Commentary
Navigating the evolving landscape in the prescribing of medications for insomnia in Singapore: Principles and considerations from a psychiatrist’s perspective
The risks of prescribing benzodiazepines and Z-drugs for insomnia are well recognised by regulators, where the prescribing of such medications in contravention of guidelines has been the subject of regulatory action.1,2 Medical practitioners involved in the prescription of such medications need to grapple with complex clinical, legal, ethical and...
Review Article
Pharmacogenomics in psychiatry: Practice recommendations from an Asian perspective (2024)
Pharmacogenomic testing in psychiatry is an emerging area with the potential clinical application of guiding medication choice and dosing. Interest in this area has been fanned by commercial pharmacogenomic providers, who have commonly marketed multiple-gene or combinatorial panels that are direct-to-consumer tests. However, this has not been adopted widely...
Editorial
The promise and challenges of pharmacogenomics in psychiatry
Pharmacogenomics (PGx) is an expanding field within precision medicine that is poised to play a crucial role in optimising patient outcomes, particularly in the realm of psychiatry. The remission rate for the initial antidepressant prescribed in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial was only approximately 30%,...
Review Article
Optimising dementia screening in community-dwelling older adults: A rapid review of brief diagnostic tools in Singapore
Persons living with dementia experience chronic and progressive cognitive decline in 1 or more cognitive domains, affecting their everyday activities.1 Globally, the number of persons living with dementia is expected to rise from 55 million in 2019 to 139 million in 2050, with an estimated two-thirds in lower- and...
Original Article
Mental wellness and health-related quality of life of young adult survivors of childhood cancer in Singapore
Advancements in technology and cancer treatments have improved childhood cancer survival rates, with up to 85% surviving 5 years or more.1 The Malaysia-Singapore Leukaemia Study Group reported an improvement in overall 5-year survival for the past 20 years in Singapore, from 69% to 91% for acute lymphoblastic leukaemia, which...
Editorial
Transcranial magnetic stimulation in psychiatry: A Singapore perspective
The use of repetitive transcranial magnetic stimulation (rTMS) for major depressive disorder (MDD) and obsessive-compulsive disorder (OCD) has not been described in Singapore. Reports on the effectiveness of rTMS in populations outside of Western countries are also limited. Thus, Ye et al.’s study on the naturalistic outcomes of rTMS...
Letter to the Editor
Factors affecting outcomes among older trauma patients in Singapore: A retrospective observational study
Dear Editor,
Singapore faces a rapidly ageing population with its median age projected to be above 45 years by 2030. Our greying demographics is accompanied by a rise in chronic diseases and medication use, including polypharmacy.1 Longer life expectancy and increased activity levels have contributed to higher incidence of geriatric...
Original Article
Healthcare burden of cognitive impairment: Evidence from a Singapore Chinese health study
Individuals with cognitive impairment (CI) are predisposed to injuries, infections and treatment complications,1 have poorer treatment compliance, and face greater difficulties with post-discharge care.2 These challenges, exacerbated by comorbidities,3-6 lead to poorer ambulatory care management, reduced contacts with primary and outpatient care providers, and greater use of emergency department...
Original Article
Prevalence of consumption of illicit drugs and associated factors from a nationwide epidemiological survey: The Singapore Health and Lifestyle Survey
Substance use disorders (SUDs) are characterised by the uncontrolled use of a substance by an individual despite its harmful consequences.1,2 The prevalence of consumption of substances and SUDs varies widely across countries. This difference in prevalence can be attributed to factors such as study methodology (the substance included in...
Editorial
Illicit drug consumption in Singapore: Where are we in the fight against drugs?
Illicit drug consumption is associated with significant negative health, financial and social consequences. Yet, illicit drug consumption remains highly prevalent and continues to be a growing problem worldwide. In 2021, 1 in 17 people aged 15–64 in the world had used a drug in the past 12 months. Notwithstanding...
Letter to the Editor
Validating two international warfarin pharmacogenetic dosing algorithms for estimating the maintenance dose for patients in Singapore
Dear Editor,
Predicting optimal warfarin dosing is difficult due to complex pharmacodynamics and pharmacokinetics, narrow therapeutic index and susceptibility to many factors.1 Genetic variations of the CYP2C9 and VKORC1 enzymes, occurring in different frequencies in different populations, play a significant role in determining warfarin dosing.1-4 Using pharmacogenetic dosing algorithms to...
Review Article
The impact of media reporting of suicides on subsequent suicides in Asia: A systematic review
Globally, around 703,000 people die by suicide annually, 77% of which occur in low- to middle-income countries.1 In 2019, suicide was the 4th leading cause of death among younger adults (15–29 years).1 Approximately 60% of the global suicide rates were attributed to Asian countries in 2012,2 with the data...
