Southeast Asia is home to intra- and inter-regional migrant workers (MWs), with the Asia–Pacific region hosting approximately 14.2% of them—around 24 million individuals, with many engaging in low-wage, labour-intensive, and often precarious employment. Migrant workers (MWs) and migrant domestic workers (MDWs) in Asia are at heightened risk of mental health problems due to long working hours, abuse, and family separation. In Singapore, despite existing support systems, formal help-seeking for mental health conditions remains limited.

The aims of the current study were to understand the mental health help-seeking behaviors among MWs and MDWs in Singapore using a mixed methods approach. The study quantitatively explored the workers’ awareness of organisations or agencies that they could seek help from; the people, agencies or organisations that they had sought help from; and the ways in which they would like information on mental health to be conveyed to them. A deeper understanding of their perceived barriers and facilitators to accessing care and the ways in which they had sought help for their emotional problems were qualitatively examined through focus group discussions (FGDs).

A mixed-methods design was employed. Phase 1 was a quantitative survey involving 1,465 MWs and 1,462 MDWs from the six largest nationality groups in Singapore. Phase 2 comprised 14 focus group discussions with 48 MWs and 52 MDWs to explore their experiences in depth.

Most MWs (79.2%) and MDWs (91.4%) reported seeking help for emotional difficulties, mainly from informal sources such as family and friends. Awareness of formal services, including the Ministry of Manpower (MOM), was moderate (58.4% of MWs; 66.8% of MDWs). Both groups preferred face-to-face workshops for receiving mental health information. Help-seeking preferences diverged: 48.1% of MWs favored trained professionals, while 51.5% of MDWs preferred trained peers. Qualitative findings highlighted key barriers to be fear of job loss, financial constraints, limited awareness, and stigma, while facilitators included supportive family and friends, and positive, culturally sensitive healthcare encounters.

Although many migrant workers seek support for emotional distress, reliance on informal networks persists due to structural and cultural barriers to formal care. Integrated support models incorporating peer-led approaches, culturally and linguistically competent services, and clearer communication about accessible resources are needed to strengthen mental health support for this population.

None Declared

Artificial intelligence (AI) language models are increasingly accessible tools that offer potential support in mental health care. Despite their promise in revolutionizing mental health care through symptom assessment and treatment suggestions, concerns about their validity, accuracy, ethical considerations, and risk management persist. This study evaluates the clinical reasoning capabilities of two leading AI language models in assessing a clinical case vignette of Major Depressive Disorder (MDD).

To evaluate the diagnostic accuracy, risk assessment proficiency, and quality of treatment recommendations provided by ChatGPT and Claude when applied to a standardised clinical vignette of a case of MDD.

A clinical vignette describing a 50-year-old male patient exhibiting symptoms consistent with MDD was presented to both ChatGPT 4o and Claude 3.5 Sonnet. The patient had significant cardiac disease, leading to unemployment, social withdrawal, and passive suicidal ideation. Both AI models were asked five identical questions regarding: (1) diagnosis, (2) severity assessment, (3) first-line treatment recommendations, (4) optimal antidepressant selection, and (5) suicide risk evaluation. Two psychiatrists independently reviewed the responses for accuracy, comprehensiveness, and alignment with established guidelines and evidence-based treatment for depression with comorbid cardiac disease.

Both AI models correctly diagnosed MDD and accurately recognized the severity of the case due to the presence of suicidal ideation and significant functional impairment. Both offered comprehensive treatment recommendations, including pharmacotherapy and psychotherapy, and specifically suggested Sertraline as the antidepressant of choice due to its favourable cardiac safety profile. Both models assessed the patient as having a moderate to high suicide risk and provided a reasonably thorough analysis of risk and protective factors. However, limitations were noted in their ability to incorporate individualized patient nuances and psychosocial factors fully.

