Editorial
Perinatal mental health in Singapore: Implementation opportunities and relevance of gender-carer roles in screening
In this issue of the Annals, the consensus statement on perinatal mental health by Chen et al. covers the handling of depression and anxiety...
Original Article
Impact of COVID-19 on mental health and social service provision in Singapore: Learnings from a descriptive mixed-methods study for future resource planning
Coronavirus disease 2019 (COVID-19) was declared a global health emergency by the World Health Organization in January 2020.1 Singapore reported its first case of...
Editorial
Impact of COVID-19 on mental health and healthcare service delivery
The COVID-19 pandemic has claimed more than 6.8 million lives globally.2 While there is yet a cure for the disease, vaccines are now available...
Review Article
Exploring loss and grief during the COVID-19 pandemic: A scoping review of qualitative studies
As of mid October 2022, the World Health Organization recorded that more than 620 million people worldwide have been infected by SARS-CoV-2, the virus...
Letter to the Editor
Employers’ attitudes towards employing people with mental health conditions
Dear Editor,
The advantages of employment for young people with mental health conditions (PMHC) are well known and documented,1 but many remain unemployed. Besides offering...
Editorial
Different strokes for different folks
Atrial fibrillation (AF) remains the most common arrhythmia since William Harvey’s observation of fibrillating auricles in open chest animal models in 1628. Willem Einthoven...
Review Article
Barriers to breast cancer screening in Singapore: A literature review
Breast cancer is a major public health concern and a leading cause of cancer death among women worldwide, including Singapore.1 According to the 2018...
Original Article
Interaction of sex and diabetes in Asian patients with heart failure with mildly reduced left ventricular ejection fraction
Diabetes mellitus (DM) is a common comorbidity worldwide with global prevalence among adults above 18 years of age increasing from 4.7% in 1980 to...
Original Article
Prevalence of burnout among healthcare professionals in Singapore
Burnout was first described in 1974 by Herbert Freudenberger, where he discussed the concept based on physical signs, behavioural indicators, judgment, emotional factors, and...
Editorial
Bridging electroconvulsive therapy in schizophrenia with cognition and quality of life
Schizophrenia is one of the most debilitating severe mental illnesses with significant impact,1 irrespective of culture or socioeconomic class.2 Over the decades, antipsychotic medication...
Original Article
Prevalence and correlates of psychological distress and coronavirus anxiety among hospital essential services workers in Singapore
The Coronavirus Disease 2019 (COVID-19) has affected almost all geographies in the world since 2020. Many countries have imposed strict isolation measures to contain...
Original Article
Prevalence, risk factors and parental perceptions of gastroesophageal reflux disease in Asian infants in Singapore
Functional gastrointestinal (GI) disorders, such as colic, gastroesophageal reflux (GER) and constipation, are common in infants under 1 year. They are a frequent cause...
Editorial
Gastroesophageal reflux disease in Asian infants: Similar condition, different perceptions
Gastroesophageal reflux disease (GERD), a common problem in infancy, may lead to troublesome symptoms or complications such as oesophagitis or oesophageal stricturing in a...
Review Article
Use of Atypical Neuroleptics in a State Mental Institute
Schizophrenia is the most severe of all mental disorders and affects about 1% of the population. The main disturbances of schizophrenia comprise positive symptoms,...
Review Article
Somatisation among Asian Refugees and Immigrants as a Culturally-shaped Illness Behaviour
During the past two decades, close to one million Southeast Asian refugees of war have resettled in North America. Together with the already significant...
Others
How the Mental Hospital was Renamed Woodbridge Hospital in 1951
In the 1920s the government embarked on an ambitious programme to build hospitals, staffed largely by graduates of the King Edward College of Medicine....
Others
Selective Serotonin Reuptake Inhibitor Discontinuation Symptoms
Selective serotonin reuptake inhibitors (SSRIs) are a new class of antidepressants which are effective, better tolerated with less side effects and more specific in...
