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Chronic suppurative lung disease in a developing country: impact on child and parent

Nathan AM, Muthusamy A, Thavagnanam S, Hashim A, de Bruyne J

Pediatr Pulmonol, 2014 May;49(5):435-40.
PMID: 24482322 DOI: 10.1002/ppul.23001

To investigate the impact of chronic suppurative lung disease (CSLD) on growth and lung function in the child as well as quality of life of the child and parent.

Matched MeSH terms: Depression/psychology
Fulltext Psychological Distress Among Infertile Women: Exploring Biopsychosocial Response To Infertility

Zuraida, A.S.

Malaysian Journal of Psychiatry, 2010;19(2):1-11.
MyJurnal

Previous studies have shown that the experience of infertility is linked with psychological responses such as depression, anxiety, guilt, social isolation, and decreased self-esteem in both men and women. The prevalence of depression among infertile women ranges from 8% to 54%. Treating gynecologists and healthcare professionals seldom recognized the psychosocial distress in women undergoing fertility treatment. Therefore this paper reviewed the bio-psychosocial response towards infertility among women with infertility.

Matched MeSH terms: Depression
Fulltext A Brief Psychotic Episode with Depressive Symptoms in Silent Right Frontal Lobe Infarct

Badrin S, Mohamad N, Yunus NA, Zulkifli MM

Korean J Fam Med, 2017 Nov;38(6):380-382.
PMID: 29209479 DOI: 10.4082/kjfm.2017.38.6.380

Psychiatric symptoms may be related to a silent cerebral infarct, a phenomenon that has been described previously in literature. Acute psychosis or other neuropsychiatric symptoms including depression may present in stroke patients and patients with lesions either within the prefrontal or occipital cortices, or in subcortical areas such as the basal ganglia, thalamus, mid-brain, and brainstem. Psychosis in clinical stroke or in silent cerebral infarction is uncommon and not well documented in the literature. Neurological deficits are the most common presentation in stroke, and nearly a third of patients that suffer a stroke may experience psychological disorders such as depression and anxiety, related to physical disability. The present case report describes an elderly female patient who presented with hallucinations and depressive symptoms, and was discovered to have a recent right frontal brain infarction, without other significant neurological deficits.

Matched MeSH terms: Depression
Fulltext The prevalence and inter-relationship of negative body image perception, depression and susceptibility to eating disorders among female medical undergraduate students

Manaf NA, Saravanan C, Zuhrah B

J Clin Diagn Res, 2016 Mar;10(3):VC01-VC04.
PMID: 27134977 DOI: 10.7860/JCDR/2016/16678.7341

Introduction: Female students are thought to be more negatively impacted by body image ideals and often more susceptible to various eating related disorders compared to men. A previous study using a sample of female students in Malaysia did not identify whether the increase in susceptibility to eating disorders can be explained by the level of body image acceptance.
Aim: To identify the prevalence of depression and susceptibility to eating disorders among a sample of 206 female students in one of the private universities in Malaysia and explore the relationship between depression, body image and susceptibility to eating disorders. In addition, this study aimed to determine whether depression is a mediator between body image and susceptibility to eating disorders among female college students.
Materials and Methods: The Body Image Acceptance and Action Questionnaire were used to assess body image acceptance, the Patient Health Questionnaire to measure depression and the Eating Attitude Test- 26 was used to assess susceptibility to eating disorders.
Results: The results showed that 65.5% (n=135) of the students were depressed and 6.3% (n=13) were susceptible to eating disorders. There was a significant positive relationship between depression and eating disorders and a negative relationship between body image and depression as well as between body image and eating disorder. Further, the regression model showed that depression was partially mediating the effect of body image on eating disorders.
Conclusion: Body image and depression contribute to eating disorders and treating depression could reduce susceptibility to eating disorders.
Keywords: Unhealthy body perception, Psychological problems, Relationship between body image and eating disorder

