Background: There is a dearth of data on positive psychiatry. There should be a greater emphasis on this aspect of mental health in all countries. The emphasis is not just on treatment but more importantly prevention. Positive psychiatry should involve the wide spectrum of mental health professionals including psychiatrists, nurses, psychologists, counselors, art and music therapists, as well as and the public. Methods: In this review, the author summarizes the Age Well Everyday (AWE) program on dementia and depression prevention for seniors conducted by the Mind Science Center, National University of Singapore. The program which started 10 years ago, is supported by volunteers in the community with funding from philanthropists. Results: Interventional strategies in the AWE program include health education, diet, exercise, art therapy, music reminiscence, gardening, and mindfulness practice. Randomized controlled trials have been conducted for all the interventional strategies, and the results are presented. This multi-modal program is a community endeavor and is now adopted by many community centers in Singapore. Conclusion: The AWE program is a nondrug and inexpensive program that can be adapted for other countries. It reflects positive psychiatry and a relevant strategy for the anti-stigma campaign in Singapore. The challenge ahead is translating research results into public health policies.

Background: Nonsuicidal self-injury (NSSI), self-harm behavior without suicidal intent, is a serious problem that is prevalent among adolescents. The fact that NSSI is listed as “condition for further study” in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, indicates that its severity is recognized in clinical medicine. Methods: In this paper, we review the recent literature on the risk factors for NSSI, as well as its epidemiology, etiology, risk factors, and treatment. Results: The prevalence of NSSI in adolescents is about 17%–18%. Notably, it is more common in girls. In psychiatric units, the reported rate of NSSI among adolescents is 60%. Considered a strategy by which adolescents blanket their emotional discomfort with physical pain, NSSI may increase the risk of developing psychiatric disorders and involve physical sequelae. NSSI has many etiologies and risk factors, including interpersonal problems, social contagion, adverse childhood experiences, and neurobiological factors. No definite evidence supports the psychopharmacological treatment of NSSI in adolescence. Recent studies showed that dialectical behavioral therapy, cognitive behavioral therapy, and mentalization-based treatment have therapeutic effects in adolescent patients with NSSI. Conclusion: NSSI is highly prevalent and highly comorbid with other psychiatric disorders. To prevent and manage this problem more effectively, further research on and understanding of the etiological characteristics is warranted.

Objective: Psychological burden is a serious issue facing by the cancer patients and their caregivers (CGs) around the world during the pandemic situations such as COVID-19. In the present study, we assessed the psychological burden on cancer patients and their CGs during this COVID-19 pandemic. Methods: The study was done using standardized questionnaire of the most validated scales - perceived stress scale and the caregiver strain index. Results: A total of 334 patients and 257 CGs participated in the present study. Majority of the patients experienced moderate to high level of stress (n = 239 [72%]), while CGs experienced a high level of strain (n = 132 [52%]). In the patient's cohort, stress was dependent significantly on education (p < 0.01), gender (p < 0.05), on active treatment (p < 0.001), and surgery (p < 0.05). Among CGs, strain was significantly affected by less education CGs (p < 0.001), patients more on active treatment (p < 0.01), and more primary gastrointestinal tumors (p < 0.01). From multivariate analysis of pandemic-specific factors, difficulty in transportation (p < 0.01) and increased financial burden (p < 0.05) were found to be significant influencing factors affecting the stress level of patients. Conclusion: To overcome the psychological burden due to lockdown, we suggest the initiation of psychosocial caring in all the necessary patients and their CGs to demonstrate its benefits in the long term.

Background: Symptoms of poststress traumatic stress disorder (PTSD) and depression are intertwined in suicide ideation (SI) in military personnel. The interpersonal psychological theory (IPT) of suicide is proposed that the presence of thwarted belongingness (TB) and perceived burdensomeness (PB) produces the desire for suicide. To clarify the putative moderating effect of IPT on the complex-mediated moderation relationship among symptoms of soldiers' PTSD, depression, and SI, we did a cross-section study through recruiting military personnel in three camps in northern Taiwan. Methods: We recruited 759 active-duty soldiers (male: female = 579: 180) from three troops in northern Taiwan. They were asked to fill out copies of questionnaire according to their current two-week situation for our analyzing the study data. Results: In this study, we found that the pathway from soldiers' PTSD symptom to SI was positively and significantly mediated through their depression (p < 0.001), and that the pathway from their PTSD to depression was positively and significantly moderated by both PB (p < 0.05) and thwarted belongingness (p < 0.05). Comparing with male counterparts, the female soldiers, although significantly and relatively younger in age (p < 0.001), suffered from significantly higher levels of depression (p < 0.05) without significant sex difference in the magnitudes of PTSD symptoms. Conclusion: This study revealed the moderating effects of IPT on the pathway from PTSD to depression and SI among soldiers. Sex difference, although is subtle, can be essential in military suicide prevention and treatments for cases with PTSD symptoms.

