MyMedR

Mirtazapine for anorexia nervosa with depression

Jaafar NR, Daud TI, Rahman FN, Baharudin A

Aust N Z J Psychiatry, 2007 Sep;41(9):768-9.

To report the use of Mirtazapine in the treatment of anorexia nervosa with depression primarily regarding its propensity for weight gain.

The female sexual response cycle: do Malaysian women conform to the circular model?

Sidi H, Naing L, Midin M, Nik Jaafar NR

J Sex Med, 2008 Oct;5(10):2359-66.

PMID: 18086161

The concept of a sexual response cycle (SRC) for women has gained interest lately with the reintroduction of terms with new definitions and a new model for the sexual response, especially the Basson's circular model.

Fulltext Sexual desire and sexual arousal in Malaysian women: are they of the same entity?

Nik Jaafar NR, Midin M, Wan Puteh SE, Musa R

ASEAN Journal of Psychiatry, 2009;10(1):43-53.

MyJurnal

Objective: To investigate the correlation between sexual desire and sexual arousal among Malaysian women in a primary care setting. Methods: The Malay Version of Female Sexual Function Index (MVFSI) was used to assess low sexual desire and lack of sexual arousal among the respondents. A total of 230 married women aged 18 – 70 years old participated in this study. Their sociodemographic, marital profiles and correlation between low sexual desire and lack of sexual arousal were examined. Results: More than 60% respondents with low sexual desire have co-exist low sexual arousal and 94.4% respondents with high sexual desire do have high sexual arousal ( χ²= 79.6, p

Fulltext The association between the attention deficit hyperactivity disorder(ADHD) symptoms and bully/victim problem among malaysian sixth-graders

Wan Ismail WS, Nik Jaafar NR, Mohd Daud TI, Shah SA, Ismail A, Shafiee Z

ASEAN Journal of Psychiatry, 2010;11(1):79-86.

MyJurnal

Objective: School bullying in Malaysia is on the rise. While efforts are put together to combat the problem, the psychiatric aspect has been neglected. This is a cross-sectional study aimed to determine the association between the symptoms of ADHD and bully/victim problems among Malaysian sixthgraders attending primary schools in Kuala Lumpur.
Methods: A total of 410 sixth-graders from seven randomly selected schools were assessed with regards to bully/victim problems and ADHD symptoms using self-reported questionnaires. Malaysian Bullying Questionnaire was used to rate bully/victim problems while ADHD symptoms were assessed using ConnersWells’ Adolescent Self-report Scale (CASS). Teachers and parents also assessed students’ ADHD symptoms using Conner’s Teachers Rating Scale (CTRS) and Conner’s Parents Rating Scale (CPRS), respectively.
Results: Self-reported questionnaires showed that 61.2% of the children were involved in bully/victim problems. The ADHD symptoms were found significant in relation to bully/victim problems as tested by multiple logistic regression. Only students and parents reported significant ADHD symptoms among the bully/victim groups. The ADHD symptoms reported by students were significant among bullies(OR=0.59,CI=0.42-0.83, p

Hypoactive sexual desire among depressed female patients treated with selective serotonin reuptake inhibitors: a comparison between escitalopram and fluoxetine

Sidi H, Asmidar D, Hod R, Jaafar NR, Guan NC

Int J Psychiatry Clin Pract, 2012 Mar;16(1):41-7.

PMID: 22122658 DOI: 10.3109/13651501.2011.617457

To determine the risk of hypoactive sexual desire (HSD) in depressed female patients treated with selective serotonin reuptake inhibitors, comparing escitalopram and fluoxetine. The associated factors were also examined.

Is increased libido an atypical symptom of bipolar depression? An interesting case

Mahadevan R, Nik Jaafar NR, Sidi H, Midin M, Das S

J Sex Med, 2013 Mar;10(3):883-6.

PMID: 23036068 DOI: 10.1111/j.1743-6109.2012.02949.x

Decreased libido is recognized as one of the vegetative symptoms of depression. Increased libido has not been acknowledged as one of its symptoms, neither has it been reported, particularly in depressed bipolar patients.

Depression in male patients on methadone maintenance therapy

Baharudin A, Mislan N, Ibrahim N, Sidi H, Nik Jaafar NR

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:67-73.

