Citation: Abdullah MY. Penjagaan Kesihatan Primer di Malaysia. Cabaran, Prospek dan Implikasi dalam latihan dan Penyelidikan Perubatan serta Sains Kesihatan di Universiti Putra Malaysia. Serdang: Penerbitan Universiti Putra Malaya; 2008
Citation: Teng CL. Family Practice: Is It For Me? In: Ong HT (editor). The Life of a Doctor. Petaling Jaya: Unipress Medical & Healthcare; 2008, p115-119
MeSH terms: Family Practice; Malaysia; Physicians, Family
This paper reported a preliminary study on Mat Rempit's activities and illegal motorcycle racing. Mat Rempit activities are becoming very popular among teenagers especially in major cities and towns in Malaysia. This phenomenon has created a new sub-culture amongst Malaysian teenagers. This study focused on psycho-social factors that encourage teenagers to involve in illegal motorcycle racing and to survey racing backgrounds (eg. racing types, time, places, prizes, etc.). Data was obtained through interview and live observations at the racing scene. One hundred racers and ex-racers had cooperated as respondents to feed this research with information. Results showed that Malay teenagers between 17-22 years old are the most involved in this activities. Also, moderating factors have been identified which are psychological factors where neurotic and extrovert personality traits and high level of self-esteem are found to correlate with racing involvement. Meanwhile, sociological factors such as peers, greatness flaunting culture and prizes are encouraging teenagers' involvement in illegal racing activities. Family and community roles to curb these unhealthy activities are suggested.
The present study was conducted in three old persons' homes located in Kinarut, Sandakan and Tawau, in the state of Sabah (East Malaysia). A total of 59 participants (28 women, 31 men) took part in the study, comprising support staff (administration and nursing) and direct staff (attendants). Participants were instructed to complete a self-reported questionnaire anonymously. The questionnaire consisted of questions on socio-demographic variables, a Bahasa Malaysia (Malay) version of the Maslach Burnout Inventory (MBI), and scales of job clarity and workload.
MeSH terms: Adult; Borneo; Burnout, Professional; Cross-Sectional Studies; Homes for the Aged; Humans; Malaysia; Prevalence
Citation: Awang R, Foong K, Lajis R, Omar M, Tan YL, Yong CY. Status of Tobacco Use and its Control: Malaysia Report Card. Bangkok, Thailand: Southeast Asia Tobacco Control Alliance; 2008
Citation: National Health Morbidity Survey 2006. Kuala Lumpur: Ministry of Health, Malaysia, 2008
Study name: National Health and Morbidity Survey (NHMS-2006)
Parasuicide has become an increasingly common response to emotional distress in young adults. The general pattern of parasuicide shows variations among the developing countries. The objectives of this study were to determine the pattern of parasuicide and suicide beside comparing the characteristics between different ethnic groups. The study was a retrospective case review of all parasuicide cases treated in Hospital Sungai Bakap and all suicides from the hospital mortuary from January 2001 to December 2005. We collected data concerning demographic data, information on method used and the circumstances. A total of 189 cases of parasuicide were analysed. There was a significant increase of parasuicide from 26.5 per 100,000 persons in 2001 to 32.1 per 100,000 persons in 2005. Seventy two percent of the cases were female. Indians constituted 64 % of the cases, followed by the Chinese (19 %), Malays (13 %) and foreigners (4 %). The age group 18-30 years ranked at the top, constituting 59.7% of the cases. Majority of the cases were by intentional poisoning and only 2 cases (1.1 %) were intentional injuries by sharp objects. In the past 5 years, the agents implicated were drugs (43.9 %), pesticides (23.5 %), household products (11.8 %), and others (20.8 %). Intentional Paracetamol poisoning had doubled from 11.7 % in 2001 to 23.4 % in 2005 while the use of pesticides had decreased from 32 % in 2001 to 17 % in 2005. Only 2 % of the cases had history of underlying disorders like schizophrenia and personalities disorders. As for suicide, the rates remained relatively unchanged at 5 per 100,000 populations. In this study, the demographic characteristics of suicide differ from parasuicide as suicides were associated with higher percentage of males and Chinese. There were 2 peaks in the age group of 31-40 and above 60 years old. The highest mode of suicide was hanging (53.5 %), followed by pesticide poisoning (25.6 %) and inhaled carbon monoxide (9.3 %).There is a need to improve on prevention and interventions for parasuicide and decrease suicide prevalence. Keywords: parasuicide, suicide, self-harm, Penang
The phenomenon of 'lost fetus' to orang bunian is quite commonly heard of in our culture. It may present in psychiatric settings and may potentially create confusion and difficulties in diagnostic and management aspects. A case of feigned full-term pregnancy followed by a pregnancy loss is described. This review emphasizes the need to recognize this phenomenon of 'lost advanced pregnancy' in context of the Malay belief. Possible etiological factors, diagnostic indicators of factitious disorder and management strategies are discussed. The possibility of cultural beliefs being used as psychological defenses is also discussed. Keywords: lost pregnancy, orang bunian, Malay mystical belief, factitious disorder
