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Prof. CHEN Yu Hai, Eric 陳友凱

MA(Oxon), MBChB(Edin), MD(Edin), FRCPsych, FHKAM(Psychiatry)

Chi-Li Pao Foundation Professor in Psychiatry
Chair Professor
Clinical Professor

 

Director of Psychosis Studies and Intervention Program (PSI), HKU

Principal Investigator of the State Key Laboratory of Brain & Cognitive Sciences

Honorary Consultant Psychiatrist, Queen Mary Hospital

Chairman of Communication Committee of Schizophrenia International Research Society (SIRS)

Convenor of Early Assessment Service for Psychosis (EASY), Hospital Authority

Convenor of LevelMind@JC

Chairman of Hong Kong Early Psychosis Foundation (EPISO)

Editorial Board in Schizophrenia Research

Editorial Board in Psychiatry Research

Editorial Board in Psychiatry Research Communications

Editorial Board in Schizophrenia Bulletin

 

Email: eyhchen@hku.hk
Website for Prof Eric Chen:
http://ericchenhongkong.wordpress.com/
The HKU Scholars Hub Page address:

http://hub.hku.hk/rp/rp00392
ORCID: 0000-0002-5247-3593

Biography

Eric has been working on understanding how the human mind could under some conditions enter into anomalous states, and how best to help people afflicted with these states of mind.

Mental distress occurs when the well-tuned brain system for engaging with reality fails. It results in a faulty experience external reality (expressed as delusions and hallucinations), as well as internal identity (sense of self) and emotions. While many people experience these in very mild forms. These experiences can also cascade to pathological states which overpowers the individual and causes substantial suffering and disruptions in the individual's lives.

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Research Interest

Psychotic disorders

Eric has been working on understanding how the human mind could under some conditions enter into anomalous states, and how best to help people afflicted with these states of mind.

Mental distress occurs when the well-tuned brain system for engaging with reality fails. It results in a faulty experience external reality (expressed as delusions and hallucinations), as well as internal identity (sense of self) and emotions. While many people experience these in very mild forms. These experiences can also cascade to pathological states which overpowers the individual and causes substantial suffering and disruptions in the individual's lives.

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Eric has been exploring the cognitive process, brain mechanisms, as well as the subjective experiences involved in the development of psychosis. With these understandings, he and his team have been working how best to help people afflicted with psychotic disorders. Current strategies include early detection and intervention, as well as focused psychological and pharmacological interventions in the first few critical years. Using longitudinal randomized-controlled studies, case-controlled studies, and naturalistic cohorts, Eric and his team have been studying the long-term effects of interventions. They have found that cognition, relapse prevention, physical exercise and suicidal tendencies may critically impact on the outcome. They are working on how to make use of this information to produce culturally adaptive intervention service in low-resource settings.

Related projects

1

Trajectories and Predictors in the Clinical High Risk for Psychosis Population: Prediction Scientific Global Consortium (PRESCIENT)” Hong Kong site in a multi-center study [Site PI]

Co-investigators:
Dr. Christy LM Hui
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. Simon SY Lui
Dr. WC Chang

Key international collaborator:
Prof. Barnaby Nelson [Orygen Australia; Project PI]

2

Risk and protective lifestyle factors of mental health of young people [PI]

Co-investigators:
Dr. Christy LM Hui
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. WC Chang
Dr. YN Suen

3

Naturalistic evaluation of a community-based early intervention model for youth mental health in Hong Kong (LevelMind@JC 賽馬會平行心間計劃)[PI]

Co-investigators:
Dr. Christy LM Hui
Dr. YN Suen
Dr. Stephanie MY Wong

4

A quasi-experimental controlled study of the effect of a community-based early intervention model for youth mentah [PI]

Co-investigators:
Dr. Christy LM Hui
Dr. YN Suen
Dr. Stephanie MY Wong

5

Improving the clinical sensitivity of the Comprehensive Assessment for At-Risk Mental State (CAARMS) in prediction of outcome in Clinical High-Risk subjects: the SK-2 Study [PI]

Co-investigators:
Dr. Christy LM Hui
Dr. YN Suen
Dr. Stephanie MY Wong

6

Ecological momentary data-informed factors for youth mental health [PI]

Co-investigators:
Dr. Christy LM Hui
Dr. YN Suen
Dr. Stephanie MY Wong

7

Longitudinal functional outcomes of young people with high schizotypal trait in an epidemiological sample of young people in Hong Kong [PI]

Co-investigators:
Dr. YN Suen
Dr. Christy LM Hui
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. WC Chang

