Positive effects of anthocyanin-rich mulberry milk on mental health problems in the working population: an open-label study.

BACKGROUND/OBJECTIVES: Depression and anxiety are common mental health problems. Anthocyanins from berries might have an inhibitory effect on monoamine oxidase (MAO) enzymes and alleviate various mood and anxiety symptoms. This study examined the effects of a daily supplement of an anthocyanin-rich product on mental health problems. SUBJECTS/METHODS: This study was a secondary analysis from a randomized, 6-week, open-label trial in 300 healthy participants aged 18-60 years who consumed 1 or 2 servings of anthocyanin-rich mulberry milk daily. The General Health Questionnaire-28 (GHQ-28) and Hospital Anxiety and Depression Scale (HADS) were used to monitor mental health problems. In addition, the saliva activity levels of MAO-A, MAO-B, and cortisol were examined at the baseline and after 6 weeks. RESULTS: The total scores of the GHQ-28 and HADS and all their subscales decreased in both groups (all P < 0.05). The cortisol, MAO-A, and MAO-B activities decreased significantly (all P <0.05), but there were no significant differences between the groups (all P > 0.05). Significant correlations were noted between the decreased activity level of MAO-A enzyme and decreased scores from the GHQ-28 somatic subscale and the HADS depression subscale (all P < 0.05). CONCLUSIONS: Daily consumption of anthocyanin-rich mulberry milk possibly improves mental health problems by reducing depressive and anxiety symptoms in the working population. The suppression of MAO-A activity is a possible underlying mechanism. Trial Registration: Thai Clinical Trial Registration: #TCTR20201031002.

The Positive Modulation Effect of a 6-Week Consumption of an Anthocyanin-Rich Mulberry Milk on Working Memory, Cholinergic, and Monoaminergic Functions in Healthy Working-Age Adults.

Due to the increase of stress-related memory impairment accompanying with the COVID-19 pandemic and financial crisis, the prevention of cognitive decline induced by stress has gained much attention. Based on the evidence that an anthocyanin-rich mulberry milk demonstrated the cognitive enhancing effect, we hypothesized that it should be able to enhance memory in working-age volunteers who are exposed to working stress. This study is an open-label, two-arm randomized study. Both men and women volunteers at age between 18 and 60 years old were randomly assigned to consume the tested product either 1 or 2 servings daily for 6 weeks. All subjects were assessed for cortisol, acetylcholinesterase (AChE), monoamine oxidase (MAO), monoamine oxidase type A (MAO-A), and monoamine oxidase type B (MAO-B) in saliva, and their working memory was determined both at baseline and at a 6-week period. The results showed that the working memory of subjects in both groups was enhanced at the end of the study period together with the reduction of saliva cortisol. The suppression of AChE, MAO, and MAO-A was also observed in subjects who consumed the tested product 2 servings daily. Therefore, we suggest the memory enhancing effect of an anthocyanin-rich mulberry milk. The possible mechanism may occur primarily via the suppression of cortisol. In addition, the high dose of mulberry milk also suppresses AChE, MAO, and MAO-A.

Mobile application for monitoring behavioral and psychological symptoms of dementia in patients with moderate to severe dementia.

AIM: Behavioral and psychological symptoms of dementia (BPSD) are common in patients with moderate-severe dementia and have negative impacts on both patients and caregivers. There is a lack of a tool for caregivers to monitor patients' BPSD by themselves. This study aimed to develop and validate a mobile application for caregivers to use in monitoring BPSD. METHODS: A total of 104 pairs of patients with moderate-severe dementia and their caregivers completed the study. The Neuropsychiatric Inventory (NPI) was modified and digitally transformed to a caregiver-rating mobile application to quantify nine domains of BPSD for their frequency and impact on the emotion of the caregivers. Data collected from the application were compared with the paper-and-pencil NPI for prevalence, concurrent validity (Spearman's rho) and internal consistency (Cronbach's alpha). RESULTS: The application was able to detect 93% of BPSD compared with the NPI. Concurrent validity was good-very good when compared with the Frequency × Severity score (ρ = 0.77, P < 0.001) and the burden score (ρ = 0.85, P < 0.001) from the NPI. Levels of internal consistency were acceptable for both frequency (α = 0.73) and impact (α = 0.79) scores. 80% of the caregivers reported that the application was "very likely to be helpful in caregiving". CONCLUSIONS: The mobile application for monitoring BPSD in patients with moderate-severe dementia had an excellent sensitivity, and good-very good validity and consistency. The caregivers had a positive perception of the application as an aid in caregiving. Geriatr Gerontol Int 2021; 21: 472-477.

