.0%), physical examination not involving private parts of the body (72.5%), and management for both medical (78.4%) and psychiatric conditions (81.4%) at the hands of LGBTQ + physicians. However, they reported feeling uncomfortable during history taking involving private matters (6.3%) and the physical examination of private parts (16.4%). Older age, absence of LGBTQ + close relatives/friends, and being a Muslim were associated with lower scores of perceived attitudes toward LGBTQ + physicians. Conversely, a higher level of education and a reported mismatch between the patient's sex and gender were associated with higher scores. CONCLUSIONS: Most participants reported positive perceived attitudes toward LGBTQ + physicians. However, some age groups and adherents of Islam showed lower perceived attitude scores and reported feeling uncomfortable receiving medical treatment from LGBTQ + physicians. On the one hand, LGBTQ + physicians have cause to be concerned about this point; on the other hand, finding appropriate approaches to promote positive attitudes toward LGBTQ + physicians among these groups of people remains a necessity.

Residual symptoms and their associated factors among Thai patients with depression: a multihospital-based survey.

BACKGROUND: Depression is a common and debilitating disease, and even residual symptoms of depression can cause significant functional impairment. To achieve normal functioning, residual symptoms should also be identified and targeted by a competent treatment strategy. Thus, this study aimed to examine residual symptoms of depression and their associated factors among patients with depression. METHODS: A cross-sectional study surveyed Thai patients with depression at two psychiatric outpatient clinics, Songklanagarind Hospital, and Songkhla hospital; from June to October 2021. The questionnaires inquired about: (1) demographic information, (2) the PHQ-9 Thai version, (3) a questionnaire focusing on depressive symptoms that impacted daily life, and were originally expected to be improved due to antidepressants. All data were analyzed using descriptive statistics, and associated factors concerning depressive symptoms were analyzed by a Chi-square and a logistic regression. RESULTS: Of all 566 respondents, the majority of them were female (75.4%). The overall mean age was 43.8 ± 18.1 years. The depressive symptoms that had high frequency, high impact on daily life, and that the participants expected that they are resolved or get better via antidepressants were: sleeping problems (81.6%), feeling depressed (79.9%), and lack of pleasure (75.4%). Most of the participants (65.7%) received one type of antidepressant, and the most prescribed antidepressants were selective serotonin reuptake inhibitors (51.1%). In regard to objectives, 45.4% of participants reported having residual depressive symptoms which included sleeping problems (71.2%), feeling down (62.6%), lack of pleasure (62.3%), and poor appetite (61.9%). The associated factors relating to residual depressive symptoms were younger age, high education level, and having physical illness. CONCLUSION: Almost half of patients with depression had residual symptoms, and they showed symptoms with high individual variability. Further to receiving effective treatment, a focused and individualized approach aiming for symptomatic remission, functional recovery, and quality of life improvements is key to recovery. Therefore, shared decision-making, and taking into account drug efficacy based on symptom profiles are both highly recommended.