Displaying publications 1 - 20 of 154 in total

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  1. Ek Zakuan Kalil, Tan, Susan M.K., Loh, Sit Fong, Norazlin Kamal Nor, Suzaily Wahab
    ASEAN Journal of Psychiatry, 2010;11(2):216-219.
    MyJurnal
    Objective: This case report highlights males as victims of sexual abuse, ascertain the factors that are associated with male sexual abuse and outline problems in management of sexual abuse with the presence of co morbidities. Methods: We report a case of sexual abuse in a 14 year old boy who has borderline mental retardation and ADHD. Results: The victim was
    traumatized due to the abuse. The perpetrator was not charged due to lack of evidence of the abuse and stigma. Conclusion: Sexual abuse that occurs in males can be influenced by multiple factors such as the presence of comorbidities. Strong awareness must be present in caregivers to prevent abuse in this population and to take appropriate and early action to effect the necessary intervention.
  2. Choon, Leng Eu, Singh, Suarn
    MyJurnal
    Objective: The objective of this case report is to highlight some learning points
    behind the reasoning of the Appellate Court in a case where there were two
    different expert opinions by two forensic psychiatrists from two distinctive
    Malaysian Approved Psychiatric Hospital in regard to the soundness of mind of
    Mr. A for an alleged offence punishable by a death penalty. Methods: This case
    report is based on the reasoning of the Appellate Court in rejecting the plea of
    the prosecutor. Results: The High Court order remained in which the defendant
    was found not guilty due to reason of insanity (NGRI) provided by the
    Malaysian Law under Section 84 of Penal Code for the charge of dangerous drug
    trafficking, and he was ordered by court to undergo treatment for his underlying
    mental illness in a Psychiatric Institution under Section 348(1) of the Malaysian
    Criminal Procedure Code. Conclusion: In writing expert report, it is preferable
    to use a singular first-person pronoun in stating the conclusion. If there are other
    experts involved in either current or previous assessment, it would be beneficial
    to address their different opinions in the expert report. However, expert opinion
    is still an ‘opinion',’ and the court would be perfectly entitled to reject or differ
    from any of the expert opinions when there are proper grounds to do so.
  3. Lai, M.H., Tan, Susan M.K.
    ASEAN Journal of Psychiatry, 2014;15(1):101-105.
    MyJurnal
    Objective: This case report highlights the complexity of eating disorder in schizophrenia and outlines the diagnostic dilemma and challenges associated with the treatment. Methods: We report a 13 years old female with early onset schizophrenia who developed anorexic symptoms and binge eating. Her eating disturbances worsened after olanzapine was commenced. Results: A combination of pharmacological and psychosocial intervention led to remission of schizophrenia co-morbid with eating disorder NOS. Conclusion: Co-morbid diagnosis of schizophrenia and eating disorder is not uncommon. Early diagnosis and evidence-based intervention are imperative as untreated illness greatly impacts the developmental trajectory of young people. Meeting family’s needs improves family functioning which in turn improves patient’s outcome. ASEAN Journal of Psychiatry, Vol. 15 (1): January - June 2014: 101-105.
  4. Kurubaran Ganasegeran, Sami Abdo Radman Al-Dubai, Surajudeen Abiola Abdulrahman, Sivashunmugam Sangaran, Hau, Wilson Wuei Yeow, Pukunan Renganathan
    ASEAN Journal of Psychiatry, 2017;18(2):226-235.
    MyJurnal
    Objectives: With the explosion in the use of WhatsApp Messenger globally, the revalence of late-night WhatsApping is poised to show a commensurate increase. This has sparked debates on a possible new wave of technological addiction that could cause serious psycho-behavioral repercussions. Acknowledging the ubiquity of WhatsApp, healthcare professionals have adopted it as a preferred communication tool in clinical practice. This preliminary cross-sectional study aimed to explore the prevalence of and psycho-behavioral factors associated with late-night WhatsApping.
    Methods: It was conducted on a universal sample of 307 healthcare professionals across medical and casualty departments in a Malaysian public hospital. The self-administered questionnaire consisted of items on socio-demographics, WhatsApp usage characteristics, and psycho-behavioral attributes.
    Results: Majority of respondents (72.9%) reported late-night WhatsApping habits. In multivariate analyses, late-night WhatsApping was significantly higher among those who used WhatsApp for more than 12 months (Adjusted odds ratio, AOR = 4.4, 95% Confidence interval, CI 2.2–8.8, p < 0.001), those who frequently kept
    mobile data on to avoid missing WhatsApp messages (AOR = 3.2, 95% CI 1.3–5.8, p = 0.006), those with frequent social connections (AOR = 3.0, 95% CI 1.4–6.4, p = 0.003), and those living alone (AOR = 2.3, 95% CI 1.1–5.2, p = 0.038).
    Conclusion: Late-night WhatsApping was significantly associated with usage characteristics and psycho-behavioral attributes.
  5. Abdul Hamid Abdul Rahman, Shamsul Azhar Shah, Normala Ibrahim
    ASEAN Journal of Psychiatry, 2009;10(2):157-168.
    MyJurnal
    Objective: The study aims to determine pattern of verbal memory and learning impairment and its associated factors among patients with bipolar I disorder in a psychiatric clinic of a university hospital. Methods: A case control study comparing verbal memory test
    performance in 40 patients with bipolar I disorder to that of 40 healthy normal subjects using Rey Auditory Verbal Learning Test (RAVLT). The association between demographic, clinical
    characteristics and poor verbal memory performance were examined. Results: Up to 92% of patients with bipolar I disorder have impaired short term working memory in this hospital-based study. They also recalled fewer words in all the RAVLT trials and had difficulties
    learning the word list in comparison to that of normal healthy individuals. Verbal memory and learning impairment are observed in bipolar illness in the absence of active mood symptoms while duration and severity of illness are not found to have any effect on verbal memory and learning. Conclusion: There is consistent verbal memory and learning problems in individuals with bipolar I disorder and their presence in the absence of mania, depression and mixed symptoms during the course of the illness suggests a trait related deficit.