Letter to the Editor
Hantavirus haemorrhagic fever and renal syndrome, caused by the Hantaan virus in Singapore: A case report
Dear Editor,
We outline a case of a 59-year-old Malaysian man of Indian origin with no known past medical history apart from diabetes mellitus and hypertension, who presented with a 7-day history of unrelenting fever, myalgia, confusion and unsteady gait. He worked as a shipyard engineer and travelled between Singapore...
Letter to the Editor
Outcomes of patients admitted for drowning
Dear Editor,
According to the latest Utstein-style consensus, drowning is defined as the primary respiratory impairment resulting from submersion or immersion in a liquid medium.1 Patients may experience hypothermia, acute respiratory distress syndrome and shock.1 The pathophysiology is poorly understood, but could relate to physiological responses to temperature, water swallowing...
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 symptoms in pregnancy, childbirth and the postnatal period.1 The guidelines were developed by a workgroup involving experts in perinatal mental health and obstetrics using a...
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 COVID-19 on 23 January 2020 and the subsequent emergence of clusters led to a string of restrictions to contain the outbreak and protect the health...
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 to minimise transmission risk and protect against severe infection. However, COVID-19 vaccines have had a mixed reception, with concerns of their side effects and of...
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 causing COVID-19, while over 6.5 million have succumbed to the disease. Many have lost family members and friends as well as jobs and familiar lifestyles,...
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 monetary benefits, employment provides a better self and social identity, helps the person gain a sense of personal achievement, and enhances mental well-being. Being unemployed...
Letter to the Editor
Response to letters arising from publication of the Academy of Medicine, Singapore clinical guideline on the use of sedation by non-anaesthesiologists during gastrointestinal endoscopy in the hospital setting
Dear Editor,
The Academy of Medicine, Singapore (AMS) guideline on the use of sedation by non-anaesthesiologists during gastrointestinal endoscopy in the hospital setting and an accompanying editorial were published in the January 2022 issue of the Annals.1,2 An evidence-based approach was used with reference made to relevant published literature. The...
Letter to the Editor
Sedation in gastrointestinal endoscopy in Singapore
Dear Editor,
I refer to the editorial “Ensuring safe sedation during gastroendoscopy”1 and the original article “Academy of Medicine, Singapore clinical guideline on the use of sedation by non-anaesthesiologists during endoscopy in the hospital setting”2 in your journal in January 2022.
The American Society of Gastrointestinal Endoscopy (ASGE) and the European...
Letter to the Editor
Non-anaesthesiologists administering propofol in the Singapore context
Dear Editor,
Propofol is a potent intravenous sedative-hypnotic agent. Its popularity for sedation has increased in the last 3 decades because of its smooth, rapid onset of action and fast post-procedural recovery.1 Nonetheless, propofol depresses cardiorespiratory function and could result in life-threatening adverse effects.
A workgroup, mainly consisting of gastroenterologists and...
Letter to the Editor
Sedation by non-anaesthesiologists in gastrointestinal endoscopy
Dear Editor,
We read with interest the paper by Ang et al.1 on Singapore guidelines in the use of sedation by non-anaesthesiologists during gastrointestinal endoscopy in the hospital setting. We are especially intrigued by Statement 6, stating that propofol sedation for endoscopy can be safely and effectively administered by trained...
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 the preventive measures to avoid burnout.1 In 2019, the World Health Organization defined burnout as an occupational phenomenon in the International Classification of Diseases 11th...
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 has been the mainstay of treatment for patients with schizophrenia. Nevertheless, about 25% of patients do not respond to first-line antipsychotic medication, with more than...
Original Article
Epidemiological trends and outcomes of children with aural foreign bodies in Singapore
Aural foreign bodies (FBs) commonly present to the emergency department (ED) worldwide. Children represent the majority of the population, believed to be due to their inquisitive minds and experimental nature.1 Aetiologies for aural FBs include accidental or intentional insertion of FBs into body orifices, ear irritation caused by rhinitis...
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 the spread of this disease. While the majority of the population has been working from home, essential workers continue manning the frontlines, facing risks such...
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, negative symptoms and disorganisation.
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Original Article
Survival after Cardiopulmonary Resuscitation in the General Wards—The Results of a Dedicated “Code” Team
Cardiopulmonary resuscitation (CPR) is widely practised for cardiopulmonary arrests with variable success. The initial intention was to defibrillate patients with ventricular fibrillation after acute myocardial infarction, to save those with “hearts too good to die”.
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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 Asian immigrant population, they represent one of the fastest growing minority groups in the United States.
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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. The “Mental Hospital”, commissioned and built by the British in 1928, was sited at Yio Chu Kang and spread out over 80 hectares of sprawling...
