Biomedical subjects

Wai-Kwong Tang

Publications and source records attributed to Wai-Kwong Tang.

6 recordsLinked to original sources

PubMed2007

Clinical correlates of clozapine prescription for schizophrenia in China.

AIMS: Few studies have investigated the prescription patterns of clozapine in outpatients with schizophrenia in China. It is an important issue due to clozapine's high efficacy and potentially fatal side effect profile. This study examined the use of clozapine and its correlates in China. METHODS: Three hundred ninety-eight clinically stable outpatients with schizophrenia were randomly selected and interviewed in Hong Kong (HK) and Beijing (BJ). Assessment instruments included the Structured Clinical Interview for DSM-IV, Brief Psychiatric Rating Scale, Simpson and Angus Scale of Extrapyramidal Symptoms, Barnes Akathisia Rating Scale and the Hong Kong and Mainland China World Health Organization Quality of Life Schedule-Brief version. Assessments were performed by the same investigator in both sites. RESULTS: Clozapine was prescribed to 15.6% of (n = 62) patients. There was a wide inter-site variation between HK and BJ. Use of clozapine was associated with age, age at onset, extrapyramidal side effects (EPS), having health insurance, use of depot and typical antipsychotic and anticholinergic drugs and benzodiazepines as well as history of suicidal attempts. On multiple logistic regression analysis, the number of hospitalizations, site (HK vs. BJ), use of typical antipsychotics, polypharmacy and co-prescription with anticholinergics were significantly associated with the prescription of clozapine. No significant differences were found between the clozapine and non-clozapine groups with regard to any of the quality of life domains. CONCLUSION: A combination of economical and clinical factors, health policies and the characteristics of the treatment settings plays important roles in determining clozapine use. Clozapine appears to have little significant influence on quality of life in clinical stable Chinese patients with schizophrenia.

Adult↗

PubMed2007

Efficacy of the Community Re-Entry Module for patients with schizophrenia in Beijing, China: outcome at 2-year follow-up.

BACKGROUND: Few psychosocial interventions have been developed in China that are suitable for use in the community. AIMS: To evaluate the effectiveness of the Chinese version of the Community Re-Entry Module (CRM; a module of a standardised, structured social skills training programme devised at the University of California, Los Angeles) for patients with schizophrenia compared with standard group psychoeducation. METHOD: Patients with schizophrenia (n=103) were randomly allocated to CRM or psychoeducation groups and followed up for 24 months. Outcome measures included social functioning, psychiatric symptoms, insight, re-employment, relapse and re-hospitalisation rates. RESULTS: The CRM group significantly improved in terms of social functioning, insight and psychiatric symptoms compared with the psychoeducation group; the re-employment rate was significantly higher and relapse and rehospitalisation rates were significantly lower in the CRM group. CONCLUSIONS: The findings support the feasibility and effectiveness of CRM as a psychosocial intervention for Chinese patients with schizophrenia in the community.

Adult↗

PubMed2006

Training patients with schizophrenia with the community re-entry module: a controlled study.

BACKGROUND: There is increasing evidence indicating that the Community Re-entry Module (CRM), a brief, structured instrument, could guide an effective intervention for patients with schizophrenia. This study evaluated the effectiveness of the Chinese version of the CRM with respect to improvement in psychiatric symptoms, social functioning as well as relapse and re-hospitalization rates in comparison with a supportive counseling (SC) intervention. METHOD: Ninety-six outpatients with DSM-IV schizophrenia were randomly allocated to either CRM (N=48) or an equally intensive intervention of SC (N=48). The CRM was composed of 16 one-hour sessions, which were conducted with groups of 6-8 patients on a twice-a-week schedule. The two groups received routine psychiatric outpatient care during the intervention. Participants were assessed on an intention-to-treat basis with the Positive and Negative Syndrome Scales (PANSS), with the Social Disability Screening Schedule (SDSS) by two independent raters before and immediately after intervention, and at 6-month follow-up. The number of relapse and re-hospitalization were also documented. RESULTS: The CRM group significantly improved in terms of psychiatric symptoms and social functioning compared with the SC group. Rates of relapse and re-hospitalization in the CRM group were lower although the difference between the two groups was not statistically significant. CONCLUSIONS: The study supports the feasibility and effectiveness of the Chinese version of the CRM as an effective psychosocial intervention for Chinese patients with schizophrenia to improve psychopathology, social functioning and relapse and re-hospitalization rates.

