56 results on '"Se-fong Hung"'
Search Results
2. Effectiveness and optimal duration of early intervention treatment in adult-onset psychosis: a randomized clinical trial
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Christy Lai Ming Hui, Andreas Kar Hin Wong, Elise Chun Ning Ho, Bertha Sze Ting Lam, Priscilla Wing Man Hui, Tiffany Junchen Tao, Wing Chung Chang, Sherry Kit Wa Chan, Edwin Ho Ming Lee, Yi Nam Suen, May Mei Ling Lam, Cindy Pui Yu Chiu, Frendi Wing Sai Li, Kwok Fai Leung, Sarah M. McGhee, Chi Wing Law, Dicky Wai Sau Chung, Wai Song Yeung, Michael Gar Chung Yiu, Edwin Pui Fai Pang, Steve Tso, Simon Sai Yu Lui, Se Fong Hung, Wing King Lee, Ka Chee Yip, Ka Lik Kwan, Roger Man Kin Ng, Pak Chung Sham, William G. Honer, and Eric Yu Hai Chen
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Psychiatry and Mental health ,Applied Psychology - Abstract
BackgroundContrasting the well-described effects of early intervention (EI) services for youth-onset psychosis, the potential benefits of the intervention for adult-onset psychosis are uncertain. This paper aims to examine the effectiveness of EI on functioning and symptomatic improvement in adult-onset psychosis, and the optimal duration of the intervention.Methods360 psychosis patients aged 26–55 years were randomized to receive either standard care (SC, n = 120), or case management for two (2-year EI, n = 120) or 4 years (4-year EI, n = 120) in a 4-year rater-masked, parallel-group, superiority, randomized controlled trial of treatment effectiveness (Clinicaltrials.gov: NCT00919620). Primary (i.e. social and occupational functioning) and secondary outcomes (i.e. positive and negative symptoms, and quality of life) were assessed at baseline, 6-month, and yearly for 4 years.ResultsCompared with SC, patients with 4-year EI had better Role Functioning Scale (RFS) immediate [interaction estimate = 0.008, 95% confidence interval (CI) = 0.001–0.014, p = 0.02] and extended social network (interaction estimate = 0.011, 95% CI = 0.004–0.018, p = 0.003) scores. Specifically, these improvements were observed in the first 2 years. Compared with the 2-year EI group, the 4-year EI group had better RFS total (p = 0.01), immediate (p = 0.01), and extended social network (p = 0.05) scores at the fourth year. Meanwhile, the 4-year (p = 0.02) and 2-year EI (p = 0.004) group had less severe symptoms than the SC group at the first year.ConclusionsSpecialized EI treatment for psychosis patients aged 26–55 should be provided for at least the initial 2 years of illness. Further treatment up to 4 years confers little benefits in this age range over the course of the study.
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- 2022
3. An elevated anxiety level among prepubertal autistic boys with non‐treatment‐seeking functional gastrointestinal disorders: A case–control study
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Oscar W H Wong, Suk Ling Ma, Sandra S. M. Chan, Kelly Y. C. Lai, Sunny H. Wong, Patrick W. L. Leung, Angela M. W. Lam, and Se-fong Hung
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Male ,Abdominal pain ,Autism Spectrum Disorder ,Gastrointestinal Diseases ,Nausea ,Gut–brain axis ,Anxiety ,03 medical and health sciences ,0302 clinical medicine ,Functional gastrointestinal disorder ,mental disorders ,Post-hoc analysis ,medicine ,Humans ,0501 psychology and cognitive sciences ,Autistic Disorder ,Child ,Genetics (clinical) ,business.industry ,General Neuroscience ,05 social sciences ,Case-control study ,medicine.disease ,Case-Control Studies ,Child, Preschool ,Autism ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery ,050104 developmental & child psychology ,Clinical psychology - Abstract
Children with autism commonly suffer from comorbid functional gastrointestinal disorders (FGID) and anxiety. The raised prevalence of both conditions in autism suggests complex reciprocal relationships, which are seldom explored in non-treatment-seeking FGID. The relationships between subtypes of FGID and anxiety are also unclear. This study recruited boys with autism and age-matched typically developing (TD) boys, aged 4-11 years, who were not actively seeking help for gastrointestinal problems. Their parents completed the Rome IV Diagnostic Questionnaires for Pediatric FGID. Four groups of children with and without autism/FGID were identified and compared on their anxiety level using the Spence children's anxiety scale. In 69 boys with autism and 69 age-matched TD boys, FGID were identified in 22 and 16 boys, respectively. ANCOVA demonstrated a significant interaction effect of autism and FGID on anxiety (F[1, 129] = 5.43, p = 0.021), while conditional logistic regression identified an interaction effect of autism and anxiety on the odds of FGID (OR 1.038, 95% CI 1.002-1.075, p = 0.038). Explorative post hoc analysis showed higher anxiety in functional nausea and vomiting disorder (p = 0.033) and functional abdominal pain disorder (p = 0.029) among boys with autism than TD boys with the same respective subtypes of FGID. In summary, among prepubertal boys with autism, the presence of FGID that are non-treatment-seeking in nature, has a significantly stronger association with higher levels of anxiety than TD boys. The strength of association may be more prominent in subtypes of FGID. Possible pathomechanisms including the underlying microbiota spectra and inflammatory paths should be explored in future studies. LAY SUMMARY: Anxiety and gastrointestinal problems are common symptoms in autism. Given that gut health could be linked to emotions, their association in young boys with autism was studied. The presence of nausea vomiting, or abdominal pain were associated with raised anxiety among boys with autism, yet this was not observed in typically developing boys. This suggests that anxiety among autistic children could be partly explained by the presence of FGID.
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- 2021
4. Autism Diagnostic Interview-Revised Within DSM-5 Framework: Test of Reliability and Validity in Chinese Children
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Patrick W. L. Leung, Se-fong Hung, Emily C W Yuen, and Kelly Y. C. Lai
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Autism Diagnostic Interview ,05 social sciences ,Context (language use) ,medicine.disease ,behavioral disciplines and activities ,Test (assessment) ,DSM-5 ,03 medical and health sciences ,0302 clinical medicine ,Autism spectrum disorder ,mental disorders ,Intellectual disability ,Developmental and Educational Psychology ,medicine ,Autism ,0501 psychology and cognitive sciences ,Psychology ,030217 neurology & neurosurgery ,Reliability (statistics) ,050104 developmental & child psychology ,Clinical psychology - Abstract
This study examines the psychometric properties of the Autism Diagnostic Interview-Revised (ADI-R) in the context of DSM-5 in a sample of Chinese children. Using re-mapped ADI-R items and algorithms matched to DSM-5 criteria, and administering to children with autism spectrum disorder (ASD) with and without intellectual disability, attention-deficit hyperactivity disorder, and typically developing, it evidenced high sensitivity and specificity. However, similar to DSM-IV algorithm, the DSM-5 algorithms were better at classifying ASD among children with intellectual disability than among those without intellectual disability. With the DSM-5's recognition of the spectrum nature of ASD, the performance of the ADI-R can be improved by having finer gradations in the ADI-R scoring and adding more items on the restricted and repetitve behavior domain.
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- 2021
5. School-Based Mental Health Initiative: Potentials and Challenges for Child and Adolescent Mental Health
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Kelly Y. C. Lai, Se-Fong Hung, Hannah W. S. Lee, and Patrick W. L. Leung
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Psychiatry and Mental health - Abstract
School-based mental health support services allow children and adolescents easy access to services without requirement of traveling to clinics and hospitals. We describe a School Mental Health Support Scheme (SMHSS) piloted in Hong Kong and discuss the challenges and learnings from the experience. This conceptual paper argues that accessibility is not the only advantage of such services. Teachers are significant others in child development, alongside with families. They play a central role in impacting the children's/adolescents' needs for competence and adult attachment, while schools provide an expanded social network of peers for one's social relationship. The fulfillment of these needs has powerful implications in the mental health of the children/adolescents. Teachers can help students to develop a sense of competence with self-worth and self-identity via providing guidance and feedback, whether they be on one's strengths or weaknesses, with acceptance, tolerance and unconditional positive regard. Particularly, the latter define a form of teacher-student relationship or adult attachment that offers the children/adolescents emotional security and nourishment, protecting them from failings and adversities. Teachers can also supervise and guide their students' social development with peers at schools. A recent meta-analysis has found preliminary evidence that those school-based mental health services integrated into the teachers' routine teaching activities are more effective. Teachers, who are overworked and stressed by the schools' overemphasis on academics and grades, have yet to fully grasp their unique roles in supporting students with mental health needs. This paper ends by advocating a paradigm shift in which both the healthcare professionals and educators should forge a mutually beneficial collaboration in jointly enhancing the mental health of children/adolescents at schools.
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- 2022
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6. Inequalities in Psychiatric Morbidity in Hong Kong and Strategies for Mitigation
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Siu-Ming Chan, Linda Chiu-Wa Lam, Wing-Yan Law, Se-Fong Hung, Wai-Chi Chan, Eric Yu-Hai Chen, Gary Ka-Ki Chung, Yat-Hang Chan, Roger Yat-Nork Chung, Hung Wong, Eng-Kiong Yeoh, and Jean Woo
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Adult ,mental morbidity ,social gradient ,inequality ,mental health policy ,Hong Kong ,Unemployment ,Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health ,Income ,Prevalence ,Humans ,Anxiety Disorders - Abstract
This study explores the social gradient of psychiatric morbidity. The Hong Kong Mental Morbidity Survey (HKMMS), consisting of 5719 Chinese adults aged 16 to 75 years, was used. The Chinese version of the Revised Clinical Interview Schedule (CIS-R) was employed for psychiatric assessment of common mental disorders (CMD). People with a less advantaged socioeconomic position (lower education, lower household income, unemployment, small living area and public rental housing) had a higher prevalence of depression and anxiety disorder. People with lower incomes had worse physical health (OR 2.01, 95% CI 1.05–3.82) and greater odds of having CMD in the presence of a family history of psychiatric illnesses (OR 1.67, 95% CI 1.18–2.36). Unemployment also had a greater impact for those in lower-income groups (OR 2.67; 95% CI 1.85–3.85), whereas no significant association was observed in high-income groups (OR 0.56; 95% CI 0.14–2.17). Mitigating strategies in terms of services and social support should target socially disadvantaged groups with a high risk of psychiatric morbidity. Such strategies include collaboration among government, civil society and business sectors in harnessing community resources.
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- 2022
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7. A comparison of sleep-wake patterns among school-age children and adolescents in Hong Kong before and during the COVID-19 pandemic
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Steven WH Chau, Samara Hussain, Sandra SM Chan, Oscar WH Wong, Jihui Zhang, Hongliang Feng, Kelly YC Lai, Suk Ling Ma, Suzanne HW So, Kelvin KF Tsoi, Yun Kwok Wing, Se Fong Hung, and Patrick WL Leung
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BackgroundLifestyle of children and adolescents have changed extensively during the COVID-19 pandemic due to school suspension and social distancing measures, which can affect their sleep health. Existing studies in the area used convenient samples and focused on the initial months of the pandemic.MethodAs part of a territory-wide epidemiological study in Hong Kong, this cross-sectional study recruited primary and secondary school students by stratified random sampling. We investigated the pandemic’s effects on sleep parameters using multivariate regression, adjusting for age, sex, household income, seasonality and presence of mental disorders, and the effects’ moderators and mediators.FindingsBetween September 1, 2019 and June 2, 2021, 791 primary and 442 school students were recruited and analysed. After correcting for multiple testing, being assessed during COVID predicted a longer sleep latency in primary and secondary school students in school days (95% CI = 1.0–5.2 minutes, adjusted p-value = 0.010; and 95% CI= 3.9–13.0 minutes, adjusted p-value =0.004, respectively) and non-school days (95% CI = 1.7–7.2 minutes, adjusted p-value = 0.005; 95% CI = 3.4–13.7 minutes, adjusted p-value = 0.014, respectively). Low household income was a moderator for later bedtime (adjusted p-value = 0.032) and later sleep onset (adjusted p-value = 0.043) during non-school days among secondary school students. Sex and digital leisure time were not moderator and mediator of the pandemic’s effect on sleep parameters, respectively.InterpretationChanges associated with the COVID-19 pandemic have a widespread and enduring effect on sleep health of school-aged students in Hong Kong. Household income play a role in adolescents’ sleep health’s resilience against these changes, and anti-epidemic measures effects on the health gap of the youth should be considered.FundingGovernment of the Hong Kong Special Administrative Region, Food and Health Bureau, Health and Medical Research Fund (Ref. No.: MHS-P1(Part 1)-CUHK).
