New Territories, Hong Kong
New Territories, Hong Kong

Time filter

Source Type

Cheng S.-T.,The Hong Kong Institute of Education | Chow P.K.,The Hong Kong Institute of Education | Yu E.C.S.,Kwai Chung Hospital | Chan A.C.M.,University of Hong Kong | And 2 more authors.
American Journal of Geriatric Psychiatry | Year: 2014

Objectives: To examine the effects of cognitive stimulation (mahjong) and physical exercise (tai chi [TC]) on cognitive performance in persons with dementia. Design: Cluster-randomized open-label controlled design. Setting: Nursing homes. Participants: One hundred ten residents,most ofwhomwere cholinesterase-inhibitor naive. Inclusion criteria were Mini-Mental State Examination (MMSE) = 10-24 and suffering from at least very mild dementia (Clinical Dementia Rating ≥ 0.5). Exclusion criteria were being bedbound, audio/visual impairment, regular activity participation before study, or contraindications for physical or group activities. Interventions: Homes were randomized into three conditions (mahjong, TC, and simple handicrafts [control]). Activities were conducted three times weekly for 12 weeks. Measurements: Primary outcome was MMSE. Secondary outcomes were immediate/delayed recall, categorical fluency, and digit span. Various biological risk factors, including apolipoprotein E e4 allele, were included as covariates. Measures were collected at 0 (baseline), 3 (posttreatment), 6, and 9 months. Results: Intent-to-treat analyses were performed using mixed-effects regression. Mahjong's effect varied by time for MMSE, delayed recall, and forward digit span. TC had similar effects but not for delayed recall. The typical pattern was that control participants deteriorated while mahjong and TC participants maintained their abilities over time, leading to enlarged treatment effects as time progressed. By 9 months, mahjong and TC differed from control by 4.5 points (95% confidence interval: 2.0-6.9; d = 0.48) and 3.7 points (95% confidence interval: 1.4-6.0; d = 0.40), respectively, on MMSE. No treatment effects were observed for immediate recall and backward digit span. Conclusions: Mahjong and TC can preserve functioning or delay decline in certain cognitive domains, even in those with significant cognitive impairment. © 2014 American Association for Geriatric Psychiatry.


Chiu M.Y.L.,Hong Kong Baptist University | Ho W.W.N.,Hong Kong Baptist University | Lo W.T.L.,Kwai Chung Hospital | Yiu M.G.C.,United Christian Hospital
Quality of Life Research | Year: 2010

Purpose: To test empirically the Substance Abuse and Mental Health Services Administration (SAMHSA) recovery model. Methods: Two hundred and four attendants aged 18-60, with schizophrenia spectrum disorder, from two participating outpatient clinics were interviewed with a number of inventories, including health-related quality of life measure (WHOQOL-BREF (HK)). Canonical correlation analysis was performed on two sets of variables (SAMHSA recovery components and QoL domain scores). Results: There were significant correlations between most recovery components proposed in the SAMHSA recovery statement and the health-related quality of life measure. Age, duration of untreated psychosis, the degree of social support, the interaction of singlehood and the number of confidants, engagement in competitive careers, and the duration of participation in community support services were all found to be important predictors. Conclusions: The SAMHSA consensus statement appeared to contain valid concepts for Chinese subjects. It presented new challenges for psychiatric rehabilitation and reminded the policy makers that there is much more psychiatric rehabilitation can achieve beyond symptom control and patient management. It also demonstrated that resolve and the commitment of resources to combat stigma, develop resilience, and foster patient empowerment were very much needed in Hong Kong and perhaps in Asia and elsewhere. © 2009 Springer Science+Business Media B.V.


Ho W.W.N.,Hong Kong Baptist University | Chiu M.Y.L.,Hong Kong Baptist University | Lo W.T.L.,Kwai Chung Hospital | Yiu M.G.C.,United Christian Hospital
Australian and New Zealand Journal of Psychiatry | Year: 2010

Objective: The Substance Abuse and Mental Health Services Administration (SAMHSA) National Consensus Statement on Mental Health Recovery proposed 10 recovery components as guiding principles for fostering recovery among people with severe mental illness. Although researchers have recognized a close association between patient-oriented recovery and health-related quality of life (HRQOL), the relation between the recovery components and patients' self-reported HRQOL is still unknown. The purpose of the present study was therefore to use structural equation modelling to predict HRQOL of schizophrenia outpatients from the recovery components proposed by SAMHSA. Methods: The recovery status of 201 outpatients with schizophrenia, schizophreniform, or schizoaffective disorder was measured using 12 variables that indicate the outcome of 10 recovery components. Canonical correlation analysis was applied to screen variables that are highly correlated with HRQOL. Valid variables were then used to build a structural model that predicted individuals' HRQOL as indicated by the World Health Organization Quality of Life Measure Abbreviated (WHOQOL-BREF (HK)). Results: The bestfit model was able to explain 80.7% of the variance in WHOQOL-BREF outcome. The model demonstrated significant direct and indirect effects of five recovery components on HRQOL. The effect of psychosocial symptoms on HRQOL was highest (total β -0.64), followed by sense of personal agency (total β 0.58), sense of optimism (total β 0.54), perceived support (total β 0.47), and internal stigma (total β -0.42). Conclusion: The recovery components proposed by the SAMHSA consensus statement provided a useful framework to explain HRQOL of outpatients with schizophrenia. The present model indicated a moderate to large effect of five major recovery components on HRQOL. It showed that patients' perceptions of support, optimism, and personal agency were influenced by psychosocial symptoms and internal stigma. This empirical study supported the use of recovery principles, such as resilience building or mastery-based intervention to improve the QOL of community dwellers with schizophrenia. © 2010 The Royal Australian and New Zealand College of Psychiatrists.


