Background: Up to date, there are handful questionnaires that have been validated in Bahasa Malaysia (BM). This study aimed to translate the Depression Anxiety Stress Scales 21-item (DASS-21) and measure its psychometric properties. Objectives: To determine the construct validity and acceptability of the DASS, BM. Methods: Two forward and backward translations were done in BM in accordance to guideline, and its validation was determined by using confirmatory factor analysis. A total of 263 subjects were selected by systematic random sampling to represent Malaysian population for reliability and validity purposes. Results: The BM DASS-21 had very good Cronbach’s alpha values of .84, .74 and .79, respectively, for depression, anxiety and stress. In addition, it had good factor loading values for most items (.39 to .73). Correlations among scales were between .54 and .68. Conclusions: BM DASS-21 is correctly and adequately translated to Bahasa Malaysia with high psychometric properties. Further studies are required to support these findings.
Objective: This study aimed to determine the prevalence of obesity among patients with schizophrenia and its association with the demographic profile. Methods: This is a cross sectional study. Subjects were selected using systematic sampling. Patients attending the out patient psychiatric clinic, Hospital Universiti Kebangsaan Malaysia, who fulfilled the criteria and able to give consent were included in this study. Diagnosis of schizophrenia was made using Structured Clinical Interview (SCID) for DSM-IV. Demographic profiles of the patients were obtained and anthropometric measurements were measured and classified according to Body Mass Index (BMI) and Waist Circumference (WC) of Asian population. Results: A total of 97 patients were included. The prevalence of overweight (BMI: 23.0- 27.4 kg/m2) was 39.2% (n=38), and the prevalence of obesity (BMI: >27.0 kg/m2) was 35.1% (n=34). BMI was higher among non-Chinese (Malay and Indian, p=.03) and those who had low total household income (p=.03). Sixty-two patients (63.9%) had high WC, which was associated with male (p=.003) and non-Chinese (p=.03). Conclusions: Obesity is highly prevalent among patients with schizophrenia. The risk factors for obesity include male, non-Chinese and those with low total income. The high WC among non-Chinese and male patients suggests that they are at a higher risk of developing obesity-related physical illnesses. These findings support that obesity is a common critical issue among schizophrenic patients, and it warrants serious clinical interventions.
Study site: Psychiatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
Objective: This study aimed to determine the association between the personality traits and
social factors with compliance to anti-hypertensive pharmachotherapy. Methods: This cross
sectional study was conducted from 1st of June until 31st of December 2004, which involved
Hospital Universiti Kebangsaan Malaysia Primary Polyclinic in Bandar Tasik Selatan,
Cheras and Salak Polyclinic in Sepang, Selangor. A total of 200 patients who fulfilled all the inclusion criteria, were selected as respondents. This study used the Mini International Neuropsychiatric Interview (M.I.N.I) for the psychiatric diagnoses and personality characteristics were assessed by using Personality Assessment Schedule (PAS) Results: The prevalence rate of non-compliance was 38.5%. Paranoid personality trait (27.3%) was the most common type of personality traits that associated with non-compliance to the medications prescribed. The results of this study revealed a statistically significant difference between drug compliance and age, race, gender and the site where the study was conducted. No association was found between patients’ education level, occupation, income, marital status, family history of hypertension and personality traits and drug compliance. Conclusion: This study suggested that drug compliance among hypertensive patients was influenced by the presence of psychosocial factors. Hence, it is important for medical practitioners to understand these factors and administer treatment more individual.
Objectives: To determine the best possible programme that suits our local setting, to determine the average dose required, and to determine possible problems that can arise from implementing such a programme locally and how best to address them. Methods: The inclusion criteria were those above 18, a positive urine test, the presence of a supportive carer and willing to engage in the programme. Methadone was initiated and observations relating to dose, adverse events, relationship with carers, work performance, crime and high risk behaviours were monitored for 18 weeks. Results: Two thirds of the 45 subjects completed the trial over the 18 week period. No significant adverse events occurred and improvement in relationship with carers and work performance were noted with reduction in crime and high risk behaviours. Conclusion: Methadone is a safe and effective drug that can be used in the local Malaysian setting.
Objective: To investigate the prevalence of genital arousal disorder and the potential risk
factors that may impair genital arousal among women at a primary care setting in Malaysia.