Matched MeSH terms: Depression*
Probiotic consumption relieved human stress and anxiety symptoms possibly via modulating the neuroactive potential of the gut microbiota

Ma T, Jin H, Kwok LY, Sun Z, Liong MT, Zhang H

Neurobiol Stress, 2021 May;14:100294.
PMID: 33511258 DOI: 10.1016/j.ynstr.2021.100294

Stress has been shown to disturb the balance of human intestinal microbiota and subsequently causes mental health problems like anxiety and depression. Our previous study showed that ingesting the probiotic strain, Lactobacillus (L.) plantarum P-8, for 12 weeks could alleviate stress and anxiety of stressed adults. The current study was a follow-up work aiming to investigate the functional role of the gut metagenomes in the observed beneficial effects. The fecal metagenomes of the probiotic (n = 43) and placebo (n = 36) receivers were analyzed in depth. The gut microbiomes of the placebo group at weeks 0 and 12 showed a significantly greater Aitchison distance (P

Matched MeSH terms: Depression
Postnatal depression and its associated factors in women from different cultures

Abdollahi F, Lye MS, Md Zain A, Shariff Ghazali S, Zarghami M

Iran J Psychiatry Behav Sci, 2011;5(2):5-11.
PMID: 24644441

OBJECTIVE: Postpartum depression (PPD) is a common health problem which affects women in the postpartum period. This is a brief note on its associated factors in women from different cultures.
METHODS: A literature review was performed in MEDLINE and Pubmed from 1991 to 2008 and Magiran from 1991 to 2009. Additional articles and book chapters were referenced from these sources.
RESULTS: The prevalence of postpartum depression has been reported to be from 0.5% to 60% globally, and from 3.5% to 63.3% in Asian countries, in which Malaysia and Pakistan had respectively the lowest and highest rates. One of the factors contributing to PPD in Asian societies can be that women may not have the empowerment to reject traditional rituals that are imposed on them by their caregivers. Unsatisfactory pre-existing relationships between the mothers and their caregivers resulting in mothers experiencing difficulties during their confinement period may be another factor. Thirdly, some features of these traditional rituals may be the cause of tension, stress and emotional distress. Emotional conflicts caused by insistence on practice of traditional rituals during the postpartum period may lead to mental breakdown.
CONCLUSION: Health care professionals should be aware that the phenomenon in Asian cultures is as prevalent as European cultures. Moreover, further research needs to be conducted on the global prevalence of the experiences of childbearing women with depressive symptoms.
KEYWORDS: Cultures; Postpartum depression; Risk factors

Matched MeSH terms: Depression, Postpartum*
Perspective of Postpartum Depression Theories: A Narrative Literature Review

Abdollahi F, Lye MS, Zarghami M

N Am J Med Sci, 2016 Jun;8(6):232-6.
PMID: 27500126 DOI: 10.4103/1947-2714.185027

Postpartum depression is the most prevalent emotional problem during a women's lifespan. Untreated postpartum depression may lead to several consequences such as child, infant, fetal, and maternal effects. The main purpose of this article is to briefly describe different theoretical perspectives of postpartum depression. A literature search was conducted in Psych Info, PubMed, and Science Direct between 1950 and 2015. Additional articles and book chapters were referenced from these sources. Different theories were suggested for developing postpartum depression. Three theories, namely, biological, psychosocial, and evolutionary were discussed. One theory or combinations of psychosocial, biological, and evolutionary theories were considered for postpartum depression. The most important factor that makes clinicians' choice of intervention is their theoretical perspectives. Healthcare providers and physicians should help women to make informed choices regarding their treatment based on related theories.

Matched MeSH terms: Depression, Postpartum
Changes in emotional distress, short term memory, and sustained attention following 6 and 12 sessions of progressive muscle relaxation training in 10-11 years old primary school children

Hashim HA, Zainol NA

Psychol Health Med, 2015;20(5):623-8.
PMID: 25603900 DOI: 10.1080/13548506.2014.1002851

This study compared the effects of 6 and 12 sessions of relaxation training on emotional distress, short-term memory, and sustained attention in primary school children.