ChatGPT 4o and Claude 3.5 Sonnet demonstrated significant capabilities in clinical reasoning, providing diagnoses and treatment recommendations that align with best clinical practices. Their responses were largely accurate and comprehensive, indicating potential utility as supportive tools for healthcare professionals. AI models may assist non-specialists in preliminary assessment and management but are not substitutes for professional psychiatric evaluation. Caution is advised in relying on AI for clinical decision making, and further refinement is necessary to enhance their ability to integrate patients-centered care and adherence to ethical guidelines, to mitigate risks associated with self-diagnosis and inappropriate treatment.

None Declared

Harmful alcohol consumption has significant cost on health and is associated with lower quality of life (e.g., Lu et al. BMC Public Health 2022; 22:789). In Singapore, a significant proportion of the adult population exhibit alcohol misuse behaviours (e.g., Lim et al. BMC Public Health 2013; 13:992). Many patients admitted into general hospitals have excessive alcohol consumption and related problems. These admissions can be an opportunity for intervention due to accessibility to the individuals and their time (Saitz et al. Ann Intern Med 2007; 146 167-176). Some studies have suggested that brief alcohol interventions (BAI) delivered in general hospitals can be effective in reducing alcohol use. However, there has been less support for the benefits of BAI on wellbeing.

This study investigated the effectiveness of BAI in improving perceived sense of wellbeing among male alcohol users admitted to a general hospital in Singapore.

108 male inpatients in various medical wards received BAI by the hospital’s addiction counsellors and completed the Personal Wellbeing Index (PWI) questionnaire. At a one-year follow-up via telephone, the PWI was again administered.

Average PWI scores were higher at follow-up (M = 7.83, SD = 1.16) than during baseline admission (M = 7.60, SD = 1.12), p < 0.01. Further analyses found that scores improved significantly on PWI items related to standard of living (M = 7.36, SD = 1.41 vs M = 7.09, SD = 1.65; p < 0.05), health (M = 7.42, SD = 1.74 vs M = 6.62, SD = 1.87; p < 0.01) and achievement (M = 7.43, SD = 1.44 vs M = 6.98, SD = 1.64; p < 0.01). There were no significant differences in scores on the other PWI items between baseline and follow-up.

Conclusions: The results suggest that BAI can be beneficial in improving patients’ sense of wellbeing.

None Declared

We aimed to study predictive factors for burnout (BO) among healthcare workers in a tertiary hospital in Singapore.

We hypothesized that burnout would be assoiciated with singles, females, and foreign born staff recently moved into this country, unaccompanied by family members.

We further hypothesised that BO would be associated with those scoring less on resilience. Recognising that social support mitigated against stress and burnout, we hypothesized that those who perceived less support would be more prone to BO.

The study questionnaire was sent via corporate email to all staff with email access. We stressed that data would be fully anonymised. No financial rewards were given for participation which was carried out on a voluntary basis.

The following instruments were used, viz. F-SozU K-6, a brief form of the perceived social support questionnaire; Connor Davidson Resilience Scale; Oldenburg Burnout Inventory; Patient Health Questionnaire-4 item; Demand Control Support Questionnaire and Leisure Time Satisfaction Scale. Ethics approval for the study was sought from the SingHealth Centralised Institutional Review Board, which granted exemption of participant consent.

Analyses were performed using Stata version 17.0 (StataCorp. 2021), with statistical significance set as 2-sided 5% (p<0.05). The reliability and internal consistency of the scales used were assessed using Cronbach Alphas and Confirmatory Factor Analysis (CFA).

Neither males nor females were more at risk for BO. And contrary to what we hypothesised those who recently moved to this nation were not at greater risk for BO (p>0.05). Multivariate analyses showed that younger workers displayed higher burnout scores (p < 0.001).The psychological demand sub-score was positively associated with burnout [ 0.61 (95% CI 0.45 to 0.77), p < 0.001)]. Conversely, decision latitude [-0.33 (95% CI -0.44 to -0.21), p < 0.001)] and support [-0.47 (95% CI -0.60 to -0.35), p < 0.001] were negatively associated with BO.

