Background:Mental Health Literacy (MHL) has become a focus of research in recent decades, as a prerequisite for early identification and intervention for mental health problems. Although several instruments have been developed for assessing MHL, there is a need for brief and psychometrically sound measures to capture important aspects of MHL in large and diverse adult samples. The present study aimed to: (1) provide a revised and shorter version of a previously validated questionnaire for assessing MHL; and (2) examine the psychometric properties of the MHLq-SVa in student samples from six different countries (China, India, Indonesia, Portugal, Thailand, and United States).Methods:The study involved 2180 senior school and undergraduate students, aged between 17 and 25 years old, from China, India, Indonesia, Portugal, Thailand, and the United States. Participants responded to the Mental Health Literacy Questionnaire for young adults (MHLq-ya), in their native language, following its translation and adaptation for each culture. The MHLq-ya comprises 29 items, organized into four dimensions: Knowledge of mental health problems; Erroneous beliefs/stereotypes; First-aid skills and help-seeking behavior; Self-help strategies. Confirmatory factor analyses and internal consistency analyses were performed on the combined data.Results:Data from the different countries supported a shorter version of the questionnaire (MHLq-SVa), composed of 16 items that fit with previously defined dimensions. Internal consistency and between-factor correlations further supported the adequacy of the instrument’s psychometric properties.Conclusion:The study provided preliminary support for the construct validity and reliability of the MHLq-SVa as a measure for assessing MHL in young adults from six different countries and languages. Future studies are needed to further validate the measure and undertake multicultural comparisons of MHL in diverse samples from around the globe.

BackgroundCognitive impairment in methamphetamine (MA) users with psychosis may be more severe than that in MA users without psychosis. This study aimed to compare the overall cognitive function and specific cognitive domains between MA users with and without psychosis. MethodsParticipants in this cross-sectional study were adult inpatients who used MA within the month prior to admission. The recent use of MA was confirmed using quantitative analysis of hair. We used the Mini International Neuropsychiatric Interview (MINI) - Plus, Psychotic Module to confirm the presence of recent psychosis in the participants who fulfilled the inclusion criteria, excluding the individuals with a lifetime history of schizophrenia. We assessed the severity of depression and MA withdrawal using the Patient Health Questionnaire (PHQ-9) and the Amphetamine Withdrawal Questionnaire. The severity of cognitive impairment was assessed using the Montreal Cognitive Assessment (MoCA). The MoCA total and subtest scores were used to compare participants with and without psychosis. ResultsParticipants included 113 MA users with psychosis and 120 MA users without psychosis. Those with psychosis had significantly lower MoCA total, visuaospatial/executive subtest, and abstract subtest scores than those without psychosis (mean differences=−0.8, −0.3, and −0.2, respectively). The association between MA psychosis and the MoCA total scores was still statistically significant after the adjustment for years in education in an ordinal logistic regression analysis. ConclusionsMA users with psychosis had poorer overall cognitive function than MA users without psychosis. The cognitive impairment is prominent in the domains of visuospatial/executive function and abstraction.

ObjectiveTo determine factors related to recent methamphetamine-associated psychosis (MAP) among individuals recently using methamphetamine (MA).DesignCross-sectional study carried out between July 2015 and June 2017.SettingFour mental health hospitals and one substance abuse treatment centre in Thailand.ParticipantsIndividuals recruited onto the study included those aged 18 years or over, of both sexes, who reported MA use in the month prior to admission.MeasuresAny recent psychosis was confirmed using the Mini International Neuropsychiatric Interview-Plus psychotic module. The Timeline Follow Back was used to determine days of MA use. The severity of MA dependence was assessed using the Severity of Dependence Scale. Quantitative hair analysis was carried out to confirm recent use of MA and to measure the amount of MA use. We compared several characteristics between those who had recently experienced psychosis and those who had not.ResultsThis study included 120 participants without MAP and 113 participants with MAP. The mean age was 28 years and the mean abstinence was 17 days. The levels of MA concentration in hair were not significantly different between groups (p=0.115). Based on the final logistic regression model, the independent factors associated with MAP (OR and 95% CI) included being male (OR 4.03, 95% CI 1.59 to 10.20), ≥16 days of MA use in the past month (OR 2.35, 95% CI 1.22 to 4.52), MA dependence (OR 9.41, 95% CI 2.01 to 44.00) and hospitalisation history related to substance abuse (OR 3.85, 95% CI 2.03 to 7.28).ConclusionsHealth professionals should closely monitor the development of MAP in MA-dependent men who frequently use MA and have a history of hospitalisation for substance abuse. The measure of MA concentration levels in the hair may add no benefit for the prediction of the development of MAP.