Characteristics and burden of hospitalization because of intentional self-harm: Thai national, hospital-based data for 2010.

BACKGROUND: There is a paucity of data on intentional self-harm and suicide in Thailand. It is crucial to re-evaluate the burden and health outcomes. OBJECTIVE: To measure the character and burden of acts of intentional self-harm in the Thai hospitalized population. MATERIAL AND METHOD: Acts of intentional-self harm were categorized using ICD 10 classification. All of inpatient-related data were analyzed using SPSS 17. RESULTS: Overall intentional self-harm in 2010 led to 24,924 hospitalizations and 854 deaths; an incidence of 35.6/100,000 people with the highest level in two age groups: 18-25 and 26-40 year-olds. Self-poisoning (89%) was the most common method and pesticide was the leading used chemical agents. The total cost of treatment was 149,672,190 baht and the mean length of stay was 2.9 +/- 6.7 days. The mortality rate increased as the population got older with the highest rate being 10.6% for 70-79 year-olds. In 33.8% of cases, psychiatric co-diagnosis were found with anxiety disorders was the leading comorbidity. CONCLUSION: The incidence of intentional self-harm was medium to high, compared to other East Asians countries. Self-poisoning by exposure to pesticides was the most common self-harm method. Age over 60 had the highest mortality rate. Having a psychiatric co-diagnosis was common.

Breathing meditation by medical students at Khon Kaen University: effect on psychiatric symptoms, memory, intelligence and academic achievement.

OBJECTIVE: To examine the short-term effects on fifth-year medical students of a 4-week, breathing meditation-based, stress reduction intervention on psychiatric symptoms, memory function, intelligence, and academic achievement. MATERIALS AND METHOD: Using a randomized control trial, the meditation group practiced every 8.00 to 8.20 a.m. before beginning daily learning schedule. Meditation emphasized mindful awareness of the breath during inhaling and exhaling. The control group went about their normal activities in the other room. The psychiatric symptoms were measured using the Symptom Checklist-90 (SCL-90), the memory used the Wechsler Memory Scale-I (WMS-I), the intelligence used the Raven's Advanced Progressive Matrices (APM), and the academic achievement used psychiatry course MCQ examination score. Analysis was done using Ancova statistic. RESULTS: Fifty-eight volunteer medical students during their psychiatry rotation between June 2008 and May 2009, were randomized into either in the meditation (n = 30) or the control (non-meditation) (n = 28) group. There was no significant difference between the groups in their respective SCL-90, WMS-I, APM, and psychiatry course MCQ examination score. CONCLUSION: Among normal, intelligent, mentally healthy persons, short-term breathing meditation practice will not likely change psychiatric symptoms, memory function, intellectual performance, and academic achievement.

Zingiber officinale Improves Cognitive Function of the Middle-Aged Healthy Women.

The development of cognitive enhancers from plants possessing antioxidants has gained much attention due to the role of oxidative stress-induced cognitive impairment. Thus, this study aimed to determine the effect of ginger extract, or Zingiber officinale, on the cognitive function of middle-aged, healthy women. Sixty participants were randomly assigned to receive a placebo or standardized plant extract at doses of 400 and 800 mg once daily for 2 months. They were evaluated for working memory and cognitive function using computerized battery tests and the auditory oddball paradigm of event-related potentials at three different time periods: before receiving the intervention, one month, and two months. We found that the ginger-treated groups had significantly decreased P300 latencies, increased N100 and P300 amplitudes, and exhibited enhanced working memory. Therefore, ginger is a potential cognitive enhancer for middle-aged women.

Effects of 12-Week Bacopa monnieri Consumption on Attention, Cognitive Processing, Working Memory, and Functions of Both Cholinergic and Monoaminergic Systems in Healthy Elderly Volunteers.

At present, the scientific evidence concerning the effect of Bacopa monnieri on brain activity together with working memory is less available. Therefore, we aimed to determine the effect of B. monnieri on attention, cognitive processing, working memory, and cholinergic and monoaminergic functions in healthy elderly. A randomized double-blind placebo-controlled design was utilized. Sixty healthy elderly subjects (mean age 62.62 years; SD 6.46), consisting of 23 males and 37 females, received either a standardized extract of B. monnieri (300 and 600 mg) or placebo once daily for 12 weeks. The cholinergic and monoaminergic systems functions were determined using AChE and MAO activities. Working memory was assessed using percent accuracy and reaction time of various memory tests as indices, whereas attention and cognitive processing were assessed using latencies and amplitude of N100 and P300 components of event-related potential. All assessments were performed before treatment, every four weeks throughout study period, and at four weeks after the cessation of intervention. B. monnieri-treated group showed improved working memory together with a decrease in both N100 and P300 latencies. The suppression of plasma AChE activity was also observed. These results suggest that B. monnieri can improve attention, cognitive processing, and working memory partly via the suppression of AChE activity.

