Biomedical subjects

S M Ko

Publications and source records attributed to S M Ko.

18 recordsLinked to original sources

PubMed1995

Psychiatric referrals from an accident and emergency department in Singapore.

A total of 500 consecutive psychiatric referrals from the Accident and Emergency (A&D) Department of the National University Hospital of Singapore were studied with regard to their demographic characteristics, diagnoses, presenting problems and management. There were 314 females (62.8%) and 186 males (37.2%), and the mean age of subjects was 35.5 years. The three main diagnoses were anxiety disorders (25.6%), depression (19.4%) and schizophrenia (17.6%). About 41% were admitted, of whom two-fifths were initially admitted to the medical ward because of drug overdose or alcohol intoxication. A further 34% were treated as out-patients, and 21% were discharged.

Adult↗

PubMed1994

The ageing of elderly people.

OBJECTIVE: To assess the performance of activities of daily living, social resources and incidence of dementia in a cohort of elderly Chinese. DESIGN: This was a longitudinal study which measured changes in a five-year interval. SETTING: The study was conducted in the Henderson district of Singapore at the subjects' homes and at a day centre. SUBJECTS: A random sample of elderly Chinese was selected in 1985 from the electoral roll of the Henderson constituency and reassessed after 5 years. OUTCOME MEASURES: A semi-structured questionnaire adapted from the Older American Resources and Services, and the computerised mental state programme, GMS-AGECAT. RESULTS: There was no apparent change in social resources after 5 years and the majority of the elderly (80.3%) were still living with their families. On activities of daily living, there was a significant decline especially after the age of 75. The incidence of dementia was 2.01%--the rate of Alzheimer's disease was 0.67% and multi-infarct dementia 1.34%. CONCLUSION: The change in performance of activities of daily living after the age of 75 and the low incidence of dementia were similar to studies in Europe and the United States.

Activities of Daily Living↗

PubMed1994

Blood-injury phobia.

Blood-injury phobia is a unique and peculiar phobia. It is different from other phobias in that it evokes a diphasic cardiovascular response; it has a propensity to induce fainting and nausea more than fear and anxiety; and often there is a family history of a similar phobia. Although it may cause no great difficulty or social handicap in everyday life compared to social phobia, agoraphobia or other simple phobias, it can have grave implications and may even become life-threatening when it prevents essential medical procedures. Unfortunately, not many of its sufferers come for treatment until circumstances require urgent attention. Yet, it can be effectively treated behaviourally by modeling and exposure therapy. Two cases of this fascinating condition are described.

Adult↗

PubMed1994

Neurotic depression in the elderly.

Depression is a common condition in the geriatric population. A retrospective study of 30 elderly patients suffering from neurotic depression, who were admitted consecutively to a general hospital psychiatric ward, showed a predominance of females (n = 21) over males (n = 9) and young-old (65 to 74 years, n = 22) more than old-old (75 years or over, n = 8). Their ages ranged from 65 to 85 years with a mean of 71.6 years, SD 5.5 years. Co-existing physical disorders were present in every patient, the average being 1.8 per patient, and half (n = 15) had two or more physical disorders. Cardiovascular diseases (e.g. ischaemic heart disease and hypertension) and diabetes mellitus were present in about seven-eighths of the patients. The two commonest symptoms were low mood (n = 18, 60%) and vague somatic complaints inexplicable by any physical pathology (n = 19, 63%). Sleep disturbance bothered 12 patients (40%), while nine (30%) had attempted suicide. Twenty patients (67%) were prescribed antidepressants and 13 (43%) received benzodiazepines in low dosages, mainly as hypnotics. Electroconvulsive therapy was necessary for two patients with high suicidal risk. The mean duration of admission was 15.3 days, SD 12.9 days.

Aged↗

PubMed1993

Spirit possession and healing among Chinese psychiatric patients.

This is a study of the illness behaviour of 100 Chinese psychiatric patients referred consecutively to the psychiatric unit of a general hospital in Singapore. More women than men felt that their illness was due to spirit possession; but belief in possession was not related to educational status. Thirty-six patients or their relatives had consulted a traditional healer before going to the hospital. Duration of illness, sex and educational status were not associated with the tendency to seek help from the traditional healer; there was also no significant difference between psychotic or neurotic patients. The majority of depressed patients (72%) presented with somatic complaints of chest discomfort, headache and abdominal discomfort. Somatization was not related to the educational level or sex of the patients.

Adult↗

PubMed1992

A questionnaire to screen for cognitive impairment among elderly people in developing countries.