Others
Disseminated Penicillium marneffei Infection: A Report of Five Cases in Singapore
Penicillium marneffei is a dimorphic fungus that can cause infection in immunocompromised hosts. Reports on infection with this organism were initially uncommon, but after the first report of disseminated P. marneffei infection in a HIV-infected individual from Bangkok in 1989, the incidence has increased markedly, almost exclusively in patients...
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 receptor activity than the older tricyclic antidepressants. However, like tricyclic antidepressants and other groups of antidepressants such as the monoamine oxidase inhibitors (MAOIs) and the...
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 and disfigurement. The underlying skin lesions may range from benign ones, e.g. barely noticeable irregularities of the skin, to more severe ones, e.g. acne, eczema,...
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 is derived from the Greek thrix which means hair; tillein, to pull; and mania, madness or frenzy.
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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 ago, it was previously regarded as an obscure condition.
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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 had its share of traumatic incidents.
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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 admitted patients over a one-year period in 1998.
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Others
Clinical Drug Trials: Practical Problems of Phase III
There has been a rapid increase in clinical trial activity in Singapore and other parts of Asia. Randomised clinical trials are the “gold standard” in study design, which enable the question of efficacy of different treatments or managements to be effectively compared.
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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 specialist care settings. To that end, professional knowledge of the recognition, management and prevention of mental disorders is critical.
This article is available only as a...
Original Article
Deep Vein Thrombosis after Total Knee Replacement
Western literature reports a very high incidence of deep vein thrombosis in its population especially after orthopaedic surgery. In total knee replacement without prophylaxis, its incidence is quoted between 46% and 84% in various studies.
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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 20s in men and the late 20s to early 30s in women. It is one of the most severe, if not the most severe, of...
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 ugly. Body dysmorphic disorder appeared in DSM-III in 1987.
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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 mainstay of treatment is neuroleptics which are largely effective for certain symptoms of this illness.
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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 itself or other related factors like life-style and medications. Reports of sudden deaths among patients taking psychotropic drugs have raised concerns that some of the...
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 lack of clinical information on convicted rapists in Singapore and elsewhere. We believe this to be the first such study in Singapore.
This article is available...
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 to a Gastroenterology clinic. It has an estimated prevalence of between 15% and 25% in the non-patient population.
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Others
Introduction of Problem-based Learning in a Traditional Medical Curriculum in Singapore—Students’ and Tutors’ Perspectives
The National University of Singapore was started in 1905. Since then, it has trained many generations of medical practitioners.
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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 from 12.4% to 48%). Asian studies show a similar prevalence range, with a 6.1% prevalence in a Malaysian study of 1- to 15-year-old children, a...
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 of Asian Psychologist announced landmarks in the education and training of clinical psychology in two major Asian communities.
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Original Article
A Retrospective Study of Melanocytic Naevi at the National Skin Centre
Melanocytic naevi are benign proliferation of melanocytes of congenital and acquired types which usually appear during adolescence or early adult life. Naevi are of three common subtypes i.e. junctional, compound and intradermal melanocytic naevi, with characteristic clinical appearance that aids in clinical diagnosis.
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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 of the Boston City Hospital with the presenting complaint of being raped. From the analysis of the responses of these women, the authors identified “an...
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, there is limited data on the interaction of thyroid dysfunction with psychotic disorders such as schizophrenia.
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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. What is the duty of the psychiatrist treating this patient?
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Original Article
Measuring Health-related Quality of Life in Singapore: Normal Values for the English and Chinese SF-36 Health Survey
Advances in diagnosis and therapy in the second half of the 20th century have lead to impressive improvements in survival for patients with many chronic illnesses. With improvements in survival, patients’ perceptions of health are increasingly being recognised as an important outcome in clinical medicine, especially in illnesses where...
Others
Validity and Reliability of the EQ-5D Self-report Questionnaire in Chinese-speaking Patients with Rheumatic Diseases in Singapore
Health-related quality of life (HRQoL) refers to patients’ perceptions of their own functioning and well-being. HRQoL is increasingly being used as a primary or secondary endpoint in clinical research and is essential in economic evaluation of new and often expensive therapies.
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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 suicide has a very respectful tradition as many studies have led to the recognition of cultural and environmental risk factors.
This article is available only as...
Editorial
Severe Acute Respiratory Syndrome (SARS) — 150 Days On
The Severe Acute Respiratory Syndrome (SARS) has been identified as a new clinical entity in the year 2003. It was on 12 March 2003 that the World Health Organization (WHO) issued a global health alert on the disease then known as atypical pneumonia.
