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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
Fulltext Self-perceived anxiety symptoms and its associated factors among type 2 Diabetic patients in rural communities of Malaysia

Azlina Wati Nikmat, Mohd Ariff Fadzil, Sakinah Idris

Journal of Clinical and Health Sciences, 2016;1(2):11-17.
MyJurnal

Introduction: Little is known about anxiety symptoms among diabetic patients, especially among those who are living in rural areas in Malaysia. Thus, the aim of this paper is to investigate the prevalence of anxiety among diabetic patients and factors associated with anxiety in rural communities in Malaysia. Methods: A cross-sectional study involving 464 diabetes mellitus patients in rural health districts and outpatient clinics in Malaysia was conducted. Each participant was interviewed using the Hospital Anxiety and Depression Scale. Results: Respondents consisted of 193 (41.6%) males and 271 (58.4%) females. The mean age of participants was 59.65 ± 10.16 years and the mean duration of diabetes mellitus was 6.9 ± 6.3 years. Results indicate that 15% of the participants have anxiety symptoms. Multiple logistic regression analysis revealed that patients with history of ischemic heart disease and depression and those who were underweight have higher anxiety scores with adjusted OR 5.06 (95% CI 1.79 to 14.27), 27.71 (95% CI 14.23 to 53.98) and 14.6 (95% CI 2.49 to 84.82), respectively. Conclusions: This study suggests that although the prevalence of anxiety among diabetics is low, primary care physician should be trained to identify high risk patients and to manage their condition in order to improve the clinical outcome.

Study site: rural health districts and outpatient clinics in Malaysia

Matched MeSH terms: Depressive Disorder
Fulltext Features of parasuicide cases presented to Hospital Melaka in year 2015 - "a wake-up call"

Kumar, P.R., Vincent, S.D.

Malaysian Journal of Psychiatry, 2016;25(1):0-0.
MyJurnal

Objective: This study aimed to collect data on features of parasuicide cases
presented to Hospital Melaka from January to December 2015. Methods:
This was a descriptive study with retrospective review of medical records of
parasuicide cases that were warded for observation in Hospital Melaka from
January to December 2015. Data collected included sociodemographic factors,
previous attempts, methods implicated and reasons for parasuicide which
were presented in descriptive statistics. Results: A total of 88 parasuicide
cases were studied. The median age was 25.6 (17.7) with a majority in age
group between 15-24 years old (43.2%). Females were the highest with 58
cases (65.9%). In terms of ethnicity, the Malays was the highest at 38 cases
(43.2 %). However, after corrected to proportion of ethnicity in Melaka,
Indians yield the highest cases. Those who were single (50.0%) and
unemployed (64.8%) contributed to higher number of cases. About 40 cases
(45.5%) had underlying psychiatry illness and majority of them were those
diagnosed with major depressive disorder (47.5%). In general, the most
common method used was self poisoning with anti-epileptics,
sedative-hypnotic, psychotropics (22.1%). Among male cases, pesticide
ingestion (37%) was more common while among female, medication overdose
(53%) was preferred. In terms of reasons for parasuicide, individuals with
interpersonal conflicts contributed to the highest percentage of cases (57.7%).
Conclusion: Data gathered in this study is useful to reflect the current
situation of parasuicide in Melaka and could serve as a foundation in
designing future studies on preventive and intervention programs in Hospital
Melaka.

Matched MeSH terms: Depressive Disorder, Major
Fulltext A better mental health for all

Jasraj, S., Viknesh, N.

