Displaying publications 1 - 20 of 67 in total

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  1. Hong JP, Malek AZA, Li CT, Paik JW, Sulaiman AH, Madriaga G, et al.
    Asia Pac Psychiatry, 2023 Dec;15(4):e12548.
    PMID: 37771084 DOI: 10.1111/appy.12548
    This post-hoc analysis evaluated the efficacy and safety of intranasal esketamine in the Asian subgroup from ASPIRE I. Patients with major depressive disorder and suicidal ideation with intent received intranasal esketamine (n = 26) or placebo (n = 27), plus standard of care for 25 days. The primary endpoint was the change in Montgomery-Åsberg Depression Rating Scale (MADRS) total score from baseline to Day 2. The MADRS score improved in favor of esketamine (least squares mean difference: -3.8). No unexpected safety concerns were noted. The Asian subgroup showed a similar efficacy and safety profile as the total ASPIRE I cohort.
  2. Low SR, Bono SA, Azmi Z
    Asia Pac Psychiatry, 2023 Jun;15(2-3):e12528.
    PMID: 37072907 DOI: 10.1111/appy.12528
    INTRODUCTION: Postpartum depression (PPD) is a chronic mood illness that typically develops in the first few months after giving birth. It affects 17.2% of women worldwide, and its deleterious consequences on infants, children, and mothers have elicited global public concern. Therefore, this paper aims to present an overview of the relationship between emotional support and PPD among postpartum mothers in the Asia region.

    METHODS: An extensive search using various keywords was conducted in Science Direct, PsycINFO, PubMed, Scopus, Cochrane Library, JSTOR, Springer Link, and Taylor Francis. The screening process was compliant with the PRISMA guideline, while the quality of the selected studies was assessed using the QuADS tool.

    RESULTS: The analysis included 15 research from 12 different countries with 6031 postpartum mothers. A decreased risk of PPD for postpartum mothers is shown to be significantly correlated with greater emotional support, and vice versa.

    DISCUSSION: Asian women are less likely to seek emotional assistance than other mothers, which is influenced by culture. There needs to be more research on the impact of culture on postpartum mothers' emotional support. Additionally, this review hopes to raise awareness among the mothers' friends and family as well as the medical community to be more attentive to postpartum mothers' emotional needs and offer specialized assistance.

  3. Huan WY, Wan Azlan WA, Lee YT
    Asia Pac Psychiatry, 2023 Mar;15(1):e12524.
    PMID: 36575636 DOI: 10.1111/appy.12524
    Cotard's syndrome is a rare neuropsychiatric disorder characterized by marked nihilistic delusions. This report describes an Indonesian woman from a small town in Malaysia who was diagnosed with depression and Cotard's delusion. The diagnosis was confirmed after thorough history-taking, clinical examination, and relevant laboratory tests. Herein, we highlight the unique psychopathology of a possible Cotard's syndrome subtype and efficacy of pharmacological combination strategies, rather than monotherapy and electroconvulsive therapy, for its treatment.
  4. Azlan WAW, Ramalingam M, Razali R, Abdullah MF, Rahman FNA
    Asia Pac Psychiatry, 2022 Mar;14(1):e12416.
    PMID: 32929893 DOI: 10.1111/appy.12416
    INTRODUCTION: Hyperemesis Gravidarum (HG) is a severe form of vomiting that occurs among pregnant mothers. Due to the nature of HG, pregnant mothers may feel fatigued and burdened by it and questions have been raised about the emergence of psychiatric illness during this period of vulnerability.

    METHODS: A comparative cross-sectional study using Hospital Anxiety and Depression Scale (HADS), M.I.N.I (MINI International Neuropsychiatric Interview) and ENRICH- EMS (Evaluation and Nurturing Relationship Issues, Communication and Happiness - Marital Satisfaction Scale) were performed in a group of 112 pregnant women.