    Study site: Psychiatric Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
  6. Rusdi Abdul Rashid, Muhammad Muhsin Ahmad Zahari, Mohammad Hussain Habil, Noor Zurani Md Haris Robson
    ASEAN Journal of Psychiatry, 2009;10(2):202-209.
    MyJurnal
    Objective: The smoking rate among patients with mental health problem is higher than in the general population. Effective pharmacotherapy to treat nicotine addiction is thus needed to reduce the morbidity and mortality associated with cigarette smoking among these patients. This article reviews the literature on the suitability of varenicline for smokers with mental health problems.
    Methods: A search of the literature was conducted using PubMed from year 2001 to July 2009 using key words varenicline alone and varenicline and mental health. Articles chosen were narrowed to those published in English. The type of articles chosen included clinical trials, metaanalyses, case reports, and review articles.
    Results: The search produced a total of 322 articles on varenicline and 14 articles on varenicline and mental health. Varenicline, a new drug for smoking cessation is an α4β2 partial agonist and partial antagonist at nicotinic acetylcholine receptor. As a partial agonist, varenicline relieves craving and withdrawal symptoms that occur during smoking abstinence and also reduce the rewarding effects of smoking in patients who relapse. However, at present, there is concern regarding the neuropsychiatric side effects such as aggressive behaviour, suicidal ideation, mania and depression associated with varenicline use in patients with mental health problems, but these reports did not show a causal-link or lack of link between these symptoms and varenicline.
    Conclusion: Current available data support the effectiveness of varenicline to treat nicotine dependence. However its safety among smokers with mental health problems remains to be elucidated. At present, further safety assessment is needed in this patient population. Until new data is available regarding the safety of varenicline in these populations, psychiatrists and physicians prescribing this medication should be extra cautious and monitor for possible psychiatric side effects when prescribing this medication to patients with pre-existing psychiatric disorders or have vulnerability to psychoses.
  7. Rohayu Hami, Noorsuzana Mohd Shariff, Siti Shahanis Md Sharif, Gokula Kumar Appalanaido, Nizuwan Azman, Mohammad Farris Iman Leong Abdullah
    MyJurnal
    Introduction: Posttraumatic growth (PTG) is a positive psychological change in
    life that occurs as a result of struggle with highly challenging life crises. There is
    a growing need to explore posttraumatic growth (PTG) in cancer patients, as
    higher PTG may enhance well-being of patients.

