Living donor uterus transplant research project in Singapore: Progress of the first case.

Introduction: To report the progress of the human living uterus transplant research project in Singapore.

Material And Methods: The uterus transplant research project began in 2012 with a collaboration between the Swedish and Singapore teams. Ethics approval was obtained from the SingHealth Centralised Institutional Review Board, the SingHealth Transplant and the Singapore General Hospital Biomedical Ethics Committee to perform 5 uterus transplant procedures in a collaborative multi-site research study at the Singapore General Hospital.

Antidepressant-induced Paradoxical Anxiety, Akathisia, and Complex Vocal Tics in a Patient with Panic Disorder and Crohn's Disease: A Case Report.

Background: Antidepressant-induced paradoxical anxiety is a fairly common phenomenon seen in patients who are initiated on antidepressants. However, akathisia is a very uncommon manifestation of antidepressants. Much more rarely, antidepressants are also associated with the emergence of motor and vocal tics.

Protocol for a multi-site randomized controlled trial of a stepped-care intervention for emergency department patients with panic-related anxiety.

Background: Approximately 40% of Emergency Department (ED) patients with chest pain meet diagnostic criteria for panic-related anxiety, but only 1-2% are correctly diagnosed and appropriately managed in the ED. A stepped-care model, which focuses on providing evidence-based interventions in a resource-efficient manner, is the state-of-the art for treating panic disorder patients in medical settings such as primary care. Stepped-care has yet to be tested in the ED setting, which is the first point of contact with the healthcare system for most patients with panic symptoms.

World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders - Version 3. Part II: OCD and PTSD.

Aim: This is the third version of the guideline of the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Posttraumatic Stress Disorders which was published in 2002 and revised in 2008.

Method: A consensus panel of 34 international experts representing 22 countries developed recommendations based on efficacy and acceptability of the treatments. In this version, not only medications but also psychotherapies and other non-pharmacological interventions were evaluated, applying the same rigorous methods that are standard for the assessment of medication treatments.

A robotic leg inspired from an insect leg.

While most insect-inspired robots come with a simple tarsus, such as a hemispherical foot tip, insect legs have complex tarsal structures and claws, which enable them to walk on complex terrain. Their sharp claws can smoothly attach and detach on plant surfaces by actuating a single muscle. Thus, installing an insect-inspired tarsus on legged robots would improve their locomotion on complex terrain.

Internalized stigma, disclosure and self-esteem among psychiatric patients in a general hospital outpatient clinic.

Objective: Psychiatric patients often experience internalized stigma. This occurs when persons accept the negative attitudes of others towards them, then internalize and apply these beliefs to themselves. We assess the effects of internalized stigma on illness disclosure and on self-esteem in psychiatric outpatients, hypothesizing that internalized stigma is more pronounced in psychiatric patients than in medical patient controls and that internalized stigma is associated with avoidance of disclosure, as well as reduced self-esteem.

Exposure Therapy With Personalized Real-Time Arousal Detection and Feedback to Alleviate Social Anxiety Symptoms in an Analogue Adult Sample: Pilot Proof-of-Concept Randomized Controlled Trial.

Background: Exposure therapy is highly effective for social anxiety disorder. However, there is room for improvement.

Objective: This is a first attempt to examine the feasibility of an arousal feedback-based exposure therapy to alleviate social anxiety symptoms in an analogue adult sample.

Screening for panic-related anxiety in emergency department patients with cardiopulmonary complaints: A comparison of two self-report instruments.

The present study examined 1) the accuracy of two self-report measures for detecting panic-related anxiety in emergency department (ED) patients with cardiopulmonary complaints; and 2) whether modified scoring resulted in improved performance. English-speaking adults presenting to the ED of a large public hospital with palpitations, chest pain, dizziness, or difficulty breathing were evaluated for the presence of panic-related anxiety with the Structured Clinical Interview for DSM-IV (SCID) over a one-year period. Patients completed the panic disorder modules of the Patient Health Questionnaire (PHQ-PD) and Psychiatric Diagnostic Screening Questionnaire (PDSQ-PD).