Malaysian Journal of Psychiatry, 2017;26(1):0-0.
MyJurnal

Psychiatric services have progressed well throughout history, marked by a shift from heavily inpatient asylums to outpatient management via deinstitutionalization, and advances in psychopharmacology. An overview of important themes is discussed at public mental health level. Firstly, differences between sexes are touched upon from theoretical and societal perspectives. Next, among the disabled, the phenomenon of diagnostic overshadowing, attributing apparent mental health problems to learning disability, contributes to their overall poorer quality of life. Mental health at both extremes of age is another important theme, whereby dementia and depression are keenly observed in the older age group, while maternal risk factors and parenting play a role in the mental well-being of the younger age group. Fourthly, inequalities, stigma and discrimination, are rife among people living with mental illness, and thereby detrimental in their road to recovery. Deinstitutionalization is explained as being more than just downsizing the inpatient load, gaining prominence with the emergence of community psychiatry services, and found to be helpful in overcoming stigma. Demographically, it was demonstrated that developing countries, as opposed to developed countries, have advantages in their approaches to psychiatric services, including better integration of people living with mental illness into society. Lastly, the psychological well-being of mental health workers should not be discounted, with measures such as stress management and resilience training proving to be key in combating burnout.

Matched MeSH terms: Depressive Disorder
Fulltext A fatal case of metformin and gliclazide poisoning and its management

Low, Qin Jian, Chew, Soo Foong

Borneo Journal of Medical Sciences, 2017;11(3):35-40.
MyJurnal

Both metformin and gliclazide have been used extensively in the management of type II diabetes mellitus. Metformin and gliclazide overdose can lead to severe hypoglycaemia refractory to intravenous (IV) dextrose rescue therapy. A 21-year-old man complained of vomiting and felt dizzy after four hours of taking 70 tablets of Metformin 500 mg and 40 tablets of Gliclazide 80 mg. He had major depressive disorder and wanted to commit suicide. He was given IV Dextrose 50% 50 cc immediately. Octreotide had been used successfully to reverse the refractory hypoglycaemia caused by gliclazide overdose. Unfortunately, he developed severe lactic acidosis with acute kidney injury. Dialysis had been done by continuous venovenous haemodiafiltrationa and intravenous sodium bicarbonate 8.4% infusion was given. However, the patient succumbed due to the severe lactic acidosis and kidney failure despite of urgent dialysis. Octreotide infusion helps in preventing refractory hypoglycaemia secondary to sulfonylurea overdose by inhibit calcium-mediated insulin release. Metformin overdose causes severe lactic acidosis due to conversion of glucose to lactate. Sodium bicarbonate therapy in metformin induced lactic acidosis is also controversial. Though sulfonylurea and metformin are the most commonly-prescribed anti-hypoglycaemic agents, thus during prescribing everyone has to be careful about the overdoses and side effects of these drugs.

Matched MeSH terms: Depressive Disorder, Major
Fulltext Stress and repetitive visual field assessment in glaucoma patients

Tan, Kok-Leong, Fhun, Lai-Chan, Ahmad Tajudin Liza Sharmini, Maizan Yaakub, Chong, Mei-Fong

Journal of Biomedical and Clinical Sciences, 2017;2(2):35-41.
MyJurnal

Glaucoma is a chronic disease that could affect the quality of life and is a potential stressor for patients. Visual field assessment is important in monitoring disease progression among glaucoma patients. Stress could influence the performance of patients in visual field test that may affect the reliability of the test. Our objective in this study was to determine the association between stress score using Depression, Anxiety and Stress Scale (DASS) questionnaire and reliability indices of Humphrey visual field analysis (HFA). A total of 155 primary and secondary glaucoma patients were recruited in the study. Face to face interview using stress component of DASS questionnaire was conducted after automated HFA test. Reliability indices; i.e. fixation loss, false positive, and false negative error, were used to determine the accuracy of HFA result. Only 12 patients (7.7%) were found to have elevated stress score. No significant correlation was found between DASS stress score and the reliability indices of HFA. There was 0.2 folds (95% confidence interval (CI) [-2.35, -0.06], p = 0.039) reduction of fixation loss for every number of HFA done. For every one year increase in age, there was 0.2 folds (95% CI [-0.38, -0.07], p = 0.006) reduction in false positive error in HFA.
Minimal stress may not affect the reliability of HFA assessment. Minimising stress among glaucoma patients is important not only for assessment of visual field but also for improvement of quality of life.