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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 of shape/weight dissatisfaction and eating abnormalities. Anorexia nervosa is characterised by significant self-induced weight loss secondary to fear of fatness, amenorrhoea (cessation of menstruation for...
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 herself in the knowledge, or expectation, of its fatal outcome. Parasuicide or attempted suicide is distinguished from suicide by the non-fatal outcome.
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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 almost every area, including epidemiology, classification and treatment.
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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 severely affected by this epidemic were Hong Kong, China, Taiwan, Canada and Singapore.
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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 the top 10 contributors to health burden and disability around the world.
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Original Article
Behcet’s Disease: Experience in a Tertiary Rheumatology Centre in Singapore and a Review of the Literature
The only published study on Behcet’s disease in Singapore by Tan E et al (34 patients at the National Skin Centre) found that only 15% had arthritis and 6% had eye complications with no other systemic manifestations. These findings are different from epidemiological studies from other countries published in...
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 least some cases of schizophrenia.
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Original Article
Characteristics and Acute Rehabilitation of Guillain-Barré Syndrome in Singapore
The Guillain-Barré syndrome (GBS) is an acute, frequently severe evolution of a demyelinating inflammatory polyradiculopathy with an autoimmune pathogenesis. In developed countries, GBS is the most common cause of acute neuromuscular paralysis.
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Original Article
Familial Risk of Allergic Rhinitis and Atopic Dermatitis among Chinese Families in Singapore
Family history has been shown to be a risk factor for the development of allergic rhinitis (AR) and atopic dermatitis (AD). However, the increase in prevalence has also been attributed to the changes in lifestyle and urbanisation in developed countries.
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Original Article
Early Dengue Infection and Outcome Study (EDEN) – Study Design and Preliminary Findings
Dengue fever/dengue haemorrhagic fever (DF/DHF) is a re-emerging disease that is endemic in the tropical world. It is caused by 4 closely-related dengue viruses which are transmitted by the Aedes mosquitoes, principally the Aedes aegypti mosquito.
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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 treatment of opioid dependence in Singapore and other countries. Buprenorphine is available in primary care clinics and can be prescribed by all licensed physicians who...
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 also associated with higher daily dosing, more frequent use of adjunctive medications such as anticholinergic agents, higher rate of adverse effects and under-utilisation of atypical...
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 that up to 2% of the population had used opiates for non-medicinal reasons.
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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 necessitated custodial and other punitive approaches. The turning point came in 1996, when, after a pilot programme in the Prisons Department, naltrexone was introduced as...
Original Article
SARS in Singapore – Predictors of Disease Severity
Severe acute respiratory syndrome (SARS) is a recently defined illness caused by a novel coronavirus. The outbreak in Singapore originated from Hong Kong via mainland China.
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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; thus, it is not an uncommon sight to see the authorities bring such patients to our psychiatric practice, whether abandoned or simply lost. What was...
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 the late 1950s until the late 1980s, when selective serotonin reuptake inhibitors (SSRIs) were introduced.
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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 outcome. The findings of these studies have led to the assertion that by reducing DUP, treatment outcome for schizophrenia and other related psychosis might be...
Original Article
The Clinical Predictors of Hypertension and Sleepiness in an Asian Population with Sleep-disordered Breathing
Sleep physicians have only recently began to learn much about the epidemiology of sleep-disordered breathing (SDB) from large, well conducted prospective community-based studies. These studies have helped identify the risk factors for identifying sleep apnoea, particularly in the Western population.
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Others
The Future of Medical Education: The Second 100 Years
This is a proud year for the medical profession in Singapore, as we celebrate 100 years of medical education. As the oldest faculty in Singapore’s first university, we are reminded that it was the Medical School which laid the foundation for tertiary education in Singapore. It is appropriate that...
Others
The Medical Students’ Societies and Medical Students’ Publications
For a very long time, King Edward VII (endearingly abbreviated “KE”) was synonymous with the medical school and its associated hall of residence. The name was first used for the School (later called College) in 1912 in recognition of a substantial gift from the King Edward VII Memorial Fund....
Others
The Teaching of Radiology
A record of Diagnostic Radiology would be incomplete without reference to Wilheim Roentgen, who discovered the rays that he could not comprehend; hence, X-rays. The day was Friday, 8 November 1895, as he worked on cathode ray tubes at the University of Wurzburg, Germany. These rays penetrated opaque substances,...
Original Article
In vitro Activities of Antifungal Drugs Against Yeasts Isolated from Blood Cultures and Moulds Isolated from Various Clinically Significant Sites in Singapore
Fungaemia carries with it high mortality rates and appropriate as well as timely antifungal therapy has been shown to be life saving. Amphotericin B has the broadest coverage amongst the antifungal drugs against fungal infection, and was regarded the gold standard treatment for severe fungal infection.
