Sawitri Assanangkornchai - Academia.edu (original) (raw)

Papers by Sawitri Assanangkornchai

PLOS ONE, 2021

Background The term "transgender" refers to an individual whose gender identity is diff... more Background The term "transgender" refers to an individual whose gender identity is different from their sex assigned at birth, whereas the term "cisgender" refers to an individual whose gender identity is the same as their sex assigned at birth. In Thailand, studies on health outcomes and quality of life of Thai transgender youths have not included assessments from nationally-representative samples. The objective of this study is to assess the extent that behavioral health outcomes and exposure to violence varied by gender among respondents of the National School Survey on Alcohol Consumption, Substance Use and Other Health-Risk Behaviors. Methods We used data from a nationally-representative self-administered survey of secondary school students in years 7, 9 and 11 and classified participants as cisgender boys, cisgender girls, transgender boys, and transgender girls. Participants also answered questions on depressive experience, suicidality, sexual behaviors, a...

BMC Public Health, 2021

Background Presence of metabolic syndrome (MetS) in early life may influence cardiovascular outco... more Background Presence of metabolic syndrome (MetS) in early life may influence cardiovascular outcome later in adulthood. There is limited data regarding MetS among Thai adolescents. This study aimed to estimate the prevalence of MetS and related factors in Thai adolescents. Methods Data on MetS components of 1934 Thai adolescents aged 10–16 years were obtained from the 5th National Health Examination Survey. Age at first screen time exposure, duration of screen time, frequency of food intake and physical activities were collected from interviews. MetS was defined according to 3 definitions: International Diabetes Federation (IDF), Cook’s, and de Ferranti’s. Results The prevalence of MetS was 4.1% by IDF, 8.0% by Cook’s, and 16.8% by de Ferranti’s definition. The overall prevalence was higher in male (19.0%) than female adolescents (15.3%). The most common MetS components composition among Thai adolescents was high waist circumference with high serum triglyceride and low HDL-cholester...

Asean Journal of Psychiatry, 2018

Objective: To test the hypothesis that drinking alcohol even at a low level is associated with lo... more Objective: To test the hypothesis that drinking alcohol even at a low level is associated with low-to-moderate health-related quality of life (HRQoL), compared to abstainers. Methods: A nested case-control study was conducted in Songkhla province, Thailand. The adult respondents (15+years) with low-to-moderate HRQoL scores (EQ-5D index  £ 0.8, n = 108) were assigned to be a case group and those with high HRQoL (EQ-5D index > 0.8, n = 443) a control group. The average alcohol consumption was estimated by the beverage-specific quantity-frequency (BSQF) questionnaire. Multivariate logistic regression models were used to evaluate the association between low-moderate HRQoL and drinking behavior. The model was adjusted for socio-demographic variables. Results: Compared with lifetime abstention, light drinking (0.1-7 drinks/week) was significantly associated with low-moderate HRQoL (Odds ratio, OR=3.16, 95%confidence interval, CI, 1.08-9.20); however, no significant associations were ...

Objective: To study the sensitivity, specificity, predictive value and validity of a depression a... more Objective: To study the sensitivity, specificity, predictive value and validity of a depression and suicidal risk screening test that compared with the psychiatristus, diagnosis. Method: The study was devided into four stage. Stage I, Revision of items of prior screening test by expertsu opioids and item analysis reconsideration. Stage II, the agreement test between psychiatristus diagnosis and psychiatric nurseus diagnosis using M.I.N.I.. Stage III, the new version of depression and suicidal risk screening test was validate by a sample to 387 outpatients at Khon-Kaen Rajanagarindra Psychiatrict Hospital. Stage IV, validatity testing of this instrument in 1,471 participants at the four Primary Care Unit of Khon-Kaen province. In the last stage, each subject was interviewed by researcherus team, if the test result was positive, they would be referred to the psychiatrist for diagnosis, if the test result was negative, they would be referred to the psychiatric nurse to interview by usi...

Objectives:To compare the differences in psychological response and associated sysptoms between a... more Objectives:To compare the differences in psychological response and associated sysptoms between a manmade and naturat disaster in different regions of Thailand. Materials and Methods:A cross-sectional survey was done of people 18 and over from Thailand’s four regions and Bangkok using stratified four-stage cluster sampling All subjects were given the Composite International Diagnostic Interview version 3.0. The data were analyzed then compared using the chi-square tests. with Rao-Scott correction. Results:We identified 292 subjects had faced traumatic events (86 manmade, 206 naturaldiasters) and psychological response. Males were more likely to be stressed from a manmade disasters than females (71.3% vs. 28.7%, respectively), while females were more likely to be stressed from a natural disasters (61.2% vs. 38.8%, respectively). The highest prevalence of facing a manmade disasters was in the northeast region (36.6%), while the highest prevalence of facing a natural disaster was in th...

Scientific Reports, 2021

There are limited data on chronic kidney disease of unknown etiology (CKDu) from Southeast Asia. ... more There are limited data on chronic kidney disease of unknown etiology (CKDu) from Southeast Asia. Initially described in working age men, a common approach to detect CKDu that includes all adults has recently been proposed. We determined the prevalence, and risk factors for CKDu using data from a cross-sectional, nationally representative survey of the adult population of Thailand. We used a proxy for CKDu as age < 70 with impaired kidney function (eGFR < 60) in the absence of diabetes and hypertension (CKDu1) and heavy proteinuria (CKDu2). Prevalence estimates were probability-weighted for the Thai population. The associations between risk factors and CKDu or elderly subjects with eGFR < 60 without traditional causes were assessed by multivariable logistic regression. Of 17,329 subjects, the prevalence were: eGFR < 60, 5.3%; CKDu1 0.78%; CKDu2, 0.75%. CKDu differed by 4.3-folds between regions. Women, farmers/laborers, older age, gout, painkillers, rural area, and stones...