Cheng S.-T.,The Hong Kong Institute of Education | Chow P.K.,The Hong Kong Institute of Education | Yu E.C.S.,Kwai Chung Hospital | Chan A.C.M.,University of Hong Kong
American Journal of Geriatric Psychiatry | Year: 2012

OBJECTIVES: To examine whether leisure activities can alleviate depressive symptoms among nursing home residents with very mild to mild dementia. METHODS: A cluster-randomized open-label controlled design. Thirty-six residents with at least moderate depressive symptoms were randomized by home into three conditions-mahjong (a.k.a. mah-jongg), tai chi, and handicrafts (placebo). Activities were conducted three times weekly for 12 weeks. Outcome measure was Geriatric Depression Scale (GDS) administered at baseline, posttreatment, and at 6 months. RESULTS: Repeated-measures analysis of variance showed a group by time interaction on the GDS. Unlike control and tai chi participants whose scores remained relatively unchanged, the mahjong group reported a drop of 3.25 points (95% confidence interval: 1.00-5.50) on the GDS at posttreatment but gained back 2.83 points (95% confidence interval: 1.95-5.47) at 6 months. Activity discontinuation might be the reason for depression to return to baseline. CONCLUSIONS: Mahjong can lower depressive symptoms in those with mild dementia, but activity maintenance may be essential for long-term effects. © 2012 American Association for Geriatric Psychiatry.


Cheng S.K.,Kwai Chung Hospital | Dizon J.,University of South Australia
Psychotherapy and Psychosomatics | Year: 2012

Background: Computerised cognitive behavioural therapy (CCBT) is an innovative mode of delivering services to patients with psychological disorders. The present paper uses a meta-analysis to systematically review and evaluate the effectiveness of CCBT for insomnia (CCBT-I). Method: A comprehensive search was conducted on 7 databases including MEDLINE, PsycINFO, EMBASE, CINAHL, Cochrane Library, Social Sciences Citation Index and PubMed (up to March 2011). Search terms covered 3 concepts: (1) [internet, web, online, computer-aided, computer-assisted, computer-guided, computerized OR computerised] AND (2) [CBT, cognitive therapy, behavio(u)ral therapy OR behavio(u)r therapy] AND (3) [insomnia, sleep disorders OR sleeping problem]. Results: 533 potentially relevant papers were identified, and 6 randomised controlled trials (RCTs) that met the selection criteria were included in the review and analysis. Two RCTs were done by the same group of investigators (Ritterband and colleagues) using the same internet programmes. Post-treatment mean differences between groups showed that the effects of CCBT-I on sleep quality, sleep efficiency, the number of awakenings, sleep onset latency and the Insomnia Severity Index were significant, ranging from small to large effect sizes. However, effects on wake time after sleep onset, total sleep time and time in bed were non-significant. On average, the number needed to treat was 3.59. The treatment adherence rate for CCBT-I was high (78%). Conclusion: The results lend support to CCBT as a mildly to moderately effective self-help therapy in the short run for insomnia. CCBT-I can be an acceptable form of low-intensity treatment in the stepped care model for insomnia. Copyright © 2012 S. Karger AG.


Lee G.Y.,Kwai Chung Hospital | Yip C.C.K.,Kwai Chung Hospital | Yu E.C.S.,Kwai Chung Hospital | Man D.W.K.,Hong Kong Polytechnic University
Clinical Interventions in Aging | Year: 2013

Background: Improving the situation in older adults with cognitive decline and evidence of cognitive rehabilitation is considered crucial in long-term care of the elderly. The objective of this study was to implement a computerized errorless learning-based memory training program (CELP) for persons with early Alzheimer's disease, and to compare the training outcomes of a CELP group with those of a therapist-led errorless learning program (TELP) group and a waiting-list control group. Methods: A randomized controlled trial with a single-blind research design was used in the study. Chinese patients with early Alzheimer's disease screened by the Clinical Dementia Rating (score of 1) were recruited. The subjects were randomly assigned to CELP (n = 6), TELP (n = 6), and waiting-list control (n = 7) groups. Evaluation of subjects before and after testing, and at three-month follow-up was achieved using primary outcomes on the Chinese Mini-Mental State Examination, Chinese Dementia Rating Scale, Hong Kong List Learning Test, and the Brief Assessment of Prospective Memory-Short Form. Secondary outcomes were the Modified Barthel Index, Hong Kong Lawton Instrumental Activities of Daily Living Scale, and Geriatric Depression Scale-Short Form. The data were analyzed using Friedman's test for time effect and the Kruskal-Wallis test for treatment effect. Results: Positive treatment effects on cognition were found in two errorless learning-based memory groups (ie, computer-assisted and therapist-led). Remarkable changes were shown in cognitive function for subjects receiving CELP and emotional/daily functions in those receiving TELP. Conclusion: Positive changes in the cognitive function of Chinese patients with early Alzheimer's disease were initially found after errorless training through CELP. Further enhancement of the training program is recommended. © 2013 Lee et al, publisher and licensee Dove Medical Press Ltd.


