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  1. Fulltext Functional impairment as a proxy measure indicating high rates of trauma exposure, post-migration living difficulties, common mental disorders, and poor health amongst Rohingya refugees in Malaysia
    Tay AK, Rees S, Miah MAA, Khan S, Badrudduza M, Morgan K, et al.
    Transl Psychiatry, 2019 09 02;9(1):213.
    PMID: 31477686 DOI: 10.1038/s41398-019-0537-z
    A major challenge in the refugee field is to ensure that scarce mental health resources are directed to those in greatest need. Based on data from an epidemiological survey of 959 adult Rohingya refugees in Malaysia (response rate: 83%), we examine whether a brief screening instrument of functional impairment, the WHO Disability Assessment Schedule (WHODAS), prove useful as a proxy measure to identify refugees who typically attend community mental health services. Based on estimates of mental disorder requiring interventions from analyses of epidemiological studies conducted worldwide, we selected a WHODAS cutoff that identified the top one-fifth of refugees according to severity of functional impairment, the remainder being distributed to moderate and lower impairment groupings, respectively. Compared to the lower impairment grouping, the severe impairment category comprised more boat arrivals (AOR: 5.96 [95% CI 1.34-26.43); stateless persons (A20·11 [95% CI 7.14-10); those with high exposure to pre-migration traumas (AOR: 4.76 [95% CI 1.64-13.73), peri-migration stressors (AOR: 1.26 [95% CI 1.14-1.39]) and postmigration living difficulties (AOR: 1.43 [95% CI 1.32-1.55); persons with single (AOR: 7.48 [95% CI 4.25-13.17]) and comorbid (AOR: 13.54 [95% CI 6.22-29.45]) common mental disorders; and those reporting poorer general health (AOR: 2.23 [95% CI 1-5.02]). In addition, half of the severe impairment grouping (50.6%) expressed suicidal ideas compared to one in six (16.2 percent) of the lower impairment grouping (OR: 2.39 [95% CI 1.94-2.93]). Differences between the severe and moderate impairment groups were similar but less extreme. In settings where large-scale epidemiological studies are not feasible, the WHODAS may serve as readily administered and brief public health screening tool that assists in stratifying the population according to urgency of mental health needs.
    Matched MeSH terms: Stress, Psychological/diagnosis*
  2. Fulltext Reliability and validity of job content questionnaire for university research laboratory staff in Malaysia
    Nehzat F, Huda BZ, Tajuddin SH
    Southeast Asian J. Trop. Med. Public Health, 2014 Mar;45(2):481-9.
    PMID: 24968690
    Job Content Questionnaire (JCQ) has been proven a reliable and valid instrument to assess job stress in many countries and among various occupations. In Malaysia, both English and Malay versions of the JCQ have been administered to automotive workers, schoolteachers, and office workers. This study assessed the reliability and validity of the instrument with research laboratory staff in a university. A cross sectional study was conducted among 258 research laboratory staff in Universiti Putra Malaysia (UPM). Malaysian laboratory staff who have worked for at least one year were randomly selected from nine faculties and institutes in the university that have research laboratory. A self-administered English and Malay version of Job Content Questionnaire (JCQ) was used. Three major scales of JCQ: decision latitude, psychological job demands, and social support were assessed. Cronbach's alpha coefficients of two scales were acceptable, decision latitude and psychological job demands (0.70 and 0.72, respectively), while Cronbach's alpha coefficient for social support (0.86) was good. Exploratory factor analysis showed five factors that correspond closely to the theoretical construct of the questionnaire. The results of this research suggest that the JCQ is reliable and valid for examining psychosocial work situations and job strain among research laboratory staff. Further studies should be done for confirmative results, and further evaluation is needed on the decision authority subscale for this occupation.
    Matched MeSH terms: Stress, Psychological/diagnosis*
  3. Fulltext Reliability and validity of the Pressure Management Inventory in a Malaysian population
    Loh SY
    Med J Malaysia, 2004 Jun;59(2):199-206.
