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  1. Fulltext Contribution of diet and major depression to incidence of acute myocardial infarction (AMI)
    Yary T, Soleimannejad K, Abd Rahim F, Kandiah M, Aazami S, Poor SJ, et al.
    Lipids Health Dis, 2010;9:133.
    PMID: 21087475 DOI: 10.1186/1476-511X-9-133
    BACKGROUND: Despite significant improvements in the treatment of coronary heart disease (CHD), it is still a major cause of mortality and morbidity among the Iranian population. Epidemiological studies have documented that risk factors including smoking and the biochemical profile are responsible for the development of acute myocardial infarction (AMI). Psychological factors have been discussed as potential risk factors for coronary heart disease. Among emotional factors, depression correlates with coronary heart disease, particularly myocardial infarction.
    METHODS: This case-control study was conducted on 120 cases (69 males and 51 females) of acute myocardial infarction (AMI) and 120 controls, with a mean age of 62.48 ± 15.39 years. Cases and controls were matched by age, residence and sex.
    RESULTS: The results revealed that severe depression was independently associated with the risk of AMI (P = 0.025, OR = 2.6, 95% CI 1.1-5.8). The analysis of variables indicated that risk factors for developing depression were unmarried, low levels of polyunsaturated fatty acids (PUFAs), total dietary fiber (TDF) and carbohydrates. The levels of these dietary factors were lowest in severely depressed patients compared to those categorised as moderate or mild cases. Furthermore, severely depressed subjects were associated with higher levels of total cholesterol, high systolic blood pressure (SBP) and WHR. Age, income, a family history of coronary heart disease, education level, sex, employment and smoking were not associated with severe depression.
    CONCLUSION: The present study demonstrated that severe depression symptoms are independent risk factors for AMI. Furthermore, severe depression was associated with an unhealthy diet and AMI risk factors.
    Study site: Mostafa Hospital, Ilam Province, Iran
    Matched MeSH terms: Depressive Disorder, Major/physiopathology*
  2. Fulltext Diabetes in Pregnancy and Risk of Antepartum Depression: A Systematic Review and Meta-Analysis of Cohort Studies
    Lee KW, Ching SM, Devaraj NK, Chong SC, Lim SY, Loh HC, et al.
    Int J Environ Res Public Health, 2020 05 26;17(11).
    PMID: 32466479 DOI: 10.3390/ijerph17113767
    Previous literature has reported that patients with diabetes in pregnancy (DIP) are at risk of developing antepartum depression but the results have been inconsistent in cohort studies. We conducted a systematic review and performed a meta-analysis to quantify the association between DIP and risk of antepartum depression in cohort studies. Medline, Cinahl, and PubMed databases were searched for studies investigating DIP involving pregnant women with pre-existing diabetes and gestational diabetes mellitus and their risk of antepartum depression that were published in journals from inception to 27 December 2019. We derived the summary estimates using a random-effects model and reported the findings as pooled relative risks (RR) and confidence interval (CI). Publication bias was assessed using a funnel plot and was quantified by Egger and Begg's tests. Ten studies, involving 71,036 pregnant women were included in this meta-analysis. The pooled RR to develop antepartum depression was (RR = 1.430, 95% CI: 1.251-1.636) among women with gestational diabetes mellitus. Combining pregnant women with pre-existing diabetes mellitus and gestational diabetes mellitus, they had a significant increased risk of developing antepartum depression (RR = 1.431, 95% CI: 1.205-1.699) compared with those without it. In comparison, we found no association between pre-existing diabetes mellitus in pregnancy (RR = 1.300, 95% CI: 0.736-2.297) and the risk of developing antepartum depression. This study has a few limitations: first, different questionnaire and cut-off points were used in evaluation of depression across the studies. Second, there was a lack of data on history of depression prior to pregnancy, which lead to confounding bias that could not be solved by this meta-analysis. Third, data were dominated by studies in Western countries; this is due to the studies from Eastern countries failing to meet our inclusion criteria for statistical analysis. Women with gestational diabetes mellitus have an increased risk of developing antepartum depression compared to those without the disease. Therefore, more attention on the mental health status should be given on pregnant women diagnosed with pre-existing diabetes mellitus and gestational diabetes mellitus.
