29^th World Psychiatrists Meet December 07-08, 2017 Dubai, UAE

Professor WK Tang was appointed to professor in the Department of Psychiatry, the Chinese University of Hong Kong in 2011. His main research areas are Addictions and Neuropsychiatry in Stroke. Professor Tang has published over 100 papers in renowned journals, and has also contributed to the peer review of 40 journals. He has secured over 20 major competitive research grants, including Health and Medical Research Fund, reference number: 02130726. Health and Medical Research Fund, reference number: 01120376. National Natural Science Foundation of China, reference number: 81371460. General Research Fund, reference number: 474513. General Research Fund, reference number: 473712. He has served the editorial boards of five scientific journals. He was also a recipient of the Young Researcher Award in 2007, awarded by the Chinese University of Hong Kong.

Introduction & Aim: Previous studies reported stroke patients exhibited post stroke behavioral disinhibition (PSBD). The prevalence rates across studies were inconsistent and vary widely (ranged from 5 to 76%). Moreover, the clinical correlates of PSDB were unknown. Therefore, this study aimed to determine the prevalence of PSDB and its correlates with clinical variables, i.e. functional dependence, cognitive functioning, anxiety and depressive symptoms, after 3-month after stroke. Methods: Stroke survivors who had ischemic stroke admitted to the Acute Stroke Unit of the Prince of Wales Hospital from September 2016 to April 2017 were recruited. PSBD was assessed by the disinhibition subscale of the Chinese version of the Neuropsychiatric Inventory (CNPI), which was responded by the caregivers. The stroke survivors’ functional dependence, anxiety and depressive symptoms were assessed by Barthel Index, the anxiety subscale of the hospital anxiety depression scale and the beck depression inventory, respectively. Results: 28 stroke survivors were recruited, 9 were excluded due to the absence of caregivers (n=8) and history of schizophrenia (n=1). Thus, 19 stroke survivors and their caregivers were assessed. The mean age of the stroke survivors was 67.11 (SD = 6.79) and 11 (57.9%) were male. The types of caregiver were spouse (63.2%), children (26.3%) and others (10.5%). None of the caregivers reported the presence of behavioral disinhibition of the corresponding stroke survivors. Conclusion: PSBD is uncommon amongst ischemic stroke survivors in Hong Kong.

Professor WK Tang was appointed to professor in the Department of Psychiatry, the Chinese University of Hong Kong in 2011. His main research areas are Addictions and Neuropsychiatry in Stroke. Professor Tang has published over 100 papers in renowned journals, and has also contributed to the peer review of 40 journals. He has secured over 20 major competitive research grants, including Health and Medical Research Fund, reference number: 02130726. Health and Medical Research Fund, reference number: 01120376. National Natural Science Foundation of China, reference number: 81371460. General Research Fund, reference number: 474513. General Research Fund, reference number: 473712. He has served the editorial boards of five scientific journals. He was also a recipient of the Young Researcher Award in 2007, awarded by the Chinese University of Hong Kong.