    Objectives: The aim of this
    study was to translate the Posttraumatic Growth Inventory-Short Form (PTGISF)
    into the Malay language and evaluate its psychometric properties for
    assessing Malaysian cancer patients in future studies.

    Methods: Two parallels
    forward and backward translations of the PTGI-SF into the Malay language
    were conducted. The test was administered to 195 cancer patients. Reliability
    was evaluated by testing internal consistency (Cronbach’s α) and calculating the
    test-retest intra-class correlation coefficient, and validity was examined by
    determining face, convergent, and discriminant validities and using
    confirmatory factor analysis (CFA).

    Results: The Malay version of the PTGI-SF
    and its five domains demonstrated good internal consistencies and acceptable
    test-retest reliability. All 10 items of this version were highly correlated with
    their own domains and thus exhibited convergent validity. Discriminant validity
    was achieved, as all domains of the Malay PTGI-SF was not highly correlated
    with the domains of the Source of Social Support Scale. CFA resulted in a bestfitting
    5-factor model.

    Conclusion: The Malay version of the PTGI-SF is a
    suitable tool for measuring PTG in Malaysian cancer patients.
  8. Nurul Hazrina Mazlan, Affizal Ahmad
    ASEAN Journal of Psychiatry, 2014;15(1):54-65.
    MyJurnal
    Objective: This study aims to establish the validity and reliability of the Malay- translated version of the CES-D. Methods: This study employed a cross-sectional study design. The participants were female inmates (n=90) from local prisons which were selected based on purposive-selective sampling. The analyses include face validation, factor analysis, and reliability testing. A test-retest was conducted within a one-week interval. Results: The mean score for depression among the participants is 18.97 (SD=6.51). Further descriptive analysis showed that 58.9% of them scored above the mean score, which is considered high. Preliminary construct validation analysis confirmed that factor analysis was appropriate for the Malay-translated version of the CES-D. Furthermore, the factor analysis showed similar factor loadings to the original English version. The total internal consistency of the translated version, which was measured by Cronbach’s alpha coefficient, was equal to 0.75. The test-retest reliability of the total score, measured by Pearson’s correlation was equal to 0.69. Conclusions: Face validity, construct validity, and reliability analysis were found satisfactory for the Malay-translated version of the CES-D. The Malay-translated version of the CES-D was found valid and reliable to be used in future studies, with comparable properties to the original version and to previous studies. ASEAN Journal of Psychiatry, Vol. 15 (1): January - June 2014: 54-65.
  9. Rohayu Hami, Noorsuzana Mohd Shariff, Siti Shahanis Md Sharif, Nizuwan Azman, Gokula Kumar Appalanaido, Mohammad Farris Iman Leong Abdullah
    MyJurnal
    Objective: It is important to investigate the association between spousal support
    and psychology of cancer patients, thus a validated instrument to measure the
    degree of perceived spousal support is required. We translated and evaluated the
    psychometric properties of the Sources of Social Support Scale-Malay version
    (SSSS-Malay) among Malaysian cancer patients.

    Methods: In this study, the
    SSSS-Malay and Hope Scale-Malay [used to compare with the SSSS-Malay to
    assess discriminant validity] were administered to 195 Malaysian cancer patients
    during baseline assessment. The SSSS-Malay was re-administered 2 months
    after the baseline assessment during follow-up.

    Results: The SSSS-Malay total
    score (Cronbach’s α = 0.70, intraclass correlation coefficient (ICC) = 0.72) and
    its domains (Cronbach’s α ranging from 0.70 to 0.83, intraclass correlation
    coefficient ranging from 0.6 to 0.76) exhibited good internal consistencies and
    good test-retest reliability. The SSSS-Malay also demonstrated good convergent
    and discriminant validities. However, confirmatory factor analysis of the SSSSMalay
    showed that it was best fit into a 3-factor model instead of the 4-factor
    model of the original English version.

