Mapping the world health organization disability assessment scale 2.0 to the EQ-5D-5L in patients with mental disorders.

OBJECTIVE: The current study aims to develop an algorithm that mapping the WHODAS 2.0 to the EQ-5D-5 L for patients with mental disorders. METHODS: This cross-sectional study was conducted at the Institute of Mental Health and the Community Wellness Clinics in Singapore between June 2019 and November 2022. We included four regression methods including the Ordinary Least Square (OLS) regression, Tobit regression model (Tobit), the robust regression with MM estimator (MM) and the adjusted limited dependent variable mixture models (ALDVMM) to map EQ-5D-5 L utility scores from the WHODAS 2.0. RESULTS: A total of 797 participants were included. The mean EQ-5D-5 L utility and WHODAS 2.0 total scores were 0.61 (SD = 0.34) and 11.96(SD = 8.97), respectively. We found that the EQ-5D-5 L utility score was best predicted by the robust regression model with the MM estimator. Our findings suggest that the WHODAS 2.0 total scores were significantly and inversely associated with the EQ-5D-5 L utility scores. CONCLUSION: This study provides a mapping algorithm for converting the WHODAS 2.0 scores into EQ-5D-5 L utility scores which can be implemented using a simple online calculator in the following web application: https://eastats.shinyapps.io/whodas_eq5d/.

The impact of media reporting of suicides on subsequent suicides in Asia: A systematic review.

Introduction: This systematic review is aimed at (1) evaluating the association between media portrayals of suicides and subsequent copycat suicides or attempts among the general public in Asia, (2) understanding the factors associated with copycat suicides and (3) determining the positive impacts of the media reporting of suicides (e.g. increased help-seeking, coping). Method: A systematic review and narrative synthesis of English and Chinese articles from 8 electronic databases (i.e. PsycINFO, MEDLINE, Embase, CINAHL, Web of Science, Ariti, China National Knowledge Infrastructure and OpenGrey) from January 2000 to May 2023 was conducted. Observational studies were included, and the data were analysed through narrative synthesis. The protocol was registered with PROSPERO (CRD42021281535). Results: Among the 32 studies included (n=29 for evidence synthesis) in the review, there is good-quality evidence to show that copycat suicides and suicide attempts increase after media reports of a suicide, regardless of country, celebrity status, study design, type of media, mode of suicide or follow-up period. Females, younger age groups and those sharing similar characteristics as the deceased in publicised suicides (age, gender) were more susceptible to negative impact. Reporting of the mode of death of the deceased increased suicides by the same method among the public. Conclusion: Media portrayals of suicide appear to have a negative impact on copycat suicides at the population level in Asia. Thus, in addition to tighter media control, healthcare systems, professional medical bodies and community outreach services should work collaboratively to promote early help-seeking in those with psychological distress.

Health care utilization, productivity losses, and burden of adverse childhood experiences in Singapore: Findings from a national survey.

OBJECTIVE: There is poor understanding on health care utilization, productivity losses, and burden of adverse childhood experiences (ACEs) in multiethnic Asian populations. Part of this research gap stems from the limited epidemiological data on neglect, emotional abuse, bullying, and dysfunctional home environments. This study estimated health care utilization, productivity losses, and burden of ACEs (at least one exposure and multiple exposures) in Singapore. METHOD: A total of 4,441 adult residents were recruited via door-to-door surveys in a nationally representative study in Singapore. All participants were assessed for ACEs, health care utilization, productivity losses, chronic physical disorders, and mental disorders on structured interviews. Approximation formulas were applied to calculate the estimated cost of ACEs in Singapore. RESULTS: ACEs were prevalent (63.9%) in the Singapore population. Individuals exposed to ≥ 3 ACEs (13.1%) utilized more direct medical care (e.g., primary care doctor and accident and emergency visits) and experienced greater productivity losses than those without ACEs (36.1%). The adjusted excess costs associated with ACEs per person were estimated to be S$767.40 (at least one ACE; 63.9%) and S$2167.84 (≥ 3 ACEs; 13.1%). The adjusted incremental costs of ACEs in the Singapore population were estimated to be S$1.18 billion (at least one ACE) and S$680 million (≥ 3 ACEs) per year. CONCLUSIONS: The health and economic burden of ACEs is substantial in Singapore. Our results highlight the importance of investing in novel, population-based ACEs interventions, and the potential return on investment through preventive care and alleviation of the health care burden. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prevalence and risk factors of depression and anxiety in primary care.

