Ratana Saipanish - Academia.edu (original) (raw)

Papers by Ratana Saipanish

Dementia and Geriatric Cognitive Disorders, 2018

Background/Aims: Independence and social engagement are important outcomes for people with dement... more Background/Aims: Independence and social engagement are important outcomes for people with dementia. The aim of this study was to conduct an in-depth psychometric assessment of the Engagement and Independence in Dementia Questionnaire (EID-Q), a measure of social independence. Methods: This was an observational study at five NHS sites across England. Participants completed the EID-Q alongside additional measures. Psychometric analysis included internal consistency, test-retest reliability, convergent validity, and factor analyses. Results: A total of 225 people living with dementia completed the study. Internal consistency was excellent (α = 0.921) and the measure remained moderately stable over a 1-week period (ICC = 0.768). Significant correlations were observed between quality of life (r = 0.682) and depression (r = –0.741; both p < 0.001), indicating the importance of these concepts for wellbeing in dementia. Factor analysis indicated the presence of five factors which loaded...

<b>Copyright information:</b>Taken from "Reliability and validity of the Thai ve... more <b>Copyright information:</b>Taken from "Reliability and validity of the Thai version of the PHQ-9"http://www.biomedcentral.com/1471-244X/8/46BMC Psychiatry 2008;8():46-46.Published online 20 Jun 2008PMCID:PMC2443128.

Objectives : To study depression in obsessive-compulsive disorder (OCD) patients. Method : This w... more Objectives : To study depression in obsessive-compulsive disorder (OCD) patients. Method : This was a cross-sectional descriptive study. Participants were OCD patients from out-patient clinic, department of Psychiatry, Ramathibodi hospital and normal adults aged from 18 to 70. All participants answered questionnaires about general identification data and the Thai version of Patient Health Questionnaire (PHQ-9), a self-rated measure for depression. They all were then rated for depression by using the Thai version of the Hamilton rating scale for depression (HAM-D), and OCD patients were further rated for OCD symptom severity by using the Thai version of the Yale-Brown Obsessive -Compulsive Scale -Second Edition (YBOCS-II-T). Result : Forty nine OCD patients and eighty normal adults participated in this study. OCD patients had higher rate of depression (28.6% and 38.8% assessed by HAM-D and PHQ-9 respectively) and suicidal idea (18.4%) than normal adults. The YBOCS-II-T obsession scor...

Objective : To examine co-morbidities in patients with obsessive-compulsive disorder (OCD). Metho... more Objective : To examine co-morbidities in patients with obsessive-compulsive disorder (OCD). Method : The descriptive cross-sectional study was conducted in patients with obsessive-compulsive disorder from the out-patient unit of the Department of Psychiatry, Ramathibodi Hospital between December 2012 to January 2014. The interviewers applied the Mini International Neuropsychiatric Interview, the Yale-Brown Obsessive-Compulsive Scale - Second edition, and the Hamilton rating scale for depression in the interview process. Results : Among 49 OCD patients, 26 cases (53.1%) had other psychiatric disorders. The most common co-morbid disorder found in this study was hypomania (16.3%), followed by panic disorder, social anxiety disorder, generalized anxiety disorder, and psychotic disorders (14.3%). The result also showed that there was suicidality in 11 of 43 OCD patients (22%), which was relatively high. Conclusion : More than half of OCD patients had co-morbid psychiatric disorders. It w...

Objectives : This study aimed to investigate the prevalence and characteristic of obsessive-compu... more Objectives : This study aimed to investigate the prevalence and characteristic of obsessive-compulsive symptoms in normal adults. Methods : This was a descriptive cross-sectional study. Participants were patients’ relatives, hospital staffs and students, including normal adults aged from 18 to 70, who had no history of psychiatric disorders. All participants were interviewed by using Mini International Neuropsychiatric Interview (MINI) and then answered questionnaires about general identification and assessed their own obsessive-compulsive symptoms by using the Thai self-report version of the Yale-Brown Obsessive-Compulsive Scale -Second Edition (YBOCS-II-SR-T). Result : One hundred and five normal adults participated in this study. The prevalence of obsessive-compulsive symptoms was relatively high (65.7%). The mean and standard deviation (SD) of total symptoms per person was 6.85 ± 12.74. The mean and SD of obsessive symptoms was 3.39 ± 6.65 and compulsive symptoms was 3.45 ± 6.34...

Thank you very much for giving us the opportunity to revise our manuscript. We would like to than... more Thank you very much for giving us the opportunity to revise our manuscript. We would like to thank the reviewers' for giving us the highly valuable comments to improve our manuscript. We have revised the manuscript in accordance with all the reviewers' comments. A point-by-point response to the comments is given below. We hope that the revised manuscript and our responses are satisfactory to you. Thank you for your consideration. We look forward to hearing your reply. Sincerely yours, Manote Lotrakul, M.D. Reviewer 1: Yvonne Forsell General 1. The paper presents a carefully designed study concerning the validity and reliability of the Thai version of the PHQ-9. It is clearly written and easy to understand. However it needs some editing of the English since there are several grammatical errors as well as spelling errors.. Response: The final manuscript will be sent to a native English speaking colleague for language revision. 2. ...The number of depressed is surprisingly low (1.9%) but as the author states this could have been due to a selection bias. This would mean that people who were depressed had chosen to go to the psychiatrists instead of to the GPs. However it could also mean that the PHQ-9 does not capture depression due to underreports of symptoms. Response: We agree with the reviewer. We have included this suggestion in the discussion section on limitations of the study-"Second, there was a possibility that a proportion of participants might have underreported their depressive symptoms on both the PHQ-9 and the MINI clinical interview." (page 15, 3rd paragraph) Major Compulsory Revisions 1. The statement that PHQ-9 was the optimal measure to establish a categorical diagnosis of depression is not supported. The authors might mean when comparing to PHQ-9 used as a continuous measure. Response: We thank the reviewer for her thoughtful comment. This section has been revised to provide more clarity. Result of the PHQ-9 categorical algorithm for detecting major depression showed that it is less useful than the cutoff score for a screening purpose. 2. A ROC curve is presented and the area under the curve is 0.89. The authors state that this means that the PHQ-9 is a good test to identify patients with depressive disorder. This is not entirely true, a better way to analyse the performance of PHQ-9 would be to use QROC curves. Response: We have revised the statement about the AUC value as "The area under the curve (AUC) in this study was 0.89 (SD=0.05, 95% CI 0.85 to 0.92) which demonstrated a moderate accuracy [21]." We thank the reviewer for her kind suggestion of the QROC curves. We agree that this is a better way to analyze the performance of PHQ-9. However, this involves a somewhat sophisticated statistical analysis and a software which is difficult for us to access. As most articles so far report the performance of a screening tool using the ROC curve, we hope that the reviewer accept our request to retain the original ROC curve for analyzing the performance of the PHQ-9.