    Conclusion: The SSSS-Malay
    demonstrated good psychometric properties for use in Malaysian cancer
    patients.
  10. Mohammad Farris Iman Leong Abdullah, Darshan Singh, Vicknasingam Kasinather, B., Nizuwan Azman
    MyJurnal
    Introduction: Kratom (Mitragyna speciosa Korth) dependence is a common psychiatric complication associated with regular kratom use in Malaysia. Hence, it is important to assess the severity of kratom dependence among regular kratom users. The Kratom Dependence Scale (KDS) was introduced to evaluate the degree of severity of kratom dependence among users. This study aimed to translate the original English version of the KDS into Malay and examine the psychometric properties of the KDS (Malay) among Malaysian kratom users.

    Methods: Initially, parallel translation and back translation of the original English version of the KDS was performed. The KDS (Malay) then was administered to 20 active Malaysian kratom users to assess face and content validities in a pilot study. Finally, the final version was administered to 150 active kratom users to evaluate its internal consistency (Cronbach’s α), face and content validities, discriminative validity, and construct validity, i.e. via exploratory factor analysis (EFA).

    Results: The KDS (Malay) Cronbach’s α of 0.94 exhibited excellent internal consistency. It also demonstrated construct validity, as EFA showed that all items of the KDS (Malay) fit into a single domain, similar to the original English version. Discriminative validity was also demonstrated by the KDS (Malay), as it could differentiate kratom dependent users from non-kratom dependent users.

    Conclusion: The KDS (Malay) has acceptable psychometric properties and is suitable to assess severity of kratom dependence in Malaysian kratom users.
  11. Zahiruddin Othman, Muhammad Najib Muhammad Alwi, Kamarul Imran Musa, Muhammad Najib Muhammad Alwi, Ruzita Jamaluddin
    ASEAN Journal of Psychiatry, 2009;10(1):54-74.
    MyJurnal
    Objective: Many studies have emphasized the significance of verbal memory for the functional outcome in schizophrenia. A preserved capability to encode and recall verbal information is essential for the long-term efficacy of psychoeducational programs and other
    psychological intervention to ensure the successful transfer of newly acquired skills or knowledge into everyday life. Aims of this study aimed to validate the MVALT among schizophrenia patients in HUSM. Methods: The subjects were 15 schizophrenia patients
    conveniently selected from the patients that attended follow up at the psychiatry clinic in HUSM or inpatients who have been admitted during the study period and 15 healthy control subjects as a comparison. Reliability and validity of the MVAVLT were analyzed. Results: The validation study showed that the Malay version Auditory Verbal Learning Test (MVAVLT) had a good validity (factor analysis 0.66 to 0.98) and test-retest reliability (pearson correlation ranged from 0.24 to 0.84) and has been shown to be sensitive in
    discriminating between normal and schizophrenia patients. In line with the previous research, the schizophrenia patients performed significantly worse than healthy control in all indexes measured in MVAVLT. Conclusion: The screening of deficits in verbal learning
    and memory among the schizophrenia patients is important, for early detection and treatment since it can be helpful for clinicians and psychologists in their counseling sessions. Subsequently, it helps patients to reduce such cognitive difficulties and their impact by using specific rehabilitation with the usage of newer antipsychotic agents.
  12. Tiong, Xun Ting, Nur Sara Shahira Abdullah, Mohamad Adam Bujang, Fatin Ellisya Sapri, Selvasingam Ratnasingam, Chong, Kok Joon, et al.
    MyJurnal
    Objective: A quick assessment tool for screening individuals with depression or anxiety is pertinent in mental-health set up. This study aims to validate the K10 and the K6 to screen patients with non-specific
    psychological distress in a Malaysian population.

    Methods: Translation of the questionnaire was done from English to Malay. Face validity was conducted on patients, and a pilot study was performed to assess the reliability of the K10 questionnaire. Fieldwork was conducted to determine the reliability and validity of the K10 questionnaire based on convenience sampling of healthy individuals and patients diagnosed with psychiatric illness. Malay version for K10 was administered to healthy participants (group without psychological distress) and patients on psychiatric clinic follow up (psychological distress). Data collection was done between August 2016 and September 2016.

