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Research paper thumbnail of Yale-Brown Obsessive-Compulsive Scale--Second Edition; Thai Version

Research paper thumbnail of Florida Obsessive-Compulsive Inventory--Thai Version

Research paper thumbnail of Reliability and validity of the Thai self-report version of the Yale–Brown Obsessive–Compulsive Scale-Second Edition

Neuropsychiatric Disease and Treatment, 2015

Research paper thumbnail of A study of diagnostic accuracy of the Florida Obsessive-Compulsive Inventory – Thai Version (FOCI-T)

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 cut-off 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 cut-off 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 cut-off score of ≥5 provided the best sensitivity (0.92) and specificity (0.82).

Research paper thumbnail of Cross-cultural aspects of psychotic symptoms in Thai major depressive patients

A retrospective study of 71 patients with major depression with psychotic features by DSM-IV crit... more A retrospective study of 71 patients with major depression with psychotic features by DSM-IV criteria was conducted based on medical records between 1987 and 1996 at the out-patient psychiatric unit of Ramathibodi Hospital. Data analysis revealed that 76.8% of patients had hallucinations, 49.3% had delusions, and 27.5% presented with both symptoms. The most common types of hallucinations and delusions were auditory hallucinations and persecutory delusions respectively. Nearly all delusions were categorized as mood-incongruent whereas only 15% showed mood-congruent delusions. In contrast to the typical finding in Western societies, very few patients had delusions of guilt. Cultural differences in the concept of the self are discussed as the main contributing factor.

Research paper thumbnail of Attitudes of psychiatrists toward obsessive–compulsive disorder patients

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.

Research paper thumbnail of Reliability and Validity of the Thai Version of the Florida Obsessive-Compulsive Inventory

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...

Research paper thumbnail of Psychiatric services in primary care settings: a survey of general practitioners in Thailand

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 ...

Research paper thumbnail of Reliability and validity of the Thai version of the WHO-Five Well-Being Index in primary care patients

Psychiatry and Clinical Neurosciences, 2009

Aims: Because of the high patient load in Thailand, we need a practical measurement to help prima... more Aims: 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.

Research paper thumbnail of How do general practitioners in Thailand diagnose and treat patients presenting with anxiety and depression?

Psychiatry and Clinical Neurosciences, 2009

Aims: To examine general practitioners' (GPs') diagnosis of a case vignette presenting both anxie... more Aims: To examine general practitioners' (GPs') diagnosis of a case vignette presenting both anxiety and depression symptoms, and to understand their treatment preferences for the case.

Research paper thumbnail of Stress among medical students in a Thai medical school

Medical Teacher, 2003

This study aimed to determine the prevalence and sources of stress among Thai medical students. T... more This study aimed to determine the prevalence and sources of stress among Thai medical students. The questionnaires,which consisted of the Thai Stress Test (TST) and questions asking about sources of stress, were sent to all medical students in the Faculty of Medicine, Ramathibodi Hospital, Thailand. A total of 686 students participated. The results showed that about 61.4% of students had some degree of stress. Seventeen students (2.4%) reported a high level of stress. The prevalence of stress is highest among third-year medical students. Academic problems were found to be a major cause of stress among all students. The most prevalent source of academic stress was the test/exam. Other sources of stress in medical school and their relationships are also discussed. The findings can help medical teachers understand more about stress among their students and guide the way to improvement in an academic context, which is important for student achievement.

Research paper thumbnail of Reliability and validity of the Thai version of the Yale–Brown Obsessive Compulsive Scale – Second Edition in clinical samples

Neuropsychiatric Disease and Treatment, 2014

Research paper thumbnail of Reliability and Validity of the Thai Version of the PHQ-9

BMC psychiatry, Jan 1, 2008

Background Most depression screening tools in Thailand are lengthy. The long process makes them i... 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 back-translation, 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 cut-off 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 cut-off score of nine or greater.