Those who experienced anxiety or depressive symptoms were respectively more likely to experience burnout [0.30 (95% CI 0.02 to 0.58), p = 0.035 and 0.72 (95% CI 0.41 to 1.02), p < 0.001], with a clear association between higher PHQ-4 scores and risk for burnout (r = 0.619).

Moreover, satisfaction with utilisation of leisure time was inversely related to BO [-0.55 (95% CI -0.68 to –0.41; p < 0.001)]. We could not find any association between number of years worked, profession, marital status and perceived social support and BO, on multivariate anbalysis (p>0.05).

Strress reduction interventions should be made available for all staff, especially addressing those at highest risk for burnout.

None Declared

The coronavirus disease 2019 (COVID-19) pandemic has led to significant strain on front-line healthcare workers.

In this multicentre study, we compared the psychological outcomes during the COVID-19 pandemic in various countries in the Asia-Pacific region and identified factors associated with adverse psychological outcomes.

From 29 April to 4 June 2020, the study recruited healthcare workers from major healthcare institutions in five countries in the Asia-Pacific region. A self-administrated survey that collected information on prior medical conditions, presence of symptoms, and scores on the Depression Anxiety Stress Scales and the Impact of Events Scale-Revised were used. The prevalence of depression, anxiety, stress and post-traumatic stress disorder (PTSD) relating to COVID-19 was compared, and multivariable logistic regression identified independent factors associated with adverse psychological outcomes within each country.

A total of 1146 participants from India, Indonesia, Singapore, Malaysia and Vietnam were studied. Despite having the lowest volume of cases, Vietnam displayed the highest prevalence of PTSD. In contrast, Singapore reported the highest case volume, but had a lower prevalence of depression and anxiety. In the multivariable analysis, we found that non-medically trained personnel, the presence of physical symptoms and presence of prior medical conditions were independent predictors across the participating countries.

This study highlights that the varied prevalence of psychological adversity among healthcare workers is independent of the burden of COVID-19 cases within each country. Early psychological interventions may be beneficial for the vulnerable groups of healthcare workers with presence of physical symptoms, prior medical conditions and those who are not medically trained.

Epidemiological studies indicate that individuals with one type of mental disorder have an increased risk of subsequently developing other types of mental disorders. This study aimed to undertake a comprehensive analysis of pair-wise lifetime comorbidity across a range of common mental disorders based on a diverse range of population-based surveys.

The WHO World Mental Health (WMH) surveys assessed 145 990 adult respondents from 27 countries. Based on retrospectively-reported age-of-onset for 24 DSM-IV mental disorders, associations were examined between all 548 logically possible temporally-ordered disorder pairs. Overall and time-dependent hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models. Absolute risks were estimated using the product-limit method. Estimates were generated separately for men and women.

Each prior lifetime mental disorder was associated with an increased risk of subsequent first onset of each other disorder. The median HR was 12.1 (mean = 14.4; range 5.2–110.8, interquartile range = 6.0–19.4). The HRs were most prominent between closely-related mental disorder types and in the first 1–2 years after the onset of the prior disorder. Although HRs declined with time since prior disorder, significantly elevated risk of subsequent comorbidity persisted for at least 15 years. Appreciable absolute risks of secondary disorders were found over time for many pairs.

Survey data from a range of sites confirms that comorbidity between mental disorders is common. Understanding the risks of temporally secondary disorders may help design practical programs for primary prevention of secondary disorders.

• Understand the theoretical background, mechanism of action and clinical applications of fNIRS and compare it to other neuroimaging modalities

• Understand the use of fNIRS in academic and clinical psychiatry through current research findings

• Be able to evaluate the future potential of fNIRS and formulate new ideas for using fNIRS in academic and clinical psychiatry

Traumatic events are common globally; however, comprehensive population-based cross-national data on the epidemiology of posttraumatic stress disorder (PTSD), the paradigmatic trauma-related mental disorder, are lacking.