Introduction: Anxiety and depressive disorders are highly prevalent mental health conditions worldwide. However, little is known about their specific prevalence in primary care settings. This study aimed to determine the prevalence of depression and anxiety in the primary care population and identify associated patient characteristics. Method: We conducted a cross-sectional study using stratified sampling by age with a self-administered questionnaire survey in Singapore's National Health-care Group Polyclinics from December 2021 to April 2022. A total score of Patient Health Questionnaire-9 (PHQ-9) ≥10 represents clinical depression, and a total score of Generalised Anxiety Disorder-7 (GAD-7) ≥10 indicates clinical anxiety. Multivariable logistic regression was used to identify the factors associated with depression and anxiety. Results: A total of 5694 patients were approached and 3505 consented to the study (response rate=61.6%). There was a higher prevalence of coexisting clinical depression and anxiety (DA) (prevalence=5.4%) compared to clinical depression only (3.3%) and clinical anxiety only (1.9%). The odds of having DA were higher among those aged 21-39 years (odds ratio [OR] 13.49; 95% confidence interval [CI] 5.41-33.64) and 40-64 years (OR 2.28; 95% CI 1.03-5.03) compared to those ≥65 years. Women had higher odds of having DA (OR 2.33; 95% CI 1.54-3.50) compared to men. Respondents with diabetes had higher odds of having DA (OR 1.78; 95% CI 1.07-2.94) compared to those without diabetes. Conclusion: Coexisting clinical depression and anxiety are significantly present in the primary care setting, especially among younger individuals, patients with diabetes and women. Mental health screening programmes should include screening for both depression and anxiety, and target these at-risk groups.

Exploring the Singapore general population's trust in COVID-19 information from different sources and its association with perceived risk of infection during the pandemic.

Background: The degree of public trust in the government's competence is crucial in preventing the spread of misinformation and reducing psychological distress during a pandemic. The study aimed to (i) explore the trust in COVID-19 information from different sources and trust in the ability of the World Health Organization (WHO), government departments and related institutions in handling the epidemic in Singapore and (ii) its association with perceived risk of infection among Singapore residents. Methods: A total of 1,129 participants (aged 21 and above) were recruited from a cross-sectional study examining the well-being and resilience of Singapore's population between May 2020 to June 2021. Trust in COVID-19 information from different sources was measured on a 10-point scale and an ordinal 7-point scale was used for perceived risk of infection. Descriptive statistics and multivariate logistic regression model were conducted. Results: 85.5% reported high trust in COVID-19 information from the government and their ability in handling the pandemic. Participants also reported high trust in COVID-19 information from local public health or infectious disease experts (84.4%) and traditional media (77.2%). Low trust in the ability of government departments and related institutions was associated with higher future (1 month) perceived risk of infection (OR: 5.7, 95% CI 1.02-32.45) and low trust in social media was associated with higher current perceived risk of infection (OR: 2.4, 95% CI 1.09-5.24). Discussion: The present study provided insight on the level of trust on COVID-19 information from different sources and its associated perceived risks of infection. Future qualitative studies are recommended to facilitate better understanding of public trust and identify strategies for how it can be effectively addressed to support future public health responses.

Problematic smartphone use and mental health outcomes among Singapore residents: The health and lifestyle survey.

BACKGROUND: The excessive use of smartphones and its association with adverse outcomes has been widely reported, with several studies showing an association between smartphone overuse, depression, anxiety, and sleep-related problems. METHODS: The study used data from the Health and Lifestyle Survey, a nationwide population survey. It examined the prevalence of Problematic Smartphone Use (PSU) and its association with mental health outcomes among Singapore residents aged 15-65 years. PARTICIPANTS: Participants were assessed for PSU using the Smartphone Addiction Scale-Short Version, psychological distress with the Patient Health Questionnaire-9, and Generalised Anxiety Disorder -7 questionnaire, sleep problems using the Insomnia Severity Index, and positive mental health with Rapid Positive Mental Health Instrument. RESULTS: In all, 6509 participants completed the survey, giving a survey response rate of 73.2 %. The prevalence of PSU was 30.2 % in the population. Individuals with PSU were more likely to have symptoms of moderate or severe depression (OR: 3.2, 95 % CI: 2.4-4.4), anxiety (OR: 3.4, 95 % CI: 2.4-4.8), insomnia (OR: 3.4, 95 % CI: 2.8-4.2), and poorer positive mental health (ß: -0.3, 95 % CI: -0.4 to -0.2). CONCLUSIONS: The study is the first to examine PSU in a national sample of Singaporeans across a wide age range. It provides valuable insights into mental health comorbidities among those with PSU, which is useful for practitioners.

