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Biomedical subjects

K T Chee

Publications and source records attributed to K T Chee.

At least 19 recordsLinked to original sources
PubMed2001

Depression in the planet's largest ethnic group: the Chinese.

OBJECTIVE: The authors reviewed the evidence for the claim that the Chinese tend to deny depression or express it somatically, examined the possible determinants of those characteristics, and explored implications of the findings for the diagnosis and management of depression in China and for psychiatry in the WEST: METHOD: This paper reviews and interprets original studies and literature reviews considering emotional distress, depression, neurasthenia, and somatization in Chinese subjects. RESULTS: Interpretation of the literature is complicated by the considerable heterogeneity among people described as "the Chinese" and by numerous factors affecting collection of data, including issues of illness definition, sampling, and case finding; differences in help-seeking behavior; idiomatic expression of emotional distress; and the stigma of mental illness. Despite difficulties in interpreting the literature, the available data suggest that the Chinese do tend to deny depression or express it somatically. CONCLUSIONS: The existing evidence supports the hypothesis that the Chinese tend to deny depression or express it somatically. However, Western influences on Chinese society and on the detection and identification of depression are likely to have modified the expression of depressive illness quite sharply since the early 1980s. Analyzing these changes may provide useful insight into the evolution of the diagnosis of depression in Western and other cultures.

Acculturation↗
PubMed1999

Clinical evaluation of risperidone in Asian patients with schizophrenia in Singapore.

OBJECTIVE: To evaluate the short-term efficacy and safety of risperidone in a group of Asian patients with schizophrenia in an 8-week open-label, prospective study. METHODS: Patients with DSM-IV schizophrenia were recruited from Woodbridge Hospital. After a washout period, they were started on a 56-day trial of risperidone. Outcome was assessed with the positive and negative syndrome scale (PANSS), the clinical global impression scale (CGI) and the extrapyramidal symptom rating scale (ESRS). RESULTS: The mean daily risperidone dose at end point was 5.6 mg (range, 3 to 8 md/day). Mean PANSS scores were reduced significantly from 78 +/- 15.1 at baseline to 56.6 +/- 10.9 at end point. Seventeen patients (85%) who were treatment responders, showed at least a 20% reduction in total PANSS scores at end point while nine patients (45%) had a greater than 50% reduction in the total PANSS scores. According to the CGI scale, 85% improved at end point. The severity of extrapyramidal symptoms (mean ESRS scores) were significantly lower at end point than at baseline. CONCLUSIONS: Risperidone was effective in the treatment of positive and negative symptoms of schizophrenia.

Adult↗
PubMed1995

Management of panic disorder.

Symptoms of panic attack can be found in both medical disease and mental disorder. At least 4 of 13 diagnostic symptoms need to be present to constitute an attack which onset is sudden and unpredictable. The duration of attack usually lasts minutes but sometimes longer. In panic disorder there is recurrent attacks of severe anxiety which are unprovoked and unexpected. Dominant symptoms vary from person to person. The syndrome is likely to be heterogeneous as the biological aetiology may be related to abnormalities in the function of a number of neurotransmitters ie serotonin, noradrenaline, gamabutyric acid, dopamine and cholecystokinin. As such different benzodiazepines and anti-depressants are efficacious in the treatment of the disorder. Medications should be titrated to prevent attacks and restore confidence. Maintenance therapy needs to be balanced with premature termination of treatment. Reassurance is important and there is a place for cognitive behavioural therapy, relaxation exercise and breathing control technique.

Anti-Anxiety Agents↗
PubMed1994

Oculogyric spasm in Asian psychiatric in-patients on maintenance medication.