8

Clinical High-Risk in the youth epidemiological sample: risk factors and outcomes [PI]

Co-investigators:
Dr. Christy LM Hui
Dr. YN Suen
Dr. Stephanie MY Wong

9

Public awareness impact of introducing “At-risk mental state” as a novel concept to the population of Hong Kong [PI]

Co-investigators:
Dr. Stephanie MY Wong
Dr. Christy LM Hui
Dr. YN Suen

Key local collaborator:
Dr. Gloria Wong [Social Work, HKU]

10

At-risk mental state (ARMS) features in predicting mental health outcomes: 5-year follow-up outcome study [Co-I]

Principal investigators:
Dr. YN Suen

Co-investigators:
Dr. Christy LM Hui
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. WC Chang

Early intervention studies

Prevention is better than cure. Eric’s team has also been studying the early evolution of psychotic tendencies in the general population, and in young people, where most of the onset of mental disorders take place. They are particularly keen to study the identification of an “at risk” group which can be helped by earlier interventions.

To study the impacts of psychosis, Eric and his team has been using a variety of approaches:

  • Psychopathology: to capture fine-grained phenomenology of evolving symptom dimensions.

  • Imaging platform for sMRI, fMRI, Resting state, DTI, spectroscopy and molecular imaging.

  • Computational neuroscience: to learn from neural network models consequences of disruptions in cognitive representations.

  • Digital Mental Health Platform integration with EI system

  • Cultural and environmental characterisation of changing mental experiences with young people to formulate potential impact on youth mental health

  • Early Detection and Intervention systems for particular at risk groups, such as young people and women with socioeconomic deprivation.

Related projects

1

Populational factors affecting the impact of early intervention on the long-term outcome of psychotic disorders [PI]

2

Unpacking the impact of DUP on the effect of early intervention in psychotic disorders [Co-I]

Principal investigator:
Dr. Christy LM Hui

Co-investigators:
Prof. Eric YH Chen
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. WC Chang

3

The impact of early medication discontinuation on the long term outcome of psychotic disorders [Co-I]

Principal investigator:
Dr. Christy LM Hui

Co-investigators:
Prof. Eric YH Chen
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. WC Chang

4

The role of shared decision making on adherence and clinical outcome of early psychosis patients [Co-I]

Principal investigator:
Dr. YN Suen

Co-investigators:
Prof. Eric YH Chen
Dr. Christy LM Hui
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. WC Chang

Key international collaborator:
Prof. Swapna Verma [IMH, Singapore]
Dr. Charmaine Tang [IMH, Singapore]

5

Clinical dialogue versus psychoeducation: a new approach to facilitating and integrating illness understanding in psychosis [Co-I]

Principal investigator:
Dr. Christy LM Hui

Co-investigators:
Prof. Eric YH Chen
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. WC Chang
Dr. YN Suen

6

Impact of pharmacotherapy of long term outcome of first episode psychosis: a big data study [PI]

Co-investigators:
Dr. Edwin HM Lee
Dr. Simon SY Lui
Dr. YN Suen

Key local collaborators:
Dr. William TL Lo [Private]
Dr. Sandra SM Chan [Psychiatry, CUHK]
Dr. Michael GC Yiu [Psychiatry, UCH]

7

Jockey Club Mental Wellness Project for Women [PI]

Co-investigators:
Dr. YN Suen
Prof. Michael TH Wong
Dr. Christy LM Hui
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. WC Chang

8

RCT for group coaching for women who are at-risk for common mental disorder in the community: a randomised controlled trial [PI]

Co-investigators:
Dr. YN Suen
Prof. Michael TH Wong
Dr. Christy LM Hui
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. WC Chang

9

Impact of multiple populational stressors on women mental health in Hong Kong [Co-I]

Principal investigator:
Dr. YN Suen

Co-investigators:
Prof. Eric YH Chen
Dr. Christy LM Hui
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. WC Chang

10

RCT for experience sampling method derived feedback for women at risk for common mental disorders [Co-I]

Principal investigator:
Dr. YN Suen

Co-investigators:
Prof. Eric YH Chen
Dr. Christy LM Hui
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. WC Chang

11

Evaluation of a large-scale community screening system for CMD and ARMS [PI]

Co-investigators:
Dr. YN Suen
Prof. Michael TH Wong

Longitudinal clinical outcomes

Eric embarks on a number of longitudinal studies on psychotic disorders in Hong Kong. He has led the development of a specialised early intervention service for psychosis in Hong Kong, the internationally recognised EASY service (Hospital Authority). With the EASY service, Eric and the team endeavoured to map out the clinical pathways in the initial critical years following psychosis onset. One important piece of knowledge assembled by the team is the role of maintenance treatment following first episode psychosis (published in the BMJ). This addressed a very significant clinical problem and has attracted widespread attention. Another collaborative study (together with Professor William Honer) addresses the treatment of patients who became treatment refractory (published in the NEJM).