    PMID: 15559170 MyJurnal
    There is a general lack of valid tools to measure work stress of Malaysian. This study examines the validity and reliability of the Pressure Management Inventory (PMI). Reliability was evaluated using test retest method, and its correlation coefficient was calculated using Pearson's r. Internal consistencies were examined using Cronbach's Alpha. For precision, the Intraclass coefficients (ICC) were calculated for all the scales. Face Validity and Content Validity were assessed using an open-ended questionnaire on 6 content experts (psychiatrists in HKL). The results show good internal consistencies (alpha < or = 0.7) for most subscales, with the best results in the 'Pressure Scale'. The weak scales are 'Individual-Differences' scale and 'Social Support' scale. The test-retest correlation coefficients were significant at the level of p<0.001 for all, except one scale. The ICC coefficients were high (>0.7) for most scales, particularly for Pressure, Health and Coping Scales. The PMI is a suitable, reliable and valid tool to measure stress of Malaysians. More in-depth study with a wider sampling needs to be carried out to add confidence of its usage on Malaysians.
    Matched MeSH terms: Stress, Psychological/diagnosis*
  4. Fulltext Prevalence and associated factors of job-related depression in laboratory technicians in Hospital Universiti Sains Malaysia (HUSM) and Ministry of Health Malaysia (MOH) Hospitals in Kelantan
    Aziah BD, Rusli BN, Winn T, Naing L, Tengku MA
    Med J Malaysia, 2004 Jun;59(2):268-78.
    PMID: 15559179
    Karasek's job strain model postulates that workers chronically exposed to adverse psychosocial work environment (high strain job)--high psychological job demands and low job control, including poor social support, increased physical demand and hazardous work condition--will eventually develop both physical illnesses such as cardiovascular diseases and psychological disorders such as depression. In order to determine the prevalence and associated factors of job-related depression, a cross-sectional study was conducted among laboratory technicians in Hospital Universiti Sains Malaysia (HUSM) and Kementerian Kesihatan Malaysia (KKM) Hospitals in Kelantan between September 2001 and February 2002. One hundred and two laboratory technicians in HUSM and 79 laboratory technicians in 7 KKM Hospitals were selected; 84/102 (82.4%) in HUSM and 71/79 (89.9%) in KKM Hospitals responded. Data was collected using self-administered questionnaires of the validated Malay version of the Job Content Questionnaire (JCQ) originally developed by Robert Karasek. Results indicated that the prevalence of high job strain in laboratory technicians in HUSM and KKM hospitals was 33.3% (28/84) and 26.8% (19/71), respectively (p>0.05). Significantly higher proportion (59.5%) (50/84) of laboratory technicians in HUSM compared to those in KKM Hospitals (39.4%) (28/71) (p = 0.016) experienced job-related depression. Significant associated factors of job-related depression were low social support (HUSM: adjusted OR 4.7, 95% CI 1.2-18.8; KKM: adjusted OR 14.8, 95%CI 2.4-89.3), high psychological demand (HUSM: adjusted OR 3.0, 95%CI 1.0-8.8), and low decision authority (KKM: adjusted OR 9.7, 95%CI 1.0-91.1). We conclude that strengthening the social support network (supervisors' and coworkers' support), reducing psychological job demand, and increasing decision-making authority of laboratory technicians may go a long way towards reducing job-related depression.
    Matched MeSH terms: Stress, Psychological/diagnosis
  5. Fulltext Stress among parents with acutely ill children
    Nizam M, Norzila MZ
    Med J Malaysia, 2001 Dec;56(4):428-34.
    PMID: 12014761
    Objectives: A child's admission into intensive care is a major cause of stress for parents. However among Malaysian parents, data concerning the perception of stress are virtually absent. Therefore we conducted a study to measure the reliability of the Malay version of Parental Stressor Scale: Pediatric Intensive Care Unit (PSS: PICU) in identifying sources of stress and to study factors that might influence their stress response.
    Methods: Over a six-month period, one hundred and twelve parents were requested to answer the questionnaires twice either in Malay or English, a week apart. Spearman's correlation and Cronbach's alpha coefficient was used to assess the repeatability and internal consistency of the questionnaires.
    Results: Ninety-four (83.9%) and seventy-one (75.3%) parents responded to the first and second administration of questionnaire respectively. All answered in the Malay language except for three. The correlation ranged from 0.50 to 0.71 with a total score of 0.76. The Cronbach's alpha coefficient ranged from 0.75 to 0.93, with total a score of 0.95.
    Alteration in parental roles was the most stressful source of stress. Fathers, parents of children with higher PRISM score and parents with no previous admission into intensive care unit scored significantly higher in staff’s communication.
