The Profile of Community Psychiatry Clients (PCPC) was developed in a Sydney-based sample of those with a mental illness as a 35-item measure of likely need for service recognition, review and possible assistance.
The permainan puteri (usually abbreviated to main puteri) is an indigenous Kelantanese healing ceremony in which the bomoh (traditional medicine-man), the sick individual and other participants become spirit-medium through whom puteri (spirits) are able to enact a permainan ('play'). It has been successfully used as a psychotherapy for depression. The bomoh assisted by his minduk (master of spirits) and a troupe of musicians, is able to provide a conceptual framework around which the sick individual can organize his vague, mysterious and chaotic symptoms so that they become comprehensible and orderly. At the same time the bomoh is able to draw the sick individual out of his state of morbid self-absorption and heighten his feelings of self-worth. The involvement of his family, relatives and friends tends to enhance group solidarity and reintegrate the sick individual into his immediate social group.
An ethnographic study of female psychiatric patients was undertaken in East Malaysia. Findings indicate that these service users were subject to a number of sexist and oppressive practices that militate against their freedom of movement on the wards as well as their social interaction in the wider context of the hospital. Stereotypic notions of female sexuality and morality act as forms of moral containment and are interpreted in the hospital context as requiring heavy custodial care by the hospital authorities.
Cambodia had suffered enormously due to war and internecine conflict during the latter half of the twentieth century, more so during the Vietnam War. Total collapse of education and health systems during the Pol Pot era continues to be a challenge for developing the necessary infrastructure and human resources to provide basic minimum mental health care which is compounded by the prevailing cultural belief and stigma over mental, neurological and substance abuse disorders (MNSDs). The mental health research and services in Cambodia had been predominantly 'trauma focused', a legacy of war, and there is a need to move toward epidemiologically sound public health oriented mental health policy and service development. Integrating mental health program with primary health care services with specifically stated minimum package of activities at primary level and complementary package of activities at secondary level is an opportunity to meet the needs and rights of persons with mental, neurological and substance abuse disorders (PWMNSDs) in Cambodia, provided there is mental health leadership, government commitment and political will.
In a prospective study of fifty consecutive outpatients (30 men and 20 women) attending the Behaviour Therapy Clinic at a general hospital, the commonest conditions were obsessive compulsive disorders (n = 16), phobic disorders (n = 11) and generalised anxiety disorders (n = 9). Three-quarters of the referrals were from psychiatrists and family physicians. The patients received between 2 to 10 sessions of behaviour treatment; most had 4 to 6 sessions with a mean of 4.7, SD 1.82. The commonest behavioural techniques administered were exposure therapy with response prevention and relaxation therapy. Initially, treatment was therapist-aided, but subsequently self-help was encouraged with regular reviews of the patient's homework. After one month, 42 patients (84%) were assessed to have improved somewhat, with 20 (40%) showing moderate improvement. After three months, 41 (82%) continued to improve, with 33 (66%) showing moderate to great improvement. Nine patients were considered to have failed in therapy-six defaulted and three were non-responders. The reasons for defaulting treatment were unwillingness to bear with the discomfort involved in exposure therapy, lack of motivation or returning to own hometown in Malaysia. Sixteen patients (n = 32%) were treated solely with behavioural techniques while the rest had a combination of behaviour therapy and drugs, especially anxiolytics and antidepressants. However, at the end of treatment, the dosages of most medications were reduced or else discontinued completely.
Study site: Behavior therapy clinic at a general hospital
Thirty-one (31) patients undergoing electroconvulsive therapy (ECT) over a three-week period in October 1982 in the Psychiatric Unit, University Hospital, Kuala Lumpur, were studied. The main indications for ECT in these patients were poor response to drug therapy, depression with suicidal ideation, and aggression, which together accounted for 87 percent of all patients started on ECT during this period. The majority of patients (86 percent) showed some improvement, and 73 percent improved by the third ECT. The most common side-effects experienced by patients were memory disturbance (45 percent) and post ECT headache (45 percent). No serious side-effects were encountered.
Individuals in a community who developed irritable bowel syndrome (IBS) after major floods have significant mental health impairment. We aimed to determine if Bifidobacterium infantis M-63 was effective in improving symptoms, psychology and quality of life measures in flood-affected individuals with IBS and if the improvement was mediated by gut microbiota changes. Design was non-randomised, open-label, controlled before-and-after. Of 53 participants, 20 with IBS were given B. infantis M-63 (1×109 cfu/sachet/day) for three months and 33 were controls. IBS symptom severity scale, hospital anxiety and depression scale, SF-36 Questionnaire, hydrogen breath testing for small intestinal bacterial overgrowth and stools for 16S rRNA metagenomic analysis were performed before and after intervention. 11 of 20 who were given probiotics (M-63) and 20 of 33 controls completed study as per-protocol. Mental well-being was improved with M-63 vs controls for full analysis (P=0.03) and per-protocol (P=0.01) populations. Within-group differences were observed for anxiety and bodily pain (both P=0.04) in the M-63 per-protocol population. Lower ratio of Firmicutes/Bacteroidetes was observed with M-63 vs controls (P=0.01) and the lower ratio was correlated with higher post-intervention mental score (P=0.04). B. infantis M-63 is probably effective in improving mental health of victims who developed IBS after floods and this is maybe due to restoration of microbial balance and the gut-brain axis. However, our conclusion must be interpreted within the context of limited sample size. The study was retrospectively registered on 12 October 2017 and the Trial Registration Number (TRN) was NCT03318614.
A rare case of complex partial seizure (psychomotor epilepsy) with varying shades of psychiatric manifestations is presented. The highlights are multiplicity of its manifestation in the same case, its interchanging pattern and the variable durations. This gray area of psychiatry and neurology is discussed with special reference to diagnosis and management.
Gut microbiomes may have a significant impact on mood and cognition, which is leading experts towards a new frontier in neuroscience. Studies have shown that increase in the amount of good bacteria in the gut can curb inflammation and cortisol level, reduces symptoms of depression and anxiety, lowers stress reactivity, improves memory and even lessens neuroticism and social anxiety. This shows that, probably the beneficial gut bacteria or probiotics function mechanistically as delivery vehicles for neuroactive compounds. Thus, a psychobiotic is a live organism, when ingested in adequate amounts, produces a health benefit in patients suffering from psychiatric illness. Study of these novel class of probiotics may open up the possibility of rearrangement of intestinal microbiota for effective management of various psychiatric disorders.
This article aims to review the social policies on mental health and mental illness in Malaysia. Using critical theory, major policy issues pertaining to mental health and mental illness such as mental health legislation, prevalence rates and quality of services available to the people with mental health problems are discussed in detail. Implications of these issues on persons with mental health problems are critically evaluated. The paper highlights that the other countries in ASEAN region also require similar review by policy literature.