BACKGROUND: The objective was to investigate the occurrence and characteristics of oculogyric spasm (OGS) in an Asian country. METHOD: All 2035 Asian (88% Chinese, 7% Malays and 5% Indonesians) psychiatric in-patients in the state psychiatric hospital in Singapore were surveyed for occurrence of oculogyric spasm (OGS) over a two-month period. RESULTS: Thirty-four patients (1.7%) developed OGS (53% male and 47% female). All the 34 patients had been on maintenance antipsychotic drugs for more than five months. Eighteen patients had recurrent attacks. The mean chlorpromazine equivalent daily dose for those patients with recurrent OGS was 511 mg. This was significantly higher (P < 0.05) than the 277 mg daily dose received by those without recurrent OGS. Most (68%) of the attacks occurred between 1400-2000 h suggesting that OGS may have a diurnal variation. CONCLUSIONS: OGS presenting as tardive dystonia may be due to a relative increase in cholinergic activity.

Adult↗
PubMed1994

De Clerambault syndrome and medical practitioners: medico legal implications.

De Clerambault's syndrome or erotomania is a condition in which a patient, usually a woman, develops a delusional belief that a man, usually older and of higher social status, is in love with her. This paper describes such cases where medical practitioners were involved. In a case where a doctor was brought to court, the judge stressed that because of the nature of the allegation, it was vital that there be corroborative evidence. When faced with such patients, a prudent doctor would ensure that a nurse be in attendance at all times, that notes be carefully kept and phone calls recorded. Other measures might be necessary, depending on the situation.

Delusions↗
PubMed1994

A postmarketing surveillance study of zopiclone in insomnia.

Zopiclone, a novel cyclopyrrolone compound has recently become available for the treatment of insomnia in Singapore. Pharmacodynamic and pharmacokinetic studies have shown it to be an effective hypnotic with a good safety profile and minimal side-effects. The efficacy of Zopiclone was studied in a group of patients with insomnia (n = 40). The study group comprised patients with and without a psychiatric diagnosis. About two-thirds (65%) of the patients had been on hypnotics previously without relief of the insomnia. There was improvement in the various sleep parameters studied: sleep latency, sleep duration, night awakening, sleep quality, dreams, "day-after" effects. The drug was well-tolerated and only four patients experienced minor side-effects.

Adult↗
PubMed1992

Medico-legal implications of electro-convulsive therapy--a Singapore viewpoint.

The clinical characteristics of 100 consecutive cases of ECT in a state mental hospital were surveyed. The medico-legal implications with regards to indications for and consent to ECT were looked into. The findings showed that ECT was given mostly for management reasons rather than based on diagnosis. Only 2 patients out of 100 gave their own consent. The discrepancy between teaching and practice was discussed.

Adolescent↗
PubMed1990

Depersonalization syndrome--a report of 9 cases.

Depersonalization is defined and the clinical characteristics of 9 patients presenting with Depersonalization Syndrome are discussed. The cases comprise 5 males and 4 females with an age range of 15-47 years, of which two-thirds presented with an acute onset of symptoms. The diagnosis is made on the patients' own descriptions of their symptoms. Criteria laid out by Ackner and ICD-9 are closely adhered to. The findings of the study are compared with those of Shorvon's 66 cases and similarities are found. Depersonalization symptoms described by Mayer-Gross are reviewed. That depersonalization itself appears to have an affective aspect and a somatic aspect is noted, and an explanation for both aspects is attempted. The resistance to various treatment is confirmed.

Adolescent↗
PubMed1989

Diminished responsibility--a psychiatric viewpoint.

Diminished responsibility is based on the notion that mental disorder may make a person only partially accountable for his act in the killing of another person. For this plea to succeed it has to be shown that an accused has to be suffering from such an abnormality of mind that his responsibility for the action is substantially diminished. As these concepts of abnormality of mind and criminal responsibility do not fit easily into psychiatric classification of mental disorders, nine senior psychiatrists who regularly attend court as expert witnesses were surveyed and their viewpoints about mental abnormality and diminished responsibility were elected.

Attitude of Health Personnel↗
PubMed1986

A cross-cultural study of the possession-trance in Singapore.

Possession-trance is a common culture-bound syndrome in Singapore. The characteristic features as seen in 36 young men of the three different ethnic communities are described. At follow-up four to five years later, none of the 26 who could be contacted showed any evidence of mental illness. The psychopathology of the possession-trance is discussed.

Adolescent↗