published_or_final_version / Psychiatry / Master / Master of Philosophy

Objectives: The study investigates the effects of different Chinese translations for psychosis on perceptions of youth service providers. The hypothesis is youth service providers believe that to have better understanding and acceptance in name si-jue-shi-tiao rather than others. Participants and methods: 100 youth service providers were recruited and interviewed with 34-item questionnaires. They were presented with a vignette describing a person with jing-shen-fen-lie-zheng/ si-jue-shi-tiao/ jing-shen-bin. Belief of cause, benevolence, separatism, stereotyping, restrictiveness, pessimistic prediction and stigmatization of different labeling were investigated. Results: The study found that si-jue-shi-tiao group has less stigmatization effect compared with jing-shen-fen-lie-zheng group and Jing-shen-bin group but the psychiatric labeling has no statistically significant effect on benevolence, separatism, stereotyping, restrictiveness, pessimistic prediction. Conclusion: The study supported renaming psychosis has an improvement on stigmatization, but not obviously seen to have improvement in the other attitudinal dimensions. People who have religious belief, profession in occupation, having previous contact with people (e.g. friend and client) who have mental illness indeed affected to have positive effect on their views towards person with psychosis. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

published_or_final_version / Psychiatry / Master / Master of Research in Medicine

Background/ Objectives: It can always be recognised that mass media is one of key sources of information to society. Moreover, it has a great power to affect our life. Printed media, for example, newspaper as one of media communications contains words and texts, which can also create a strong power to influence readers to receive information, including news coverage of mental illness. The objective of this study is to analyse our selected the terms of Schizophrenia, Psychosis and Psychotic Patients from our selected three local Chinese newspapers in Hong Kong, to see the frequency and the trend of reporting incidents on news stories, and the use of language/words to portray people with mental illness on press coverage. Research questions were about 1) the change of frequency using the term of Schizophrenia, and under the same question the hypothesis was to see if using the term of Psychosis was more than Schizophrenia; 2) reviewed the term of Schizophrenia to see our selected three local newspapers whether or not choosing the term of Schizophrenia on news coverage more than Psychosis; 3) assessed both terms of Schizophrenia and Psychosis regarding incidents in all articles, the former was related to negative stories and the latter was related to good news coverage. 4) We reviewed the trend of using all keywords akin to metaphorical (words) usage in all articles. At last, 5) we also assessed all keywords in regard to the trend of using of stereotyping wordings in all papers in our selected years. Method: We assessed the database of retrospective newspaper via WiseNews of electronic resource at the University of Hong Kong, to retrieve the total of 1884 articles, from chosen newspapers, for example, Apple Daily, Ming Pao Daily News and Tai Kung Pao Daily News. We retrieved those newspapers in 2002, 2004, 2007, 2010 and 2012 for our research study. Results: It is good to see that, since 2001 renaming in Psychosis (思覺失調), the term has been widely accepted in the public and has already been used on news coverage. In comparison with both terms of Schizophrenia (精神分裂 [症]) and Psychosis (思覺失調), we noticed that the frequency of using the name of Schizophrenia on printed media has, however, still remained higher than the term of psychosis to portray people with mental illness in all news papers [Schizophrenia – 40.2% 757/1884 /Psychosis – 24.9% 469/1884]. And we also noted that the term of Psychotic Patients was strong association with people in Schizophrenia to appear on same news coverage, according to our research findings. Meanwhile, it can be seen that using Psychosis (renaming in Chinese) on news coverage was increased gradually from 2002 – 2012, whereas using Schizophrenia was a lead in association with criminal cases, with 35/132 of unfavourable events. On the one hand, it can be noted that the trend of