PLOS ONE, 2021

Background In the context of scaling up free antiretroviral therapy (ART), healthcare equality is... more Background In the context of scaling up free antiretroviral therapy (ART), healthcare equality is essential for people living with HIV. We aimed to assess socioeconomic-related inequalities in uptake of continuous care for people living with HIV receiving ART, including retention in care in the last six months, routine toxicity monitoring, adequate immunological and virological monitoring, and uptake of mental health assessment in the last 12 months. We also determined the contributions of socioeconomic factors to the degree of inequalities. Methods A hospital-based cross-sectional survey was conducted among consecutive clients visiting an HIV treatment center in Kunming, China in 2019. Participants were 702 people living with HIV aged ≥18 years (median age: 41.0 years, 69.4% male) who had been on ART for 1–5 years. Socioeconomic-related inequality and its contributing factors were assessed by a normalized concentration index (CIn) with a decomposition approach. Results The uptake o...

BMC Infectious Diseases, 2021

Background Continuous care is essential for people living with HIV. This study aimed to measure c... more Background Continuous care is essential for people living with HIV. This study aimed to measure continuous care uptake and investigate the association between higher uptake of continuous care and behavioral and social factors, including HIV-acquisition risk and socioeconomic characteristics. Methods A hospital-based cross-sectional study was conducted from April to November 2019 in an HIV treatment center of a specialized hospital in Kunming city, China. Fourteen service indicators were used to calculate composite care scores, which were classified into three levels (low, middle, and high), using principal component analysis. The Behavioral Model for Vulnerable Populations was employed to examine predisposing, enabling, and need factors associated with composite care scores among people living with HIV. Results A total of 702 participants living with HIV aged ≥ 18 years (median age: 41.0 years, 69.4% male) who had been on ART for 1–5 years were recruited. Based on ordinal logistic r...

Purpose Previous evidence indicates significant associations between alcohol-use disorders (AUD) ... more Purpose Previous evidence indicates significant associations between alcohol-use disorders (AUD) and depressive disorders and their strong links with social conditions. This study aims to investigate the association between AUD and major depressive episode (MDE) across various socio-economic groups. Methods Data from the 2014 Thai National Health Examination Survey was obtained containing a random sample of 13,177 adults aged > 20 years from the whole population. The Alcohol-Use Disorders Identification Test (AUDIT) was used to classify respondents into non-problem, hazardous drinking (score 8-15) and harmful-dependent drinking (score 16-40). MDE was identified using questions based on the DSM-IV. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated using logistic regression to determine the strength of associations. Results The prevalence of hazardous, harmful-dependent drinking and MDE was 10.3%, 1.9% and 2.5%, respectively. The association between MDE a...

Substance Abuse Treatment, Prevention, and Policy, 2020

Introduction Alcohol consumption is associated with domestic violence, but the extent that binge-... more Introduction Alcohol consumption is associated with domestic violence, but the extent that binge-drinking and the household role of drinkers strengthens this association is unknown. We assessed the extent that binge-drinking behavior and the household role of the drinker were associated with alcohol-related domestic violence. Methods We analyzed data from a nationally-representative census survey of 36,364 households in Thailand, of whom 17,759 households had one or more drinkers (n = 17,759 households). We aggregated the interview data of individuals living in the same households to create household-level attributes. We used multivariate log-binomial regression analyses to calculate prevalence ratios (PR) and measure the association between drinking behavior of household members and reported domestic violence during the previous 12 months. Results Among households with one current drinker, households with a binge-drinker had higher prevalence of reported domestic violence than hous...

Quality of Life Research, 2020

Objective To assess health status of HIV-positive patients and to examine its predictors in Kunmi... more Objective To assess health status of HIV-positive patients and to examine its predictors in Kunming, China. Methods HIV-positive patients were recruited from a general hospital and an infection hospital in 2015. Health status of the patients was evaluated using standardized questions on eight health domains (mobility, self-care, pain and discomfort, cognition, interpersonal activities, vision, sleep and energy, and emotional distress) of the WHO World Health Survey. A multivariate linear regression model was employed to explore the predictors of health status. Results A total of 1,363 HIV patients were recruited. The mean (SD) health status score was 73.4 (18.2), with the prevalence of reporting problems ranging from 17.6% (self-care problems) to 86.3% (vision problems). CD 4 count, occupation, household income, accessibility to healthcare services, and healthcare expenditures were found to be significant predictors of health status. Conclusions Healthcare services for HIV patients may assist improvement of interpersonal activities and relieve emotional distress, and efforts are needed to continually increase accessibility to the services. Special attention should be given to those at low socioeconomic level and those suffering from low CD 4 count.

International Journal of Environmental Research and Public Health, 2020

Little is known about the impact of methodological decisions on estimating disability weights amo... more Little is known about the impact of methodological decisions on estimating disability weights among patients with mental and physical disorders, and the effects of socio-demographic status on the estimation of these weights. A cross-sectional study was conducted in three hospitals in southern Thailand to describe the disability weights based on different valuation methods. Altogether, 150 patients with major depressive disorder, 150 with alcohol use disorder, and 150 with osteoarthritis with varying levels of severity were recruited. Using a face-to-face interview, all patients completed a visual analogue scale (VAS) and were randomly assigned to complete either the European Quality of Life-5 Dimensions (EQ-5D) or Time-trade-off (TTO) instrument to estimate their current utility score, which was consequently transformed to a disability weight. Significant differences were found between disability weights derived from the three instruments for the same disease, with the VAS providing...

