香港心理衞生期刊
四十九卷 第一期  二0二三冬

Hong Kong Journal of Mental Health
Volume 49 No. 1 2023 Winter
Message from Issue Editor
Early Detection and Intervention for First-Episode Psychosis 
S M Ng 
 
Download
PDF
 
Sensory Modulation for People with Schizophrenia in Hong Kong
Angus Y K Lam
School of Health Sciences, Western Sydney University

Aquina L Y Wong 
School of Social Sciences, University of Tasmania

Abstract 
Adults with psychiatric conditions could benefit from intervention that improves their sensory modulation. Related assessment and intervention have been implemented widely in the international community. However, the application of this approach is comparatively underdeveloped in Hong Kong. Sensory modulation approach was found to be beneficial in enhancing individuals’ self-management of distress, reducing disruptive behaviors, and minimizing the use of seclusion and restraint and is conveyed as a recovery-oriented, trauma-informed, harmless, and effective clinical intervention. The Sensory Responsiveness Questionnaire (SRQ) and Adolescent/Adult Sensory Profile (A/ASP) are both reported to be reliable and valid tools for assessments, whereas tool validation was not available locally. Intervention should involve both psychoeducation at the early stage of psychosis and their family as individuals in the first-episode schizophrenia spectrum or early stages of schizophrenia mostly exhibited impaired sensory modulation issue. In short, it is essential to establish the sensory processing profile for people with schizophrenia to provide an accurate measure to guide early intervention and support. Occupational therapists and health professionals should address the importance of early identification and establishing the referral process. Lastly, it is essential for the practitioners to equip the skills and knowledge related to sensory modulation.

 

摘要

精神分裂症患者感覺調節於香港的應用

感覺調節是成人精神健康的診斷和治療的工作之一。相關的工作,在國際間已有數十年的經驗,但在香港卻仍未得到廣泛關注。感覺調節的介入手法,與復元及創傷知情的臨床工作理論相符,並獲證明能減少使用約束病人的介入手法。SRQ及A/ASP 是較多臨床人員選用的評估工具。精神分裂症患者初期也會出現感覺調節的困難,所以在評估及介入工作,應能照顧他們的需要。總的來說,本地應盡快制定符合病人需要的評估工具,以及相關的介入指引。與此同時,服務機構亦要提供培訓,使前線工作人員能對感覺調節有更深入的認識。


Keywords 
Sensory modulation, schizophrenia

Download
PDF
 
Early Intervention Service for Psychosis: A Discussion on The History and Future Development
Sherry K W Chan
Department of Psychiatry, The University of Hong Kong

Eric W C Yan
Department of Psychiatry, Kowloon Hospital

Clara Siu
Department of Psychiatry, Kowloon Hospital

L T Poon 
Department of Psychiatry, United Christian Hospital

Jenny Lam 
Castel Peak Hospital

Charles Chan 
Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital

Abstract
Early intervention service (EIS) for psychosis has been a global movement in the last 30 years with an aim to improve outcomes of patients with psychotic disorders. In Hong Kong, the early intervention service for psychosis, EASY, was developed and implementedas a region-wide service by the Hospital Authority since 2001. Over the past 20 years, multiple research studies have been conducted to understand the effect of EIS locally and internationally, which continue to inform the further development of the services. This current article provides a review on the history of the development of the EIS locally and internationally and the results of some of the evaluation studies. The possible direction of the future development will also be discussed.

 

摘要

思覺失調的早期介入服務:關於其歷史和未來發展的簡討

早期干預服務是過去30 年全球範圍內改善精神病患者康復的運動。在香港,思覺失調早期干預服務(EASY)於2001 年由醫院管理局作為全港性的服務開發和實施。在過去的20 年中,進行了多項研究以了解本地和國際早期干預服務的短期及長期影響,這些研究繼續為服務的進一步發展提供指導。本文對本地和國際早期干預服務發展歷程,以及一些評估研究結果進行了概括性回顧,並探討了未來發展的可能方向。


Keywords 
Early intervention, first-episode psychosis, outcome evaluation

 Download
PDF
 
Expressed Emotion in First-Episode Psychosis and Chronic Psychosis: Implications for Family Interventions
Y Z He
Department of Social Work and Social Administration, The University of Hong Kong

H Y Li
Department of Social Work and Social Administration, The University of Hong Kong

Abstract
Expressed Emotion (EE) represents vital aspects of interpersonal relationships between caregivers and an ill family member. EE has been extensively studied since the 1950s because it predicts relapse in many psychoses, especially schizophrenia. Family interventions targeting modifying EE to prevent relapse have more and more been emphasized as a comprehensive approach that considers the role of the social environment, especially family dynamics, in mental health, instead of a purely biological perspective. This article reviewed research in EE regarding its construct, prediction of relapse, and prevention aims at lowering it. Specifically, this article focuses on 1) EE in first-episode psychosis (FEP); 2) the possibility of integrating music therapy (MT) into family intervention by reducing high EE. Due to the differences between FEP and chronic psychosis (CP), more studies are yet to be conducted to explore EE in FEP.