Matched MeSH terms: Depressive Disorder
Fulltext Knowledge, attitude and preventive practices regarding tuberculosis and its predictors among HIV patients in general hospital, Minna, North-Central, Nigeria

Chindo Ibrahim Bisallah, Lekhraj Rampal, Sherina Mohd Sidik, Zubairu Iliyasu, Munn-Sann Lye, Michael Ochigbo Onyilo

Malaysian Journal of Medicine and Health Sciences, 2018;14(1):45-55.
MyJurnal

Introduction: Tuberculosis is the commonest cause of death among HIV patients in Nigeria. Though tuberculosis is common among HIV patients, their knowledge about transmission and prevention is poor. Objective: To determine knowledge, attitude and preventive practices regarding tuberculosis and its predictors among HIV patients receiving treatment. Methods: A cross sectional study was carried out involving 226 randomly selected HIV patients receiving care at General Hospital, Minna. Study duration was from June 2015 to July 2017. Data on socio-demographic characteristics, psychosocial factors, knowledge, attitude and preventive practices regarding tuberculosis was collected using a self-administered, WHO modified, pretested and validated questionnaires. Data collected was analysed using SPSS version 22. Results: Out of 226 respondents, 60(26.5%) had poor knowledge, 123(54.4%) had negative attitude and 48(21.2%) had poor preventive practices regarding tuberculosis. The predictors of knowledge were age (B=0.087, 95%CI=0.031, 0.143, p=0.002), depression (B=-0.444, 95%CI=-0.673,-0.214, p

Matched MeSH terms: Depressive Disorder
Fulltext Internet addiction among secondary school students in Klang Valley, Malaysia: what is the association with depressive symptoms, anxiety symptoms, and selfesteem?

Abdul Aziz, M., Wan Ismail W.S., Bahar N., Mahadevan R., Azhar Shah S.

International Medical Journal Malaysia, 2018;17(2):17-26.
MyJurnal

Introduction: Internet addiction is becoming a global problem and has been associated with mental health issues such as depression and anxiety. There is a strong need for local research, given the recent rise of mental health issues amongst children and adolescents in Malaysia, as well as lack of research in this field locally. Methods: This study assessed the prevalence of internet addiction, and its association with internetrelated factors, depressive symptoms, anxiety symptoms, and self-esteem, amongst selected secondary school students in the Klang Valley, Malaysia. In a cross-sectional study, 199 adolescents were conveniently chosen from six randomly selected secondary schools within Klang Valley. Subjects completed a demographic questionnaire, as well as Malay versions of the Internet Addiction Test (MVIAT), Children’s Depression Inventory (CDI), Depression Anxiety Stress Scales-21 anxiety subscale (DASS-21) and Rosenberg Self-Esteem Scale (RSES). Multiple logistic regression analysis was carried out. Results: This study found that 49.2% of students were addicted to the internet. Significant factors associated with internet addiction were spending longer hours online during the holidays (OR 1.20, CI 1.01-1.35), easy access to a computer (OR 4.01, CI 1.50 - 10.76), confiding on the internet (OR 4.07, CI 1.49-11.13), severe level of anxiety (OR 3.63, CI 1.04-12.73) and high depression scores (OR 1.10, CI 1.01-1.20). Contrary to previous studies, self-esteem was not found to be significantly associated with internet addiction. Conclusion: This study has important implications in relation to clinical practice, research, and policy-making in Malaysia.

Matched MeSH terms: Depressive Disorder
Fulltext Prevalence and related factors of depression among healthcare personnel at primary healthcare centers

Eusof Izzudin MP, Al–Bedri A, Subramaniam V, Matthews P, Cheong AT

Malaysian Journal of Medicine and Health Sciences, 2018;14(Special 2):32-36.
MyJurnal