PMID: 23857840 DOI: 10.1111/appy.12069

INTRODUCTION: Depression is one of the most common psychiatric conditions in men. The aim of the study was to determine the depressive symptoms and associated factors among men on methadone maintenance therapy (MMT).
METHODS: A cross-sectional study was conducted involving 108 subjects who attended the Drug Clinic at Hospital Kuala Lumpur. The instruments used include the Structured Clinical Interview for Diagnostic and Statistical Manual, Fourth Edition Axis-I Disorder, Beck Depression Inventory and the 15-item International Index of Erectile Function.
RESULTS: The rate of depression was 44.4%. There were significant associations between Malay ethnicity, secondary education level and concurrent illicit cannabis use with depression (P

Externalizing and internalizing syndromes in relation to school truancy among adolescents in high-risk urban schools

Nik Jaafar NR, Tuti Iryani MD, Wan Salwina WI, Fairuz Nazri AR, Kamal NA, Prakash RJ, et al.

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:27-34.

PMID: 23857834 DOI: 10.1111/appy.12072

To examine the relationship between externalizing/internalizing syndromes and school truancy among Form Four (10th grade) students attending "high-risk" schools in Kuala Lumpur.

Risk and associated factors of female sexual orgasmic disorder in women with hypertension in Malaysia

Abdul Latif R, Muhamad R, Kanagasundram S, Sidi H, Nik Jaafar NR, Midin M, et al.

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:21-6.

PMID: 23857833 DOI: 10.1111/appy.12039

The objective of this study was to examine the risk of female sexual orgasmic disorder among a group of women with hypertension in Malaysia. The associated factors were also examined.

Phases of female sexual response cycle among Malaysian women with infertility: a factor analysis study

Seen Heng Y, Sidi H, Nik Jaafar NR, Razali R, Ram H

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:50-4.

PMID: 23857837 DOI: 10.1111/appy.12044

This cross-sectional study aimed to determine the construct of the phases of the female sexual response cycle (SRC) among women attending an infertility clinic in a Malaysian tertiary center.

Association between 5HT2A polymorphism and selective serotonin re-uptake inhibitor (SSRI)-induced sexual desire disorder (SDD) among Malaysian women

Masiran R, Sidi H, Mohamed Z, Mohamed Saini S, Nik Jaafar NR

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:41-9.

PMID: 23857836 DOI: 10.1111/appy.12043

SSRIs are known for their sexual side-effects with a variable rate of sexual dysfunction (SD). 5HT2A (rs6311) single nucleotide polymorphism (SNP) was found to have significant association with SD. The purpose of this study was to determine the prevalence of female SDD, its clinical correlates and association with 5HT2A (rs6311) SNP in patients with major depressive disorder (MDD) treated with SSRIs.

Risk factors for depression and anxiety among pregnant women in Hospital Tuanku Bainun, Ipoh, Malaysia

Fadzil A, Balakrishnan K, Razali R, Sidi H, Malapan T, Japaraj RP, et al.

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:7-13.

PMID: 23857831 DOI: 10.1111/appy.12036

Anxiety and depression are prevalent during pregnancy. Estimates of the prevalence of anxiety and depression during pregnancy vary according to the criteria used, variable methodologies and population characteristics.

Behavioral and emotional problems in a Kuala Lumpur children's home

Abd Rahman FN, Mohd Daud TI, Nik Jaafar NR, Shah SA, Tan SM, Wan Ismail WS

Pediatr Int, 2013 Aug;55(4):422-7.

PMID: 23617604 DOI: 10.1111/ped.12115

There is a dearth of studies on behavioral and emotional problems in residential care children in Malaysia. This study describes the behavioral and emotional problems in a sample of children in a government residential care home and compares them with their classmates living with their birth parents.

Risk factors of erectile dysfunction in patients receiving methadone maintenance therapy

Nik Jaafar NR, Mislan N, Abdul Aziz S, Baharudin A, Ibrahim N, Midin M, et al.

J Sex Med, 2013 Aug;10(8):2069-76.

