Displaying publications 1 - 20 of 85 in total

Abstract:
Sort:
  1. Chen L, Xu YY, Lin JY, Ji ZP, Yang F, Tan S, et al.
    Asian J Psychiatr, 2024 Mar;93:103958.
    PMID: 38364597 DOI: 10.1016/j.ajp.2024.103958
    BACKGROUND AND AIM: Suicide is nearly always associated with underlying mental disorders. Risk factors for suicide attempts (SAs) in patients with bipolar disorder (BD) misdiagnosed with major depressive disorder (MDD) remain unelucidated. This study was to evaluate the prevalence and clinical risk factors of SAs in Chinese patients with BD misdiagnosed with MDD.

    METHODS: A total of 1487 patients with MDD from 13 mental health institutions in China were enrolled. Mini International Neuropsychiatric Interview (MINI) was used to identify patients with BD who are misdiagnosed as MDD. The general sociodemographic and clinical data of the patients were collected and MINI suicide module was used to identify patients with SAs in these misdiagnosed patients.

    RESULTS: In China, 20.6% of patients with BD were incorrectly diagnosed as having MDD. Among these misdiagnosed patients, 26.5% had attempted suicide. These patients tended to be older, had a higher number of hospitalizations, and were more likely to experience frequent and seasonal depressive episodes with atypical features, psychotic symptoms, and suicidal thoughts. Frequent depressive episodes and suicidal thoughts during depression were identified as independent risk factors for SAs. Additionally, significant sociodemographic and clinical differences were found between individuals misdiagnosed with MDD in BD and patients with MDD who have attempted suicide.

    CONCLUSIONS: This study highlights the importance of accurate diagnosis in individuals with BD and provide valuable insights for the targeted identification and intervention of individuals with BD misdiagnosed as having MDD and those with genuine MDD, particularly in relation to suicidal behavior.

  2. Luo J, Tang L, Kong X, Li Y
    Asian J Psychiatr, 2024 Feb;92:103905.
    PMID: 38262303 DOI: 10.1016/j.ajp.2023.103905
    BACKGROUND: Depressive disorders (DD) including dysthymia and major depressive disorder (MDD) are common among adolescents and young adults. However, global trends in DD burden remain unclear.

    METHODS: We analysed data from the Global Burden of Disease 2019 study on incidence, prevalence, disability-adjusted life years (DALYs), and mortality due to DD from 1990 to 2019 at global, regional and national levels.

    RESULTS: Globally, dysthymia incidence increased notably in females, older age groups, and lower-middle income countries from 1990 to 2019. In contrast, MDD incidence decreased slightly over this period except in high-income North America. Females and middle-income countries had the highest dysthymia burden while North America had the highest MDD incidence and DALYs. Oman and Malaysia experienced largest increases in dysthymia and MDD burden respectively.

    CONCLUSION: Despite certain global indicators suggesting a leveling off or decrease, it's clear that depressive disorders continue to be a significant and increasing issue, particularly among women, teenagers, and young adults. Differences between regions and countries indicate that specific interventions aimed at addressing economic inequalities, improving healthcare systems, and taking cultural factors into account could make a real difference in lessening the burden of depressive disorders. More research is needed to understand what's driving these trends so that we can develop better strategies for preventing and managing these conditions.

  3. Tan YK, Siau CS, Chan LF, Kõlves K, Zhang J, Ho MC, et al.
    Asian J Psychiatr, 2023 Nov;89:103772.
    PMID: 37748229 DOI: 10.1016/j.ajp.2023.103772
    This cross-sectional study aimed to validate the Life Events Checklist for DSM-5 (LEC-5) among Malaysian undergraduates (N = 500; mean age = 21.66 ± 1.57), of which 90.4% had ever experienced a lifetime traumatic event. Cronbach's alpha of .87 (95% CI [.86, .89]) and McDonald's omega of .89 (95% CI [.89, .93]) indicated good reliability. Confirmatory factor analysis based on a six-factor structure showed the best fit. The measurement invariance showed that the six-factor structure was similar across sexes. Therefore, the Malay LEC-5 is a valid and reliable instrument to screen for traumatic events among Malaysian undergraduates.
  4. Kasahara-Kiritani M, Saga Y, Wakamatsu A, Wu DB, Tsai IC
    Asian J Psychiatr, 2023 Aug;86:103671.
    PMID: 37311333 DOI: 10.1016/j.ajp.2023.103671
    BACKGROUND: Real-world evidence on the benefits of long-acting injectable (LAI) antipsychotics (AP) in patients with schizophrenia is limited, especially in the employed population in Japan. This study evaluates the effectiveness of LAI AP in preventing re-hospitalization in patients with schizophrenia, including the employed population.