Depressive disorders are common. As compared to the general population, healthcare personnel are hypothesized to have an above than average risk to develop this condition. The aim of this study is to assess the prevalence of this condition and its contributing factors amongst primary healthcare personnel.
Methods: A cross-sectional study was conducted by universally sampling 179 primary healthcare personnel at nine primary healthcare centers across Kuala Lumpur and Selangor in May 2015. Depressive symptoms were screened using self-administered Patient Health Questionnaire-9 (PHQ-9) questionnaire. Socio-demographic and work profile data were also assessed.
Results: 92.7% of the 179 personnel agreed to participate. Near half of the respondents were staff nurses (49%), followed by doctors (22%), assistant medical officers (10%), attendants (10%) and the remaining were pharmacists, dieticians, and laboratory technicians (9%). Depression was found to be present in 38% of the participants with one-third found to have moderate to severe depression. Bivariate analysis show that males (p=0.043), assistant medical officers (p=0.048), and working more than 10 hours per day (p=0.019) are significant risk factors. Further analysis by logistic regression shows that working more than 10 hours per day increases the odds of depression by 3.1 (OR 3.1, 95% CI 1.1-8.7, p=0.03).
Conclusions: A high prevalence of depression was found within the healthcare personnel population at the primary healthcare centres studied. Being a male, employed as an assistant medical officer, and, prolonged hours at the workplace is a significant risk factor for depression.

Matched MeSH terms: Depressive Disorder, Major
Lactobacillus paracasei PS23 reduced early-life stress abnormalities in maternal separation mouse model

Liao JF, Hsu CC, Chou GT, Hsu JS, Liong MT, Tsai YC

Benef Microbes, 2019 Apr 19;10(4):425-436.
PMID: 30882243 DOI: 10.3920/BM2018.0077

Maternal separation (MS) has been developed as a model for inducing stress and depression in studies using rodents. The concept of the gut-brain axis suggests that gut health is essential for brain health. Here, we present the effects of administration of a probiotic, Lactobacillus paracasei PS23 (PS23), to MS mice against psychological traits including anxiety and depression. The administration of live and heat-killed PS23 cells showed positive behavioural effects on MS animals, where exploratory tendencies and mobility were increased in behavioural tests, indicating reduced anxiety and depression compared to the negative control mice (P<0.05). Mice administered with both live and heat-killed PS23 cells also showed lower serum corticosterone levels accompanied by higher serum anti-inflammatory interleukin 10 (IL-10) levels, compared to MS separated mice (P<0.05), indicating a stress-elicited response affiliated with increased immunomodulatory properties. Assessment of neurotransmitters in the brain hippocampal region revealed that PS23 affected the concentrations of dopaminergic metabolites differently than the control, suggesting that PS23 may have improved MS-induced stress levels via neurotransmitter pathways, such as dopamine or other mechanisms not addressed in the current study. Our study illustrates the potential of a probiotic in reversing abnormalities induced by early life stress and could be an alternative for brain health along the gut-brain axis.

Matched MeSH terms: Depressive Disorder
Fulltext The burden of mental illness: an emerging global disaster

Mohd Razali Salleh

Journal of Clinical and Health Sciences, 2018;3(1):5-12.
MyJurnal

The global burden of disease (GBD) has shifted from communicable to non-communicable diseases, and from premature death to years live with disabilities (YLDs) over the past 30 years. Mental and substance use disorders constitute a major component in the scenario of the global health with a significant impact on the global burden of disease, especially in the developing countries. The 1990 GBD study listed depression as the fourth common cause of global burden of disease; while lower respiratory infections, diarrheal diseases and conditions arising during perinatal period are top in the list. In GBD 2000 study depressive disorders climbed to the third place, however still behind lower respiratory infections and diarrheal diseases. The subsequent 2010 GBD study ranked depression in the second place of the global disability burden, and are also considered as a major contributor to the burden of suicide and ischaemic heart disease. The WHO predicted that depressive disorders will be the leading cause of global burden in 2030.

Matched MeSH terms: Depressive Disorder
Fulltext Postpartum Mental Health in First-Time Mothers: A Cohort Study

Abdollahi F, Agajani-Delavar M, Zarghami M, Lye MS

Iran J Psychiatry Behav Sci, 2016 Mar;10(1):e426.
PMID: 31168307 DOI: 10.17795/ijpbs-426

Background: Post-partum depression (PPD) can produce adverse symptoms that make motherhood one of the most tumultuous events in a female's life. First-time mothers who have problems adapting themselves to the mother's role are more vulnerable to PPD.

Objectives: The current study aimed to explore the extent of social support and parental self-efficacy on PPD, this study was conducted among the first-time pregnant women.