This article is available...
Editorial
Antimicrobial Resistance: A New Beginning and the Need for Action
In this issue, the articles (historical, original and review papers) highlight the extent and problem of antimicrobial resistance in Singapore. The authors should be congratulated on their efforts.
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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 recent survey of low-income and middle-income countries (as per World Bank classification) revealed that government spending on mental health is much lower than what is...
Original Article
Diabetic Retinopathy in Diabetics Referred to a Tertiary Centre from a Nationwide Screening Programme
Diabetic retinopathy (DR) is a leading cause of vision loss in Asia. Singapore has one of the highest prevalence rates of diabetes mellitus (DM) worldwide, with 8.2% of Singapore adults between the ages of 18 and 69 having diabetes and there is little data on the prevalence of diabetic...
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 negligence of mental health and the lack of recognition of the importance of mental disorders.
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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 depends on the initial assessments and findings, the presence of comorbidity and/or difficulties in treating the underlying problems.
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Editorial
Suicide
The word suicide is derived from the Latin word suicidium, itself derived from sui (of oneself) and cidium (a killing; caedere = to kill. The word appears to have been first used around 1651, although the self-killing act itself is recorded in antiquity.
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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 often overlooked by healthcare practitioners.
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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 state of increased concentration and awareness.
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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 current version of the Diagnostic and Statistical Manual of Diseases (DSM), fourth edition, has 2 lists of behavioural symptoms grouped under “inattentive” and “hyperactive-impulsive” symptoms,...
Others
A Doctor’s Duty is to Heal the Unhealthy: The Story of Tun Dr Mahathir Mohamad
Mahathir Mohamad was born in 1925 in Alor Setar, Kedah. In 1947, after living through the turbulent times of the Second World War, he entered the King Edward VII College of Medicine in Singapore. He graduated in 1953, and was in government service for the next 4 years before...
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 were diagnosed from 1993 to 1997. The age-standardised rate for the same period was 5.8 per 100,000.1 The predominant histologic type is squamous cell carcinoma,...
Original Article
Acceptance of Prophylactic Surgery and Chemoprevention of Cancer in Singapore – A Survey
The Singapore healthcare philosophy aims to establish a healthy population through preventive healthcare programmes and public health education. Public education usually emphasises the adverse consequences of harmful habits like smoking, alcohol consumption, poor dietary habits and sedentary lifestyles that may contribute to chronic and fatal diseases such as ischaemic...
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. In more practical terms, it often, though not necessarily, narrows down to psychiatric comorbidities of neurologic diseases (e.g. depression in a patient with stroke) and...
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 services.
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Original Article
Concerns, Perceived Impact and Preparedness in an Avian Influenza Pandemic – a Comparative Study between Healthcare Workers in Primary and Tertiary Care
The danger posed by emerging infectious diseases has become greater in the past few years with the World Health Organization (WHO) warning that the threat of an avian influenza (AI) pandemic is imminent. Healthcare institutions are expected to be key players during a pandemic, with healthcare workers (HCWs) at...
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 everyday life. The Internet has become more accessible in homes, schools, colleges, libraries and Internet cafes; access is further aided with the increasing affordability of...
Original Article
Concomitant Use of Midazolam and Buprenorphine and its Implications Among Drug Users in Singapore
Benzodiazepines (BDZs) (commonly known as “sleeping pills”) are routinely and successfully used in the treatment of sleep and anxiety disorders. However, studies have indicated that BZD use among injecting drug users (IDUs) constitutes a major clinical and public health problem. Misuse has been linked to higher rates of risk-taking...
Others
A Brief History of Pathology and the Chapter of Pathologists
A history of the Chapter of Pathologists would be incomplete without a history of the specialty of Pathology in Singapore. Pathology is in fact the first specialty practiced in Singapore. This was due to the seriousness of the public health situation and infections like water borne diseases in Singapore...
Others
From the Chapter of Physicians, Academy of Medicine, Singapore to the College of Physicians, Singapore
The transformation of the previous Chapter of Physicians, Academy of Medicine, Singapore to the current College of Physicians, Singapore in 2004 was the outcome of a steady progress in and a natural evolution of medical specialty development in Singapore. Just like the Academy which was established in 1957 as...
Others
From the Chapter of Anaesthetists to the College of Anaesthesiologists, Singapore
The arrival of Sir Stamford Raffles in 1819 herald the birth of western medicine in Singapore. Doctors were then sent here from Britain. These early doctors were ‘jack of all trades’ practising everything from public health to pathology. They had difficulties communicating with the locals and had little knowledge...