Review Article
Under-diagnosed Psychiatric Syndrome II: Pathologic Skin Picking
Pathologic skin picking may be defined as the habitual picking of skin lesions, which when chronic and extensive, can lead to significant distress, dysfunction...
Original Article
A Clinical Study of Seven Cases of Trichotillomania in Singapore
Trichotillomania was first described by a French dermatologist Hallopeau (1889) of a young man who pulled out his hair in tufts. The word trichotillomania...
Review Article
Under-diagnosed Psychiatric Syndrome I: Trichotillomania
Trichotillomania (TTM) is a chronic psychiatric condition characterised by uncontrollable, self-inflicted, hair pulling, resulting in noticeable hair loss. First described by Hallopeau a century...
Others
Psychological Trauma, Physical Health and Somatisation
Trauma does not respect persons or culture. While Singapore is fortunate to have been spared large-scale disaster and war for decades, it has nevertheless...
Others
Medical Leave Granted to Psychiatric Inpatients—A One-year Retrospective Review
The Department of Psychological Medicine, National University Hospital (NUH) has a 26-bedded inpatient unit. This study retrospectively examines the medical leave granted to all...
Original Article
Mental Health Literacy in Singapore: A Comparative Survey of Psychiatrists and Primary Health Professionals
The management of mental health disorders within a nation requires a system of care extending from the primary health care setting to tertiary and...
Others
Identification of Genes for Schizophrenia Susceptibility
Schizophrenia, described as “the most human of all diseases,” affects about 0.5 % to 1% of the population and typically develops in the early...
Others
Muscle Dysmorphia in a Young Chinese Male
In 1891, Morselli described “dysmorphophobia” in 78 patients who were severely miserable, preoccupied and distressed by perceived deformities. The word “dysmorphia” in Greek means...
Original Article
Contrasting Clozapine Prescribing Patterns in the East and West?
Schizophrenia is a severe mental illness which causes enormous suffering, impaired social and occupational functioning, as well as higher mortality among the sufferers. The...
Review Article
Cardiac Effects of Psychotropic Drugs
The incidence of mortality is higher among psychiatric patients than among the general population and the cause of which may be the psychiatric disorder...
Original Article
Men Who Commit Rape in Singapore
Of all the sexual crimes committed, rape stands out as one of the most serious forms of sexual assault, yet there is a general...
Original Article
Psychiatric Illness, Personality Traits and the Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder seen by gastroenterologists and has been found to account for 50% of referrals...
Review Article
Behavioural Disorders in Childhood: A Singapore Perspective
A review of five Western epidemiological studies of children aged 6 to 11 years revealed an average prevalence of 25% for psychiatric disorder (ranging...
Original Article
The Views of Mental Health Professionals Towards Psychotherapy—A Singapore Survey
There is a trend in Asia towards a greater application of psychotherapeutic approaches in multidisciplinary settings to emotional and behavioural disturbances. The inaugural issue...
Original Article
Pilot Study to Assess the Viability of a Rape Trauma Syndrome Questionnaire
In their 1974 study, Burgess and Holmstrom1 interviewed a heterogeneous sample of 92 adult females admitted between 1972 and 1973 to the emergency ward...
Original Article
Thyroid Dysfunction in Chronic Schizophrenia Within a State Psychiatric Hospital
Thyroid dysfunction can give rise to various psychiatric symptoms. While there is a persistent interest in the role of thyroid axis in affective disorders,...
Commentary
Mental Disorders and Public Safety of the Community at Large—Does the Tarasoff Principle Apply in Singapore?
In the course of their work, psychiatrists treat patients who, because of their mental disorders, may pose a danger to themselves and/or to others....
Letter to the Editor
Preventing Youth Suicide
This letter is in reference to Dr Ung’s article published in the Annals which investigated youth suicide and parasuicide in Singapore. The study of...
Review Article
Eating Disorders in Singapore: A Review
Anorexia nervosa, bulimia and binge-eating disorder are the three best described ‘eating disorders’. All three are predominantly disorders of women with the core symptoms...
