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Predictors of early removal of intragastric balloon due to intolerance: Insights from a multiethnic Asian cohort

Obesity, affecting over 2.1 billion people globally, is an escalating health crisis with serious economic consequences.1 It is associated with multiple comorbidities including type 2 diabetes mellitus (T2DM), hypertension, coronary artery disease, stroke, sleep apnea, osteoarthritis and even certain cancers.2 In the US alone, USD190 billion per year is...

Beyond survival: Addressing gaps in psychosocial support for survivors of childhood cancer

I read with great interest the study conducted by Fong et al. published in this issue of Annals, which evaluated psychological symptoms and health-related quality of life (HRQOL) among a cohort of 143 young adult survivors of childhood cancer in Singapore.1 Almost 1 in 4 survivors demonstrated significant psychological...

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...

Prevalence and risk factors of depression and anxiety in primary care

The global prevalence of individuals living with a mental disorder in 2019 was 970 million, with anxiety and depressive disorders being the most common.1 The Singapore Mental Health Study 2016 showed that the lifetime prevalence of at least one mood, anxiety or alcohol use disorder was 13.9% in the...

Asian media reporting on suicide: Concerning trends

Asharani et al. present an enlightening study of media influences on suicidality and suicides from multinational data, all within Asia.1 This is important, as knowledge based on media and suicide has been dominated by Western cultures and English and other European languages. Pulling together various independent studies, as Asharani...

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...

Impact of pre-existing depression on severe COVID-19 outcomes

The outbreak of the COVID-19 virus in 2019 had rapidly developed into a global pandemic, causing more than 6.8 million deaths and impacting the lives of billions of individuals around the world.1 Public healthcare around the work have mainly focused on the clinical manifestations and treatment of the deadly...

Healthcare worker job burnout, anxiety and depression: A one-year comparison during COVID-19 in Singapore

Dear Editor, The mental health of our healthcare workforce has never been as scrutinised as it has the last three years since the COVID-19 pandemic. Worldwide, appreciation of healthcare workers (HCWs) as the first line of defence during the pandemic soared, even as studies of HCW mental wellness increased exponentially.1,2...

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...

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...

Self-esteem and positive body image to overcome female sexual dysfunction

Human sexuality is arguably one of the main pillars of health, like nutrition and sleep. Improvements in diagnostic and therapeutic biotechnologies have enabled focus on not only deadly diseases, but also on the quality of life and sexual functions of men and women. Digital media also play a considerable...

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...

The global emergence of monkeypox

Monkeypox is so named because the poxvirus was first identified in 2 outbreaks among cynomolgus monkeys housed at the Statens Serum Institut, Denmark, in 1958.1 Both outbreaks occurred approximately 2 months after the monkeys arrived by plane from Singapore.1 However, the natural reservoir of the virus is not monkeys...

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...

The moderating effect of employment status on the relationship between lifetime major depressive disorder and positive mental health

Studies across the world have reported a high prevalence of mental disorders,1-3 highlighting that mental disorders remain one of the major causes of “non-fatal burden”.4 In particular, major depressive disorder (MDD) has been identified as a highly prevailing mental disorder and the leading cause of disability worldwide. More than...

The relationship between major depressive disorder and employment status

Major depressive disorder is associated with executive dysfunction that includes impairment in problem-solving and decision-making,1 as well as with occupational impairment.2 One of the challenges during the COVID-19 pandemic has been to maintain employment status. It has been reported that employment status is associated with measures of quality of...

Body Mass Index and Its Related Factors in the Elderly

Cardiovascular disease is one of the leading causes of mortality and morbidity in developed countries, especially among the elderly. In Taiwan, cardiovascular disease is the third leading cause of death after neoplasm and cerebrovascular disease. This article is available only as a PDF. Please click on “Download PDF” on top...

Body Mass Index Profile in Hong Kong Chinese Adults

Obesity is considered a chronic disease and not just a social stigma due to the associated morbidity and early mortality. Obesity has now become an epidemic with increasing prevalence in most parts of the world. This article is available only as a PDF. Please click on “Download PDF” on top...