    RESULTS: There were no differences in the prevalence rate of any anxiety disorder among the patient with HG vs comparative group (9% vs 3%, P > 0.05) and depressive disorder in women with HG vs comparative group (16% vs 8%, P > 0.05) respectively. There were associations between HG and gravida, past history of miscarriage, and gestational diabetes (P 

  5. Munawar K, Mukhtar F, Choudhry FR, Ng ALO
    Asia Pac Psychiatry, 2022 Mar;14(1):e12475.
    PMID: 33963816 DOI: 10.1111/appy.12475
    BACKGROUND: Mental health problems in Malaysia are on a rise. This study aimed at performing a systematic review of mental health literacy (MHL) in Malaysia.

    METHODS: Medline, Embase, ERIC/Proquest, ScienceDirect, Pubmed, PsycINFO, CINAHL, Scopus, EBM Reviews - Cochrane Central Register of Controlled Trials, Ovid Emcare and reference lists of included studies were searched in February 2020. Studies that evaluated at least one of the main components of MHL, including (1) knowledge related to mental health issues, and (2) stigma, were included irrespective of study design. As secondary findings, the review also synthesized results related to facilitators and barriers to seeking mental health services. Depending on the research design, the quality of each study was assessed through checklists.

    RESULTS: Forty six studies published between 1995 to 2019 were included. Most studies used cross-sectional designs to investigate MHL. Findings indicate that most Malaysians have stigmatizing attitudes towards mental health problems. Participants in the included studies endorsed multifactorial explanations of mental health issues with a dominance of supernatural and religious aetiologies. Likewise, the commonest barrier was considering sources other than professional sources of mental-health services. Presence of adequate knowledge and considering providers as competent facilitated help-seeking. Additionally, there was considerable heterogeneity in studies and a lack of standardized measures assessing MHL.

    CONCLUSIONS: There is an increase in studies on MHL in Malaysia. A few of these studies, based on experimental design, have shown positive effects. Researchers, practitioners, and policymakers should develop standardized measures and interventional studies based on all the components of MHL.

  6. Jusoh M, Dzulkarnain AAA, Rahmat S, Musa R, Che Azemin MZ
    Asia Pac Psychiatry, 2021 Jun;13(2):e12414.
    PMID: 32815284 DOI: 10.1111/appy.12414
    The aim of this study is to evaluate the psychometric properties of the Malay version of the Swanson, Nolan, and Pelham Parent Rating Scale of attention deficit hyperactivity disorders (ADHD) symptoms (M-SNAP-IV). For this purpose, the SNAP-IV scale was translated into the Malay language and was pilot-tested on 91 parents of children aged 8 to 11 years (ADHD [n = 36] and non-ADHD children [n = 55]). The findings depicted that the M-SNAP-IV has excellent content validity, internal consistency, and test-retest reliability. The M-SNAP-IV is a valid and reliable screening tool to detect ADHD symptoms in children and has the advantages to assess the specific presentation of ADHD.
  7. Arokiamary B, Russell V, Lim HA, Koay JM, Xia J, Zhao XH, et al.
    Asia Pac Psychiatry, 2021 Jun;13(2):e12454.
    PMID: 33646626 DOI: 10.1111/appy.12454
    INTRODUCTION: Perceptions of the educational environment (EE) represent an important source of information on medical students' learning experience. Understanding and addressing these perceptions can help inform initiatives designed to improve the learning experience and educational outcomes, while comparison of student perceptions across medical schools can provide an added perspective. The aim of the study was to compare the EEs of three Asian medical schools: Royal College of Surgeons in Ireland and University College Dublin Malaysia Campus, Yong Loo Lin School of Medicine, Singapore and Xiangya School of Medicine, China.

    METHODS: Medical students in the clinical years (N = 1063) participated in a cross-sectional study using the Dundee Ready Educational Environment Measure (DREEM). Data were analyzed using SPSS version 22.