    Matched MeSH terms: Depressive Disorder, Major*
  3. Fulltext Predictors of recurrence of major depressive disorder
    Lye MS, Tey YY, Tor YS, Shahabudin AF, Ibrahim N, Ling KH, et al.
    PLoS One, 2020;15(3):e0230363.
    PMID: 32191745 DOI: 10.1371/journal.pone.0230363
    A total of 201 patients with major depressive disorder from four hospitals in Malaysia were followed up for 5 years to determine the prognostic factors of recurrent major depressive disorder that could potentially contribute to improving the management of MDD patients. For each individual patient, at the time of recruitment as part of a case-control study, information was collected on recent threatening life events, personality and social and occupational functioning, while blood samples were collected to genotype single nucleotide polymorphisms of vitamin D receptor (VDR), zinc transporter-3 (ZnT3), dopamine transporter-1 (DAT1), brain-derived neurotropic factor (BDNF), serotonin receptor 1A (HT1A) and 2A (HT2A) genes. Kaplan-Meier and Cox-regression were used to estimate hazard functions for recurrence of major depressive disorder. Individuals with severe MDD in previous major depressive episodes had five and a half times higher hazard of developing recurrence compared to mild and moderate MDD (HR = 5.565, 95% CI = 1.631-18.994, p = 0.006). Individuals who scored higher on social avoidance had three and a half times higher hazard of recurrence of MDD (HR = 3.525, 95% CI = 1.349-9.209; p = 0.010). There was significant interaction between ApaI +64978C>A single nucleotide polymorphism and severity. The hazard ratio increased by 6.4 times from mild and moderate to severe MDD for A/A genotype while that for C/A genotype increased by 11.3 times. Social avoidance and severity of depression at first episode were prognostic of recurrence. Screening for personality factors at first encounter with MDD patients needs to be considered as part of the clinical practice. For those at risk of recurrence in relation to social avoidance, the psychological intervention prescribed should be customized to focus on this modifiable factor. Prompt and appropriate management of severe MDD is recommended to reduce risk of recurrence.
    Matched MeSH terms: Depressive Disorder, Major/diagnosis*; Depressive Disorder, Major/genetics
  4. Fulltext Working Memory From the Psychological and Neurosciences Perspectives: A Review
    Chai WJ, Abd Hamid AI, Abdullah JM
    Front Psychol, 2018;9:401.
    PMID: 29636715 DOI: 10.3389/fpsyg.2018.00401
    Since the concept of working memory was introduced over 50 years ago, different schools of thought have offered different definitions for working memory based on the various cognitive domains that it encompasses. The general consensus regarding working memory supports the idea that working memory is extensively involved in goal-directed behaviors in which information must be retained and manipulated to ensure successful task execution. Before the emergence of other competing models, the concept of working memory was described by the multicomponent working memory model proposed by Baddeley and Hitch. In the present article, the authors provide an overview of several working memory-relevant studies in order to harmonize the findings of working memory from the neurosciences and psychological standpoints, especially after citing evidence from past studies of healthy, aging, diseased, and/or lesioned brains. In particular, the theoretical framework behind working memory, in which the related domains that are considered to play a part in different frameworks (such as memory's capacity limit and temporary storage) are presented and discussed. From the neuroscience perspective, it has been established that working memory activates the fronto-parietal brain regions, including the prefrontal, cingulate, and parietal cortices. Recent studies have subsequently implicated the roles of subcortical regions (such as the midbrain and cerebellum) in working memory. Aging also appears to have modulatory effects on working memory; age interactions with emotion, caffeine and hormones appear to affect working memory performances at the neurobiological level. Moreover, working memory deficits are apparent in older individuals, who are susceptible to cognitive deterioration. Another younger population with working memory impairment consists of those with mental, developmental, and/or neurological disorders such as major depressive disorder and others. A less coherent and organized neural pattern has been consistently reported in these disadvantaged groups. Working memory of patients with traumatic brain injury was similarly affected and shown to have unusual neural activity (hyper- or hypoactivation) as a general observation. Decoding the underlying neural mechanisms of working memory helps support the current theoretical understandings concerning working memory, and at the same time provides insights into rehabilitation programs that target working memory impairments from neurophysiological or psychological aspects.