Others
Academy of Medicine, Singapore – The Next Twenty-Five Years (1982-2007)
The Academy of Medicine was founded in 1957 as the professional corporate body of medical and dental specialists in Singapore. From a modest beginning with only 34 members, it has since grown in membership, activities, stature and international reputation. Of special mention among the major activities in the first...
Original Article
Epidemiology, Management and Treatment Outcome of Medulloblastoma in Singapore
Medulloblastoma (MBL) is the most common type of malignant brain tumour in childhood. It belongs to the group of tumours known as primitive neuroectodermal tumour (PNET), which is a highly malignant, small round blue cell tumour of the central nervous system. The term “medulloblastoma” is classically reserved for PNETs...
Original Article
Timing of Hospital Presentation After Acute Cerebral Infarction and Patients’ Acceptance of Intravenous Thrombolysi
Intravenous thrombolysis in acute cerebral infarction has been proven to be efficacious in improving functional outcome if given within 3 hours from stroke onset.1 Singapore recently received national licensing for the use of intravenous thrombolysis for this indication. Delay in hospital presentation is an important hindrance to the administration...
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 made if the gambling behaviour is better accounted for by a Manic Episode .1 Diagnostic criteria are similar to those for substance dependence and include...
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 the US prioritised a more holistic and consumer-driven understanding of recovery.2 This paradigm shift emphasises that recovery is best defined by people with lived experiences,...
Others
Successful Rehabilitation With Cochlear Implant in Post-irradiation Induced Hearing Loss in Nasopharyngeal Carcinoma Patient
Nasopharyngeal carcinoma (NPC) is a common disease in Asia.1 Radiotherapy is the mainstay of treatment. Following radiotherapy, complications like profound sensorineural hearing loss may occur. If functionally active auditory fibres survive and there are no signs of recurrent tumour, we believe that successful rehabilitation is possible with a cochlear...
Original Article
A Prospective Cohort Study on the Impact of a Modified Basic Military Training (mBMT) Programme Based on Pre-enlistment Fitness Stratification Amongst Asian Military Enlistees
Basic military training (BMT) is seen as a vital initiation phase into military service when new recruits are conditioned to the rigours of military training in terms of physical and combat fitness. This training period assumes a great significance in Singapore where all able-bodied males between the ages of...
Original Article
Where the Elderly Die: The Influence of Socio-Demographic Factors and Cause of Death on People Dying at Home
The subject of place of death was brought to the forefront of the medical community in July 2004 when 2 important publications were released; one by the World Health Organization1 and another from the House of Commons Select Committee on Health.2 Both reports highlighted that the proportion of deaths...
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 of the individuals suffering from this illness. Singapore, a multi-ethnic country in Southeast Asia, with Chinese, Malay and Indian as the three main ethnic groups,...
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 and Risperidone. Antipsychotics inhibit the dopamine receptors and induce hyperprolactinemia via the tubulo-infundibular pathway, with subsequent downstream effects on multiple systems.
This article is available only...
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. The psychological problems found in obese patients have recently received increasing attention.
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Original Article
Trends in Importation of Communicable Diseases into Singapore
Singapore is a city-state in Southeast Asia, with a total population in 2007 of 4,839,400, of which 3,642,700 (75.3%) are Singaporean residents. The remaining 25% constitute of immigrant workers on work permit, foreigners on employment pass, and student pass holders.
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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 most instances, had been preventive measures. The most obvious examples are the infectious diseases which were – to use the cliché – the scourge of...
Original Article
Acceptance of Information and Communication Technologies for Healthcare Delivery: A SingHealth Polyclinics Study
Information and communication technologies, such as internet portal and short message system (SMS), are increasingly used in healthcare delivery worldwide.1,2 Typically, these technologies are used to facilitate or enhance communication and exchange of information between patients and doctors or other health professionals. Both healthcare consumers and providers can benefit...
Original Article
Timing of Arrival to a Tertiary Hospital after Acute Ischaemic Stroke – A Follow-up Survey 5 Years Later
Intravenous tPA is a proven treatment for acute ischaemic stroke. However as it has to be given in a narrow time window from symptom onset, utilisation is limited by delayed arrival of most patients to hospital.
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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 reducing consumption of illegal drug use, criminal activities, injecting and sharing behaviours, the spread of blood-borne diseases and mortality, now spans several decades and countries.
This...
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 a physician not to consider it as a possible diagnosis in any patient presenting with acute symptoms of chest tightness or discomfort, palpitations, dyspnoea, diaphoresis,...
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 light of some of the points raised such as frequent comorbidities that occur with ADHD as is the case of Autistic disorder and other conditions...
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 curing for attention deficit hyperactivity disorder (ADHD) is taking place. There are some evidence-based points that should be noted.
This article is available only as a...