    Conclusion: The Malay version of PSS: PICU is reliable in identifying sources of stress. Alteration in parental roles was the most stressful source of stress. Parents' gender, previous experience and severity of the child illness may influence their stress responses.
    Matched MeSH terms: Stress, Psychological/diagnosis*
  6. Construct validity and internal consistency reliability of the Malay version of the 21-item depression anxiety stress scale (Malay-DASS-21) among male outpatient clinic attendees in Johor
    Rusli BN, Amrina K, Trived S, Loh KP, Shashi M
    Med J Malaysia, 2017 10;72(5):264-270.
    PMID: 29197880 MyJurnal
    BACKGROUND: The 21-item English version of the Depression Anxiety Stress Scale (DASS-21) has been proposed as a method for assessing self-perceived depression, anxiety and stress over the past week in various clinical and nonclinical populations. Several Malay versions of the DASS-21 have been validated in various populations with varying success. One particular Malay version has been validated in various occupational groups (such as nurses and automotive workers) but not among male clinic outpatient attendees in Malaysia.

    OBJECTIVE: To validate the Malay version of the DASS-21 (Malay-DASS-21) among male outpatient clinic attendees in Johor.

    METHODS: A validation study with a random sample of 402 male respondents attending the outpatient clinic of a major public outpatient clinic in Johor Bahru and Segamat was carried out from January to March 2016. Construct validity of the Malay-DASS-21 was examined using Exploratory Factor Analysis (KMO = 0.947; Bartlett's test of sphericity is significant, p<0.001) through Principal Component Analysis and orthogonal (varimax) rotation with Kaiser Normalization to confirm the psychometric properties of the Malay-DASS- 21 and the internal consistency reliability using Cronbach's alpha.

    RESULTS: Construct validity of the Malay-DASS-21 based on eigenvalues and factor loadings to confirm the three factor structure (depression, anxiety, and stress) was acceptable. The internal consistency reliability of the factor construct was very impressive with Cronbach's alpha values in the range of 0.837 to 0.863.

    CONCLUSIONS: The present study showed that the Malay- DASS-21 has acceptable psychometric construct and high internal consistency reliability to measure self-perceived depression, anxiety and stress over the past week in male outpatient clinic attendees in Johor. Further studies are necessary to revalidate the Malay-DASS-21 across different populations and cultures, and using confirmatory factor analyses.

    Matched MeSH terms: Stress, Psychological/diagnosis*
  7. Fulltext EEG Mental Stress Assessment Using Hybrid Multi-Domain Feature Sets of Functional Connectivity Network and Time-Frequency Features
    Hag A, Handayani D, Pillai T, Mantoro T, Kit MH, Al-Shargie F
    Sensors (Basel), 2021 Sep 20;21(18).
    PMID: 34577505 DOI: 10.3390/s21186300
    Exposure to mental stress for long period leads to serious accidents and health problems. To avoid negative consequences on health and safety, it is very important to detect mental stress at its early stages, i.e., when it is still limited to acute or episodic stress. In this study, we developed an experimental protocol to induce two different levels of stress by utilizing a mental arithmetic task with time pressure and negative feedback as the stressors. We assessed the levels of stress on 22 healthy subjects using frontal electroencephalogram (EEG) signals, salivary alpha-amylase level (AAL), and multiple machine learning (ML) classifiers. The EEG signals were analyzed using a fusion of functional connectivity networks estimated by the Phase Locking Value (PLV) and temporal and spectral domain features. A total of 210 different features were extracted from all domains. Only the optimum multi-domain features were used for classification. We then quantified stress levels using statistical analysis and seven ML classifiers. Our result showed that the AAL level was significantly increased (p < 0.01) under stress condition in all subjects. Likewise, the functional connectivity network demonstrated a significant decrease under stress, p < 0.05. Moreover, we achieved the highest stress classification accuracy of 93.2% using the Support Vector Machine (SVM) classifier. Other classifiers produced relatively similar results.
    Matched MeSH terms: Stress, Psychological/diagnosis
  8. Fulltext Enhancing EEG-Based Mental Stress State Recognition Using an Improved Hybrid Feature Selection Algorithm
    Hag A, Handayani D, Altalhi M, Pillai T, Mantoro T, Kit MH, et al.
    Sensors (Basel), 2021 Dec 15;21(24).
