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Fulltext The management of an adolescent with conduct problems in a primary care clinic - a case report

Azimah M, Khairani O

Malays Fam Physician, 2009;4(2-3):88-90.
PMID: 25606170

PURPOSE: To describe the management of mild conduct problems in an adolescent at the primary care level.
CASE REPORT: A 16 year old girl presented with conduct problems with impending school suspension. The cause of her behavioural problems was mainly related to poor parenting skills of her parents and anger in herself. She was successfully managed with counselling and improvement of parenting styles in her parents.
CONCLUSION: This case report illustrates the opportunity for family physicians to manage simple conduct problems at primary care level.
KEYWORDS: Conduct problems; adolescents; anger management; parenting skills

Matched MeSH terms: Conduct Disorder*
Fulltext Deep neural network technique for automated detection of ADHD and CD using ECG signal

Loh HW, Ooi CP, Oh SL, Barua PD, Tan YR, Molinari F, et al.

Comput Methods Programs Biomed, 2023 Nov;241:107775.
PMID: 37651817 DOI: 10.1016/j.cmpb.2023.107775

BACKGROUND AND OBJECTIVE: Attention Deficit Hyperactivity problem (ADHD) is a common neurodevelopment problem in children and adolescents that can lead to long-term challenges in life outcomes if left untreated. Also, ADHD is frequently associated with Conduct Disorder (CD), and multiple research have found similarities in clinical signs and behavioral symptoms between both diseases, making differentiation between ADHD, ADHD comorbid with CD (ADHD+CD), and CD a subjective diagnosis. Therefore, the goal of this pilot study is to create the first explainable deep learning (DL) model for objective ECG-based ADHD/CD diagnosis as having an objective biomarker may improve diagnostic accuracy.
METHODS: The dataset used in this study consist of ECG data collected from 45 ADHD, 62 ADHD+CD, and 16 CD patients at the Child Guidance Clinic in Singapore. The ECG data were segmented into 2 s epochs and directly used to train our 1-dimensional (1D) convolutional neural network (CNN) model.
RESULTS: The proposed model yielded 96.04% classification accuracy, 96.26% precision, 95.99% sensitivity, and 96.11% F1-score. The Gradient-weighted class activation mapping (Grad-CAM) function was also used to highlight the important ECG characteristics at specific time points that most impact the classification score.
CONCLUSION: In addition to achieving model performance results with our suggested DL method, Grad-CAM's implementation also offers vital temporal data that clinicians and other mental healthcare professionals can use to make wise medical judgments. We hope that by conducting this pilot study, we will be able to encourage larger-scale research with a larger biosignal dataset. Hence allowing biosignal-based computer-aided diagnostic (CAD) tools to be implemented in healthcare and ambulatory settings, as ECG can be easily obtained via wearable devices such as smartwatches.

Matched MeSH terms: Conduct Disorder*
Why do young adolescents bully? Experience in Malaysian schools

Wan Ismail WS, Nik Jaafar NR, Sidi H, Midin M, Shah SA

Compr Psychiatry, 2014 Jan;55 Suppl 1:S114-20.
PMID: 23763872 DOI: 10.1016/j.comppsych.2013.05.002

INTRODUCTION: To determine sociodemographic and psychological factors associated with bullying behavior among young adolescents in Malaysia.
METHODS: This is a cross-sectional study of four hundred ten 12-year-old adolescents from seven randomly sampled schools in the Federal Territory of Kuala Lumpur, Malaysia. Sociodemographic features of the adolescents and their parents, bullying behavior (Malaysian Bullying Questionnaire), ADHD symptoms (Conners Rating Scales), and internalizing and externalizing behavior (Child Behaviour Checklist) were obtained from adolescents, parents and teachers, respectively.
RESULTS: Only male gender (OR=7.071, p=0.01*, CI=1.642-30.446) was a significant sociodemographic factor among bullies. Predominantly hyperactive (OR=2.285, p=0.00*, CI=1.507-3.467) and inattentive ADHD symptoms reported by teachers (OR=1.829, p=0.03*, CI=1.060-3.154) and parents (OR=1.709, p=0.03*, CI=1.046-2.793) were significant risk factors for bullying behavior while combined symptoms reported by young adolescents (OR=0.729, p=0.01*, CI=0.580-0.915) and teachers (OR=0.643, p=0.02*, CI=0.440-0.938) were protective against bullying behavior despite the influence of conduct behavior (OR=3.160, p=0.00*, CI=1.600-6.241). Internalizing behavior, that is, withdrawn (OR=0.653, p=0.04*, CI=0.436-0.977) and somatic complaints (OR=0.619, p=0.01*, CI=0.430-0.889) significantly protect against bullying behavior.
DISCUSSIONS: Recognizing factors associated with bullying behavior, in particular factors distinctive to the local population, facilitates in strategizing effective interventions for school bullying among young adolescents in Malaysian schools.

