MyMedR

Kua EH

Med J Malaysia, 1982 Mar;37(1):60-1.

Thyrotoxic psychosis is an uncommon phenomenon and the presentation is usually of the affective disorders. Three cases manifesting psychotic symptoms akin to schizophrenia are described. The neurobiocheinistry and treatment are discussed.

Amok in nineteenth-century British Malaya history

Kua EH

Hist Psychiatry, 1991 Dec;2(8):429-36.

PMID: 11612605

Fulltext Designer drugs--the Ecstasy and the agony

Kua EH

Singapore Med J, 1997 Jan;38(1):6.

PMID: 9269344

Fulltext Dementia in elderly Malays--preliminary findings of a community survey

Kua EH

Singapore Med J, 1993 Feb;34(1):26-8.

PMID: 8266123

This is a study of the prevalence of dementia in elderly Malays living in the Eunos district of Singapore. The subjects included all Malays 65 years and more living in public housing, and they were first interviewed and screened for any cognitive deficit using the Malay version of the Elderly Cognitive Assessment Questionnaire (ECAQ). All those who scored 5 or less in the ECAQ were assessed again with a more detailed questionnaire called the Geriatric Mental State (GMS) schedule. This is the preliminary results of 149 subjects interviewed--77 men and 72 women. Data from the GMS were analysed by a computer diagnostic programme, AGECAT. There were only 6 cases of dementia and the overall prevalence of dementia in the sample was estimated as 4.0%. In the age group 65 to 74 years the rate was 2.5% and this increased to 10.3% in those 75 years and more. The prevalence of dementia in elderly Malays is higher than elderly Chinese in Singapore, but it is similar to the results of studies in New York and Liverpool. All the subjects with dementia were living with their families and they had good social resources.

Prevalence of dementia among elderly Chinese and Malay residents of Singapore

Kua EH, Ko SM

Int Psychogeriatr, 1995;7(3):439-46.

PMID: 8821351

This is a comparative study of the prevalence of dementia among elderly Chinese and Malay persons living in the community in Singapore. The subjects, aged 65 years and over, were all living in public housing estates. Two hundred elderly Chinese and 149 elderly Malay persons were interviewed. They were first screened for any cognitive deficit with the Elderly Cognitive Assessment Questionnaire (ECAQ). All those who scored 5 or fewer points on the ECAQ were then assessed with the Geriatric Mental State schedule. The results showed an overall dementia prevalence of 4.0% among the Malay elderly and 2.5% among the Chinese elderly. The rate of dementia of the Alzheimer's type was 1.8% for Chinese women and 1.5% for Malay women; for multi-infarct dementia the rate for Malay women was 4.4% and for Chinese women 0.9%. For Chinese and Malay men, the prevalence of Alzheimer's disease and multi-infarct dementia was quite similar (1.1% and 1.2%).

Fulltext A psychiatric rating scale for schizophrenia in Singapore (Woodbridge Hospital rating scale for schizophrenia)

Tsoi WF, Kua EH

Med J Malaysia, 1982 Dec;37(4):300-5.

PMID: 7167079

This scale is constructed to meet the need for an efficient, rapid and economical method of
measuring change in schizophrenic patients during the course of psychotropic medication (drug trial) in a multi-cultural, multi-lingual population of low educational level. Items are included only if (1) they can be elicited objectively, (2) they are important symptoms of schizophrenia and (3) they are frequent maniJestatz'on of the schizophrenic syndrome as recorded in Woodbridge Hospital. It could be used by a single rater but its reliability should be further improved if two raters are involved.

Suicide in the island of Singapore

Kua EH, Tsoi WF

Acta Psychiatr Scand, 1985 Mar;71(3):227-9.

PMID: 3984765

In a study of suicide in Singapore in 1980 there were 230 cases and the suicide rate for the general population was 9.5 per 100,000. The age-specific rates increased steeply after 50 years and there was a male preponderance especially in the age group 60 years and over. Comparing the three major ethnic groups in Singapore, the highest rate was seen in the Indians and Chinese, whereas the Malays had the lowest. Amongst the suicides there were 59 (25.7%) with mental illness, mainly schizophrenia, and they were of a younger age group, 20-39 years. The commonest method of suicide was jumping from high-rise flats.

