Displaying publications 21 - 40 of 72 in total

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  1. Chan CMH, Ng CG, Taib NA, Wee LH, Krupat E, Meyer F
    Cancer, 2018 01 15;124(2):406-416.
    PMID: 29152719 DOI: 10.1002/cncr.30980
    BACKGROUND: Scant evidence exists on the long-term course of cancer-related post-traumatic stress disorder (PTSD). This is among the few studies worldwide, and the first in the South-East Asian region, to prospectively evaluate PTSD in patients with cancer using gold-standard clinical interviews. The objective of the study was to assess the course and predictors of PTSD in adult patients with cancer in a South-East Asian population.

    METHODS: A prospective, longitudinal study was conducted in a cohort of 469 consecutively recruited patients (aged ≥18 years) with various cancer types within 1 month of diagnosis at a single oncology referral center. Only patients who had significant psychological distress (Hospital Anxiety and Depression Scale total cutoff score ≥16) underwent the PTSD module of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (SCID) at at 6-months follow-up. All patients completed the SCID at the 4-year follow-up assessment regardless of their initial Hospital Anxiety and Depression Scale score.

    RESULTS: In an analysis combining patients who had both full and subsyndromal PTSD, there was a 21.7% incidence of PTSD at the 6-month follow-up assessment (n = 44 of 203 SCID-interviewed patients), with rates dropping to 6.1% at the 4-year follow-up assessment (n = 15 of 245 SCID-interviewed patients). Patients with breast cancer (compared with those who had other types of cancer) were 3.68 times less likely to develop PTSD at 6-months, but not at 4-years follow-up.

    CONCLUSIONS: The overall rates of PTSD decreased with time, but one-third of patients (34.1%) who were initially diagnosed had persistent or worsening PTSD 4 years later. There is a need for early identification of this subset of patients who have cancer with PTSD to design risk-targeted interventions. Cancer 2018;124:406-16. © 2017 American Cancer Society.

  2. Chan CMH, Ng CG, Taib A, Wee LH, Krupat E, Meyer F
    Cancer, 2018 04 15;124(8):1839-1840.
    PMID: 29499076 DOI: 10.1002/cncr.31281
  3. Aida SA, Aili HH, Manveen KS, Salwina WI, Subash KP, Ng CG, et al.
    Int J Prison Health, 2014;10(2):132-43.
    PMID: 25764076 DOI: 10.1108/IJPH-06-2013-0029
    The number of juvenile offenders admitted to Malaysian prisons is alarming. The purpose of this paper is to determine the presence of any psychiatric disorders and their association with personal characteristics of juvenile detainees in prisons across Peninsular Malaysia.
  4. Cheng ML, See MH, Sinnadurai S, Islam T, Alip A, Ng CG, et al.
    Breast J, 2020 Mar;26(3):568-570.
    PMID: 31495038 DOI: 10.1111/tbj.13617
  5. Ng CG, Mohamed S, See MH, Harun F, Dahlui M, Sulaiman AH, et al.
    PMID: 26715073 DOI: 10.1186/s12955-015-0401-7
    Depression and anxiety are common psychiatric morbidity among breast cancer patient. There is a lack of study examining the correlation between depression, anxiety and quality of life (QoL) with perceived social support (PSS) among breast cancer patients. This study aims to study the level of depression, anxiety, QoL and PSS among Malaysian breast cancer women over a period of 12 months and their associations at baseline, 6 and 12 months.
  6. Ng CG, Mohamed S, Kaur K, Sulaiman AH, Zainal NZ, Taib NA, et al.
    PLoS One, 2017;12(3):e0172975.
    PMID: 28296921 DOI: 10.1371/journal.pone.0172975
    BACKGROUND: Breast cancer patients often experience a high level of distress. Psychological distress is a broad construct encompass both depression and anxiety. Previous studies in examining which of these psychological symptoms (either anxiety or depression) were more significantly associated with the distress level in breast cancer patients is lacking. This study aims to compare the level of depression and anxiety between patients with different level of distress. The correlation between the changes in distress level with depression or anxiety over 12 months was also examined.

    METHODS: This study is from the MyBCC cohort study. Two hundred and twenty one female breast cancer patients were included into the study. They were assessed at the time of diagnosis, 6 months and 12 month using Hospital Anxiety and Depression Scale (HADS) and distress thermometer. The information on age, ethnicity, treatment types and staging of cancer were collected.