Evaluating a mobile-based intervention to promote the mental health of informal dementia caregivers in Singapore: Study protocol for a pilot two-armed randomised controlled trial.

BACKGROUND: Informal caregivers of persons with dementia (PWD) often suffer adverse impacts on their mental health and require interventions for effective support. As they are often occupied with providing care, web-based interventions could be more convenient and efficient for them. However, there is currently a dearth of evidence-based mobile interventions to enhance the mental well-being of dementia caregivers locally, especially ones that are user-centered and culturally relevant. Hence, having designed an app based on feedback from local dementia caregivers, this study will evaluate the effectiveness of this mobile app in promoting the mental health of informal caregivers of PWD in Singapore. METHODS: A pilot two-armed randomised controlled trial will be conducted on 60 informal caregivers of PWD recruited via convenience and snowball sampling. Thirty participants will be assigned to the intervention group, while another 30 will be in a waiting-list control group. Questionnaires will be administered at baseline and one month after, with the primary outcome being the difference in the change of depressive symptoms among the two groups. STATISTICAL ANALYSIS: Primary analyses will follow the intention-to-treat principle and compare changes from baseline to the one-month follow-up time point relative to the control group. A repeated measures ANOVA will be conducted to examine differences between the groups over time. SIGNIFICANCE: To our knowledge, this is the first study in Singapore that seeks to promote the mental health of informal dementia caregivers through a mobile-based intervention. The findings can inform the development and evaluation of future evidence-based digital interventions for local informal caregivers of PWD to address the gap in availability of such resources for them. TRIAL REGISTRATION: ClinicalTrials.gov (NCT05551533). Registration date: September 22, 2022.

Prevalence of consumption of illicit drugs and associated factors from a nationwide epidemiological survey: The Singapore Health and Lifestyle Survey.

Introduction: The primary aims of the current nationwide study were to establish the lifetime and 12-month prevalence of consumption of illicit drugs and its correlates in the general population of Singapore. Method: A representative sample of 6509 Singapore residents (Singapore citizens and permanent residents) aged between 15 and 65 years were randomly selected for participation. Questionnaires were administered to assess the consumption of illicit drugs and collect information on correlates. All analyses were weighted to produce prevalence estimates for the consumption of drugs and other measured outcomes. Rao-Scott chi-square test and logistic regression analyses were performed to determine the association of sociodemographic and clinical characteristics with lifetime consumption of illicit drugs. Results: The study was completed with a response rate of 73.2%. The lifetime prevalence of consuming illegal drugs was 2.3% (95% confidence interval [CI] 1.9-2.8) (n=180). Compared to individuals aged 15-34, those aged 50-65 (odds ratio [OR] 0.3, 95% CI 0.2-0.7) had lower odds of lifetime drug consumption. Current smokers (OR 4.7, 95% CI 2.7-8.3) and ex-smokers (OR 5.9, 95% CI 3.2-11.1) had significantly higher odds of lifetime drug consumption than non-smokers. Individuals with hazardous alcohol use (OR 3.3, 95% CI 1.7-6.5) had higher odds of lifetime drug consumption than those without hazardous alcohol use. Conclusion: This is the first nationwide study to examine the prevalence of illicit drug consumption in the general population of Singapore. The results highlight the need to increase awareness of drug consumption in Singapore, especially among parents, teachers, healthcare workers and others who work with young people.

Evaluating a maladaptive personality-informed model of social support and post-traumatic stress disorder.