Patients and Methods: A prospective cohort study assessed the depressive symptoms and related factors among 838 first-time not depressed pregnant women from third trimester of pregnancy to 12 weeks postpartum who attended primary health centers (Jan to July 2009). The study employed Edinburgh postnatal depression scale, social support appraisals scale, network orientation scale, marital inventory, parental expectation survey and socio-demographic questionnaires. Logistic regression was used for data analysis.

Results: The incidence of depression was 10.7% at three months post-partum. The adjusted odds ratio showed the PPD was associated with perceived social isolation (OR = 1.06; 95% CI = 1.01 - 1.12), lack of marital satisfaction (OR = 0.91; 95% CI = 0.86 - 0.97) and low parental self-efficacy (OR = 0.74; 95% CI = 0.65 - 0.85).

Conclusions: A high incidence of PPD was identified among the first-time mothers which makes PPD one of the major health problems in females. The important effects of perceived social isolation, maternal parental self-efficacy, and marital satisfaction on reducing the risk of PPD should be considered.

Matched MeSH terms: Depressive Disorder
Fulltext Impacts of three different relaxation techniques on mood states among athletes

Hazliza Razali, Rohayah Husain, Marhasiyah Rahim, Nor Najibah Endut, Khairi Che Mat, Nordin Simbak, et al.

Malaysian Journal of Public Health Medicine, 2017;17(2):49-58.

Relaxation technique is a method, process, procedure or activity that helps a person to relax. There are several methods of relaxation techniques that can be used proven beneficial to improve the individual state of relaxation. Relaxation can be performed individually or in a group. With suitable technique of relaxation, it will improve quality of life as well as emotional and physical. This study aims to investigate the impact of three different relaxation techniques, namely Autogenic (AGR), Progressive Muscle (PMR) and Music Relaxation (MR) on mood states among Universiti Sultan Zainal Abidin (UniSZA) athletes. Eighty UniSZA athletes aged between 18 to 25 years old were randomly assigned into four groups which were AGR, PMR, MR and control group. Each groups consisted of 20 subjects which were male and female athletes with multidiscipline of the sports involvement. The mood states were determined by Brunel Mood Scale (BRUMS) during pre and post-intervention. The subjects in the three intervention groups received relaxation training twice a week for four weeks, 30 minutes per sessions. While, a control group not received any relaxation training during the intervention time. Repeated measure ANOVA conducted showed that the two parameters in BRUMS significantly changes in post-intervention such vigour (F=16.083, p<0.0001) and confusion (F=3.412, p=0.022). Other negative mood scores showed no significant changes such; (anger; F=2.235, p=0.091, depression; F=0.960, p=0.416, fatigue; F=0.724, p=0.540, tension; F=16.083, p=0.913).The results of Pairwise Comparison revealed that the three types of relaxation techniques (AGR, PMR and MR) effective to enhance vigour (positive mood) score among the adult subjects. In this study, PMR was the most effective relaxation technique followed by AGR and MR to regulate the mood state among adults.

Matched MeSH terms: Depressive Disorder
Fulltext High carbonated soft drink consumption is associated with externalizing but not internalizing behaviours among university students in five ASEAN states

Pengpid S, Peltzer K

Psychol Res Behav Manag, 2019;12:585-592.
PMID: 31534377 DOI: 10.2147/PRBM.S209611

Background: The investigation aimed to estimate the association between carbonated soft drink consumption frequency and externalizing and internalizing behaviour among university students in five ASEAN counties.
Methods: A cross-sectional survey included 3353 university students from Indonesia, Malaysia, Myanmar, Thailand and Vietnam, median age 20 years (interquartile range 3 years).
Results: In all five ASEAN countries, the study found a prevalence no soft drink consumption in the past 30 days of 20.3%, less than one time a day 44.7%, once a day 25.4% and two or more times a day 9.6%. In the adjusted logistic regression analysis, higher frequency of soft drink consumption (one and/or two or more times a day) was associated with externalizing behaviour (in physical fight, injury, current tobacco use, problem drinking, drug use, pathological internet use and gambling behaviour), and higher frequency of soft drink consumption (two or more times a day) was associated with depression in females, but no association was found for the general student population in relation to internalizing behaviour (depression, posttraumatic stress disorder, suicidal ideation, suicide plan, suicide attempt and sleeping problem).
Conclusions: Findings suggest that carbonated soft drink consumption is associated with a number of externalizing but not internalizing health risk behaviours.