A Brief Interview to Detect Panic Attacks and Panic Disorder in Emergency Department Patients with Cardiopulmonary Complaints.

Objectives: Patients with panic-related anxiety often initially present to the emergency department (ED) complaining of respiratory or cardiac symptoms, but rates of detection of panic symptoms by ED physicians remain low. This study was undertaken to evaluate the relevance of panic attacks and panic disorder in ED patients who present with cardiopulmonary symptoms and to determine whether a brief symptom-based tool could be constructed to assist in rapid recognition of panic-related anxiety in the ED setting.

Materials And Methods: English-speaking adult ED patients with a chief complaint of palpitations, chest pain, dizziness, or difficulty breathing were evaluated for the presence of panic attacks and panic disorder with the Structured Clinical Interview for DSM-IV Axis I Disorders.

Evaluation of sleep profile in schizophrenia patients treated with extended-release paliperidone: an open-label prospective study in Southeast Asia.

Objective: To evaluate the effect of 6 months of treatment with paliperidone extended-release (ER) tablets on the sleep profile of patients with schizophrenia.

Methods: A total of 984 patients meeting the (DSM-IV) criteria for schizophrenia who switched their antipsychotic to paliperidone ER were recruited from 61 sites in five countries in Southeast Asia. We recorded patient demographics and assessed sleep quality and daytime drowsiness using visual analog scales.

Mania following antidepressant discontinuation in depression: two case reports.

Objective: Antidepressant-induced mania and an antidepressant discontinuation syndrome are well documented, whereas mania occurring after antidepressant cessation has been infrequently reported.

Method: We describe antidepressant discontinuation-related mania in two Chinese patients, as well as a review of the literature on this phenomenon in unipolar depression.

Results: A 72-year-old man and a 65-year-old woman had late-onset depression with vascular risk factors, but no personal or family history of mood disorders.

Attitudes toward utility, effects and side effects of treatment for anxiety and depression.

Objectives: Negative perceptions about psychiatric treatment are likely to affect treatment adherence. We compared attitudes of patients with psychiatric illness and those of medical patients towards psychiatric treatment.

Methods: Both patients with psychiatric illness and medical patients (controls) were shown a printed copy of two vignettes depicting major depression and generalized anxiety disorder.

Ministry of Health Clinical Practice Guidelines: Anxiety Disorders.

The Ministry of Health (MOH) has developed the clinical practice guidelines on Anxiety Disorders to provide doctors and patients in Singapore with evidence-based treatment for anxiety disorders. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on anxiety disorders, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.

Jikoshu-kyofu in Singapore.

Objective: Jikoshu-kyofu (JKF), a condition characterised by a fear of offending others through emitting foul body odour, was first described in Japan in the 1960s. Although initially thought to be a culture-bound syndrome, it has been described in other countries. It is well established that there are two variants, a non- delusional and a delusional variant.

Validation of the emotion thermometers and hospital anxiety and depression scales in Singapore: Screening cancer patients for distress, anxiety and depression.

Aim: To validate the emotion thermometer (ET) and hospital anxiety and depression scales (HADS) in Singapore, screening cancer patients for distress, anxiety and depression.

Methods: Three hundred fifteen cancer patients from National Cancer Centre and Singapore General Hospital participated in the study. Interviews and assessments were conducted in English, assessing patients' sociodemographic data and screening for emotional symptoms using the ET, HADS and Mini-International Neuropsychiatric Interview (MINI) tools.

Bipolar patients sing more in singapore: singing as a signal for mania in psychotic patients.

Introduction: Singing in psychotic patients has received little attention in the psychiatric literature. In this preliminary study, we test the hypothesis that manic patients sing more than schizophrenic patients (SPs).

Materials And Methods: Manic patients and SP inpatients and outpatients were interviewed using a semi-structured questionnaire which included questions on musical interests, and how much they felt like singing prior to their most recent admission to hospital.

Asthma, life events and psychiatric disorders: a population-based study.