    METHODS: This retrospective, observational, population-based study used the Japan Medical Data Center (JMDC) health insurance claims database to identify patients having schizophrenia before or on the day of the first LAI AP prescription (index date), and receiving LAI AP between April 1, 2012 and December 31, 2019. The number of all-cause, psychiatric-, and schizophrenia-related hospitalizations at baseline (365 days before index date) and during the 1-year follow-up period were evaluated.

    RESULTS: Of the 1692 patients who received LAI AP during the study period, 146 were included (employed: 55 [37.7 %]; dependent: 91 [62.3 %]). The mean age was 37 years; 50.7 % (n = 74) were females. During baseline period, 61 (41.8 %) patients were not hospitalized. During the follow-up period, 67 (45.9 %) patients underwent hospitalization ≤ 7 days; all-cause: 100 (68.7 %); psychiatry-related: 104 (76.2 %); schizophrenia-related: 114 (78.1 %). A higher proportion of patients were hospitalization-free during the follow-up in the employed vs. dependent population: all cause: 69.1 % vs. 61.5 %; psychiatric-related 76.4 % vs. 67.0 %, schizophrenia-related: 87.3 % vs. 71.4 %.

    CONCLUSION: This study demonstrated the effectiveness of LAI AP in preventing hospitalization in Japan. During the follow-up period, patients with schizophrenia receiving LAI AP, including the employed population, had a significant decrease in hospitalization length and re-hospitalization rate compared to baseline.

  5. Chen CK, Yang SY, Park SC, Jang OJ, Zhu X, Xiang YT, et al.
    Asian J Psychiatr, 2023 Jul;85:103613.
    PMID: 37163943 DOI: 10.1016/j.ajp.2023.103613
    OBJECTIVE: Mood stabilizers are psychotropic drugs mainly used to treat bipolar disorder in the acute phase or for maintenance therapy to prevent relapse. In clinical practice, mood stabilizers are commonly prescribed for conditions other than bipolar disorder. This study investigated the distribution of mood stabilizer prescriptions for different psychiatric diagnoses and studied differences in the drugs, dosage, and plasma concentration in 10 Asian countries including Taiwan, South Korea, Malaysia, China, Thailand, India, Pakistan, Singapore, Indonesia, and Myanmar.

    METHODS: Patients prescribed mood stabilizers (lithium, carbamazepine, valproic acid, or lamotrigine) for a psychiatric condition other than bipolar disorder (codes F31.0-F31.9 in the International Classification of Diseases, 10th Edition, Clinical Modification) were recruited through convenience sampling. A website-based data entry system was used for data collection.

    RESULTS: In total, 1557 psychiatric patients were enrolled. Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders (F20-F29, 55.8 %) was the most common diagnosis, followed by non-bipolar mood disorders (F30, F31- F39, 25.3 %), organic mental disorder (F00-F09, 8.8 %), mental retardation (F70-F79, 5.8 %) and anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders (F40-F48, 4.4 %). The most frequently targeted symptoms (>20 %) were irritability (48 %), impulsivity (32.4 %), aggression (29.2 %), anger (20.8 %), and psychosis (24.1 %). Valproic acid was the most frequently used medication.

    CONCLUSIONS: Clinicians typically prescribe mood stabilizers as empirically supported treatment to manage mood symptoms in patients with diagnoses other than bipolar disorders, though there is on official indication for these disorders. The costs and benefits of this add-on symptomatic treatment warrant further investigation.

  6. Siraji MA, Jahan N, Borak Z
    Asian J Psychiatr, 2023 Jun;84:103586.
    PMID: 37079986 DOI: 10.1016/j.ajp.2023.103586
    BACKGROUND: Assessing communication skills is necessary to facilitate pro-communication skills development programs. The 23-item Communication Scale (CS) is the most widely used tool for this purpose. Since there is a scarcity of validated tools to assess communication skills among Bangladeshi adolescents, we translated this questionnaire into Bangla and validated it on a Bangladeshi adolescent sample.