Methods: A validated questionnaire for sexual function was used to assess genital arousal
function. A total of 230 married women aged 18–70 years old participated in this study. Their sociodemographic and marital profiles were compared between those who had genital arousal disorder and those who did not. The risk factors were examined. Results: The prevalence of genital arousal disorder in the primary care population was 50.4% (116/230). Women with genital arousal disorder were found to be significantly higher in groups of more than 45 years old (p55) (p=.001), those having 4 children or more (p=.028), those having less sexual intercourse (less than 1–2 times a week) (p=.001), and those at post-menopausal state (p=.002). There was no significant difference between these two groups in term of salary (p=.29), suffering from medical problems (p=.32), dysmenorrhea (p=.95), menarche (p=.5) and hormonal replacement therapy (p=.6). Conclusion: Women with infrequent sexual intercourse are less likely to be sexually aroused (OR=0.29, 95% CI: 0.11-0.74).
This is a cross-sectional, two-year follow up study. The authors determined the varied presentations of delirium, dementia and other organic disorders to assess their mortality and outcome. They described the diagnosis of patients suffering from the psychiatric effects of those organic states and compared their symptom resolution and mortality between those with the acute and chronic varieties during their index hospitalization and again, 24 months later. Although mortality rates did not differ, patients with the acute syndrome had significantly better outcomes in terms of symptom resolution as compared to those with the chronic syndrome (p=0.001). Patients with symptom resolution upon discharge did not show statistically significant lower mortality rates.
Introduction: To date, there are limited published literatures addressing behaviors of Attention Deficit and Hyperactive Disorder (ADHD) children and their parents’ psychological
characteristics. It is also crucial to know the relationship between characteristics of ADHD
behaviors on their parental psychological impacts. Objective: To determine the level of stress, anxiety and depressive among mothers of ADHD children compared to control group and also to determine the associations between domains of children’s behaviors (externalizing or internalizing) that gives most impact to these maternal psychological aspects. Method: This is a cross-sectional study. Seventy mothers of ADHD children who came to Child and Adolescent Clinic, Universiti Kebangsaan Malaysia Hospital completed self-rating questionnaires of Child Behavior Checklist (CBCL), Parenting Stress Index (PSI) and Hospital Anxiety and Depressive Scale (HADS). Seventy mothers of asthmatic children were recruited as a control group. Results: Mothers with ADHD children are more anxious, depressed and stressed (p
The Association of South East Asian Nations (ASEAN) was formed in 1971, and 10 years
later the ASEAN Federation for Psychiatry and Mental Health (AFPMH) was formally
launched. This article reviews the objectives, structure, membership, and the principles of
rotational participation and responsibility of the AFPMH, which has just celebrated its jubilee anniversary last year. Twenty-six years have passed, and the AFPMH has achieved many successes, including the congress, which is currently held every two years, and the ASEAN Journal of Psychiatry, which may be the oldest regional journal in the Asian continent. The bright future of ASEAN psychiatry is expected but relies heavily on the unity and commitment of all individual psychiatric associations within the ASEAN.
Objective: To assess postgraduate candidates’ knowledge on basic sciences and to compare
their achievement based on two years study in the Department of Psychiatry, National University of Malaysia (UKM), Kuala Lumpur, Malaysia. Methods: This is a study assessing
areas of difficulties in basic sciences for the Malaysian postgraduate candidates sitting for
mock MCQ examination papers in two consecutive years. Results: The candidates in both
years failed on MCQ papers (scoring marks are only 43% and 40% for the year 2006 and
2005 respectively), which is consistent with their final examination outcomes. The candidates in the year 2006 were much superior in neuroanatomy (percentages of median scores: 47% vs. 31%, p
Food is closely related with emotion. It often provides comfort and satisfaction. Some individuals choose to turn to food to curb their negative emotion, resulting in disturbances in
eating patterns, such as overeating which lead to obesity and severely controlling food intake, which culminate in eating disorders like anorexia nervosa, bulimia nervosa and binge eating. These disorders are not related to the eating problems per se but often due to underlying or complicated by psychological factors, namely depression, anxiety, impulse control problems and personality. The roles of psychological factors in eating disorders and obesity should therefore not be downplayed. These disorders should be managed comprehensively involving multiple approaches, including not only biological but also psychological interventions provided by a professional team comprising endocrinologists, psychiatrists, dietitians, exercise physicians and surgeons.
Objective: To investigate patient’s perceived satisfaction and adequacy of information given by doctors on prescribed drugs in an outpatient psychiatric setting.