Use of methamphetamine (MA) commonly co-occurs with the use of other substances. The present study aims to examine substance initiation patterns of other substances, including alcohol, nicotine, inhalants, and cannabis (OTH), in MA users and its consequence on the time lag of MA dependence. Sociodemographic, environmental, and clinical data were obtained from MA users at a Thai substance treatment center. The Semi-Structured Assessment for Drug Dependence and Alcoholism was employed to diagnose drug dependence. Of 991 MA users, 52.6% were males, and the average age was 26.8 ± 7.1 years. The mean age of first MA use (18 years) was greater than the mean age of first use of alcohol (17 years), nicotine (16 years), and inhalants (15 years) (P < 0.001), but was comparable with the mean age at the first use of cannabis (P > 0.05). Family history of MA use and nicotine dependence were associated with early MA onset. Participants who used MA as their first drug (MA>OTH) were more likely to be female and less likely to smoke intensely and to be exposed to severe traumatic events than those who used MA later than other substances (OTH>MA). The time lag from age at onset of MA use to MA dependence was shorter in OTH>MA than in MA>OTH (3 vs 5 years; χ = 5.7, P = 0.02, log-rank test). A higher proportion of women was observed in MA>OTH than in OTH>MA. The use of other substances before MA increases the individual's vulnerability in shortening the interval between age at onset of MA use and MA dependence in a substance treatment cohort.

The study reviews recent publications on methamphetamine use and dependence women in term of their epidemic, physical health impact, psychosocial impacts, and also in the identified vulnerable issues. Studies of vulnerable populations of women are wide ranging and include sex workers, sexual minorities, homeless, psychiatric patients, suburban women, and pregnant women, in which amphetamine type stimulants (ATSs) are the most commonly reported illicit drug used among them. The prenatal exposure of ATS demonstrated the small for gestational age and low birth weight; however, more research is needed on long-term studies of methamphetamine-exposed children. Intimate partner violence (IPV) is commonly reported by female methamphetamine users as perpetrators and victims. However, statistics and gendered power dynamics suggest that methamphetamine-related IPV indicates a higher chance of femicide. Methamphetamine-abusing women often have unresolved childhood trauma and are introduced to ATS through families or partners. Vulnerable populations of women at risk of methamphetamine abuse and dependence. Impacts on their physical and mental health, IPV, and pregnancy have been reported continuing, which guide that empowering and holistic substance abuse are necessary for specific group.

Males and females who use methamphetamine (MA) differ in sociodemographics, MA diagnoses, comorbidities, and brain activity. The objective of this study was to investigate sex differences in the characteristics of MA use and dependence in patients at a Thai substance treatment center. Demographic, MA use, and diagnostic data for 782 MA users were obtained by using the Semi-Structured Assessment for Drug Dependence and Alcoholism-Thai version. Categorical comparisons of males (n = 413, 53%) and females (n = 369, 47%) were made by chi-square test. Factors significantly differentiating men and women with respect to MA-dependence were identified by logistic regression analysis controlling for demographic, diagnostic, and MA use variables. Males admitted to residential drug treatment for MA use had an earlier age of onset for both MA use (17.7 ± 4.1 vs 19.7 ± 6.2 years; t = -5.3, P < 0.001) and dependence (20.4 ± 5.2 vs 22.2 ± 6.4 years; t = -3.6, P < 0.001). Females were more likely than males to be MA-dependent (79% vs 60%; χ1 = 33.7, P < 0.001), and to experience MA withdrawal (65.3% vs 48.9%; χ1 = 21.4, P < 0.001), withdrawal-related hypersomnia (77.2% vs 64.8%; χ1 = 14.5, P < 0.001), fatigue (77.5% vs 70.3%; χ1 = 5.2, P = 0.02), and psychomotor retardation (64.5% vs 57.0%; χ1 = 4.5, P = 0.03). Similarly, females had heavier (eg, largest daily amount [χ1 = 12.4, P < 0.001), more frequent (χ1 = 5.1, P = 0.02]) and greater lifetime episodes of MA use (χ1 = 24.1, P < 0.001) than males. After controlling for such variables by logistic regression, being female remained a significant factor influencing the occurrence of MA-dependence (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.8-4.1, P < 0.001). Shared associated factors (or comorbidities) for MA-dependence in both sexes included nicotine dependence (in males: OR 4.1, 95% CI 2.4-7.0, P < 0.001; and in females: OR 2.4, 95% CI 1.3-4.4, P = 0.007), greater lifetime episodes of MA use (in males: OR 3.5, 95% CI 1.9-6.4, P < 0.001; and in females: OR 5.9, 95% CI 3.1-11.4, P < 0.001), and more frequent use (in males: OR 5.1, 95% CI 2.8-9.1, P < 0.001; and in females: OR 3.6, 95% CI 1.9-6.9, P < 0.001). Comorbid antisocial personality disorder predicted MA-dependence in males only (OR 3.7, 95% CI 1.6-8.6, P = 0.002). The current study highlights both common (eg, nicotine dependence and severity of MA use) and sex-specific differences (eg, MA use/dependence characteristics and comorbidities), including sex itself, with respect to MA-dependence in a Thai treatment cohort.