BACKGROUND: Social support is a robust predictor of post-traumatic stress disorder (PTSD). Although the inverse relationship between perceived social support and PTSD (social causation model) is supported, less is understood about the antecedents of the social causation model. Further, there is limited research in non-Western psychiatric populations that experience elevated rates of trauma and PTSD (e.g., mood disorders). The present study evaluated whether cumulative traumatic life events influenced current PTSD symptoms through maladaptive personality traits and perceptions of social support among Asian patients with mood disorders. METHODS: A total of 200 Asian patients (77.5 % Chinese) with mood disorders were assessed for maladaptive personality traits, perceptions of social support, cumulative traumatic life events, PTSD, and depressive symptoms. Structural equation modelling was conducted to evaluate the extended social causation model. RESULTS: The extended social causation model demonstrated acceptable fit to the data (Comparative Fit Index [CFI] = 0.90; absolute Root Mean Square Error of Approximation [RMSEA] = 0.08). There were significant indirect effects of cumulative traumatic life events on current PTSD symptoms (ß = 0.29, p < .001; 85 % variance explained) and depressive symptoms (ß = 0.28, p < .001; 69 % variance explained). LIMITATIONS: Results may not be generalizable beyond the Singapore population due to the socio-cultural and environmental context. CONCLUSIONS: The present findings provide conceptual support for a maladaptive personality-informed model of social support and PTSD, which could better inform trauma-focused interventions in preventing and treating the debilitating effects of PTSD in psychiatric populations.

The clinical significance of emotional urgency in bipolar disorder: a scoping review.

BACKGROUND: Emotional urgency, defined as a trait concept of emotion-based impulsivity, is at least moderately associated with general psychopathology. However, its clinical significance and associations with clinically relevant features of bipolar disorder remain unclear. This scoping review aims address this gap by determining the extent of evidence in this niche scope of study. METHODS: Evidence of between-group differences of positive and negative urgency, its associations with mood severity, and all peripheral associations related to illness and psychosocial outcomes were synthesized based on PRISMA checklists and guidelines for scoping reviews (PRISMA-ScR). DESIGN: Electronic databases were searched for articles published between January 2001 and January 2024. A total of 1013 entries were gathered, and a total of 10 articles were included in the final selection after the removal of duplicates and ineligible articles. RESULTS: Differences in urgency scores between bipolar disorder and healthy controls were large (Cohen's d ranged from 1.77 to 2.20). Negative urgency was at least moderately associated with overall trauma, emotional abuse, neglect, suicide ideation, neuroticism, and irritable/cyclothymic temperament, whereas positive urgency was at least moderately associated with various aspects of aggression and quality of life. Positive but not negative urgency was associated with quality of life in bipolar disorder. CONCLUSION: Large between-group differences found for emotional urgency in bipolar disorder imply large clinical significance. Emotional urgency was associated with worse clinical features and outcomes. Given the high clinical heterogeneity of the disorder, emotional urgency may be an important phenotype indicative of greater disorder severity.

The protective role of resilience and social support against burnout during the COVID-19 pandemic.

Background: The COVID-19 pandemic brought on a range of stressors in homes and workplaces. With no sign of ending after one year, burnout was a concern. Resilience has been known to shield against the effects of stress. While often thought of as an individual trait, previous studies have shown social support to improve resilience. The study aimed to examine the extent of burnout in the Singapore population and whether social support and resilience cushioned the impact of COVID-19 related stressors a year into the pandemic. Methods: Participants were 858 Singapore residents who participated in a larger study between October 2021 and September 2022. The Copenhagen Burnout Inventory provided Work-and Personal-related burnout scores. Multivariable linear regression was used to identify demographic variables associated with burnout. Path analysis revealed the associations between COVID-19 stressors, social support, resilience and burnout. Results: 22 and 19% of the sample reported work and personal burnout respectively, with younger adults being more burnt out than older adults. Higher stress was associated with higher burnout and higher social support was associated with lower burnout. Path analysis revealed that the relationship between social support and burnout was partially accounted for by increased resilience. Conclusion: Managing altered work arrangements, career expectations, and increased responsibilities at home may contribute to greater levels of burnout in the younger adults. Increased employer support and targeted interventions could mitigate the impact of these stressors. The study also highlighted the importance of maintaining social connections even while physically distancing.

The relationship between therapeutic alliance, frequency of consultation and uptake of telemedicine among patients seeking treatment for early psychosis: A moderated mediation model.