Matched MeSH terms: Depressive Disorder
Self-esteem among cancer patients receiving chemotherapy in selected

Vidthya S, Sherina MS, Rampal L, Fadhilah SI, Ummavathy P

Med J Malaysia, 2019 Oct;74(5):405-412.
PMID: 31649217

INTRODUCTION: The number of cancer cases in Malaysia has increased from 32,000 cases in 2008 with to 37,000 in 2012 (check figures in text). This number is expected to rise to 56,932 by 2025. Cancer patients undergoing chemotherapy experience low to moderate level of self-esteem.
OBJECTIVES: To determine the self-esteem among oncology patients receiving chemotherapy in selected government state hospitals, Peninsular Malaysia.
METHODS: A cross-sectional study was conducted using selfadministered questionnaires. 953 respondents were given questionnaires which included socio-demographic profile, physical effect, depression, anxiety, quality of life and self esteem. Inferential analysis was done by using Independent T-test or Pearson's Correlation and the level of significance was p<0.05. Multivariate logistic regression was then used to determine the predictors using Statistical Package for Social Sciences software version 22.0 RESULTS: All 953 respondents selected participated in this study. The overall mean self-esteem in this study was 22.67, SD=4.98. The significant predictors of self-esteem where pvalue was <0.05 were age; gender; marital status; working status; anxiety; depression; nausea; anemia; hair loss; skin and nail changes; overall quality of life and psychological domain of quality of life. The finding of this study indicates that predictors of selfesteem among patients undergoing chemotherapy should be taken into account to improve their quality of life. Guidelines on how to manage self-esteem in a chemotherapy patient can be done using this study as the baseline.

Matched MeSH terms: Depressive Disorder
Fulltext Weather fluctuations: predictive factors in the prevalence of acute coronary syndrome

Sharif Nia H, Chan YH, Froelicher ES, Pahlevan Sharif S, Yaghoobzadeh A, Jafari A, et al.

Health Promot Perspect, 2019;9(2):123-130.
PMID: 31249799 DOI: 10.15171/hpp.2019.17

Background: Meteorological parameters and seasonal changes can play an important role in the occurrence of acute coronary syndrome (ACS). However, there is almost no evidence on a national level to suggest the associations between these variables and ACS in Iran. We aim to identify the meteorological parameters and seasonal changes in relationship to ACS. Methods: This retrospective cross-sectional study was conducted between 03/19/2015 to 03/18/2016 and used documents and records of patients with ACS in Mazandaran ProvinceHeart Center, Iran. The following definitive diagnostic criteria for ACS were used: (1) existence of cardiac enzymes (CK or CK-MB) above the normal range; (2) Greater than 1 mm ST-segment elevation or depression; (3) abnormal Q waves; and (4) manifestation of troponin enzyme in the blood. Data were collected daily, such as temperature (Celsius) changes, wind speed and its direction, rainfall, daily evaporation rate; number of sunny days, and relative humidity were provided by the Meteorological Organization of Iran. Results: A sample of 2,054 patients with ACS were recruited. The results indicated the highest ACS events from March to May. Generally, wind speed (18 PM) [IRR = 1.051 (95% CI: 1.019 to1.083), P=0.001], daily evaporation [IRR = 1.039 (95% CI: 1.003 to 1.077), P=0.032], daily maximum (P<0.001) and minimum (P=0.003) relative humidity was positively correlated withACS events. Also, negatively correlated variables were daily relative humidity (18 PM) [IRR =0.985 (95% CI: 0.978 to 0.992), P<0.001], and daily minimum temperature [IRR = 0.942 (95%CI: 0.927 to 0.958), P<0.001]. Conclusion: Climate changes were found to be significantly associated with ACS; especially from cold weather to hot weather in March, April and May. Further research is needed to fully understand the specific conditions and cold exposures.