Matched MeSH terms: Conduct Disorder/ethnology; Conduct Disorder/psychology*
Childhood cruelty to animals: a tri-national study

Mellor D, Yeow J, Mohd Hapidzal NF, Yamamoto T, Yokoyama A, Nobuzane Y

Child Psychiatry Hum Dev, 2009 Dec;40(4):527-41.
PMID: 19449100 DOI: 10.1007/s10578-009-0142-0

Childhood cruelty to animals is a symptom of conduct disorder that has been linked to the perpetration of violence in later life. Research has identified several factors associated with its etiology, including social factors. However, no cross-cultural studies on this phenomenon have been reported. This study investigated childhood cruelty to animals in Japan, Australia and Malaysia. Parents of 1,358 children between the ages of 5 and 13 years completed the Children's Attitudes and Behaviours towards Animals questionnaire (CABTA) which assesses Typical and Malicious Cruelty to animals. Analyses revealed no overall differences between children from these countries on either scale. However, younger boys were more likely to be cruel than younger girls in each country, and younger children in Australia and Japan were more likely to be cruel that older children in those countries. The findings are discussed in relation to previous research, and recommendations for future studies are suggested.

Matched MeSH terms: Conduct Disorder/epidemiology; Conduct Disorder/psychology*
Incidence rates of emotional and behavioural problems in Malaysian children as measured by parent ratings of the Strengths and Difficulties Questionnaire

Gomez R, Suhaimi AF

Asian J Psychiatr, 2013 Dec;6(6):528-31.
PMID: 24309866 DOI: 10.1016/j.ajp.2013.06.009

The aim of this study was to ascertain the rates of emotional and behavioural problems (emotional problems, conduct problems, hyperactivity, peer problems, and low prosocial behaviour) of Malaysian children.

Matched MeSH terms: Conduct Disorder/epidemiology*
Conduct disorders seen in child psychiatric outpatient clinic, Hospital Kuala Lumpur

Loh, C.C., Mohd Amin, S., Kasmini, K.

Malaysian Journal of Child Health, 1994;6(1):12-17.
MyJurnal

This is a retrospective and descriptive study of 30 children and adolescents with conduct disorders diagnosed for the first time this year (1993) at the Child and Family Consultation Unit, UKM. Eleven of them were diagnosed to have a Socialized Conduct Disorder, 8 had symptoms of Unsocialized Conduct Disorder, whilst 4 had Conduct Disorder confined to the family context. Another 5 had Depressive Conduct Disorders while 2 had features of other mixed disorders of conduct and emotions. Most them were boys and were ten years old and above. The majority presented with at least one year history of illness and school authorities played an important role in being the main referral agency. Prominent abnormal psychosocial situations were inadequate or inconsistent parental control and discordant intro familial relationships. Socio-economic status and geographical differences were associated with the prevalence of the disorder. The main symptomatology found were disobedience and frequent lying, stealing, truancy and fighting or bullying.