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Related projects

1

Visual Stress (VS)-related cortical excitability in schizophrenia: a potential biomarker for clozapine response [PI]

Co-investigators:
Dr. Christy LM Hui
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. WC Chang

Key local collaborator:
Dr. Henry KF Mak [Radiology, HKU]

Key international collaborator:
Prof. Arnold Wilkins [Emeritus Professor of Psychology U. Essex]

2

Neurocognitive predictors for relapse/non-relapse in psychotic disorders [Co-I]

Principal investigator:
Dr. Christy LM Hui

Co-investigators:
Prof. Eric YH Chen
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. WC Chang

3

Long-term consequences of early relapse following remission from first episode psychosis [Co-I]

Principal investigator:
Dr. Christy LM Hui

Co-investigators:
Prof. Eric YH Chen
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. WC Chang

4

Multicenter survey of clinician practice and views towards medication discontinuation following remission from first episode psychosis [Co-I]

Principal investigator:
Dr. Christy LM Hui

Co-investigators:
Prof. Eric YH Chen
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. WC Chang

Psychopathology

Psychopathology retraces the foundations of classical phenomenological psychopathology and integrates them with modern ideas drawn from anthropology, cognitive neuroscience, computational science, and evolutionary biology to synthesize a comprehensive framework and provide fresh insights. Eric explores how the scientific concepts of “information and representation” can be used to understand subjective mental phenomena and integrate them in empathic clinical dialogues during interactions with patients. He also explores key issues in clinical psychopathology, how to illustrate advanced topics in an accessible manner, and links advanced conceptual frameworks with pragmatic skills in the clinical dialogue process.

Related projects

1

A multi-molecular imaging study of dopamine synthesis capacity by PET and glutamate abnormality by MRS in first episode psychosis [PI]

2

A longitudinal study of the relationship between dopamine synthesis capacity and negative symptoms in first-episode delusional disorder and later-onset schizophrenia [PI]

3

Molecular imaging predictors on Outcomes of first episode psychosis [PI]

4

Neurocognitive correlates of dopaminergic abnormalities in first episode psychosis [PI]

5

Quantitative study of motor in-coordination (postural sway and soft-neurological signs) as markers of neurocognitive dysfunction deficits in first episode psychosis [PI]

Co-investigators:
Dr. Christy LM Hui
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. WC Chang
Dr. YN Suen
Dr. Stephanie MY Wong

Key international collaborator:
Prof Kelvin Lim [Psychiatry, U Minnesota]

6

Spontaneous blink rate and salience induced blink rate as clinical markers of first episode psychosis [PI]

Co-investigators:
Dr. Christy LM Hui
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. WC Chang
Dr. YN Suen
Dr. Stephanie MY Wong

7

Longitudinal study of large scale semantic network in early schizophrenia and other psychotic disorders [PI]

Co-investigators:
Dr. Christy LM Hui
Dr. Sherry KW Chan
Dr. Edwin HM Lee
Dr. WC Chang

Key international collaborator:
Prof. Brita Elvevaag [Clinical Medicine, U Tromsø]
Dr. Simon de Deyne [Cognitive Scientist, U Melbourne]

8

Visual stress as a potential clinical marker in psychosis [PI]

Co-investigators:
Dr. Christy LM Hui
Dr. YN Suen
Dr. Stephanie MY Wong

Key international collaborator:
Prof. Arnold Wilkins [Emeritus Professor of Psychology U. Essex]

9

An integrated humanistic and neurocomputational framework for psychopathology: the empathic representational approach [PI]

10

Switching and clustering in semantic memory retrieval as potential clinical markers for outcome prediction of first episode psychosis [PI]

Co-investigators:
Dr. Christy LM Hui
Dr. YN Suen
Dr. Stephanie MY Wong

11

An ecological study of eye-tracking in ideas of reference [PI]

Co-investigators:
Dr. Christy LM Hui
Dr. YN Suen
Dr. Stephanie MY Wong

Co-investigators:

Prof. PC Sham

Dr. Christy LM Hui

Dr. Sherry KW Chan

Dr. Edwin HM Lee

Dr. WC Chang

 

Key local collaborator:

Dr. Garett CL Ho [Nuclear Medicine, HKSH]

Dr. Gladys G Lo [Radiology, HKSH]

 

Key international collaborator:

Prof. Oliver Howes [Molecular Psychiatry,  KCL]

Dr. Mattia Veronese [Neuroimaging,  KCL]

Youth Mental Health

Our major development in early intervention development is to detect and prevent at an early stage of the evolution of psychopathology, particularly for young people in whom the most onset of mental disorder occur. Designing awareness and early intervention program for young people is a global challenge. It is important to offer engaging youth-friendly programs. It is important to study and characterise early psychopathological experiences in non-clinical populations and to relate symptoms to risk factors. Young people in the at-risk state can be increasingly reliably identified with increasingly refined technology (Further refinement of at-risk prediction is a key focus in research). Recent data suggest that the evolution of such at risk-states can be captured with changing patterns in a number of symptom dimensions.  At  an

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early stage, symptoms occur in different dimensions and are less severe. At a later stage, symptoms become more specifically focused on specific dimensions. Preventative intervention can then be offered to reduce the progression to a more definitive expression of an established illness.

Our well-established work in early detection (public awareness and open referral system) and phase-specific intervention using case management for psychotic disorders provide an excellent base for this development. Our previous studies have established the efficacy of this system in improving outcome. Further enhancements could be achieved through effective relapse monitoring and prevention, as well as enhancement of cognitive function through physical exercise. Both of these components are being developed with clinical studies, as well as the application of digital technology. The treatment refractory state can be minimised through better pharmacological strategies, such as the prediction of clozapine response, as well as the use of long-acting depot medication. This cohort can be consolidated with a comprehensive digital system whereby more refined course and outcome information can be fed into a naturalistic data pool with the possibility of using deep-learning to identify prognostic factors at each stage of the illness (e.g. treatment response, remission, relapse, treatment-refractory, ultra-refractory).

 

Long-term outcome data is key for informing many clinical decisions. We have successfully established a number of long-term cohorts either from naturalistic studies or randomized controlled studies. The assessment of long-term outcome is particularly valuable for samples which have received an earlier RCT and subsequently received similar care. This design will importantly allow the elucidation of the consequences of treatment decision at an earlier stage in the course of the illness. For example, we have identified that early medication discontinuation is associated with a more adverse outcome 10 years later.

Related projects

1

An epidemiological study of mental health of young people in Hong Kong (HK-YES): prevalence of psychiatric conditions [PI]

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2

Prediction of 1-year follow-up mental health outcomes using data from a large-scale epidemiological youth sample [PI]

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3

Interactions between symptom dimensions in a large epidemiological youth sample in Hong Kong [PI]

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4

Prevalence and correlates of suicidal ideation and behaviours in a representative epidemiological youth sample in Hong Kong: the significance of suicide-related rumination, family functioning, and ongoing population-level stressors [PI]

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5

The additive and interactive impacts of social unrest and COVID-19 on mental health and the role of event-based rumination [PI]

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6

The role of personality dimensions (Big-5) in mediating mental health outcomes [PI]

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7

Prevalence and correlates of trypophobia among young people in Hong Kong [PI]

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8

Visual stress as a prospective marker for depressive symptoms in youth [PI]

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9

Development and validation of a smartphone-based visual stress assessment in young people [PI]

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10

Spectrum of eating-related dysfunctions in an epidemiological youth sample [PI]

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11

The role of nightmares and other sleep-related symptoms in current and prospective mental health outcomes among young people [PI]

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12

PTSD symptoms and relationship to ruminations in response to population-level stressors [PI]

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13

Development of self-concepts and its mental health correlates among young people of Hong Kong [PI]

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14

Loneliness & boredom and positive solitude in young people [PI]

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15

Youths not in employment, education or training (NEET) in HK [PI]

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16

Risk and protective lifestyle factors of mental health of young people [PI]

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17

Naturalistic evaluation of a community-based early intervention model for youth mental health in Hong Kong (LevelMind@JC 賽馬會平行心間計劃)[PI]

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18

A quasi-experimental controlled study of the effect of a community-based early intervention model for youth mentah [PI]

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19

RCT for group cognitive behavioural therapy (CBT) for distressed youth [PI]

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20

Transdiagnostic neurocognitive markers for mental health outcomes (e.g. postural sway, blink, randomness, neurological soft signs, working memory, verbal fluency) [PI]

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21

Ecological momentary data-informed factors for youth mental health [PI]

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22

A large-scale online screening and self-help tool in response to co-occurring population-level stressors (the Flow tool) [PI]

