Suchergebnisse

Vision / Goh Yen-Li -- Mental Health - GP Partnership Programme (MH-GPPP) : Process, Planning and Implementation / Gina Teo -- Case Management / Junie Seah and Margaret Hendriks -- Managing GP Engagement : Strategies and Lessons Learnt / Alvin Lum -- GP Training and Education in Mental Health / Chiam Peak Chiang, Alvin Lum, and Nirhana Japar -- Research : An Explorative Journey Ahead / Alvin Lum -- GP Perspectives : Managing Patients with Mental Illness in the Community / Mark Yap, Kwek Thiam Soo, Grace Cheng, Rodney Lim, and Gina Teo -- MH-GP Partnership Programme and Beyond : Working with the Community to Sustain Mental Healthcare / Wei Ker-Chiah, Jayaramam Hariram, Jared Ng and Chan Mei Chern

People with mental illness may be unable to provide critical input about the care they wish to receive during a psychiatric crisis because of altered mental states. It is therefore imperative that clinicians seek to understand service users' wishes for care while they are well and able to provide meaningful input into the discussion. Achieving such an end may be done by discussing and completing a psychiatric advance directive. However, very few Asian countries have legislation that supports such advance directives. The present article seeks to give physicians more information about advance psychiatric directives and the potential role they could play to improve the healthcare provided in Asia to people at risk of losing capacity due to a mental illness. The degree to which mental health legislation supports psychiatric advance directives is documented for each country of South East Asia and Eastern Asia.

Background: Previous studies have identified the significant role of stressful life events in the onset of depressive episodes. However, there is a paucity of cross-national studies on stressful life events that precede depression. Aims: We aimed to compare types of stressful life events associated with the onset of depressive episodes in patients with major depressive disorder (MDD) in five Asian countries. Method: A total of 507 outpatients with MDD were recruited in China ( n = 114), South Korea ( n = 101), Malaysia ( n = 90), Thailand ( n = 103) and Taiwan ( n = 99). All patients were assessed with the Mini-International Neuropsychiatric Interview and the List of Threatening Experiences. The prevalence of each type of stressful life events was calculated and compared between each country. Results: The type of stressful life event that preceded the onset of a depressive episode differed between patients in China and Taiwan and those in South Korea, Malaysia and Thailand. Patients in China and Taiwan were less likely to report interpersonal relationship problems and occupational/financial problems than patients in South Korea, Malaysia and Thailand. Conclusion: Understanding the nature and basis of culturally determined susceptibilities to specific stressful life events is critical for establishing a policy of depression prevention and providing effective counseling services for depressed patients.