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- 2022
8. Disentangling the relationship of gut microbiota, functional gastrointestinal disorders and autism: a case-control study on prepubertal Chinese boys
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Oscar W. H. Wong, Angela M. W. Lam, Brian P. N. Or, Flora Y. M. Mo, Caroline K. S. Shea, Kelly Y. C. Lai, Suk Ling Ma, Se Fong Hung, Sandra Chan, Thomas N. Y. Kwong, Sunny Wong, and Patrick W. L. Leung
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Male ,China ,Multidisciplinary ,Autism Spectrum Disorder ,Gastrointestinal Diseases ,Case-Control Studies ,Humans ,Autistic Disorder ,Gastrointestinal Microbiome - Abstract
Emerging evidence of an altered gut microbiome in autism spectrum disorder (ASD) suggests a pathomechanism through the gut–brain axis despite the inconsistent microbiome profile reported across studies. One of the knowledge gaps in the existing ASD microbiota studies is the lack of systematic exploration of the role of comorbid functional gastrointestinal disorder (FGID) in the association of ASD and altered gut microbiome. Consequently, 92 ASD and 112 age-matched typically developing (TD) boys were profiled on general psychopathology, FGID status by Rome IV classification, and gut microbiota using 16S ribosomal RNA amplicon sequencing at the V4 hypervariable region. Compared to TD, a significant decrease in the within-sample abundance of taxa was observed in ASD, regardless of FGID status. The microbiota of ASD FGID+ and ASD FGID− clustered apart from the TD groups. The microbiota of ASD FGID+ also showed qualitative differences from that of ASD FGID− and had the highest-level Firmicutes: Bacteroidetes ratio, which was paralleled by elevated levels of anxiety and overall psychopathology. The altered gastrointestinal microbiota composition in ASD appeared to be independent of comorbid FGID. Further studies should address how FGID may mediate neuropsychiatric symptoms in ASD through inflammation along the microbiota–gut–brain axis.
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- 2022
9. Gastrointestinal Problems in Chinese Children with Autism Spectrum Disorder
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Kelly Y. C. Lai, Fanny L F Lau, Mark R. Dadds, Kiti K. I. Che, Flora Mo, Justin C Y Wu, Suzanne So, Patrick W. L. Leung, Se-fong Hung, Chun-Yu Tse, Suk Ling Ma, and Caroline K. S. Shea
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education.field_of_study ,Pediatrics ,medicine.medical_specialty ,Constipation ,business.industry ,Population ,Confounding ,Abdominal migraine ,medicine.disease ,030227 psychiatry ,03 medical and health sciences ,0302 clinical medicine ,Gastrointestinal problems ,Autism spectrum disorder ,mental disorders ,medicine ,medicine.symptom ,Aerophagia ,education ,business ,030217 neurology & neurosurgery ,Depression (differential diagnoses) - Abstract
Purpose Gastrointestinal symptoms in individuals with autism spectrum disorder may constitute a subgroup with complex gut-brain interactions underlying the pathogenesis. This study examined the prevalence of gastrointestinal symptoms in a sample of Chinese children with autism spectrum disorder, as well as the factors related to them. Participants and methods The participants included a clinic sample of 107 children with autism spectrum disorder and 249 gender- and age-matched typically developing community children. Results Results found children with autism spectrum disorder to be twice as likely to suffer from gastrointestinal symptoms, reporting increased rates of constipation, abdominal migraine and aerophagia. Autism spectrum disorder diagnosis remained a significant predictor of gastrointestinal symptoms after taking into account the potential confounders that included comorbid psychopathologies, diets, and parental anxiety and depression. Conclusion Our results suggest that autism spectrum disorder with gastrointestinal symptoms may constitute a subgroup within the autism spectrum disorder population that warrants further investigation.
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- 2020
10. Genetic Overlap Between Attention Deficit/Hyperactivity Disorder and Autism Spectrum Disorder in SHANK2 Gene
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Suk-Ling Ma, Lu Hua Chen, Chi-Chiu Lee, Kelly Y. C. Lai, Se-Fong Hung, Chun-Pan Tang, Ting-Pong Ho, Caroline Shea, Flora Mo, Timothy S. H. Mak, Pak-Chung Sham, and Patrick W. L. Leung
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business.industry ,pleiotropic gene ,General Neuroscience ,Neurosciences. Biological psychiatry. Neuropsychiatry ,Single-nucleotide polymorphism ,medicine.disease ,ASD ,behavioral disciplines and activities ,Comorbidity ,SHANK2 ,Autism spectrum disorder ,mental disorders ,Multiple comparisons problem ,SHANK genes ,medicine ,ADHD ,Attention deficit hyperactivity disorder ,genetic overlap ,business ,Allele frequency ,Gene ,RC321-571 ,Neuroscience ,Original Research ,Clinical psychology - Abstract
Background: Recent findings indicated a high comorbidity between attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), as well as shared genetic influences on them. The latter might contribute at least partly to the former clinical scenario. This study aimed at investigating whether SHANK genes were potential pleiotropic genes to the two said disorders, underlying their genetic overlap.Methods: This study recruited 298 boys with ADHD (including 256 family trios of 1 ADHD boy and his 2 biological parents), 134 boys with ASD, 109 boys with both ADHD and ASD, and 232 typically developing boys as community controls. They were aged between 6 and 11 years old.Results: There was no significant difference in allele frequency of a number of single nucleotide polymorphisms (SNPs) in SHANK2/SHANK3 between the three clinical groups (ADHD, ASD, and ADHD + ASD) and between the two control groups (community controls and pseudo-controls), respectively. The three clinical groups and the two control groups were thus, respectively, combined. A comparison between the two aggregated samples identified significant evidence of disease association for three SHANK2 SNPs with both ADHD and ASD, even after multiple testing correction: rs11236616 (OR = 0.762, permuted p = 0.0376), rs7106631 (OR = 0.720, permuted p = 0.0034), and rs9888288 (OR = 0.770, permuted p = 0.0407). Comparisons among individual groups pointed to a similar trend of findings.Conclusion:SHANK2 could be considered a potential pleiotropic gene underlying the genetic overlap between ADHD and ASD. This might contribute partly to their high comorbidity in the afflicted children.
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- 2021
11. The 12-month prevalence of psychotic experiences and their association with clinical outcomes in Hong Kong: an epidemiological and a 2-year follow up studies
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Corine Sau Man Wong, Veronica Chan, Wing Chung Chang, Herbert Pang, Eric Y.H. Chen, Eric Fuk Chi Cheung, Kaspar Kit Wai Lee, Helen F.K. Chiu, Christy Lai Ming Hui, Wai Chi Chan, Sherry Kit Wa Chan, Linda C. W. Lam, Tin Po Chiang, Edwin Ho Ming Lee, Ming Lam, Roger Man King Ng, Joseph Lau, and Se Fong Hung
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Adult ,Male ,Paranoid Disorders ,Psychosis ,medicine.medical_specialty ,Adolescent ,Hallucinations ,Population ,Suicidal Ideation ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Asian People ,Surveys and Questionnaires ,Epidemiology ,medicine ,Humans ,Paranoia ,Association (psychology) ,education ,Applied Psychology ,Aged ,education.field_of_study ,business.industry ,Mental Disorders ,Follow up studies ,Middle Aged ,medicine.disease ,Mental health ,Latent class model ,030227 psychiatry ,body regions ,Psychiatry and Mental health ,Psychotic Disorders ,Hong Kong ,Female ,Independent Living ,medicine.symptom ,business ,human activities ,030217 neurology & neurosurgery ,Clinical psychology ,Follow-Up Studies - Abstract
BackgroundThe relationship between the subtypes of psychotic experiences (PEs) and common mental health symptoms remains unclear. The current study aims to establish the 12-month prevalence of PEs in a representative sample of community-dwelling Chinese population in Hong Kong and explore the relationship of types of PEs and common mental health symptoms.MethodThis is a population-based two-phase household survey of Chinese population in Hong Kong aged 16–75 (N = 5719) conducted between 2010 and 2013 and a 2-year follow-up study of PEs positive subjects (N = 152). PEs were measured with Psychosis Screening Questionnaire (PSQ) and subjects who endorsed any item on the PSQ without a clinical diagnosis of psychotic disorder were considered as PE-positive. Types of PEs were characterized using a number of PEs (single v. multiple) and latent class analysis. All PE-positive subjects were assessed with common mental health symptoms and suicidal ideations at baseline and 2-year follow-up. PE status was also assessed at 2-year follow-up.ResultsThe 12-month prevalence of PEs in Hong Kong was 2.7% with 21.1% had multiple PEs. Three latent classes of PEs were identified: hallucination, paranoia and mixed. Multiple PEs and hallucination latent class of PEs were associated with higher levels of common mental health symptoms. PE persistent rate at 2-year follow-up was 15.1%. Multiple PEs was associated with poorer mental health at 2-year follow-up.ConclusionsResults highlighted the transient and heterogeneous nature of PEs, and that multiple PEs and hallucination subtype of PEs may be specific indices of poorer common mental health.
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- 2020
12. Multi-disciplinary Psychiatric Case Management Model in Hong Kong: Service Coverage and Risk Stratification
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William Wh Chui, Sharon Pf Lau, Chi-chiu Lee, Po-keung Kwong, Sania Sw Yau, Terry Cb Wong, Se-fong Hung, and Sui-lung Wong
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Adult ,Male ,medicine.medical_specialty ,Project commissioning ,Risk Assessment ,Rating scale ,Risk Factors ,medicine ,Humans ,Patient Care Team ,business.industry ,Mental Disorders ,Middle Aged ,Case management ,Mental health ,Community Mental Health Services ,Publishing ,Family medicine ,Risk stratification ,Hong Kong ,Female ,business ,Psychology ,Psychosocial ,Case Management ,Psychopathology - Abstract
Introduction: Community mental health services in Hong Kong follow a multi-disciplinary case management model. We investigated whether at-risk patients received higher intensity care and whether risk stratification concorded between personalised care programmes and integrated community centres of mental wellness. Methods: Records of all patients in North Lantau and Mongkok districts who received case management services (from personalised care programmes and/or integrated community centres of mental wellness) between 1 April 2014 and 30 June 2015 were reviewed. Patients' levels of risk, demographic data, and clinical characteristics were analysed. Results: Identified at-risk patients received high-intensity care from personalised care programmes and integrated community centres of mental wellness. Case management was coordinated between the Hospital Authority and non-government organisations. However, risk stratification did not correlate with assessment rating scores of psychopathology or psychosocial functioning. Assessment rating scales appear unsuitable to provide any optimal cut-off scores for risk stratification. Conclusions: Risk stratification should be a structured clinical judgement based on comprehensive and accurate information of protective and risk factors, rather than relying on cut-off scores of assessment rating scales.
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- 2020
13. Diagnostic Outcomes of Childhood ADHD in Chinese Adults
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Se-fong Hung, Arthur D. P. Mak, Sing Lee, Alicia K. W. Chan, Kelly Y. C. Lai, Sheila Wong, Chun-pan Tang, Patrick S.C. Leung, Phyllis K L Chan, and Linda C. W. Lam
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Adult ,Persistence (psychology) ,Longitudinal study ,medicine.medical_specialty ,Comorbidity ,World health ,Disability assessment ,03 medical and health sciences ,Psychiatric comorbidity ,0302 clinical medicine ,mental disorders ,Developmental and Educational Psychology ,medicine ,Humans ,0501 psychology and cognitive sciences ,Child ,Psychiatry ,Clinical interview ,05 social sciences ,Chinese adults ,medicine.disease ,Diagnostic and Statistical Manual of Mental Disorders ,Clinical Psychology ,Attention Deficit Disorder with Hyperactivity ,Impulsive Behavior ,Hong Kong ,Psychology ,030217 neurology & neurosurgery ,050104 developmental & child psychology - Abstract
Objective: We examined adulthood diagnostic, functioning, and social outcomes of childhood ADHD in a Hong Kong Chinese clinical sample. Method: We identified from the central registry 499 Chinese adults clinically diagnosed with ADHD aged 6 to 12 in 2002-2005 in four Hong Kong child psychiatric centers. Assessments included ADHD Clinical Diagnostic Scale (ACDS), Structured Clinical Interview for DSM Disorders (SCID), and World Health Organization Disability Assessment Schedule (WHO-DAS). Results: Eligible participants = 499. One hundred forty-five completed assessments, two deceased, six incarcerated, 100 had invalid contact, 83 declined, 34 emigrated, and 129 unable to attend. Mean follow-up duration = 14.9 years. Nonrespondents were slightly younger (19.78 vs. 20.53, p < .001). In all, 83.1% of all participants currently met Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) ADHD criteria (36.8% inattentive subtype (IA), 43% combined, 3.3% hyperactive/impulsive subtype (H/I) ). One third of persistent ADHD participants currently received care. ADHD persistence was associated with significantly increased psychiatric comorbidity (49.5% vs. 22.7%, p = .02) and poor academic and social outcomes. ADHD persistence and comorbidity independently predicted impairment. Conclusion: Adulthood-persistence of clinically presented childhood ADHD is common and impairing in Hong Kong Chinese.
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- 2018
14. Are psychiatric comorbidities and associated cognitive functions related to treatment response to methylphenidate in boys with attention-deficit/hyperactivity disorder?