Validity and reliability of the Rosenberg Self-Esteem Scale-Thai version as compared to the Self-Esteem Visual Analog Scale.

OBJECTIVE: To compare the validity and reliability of the Thai version of the Rosenberg Self-Esteem Scale with the Self-Esteem Visual Analog Scale. MATERIAL AND METHOD: The Rosenberg Self-Esteem Scale was translated into Thai and its content-validity checked by bacA translation. The reliability of the Rosenberg Self-Esteem Scale compared with the Self-Esteem Visual Analog Scale was ther tested between February and March 2008 on 270 volunteers, including 135 patients with psychiatric illness and 135 normal volunteers. The authors analyzed the internal consistency and factor structure of the Rosenberg Self-Esteem Scale-Thai version and the correlation between it and the Visual Analog Scale. RESULTS: The Cronbach's Alpha for the Rosenberg Self-Esteem scale-Thai version was 0.849 and the Pearson's correlation between it and the Self-Esteem Visual Analog Scale 0.618 (p = 0.01). Two factors, viz, the positively and negatively framea items, from the Rosenberg Self-Esteem Scale-Thai version accounted for 44.04% and 12.10% of the variance, respectively. CONCLUSION: The Rosenberg Self-Esteem Scale-Thai version has acceptable reliability. The Self-Esteem Visual Analog Scale provides an effective measure of self-esteem.

Meditation therapies for attention-deficit/hyperactivity disorder (ADHD).

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common developmental disorders experienced in childhood and can persist into adulthood. The disorder has early onset and is characterized by a combination of overactive, poorly modulated behavior with marked inattention. In the long term it can impair academic performance, vocational success and social-emotional development. Meditation is increasingly used for psychological conditions and could be used as a tool for attentional training in the ADHD population. OBJECTIVES: To assess the effectiveness of meditation therapies as a treatment for ADHD. SEARCH STRATEGY: Our extensive search included: CENTRAL, MEDLINE, EMBASE, CINAHL, ERIC, PsycINFO, C2-SPECTR, dissertation abstracts, LILACS, Virtual Health Library (VHL) in BIREME, Complementary and Alternative Medicine specific databases, HSTAT, Informit, JST, Thai Psychiatric databases and ISI Proceedings, plus grey literature and trial registries from inception to January 2010. SELECTION CRITERIA: Randomized controlled trials that investigated the efficacy of meditation therapy in children or adults diagnosed with ADHD. DATA COLLECTION AND ANALYSIS: Two authors extracted data independently using a pre-designed data extraction form. We contacted study authors for additional information required. We analyzed data using mean difference (MD) to calculate the treatment effect. The results are presented in tables, figures and narrative form. MAIN RESULTS: Four studies, including 83 participants, are included in this review. Two studies used mantra meditation while the other two used yoga compared with drugs, relaxation training, non-specific exercises and standard treatment control. Design limitations caused high risk of bias across the studies. Only one out of four studies provided data appropriate for analysis. For this study there was no statistically significant difference between the meditation therapy group and the drug therapy group on the teacher rating ADHD scale (MD -2.72, 95% CI -8.49 to 3.05, 15 patients). Likewise, there was no statistically significant difference between the meditation therapy group and the standard therapy group on the teacher rating ADHD scale (MD -0.52, 95% CI -5.88 to 4.84, 17 patients). There was also no statistically significant difference between the meditation therapy group and the standard therapy group in the distraction test (MD -8.34, 95% CI -107.05 to 90.37, 17 patients). AUTHORS' CONCLUSIONS: As a result of the limited number of included studies, the small sample sizes and the high risk of bias, we are unable to draw any conclusions regarding the effectiveness of meditation therapy for ADHD. The adverse effects of meditation have not been reported. More trials are needed.

Validity and reliability study of the Thai version of WHO Schedules for Clinical Assessment in Neuropsychiatry version 2.1.