Dysexecutive syndrome (DES) is defined as an impairment of executive functions constituting of two domains: behavioral dysexecutive syndrome (BDES) and cognitive dysexecutive syndrome (CDES) which are not accompanied always[1]. A growing body of studies demonstrated that BDES is a common post-stroke neuropsychiatric comorbidity. The prevalence of BDES in stroke survivors varies ranging from 3% to 25% possibly attributed to the lack of standardized diagnosis methods and variances in study sample and study mode. Post-stroke BDES comprises varieties of clinical presentations, the most prevalent of which are anosognosia and hypoactivity with apathy-abulia[2]. Experimental Studies: The clinical course of BDES in stroke population has not yet fully elucidated. Some studies showed that there was only a minor decrease of prevalence of BDES several months after stroke, suggesting the possible chronicity of BDES. Possible clinical correlates of behavioral symptoms in stroke are global cognitive impairment, executive dysfunction, premorbid personality and psychopathology and stroke severity. Despite BDES is also a possible predictor of poor post-stroke physical function and can increase the burden of caregivers, it is still often underestimated and untreated. Furthermore, the treating methods for BDES are limited and lack of high quality supporting evidences. The methods of psychosocial treatments varies including caregiver education, aromatherapy,exercise and behavioral intervention whereas their effectiveness is still under debated. Results: First of all, frontal lobe is treated as the key component of FSC. Frontal lesion and reduced frontal volume contribute to behavioral disturbances. Particularly, abnormalities of orbitofrontal cortex (OFC) and medial prefrontal cortex (MPC) involving the reward representation, response selection and behavioral flexibility are closely correlated with apathy, disinhibition and other dysexecutive syndromes in patients with neurologic diseases. Some studies suggested that antipsychotic drugs might be effective in controlling behavioral dysexecutive problems such as agitation, apathy and disinhibition. Conclusion: Standardized diagnosis criteria and a deeper understanding of the mechanism of post-stroke BDES is urgently needed , which may benefit to recognize BDES in stroke survivors as early as possible and select the appropriate treatment, therefore, result in a better outcome of stroke. References: 1. Godefroy O: Frontal syndrome and disorders of executive functions. Journal of neurology 2003, 250(1):1-6. 2. Godefroy O, Azouvi P, Robert P, Roussel M, LeGall D, Meulemans T: Dysexecutive syndrome: diagnostic criteria and validation study. Annals of neurology 2010, 68(6):855-864. 3. Cummings JL: Frontal-subcortical circuits and human behavior. Archives of neurology 1993, 50(8):873-880.

Rafidah Bahari has obtained her Medical degree from the Queen’s University of Belfast and Membership of the Royal Colleges of Psychiatrist from the Royal College of Psychiatrist in London. She is currently pursuing her PhD form Cyberjaya University College of Medical Sciences, Malaysia, in developing a novel faith based intervention for PTSD. Her research interests include PTSD, spiritual and religious interventions, validation, systematic reviews and qualitative studies.

Introduction: In June 2015, an earthquake shook the quiet district of Ranau in Sabah, Malaysia. Measuring 6.0 in magnitude, it was the worst to affect the area since 1976. Major natural disaster does not only result in destruction and physical injuries. Psychological consequences are frequent but are seldom recognized. Left unchecked, they can result in disabling mental and physical conditions. Objective: The aim of this study is to explore the emotional impact of the earthquake on the residents of Ranau and the coping strategies used to deal with the emotional distress. Methods: This study was conducted during humanitarian missions to villages in Ranau between August and November 2015. Convenient sampling was done which included residents present during the earthquake and aged at least 18. This study uses a qualitative exploration design. Subjects gave written consent to participate and were interviewed individually using a semi-structured interview schedule. Results: A total of 119 subjects were interviewed. Al subjects admitted to having emotional distress especially immediately in the aftermath of the major earthquake. The most common emotional sequel was fear, followed by shock and worry. For most, the distress lasted about 2 weeks. Subjects used a variety of psychological, social and religious coping techniques to manage their emotional distress. Many quoted acceptance, prayers, talking about the event and good social support as the most beneficial methods for handling their distress. Very few have received counseling for their symptom. Conclusion: Emotional distress is extremely common in the residents of Ranau following the big earthquake in 2015. Fortunately for the majority, symptoms were self-limiting. Nevertheless, further studies are needed to explore the long term impact of such an event in this population. Recent Publications 1. Bahari R, Mohamad Alwi M N, Jahan N, Ahmad M R, Mohd Saiboon I (2016) How do people cope with post traumatic distress after an accident? The role of psychological, social and spiritual coping in Malaysian Muslim patients. European Journal of Psychotherapy & Counseling, 2537: 1-18. 2. Bahari R, Alwi M N M, Ahmad M R, Saiboon I M (2015) Translation and Validation of the Malay Post Traumatic Stress Disorder Checklist for Civilians. Asian Journal of Psychiatry; 16(2).