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T. P. Ho, Patrick W. L. Leung, Pak C. Sham, Fefe Hk Chan, Ka-chai Cheung, Se-fong Hung, Merce Garcia-Barcelo, Chi-chiu Lee, Chun-pan Tang, Fung-yee Ching, Mandy H Lissillour Chan, and Lu-hua Chen
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medicine.medical_specialty ,Treatment response ,Neuropsychiatric Disease and Treatment ,cognitive functions ,methylphenidate ,behavioral disciplines and activities ,03 medical and health sciences ,0302 clinical medicine ,psychiatric comorbidities ,mental disorders ,medicine ,Attention deficit hyperactivity disorder ,ADHD ,0501 psychology and cognitive sciences ,Adhd symptoms ,Psychiatry ,Pre and post ,Original Research ,business.industry ,Methylphenidate ,05 social sciences ,treatment response ,Cognition ,medicine.disease ,Post treatment ,business ,Neurocognitive ,human activities ,030217 neurology & neurosurgery ,050104 developmental & child psychology ,medicine.drug - Abstract
Mandy H Chan,1 Patrick WL Leung,2 Ting-pong Ho,3 Se-fong Hung,4 Chi-chiu Lee,5 Chun-pan Tang,5 Ka-chai Cheung,2 Fung-yee Ching,2 Fefe HK Chan,6 Lu-hua Chen,2 Merce Garcia-Barcelo,7 Pak-chung Sham3 1Department of Clinical Psychology, Kowloon Hospital, Hospital Authority, 2Department of Psychology, The Chinese University of Hong Kong, 3Department of Psychiatry, University of Hong Kong, 4Department of Psychiatry, The Chinese University of Hong Kong, 5Department of Psychiatry, Kwai Chung Hospital, Hospital Authority, 6Department of Clinical Psychology, Alice Ho Mui Ling Nethersole Hospital, Hospital Authority, 7Department of Surgery, University of Hong Kong, Hong Kong, People’s Republic of China Background: Methylphenidate (MPH) has been found to be an effective medication for attention-deficit/hyperactivity disorder (ADHD). However, there are neither consistent nor sufficient findings on whether psychiatric comorbidities and associated cognitive functions of ADHD are related to treatment response to MPH in ADHD children.Objectives: This study investigated whether psychiatric comorbidities, IQ, and neurocognitive deficits are related to treatment response to MPH in ADHD children. In some ways, it is preferable to have a drug that the effectiveness of which to a disorder is not affected by its associated cognitive functions and psychiatric comorbidities. On the other hand, it is likely that the baseline symptom severity of ADHD is associated with the effectiveness of MPH treatment on the symptoms post treatment.Methods: A total of 149 Chinese boys (aged 6–12years) with ADHD, combined type, and normal IQ participated in this study. Assessment of ADHD symptom severity was conducted pre and post MPH treatment, while assessment of psychiatric comorbidities, IQ, and neurocognitive deficits was performed in a non-medicated condition. Treatment response was defined as the ADHD symptom severity post MPH treatment.Results: Results indicated that MPH treatment was effective, significantly improving the ADHD condition. Yet, comorbid disorders, IQ, and neurocognitive deficits were not related to MPH treatment response on ADHD symptoms. These findings indicated that the effectiveness of MPH was not affected by psychiatric comorbidities and associated cognitive functions of ADHD. Instead, as expected, it was the baseline symptom severity that was mainly related to the treatment response, ie, the milder the baseline condition, the better the treatment response.Conclusion: The current findings positively endorse the widespread clinical use of MPH for treating ADHD. It improves the behavioral symptoms of ADHD regardless of varying psychiatric comorbidities, IQ, and neurocognitive deficits. Keywords: ADHD, psychiatric comorbidities, cognitive functions, treatment response, methylphenidate
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- 2017
15. Present and future of severe mental illness (SMI) policies: Reflections from an Asia–Pacific Expert Forum series
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Liang Ma, Oğuz Karamustafalioglu, Tae Yeon Hwang, Wai Lun Szeto, Yen Kuang Yang, Asif Iqbal Ahmed, Bridget Organ, Myung Soo Lee, Jun Li, Te Jen Lai, Michael Ming Cheuk Wong, WS Yeung, Yoshio Yamanouchi, Tak Lam Lo, Se Fong Hung, David J. Castle, Nimesh Desai, Jagadisha Thirthalli, Kimmy Ho, and Eileena Chui
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medicine.medical_specialty ,Bipolar Disorder ,Community Mental Health Centers ,Turkey ,education.educational_degree ,MEDLINE ,India ,Psychiatric rehabilitation ,Patient rights ,Psychiatric Rehabilitation ,Asia pacific ,medicine ,Humans ,Bipolar disorder ,Letters to the Editor ,Psychiatry ,education ,Letter to the Editor ,Depressive Disorder ,Asia, Eastern ,General Neuroscience ,Australia ,General Medicine ,Congresses as Topic ,medicine.disease ,Mental illness ,Community Mental Health Services ,Clinical neurology ,Psychiatry and Mental health ,Patient Rights ,Neurology ,Schizophrenia ,Neurology (clinical) ,Societies ,Psychology - Published
- 2019
16. GENETIC OVERLAP BETWEEN ADHD AND ASD IN SHANK GENES IN CHINESE POPULATION
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Lu Hua Chen, Yee Ching Kelly Lai, Yi Man Flora Mo, T. P. Ho, Chun-pan Tang, Chi-chiu Lee, Se-fong Hung, Ming Chung Marshall Lee, Merce Garcia-Barcelo, Suk Ling Ma, Ka Sin Caroline Shea, Patrick W. L. Leung, and Pak C. Sham
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Pharmacology ,Candidate gene ,business.industry ,Single-nucleotide polymorphism ,medicine.disease ,Impulsivity ,behavioral disciplines and activities ,Comorbidity ,Psychiatry and Mental health ,Neurology ,Autism spectrum disorder ,mental disorders ,medicine ,Genetic predisposition ,Pharmacology (medical) ,Neurology (clinical) ,medicine.symptom ,business ,Allele frequency ,Biological Psychiatry ,Clinical psychology ,Genetic association - Abstract
Background Attention Deficit/Hyperactivity Disorder (ADHD) is characterized with inattention, hyperactivity and impulsivity, while Autism Spectrum Disorder (ASD) is characterized with impaired social communication and interaction, restricted and repetitive patterns of behavior and activities. Phenotypically, both appear to be quite different. However, clinically it has been found that 20–50% ADHD children meet diagnostic criteria for ASD, while 30–80% ASD children meet diagnostic criteria for ADHD. These rates of comorbidity between the two disorders imply that they may share underlying etiologies. Although recent evidence has suggested a genetic overlap between ADHD and ASD, little progress has been made so far to identify the specific genes involved. The shank synaptic scaffold proteins, which are encoded by SHANK genes and located at the post-synaptic density of glutamatergic synapses, have been reported to be associated with a number of psychiatric disorders, including ADHD and ASD, separately. The aim of the current study is to investigate whether there is a genetic overlap between ADHD and ASD in SHANK genes. Methods In the present study, only male children with Chinese ethnicity, aged between 6 to 12 years, were included. 298 ADHD family trios (including ADHD children without ASD and their biological fathers and mothers), 134 ASD children without ADHD, and 109 children with both ASD and ADHD were recruited from public hospitals in Hong Kong. 232 normal control children were recruited from local primary schools. A number of single-nucleotide polymorphisms (SNPs) from SHANK2 and SHANK3 were selected for genotyping. After quality control, 14 SNPs from SHANK2 and 7 SNPs from SHANK3 were included for data analyses. For ADHD family trios’ data, we constructed ADHD cases and matched pseudo-control, which were based on transmitted and un-transmitted parental alleles using the Haplotype-Relative-Risk (HRR) principle. The pseudo-control supplemented the normal control to increase the statistical power. Likewise, ASD children with or without ADHD were also paired with samples of normal control and pseudo-control for association analysis. PLINK and KGG were used for statistical association analyses at SNP-level and gene-level, respectively. Results When association analysis was done between ADHD children without ASD and samples of normal control and pseudo-control, the T allele of rs7106631 of SHANK2 significantly decreased the ADHD risk (p=0.001, OR=0.70). When allele frequencies’ comparisons were conducted between ASD children with or without ADHD and samples of normal control and pseudo-control, the same protective effect of rs7106631 T allele was identified with OR=0.74 (p=0.011). Further association analysis conducted between all clinical children (i.e., ADHD children without ASD & ASD children with or without ADHD) and samples of normal control and pseudo-control yielded more significant results for rs7106631 (p=0.0003, OR=0.72). Additionally, significant associations were found for other SHANK2 SNPs, namely, rs7113016 (p=0.027), rs1073294 (p=0.008), rs11236616 (p=0.003), rs10899158 (p=0.048), and rs9888288 (p=0.004). However, no significant result was detected for SNPs of SHANK3. Subsequent gene-level analysis based on whole dataset suggested the significant role of SHANK2 in both ADHD and ASD (gene-level p=0.003). Discussion Consistent with previous findings in Western populations, this current study provides additional evidence for the significant association of SHANK2 with ASD from a Chinese population. A new finding rarely reported in previous studies is the association of SHANK2 with ADHD. This implies a shared genetic susceptibility between ADHD and ASD. Both disorders do share a number of characteristics, including male preponderance, increased level of oxidative stress, and abnormal neuronal connectivity, reflecting potentially common underlying neurodevelopmental abnormality. Speculatively, the identification of SHANK2 from this current candidate gene study as associating to both ADHD and ASD may provide the common genetic etiology to explain their shared characteristics and higher-than-chance comorbidity. Further studies examining the functional abnormalities of the identified gene, SHANK2, are warranted in the future.
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- 2019
17. Prevalence, psychosocial correlates and service utilization of depressive and anxiety disorders in Hong Kong: the Hong Kong Mental Morbidity Survey (HKMMS)
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Se-Fong Hung, Min-Jung Wang, Joseph Lau, Wing Chung Chang, Glyn Lewis, Corine Sau Man Wong, Eric Y.H. Chen, Linda C. W. Lam, Wai Chi Chan, Paul Bebbington, Ming Lam, Roger Man Kin Ng, Eric F.C. Cheung, TP Chiang, Edwin Ho Ming Lee, Jim van Os, Pak C. Sham, Helen F.K. Chiu, MUMC+: MA Psychiatrie (3), MUMC+: Hersen en Zenuw Centrum (3), Psychiatrie & Neuropsychologie, and RS: MHeNs - R2 - Mental Health
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Gerontology ,Adult ,Male ,Mental Health Services ,medicine.medical_specialty ,Health (social science) ,Social Psychology ,Adolescent ,Epidemiology ,Population ,Poison control ,Health service utilization ,Mental disorders ,Occupational safety and health ,Young Adult ,Prevalence of mental disorders ,Risk Factors ,Prevalence ,Medicine ,Humans ,education ,Psychiatry ,Aged ,education.field_of_study ,Depressive Disorder ,business.industry ,Middle Aged ,Mental health ,Anxiety Disorders ,Health Surveys ,Psychiatry and Mental health ,National Comorbidity Survey ,Anxiety ,Hong Kong ,Female ,medicine.symptom ,business ,Psychosocial - Abstract
Data on mental disorder prevalence and health service utilization required to inform healthcare management and planning are lacking in Hong Kong. The current study determined the prevalence of common mental disorders (CMD), and examined the patterns of mental health service utilization and associated factors. We analyzed data from the Hong Kong Mental Morbidity Survey (HKMMS) of 5,719 Chinese adults aged 16–75 years in the general Hong Kong population, using the Chinese Revised Clinical Interview Schedule (CIS-R). The weighted prevalence estimate for any past-week CMD was 13.3 %, with mixed anxiety and depressive disorder being the most frequent diagnoses. CMD was positively associated with female gender, being divorced or separated, alcohol misuse, substance dependence, lack of regular physical exercise, and a family history of mental disorder. Among individuals with CMD, only 26 % had consulted mental health services in the past year; less than 10 % consulted general practitioners or family physicians. Lack of mental health service usage was significantly more likely in men and those with lower educational attainment. Apart from attention to psychosocial risks, health and lifestyle factors are important considerations for mental health promotion. Service utilization for individuals with CMD in Hong Kong remains suboptimal, and would be enhanced by strengthening community primary care.