Adolescent↗

PubMed2004

Performance of schizophrenia patients on time-, event-, and activity-based prospective memory tasks.

The present study aimed to determine whether individuals with long-term schizophrenia have impaired prospective memory (PM), the ability to remember to perform intended actions in the future. Three PM tasks (time-, event-, and activity-based) were administered to 60 schizophrenia patients and 60 matched controls. Patients performed significantly more poorly than controls on all three tasks. The between-group difference was disproportionately larger on the time-based task, a task that required a prefrontal lobe process called self-initiated retrieval. To examine the relationship between PM and prefrontal lobe functions, subjects were also administered the Design Fluency Test (DFT), the Tower of London (TOL), and the Wisconsin Card Sorting Test (WCST). For patients, performance on the event-based task was found to correlate significantly with performance on the DFT, and performance on the time-based task was found to correlate significantly with performance on the TOL. Results of this study support the importance and contribution of prefrontal lobe processes in prospective remembering and have implications for the assessment and treatment of individuals with schizophrenia.

Adult↗

PubMed2003

Efficacy of electroconvulsive therapy in treatment-resistant schizophrenia: a prospective open trial.

There is a lack of controlled trials examining the effectiveness of electroconvulsive therapy (ECT) combined with olanzapine or risperidone in treatment-resistant schizophrenia (TRS). The authors conducted a prospective, open, controlled trial of ECT in TRS in a long-term psychiatric rehabilitation unit in Hong Kong. Thirty patients with TRS from an inpatient psychiatric rehabilitation unit participated in this study. All subjects were resistant to a host of antipsychotic medications given singly or in different combinations. In addition, they were also resistant to or they refused clozapine treatment. Fifteen patients completed a course of ECT consisting of 8-20 sessions. Fifteen patients who refused ECT formed the control Subjects were assessed at baseline, 1 week, 1 month, and 2 months after their last ECT. Assessment instruments included the Brief Psychiatric Rating Scale (BPRS), Hamilton Depression Rating Scale (HDRS), Scale for the Assessment of Negative Symptoms (SANS), Global Assessment Scale (GAS), Clinical Global Impression (CGI), CGI Severity of Illness [CGI(SOI)], CGI Global Improvement [CGI(GI)], Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30), and occupational therapists' rating of the subjects' functioning with respect to work (OT-W), social (OT-S), and leisure (OT-L) activities. In comparison with the control group, the ECT group showed statistically significant improvement only in the GAS and CGI at each posttreatment evaluation. There was a trend for ECT to reduce positive and negative symptoms, although the rate of improvement did not reach statistically significant levels. ECT augmentation of risperidone and olanzapine is of marginal efficacy compared to reports of the greater augmentation of these antipsychotics with other agents.

Adult↗

PubMed2002

Distant visual acuity in chronic psychiatric patients. A pilot study.

BACKGROUND: There is a paucity of systematically collected data on visual impairment in patients with chronic psychiatric disorders. The aim of this pilot study was to estimate the magnitude of impairment of distant visual acuity (DVA) including refractive and non-refractive errors in institutionalized psychiatric patients awaiting resettlement in the community in Hong Kong. METHOD: DVA was tested using the Snellen method in a randomly selected cohort of 428 institutionalized psychiatric patients from the four long-stay rehabilitation units in Hong Kong. The pinhole method was employed to differentiate between refractive and non-refractive impairment of DVA. RESULTS: Seventy-five percent of the sample had impaired DVA; 39 % of the subjects had refractive error (myopia). Only a small percentage of patients wore spectacles and had adequately corrected vision. Patients with impaired DVA were significantly older than those with normal DVA. CONCLUSION: While the frequency of myopia corresponds to that found in the general population in Hong Kong, the nature of non-refractive impairment needs further investigation including systematic eye examination, and examination of medication and life-style factors. Periodical eye examinations should be part of comprehensive health assessment for chronic psychiatric patients.

Chronic Disease↗