    METHODS: We conducted two independent rounds of large-scale surveys that yielded data from 621 Bangladeshi adolescents (AgeMean ± SD = 16.44 ± 1.32), of which 378 were males, and 244 were females. The participants completed the Bangla CS. A subset of the participants (n = 160) also completed the Bangla Beck's Hopelessness Scale (BBHS)-a measure of hopelessness.

    RESULTS: Exploratory factor analysis on the first-round data (n = 340) discarded six items and retained 17 items and revealed a unidimensional factor structure. Confirmatory Factor Analysis on the second-round data (n = 281) supported the unidimensional structure (CFI = 0.94, TLI = 0.93). Measurement invariance analysis indicated that the unidimensional structure was robust across gender (143 males vs 139 females). The scale exhibited a negative correlation with BBHS revealing the scale's concurrent validity (r = - 0.16, p  0.70) across a sizable range of communication skills continuum (θ = - 5.3 to 2.3) and had excellent marginal reliability (0.80). All items had adequate discriminating power (0.90 ± 0.20).

    CONCLUSION: The psychometric analysis of the 17-item Bangla-CS indicated that the scale is reliable and valid. We recommend that researchers and mental health practitioners utilize this scale to evaluate communication skills among Bangladeshi adolescents.

  7. Mahmood S, Siraji MA, Naher R, Arató N, Kaló Z
    Asian J Psychiatr, 2023 Feb 17;83:103514.
    PMID: 36906995 DOI: 10.1016/j.ajp.2023.103514
    BACKGROUND: The assessment of bullying-related attributes is vital in developing anti-bullying intervention and prevention programs. The revised Olweus Bully/Victim Questionnaire (OBVQ-R) is one tool that has been widely used for this purpose. Thus, as we noticed a rising interest in research on bullying and there is a scarcity of proper psychometric tools to assess bullying-related attributes in Bangladesh, our study aimed to translate the OBVQ-R and test the psychometric properties of the Bangla version of this questionnaire on a large Bangladeshi adolescent sample.

    METHOD: In Bangladesh, we collected data from grade 8-10 students (N = 567, 309 females, 258 males, AgeMean±SD=15.12 ± 0.81). The participants completed Bangla OBVQ-R, Beck Youth Inventory (BYI), and Children's Revised Impact of Events Scale-13 (CRIES-13).

    RESULTS: The item response theory (IRT) analysis discarded five items and retained 15 items (Victimization=8, Perpetration=7). Both subscales had items with high discrimination (Victimization: 3.14 ± 0.67; Perpetration: 3.40 ± 1.04). Confirmatory factor analysis supported a correlated two-factor model (CFI=0.99; TLI=0.99). Both subscales (Victimization and Perpetration) and the 15-item full scale exhibited satisfactory reliability (>0.80). In line with our predictions, both subscales demonstrated significant positive correlations with BYI and CRIES-13, indicating satisfactory concurrent validity.

    CONCLUSION: The results of the psychometric analyses supported the reliability and validity of the 15-item Bangla-version OBVQ-R to assess bullying involvement. Hence, this new, adapted measurement can facilitate further bullying research in Bangladesh and, thus, the development of prevention and intervention programs.