The Thai Delirium Rating Scale (TDRS) 10 item is a valid diagnostic scale for delirium but has so... more The Thai Delirium Rating Scale (TDRS) 10 item is a valid diagnostic scale for delirium but has some limitations such as low internal consistency of item 2,3,4 and 9, difficulty in assessing derealization or depersonalization symptoms, especially for general practitioners and difficulty in calculating a total score for grading the severity of delirium. TDRS 6 item version has been reanalysed for its validity. The TDRS 10 item were reduced to 6 items and administered to a sample of 85 psychiatric patients to test its reliability and validity. The TDRS 6 item version can discriminate delirium from other psychiatric disease at a cut-off point >10 and has a greater validity and internal consistency than the TDRS 10 item. Cronbach's alpha coefficients of the TDRS 6 item version were nearly the same as TDRS 10 item. The Thai Delirium Rating Scale 6 item version should be used as a brief, feasible and valid instrument to diagnose delirium instead of the Thai Delirium Rating Scale 10 ...

Neuropsychiatric Disease and Treatment, 2015

The self-report version of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) has been developed ... more The self-report version of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) has been developed to overcome the limitations of the clinician-administered version, which needs to be executed by trained personnel and is time consuming. The second edition of the Y-BOCS (Y-BOCS-II) was developed to address some limitations of the original version. However, there is no self-report version of the Y-BOCS-II at the moment. This study aimed to evaluate the psychometric properties of the developed Thai self-report version of the Yale-Brown Obsessive-Compulsive Scale-Second Edition (Y-BOCS-II-SR-T). Patients and methods: Y-BOCS-II-SR-T was developed from the Thai version of the Yale-Brown Obsessive-Compulsive Scale-Second Edition (Y-BOCS-II-T). The Y-BOCS-II-SR-T, the Y-BOCS-II-T, the Thai version of the Florida Obsessive-Compulsive Inventory (FOCI-T), the Hamilton Rating Scale for Depression (HAM-D), the nine-item Patient Health Questionnaire (PHQ-9), and the Pictorial Thai Quality of Life (PTQL) instrument were administered to 52 obsessive-compulsive disorder (OCD) patients. Internal consistency for the Y-BOCS-II-SR-T was calculated with Cronbach's alpha coefficient (α), and the factor analyses were completed. Pearson's correlation was used in determining convergent and divergent validity among the other measures. Results: The mean score of the Y-BOCS-II-SR-T total score was 20.71±11.16. The internal consistencies of the Y-BOCS-II-SR-T total scores, the obsession subscale, and the compulsion subscale scores were excellent (α=0.94, α=0.90, and α=0.89, respectively). The correlation between each item and the Y-BOCS-II-SR-T total score showed strong correlation for all items. Confirmatory factor analysis with model modification showed adequate fit for obsession and compulsion factor models. The Y-BOCS-II-SR-T had strong correlation with the YBOCS-II-T and the FOCI-T (r s .0.90) and weaker correlation with the HAM-D, PHQ-9, and PTQL (r s ,0.60), which implied good convergent and divergent validity. Conclusion: The Y-BOCS-II-SR-T is a psychometrically sound and valid measure for assessing obsessive-compulsive symptoms.

BMC Psychiatry, 2015

Background: The Florida Obsessive-Compulsive Inventory (FOCI) is a self-reported measure to asses... more Background: The Florida Obsessive-Compulsive Inventory (FOCI) is a self-reported measure to assess the symptoms and severity of obsessive-compulsive disorder (OCD), which can be completed in five minutes. Although preliminary studies have shown its good psychometric properties, the study of receiver operating characteristics (ROC) to use it as a screening tool has never been reported elsewhere. This study aimed to use the ROC analysis to determine the optimal cutoff score of the Thai version of the FOCI (FOCI-T). Methods: A total of 197 participants completed the FOCI-T, the Patient Health Questionnaire (PHQ-9), and the Pictorial Thai Quality of Life (PTQL), and they were also interviewed with the Mini International Neuropsychiatric Interview (MINI) for their diagnosis. The ROC analyses of the FOCI-T Severity Scores were computed to determine the best cutoff score. Results: When the Thai version of the MINI was used in the interview, it was found that 38 participants were diagnosed with OCD, 43 participants were non-OCD, and 116 participants were healthy adults. The ROC analyses indicated that the FOCI-T Severity Scale could significantly distinguish OCD patients from non-OCD patients and healthy adults. The area under curve was estimated to be 0.945 (95%CI = 0.903-0.972). A cutoff score of ≥5 provided the best sensitivity (0.92) and specificity (0.82). Conclusion: The Thai version of the Florida Obsessive-Compulsive Inventory has demonstrated its good predictive abilities, so it could be used as a brief screening tool to detect obsessive-compulsive disorder patients with high sensitivity and specificity.

Neuropsychiatric Disease and Treatment, 2015

Purpose: Negative attitudes from doctors and the resulting stigmatization have a strong impact on... more Purpose: Negative attitudes from doctors and the resulting stigmatization have a strong impact on psychiatric patients' poor access to treatment. There are various studies centering on doctors' attitudes toward psychiatric patients, but rarely focusing on the attitudes to specific disorders, such as obsessive-compulsive disorder (OCD). This research aimed to focus on psychiatrists' attitudes toward OCD patients. Patients and methods: The participants were actual psychiatrists who signed a form of consent. The main tool used in this study was a questionnaire developed from a focus group interview of ten psychiatrists about their attitudes toward OCD patients. Results: More than 80% of the participating psychiatrists reported a kindhearted attitude toward OCD patients in the form of pity, understanding, and empathy. Approximately one-third of the respondents thought that OCD patients talk too much, waste a lot of time, and need more patience when compared with other psychiatric disorder sufferers. More than half of the respondents thought that OCD patients had poor compliance with behavioral therapy. The number of psychiatrists who had confidence in treating OCD patients with medications (90.1%) was much higher than those expressing confidence in behavioral therapy (51.7%), and approximately 80% perceived that OCD patients were difficult to treat. Although 70% of the respondents chose medications combined with behavioral therapy as the most preferred mode of treatment, only 7.7% reported that they were proficient in exposure and response prevention. Conclusion: Even though most psychiatrists had a more positive than negative attitude toward OCD patients, they still thought OCD patients were difficult to treat and had poor compliance with behavioral therapy. Only a small number of the participating psychiatrists reported proficiency in exposure and response prevention.