Drug and Alcohol Dependence, 2019

Background: To estimate and compare the socioeconomic inequities in alcohol-related harms among h... more Background: To estimate and compare the socioeconomic inequities in alcohol-related harms among households in Thailand between 2007 and 2017 adjusted for socioeconomic status with the proportions of current and binge drinkers in each household. Methods: A secondary data analysis of the 2007 and 2017 National Cigarette and Alcohol Consumption Survey was conducted. The unit of analysis was household-level. Concentration index (CI) was used to measure household income-based inequalities in alcohol-related harms (i.e., workplace, domestic, non-domestic, financial, and drinking-and-driving) in the previous 12 months. Results: Based on data from two waves of survey (n = 66,776 in 2007 and 39,630 in 2017), the prevalence of households that had at least one member who had an alcohol-related harm event was 21.8% and 26.2% in 2007 and 2017, respectively. The highest prevalence was the drinking-and-driving domain (about 20%). The prevalence increased between 2007 and 2017 with an annual rate of change ranged from 1.2 to 4.4%. All of the CI values were negative for both survey waves, except the drink-and-driving domain in 2007. The CI values for all domains in 2017 had a larger magnitude than in 2007, except the domestic domain. For any alcohol-related harm, the CI value was not significant at +0.002 (Standard error [SE] 0.004) in 2007, but significant at-0.014 (SE 0.004) in 2017. So, the index changed around-0.016. Conclusions: The poor households had a slightly greater tendency to incur harms from alcohol and there existed more inequality in the prevalence of harms in 2017 compared with 2007.

Current Addiction Reports, 2019

Purpose of review: The 5 th edition of the Diagnostic and Statistical Manual of Mental Disorders ... more Purpose of review: The 5 th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorizes gambling disorder in the section on substance-related and addictive disorders and the 11 th revision of the International Classification of Diseases (ICD-11) includes both gambling and gaming disorder as disorders due to addictive behaviors. However, there is less evidence for other putative behavioral addictions. This review focuses on requirements for epidemiological studies of disorders that may be considered as behavioral addictions and compares the current state of research with principles of sound epidemiological research. Recent findings: In studies of behavioral addictions, samples are often quite small, which may lead to increased random error. The lack of sound assessment tools-particularly the lack of agreed-upon diagnostic criteria and standardized diagnostic interviews-may also increase systematic error. Other concerns related to systematic bias include the use of convenience samples, lack of pro-active recruitment, inadequate assessment of confounding variables, and a dearth of representative and longitudinal studies. Summary: This review recommends that future studies of putative behavioral addictions should more closely adhere to methodological standards of epidemiological research to reduce random and systematic error. Specific recommendations are detailed to advance epidemiological research in this area with the aim of improving the evidence base and generating more refined public health recommendations and policies.

Journal of Substance Use, 2018

Despite the availability of numerous anecdotal reports of polydrug use in kratom users, few studi... more Despite the availability of numerous anecdotal reports of polydrug use in kratom users, few studies have been carried out in Thailand. This study aimed to explore the problem of polydrug use among Thai kratom users. A national household survey on the prevalence of substance use was conducted in 2011 using a multistage random sampling technique. Participants were interviewed using a structured questionnaire. The frequency of other substance use was compared between respondents with and without a history of kratom use. Of the total sample (18,457), 544 (2.9%) acknowledged kratom use. Eighty-nine (46.1%) used it almost every day. The mean age of users (SD) was 42.7 (12.8) years old, 459 (84.4%) were male, and 264 (48.5%) had used other illicit drugs in the past. Kratom users were significantly more likely to use heroin, ecstasy, and ice with adjusted odds ratios of 39.7, 30.5, and 29.1, respectively. Of 195 who acknowledged kratom use in the past 12 months, 22 (11.3%) concurrently used other illicit drugs, including cannabis, amphetamine-type stimulants (ATSs), and inhalants. Polydrug use is common in Thai kratom users who are more likely to use opiates and ATSs in their lifetime. Another drug concurrently used was cannabis. Health personnel need to be aware of polydrug use in this population.`A RTICLE HISTORY

Asian Journal of Psychiatry, 2019

Objectives: To estimate the average cost of an integrated alcohol intervention program at communi... more Objectives: To estimate the average cost of an integrated alcohol intervention program at community hospitals of Thailand and identify patient predictors and sources of variation of the program cost. Methods: Activity-based costing was conducted under a societal perspective among 113 outpatient alcohol users (29 low-risk, 43 high-risk and 41 dependent drinkers), aged 15 years and older, at four community hospitals in southern Thailand. Multivariate regression models were performed to identify individual-level determinants of cost components. Results: The average cost per low-risk, high-risk, and dependent drinkers were 516 (16 USD), 2,961 (94 USD), and 5,325 baht (168 USD), respectively, of which labor and patient costs were the major components. Regardless of drinking risk level, past-year functional disturbance lasting more than 20 days (β=0.215, p=0.035) and increasing number of previous treatment episodes (β=0.035, p=0.046) independently increased overall program cost. Variation in the program cost was mainly caused by length of hospital stay followed by staff time for screening and delivering interventions. Conclusion: The study underlines the important role of pretreatment alcohol-related problems and human resources in alcohol intervention programs. Efforts should be focused on adequacy of treatment for the very first episode of alcohol problems to reduce the high healthcare costs.