  8. Balasingam K, Kanagasundram S, Ann AYH, Kasmuri K, Gooding DC
    Asian J Psychiatr, 2023 Jan;79:103350.
    PMID: 36462388 DOI: 10.1016/j.ajp.2022.103350
    The reduced capacity for social and interpersonal interactions, social anhedonia, is an important aspect of various psychiatric disorders, especially schizophrenia-spectrum disorders. The goal of the present study was to validate a Malay translation of the adult version of the Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS; Gooding and Pflum, 2014), a relatively short and easy to administer indirect measure of social anhedonia. This cross-sectional study included 95 (47 male, 48 female) schizophrenia patients and 300 (77 male, 223 female) healthy subjects. Participants were given Malay versions of the ACIPS, Snaith Hamilton Pleasure Scale (SHAPS-M), and Beck Depression Inventory (BDI-M). The ACIPS exhibited good internal consistency (Ordinal alpha = 0.966). Total ACIPS scores were inversely correlated with the BDI-M scores, and positively correlated with total SHAPS-M scores. Factor analysis yielded a three-factor solution which accounted for 52.06% of the variance. As expected, the schizophrenia patients scored significantly lower than the healthy community participants on the ACIPS, t(130) = 4.26, p 
  9. Nordin N, Zainol Z, Mohd Noor MH, Chan LF
    Asian J Psychiatr, 2023 Jan;79:103316.
    PMID: 36395702 DOI: 10.1016/j.ajp.2022.103316
    Machine learning approaches have been used to develop suicide attempt predictive models recently and have been shown to have a good performance. However, those proposed models have difficulty interpreting and understanding why an individual has suicidal attempts. To overcome this issue, the identification of features such as risk factors in predicting suicide attempts is important for clinicians to make decisions. Therefore, the aim of this study is to propose an explainable predictive model to predict and analyse the importance of features for suicide attempts. This model can also provide explanations to improve the clinical understanding of suicide attempts. Two complex ensemble learning models, namely Random Forest and Gradient Boosting with an explanatory model (SHapley Additive exPlanations (SHAP)) have been constructed. The models are used for predictive interpretation and understanding of the importance of the features. The experiment shows that both models with SHAP are able to interpret and understand the nature of an individual's predictions with suicide attempts. However, compared with Random Forest, the results show that Gradient Boosting with SHAP achieves higher accuracy and the analyses found that history of suicide attempts, suicidal ideation, and ethnicity as the main predictors for suicide attempts.
  10. Alibudbud R
    Asian J Psychiatr, 2022 Dec;78:103311.
    PMID: 36335844 DOI: 10.1016/j.ajp.2022.103311
    This infodemiological study utilized Relative Search Volumes (RSV) from Google Trends. It determined changes in public interest in mental health after the implementation of the mental health laws of Malaysia, the Philippines, Singapore, and Thailand using search volumes from 2004 to 2021. It found that public interest in mental health increased in Malaysia, the Philippines, and Singapore after implementing their mental health laws. On the contrary, public interest in mental health continued to decrease in Thailand despite its mental health law implementation. This can be explained by the unequal prioritization of mental health among these countries.
  11. Kurniawan L, Sutanti N, Ningsih R, Wulandari NY, Ahmad AB, Kee P, et al.
    Asian J Psychiatr, 2022 Sep;75:103226.
    PMID: 35926297 DOI: 10.1016/j.ajp.2022.103226
  12. Goh XX, Tang PY, Tee SF
    Asian J Psychiatr, 2022 Jan;67:102932.
    PMID: 34839098 DOI: 10.1016/j.ajp.2021.102932
    Increased reactive species due to the effect of antipsychotics on oxidative stress may be involved in the development of schizophrenia. However, antipsychotics may have different direct antioxidant effects due to their chemical structures. The present meta-analysis aimed to investigate whether the cause increased oxidant status in schizophrenia patients is due to the illness or induction by antipsychotics. Studies published from 1964 to 2021 were selected from Pubmed and Scopus databases. Data were analysed using Comprehensive Meta-Analysis version 2. Effect sizes were calculated and compared between unmedicated and medicated patients and healthy controls. Heterogeneity and publication bias were assessed. Subgroup analyses were conducted on drug-free and drug-naïve patients, and patients treated with atypical and typical antipsychotics. We found that medicated patients had significantly higher malondialdehyde (MDA), thiobarbituric acid reactive substances (TBARS) and total oxidant status (TOS). Meanwhile, significantly increased plasma/serum MDA and nitric oxide (NO) were observed in unmedicated patients only. Higher lipid peroxidation in the drug-naïve group may be associated schizophrenia. However, both atypical and typical antipsychotics may worsen lipid peroxidation. Antipsychotic discontinuation in the drug-free group led to significantly increased plasma/serum NO, with larger effect size than the atypical antipsychotic group. In conclusion, medicated schizophrenia patients were more suffered from increased oxidative stress. Therefore, future study may focus on the mechanism of action of specific antipsychotic on oxidative stress.
  13. Chandrasekaran PK, Yan Qi OW, O Brien FM
    Asian J Psychiatr, 2021 Dec;66:102884.
    PMID: 34740125 DOI: 10.1016/j.ajp.2021.102884
    Lithium therapy is a common treatment for affective disorders and is widely regarded as a lifesaving drug. However, because its elimination is almost wholly unchanged via the kidneys, both acute and long-term adverse effects relating to toxicity may occur, including declining renal function and nephrogenic diabetes insipidus (DI). DI may be difficult to detect and is frequently preceded by dehydration and which, in our patient, was discovered by chance. We describe a case of an elderly woman on chronic lithium therapy for bipolar affective disorder who initially presented with dehydration from vomiting but possibly developed extra-pontine myelinolysis (EPM) after over-zealous correction of hyponatraemia. Steroids administered appeared to have prevented further progression but a persisting hyperosmolar state then alerted us to the presence of nephrogenic DI. Although both conditions were later successfully reversed with no obvious chronic sequelae, the recovery of the patient was protracted. Clinicians should be vigilant for complications of managing dehydration states in people prescribed with lithium.
  14. Chong SC, Ang JK, Tan KP
    Asian J Psychiatr, 2021 Nov;65:102835.
    PMID: 34534918 DOI: 10.1016/j.ajp.2021.102835
    Covid-19 pandemic and the public health measure have forced an en masse transition to remote therapy from physical sessions. Remote psychodynamic psychotherapy is not a new treatment modality, but its effectiveness in holding the analytic frame has been concerned by some therapists. We would like to highlight some of the therapeutic processes involved with remote psychodynamic psychotherapy, via the help of a narrative experience of a psychiatry trainee who was novice to this delivery method of therapy. Reflections on these concerns have been made in line with the experiences highlighted.
  15. Vasantha Kumar P, Subramaniam P, Che Din N
    Asian J Psychiatr, 2021 Jun;60:102646.
    PMID: 33873045 DOI: 10.1016/j.ajp.2021.102646
    BACKGROUND: The effects of aging and its associated cognitive decline is particularly acute in Asia given the exponential growth of older adults as a proportion of the population as a whole. Many structured cognitive interventions have been proposed to prevent the cognitive decline typically seen in older age, but their utility as a viable means of achieving these goals is questionable.