The Scientific World Journal, 2015

This study aimed to examine the reliability and validity of the Thai version of the FOCI (FOCI-T)... more This study aimed to examine the reliability and validity of the Thai version of the FOCI (FOCI-T), which is a brief self-report questionnaire to assess the symptoms and severity of obsessive-compulsive disorder (OCD). Forty-seven OCD patients completed the FOCI-T, the Patient Health Questionnaire (PHQ-9), and the Pictorial Thai Quality of Life (PTQL). They were then interviewed to determine the OCD symptom severity by the Yale-Brown Obsessive-Compulsive Scale-Second Edition (YBOCS-II) and depressive symptoms by the Hamilton Rating Scale for Depression (HAM-D), together with the Global Assessment of Functioning (GAF) and the Clinical Global Impression-Severity Scales (CGI-S). The result showed that the FOCI-T had satisfactory internal consistency reliability on both the Symptom Checklist (KR-20 = 0.86) and the Severity Scale (α=0.92). Regarding validity analyses, the FOCI-T Severity Scale had stronger correlations with the YBOCS-II and CGI-S than the FOCI-T Symptom Checklist. This im...

BMC family practice, Jan 24, 2006

General Practitioners (GPs) in Thailand play an important role in treating psychiatric disorders ... more General Practitioners (GPs) in Thailand play an important role in treating psychiatric disorders since there is a shortage of psychiatrists in the country. Our aim was to examine GP's perception of psychiatric problems, drug treatment and service problems encountered in primary care settings. We distributed 1,193 postal questionnaires inquiring about psychiatric practices and service problems to doctors in primary care settings throughout Thailand. Four hundred and thirty-four questionnaires (36.4%) were returned. Sixty-seven of the respondents (15.4%) who had taken further special training in various fields were excluded from the analysis, giving a total of 367 GPs in this study. Fifty-six per cent of respondents were males and they had worked for 4.6 years on average (median = 3 years). 65.6% (SD = 19.3) of the total patients examined had physical problems, 10.7% (SD = 7.9) had psychiatric problems and 23.9% (SD = 16.0) had both problems. The most common psychiatric diagnoses ...

Psychiatry and Clinical Neurosciences, 2009

Because of the high patient load in Thailand, we need a practical measurement to help primary phy... more Because of the high patient load in Thailand, we need a practical measurement to help primary physicians detect depression. This study aimed to examine the reliability and validity of the Thai version of the World Health Organization-Five Well-Being Index (WHO-5-T), which is short and easy to use as a screening tool for major depression in primary care patients. Methods: The English version of the WHO-Five Well-Being Index was translated into Thai. Backtranslations, cross-cultural adaptation and field testing of the pre-final version with final adjustments were performed accordingly. The WHO-5-T was administered randomly to 300 patients in our primary care clinic. Then the patients were further assessed using the Mini International Neuropsychiatric Interview and the Hamilton Rating Scale for Depression as the gold standard of diagnosis and symptom severity, respectively. Results: Completed data were obtained from 274 respondents. Their mean age was 44.6 years [standard deviation (SD) = 14.7] and 73.7% of them were female. The mean WHO-5-T score was 14.32 (SD = 5.26). The WHO-5-T had a satisfactory internal consistency (Cronbach's alpha = 0.87) and showed moderate convergent validity with the Hamilton Rating Scale for Depression (r =-0.54; P < 0.001). The optimal cutoff score of the WHO-5-T <12 revealed a sensitivity of 0.89 and a specificity of 0.71 in detecting depression. The area under the curve in this study was 0.86 (SD = 0.03, 95% confidence interval 0.81 to 0.89). Conclusions: The Thai version of the WHO-Five Well-Being Index was found to be a reliable and valid self-assessment to screen for major depression in primary care setting at a cutoff point of <12.

Psychiatry and Clinical Neurosciences, 2009

To examine general practitioners&amp;amp;#39; (GPs&amp;amp;#39;) diagnosis of a case vign... more To examine general practitioners&amp;amp;#39; (GPs&amp;amp;#39;) diagnosis of a case vignette presenting both anxiety and depression symptoms, and to understand their treatment preferences for the case. A total of 1193 copies of a questionnaire were sent to doctors in primary care settings throughout Thailand. The questionnaire inquired about GPs&amp;amp;#39; demographic information and training background, as well as common psychiatric diagnoses and drug prescriptions to patients in their practise. A case vignette of a patient presenting both anxiety and depression symptoms was then given, and GPs were asked to describe their diagnosis and treatment preferences. For comparison, postal questionnaires of the same case vignette were also sent to 40 psychiatrists practising in general hospitals, asking their opinion about the diagnosis and treatment preferences. A total of 434 questionnaires (36.4%) were returned. GPs reported that 37.7% of their patients suffered from anxiety disorders while 28.4% suffered from depressive disorders. For the patient in the case vignette, GPs made a diagnosis of anxiety disorders (53.5%) more often than depressive disorders (31.9%), whereas the psychiatrists at the general hospitals made a diagnosis of depressive disorders (54%) more often than anxiety disorders (9.1%). One-third of the GPs prescribed only anxiolytics, while 15.4% prescribed only antidepressants. The most commonly prescribed antidepressant by GPs was amitriptyline, which 93% of GPs used at a dosage below 50 mg/day. Only 5.8% of them prescribed fluoxetine as antidepressant. The most frequently prescribed anxiolytic drug was diazepam (65.4%). The most common combination of drugs prescribed was amitriptyline and diazepam (38.7%). Compared to psychiatrists, GPs were more likely to diagnose anxiety than depression in patients with the same set of symptoms. They also preferred to use amitriptyline to treat depression, and prescribed the drug at a low dose. GPs in Thailand should be encouraged to prescribe fluoxetine for treatment of depression because it is safer and more convenient to use than tricyclic antidepressants.