Purpose: Although asthma and other chronic physical conditions have been shown to be associated with psychiatric symptoms, the relative contributions of negative life events to this association and impaired quality of life (QOL) are not clear.

Methods: This is a cross-sectional study of a nationally representative sample of Singaporean adults aged 20-59 (n = 2,847). Individuals were grouped by asthma, other chronic physical conditions, and no chronic physical conditions.

A case of Jikoshu-Kyofu treated with cognitive behavioural therapy.

Jikoshu-Kyofu (JKF) is a subtype of Taijin-Kyofu-Sho (TKS), a form of social anxiety first described in Japanese sufferers. Unlike the Diagnostic and Statistical Manual of Mental Disorders - 4th edition text revised definition of social anxiety disorder, TKS is characterised by a fear of offending others, whereas in the case of JKF, it is the fear of giving off a smell, thus causing offence. We describe the symptoms of JKF in a young woman who was treated with cognitive behavioural therapy (CBT).

Doctor-patient communication, knowledge, and question prompt lists in reducing preoperative anxiety: a randomized control study.

Objective: The aims of the study were to assess factors responsible for the reduction of preoperative anxiety in patients undergoing breast and abdominal surgeries. In particular, we investigated whether question prompt lists (QPL), patients' knowledge, or the communication skills of surgeons had effects on anxiety reduction.

Methods: Patients were randomly assigned to QPL and control groups.

Qualities of a psychiatric mentor: a quantitative Singaporean survey.

Objective: Psychiatric mentors are an important part of the new, seamless training program in Singapore. There is a need to assess the qualities of a good psychiatric mentor vis-à-vis those of a good psychiatrist.

Method: An anonymous survey was sent out to all psychiatry trainees and psychiatrists in Singapore to assess quantitatively the relative importance of 40 qualities for a good psychiatrist and a good mentor.

Anxiety and depression, chronic physical conditions, and quality of life in an urban population sample study.

Objective: No previous studies have empirically demonstrated a multiplicative interactive effect of anxiety disorders and/or depression (ADD) and chronic medical conditions on quality of life (QOL). We hypothesized that QOL impairment was worsened by the presence of ADD and medical co-morbidity, more than when it was with either medical co-morbidity alone or ADD alone.

Methods: Complete data of 2,801 participants from the National Mental Health Survey of Adults in Singapore were analyzed, using SCAN diagnoses of anxiety disorders and depression, self-reports of chronic medical conditions, and SF-12 measures of QOL (Mental Component Summary, MCS, and Physical Component Summary, PCS).

Alcohol and aldehyde dehydrogenase polymorphisms in Chinese and Indian populations.

The association between two functional polymorphisms in alcohol dehydrogenase (ADH2/ADH1B) and aldehyde dehydrogenase (ALDH2) genes and alcohol dependence was examined in 182 Chinese and Indian patients undergoing treatment for alcohol dependence and 184 screened control subjects from Singapore. All subjects were screened by the Alcohol Use Disorders Identification Test (AUDIT). Patients were also administered the Severity of Alcohol Dependence Questionnaire (SADQ).

Health beliefs and help seeking for depressive and anxiety disorders among urban Singaporean adults.

Objective: This study examined whether help seeking for mental problems was predicted by beliefs about mental illness and services and by family and social support.

Methods: Singaporean adults (N= 2,801) were interviewed with the Schedule for Clinical Assessment in Neuropsychiatry and with questions on mental health status, beliefs about the curability of mental illness, embarrassment and stigma, ease of discussing mental problems, effectiveness and safety of treatment, and trust in professionals.

Results: Although 10% of respondents had a depressive or anxiety disorder or combination, only 3% acknowledged having mental problems, 5% rated their mental health as fair or poor, and 6% sought help for their mental health problems.

Psychotic disorder in a patient with central and extrapontine myelinolysis.

Central pontine and extrapontine myelinolysis (CPEM) are rare conditions usually associated with rapid correction of hyponatremia. Neurologic complications are the usual sequelae although neuropsychiatric features are rare. Described herein are unusual psychotic symptoms following CPEM and discussion of the likely pathogenesis and implications for treatment.