Original Article
Diagnostic Accuracy of Anthropometric Indices for Obesity Screening Among Asian Adolescents
Obesity or excess body fat is strongly associated with enhanced risks of morbidity and mortality, and its prevalence is rapidly escalating worldwide. Despite these concerns, no standard definition of obesity for screening, diagnosis and subsequent intervention has been agreed upon internationally. The current definitions are mostly defined statistically, and...
Original Article
Socio-demographic Profile and Psychiatric Comorbidity of Subjects with Pathological Gambling
Gambling has been defined as a wager of any type of item or possession of value upon a game or event of uncertain outcome in which chance, of a variable degree, determines the outcome. The failure to resist the impulse to gamble despite disruption to personal, family and vocational...
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 greater than with the high potency first-generation antipsychotics (FGA).
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Original Article
Health-related Quality of Life is Associated with Diabetic Complications, but not with Short-term Diabetic Control in Primary Care
Type 2 diabetes mellitus is a major chronic disease globally. With increasing life expectancy, long-term complications of diabetes mellitus leading to significant morbidity and mortality have great impact on each patient’s health. Health-related quality of life refers to a person’s self-perceived functioning and well-being, and is increasingly used to...
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. The disorder is characterised by an excess preoccupation with gambling, need to gamble with increasing amounts of money in order to achieve the desired excitement,...
Original Article
Causes of Death in Hospitalised Human Immunodeficiency Virus (HIV)-infected Patients at a National Referral Centre in Singapore: A Retrospective Review from 2008 to 2010
The advent of the highly active antiretroviral therapy (HAART) era has greatly reduced the mortality and incidence of new diagnoses of acquired immune deficiency syndrome (AIDS)-defining illnesses (ADIs) in individuals infected with human immunodeficiency virus (HIV) in many countries. This has led to a paradigm shift in the management...
Original Article
Causes of Death and Factors Associated with Early Death Among Human Immunodeficiency Virus (HIV)-Infected Persons in Singapore: Pre-Highly Active Antiretroviral Therapy (HAART) and Peri-HAART
Since the first case of human immunodeficiency virus (HIV) was diagnosed in Singapore in May 1985, a total of 4845 cases and 1389 HIV/acquired immune deficiency syndrome (AIDS) deaths have been reported as of December 2010. With the introduction of highly active antiretroviral therapy (HAART), AIDS diagnoses declined by...
Original Article
Melanoma: Differences between Asian and Caucasian Patients
Cutaneous melanoma is the most common cause of mortality amongst skin cancer in Caucasian populations and incidence rates per 100,000 patient years vary between 21.9 in the United States to 55.9 in Australian males. In contrast, the incidence of melanoma in Asia is significantly lower with incidence rates of...
Original Article
Overcoming Barriers to Mammography Screening: A Quasi-randomised Pragmatic Trial in a Community-based Primary Care Setting
Breast cancer is the leading cancer among women in Singapore, accounting for 29% of all cancers occurring in women between 2006 and 2010. Evidence shows that breast cancer screening with mammography is effective at reducing breast cancer mortality, particularly where the uptake of screening is high, at a recommended...
Original Article
Hoarding in an Asian Population: Prevalence, Correlates, Disability and Quality of Life
Hoarding is defined as the acquisition of, and inability to discard items even though they appear to others to have no value, leading to clutter, distress, and disability. The clutter in severe hoarding precludes the use of space to accomplish the activities for which they were designed, such as...
Original Article
Clinical Outcome and Cost Comparison Between Laparoscopic and Open Appendicectomy
Acute appendicitis is one of the most common causes of acute abdominal pain requiring surgical intervention. The traditional operation of choice was the open appendicectomy (OA) pioneered by McBurney in 1894. In 1981, the laparoscopic technique was introduced by Kurt Semm and since then, laparoscopic appendicectomy (LA) is increasingly...
Original Article
Osteogenic Sarcoma in Children and Young Adults
Osteogenic sarcoma (OS) is a primary malignant tumour of the bone, derived from primitive bone-forming mesenchyme and characterised by the production of osteoid tissue or immature bone by the malignant proliferating spindle cell stroma. Although primary bone tumours are rare in childhood, they are the sixth most common malignant...
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 relapses or readmission rates. In Manila, Philippines, the National Mental Hospital has successfully reduced hospitalisation by 70% after introducing the Acute Crisis Intervention Services (ACIS),...
Original Article
Single Centre Experience of Transjugular Liver Biopsy in 152 Patients
The first reported case of liver biopsy was recorded in 1883 by Ehrlich. Since then, the technique of liver biopsy has been modified tremendously with major advances over the last 50 years, allowing safer and more reliable methods of performing liver biopsy.