Man D.W.K.,Hong Kong Polytechnic University | Chung J.C.C.,Hong Kong Polytechnic University | Lee G.Y.Y.,Kwai Chung Hospital
International Journal of Geriatric Psychiatry | Year: 2012

Background Older adults with questionable dementia are at risk of progressing to dementia, and early intervention is considered important. The present study investigated the effectiveness of a virtual reality (VR)-based memory training for older adults with questionable dementia. Methods A pre-test and post-test design was adopted. Twenty and 24 older adults with questionable dementia were randomly assigned to a VR-based and a therapist-led memory training group, respectively. Primary outcome measures included the Multifactorial Memory Questionnaire and Fuld Object Memory Evaluation. Results Both groups demonstrated positive training effects, with the VR group showing greater improvement in objective memory performance and the non-VR group showing better subjective memory subtest results in the Multifactorial Memory Questionnaire. Conclusion The use of VR seems to be acceptable for older adults with questionable dementia. Further study on the effect of educational background and memory training modality (visual, auditory) is warranted. Copyright © 2011 John Wiley & Sons, Ltd.


Two women presented independently with a clinical picture of mania-like psychosis after taking over-the-counter herbal slimming pills. Subsequent toxicology investigation found sibutramine in the samples of both patients. Sibutramine is an effective pharmacological treatment for obesity with a relatively favourable side-effect profile. However, neuropsychiatric side-effects of sibutramine have emerged with increasing use of the medication. Sibutramine may be associated with the development of psychotic symptoms in susceptible individuals. Further studies should aim at establishing any causal relationship between sibutramine and psychosis. There also seems to be an emerging trend of adulteration of over-the-counter slimming products with pharmaceutical analogues in Hong Kong. Physicians should be vigilant to the possibility of non-prescribed drug use when patients present with suspicious symptoms while using herbal remedies. © 2010 Hong Kong College of Psychiatrists.


Liem S.K.,Kwai Chung Hospital | Lee C.C.,Kwai Chung Hospital
Psychiatric Services | Year: 2013

Objective: This study examined the effectiveness of assertive community treatment (ACT) for a group of psychiatric patients in Hong Kong with frequent hospital admissions. Methods: The study compared hospitalization and other outcomes among participants of a two-year ACT intervention and a control group who had received treatment as usual two years earlier. The patients were Chinese adult psychiatric patients who had three or more admissions in the 12 months before the study. Results: Seventy patients were recruited for each group. Although all the outcome measures decreased with time for both groups, repeatedmeasures analysis of variance indicated that the treatment group had significantly greater reductions in readmission rate, length of stay, and total days between a missed medical appointment and the next service contact. Conclusions: ACT was effective in reducing hospitalization and enhancing service contacts for a group of Chinese psychiatric patients with frequent hospital admissions.


Kwok H.W.M.,Kwai Chung Hospital | Cui Y.,Beijing Huilongguan Hospital | Li J.,Chinese Academy of Sciences
Current Opinion in Psychiatry | Year: 2011

PURPOSE OF REVIEW: This review aims to provide an overview of the current status and recent developments in epidemiology, public policy and services for children and adults with intellectual disability in China. RECENT FINDINGS: The most recent national survey on disability conducted in 2006 estimated that the prevalence of intellectual disability was 0.75% in China. People with intellectual disability accounted for 11.9% of all the people with disabilities and they have an uneven geographical distribution. The prevalence in urban areas was 0.4%, whereas that in rural areas was 1.02%. The Constitution of the People's Republic of China stated that people with disabilities have the right to receive assistance from the state and society. Based on this, laws have been formulated and revised to protect people with disabilities in areas of education, employment and rehabilitation. The variety, capacity and quality of services for people with intellectual disability are steadily increasing or improving, but there are still gaps and deficiencies such as mental health care and professional services. SUMMARY: Supported by the Central Government of the People's Republic of China, there has been remarkable progress in the formulation of policies and provision of services for people with intellectual disability in recent years. However, there continue to be a lot of unmet needs among this population, particularly those living in rural areas. Therefore, further commitment, coordination and resource allocation are required to improve the lives of people with intellectual disability in China. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Loading Kwai Chung Hospital collaborators
Loading Kwai Chung Hospital collaborators