Neuropsychiatric Disease and Treatment, 2014

The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is regarded as the most acceptable tool for me... more The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is regarded as the most acceptable tool for measuring obsessive-compulsive disorder symptom severity. Recently, the Yale-Brown Obsessive Compulsive Scale-Second Edition (Y-BOCS-II) was developed for better measurement. The study reported here aimed to evaluate the psychometric properties of the Thai version of the Yale-Brown Obsessive Compulsive Scale-Second Edition (Y-BOCS-II-T). Patients and methods: The original version of the Y-BOCS-II was translated into Thai, which involved forward translation, synthesis of the translation, and back translation. Modification and cross-cultural adaptation were completed accordingly. The developed Y-BOCS-II-T, together with the Hamilton Rating Scale for Depression, was administered to 41 patients who had a primary diagnosis of obsessive-compulsive disorder. The patients then completed the Pictorial Thai Quality of Life instrument and Patient Health Questionnaire. Lastly, the Global Assessment of Functioning (GAF) and the Clinical Global Impression-Severity Scale (CGI-S) of all patients were blindly rated by another experienced psychiatrist who was not the interviewer. Results: The mean total score of the Yale-Brown Obsessive Compulsive Scale-Second Edition-Severity Scale (Y-BOCS-II-SS) and the Yale-Brown Obsessive Compulsive Scale-Second Edition-Symptom Checklist (Y-BOCS-II-SC) were 18.44 (standard deviation =10.51) and 15.85 (standard deviation =9.58), respectively. The Y-BOCS-II-T had satisfactory internal consistency (Cronbach's alpha =0.94 for the Severity Scale, and Kuder-Richardson Formula 20 =0.90 for the Symptom Checklist). Inter-rater reliability was excellent for both the Y-BOCS-II-SS and Y-BOCS-II-SC. Factor analysis of Y-BOCS-II-SS items revealed a twofactor component associated with obsession and compulsion. The Y-BOCS-II-SS correlated highly with the CGI-S and GAF (r =0.75 and −0.76, respectively), but the Y-BOCS-II-SC correlated moderately (r=0.42 for CGI-S; r=−0.39 for GAF). The Y-BOCS-II-SS and Y-BOCS-II-SC slightly to moderately correlated with the Hamilton Rating Scale for Depression, Patient Health Questionnaire, and Pictorial Thai Quality of Life, which might indicate the comorbidity depression and its effect on quality of life. Conclusion: The Y-BOCS-II-T is a psychometrically reliable and valid measure for the assessment of both severity and characteristics of obsessive-compulsive symptoms in Thai clinical samples.

BMC Psychiatry, 2008

Background: Most depression screening tools in Thailand are lengthy. The long process makes them ... more Background: Most depression screening tools in Thailand are lengthy. The long process makes them impractical for routine use in primary care. This study aims to examine the reliability and validity of a Thai version Patient Health Questionnaire (PHQ-9) as a screening tool for major depression in primary care patients. Methods: The English language PHQ-9 was translated into Thai. The process involved backtranslation, cross-cultural adaptation, field testing of the pre-final version, as well as final adjustments. The PHQ-9 was then administered among 1,000 patients in family practice clinic. Of these 1,000 patients, 300 were further assessed by the Thai version of the Mini International Neuropsychiatric Interview (MINI) and the Thai version of the Hamilton Rating Scale for Depression (HAM-D). These tools served as gold-standards for diagnosing depression and for assessing symptom severity, respectively. In the assessment, reliability and validity analyses, and receiver operating characteristic curve analysis were performed. Results: Complete data were obtained from 924 participants and 279 interviewed respondents. The mean age of the participants was 45.0 years (SD = 14.3) and 73.7% of them were females. The mean PHQ-9 score was 4.93 (SD = 3.75). The Thai version of the PHQ-9 had satisfactory internal consistency (Cronbach's alpha = 0.79) and showed moderate convergent validity with the HAM-D (r = 0.56; P < 0.001). The categorical algorithm of the PHQ-9 had low sensitivity (0.53) but very high specificity (0.98) and positive likelihood ratio (27.37). Used as a continuous measure, the optimal cutoff score of PHQ-9 ≥ 9 revealed a sensitivity of 0.84, specificity of 0.77, positive predictive value (PPV) of 0.21, negative predictive value (NPV) of 0.99, and positive likelihood ratio of 3.71. The area under the curve (AUC) in this study was 0.89 (SD = 0.05, 95% CI 0.85 to 0.92). Conclusion: The Thai version of the PHQ-9 has acceptable psychometric properties for screening for major depression in general practice with a recommended cutoff score of nine or greater.

Medical Teacher, 2003

Objective: To assess the prevalence of mistreatment perception among medical students as well as ... more Objective: To assess the prevalence of mistreatment perception among medical students as well as to identify the types of mistreatment and their associated factors. Methods: This cross-sectional study surveyed all of the 4 th to 6 th year medical students at the Faculty of Medicine, Prince of Songkla University, from January to April 2017. Three questionnaires were employed: 1) Demographic data 2) Mistreatment perception, and 3) the Patient Health Questionnaire (PHQ)-9 Thai version. The data were analyzed using descriptive statistics. The results were presented as frequency, percentage, average and standard deviation. The factors associated with mistreatment perception were analyzed by means of the chi-square test and logistic regression. Results: Two hundred and ninety-eight medical students (55.0%) completed the questionnaires, 66.1% of them were female. Their mean age was 22.5+1.1 years. As to the medical students' perception, the majority (63.4%) reported experiencing at least one incidence of mistreatment by attending physicians (53.7%), residents (36.2%) and nurses (16.4%) within the previous year. The majority of mistreatment types were verbal criticism (59.7%) and discriminative behavior (51.4%). The mistreated medical students reported consequences such as experiencing unpleasant feelings (41.3%) and burnout (35.6%). According to the PHQ-9 Thai version findings, 11.1% of all of our students had depression; however, depression did not correlate with the mistreatment perception. The significant factor that correlated with mistreatment perception was the academic year. Conclusion: More than a half of the surveyed medical students perceived being mistreated and reported experiencing unpleasant feelings as a consequence.