    PMID: 34960469 DOI: 10.3390/s21248370
    In real-life applications, electroencephalogram (EEG) signals for mental stress recognition require a conventional wearable device. This, in turn, requires an efficient number of EEG channels and an optimal feature set. This study aims to identify an optimal feature subset that can discriminate mental stress states while enhancing the overall classification performance. We extracted multi-domain features within the time domain, frequency domain, time-frequency domain, and network connectivity features to form a prominent feature vector space for stress. We then proposed a hybrid feature selection (FS) method using minimum redundancy maximum relevance with particle swarm optimization and support vector machines (mRMR-PSO-SVM) to select the optimal feature subset. The performance of the proposed method is evaluated and verified using four datasets, namely EDMSS, DEAP, SEED, and EDPMSC. To further consolidate, the effectiveness of the proposed method is compared with that of the state-of-the-art metaheuristic methods. The proposed model significantly reduced the features vector space by an average of 70% compared with the state-of-the-art methods while significantly increasing overall detection performance.
    Matched MeSH terms: Stress, Psychological/diagnosis
  9. The relation of childhood trauma to suicide ideation in patients suffering from obsessive-compulsive disorder with lifetime suicide attempts
    Khosravani V, Kamali Z, Jamaati Ardakani R, Samimi Ardestani M
    Psychiatry Res, 2017 09;255:139-145.
    PMID: 28549337 DOI: 10.1016/j.psychres.2017.05.032
    The aim of this study was to evaluate the relations of childhood trauma (CT) and obsessive-compulsive (OC) symptom dimensions to suicide ideation in patients with obsessive-compulsive disorder (OCD). Seventy OCD outpatients with lifetime suicide attempts and 60 controls were included. Participants completed the Scale for Suicide Ideation (SSI), the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). Among OCD patients, 97.1% had current suicide ideation. OCD patients revealed higher scores on CT, suicide ideation, depression and anxiety than controls. The CT history of sexual abuse (SA) and OC symptom dimension of unacceptable thoughts explained suicide ideation. It was concluded that SA and unacceptable thoughts may contribute to high suicidality and have important implications for the assessment and treatment of suicide risk in OCD patients with lifetime suicide attempts.
    Matched MeSH terms: Stress, Psychological/diagnosis
  10. Fulltext The impact of COVID-19 pandemic on physical and mental health of Asians: A study of seven middle-income countries in Asia
    Wang C, Tee M, Roy AE, Fardin MA, Srichokchatchawan W, Habib HA, et al.
    PLoS One, 2021;16(2):e0246824.
    PMID: 33571297 DOI: 10.1371/journal.pone.0246824
    The coronavirus disease (COVID-19) pandemic has impacted the economy, livelihood, and physical and mental well-being of people worldwide. This study aimed to compare the mental health status during the pandemic in the general population of seven middle income countries (MICs) in Asia (China, Iran, Malaysia, Pakistan, Philippines, Thailand, and Vietnam). All the countries used the Impact of Event Scale-Revised (IES-R) and Depression, Anxiety and Stress Scale (DASS-21) to measure mental health. There were 4479 Asians completed the questionnaire with demographic characteristics, physical symptoms and health service utilization, contact history, knowledge and concern, precautionary measure, and rated their mental health with the IES-R and DASS-21. Descriptive statistics, One-Way analysis of variance (ANOVA), and linear regression were used to identify protective and risk factors associated with mental health parameters. There were significant differences in IES-R and DASS-21 scores between 7 MICs (p<0.05). Thailand had all the highest scores of IES-R, DASS-21 stress, anxiety, and depression scores whereas Vietnam had all the lowest scores. The risk factors for adverse mental health during the COVID-19 pandemic include age <30 years, high education background, single and separated status, discrimination by other countries and contact with people with COVID-19 (p<0.05). The protective factors for mental health include male gender, staying with children or more than 6 people in the same household, employment, confidence in doctors, high perceived likelihood of survival, and spending less time on health information (p<0.05). This comparative study among 7 MICs enhanced the understanding of metal health in the general population during the COVID-19 pandemic.
    Matched MeSH terms: Stress, Psychological/diagnosis
  11. Fulltext The Impact of Poor Nutrient Intakes and Food Insecurity on the Psychological Distress among Community-Dwelling Middle-Aged and Older Adults during the COVID-19 Pandemic
    Malek Rivan NF, Yahya HM, Shahar S, Ajit Singh DK, Ibrahim N, Mat Ludin AF, et al.