    Matched MeSH terms: Depressive Disorder, Major
  5. Fulltext A preliminary study on the specificity and sensitivity values and inter-rater reliability of MINI International Neuropsychiatric Interview (MINI) in Malaysia
    Mukhtar F, Abu Bakar AK, Mat Junus M, Awaludin A, Abdul Aziz S, Midin M, et al.
    ASEAN Journal of Psychiatry, 2012;13(2):157-164.
    MyJurnal
    Objective: The MINI International Neuropsychiatric Interview (MINI) is a short, structured diagnostic interview compatible with the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). It was designed for clinical practice, research in psychiatric, primary care settings and epidemiological surveys. This preliminary study aims to evaluate the reliability and validity of the Malaysian Version of MINI for Major Depressive Disorder and Generalized Anxiety Disorder symptoms criteria only.

    Methods: Six hours of MINI training was given as part of a National Health Morbidity Survey training program for layman interviewers (n=229) and three videos were prepared by an expert psychiatrist for inter-rater reliability purposes. Meanwhile, for validity purposes, the MINI was administered to patients with Major Depressive Disorder (n=30), Generalized Anxiety Disorder (n=20) and to a normal population (n=60), to conform against the Diagnostic and Statistical Manual of Mental Disorder (DSM-IV) that was administered by psychiatrists.

    Results: Overall the inter-rater reliability was satisfactory (0.67 to 0.85) and the concordance between the MINI’s and expert diagnoses was good, with kappa values of greater than 0.88.

    Conclusions: The Malay version of the MINI is adjusted to the clinical setting and for the assessment of positive cases in a community setting. Modifications were highlighted to correct any identified problems and to improve the reliability of the MINI for future research and clinical use.
    Matched MeSH terms: Depressive Disorder, Major
  6. Fulltext A Comparison of Insight in Schizophrenia, Bipolar Affective Disorder with Psychosis and Major Depressive Disorder with Psychosis
    Sharmilla, K., Ahmad, H.S.
    Malaysian Journal of Psychiatry, 2006;14(1):35-40.
    MyJurnal
    Objective: The objective of the study is to compare insight in Schizophrenia, bipolar affective disorder with psychosis and major depressive disorder with psychosis. Also to ascertain if impaired insight is associated with poorer psychosocial function. Method: 90 consecutively'admitted patients who were diagnosed with Schizophrenia, bipolar affective disorder with psychosis and major depressive disorder with psychosis were administered the scale to assess unawareness to mental illness to measure insight, the global assessment of function to measure psychosocial function and the brief psychiatric rating scale to measure psychosis.

    Results: Schizophrenia was found to be associated wit h the poorest insight compared to the affective disorders. Major depression with psychosis was found to be associated with better insight than bipolar affective disorder. Results being significant in both cases. Also it was noted that there was a negative correlation between insight and psychosocial function.

    Conclusion: We can conclude that Schizophrenics have the poorest insight followed by bipolar affective disorder with psychosis and then major depressive disorder with psychosis. We also infer that Schizophrenics have the poorest psychosocial function followed by bipolar affective disorder with psychosis and then major depressive disorder patients with psychosis. Also impaired insight is associated with impaired function.
    Matched MeSH terms: Depressive Disorder, Major
  7. Fulltext Post Stroke Laughter – A Case Report
    Amarpreet, K., Nor Zuraida, Z., Ng, C.G., Aida, S.A.
    Malaysian Journal of Psychiatry, 2008;17(2):1-5.