OBJECTIVE: To determine the validity and reliability of the Thai version of WHO Schedule for Clinical Assessment in Neuropsychiatry (SCAN) version 2.1. MATERIAL AND METHOD: The SCAN interview book version 2.1 was translated from English into Thai. The content validity of the translation was verified by examining the back-translation. Whenever inconsistencies were encountered, the Thai version was adapted to convey the meaning of the original. The revised Thai version was then field-tested in 4 regions of Thailand for comprehensibility of the relatively technical language. Re-edition of the Thai version was made in accordance with suggestions from the field trial. The complete SCAN Thai version was put into the computerized I-Shell program for inter and intra-rater reliability study. RESULTS: Based on the response from Thai subjects and consultations with competent and well SCAN-trained psychiatrists, content validity was established. The inter- and intra-rater agreement of somatoform and dissociative symptoms module were 0.77, 0.85; anxiety: 0.79, 0.84; mood: 0.80, 0.86; eating disorders: 0.73, 0.76; use of alcohol: 0.66, 0.82; stress and adjustment disorders: 0.90, 0.94; psychosis: 0.68, 0.76; cognitive impairment: 0 72, 0.78 and observed behavior, affect and speech module were 0.45 and, 0.51 respectively. CONCLUSION: The SCAN version 2.1 Thai version proved to be a reliable tool for assessing psychiatric illness among Thais.

Acute valproic acid overdose: enhance elimination with multiple-doses activated charcoal.

Multiple dose activated charcoal (MDAC) is used to enhance elimination of toxic substance in acute poisoning. However, its role in acute valproic acid (VA) overdose is controversial. The authors report a case of VA overdose that successfully recovered with MDAC treatment. The half-life of VA in the presented patient was decreased from 12 to 8 hours during MDAC administration. MDAC treatment in acute poisoning enhanced VA elimination four times than without treatment. MDAC should be considered for the treatment of acute VA intoxication.

Validity and reliability of WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN)-Thai version: Cognitive Impairment or Decline Section.

OBJECTIVE: To determine the validity and reliability of the Thai version of the Cognitive Impairment or Decline section of WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN) version 2.1. MATERIAL AND METHOD: The SCAN interview version 2.1 Cognitive Impairment or Decline Section was translated into Thai and its content validity tested by back translation. Psychiatrists competent in the use of the schedules and aware of their underlying objectives tested the linguistic clarity of the psychiatric schedules for Thais from the country's four regions. The reliability of SCAN: Cognitive Impairment or Decline Section was tested between June and November 2005 on 30 participants, including 15 patients with cognitive impairment and 15 normal volunteers. RESULTS: Based on reactions from Thais and consultations from competent psychiatrists, content validity was indeed established. The duration of interviews for the Cognitive Impairment or Decline Section averaged 48.99 min (59.71 for patients with cognitive impairment and 33.77 for normal subjects). The respective mean inter- and intra-rater reliability kappa was 0.72 (SD = 0.31) and 0.78 (SD = 0.23). The reliability of the majority of items reached a substantial to almost perfect level; however, three items (3.66%) had poor and nine (6.67%) only slight inter-rater agreement. Some items needed clarification of the scoring method. The respective inter- and intra-rater reliability of the continuous data was 0.93 and 0.96. CONCLUSION: The Cognitive Impairment or Decline Section of the WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN Thai Version) is demonstrably an effective tool for diagnosing cognitive impairment disorders among Thais.

Stress and Adjustment Disorder Section of WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN)--Thai version: validity and reliability study.

OBJECTIVES: To determine the validity and reliability of the Thai version of the Stress and Adjustment Disorder section of WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN) version 2.1. MATERIAL AND METHOD: The SCAN interview version 2.1 Stress and Adjustment Disorder section was translated into Thai and its content validity tested by back translation. The linguistic clarity of the psychiatric schedules for Thais from the country's four regions was tested by psychiatrists competent in the use of the schedules and aware of their underlying objectives. The reliability of SCAN: Stress and Adjustment Disorder section was tested between June and November 2006 on 30 participants, including 18 patients with stress-related disorders (adjustment disorder post-traumatic stress disorder, acute stress reaction) and 12 normal volunteers. RESULTS: Based on reactions from the sample and consultations from competent psychiatrists, content validity was established The duration of interviews for the Stress and Adjustment Disorder section averaged 17.92 min (25.59 for patients with stress-related disorders and 6.41 for normal subjects). The respective mean inter- and intra-rater reliability kappa was 0.90 (SD = 0.12) and 0.94 (SD = 0.09). A respective 77.05% and 85.26% of the items reached a substantial to almost perfect level of inter- and intra-rater agreement. CONCLUSION: The Stress and Adjustment Disorder section of the WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN Thai Version) is demonstrably an effective tool for diagnosing stress-related disorders among Thais.