Methods: The sampling was done consecutively with a target sample size of 200 patients. A simple questionnaire that was developed with 10 close-ended questions and yes or no answers was administered by the interviewing team. This questionnaire assessed patients' knowledge on prescribed medications and their perception on the adequacy of information given.
Results: More than 80% of the patients were informed regarding the reasons, timing to take medication(s), duration of drug treatment and type of prescribed drugs. Half of them were informed regarding the side effect profiles of their prescribed medications. Majority of them (80%) were satisfied with the information given despite only 49% of the patients being given adequate information on their medications.
Conclusion: Patients who are adequately informed about their medications are more significantly satisfied than those inadequately informed. (χ2=4.085, p<0.05).
Key words: perceived satisfaction, adequacy of information, prescribed psychotropic drug
Study site: Psychiatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Objectives: To determine the association of students’ perception of schooling with externalizing/internalizing scores; and to examine the different perceptions related to truancy. Methods:A total of 373 predominantly 16 year-old students attending three high risk schools in Pudu, Kuala Lumpur completed the questionnaires on schooling variables (four items) and externalizing/internalizing syndromes (Youth Self-Report, 112 items). Results: Certain negative perceptions (uncertainty of the schooling purpose, thinking schooling as time wasting) were significantly associated with higher internalizing (p
Dissociation, including multiple personality disorder, has long been a controversial topic. Patients with suggestive symptoms are often misdiagnosed as malingering or even having
schizophrenia. The former as a result of the overlooking of a clinician on the fact that suggestibility itself plays a key role in the emergence and perpetuation of this illness and the latter due to the lack of knowledge of the whole dissociative disorder spectrum, often resembling that of a psychotic disorder. Another contributing factor to the small number of patients with this diagnosis is due to the reluctance of a psychiatrist to do so because of his/her lack of experience and also fear of humiliation of being accused of seeking fame from diagnosing this somewhat glamorous phenomenon. In Malaysia, various culture bound syndromes often present with similar symptoms too. This article will attempt to understand this dissociation on the local context using case studies as a reference point.
Objective: To investigate the prevalence of parental stress and psychological wellbeing among parents with autistic children and their associations with dimensions of support system.
Methods: This is a preliminary cross sectional study which randomly selected parents with clinically diagnosed autistic children. Those parents who attended psycho-education session on management of autistic children at Health Psychology Unit were randomly selected to enroll in the study. Psychological wellbeing, parental stress and dimensions of support system were assessed by using the General Health Questionnaire (GHQ-28), the Parenting Stress Index (PSI) and the Provision Social Relation (PSR), respectively.
Results: Of 52 parents with autistic children (34 female and 18 male), about 90.4% of parents had significant parenting stress, and 53.8% of parents showed clinical disturbance in psychological wellbeing. Gender (t=1.67, p=0.02) and occupation (F=4.78, p=0.01) showed statistically significant association with psychological wellbeing. No association found between other socio-demographic factors, parental stress and psychological wellbeing with dimensions of support system among parents with autistic children.
Conclusion: Parents with autistic children have high prevalence of stress and psychological disturbances. Interactions of various factors need to be acknowledged and considered in order to reduce the burden of parents with autistic children.
Objective: This descriptive cross-section, community-based study examined the prevalence of psychiatric morbidity and quality of life (QOL) and the associated factors among family caregivers of hospice patients with cancer. Methods: Subjects were 50 family caregivers of cancer patients under the care of Hospice Malaysia homecare. Home visits were done in Klang Valley. Psychiatric morbidity was detected using GHQ-30 English and Bahasa Malaysia versions, and the QOL was assessed by the Short Form 36 items (SF-36) questionnaire. Results:The study results showed that 54% of respondents had psychiatric morbidity. The educational status and the relationship between family caregivers and the cancer patients were statistically significant (p
We aimed to report the first case of anorexia nervosa in a young Malaysian Malay homosexual man with underlying borderline personality disorder and major depression. Patient and parents were interviewed. The Structured Clinical Interview for DSM IV was used to generate Axis-I diagnosis. The Hamilton Depressive Rating Scale was used to assess the severity of depression. His parents had marital discord. His father was overinvolved. Regarding anorexia nervosa, he had 163 cm height, 46kg weight and a body mass index (BMI) of 17 kg/m2. His four limbs had multiple scratch marks. Laboratory test results showed anemia, leukocytosis and hypoalbuminemia. Family pathology, borderline personality disorder and homosexuality could be the risk factors of anorexia nervosa in this patient.