PMID: 23445463 DOI: 10.1111/jsm.12105

INTRODUCTION: While methadone effectively treats opiate dependence, the side effect of erectile dysfunction (ED) may interfere with treatment adherence and benefits.
AIM:To determine the rate of ED and the associated factors which predict ED in male patients on methadone maintenance therapy (MMT) in a Malaysian population.
MAIN OUTCOME MEASURES: The main outcome measures were the International Index of Erectile Function-15 (IIEF-15) and the Beck Depression Inventory (BDI).
METHODS: A total of 108 participants diagnosed with heroin dependence were assessed. We used the Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I) on subjects who received MMT, and they were assessed using the IIEF-15, the BDI, and measures of other clinical and sociodemographic variables.
RESULTS: The rate of ED among men on MMT was 68.5% (mild ED, 36.1%; mild to moderate ED, 22.2%; severe ED, 3.7%). The mean age of the participants was 43.45 years. Older age (P = 0.002), concurrent illicit heroin use (P = 0.024), and having an older partner (P = 0.039) were significantly associated with ED. Following multivariate analysis, it was found that older age was the only significant predictor of ED, with an adjusted odds ratio of 1.07 (95% CI = 1.02-1.16). Methadone dose and duration of methadone treatment were not significantly associated with ED.
CONCLUSION: ED was highly prevalent among male patients on MMT. This suggests that there is a need for routine assessment of sexual function in patients on methadone. Among the risk factors, age was the only factor that was significantly associated with ED. The current use of MMT in Malaysia in terms of dosage and duration did not pose a significant risk for ED.
KEYWORDS: Erectile Dysfunction; Methadone Therapy; Opiate Dependence
Study site: outpatient clinic for opiate substitution therapy, Hospital Kuala Lumpur (HKL), Malaysia

Prevalence of depression in breast cancer survivors: a systematic review of observational studies

Zainal NZ, Nik-Jaafar NR, Baharudin A, Sabki ZA, Ng CG

Asian Pac J Cancer Prev, 2013;14(4):2649-56.

PMID: 23725190

BACKGROUND: Depression is common in breast cancer patients. The aim of this paper was to make a systematic review of its prevalence and associated factors oin breast cancer survivors.

MATERIALS AND METHODS: An extensive systematic electronic review (PUBMED, CINAHL, PsyINFO and Ovid) and handsearch were carried out to retrieve published articles up to November 2012, using Depression OR Dysthymia AND (Cancer OR Tumor OR Neoplasms as the keywords. Information about the design of the studies, measuring scale, characteristics of the participants, prevalence of depression and its associated factors from the included studies were extracted and summarized.

RESULTS: We identified 32 eligible studies that recruited 10,826 breast cancer survivors. Most were cross-sectional or prospective designed. The most frequent instrument used to screen depression was the Center for Epidemiological Studies for Depression (CES-D, n=11 studies) followed by the Beck Depression Inventory (BDI, n=6 studies) and the Hospital Anxiety and Depression Scale (HADS, n=6 studies). CES-D returned about similar prevalence of depression (median=22%, range=13-56%) with BDI (median=22%, range=17-48%) but higher than HADS (median=10%, range=1-22%). Depression was associated with several socio-demographic variables, cancer-related factors, treatment-related factors, subject psychological factors, lifestyle factors, social support and quality of life.

CONCLUSIONS: Breast cancer survivors are at risk for depression so that detection of associated factors is important in clinical practice.

Is the Bahasa Malaysia version of the Montreal Cognitive Assessment (MoCA-BM) a better instrument than the Malay version of the Mini Mental State Examination (M-MMSE) in screening for mild cognitive impairment (MCI) in the elderly?

Razali R, Jean-Li L, Jaffar A, Ahmad M, Shah SA, Ibrahim N, et al.

Compr Psychiatry, 2014 Jan;55 Suppl 1:S70-5.

PMID: 24314103 DOI: 10.1016/j.comppsych.2013.04.010

Mild Cognitive Impairment (MCI) is a known precursor to Alzheimer disease, yet there is a lack of validated screening instruments for its detection among the Malaysian elderly.

Waist circumference and not body mass index as the outcome of a group weight intervention for patients with severe mental illness

Nik Jaafar NR, Midin M, Mahadevan R, Sinniah A, Rahman AH, Ming W, et al.

Compr Psychiatry, 2014 Jan;55 Suppl 1:S60-4.