Matched MeSH terms: Depression/therapy*
Fulltext Translation, validation and psychometric properties of Bahasa Malaysia version of the Depression Anxiety and Stress Scales (DASS)

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.

Matched MeSH terms: Depression
Fulltext Anxiety, depression and coping strategies in breast cancer patients on chemotherapy

Saniah, A.R., Zainal, N.Z.

Malaysian Journal of Psychiatry, 2010;19(2):1-6.
MyJurnal

The aim of the study was to determine coping strategies among breast cancer patients with depression and anxiety during chemotherapy. Methods: Breast cancer patients with confirmed diagnosis who were undergoing out-patient chemotherapy at the Oncology Unit, University Malaya Medical Centre were invited to participate in the study. They were assessed on their socio demographic profiles and clinical history. The Hospital Anxiety Depression Scale (HADS) was used by patients to report anxiety and depression. The Brief COPE Scale was used to assess coping strategies among the patients. Results: One hundred and forty one patients with mean age of fifty years participated in the study. Prevalence for depression was 19.1% and prevalence for anxiety was 24.1%. Patients who were having anxiety symptoms scored significantly higher on denial, behavioural disengagement and venting as their coping strategies compared to patients who were not anxious. Patients with depressive symptoms scored significantly higher in behavioural disengagement and self-blame as their coping strategies compared to those who were not depressed. Conclusion: Breast cancer patients undergoing chemotherapy experienced high level of depressive and anxiety symptoms. However different coping strategies were adopted to cope with their illness, chemotherapy treatment, practical and family problems, emotional and physical symptoms.
Study site: Oncology clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Depression
Fulltext Depression In Parkinson Disease: Clinical Features And Aetiology

Chan, Y.F., Zainal, N.Z.

Malaysian Journal of Psychiatry, 2010;19(1):1-11.
MyJurnal

Parkinson Disease (PD) is a neurodegenerative disorder of the central nervous system that often impairs the patient’s motor skills, speech and other functions. The four cardinal signs of parkinsonism are resting tremor, bradykinesia, cogwheel rigidity and postural instability. The prevalence of depression in PD ranges from 4% to 75%. However depression in PD is often mistakenly as the presentation of the disease itself. Therefore this paper reviewed the clinical feature of depression in PD and explored the aetiology of depression in PD.

Matched MeSH terms: Depression
Fulltext Relationship of Depressive Symptoms to Hypertension in a Household Survey

Lam, H.H., Ng, E.K., Ooi, A.L., Ooi, P.Y., Sellymiah, A., Siti Fareeda, A., et al.

Malaysian Journal of Psychiatry, 2011;20(1):1-12.
MyJurnal

Objectives: To study relationship of depressive symptoms to hypertension. Methods: A cross sectional study was carried out on respondents from Kampung Awal. Hypertension was defined as self-reported or by measurement using a mercury sphymomanometer and depressive symptoms were evaluated by CES-D scale. Results: A total 103 respondents were studied. The male:female ratio was 1:1.5 with mean age of 41.8 years. Majority had formal education up to secondary school. 45% were government servant and over 95% subjects had income of RM1000 or less per each family member per month. 21.4% (n=22) self-reported to have hypertension and 7.8%(n=91) met the criteria for incident hypertension. 7.8% met the criteria for both. Mean score based on CES-D was 13.08. 32.0% subjects had depression. 54 subjects reported never experienced any strain for past 6 months and 24 reported to have 2 or more .61 subjects were overweight with mean value of BMI=26.19 kg/m2. Self-reported hypertension and incident hypertension were strongly associated with age but only selfreported hypertension was strongly associated with overweight. However, there was no significant association between hypertension with chronic strains and depressive symptoms. Conclusions: Depressive symptomatology was not associated with hypertension in this survey. Women had a significant risk in having depressive symptoms. Age =45 years & overweight were significant risks for hypertension. A prospective study will be more useful in the future to find out the association between depression and hypertension.