Dementia and Geriatric Cognitive Disorders, 2018

Background/Aims: Independence and social engagement are important outcomes for people with dement... more Background/Aims: Independence and social engagement are important outcomes for people with dementia. The aim of this study was to conduct an in-depth psychometric assessment of the Engagement and Independence in Dementia Questionnaire (EID-Q), a measure of social independence. Methods: This was an observational study at five NHS sites across England. Participants completed the EID-Q alongside additional measures. Psychometric analysis included internal consistency, test-retest reliability, convergent validity, and factor analyses. Results: A total of 225 people living with dementia completed the study. Internal consistency was excellent (α = 0.921) and the measure remained moderately stable over a 1-week period (ICC = 0.768). Significant correlations were observed between quality of life (r = 0.682) and depression (r = –0.741; both p < 0.001), indicating the importance of these concepts for wellbeing in dementia. Factor analysis indicated the presence of five factors which loaded...

<b>Copyright information:</b>Taken from "Reliability and validity of the Thai ve... more <b>Copyright information:</b>Taken from "Reliability and validity of the Thai version of the PHQ-9"http://www.biomedcentral.com/1471-244X/8/46BMC Psychiatry 2008;8():46-46.Published online 20 Jun 2008PMCID:PMC2443128.

Objectives : To study depression in obsessive-compulsive disorder (OCD) patients. Method : This w... more Objectives : To study depression in obsessive-compulsive disorder (OCD) patients. Method : This was a cross-sectional descriptive study. Participants were OCD patients from out-patient clinic, department of Psychiatry, Ramathibodi hospital and normal adults aged from 18 to 70. All participants answered questionnaires about general identification data and the Thai version of Patient Health Questionnaire (PHQ-9), a self-rated measure for depression. They all were then rated for depression by using the Thai version of the Hamilton rating scale for depression (HAM-D), and OCD patients were further rated for OCD symptom severity by using the Thai version of the Yale-Brown Obsessive -Compulsive Scale -Second Edition (YBOCS-II-T). Result : Forty nine OCD patients and eighty normal adults participated in this study. OCD patients had higher rate of depression (28.6% and 38.8% assessed by HAM-D and PHQ-9 respectively) and suicidal idea (18.4%) than normal adults. The YBOCS-II-T obsession scor...

Objective : To examine co-morbidities in patients with obsessive-compulsive disorder (OCD). Metho... more Objective : To examine co-morbidities in patients with obsessive-compulsive disorder (OCD). Method : The descriptive cross-sectional study was conducted in patients with obsessive-compulsive disorder from the out-patient unit of the Department of Psychiatry, Ramathibodi Hospital between December 2012 to January 2014. The interviewers applied the Mini International Neuropsychiatric Interview, the Yale-Brown Obsessive-Compulsive Scale - Second edition, and the Hamilton rating scale for depression in the interview process. Results : Among 49 OCD patients, 26 cases (53.1%) had other psychiatric disorders. The most common co-morbid disorder found in this study was hypomania (16.3%), followed by panic disorder, social anxiety disorder, generalized anxiety disorder, and psychotic disorders (14.3%). The result also showed that there was suicidality in 11 of 43 OCD patients (22%), which was relatively high. Conclusion : More than half of OCD patients had co-morbid psychiatric disorders. It w...

Objectives : This study aimed to investigate the prevalence and characteristic of obsessive-compu... more Objectives : This study aimed to investigate the prevalence and characteristic of obsessive-compulsive symptoms in normal adults. Methods : This was a descriptive cross-sectional study. Participants were patients’ relatives, hospital staffs and students, including normal adults aged from 18 to 70, who had no history of psychiatric disorders. All participants were interviewed by using Mini International Neuropsychiatric Interview (MINI) and then answered questionnaires about general identification and assessed their own obsessive-compulsive symptoms by using the Thai self-report version of the Yale-Brown Obsessive-Compulsive Scale -Second Edition (YBOCS-II-SR-T). Result : One hundred and five normal adults participated in this study. The prevalence of obsessive-compulsive symptoms was relatively high (65.7%). The mean and standard deviation (SD) of total symptoms per person was 6.85 ± 12.74. The mean and SD of obsessive symptoms was 3.39 ± 6.65 and compulsive symptoms was 3.45 ± 6.34...

Thank you very much for giving us the opportunity to revise our manuscript. We would like to than... more Thank you very much for giving us the opportunity to revise our manuscript. We would like to thank the reviewers' for giving us the highly valuable comments to improve our manuscript. We have revised the manuscript in accordance with all the reviewers' comments. A point-by-point response to the comments is given below. We hope that the revised manuscript and our responses are satisfactory to you. Thank you for your consideration. We look forward to hearing your reply. Sincerely yours, Manote Lotrakul, M.D. Reviewer 1: Yvonne Forsell General 1. The paper presents a carefully designed study concerning the validity and reliability of the Thai version of the PHQ-9. It is clearly written and easy to understand. However it needs some editing of the English since there are several grammatical errors as well as spelling errors.. Response: The final manuscript will be sent to a native English speaking colleague for language revision. 2. ...The number of depressed is surprisingly low (1.9%) but as the author states this could have been due to a selection bias. This would mean that people who were depressed had chosen to go to the psychiatrists instead of to the GPs. However it could also mean that the PHQ-9 does not capture depression due to underreports of symptoms. Response: We agree with the reviewer. We have included this suggestion in the discussion section on limitations of the study-"Second, there was a possibility that a proportion of participants might have underreported their depressive symptoms on both the PHQ-9 and the MINI clinical interview." (page 15, 3rd paragraph) Major Compulsory Revisions 1. The statement that PHQ-9 was the optimal measure to establish a categorical diagnosis of depression is not supported. The authors might mean when comparing to PHQ-9 used as a continuous measure. Response: We thank the reviewer for her thoughtful comment. This section has been revised to provide more clarity. Result of the PHQ-9 categorical algorithm for detecting major depression showed that it is less useful than the cutoff score for a screening purpose. 2. A ROC curve is presented and the area under the curve is 0.89. The authors state that this means that the PHQ-9 is a good test to identify patients with depressive disorder. This is not entirely true, a better way to analyse the performance of PHQ-9 would be to use QROC curves. Response: We have revised the statement about the AUC value as "The area under the curve (AUC) in this study was 0.89 (SD=0.05, 95% CI 0.85 to 0.92) which demonstrated a moderate accuracy [21]." We thank the reviewer for her kind suggestion of the QROC curves. We agree that this is a better way to analyze the performance of PHQ-9. However, this involves a somewhat sophisticated statistical analysis and a software which is difficult for us to access. As most articles so far report the performance of a screening tool using the ROC curve, we hope that the reviewer accept our request to retain the original ROC curve for analyzing the performance of the PHQ-9.

