Background: Anxiety disorders are the most common psychiatric disorders among children. Because of their internalizing nature, anxiety disorders are underdiagnosed and untreated. Therefore, self-report screening tools play an important role in the early identification of these cases. This study aimed to examine the psychometric properties of the Screen for Child Anxiety Related Disorders (SCARED)-Thai version in a clinical population. Methods: One hundred and eight participants were enrolled from patients aged 9-16 years with any psychiatric diagnosis and their parents who visited a child and adolescent psychiatric clinic in Thailand. All the parent-child pairs completed the SCARED and the Strengths and Difficulties Questionnaire (SDQ)-emotional subscale. Clinical diagnosis of an anxiety disorder was endorsed through a standard clinical interview by certified child and adolescent psychiatrists blinded to the results of the SCARED and SDQ. Internal consistency, predictive validity, and convergent validity of the screens were assessed.Results: This study found that the SCARED-Thai version had very good reliability, with internal consistency (Cronbach's alpha) of 0.913 for the SCARED-Child form and 0.925 for the SCARED-Parent form. With an optimal cut-off point of 23, the SCARED-Child version significantly distinguished anxious from non-anxious young people in clinical settings with a sensitivity of 0.74 and a specificity of 0.50, while the SCARED-Parent version had a sensitivity of 0.74 and a specificity of 0.67 at the same threshold. The convergent validity between the SCARED-Thai (total) and SDQ (emotional subscale) was at a highly suitable range (r = 0.81). Conclusion:The SCARED-Thai version exhibited good psychometric quality for identifying young people with comorbid anxiety disorders when used in clinical settings.
Background: The COVID-19 pandemic has impacted on medical education and other areas of life causing psychological distress. Objectives: The study aimed to assess psychological impact and coping and to identify factors associated psychological impact among medical students. Methods: An online cross-sectional study was conducted at Phramongkutklao College of Medicine (PCM) in April 2021. All medical students were invited to complete a standardized online questionnaire for demographics data, impact of COVID-19, coping, fear of illness and virus evaluation (FIVE). The Depression Anxiety Stress Scales (DASS-21) Thai version was used to assess the psychological impact. The factors associated with depression, anxiety and stress were analyzed using logistic regression analysis. Results: In total, 256 medical students completed the questionnaire. Of these, 54.7% reported having psychological impact, 43.4% depression, 36.7% anxiety and 29.7% stress. Depression was associated with preclinical students (adjusted OR(AOR) =3.03, 95% confidence interval (95% CI) =1.54-5.97), sleep problem (AOR =2.20, 95% CI=1.16-4.16) and extreme deterioration of family income (AOR =7.27, 95% CI=1.81-29.29). Anxiety was associated with preclinical students (AOR =3.20, 95% CI=1.52-6.72), COVID-19 like symptoms (AOR =2.93, 95% CI=1.26-6.83), slight problems adjusting to new learning methods (AOR =6.11, 95% CI=1.54-24.24) and extreme deterioration of family income (AOR =8.29, 95% CI=1.44-47.59). Stress was associated with preclinical students (AOR =3.84, 95% CI=1.75-8.40), COVID-19-like symptoms (AOR =3.54, 95% CI=1.53-8.19), and no confidence in COVID-19 policy of PCM (AOR =2.3, 95% CI=1.06-4.98). A positive correlation between Fear of Illness and Virus Evaluation (FIVE) and psychological impact was observed (r=0.449; p<0.001). Common coping activities were the use of social media, video chats and exercise. Conclusion: A high prevalence of psychological impact was observed among medical students during the COVID-19 pandemic. To establish psychological support and resilience, training is needed to improve mental wellbeing and prepare medical students to cope with unprecedented situations.
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