Matched MeSH terms: Depression
Fulltext Factorial validation of the Malay version of multidimensional scale of perceived social support among a group of psychiatric patients

Ng, C.G., Nurasikin, M.S., Loh, H.S., Yee, Anne H.A., Zainal, N.Z.

Malaysian Journal of Psychiatry, 2012;21(2):0-0.
MyJurnal

Introduction: There is increasing awareness of the contribution of perceived social support (PSS) to emotional and physical well-being. Numerous scales measuring PSS have been developed, including the widely used Multidimensional Scale of Perceived Social Support (MSPSS). The psychometric properties of the MSPSS have been demonstrated in diverse samples, however mostly are conducted in English. Malay is the official languange in Malaysia, and this study was conducted to provide evidence of the validity and reliability of a Malay version MSPSS (MSPSS-M) suited for our population.
Methods: This is a cross sectional study. The socio-demographic and clinical information of the selected patients from psychiatric outpatient clinic over a 3-month period, were obtained via pre-designed questionnaire, interviews and medical records. Assessment of psychiatric symptoms and social support were measured by various instruments including the Brief Psychiatric Rating Scale (BPRS-E), Depressive, Anxiety and Stress Scale (DASS) and MSPSS-M.
Results: Data were reported for 228 psychiatric outpatients with the mean age of 40.3 years old. The 3-factor structure of the MSPSS-M (significant others, family, and friends) fitted the data well. The MSPSS-M showed good internal consistency (Cronbach α of 0.89) and validity. The scores of the total subscales for MSPSS-M were negatively correlated with the depression subscale in DASS (P < 0.05). BPRS was negatively correlated with significant others (P < 0.01) compared to the other two subscales in MSPSS-M.
Conclusions: The Malay version MSPSS (MSPSS-M) is a psychometrically valid instrument with high internal consistency, which is useful in assessing perceived social support in Malaysian population.

Study site: psychiatric clinic, University Malaya
Medical Center (UMMC)

Matched MeSH terms: Depression
Fulltext Serotonin transporter gene polymorphism is associated with antidepressant response to escitalopram in multiethnic Malaysians with major depressive disorder: a preliminary study

Tiong, C.P., Loke, A.C., Mohamed, Z., Zainal, N.Z.

Malaysian Journal of Psychiatry, 2013;22(2):59-71.
MyJurnal

Objective: This study investigates the relationship between antidepressant response to escitalopram and polymorphism of the serotonin transporter gene promoter region (5-HTTLPR) in multi ethnic Malaysian patients with Major Depressive Disorder. Methods: An eight weeks prospective study of treatment response to escitalopram was conducted on 29 Malaysian patients with Major Depressive Disorder. The severity and improvement of depression were assessed with the Montgomery-Asberg Depression Rating Scale. Patients were also genotyped for long (L) and short (S) polymorphisms in 5-HTTLPR using polymerase chain reaction. Results: Response to escitalopram treatment was more frequent in patients with 5-HTTLPR SS genotype than in those with LL or LS genotypes (p = 0.04, OR = 10.0, 95% CI = 1.05-95.2). The favourable allelic variant for response was S allele (p

Matched MeSH terms: Depression
Impact of applied progressive deep muscle relaxation training on the level of depression, anxiety and stress among prostate cancer patients: a quasi-experimental study