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- 2015
18. Family-based association study of DRD4 gene in methylphenidate-responded Attention Deficit/Hyperactivity Disorder
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Lu Hua Chen, Patrick W. L. Leung, Robert K. Moyzis, Se-fong Hung, Chun Pan Tang, Ting Pong Ho, Janice Ka Yan Chan, Chi Chiu Lee, and James M. Swanson
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0301 basic medicine ,Male ,Heredity ,Etiology ,Dopamine ,lcsh:Medicine ,Artificial Gene Amplification and Extension ,Minisatellite Repeats ,Pathology and Laboratory Medicine ,Biochemistry ,Polymerase Chain Reaction ,Geographical locations ,0302 clinical medicine ,Catecholamines ,Gene Frequency ,Medicine and Health Sciences ,Ethnicities ,Amines ,lcsh:Science ,Child ,Genetics ,education.field_of_study ,Multidisciplinary ,biology ,Organic Compounds ,Neurochemistry ,Transmission disequilibrium test ,Neurotransmitters ,Exons ,Variable number tandem repeat ,Chemistry ,Genetic Mapping ,Neurology ,Physical Sciences ,Hong Kong ,Female ,Research Article ,Biogenic Amines ,Asia ,Adolescent ,Population ,Neuropsychiatric Disorders ,Population stratification ,Research and Analysis Methods ,03 medical and health sciences ,Developmental Neuroscience ,Asian People ,mental disorders ,Mental Health and Psychiatry ,Dopamine receptor D4 ,medicine ,Attention deficit hyperactivity disorder ,Humans ,Family ,Allele ,education ,Molecular Biology Techniques ,Allele frequency ,Molecular Biology ,Alleles ,Polymorphism, Genetic ,lcsh:R ,Organic Chemistry ,Receptors, Dopamine D4 ,Chemical Compounds ,Biology and Life Sciences ,medicine.disease ,Hormones ,030104 developmental biology ,Haplotypes ,Neurodevelopmental Disorders ,Genetic Loci ,Attention Deficit Disorder with Hyperactivity ,People and Places ,biology.protein ,Methylphenidate ,lcsh:Q ,Adhd ,Population Groupings ,Chinese People ,030217 neurology & neurosurgery ,Neuroscience - Abstract
The 48-basepair (48-bp) variable number tandem repeat (VNTR) polymorphism in exon 3 of the dopamine receptor D4 gene (DRD4) is implicated in the etiology of attention-deficit/ hyperactivity disorder (ADHD). In particular, ADHD in European-ancestry population is associated with an increased prevalence of the 7-repeat (7R) allele of the exon 3 VNTR. However, it is intriguing to note that the 7R allele has been found to be of very low prevalence in the Chinese general population. In a previous case-control study, our research team had found that the 7R allele was similarly absent in Chinese ADHD children in Hong Kong. Instead, there was an increased prevalence of the 2R allele in Chinese ADHD children. Interestingly, in Asian samples, the 2R allele had been found to be an evolutionary derivative of the 7R allele with equivalent biochemical functionality. So, the finding of an association between ADHD and 2R allele in Chinese population does not exactly contradict the original 7R allele finding in European-ancestry population. However, given the potential pitfall of population stratification in the previous case-control design, this current study tested the 2R allele and ADHD association using a methodologically more rigorous family-based approach on 33 Chinese ADHD probands who had favorable clinical responses to stimulant medication (methylphenidate). Haplotype Relative Risk (HRR) analysis and Transmission Disequilibrium Test (TDT) both showed a significant preferential transmission of the 2R allele from the biological parents to ADHD probands (pone-tailed = 0.038, OR = 2.04; pone-tailed = 0.048, OR = 2.29, respectively). A second hypothesis speculates that it is the deviation, including 7R and 2R alleles, from the conserved ancestral 4R allele which confers risk to ADHD. Thus, a preferential transmission of non-4R alleles, against the 4R allele, from biological parents to their ADHD probands is predicted. Both HRR analysis and TDT confirmed such prediction (pone-tailed = 0.029, OR = 2.07; pone-tailed = 0.032, OR = 2.43, respectively). This study re-confirmed the original finding of a previous study that in Chinese population, the 2R allele of the DRD4 exon 3 VNTR was related to ADHD. This endorses the general thesis that DRD4 exon 3 VNTR polymorphism is related to ADHD, despite that the exact length or number of repeats of the associated alleles varies across ethnicity. This in turn supports the dopamine dysregulation theory of ADHD.
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- 2017
19. Prospective relationship between duration of untreated psychosis and 13-year clinical outcome: A first-episode psychosis study
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Gloria H.Y. Wong, Eric Y.H. Chen, Christy L.M. Hui, Wai-Nang Tang, Edwin P F Pang, Wah-Fat Chan, CK Wong, Roger Man Kin Ng, Wing Chung Chang, Se-Fong Hung, Pak C. Sham, WS Yeung, Jennifer Y.M. Tang, Sherry Kit Wa Chan, Eva Lai-Wah Dunn, Steve Tso, and Edwin Ho Ming Lee
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Adult ,Male ,congenital, hereditary, and neonatal diseases and abnormalities ,Psychosis ,Pediatrics ,medicine.medical_specialty ,Time Factors ,Economics ,Psychological intervention ,Untreated psychosis ,Cohort Studies ,Young Adult ,Predictive Value of Tests ,First episode psychosis ,medicine ,Humans ,Adverse effect ,Prospective cohort study ,Psychiatry ,Biological Psychiatry ,Psychiatric Status Rating Scales ,medicine.disease ,Psychiatry and Mental health ,Treatment Outcome ,Psychotic Disorders ,ROC Curve ,Cohort ,dup ,Hong Kong ,Female ,Psychology ,Antipsychotic Agents - Abstract
Background The adverse effects of a long duration of untreated psychosis (DUP) have been explored in numerous short-term studies. These studies support the development of early interventions that reduce treatment delay and promote recovery. However, the enduring impact of DUP is largely unknown, partly due to the paucity of prospective long-term studies. Although the DUP–outcome relationship is commonly assumed to be linear, the threshold effect has not been adequately examined. Objective To explore the relationship between DUP and long-term symptomatic remission. Methods This was a prospective study of a cohort of 153 first-episode psychosis patients in Hong Kong at the 13-year follow-up. The patients were categorized into short (≤ 30 days), medium (31–180 days) and long (> 180 days) DUP groups. Results The long-term outcome was ascertained in 73% of the patients. Nearly half of the patients (47%) fulfilled the criteria for symptomatic remission. The short DUP group experienced a significantly higher remission rate over the course of the illness. The odds of long-term symptomatic remission was significantly reduced in the medium DUP (by 89%) and long DUP (by 85%) groups compared with the short DUP group. Further analysis showed that DUP had a specific impact on negative symptom remission. Conclusion The findings support the threshold theory that DUP longer than 30 days adversely impacts the long-term outcome. The present study is one of the few studies that confirmed the enduring impact of DUP on long-term outcomes based on well-defined criteria and adequate statistical adjustment.
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- 2014
20. Prevalence of anxiety disorders in community dwelling older adults in Hong Kong
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Eric Y.H. Chen, Se-Fong Hung, Corine Sau Man Wong, Jim van Os, Glyn Lewis, Ming Lam, Tin Po Chiang, Joseph Lau, Pak C. Sham, Helen F.K. Chiu, Linda C. W. Lam, Wing Chung Chang, Roger Man Kin Ng, Ada W.T. Fung, Edwin Ho Ming Lee, Paul Bebbington, Wai Chi Chan, Eric F.C. Cheung, RS: MHeNs - R2 - Mental Health, MUMC+: Hersen en Zenuw Centrum (3), MUMC+: MA Psychiatrie (3), and Psychiatrie & Neuropsychologie
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Male ,SYMPTOMS ,LATE-LIFE DEPRESSION ,Comorbidity ,memory ,0302 clinical medicine ,Cognition ,Prevalence ,Depression (differential diagnoses) ,older adults ,POPULATION ,SCALE ,education.field_of_study ,Depression ,Late life depression ,Middle Aged ,Anxiety Disorders ,Psychiatry and Mental health ,Clinical Psychology ,Anxiety ,community ,Hong Kong ,Female ,Independent Living ,medicine.symptom ,Psychology ,Anxiety disorder ,mental health ,medicine.medical_specialty ,Population ,03 medical and health sciences ,Prevalence of mental disorders ,Sex Factors ,Internal medicine ,medicine ,Humans ,education ,Psychiatry ,cognitive function ,early sign ,Aged ,Psychiatric Status Rating Scales ,DECLINE ,Depressive Disorder ,Genitourinary system ,medicine.disease ,Mental health ,Health Surveys ,030227 psychiatry ,Logistic Models ,MYOCARDIAL-INFARCTION ,Geriatrics and Gerontology ,Gerontology ,030217 neurology & neurosurgery - Abstract
Background:Anxiety disorders are prevalent yet under-recognized in late life. We examined the prevalence of anxiety disorders in a representative sample of community dwelling older adults in Hong Kong.Method:Data on 1,158 non-demented respondents aged 60–75 years were extracted from the Hong Kong Mental Morbidity survey (HKMMS). Anxiety was assessed with the revised Clinical Interview Schedule (CIS-R).Result:One hundred and thirty-seven respondents (11.9%, 95% CI = 10–13.7%) had common mental disorders with a CIS-R score of 12 or above. 8% (95% CI = 6.5–9.6%) had anxiety, 2.2% (95% CI = 1.3–3%) had an anxiety disorder comorbid with depressive disorder, and 1.7% (95% CI = 1–2.5%) had depression. Anxious individuals were more likely to be females (χ2 = 25.3, p < 0.001), had higher chronic physical burden (t = −9.3, p < 0.001), lower SF-12 physical functioning score (t = 9.2, p < 0.001), and poorer delayed recall (t = 2.3, p = 0.022). The risk of anxiety was higher for females (OR 2.8, 95% C.I. 1.7–4.6, p < 0.001) and those with physical illnesses (OR 1.4, 95% C.I. 1.3–1.6, p < 0.001). The risk of anxiety disorders increased in those with disorders of cardiovascular (OR 1.9, 95% C.I. 1.2–2.9, p = 0.003), musculoskeletal (OR 2.0, 95% C.I. 1.5–2.7, p < 0.001), and genitourinary system (OR 2.0, 95% C.I. 1.3–3.2, p = 0.002).Conclusions:The prevalence of anxiety disorders in Hong Kong older population was 8%. Female gender and those with poor physical health were at a greater risk of developing anxiety disorders. Our findings also suggested potential risk for early sign of memory impairment in cognitively healthy individuals with anxiety disorders.
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- 2016
21. MOESM1 of Diagnostic yield of array CGH in patients with autism spectrum disorder in Hong Kong
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Wai-Kwan Siu, Ching-Wan Lam, Mak, Chloe, Lau, Elizabeth, Tang, Mary, Wing-Fai Tang, Poon-Mak, Rachel, Chi-Chiu Lee, Se-Fong Hung, Leung, Patrick, Kwong, Karen, Yau, Eric, Ng, Grace, Nai-Chung Fong, and Kwok-Yin Chan
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Data_FILES - Abstract
Additional file 1. Figures of array CGH data.
- Published
- 2016
- Full Text
- View/download PDF
22. Early intervention for psychotic disorders: Real-life implementation in Hong Kong
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Gloria H.Y. Wong, Christy L.M. Hui, Se-Fong Hung, Wing Chung Chang, Dik Chee Lai, Wendy Wan Yee Tam, Eric Y.H. Chen, J. Q. Xu, Jennifer Y.M. Tang, Joy Kok, Dicky W.S. Chung, Jessie J.X. Lin, and Sherry Kit Wa Chan
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Mental Health Services ,Psychosis ,medicine.medical_specialty ,Social stigma ,Cost-Benefit Analysis ,Social Stigma ,Standard care ,Early Medical Intervention ,medicine ,Humans ,Psychiatry ,Health Education ,General Psychology ,Cost–benefit analysis ,business.industry ,General Medicine ,medicine.disease ,Early intervention in psychosis ,Hospitalization ,Psychiatry and Mental health ,Early Diagnosis ,Psychotic Disorders ,Schizophrenia ,Hong Kong ,Public service ,Health education ,Club ,business - Abstract
Hong Kong is among the first few cities in Asia to have implemented early intervention for psychosis in 2001. Substantial changes in psychosis service have since taken place. We reviewed available outcome data in Hong Kong, with reference to the philosophy of early intervention in psychosis, discussing experience and lessons learned from the implementation process, and future opportunities and challenges. Data accumulated in the past decade provided evidence for the benefits and significance of early intervention programmes: patients under the care of early intervention service showed improved functioning, milder symptoms, and fewer hospitalizations and suicides. Early intervention is more cost-effective compared with standard care. Stigma and misconception remains an issue, and public awareness campaigns are underway. In recent years, a critical mass is being formed, and Hong Kong has witnessed the unfolding of public service extension, new projects and organizations, and increasing interest from the community. Several major platforms are in place for coherent efforts, including the public Early Assessment Service for Young people with psychosis (EASY) programme, the Psychosis Studies and Intervention (PSI) research unit, the independent Hong Kong Early Psychosis Intervention Society (EPISO), the Jockey Club Early Psychosis (JCEP) project, and the postgraduate Psychological Medicine (Psychosis Studies) programme. The first decade of early intervention work has been promising; consolidation and further development is needed on many fronts of research, service and education.