Research paper thumbnail of Yale-Brown Obsessive-Compulsive Scale--Second Edition; Thai Version

Research paper thumbnail of Florida Obsessive-Compulsive Inventory--Thai Version

Research paper thumbnail of Reliability and validity of the Thai self-report version of the Yale–Brown Obsessive–Compulsive Scale-Second Edition

Neuropsychiatric Disease and Treatment, 2015

Research paper thumbnail of A study of diagnostic accuracy of the Florida Obsessive-Compulsive Inventory – Thai Version (FOCI-T)

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 cut-off 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 cut-off 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 cut-off score of ≥5 provided the best sensitivity (0.92) and specificity (0.82).

Research paper thumbnail of Cross-cultural aspects of psychotic symptoms in Thai major depressive patients

A retrospective study of 71 patients with major depression with psychotic features by DSM-IV crit... more A retrospective study of 71 patients with major depression with psychotic features by DSM-IV criteria was conducted based on medical records between 1987 and 1996 at the out-patient psychiatric unit of Ramathibodi Hospital. Data analysis revealed that 76.8% of patients had hallucinations, 49.3% had delusions, and 27.5% presented with both symptoms. The most common types of hallucinations and delusions were auditory hallucinations and persecutory delusions respectively. Nearly all delusions were categorized as mood-incongruent whereas only 15% showed mood-congruent delusions. In contrast to the typical finding in Western societies, very few patients had delusions of guilt. Cultural differences in the concept of the self are discussed as the main contributing factor.

Research paper thumbnail of Attitudes of psychiatrists toward obsessive–compulsive disorder patients

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.

Research paper thumbnail of Reliability and Validity of the Thai Version of the Florida Obsessive-Compulsive Inventory

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...

Research paper thumbnail of Psychiatric services in primary care settings: a survey of general practitioners in Thailand

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 ...

Research paper thumbnail of Reliability and validity of the Thai version of the WHO-Five Well-Being Index in primary care patients

Psychiatry and Clinical Neurosciences, 2009

Aims: Because of the high patient load in Thailand, we need a practical measurement to help prima... more Aims: 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.

Research paper thumbnail of How do general practitioners in Thailand diagnose and treat patients presenting with anxiety and depression?

Psychiatry and Clinical Neurosciences, 2009

Aims: To examine general practitioners' (GPs') diagnosis of a case vignette presenting both anxie... more Aims: To examine general practitioners' (GPs') diagnosis of a case vignette presenting both anxiety and depression symptoms, and to understand their treatment preferences for the case.

Research paper thumbnail of Stress among medical students in a Thai medical school

Medical Teacher, 2003

This study aimed to determine the prevalence and sources of stress among Thai medical students. T... more This study aimed to determine the prevalence and sources of stress among Thai medical students. The questionnaires,which consisted of the Thai Stress Test (TST) and questions asking about sources of stress, were sent to all medical students in the Faculty of Medicine, Ramathibodi Hospital, Thailand. A total of 686 students participated. The results showed that about 61.4% of students had some degree of stress. Seventeen students (2.4%) reported a high level of stress. The prevalence of stress is highest among third-year medical students. Academic problems were found to be a major cause of stress among all students. The most prevalent source of academic stress was the test/exam. Other sources of stress in medical school and their relationships are also discussed. The findings can help medical teachers understand more about stress among their students and guide the way to improvement in an academic context, which is important for student achievement.

Research paper thumbnail of Reliability and validity of the Thai version of the Yale–Brown Obsessive Compulsive Scale – Second Edition in clinical samples

Neuropsychiatric Disease and Treatment, 2014

Research paper thumbnail of Reliability and Validity of the Thai Version of the PHQ-9

BMC psychiatry, Jan 1, 2008

Background Most depression screening tools in Thailand are lengthy. The long process makes them i... 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 back-translation, 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 cut-off 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 cut-off score of nine or greater.