Review Article
Youth Suicide and Parasuicide in Singapore
The World Health Organization defines suicide as an act with a fatal outcome that is deliberately initiated and performed by the person himself or...
Original Article
Five-Year Review of Adolescent Mental Health Usage in Singapore
The past 20 years have seen much growth in the knowledge of child and adolescent psychiatric practice. Research has provided an improved understanding in...
Original Article
Post-SARS Psychological Morbidity and Stigma Among General Practitioners and Traditional Chinese Medicine Practitioners in Singapore
Severe acute respiratory syndrome (SARS) is the first severe and readily transmissible new disease to emerge in the 21st century (WHO). The countries most...
Review Article
A Risk Reduction Approach for Schizophrenia: The Early Psychosis Intervention Programme
Schizophrenia is a serious mental disorder with a profound impact on patients, their caregivers and society. The Global Burden of Disease lists schizophrenia among...
Original Article
Clinico-pathological Analysis of Myelodysplastic Syndromes According to French-American-British Classification and International Prognostic Scoring System
Myelodysplastic syndromes (MDS) are a heterogeneous group of acquired clonal haemopoietic stem cell disorders characterised by ineffective haematopoiesis and peripheral cytopenia. The natural history...
Original Article
Interleukin-2 Levels in Chronic Schizophrenia Patients
Autoimmune processes have been implicated in the pathogenesis of schizophrenia. Several pieces of indirect evidence point towards a role of autoimmune processes in at...
Others
Abuse of Prescription Buprenorphine, Regulatory Controls and the Role of the Primary Physician
Buprenorphine is an opiate partial agonist that has been used for pain management, and in the past few years has been approved for the...
Original Article
Reducing Polypharmacy Through the Introduction of a Treatment Algorithm: Use of a Treatment Algorithm on the Impact on Polypharmacy
The use of 2 or more antipsychotic medications (polypharmacy) for an episode of psychosis is pervasive despite the lack of evidence-based data. It is...
Original Article
Socio-demographic Profile and Help-seeking Behaviour of Buprenorphine Abusers in Singapore
Opiate dependence is a major health and social concern in many countries across the world. The burden of disease is considerable, with surveys indicating...
Editorial
Medicalising the Treatment of Opioid Dependence
Traditionally the treatment of opioid dependence in Singapore has not been viewed as a public health problem, but rather as a social problem that...
Others
“The one” Annoying Patient
Schizophrenia – a mind torn asunder – is a difficult illness to live with, both for the patient as well as for the caregiver;...
Review Article
The Risk of Suicidality with Selective Serotonin Reuptake Inhibitors
The first antidepressants were discovered 50 years ago by chance. Monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs) dominated the treatment of depression from...
Original Article
Clinical and Social Correlates of Duration of Untreated Psychosis in First-episode Psychosis Patients
First-episode studies of schizophrenia have reported that the longer the duration of untreated psychosis (DUP), the poorer the response to antipsychotic medication and treatment...
Commentary
The Media and Suicide
Suicide worldwide is estimated to represent 1.8% of the total global burden of disease in 1998, and 2.4% in countries with market and former...
Commentary
Performance Measures for Mental Healthcare in Singapore
Mental disorders are prevalent worldwide and while they are disabling and costly, they have not received that amount of attention and resources needed. A...
Original Article
Mental Health Professionals’ Perceived Barriers and Benefits, and Personal Concerns in Relation to Psychiatric Research
Epidemiological research has shown that mental disorders can result in considerable healthcare and other opportunity costs. There are some reports that have highlighted the...
Original Article
Pathways to Specialist Care in an Insomnia Clinic at a Psychiatric Hospital: A Comparative Analysis of Two Periods
The complaint of insomnia is common and patients generally either self-medicate and/or consult primary healthcare providers. Referrals to a specialist for further management largely...
Review Article
Behavioural Sleep Disorders in Children and Adolescents
Overall, children spend one-third to one-half of their life sleeping. Although sleep comprises such a significant portion of a child’s day, sleep disturbances are...