    RESULTS: 50.2%, 51.6% and 40.3% of patients had perceived high level of distress at baseline, 6 months and 1 year after diagnosis. Those with high perceived level of distress had significant higher anxiety scores even after adjusted for the underlying depressive scores (Adjusted OR at baseline = 1.28, 95% CI = 1.13-1.44; adjusted OR at 6 months = 1.27, 95% CI = 1.11-1.45; adjusted OR at 12 months = 1.51, 95% CI = 1.29-1.76). There were no significant differences in the depressive scores between the subjects with either low or high distress level. There was reduction in perceived level of distress, anxiety and depression scores at 12 months after the diagnosis. The decrease of distress was positively correlated with the reduction of anxiety scores but not the changes of depressive scores (r' = 0.25).

    CONCLUSION: Anxiety is a more significant psychological state that contributed to the feeling of distress in breast cancer as compared with depression. Levels of anxiety at diagnosis in this study would justify screening for anxiety, early identification and therapy for maintaining the psychological well-being of breast cancer patients. Further studies will be needed to measure the effectiveness of therapeutic interventions.

  7. Islam T, Bhoo-Pathy N, Su TT, Majid HA, Nahar AM, Ng CG, et al.
    BMJ Open, 2015 Oct 26;5(10):e008643.
    PMID: 26503386 DOI: 10.1136/bmjopen-2015-008643
    INTRODUCTION: Over recent decades, the burden of breast cancer has been increasing at an alarming rate in Asia. Prognostic research findings from Western countries may not readily be adapted to Asia, as the outcome of breast cancer depends on a multitude of factors ranging from genetic, clinical and histological predictors, to lifestyle and social predictors. The primary aim of this study is to determine the impact of lifestyle (eg, nutrition, physical activity), mental and sociocultural condition, on the overall survival and quality of life (QoL) among multiethnic Malaysian women following diagnosis of breast cancer. This study aims to advance the evidence on prognostic factors of breast cancer within the Asian setting. The findings may guide management of patients with breast cancer not only during active treatment but also during the survivorship period.

    METHODS: This hospital-based prospective cohort study will comprise patients with breast cancer (18 years and above), managed in the University Malaya Medical Centre (UMMC). We aim to recruit 1000 cancer survivors over a 6-year period. Data collection will occur at baseline (within 3 months of diagnosis), 6 months, and 1, 3 and 5 years following diagnosis. The primary outcomes are disease-free survival and overall survival, and secondary outcome is QoL. Factors measured are demographic and socioeconomic factors, lifestyle factors (eg, dietary intake, physical activity), anthropometry measurements (eg, height, weight, waist, hip circumference, body fat analysis), psychosocial aspects, and complementary and alternative medicine (CAM) usage.

    ETHICS AND DISSEMINATION: This protocol was approved by the UMMC Ethical Committee in January 2012. All participants are required to provide written informed consent. The findings from our cohort study will be disseminated via scientific publication as well as presentation to stakeholders including the patients, clinicians, the public and policymakers, via appropriate avenues.

  8. Ng CG
    Med J Malaysia, 2014 Aug;69 Suppl A:42-5.
    PMID: 25417950 MyJurnal
    Depression is a debilitating illness and has become a leading cause of morbidity globally. We aim to summarise the evidence available in regard to the prevalence, type of assessment tools used and treatment options for depression in Malaysia. Two hundred and forty seven articles related to depression were found in a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. Fifty seven articles were selected and reviewed on the basis of clinical relevance and future research implications. Findings were summarised, categorised and presented according to prevalence of depression, depression in women, depression in clinical condition, assessment tools, and treatment of depression. The prevalence of depression in Malaysia was estimated to be between 8 and 12%. The figures were higher among women of low socio-economic background or those with comorbid medical condition. The common assessment tools used in Malaysia include Beck Depression Inventory (BDI), Depression, Anxiety and Stress Scale (DASS), Patient Health Questionnaire 9 (PHQ-9) and Hospital Anxiety and Depression Scale (HADS). They were translated into the Malay language and their psychometric properties were established. Both pharmacological treatment and psychotherapy were commonly used in Malaysia, and were highly recommended in local clinical practice guidelines. There are discrepancies in the reported rates of depression in Malaysia and this needs to be addressed. There were lack of studies looking into the depression among subgroups in Malaysia especially in the male population. There were several instruments available for assessment of depression in Malaysia but their suitability for the local setting need further research. Both pharmacotherapy and psychotherapy were recommended in the local treatment guideline in Malaysia. With the emergence of generic medication, we need to compare their clinical efficacy and tolerability with original products.
  9. Yee A, Loh HS, Hisham Hashim HM, Ng CG
    J Sex Med, 2014 Jan;11(1):22-32.
    PMID: 24344738 DOI: 10.1111/jsm.12352
    INTRODUCTION: For many years, methadone has been recognized as an effective maintenance treatment for opioid dependence. However, of the many adverse events reported, sexual dysfunction is one of the most common side effects.