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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 age 18 to 19 and suicide mortality over 15 years of follow-up. Similarly, a study of Filipinos demonstrated an inverse association between height at age...
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. This has declined by around 3 orders
of magnitude in the last 100 years to about 3 in 100,000 live births in places like Singapore. Perinatal...
Commentary
Projecting the Number of Older Singaporeans with Activity of Daily Living Limitations Requiring Human Assistance Through 2030
Similar to other developed countries in Asia, including Japan, South Korea and Taiwan, the population of Singapore is ageing rapidly. In 2011, 9.3% of the population was 65 years of age or older. Due in part to decades of sub-replacement level fertility rates and increases in longevity, by 2030...
Original Article
Determinants of Health-Related Quality of Life Among Community Dwelling Elderly
Singapore is experiencing an unprecedented age shift as the post-war baby boomers turn 65 years in 2012. Currently there are 378,700 people aged 65 and above, and these numbers are estimated to go up to 600,000 by 2020. These growing elderly population have multiple coexisting medical conditions which are...
Original Article
A Review of Back Injury Cases Notified to the Ministry of Manpower from 2011 to 2012
Work-related low back disorders consist of both low back pain (LBP) and low back injuries. They are a significant and increasing problem all over the world. Studies estimate that between 60% and 90% of people will suffer from low back disorders at some point in their life. Among the...
Original Article
Academic Medicine Education Institute (AM∙EI): Transforming the Educational Culture of Health Professionals
In 2010, Duke-NUS Graduate Medical School (Duke-NUS) and Singapore Healthcare Services (SingHealth) launched an initiative to improve the lives of patients by combining their individual strengths to become an integrated academic healthcare cluster. This new academic healthcare cluster has a mission to provide outstanding clinical service, discover and promote...
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 researched as a potential means of preventing and managing psychopathology. These fatty acids are ingested through dietary sources (e.g. fish), with inadequate concentrations implicated in...
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 examining outcome. The discovery of antipsychotics represented a major breakthrough in the treatment of schizophrenia, while more recently we have witnessed promising initiatives such as...
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, coupled with the need to obtain leave from work form a significant financial and logistical burden on patients for the treatment of mental health conditions....
Original Article
Evolution and trends in the adoption of laparoscopic liver resection in Singapore: Analysis of 300 cases
Over the past few decades, the introduction of laparoscopic surgery has been the biggest game changer in abdominal surgery.1 However, although the first laparoscopic liver resections (LLR) were reported in the early 1990s,2,3 widespread adoption of LLR was met with initial skepticism due to technical concerns and the fear...
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 the life expectancy of the population has improved significantly in the past few decades, a substantial portion of this rapidly ageing population will place a...
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 fires, has vast effects on multiple countries in the region.
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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 of diet and nutrition in mental health. Since its beginnings in the 2000s, a notable change in the field was a switch in focus from...
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 in the presence of disease or infirmary. Singaporeans’ average life expectancy is projected to reach 85.4 years by the year 2040 and the burden of...
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 trauma patients as part of the Acute Care Surgery (ACS) service at the Singapore General Hospital, Singapore. The ACS team may be exposed to COVID-19...
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 Institute of Mental Health in Singapore to address competency gaps, which proved to be relevant and helpful to the trainees.
This article is available only as...
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 frontline. HCWs exposed directly to COVID-19 may be affected not only by fears of contracting the virus and spreading it to their loved ones, but...
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 the spread of the virus and demand on the healthcare system, governments globally executed multiple public health measures including lockdown, social distancing, significant closure of...
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 the first page and a hash-marked visual analogue scale (EQ-VAS) on the second page. Importantly, responses to the DS can be converted into a utility...
Editorial
Transcatheter Aortic Valve Implantation in Singapore: Reflecting on the First Decade
Transcatheter aortic valve implantation (TAVI) has markedly changed the way aortic valve stenosis is treated. It is 18 years since the first patient was treated with TAVI for severe aortic stenosis. The original concept of TAVI was simple: insert a stent-like device by creating an opening in the obstructed...
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 (Ministry of Health, Singapore, unpublished data). Children generally have mild disease, although there is emerging literature on paediatric multisystem inflammatory syndrome temporally associated with COVID-19....
Original Article
Comparative Analysis of Symptomatic and Asymptomatic SARS-CoV-2 Infection in Children
Singapore confirmed its first case of COVID-19 on 23 January 2020 in a Chinese national from Wuhan, and its first paediatric case on February 4, 2020. As of 24 July 2020, Singapore has reported 49,071 cases of COVID-19. Singapore initiated a comprehensive surveillance, testing and contact tracing strategy as...
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 number of cases soared across 34 regions in Mainland China and surpassed that of severe acute respiratory syndrome (SARS) in 2003. The virus was believed...