The Thai Delirium Rating Scale (TDRS) 10 item is a valid diagnostic scale for delirium but has so... more The Thai Delirium Rating Scale (TDRS) 10 item is a valid diagnostic scale for delirium but has some limitations such as low internal consistency of item 2,3,4 and 9, difficulty in assessing derealization or depersonalization symptoms, especially for general practitioners and difficulty in calculating a total score for grading the severity of delirium. TDRS 6 item version has been reanalysed for its validity. The TDRS 10 item were reduced to 6 items and administered to a sample of 85 psychiatric patients to test its reliability and validity. The TDRS 6 item version can discriminate delirium from other psychiatric disease at a cut-off point >10 and has a greater validity and internal consistency than the TDRS 10 item. Cronbach's alpha coefficients of the TDRS 6 item version were nearly the same as TDRS 10 item. The Thai Delirium Rating Scale 6 item version should be used as a brief, feasible and valid instrument to diagnose delirium instead of the Thai Delirium Rating Scale 10 ...

Neuropsychiatric Disease and Treatment, 2015

The self-report version of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) has been developed ... more The self-report version of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) has been developed to overcome the limitations of the clinician-administered version, which needs to be executed by trained personnel and is time consuming. The second edition of the Y-BOCS (Y-BOCS-II) was developed to address some limitations of the original version. However, there is no self-report version of the Y-BOCS-II at the moment. This study aimed to evaluate the psychometric properties of the developed Thai self-report version of the Yale-Brown Obsessive-Compulsive Scale-Second Edition (Y-BOCS-II-SR-T). Patients and methods: Y-BOCS-II-SR-T was developed from the Thai version of the Yale-Brown Obsessive-Compulsive Scale-Second Edition (Y-BOCS-II-T). The Y-BOCS-II-SR-T, the Y-BOCS-II-T, the Thai version of the Florida Obsessive-Compulsive Inventory (FOCI-T), the Hamilton Rating Scale for Depression (HAM-D), the nine-item Patient Health Questionnaire (PHQ-9), and the Pictorial Thai Quality of Life (PTQL) instrument were administered to 52 obsessive-compulsive disorder (OCD) patients. Internal consistency for the Y-BOCS-II-SR-T was calculated with Cronbach's alpha coefficient (α), and the factor analyses were completed. Pearson's correlation was used in determining convergent and divergent validity among the other measures. Results: The mean score of the Y-BOCS-II-SR-T total score was 20.71±11.16. The internal consistencies of the Y-BOCS-II-SR-T total scores, the obsession subscale, and the compulsion subscale scores were excellent (α=0.94, α=0.90, and α=0.89, respectively). The correlation between each item and the Y-BOCS-II-SR-T total score showed strong correlation for all items. Confirmatory factor analysis with model modification showed adequate fit for obsession and compulsion factor models. The Y-BOCS-II-SR-T had strong correlation with the YBOCS-II-T and the FOCI-T (r s .0.90) and weaker correlation with the HAM-D, PHQ-9, and PTQL (r s ,0.60), which implied good convergent and divergent validity. Conclusion: The Y-BOCS-II-SR-T is a psychometrically sound and valid measure for assessing obsessive-compulsive symptoms.

BMC Psychiatry, 2015

Background: The Florida Obsessive-Compulsive Inventory (FOCI) is a self-reported measure to asses... more Background: The Florida Obsessive-Compulsive Inventory (FOCI) is a self-reported measure to assess the symptoms and severity of obsessive-compulsive disorder (OCD), which can be completed in five minutes. Although preliminary studies have shown its good psychometric properties, the study of receiver operating characteristics (ROC) to use it as a screening tool has never been reported elsewhere. This study aimed to use the ROC analysis to determine the optimal cutoff score of the Thai version of the FOCI (FOCI-T). Methods: A total of 197 participants completed the FOCI-T, the Patient Health Questionnaire (PHQ-9), and the Pictorial Thai Quality of Life (PTQL), and they were also interviewed with the Mini International Neuropsychiatric Interview (MINI) for their diagnosis. The ROC analyses of the FOCI-T Severity Scores were computed to determine the best cutoff score. Results: When the Thai version of the MINI was used in the interview, it was found that 38 participants were diagnosed with OCD, 43 participants were non-OCD, and 116 participants were healthy adults. The ROC analyses indicated that the FOCI-T Severity Scale could significantly distinguish OCD patients from non-OCD patients and healthy adults. The area under curve was estimated to be 0.945 (95%CI = 0.903-0.972). A cutoff score of ≥5 provided the best sensitivity (0.92) and specificity (0.82). Conclusion: The Thai version of the Florida Obsessive-Compulsive Inventory has demonstrated its good predictive abilities, so it could be used as a brief screening tool to detect obsessive-compulsive disorder patients with high sensitivity and specificity.

Neuropsychiatric Disease and Treatment, 2015

Purpose: Negative attitudes from doctors and the resulting stigmatization have a strong impact on... more Purpose: Negative attitudes from doctors and the resulting stigmatization have a strong impact on psychiatric patients' poor access to treatment. There are various studies centering on doctors' attitudes toward psychiatric patients, but rarely focusing on the attitudes to specific disorders, such as obsessive-compulsive disorder (OCD). This research aimed to focus on psychiatrists' attitudes toward OCD patients. Patients and methods: The participants were actual psychiatrists who signed a form of consent. The main tool used in this study was a questionnaire developed from a focus group interview of ten psychiatrists about their attitudes toward OCD patients. Results: More than 80% of the participating psychiatrists reported a kindhearted attitude toward OCD patients in the form of pity, understanding, and empathy. Approximately one-third of the respondents thought that OCD patients talk too much, waste a lot of time, and need more patience when compared with other psychiatric disorder sufferers. More than half of the respondents thought that OCD patients had poor compliance with behavioral therapy. The number of psychiatrists who had confidence in treating OCD patients with medications (90.1%) was much higher than those expressing confidence in behavioral therapy (51.7%), and approximately 80% perceived that OCD patients were difficult to treat. Although 70% of the respondents chose medications combined with behavioral therapy as the most preferred mode of treatment, only 7.7% reported that they were proficient in exposure and response prevention. Conclusion: Even though most psychiatrists had a more positive than negative attitude toward OCD patients, they still thought OCD patients were difficult to treat and had poor compliance with behavioral therapy. Only a small number of the participating psychiatrists reported proficiency in exposure and response prevention.