    Nutrients, 2021 Jan 25;13(2).
    PMID: 33503860 DOI: 10.3390/nu13020353
    This study aimed to investigate the impact of food insecurity and poor nutrient intake on the psychological health of middle-aged and older adults during the COVID-19 pandemic. A sub-sample of 535 individuals aged 52 years and above, from the earlier cohort and interventional studies (n = 4) from four selected states in Peninsular Malaysia, were recruited during the COVID-19 outbreak (April to June 2020). Telephone interviews were conducted by trained interviewers with a health sciences background to obtain participants' information on health status, physical activity, food security, and psychological health (General Health Questionnaire-12; normal and psychological distress). Univariate analyses were performed for each variable, followed by a logistic regression analysis using SPSS Statistics version 25.0. Results revealed food insecurity (OR = 17.06, 95% CI: 8.24-35.32, p < 0.001), low protein (OR = 0.981, 95% CI: 0.965-0.998, p < 0.05), and fiber intakes (OR = 0.822, 95% CI: 0.695-0.972, p < 0.05) were found to be significant factors associated with the psychological distress group after adjusting for confounding factors. The findings suggested that food insecurity and insufficiencies of protein and fiber intakes heightened the psychological distress during the COVID-19 pandemic. Optimal nutrition is vital to ensure the physical and psychological health of the older population, specifically during the current pandemic.
    Matched MeSH terms: Stress, Psychological/diagnosis
  12. Fulltext Genetic Differences in the Immediate Transcriptome Response to Stress Predict Risk-Related Brain Function and Psychiatric Disorders
    Arloth J, Bogdan R, Weber P, Frishman G, Menke A, Wagner KV, et al.
    Neuron, 2015 Jun 03;86(5):1189-202.
    PMID: 26050039 DOI: 10.1016/j.neuron.2015.05.034
    Depression risk is exacerbated by genetic factors and stress exposure; however, the biological mechanisms through which these factors interact to confer depression risk are poorly understood. One putative biological mechanism implicates variability in the ability of cortisol, released in response to stress, to trigger a cascade of adaptive genomic and non-genomic processes through glucocorticoid receptor (GR) activation. Here, we demonstrate that common genetic variants in long-range enhancer elements modulate the immediate transcriptional response to GR activation in human blood cells. These functional genetic variants increase risk for depression and co-heritable psychiatric disorders. Moreover, these risk variants are associated with inappropriate amygdala reactivity, a transdiagnostic psychiatric endophenotype and an important stress hormone response trigger. Network modeling and animal experiments suggest that these genetic differences in GR-induced transcriptional activation may mediate the risk for depression and other psychiatric disorders by altering a network of functionally related stress-sensitive genes in blood and brain.
    Matched MeSH terms: Stress, Psychological/diagnosis
  13. Towards multilevel mental stress assessment using SVM with ECOC: an EEG approach
    Al-Shargie F, Tang TB, Badruddin N, Kiguchi M
    Med Biol Eng Comput, 2018 Jan;56(1):125-136.
    PMID: 29043535 DOI: 10.1007/s11517-017-1733-8
    Mental stress has been identified as one of the major contributing factors that leads to various diseases such as heart attack, depression, and stroke. To avoid this, stress quantification is important for clinical intervention and disease prevention. This study aims to investigate the feasibility of exploiting electroencephalography (EEG) signals to discriminate between different stress levels. We propose a new assessment protocol whereby the stress level is represented by the complexity of mental arithmetic (MA) task for example, at three levels of difficulty, and the stressors are time pressure and negative feedback. Using 18-male subjects, the experimental results showed that there were significant differences in EEG response between the control and stress conditions at different levels of MA task with p values stress level to another level, p values stress levels. In addition, we developed a discriminant analysis method based on multiclass support vector machine (SVM) with error-correcting output code (ECOC). Different stress levels were detected with an average classification accuracy of 94.79%. The lateral index (LI) results further showed dominant right prefrontal cortex (PFC) to mental stress (reduced alpha rhythm). The study demonstrated the feasibility of using EEG in classifying multilevel mental stress and reported alpha rhythm power at right prefrontal cortex as a suitable index.