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- 2012
23. Three-year outcome of phase-specific early intervention for first-episode psychosis: a cohort study in Hong Kong
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Chi Wing Law, Kathy P. M. Chan, Se-Fong Hung, Christy L.M. Hui, Gloria H.Y. Wong, Ka Chee Yip, Steve Tso, May M.L. Lam, William G. Honer, Jennifer Y.M. Tang, Carol W.S. Yew, Cindy P.Y. Chiu, Eric Y.H. Chen, and Dicky W.S. Chung
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Psychosis ,medicine.medical_specialty ,business.industry ,Case-control study ,Poison control ,medicine.disease ,Mental health ,Suicide prevention ,Psychiatry and Mental health ,Intervention (counseling) ,Severity of illness ,Medicine ,Pshychiatric Mental Health ,business ,Psychiatry ,Biological Psychiatry ,Cohort study - Abstract
Aim: Although phase-specific early intervention for first-episode psychosis has been implemented in many different parts of the world, limited medium-term outcome data are available in non-Western populations with relatively low mental health resources. The study aimed to determine the effectiveness of phase-specific early intervention in first-episode psychosis. Method: In this cohort study, we compared the 3-year outcome of 700 first-episode psychosis patients who received phase-specific early intervention with that of 700 patients matched for age, sex and diagnosis who received standard psychiatric care prior to early intervention. Using a structured data acquisition procedure, we determined functional outcome, symptom levels, relapse, recovery, suicidal behaviour and service utilization from clinical records. Results: Patients in the early intervention group had longer full-time employment or study (P Language: en
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- 2011
24. Gender Differences in Patients Presenting with First-Episode Psychosis in Hong Kong: A Three-Year Follow Up Study
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Gloria H.Y. Wong, Kathy P. M. Chan, Christy L.M. Hui, May M.L. Lam, Chi Wing Law, Jennifer Y.M. Tang, Steve Tso, Wing Chung Chang, Eric Y.H. Chen, Dicky W.S. Chung, Cindy P.Y. Chiu, and Se-Fong Hung
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Adult ,Male ,medicine.medical_specialty ,Psychosis ,Adolescent ,Poison control ,Suicide, Attempted ,Suicide prevention ,Internal medicine ,Injury prevention ,medicine ,Humans ,Young adult ,Psychiatry ,Psychiatric Status Rating Scales ,First episode ,Sex Characteristics ,General Medicine ,medicine.disease ,Psychiatry and Mental health ,Psychotic Disorders ,Schizophrenia ,Hong Kong ,Female ,Age of onset ,Psychology ,Follow-Up Studies - Abstract
Objective: The aim of the current study was to investigate gender differences with respect to pre-treatment characteristics, clinical presentation, service utilization and functional outcome in patients presenting with first-episode psychosis. Methods: A total of 700 participants (men, n = 360; women, n = 340) aged 15 to 25 years consecutively enrolled in a territory-wide first-episode psychosis treatment programme in Hong Kong from July 2001 to August 2003 were studied. Baseline and three-year follow up variables were collected via systematic medical file review. Results: At service entry, men had significantly lower educational attainment (p < 0.01), longer median duration of untreated psychosis (p < 0.001), fewer past suicidal attempts (p < 0.01), more severe negative symptoms (p < 0.05) and fewer affective symptoms (p < 0.01) than women. There was no significant gender difference in age of onset. In three-year follow up, men had more prominent negative symptoms (p < 0.001), fewer affective symptoms (p < 0.01), more violent behaviour and forensic records (p < 0.01), and higher rate of substance abuse (p < 0.01). Women achieved higher levels of functioning than men (Social Occupational Functioning Assessment Scale (SOFAS), p < 0.001) and a significantly higher proportion of women than men engaged in full-time employment or study for at least 12 consecutive months (p < 0.001) in the initial three years after psychiatric treatment. Conclusion: Notable gender differences in clinical profiles, illness trajectory and functional outcome were demonstrated in Chinese young people suffering from first-episode psychosis. Differential needs between men and women and hence gender-specific therapeutic strategies should be considered in early intervention service.
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- 2011
25. Naming psychosis: the Hong Kong experience
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Se-Fong Hung, Eric Y.H. Chen, Sherry Kit Wa Chan, May M.L. Lam, Gloria H.Y. Wong, Christy L.M. Hui, Dicky W.S. Chung, Cindy P.Y. Chiu, and Jennifer Y.M. Tang
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Psychosis ,Vocabulary ,medicine.medical_specialty ,Psychotherapist ,Conceptualization ,Schizophrenia (object-oriented programming) ,media_common.quotation_subject ,Context (language use) ,medicine.disease ,Local community ,Terminology ,Psychiatry and Mental health ,Intervention (counseling) ,medicine ,Pshychiatric Mental Health ,Psychology ,Psychiatry ,Biological Psychiatry ,media_common - Abstract
Aim: Schizophrenia translates in Chinese as ‘Mind Split Disease’ which is heavily stigmatizing. The narrow conceptualization for schizophrenia alone was insufficient, in the context of early detection and intervention for psychosis. The need for an effective Chinese translation for psychotic disorders was imminent upon the launch of the Early Assessment Service for Young People with Psychosis in Hong Kong, where public awareness strategies had to be built upon effective communication of the disorder. Methods: ‘Si Jue Shi Tiao’, the new term for psychosis, described ‘thought and perceptual dysregulation’. This new terminology and concept was strategically introduced to the local community. Results: The term ‘Si Jue Shi Tiao’ was taken up well locally and had demonstrated interactions within the Chinese and East Asian communities. The public has taken in the broader concept of psychosis, in contrary to the previous concept of schizophrenia per se. Conclusions: In Hong Kong, the restrictive view of perceiving psychotic disorders as schizophrenia was broadened upon the introduction of a more embracing, less stigmatizing term ‘Si Jue Shi Tiao’. Effective establishment of this term to the local vocabulary allowed a basis for communication as well as public education work. Further evaluation is necessary to determine the effectiveness of the naming and to guide further public awareness strategies.
- Published
- 2010
26. Outcome of a postnatal depression screening programme using the Edinburgh Postnatal Depression Scale: a randomized controlled trial
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May Miao, Shirley S. L. Leung, Tai Hing Lam, Aster Lau, Se-Fong Hung, Dominic T.S. Lee, Shu-Hung Leung, Ruth Chan, Sammy K. W. Cheng, Cynthia Leung, and Timothy Yeung
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Postpartum depression ,Pediatrics ,medicine.medical_specialty ,Maternal-Child Health Centers ,Mothers ,Nurses ,law.invention ,Depression, Postpartum ,Diagnostic Self Evaluation ,Randomized controlled trial ,law ,Surveys and Questionnaires ,medicine ,Humans ,Depression (differential diagnoses) ,Psychiatric Status Rating Scales ,Intention-to-treat analysis ,business.industry ,Public Health, Environmental and Occupational Health ,Infant ,General Medicine ,medicine.disease ,Mental health ,Confidence interval ,Intention to Treat Analysis ,Treatment Outcome ,Edinburgh Postnatal Depression Scale ,Relative risk ,Hong Kong ,Female ,business - Abstract
Background There is a lack of evidence on the effectiveness of postnatal depression (PND) screening programmes in reducing morbidity. The aim of this study was to evaluate the effectiveness of a PND screening programme using Edinburgh Postnatal Depression Scale (EPDS) in improving maternal mental health. Methods The randomized controlled trial design was used. Participants were 462 Chinese mothers with 2-month-old babies visiting Maternal and Child Health Centres in Hong Kong. Participants in the intervention group were screened for PND using the EPDS, whereas those in the control group were screened by clinical assessment. In both groups, participants identified with PND were offered follow-up management according to protocol. Results Participants in the intervention group had better maternal mental health outcome as assessed by EPDS at 6 months (risk ratio: 0.59; 95% confidence interval: 0.39‐0.89). The number needed to screen was 25. Conclusions A PND screening programme comprising the use of EPDS as the screening tool and the provision of follow-up care had resulted in an improvement in maternal mental health at 6 months. Trial Registration: ClinicalTrials.gov (US NIH) (NCT00251342).
- Published
- 2010
27. Early intervention for psychosis in Hong Kong - the EASY programme
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Cindy P.Y. Chiu, Se-Fong Hung, Steve Tso, Kathy P. M. Chan, Eric Y.H. Chen, May M.L. Lam, Christy L.M. Hui, Gloria H.Y. Wong, K. C. Yip, Dicky W.S. Chung, Jennifer Y.M. Tang, and Sherry Kit Wa Chan
- Subjects
Psychosis ,Rehabilitation ,business.industry ,media_common.quotation_subject ,medicine.medical_treatment ,medicine.disease ,Psychiatry and Mental health ,Promotion (rank) ,Nursing ,Intervention (counseling) ,Vocational education ,Service (economics) ,Medicine ,Health education ,Pshychiatric Mental Health ,business ,Psychosocial ,Biological Psychiatry ,media_common - Abstract
Aim: This article aims to describe the Hong Kong experience in developing and implementing an early psychosis programme. Methods: In 2001, the Early Assessment Service for Young People with Psychosis programme was launched in Hong Kong, providing both educational and service components. Public education includes promotion of timely help-seeking, accessible channels to service and knowledge of psychosis. The 2-year phase-specific intervention includes intensive medical follow-up and individualized psychosocial intervention. The programme has adopted the case-management approach, in which case managers provide protocol-based psychosocial intervention. The programme collaborates with non-governmental organizations and community networks in the provision of rehabilitation service. Results: An average of over 600 young patients enter the programme for intensive treatment each year. Based on preliminary data from a 3-year outcome study, patients in the programme have remarkable reductions in hospital stay accompanied by improvements in vocational functioning. Conclusions: The results suggested that the programme improved patients' outcome. Additional costs such as extra medical staff and medications may be offset by the shortened hospital stay. Further directions in early intervention are also discussed.
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- 2010
28. Age-related grey matter volume correlates of response inhibition and shifting in Attention Deficit Hyperactivity Disorder
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Se-Fong Hung, Grainne M. McAlonan, Shi-leung Kwong, Jaap Oosterlaan, Charlton Cheung, Vinci Cheung, Siew E. Chua, Chi-chiu Lee, T. P. Ho, Patrick W. L. Leung, John Suckling, Chun-pan Tang, Clinical Neuropsychology, and Other departments
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Male ,medicine.medical_specialty ,Central nervous system ,Neuropsychological Tests ,Grey matter ,Stop signal ,Audiology ,03 medical and health sciences ,0302 clinical medicine ,Cerebellum ,Age related ,Reaction Time ,medicine ,Humans ,Attention deficit hyperactivity disorder ,030212 general & internal medicine ,Child ,Cerebrum ,Response inhibition ,medicine.diagnostic_test ,Brain maturation ,Age Factors ,Magnetic resonance imaging ,medicine.disease ,Magnetic Resonance Imaging ,030227 psychiatry ,Psychiatry and Mental health ,medicine.anatomical_structure ,Attention Deficit Disorder with Hyperactivity ,Case-Control Studies ,Psychology ,Neuroscience - Abstract
BackgroundChildren with attention-deficit hyperactivity disorder (ADHD) have difficulties with executive function and impulse control which may improve with age.AimsTo map the brain correlates of executive function in ADHD and determine age-related changes in reaction times and brain volumes.MethodAttention-deficit hyperactivity disorder and control groups were compared on the change task measures of response inhibition (stop signal reaction time, SSRT) and shifting (change response reaction time, CRRT). Voxel-wise magnetic resonance imaging (MRI) correlations of reaction times and grey matter volume were determined, along with bivariate correlations of reaction times, brain volumes and age.ResultsIndividuals in the ADHD group had longer SSRTs and CRRTs. Anterior cingulate, striatal and medial temporal volumes highly correlated with SSRT. Striatal and cerebellar volumes strongly correlated with CRRT. Older children had faster reaction times and larger regional brain volumes. In controls, orbitofrontal, medial temporal and cerebellar volumes correlated with CRRT but not SSRT. Neither reaction times nor regional brain volumes were strongly age-dependent.ConclusionsOur evidence supports delayed brain maturation in ADHD and implies that some features of ADHD improve with age.
- Published
- 2009
29. Treatment effectiveness of combined medication/behavioural treatment with chinese ADHD children in routine practice
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Patrick W. L. Leung, Se-Fong Hung, and Cheryl Y C So
- Subjects
Male ,Parents ,medicine.medical_specialty ,medicine.medical_treatment ,MEDLINE ,Behaviour therapy ,Experimental and Cognitive Psychology ,Routine practice ,law.invention ,Combined treatment ,Dopamine Uptake Inhibitors ,Randomized controlled trial ,Behavior Therapy ,law ,Rating scale ,mental disorders ,medicine ,Humans ,Child ,Psychiatry ,Methylphenidate ,Combined Modality Therapy ,Psychiatry and Mental health ,Clinical Psychology ,Treatment Outcome ,El Niño ,Attention Deficit Disorder with Hyperactivity ,Hong Kong ,Patient Compliance ,Female ,Psychology ,medicine.drug - Abstract
Background The effectiveness of a combined methylphenidate/behavioural treatment (BT) versus methylphenidate-only for Chinese children with Attention-Deficit/Hyperactivity Disorder (ADHD) was tested in routine clinical practice in Hong Kong. Methods A randomized group comparison design was adopted with two treatment conditions (methylphenidate-only; methylphenidate/BT), which lasted for 6 months. There were four assessment time points (pre-treatment, post-treatment, and 6-month and 12-month follow-ups), using the Strengths and Weaknesses of ADHD Symptoms and Normal Behaviours (SWAN) Rating Scale. Parental attitude toward different treatment options of ADHD was also assessed at pre-treatment and post-treatment. Participants included 90 Chinese ADHD children (mean age = 8 years, SD = .95). Results The combination of BT and a low-dose methylphenidate was significantly more effective than methylphenidate-only in reducing ADHD and ODD symptoms at post-treatment. At follow-ups, the benefits of the combined treatment were maintained, while the methylphenidate-only group caught up in improvement in ADHD symptoms. Parents in both treatment conditions showed improved attitude toward medication after the 6-month treatment phase, while their attitude toward BT was positive all along. Conclusions This study supported the added benefits of BT, on top of medication, for Chinese ADHD children in routine practice with treatments conducted by regular medical and paramedical staffs.