Study site: outpatient clinic, Hospital Kuala Lumpur

Matched MeSH terms: Conduct Disorder
Fulltext A Longitudinal Study of Emotional and Behavioral Problems among Malaysian School Children

Idris IB, Barlow J, Dolan A

Ann Glob Health, 2019 03 07;85(1).
PMID: 30873768 DOI: 10.5334/aogh.2336

BACKGROUND: Emotional and behavioral problems (EBD) or mental health problems in children and adolescents are an important public health issue, but there has been no evaluation to date of the extent of such problems in near-developed countries. This study evaluated the prevalence and stability of EBD among children in Malaysia.
METHODS: This research comprises a longitudinal population-based study that measured the prevalence and 6-month stability of EBD in children aged seven to eight years and thirteen to fourteen years attending public schools in Malaysia based on parents, teachers and children's (aged 13 to 14 years) report of the Strengths and Difficulties Questionnaire (SDQ) at baseline and 6 months later.
FINDINGS: The prevalence of EBD in Malaysian school children was 9.3% for teacher-report, 8.5% for parent-report and 3.9% for child-report. There was no significance difference in the prevalence of emotional and behavioral problems over six-months for all informants, except for teacher-report Emotional and Conduct problems scores which increased significantly and child-report Total Difficulties and Emotional problems scores which decreased significantly (p < 0.05).
CONCLUSIONS: This study shows that the prevalence of EBD among Malaysian children is almost similar to the Western countries and stable over a 6-month period. These findings suggest the need for policy makers in near-developed countries to provide services aimed at preventing EBD and treating children identified as having such problems.

Matched MeSH terms: Conduct Disorder/epidemiology*
Fulltext Polypharmacy in a nine year old boy with Attention Deficit Hyperactivity Disorder and Tourette Syndrome: what worsened the tics?

Wan Salwina Wan Ismail, Aili Hanim Hashim, Kaur, Manveen, Choo, Shell Pin, Fairuz Nazri Abdul Rahman

Malaysian Journal of Medicine and Health Sciences, 2014;10(2):79-81.
MyJurnal

Attention Deficit Hyperactivity Disorder(ADHD) and Tourrete Syndrome(TS) commonly
co-occur, imposing a special challenge in the management. Case report: This is a case of a nine year old boy with ADHD and TS, who had been on methylphenidate, risperidone, fluvoxamine and atomoxetine, alone and in combination. Tics worsened with methylphenidate but improved after its withdrawal, and the addition of risperidone and fluvoxamine. Later, atomoxetine was added which worsened the tics, even when it was removed. Significant improvement in the tics were only obvious when fluvoxamine was taken off. Discussion: The possible roles of dopamine and serotonin neurotransmission, and metabolism of cytochrome P450 D26 in the pathophysiology were discussed. Conclusion: The use of multiple medications need cautious consideration and monitoring in a child patient to avoid unwanted complications and risks.

Matched MeSH terms: Conduct Disorder
Fulltext Clinical and developmental characteristics of sex offenders in Malaysian prisons

Manveen, K.S., Pillai, S.K., Muhsin, M., Salwina, W., Aili, H.H.

Malaysian Journal of Psychiatry, 2012;21(1):0-0.
MyJurnal

The population of incarcerated sex offenders in Malaysia is steadily growing. Objective: This is a descriptive study to look at what clinical and developmental characteristic are present amongst the sex offenders in Malaysia, which could be possible mitigating factors. Methods: Data was collected from offenders located in 3 prisons where the offenders are held. Results: a total of 147 prisoners participated in the study. Slightly more than half of the victims were below the age of 18, of which 10% were below the age of 12. Three quarters of offenders were thirty years and older, while 12% were below 18 years. However their problems begun much earlier in their life with 50% of the offenders reporting that they had difficulties in their
primary support group, resulting in them feeling their families were less expressive, their parents were distant and unsupportive.29% of the offenders had not lived with their parents from the age of 16. More than half of the offenders reported academic, behavior and developmental difficulties; they reported losing interest in their studies and were struggling during their schooling days. 43% had history of aggressive behaviour during their adolescent years and 76% had peers who often indulged in risky behaviors. 85% of the offenders were Muslim. 40% made the criteria of Attention Deficit Hyperactive Disorder and conduct disorder while a quarter were diagnosed with having personality disorder. Slightly more than half of the offenders had alcohol and drug-related problems, 36% had history of previous crimes, mainly drug and theft offence. Conclusion: The findings show that the sex offenders are indeed a heterogeneous group with pervasive familial, behaviour, academic and social problems which are possible risk that can be identified early in the lives of offenders.

Matched MeSH terms: Conduct Disorder