    MyJurnal
    Pathological laughing or crying (PLC) were recognized after the occurrence of stroke, with a prevalence of 15% to 18%. There is no apparent triggering stimulus, and is often misdiagnosed as a mood disorder as it is a disorder of emotional expression rather than a primary disturbance of feeling. We reported a case of a 32 year old lady, who presented with giddiness and altered consciousness progressing to fever and neck stiffness, who’s CT showed a massive left cerebellar infarct. No risk factors were identified. Psychiatrically, she developed sudden crying spells after one month and a diagnosis of Major Depressive Disorder was made with subsequent commencement of anti-depressants. A week later, she developed continuous inappropriate laughter without the feeling of elation, which was beyond her control. There were no symptoms of mania or psychosis.
    Matched MeSH terms: Depressive Disorder, Major
  8. Fulltext Anorexia nervosa with comorbid borderline personality disorder, major depression and homosexuality in a young Malay man: a case report
    Osman Che Bakar, Ainsah Omar
    ASEAN Journal of Psychiatry, 2008;9(2):126-128.
    MyJurnal
    We aimed to report the first case of anorexia nervosa in a young Malaysian Malay homosexual man with underlying borderline personality disorder and major depression. Patient and parents were interviewed. The Structured Clinical Interview for DSM IV was used to generate Axis-I diagnosis. The Hamilton Depressive Rating Scale was used to assess the severity of depression. His parents had marital discord. His father was overinvolved. Regarding anorexia nervosa, he had 163 cm height, 46kg weight and a body mass index (BMI) of 17 kg/m2. His four limbs had multiple scratch marks. Laboratory test results showed anemia, leukocytosis and hypoalbuminemia. Family pathology, borderline personality disorder and homosexuality could be the risk factors of anorexia nervosa in this patient.
    Matched MeSH terms: Depressive Disorder, Major
  9. High prevalence of hypokalemia after acute acetaminophen overdose: impact of psychiatric illness
    Zyoud SH, Awang R, Syed Sulaiman SA, Al-jabi SW
    Hum Exp Toxicol, 2010 Sep;29(9):773-8.
    PMID: 20144962 DOI: 10.1177/0960327110361759
    Hypokalemia is not an isolated disease but an associated finding in a number of different diseases. It is also a commonly neglected condition among patients with acute acetaminophen overdose.
    Matched MeSH terms: Depressive Disorder, Major/blood; Depressive Disorder, Major/complications
  10. Fulltext Examining the relationship between adherence and satisfaction with antidepressant treatment
    Aljumah K, Ahmad Hassali A, AlQhatani S
    Neuropsychiatr Dis Treat, 2014;10:1433-8.
    PMID: 25120364 DOI: 10.2147/NDT.S67008
    Adherence to antidepressant treatment is an essential step in the management of patients with major depressive disorder, and several factors can contribute to antidepressant nonadherence. Evidence supports the hypothesis that patient treatment satisfaction will result in improved adherence; therefore, the aim of this study was to investigate the relationship between patient treatment satisfaction and adherence to antidepressants, and the role of patient beliefs toward medication in patient treatment satisfaction.
    Matched MeSH terms: Depressive Disorder, Major
  11. Fulltext Manic switch on mirtazapine: a case report
    Khairani Yahya, Azizah Saie
    Malaysian Journal of Psychiatry, 2018;27(1):0-0.
    MyJurnal
    In recent years, more cases of manic switches on Mirtazapine have been reported. In this report, we discuss a case of manic switch in a gentleman who was treated as unipolar depression. A 66-year-old man presented to psychiatry 8 months following a nephrectomy for symptoms of depression. Treatment with Sertraline 50mg daily was initiated and titrated to 150mg, along with Zolpidem and Clonazepam to aid his sleep. Despite these medications he never achieved remission and continued to have persistent anxiety and insomnia. Due to suboptimal control, treatment was changed to Mirtazapine 15mg daily. At day 20 he showed symptoms of mania which included talkativeness, increased goal directed activities, reduced need for sleep and socially disinhibited behavior. Mirtazapine was discontinued, and treatment was changed to Sodium Valproate, optimized to 1000mg daily, augmented with Quetiapine 150mg daily. Remission was achieved after 4 months and he has remained asymptomatic for 2 months. This was his first episode of mania, and a diagnosis of Bipolar I disorder was made. In conclusion, antidepressant induced manic switches are common, they are relatively under-appreciated and under-reported, especially with the use of sleep-promoting antidepressants. All antidepressants should be considered to be a potential mediator of a switch in view of its pharmacological properties.