Review Article
Diagnosis and Evaluation of Obstructive Sleep Apnoea in Children
Children with obstructive sleep apnoea (OSA) may present with nocturnal and/or diurnal symptoms. The history is best obtained from parents, or siblings who share...
Review Article
Hypnotherapy for Sleep Disorders
Derived from ‘Hypnos’, the Greek God of sleep, the word hypnosis literally means sleep. Ironically, hypnosis is not a form of sleep but a...
Original Article
Sleep Disturbances in Singaporean Children with Attention Deficit Hyperactivity Disorder
Attention deficit hyperactivity disorder (ADHD) is a common childhood psychiatric disorder with various studies reporting prevalence rates of between 1.7% and 16%. The most...
Original Article
Concurrent Chemoradiotherapy followed by Surgery in Locally Advanced Squamous Cell Carcinoma of the Oesophagus: A Single Centre Experience
Carcinoma of the oesophagus is a relatively uncommon malignancy in Singapore and incidence rates have been declining since 1968. A total of 506 cases...
Commentary
Neuropsychiatry – An Emerging Field
Neuropsychiatry can be described as the interface between neurology and psychiatry – the intersecting field of enquiry for both the brain and the mind....
Others
Clinical Characteristics of Renal Infarction in an Asian Population
Renal infarction is a rare disease. Domanovits et al reported an incidence rate of 0.007% (17/248,842) during a study period of 45 months.
This article...
Original Article
Review of the Management Outcome of Slipped Capital Femoral Epiphysis and the Role of Prophylactic Contra-lateral Pinning Re-examined
Slipped capital femoral epiphysis is the commonest hip problem in the adolescent age group. The goals of treatment are aimed at avoiding the complications...
Commentary
Providing Integrated Mental Health Services in the Singapore Primary Care Setting – the General Practitioner Psychiatric Programme Experience
Mental disorders are recognised as a major public health problem worldwide, and the management of mental health problems places an enormous burden on health...
Original Article
Prevalence and Correlates of Excessive Internet Use among Youth in Singapore
There has been an explosive growth of Internet usage worldwide and this is expected to continue with its use becoming an integral part of...
Original Article
Hip Fractures in the Elderly: The Impact of Comorbid Illnesses on Hospitalisation Costs
Management of hip fractures is costly and continues to generate significant costs throughout the one-year period after discharge.1 They demand considerable resources from a...
Original Article
Application of the McDonald MRI Criteria in Multiple Sclerosis
Since its advent in 1982, magnetic resonance imaging (MRI) has become an important component in the evaluation of multiple sclerosis (MS). MRI is a...
Original Article
Extracranial Non-vestibular Head and Neck Schwannomas: A Ten-year Experience
Schwannomas, also known as neurilemmomas, neuromas, or neurinomas, are uncommon nerve sheath neoplasms that may originate from any peripheral, cranial or autonomic nerve of...
Original Article
Demographic and Clinical Features of 150 Pathological Gamblers Referred to a Community Addictions Programme
Pathological gambling has been defined as a persistent and recurrent maladaptive gambling behaviour that disrupts personal, family and work life. The diagnosis is not...
Commentary
The personal recovery movement in Singapore – past, present and future
Early psychiatric conceptions of successful mental health recovery traditionally focused on reducing or eradicating symptoms.1 The personal recovery movement of the early 1990s in...
Original Article
Impact of Depression on Health Related Quality of Life in Patients with Diabetes
Diabetes Mellitus (DM) is a serious chronic illness that imposes significant morbidity and mortality and has a major impact on the quality of life...
Letter to the Editor
Management of a Patient with Schizophrenia and Underlying Pituitary Macroadenoma
Hyperprolactinemia was found to be prevalent in a multi-centred study of 402 patients with schizophrenia, schizoaffective disorder and schizophreniform disorder treated with conventional antipsychotics...
Original Article
Psychological Symptoms in People Presenting for Weight Management
Multiple factors contribute to the genesis and maintenance of obesity which is a difficult condition to treat and weight loss is often not maintained....
