EY1920 Year Book

226 Overview I enrolled in the Master of Research in Medicine intercalation programme for the Enrichment Year. I have conducted full-time research training in the Department of Psychiatry in HKU since July 2019 and the training is supposed to finish at the end of June 2020. In the meantime, I took several courses on psychopathology and statistics in complement with my research projects. My initial project was a clinical study, but recruitment of patients was forbidden due to the COVID-19 pandemic. I also underwent a group of studies on the mortality in psychotic disorders, which became my major project since the initial project had been paused. Initial clinical study My initial study aimed to investigate the neurocognitive mechanisms accounting for delusions in patients with first- episode psychosis (FEP). It was a case-control study with a target of recruiting around 40 FEP patients and 40 demographically matched healthy controls. For each of the recruited subjects, I conducted a set of clinical interview and cognitive tests and administered a computerized task which aims to examine the decision making process in FEP patients and whether certain task parameters are associated with symptom severity. My supervisor discussed with me the dimensions of symptoms in psychosis and taught me how to probe the patients and rate their symptoms based on a number of well-validated rating scales. Before patient recruitment, my supervisor and I had several Skype meetings with our collaborator who designed the computerized task. They emphasized on explaining the instructions in a way that our subjects could understand and be incentivized to put effort into the task by relating real monetary reward to task performance. Mortality in psychotic disorders The following studies were conducted using databases obtained from the Clinical Data Analysis and Reporting System (CDARS). It is a territory-wide electronic record database developed by the Hospital Authority, containing demographic and clinical information of patients who utilized public healthcare facilities. Post-stroke mortality in schizophrenia 817 schizophrenia patients who were admitted for incident ischemic stroke between 2006 and 2016 were identified and compared to 8170 incident ischemic stroke patients without psychotic disorder (matched on demographics, treatment site and calendar period of admission). Multivariate logistic regression analyses adjusting for medical comorbidities revealed that schizophrenia patients had higher 30-day (marginal) and 1-year post-stroke mortality rates. Outcome Schizophrenia, N (%) Control, N (%) Adjusted Odds Ratio (95% CI) P value 30-day mortality 59 (7.2) 436 (5.3) 1.34 (1.00–1.79) 0.052 1-year mortality 138 (16.9) 985 (12.1) 1.51 (1.22–1.85) <0.001 Cause of death Schizophrenia, SMR (95% CI) ONAP, SMR (95% CI) All causes 2.49 (2.43–2.55) 2.00 (1.92–2.09) Natural causes 1.80 (1.74–1.85) 1.47 (1.40–1.54) Cardiovascular diseases 1.38 (1.29–1.48) 1.03 (0.89–1.13) Neoplasms 0.97 (0.91–1.03) 0.87 (0.77–0.98) Respiratory diseases 3.82 (3.64–4.01) 2.68 (2.48–2.90) Unnatural causes 6.97 (6.47–7.49) 8.53 (7.61–9.52) Excess mortality in schizophrenia and other non-affective psychotic disorders (ONAP) This study investigated excess mortality in 46896 schizophrenia patients and 20651 ONAP patients between 2006 and 2016 in Hong Kong (HK), followed up till the end of 2017. Standardized mortality ratios (SMRs) and excess life-year lost (LYL) were used to quantify excess mortality compared to the general population during the same period. Schizophrenia and ONAP patients had higher all-cause and an array of cause-specific mortality rates than the general population (selected causes shown in the table below). Excess LYLs were 9.53 years for men and 8.07 years for women in schizophrenia, and 8.18 years for men and 5.44 years for women in ONAP. Mortality trend in first-episode schizophrenia (FES) patients This study followed up 13422 FES patients included between 2006 and 2016 till the end of 2017. Overall, the mortality rates from unnatural causes and several natural causes decreased consistently from the peak in the first year of follow-up and maintained at a relatively stable rate after three years of follow-up. This is possibly explained by the higher suicide risk during post-discharge periods and the early stage of psychosis, and serious adverse effects and complications caused by the initiation of antipsychotics. Besides, hospital-treated FES patients (n=6060) had higher mortality risk in the first 5 years of follow-up compared to non-admitted FES patients (n=7362), especially in the first month of follow-up, during which they had 4 times the mortality risk. This was not explained by demographic or medical comorbidities such as alcohol and substance abuse, but attributed to other psychosocial and clinical factors such as previous suicide attempts, comorbid depression and illness severity. Trends of natural- and unnatural-cause mortality in FES patients MBBS Enrichment Year 2019/20 Yung Chak Lam Full Year < IC - M R e s( Me d) at HK U, H o ng K o ng > Yung Chak Lam Scholarship and Financial Assistance In addition to the financial support from the University, the Faculty offers over 15 scholarships and financial assistance schemes to fund students with their Enrichment Year. The generosity of our Donors has always been instrumental in motivating and inspiring MBBS students to strive for their best. Faculty Scholarships Aspiration Foundation Enrichment Scholarship Bau Tsu Zung Bau Kwan Yeu Hing Scholarship Dr Mok Hing Yiu Scholarship Francis Lau Scholarships for Medical Students HKCP Scholarships for Medical Students HKUMAA Enrichment Scholarship for Medical Students Hui Ping Cheung Memorial Enrichment Scholarship for Medical Students Lee Sum Ping Medical Humanities Enrichment Award Leong Che-hung Medical and Research Enrichment Scholarship Leung Tong Leung Au Sue Har Enrichment Scholarships Loke Yew Enrichment Scholarship Medical Faculty Enrichment Scholarship Paul and Margaret Todd Scholarship for Medical and Nursing Students S K Yee Medical Foundation David Todd Memorial Enrichment Scholarship Sun Chieh Yeh Heart Foundation Enrichment Scholarship Warren Chan Enrichment Scholarship for Medical Students Wong Tsang Pan Memorial Award The award has lightened my financial burden which allows me to focus more of my time on learning. The Donor’s generosity and support have inspired me to help others. I promise that I will work very hard and hopefully one day I will be able to help students achieve their goals just as the award has helped me. Lam Tin Chung Adrian MBBS III Student HKUMAA Enrichment Scholarship for Medical Students 2019-20 Recipient With the support of the scholarship, I have aspirations to become a medical educationalist involved in curriculum reform and practitioner research one day. I intended on using this award to support my research endeavours and further cultivate my skills in academic writing and public speaking to better prepare myself for journal submissions and conference presentations. Wong Hoi Yan Corliss MBBS III Student Hui Ping Cheung Memorial Enrichment Scholarship for Medical Students 2019-20 Recipient The award supported my humanitarian service work with the Elderly Unit at the Hong Kong Red Cross. My goal is to become a compassionate and capable doctor who can truly address the breadth of my patients’ health needs, and this award enabled me to participate in activities that led me closer to that goal. Lam Yat Hym MBBS III Student Loke Yew Student Enrichment Scholarship 2019-20 Recipient 227