metaphorical usage was increased gradually from 2002 – 2012, and in all newspapers the more frequency of using metaphorical words/usage was to insult/cite someone with 46.2% (175/379 articles). On the other hand, it is not surprising to see that the more frequency of using stereotyping words was “Dangerous” or “Violence” to portray people with mental illness in all newspapers, which was highest record with 61.8% (202/327 counted articles) Conclusion: Mass media is generally recognised as key source of information to society, including media coverage of mental illness. Moreover, press media has a great power to influence us. In content analysis of our selected articles, it can be noted that in 2002 –2012, using the term of Schizophrenia was more than using Psychosis in our selected three local Chinese newspapers. It was revealed that the trend of using metaphorical (words) usage in all papers was increased gradually and the more frequency using of both terms was to insult/cite someone. It can be no doubt that inappropriate words and negative descriptive languages to portray people with mental illness on news coverage could influence people’s perception with negative towards psychotic patients. Stigma is a great impact on people with mental illness to receive treatment appropriately and can minimise their self-esteem as a result of causing social withdrawal. Family and relatives are also considerably stigmatised. Educational promotion is one of critical ways to promote mental health, to increase more public awareness and knowledge of mental illness in our society. It could be suggested that training for journalists could be essential, in order to avoid using of sensational or negative descriptive language on news coverage of mental illness that could reduce stigma. We believe that the more people know and receive information accurate on media coverage of mental illness, the less people can form stigma in our society. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

published_or_final_version / abstract / toc / Social Work and Social Administration / Doctoral / Doctor of Philosophy

Objective: The aim of the current study was to investigate the differences in baseline characteristics and three-year outcomes between two diagnostic categories with presentation of first-episode psychosis: bipolar affective disorder (mania with psychotic features) and schizophrenia. The comparison was based on pre-treatment characteristics, clinical presentation, symptomatic and functional outcomes, and engagement in risk behaviours. Methods:461 schizophrenic patients and 54 bipolar affective disorder (BAD) patients between the ages of 15 to 25 years from a local first-episode psychosis treatment program within the years2001 to 2003 were studied. Researchers collected detailed data on baseline and three-year follow up variables from systematic medical file review for statistical analyses. Results: At service entry, compared to schizophrenic patients, bipolar affective disorder(BAD)patients exhibited more prominent positive symptoms (p = 0.01), were younger at first presentation and had a higher unemployment rate (p < 0.01), were more likely to have acute onset of psychosis, shorter duration of untreated psychosis (DUP), a higher rate of hospital admission within first month after initial contact, and lower pre-treatment functioning (Social and Occupational Functioning Assessment Scale (SOFAS), p < 0.001). There was no significant difference in gender, education level, age of onset and pre-treatment risk taking behaviours. After applying univariate analysis of variance (ANCOVA)by controlling baseline variables that showed significant differences, the three year follow up reveals that schizophrenic patients displayed fewer numbers of hospitalization (p <0.01)with no difference in the total length (days) of hospitalization, more prominent positive symptoms(p < 0.01), poorer functioning at year 3 (p <0.05), and consistently significant lower employment rate at 12 month (p < 0.001), 24 month (p < 0.001) and 36 month (p < 0.01). Finally, more schizophrenic patients received social benefits (p < 0.05). Conclusion: The outstanding baseline poorer functioning level of bipolar affective disorder patients have progressively made a modest improvement in functional outcomes at the end of three-year follow up. BAD patients also displayed a marked improvement with fewer positive symptoms