PLOS ONE, 2018

There are many survey instruments to determine drinking patterns and alcohol consumption levels i... more There are many survey instruments to determine drinking patterns and alcohol consumption levels in the general population. This study aims to compare the context-specific quantityfrequency (CSQF) and beverage-specific quantity-frequency (BSQF) methods to estimate alcohol consumption indices at individual and sample levels. A community-based cross-sectional study was conducted among a population aged 15 years and older in Songkhla Province, Thailand. The BSQF and CSQF questionnaires with a 3-month retrospective time frame and in random order were applied to each participant. The CSQF was developed to ask more about the drinking contexts. The questions elicited information on location, partner, beverage, quantity, and frequency for five common drinking situations. Among 804 participants, 183 drank alcohol in the last three months. At the individual level, total alcohol consumption of almost all types of beverage by the CSQF was higher than the BSQF in approximately 50% of current drinkers and was mainly accounted for by the higher report of average quantity. At the sample level, there were no significant differences in the average daily intake, 3-month intake per drinker or per capita consumption between instruments. The interview duration and burden of answering the questions by the participants for the CSQF were not significantly higher than those for the BSQF. In summary, the fuller picture of drinking behaviors from the CSQF has several valuable methodological advantages and provides information allowing alcohol policies to be more directly specific to certain target populations or situations. The CSQF is a prototype questionnaire and forms the basis for a contextual approach. However, additional methodological studies need to be explored.

Drug and Alcohol Review, 2019

Introduction and Aims. Alcohol-related harm reduction may target individuals, their households or... more Introduction and Aims. Alcohol-related harm reduction may target individuals, their households or communities. This study investigates the prevalence of and socioeconomic inequalities in alcohol use and alcohol-related consequences (injury, accident, property loss and interpersonal violence) at the family-level. Designs and Methods. A cross-sectional survey of 2394 households was conducted in eight provinces from six socioeconomic regions and two metropolitan cities in Vietnam. Family-level alcohol use and injury were computed from individual data, while other measures were on a household basis. Unstandardised and indirectly standardised concentration index was used to measure degree of expenditure-based inequality in alcohol use and its consequences. Results. Over the previous 12 months, 88.5% and 46.2% of households had at least one current-drinker and one heavy episodic drinking person, and in 41.7% the heavy episodic drinking person was the breadwinner. About 5.3% of households suffered alcohol-related injury, accident or property loss; 11.4% reported alcohol-related interpersonal violence. Poor and near-poor households suffered the double-burdens of both having heavy episodic drinking person and alcohol-related harm. A modest socioeconomic gradient was observed with all types of drinker, more concentrated among higher living-standard households, especially in urban areas. However, there was a persistent high-level inequality disadvantaging lower living-standard families, especially in rural areas, in suffering all measured alcohol-related harms. Discussion and Conclusions. Alcohol use and alcohol-related consequences are highly prevalent in Vietnam. Lower socioeconomic households, especially in rural areas, are important target groups for alcohol-related harm prevention and reduction interventions. The concentration index appeared to be a useful measure of inequalities in alcohol-related harms. [Hanh HTM, Assanangkornchai S, Geater AF, Hanh VTM. Socioeconomic inequalities in alcohol use and some related consequences from a household perspective in Vietnam. Drug Alcohol Rev 2019]

PLOS ONE, 2019

Objectives To estimate the impacts and social value relative to the cost of the Integrated Manage... more Objectives To estimate the impacts and social value relative to the cost of the Integrated Management of Alcohol Intervention Program in the Health Care System (i-MAP) on direct beneficiaries, using a Social Return on Investment (SROI) analysis. Method A mixed-method approach was conducted among stakeholders and 113 drinkers (29 lowrisk, 43 high-risk, and 41 dependent drinkers) who consecutively received i-MAP at four community hospitals in Songkhla province of Thailand. Resources for program implementation as well as drinking and a list of psychosocial outcomes, selected through stakeholder interviews, were measured among participants during and at the sixth month after participation, respectively. SROI (societal benefit-to-cost) ratio of i-MAP was estimated over a 5-year time horizon and shown in 2017 Thai baht, where US$1.00 = 33.1 baht. One-way and probabilistic sensitivity analyses of key parameters were performed among treatment subgroups. Results Baseline estimates of the annual cost and 5-year social value of i-MAP were 25.5 and 51.0 million baht, respectively, yielding an estimated SROI ratio of 2.0, with a possible range of 1.3 to 2.4. Value created by the program was mostly attributed to broader gains to society (productivity gains and averted crime costs) and drinkers. Subgroup analyses suggested that the SROI ratio for high-risk drinkers was twice that for dependent drinkers (2.8 vs. 1.5). The probabilistic sensitivity analysis showed that more than 99% of the simulated treatments for both high-risk and dependent groups yielded benefits beyond the corresponding costs.

Asian journal of psychiatry, Jan 6, 2018

The study investigated the prevalence of depressive and anxiety disorders and suicide risk in ger... more The study investigated the prevalence of depressive and anxiety disorders and suicide risk in geriatric outpatients in tertiary care hospitals. An observational, cross-sectional study was conducted with 803 participants aged 60 and above attending geriatric outpatient clinics in tertiary care hospitals in Thailand. Participants were assessed using DSM-IV-TR criteria to calculate the prevalence of deressive and anxiety disorders, and their suicide risk. Montreal Cognitive Assessment (MoCA), Perceived Stress Scale (PSS), Multidimensional Scale of Perceived Social Support, Core Symptom Index (CSI), 15-item Geriatric Depression Scale (GDS-15), Neuroticism Inventory (NI) and the Revised Experience of Close Relationships Questionnaire (ECR-R) were administered. Quality of life was assessed using the EuroQoL (EQ-5D). The prevalence rate for depressive disorders was 23.7%, anxiety disorders was 6.4%, and current suicide risk was 20.4%. PSS, MSPSS, GDS, CSI, and NI scores were significantly ...

