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  1. Grewal GS, Kanagasundram S, Jambunathan S
    Turk Psikiyatri Derg, 2011;22(4):266-8.
    PMID: 22143952
    Frontotemporal dementia (FTD) is now increasingly being recognized as one of the causes of young onset dementia (YOD). The presentation of FTD can be subtle with a broad range of symptoms. This frequently causes misdiagnosis and a delay in initiating the correct treatment. While subtle personality changes, disinhibition and problems in executive functioning are frequently encountered in FTD, frank psychotic symptoms resembling schizophrenia are unusual. This is a case of a 38 year old Chinese female that highlights how obsessive compulsive symptoms which progressed to florid psychosis and disorganized speech and behavior can be a presenting picture in FTD. For seven years, this patient was treated as a case of schizophrenia and was thought to have poor response to electroconvulsive therapy (ECT) as well as antipsychotic medication. Her blood work and electroencephalogram (EEG) were normal. Magnetic resonance imaging (MRI) showed progressive cerebral atrophy. This case report suggests that psychosis should be investigated in detail especially when the clinical presentation is not typical of a functional disorder and more so when the patient is not responsive to conventional treatment. This report also highlights the importance of eliciting symptoms suggestive of an "organic" etiology, such as incontinence and disorientation. In addition, the usefulness of repeated imaging to show the rapidly progressive course of FTD has been illustrated. Other possible differential diagnoses of this patient are also discussed.
  2. Srisurapanont M, Mok YM, Yang YK, Chan HN, Della CD, Zainal NZ, et al.
    J Affect Disord, 2018 05;232:237-242.
    PMID: 29499506 DOI: 10.1016/j.jad.2018.02.014
    BACKGROUND: Several studies have described the presence of perceived cognitive dysfunction amongst Asian patients with major depressive disorder (MDD). To date, no study has been conducted investigating the predictors of perceived cognitive dysfunction amongst Asian MDD patients.

    METHODS: This was a post-hoc analysis of the Cognitive Dysfunction in Asian patients with Depression (CogDAD) study. Descriptive statistics were used to describe the most common cognitive complaints by patients. Univariate and multivariate analyses were performed to determine variables associated with perceived cognitive dysfunction (Perceived Deficit Questionnaire-Depression, PDQ-D).

    RESULTS: The CogDAD study population is comprised of MDD patients with mild-to-moderate depression (Patient Health Questionnaire 9-item [PHQ-9]: 11.3 ± 6.9) who reported perceived cognitive dysfunction (PDQ-D = 22.6 ± 16.2). The most common cognitive complaints were: mind drifting (42.3%), trouble making decision (39.6%) and trouble concentrating (38.0%). Predictors of perceived cognitive dysfunction were: being Southeast Asians (vs. Taiwanese) (p 