Objectives: Medical students from several parts of the world have increasingly been reported to have higher rates of stress and distress. In this study, we intended to explore the prevalence of perceived stress, disordered eating, and poor quality and pattern of sleep among medical students in the Arabian Gulf country, Oman. The related objective was to explore the relationship between sociodemographic variables and the expression of perceived stress. Methods: A cross-sectional online survey was conducted among medical students at the only national university in Oman. The outcome measures included perceived stress (Perceived Stress Scale-10), disordered eating (Eating Attitudes Test-26), and the quality and pattern of sleep (Pittsburgh Sleep Quality Index). The study survey also included sociodemographic variables and risk factors. Results: We contacted 600 students, and 253 students responded (response rate = 42.2%) with a filled study survey. We found that 51.4% (n = 130) of the sample scored in the threshold of perceived stress, 16.2% showed disordered eating, and 79.1% displayed poor quality and disrupted pattern of sleep. The total sample comprised more females (73.1%) as compared to males (26.9%) at an average age of 22.0 ± 2.0 (mean ± standard deviation) years. More than 77% (n = 196) of them were senior students (year 4th–7th), and their average body mass index (BMI) was 23.6 ± 5.9) kg/m². Twenty-five participants had a history of psychiatric illness. Among those with psychiatric illness, 7.5% (n = 19) were on regular psychotropic medications. In multivariate analysis, perceived stress was found to be significantly correlated with age (p < 0.01), years of study (p < 0.05), and poor quality and disrupted patterns of sleep (p < 0.001). Conclusion: This study was embarked upon to examine the risk factors related to perceived stress among medical students in Oman. The rates of perceived stress, disordered eating, and poor quality and disrupted pattern of sleep were to echo international trends among medical students. The factors that were found to be related to perceived stress included age, having completed less than four years of their medical education, and poor quality and disrupted pattern of sleep. In addition to laying the groundwork for further studies, this data can be used for the prevention and mitigation of poor mental health outcomes.

Objectives: Nonalcoholic fatty liver disease (NAFLD) is a notable chronic liver disease due to metabolic syndrome, which has yet to be explored in long-term hospitalized patients with schizophrenia. In this study, we intended to study the prevalence of NAFLD and related risk factors for patients with schizophrenia who were long-term hospitalized. Methods: All of 182 patients with schizophrenia were recruited from a public psychiatric hospital in Taiwan. Abdomen ultrasonography was carried out for all patients. In addition to age and sex, covariates including medical diagnoses (e.g., hypertension, hypertriglyceridemia, hypercholesterolemia, and diabetes), obesity, one-year cumulative dose of antipsychotics before the entry of this study, and abnormal liver function were included in the logistic regression model. Results: The mean age ± standard deviation (SD) was 50.3 ± 9.2 years. The mean duration ± SD of hospitalization was 8.7 ± 5.0 years. Males accounted for 60.4% (110/182). The percentage of NAFLD was 70.8% (129/182). In multivariate logistic regression, patients' odd ratios (OR) (95% confidence interval [CI]) for a diagnosis of hypertriglyceridemia were 4.3 (1.11–16.7, p < 0.05) and for a finding of obesity 15.8 (3.82–65.6, p < 0.01), were significantly to have NAFLD. But patients with chronic hepatitis B were not significant to have NAFLD (OR [95% CI] = 0.17 [0.05–0.6]). Conclusion: The prevalence of NAFLD was high in patients with long-term hospitalized patients with schizophrenia in this study. We suggest that patients with schizophrenia and with long-term hospitalization need to receive timely, comprehensive, and prompt assessments for the presence of NAFLD as well as that intervention for their NAFLD is mandatory for maintaining well-being and quality of life in them.

Objective: The coronavirus disease pandemic has been posing as a serious health hazard with high mortality risks along with global disastrous economic consequences. A pervasive and long-term impact of the pandemic on mental health has been expected and reported in literature. It is vital to study its nature and whether there has been any change in the impact perception and coping of people toward the COVID pandemic after a year it started. Methods: The study was conducted in two phases, with a gap of one year in between the phases. The present study produced the findings of second phase, which was basically a follow-up after one year. Totally, 100 consenting participants of both sex from the pool of first phase (n = 625) who agreed for follow-up assessment were re-assessed to see the changes in psychological impact of COVID pandemic and their coping using the Psychological Impact and Coping in COVID Pandemic Questionnaire. Results: The psychological coping of the participants significantly lowered from the first phase to the second phase (22.09 ± 3.44 vs. 20.02 ± 3.37, t = 3.75, p < 0.001). Under domain category, psychological coping showed significant lowering in male student participants (21.67 ± 3.50 vs. 19.09 ± 3.35, t = 3.001, p < 0.01) and in female student participants (22.37 ± 3.43 vs. 20.26 ± 3.43, t = 3.2, p < 0.01) from the first to the second phase. Young-aged adults had significantly lowered in psychological coping (22.50 ± 3.15 vs. 19.26 ± 3.72, t = 4.4 p < 0.001) from the first to the second phase. No change in psychological impact on the participants existed, across first to second phase, in the domain for age and sex. Conclusion: The psychological impact of the pandemic was reduced but not conclusively after a year of the COVID pandemic, and the coping was poorer after a year, especially in young adults. The continuation of the pandemic with a persistent increase in infection and mortality numbers and uncertainty over treatment and vaccination is to maintain the phenomenon and needs to be controlled to limit secondary long-term mental issues in the population.