Matched MeSH terms: Depressive Disorder
Elderly people with mental illness in South-East Asia: rethinking a model of care

Heok KE

Int Psychiatry, 2010 Apr;7(2):34-36.
PMID: 31508029

The report World Population Ageing 1950-2050 (United Nations, 2002) estimated that in 2005 there were 37.3 million elderly people (i.e. aged 65 years or more) in South-East Asia (a region incorporating Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Vietnam). There are only a few epidemiological studies on mental disorders among elderly people in this region and the published data are mainly from Singapore, Malaysia and Thailand. Using Singapore's prevalence rate of 3% for dementia and 5.7% for depression, the numbers of elderly people with dementia in this region would be 1.2 million and with depression 2.12 million (Kua, 1992; Kua & Ko, 1995). However, even in Singapore, we have identified only 10% of all potential cases of dementia and depression - meaning that the large majority of elderly people with mental disorders are not detected, although they may be known, for other reasons, to the health services.

Matched MeSH terms: Depressive Disorder
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
Fulltext Sociodemographic, lifestyle and health factors associated with depression among adults in Malaysia: an ethnic comparison

Cheah, Y.K., Azahadi, M., Phang, S.N., Abd Manaf, N.H.

JUMMEC, 2019;22(1):33-40.
MyJurnal

Background: Depression is a serious mental health illness worldwide. The purpose of the study was to
investigate the relationships between depression and its risk factors of sociodemography, lifestyle, and health
among the adults of the different ethnic groups in Malaysia.

Method: A nationwide database with 10141 observations was used. Multivariable logistic regression analyses
stratified by ethnicity were estimated.

Results: Ethnicity and gender, age, education, marital status and self-rated health were correlated to the
likelihood of having depression. Malay females and smokers (AOR: 2.083) were more likely to suffer from
depression than Malay males (AOR: 0.305) and non-smokers. Higher-income Chinese displayed higher odds of
having depression than lower-income Chinese (AOR: 1.009). Indians and others with secondary-level education
displayed a lower likelihood of developing depression compared to those with primary-level education (AOR:
0.587).

Conclusion: This study could contribute significantly to the formulation and development of an effective
policy directed towards reducing the prevalence of depression in the vulnerable. These were the adults, in
the younger age group, with lower education, with self-rated poor health, being female, unmarried, Malay
and Chinese, and Indians and others. A nationwide policy targeted towards the Malay females to reduce
their depression, with attention to the Chinese with a high income, and to the Indians and others with poor
educational background to improve their knowledge of mental health, would be worthy of consideration.

Matched MeSH terms: Depressive Disorder
Fulltext Patterns of Referral to Clinical Psychology Services in the Ministry of Health Malaysia

Martadza M, Saedon UI, Darus N, Badli TST, Ghazalan SA, Yunus WMAWM

Malays J Med Sci, 2019 Nov;26(6):111-119.
PMID: 31908592 MyJurnal DOI: 10.21315/mjms2019.26.6.11

Background: This descriptive study identifies the demographic characteristics and patterns of referral to clinical psychology services, which include types of diagnosis, types of referral and source of referrals in child, adolescent, adult and geriatric cases in Malaysia.
Methods: We utilised 2,179 referrals between January and December 2015 from six general hospitals and three mental health institutions that provide clinical psychology services.
Results: The percentage of male referrals (60.3%) is higher than that of female referrals (39.7%). Adult cases had the highest percentage of referrals (48.2%). Children (48.8%) and adolescent (28.1%) cases were mainly referred for psychological assessment. Meanwhile, adult cases (74.8%) were mainly referred for psychological intervention. Neurodevelopmental disorders was the diagnosis with the highest percentage of referrals recorded (41.4%), followed by depressive disorders (13.3%) and anxiety disorders (12.7%), and the combination of other disorders. Psychiatrists provided the highest number of referrals (82.2%), which is unsurprising as both fields are closely related.
Conclusion: Clinical psychology services within the Ministry of Health (MOH) Malaysia play an important role in mental health care.

Matched MeSH terms: Depressive Disorder

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