BackgroundCyberbullying is presently an alarming problem worldwide due to its impact on the emotions, behaviour and psychological well-being of not only the victims, but the bullies themselves and also bystanders.AimThis study aims to investigate bystanders’ behaviours in cyberbullying and associated factors.MethodsThis research is a cross-sectional study of 578 secondary school students in Bangkok, Thailand. Simple random sampling was used to select four secondary schools. Data were collected through online questionnaires which included four sections: (1) demographic data, (2) bystanders’ behaviour in cyberbullying (cyberbullying experience and attitude towards cyberbullying were included in this section), (3) parental attachment (Inventory of Parent Attachment-Revised), and (4) self-esteem (Rosenberg Self-Esteem Scale-Revised).ResultsIt was found that most occurrences of bystanders’ behaviour were: (a) willing to intervene or help victims (34.6%), (b) ignoring the cyberbullying (28%) or (c) partaking in cyberbullying (26.3%). Participants who either were victims of cyberbullying or knew of cyberbullying happening to friends or relatives and had high parental attachment would intervene more than those who never had such experiences. Participants who knew of cyberbullying happening to the general public had tendencies towards ignoring the cyberbullying. Participants who indicated they were bullies and had positive attitude towards joining in tended to partake in the cyberbullying more than those who were not.ConclusionFactors relating to the behaviours of bystanders in cyberbullying should be further explored to provide support in the discouragement of ignoring and averting participation in cyberbullying. Secure parental attachment is one important factor that should be instilled during childhood years.

Background: Depression affects about 30% of stroke survivors within 5 years. Timely diagnosis and management of post-stroke depression facilitate motor recovery and improve independence. The original version of the Patient Health Questionnaire-9 (PHQ-9) is recognized as a good screening tool for post-stroke depression. However, no validation studies have been undertaken for the use of the Thai PHQ-9 in screening for depression among Thai stroke patients. Methods: The objectives were to determine the criterion validity and reliability of the Thai PHQ-9 in screening for post-stroke depression by comparing its results with those of a psychiatric interview as the gold standard. First-ever stroke patients aged ≥45 years with a stroke duration 2 weeks-2 years were administered the Thai PHQ-9. The gold standard was a psychiatric interview leading to a DSM-5 diagnosis of depressive disorder and adjustment disorder with a depressed mood. The summed-scored-based diagnosis of depression with the PHQ-9 was obtained. Validity and reliability analyses, and a receiver operating characteristic curve analysis, were performed. Results: In all, 115 stroke patients with a mean age of 64 years (SD: 10 years) were enrolled. The mean PHQ-9 score was 5.2 (SD: 4.8). Using the DSM-5 criteria, 11 patients (9.6%) were diagnosed with depressive disorder, 12 patients (10.5%) were diagnosed with adjustment disorder with a depressed mood. Both disorders were combined as a group of post-stroke depression. The Thai PHQ-9 had satisfactory internal consistency (Cronbach's alpha: 0.78). The algorithm-based diagnosis of the Thai PHQ-9 had low sensitivity (0.52) but very high specificity (0.94) and positive likelihood ratio (9.6). Used as a summed-scored-based diagnosis, an optimal cutoff score of six revealed a sensitivity of 0.87, specificity of 0.75, positive predictive value of 0.46, negative predictive value of 0.95, and positive likelihood ratio of 3.5. The area under the curve was 0.87 (95% CI: 0.78-0.96). Conclusions: The Thai PHQ-9 has acceptable psychometric properties for detecting a mixture of major depression and adjustment disorder in post-stroke patients, with a recommended cutoff score of ≥6 for a Thai population.

Background Delirium, a neuropsychiatric syndrome that occurs throughout medical illness trajectories, is frequently misdiagnosed. The Memorial Delirium Assessment Scale (MDAS) is a commonly used tool in palliative care (PC) settings. Our objective was to establish and validate the Memorial Delirium Assessment Scale‐Thai version (MDAS‐T) in PC patients. Materials and Methods The MDAS was translated into Thai. Content validity, inter‐rater reliability, and internal consistency were explored. The construct validity of the MDAS‐T was analyzed using exploratory factor analysis. Instrument testing of the MDAS‐T, the Thai version of the Confusion Assessment Method for the Intensive Care Unit (CAM‐ICU‐T), and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition as the gold standard was performed. The receiver operating characteristic (ROC) curve was used to determine the optimal cutoff score. The duration of each assessment was recorded. Results The study enrolled 194 patients. The content validity index was 0.97. The intraclass correlation coefficient and Cronbach's α coefficient were 0.98 and 0.96, respectively. A principal component analysis indicated a homogeneous, one‐factor structure. The area under the ROC curve was 0.96 (95% confidence interval [CI], 0.93–0.99). The best combination of sensitivity and specificity (95% CI) of the MDAS‐T were 0.92 (0.85–0.96) and 0.90 (0.82–0.94), respectively, with a cutoff score of 9, whereas the CAM‐ICU‐T yielded 0.58 (0.48–0.67) and 0.98 (0.93–0.99), respectively. The median MDAS‐T assessment time was 5 minutes. Conclusion This study established and validated the MDAS‐T as a good and feasible tool for delirium screening and severity rating in PC settings. Implications for Practice Delirium is prevalent in palliative care (PC) settings and causes distress to patients and families, thereby making delirium screening necessary. This study found that the MDAS‐T is a highly objective and feasible test for delirium screening and severity monitoring in PC settings and can greatly improve the quality of care for this population.