- Published
- 2008
30. Growing Wealth and Growing Pains: Child and Adolescent Psychiatry in Hong Kong, Malaysia and Singapore
- Author
-
Daniel Fung, Se fong Hung, Joseph M. Rey, and Susan Tan
- Subjects
Male ,Mental Health Services ,medicine.medical_specialty ,Economic growth ,Adolescent ,Identity (social science) ,Face (sociological concept) ,Population health ,Adolescent Psychiatry ,medicine ,Child and adolescent psychiatry ,Humans ,Child ,Psychiatry ,Child Psychiatry ,Singapore ,business.industry ,Mental Disorders ,Infant, Newborn ,Malaysia ,Infant ,Mental health ,Psychiatry and Mental health ,Socioeconomic Factors ,Child, Preschool ,Workforce ,Spite ,Hong Kong ,Female ,business - Abstract
Objective: Several Asian regions have undergone a dramatic transformation, some becoming very affluent. This paper aims to ascertain how countries that are becoming wealthy have dealt with child and adolescent mental health issues. Method: Population health status, child and adolescent mental health services, child psychiatry training, the number of child psychiatrists and related matters were examined in Hong Kong, Malaysia and Singapore. Results: Hong Kong, Malaysia and Singapore are ethnically, religiously, socially and politically very different. In spite of considerable wealth and a growing recognition that mental health problems in the young are increasing, they face similar problems – lack of access to treatment due to a dearth of services and a lack of child psychiatrists (2.5, 0.5 and 2.8 per million people, respectively). Conclusions: Because the number of child psychiatrists is so small, their ability to provide services, advocate, train, maintain a professional identity, and deal with future crises is very limited. Other rapidly developing countries can learn from this experience and should take action early to prevent a similar outcome.
- Published
- 2008
31. Cognitive profiling in Chinese developmental dyslexia with attention-deficit/hyperactivity disorders
- Author
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Cheuk Kiu Kathy Lee, Suet Nga Liu, Won Shing Raymond Chan, and Se Fong Hung
- Subjects
Linguistics and Language ,medicine.medical_specialty ,Neurology ,Dyslexia ,Cognition ,Adhd group ,medicine.disease ,behavioral disciplines and activities ,Psycholinguistics ,Education ,Developmental psychology ,Speech and Hearing ,Neuropsychology and Physiological Psychology ,mental disorders ,medicine ,Developmental dyslexia ,Attention deficit ,medicine.symptom ,Psychology ,Cognitive deficit - Abstract
The cognitive profiles of children with Developmental Reading Disorder (RD) and Attention-Deficit/Hyperactivity Disorders (ADHD) have been extensively studied in alphabetic language communities. Deficits in phonological processing and rapid naming have been implicated as core features of RD although whether the latter is a deficit specific to RD remains controversial. Similar research aiming to explore the cognitive profiles of children with both RD and ADHD in non-alphabetic language communities is limited. The specificity of rapid naming deficit to RD among Chinese has yet to be studied. In the first study, 43 Chinese children with confirmed diagnoses of RD + ADHD were assessed on their cognitive abilities in relating to reading. In the second study, the specificity deficit hypothesis of rapid naming to RD but not ADHD was examined. A digit naming test was administered to the RD + ADHD group (43 subjects) and an ADHD only group (49 subjects). In regard to cognitive profiling, rapid naming and orthographic knowledge were found to be the most common deficits among the Chinese RD + ADHD group. This co-morbid group was also found to have a significant deficit performance on the rapid naming task than the ADHD only group. The present findings support the double dissociation hypothesis in cognitive deficit between RD and ADHD. The results of both studies are discussed with reference to the findings of the Western counterparts.
- Published
- 2007
32. Testâretest reliability and criterion validity of the Chinese version of CBCL, TRF, and YSR
- Author
-
Se-Fong Hung, S.L. Hong, Chi-chiu Lee, C.M. Chiu, Patrick W. L. Leung, Wai-sum Liu, Chun-pan Tang, T. P. Ho, and Shi-leung Kwong
- Subjects
Predictive validity ,medicine.medical_specialty ,Psychometrics ,CBCL ,Test validity ,medicine.disease ,behavioral disciplines and activities ,Test (assessment) ,Psychiatry and Mental health ,mental disorders ,Pediatrics, Perinatology and Child Health ,Developmental and Educational Psychology ,medicine ,Criterion validity ,Attention deficit hyperactivity disorder ,Psychology ,Psychiatry ,Reliability (statistics) - Abstract
Background: Psychometric properties of the Chinese version of CBCL, TRF, and YSR were understudied. This study aimed at examining their test–retest reliability and criterion validity. Methods: Three Chinese community and clinic samples were recruited in Hong Kong. The parents, teachers, and youths respectively completed the CBCL, TRF, and YSR. Results: The Chinese CBCL, TRF, and YSR were test–retest reliable and valid. However, there was score/case attenuation at retest. CBCL and TRF appeared to screen externalizing and ADHD problems better, while YSR screened internalizing problems better. Conclusions: Clinicians should be cautious about score/case attenuation at retest while using CBCL, TRF, and YSR to chart patients’ progress. They should also recognize their different strengths in screening various disorders.
- Published
- 2006
33. Experience of caregiving amongst caregivers of first psychotic patients: a preliminary study
- Author
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Molly S. M. Lo, Raymond C.K. Chan, D. Lau, Eric Y.H. Chen, and Se-Fong Hung
- Subjects
Psychiatry and Mental health ,Chinese version ,Early onset psychosis ,Personal experience ,Psychology ,Negativism ,Clinical psychology ,Preliminary analysis - Abstract
This study aimed to investigate the dimensions of the Chinese version of the Experience of Caregiving Inventory (ECI) in caregivers of people with early onset psychosis. The ECI was administered to 105 primary caregivers of people with early onset psychosis. A preliminary analysis of the responses was carried out using a principal components analysis (PCA) to identify the major dimensions. A total of 19 factors with eigenvalues greater than 1 was identified, and accounted for 73.12% of the total variance. Then, PCAs were run for a 6-, 8-, and 10-factor solutions with the criteria of items loading 0.5 or higher on only one factor and separated by at least 0.1 from its loading on any other. Many distinct dimensions emerged, the best coverage requiring a 8-factor solution (42 items accounting for 41.9% of the total variance). These factors were emotional disturbance and negativism, positive personal experiences, dependency, loss, stigma, problems with services, good aspects of relationship, and need to back up. The preliminary findings suggest a shorter version of the ECI may best fit for the Hong Kong Chinese context.
- Published
- 2002
34. 10-year outcome study of an early intervention program for psychosis compared with standard care service
- Author
-
Hon-Cheong So, Eric Y.H. Chen, Wing Chung Chang, K. C. Yip, Sherry Kit Wa Chan, Se-Fong Hung, Christy Lai Ming Hui, Edwin Ho Ming Lee, Dicky W.S. Chung, Erin C. Dunn, and Steve Tso
- Subjects
Adult ,Male ,Psychosis ,Pediatrics ,medicine.medical_specialty ,Time Factors ,Suicide rates ,Standard care ,Early Medical Intervention ,Outcome Assessment, Health Care ,medicine ,Humans ,Longitudinal Studies ,Applied Psychology ,Service (business) ,Intervention program ,business.industry ,Odds ratio ,medicine.disease ,Functional recovery ,Psychotherapy ,Psychiatry and Mental health ,Psychotic Disorders ,Schizophrenia ,Hong Kong ,Female ,Historical control ,business - Abstract
Background.Despite evidence on the short-term benefits of early intervention (EI) service for psychosis, long-term outcome studies are limited by inconsistent results. This study examined the 10-year outcomes of patients with first-episode psychosis who received 2-year territory-wide EI service compared to those who received standard care (SC) in Hong Kong using an historical control design.Method.Consecutive patients who received the EI service between 1 July 2001 and 30 June 2002, and with diagnosis of schizophrenia-spectrum disorders, were identified and matched with patients who received SC first presented to the public psychiatric service from 1 July 2000 to 30 June 2001. In total, 148 matched pairs of patients were identified. Cross-sectional information on symptomatology and functioning was obtained through semi-structured interview; longitudinal information on hospitalization, functioning, suicide attempts, mortality and relapse over 10 years was obtained from clinical database. There were 70.3% (N = 104) of SC and 74.3% (N = 110) of EI patients interviewed.Results.Results suggested that EI patients had reduced suicide rate (χ2(1) = 4.35, p = 0.037), fewer number [odds ratio (OR) 1.56, χ2 = 15.64, p χ2 = 4.06, p = 0.04), longer employment periods (OR −0.28, χ2 = 14.64, p χ2 = 11.47, df = 1, p = 0.001) over 10 years. At 10 years, no difference was found in psychotic symptoms, symptomatic remission and functional recovery.Conclusions.The short-term benefits of the EI service on number of hospitalizations and employment was sustained after service termination, but the differences narrowed down. This suggests the need to evaluate the optimal duration of the EI service.
- Published
- 2014
35. Mental health in Hong Kong: transition from hospital-based service to personalised care
- Author
-
Linda C. W. Lam, Se-Fong Hung, and Eric F.C. Cheung
- Subjects
education.field_of_study ,business.industry ,media_common.quotation_subject ,Population ,Hospital based ,Mental health ,Gross domestic product ,Infant mortality ,030227 psychiatry ,03 medical and health sciences ,0302 clinical medicine ,Geography ,Service (economics) ,Health care ,030212 general & internal medicine ,Socioeconomics ,China ,education ,business ,media_common - Abstract
Hong Kong was a UK colony before 1997 but has since been a Special Administrative Region of the People's Republic of China. It is located in southern China and has an area of 1104 km2. Approximately 95% of Hong Kong's population is ethnic Chinese. Hong Kong is a developed capitalist economy, with a gross domestic product of US$301.6 billion (2009 estimate), of which about 5.5% is spent on healthcare and about 0.24% on mental health (World Health Organization, 2005). Despite the relatively low level of spending on healthcare, Hong Kong nevertheless has one of the longest life expectancies in the world (79.2 years for men; 84.8 years for women) and a very low infant mortality rate (2.93 per 1000 live births) (Central Intelligence Agency, 2010).
- Published
- 2010
36. The Mental Health of the Peers of Suicide Completers and Attempters
- Author
-
Chi-chiu Lee, T. P. Ho, Patrick W. L. Leung, Se-Fong Hung, and Chun-pan Tang
- Subjects
medicine.medical_specialty ,Suicide attempt ,education ,Poison control ,Human factors and ergonomics ,CBCL ,Mental health ,Suicide prevention ,Psychiatry and Mental health ,Pediatrics, Perinatology and Child Health ,Injury prevention ,Developmental and Educational Psychology ,medicine ,Risk factor ,Psychiatry ,Psychology ,Clinical psychology - Abstract
This study examined the prevalence and risk of psychiatric disturbances and suicidal behaviours among the peers of suicide attempters and completers. The subjects were selected from high schools with and without history of student suicides in the past 3 years. The psychiatric disturbances (as measured by the YSR and CBCL), suicidal behaviours, drug use, and a wide range of potential risk factors were measured. About a quarter of the peers of suicide completers and attempters were probable psychiatric cases and 15-21% of them reported suicidal acts. The increased risk of psychiatric disturbances and suicidal behaviours were still evident after controlling for age, sex, and potential risk factors. The presence of psychiatric disturbances could not wholly account for the increased odds of suicidal behaviours. Peers of suicide attempters carried a higher risk than peers of suicide completers. The close friends of suicide completers were particularly at risk of internalising problems, whereas the close friends of suicide attempters were at high risk of externalising problems. The peers of suicide completers and attempters represent a high-risk group for psychiatric disturbances and suicidal behaviours. The specific association of different types of psychiatric disturbances in the peers of suicide completers and attempters suggested that different risk mechanisms might be in operation within these peer groups.