Background: Telehealth services ensure the delivery of healthcare services to a wider range of consumers through online platforms. Nonetheless, the acceptance and uptake of telehealth remain elusive. This study aims to understand the (a) uptake and (b) acceptability of telemedicine, (c) if therapeutic alliance mediates the relationship between the frequency of consultations with clinicians and the uptake of telemedicine in patients with early psychosis, and (d) role of education in moderating the relationship between therapeutic alliance and the uptake of telemedicine for their mental healthcare. Methods: A convenience sample of outpatients (n = 109) seeking treatment for early psychosis and their care providers (n = 106) were recruited from a tertiary psychiatric care centre. Sociodemographic and clinical characteristics, therapeutic alliance (Working Alliance Inventory), and telemedicine use were captured through self-administered surveys. The moderated mediation analysis was performed using PROCESS macro 3.4.1 with therapeutic alliance and level of education as the mediating and moderating factors, respectively. Results: The acceptance of telemedicine was high (possibly will use: 47.7%; definitely will use: 26.6%) whilst the uptake was low (11%). Therapeutic alliance mediated the relationship between the frequency of consultation and the uptake of telemedicine (ß: 0.326; CI: 0.042, 0.637). This effect was moderated by the level of education (ß: -0.058; p < 0.05). Conclusion: Therapeutic alliance mediates the relationship between the frequency of consultations and the uptake of telemedicine services with the level of education moderating this mediation. Focusing on the patients with lower education to improve their telemedicine knowledge and therapeutic alliance might increase the uptake.

Roles and Dynamics within Community Mental Health Systems During the COVID-19 Pandemic: A Qualitative Systematic Review and Meta-Ethnography.

Globally, COVID-19 had an immense impact on mental health systems, but research on how community mental health (CMH) systems and services contributed to the pandemic mental health response is limited. We conducted a systematic review and meta-ethnography to understand the roles of CMH services, determinants of the quality of CMH care, and dynamics within CMH systems during COVID-19. We searched and screened across five databases and appraised study quality using the CASP tool, which yielded 27 qualitative studies. Our meta-ethnographic process used Noblit and Hare's approach for synthesizing findings and applying interpretive analysis to original research. This identified several key themes. Firstly, CMH systems played the valuable pandemic role of safety nets and networks for the broader mental health ecosystem, while CMH service providers offered a continuous relationship of trust to service users amidst pandemic disruptions. Secondly, we found that the determinants of quality CMH care during COVID-19 included resourcing and capacity, connections across service providers, customized care options, ease of access, and human connection. Finally, we observed that power dynamics across the CMH landscape disproportionately excluded marginalized groups from mainstream CMH systems and services. Our findings suggest that while the pandemic role of CMH was clear, effectiveness was driven by the efforts of individual service providers to meet demand and service users' needs. To reprise its pandemic role in the future, a concerted effort is needed to make CMH systems a valuable part of countries' disaster mental health response and to invest in quality care, particularly for marginalized groups.

Changes in body mass index and its association with socio-demographic characteristics between 2010 and 2016 in Singapore.

Background: Epidemiological studies have observed an increase in the prevalence of obesity in both western and Asian countries. This study aims to compare the distribution of body mass index (BMI) in the general population of Singapore between 2010 and 2016, and to explore the socio-demographic risk factors associated with it. Methods: Data for this study were extracted from two national-wise studies in 2010 and 2016, two population-based, cross-sectional epidemiological studies. BMI cut-off scores were used as an indicator to assess obesity in this study, and the data included in the analysis was self-reported by the respondents. Results: Overall, the study observed decreasing prevalence in underweight and normal weight categories; and an increasing prevalence in overweight and obesity categories in the Singapore adult population between 2010 and 2016. Age, gender, ethnicity, marital status, and educational level were found to be significantly associated with BMI categories. Conclusion: The observed increase in the population's BMI between 2010 and 2016 may lead to an increase in the incidence of chronic diseases in Singapore. Our study findings add to the existing local literature and provides data for evidence-based policymaking on health-related interventions and program planning.

Navigating drug use, cessation, and recovery: a retrospective case notes review among sexual minority men at a community-based service in Singapore.