    RESULTS: There were significant differences between the three medical schools in the total DREEM scores (F [2, 1059] = 38.29, p 

  8. Stuart S, Pereira XV, Chung JP
    Asia Pac Psychiatry, 2021 Mar;13(1):e12439.
    PMID: 33089661 DOI: 10.1111/appy.12439
    Interpersonal Psychotherapy (IPT) has been utilized with great efficacy and effectiveness across many cultural settings. The attachment theory upon which IPT rests provides a strong foundation for IPT cross-culturally: regardless of their geographic location, people are people and their relationships are important. Though the structure of families and individual social roles varies greatly across cultures, people relate to one another. They become distressed when they have problems with interpersonal conflict, change, and loss of relationships. In this article, we review the basics of IPT and then describe the ways in which cultural adaptations can be made for people in Asia. Both are large tasks-to summarize IPT concisely while providing sufficient information is difficult; describing cultural adaptions for people in geographical areas from Russia to China to India to Southeast and Central Asia and all of the ethnic and language groups that area includes is nigh well impossible within a review article. Thus we have restricted our cultural overview to areas in which we have experience clinically and in which we have been active with IPT training, supervision, and implementation. All of the work we describe, however, elaborate on the principles of cultural adaptations which can be used to implement IPT in other local contexts.
  9. Roche GC, Fung P, Ransing R, Noor IM, Shalbafan M, El Hayek S, et al.
    Asia Pac Psychiatry, 2021 Mar;13(1):e12432.
    PMID: 33145988 DOI: 10.1111/appy.12432
    INTRODUCTION: This study aims to review recent scientific publications and research output in the field of psychiatry, from a series of countries in the Asia-Pacific region (Australia, India, Indonesia, Iran, Lebanon, Malaysia, and Nepal), with a view to identify themes and similarities across regions, as well as to examine the barriers and challenges in mental health research faced by countries in the region.

    METHODS: Seven psychiatrists from seven countries reviewed recent published and ongoing research in psychiatry in their respective nations, with respect to themes, as well as any barriers or challenges faced by mental health researchers.

    RESULTS: While the seven nations included in this review vary in terms of research capabilities and economic development level, they share many similarities both in terms of research direction, and with regards to challenges faced. Limitations in the form of sociocultural differences from the West, and a lack of funding were some of the barriers identified.

    DISCUSSION: Mental health research in the region has been progressing well. However, more varied research in the form of qualitative or economic studies are lacking, as are multi-center studies. The similar issues that nations face with regards to research could perhaps benefit from collaborative efforts and initiatives for the furtherance of research in the region.

  10. Naeem F, Latif M, Mukhtar F, Kim YR, Li W, Butt MG, et al.
    Asia Pac Psychiatry, 2021 Mar;13(1):e12442.
    PMID: 33103344 DOI: 10.1111/appy.12442
    BACKGROUND: Cognitive behavior therapy (CBT) is an evidence based therapy and is now recommended by national organizations in many high income countries. CBT is underpinned by the European values and therefore for it to be effective in other cultures it needs to be adapted.

    AIMS: This paper describes an evidence based approach to culturally adapt CBT in Asian context, areas of focus for such adaptation and lessons learned.

    METHODS: An environmental scan of the literature, description of local CBT associations and perspectives from these organizations.

    RESULTS: Cultural adaptation of CBT focuses on three main areas; 1 awareness of culture and related issues, 2 assessment and 3 adjustment in therapy techniques.

    CONCLUSIONS: The last decade has seen an increase in culturally adapted CBT in Asia, however, more work needs to be done to improve access to CBT in Asia.

  11. Loo JL, Keng SL, Ramírez-Espinosa IG, Nor Hadi NM, Ramírez-Gutiérrez JA, Shoesmith W
    Asia Pac Psychiatry, 2021 Mar;13(1):e12437.
    PMID: 33188568 DOI: 10.1111/appy.12437
    BACKGROUND: Borderline personality disorder (BPD) contributes to suicide-related morbidity and mortality and requires more intensive psychotherapeutic resources due to its high mental health service usage. Accessibility to an evidence-based treatment program is a cornerstone to support patients with BPD and part of broader suicide prevention efforts as well as improving their quality of life.

    AIMS: In this article, the authors aim to discuss and review available dialectical behavior therapy (DBT) and DBT-informed services of selected countries in the Asia-Pacific Rim, namely Singapore, Malaysia, and Mexico.

    MATERIALS & METHODS: We contacted providers of different services and gathered information on the process of setting up the service and adapting the treatment, in addition to reviewing the available literature published in the countries.