in the follow up. The results suggest a differentiation in symptomatology and the course of illness between bipolar affective disorder and schizophrenia with first-episode psychosis. In coherence with other scholastic literature, duration of untreated psychosis (DUP) associates with remission(Crumlish et al., 2009;Chang et al., 2012a), positive symptoms(Barnes et.al., 2008; Chang et.al., 2012b; Clarke et al., 2006; Crumlish et.al., 2009;), and functional outcomes(Barnes et al., 2008; Chang et al., 2012b; Clarke et.al., 2006; Crumlish et.al, 2009; Fusar-Poli et al., 2009). Moreover, further exploration about the diagnostic-specific therapeutic window for early intervention, symptoms management, and rehabilitation strategies in occupational training are in demand. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Background. Subjective quality of life (SQOL) is increasingly gaining attention in psychiatric practice and research. To date, few studies have examined the SQOL in outpatients with schizophrenia in China. / Conclusions. Despite considerable differences between the two sites in terms of socio-cultural background, health care delivery and the economic conditions of the subjects, the SQOL did not differ significantly between HK and BJ. SQOL was more strongly related to the severity of depressive symptoms and had only weak association with socio-demographic factors. / Method. In the psychiatric outpatient services of two university-affiliated teaching hospitals in BJ and HK, 522 (264 in BI and 258 in HK) clinically stable outpatients diagnosed with schizophrenia (age: 18-60 years) were randomly selected according to the same inclusion and exclusion criteria. The two samples were matched according to age, sex, educational level, and length of illness. The diagnosis of schizophrenia was confirmed on the basis of a chart review followed by a diagnostic interview on both sites by the candidate. Socio-demographic data were collected and clinical characteristics including psychotic and depressive symptoms, drug-induced extrapyramidal side effects (EPS), and SQOL were assessed by the candidate. Analysis of covariance (ANCOVA) was used to compare the SQOL and its four domains between the two sites after controlling for the effect of the clinical condition of the subjects. Bi-variate correlation and multiple regression analyses were used to evaluate the relationship between SQOL and socio-demographic and clinical data. / Objectives of the study. This study compared SQOL in schizophrenia patients living with their families in Hong Kong (HK) and Beijing (BI) and explored the relationship between SQOL and socio-demographic and clinical factors. / Results. There was no significant difference in SQOL and its domains between the two cohorts after controlling for the effect of other confounding variables. Length of illness, history of suicide attempts, positive, negative, depressive and anxiety symptoms and EPS were all significantly correlated with SQOL. Multiple regression analysis revealed that depressive symptoms predicted all SQOL domains while positive symptoms predicted the psychological, the social relationship and environmental SQOL domains. Married status predicted the social relationship SQOL domain and length of illness predicted the environmental SQOL domain. / Xiang Yu-tao. / "October 2006." / Advisers: G. S. Ungvari; W. K. Tang. / Source: Dissertation Abstracts International, Volume: 68-08, Section: B, page: 5131. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 107-122). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

精神分裂症（簡稱精分）是一種常見且嚴重的精神疾病，它對患者及其家人的生活有著毀滅性的影響。在西方國家，研究者已經對精分患者子女的經歷研究了許多年，得出的結論在政府以及社會工作者幫助這些家庭時起到重要的參考作用。然而，在中國這個問題被忽視了，目前針對這個群體的、學術規範的研究還沒有在中國大陸展開。鑒於中西巨大的社會和文化差異，我們不可以照搬西方學者的研究成果。為了填補這方面的知識空缺，我們在上海展開了對精神分裂症患者子女經歷的質化研究。 / 本文的資料來自八個家庭的成員對於相關經驗的敘述。我們從三個層面來探究這些青少年的特殊經歷，包括他們對家長的經歷、他們從患病與健康家長處感受到的養育模式、以及他們所經歷的擴展家庭和社會的支持。 / 我們的研究發現包括：1）青少年對家長疾病的適應經歷了三個階段：漠然、焦慮、消極應對。2）患病家長大多對孩子溫暖有餘、管教不足。健康家長對孩子的管教很大程度上取決於家庭經濟情況。當經濟情況惡劣時他們往往忽視孩子的成長需求3）支援系統作用缺失。 / 基於以上發現，本文提煉出三個主題：在惡劣成長環境中掙扎、消極應對、缺乏支持。我們提倡為這些家庭提供社會服務。 / Schizophrenia is a serious and common mental illness which has devastating effects on those affected by schizophrenia, as well as family members including their offspring. In western countries, the topic about the experience of offspring living with a parent diagnosed with schizophrenia has been studied for many years. The outcomes are useful references to the government and social workers in helping these families. However, this topic has been neglected in the Chinese context. A well-designed qualitative study has never been carried out in mainland China. The result from western researcher cannot be used in China due to the vast differences in society and culture. To fill in the gap, a qualitative research was carried out in Shanghai to study children’s experience of parental schizophrenia. / This paper is based on the narratives elicited from eight families, including the parents diagnosed with schizophrenia, the adolescent children, and sometimes other family members. We studied the experience of this special group of adolescents, which contains the experience of their parent’s mental illness, the parenting from both the parent diagnosed with schizophrenia and the healthy parent, as well as the support from extended family and the society. / Our findings include: 1) Adolescents’ attitude towards parental schizophrenia can be divided into three phases: indifference, anxiety, and finally passive coping. The help they can provide for their parents with schizophrenia is very limited in most cases. 2) The parenting they received from the parents with schizophrenia is generally perceived as with high level of warmth and low level of demandingness. The healthy parents may or may not provide enough discipline to the adolescents depending on the families’ economic status. They would fail to focus on the need of the growing children when the economic pressure is high. 3) The supportive network failed to provide enough help to the growing adolescents. / Three themes are proposed based on the findings, namely struggling in poor growing environment, passive coping, and helplessness. We advocate for the development of social work services for these families. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Du, Juan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 264-302). / Abstracts also in Chinese; appendixes in Chinese. / Chapter Chapter 1 --- : Introduction --- p.1 / Chapter 1.1 --- Rationale of the study --- p.1 / Chapter 1.2 --- Research background --- p.3 / Chapter 1.2.1 --- Schizophrenia in China --- p.5 / Chapter 1.2.2 --- Social stigma and discourse on mental illness --- p.6 / Chapter 1.2.3 --- Great challenges for a family with a member with schizophrenia --- p.9 / Chapter 1.2.4 --- Limited mental health service available to these families --- p.11 / Chapter 1.2.5 --- Cultural influences in Chinese society --- p.14 / Chapter 1.3 --- Research objectives and research questions --- p.18 / Chapter 1.3.1 --- Research questions --- p.18 / Chapter 1.3.2 --- Research objectives --- p.19 / Chapter 1.4 --- Significance of the research --- p.20 / Chapter Chapter 2 --- : Literature Review --- p.21 / Chapter 2.1 --- Schizophrenia --- p.21 / Chapter 2.1.1 --- Different perspectives on schizophrenia --- p.21 / Chapter 2.1.2 --- Treatment and Recovery of schizophrenia --- p.33 / Chapter 2.1.3 --- Schizophrenia’s influence on social functioning --- p.37 / Chapter 2.1.4 --- Schizophrenia’s influence on parenting --- p.39 / Chapter 2.2 --- Developing adolescents --- p.46 / Chapter 2.2.1 --- Different perspectives on adolescents --- p.47 / Chapter 2.2.2 --- Offspring with parental psychiatric disorder --- p.53 / Chapter 2.2.3 --- Supportive network of adolescents --- p.60 / Chapter 2.3 --- The roles of social work in mental health facilities --- p.61 / Chapter 2.3.1 --- Condition of mental health social work in Shanghai --- p.62 / Chapter 2.3.2 --- The roles of social workers in other areas --- p.63 / Chapter 2.3.3 --- Social workers serving families with parental schizophrenia --- p.69 / Chapter 2.4 --- Knowledge gap in existed literature --- p.70 / Chapter Chapter 3 --- : Research Methodology --- p.72 / Chapter 3.1 --- Paradigmatic Considerations --- p.72 / Chapter 3.1.1 --- Social constructionism --- p.74 / Chapter 3.1.2 --- Proposed Theoretical Framework --- p.77 / Chapter 3.2 --- Research Design --- p.79 / Chapter 3.2.1 --- Research Site --- p.80 / Chapter 3.2.2 --- Sampling --- p.81 / Chapter 3.2.3 --- Data collection --- p.86 / Chapter 3.2.4 --- Data analysis --- p.89 / Chapter 3.2.5 --- Ethical issues and trustworthiness --- p.91 / Chapter 3.3 --- Strengths and Limitations of this Study --- p.96 / Chapter Chapter 4 --- : Background Information of the Research Participants --- p.98 / Chapter 