    AIM: We conducted a meta-analysis to evaluate the prevalence of sexual dysfunction among male patients on methadone and buprenorphine treatments.

    METHODS: Relevant studies published from inception until December 2012 were identified by searching PubMed, OVID, and Embase. Studies were selected using prior defined criteria. Heterogeneity, publication bias, and odds ratio were assessed thoroughly.

    MAIN OUTCOME MEASURES: To examine the prevalence and odds ratio of sexual dysfunctions among the methadone and buprenorphine groups.

    RESULTS: A total of 1,570 participants from 16 eligible studies were identified in this meta-analysis. The studies provided prevalence estimates for sexual dysfunction among methadone users with a meta-analytical pooled prevalence of 52% (95% confidence interval [CI], 0.39-0.65). Only four studies compared sexual dysfunction between the two groups, with a significantly higher combined odds ratio in the methadone group (OR = 4.01, 95% CI, 1.52-10.55, P = 0.0049).

    CONCLUSIONS: Evidence showed that the prevalence of sexual dysfunction was higher among the users of methadone compared with buprenorphine. Patients with sexual difficulty while on methadone treatment were advised to switch to buprenorphine.

  10. Narkunam N, Hashim AH, Sachdev MK, Pillai SK, Ng CG
    Asia Pac Psychiatry, 2014 Jun;6(2):207-16.
    PMID: 23857633 DOI: 10.1111/j.1758-5872.2012.00216.x
    Attention deficit hyperactivity disorder (ADHD) is a chronic debilitating illness with onset in early childhood. The objective of this study was to look at the impact of children with ADHD on their parents.
  11. Abdul Latif R, Muhamad R, Kanagasundram S, Sidi H, Nik Jaafar NR, Midin M, et al.
    Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:21-6.
    PMID: 23857833 DOI: 10.1111/appy.12039
    The objective of this study was to examine the risk of female sexual orgasmic disorder among a group of women with hypertension in Malaysia. The associated factors were also examined.
  12. Nurasikin MS, Khatijah LA, Aini A, Ramli M, Aida SA, Zainal NZ, et al.
    Int J Soc Psychiatry, 2013 Jun;59(4):332-8.
    PMID: 22408116 DOI: 10.1177/0020764012437127
    Patients having psychiatric diagnoses often experience high level of distress. Religiousness is often used by them as part of their coping mechanism and problem-solving strategies.
  13. Yee HA, Loh HS, Ng CG
    Int J Psychiatry Clin Pract, 2013 Oct;17(4):292-7.
    PMID: 23170840 DOI: 10.3109/13651501.2012.752012
    To determine the prevalence of alcohol-use disorder and associated correlates amongst bipolar patients in a university hospital in Malaysia.
  14. Yee A, Chin SC, Hashim AH, Harbajan Singh MK, Loh HS, Sulaiman AH, et al.
    Int J Psychiatry Clin Pract, 2015;19(3):182-7.
    PMID: 25874350 DOI: 10.3109/13651501.2015.1031139
    Anhedonia is the reduced ability to experience pleasure. It is a core symptom of depression and is particularly difficult to treat. This study aims to compare the level of anhedonia between depressed patients on anti-depressants and healthy subjects.
  15. Yee A, Loh HS, Hisham Hashim HM, Ng CG
    Int J Impot Res, 2014 Sep-Oct;26(5):161-6.
    PMID: 24990199 DOI: 10.1038/ijir.2014.18
    Methadone maintenance treatment is proven to be effective treatment for opioid dependence. Of the many adverse events reported, sexual dysfunction is one of the most common side effects. However, there may be other clinical factors that are associated with sexual dysfunction among methadone users. We conducted a meta-analysis to examine the clinical factors associated with sexual dysfunction among male patients on methadone and buprenorphine treatments, of which eligible studies were selected using prior defined criteria. A total of 2619 participants from 16 eligible studies, published from inception till December 2012, were identified from the PubMed, OVID and EMBASE databases. The included studies provided prevalence estimates for sexual dysfunction among methadone users with a meta-analytical pooled prevalence of 52% (95% confidence interval (CI), 0.39-0.65). Only four studies compared sexual dysfunction between the two groups, with a significantly higher combined odds ratio in the methadone group (odds ratio=4.01, 95% CI, 1.52-10.55, P=0.0049). Our study shows that eight clinical factors are associated with sexual dysfunction among men receiving opioid substitution treatment, namely age, hormone assays, duration of treatment, methadone dose, medical status, psychiatric illness, other current substance use and familial status, and methadone versus buprenorphine treatment. Despite the methodological limitations, the findings of this meta-analysis study may offer better insights to clinicians in dealing with both sexual dysfunction and its related problems.
  16. Ismail AH, Baw R, Sidi H, Ng CG
    MyJurnal
    Objectives: This study aims to determine the prevalence and associated factors of sexual pain disorders among Malay women in Malaysia with type 2 diabetes mellitus.
    Methods: This is a cross-sectional study involving 347 women (174 non- diabetic and 173 diabetic subjects) who attended the diabetic clinic in a university hospital. Sexual pain disorders were assessed using the Pain sub scale of Malay Version of the Female Sexual Function Index (MVFSFI). Socio-demographic information of the subjects was collected with a pre-designed questionnaire.
    Results: Prevalence of sexual pain disorders among Malay women with type 2 diabetes mellitus was 10.4% and the control group was 9.2% but the difference was not statistically significant (p > 0.05). Multivariate logistic regression analysis did not find any relevant associated factor with sexual pain disorder.
    Conclusion: Sexual pain disorders among Malay women were not dependent on the diabetic status. Further studies with different population of diabetic patients are needed to confirm the results.
    Study site: Diabetic clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
  17. Shari NI, Zainal NZ, Ng CG
    J Psychosoc Oncol, 2021;39(6):695-714.
    PMID: 33287685 DOI: 10.1080/07347332.2020.1856283
    PURPOSE: This study examined the efficacy of a brief acceptance and commitment therapy (ACT) on subjective cognitive impairment in breast cancer patients undergoing chemotherapy.