Fulltext Amok--from the writings of Sir Frank Swettenham

Kua EH, Sulaimi MS

Singapore Med J, 1999 Apr;40(4):327-8.

PMID: 10487096

Somatic and non-affective symptoms of old age depression: ethnic differences among Chinese, Indians and Malays

Soh KC, Kua EH, Ng TP

Int J Geriatr Psychiatry, 2009 Jul;24(7):723-30.

PMID: 19089846 DOI: 10.1002/gps.2188

Somatic and other non-affective symptomatology characterizes late life depression and contributes to its under-diagnosis, especially in some ethnic groups.

Recent trends in elderly suicide rates in a multi-ethnic Asian city

Kua EH, Ko SM, Ng TP

Int J Geriatr Psychiatry, 2003 Jun;18(6):533-6.

PMID: 12789675

There are a few reports on the trends of elderly suicide rates in western countries but none from Asian countries.

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

Kua EH, Sim LP, Chee KT

Aust N Z J Psychiatry, 1986 Sep;20(3):361-4.

PMID: 3467715

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.

Ethnic variations in dementia: the contributions of cardiovascular, psychosocial and neuropsychological factors

Ng TP, Leong T, Chiam PC, Kua EH

Dement Geriatr Cogn Disord, 2010;29(2):131-8.

PMID: 20145399 DOI: 10.1159/000275668

Ethnic variations in dementia rate have been reported worldwide. Understanding these differences is vital for aetiological research, clinical care and health service planning. While age and gender have been consistently implicated, the reasons behind interethnic variation remain unclear.

Item response bias was present in instrumental activity of daily living scale in Asian older adults

Niti M, Ng TP, Chiam PC, Kua EH

J Clin Epidemiol, 2007 Apr;60(4):366-74.

PMID: 17346611

Item response bias (also called differential item functioning, DIF) in Instrumental Activities of Daily Living (IADL) occurs when members of different groups possessing the same disability level do not have the same probability of responding positively for a given item(s). This study aimed to identify the extent of DIF by gender, age, ethnicity, and dementia groups in IADL estimates in Asian (Chinese, Malays, and Indian) elderly subjects.

Prevalence and correlates of functional disability in multiethnic elderly Singaporeans

Ng TP, Niti M, Chiam PC, Kua EH

J Am Geriatr Soc, 2006 Jan;54(1):21-9.

PMID: 16420194

To make comparative estimates of prevalence of late-life functional disability, examine sociodemographic and health correlates, investigate sex and ethnic differences, and estimate population attributable risk of modifiable risk factors.

Physical and cognitive domains of the Instrumental Activities of Daily Living: validation in a multiethnic population of Asian older adults

Ng TP, Niti M, Chiam PC, Kua EH

J Gerontol A Biol Sci Med Sci, 2006 Jul;61(7):726-35.

PMID: 16870636

BACKGROUND: We sought to assess the validity of the physical and cognitive domains of Lawton and Brody's Instrumental Activities of Daily Living (IADL) scale and its cross-cultural applicability across ethnic groups in an Asian population of community-living older adults.

METHODS: Using data from a random population sample of noninstitutionalized Chinese, Malay, and Indian older adults 60 years old and older in Singapore (N = 1072), we modeled the dimensional structure of the 8-item IADL Scale using exploratory and confirmatory factor analyses, and assessed its convergent and divergent validity using known group differences and strengths of association.

RESULTS: Factor analyses yielded two strong and reliable factors representing underlying physical and cognitive dimensions of IADL. The validity of the model was supported by the pattern of associations of the IADL with age, gender, education, self-reported health status, hospitalization, physical comorbidities, dementia and depression, and Mini-Mental State Examination (MMSE) scores. Notably, cognitive IADL showed a greater total effect on MMSE cognitive performance score than did physical IADL, with the effect of physical IADL on MMSE score mostly explained by cognitive IADL. Reasonably good cross-cultural validity was demonstrated among Chinese, Malays, and Indians, with strongest validity for Indians.