BACKGROUND: In Singapore, where drug use is a highly stigmatized and criminalized issue, there is limited understanding of the challenges faced by individuals, particularly sexual minority men, in their journey towards recovery from substance dependence or addiction. This qualitative study aimed to investigate the driving forces behind drug use, the factors contributing to drug cessation, and the elements influencing the recovery process. METHODS: Data were extracted from clinical records provided by  The Greenhouse Community Services Limited between January 2020 to May 2022. These records encompassed information from four distinct forms: the intake assessment, progress notes, case closing summary, and the care plan review. Thematic analysis was employed to identify and categorize recurring themes within the data. RESULTS: Data from beneficiaries (n = 125) were analyzed and yielded a series of themes related to facilitators of drug use, motivations to cease drug use, and managing one's ongoing recovery. Within the facilitators of drug use, two sub-themes were identified: (a) addressing trauma and triggers and (b) managing emotions. Additionally, managing one's recovery was marked by four significant sub-themes: (a) uncovering personal identities, (b) losing motivation and drive, (c) overcoming obstacles, and (d) preparing for aftercare. CONCLUSIONS: The study contributes valuable insights into the dynamics of ongoing recovery management, offering potential avenues for interventions that could enhance support for individuals in their journey to overcome substance dependence. Enhancing psychoeducation and fostering peer support have the potential to facilitate the recovery process. Clearly, a holistic approach is needed to address these complex issues that cuts across our societies.

Association between sleep quality and quality of life in Singapore.

PURPOSE: Several studies have examined the relationship between sleep quality and health-related quality of life (HRQOL). However, there are a lack of generalizable data on this association in Singapore. Our study aimed to (1) investigate the association between sleep quality and HRQOL and (2) examine whether age moderated these associations. METHODS: Data were obtained from nationwide Singapore Mental Health Study 2016 (n = 6126, response rate = 69.5%). Sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI) where higher scores indicate poorer sleep quality. HRQOL [Physical component summary (PCS) and Mental component summary (MCS)] were measured using 12-item Short-Form Survey. Associations were investigated using multivariable linear regression models, adjusted for sociodemographic, physical, and mental comorbidities. Interactions between age and sleep quality were examined by including interaction terms individually. RESULTS: Poorer PSQI score was significantly associated with lower PCS (ß = - 0.44) and lower MCS (ß = - 0.73). Among PSQI components, lower PCS was significantly associated with subjective sleep quality (ß = - 1.06), sleep duration (ß = - 0.30), sleep disturbance (ß = - 0.33), and daytime dysfunction (ß = - 0.75). Lower MCS was significantly associated with subjective sleep quality (ß = - 1.36), sleep latency (ß = - 0.24), sleep disturbance (ß = - 0.16), using of sleeping medication (ß = - 1.12), and daytime dysfunction (ß = - 2.08). Age moderated the association between PSQI score with PCS and MCS. Stronger association between PSQI score and MCS was observed in younger individuals (ß = - 0.90) than older adults (ß = - 0.45). CONCLUSION: Our study found that poor sleep quality was associated with HRQOL of certain age groups more than others. Future studies may identify potential mediators to help people with chronic sleep problems.

Public awareness of war on diabetes campaign and its association with behavioural outcomes.

The War on Diabetes campaign was launched in 2016, encouraging Singapore residents to engage in regular exercise, adopt healthy dietary habits and screen for early detection of diabetes. This study aims to examine campaign awareness and its associations with sedentary behaviour, dietary habits and identifying diabetes. Data were obtained from the nationwide Knowledge, Attitudes and Practices study on diabetes in Singapore. A total of 2895 participants responded to a single question assessing campaign awareness. The Dietary Approaches to Stop Hypertension (DASH) diet screener assessed dietary habits, and the Global Physical Activity Questionnaire (GPAQ) measured sedentary behaviour. Recognition of diabetes was established using a vignette depicting a person with diabetes mellitus. Logistic and linear regression models were used to measure the associations. Most participants were 18- to 34-years old (29.9%) and females (51.6%). About 57.4% identified the campaign. Campaign awareness exhibited positive associations with identifying diabetes based on the vignette [odds ratio (OR): 1.5; 95% confidence interval (CI): 1.1-2.2; P = 0.022], lower odds of sedentary behaviour ≥7 h/day (OR: 0.7; CI: 0.5-0.9; P = 0.018) and higher DASH scores (ß = 1.3; P < 0.001). The study recognized early significant associations between the behavioural outcomes and the campaign, emphasizing the need for ongoing campaign sustainability and evaluation of its long-term impact on population health.