    Matched MeSH terms: Depressive Disorder, Major
  12. Fulltext Managing ‘schizophrenia in the midst of schizophrenia’- the role of assertive community treatment
    Ahmad Nabil, M.R., Marhani, M., Azlin, B.
    Medicine & Health, 2014;9(2):139-142.
    MyJurnal
    This case report emphasizes the role of Assertive Community Treatment (ACT) in managing a family with four members suffering from mental illness, mainly schizophrenia. We report a case of middle-aged lady who was diagnosed with treatment resistant schizophrenia (TRS) living with two other family members with the same illness and their carer who developed major depression from shouldering the burden of caring for mentally ill family members. ACT, through its holistic approach, proved to have reduced hospitalizations and improve symptom control and quality of life in this family.
    Matched MeSH terms: Depressive Disorder, Major
  13. Fulltext The psychological impact of diabetic limb problems
    Bahari R
    International Medical Journal Malaysia, 2015;14(2):3-8.
    MyJurnal
    Limb problem is a common complication for patients with diabetes. While the impact of diabetic limb problems
    on physical health is well known, the psychological impact of the condition is still largely unknown. People with
    diabetes with or without foot ulcers frequently suffer from major depressive disorder, and this is made worse
    by the presence of limb complications. Furthermore, depression itself can have negative consequences on the
    person’s diabetes. Hence, in caring for people with diabetic foot problem, the psychological sequelae must not
    be overlooked but managed accordingly
    Matched MeSH terms: Depressive Disorder, Major
  14. Fulltext Coping styles in patients with haematological cancer in a Malaysian hospital
    Priscilla D, Hamidin A, Azhar MZ, Noorjan KO, Salmiah MS, Bahariah K
    East Asian Arch Psychiatry, 2011 Jun;21(2):44-51.
    PMID: 21838206
    Objectives: To determine the relationship between major depressive disorder, anxiety disorders and the quality of life of haematological cancer patients.
    Methods: This cross-sectional study was conducted at Ampang Hospital Kuala Lumpur, Malaysia, a tertiary referral centre hospital for haematological cancer. The Mini-International Neuropsychiatric Interview was used for the diagnosis of major depressive disorder and anxiety disorders. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire was utilised to measure patients’ quality of life.
    Results: A total of 105 haematological cancer patients ere included in the study with response rate of 100%. Major depressive disorder correlated with almost all domains of the quality of life, except the pain scores. Logistic regression showed that insomnia and financial difficulties were related to major depressive disorder. Different anxiety disorders also correlated with quality of life in specific domains. The leading anxiety disorders that correlated mostly with quality﹣of life scales were generalised anxiety disorder, followed by obsessive-compulsive disorder, social anxiety disorder, as well as post-traumatic stress disorder and panic disorder with agoraphobia (p < 0.05).
    Conclusions: Psychological treatment along with medication and intervention should be implemented to improve the overall quality of life and psychiatric disorder symptoms among the haematological cancer patients.
    Key words: Anxiety; Depression; Hematologic neoplasms; Quality of life
    Matched MeSH terms: Depressive Disorder, Major/complications; Depressive Disorder, Major/psychology
  15. Fulltext Assessment of depression and anxiety in haematological cancer patients and their relationship with quality of life
    Priscilla D, Hamidin A, Azhar MZ, Noorjan KO, Salmiah MS, Bahariah K
    East Asian Arch Psychiatry, 2011 Sep;21(3):108-14.