  3. Hatim A, Habil H, Jesjeet SG, Low CC, Joseph J, Jambunathan ST, et al.
    Hum Psychopharmacol, 2006 Jul;21(5):313-8.
    PMID: 16856220
    In this open-label pilot study, 20 adult patients hospitalized for acute bipolar mania received oral quetiapine as a single evening dose of 200 mg on day 1, increased by 200 mg/day on days 2, 3, and 4 until 800 mg/day taken in 2 divided doses on day 4. From day 5 onward, patients received a flexible total dose of 400-800 mg/day until completion of 3 weeks of treatment. Safety and tolerability were assessed by adverse-event (AE)-related dropouts in week 1, incidence of AEs including EPS, changes in electrocardiogram, and vital signs. Efficacy was assessed using the YMRS, PANSS, and CGI scales. Nineteen of 20 patients (95%) completed the quetiapine rapid titration during week 1. Significant improvement was observed in YMRS, PANSS, and CGI Severity of Illness scores by day 5, and was maintained throughout the study. A reduction of > or = 50% in YMRS score was achieved by 75% of patients by day 7, and maintained to day 21. Overall, 20% of patients discontinued due to AEs. Agitation was the most common cause of AE-related study discontinuation. Thirty-five per cent of patients required dose adjustment due to AEs after rapid dose administration was completed. Most patients tolerated rapid titration of quetiapine to 800 mg/day by day 4 of therapy, with a significant improvement in manic symptoms by day 7 of treatment.
  4. Benedict F, Lim KS, Jambunathan ST, Hashim AH
    East Asian Arch Psychiatry, 2016 Sep;26(3):109-11.
    PMID: 27703099
    We present a patient with topiramate-induced psychosis who developed alternative psychosis following temporal lobectomy. The number of surgical candidates for temporal lobectomy is increasing as is the frequency of psychiatric co-morbidities. Preoperative planning should take account of these psychiatric co-morbidities. In particular, precautions should be taken when antiepileptic drug-induced psychosis occurs, as this could predict the occurrence of alternative psychosis following lobectomy.
  5. Yee A, Bt Nek Mohamed NN, Binti Hashim AH, Loh HS, Harbajan Singh MK, Ng CG, et al.
    Biomed Res Int, 2015;2015:730291.
    PMID: 26060820 DOI: 10.1155/2015/730291
    INTRODUCTION: Our study aims to determine the prevalence of nicotine dependence and investigate the effect of nicotine dependence on psychopathology among schizophrenia patients.
    METHODS: A cross-sectional study was carried out in an outpatient psychiatric clinic at a general hospital in Malaysia. 180 recruited subjects were administered the Malay version of Mini International Neuropsychiatric Interview (MINI), the Positive and Negative Symptom Scale (PANSS), and the Malay version of Fagerstrom Test for Nicotine Dependence (FTND-M) questionnaires.
    RESULTS: The prevalence of nicotine dependence among the subjects was 38.1% (n = 69) and they were mainly composed of male gender, Malay ethnicity, being treated with atypical antipsychotics, and taking other illicit drugs or alcohol. Subjects with severe nicotine dependence scored less in the negative subscale of PANSS compared with the nonsmokers (P = 0.011). On performing the hierarchy multiple regressions, dependence status still significantly predicted negative scores after adjusting the confounders (t = -2.87, P = 0.005).
    CONCLUSION: The rate of nicotine use disorder among schizophrenia patients in this study is higher than that of the general population in Malaysia. The significant association between nicotine dependence and negative psychopathology symptoms will help the healthcare practitioners in their management of nicotine dependence among schizophrenia patients.

    Study site: outpatient psychiatric clinic in a general hospital
  6. Ng CG, Tan LK, Gill JS, Koh OH, Jambunathan S, Pillai SK, et al.
    Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:118-22.
    PMID: 23857847 DOI: 10.1111/appy.12056
    INTRODUCTION: This study aims to examine the validity and reliability of the Malay version of Attitudes toward Lesbians and Gay Men (MVATL/MVATG) among a group of medical students in Malaysia.
    METHODS: It is a cross-sectional study of 173 medical students in the Faculty of Medicine, University of Kuala Lumpur, Malaysia. The participants were given the MVATL/MVATG, Index of Attitudes toward Homosexuals (IATH), Homosexuality Attitude Scale (HAS) and the English version of Attitude toward Lesbians and Gay Men. Two weeks later, these students were given the MVATLG again.
    RESULTS: Significant correlation was found between the individual scores of MVATL and MVATG with IATH and HAS in the results. The scale was able to differentiate Muslim and Non-Muslim subjects. The internal consistency (Cronbach's alpha) of both the MVATL and MVATG were good, at 0.76 and 0.82, respectively. The parallel form reliability (Pearson's correlation) of MVATL was 0.0.73 and 0.74 for MVATG. The test-retest reliability of MVATL/MVATG was good (Intraclass correlation coefficient, ICC = 0.67 for MVATL and 0.60 for MVATG).
    DISCUSSION: The MVATLG demonstrated good psychometric properties in measuring attitudes toward homosexuality among a group of medical students in Malaysia and it could be used as a simple instrument on young educated Malaysian adults.
    KEYWORDS: Malaysia; attitude; gay men; homosexuality; lesbians; validation
  7. Gill JS, Jambunathan S, Wong S, Wong A
    Asia Pac Psychiatry, 2015 Jun;7(2):230.
    PMID: 25923587 DOI: 10.1111/appy.12171
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