Objective: To describe the setting up of a pilot project on weight management programme for patients with severe mental illness (SMI) in a general hospital setting, the effectiveness of the programme on 5 patients and the feasibility of such programme to be developed in our local setting. Methods: Key staff members from relevant disciplines were involved through out the programme, which was based on dietary education, exercise and behavioural techniques. It was conducted weekly for physical exercise and biweekly for topic discussion with a total duration of 16 weeks. Results: Patients achieved means (SDs) weight loss of 1.78 (2.83) kg; BMI reduction of 0.92 (1.41) kg/m2; and reduction of waist circumference of 6.8 (4.97) cm. Factors associated with positive health outcome were high baseline BMI, high educational level and committed family members. Conclusion: The programme appears to be effective for patients and is feasible to be developed in Malaysian hospitals.
Objective: The fact that childhood sexual abuse is associated with depression is well-known. To date, there is no proper study done on screening for depression and coping strategies among sexually abused children in Malaysia. This study aimed to determine the prevalence of depression and examine the association of depression with the socio-demographics and
coping strategies used by sexually abused children. Methods: Sixty-five sexually abused children who attended the One Stop Crisis Centre (OSCC) services at Hospital Universiti Sains Malaysia and fulfilled the study criteria were screened for depression using a validated Malay version of Children Depression Inventory (CDI).Depression was determined by a positive score of the Malay-CDI with depression being indicated in scores of more than 18.
Results: In the study sample, 16 (24.6 %) participants had been depressed and 49 (75.4 %) participants had not been depressed. Having a confidante was a protective factor against depression. Short duration of time between the abuse incident and the clinical interview was significantly associated with depression. With respect to coping strategies, 59 (90.8 %) used emotionfocused strategies and 6 (9.2 %) used problem or task-focused strategies. Among emotion-focused coping strategies, participants did the following: deciding that nothing could be done to change things, were in denial, and suppressed their feelings. Conclusion: Twenty five percent of the sample suffered from depression. The screening of depression in the vulnerable group such as sexually abused children is important, particularly for early
detection and treatment. By recognizing the coping strategies used in sexually abused children, the clinician could understand them better and plan for their psychological management.
Objectives: This paper reports the outcome of Session With Carer, one of the activities in the Year 4 Personal and Professional Development (PPD) module in the new integrated curriculum of the Undergraduate Medical Programme at the Faculty of Medicine,
Universiti Kebangsaan Malaysia (UKM). Methods: This activity involves groups of 14 – 15 students sitting in with family members of individuals with mental illness. The session starts with the carer giving his or her perspective of patient’s care and the challenges involved. This is followed by a question and answer session. Finally, the carer provides a written feedback by way of scoring certain items as well as brief comments. After the session, each student is required to prepare an individual report in the form of reflective writing. Results: Out of a total of 224 students, the reflections of 126 students were reviewed to assess what they had learnt from the Session With Carer. Among the more significant findings were: 100% learnt about the various challenges faced by carers. 31.7% learnt the importance of
faith/spirituality of the carer in caring for a mentally ill family member. 29.4% learnt the importance of family and others’ support. An equal number, that is, 26.2% learnt that it helps for the carer to have good mental health and a positive attitude, as well as good
knowledge of the illness. Those who became aware of the benefits of the carer having patience and determination made up 23.8% of the total reflections reviewed. Conclusion: The findings show that the Session With Carer is very educational, and helps create more
awareness of the importance of the carer’s role in patient management and support. In other words, carers can act as teachers in creating more public awareness about mental illness and
ultimately, help in gradually removing the stigma associated with mental illness. Therefore, carers should be utilized for this purpose.
Objective: This is a case report discussing about the Charles Bonnet Syndrome (CBS). CBS is a condition in which extremely vivid and well-formed visual hallucinations occur episodically with great profusion. They are typically experienced in clear consciousness, and
the insight is either retained or very quickly attained into the unreal nature of the phenomena. Method: We report a case of a 70 year-old Malaysian male who has been suffering from Tourette disorder for the past 40 years and was blind bilaterally. Results: He presented with episodic, nocturnal visual hallucinations. These occurred in clear
consciousness and the patient’s insight to these experiences was retained. There was no history of any other major psychiatric illness in this patient. Conclusion: This case illustrates a diagnosis of CBS with the differential diagnoses of epilepsy and other organic conditions.