Psychiatric disorders in tsunami-affected children in Ranong province, Thailand.

OBJECTIVE: To study the prevalence of psychiatric disorders in children affected by the Asian tsunami in Ranong province, Southern Thailand 10 months after the disaster. SUBJECTS AND METHODS: The subjects were 47 boys and 47 girls, age 1-18 years, who were affected by the tsunami. They were participants in the Psychosocial Care and Protection System for Tsunami-Affected Children in Ranong Province project. The subjects were interviewed by a psychiatrist and diagnoses were made according to DSM IV criteria. RESULTS: Of the 94 children, 47 (50%) had at least one psychiatric diagnosis: posttraumatic stress disorder (PTSD): n = 31 (33%); major depression: n = 9 (9.6%); adjustment disorder: n = 9 (9.6%), and separation anxiety disorder: n = 3 (3.2%). The psychiatric diagnoses, specifically PTSD, were significantly associated with the child's age and exposure to the traumatic events. CONCLUSION: Ten months after the tsunami disaster, there is a high prevalence of psychiatric disorders in children, suggesting the importance of early identification, intervention and follow-up.

Validity and reliability study of the Thai version of WHO SCAN: somatoform and dissociative symptoms section.

OBJECTIVES: To determine the validity and reliability of the Thai version of the WHO Somatoform and Dissociative Symptoms Section of the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) Version 2.1 MATERIAL AND METHOD: The SCAN interview version 2.1 Somatoform and Dissociative Symptoms Section was translated into Thai. The content validity of the translation was verified by comparing a back-translation (to English) of the Thai version to the English original. Whenever inconsistencies were encountered, the Thai version was adapted so that it correctly conveyed the meaning of the original English version. The revised Thai version was then field-tested nationwide for the comprehensibility of the relatively technical language. Between October 2003 and August 2004, 30 persons were recruited for the reliability study (16 males; 14 females) Fifteen subjects had somatoform disorders and 15 were normal. The number of years of formal education varied widely and occupations were diverse. Subjects were interviewed by a psychiatrist competent in using the Thai version of SCAN. The interviews were recorded on video so that the material could be rerated. RESULTS: Based on the response from Thai subjects and consultations with competent psychiatrists, the content validity was established. The time taken to interview a somatoform patient averaged 57.1 +/- 12.1 minutes while it was 42.1 +/- 13.9 minutes for a normal subject. The inter-rater reliability (kappa) of the 113 Items were: 0.81-1.0, 0.61-0.80 and 0. 00-0.20 in 49.6, 30.0 and 8.9 percent, respectively. Kappas could not be calculated for 11.5% of the Items. The intra-rater reliabilities were. 0.81-1.0, 0.61-0.80 and 0.00-0.20 in 54.9, 26.5 and 2.7 percent, respectively. Kappas could not be calculated for 15.9% of the Items. CONCLUSION: The Thai version of the Somatoform and Dissociative Symptoms Section of SCAN version 2.1 proved to be a valid and reliable tool for assessing somatoform and dissociative symptoms among Thai speakers.

The validity and reliability of the WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN Thai Version): Mood Disorders Section.

BACKGROUND: Mood disorders are one of the most prevalent psychiatric disorders that have early onset, are chronic and can cause functional impairment. It is therefore crucial to establish an accurate diagnosis for treatment and research purposes. OBJECTIVES: The authors aimed to test the validity and reliability of the WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN Thai Version): Mood Disorders Section. MATERIAL AND METHOD: First, psychiatrists competent in the use of the schedules and their underlying objectives tests the linguistic clarity of the Thai psychiatric schedules in four regions of the country. Then between October 2003 and August 2004, Reliability of SCAN: mood disorder section was tested among 30 participants, including mood disordered patients and normal volunteers. RESULTS: Based on reactions from Thais and consultations from competent psychiatrists, content validity was established. The duration of interviews for the mood disorder sections averaged 63.6 min (SD = 17.1). The inter- and intra-rater reliability kappa were 0.80 (0.77-0.83) and 0.86 (0.84-0.88), respectively. The reliability of the majority of items reached substantial to almost perfect agreement; however, 1 item (1%) had only slight agreement and 15 items (12%) had moderate agreement, and needed clarification of the scoring method CONCLUSION: The Mood Disorders Sections of the WHO Neuropsychiatry Schedules for Clinical Assessment (SCAN Thai Version) were effective tools for diagnosing mood disorders among Thais.