Background. Reduction of cortical thickness and Hippocampal volume (HV) in Methamphetamine abusers (MA) has been reported. However, change of white matter volume (WMV) in MA group is inconclusive. We aim to compare cortical thickness, Hippocampal volume (HV), and WMV per intra-cranial volume (ICV) among MA in Thai adolescents. Methods. 3D T1-wighted high resolution MR images from 11 MAs and 10 HCs with gender and age match with mean age 25.48 ±4.9 were acquired on a 1.5T Philips MR scanner. Automated Talairach transform and images group analysis with general linear model (GLM) were performed using FreeSurfer software. HV, FWMV/ICV, and WMV/ICV between MA and HC groups were compared. Results. Significant thinner regions (p < 0.05) of cortical thickness in MA group were found at the right temporal and parietal lobes. Trends of smaller Hippocampal volume on left and right by 5.1% and 4.3% and increasing of Left FWMV/ICV, right FWMV/ICV, and tWMV/ICV by 3.1%, 4.5% and 3.8% respectively in MA group compared to HC group. Conclusions. The results demonstrated significant thinner of cortical thickness at the right temporal and parietal lobes and the trend of WM hypertrophy and smaller Hippocampus in MA group.

Background. Cerebral injury from MA use and HIV infection are well established. Frontal or the executive brain functions are most affected in MA abusers with development neurological conditions of inability to attend and concentrate slowness in thinking and moving. HIV infection, on the other hand, is thought to be indirect process due as neurons are not infected by the virus. Cells including brain microphages, microglia is infected and a reactive astrocytosis is often present. Methods. Fifteen healthy volunteers, 15 HIV seropositive patients with no history of MA use, 15 MA users with no HIV infection and 15 MA users who are HIV infected during the next 15 months. This is cross-sectional study, each participant will undergo MRI/MRS scans and neuropsychological evaluation. We present results of single voxel proton MRS in MA users's brain. Results. Significant reduction (p = 0.041) for neuronal marker, N-acetylaspartate in the frontal white matter was observed with mean NAA/Cr for healthy control and MA users of 0.855 and 0.746, respectively. Similar reduction (p = 0.028) was also observed in the basal ganglia with mean NAA/Cr for healthy control and MA users of 0.687 and 0.548 respectively. Conclusions. The results demonstrated significant neuronal loss in methamphetamine users.

Early diagnosis of breast cancer is the most importance factor that improve patient prognosis. Mammography has been proven in various randomized control trial as an effective screening tool for breast cancer. However, with the increasing of various breast surgical procedures such as breast augmentation, reduction mammoplasty and reconstruction, it may result in more challenging in surveillance and screening of the breast cancer. Imaging appearances of breast augmentation and other surgical altered breast are diverse. Understanding and familiar with the spectrum of imaging findings in the surgical altered breast may require to prevent image misinterpretation and which can result in delay diagnosis of malignancy and detection of locoregional recurrence.

To our knowledge, only a few double-blind randomized controlled trials with antipsychotic drugs have been conducted to examine the treatment of methamphetamine-induced psychosis (MAP). The aims of this study are to compare the antipsychotic and adverse events of quetiapine, an atypical antipsychotic drug, to haloperidol, a standard treatment for primary psychotic disorder, in individuals with MAP. Eighty individuals with MAP were randomly assigned into two groups, i.e. treatment with quetiapine (n = 36) and haloperidol (n = 44). Sixty-eight patients (85 %) completed the study protocol, i.e. treatment with quetiapine at least 100 mg per day or haloperidol at least 2 mg per day orally once a day for 4 weeks. The doses were increased every 5 days until no psychotic symptom was observed from the Positive and Negative Syndrome Scale (PANSS). Data were analysed by survival analysis with Cox's proportional regression analysis, general estimating equations and log-rank tests. Thirty-two (89 %) subjects from the quetiapine group and 37 subjects (84 %) from the haloperidol group met the remission criteria at the end of the study. Baseline PANSS total scores of quetiapine and haloperidol groups were 82.4 ± 16.6 and 90.0 ± 18.4, respectively (mean ± SD; p = 0.06). The change-from-baseline scores were -47.8 for the quetiapine group and -53.2 for the haloperidol group. There were no significant differences between the antipsychotic effects (coefficient value = -2.6, p = 0.32, 95%CI = -7.6, 2.5) and the adverse effects of quetiapine and haloperidol. Quetiapine may be used as an antipsychotic treatment for MAP with comparable therapeutic effects and adverse events to treatment with classical antipsychotic drugs.