    Matched MeSH terms: Stress, Psychological/diagnosis*
  14. The Suffering Pictogram: Measuring Suffering in Palliative Care
    Beng TS, Ann YH, Guan NC, Chin LE, Loong LC, Ying NT, et al.
    J Palliat Med, 2017 08;20(8):869-874.
    PMID: 28410449 DOI: 10.1089/jpm.2016.0448
    BACKGROUND: Measuring suffering objectively presents a challenge because suffering is a unique and subjective experience. However, objective tools are of profound importance in the detection and management of suffering in clinical practice for optimal patient care.

    OBJECTIVE: The objective of the study is to assess the psychometric properties of the Suffering Pictogram, a new suffering assessment instrument on a population of palliative care patients.

    DESIGN AND SETTING: This is a validation study conducted at University of Malaya Medical Centre, Kuala Lumpur, Malaysia. Ninety one palliative care patients were recruited. Patients were interviewed with the Suffering Pictogram and FACIT-Sp.

    RESULTS: The median completion time for the Suffering Pictogram was five minutes. The Suffering Pictogram showed good internal consistency, with a Cronbach's alpha of 0.836. The total scores of the Suffering Pictogram correlated strongly and negatively with FACIT-Sp total score (Spearman's Rho = -0.625, p 

    Matched MeSH terms: Stress, Psychological/diagnosis*
  15. Predictors of parenting stress among Malaysian mothers of children with Down syndrome
    Norizan A, Shamsuddin K
    J Intellect Disabil Res, 2010 Nov;54(11):992-1003.
    PMID: 20868445 DOI: 10.1111/j.1365-2788.2010.01324.x
    Having children with intellectual disability can be stressful for most parents. Currently there are very few studies focusing on parenting stress among mothers of children with Down syndrome (DS) in Asia. The present study examined the level of parenting stress experienced by Malaysian mothers of children with DS and evaluated the child and maternal factors that contributed to parenting stress based on Hill's ABC-X Model (Hill 1949).
    Matched MeSH terms: Stress, Psychological/diagnosis*
  16. Testing comparison models of DASS-12 and its reliability among adolescents in Malaysia
    Osman ZJ, Mukhtar F, Hashim HA, Abdul Latiff L, Mohd Sidik S, Awang H, et al.
    Compr Psychiatry, 2014 Oct;55(7):1720-5.
    PMID: 24952938 DOI: 10.1016/j.comppsych.2014.04.011
    OBJECTIVE: The 21-item Depression, Anxiety and Stress Scale (DASS-21) is frequently used in non-clinical research to measure mental health factors among adults. However, previous studies have concluded that the 21 items are not stable for utilization among the adolescent population. Thus, the aims of this study are to examine the structure of the factors and to report on the reliability of the refined version of the DASS that consists of 12 items.
    METHOD: A total of 2850 students (aged 13 to 17 years old) from three major ethnic in Malaysia completed the DASS-21. The study was conducted at 10 randomly selected secondary schools in the northern state of Peninsular Malaysia. The study population comprised secondary school students (Forms 1, 2 and 4) from the selected schools.
    RESULTS: Based on the results of the EFA stage, 12 items were included in a final CFA to test the fit of the model. Using maximum likelihood procedures to estimate the model, the selected fit indices indicated a close model fit (χ(2)=132.94, df=57, p=.000; CFI=.96; RMR=.02; RMSEA=.04). Moreover, significant loadings of all the unstandardized regression weights implied an acceptable convergent validity. Besides the convergent validity of the item, a discriminant validity of the subscales was also evident from the moderate latent factor inter-correlations, which ranged from .62 to .75. The subscale reliability was further estimated using Cronbach's alpha and the adequate reliability of the subscales was obtained (Total=76; Depression=.68; Anxiety=.53; Stress=.52).
    CONCLUSION: The new version of the 12-item DASS for adolescents in Malaysia (DASS-12) is reliable and has a stable factor structure, and thus it is a useful instrument for distinguishing between depression, anxiety and stress.
    Matched MeSH terms: Stress, Psychological/diagnosis*
  17. Association of psychological distress with arm morbidity symptoms in breast cancer survivors: outcomes from the use of PHQ-9 and GAD-7 questionnaires
    Yusof KM, Mohd Sidik S, Mahmud R, Abdullah M, Avery-Kiejda KA, Rosli R
    Breast Cancer, 2023 Sep;30(5):810-819.