The Scientific World Journal, 2015

This study aimed to examine the reliability and validity of the Thai version of the FOCI (FOCI-T)... more This study aimed to examine the reliability and validity of the Thai version of the FOCI (FOCI-T), which is a brief self-report questionnaire to assess the symptoms and severity of obsessive-compulsive disorder (OCD). Forty-seven OCD patients completed the FOCI-T, the Patient Health Questionnaire (PHQ-9), and the Pictorial Thai Quality of Life (PTQL). They were then interviewed to determine the OCD symptom severity by the Yale-Brown Obsessive-Compulsive Scale-Second Edition (YBOCS-II) and depressive symptoms by the Hamilton Rating Scale for Depression (HAM-D), together with the Global Assessment of Functioning (GAF) and the Clinical Global Impression-Severity Scales (CGI-S). The result showed that the FOCI-T had satisfactory internal consistency reliability on both the Symptom Checklist (KR-20 = 0.86) and the Severity Scale (α=0.92). Regarding validity analyses, the FOCI-T Severity Scale had stronger correlations with the YBOCS-II and CGI-S than the FOCI-T Symptom Checklist. This im...

BMC family practice, Jan 24, 2006

General Practitioners (GPs) in Thailand play an important role in treating psychiatric disorders ... more General Practitioners (GPs) in Thailand play an important role in treating psychiatric disorders since there is a shortage of psychiatrists in the country. Our aim was to examine GP's perception of psychiatric problems, drug treatment and service problems encountered in primary care settings. We distributed 1,193 postal questionnaires inquiring about psychiatric practices and service problems to doctors in primary care settings throughout Thailand. Four hundred and thirty-four questionnaires (36.4%) were returned. Sixty-seven of the respondents (15.4%) who had taken further special training in various fields were excluded from the analysis, giving a total of 367 GPs in this study. Fifty-six per cent of respondents were males and they had worked for 4.6 years on average (median = 3 years). 65.6% (SD = 19.3) of the total patients examined had physical problems, 10.7% (SD = 7.9) had psychiatric problems and 23.9% (SD = 16.0) had both problems. The most common psychiatric diagnoses ...

Psychiatry and Clinical Neurosciences, 2009

Because of the high patient load in Thailand, we need a practical measurement to help primary phy... more Because of the high patient load in Thailand, we need a practical measurement to help primary physicians detect depression. This study aimed to examine the reliability and validity of the Thai version of the World Health Organization-Five Well-Being Index (WHO-5-T), which is short and easy to use as a screening tool for major depression in primary care patients. Methods: The English version of the WHO-Five Well-Being Index was translated into Thai. Backtranslations, cross-cultural adaptation and field testing of the pre-final version with final adjustments were performed accordingly. The WHO-5-T was administered randomly to 300 patients in our primary care clinic. Then the patients were further assessed using the Mini International Neuropsychiatric Interview and the Hamilton Rating Scale for Depression as the gold standard of diagnosis and symptom severity, respectively. Results: Completed data were obtained from 274 respondents. Their mean age was 44.6 years [standard deviation (SD) = 14.7] and 73.7% of them were female. The mean WHO-5-T score was 14.32 (SD = 5.26). The WHO-5-T had a satisfactory internal consistency (Cronbach's alpha = 0.87) and showed moderate convergent validity with the Hamilton Rating Scale for Depression (r =-0.54; P < 0.001). The optimal cutoff score of the WHO-5-T <12 revealed a sensitivity of 0.89 and a specificity of 0.71 in detecting depression. The area under the curve in this study was 0.86 (SD = 0.03, 95% confidence interval 0.81 to 0.89). Conclusions: The Thai version of the WHO-Five Well-Being Index was found to be a reliable and valid self-assessment to screen for major depression in primary care setting at a cutoff point of <12.

Psychiatry and Clinical Neurosciences, 2009

To examine general practitioners&amp;amp;#39; (GPs&amp;amp;#39;) diagnosis of a case vign... more To examine general practitioners&amp;amp;#39; (GPs&amp;amp;#39;) diagnosis of a case vignette presenting both anxiety and depression symptoms, and to understand their treatment preferences for the case. A total of 1193 copies of a questionnaire were sent to doctors in primary care settings throughout Thailand. The questionnaire inquired about GPs&amp;amp;#39; demographic information and training background, as well as common psychiatric diagnoses and drug prescriptions to patients in their practise. A case vignette of a patient presenting both anxiety and depression symptoms was then given, and GPs were asked to describe their diagnosis and treatment preferences. For comparison, postal questionnaires of the same case vignette were also sent to 40 psychiatrists practising in general hospitals, asking their opinion about the diagnosis and treatment preferences. A total of 434 questionnaires (36.4%) were returned. GPs reported that 37.7% of their patients suffered from anxiety disorders while 28.4% suffered from depressive disorders. For the patient in the case vignette, GPs made a diagnosis of anxiety disorders (53.5%) more often than depressive disorders (31.9%), whereas the psychiatrists at the general hospitals made a diagnosis of depressive disorders (54%) more often than anxiety disorders (9.1%). One-third of the GPs prescribed only anxiolytics, while 15.4% prescribed only antidepressants. The most commonly prescribed antidepressant by GPs was amitriptyline, which 93% of GPs used at a dosage below 50 mg/day. Only 5.8% of them prescribed fluoxetine as antidepressant. The most frequently prescribed anxiolytic drug was diazepam (65.4%). The most common combination of drugs prescribed was amitriptyline and diazepam (38.7%). Compared to psychiatrists, GPs were more likely to diagnose anxiety than depression in patients with the same set of symptoms. They also preferred to use amitriptyline to treat depression, and prescribed the drug at a low dose. GPs in Thailand should be encouraged to prescribe fluoxetine for treatment of depression because it is safer and more convenient to use than tricyclic antidepressants.