Barriers to using eHealth/mHealth platforms and perceived beneficial eHealth/mHealth platform features among informal carers of persons living with dementia: a qualitative study.

BACKGROUND: New technologies have brought about a new age of technology-enabled aids that can equip informal carers with the relevant resources for better care. These include but are not limited to facilitating access to healthcare providers, knowledge of caring for persons living with dementia, and sources of support for carers' well-being. This qualitative study explores barriers to using eHealth/mHealth platforms and perceived beneficial eHealth/mHealth platform features among informal carers of persons living with dementia. METHODS: An exploratory qualitative study design was employed. Semi-structured interviews were conducted among 29 informal carers of persons living with dementia in Singapore recruited via convenience and snowball sampling. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the data. RESULTS: The participants in this study identified several barriers to using eHealth/mHealth platforms, including personal preference, apprehension, poor user experience and lack of skills. On the other hand, knowledge of dementia, caring for persons living with dementia and self-care, a list of resources, social support, location monitoring and alert systems, and the ability to manage appointments and transactions were valuable features for eHealth/mHealth platforms. CONCLUSIONS: Despite the underutilisation of eHealth/mHealth platforms, carers expressed a keen interest in using them if they are functional and capable of reducing their care burden. The findings from this study can contribute to developing content and features for eHealth/mHealth interventions aimed at lightening carers' burden in their day-to-day caring routine.

Equipercentile linking of the Sheehan Disability Scale and the World Health Organization Assessment Schedule 2.0 scales in people with mental disorders.

BACKGROUND: The Sheehan Disability Scale (SDS) and the World Health Organization Disability Assessment Scale (WHODAS 2.0) have been widely used to measure functional impairment and disability. To ensure that the scores from these two scales are practically exchangeable across diseases, therapies, and care programmes, the current study aimed to examine the linkage of the WHODAS 2.0 with the SDS and develop a simple and reliable conversion table for the two scales in people with mental disorders. METHODS: A total of 798 patients (mean age = 36.1, SD = 12.7) were recruited from outpatient clinics of the Institute of Mental Health, and the Community Wellness Clinic in Singapore. Using a single-group design, an equipercentile equating method with log-linear smoothing was used to establish a conversion table from the SDS to the WHODAS 2.0 and vice versa. RESULTS: The conversion table showed that the scores were consistent for the entire range of scores when the scores were converted either from the SDS to the WHODAS 2.0 or from the WHODAS 2.0 to the SDS. The agreement between the WHODAS 2.0's raw and converted scores and SDS's raw and converted scores were interpreted as good with intraclass correlation coefficient of 0.711 and 0.725, respectively. CONCLUSION: This study presents a simple and reliable method for converting the SDS scores to the WHODAS 2.0 scores and vice versa, enabling interchangeable use of data across these two disability measures.

How do professionals and non-professionals respond to non-suicidal self-injury? Lived experiences of psychiatric outpatients in Singapore.

BACKGROUND: For young people who engage in non-suicidal self-injury (NSSI), receiving negative responses to their NSSI can pose a barrier to future help-seeking. This qualitative study aimed to explore helpful and unhelpful ways in which professionals and non-professionals respond to NSSI, from the perspectives of individuals with lived experiences of NSSI. METHODS: Semi-structured interviews were conducted with 20 outpatients (6 males, 14 females) aged 17 to 29 years from a tertiary psychiatric hospital in Singapore, who had reported engaging in NSSI behavior in an earlier study. The interviews were audio recorded and transcribed verbatim. Thematic analysis was used to identify themes and subthemes in the data. RESULTS: Professionals' responses were organized into three main themes: 'prescribing solutions without understanding needs', 'disapproval or judgment', and 'helpful responses'. Non-professionals' responses were organized into four main themes: 'emotionally charged responses', 'avoidance and inaction', 'poor understanding of reasons for NSSI', and 'providing tangible support and acknowledging NSSI'. Participants also described how unhelpful responses negatively impacted their willingness to seek help. CONCLUSIONS: Our findings provide a better understanding of responses to NSSI that are considered helpful and unhelpful, and can be used to improve existing guidelines on responding to NSSI.