    Result: A total of 94 subjects were recruited in the study, of which 32 formed the case group. The Cronbach’s alpha coefficients for K10
    were 0.837(control) and 0.885 (case), as for K6 were 0.716 (control) and 0.859 (case). The total score of the
    K10 and the K6 clearly differentiated between the control and case groups (p

    Study site: Sarawak General Hospital
  13. Rafidah Bahari, Muhammad Najib Mohamed Alwi
    MyJurnal
    Objective: The aim of this paper is to examine medical students’ views on the usefulness of a community project as a venue to train professionalism. Methods:Medical students at Cyberjaya University College of Medical Sciences (CUCMS) were surveyed following psychiatry community projects organized during year 4 undergraduate attachments in psychiatry. Results: A total of 176 students returned the survey forms. A majority of medical students thought that the psychiatry community project promotes teamwork and leadership skills. About a quarter thought that it helped foster their communication ability and encouraged them to be more reflective in their daily lives. These findings were translated into the potential of the community project to train “collaborative” and “managerial” affective domain learning outcomes of the university. Conclusions: The findings indicate that psychiatry community project or similar programmes may be useful tools to train several elements of medical professionalism. Future research however should utilise specific measurements to confirm this finding.
  14. Maryam Farooqui, Mohamed Azmi Hassali, Aishah Knight Abdul Shatar, Asrul Akmal Shafie, Muhammad Aslam Farooqui, Fahad Saleem, et al.
    MyJurnal
    Objectives: Prayers, spiritual healing, yoga, meditation, t'ai chi, qigong and support groups are classified as mind body complementary therapies (MBCTs). The study aimed to examine the prevalence of MBCTs use and the Health Related Quality of Life (HRQoL) in a group of Malaysian cancer patients.
    Methods: This crosssectional study was conducted on 184 cancer patients at the oncology clinic of Penang general hospital, Malaysia. MBCTs was assessed using a self- administered questionnaire while the HRQoL of the participants was assessed by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30).
    Results: Among the complementary and alternative medicines (CAM) users, 75(40.7%) patients self-reported using MBCTs while having cancer. Majority of MBCTs users were female 60(80%, p=0.01), aged between 38 and 57 (58%), and were of Malay ethnicity (61%). Socio-demographic factors including age (r=0.15, p=0.03) and monthly house-hold income (r= -0.25, p<0.001) were significantly correlated with MBCTs use. Prayers for health reasons was the most frequently practised MBCTs modality, followed by spiritual practices 20(10.8%), meditation 7(5.9%), t'ai chi 7(3.8%), music therapy 4(2.1%), qigong 1(0.5%), hypnotherapy 1(0.5%), and reiki 1(0.5%). Recommendations from friends and family members 53(70%) were the most common reasons of MBCTs use followed by patient's own will 22(29.3%). Health related Quality of Life (HRQoL) scores showed significant difference in all functional and symptoms scores among MBCTs users and non-users (p<0.05). Conclusion: The study helps to identify numerous MBCTs commonly practised by a group of Malaysian cancer patients. Prayers specifically for health reasons and spiritual practices were somewhat common among patients. Viewing MBCTs, not as alternative but to complement conventional cancer therapies may help to address cancer patients' emotional and psychological needs.
    Study site: Oncology clinic, Hospital Pulau Pinang, Malaysia
  15. Loo, Jiann Lin, Eu, Choon Leng, Johari Khamis, Raba'iah Mohd Salleh, Suarn Singh Jasmit Singh
    MyJurnal
    Objective: Pritchard Criteria are adopted in a Malaysian criminal-justice system while assessing fitness to plead. There is limited data on the reason of unfitness to plead for female offenders in Malaysia.

    Methods: A case series of five patients hospitalized to Hospital Bahagia Ulu Kinta, Malaysia due to unfitness to plead was presented and discussed.

    Result: The offences include three homicides, one assault, and one stealing. All of them were diagnosed to have schizophrenia with prominent looseness of association. Four of them subsequently treated as Treatment-Resistant Schizophrenia (TRS) with a minimal response toward clozapine.

    Conclusion: Looseness of association may be a contributing factor for unfitness to plead among Malaysian female offenders, which can result in indeterminate hospitalization. This should be confirmed in a larger prospective study.
  16. Yin, Ping Ng, Saminah Md Kassim, Maniam, T.
    ASEAN Journal of Psychiatry, 2013;14(2):157-160.
    MyJurnal
    Objective: This case report highlights the clinical dilemmas encountered in deciding the diagnostic status of persons with unipolar depression who develop hypomania during antidepressant/electroconvulsive therapy.

