MyMedR

Psychiatry with the aborigines of West Malaysia

Kinzie JD, Bolton JM

Am J Psychiatry, 1973 Jul;130(7):769-73.

PMID: 4712728

Matched MeSH terms: Schizophrenia/diagnosis

New admissions to Woodbridge Hospital 1975 with special reference to schizophrenia

Tsoi WF, Chen AJ

Ann Acad Med Singap, 1979 Jul;8(3):275-9.

PMID: 547870

Woodbrige Hospital had 2,257 patients in 1975. Of these 75 percent were suffering from Schizophrenia. This pattern was similar to that of developing countries like Padistan and Malaya. A study was carried out on all new admissions in 1975. There were 1,068 patients whose age ranged from 10 to 89. Schizophrenia which constituted 62% of the cases was analysed in detail. They were mainly in the age range 10-29 (64%). The sex ratio was 3 males to 2 females. Their distribution by their type of housing was similar to that of the general populations. They were better educated. The most common presentation were reports of aggressive, violent, disturbed, abnormal or withdrawn behaviour. The 10 most common symptoms were paranoid ideas, hearing of voices, talking to oneself, insomnia, aggression, abnormal behaviour, laughing to oneself, disturbed behaviour, crying to oneself and withdrawn behaviour. The most common drugs used were trifluoperazine (47%) and chlorpromazine (45%). Electroconvulsive therapy was given to 25% of the patients. Most of the patients (63%) stayed less than 20 days.

Matched MeSH terms: Schizophrenia/diagnosis

Fulltext A psychiatric rating scale for schizophrenia in Singapore (Woodbridge Hospital rating scale for schizophrenia)

Tsoi WF, Kua EH

Med J Malaysia, 1982 Dec;37(4):300-5.

PMID: 7167079

This scale is constructed to meet the need for an efficient, rapid and economical method of
measuring change in schizophrenic patients during the course of psychotropic medication (drug trial) in a multi-cultural, multi-lingual population of low educational level. Items are included only if (1) they can be elicited objectively, (2) they are important symptoms of schizophrenia and (3) they are frequent maniJestatz'on of the schizophrenic syndrome as recorded in Woodbridge Hospital. It could be used by a single rater but its reliability should be further improved if two raters are involved.

Matched MeSH terms: Schizophrenia/diagnosis*

Specificity of Schneider's first rank symptoms for schizophrenia in Malay patients

Salleh MR

Psychopathology, 1992;25(4):199-203.

PMID: 1492143

The frequency of Schneider's first rank symptoms (FRS) was studied in 221 Malay patients with functional psychosis. The prevalence of FRS in schizophrenia was 26.7%. The most common symptoms were voice arguing, passivity phenomena and somatic passivity. In the absence of organic brain dysfunction, the specificity of FRS for schizophrenia was 87.8%, and their positive predictive value was 90.6%. These findings indicate that although FRS is not pathognomonic of schizophrenia, their presence should be regarded as strongly suggestive of schizophrenia in the absence of organic etiology. FRS do not however occur with sufficient frequency to have potential diagnostic in schizophrenia.

Matched MeSH terms: Schizophrenia/diagnosis*

Fulltext Decentralization of psychiatric services in Malaysia--what is the prospect?

Salleh MR

Singapore Med J, 1993 Apr;34(2):139-41.

PMID: 8266154

Since the Government was implementing the policy of decentralization of psychiatric services, a large number of chronic schizophrenic patients failed community management because of the breakdown of family support. The rejected patients were admitted to the Old Persons' Home for protection because no other suitable places were available for them. In a follow-up study in one of the Homes, the one-year prevalence rate of treated psychiatric illness and schizophrenia was found to be 27.5% and 15.3% respectively. Lack of rehabilitation and community care facilities and inadequate staff in all categories were the root of the problem. The author foresees that the Government will face a serious problem in future to cater for the increasing number of chronic schizophrenic patients in the community if it does not take immediate action to improve mental health services in the country.

Matched MeSH terms: Schizophrenia/diagnosis

Psychiatric morbidity in the first-degree relatives of schizophrenic patients

Varma SL, Sharma I

Br J Psychiatry, 1993 May;162:672-8.