    RESULTS: To date, there have been a pair of DBT-informed services in Singapore, four in Malaysia, and several in Mexico with a few of them offering standard DBT. Different efforts have been put in place to increase the accessibility to training and also the number of DBT practitioners.

    DISCUSSION: Important considerations during the process of setting up new services include the use of domestic examples and local language that are contextually appropriate for the local community. Selected challenges faced in common include shortage of workforce, affordability of training programs, and the need for language adaptation with or without translation.

    CONCLUSION: Further long-term evaluation of locally adapted DBT-informed mental health services will help to elucidate the effectiveness and efficacy of the program which will potentially serve as a guide for other resource-scarce regions.

  12. Um Min Allah N, Arshad S, Mahmood H, Abbas H
    Asia Pac Psychiatry, 2020 Dec;12(4):e12409.
    PMID: 32767510 DOI: 10.1111/appy.12409
  13. Tang CT, Chua EC, Chew QH, He YL, Si TM, Chiu HF, et al.
    Asia Pac Psychiatry, 2020 Dec;12(4):e12393.
    PMID: 32468725 DOI: 10.1111/appy.12393
    INTRODUCTION: Patterns of clinical use of long-acting injectable (LAI) antipsychotic drugs in many countries, especially in Asia, for treatment of patients diagnosed with chronic psychotic disorders including schizophrenia are not well established.

    METHODS: Within an extensive research consortium, we evaluated prescription rates for first- (FGA) and second-generation antipsychotic (SGA) LAI drugs and their clinical correlates among 3557 subjects diagnosed with schizophrenia across 15 Asian countries and region.

    RESULTS: Overall, an average of 17.9% (638/3557; range: 0.0%-44.9%) of treated subjects were prescribed LAI antipsychotics. Those given LAI vs orally administered agents were significantly older, had multiple hospitalizations, received multiple antipsychotics more often, at 32.4% higher doses, were more likely to manifest disorganized behavior or aggression, had somewhat superior psychosocial functioning and less negative symptoms, but were more likely to be hospitalized, with higher BMI, and more tremor. Being prescribed an FGA vs SGA LAI agent was associated with male sex, aggression, disorganization, hospitalization, multiple antipsychotics, higher doses, with similar risks of adverse neurological or metabolic effects. Rates of use of LAI antipsychotic drugs to treat patients diagnosed with schizophrenia varied by more than 40-fold among Asian countries and given to an average of 17.9% of treated schizophrenia patients. We identified the differences in the clinical profiles and treatment characteristics of patients who were receiving FGA-LAI and SGA-LAI medications.

    DISCUSSION: These findings behoove clinicians to be mindful when evaluating patients' need to be on LAI antipsychotics amidst multifaceted considerations, especially downstream adverse events such as metabolic and extrapyramidal side effects.

  14. Munawar K, Abdul Khaiyom JH, Bokharey IZ, Park MS, Choudhry FR
    Asia Pac Psychiatry, 2020 Dec;12(4):e12408.
    PMID: 32803860 DOI: 10.1111/appy.12408
    Individual mental health has become a primary global concern. In Pakistan, the prevalence of mental health issues is still unclear, as not many studies have assessed the level of mental health literacy (MHL) in the country. This systematic review aims to bridge this gap by encouraging the early detection of mental disorders, lessening stigma, and improving help-seeking behavior. Nine electronic databases were searched to identify empirical literature in this area. Only studies that evaluated MHL efficacy and those published in English were selected. Non-peer reviewed articles and gray literature were excluded. From 613 studies retrieved, 59 studies met the inclusion criteria and were reviewed. Forty-three of the included studies mentioned mental health outcome measures (of which only four mentioned reliability indices), 13 discussed stigma, 18 examined help-seeking approaches to mental illness treatments, and 47 discussed mental health knowledge. Additionally, the outcome of the MHL measures had considerable heterogeneity and limited validity. Meta-analysis was not conducted due to a lack of MHL operationalization. Besides, the measurement tools in the studies lacked consistency and standardization. This review compiled the available studies on MHL to assist researchers currently studying the various dimensions of MHL, as well as those designing new studies or investigating effective methods to increase MHL. This review highlights the need for well-designed controlled intervention studies. Further implications for researchers, practitioners, and policymakers are mentioned.
  15. Ismail M, Lee KY, Sutrisno Tanjung A, Ahmad Jelani IA, Abdul Latiff R, Abdul Razak H, et al.
    Asia Pac Psychiatry, 2020 Aug 26;13(2):e12417.
    PMID: 32964660 DOI: 10.1111/appy.12417
    INTRODUCTION: The prevalence of psychological distress is increasing worldwide. Stressful working environments and high expectations in medical practice put doctors at high risk of depression, anxiety, and stress, especially among medical interns. Effective coping strategies may reduce psychological distress in the clinical setting. This study aimed to determine the prevalence of psychological distress and its association with coping strategies among medical interns in Malaysia.