    PMID: 21921304
    Objectives: To determine the relationship between major depressive disorder, anxiety disorders and the quality of life of haematological cancer patients.
    Methods: This cross-sectional study was conducted at Ampang Hospital Kuala Lumpur, Malaysia, a tertiary referral centre hospital for haematological cancer. The Mini-International Neuropsychiatric Interview was used for the diagnosis of major depressive disorder and anxiety disorders. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire was utilised to measure patients’ quality of life.
    Results: A total of 105 haematological cancer patients were included in the study with response rate of 100%. Major depressive disorder correlated with almost all domains of the quality of life, except the pain scores. Logistic regression showed that insomnia and financial difficulties were related to major depressive disorder. Different anxiety disorders also correlated with quality of life in specific domains. The leading anxiety disorders that correlated mostly with quality of life scales were generalised anxiety disorder, followed by obsessive-compulsive disorder, social anxiety disorder, as well as post-traumatic stress disorder and panic disorder with agoraphobia (p < 0.05).
    Conclusions: Psychological treatment along with medication and intervention should be implemented to
    improve the overall quality of life and psychiatric disorder symptoms among the haematological cancer
    patients.
    Key words: Anxiety; Depression; Hematologic neoplasms; Quality of life
    Matched MeSH terms: Depressive Disorder, Major/epidemiology*; Depressive Disorder, Major/psychology*
  16. Fulltext Depression and quality of life among patients with hematological cancer in a Malaysian hospital
    Priscilla, D., Hamidin, A., Azhar, M. Z., Noorjan, K. O. N., Salmiah, M. S., Bahariah, K.
    Malaysian Journal of Medicine and Health Sciences, 2011;7(1):65-74.
    MyJurnal
    Objective: To determine the prevalence of major depressive disorder (MDD) in hematological cancer patients and to investigate MDD with quality of life. Methods: The research, which uses a cross sectional design, has been carried out at Ampang Hospital, Kuala Lumpur. The hospital is a tertiary referral center for cancer cases that include non-Hodgkin lymphoma, acute myelogenous leukemia, acute lymphoblastic leukemia, Hodgkin lymphoma and other hematological cancers. In total, 105 patients with hematological malignancies were included in the study. This study employed the MINI International Neuropsychiatric Interview for diagnosis of MDD, the Patient Health Questionnaire (PHQ-9) for symptom severity of depression and the European Organisation for Research and Treatment of Cancer Quality Of Life questionnaire (EORTC QLQ-C30) to assess the quality of life of the respondents. Result: The response rate was 83.3%. The prevalence of MDD was 24.8% (n=26) with the majority of cases classified as moderately severe depression (38.5%). About 92.3% (n=24) of depressed hematological cancer patients were diagnosed with a current episode of MDD. The depressed patients also had significantly reduced quality of life in physical, role, emotional, cognitive and social domains (p
    Matched MeSH terms: Depressive Disorder, Major
  17. Clinical depression while caring for loved ones with breast cancer
    Nik Jaafar NR, Selamat Din SH, Mohamed Saini S, Ahmad SN, Midin M, Sidi H, et al.
    Compr Psychiatry, 2014 Jan;55 Suppl 1:S52-9.
    PMID: 23706655 DOI: 10.1016/j.comppsych.2013.03.003
    The period of the cancer patients undergoing treatment is also the most stressful time for their family caregivers. This study aimed to determine the rates of major depressive disorder and dysthymia; and their associated factors in the caregivers during this time.

    Study site: Oncology centre, Pusat Perubatan Universiti Kebangsaan Malaysia
    Matched MeSH terms: Depressive Disorder, Major/etiology; Depressive Disorder, Major/epidemiology; Depressive Disorder, Major/psychology*
  18. Mirtazapine for anorexia nervosa with depression
    Jaafar NR, Daud TI, Rahman FN, Baharudin A
    Aust N Z J Psychiatry, 2007 Sep;41(9):768-9.
