Purpose
To explore whether the ‘hikikomori’ syndrome (social withdrawal) described in Japan exists in other countries, and if so, how patients with the syndrome are diagnosed and treated.
Methods
Two hikikomori case vignettes were sent to psychiatrists in Australia, Bangladesh, India, Iran, Japan, Korea, Taiwan, Thailand and the USA. Participants rated the syndrome's prevalence in their country, etiology, diagnosis, suicide risk, and treatment.
Results
Out of 247 responses to the questionnaire (123 from Japan and 124 from other countries), 239 were enrolled in the analysis. Respondents’ felt the hikikomori syndrome is seen in all countries examined and especially in urban areas. Biopsychosocial, cultural, and environmental factors were all listed as probable causes of hikikomori, and differences among countries were not significant. Japanese psychiatrists suggested treatment in outpatient wards and some did not think that psychiatric treatment is necessary. Psychiatrists in other countries opted for more active treatment such as hospitalization.
Conclusions
Patients with the hikikomori syndrome are perceived as occurring across a variety of cultures by psychiatrists in multiple countries. Our results provide a rational basis for study of the existence and epidemiology of hikikomori in clinical or community populations in international settings.
The objective of our study was to assess the accuracy of the Thai version of the Addenbrooke's Cognitive Examination III (ACE-T). We used the ACE-T to assess 107 participants aged 60 or over, divided into the following groups: early dementia, n=30; mild cognitive impairment (MCI), n=29; and normal controls (NC), n=48. The ACE-T exhibited good internal consistency (0.93) and inter-rater reliability (1.0). The optimal cut-off score for the ACE-T to differentiate MCI from NC was 75/76, giving a sensitivity of 0.9 and specificity of 0.86. At the optimal cut-off of 61/62, the ACE-T had excellent sensitivity (1.0) and specificity (0.97) to distinguish early dementia from non-dementia. The ACE-T had high diagnosis accuracy in the detection of the MCI and early dementia in the Thai population.
Objective: This study investigates the psychological impacts and their associated factors on patients with COVID-19 at a Thai field hospital. Methods: All eligible patients confirmed to have COVID-19 at Thammasat University field hospital completed an online self-reported mental health screening questionnaire which collected sociodemographic data, their clinical characteristics, and used the depression, anxiety, and stress scale (DASS-21). Results: A total of 40 patients participated in the study. The depression rate was found to be 22.5%, while the anxiety rate was 30%, and the stress rate was 20%. Having a history of psychiatric disorder alone was significantly associated with a higher DASS-21 score (p = 0.001). Meanwhile, gender, age, level of education, occupation, living status, severity of COVID-19, and the number of days admitted to hospital prior to the field hospital were not found to be associated with the DASS-21 scores (P > 0.05).
Conclusion:The depression, anxiety, and stress symptoms in patients with COVID-19 at the field hospital were common. Patients with a history of psychiatric disorder should undergo specific evaluation during the isolation phase.
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