Editorial
Preventive Psychiatry
In medicine, measures that save the most lives and improved the quality of life of millions have largely been public health measures that in...
Original Article
Acceptability of Medical Students by Patients from Private and Public Family Practices and Specialist Outpatient Clinics
In recent decades, medical advances and economic pressures have shifted medical student training from hospital inpatient to ambulatory settings such as hospital outpatient and...
Original Article
Monthly Take-Home Methadone Maintenance Regime for Elderly Opium-Dependent Users in Singapore
The misuse of illicit opiates remains a global problem, placing a heavy burden on society. Literature on the effectiveness of opiate substitution pharmacotherapies in...
Original Article
The Singapore National Healthcare Group Diabetes Registry – Descriptive Epidemiology of Type 2 Diabetes Mellitus
Diabetes mellitus is one of the most challenging global health problems in the 21st century. It is associated with excess mortality and significant morbidity...
Review Article
Panic Attack and its Correlation with Acute Coronary Syndrome – More Than Just a Diagnosis of Exclusion
Acute coronary syndrome (ACS) is a life-threatening condition which benefits from prompt evaluation and proper treatment, such that it would be considered negligent for...
Letter to the Editor
Reply from Author: Is It Time to Revise the Definition of Attention Deficit Hyperactivity Disorder?
We would like to thank the author for suggesting that the definition of ADHD should be revised. This is an important consideration in the...
Letter to the Editor
Is It Time to Revise the Definition of Attention Deficit Hyperactivity Disorder?
I read with interest the article published in the Annals entitled “Attention Deficit Hyperactivity Disorder: Coping or Curing?”, which concluded that coping rather than...
Original Article
Weight Gain in Asian Patients on Second-generation Antipsychotics
Weight gain is a serious side-effect with antipsychotic medication use. There is increasing evidence that with certain second-generation antipsychotics (SGA) weight gain liability is...
Original Article
Quality of Life in Pathological Gamblers in a Multiethnic Asian Setting
Pathological gambling is categorized under the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR) as an impulse control disorder not elsewhere classified....
Original Article
Supplementary Breast Ultrasound Screening in Asian Women with Negative But Dense Mammograms—A Pilot Study
Mammogram has been the gold standard for breast cancer screening and Magnetic Resonance Imaging (MRI) has been advocated for screening of high- risk individuals....
Original Article
Male Breast Cancer in Singapore: 15 Years of Experience at a Single Tertiary Institution
Male breast cancer is a rare disease entity, traditionally said to represent <1% of all diagnosed breast cancers. Recent statistics, however, suggest that its...
Original Article
Effectiveness of Assertive Community Management in Singapore
In Asia, various community programmes have been adopted and studied in several countries in an effort to promote de-institutionalisation, community psychiatric services and reduce...
Original Article
A 10-Year Profile of Trauma Admissions Caused by Interpersonal Violence: A Major Trauma Centre’s Experience
The World Health Organization (WHO) has divided violence into 3 categories: interpersonal violence, self-directed violence, and collective violence. Violence is defined as “the intentional...
Original Article
Height and Mental Health and Health Utility Among Ethnic Chinese in a Polyclinic Sample in Singapore
Several studies have found adult height predictive of mental health and emotional well-being. A study of Swedish conscripts demonstrated an inverse association between
height at...
Editorial
You Are Worth More Than What You Weigh: Preventing Eating Disorders
Times have changed. Maternal mortality rates at the start of the 1900s were around 1 in 100 live births in the best maternity institutions....
Original Article
An Analysis of Blinding Success in a Randomised Controlled Trial of Fish Oil Omega-3 Fatty Acids
There has been growing interest in the use of dietary supplementation to treat psychiatric disorders. In particular, supplementation of omega-3 fatty acids has been...
Commentary
Schizophrenia as a Lifelong Illness: Implications for Care
The management of schizophrenia has advanced considerably since the term was first coined in 1911, with Kraepelin’s early pessimism tempered by more recent evidence...