    PMID: 37306933 DOI: 10.1007/s12282-023-01475-0
    BACKGROUND: Although higher survival rates of breast cancer are achieved these days, breast cancer survivors are challenged with unwanted side effects from treatment or management that affect physical, functional, and psychological well-being of an individual. This study aimed to assess psychological distress status in Malaysian breast cancer survivors and factors that affected the condition.

    METHODS: A cross-sectional study design was conducted on 162 breast cancer survivors from various breast cancer support groups in Malaysia. Psychological distress status was assessed based on depression and anxiety scores by applying the Malay version of Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7). Both instruments were self-administered along with a set of questionnaires comprising demographic, medical history, quality of life, and upper extremity function assessment. Outcomes from the PHQ-9 and GAD-7 were analyzed for severity level of psychological distress, and its association with relevant variables, arm morbidity symptoms, as well as the duration of cancer survivorship.

    RESULTS: The univariate analysis showed that breast cancer survivors with arm morbidities after breast surgery had a higher score of depression (5.0 vs 4.0, p = 0.011) and anxiety (3.0 vs 1.0, p = 0.026) than those who did not. Besides that, receiving fewer post-rehabilitation treatments (p = 0.049) and having a family history of cancer (p = 0.022) were correlated with higher anxiety level. The level of depression and anxiety was inversely proportionate with quality of life and positively correlated with greater disability of the arm function (p 

    Matched MeSH terms: Stress, Psychological/diagnosis
  18. Fulltext The validity and reliability of the English version of the diabetes distress scale for type 2 diabetes patients in Malaysia
    Chin YW, Lai PS, Chia YC
    BMC Fam Pract, 2017 02 20;18(1):25.
    PMID: 28219325 DOI: 10.1186/s12875-017-0601-9
    BACKGROUND: Several disease specific instruments have been developed to identify and assess diabetes distress. In Malaysia, the Problem Areas in Diabetes Scale has been validated in Malay, but it does not have specific domains to assess the different areas of diabetes-related distress. Hence, we decided to use the Diabetes Distress Scale instead. To date, only the Malay version of the Diabetes Distress Scale has been validated in Malaysia. However, English is widely spoken by Malaysians, and is an important second language in Malaysia. Therefore, our aim was to determine the validity and reliability of the English version of the Diabetes Distress Scale among patients with type 2 diabetes in Malaysia.
    METHODS: The Diabetes Distress Scale was administered to 114 patients with type 2 diabetes, who could understand English, at baseline and 4 weeks later, at a primary care clinic in Malaysia. To assess for convergent validity, the Depression Anxiety Stress Scale was administered at baseline. Discriminative validity was assessed by analysing the total diabetes distress scores of participants with poor (HbA1c > 7.0%) and good glycaemic control (HbA1c ≤ 7.0%).
    RESULTS: The majority of our participants were male 65(57.0%), with a median duration of diabetes of 9.5 years. Exploratory factor analysis showed that the Diabetes Distress Scale had 4 subscales, as per the original Diabetes Distress Scale. The overall Cronbach's α was 0.920 (range = 0.784-0.859 for each subscale). The intraclass correlation ranged from 0.436 to 0.643 for test-retest. The Diabetes Distress Scale subscales were significantly correlated with the different subscales of the Depression Anxiety Stress Scale (spearman's rho range = 0.427-0.509, p 
    Matched MeSH terms: Stress, Psychological/diagnosis*
  19. Depression in the young, parental depression and parenting stress
    Tan S, Rey J
    Australas Psychiatry, 2005 Mar;13(1):76-9.
    PMID: 15777418
    To examine the relationship between depression in children and adolescents, parental depression and parenting stress.
    Matched MeSH terms: Stress, Psychological/diagnosis
  20. Correlates of depression, anxiety and stress among Malaysian university students
    Shamsuddin K, Fadzil F, Ismail WS, Shah SA, Omar K, Muhammad NA, et al.
    Asian J Psychiatr, 2013 Aug;6(4):318-23.
    PMID: 23810140 DOI: 10.1016/j.ajp.2013.01.014
    University students face not only challenges related with independent living, but also academic challenges. This predisposes them to depression, anxiety and stress, which are fairly common.
    Matched MeSH terms: Stress, Psychological/diagnosis*
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