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An unusual case of ear pain in a child

A previously healthy 4-year-old French boy presented to the children’s emergency department complaining of left otalgia for 3 days. He had initially experienced left...

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...

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...

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...

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,...

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...

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....

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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,...

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....

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...

HIV/AIDS in Children

The human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) epidemic in Asia has grown from a handful of cases to a major...

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...

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...

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...

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...

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...

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...

Viral Warts in Children Seen at a Tertiary Referral Centre

Viral warts are a common affliction in children. It is caused by the human papilloma virus, of which there are more than 80 serotypes. This...

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...

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...

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...

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...

“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;...

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...

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...

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...

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...

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...

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...

Suicide

The word suicide is derived from the Latin word suicidium, itself derived from sui (of oneself) and cidium (a killing; caedere = to kill....

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...

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...

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...

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....

Immunogenicity, Reactogenicity and Safety of a Diphtheria-Tetanus-Acellular Pertussis-Inactivated Polio and Haemophilus Influenzae Type b Combination Vaccine in a Placebo-controlled Rotavirus Vaccine Study

Singapore’s national immunisation programme for the 6 traditional Expanded Programme on Immunisation (EPI) vaccines (i.e. BCG, diphtheria, tetanus, pertussis, polio and measles) and hepatitis...

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...

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...

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...

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...

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...

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....

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...

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...

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...

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...

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...

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...

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...

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...

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...

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....

Severe Vitamin B12 Deficiency in a 7-Month-Old Boy

Infantile vitamin B12 deficiency often affects children born to mothers whose nutritional intake is inadequate. We describe a 7-month-old boy with a 2-month history...

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...

Risk Factors for Severe Adenovirus Infection in Children during an Outbreak in Singapore

Human adenoviruses (HAdVs) are well known pathogens that cause a variety of human illnesses. They are non-enveloped, linear double-stranded deoxyribonucleic acid (DNA) viruses. More...

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...

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,...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...