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Objective: To study the prevalence of substance use and associated factors in school students in Tsunami affected areas in southern Thailand., Material and Method: The study was a school-based, cross-sectional, anonymous survey that used a translated questionnaire, ESPAD-03, in 5 schools. Chi-square tests and odds ratios were used to evaluate factors associated with substance use., Results: Two thousand seven hundred and sixteen students (87.8%) were enrolled in the study. Lifetime, last 12 months, and last 30 days prevalence rates of any substance use were 50.3, 33.9, and 24.8%, respectively. Lifetime, last 12 months, and last 30 days prevalence rates of alcohol use were 43.2, 30.1, and 17.5%, respectively. Lifetime and last 30 days prevalence rates of smoking were 21.7 and 12.0%. Fighting, stealing, truancy, running away, unsafe sex, and thought of self-harming were associated with alcohol and substance use. Siblings and friends with alcohol and substance use were risk factors. Close support from parents and friends were protective factors., Conclusion: There was a high prevalence of smoking, alcohol, and substance use among school students in Tsunami affected areas. Behavioral problems and psychosocial risk factors were associated with history of smoking, alcohol and substance use. School-based intervention in students with behavioral problems seems to be a worthwhile investment. However, longitudinal studies should be done to confirm the correlation of PTSD and substance use.

Objective: Problematic alcohol consumption is associated with multiple medical conditions and psychiatric comorbidities. Previous publications reported the under-recognition of alcohol-related problems in the clinical setting. The present study comprises of two objectives, 1) to examine the process use by physicians to recognize alcohol-related problems in psychiatric outpatient units, and 2) to compare the results of a CAGE interview and a written version of the CAGE questionnaire., Material and Method: The participants were recruited via interview using the alcohol section of the Thai version of Diagnostic Interview for Genetic Studies (Th-DIGS), which included 165 psychiatric outpatients with alcohol dependence and 165 psychiatric outpatients without alcohol-related disorders. The validity of diagnoses provided by psychiatrists and physicians (in the records) compared with the Th-DIGS diagnoses were analyzed. Kappa statistics were applied to compare the agreement of the responses for the written version and the oral CAGE interviews., Results: Compared with the diagnoses using Th-DIGS, the physician specificity and positive predictive value were 100% (95% CI: 97.8-100% and 94.9-100%, respectively). However the sensitivity and negative predictive value were 43% (95% CI: 35.4-51%) and 63.5% (95% CI: 57.5-69.6%), respectively. The Kappa value for the written version of the CAGE questionnaire and the CAGE oral interview was 0.723., Conclusion: The results of the present study suggest the need to increase physician awareness regarding alcohol-related problems. A brief and high-sensitivity screening questionnaire, such as the CAGE questionnaire, written versions and oral interview, can be implemented for screening alcohol-related disorders in a clinical setting.

Background: Children may suffer from post-traumatic stress disorder after disaster. There was a severe tsunami following an undersea earthquake off the Sumatra coast of Indonesia. There were 20,000 children in 6 southwestern provinces of Thailand who were possibly affected., Objective: To study the prevalence of post-traumatic stress disorder (PTSD) in Thai students in the area affected by the December 26th, 2004 tsunami disaster, Thailand., Material and Method: One thousand six hundred and fifteen surviving students from two schools in Takua Pa district located in Phang-nga Province, Thailand participated in this longitudinal study. Screening was done by using Pediatric Symptom Checklists part II (PSC-II), Childhood Depressive Intervention (CDI) and the Revised Child Impact of Events Scales (CRIES 8). PTSD was diagnosed by child and adolescent psychiatrists by using criteria of DSM-IV. The intervention included psychological first aid, psycho-education, cognitive-behavioral therapy, medication in severe cases, group support for students, parents and teachers which was done, beginning at 10 days after the tsunami disaster. Data were analyzed by using SPSS version 12.0., Results: The prevalence rates of PTSD in the students facing the tsunami disaster in the study group were 573, 46.1, 31.6, 7.6, 4.5, 3.9 and 2.7% at 6 weeks, 6 months, 1 year, 2 years, 3 years, 4 years and 5 years after the disaster, respectively. Female to male ratio was 1.7: 1. The peak age was 9-10 years old. The top five on the list of symptoms in PTSD were distress with cue, intrusive thought, functioning impairment, startled response, terrified and hyper vigilance. Seven cases (3.1%) were diagnosed partial PTSD, still exhibited a wide range of PTSD symptoms but did not fulfill the DSM-IV diagnostic criteria. The top five on the list of symptoms in partial PTSD were avoiding thought/feelings, terrified, avoiding place/activities, distress with cue and startled response., Conclusion: The prevalence of PTSD among tsunami victims was 57.3% at 6 weeks after the disaster. It declined sharply at 2 years after the event. Despite receiving financial, rehabilitation and mental health support, 2.7% of the victims continued to suffer from PTSD 5 years after the disaster.