4.1 --- General Information --- p.98 / Chapter 4.1.1 --- Personal information of adolescents --- p.99 / Chapter 4.1.2 --- Personal Information of parent diagnosed with schizophrenia --- p.101 / Chapter 4.1.3 --- Background Information of participant families --- p.105 / Chapter 4.2 --- Family stories --- p.111 / Chapter 4.3 --- Conditions of the parent with schizophrenia --- p.126 / Chapter 4.3.1 --- Competent youths in the past --- p.126 / Chapter 4.3.2 --- Experience of schizophrenia --- p.127 / Chapter 4.3.3 --- Self-blaming for offspring’s current situation --- p.139 / Chapter 4.4 --- The adolescents --- p.141 / Chapter 4.4.1 --- School Achievement --- p.141 / Chapter 4.4.2 --- Peers --- p.146 / Chapter 4.5 --- Summary --- p.150 / Chapter Chapter 5 --- : Experience of parental schizophrenia --- p.152 / Chapter 5.1 --- Discovery of parental schizophrenia --- p.152 / Chapter 5.2 --- Experience relevant to parental schizophrenia --- p.155 / Chapter 5.2.1 --- Symptoms --- p.155 / Chapter 5.2.2 --- Deterioration of parent’s daily functioning --- p.157 / Chapter 5.2.3 --- Parents’ hospitalization --- p.161 / Chapter 5.2.4 --- Social stigma attached to schizophrenia --- p.166 / Chapter 5.2.5 --- Parent’s concealment of schizophrenia --- p.168 / Chapter 5.3 --- Knowledge of schizophrenia --- p.170 / Chapter 5.4 --- Reaction after knowing parental schizophrenia --- p.174 / Chapter 5.4.1 --- Indifference --- p.174 / Chapter 5.4.2 --- Concern and curiosity --- p.175 / Chapter 5.4.3 --- Passive attitude --- p.179 / Chapter 5.5 --- Coping with parental schizophrenia --- p.182 / Chapter 5.5.1 --- Support and help from the children to the parents with schizophrenia --- p.182 / Chapter 5.5.2 --- Selective concealment of parental schizophrenia --- p.185 / Chapter Chapter 6 --- : Experience of parenting from the parent with schizophrenia --- p.189 / Chapter 6.1 --- Less parental demandingness from the parent with schizophrenia --- p.189 / Chapter 6.1.1 --- Less discipline --- p.190 / Chapter 6.1.2 --- Low pressure on study --- p.191 / Chapter 6.1.3 --- Low expectation for future career --- p.192 / Chapter 6.2 --- More parental warmth from the parent with schizophrenia --- p.195 / Chapter Chapter 7 --- : Supporting Network --- p.197 / Chapter 7.1 --- Interaction between adolescent children with healthy parents --- p.197 / Chapter 7.1.1 --- The condition of the healthy parents --- p.198 / Chapter 7.1.2 --- The parenting style of the healthy parents --- p.203 / Chapter 7.2 --- Support from extended family --- p.207 / Chapter 7.3 --- Support from the society --- p.214 / Chapter 7.3.1 --- Teaching VS. Support --- p.214 / Chapter 7.3.2 --- Little support from school --- p.216 / Chapter Chapter 8 --- : Discussion --- p.219 / Chapter 8.1 --- Parenting style of both parents --- p.219 / Chapter 8.1.1 --- Indulgent parenting of the parent diagnosed with schizophrenia --- p.219 / Chapter 8.1.2 --- The parenting style of the healthy parent --- p.222 / Chapter 8.1.3 --- The influence of the parenting on the developing children --- p.225 / Chapter 8.2 --- Three stages after knowing parental schizophrenia --- p.227 / Chapter 8.3 --- Themes --- p.233 / Chapter 8.3.1 --- Struggle in poor family environment --- p.233 / Chapter 8.3.2 --- Passive coping --- p.239 / Chapter 8.3.3 --- Helplessness --- p.241 / Chapter 8.4 --- Reflection on theoretical framework --- p.244 / Chapter 8.5 --- Implications for practice --- p.247 / Chapter 8.6 --- Implications for theory and research --- p.255 / Chapter 8.6.1 --- Similarities and differences compared with literature --- p.255 / Chapter 8.6.2 --- Directions for future research --- p.257 / List of tables and figures / Chapter Table 1 Length of interviews --- p.89 / Chapter Table 2 Condition of adolescents --- p.99 / Chapter Table 3 Personal information of the parents with schizophrenia --- p.101 / Chapter Table 4 Symptoms and hospitalization --- p.102 / Chapter Table 5 Medication --- p.104 / Chapter Table 6 General family background --- p.105 / Chapter Table 7 Family social economic status --- p.108 / Chapter Table 8 Possible interventions --- p.250 / Chapter Figure 1 Proposed theoretical framework --- p.77 / Chapter Figure 2 Revised theoretical framework --- p.245 / Chapter Appendices --- p.259 / Chapter Appendix 1: Interview Guide (Chinese version) --- p.259 / Chapter Appendix 2: Consent form (Chinese version) --- p.262 / Bibliography --- p.264