Psychiatric community-based services are being developed in Malaysia currently to ensure more comprehensive mental health care to especially patients with severe mental illness. Assertive Community Treatment (ACT) as one of the earliest component of community-based services has been observed to be useful and able to provide favourable outcomes in this group of patients. Though the paradigm shift has gradually occurred among mental health practitioners and policy makers, challenges are mainly in the implementation process. This article will present the discussion and academic view on various aspects of ACT including the rationale, elements, clinical and psychosocial impacts on patients as well as the current challenges in the Malaysian context. Keywords: Psychiatric community-based services, Assertive community treatment (ACT), severe mental illness (SMI
The aim of this study is to validate the Malay version of CDI among children and adolescents attending outpatient clinics at Universiti Sains Malaysia Hospital (USM), Kota Bharu, Kelantan. Sixty children and adolescents attending outpatient clinics were interviewed using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and completed the Malay version of CDI. Reliability and validity of the Malay version of CDI were analyzed. Validation study showed that the Malay version of CDI had a satisfactory reliability (Cronbach's alpha 0.83). At the cut-off score of 18, the Malay version CDI had 90% sensitivity and 98% specificity in detecting depression. In conclusion, the Malay version of CDI has a satisfactory validity and reliability. Keywords :Children Depression Inventory, depression
MeSH terms: Adolescent; Mental Disorders; Child; Depression; Hospitals; Humans; Malaysia; Outpatient Clinics, Hospital; Outpatients; Sensitivity and Specificity; Reproducibility of Results; Women's Health; Validation Studies; Diagnostic and Statistical Manual of Mental Disorders
The prevalence of psychiatric morbidity among patients attending primary care clinics is high and their attitudes towards psychiatry are often negative. The objectives of this study were to assess the prevalence of psychiatric morbidity and attitudes towards mental illness in relation to socio-demographic factors among primary care patients. A cross-sectional study was conducted on 245 patients attending the primary care clinic of Hospital Universiti Kebangsaan Malaysia at Bandar Tasik Selatan. A two-stage case identification process was used to detect psychiatric morbidity. The Malay translation of General Health Questionnaire-30 (GHQ-30) was used for screening and the Structured Clinical Interview for DSM-IV (SCID) was used to generate Axis-1 diagnosis. The Attitudes Towards Mental Illness Questionnaire was used to assess their attitudes towards mental illness. 8.2% of patients were found to have psychiatric morbidity, and they were significantly associated with the younger age group (p<0.05). Nevertheless, there was no significant association between psychiatric morbidity and sex, race, marital status, educational level, and social class of patients. The attitudes towards mental illness were significantly associated with age, race, marital status, educational level, social class and the presence of family history of psychiatry illness (p<0.05). There was no significant association between attitudes towards mental illness and patients'sex. Primary care doctors need to be equipped with psychiatry knowledge in order not to miss patients with psychiatry morbidity. Patients with psychiatry morbidity significantly believed in supernatural causes of mental illness compared with those without psychiatric morbidity. Keywords: Primary care, psychiatric morbidity, attitude towards psychiatry
MeSH terms: Ambulatory Care Facilities; Attitude; Mental Disorders; Cross-Sectional Studies; Diagnosis; Humans; Malaysia; Mass Screening; Primary Health Care; Social Class; Prevalence; Marital Status; Knowledge
Globally women's mental health issues have been emphasized since many decades ago. World Health Organization (WHO) has highlighted the importance of justice and equality in term of social context related to gender in order to achieve good mental well-being. Gender differences in the prevalence of psychiatric disorders have been recognized long ago where women commonly exceeds the men for a number of psychiatric illnesses (1). Women are more likely to suffer from depression, anxiety, somatic problems and being victims of sexual or physical violence. At least 1 in 5 women suffer rape in their lifetime but the rate differ from various country (2). Much work has been done to look into the general well-being and psychological distress in women as well as to understand the reason for women become more vulnerable to stress as compared to men. Multiple factors such as biological determinants and psychosocial issues have been found to be correlated to depression. Women with chronic major depression tend to have a younger age at the onset of her illness, a more extensive family history of mood disorder, poorer social adjustment, and poorer quality of life compared to chronically depressed men (3). Women are also known to be more likely to seek help for their mental health problem from primary care physician. Furthermore, across socio-economic levels many women nowdays are doing multiple roles in the society. They are not only wives and mothers in their family, but women also go out to earn for living. Some women are holding a higher position at workplace or in any organization. These multitasking roles may cause stress to women especially if she has to handle family-work or work-family conflicts. Biological differences related to gender have been increasingly explored. Differences exist in brain anatomy and that male and female reproductive hormones i.e. estrogen and progesterone produce psychoactive effects (4). Estrogen's antidopaminergic (5) and serotonin-enhancing (6) effects may play a role in psychiatric disorders in women. These are the areas that need more research investigations.