 

摘要

首發與慢性精神分裂症中的表達情緒及其對家庭干預的啟示

表達情緒(Expressed Emotion)(EE) 是影響照顧者與患病家庭成員之間人際關係的關鍵因素。EE 對精神分裂症患者的復發有一定的預測作用,故自20 世紀50 年代以來,EE 已經在精神健康領域,特別是思覺失調領域,被廣泛研究。利用家庭干預來改變精神分裂症患者家庭環境中的表達情緒近來收到學界的重視。作為一種綜合的干預方式,它不僅關注單純的生物學因素,還考慮社會環境,尤其是家庭動態對精神健康的影響。本文回顧了表達情緒的建構,預測及預防復發的文獻,專門就以下兩方面展開論述:1)首發精神病的家屬的情緒表達;2)音樂療法融入家庭干預以降低表達情緒的可能性。由於首發精神病與慢性精神病的不同,建議學界繼續探究首發精神病階段表達情緒的特徵,以建立更有針對性且有效的干預方案。


Keywords 
Expressed emotion, schizophrenia, first-episode psychosis, music therapy
 
Download
PDF
 
Youth Mental Health Promotion at Youth Services: Experience Sharing by Yang Memorial Methodist Social Service
H N Tai
Yang Memorial Methodist Social Service

Abstract
Youth mental health has been under the spotlight of Hong Kong public health since 2015,especially with the rising concern of students’ suicide problem and hidden mood problems among the population (Yang and Yip, 2021).Injecting resources for primary and secondary care which focused on treatment and rehabilitation are important. However, young people have low motivation in reaching out to services when compares to other age groups. Thus, early detection and health education are the forefront work for youth mental health. Youth services’ trials and experience of Yang Memorial Methodist Social Service will be shared in the article,together with insight gained through the process.

 

摘要

青少年服務之精神健康推廣:循道衛理楊震社會服務處青少年服務經驗分享整合

青少年精神健康自2015 年起一直為香港公共健康關注之議題,此年齡層之學童自殺問題上升及隱藏情緒健康問題更特別得到關注 (Yang and Yip, 2021)。大量資源投放於以治療及復康為主之基層及專科健康服務,此舉當然有相當重要性,但此年齡層對求助及服務尋求不具動力,因應此獨特性,早期偵測及教育成為青少年精神健康工作之首要任務。本文章藉分享循道衛理楊震社會服務處青少年服務之青少年精神健康工作歷程及嘗試,以總結當中所學。


Keywords
Youth, mental health promotion

Download
PDF
Narrative Life Design Project for High Functioning Youth with Psychosis in Hong Kong
Ruth D H Zhou
Hong Kong Shue Yan University

L K Tang
Hong Kong Shue Yan University

Y H Chui 
HKCT Institute of Higher Education

Marcus Y L Chiu 
School of Health and Wellbeing, University of Bolton
Centre for Mental Health and Society, Bangor University

Y Y Choi 
Kwai Chung Hospital, Hong Kong

Bien S Y Lau 
Kwai Chung Hospital, Hong Kong

Charles K S Lau
Kwai Chung Hospital, Hong Kong

William T L Lo 
The Mental Health Association of Hong Kong

Clara M W Siu 
Kwai Chung Hospital, Hong Kong

Magdalene Y C Poon 
Kwai Chung Hospital, Hong Kong

Menza H W Chu 
Kwai Chung Hospital, Hong Kong

W S Choi 
Hong Kong Shue Yan University

Stephen Wong 
Hong Kong Shue Yan University

L K Tang 
Hong Kong Shue Yan University

Jolie Chan 
The Mental Health Association of Hong Kong

Alan S L Au 
Hong Kong Shue Yan University

Abstract
Work plays an important role in the recovery of youth with mental health issues. Vocational counselling service helps these young people develop a career in line with their preferred identities. This paper introduces a narrative life design approach that facilitates high functioning youth with psychosis to identify their strengths and explore their life theme and meanings in life. Building on these insights, they can make career planning appropriate to their recovery status.

 

摘要

為香港患有思覺失調高功能青年人提供的敘事人生設計計劃

工作對於有心理健康問題的青少年的復元意義重大。生涯輔導服務幫助年青人發展符合理想身份的職業生涯。本文介紹的敘事人生設計,可幫助患有思覺失調的高功能青年人探索自身優勢、人生主題和生活意義。他們可根據在生涯輔導中所獲得的啟示,設計適合其自身復元進程的生涯規劃。

 
Keywords 
Vocation, Recovery, Work, Youth with Psychosis, Narrative Life Design
 
Download
PDF