Isa MR, Moy FM, Abdul Razack AH, Zainuddin ZM, Zainal NZ

Asian Pac J Cancer Prev, 2013;14(4):2237-42.
PMID: 23725119

BACKGROUND: The aim of this study was to determine the impact of applied progressive muscle relaxation training on the levels of depression, anxiety and stress among prostate cancer patients.
MATERIALS AND METHODS: A quasi-experimental study was conducted at the University Malaya Medical Centre (UMMC) and Universiti Kebangsaan Malaysia Medical Centre (UKMMC) over six months. Prostate cancer patients from UMMC received the intervention and patients from UKMMC were taken as controls. The level of depression, anxiety and stress were measured using Depression, Anxiety Stress Scales - 21 (DASS-21).
RESULTS: A total of 77 patients from the UMMC and 78 patients from the UKMMC participated. At the end of the study, 90.9% and 87.2% of patients from the UMMC and UKMMC groups completed the study respectively. There were significant improvements in anxiety (p<0.001, partial ?2=0.198) and stress (p<0.001, partial ?2=0.103) at the end of the study in those receiving muscle training. However, there was no improvement in depression (p=0.956).
CONCLUSIONS: The improvement in anxiety and stress showed the potential of APMRT in the management of prostate cancer patients. Future studies should be carried out over a longer duration to provide stronger evidence for the introduction of relaxation therapy among prostate cancer patients as a coping strategy to improve their anxiety and stress.

Matched MeSH terms: Depression/diagnosis; Depression/etiology; Depression/prevention & control*
Depressive symptoms in middle-aged women in peninsular Malaysia

Zainal NZ

Asia Pac J Public Health, 2008;20(4):360-9.
PMID: 19124330 DOI: 10.1177/1010539508322538

A household survey was carried out in Peninsular Malaysia to determine the prevalence rate of depressive symptoms in middle-aged women and to explore its associated factors. Women aged 45 to 60 years were assessed on sociodemographic profiles, menopausal status, depressive symptoms, marital dissatisfaction, and coping strategies. A total of 3934 women participated, and the mean age was 51 years. The prevalence rate of depressive symptoms was 54.2%. Of the married women, 38.4% had poor to very severe problems in their marriage. Depressive symptoms were significantly associated with marital status (P < .001), ethnicity (P < .001), educational levels (P < .001), occupational status ( P < .001), domicile (P < .001), and menopausal status ( P < .05). Depressive symptoms were correlated with marital dissatisfaction scores. Women who consulted professionals, shared with relatives, kept problems to themselves, or consulted parents/siblings had higher mean scores on depressive symptoms compared with those who did not use these coping strategies.

Matched MeSH terms: Depression/epidemiology*
Fulltext Exploring burnout among Malaysian junior doctors using the abbreviated Maslach Burnout Inventory

Zuraida Ahmad Sabki, Zainal NZ

Malaysian Journal of Psychiatry, 2015;24(1):23-32.
MyJurnal

Objective: The study aimed to explore the prevalence of burnout among the junior doctors and to examine the psychometric properties of abbreviated Maslach Burnout Inventory (aMBI). Methods: A cross-sectional study was conducted using aMBI self-reported questionnaire and Hospital Anxiety Depression Scale which was carried out on a sample of 117 junior doctors working in a teaching hospital in Malaysia. Results: Exploratory factor analysis of aMBI revealed a three-factor structure labelled as emotional exhaustion, depersonalization and personal accomplishment with Crohnbach’s alpha of 0.85, 0.59 and 0.64 respectively. The total variance was 67%. Prevalence of burnout was found at 26.5%. Emotional exhaustion and depersonalization were positively correlated with depression and anxiety. Shorter duration of residence (less than six months) and being posted to Trauma & Emergency unit were associated with higher mean score of burnout. Conclusion: This study provides the knowledge of level of burnout among the junior doctors and the abbreviated Maslach Burnout Inventory has a satisfied psychometirc properties for screening burnout among junior doctors in Malaysia.