    PMID: 17687663
    To report the use of Mirtazapine in the treatment of anorexia nervosa with depression primarily regarding its propensity for weight gain.
    Matched MeSH terms: Depressive Disorder, Major/drug therapy*
  19. Fulltext The Accuracy of the Patient Health Questionnaire-9 Algorithm for Screening to Detect Major Depression: An Individual Participant Data Meta-Analysis
    He C, Levis B, Riehm KE, Saadat N, Levis AW, Azar M, et al.
    Psychother Psychosom, 2020;89(1):25-37.
    PMID: 31593971 DOI: 10.1159/000502294
    BACKGROUND: Screening for major depression with the Patient Health Questionnaire-9 (PHQ-9) can be done using a cutoff or the PHQ-9 diagnostic algorithm. Many primary studies publish results for only one approach, and previous meta-analyses of the algorithm approach included only a subset of primary studies that collected data and could have published results.

    OBJECTIVE: To use an individual participant data meta-analysis to evaluate the accuracy of two PHQ-9 diagnostic algorithms for detecting major depression and compare accuracy between the algorithms and the standard PHQ-9 cutoff score of ≥10.

    METHODS: Medline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, Web of Science (January 1, 2000, to February 7, 2015). Eligible studies that classified current major depression status using a validated diagnostic interview.

    RESULTS: Data were included for 54 of 72 identified eligible studies (n participants = 16,688, n cases = 2,091). Among studies that used a semi-structured interview, pooled sensitivity and specificity (95% confidence interval) were 0.57 (0.49, 0.64) and 0.95 (0.94, 0.97) for the original algorithm and 0.61 (0.54, 0.68) and 0.95 (0.93, 0.96) for a modified algorithm. Algorithm sensitivity was 0.22-0.24 lower compared to fully structured interviews and 0.06-0.07 lower compared to the Mini International Neuropsychiatric Interview. Specificity was similar across reference standards. For PHQ-9 cutoff of ≥10 compared to semi-structured interviews, sensitivity and specificity (95% confidence interval) were 0.88 (0.82-0.92) and 0.86 (0.82-0.88).

    CONCLUSIONS: The cutoff score approach appears to be a better option than a PHQ-9 algorithm for detecting major depression.

    Matched MeSH terms: Depressive Disorder, Major/diagnosis*
  20. Malaysian Moslem mothers' experience of depression and service use
    Abdul Kadir NB, Bifulco A
    Cult Med Psychiatry, 2010 Sep;34(3):443-67.
    PMID: 20549550 DOI: 10.1007/s11013-010-9183-x
    Standard psychiatric criteria for depression developed in the United States and United Kingdom are increasingly used worldwide to establish the prevalence of clinical disorders and to help develop services. However, these approaches are rarely sensitive to local and cultural expressions of symptoms or beliefs about treatment. Mismatch between diagnostic criteria and local understanding may result in underreporting of depression and underutilization of services. Little such research has been conducted in Malaysia, despite the acknowledged high rate of depression and low access to services. This study examines depression in Moslem Malay women living in Johor Bahru, Southern Peninsular Malaysia, to explore depression symptoms using the Structured Clinical Interview for DSM-IV. The 61 women interviewed were selected on the basis of high General Health Questionnaire scores from a large questionnaire survey of 1,002 mothers. The illustrative analysis looks at descriptions of depressed mood, self-depreciation and suicidal ideation, as well as attitudes toward service use. The women gave full and open descriptions of their emotional symptoms, easily recognizable by standard symptom categories, although somatic symptoms were commonly included, and the spiritual context to understanding depression was also prevalent. However, few women had knowledge about treatment or sought medical services, although some sought help from local spiritual healers. Attending to such views of depression can help develop services in Malaysia.
    Matched MeSH terms: Depressive Disorder, Major/diagnosis; Depressive Disorder, Major/drug therapy; Depressive Disorder, Major/ethnology*; Depressive Disorder, Major/psychology
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