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Co-investigators: 

Dr. Christy LM Hui

Dr. YN Suen

Dr. Stephanie MY Wong

Dr. Sherry KW Chan

Prof. Michael TH Wong

Dr. KT Chan

Dr. Simon SY Lui

Dr. Edwin HM Lee

Dr. WC Chang

Prof. PC Sham

Dr. Charlton Cheung


Key local collaborators: 

Prof. Linda CW Lam

Prof. TH Lam

Prof. Frendi WS Li

Dr. Gloria HY Wong

Dr. Paul WC Wong

Dr. Hung SF

Dr. Agatha WS Wong

 

Key international collaborators

Prof. Arnold Wilkins

Prof. Patrick McGorry

Prof. Peter Jones

Prof Debra Rickwood

Prof. Martin Knapp

Prof., David Mcdaid

Prof. Inez Myin-germeys

Prof. Brita Elvevåg

Prof. Craig Morgan

Prof. Sarah M McGhee

Prof. Jim van Os

Dr. Marcella LY Fok

Digital Psychiatry

The use of Internet-based and online methods for mental health work, ranging from early detection to intervention and treatment, is becoming ever more important in the 21st Century with the growing reliance on digital devices. The importance of involving the use of such means in addition to existing modalities became even more apparent during the COVID-19 pandemic when in-person interventions and treatments became disrupted. 

 

Professor Eric Chen and his team has therefore been actively developing and undertaking multiple research projects under the framework of digital psychiatry across populations, from community women at-risk for common mood disorders and at-risk mental states, to community-based youth and epidemiological youth samples. 

 

His research projects include the follows: (i) the use of large-scale Internet-based mental health self-help survey tool for early engagement of community members at potential risks for mental disorders with the addition of a real-time personalised feedback component, with suggestions for self-help or professional help-seeking depending on symptom severity of the user; (ii) an open and free-of-charge online psychiatric consultation service for community members of all age, with specific service targeting young people with distress, and the provision of online-based low-intensity intervention; (iii) smartphone-based ecological momentary intervention for community members with depressive symptoms; (iv) smartphone-based ecological momentary intervention for women at risk for common mental disorders, and (v) experience sampling method studies in community-based and household-based epidemiological youth samples in Hong Kong. 

 

While these research projects and data analyses are in progress, our preliminary findings have provided support of the use of such means for early engagement and intervention for the population of Hong Kong.

Related projects

1

Online assessment of cognitive markers in psychosis and youth mental health [PI]

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Co-investigators:
Dr. Christy LM Hui
Dr. YN Suen
Dr. Stephanie MY Wong

2

Prevalence and correlates of smartphone use [PI]

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Co-investigators:
Prof. Michael TH Wong
Dr. Christy LM Hui
Dr. YN Suen
Dr. Stephanie MY Wong

3

Digital native vs digital migrant and mental health [PI]

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Co-investigators:
Dr. KT Chan
Dr. Christy LM Hui
Dr. YN Suen
Dr. Stephanie MY Wong

4

Relationship of digitalization with self-concepts and personal features in youths [Co-I]

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Principal investigator:
Dr. KT Chan

Co-investigators:
Prof. Eric YH Chen
Dr. Christy LM Hui
Dr. YN Suen
Dr. Stephanie MY Wong

5

A large-scale online screening and self-help tool in response to co-occurring population-level stressors (the Flow tool) [PI]

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Co-investigators:
Dr. Stephanie MY Wong

6

Evaluation of a face-to-face, psychiatrist online advisory service [PI]

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Co-investigators:
Prof. Michael TH Wong
Dr. KT Chan
Dr. Simon SY Lui
Dr. Edwin HM Lee
Dr. Christy LM Hui
Dr. YN Suen
Dr. Stephanie MY Wong

7

Smartphone-based Ecological Momentary Intervention for Individuals with Depressive Symptoms in the Community: a Randomised Controlled Trial [PI]

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Co-investigators:
Dr. Christy LM Hui
Dr. YN Suen
Dr. Stephanie MY Wong

Key international collaborators:
Prof. Inez Myin-germeys

8

RCT for low-intensity online intervention for distressed youth [PI]

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Co-investigators:
Prof. Michael TH Wong
Dr. KT Chan
Dr. Simon SY Lui
Dr. Edwin HM Lee
Dr. Christy LM Hui
Dr. YN Suen
Dr. Stephanie MY Wong
Dr. CM Leung

9

Evaluation of brief online intervention for community women in Hong Kong [PI]

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Co-investigators:
Dr. YN Suen

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