    METHOD: A total of 431 medical interns at 26 Malaysian Ministry of Health hospitals participated in this cross-sectional study in 2017. Self-administered questionnaires consisting of sociodemographic characteristics, items from DASS and BRIEF COPE were used. Descriptive analysis was done followed by further analysis with chi-square and Spearman correlation tests.

    RESULTS: The prevalence of stress, anxiety, and depression was 29.7%, 39.9%, and 26.2%, with a significantly higher prevalence among female and younger interns. Three-quarters of them (73.1%) applied problem-focused strategies as the main coping mechanism. Emotion-focused coping strategies showed a significant but weak correlation with anxiety and stress whereas avoidance-based coping strategies were significantly correlated with depression, anxiety, and stress.

    DISCUSSION: Medical internship is a highly grueling period. Besides emphasizing clinical competency, internship training should also impart the practice of healthy coping mechanisms. The vulnerable groups of females and younger interns should be taught positive coping skills so that they are empowered to handle any stressors on their personal and professional lives. Optimum psychological wellbeing of the medical interns can improve the overall work performance and quality of care for patients.

  16. Higuchi T, Ishigooka J, Iyo M, Hagi K
    Asia Pac Psychiatry, 2020 Mar;12(1):e12377.
    PMID: 31837113 DOI: 10.1111/appy.12377
    INTRODUCTION: This study was designed to evaluate the long-term safety and effectiveness of lurasidone in the treatment of schizophrenia among Asian patients.

    METHODS: Patients (N = 281) with schizophrenia who had completed a randomized, double-blind (DB), 6-week comparison of lurasidone (40 and 80 mg/day) and placebo were enrolled in a 26-week extension study in which all patients received open-label (OL), flexible doses of lurasidone (40 or 80 mg/day). Effectiveness was measured using the Positive and Negative Syndrome Scale (PANSS) scale.

    RESULTS: Fifty-seven percent of patients completed the OL extension study; 16.7% discontinued early due to lack of effectiveness; and 10.3% due to adverse events. The most common adverse events were insomnia (11.3%), akathisia (11.0%), and nasopharyngitis (10.6%). Adverse events related to weight gain, metabolic parameters, prolactin, and ECG measures were uncommon. Mean change in the PANSS total score from the DB baseline to OL endpoint was -28.4, with mean improvement of -7.5 observed from baseline to OL endpoint, and with a PANSS responder rate of 73.7%.

    DISCUSSION: The results of the current 26-week extension study found lurasidone to be a generally safe, well-tolerated, and effective long-term treatment for schizophrenia in Asian patients.

  17. Higuchi T, Ishigooka J, Iyo M, Yeh CB, Ebenezer EG, Liang KY, et al.
    Asia Pac Psychiatry, 2019 Jun;11(2):e12352.
    PMID: 30950208 DOI: 10.1111/appy.12352
    INTRODUCTION: To evaluate efficacy and safety of lurasidone for the treatment of Asian patients with schizophrenia.

    METHODS: Patients with schizophrenia from Japan, South Korea, Malaysia, and Taiwan were randomly assigned to 6 weeks of double-blind treatment with 40 or 80 mg/d of lurasidone or placebo. The primary efficacy measure was change from baseline to week 6 on the Positive and Negative Syndrome Scale (PANSS) total score. Efficacy was evaluated using a mixed-model repeated-measures (MMRM) analysis in the modified intention-to-treat (mITT) population.

