1. Clinical Insight in schizophrenia

Though there have been many studies exploring clinical and cognitive correlates of insight in patients with schizophrenia, mostly were with cross-sectional approach and with patients of different stage of illness. One of our studies examined clinical and cognitive correlates in drug naive patients with schizophrenia and the other study looked at longitudinal changes of relationship of insight and cognition. Another study explored the relationship between medication adherence, insight and knowledge about the illness.

1. Chan KW, Hui LM, Wong HY, Lee HM, Chang WC, Chen YH. Medication adherence, knowledge about psychosis, and insight among patients with a schizophrenia-spectrum disorder. J Nerv Ment Dis. 2014 Jan;202(1):25-9. PubMed PMID: 24375208.

2. Chan SK, Chan KK, Hui CL, Wong GH, Chang WC, Lee EH, Tang JY, Chen EY. Correlates of insight with symptomatology and executive function in patients with first-episode schizophrenia- spectrum disorder: a longitudinal perspective. Psychiatry Res. 2014 May 15;216(2):177-84. PubMed PMID: 24560612.

3. Chan SK, Chan KK, Lam MM, Chiu CP, Hui CL, Wong GH, Chang WC, Chen EY. Clinical and cognitive correlates of insight in first-episode schizophrenia. Schizophr Res. 2012 Mar;135(1-3):40-5. PubMed PMID: 22245186.

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2. Evaluation of Long term outcomes of early intervention of psychosis service

One of the key questions in establishing the early intervention service for psychosis is whether the shortterm effect of the early intervention service can sustain in the long term. The early intervention service in different countries is usually about 2-3 years. There has been some studies on the medium term effect of early intervention service such as 5-7 years, studies on longer term effect is limited. We have conducted studies systematically evaluating 10-year outcomes of early intervention service comparing with the standard care and results have contributed to this gap of research.

1. Chan S.K.W.*; Chan V.H.Y., Pang H.H., Hui C.L.M., Suen Y.N., Chang W.C., Lee E. H.M., Sham P, Chen E.Y.H. (2020) Ten-year trajectory and outcomes of negative symptoms of patients with first-episode schizophrenia spectrum disorders. Schizophrenia Research doi: 10.1016/j.schres.2020.03.061.

2. Sherry Kit Wa Chan, Herbert H. Pang, Kang K. Yan, Christy Lai Ming Hui, Yi Nam Suen, Wing Chung Chang, Edwin Ho Ming Lee, Pak Sham, Eric Yu Hai Chen (2019). 10-year employment patterns of patients with first-episode schizophrenia-spectrum disorders: Comparison of early intervention and standard care services. British Journal of Psychiatry. doi: 10.1192/bjp.2019.161

3. Sherry Kit Wa Chan,  Stephanie Wing Yan Chan, Herbert H. Pang, Kang K. Yan, Christy Lai Ming Hui, Wing Chung Chang, Edwin Ho Ming Lee, Eric Yu Hai Chen (2018) Association of an Early Intervention Service for Psychosis With Suicide Rate Among Patients With First-Episode Schizophrenia-Spectrum Disorders. JAMA Psychiatry Published online April 4, 2018. doi:10.1001/jamapsychiatry.2018.0185

4. Sherry Kit Wa Chan*; Christy Lai Ming Hui; Wing Chung Chang; Edwin Ho Ming Lee; Eric Yu Hai Chen (2018). Ten-year follow up of patients with first-episode schizophrenia spectrum disorder from an early intervention service: predictors of clinical remission and functional recovery. Schizophrenia Research https://doi.org/10.1016/j.schres.2018.08.022

5. Chan SK, So HC, Hui CL, Chang WC, Lee EH, Chung DW, Tso S, Hung SF, Yip KC, Dunn E, Chen EY. 10-year outcome study of an early intervention program for psychosis compared with standard care service. Psychol Med. 2015 Apr;45(6):1181-93. PubMed PMID: 25233868.

6. Chan KWS*, Chau EHS, Hui CLM, Chang WC, Lee WHM, Chen EYH. Long term effect of early    intervention (EI) service on duration of untreated psychosis (DUP) in youth and adult population in         Hong Kong. Early Intervention in Psychiatry. 2016. Doi:10.1111/eip.12313.

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3. Public stigma of psychosis

Public stigma on psychosis is one of the major barriers towards help seeking and patient recovery. It is also likely to be related to the development of self-stigma and insight deficit. We have explored factors contributing to the public stigma in order to support further development of effective intervention. Our finding further suggested gender specific intervention should be considered.