    Methods: We report a case of a 52 year-old Chinese lady, diagnosed with unipolar depression, which developed hypomania after she was started on T. Fluvoxamine 100mg daily and completed 8 sessions of Electroconvulsive therapy.

    Results: Her diagnosis was revised to Bipolar Disorder and she was treated with T. Sodium Valproate 400mg twice daily after which she improved.

    Conclusion: Treatment-emergent hypomania is likely a subtype of bipolar spectrum disorder and patients with Treatment - emergent Hypomania should be treated as Bipolar Disorder.
  17. Rahima Dahlan, Siti Nor Aizah Ahmad
    MyJurnal
    Objective: This case report highlights on the challenges in the management of people with bipolar disorder. Method: We report a case of 36 year-old lady living with this disorder and her journey in a search for a meaningful life. Result: Adherence to treatment is a major determinant of outcome in bipolar patient like Ms WMY. Poor insight, negative attitudes towards treatment and poor understanding of medications and the illness can all lead to reduced adherence. Conclusion: This case demonstrates on how poverty of insight, poor social support, on-going stressors with significant life events and poor compliance to treatment create a series of stumbling blocks in recovery from bipolar disorder.
  18. Ramli Musa, Mohd Ariff Fadzil, Zaini Zain
    ASEAN Journal of Psychiatry, 2007;8(2):82-89.
    MyJurnal
    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.
  19. Rafidah Bahari, Muhammad N Mohamad Alwi, Muhammad R Ahmad, Ismail Mohd Saiboon
    ASEAN Journal of Psychiatry, 2015;16(2):203-211.
    MyJurnal
    There are a number of validated questionnaires available for the screening of Post-Traumatic Stress Disorder (PTSD), and the PTSD Checklist for Civilians is one of them. However, none was translated into the Malay Language and validated for use in the Malaysian population. The aim of this study is to translate and validate the Malay PTSD Checklist for Civilians (MPCL-C). Methods: The PCL-C was translated into the Malay Language and back-translated. The reliability and validity of the MPCL-C were then determined by administering them to those who presented at the emergency department for motor vehicle accident at least one month before. Results: The MPCL-C has good face and content validity. In terms of reliability, it is also good, with Chronbach’s alpha values of 0.90, 0.77, 0.75 and 0.74 for the full scale, re-experiencing, avoidance and arousal domains respectively. Conclusions: The MPCL-C is a valid and reliable instrument to screen for PTSD in motor vehicle accident victims for the studied population.
  20. Marhani Midin, Salina Abdul Aziz, Phang, Cheng-Kar
    ASEAN Journal of Psychiatry, 2010;11(2):206-215.
    MyJurnal
    Objective: Mental health services in Malaysia often face competition from traditional healers especially among patients with psychosis. The objective of the study is to determine whether patients who sought help earlier from traditional healers had longer duration of untreated psychosis (DUP), and more adverse experiences in pathways to psychiatric care. Methods: This is a hospital-based cross-sectional study of 50 inpatients with first-episode
    psychosis in Hospital Kuala Lumpur. Structured Clinical Interview for DSM-IV (Diagnostic and statistical manual, 4th edition) Clinical Version for Axis I Disorders (SCID-CV) was used for establishing diagnosis. Onset of psychosis was defined as any one positive symptom with a score of >3 on the Positive and Negative Syndrome Scale (PANSS). Socio-demographic
    data, information on pathways and treatment delaying factors were determined through face-to-face interview and semi-structured questionnaire. Results: Fifty-four percent of the patients had at least one contact with traditional healers prior to consulting psychiatric service, and it was the most popular first point of non-psychiatric help-seeking contact
    (48%). Contact with traditional healers was not associated with age, gender, ethnic, education level, longer DUP or treatment delay, and admissions with violent behaviour or police assistance. Of those who had sought help from traditional healers, one third were recommended by at least one of their traditional healers to seek medical help. Conclusion:
    Consultation involving traditional healers was a popular choice, and not associated with treatment delay. Traditional healers in an urban setting may be potential collaborators in managing patients with first-episode psychosis. Future research should explore the frontiers of such collaborative work.
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