PMID: 8149120

First-degree relatives (FDRs) of 162 schizophrenic and 106 control probands were investigated [corrected]. Psychiatric morbidity was present in 34.8% of FDRs of schizophrenic probands and in 9.2% of FDRs of controls. There was significantly more psychiatric illness in the siblings and parents than in the offspring of both schizophrenic and control subjects. The morbidity risks for schizoid-schizotypal personality disorders, cannabis-use disorder and paranoid personality disorder were significantly higher in the FDRs of schizophrenic patients than in those of controls, suggesting a biological relationship.

Matched MeSH terms: Schizophrenia/diagnosis

High prevalence of thyroid function test abnormalities in chronic schizophrenia

Othman SS, Abdul Kadir K, Hassan J, Hong GK, Singh BB, Raman N

Aust N Z J Psychiatry, 1994 Dec;28(4):620-4.

PMID: 7794205

The thyroid status of 249 patients with chronic schizophrenia (males = 136, females = 113) with a median age of 36 years (range: 16 to 58 years) and a median duration of hospitalisation of 10 years (range: 1 to 30 years) was assessed. Thyroid antibodies (TAb) were found in 51 patients (20%). In female patients, 32 (28%) were TAb positive compared to 13% (n = 152, p = 0.01) in healthy female blood donors. In male patients, the prevalence of TAb was 14% compared to 7% (n = 449, p = 0.01) in healthy male blood donors. Of the 183 patients who had thyroid hormone measurements, 60% had normal test, 5% had elevated TSH and 17% had low TSH. The T4, FT41 and FT31 were significantly lower in those with low or high TSH (p < 0.001) compared to those with normal TSH. Of the 143 patients with normal TSH, 33 (23%) had low T3. In conclusion, there is a spectrum of thyroid function test abnormalities in chronic schizophrenia; this may be related to an abnormality in the central regulation of the hypothalamo-pituitary thyroid axis as well as at the peripheral level. However the association between chronic schizophrenia and the presence of thyroid antibodies, and the clinical relevance of these biochemical abnormalities, are still not clear.

Matched MeSH terms: Schizophrenia/diagnosis

Thought disorder and its correlation with clinicodemographic variables in schizophrenia

Mazumdar PK, Chaturvedi SK, Gopinath PS

Psychopathology, 1994;27(1-2):37-42.

PMID: 7972638

The correlation of clinical and demographic variables of thought disorder was studied in 45 Research Diagnostic Criteria (RDC) schizophrenics. Thought disorder was assessed by the scale for the assessment of Thought, Language and Communication (TLC). Negative thought disorder was significantly correlated with the rural background. Individual TLC items like Distractible speech, Illogicality, Clanging, Neologisms, etc. were correlated with the literate group and perseveration with the illiterate group. No significant correlation was noted between thought disorder and clinical variables.

Matched MeSH terms: Schizophrenia/diagnosis*

Dermatoglyphic patterns in schizophrenic patients

Varma SL, Chary TV, Singh S, Azhar MZ, Dharap AS

Acta Psychiatr Scand, 1995 Mar;91(3):213-5.

PMID: 7625199

Schizophrenics (n = 250) and normal controls (n = 90) were studied to investigate and compare their dermatoglyphic patterns. Their fingerprint patterns were studied. The frequency of arches in the patient and control groups was similar. The frequency of loops in the control group was higher than in the patient group, and the trend was consistent in all the digits. The whorls in the patient group showed an increase over the control group in all the digits, although this finding was not statistically significant.

Matched MeSH terms: Schizophrenia/diagnosis

A comparative study of thought disorder in acute and chronic schizophrenia

Mazumdar PK, Chaturvedi SK, Gopinath PS

Psychopathology, 1995;28(4):185-9.

PMID: 7480574

A differential phenomenological study of acute and chronic schizophrenia is scanty. Thought disorder was assessed in 22 acute and 23 chronic schizophrenics. The scale for the assessment of thought, language and communication was used. Poverty of speech was significantly more frequent in acute schizophrenia. Positive formal thought disorder was unusually found to be severer in chronic schizophrenia. No other significant difference was found. From the perspective of thought disorder, acute and chronic forms of schizophrenia seem to be in a continuum with minimal difference.

Matched MeSH terms: Schizophrenia/diagnosis*

Aspects of psychiatric admissions of migrants to hospitals in Perth, Western Australia

Bruxner G, Burvill P, Fazio S, Febbo S

Aust N Z J Psychiatry, 1997 Aug;31(4):532-42.

PMID: 9272263

Recent Australian Government initiatives have emphasised problems with service provision to the ethnic mentally ill. This study aims to address the paucity of contemporary data describing the disposition of the ethnic mentally ill in hospital settings.