Most questionnaires designed to assess cognitive impairment among elderly people are constructed in the West, where literacy is high. However, such questionnaires may not be applicable in developing countries because of cultural differences or low literacy. The Elderly Cognitive Assessment Questionnaire (ECAQ) is derived from items in the Mini-Mental State Examination and Geriatric Mental State Schedule. It is a satisfactory scale for quantitative assessment of cognitive impairment among elderly people living in developing countries. This 10-item questionnaire shows a sensitivity of 85.3%, specificity 91.5%, positive predictive value 82.8% and overall miscalculation rate 10.5%. In a sample of 105 elderly subjects from 2 day centres and a psychiatric outpatient clinic in Singapore, the ECAQ was compared with Kahn's Mental Status Questionnaire. The sensitivity of the scales was found to be similar but the ECAQ had a higher specificity and positive predictive value, and lower overall miscalculation rate.

Age Factors↗

PubMed1992

A cross-cultural study of suicide among the elderly in Singapore.

In the general population of Singapore the mean annual suicide rate over 1985-88 was highest in the Indians (20.4 per 100,000), followed by Chinese (15.8 per 100,000), and the Malays (2.4 per 100,000). However, in the elderly population (65 years and over) the rate was highest in the Chinese (61.2 per 100,000) with Indians second (30.5 per 100,000), and Malays still the lowest (3.2 per 100,000). Among elderly Chinese, women had a higher suicide rate than men.

Adolescent↗

PubMed1992

Psychiatric syndromes in pernicious anaemia--a case report.

Surveys of psychiatric population had previously shown a high incidence of patients with low serum vitamin B12. A variety of psychiatric syndromes have been described, ranging from mild disturbance in mood state like depression to maniacal excitement; psychotic conditions like paranoid states and schizophrenia; and cognitive dysfunctions such as memory defect, delirium and dementia. A case of a 67-year-old Chinese lady suffering from pernicious anaemia, but presenting with prominent paranoid delusions is reported. Treatment with cyanocobalamine and anti-psychotic medication led to prompt resolution of her psychotic experience. Subsequently she developed a transient depressive syndrome which also responded well to a short course of antidepressant.

Aged↗

PubMed1991

New admissions to a psychiatric ward in a general hospital.

A study of 343 new patients in the first psychiatric department in a general hospital in Singapore revealed a large proportion (40%, n = 137) of neurotic patients, especially neurotic depressives (n = 76). The next largest group is the non-organic psychoses 35% (n = 120), most of which were schizophrenic psychoses (n = 73). The other major diagnostic groups were adjustment or acute stress reactions, alcohol or drug dependence and personality disorders. The neurotic patients were generally older than the psychotic patients at the time of admission (p less than 0.02). More of them were married (62.7%) compared with the psychotics of whom 51.5% remained unmarried (p less than 0.02). Comparison between neurotic depressives and manic-depressive psychotics should have no difference in sex ratio and marital status. However, the duration of admission for the latter was longer.

Adolescent↗

PubMed1990

Drinking problems.

This is a study of 54 patients referred for treatment of drinking problems. They were from two age groups--20 to 39 years and 40 to 59 years. More of the younger patients were referred by their families and older patients by their doctors or other health professionals. The younger patients had a mean duration of 8.2 years of drinking and were more severely dependent on alcohol (higher mean SADQ score). The older patients' mean duration of drinking was 14.1 years and had a lower mean SADQ score. More younger patients had work and family problems, but did not differ significantly from the older patients in alcohol-related physical or mental disabilities.

Adult↗

PubMed1989

Cotard's syndrome--two case reports.

Two cases of Cotard's Syndrome are described--one in a 33-year-old housewife suffering from paranoid schizophrenia and another in a 43-year-old housewife with acute psychotic depression. This rare syndrome is characterized by an extreme form of nihilistic delusion in which the patient, more frequently a woman, denies her own existence and that of the external world. Its onset is often sudden with no previous psychiatric history. Treatment of the condition depends on the underlying psychiatric illness. Both cases responded well to treatment.

Adult↗

PubMed1989

Cerebral tumours presenting with psychiatric symptoms.

Four cases of cerebral tumours presenting with psychiatric symptoms were referred to the psychiatrist for management. They displayed some degree of cognitive impairment, notably impaired memory for recent events, and nominal aphasia. Clinical neurological examinations were generally unremarkable with no evidence of focal signs or features of raised intracranial pressure. CT scan demonstrated parietal lobe lesions in all four patients with two showing involvement of the frontal lobe, one the temporal lobe and another the occipital lobe as well. Only one patient was operated, two died and the last continued treatment elsewhere. Factors contributing to the psychiatric symptomatology of cerebral tumours are raised intracranial pressure, location of the tumour, nature of the tumour and the individual constitution and response of the patient.