The Beck Depression Inventory (BDI) has been shown to have good psychometric properties in Western and non-Western populations for the past 40 years. The present study reported on the factor structures and provided evidence of the psychometric properties of the BDI for the Malays in Malaysia. A total of 1090 Malays in four samples (students, general community, general medical patients, and patients with major depressive disorders) were recruited in this study. They completed a battery of questionnaires that included symptoms, cognition and quality of life measures. Two factors of the BDI-Malay namely Cognitive/Affective and Somatic/Vegetative were extracted from Exploratory Factor Analysis (EFA) and were confirmed through Confirmatory Factor Analysis (CFA). Internal consistency (Cronbach's ) ranging from = .71 to .91 and validity of the BDI-Malay were satisfactory. The BDI-Malay can be used with confidence as an instrument to measure levels of depression for Malays in Malaysia. Keywords: Beck Depression Inventory, Malaysia, psychometric, confirmatory factor analysis
The compulsive behaviour of observing an unsuspecting person undressing or being naked in voyeurism may be related to Obsessive-Compulsive spectrum disorder. The aim of this paper is to report a case that reiterates a unique psychopathology of a Malaysian male voyeur with an obsession on female body parts. This 35 year-old voyeur man who attended psychiatric outpatient clinic in an academic medical centre presented to a psychiatrist for taking photos of his sisters' naked bodies and collected nails and hairs from their body, coded them with intend for masturbation. His voyeuristic thoughts and urges which came repeatedly and intrusively, involving attempts to resist them and was associated with an inner tension for the urges to be fulfilled. He responded both to Paroxetine and behaviour therapy. The possibility that voyeurism, a paraphilia can manifest itself as a subtype of OCD is discussed. Keywords: Malaysian voyeur, obsession-compulsive spectrum disorder, body parts
Satisfaction on teaching in basic science is an important element for academic performance in final postgraduate examination. Basic sciences is an important subject in bridging understanding in clinical psychiatry but often poses difficulties among young postgraduate trainees, especially if they have not been exposed frequently to the topic areas like integrative neuroanatomy, neurophysiology and neurochemistry. Simple questionnaire regarding satisfaction on teaching was asked to 17 postgraduate candidates from Universiti Kebangsaan Malaysia (UKM) and Universiti Malaya (UM) and their MCQ paper performance was obtained to validate between satisfaction on teaching and their academic achievement. This simple descriptive study was to determine areas of difficulties and teaching satisfactory levels on basic sciences. Moderately satisfied candidates scored better on basic sciences topic compared to candidates with low and high satisfaction ((Mean, SD = 49.7 ± 4.5, 41.6 ± 5.9 and 39.6 ± 0) respectively. Recommendation avenues for improvement in the near future, especially concerning the ongoing revision course that is organized by the Department of Psychiatry, Universiti Kebangsaan Malaysia was briefly discussed. Keywords: satisfaction, postgraduate psychiatry, training
The use of Electro-Convulsive Therapy (ECT) has again risen, and so have the restrictions laid in the path for its use. This communication serves to discuss the thoughts and practices of ECT in our setting and that in the West, which we all know vary from center to center and individual to individual. A reminder guide, incorporating those ideas along with a simple risk-benefit assessment checklist, is suggested to induce an approved perspective that will enable the drawing-up of a standard, sanctioned guideline on the applications of ECT in our region. This proposal will then be hoped to be of substantial medico-legal benefit in the future. Keywords: Re-stimulation, dosing, unilateral ECT, bilateral ECT, frequency, multiple monitored ECT
Objective: The aim of this study was to study the rate of readmission and look into factors that may contribute to this. Methods: This is a retrospective descriptive study of all psychiatric patients who were discharged from University Malaya Medical Center (UMMC). Case notes of those discharged during the study period was retrieved and analyzed. Those fulfilling the inclusion criteria were recruited and subjected to a questionnaire. Results: A total 107 patients were identified and only 95 participated. The readmission rate was 16.8%. Severity of illness was identified as the main risk factor for readmission in this study. Conclusion: Our readmission rate was similar to some developed nations and indicated good quality of care in UMMC. There appears to be other factors that may influence rate for readmission other than quality of in-patient care and outpatient community care. Keywords: readmission, mental illness, quality of care, Malaysia