CONCLUSION: The eight-item IADL Scale has physical and cognitive domains and is cross-culturally applicable. The cognitive IADL domain taps a set of activities directly related to cognitive functioning.

An overview of mental health legislation in Singapore

Ho RC, Ho CS, Khan N, Kua EH

BJPsych Int, 2015 May;12(2):42-44.

PMID: 29093849

This article summarises the development of mental health legislation in Singapore in three distinctive periods: pre-1965; 1965-2007 and 2007 onwards. It highlights the origin of mental health legislation and the relationship between mental health services and legislation in Singapore. The Mental Health (Care and Treatment) Act 2008 and Mental Capacity Act 2008 are described in detail.

Mental health in Asia: social improvements and challenges

Tseng WS, Ebata K, Kim KI, Krahl W, Kua EH, Lu Q, et al.

Int J Soc Psychiatry, 2001;47(1):8-23.

PMID: 11322408

Remarkable improvements in economic conditions and a considerable upgrade in the quality of life have been observed in many parts of Asia during the past several decades. At the same time, many mental health challenges face the people of Asia. Various social mental health indexes are reviewed here, with available data from China, Japan, Korea, Singapore, Malaysia, and other Asian societies. The data are compared with data from the United States, Australia in the Pacific Rim, and some other Western countries to examine patterns of similarity or difference between East and West in the process of modernization. Common trends in mental health issues associated with rapid sociocultural change observed in different Asian societies are discussed, as well as the relative shortage of mental health personnel available in many Asian societies. It is emphasized that, in addition to expanding psychiatric services, there is an even more urgent need to promote mental health knowledge and concern through education in the general population. Mental health needs to be cultivated and maintained by social forces and cultural strengths. It is stressed that there is a challenge for Asian people to advance mental health beyond economic development in the 21st century.

Educational environments in Asian medical schools: A cross-national comparison between Malaysia, Singapore, and China

Arokiamary B, Russell V, Lim HA, Koay JM, Xia J, Zhao XH, et al.

Asia Pac Psychiatry, 2021 Jun;13(2):e12454.

PMID: 33646626 DOI: 10.1111/appy.12454

INTRODUCTION: Perceptions of the educational environment (EE) represent an important source of information on medical students' learning experience. Understanding and addressing these perceptions can help inform initiatives designed to improve the learning experience and educational outcomes, while comparison of student perceptions across medical schools can provide an added perspective. The aim of the study was to compare the EEs of three Asian medical schools: Royal College of Surgeons in Ireland and University College Dublin Malaysia Campus, Yong Loo Lin School of Medicine, Singapore and Xiangya School of Medicine, China.

METHODS: Medical students in the clinical years (N = 1063) participated in a cross-sectional study using the Dundee Ready Educational Environment Measure (DREEM). Data were analyzed using SPSS version 22.

RESULTS: There were significant differences between the three medical schools in the total DREEM scores (F [2, 1059] = 38.29, p

Prescribing patterns of low doses of antipsychotic medications in older Asian patients with schizophrenia, 2001-2009

Xiang YT, Dickerson F, Kreyenbuhl J, Ungvari GS, Wang CY, Si TM, et al.

Int Psychogeriatr, 2012 Jun;24(6):1002-8.

PMID: 22300452 DOI: 10.1017/S1041610211002791

This study examined the use of low doses of antipsychotic medications (300 mg/day CPZeq or less) in older Asian patients with schizophrenia and its demographic and clinical correlates.

Use of first- and second-generation antipsychotic medications in older patients with schizophrenia in Asia (2001-2009)

Xiang YT, Kreyenbuhl J, Dickerson FB, Ungvari GS, Wang CY, Si TM, et al.

Aust N Z J Psychiatry, 2012 Dec;46(12):1159-64.

PMID: 22790175 DOI: 10.1177/0004867412453625

This study examined the prescribing patterns of several first- (FGAs) and second-generation antipsychotic (SGAs) medications administered to older Asian patients with schizophrenia during the period between 2001 and 2009.

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