- Published
- 2000
37. Predicting 1-year risk for relapse in patients who have discontinued or continued quetiapine after remission from first-episode psychosis
- Author
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Eric Y.H. Chen, Sherry Kit Wa Chan, Se-Fong Hung, Gloria H.Y. Wong, Steve Tso, Christy L.M. Hui, Dicky W.S. Chung, K.T. Chan, Edwin P F Pang, C.W. Law, William G. Honer, Y C Wong, Flora Y M Mo, Jennifer Y.M. Tang, Cindy P.Y. Chiu, May M.L. Lam, Kathy P. M. Chan, Wing Chung Chang, and Edwin Ho Ming Lee
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Psychosis ,Dibenzothiazepines ,Adolescent ,Relapse prevention ,Drug Administration Schedule ,law.invention ,Quetiapine Fumarate ,Young Adult ,Randomized controlled trial ,Double-Blind Method ,law ,Predictive Value of Tests ,medicine ,Secondary Prevention ,Humans ,Psychiatry ,Biological Psychiatry ,Aged ,Psychiatric Status Rating Scales ,Middle Aged ,medicine.disease ,Discontinuation ,Psychiatry and Mental health ,Treatment Outcome ,Psychotic Disorders ,Disinhibition ,Quetiapine ,Female ,medicine.symptom ,Psychology ,Neurocognitive ,medicine.drug ,Diagnosis of schizophrenia ,Antipsychotic Agents ,Follow-Up Studies - Abstract
Objective Relapse is common among patients with psychotic disorders. Identification of relapse predictors is important for decision regarding maintenance medication. Naturalistic studies often identify medication non-adherence as a dominant predictor. There are relatively few studies for predictors where adherence is already known. It is this situation i.e., discontinuation of medication that predictors will be most useful. We identify predictors for relapse in situations of (i) discontinuation and (ii) continuation of maintenance medication. Method Analysis of relapse predictors is based on a randomized controlled study ( n = 178) comparing relapse rates between patients who discontinued or continued medication for at least 1 year following first-episode psychosis. Demographic, clinical and neurocognitive variables were assessed at baseline as predictors of relapse within 1 year. Results Risk of relapse was 79% in the discontinuation group and 41% in the maintenance group. Predictors in the discontinuation group were diagnosis of schizophrenia, poorer semantic fluency performance, and higher blink rate. Predictors in the continuation group were disinhibition soft signs and more general psychopathology symptoms. Conclusion Different predictors of relapse were identified for first episode psychosis patients who discontinued and continued maintenance medication. Neurocognitive dysfunctions are important predictors for both groups. While signs of frontal dysfunction and dopamine hyperactivity predict relapse in the discontinuation group, sign of cognitive disinhibition predicts relapse in the continuation group.
- Published
- 2013
38. Antenatal risk factors for postnatal depression: a prospective study of chinese women at maternal and child health centres
- Author
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Patrick Ip, Shirley S. L. Leung, Michael W. O'Hara, Se-Fong Hung, and Bonnie W.M. Siu
- Subjects
Adult ,medicine.medical_specialty ,Multivariate analysis ,Adolescent ,lcsh:RC435-571 ,media_common.quotation_subject ,Emotions ,Personal Satisfaction ,Anxiety ,Anxiety - complications - psychology ,Depression, Postpartum ,Pregnancy ,lcsh:Psychiatry ,Humans ,Medicine ,Personality ,Antenatal ,Prospective Studies ,Marriage ,Psychiatry ,Prospective cohort study ,Depression (differential diagnoses) ,reproductive and urinary physiology ,media_common ,Chinese ,business.industry ,Obstetrics ,Depression ,Middle Aged ,medicine.disease ,Postnatal ,Marriage - psychology ,Psychiatry and Mental health ,Depression, Postpartum - etiology - psychology ,Risk factors ,Relative risk ,Cohort ,Female ,Family Relations ,medicine.symptom ,business ,Research Article - Abstract
Background: Risk factors for postnatal depression (PND) are under-explored in the Chinese populations. There is increasing recognition of the importance of identifying predictive factors during the antenatal period for PND. The present study aimed to identify the risk factors for postnatal depression in a community cohort of Chinese women with special focus on the antenatal risk factors.Methods: Eight hundred and five Chinese women were interviewed during their third trimester of pregnancy and at around 2 months postnatally. Putative risk factors for PND were collected and the diagnosis of PND was confirmed by the Structured Clinical Interview for DSM-IV Axis I Disorders. The 2-month postnatal depression status was used as the dependent variable for univariate and multivariate analyses against putative risk factors.Results: Marital dissatisfaction (Relative Risk = 8.27), dissatisfied relationship with mother-in-law (Relative Risk = 3.93), antenatal depressive symptomatology (Relative Risk = 3.90), and anxiety-prone personality (Relative Risk = 2.14) predicted PND in Chinese women independently.Conclusions: Chinese women tend to keep their own feelings and emotions and it is important to monitor Chinese pregnant women with these predictive risk factors so that PND can be identified early. © 2012 Siu et al; licensee BioMed Central Ltd., published_or_final_version
- Published
- 2012
39. Three-year outcome of phase-specific early intervention for first-episode psychosis: a cohort study in Hong Kong
- Author
-
Eric Y H, Chen, Jennifer Y M, Tang, Christy L M, Hui, Cindy P Y, Chiu, May M L, Lam, Chi Wing, Law, Carol W S, Yew, Gloria H Y, Wong, Dicky W S, Chung, Steve, Tso, Kathy P M, Chan, Ka Chee, Yip, Se Fong, Hung, and William G, Honer
- Subjects
Adult ,Male ,Psychiatric Status Rating Scales ,Suicide Prevention ,Time Factors ,Middle Aged ,Severity of Illness Index ,Community Mental Health Services ,Health Services Accessibility ,Cohort Studies ,Hospitalization ,Suicide ,Early Diagnosis ,Logistic Models ,Treatment Outcome ,Psychotic Disorders ,Case-Control Studies ,Early Medical Intervention ,Hong Kong ,Humans ,Female ,Aged ,Antipsychotic Agents ,Follow-Up Studies - Abstract
Although phase-specific early intervention for first-episode psychosis has been implemented in many different parts of the world, limited medium-term outcome data are available in non-Western populations with relatively low mental health resources. The study aimed to determine the effectiveness of phase-specific early intervention in first-episode psychosis.In this cohort study, we compared the 3-year outcome of 700 first-episode psychosis patients who received phase-specific early intervention with that of 700 patients matched for age, sex and diagnosis who received standard psychiatric care prior to early intervention. Using a structured data acquisition procedure, we determined functional outcome, symptom levels, relapse, recovery, suicidal behaviour and service utilization from clinical records.Patients in the early intervention group had longer full-time employment or study (P0.001), fewer days of hospitalization (P0.001), less severe positive symptoms (P=0.006), less severe negative symptoms (P =0.001), fewer suicides (P=0.009) and fewer disengagements (P=0.002) than the historical control group. Additionally, more patients in the early intervention group experienced a period of recovery (P=0.001), but the two groups had similar rates of relapse (P=0.08) and durations of untreated psychosis (P=0.72).The 3-year outcome in phase-specific early intervention compared favourably with that of standard psychiatric care, particularly with respect to functional outcome and reduction in hospitalizations, suicides and disengagements. However, intervention did not appear to reduce the rate of relapse.
- Published
- 2011
40. Duration of untreated psychosis: relationship with baseline characteristics and three-year outcome in first-episode psychosis
- Author
-
Se-Fong Hung, Steve Tso, Sherry Kit Wa Chan, Jennifer Y.M. Tang, Wing Chung Chang, Dicky W.S. Chung, Cindy P.Y. Chiu, Christy L.M. Hui, Eric Y.H. Chen, Kathy P. M. Chan, Chi Wing Law, Gloria H.Y. Wong, and May Mei Ling Lam
- Subjects
Adult ,Employment ,Male ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Pediatrics ,Psychosis ,Younger age ,Time Factors ,Untreated psychosis ,Intervention (counseling) ,First episode psychosis ,medicine ,Humans ,Age of Onset ,Psychiatry ,Biological Psychiatry ,Psychiatric Status Rating Scales ,Sex Characteristics ,medicine.disease ,Prognosis ,Hospitalization ,Psychiatry and Mental health ,Treatment Outcome ,Psychotic Disorders ,Baseline characteristics ,dup ,Cohort ,Female ,Schizophrenic Psychology ,Psychology - Abstract
Duration of untreated psychosis (DUP) has been considered as one of the few potentially malleable prognostic factors in psychotic illness. The literature demonstrated that prolonged DUP predicted the level of positive symptoms, but its relationships with negative symptoms and functional outcome were less clear-cut. Thus far, most first-episode studies have been conducted in western countries. Yet, it is known that illness outcome might be modified by socio-cultural factors. In this study, we aimed to examine the impact of DUP on baseline characteristics, clinical and vocational outcomes over 3 years in 700 Chinese young people who presented with first-episode psychosis to a specialized early intervention service in Hong Kong. Our results showed that prolonged DUP was associated with male sex, younger age of onset, schizophrenia-spectrum diagnosis, insidious development of psychosis, fewer baseline positive symptoms and less likelihood of hospitalization at intake. Regression analyses revealed that prolonged DUP was significantly predictive of outcome on positive symptoms, recovery and sustained full-time employment in our first-episode psychosis cohort. Taken together, our study provided further supportive evidence regarding the prognostic value of DUP on illness outcome. Additionally, it suggested that an adverse impact of treatment delay for psychosis may likely be applied across regions of various ethno-cultural backgrounds.
- Published
- 2011
41. Naming psychosis: the Hong Kong experience
- Author
-
Cindy P-Y, Chiu, May M-L, Lam, Sherry K-W, Chan, Dicky W-S, Chung, Se-Fong, Hung, Jennifer Y-M, Tang, Gloria H-Y, Wong, Christy L-M, Hui, and Eric Y-H, Chen
- Subjects
Stereotyping ,Early Diagnosis ,Psychotic Disorders ,Terminology as Topic ,Schizophrenia ,Hong Kong ,Humans ,Translating - Abstract
Schizophrenia translates in Chinese as 'Mind Split Disease' which is heavily stigmatizing. The narrow conceptualization for schizophrenia alone was insufficient, in the context of early detection and intervention for psychosis. The need for an effective Chinese translation for psychotic disorders was imminent upon the launch of the Early Assessment Service for Young People with Psychosis in Hong Kong, where public awareness strategies had to be built upon effective communication of the disorder.'Si Jue Shi Tiao', the new term for psychosis, described 'thought and perceptual dysregulation'. This new terminology and concept was strategically introduced to the local community.The term 'Si Jue Shi Tiao' was taken up well locally and had demonstrated interactions within the Chinese and East Asian communities. The public has taken in the broader concept of psychosis, in contrary to the previous concept of schizophrenia per se.In Hong Kong, the restrictive view of perceiving psychotic disorders as schizophrenia was broadened upon the introduction of a more embracing, less stigmatizing term 'Si Jue Shi Tiao'. Effective establishment of this term to the local vocabulary allowed a basis for communication as well as public education work. Further evaluation is necessary to determine the effectiveness of the naming and to guide further public awareness strategies.
- Published
- 2010
42. Impairment of mother-infant relationship: validation of the Chinese version of Postpartum Bonding Questionnaire
- Author
-
Patrick Ip, Shirjolina S.-P. Kwok, Oi-Lin Li, Bonnie W.M. Siu, Mei-Ling Koo, Timothy M. H. Yeung, Se-Fong Hung, Eric F.C. Cheung, and Hesione M.-T. Chow
- Subjects
Predictive validity ,Psychometrics ,media_common.quotation_subject ,Test validity ,Anger ,Sensitivity and Specificity ,Developmental psychology ,Depression, Postpartum ,Asian People ,Surveys and Questionnaires ,Content validity ,Humans ,Face validity ,media_common ,Infant ,Reproducibility of Results ,Translating ,Mental health ,Child development ,Object Attachment ,Mother-Child Relations ,Psychiatry and Mental health ,Hong Kong ,Female ,Rejection, Psychology ,Psychology ,Clinical psychology - Abstract
The implementation of the Comprehensive Child Development Service in Hong Kong brought about the need for the development of an instrument for assessing mother-infant relationship impairments in women with postnatal depression. The Postpartum Bonding Questionnaire by was first translated into Chinese, then back-translated into English. An expert panel was set up to evaluate the content validity and a focus group discussion was held to explore the face validity and acceptability of the questionnaire. The Chinese version of the Postpartum Bonding Questionnaire (C-PBQ) was administered to 62 women suffering from postnatal depression. Scale 1 of the C-PBQ had a sensitivity of 84% for detecting women with any forms of mother-infant relationship impairments and scale 2 had a sensitivity of 89% for detecting rejection of infant and a sensitivity of 77% for detecting pathological anger towards infant. The C-PBQ is a useful instrument for detecting mother-infant relationship impairments as perceived by women with postnatal depression.