Commentary
Integrating mental healthcare in primary care in Singapore
Management of mental health conditions can be both resource-intensive and costly. The rigour of obtaining appointments and the long waiting time at tertiary hospitals,...
Commentary
Prehabilitation and Its Role in Geriatric Surgery
The population in Singapore is ageing rapidly. According to statistics, by 2030, 1 in 2 adults in Singapore will be >65 years old. As...
Editorial
Seasonal haze: Knowledge gaps and risk perception behaviours
The seasonal haze in Southeast Asia has been a recurrent concern whenever we enter the southwest monsoon season (June–September). This phenomenon, caused by agricultural...
Original Article
Dietary intake of persons with depressive and psychotic disorders in Singapore
Unhealthy diet is a modifiable risk factor in many health conditions, including mental disorders. Nutritional psychiatry is an emerging field that examines the role...
Editorial
Nutritional psychiatry: The next frontier in mental health treatment
The World Health Organization has envisioned for every human being’s fundamental right to be able to enjoy the highest attainable standard of health, even...
Original Article
Accuracy of self-reported height, weight and BMI in a multiethnic Asian population
Overweight and obesity continue to be one of the most critical public health issues worldwide. Body mass index (BMI) derived from height and weight...
Letter to the Editor
Impact of COVID-19 on mental health and occupational burnout in a surgical unit in Singapore
In this study, we assessed the impact of COVID-19 on the psychological well-being and burnout among staff who manage critically ill general surgery and...
Letter to the Editor
A resuscitation course designed for a psychiatric hospital
It is challenging to maintain the resuscitation skills of doctors in a psychiatric hospital. Our study describes a resuscitation course designed specifically for the...
Letter to the Editor
Carbamazepine-induced toxic epidermal necrolysis in a patient despite testing negative for HLA B*15:02 allele
Carbamazepine (CBZ) has been used in Singapore since 19881 as an effective drug for the treatment of conditions such as epilepsy, neuropathy, neuralgia and...
Review Article
Endovenous cyanoacrylate ablation for chronic venous insufficiency and varicose veins among Asians
In the past 2 decades, the management of chronic venous insufficiency (CVI) has been revolutionised by the introduction of minimally invasive endovenous techniques, which...
Original Article
Psychosocial impact of the COVID-19 pandemic on paediatric healthcare workers
Early studies done in China during this COVID-19 pandemic have shown considerable mental health impact on healthcare workers (HCWs), especially those working on the...
Editorial
The impact of COVID-19 pandemic on global mental health: From the general public to healthcare workers
The COVID-19 pandemic began in late 2019 and was declared a pandemic by the World Health Organization (WHO) on 11 March 2020. To decrease...
Original Article
Assessing the Content Validity of the EQ-5D Questionnaire Among Asians in Singapore: A Qualitative Study
EQ-5D is a tool to measure and value health status. It is a standardised questionnaire that comprises 2 components: a Descriptive System (DS) on...
Commentary
Autism Spectrum Disorder and COVID-19: Helping Caregivers Navigate the Pandemic
The coronavirus disease 2019 (COVID-19) pandemic has disrupted societies globally. As of 11 May 2020, 53 children have been infected with COVID-19 in Singapore...
Review Article
Obesity in COVID-19: A Systematic Review and Meta-analysis
Coronavirus disease 2019 (COVID-19) is an ongoing global pandemic infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is established that increasing...
Original Article
Long-term outcomes of ischaemic stroke patients with diabetes in a multi-ethnic cohort in Singapore
Asia faces an epidemic of diabetes. The prevalence of diabetes in Asia is projected to grow from 114 million in 2007 to 180 million...
Commentary
Mental Health Strategies to Combat the Psychological Impact of Coronavirus Disease 2019 (COVID-19) Beyond Paranoia and Panic
On 30 January 2020, the World Health Organization (WHO) declared the outbreak of coronavirus disease 2019 (COVID-19) an international public health emergency after the...