Data were analyzed from 26 population surveys in the World Health Organization World Mental Health Surveys. A total of 71 083 respondents ages 18+ participated. The Composite International Diagnostic Interview assessed exposure to traumatic events as well as 30-day, 12-month, and lifetime PTSD. Respondents were also assessed for treatment in the 12 months preceding the survey. Age of onset distributions were examined by country income level. Associations of PTSD were examined with country income, world region, and respondent demographics.

The cross-national lifetime prevalence of PTSD was 3.9% in the total sample and 5.6% among the trauma exposed. Half of respondents with PTSD reported persistent symptoms. Treatment seeking in high-income countries (53.5%) was roughly double that in low-lower middle income (22.8%) and upper-middle income (28.7%) countries. Social disadvantage, including younger age, female sex, being unmarried, being less educated, having lower household income, and being unemployed, was associated with increased risk of lifetime PTSD among the trauma exposed.

PTSD is prevalent cross-nationally, with half of all global cases being persistent. Only half of those with severe PTSD report receiving any treatment and only a minority receive specialty mental health care. Striking disparities in PTSD treatment exist by country income level. Increasing access to effective treatment, especially in low- and middle-income countries, remains critical for reducing the population burden of PTSD.

Although specific phobia is highly prevalent, associated with impairment, and an important risk factor for the development of other mental disorders, cross-national epidemiological data are scarce, especially from low- and middle-income countries. This paper presents epidemiological data from 22 low-, lower-middle-, upper-middle- and high-income countries.

Data came from 25 representative population-based surveys conducted in 22 countries (2001–2011) as part of the World Health Organization World Mental Health Surveys initiative (n = 124 902). The presence of specific phobia as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition was evaluated using the World Health Organization Composite International Diagnostic Interview.

The cross-national lifetime and 12-month prevalence rates of specific phobia were, respectively, 7.4% and 5.5%, being higher in females (9.8 and 7.7%) than in males (4.9% and 3.3%) and higher in high- and higher-middle-income countries than in low-/lower-middle-income countries. The median age of onset was young (8 years). Of the 12-month patients, 18.7% reported severe role impairment (13.3–21.9% across income groups) and 23.1% reported any treatment (9.6–30.1% across income groups). Lifetime co-morbidity was observed in 60.5% of those with lifetime specific phobia, with the onset of specific phobia preceding the other disorder in most cases (72.6%). Interestingly, rates of impairment, treatment use and co-morbidity increased with the number of fear subtypes.

Specific phobia is common and associated with impairment in a considerable percentage of cases. Importantly, specific phobia often precedes the onset of other mental disorders, making it a possible early-life indicator of psychopathology vulnerability.

There is lack of published data on bulbar signs among the healthy population. This study aims to determine the range of normality of bulbar signs particularly among the elderly.

Systemic examination of bulbar signs was carried out according to a predetermined protocol on a cohort of young and elderly healthy subjects.

A total of 206 subjects were recruited in the study, 104 young adults with mean age of 20 years, and 102 elderly with mean age of 73 years. Uvula deviation was seen in 28 (26.9%) young subjects and 22 (21.6%) elderly. Irregular tongue border was seen in 17 subjects, unilateral in 4 subjects. Fourteen (6.8%) subjects had deviation on tongue protrusion. Occasional tremor of tongue on protrusion is common in both young and old. Persistent (severe) tongue tremor on protrusion was seen in 18.6% of the elderly, and 4.8% of the young. None of the subjects had tremor of tongue at rest. In gag reflex, absence of gagging response was common in elderly, seen in two thirds of the subjects on stimulation of the posterior pharyngeal wall. However, all the subjects had uvular movement. Habituation or suppression of gagging response was seen in close to 90% of young males.

There is wide range of normality in bulbar signs in normal population, particularly among the elderly.