    RESULTS: On the basis of the analysis for the mITT population, the estimated difference score for lurasidone 40 and 80 mg/d vs placebo was -4.8 (P = 0.050) and -4.2 (P = 0.080). For the full intention-to-treat (ITT) population, the difference score for lurasidone 40 and 80 mg/d vs placebo was -5.8 (P = 0.017) and -4.2 (P = 0.043). The most frequent adverse events in the lurasidone 40 and 80 mg/d and placebo groups, respectively, were akathisia (7.3%, 10.4%, 3.3%), somnolence (6.0%, 2.6%, 0.7%), and vomiting (6.0%, 5.8%, 2.0%). The proportion of patients experiencing clinically significant weight gain (≥7%) was 5.3% for lurasidone 40 mg/d, 1.3% for 80 mg/d, and 1.4% for placebo. End point changes in metabolic parameters and prolactin were comparable for both lurasidone groups and placebo.

    CONCLUSIONS: In the ITT (but not the mITT) population, treatment with lurasidone was associated with significant improvement in the PANSS total score in patients with schizophrenia. Lurasidone was generally well tolerated with minimal impact on weight and metabolic parameters.

  18. Zainal NZ, Kalita P, Herr KJ
    Asia Pac Psychiatry, 2019 Mar;11(1):e12346.
    PMID: 30511420 DOI: 10.1111/appy.12346
    INTRODUCTION: Cognitive dysfunction has been significantly associated with functional impairment in patients with major depressive disorder (MDD).

    METHODS: This is a subgroup analysis of 211 Malaysian patients recruited from the multicountry, multicenter, cross-sectional Cognitive Dysfunction in Asian patients with Depression (CogDAD) study. Depression severity, cognitive dysfunction, and functional disability were assessed and compared with the overall CogDAD study population. Factors associated with functional disability were also evaluated in this Malaysian patient population.

    RESULTS: Approximately half of the Malaysian patients were in their first depressive episode, with the majority being treated for mild-to-moderate depression. Furthermore, Malaysian patients experienced cognitive dysfunction, with self-reported Perceived Deficits Questionnaire (PDQ-D) scores falling within the third quartile of PDQ-D severity. Malaysian patients also reported functional disability evidenced by a mean total Sheehan Disability Scale (SDS) score of 11.47 ± 6.68, with the highest SDS score reported in the "Social Life/Leisure Activities" domain. Compared with the overall CogDAD study population, the Malaysian patient population had comparable patient demographics in terms of marital and working status; outcome scores for PHQ-9 (9-item Patient Health Questionnaire for self-reported depression severity), PDQ-D and SDS; and worst perceived cognitive dysfunction reported in the "Attention/Concentration" domain. Factors found to be significantly associated with functional disability were PDQ-D score, sick leave taken, and antidepressant treatment (P 
  19. Barron D, Morgan KD, Towell T, Jaafar JL, Swami V
    Asia Pac Psychiatry, 2018 Mar;10(1).
    PMID: 28677341 DOI: 10.1111/appy.12293
    INTRODUCTION: The Schizotypal Personality Questionnaire (SPQ) is a widely used self-report measurement instrument for the assessment of schizotypal personality traits. However, the factor structure of the SPQ has been a matter of some debate. As a contribution to this debate, we examined the factor structure of the SPQ in Malaysian adults.

    METHOD: A total of 382 Malaysian adults completed a Malay translation of the SPQ. Confirmatory factory analysis was used to examine the fit of 3- and 4-factor solutions for the higher-order dimensionality of the SPQ. Ethnic invariance for the best-fitting model was tested at the configural, metric, and scalar levels, and a multivariate analysis of variance was used to examine sex and ethnicity differences in domain scores.

    RESULTS: The 4-factor model provided a better fit to the data than did the 3-factor model. The 4-factor model also demonstrated partial measurement invariance across ethnic groups. Latent mean comparisons for sex and ethnicity revealed a number of significant differences for both factors, but effect sizes were small.

    DISCUSSION: The 4-factor structure of the SPQ received confirmatory support and can be used in Malay-speaking populations.

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