- Published
- 2010
43. Prevalence of DSM-IV disorders in Chinese adolescents and the effects of an impairment criterion: a pilot community study in Hong Kong
- Author
-
Patrick W. L. Leung, Chi-chiu Lee, T. P. Ho, Shi-leung Kwong, Wai-sum Liu, Se-Fong Hung, and Chun-pan Tang
- Subjects
Male ,medicine.medical_specialty ,Generalized anxiety disorder ,Adolescent ,Pilot Projects ,Prevalence of mental disorders ,Epidemiology ,Developmental and Educational Psychology ,medicine ,Child and adolescent psychiatry ,Odds Ratio ,Prevalence ,Humans ,Sex Distribution ,Psychiatry ,Child ,Psychiatric Status Rating Scales ,Schools ,Mental Disorders ,General Medicine ,Odds ratio ,medicine.disease ,Diagnostic and Statistical Manual of Mental Disorders ,Psychiatry and Mental health ,Conduct disorder ,Adolescent Behavior ,Pediatrics, Perinatology and Child Health ,Anxiety ,Hong Kong ,Female ,medicine.symptom ,Psychology ,Psychopathology ,Clinical psychology - Abstract
To provide preliminary prevalence estimates of common DSM-IV (Diagnostic and Statistical Manual of Mental Disorders—4th Edition) disorders in a sample of Hong Kong Chinese adolescents. 541 Chinese adolescents were recruited from Grades 7, 8 and 9 of 28 mainstream high schools in Hong Kong (mean age=13.8 years; SD=1.2). The adolescents and their parents were separately administered the Youth and Parent versions of DISC-IV (Diagnostic Interview Schedule for Children-Version 4), respectively. Based upon both symptom and impairment criteria, as required by DSM-IV, the overall prevalence estimate of DSM-IV disorders in our sample of Chinese adolescents was 16.4%. Estimates for such individual disorders/diagnostic groupings as anxiety disorders, depressive disorders, attention deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), and substance use disorders were 6.9, 1.3, 3.9, 6.8, 1.7, and 1.1%, respectively. These rates were largely compatible with those reported in previous studies with perhaps lower rates of generalized anxiety disorder (GAD), depressive disorders, CD, and substance use disorders, but a higher rate of ODD. The rate of ADHD was somewhat higher, but this might reflect the current DSM-IV diagnostic practice. The rate of anxiety disorders was not as high as predicted from some previous questionnaire surveys. The application of an impairment criterion had discernible impacts on prevalence estimates, greater on anxiety and substance use disorders, but smaller on depressive and disruptive behavior disorders. There was a lack of gender difference in rates of ODD and CD. While the findings reported here are broadly compatible with those of other studies, there may be cross-cultural differences in rates of some individual disorders, e.g., GAD, depressive disorders, ODD, CD, and substance use disorders, as well as in gender difference regarding rates of ODD and CD. However, exact comparison between studies is confounded by methodological differences in sample characteristics, measures, and case definition. Standardization of methodology in epidemiological surveys should allow more precise identification of any within- or between-culture variations in prevalence estimation.
- Published
- 2008
44. Transition to psychosis: 6-month follow-up of a Chinese high-risk group in Hong Kong
- Author
-
May M.L. Lam, Se-Fong Hung, and Eric Y.H. Chen
- Subjects
Adult ,Male ,Psychosis ,medicine.medical_specialty ,Adolescent ,Prodrome ,03 medical and health sciences ,0302 clinical medicine ,Asian People ,Risk Factors ,Surveys and Questionnaires ,medicine ,Prevalence ,Humans ,030212 general & internal medicine ,Prospective Studies ,Risk factor ,Family history ,Psychiatry ,Child ,Referral and Consultation ,Demography ,Positive and Negative Syndrome Scale ,At risk mental state ,General Medicine ,medicine.disease ,030227 psychiatry ,Psychiatry and Mental health ,Psychotic Disorders ,Schizophrenia ,Disease Progression ,Hong Kong ,Female ,Psychology ,Psychopathology ,Follow-Up Studies - Abstract
Objectives: The identification of individuals at high risk of becoming psychotic within the near future creates opportunities for early intervention before the onset of psychosis. This study sets out to identify a group of symptomatic young people in a Chinese population with the high likelihood of transition to psychosis within a follow-up period of 6 months, and to determine the rate of transition to psychosis in this group. Method: Symptomatic individuals with a family history of psychotic disorder, subthreshold psychotic symptoms or brief transient psychotic symptoms were identified using the operationalized criteria of an ‘At Risk Mental State’. The individuals were prospectively assessed monthly on a measure of psychopathology for 6 months. Results: Eighteen out of 62 individuals (29%) made the transition to frank psychosis within a 6 month follow-up period, with the majority occurring within 3 months. In addition, significant differences were found in the intake Positive and Negative Syndrome Scale, Comprehensive Assessment of ‘At Risk Mental State’ and Global Assessment of Functioning scores between the group that ultimately became psychotic and the group that did not. Conclusion: The period of the highest risk of transition to psychosis was within the 3 months after the study began. Thus, distressed youths in our outpatient clinic, who meet the high-risk criteria should be monitored most closely in the initial 3 months, particularly those individuals with high levels of psychopathology and functional decline.
- Published
- 2006
45. Test-retest reliability of the Chinese version of the Diagnostic Interview Schedule for Children-Version 4 (DISC-IV)
- Author
-
Shi-leung Kwong, F. Lieh-Mak, Christopher P. Lucas, Chun-pan Tang, Patrick W. L. Leung, Chi-chiu Lee, David Shaffer, Se-Fong Hung, and T. P. Ho
- Subjects
Male ,medicine.medical_specialty ,Psychometrics ,Adolescent ,Population ,behavioral disciplines and activities ,mental disorders ,Interview, Psychological ,Developmental and Educational Psychology ,medicine ,Attention deficit hyperactivity disorder ,Humans ,education ,Psychiatry ,Child ,education.field_of_study ,Depressive Disorder ,Mental Disorders ,Reproducibility of Results ,medicine.disease ,Anxiety Disorders ,Test (assessment) ,Psychiatry and Mental health ,El Niño ,Attention Deficit and Disruptive Behavior Disorders ,Pediatrics, Perinatology and Child Health ,Major depressive disorder ,Anxiety ,Hong Kong ,Female ,medicine.symptom ,Psychology ,Anxiety disorder ,Clinical psychology - Abstract
Background: Despite the huge youth population, there is a lack of psychiatric diagnostic instruments with reported psychometric properties in Chinese. This study reports the development of the Chinese version of DISC-IV and examines its test–retest reliability. Method: Seventy-eight parents and 79 youths (mean age 13.1 years) attending child psychiatric clinics were interviewed twice using the Chinese DISC-IV (Diagnostic Interview Schedule for Children-IV) about 22 days apart. Results: The kappa coefficients were good to excellent for obsessive compulsive disorder (OCD) (both youth (Y) and parent (P) versions), major depressive disorder (MDD) (P), attention deficit hyperactivity disorder (ADHD) (P); fair for anxiety disorder (P), oppositional defiant disorder (ODD) (P, Y), MDD (Y); but poor for anxiety disorder (Y) and ADHD (Y). Parent informants had better test–retest reliability than youth informants. Conclusions: The Chinese DISC-IV had comparable test–retest reliability with the original English version.
- Published
- 2005
46. The test-retest reliability and screening efficiency of DISC Predictive Scales-version 4.32 (DPS-4.32) with Chinese children/youths
- Author
-
David Shaffer, Chi-chiu Lee, Se-Fong Hung, T. P. Ho, Patrick W. L. Leung, Shi-leung Kwong, Chun-pan Tang, F. Lieh-Mak, and Christopher P. Lucas
- Subjects
Male ,medicine.medical_specialty ,Psychometrics ,Adolescent ,Sample (statistics) ,Test validity ,Developmental psychology ,Predictive Value of Tests ,Interview, Psychological ,Developmental and Educational Psychology ,Child and adolescent psychiatry ,medicine ,Humans ,Mass Screening ,Medical diagnosis ,Diagnostic interview schedule ,Child ,Reliability (statistics) ,Analysis of Variance ,Mental Disorders ,Reproducibility of Results ,General Medicine ,Test (assessment) ,Psychiatry and Mental health ,Pediatrics, Perinatology and Child Health ,Hong Kong ,Female ,Psychology ,Clinical psychology - Abstract
The DISC Predictive Scales-4.32 (DPS-4.32) were short-forms of the Diagnostic Interview Schedule for Children-IV (DISC-IV). The psychometric properties of DPS-4.32 were tested on two Chinese samples: a clinic sample of 83 children/youths, and a community sample of 541 youths. Both Parent and Youth DPS-4.32 exhibited good-to-excellent test-retest reliability. Their screening efficiency was examined respectively against DSM-IV diagnoses of the full-length Parent and Youth DISC-IV. Results indicated large AUCs (Area under Receiver—Operating Charateristic Curve), as well as high sensitivity, specificity, and negative predictive values, supporting the capability of DPS-4.32 to differentiate cases from noncases. DPS-4.32 held promise as efficient short-forms of DISC-IV, screening DSM-IV diagnoses. They were also applicable to the Chinese population, demonstrating their cross-cultural applicability.
- Published
- 2005
47. GENDER DIFFERENCES IN PATIENTS PRESENTED WITH FIRST-EPISODE PSYCHOSIS IN HONG KONG
- Author
-
C.W. Law, Jennifer Y.M. Tang, Kathy P. M. Chan, Steve Tso, Christy L.M. Hui, Wing Chung Chang, Cindy P.Y. Chiu, May M.L. Lam, Se-Fong Hung, Gloria H.Y. Wong, Dicky W.S. Chung, and Eric Y.H. Chen
- Subjects
Psychiatry and Mental health ,medicine.medical_specialty ,business.industry ,First episode psychosis ,Medicine ,In patient ,business ,Psychiatry ,Biological Psychiatry - Published
- 2010
48. A double-blind randomized placebo-controlled study of relapse prevention in remitted first-episode psychosis patients following one year of maintenance therapy
- Author
-
Steve Tso, Cindy P. Y. Chiu, Se-Fong Hung, Edwin P F Pang, Y.C. Wong, Dicky W.S. Chung, Flora Y M Mo, Clm Hui, M. Lam, William G. Honer, Kathy P. M. Chan, K.T. Chan, Eric Y.H. Chen, and CW Law
- Subjects
Double blind ,Psychiatry and Mental health ,medicine.medical_specialty ,Pediatrics ,Maintenance therapy ,First episode psychosis ,medicine ,Placebo-controlled study ,Psychiatry ,Psychology ,Relapse prevention ,Biological Psychiatry - Published
- 2008
49. Characteristics of youth suicide in Hong Kong
- Author
-
Ka Fai Chung, T. P. Ho, Se-Fong Hung, S. Y. Chung, and Caroline C. Lee
- Subjects
Gerontology ,Adult ,Cross-Cultural Comparison ,Male ,Health (social science) ,Social Psychology ,Adolescent ,Epidemiology ,Cross-sectional study ,Population ,Poison control ,Suicide prevention ,Coroner ,Life Change Events ,Risk Factors ,Injury prevention ,Medicine ,Humans ,education ,education.field_of_study ,business.industry ,Incidence ,Human factors and ergonomics ,Cross-cultural studies ,Psychiatry and Mental health ,Suicide ,Cross-Sectional Studies ,Hong Kong ,Female ,business ,Demography - Abstract
This paper explores the intrapersonal and sociocultural factors behind youth suicide in Hong Kong. The coroner's court reports of consecutive population-based youth suicide (below age of 25 years, n = 303) cases from 1986 to 1992 were reviewed. Compared with other countries, Hong Kong had low male but high female youth suicide rates. The number of undetermined deaths did not significantly affect the estimated suicide rates. Cross-cultural differences in youth suicide rates may be understood from a differential distribution of risk factors and cultural attitudes towards role behaviours and suicide. Youth suicides in Hong Kong were characterised by a high prevalence of psychiatric disturbances and age-normative precipitants; both findings bear great resemblances to samples studied elsewhere. The results were evaluated in light of studies in different sociocultural backgrounds and highlighted the universality and specificity of youth suicide in Hong Kong.
- Published
- 1995
50. Vitamin E in the treatment of tardive dyskinesia: a replication study
- Author
-
Se-Fong Hung, Helen F.K. Chiu, and Linda C. W. Lam
- Subjects
Adult ,Male ,Dyskinesia, Drug-Induced ,Adolescent ,medicine.medical_treatment ,Neurological disorder ,Bioinformatics ,Tardive dyskinesia ,Placebos ,Double-Blind Method ,mental disorders ,Replication (statistics) ,otorhinolaryngologic diseases ,medicine ,Humans ,Vitamin E ,Physical Examination ,Aged ,Involuntary movement ,Psychiatric Status Rating Scales ,Chemotherapy ,business.industry ,Middle Aged ,medicine.disease ,nervous system diseases ,Psychiatry and Mental health ,Dyskinesia ,Anesthesia ,Female ,medicine.symptom ,business - Abstract
The aim of our study was to provide further information as to the efficacy of vitamin E for the management of tardive dyskinesia
- Published
- 1994
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