PLOS ONE, 2021

Background The term "transgender" refers to an individual whose gender identity is diff... more Background The term "transgender" refers to an individual whose gender identity is different from their sex assigned at birth, whereas the term "cisgender" refers to an individual whose gender identity is the same as their sex assigned at birth. In Thailand, studies on health outcomes and quality of life of Thai transgender youths have not included assessments from nationally-representative samples. The objective of this study is to assess the extent that behavioral health outcomes and exposure to violence varied by gender among respondents of the National School Survey on Alcohol Consumption, Substance Use and Other Health-Risk Behaviors. Methods We used data from a nationally-representative self-administered survey of secondary school students in years 7, 9 and 11 and classified participants as cisgender boys, cisgender girls, transgender boys, and transgender girls. Participants also answered questions on depressive experience, suicidality, sexual behaviors, a...

BMC Public Health, 2021

Background Presence of metabolic syndrome (MetS) in early life may influence cardiovascular outco... more Background Presence of metabolic syndrome (MetS) in early life may influence cardiovascular outcome later in adulthood. There is limited data regarding MetS among Thai adolescents. This study aimed to estimate the prevalence of MetS and related factors in Thai adolescents. Methods Data on MetS components of 1934 Thai adolescents aged 10–16 years were obtained from the 5th National Health Examination Survey. Age at first screen time exposure, duration of screen time, frequency of food intake and physical activities were collected from interviews. MetS was defined according to 3 definitions: International Diabetes Federation (IDF), Cook’s, and de Ferranti’s. Results The prevalence of MetS was 4.1% by IDF, 8.0% by Cook’s, and 16.8% by de Ferranti’s definition. The overall prevalence was higher in male (19.0%) than female adolescents (15.3%). The most common MetS components composition among Thai adolescents was high waist circumference with high serum triglyceride and low HDL-cholester...

Asean Journal of Psychiatry, 2018

Objective: To test the hypothesis that drinking alcohol even at a low level is associated with lo... more Objective: To test the hypothesis that drinking alcohol even at a low level is associated with low-to-moderate health-related quality of life (HRQoL), compared to abstainers. Methods: A nested case-control study was conducted in Songkhla province, Thailand. The adult respondents (15+years) with low-to-moderate HRQoL scores (EQ-5D index  £ 0.8, n = 108) were assigned to be a case group and those with high HRQoL (EQ-5D index > 0.8, n = 443) a control group. The average alcohol consumption was estimated by the beverage-specific quantity-frequency (BSQF) questionnaire. Multivariate logistic regression models were used to evaluate the association between low-moderate HRQoL and drinking behavior. The model was adjusted for socio-demographic variables. Results: Compared with lifetime abstention, light drinking (0.1-7 drinks/week) was significantly associated with low-moderate HRQoL (Odds ratio, OR=3.16, 95%confidence interval, CI, 1.08-9.20); however, no significant associations were ...

Objective: To study the sensitivity, specificity, predictive value and validity of a depression a... more Objective: To study the sensitivity, specificity, predictive value and validity of a depression and suicidal risk screening test that compared with the psychiatristus, diagnosis. Method: The study was devided into four stage. Stage I, Revision of items of prior screening test by expertsu opioids and item analysis reconsideration. Stage II, the agreement test between psychiatristus diagnosis and psychiatric nurseus diagnosis using M.I.N.I.. Stage III, the new version of depression and suicidal risk screening test was validate by a sample to 387 outpatients at Khon-Kaen Rajanagarindra Psychiatrict Hospital. Stage IV, validatity testing of this instrument in 1,471 participants at the four Primary Care Unit of Khon-Kaen province. In the last stage, each subject was interviewed by researcherus team, if the test result was positive, they would be referred to the psychiatrist for diagnosis, if the test result was negative, they would be referred to the psychiatric nurse to interview by usi...

Objectives:To compare the differences in psychological response and associated sysptoms between a... more Objectives:To compare the differences in psychological response and associated sysptoms between a manmade and naturat disaster in different regions of Thailand. Materials and Methods:A cross-sectional survey was done of people 18 and over from Thailand’s four regions and Bangkok using stratified four-stage cluster sampling All subjects were given the Composite International Diagnostic Interview version 3.0. The data were analyzed then compared using the chi-square tests. with Rao-Scott correction. Results:We identified 292 subjects had faced traumatic events (86 manmade, 206 naturaldiasters) and psychological response. Males were more likely to be stressed from a manmade disasters than females (71.3% vs. 28.7%, respectively), while females were more likely to be stressed from a natural disasters (61.2% vs. 38.8%, respectively). The highest prevalence of facing a manmade disasters was in the northeast region (36.6%), while the highest prevalence of facing a natural disaster was in th...

Scientific Reports, 2021

There are limited data on chronic kidney disease of unknown etiology (CKDu) from Southeast Asia. ... more There are limited data on chronic kidney disease of unknown etiology (CKDu) from Southeast Asia. Initially described in working age men, a common approach to detect CKDu that includes all adults has recently been proposed. We determined the prevalence, and risk factors for CKDu using data from a cross-sectional, nationally representative survey of the adult population of Thailand. We used a proxy for CKDu as age < 70 with impaired kidney function (eGFR < 60) in the absence of diabetes and hypertension (CKDu1) and heavy proteinuria (CKDu2). Prevalence estimates were probability-weighted for the Thai population. The associations between risk factors and CKDu or elderly subjects with eGFR < 60 without traditional causes were assessed by multivariable logistic regression. Of 17,329 subjects, the prevalence were: eGFR < 60, 5.3%; CKDu1 0.78%; CKDu2, 0.75%. CKDu differed by 4.3-folds between regions. Women, farmers/laborers, older age, gout, painkillers, rural area, and stones...