Matched MeSH terms: Schizophrenia/diagnosis

Cultural formulation of psychiatric diagnosis. Sakit Gila in an Iban longhouse: chronic schizophrenia

Barrett RJ

Cult Med Psychiatry, 1997 Sep;21(3):365-79.

PMID: 9352169

Matched MeSH terms: Schizophrenia/diagnosis*

Fulltext Current trends in the management of schizophrenia

George PP

Med J Malaysia, 2002 Mar;57(1):128-31; quiz 132.

PMID: 14569733

Schizophrenia is a common and devastating illness. Patients with schizophrenia may develop many disabilities both due to the disease process as well as due to side effects of the medication used. There are many advances in the treatment of schizophrenia, which can effectively reduce many of these disabilities. Treatment of schizophrenia is a primary health care responsibility and thus all health care personnel need to equip themselves with the latest knowledge on management issues. This article outlines the current management issues in schizophrenia.

Matched MeSH terms: Schizophrenia/diagnosis*

Treatment with olanzapine, risperidone or typical antipsychotic drugs in Asian patients with schizophrenia

Lee C, Wu KH, Habil H, Dyachkova Y, Lee P

Aust N Z J Psychiatry, 2006 May;40(5):437-45.

PMID: 16683970

To examine clinical outcomes in Asian patients with schizophrenia receiving monotherapy with olanzapine, risperidone or typical antipsychotics in naturalistic settings.

Matched MeSH terms: Schizophrenia/diagnosis

The pathway followed by psychotic patients to a tertiary health center in a developing country: a comparison with patients with epilepsy

Razali SM, Mohd Yasin MA

Epilepsy Behav, 2008 Aug;13(2):343-9.

PMID: 18514034 DOI: 10.1016/j.yebeh.2008.04.009

The objective of this study was to describe and compare the pathways followed by Malay patients with psychoses (schizophrenia and schizophreniform disorder) and Malay patients with epilepsy to a tertiary health center in the northeastern area of peninsular Malaysia. There were 60 patients in each group. The most popular pathway for both groups was first contact with traditional or alternative healers. Consultation with Malay traditional healers (bomohs) and/or homeopathic practitioners (44.2%) was significantly higher for psychotic patients (61.7%) than for patients with epilepsy (26.7%) (chi(2)(2)=15.609, P<0.001). Direct access (24.2%) was the second most popular pathway and almost equally followed by both groups of patients. The third and last pathway was initial contact with private general practitioners and government doctors, respectively. Patients with epilepsy dominated the last two pathways. The treatment delay (TD) was significantly longer in epileptic than psychotic patients regardless of their visit to a bomoh and/or homeopathic practitioner (P<0001) or not (p<0.01). The socioeconomic status of psychotic patients also was significantly better than people with epilepsy (chi(2)=9.957, chi(2)(4), p=0.041).

Study site: Psychiatric clinic, Hospital Universiti Sains Malaysia HUSM

Matched MeSH terms: Schizophrenia/diagnosis

Outcome study of first-episode schizophrenia in a developing country: quality of life and antipsychotics

Chee KY

Soc Psychiatry Psychiatr Epidemiol, 2009 Feb;44(2):143-50.

PMID: 18642120 DOI: 10.1007/s00127-008-0415-0

AIM: Quality of life has recently been emphasized in the management of schizophrenia, yet data from developing country is lacking. We explored the differences in subjective quality of life between conventional antipsychotics (CAs) and atypical antipsychotics (AAs).

METHODS: This is a naturalistic study conducted in Kuala Lumpur, Malaysia. Patients with first-episode schizophrenia and related psychosis were recruited from Kuala Lumpur Hospital. WHOQOL-BREF, side effects of medications and other variables were assessed after 1 year of treatment in routine clinical situation.

RESULTS: The study comprised 120 adults. There were no significant statistical differences between groups concerning subjective quality of life, extrapyramidal side effects and employment. Significant less benzhexol usage was reported among AAs (P<0.001) compared to CAs and sulpiride.

CONCLUSION: Patients treated with CAs, sulpiride or AAs experienced similar quality of life, clinical and health outcomes after 1 year commencing treatment. Overall, the results are in line with other major pragmatic clinical trials. This study also found sulpiride cost-effective.

Matched MeSH terms: Schizophrenia/diagnosis

Determinants of subjective quality of life in first-episode schizophrenia: perspective from Malaysia

Chee KY

Early intervention in psychiatry, 2010 May;4(2):111-8.