Subdural Block—From a Spinal? A Case Report

There have been multiple reports of accidental subdural blocks published in the last 20 years. Majority of these have been the result of an epidural gone astray, and the lowest reported volume of local anaesthetic used was 3.5 mL. This article is available only as a PDF. Please click on...

Diabetes in Asia – From Understanding to Action

In the present pandemic of diabetes and obesity, 60% of the affected population will come from Asia. Between India and China, these two most populous nations will contribute more than 100 million to the world’s population of people with diabetes, many of whom remain undiagnosed, untreated or suboptimally managed. This...

The Metabolic Syndrome in Hypertensive and Normotensive Subjects: The Isfahan Healthy Heart Programme

The metabolic syndrome (MS) is characterised by a clustering of metabolic risk factors and an insulin-resistant state.1 Its prevalence is high in Western, as well as Asian, populations.2-4 There are numerous correlations between the MS and hypertension, although this is not always the case.5 Resistance to insulin-mediated glucose disposal...

Risk Factor Profile and Treatment Patterns of Patients with Atherothrombosis in Singapore: Insight from the REACH Registry

Atherothrombosis is a global problem that affects every ethnic group. It can lead to ischemic stroke, myocardial infarction or vascular death. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

A Brief History of the Chapter of Psychiatrists

The Inaugural Meeting of the Chapter of Psychiatrists and Chapter of Pathologists, Academy of Medicine, was held on 5 December 1986 at King’s Hotel.1,2 At that time the Academy already had 7 Chapters in her fold. The Chairman, Dr Lawrence Chan (then Master of the Academy of Medicine) remarked...

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. This article is available only as a PDF. Please click on “Download PDF” on...

The Role of Leptin-Melanocortin System and Human Weight Regulation: Lessons from Experiments of Nature

Obesity predisposes to significant morbidities and premature mortality, and the increasing obesity prevalence all over the world has been attributed to industrialisation and modernisation which encourages a sedentary lifestyle and increased calorie intake. This results in energy intake and expenditure imbalance and the net deposition of calories as fat....

The Role of Genes in the Current Obesity Epidemic

Obesity is a global pandemic and a major health concern because of the consequent morbidity and premature mortality; obesity predisposes to serious morbidities such as type 2 diabetes, hypertension and coronary heart disease. Industrialisation and modernisation is rightly blamed for the increasing obesity prevalence all over the world, as...

The Relevance of the Metabolic Syndrome

Metabolic syndrome describes a constellation of interrelated metabolic risk factors, in which components coexist more frequently in a given individual than could be expected by chance alone. These risk factors include hypertension, hyperglycaemia, dyslipidaemia and obesity. The underlying pathophysiology is as yet unclear, but has been closely linked to...

Development of Bariatric Surgery: The Effectiveness of a Multi-disciplinary Weight Management Programme in Hong Kong

Obesity is one of the most common chronic illnesses in the Western World with a frequency of 10% to 15%. It causes or exacerbates many diseases and is associated with major physical and psychological disability. Data from US national population surveys have shown that the prevalence of being overweight...

Prevalence of Metabolic Syndrome Among Patients with Schizophrenia in Singapore

Schizophrenia has been linked to metabolic disturbances such as obesity, dyslipidaemia and hyperglycaemia. It has also been associated with a more than 3-fold increase in mortality associated with cardiovascular causes. This increase in cardio-metabolic morbidity and mortality might be due to several factors such as inherent genetic vulnerability or...

Prevalence of Overweight and Obesity in Chinese Preschoolers in Singapore

The increasing prevalence of childhood overweight and obesity and its associated adverse health outcomes have become an important health issue. Childhood obesity can persist into adulthood and increases the risk of cardiovascular metabolic diseases, giving rise to an increased healthcare burden. In Singapore, the prevalence of obesity for adults...

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....

New-onset cardiovascular risk factors following liver transplantation: A cohort analysis in Singapore

Malnutrition is well described in liver cirrhosis. The hyperdynamic circulation and altered metabolism in cirrhosis result in a hypercatabolic state which accelerates tissue breakdown. Ascites and gastrointestinal dysmotility in advanced cirrhosis, compounded by the need for dietary restrictions, often result in early satiety and anorexia. Inevitably, liver transplant wait-list...