Brain Neoplasms↗

PubMed1989

A retrospective study of the profile of ESN children seen at the Child Psychiatric Clinic.

A retrospective study of 50 cases of educationally subnormal children seen at the Child Psychiatric Clinic was done. Almost half of the referrals were initiated by schools, the majority being picked up at Primary 1. Forty-six percent of fathers and sixty percent of mothers had no more than primary education. Eighty-two percent of fathers had unskilled or semi-skilled jobs. Besides being below average in academic performance in school, these children also showed some behavioural problems like restlessness, disobedience, bullying, quarrelling or fighting with other children. They tended to be solitary, unresponsive, inert or apathetic, and were not much liked by others. Although all the children were referred and registered for special education, only half the number of parents accepted the offer for their children.

Child↗

PubMed1989

A comparative study of new cases seen at the Child Psychiatric Clinic in 1975 and 1985.

A comparative analysis of new cases seen at the Child Psychiatric Clinic in 1975 and 1985 is made in this study. There was a three and a half fold increase in the number of patients seen from 245 to 893. There was no significant change in sex ratio or ethnic groups. However, in 1985 more younger children (aged less than 6 years) were seen at the Clinic. The waiting time remained short with half the number of cases seen within one week of appointment. The commonest conditions besides Normal Variation were Adjustment Reaction, Mental Retardation, Conduct Disorder and Neurosis. Three-fifths of cases were discharged from follow-up within three months of therapy. Most cases (90%) did not require pharmacological therapy whilst family therapy was prescribed for a fifth of cases seen in 1985.

Adolescent↗

PubMed1989

Work stress and mental distress.

In a study of 14 managers and 25 workers who were referred for psychiatric treatment, the majority suffered from depressive illness (60%) or anxiety neurosis (28%). The main work problem of the managers was conflict with the employers (or directors), but for the workers the main problem was difficulty with fellow workers. The patients' scores on the Work Environment Scale (WES) indicated that the managers felt they had little supervisor support and work pressure was great. However the workers complained of poor peer cohesion but could get on well with the employers, and their work was not too taxing.

Adolescent↗

PubMedDate not supplied

Family violence and Asian drinkers.

This is a study of 70 consecutive referrals to the Department of Psychological Medicine, National University Hospital, for treatment of drinking problems. There were 31 Chinese and 39 Indian drinkers, with 63 males and 7 females. Family violence with physical abuse occurred in 21 cases (30%). One of three wives of drinkers had been physically abused, but no children were victims. Drinkers with family violence were generally younger and more severely dependent on alcohol than the non-violent drinkers. There was no relationship between family violence and the ethnicity or marital status of the drinkers.

Adult↗

PubMedDate not supplied

Calcium, magnesium, and psychotic symptoms in a girl with idiopathic hypoparathyroidism.

A case of psychosis due to idiopathic hypoparathyroidism (IHP) has been followed for over 9 years. The optimal treatment for IHP psychosis was found to be a combination of ergocalciferol and fairly large doses of antipsychotic medication. In general, psychotic episodes occurred when there was hypocalcemia, hypercalcemia, or hypomagnesemia. Antipsychotic medication was not efficacious unless serum calcium and magnesium levels were both normal. It is suggested that psychiatric disturbances in hypoparathyroidism and treatment resistance to antipsychotic medication in other functional psychoses may also be related to hypomagnesemia.

Adolescent↗

PubMedDate not supplied

Pharmacotherapy of obsessive-compulsive disorder.

Previously thought of as merely an interesting syndrome, obsessive-compulsive disorder is now estimated to afflict 1%-2% of the world's population. Over the past decade extensive research into the epidemiology, aetiology, pathophysiology and pharmacological treatment of this condition has greatly improved its prognosis. This is largely due to the development of the serotonergic group of antidepressants, the selective serotonin reuptake inhibitors (SSRIs), which have consistently demonstrated antiobsessional properties. Monoamine oxidase inhibitors (MAOIs) and lithium have also contributed to the amelioration of symptoms in some patients. Other pharmacological treatment, often prescribed in combination with the SSRIs, include the antipsychotic drugs, benzodiazepines, and anticonvulsants.

Antipsychotic Agents↗