    OBJECTIVES: To summarize and synthesize evidence on the utility and methodological quality of cognitive-based interventions on cognitive performance and associated secondary outcomes among healthy older adults in Asia, as well as novel, culture-specific components of cognitive interventions across the region.

    DATA SOURCES: The PubMed/Medline, Web of Science, Scopus, and ScienceDirect databases were searched through May 2020.

    ELIGIBILITY: Studies including individuals aged 60 years and above, who had no previous history of physical and/or mental illness. Few restrictions placed on intervention design, duration and mode of delivery, provided that participants were randomized to study conditions, and intervention included components addressing at least one cognitive domain.

    RESULTS: A total of 17 studies from six countries met the eligibility criteria and were included in the final review. Evidence from those studies indicated that cognitive interventions may be most effective when the design and aims were directed towards improvement in specific cognitive domains, but evidence regarding long-term effectiveness in preventing progression to clinical-level cognitive deficits is still unclear. Several studies highlighted culture-specific activities as components of their interventions, though these will need to be further outlined and standardized clearly in future research.

  16. Javed A, Lee C, Zakaria H, Buenaventura RD, Cetkovich-Bakmas M, Duailibi K, et al.
    Asian J Psychiatr, 2021 Apr;58:102601.
    PMID: 33611083 DOI: 10.1016/j.ajp.2021.102601
    Mental health disorders are a burgeoning global public health challenge, and disproportionately affect the poor. Low- and middle-income countries (LMICs) bear 80 % of the mental health disease burden. Stigma associated with mental health results in delayed help seeking, reduced access to health services, suboptimal treatment, poor outcomes and an increased risk of individuals' human rights violations. Moreover, widespread co-occurrence of physical comorbidities such as noncommunicable diseases with mental health disorders makes the treatment of both conditions challenging and worsens prognosis. This paper explores various aspects of stigma towards mental health with a focus on LMICs and assesses measures to increase help-seeking and access to and uptake of mental health services. Stigma impacts persons living with mental illness, their families and caregivers and healthcare professionals (mental health professionals, non-psychiatric specialists and general practitioners) imparting mental health care. Cultural, socio-economic and religious factors determine various aspects of mental health in LMICs, ranging from perceptions of health and illness, health seeking behavior, attitudes of the individuals and health practitioners and mental health systems. Addressing stigma requires comprehensive and inclusive mental health policies and legislations; sustainable and culturally-adapted awareness programs; capacity building of mental health workforce through task-shifting and interprofessional approaches; and improved access to mental health services by integration with primary healthcare and utilizing existing pathways of care. Future strategies targeting stigma reduction must consider the enormous physical comorbidity burden associated with mental health, prioritize workplace interventions and importantly, address the deterioration of population mental health from the COVID-19 pandemic.
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links