PLOS ONE, 2021

Background In the context of scaling up free antiretroviral therapy (ART), healthcare equality is... more Background In the context of scaling up free antiretroviral therapy (ART), healthcare equality is essential for people living with HIV. We aimed to assess socioeconomic-related inequalities in uptake of continuous care for people living with HIV receiving ART, including retention in care in the last six months, routine toxicity monitoring, adequate immunological and virological monitoring, and uptake of mental health assessment in the last 12 months. We also determined the contributions of socioeconomic factors to the degree of inequalities. Methods A hospital-based cross-sectional survey was conducted among consecutive clients visiting an HIV treatment center in Kunming, China in 2019. Participants were 702 people living with HIV aged ≥18 years (median age: 41.0 years, 69.4% male) who had been on ART for 1–5 years. Socioeconomic-related inequality and its contributing factors were assessed by a normalized concentration index (CIn) with a decomposition approach. Results The uptake o...

BMC Infectious Diseases, 2021

Background Continuous care is essential for people living with HIV. This study aimed to measure c... more Background Continuous care is essential for people living with HIV. This study aimed to measure continuous care uptake and investigate the association between higher uptake of continuous care and behavioral and social factors, including HIV-acquisition risk and socioeconomic characteristics. Methods A hospital-based cross-sectional study was conducted from April to November 2019 in an HIV treatment center of a specialized hospital in Kunming city, China. Fourteen service indicators were used to calculate composite care scores, which were classified into three levels (low, middle, and high), using principal component analysis. The Behavioral Model for Vulnerable Populations was employed to examine predisposing, enabling, and need factors associated with composite care scores among people living with HIV. Results A total of 702 participants living with HIV aged ≥ 18 years (median age: 41.0 years, 69.4% male) who had been on ART for 1–5 years were recruited. Based on ordinal logistic r...

Purpose Previous evidence indicates significant associations between alcohol-use disorders (AUD) ... more Purpose Previous evidence indicates significant associations between alcohol-use disorders (AUD) and depressive disorders and their strong links with social conditions. This study aims to investigate the association between AUD and major depressive episode (MDE) across various socio-economic groups. Methods Data from the 2014 Thai National Health Examination Survey was obtained containing a random sample of 13,177 adults aged > 20 years from the whole population. The Alcohol-Use Disorders Identification Test (AUDIT) was used to classify respondents into non-problem, hazardous drinking (score 8-15) and harmful-dependent drinking (score 16-40). MDE was identified using questions based on the DSM-IV. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated using logistic regression to determine the strength of associations. Results The prevalence of hazardous, harmful-dependent drinking and MDE was 10.3%, 1.9% and 2.5%, respectively. The association between MDE a...

Substance Abuse Treatment, Prevention, and Policy, 2020

Introduction Alcohol consumption is associated with domestic violence, but the extent that binge-... more Introduction Alcohol consumption is associated with domestic violence, but the extent that binge-drinking and the household role of drinkers strengthens this association is unknown. We assessed the extent that binge-drinking behavior and the household role of the drinker were associated with alcohol-related domestic violence. Methods We analyzed data from a nationally-representative census survey of 36,364 households in Thailand, of whom 17,759 households had one or more drinkers (n = 17,759 households). We aggregated the interview data of individuals living in the same households to create household-level attributes. We used multivariate log-binomial regression analyses to calculate prevalence ratios (PR) and measure the association between drinking behavior of household members and reported domestic violence during the previous 12 months. Results Among households with one current drinker, households with a binge-drinker had higher prevalence of reported domestic violence than hous...

Quality of Life Research, 2020

Objective To assess health status of HIV-positive patients and to examine its predictors in Kunmi... more Objective To assess health status of HIV-positive patients and to examine its predictors in Kunming, China. Methods HIV-positive patients were recruited from a general hospital and an infection hospital in 2015. Health status of the patients was evaluated using standardized questions on eight health domains (mobility, self-care, pain and discomfort, cognition, interpersonal activities, vision, sleep and energy, and emotional distress) of the WHO World Health Survey. A multivariate linear regression model was employed to explore the predictors of health status. Results A total of 1,363 HIV patients were recruited. The mean (SD) health status score was 73.4 (18.2), with the prevalence of reporting problems ranging from 17.6% (self-care problems) to 86.3% (vision problems). CD 4 count, occupation, household income, accessibility to healthcare services, and healthcare expenditures were found to be significant predictors of health status. Conclusions Healthcare services for HIV patients may assist improvement of interpersonal activities and relieve emotional distress, and efforts are needed to continually increase accessibility to the services. Special attention should be given to those at low socioeconomic level and those suffering from low CD 4 count.

International Journal of Environmental Research and Public Health, 2020

Little is known about the impact of methodological decisions on estimating disability weights amo... more Little is known about the impact of methodological decisions on estimating disability weights among patients with mental and physical disorders, and the effects of socio-demographic status on the estimation of these weights. A cross-sectional study was conducted in three hospitals in southern Thailand to describe the disability weights based on different valuation methods. Altogether, 150 patients with major depressive disorder, 150 with alcohol use disorder, and 150 with osteoarthritis with varying levels of severity were recruited. Using a face-to-face interview, all patients completed a visual analogue scale (VAS) and were randomly assigned to complete either the European Quality of Life-5 Dimensions (EQ-5D) or Time-trade-off (TTO) instrument to estimate their current utility score, which was consequently transformed to a disability weight. Significant differences were found between disability weights derived from the three instruments for the same disease, with the VAS providing...