Matched MeSH terms: Depression
Psychotherapy for cancer patients

Chong Guan N, Mohamed S, Kian Tiah L, Kar Mun T, Sulaiman AH, Zainal NZ

Int J Psychiatry Med, 2016 07;51(5):414-430.
PMID: 28629286 DOI: 10.1177/0091217416680197

Objective Psychotherapy is a common non-pharmacological approach to help cancer patients in their psychological distress. The benefit of psychotherapies was documented, but the types of psychotherapies proposed are varied. Given that the previous literature review was a decade ago and no quantitative analysis was done on this topic, we again critically and systematically reviewed all published trials on psychotherapy in cancer patients. Method We identified 17 clinical trials on six types of psychotherapy for cancer patients by searching PubMed and EMBASE. Result There were four trials involved adjunct psychological therapy which were included in quantitative analysis. Each trial demonstrated that psychotherapy improved the quality of life and coping in cancer patients. There was also a reduction in distress, anxiety, and depression after a psychological intervention. However, the number and quality of clinical trials for each type of psychotherapy were poor. The meta-analysis of the four trials involved adjunct psychological therapy showed no significant change in depression, with only significant short-term improvement in anxiety but not up to a year-the standardized mean differences were -0.37 (95% confidence interval (CI) = -0.57, -0.16) at 2 months, -0.21 (95% CI = -0.42, -0.01) at 4 months, and 0.03 (95 % CI = -0.19, 0.24) at 12 months. Conclusion The evidence on the efficacy of psychotherapy in cancer patients is unsatisfactory. There is a need for more rigorous and well-designed clinical trials on this topic.

Matched MeSH terms: Depression/complications; Depression/psychology; Depression/therapy*
Fulltext Prevalence of depression in cancer patients: a review on the comparison between different regions

Ng, C.G., Zainal N.Z.

Malaysian Journal of Psychiatry, 2014;23(2):90-113.
MyJurnal

Introduction: Depression is the most common psychological sequelae in cancer patients. It is challenging to diagnose depression in cancer patients. Furthermore, the presentation is influenced by the patients’ cultural background. Objectives: This literature review aims to determine the prevalence of depression in cancer patients across regions of different cultural background. Methods: A literature search was undertaken by using Pubmed electronic database. Studies were included in this review if they (a) examined the prevalence of depression in cancer patients and (b) published in English peer-review journal between 2000 and 2009. Results: A total of 59 studies from 21 countries were reviewed and summarised. The prevalence of depression in cancer patients ranged from 3% to 72%. Studies from Asia reported the lowest prevalence (3-39%) and Europe reported the highest prevalence (7-72%). Conclusion: Cultural influence may play a role in the prevalent difference of depression in cancer patients. Somatization and stigmatization are suggested as the possible reasons of lower prevalence of depression in Asia region. The biopsychiatric model of mental illness and western psychologization explain the higher prevalence in Western region. Future research on the cross-cultural variability in the presentation of depression in cancer patients is recommended.

Matched MeSH terms: Depression
Fulltext The pyramid counteracts chronic prenatal restraint-stress effects on the milestones, anthropometry, and body, brain and adrenal gland weights of pups in rats

George, Mitchel Constance, Murthy, Krishna Dilip, Zainal Arifin Mustapha

Borneo Journal of Medical Sciences, 2018;12(1):49-56.
MyJurnal

Prenatal exposure to chronic stress during critical periods of foetal development produces depression, attention and learning deficits, hormonal imbalances and affects the brain. The effect of prenatal restraint-stress on the postnatal developmental milestones, anthropometric measurements, and the body, brain and adrenal gland weights of the pups were examined and compared with the unrestrained control and the restrained group under the pyramid at postnatal day 10 and 21. Pregnant rats were restrained (9h/day) from gestation day 7 until parturition. Results showed significant delay in the milestones by one day in the restraint control (RC) compared to the unrestrained normal control (NC), while pups of the restrained pyramid (RP) group did not show the delay. Significant decreases in the anthropometric measurements, body and brain weights in RC group were observed at both postnatal days, while the RP group results matched with the NC group. Significant increase in the adrenal weights was found in the RC group compared to NC group and not the RP group. Results suggest prenatal restraint-stress definitely hampers the developmental milestones, anthropometric measurements, and body and brain weights of the young offspring. Results suggest, pyramid environment counteracts and protects the deleterious effects of chronic prenatal stress.

Matched MeSH terms: Depression

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