PMID: 24139853 DOI: 10.1016/j.comppsych.2013.09.002

OBJECTIVE: Most weight interventions among patients with severe mental illness (SMI) used body mass index (BMI) as outcome measure but excluded waist circumference (WC) although the latter is a stronger predictor of obesity complications. This study aimed to assess a weight-management program consisting of education, exercise and behavioural techniques for patients with SMI using weight parameters including WC as the outcome measures.
METHODS: A group intervention was carried out as part of psychiatric outpatient community service. It used structured modules on diet, exercise and related topics comprising of education and exercises sessions with a total of 12-week duration. The participants were outpatients with SMI recruited through referrals to the program by the treating doctor. The participants' body weight, BMI and WC were measured at the baseline, fortnightly and at the end of the program.
RESULTS: A total of 27 patients participated in the program which was carried out in 6 cycles. The pre- and post-intervention comparisons analysis of the weight parameters found a significant reduction in the WC (mean=3.878 cm+5.165, p=0.001) while no significant changes were recorded in body weight and BMI.
CONCLUSION: Small but significant loss in WC and possibly weight maintenance were achieved using this non-pharmacological intervention. Modest loss in WC may have an impact on reducing the risk of obesity-related health risks.
Study site: Psychiatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia

Why do young adolescents bully? Experience in Malaysian schools

Wan Ismail WS, Nik Jaafar NR, Sidi H, Midin M, Shah SA

Compr Psychiatry, 2014 Jan;55 Suppl 1:S114-20.

PMID: 23763872 DOI: 10.1016/j.comppsych.2013.05.002

INTRODUCTION: To determine sociodemographic and psychological factors associated with bullying behavior among young adolescents in Malaysia.
METHODS: This is a cross-sectional study of four hundred ten 12-year-old adolescents from seven randomly sampled schools in the Federal Territory of Kuala Lumpur, Malaysia. Sociodemographic features of the adolescents and their parents, bullying behavior (Malaysian Bullying Questionnaire), ADHD symptoms (Conners Rating Scales), and internalizing and externalizing behavior (Child Behaviour Checklist) were obtained from adolescents, parents and teachers, respectively.
RESULTS: Only male gender (OR=7.071, p=0.01*, CI=1.642-30.446) was a significant sociodemographic factor among bullies. Predominantly hyperactive (OR=2.285, p=0.00*, CI=1.507-3.467) and inattentive ADHD symptoms reported by teachers (OR=1.829, p=0.03*, CI=1.060-3.154) and parents (OR=1.709, p=0.03*, CI=1.046-2.793) were significant risk factors for bullying behavior while combined symptoms reported by young adolescents (OR=0.729, p=0.01*, CI=0.580-0.915) and teachers (OR=0.643, p=0.02*, CI=0.440-0.938) were protective against bullying behavior despite the influence of conduct behavior (OR=3.160, p=0.00*, CI=1.600-6.241). Internalizing behavior, that is, withdrawn (OR=0.653, p=0.04*, CI=0.436-0.977) and somatic complaints (OR=0.619, p=0.01*, CI=0.430-0.889) significantly protect against bullying behavior.
DISCUSSIONS: Recognizing factors associated with bullying behavior, in particular factors distinctive to the local population, facilitates in strategizing effective interventions for school bullying among young adolescents in Malaysian schools.

Clinical depression while caring for loved ones with breast cancer

Nik Jaafar NR, Selamat Din SH, Mohamed Saini S, Ahmad SN, Midin M, Sidi H, et al.

Compr Psychiatry, 2014 Jan;55 Suppl 1:S52-9.

PMID: 23706655 DOI: 10.1016/j.comppsych.2013.03.003

The period of the cancer patients undergoing treatment is also the most stressful time for their family caregivers. This study aimed to determine the rates of major depressive disorder and dysthymia; and their associated factors in the caregivers during this time.

Study site: Oncology centre, Pusat Perubatan Universiti Kebangsaan Malaysia

Functional remission and employment among patients with schizophrenia in Malaysia

Dahlan R, Midin M, Shah SA, Nik Jaafar NR, Abdul Rahman FN, Baharudin A, et al.

Compr Psychiatry, 2014 Jan;55 Suppl 1:S46-51.

PMID: 23679983 DOI: 10.1016/j.comppsych.2013.03.007

The study aimed to determine the rates of functional remission and employment as well as the factors associated with functional remission among patients with Schizophrenia, receiving community psychiatric service in an urban setting in Malaysia.

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