Drug and Alcohol Dependence, 2019

Background: To estimate and compare the socioeconomic inequities in alcohol-related harms among h... more Background: To estimate and compare the socioeconomic inequities in alcohol-related harms among households in Thailand between 2007 and 2017 adjusted for socioeconomic status with the proportions of current and binge drinkers in each household. Methods: A secondary data analysis of the 2007 and 2017 National Cigarette and Alcohol Consumption Survey was conducted. The unit of analysis was household-level. Concentration index (CI) was used to measure household income-based inequalities in alcohol-related harms (i.e., workplace, domestic, non-domestic, financial, and drinking-and-driving) in the previous 12 months. Results: Based on data from two waves of survey (n = 66,776 in 2007 and 39,630 in 2017), the prevalence of households that had at least one member who had an alcohol-related harm event was 21.8% and 26.2% in 2007 and 2017, respectively. The highest prevalence was the drinking-and-driving domain (about 20%). The prevalence increased between 2007 and 2017 with an annual rate of change ranged from 1.2 to 4.4%. All of the CI values were negative for both survey waves, except the drink-and-driving domain in 2007. The CI values for all domains in 2017 had a larger magnitude than in 2007, except the domestic domain. For any alcohol-related harm, the CI value was not significant at +0.002 (Standard error [SE] 0.004) in 2007, but significant at-0.014 (SE 0.004) in 2017. So, the index changed around-0.016. Conclusions: The poor households had a slightly greater tendency to incur harms from alcohol and there existed more inequality in the prevalence of harms in 2017 compared with 2007.

Current Addiction Reports, 2019

Purpose of review: The 5 th edition of the Diagnostic and Statistical Manual of Mental Disorders ... more Purpose of review: The 5 th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorizes gambling disorder in the section on substance-related and addictive disorders and the 11 th revision of the International Classification of Diseases (ICD-11) includes both gambling and gaming disorder as disorders due to addictive behaviors. However, there is less evidence for other putative behavioral addictions. This review focuses on requirements for epidemiological studies of disorders that may be considered as behavioral addictions and compares the current state of research with principles of sound epidemiological research. Recent findings: In studies of behavioral addictions, samples are often quite small, which may lead to increased random error. The lack of sound assessment tools-particularly the lack of agreed-upon diagnostic criteria and standardized diagnostic interviews-may also increase systematic error. Other concerns related to systematic bias include the use of convenience samples, lack of pro-active recruitment, inadequate assessment of confounding variables, and a dearth of representative and longitudinal studies. Summary: This review recommends that future studies of putative behavioral addictions should more closely adhere to methodological standards of epidemiological research to reduce random and systematic error. Specific recommendations are detailed to advance epidemiological research in this area with the aim of improving the evidence base and generating more refined public health recommendations and policies.

Journal of Substance Use, 2018

Despite the availability of numerous anecdotal reports of polydrug use in kratom users, few studi... more Despite the availability of numerous anecdotal reports of polydrug use in kratom users, few studies have been carried out in Thailand. This study aimed to explore the problem of polydrug use among Thai kratom users. A national household survey on the prevalence of substance use was conducted in 2011 using a multistage random sampling technique. Participants were interviewed using a structured questionnaire. The frequency of other substance use was compared between respondents with and without a history of kratom use. Of the total sample (18,457), 544 (2.9%) acknowledged kratom use. Eighty-nine (46.1%) used it almost every day. The mean age of users (SD) was 42.7 (12.8) years old, 459 (84.4%) were male, and 264 (48.5%) had used other illicit drugs in the past. Kratom users were significantly more likely to use heroin, ecstasy, and ice with adjusted odds ratios of 39.7, 30.5, and 29.1, respectively. Of 195 who acknowledged kratom use in the past 12 months, 22 (11.3%) concurrently used other illicit drugs, including cannabis, amphetamine-type stimulants (ATSs), and inhalants. Polydrug use is common in Thai kratom users who are more likely to use opiates and ATSs in their lifetime. Another drug concurrently used was cannabis. Health personnel need to be aware of polydrug use in this population.`A RTICLE HISTORY

Asian Journal of Psychiatry, 2019

Objectives: To estimate the average cost of an integrated alcohol intervention program at communi... more Objectives: To estimate the average cost of an integrated alcohol intervention program at community hospitals of Thailand and identify patient predictors and sources of variation of the program cost. Methods: Activity-based costing was conducted under a societal perspective among 113 outpatient alcohol users (29 low-risk, 43 high-risk and 41 dependent drinkers), aged 15 years and older, at four community hospitals in southern Thailand. Multivariate regression models were performed to identify individual-level determinants of cost components. Results: The average cost per low-risk, high-risk, and dependent drinkers were 516 (16 USD), 2,961 (94 USD), and 5,325 baht (168 USD), respectively, of which labor and patient costs were the major components. Regardless of drinking risk level, past-year functional disturbance lasting more than 20 days (β=0.215, p=0.035) and increasing number of previous treatment episodes (β=0.035, p=0.046) independently increased overall program cost. Variation in the program cost was mainly caused by length of hospital stay followed by staff time for screening and delivering interventions. Conclusion: The study underlines the important role of pretreatment alcohol-related problems and human resources in alcohol intervention programs. Efforts should be focused on adequacy of treatment for the very first episode of alcohol problems to reduce the high healthcare costs.

