Culturally informed psychotherapy in Asian consultation-liaison psychiatry.

Psychotherapy provides substantial benefits for patients with medical illness. Western-based psychotherapies are commonly practiced by consultation-liaison psychiatrists in Asia. Although such interventions benefit Asian patients, they are limited by their cultural applicability. Sociocultural factors shape the meaning, expression, and treatment of medical illnesses. In helping patients with medical problems, it is imperative that psychiatrists be mindful of the value of culture in their clinical work. The concept of the self, religion, spirituality, adaptation, coping, and defense mechanisms are all culturally determined. This article discusses how these concepts impact the practice of psychotherapy in the Asian consultation-liaison psychiatry setting. Currently, there is a dearth of systematic research about this subject matter. Most studies describe the application of Western-based psychotherapies for patients with medical illness with little input as to cultural modifications or implications of such interventions. The authors of this article identify culturally consonant psychotherapeutic techniques in the Asian consultation-liaison psychiatry context. Furthermore, they also propose general guidelines in the cultural adaptation of psychotherapy interventions or development of indigenous psychotherapies.

Psychodynamic Psychiatry in the Philippines.

The authors describe the practice of psychodynamic psychiatry in the Philippines. They review features of contemporary psychodynamic psychiatry, the state of psychodynamic psychiatry in training programs, and its integration in national professional societies. Despite psychodynamic psychiatry's wide acceptance in the professional community in the Philippines and neighboring Southeast Asian countries, delivery of care to over 110 million residents of the archipelago requires creativity given the small number of psychiatrists. The authors discuss how psychodynamic psychiatry impacts the national mental health scene and propose future directions involving forging international linkages.

Examining the competency of Filipino mental health professionals in psychodynamic psychotherapy.

INTRODUCTION: Psychodynamic psychiatry forms the fundamental theoretical frame of reference for psychodynamic psychotherapy and related therapies using psychodynamic concepts. Over time, it faced questions about its empiricism, evidence base, cost-effectiveness, and fitness to the medical role. Although recent studies have reaffirmed its effectivity in mainstream medicine, its clinical practice in the local setting raises questions about the Filipino psychiatrists' systematic understanding and orientation to it, and signals a call for action. METHODOLOGY: Attendees in the UP Philippine General Hospital - Department of Psychiatry and Behavioral Medicine (UP PGH-DPBM), 13th Post-Graduate Course on Psychodynamic Psychotherapy, participated in an informal survey to generate hypotheses on the knowledge, perceptions, and attitudes of Filipino mental health professionals regarding psychodynamic psychotherapy. One hundred eighty-two (182) respondents answered the survey and results were analyzed using descriptive statistics. RESULTS AND DISCUSSION: Among the respondents, about 30% practiced psychodynamic psychotherapy and cognitive behavioral therapy (CBT) in equal parts, 15% practiced mostly psychodynamic psychotherapy and 15% practiced mostly CBT, while the rest were either unsure or practiced other forms of psychotherapy. Most agreed that psychodynamic psychotherapy required scientific rigor and remained applicable, but were divided on treatment frame and boundary setting, approach selection, and specific concepts and techniques. In terms of perceptions and attitudes toward psychodynamic psychotherapy, most respondents displayed positive attitudes and interest in the intervention, but did not highly regard their own competence. These findings steer psychodynamic psychotherapy research toward the systematic review of the competence of trainees and practitioners, the standardization of its education and training, and its applicability in a cultural context of limited resources.

Cognitive complaints and predictors of perceived cognitive dysfunction in adults with major depressive disorder: Findings from the Cognitive Dysfunction in Asians with Depression (CogDAD) study.

BACKGROUND: Several studies have described the presence of perceived cognitive dysfunction amongst Asian patients with major depressive disorder (MDD). To date, no study has been conducted investigating the predictors of perceived cognitive dysfunction amongst Asian MDD patients. METHODS: This was a post-hoc analysis of the Cognitive Dysfunction in Asian patients with Depression (CogDAD) study. Descriptive statistics were used to describe the most common cognitive complaints by patients. Univariate and multivariate analyses were performed to determine variables associated with perceived cognitive dysfunction (Perceived Deficit Questionnaire-Depression, PDQ-D). RESULTS: The CogDAD study population is comprised of MDD patients with mild-to-moderate depression (Patient Health Questionnaire 9-item [PHQ-9]: 11.3 ±â€¯6.9) who reported perceived cognitive dysfunction (PDQ-D = 22.6 ±â€¯16.2). The most common cognitive complaints were: mind drifting (42.3%), trouble making decision (39.6%) and trouble concentrating (38.0%). Predictors of perceived cognitive dysfunction were: being Southeast Asians (vs. Taiwanese) (p < 0.001), current episode longer than 8 weeks (vs. 1-8 weeks) (p < 0.05), the presence of disability (vs. no disability) (p < 0.05), younger age (p < 0.01), and higher PHQ-9 total scores (p < 0.001). LIMITATIONS: The causal relationship between predictive variables and PDQ-D could not be tested due to the cross-sectional nature of the study. Furthermore, a neuropsychological test was not included in the CogDAD study and use of concomitant medications, including anti-depressants, could have impacted patient's perceived cognitive ability. CONCLUSIONS: The present study results suggest a potential role for subjective cognitive assessment in patients with MDD who are young, with long durations of depression or severe depression.