PMID: 20536966 DOI: 10.1111/j.1751-7893.2010.00176.x

This study sought to examine the determinants of subjective quality of life among patients with first-episode schizophrenia in a developing country.

Matched MeSH terms: Schizophrenia/diagnosis*

Schizophrenia or frontotemporal dementia in a young Chinese female: a purview of possible diagnoses

Grewal GS, Kanagasundram S, Jambunathan S

Turk Psikiyatri Derg, 2011;22(4):266-8.

PMID: 22143952

Frontotemporal dementia (FTD) is now increasingly being recognized as one of the causes of young onset dementia (YOD). The presentation of FTD can be subtle with a broad range of symptoms. This frequently causes misdiagnosis and a delay in initiating the correct treatment. While subtle personality changes, disinhibition and problems in executive functioning are frequently encountered in FTD, frank psychotic symptoms resembling schizophrenia are unusual. This is a case of a 38 year old Chinese female that highlights how obsessive compulsive symptoms which progressed to florid psychosis and disorganized speech and behavior can be a presenting picture in FTD. For seven years, this patient was treated as a case of schizophrenia and was thought to have poor response to electroconvulsive therapy (ECT) as well as antipsychotic medication. Her blood work and electroencephalogram (EEG) were normal. Magnetic resonance imaging (MRI) showed progressive cerebral atrophy. This case report suggests that psychosis should be investigated in detail especially when the clinical presentation is not typical of a functional disorder and more so when the patient is not responsive to conventional treatment. This report also highlights the importance of eliciting symptoms suggestive of an "organic" etiology, such as incontinence and disorientation. In addition, the usefulness of repeated imaging to show the rapidly progressive course of FTD has been illustrated. Other possible differential diagnoses of this patient are also discussed.

Matched MeSH terms: Schizophrenia/diagnosis*

Cancer mortality in patients with psychiatric diagnoses: a higher hazard of cancer death does not lead to a higher cumulative risk of dying from cancer

Guan NC, Termorshuizen F, Laan W, Smeets HM, Zainal NZ, Kahn RS, et al.

Soc Psychiatry Psychiatr Epidemiol, 2013 Aug;48(8):1289-95.

PMID: 23104669 DOI: 10.1007/s00127-012-0612-8

PURPOSE: Both increased as well as decreased cancer mortality among psychiatric patients has been reported, but competing death causes were not included in the analyses. This study aims to investigate whether observed cancer mortality in patients with psychiatric disorders might be biased by competing death causes.

METHOD: In this retrospective cohort study on data from the Psychiatric Case Register Middle Netherlands linked to the death register of Statistics Netherlands, the risk of cancer death among patients with schizophrenia (N = 4,590), bipolar disorder (N = 2,077), depression (N = 15,130) and their matched controls (N = 87,405) was analyzed using a competing risk model.

RESULTS: Compared to controls, higher hazards of cancer death were found in patients with schizophrenia (HR = 1.61, 95 % CI 1.26-2.06), bipolar disorder (HR = 1.20, 95 % CI 0.81-1.79) and depression (HR = 1.26, 95 % CI 1.10-1.44). However, the HRs of death due to suicide and other death causes were more elevated. Consequently, among those who died, the 12-year cumulative risk of cancer death was significantly lower.

CONCLUSIONS: Our analysis shows that, compared to the general population, psychiatric patients are at higher risk of dying from cancer, provided that they survive the much more elevated risks of suicide and other death causes.

Matched MeSH terms: Schizophrenia/diagnosis

Schizophrenia relapse in Kuala Lumpur, Malaysia: do relatives' expressed emotion and personality traits matter?

Roseliza-Murni A, Oei TP, Fatimah Y, Asmawati D

Compr Psychiatry, 2014 Jan;55(1):188-98.

PMID: 23374905 DOI: 10.1016/j.comppsych.2012.12.026

Schizophrenia which is perhaps the most disabling and puzzling form of a mental disorder is often conceptualized as 'gila' (lunacy or madness) by the Malaysian society. The debilitating nature of the disorder and recurrent relapse of its psychotic episodes have often been misunderstood and lead to confusion among the family members, who play the role as primary caregivers. While expressed emotion (EE) has been widely studied in the Western world, it is not well understood in Malaysia.

Matched MeSH terms: Schizophrenia/diagnosis*

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