1. Min Yi Sum, Sherry Kit Wa Chan*, Samson Tse, John R. Bola, Roger Man Kin Ng, Christy Lai Ming Hui, Edwin Ho Ming Lee, Wing Chung Chang, Eric Yu Hai Chen (2020) Elucidating the Relationship between Internalized Stigma, Cognitive Insight, Illness Severity, and Functioning in Patients with Schizophrenia Using a Path Analysis Approach. Journal of Mental Health. doi.org/10.1080/09638237.2020.1836553

2. Sherry Kit Wa Chan, Otilia Wai Tung Li, Christy Lai Ming Hui, Wing Chung Chang, Edwin Ho Min Lee, Eric Yu Hai Chen (2019). The effect of media reporting of a homicide committed by a patient with schizophrenia on the public stigma and knowledge of psychosis among the general population of Hong Kong. Social Psychiatry and Psychiatric Epidemiology. 54(1):43-50. doi: 10.1007/s00127-018-1610-2.

3. Chan SK, Lee KW, Hui CL, Chang WC, Lee EH, Chen EY. Gender effect on public stigma changes towards psychosis in the Hong Kong Chinese population: a comparison between population surveys of 2009 and 2014. Soc Psychiatry Psychiatr Epidemiol. 2016 Dec 1;PubMed PMID: 27909775.

4. Chan SK, Tam WW, Lee KW, Hui CL, Chang WC, Lee EH, Chen EY. A population study of public stigma about psychosis and its contributing factors among Chinese population in Hong Kong. Int J Soc Psychiatry. 2016 May;62(3):205-13. PubMed PMID: 26721540.

5. Chan SK, Ching EY, Lam KS, So HC, Hui CL, Lee EH, Chang WC, Chen EY. Newspaper coverage of mental illness in Hong Kong between 2002 and 2012: impact of introduction of a new Chinese name of psychosis. Early Interv Psychiatry. 2015 Nov 23;PubMed PMID: 26593744.

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4. Reference delusion in psychosis

Reference delusion is one of the commonest delusion in patients with psychosis. Typically, patients believe that non-self-related events are relevant to self eg believe others are looking at self but others are not, named as self-referential gaze perception. Self-referential gaze perception is also highly relevant in social cognition. I have developed a behavioral paradigm in looking into this phenomenon in different populations, first episode patients, patients in remission and those in prodromal state to explore it underlying mechanisms.

1. Chan S.K.W.*, Liu T., Wong A.O.Y., Wong G.H.Y., Hsiao J., Hui C.L.M., Chang W.C., Lee E.H.M., Chen E.Y.H. (2021) Self-referential gaze perception of patients with schizophrenia and its relationship with symptomatology and cognitive functions. Schizophrenia Research 228: 288-294 https://doi.org/10.1016/j.schres.2020.12.034

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5. Treatment resistant schizophrenia

Thought antipsychotic medication is effective in ameliorate positive symptoms of patients with schizophrenia, about 20-40% of patients are not responding to the current form of antipsychotic medications and are considered as treatment resistant state. They are often the group of patients with poorer outcomes and require more health care resources. Clozapine is the only antipsychotic medication is found to be effective in treating treatment resistant schizophrenia, yet only about 60% patients are responding. Therefore understanding the mechanisms of treatment resistant schizophrenia and predictors can help to improve our care to this group of patients.

1. Chan S.K.W.*; Chan H.Y.V., Honer W.G., Bastiampillai T., Suen Y.N., Yeung W.S., Lam M., Lee W.K., Ng R.M.K., Hui C.L.M., Chang W.C., Lee E.H.M., Chen E.Y.H. (2020) Predictors of treatment resistant and clozapine resistant schizophrenia: A 12 years follow up study of first episode schizophrenia-spectrum disorders. Schizophrenia Bulletin. DOI: 10.1093/schbul/sbaa145

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6. Psychotic-like experience

Psychotic-like experience in the general public has been studied from two perspectives. One is transdiagnostic and dimensional understanding of the psychiatric conditions. The second one is psychosis continuum perspective. I am interested to have detail understanding of this phenomenon through difference approach including epidemiologically, psychopathology, cognitive function and neuroscience.

1. Chan S.K.W*., Lee K.K.W., Chan V.H.Y., Pang H.H., Wong C.S.M., Hui C.L.M., Chang W. C., Lee E.H.M., Chan W.C., Cheung E.F.C., Chiu H.F.K., Chiang T.P., Lam M., Lau J. T.F., Ng R.M.K., Hung S.F., Lam L.C.W., Chen E.Y.H. (2020) 12-month prevalence of psychotic experiences and their association with clinical outcomes in Hong Kong: an epidemiological and a 2-year follow up studies. Psychological Medicine. 1-8. doi: 10.1017/S0033291720001452 Lee K.W., Chan K.W*, Chang W.C.,

2. Lee K.W., Chan S.K.W*, Chang W.C.,Lee H.M.E., Hui C.L.M. and Chen E.Y.H. (2016) A systematic review on definitions and assessments of psychotic-like experiences, Early Intervention in Psychiatry. 10 (1): 3-16. doi: 10.1111/eip.12228

 

*Corresponding author