Neuropsychiatric Disease and Treatment, 2014

The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is regarded as the most acceptable tool for me... more The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is regarded as the most acceptable tool for measuring obsessive-compulsive disorder symptom severity. Recently, the Yale-Brown Obsessive Compulsive Scale-Second Edition (Y-BOCS-II) was developed for better measurement. The study reported here aimed to evaluate the psychometric properties of the Thai version of the Yale-Brown Obsessive Compulsive Scale-Second Edition (Y-BOCS-II-T). Patients and methods: The original version of the Y-BOCS-II was translated into Thai, which involved forward translation, synthesis of the translation, and back translation. Modification and cross-cultural adaptation were completed accordingly. The developed Y-BOCS-II-T, together with the Hamilton Rating Scale for Depression, was administered to 41 patients who had a primary diagnosis of obsessive-compulsive disorder. The patients then completed the Pictorial Thai Quality of Life instrument and Patient Health Questionnaire. Lastly, the Global Assessment of Functioning (GAF) and the Clinical Global Impression-Severity Scale (CGI-S) of all patients were blindly rated by another experienced psychiatrist who was not the interviewer. Results: The mean total score of the Yale-Brown Obsessive Compulsive Scale-Second Edition-Severity Scale (Y-BOCS-II-SS) and the Yale-Brown Obsessive Compulsive Scale-Second Edition-Symptom Checklist (Y-BOCS-II-SC) were 18.44 (standard deviation =10.51) and 15.85 (standard deviation =9.58), respectively. The Y-BOCS-II-T had satisfactory internal consistency (Cronbach's alpha =0.94 for the Severity Scale, and Kuder-Richardson Formula 20 =0.90 for the Symptom Checklist). Inter-rater reliability was excellent for both the Y-BOCS-II-SS and Y-BOCS-II-SC. Factor analysis of Y-BOCS-II-SS items revealed a twofactor component associated with obsession and compulsion. The Y-BOCS-II-SS correlated highly with the CGI-S and GAF (r =0.75 and −0.76, respectively), but the Y-BOCS-II-SC correlated moderately (r=0.42 for CGI-S; r=−0.39 for GAF). The Y-BOCS-II-SS and Y-BOCS-II-SC slightly to moderately correlated with the Hamilton Rating Scale for Depression, Patient Health Questionnaire, and Pictorial Thai Quality of Life, which might indicate the comorbidity depression and its effect on quality of life. Conclusion: The Y-BOCS-II-T is a psychometrically reliable and valid measure for the assessment of both severity and characteristics of obsessive-compulsive symptoms in Thai clinical samples.

BMC Psychiatry, 2008

Background: Most depression screening tools in Thailand are lengthy. The long process makes them ... more Background: Most depression screening tools in Thailand are lengthy. The long process makes them impractical for routine use in primary care. This study aims to examine the reliability and validity of a Thai version Patient Health Questionnaire (PHQ-9) as a screening tool for major depression in primary care patients. Methods: The English language PHQ-9 was translated into Thai. The process involved backtranslation, cross-cultural adaptation, field testing of the pre-final version, as well as final adjustments. The PHQ-9 was then administered among 1,000 patients in family practice clinic. Of these 1,000 patients, 300 were further assessed by the Thai version of the Mini International Neuropsychiatric Interview (MINI) and the Thai version of the Hamilton Rating Scale for Depression (HAM-D). These tools served as gold-standards for diagnosing depression and for assessing symptom severity, respectively. In the assessment, reliability and validity analyses, and receiver operating characteristic curve analysis were performed. Results: Complete data were obtained from 924 participants and 279 interviewed respondents. The mean age of the participants was 45.0 years (SD = 14.3) and 73.7% of them were females. The mean PHQ-9 score was 4.93 (SD = 3.75). The Thai version of the PHQ-9 had satisfactory internal consistency (Cronbach's alpha = 0.79) and showed moderate convergent validity with the HAM-D (r = 0.56; P < 0.001). The categorical algorithm of the PHQ-9 had low sensitivity (0.53) but very high specificity (0.98) and positive likelihood ratio (27.37). Used as a continuous measure, the optimal cutoff score of PHQ-9 ≥ 9 revealed a sensitivity of 0.84, specificity of 0.77, positive predictive value (PPV) of 0.21, negative predictive value (NPV) of 0.99, and positive likelihood ratio of 3.71. The area under the curve (AUC) in this study was 0.89 (SD = 0.05, 95% CI 0.85 to 0.92). Conclusion: The Thai version of the PHQ-9 has acceptable psychometric properties for screening for major depression in general practice with a recommended cutoff score of nine or greater.

Medical Teacher, 2003

Objective: To assess the prevalence of mistreatment perception among medical students as well as ... more Objective: To assess the prevalence of mistreatment perception among medical students as well as to identify the types of mistreatment and their associated factors. Methods: This cross-sectional study surveyed all of the 4 th to 6 th year medical students at the Faculty of Medicine, Prince of Songkla University, from January to April 2017. Three questionnaires were employed: 1) Demographic data 2) Mistreatment perception, and 3) the Patient Health Questionnaire (PHQ)-9 Thai version. The data were analyzed using descriptive statistics. The results were presented as frequency, percentage, average and standard deviation. The factors associated with mistreatment perception were analyzed by means of the chi-square test and logistic regression. Results: Two hundred and ninety-eight medical students (55.0%) completed the questionnaires, 66.1% of them were female. Their mean age was 22.5+1.1 years. As to the medical students' perception, the majority (63.4%) reported experiencing at least one incidence of mistreatment by attending physicians (53.7%), residents (36.2%) and nurses (16.4%) within the previous year. The majority of mistreatment types were verbal criticism (59.7%) and discriminative behavior (51.4%). The mistreated medical students reported consequences such as experiencing unpleasant feelings (41.3%) and burnout (35.6%). According to the PHQ-9 Thai version findings, 11.1% of all of our students had depression; however, depression did not correlate with the mistreatment perception. The significant factor that correlated with mistreatment perception was the academic year. Conclusion: More than a half of the surveyed medical students perceived being mistreated and reported experiencing unpleasant feelings as a consequence.