PLOS ONE, 2018

There are many survey instruments to determine drinking patterns and alcohol consumption levels i... more There are many survey instruments to determine drinking patterns and alcohol consumption levels in the general population. This study aims to compare the context-specific quantityfrequency (CSQF) and beverage-specific quantity-frequency (BSQF) methods to estimate alcohol consumption indices at individual and sample levels. A community-based cross-sectional study was conducted among a population aged 15 years and older in Songkhla Province, Thailand. The BSQF and CSQF questionnaires with a 3-month retrospective time frame and in random order were applied to each participant. The CSQF was developed to ask more about the drinking contexts. The questions elicited information on location, partner, beverage, quantity, and frequency for five common drinking situations. Among 804 participants, 183 drank alcohol in the last three months. At the individual level, total alcohol consumption of almost all types of beverage by the CSQF was higher than the BSQF in approximately 50% of current drinkers and was mainly accounted for by the higher report of average quantity. At the sample level, there were no significant differences in the average daily intake, 3-month intake per drinker or per capita consumption between instruments. The interview duration and burden of answering the questions by the participants for the CSQF were not significantly higher than those for the BSQF. In summary, the fuller picture of drinking behaviors from the CSQF has several valuable methodological advantages and provides information allowing alcohol policies to be more directly specific to certain target populations or situations. The CSQF is a prototype questionnaire and forms the basis for a contextual approach. However, additional methodological studies need to be explored.

Drug and Alcohol Review, 2019

Introduction and Aims. Alcohol-related harm reduction may target individuals, their households or... more Introduction and Aims. Alcohol-related harm reduction may target individuals, their households or communities. This study investigates the prevalence of and socioeconomic inequalities in alcohol use and alcohol-related consequences (injury, accident, property loss and interpersonal violence) at the family-level. Designs and Methods. A cross-sectional survey of 2394 households was conducted in eight provinces from six socioeconomic regions and two metropolitan cities in Vietnam. Family-level alcohol use and injury were computed from individual data, while other measures were on a household basis. Unstandardised and indirectly standardised concentration index was used to measure degree of expenditure-based inequality in alcohol use and its consequences. Results. Over the previous 12 months, 88.5% and 46.2% of households had at least one current-drinker and one heavy episodic drinking person, and in 41.7% the heavy episodic drinking person was the breadwinner. About 5.3% of households suffered alcohol-related injury, accident or property loss; 11.4% reported alcohol-related interpersonal violence. Poor and near-poor households suffered the double-burdens of both having heavy episodic drinking person and alcohol-related harm. A modest socioeconomic gradient was observed with all types of drinker, more concentrated among higher living-standard households, especially in urban areas. However, there was a persistent high-level inequality disadvantaging lower living-standard families, especially in rural areas, in suffering all measured alcohol-related harms. Discussion and Conclusions. Alcohol use and alcohol-related consequences are highly prevalent in Vietnam. Lower socioeconomic households, especially in rural areas, are important target groups for alcohol-related harm prevention and reduction interventions. The concentration index appeared to be a useful measure of inequalities in alcohol-related harms. [Hanh HTM, Assanangkornchai S, Geater AF, Hanh VTM. Socioeconomic inequalities in alcohol use and some related consequences from a household perspective in Vietnam. Drug Alcohol Rev 2019]

PLOS ONE, 2019

Objectives To estimate the impacts and social value relative to the cost of the Integrated Manage... more Objectives To estimate the impacts and social value relative to the cost of the Integrated Management of Alcohol Intervention Program in the Health Care System (i-MAP) on direct beneficiaries, using a Social Return on Investment (SROI) analysis. Method A mixed-method approach was conducted among stakeholders and 113 drinkers (29 lowrisk, 43 high-risk, and 41 dependent drinkers) who consecutively received i-MAP at four community hospitals in Songkhla province of Thailand. Resources for program implementation as well as drinking and a list of psychosocial outcomes, selected through stakeholder interviews, were measured among participants during and at the sixth month after participation, respectively. SROI (societal benefit-to-cost) ratio of i-MAP was estimated over a 5-year time horizon and shown in 2017 Thai baht, where US$1.00 = 33.1 baht. One-way and probabilistic sensitivity analyses of key parameters were performed among treatment subgroups. Results Baseline estimates of the annual cost and 5-year social value of i-MAP were 25.5 and 51.0 million baht, respectively, yielding an estimated SROI ratio of 2.0, with a possible range of 1.3 to 2.4. Value created by the program was mostly attributed to broader gains to society (productivity gains and averted crime costs) and drinkers. Subgroup analyses suggested that the SROI ratio for high-risk drinkers was twice that for dependent drinkers (2.8 vs. 1.5). The probabilistic sensitivity analysis showed that more than 99% of the simulated treatments for both high-risk and dependent groups yielded benefits beyond the corresponding costs.

Asian journal of psychiatry, Jan 6, 2018

The study investigated the prevalence of depressive and anxiety disorders and suicide risk in ger... more The study investigated the prevalence of depressive and anxiety disorders and suicide risk in geriatric outpatients in tertiary care hospitals. An observational, cross-sectional study was conducted with 803 participants aged 60 and above attending geriatric outpatient clinics in tertiary care hospitals in Thailand. Participants were assessed using DSM-IV-TR criteria to calculate the prevalence of deressive and anxiety disorders, and their suicide risk. Montreal Cognitive Assessment (MoCA), Perceived Stress Scale (PSS), Multidimensional Scale of Perceived Social Support, Core Symptom Index (CSI), 15-item Geriatric Depression Scale (GDS-15), Neuroticism Inventory (NI) and the Revised Experience of Close Relationships Questionnaire (ECR-R) were administered. Quality of life was assessed using the EuroQoL (EQ-5D). The prevalence rate for depressive disorders was 23.7%, anxiety disorders was 6.4%, and current suicide risk was 20.4%. PSS, MSPSS, GDS, CSI, and NI scores were significantly ...