    METHODS: Data collection was carried out in 3-time points: baseline (T1), screening (T2), and post-treatment (T3). Respondents who had significant subjective cognitive impairment were randomly divided into two groups: intervention (n = 30) and waitlist (n = 30). Respondents in the intervention group received 4 sessions of 1 hour of ACT therapy.

    FINDINGS: Respondents in the intervention group showed significant improvement in subjective cognitive impairment, depression, anxiety, and psychological inflexibility after the ACT intervention (p 

  18. Zhang MWB, Ho RCM, Ng CG
    Technol Health Care, 2017 Dec 04;25(6):1173-1176.
    PMID: 28946598 DOI: 10.3233/THC-170868
    In psychiatry, mindfulness based intervention has been increasingly popular as a means of psychosocial intervention over the last decade. With the alvanche of technological advances, there has been a myriad of mindfulness based applications. Recent reviews have highlighted how these applications are lacking in functionalities and without demonstrated efficacy. Other reviews have emphasized that there is a need to take into consideration the design of an application, due to placebo effects. It is the aim of this technical note to illustrate how the 5-Minutes Mindfulness application, which is an application designed to provide mindfulness exercises to relieve distress and suffering amongst palliative patients, have been conceptualized. The conceptualized application builds on previous evidence of the efficacy of 5-Minutes Mindfulness demonstrated by pilot and randomized trials. In terms of design, the currently conceptualized application has been designed such that placebo effects could be controlled for.
  19. Adawiyah J, Moonyza AAK, Mohd Rizal AM, Hatta S, Nik Ruzyanei NJ, Marhani M, et al.
    MyJurnal
    Introduction: Psoriasis is a chronic, immune mediated, hyperproliferative skin disease that has substantial impact on the sexual functions. This study aimed to determine the prevalence and associated factors of female sexual dysfunction (FSD) in patients with psoriasis.
    Methods: A cross-sectional study involving 79 women with psoriasis attending two Dermatology Outpatient Clinics were interviewed and assessed for female sexual dysfunction and severity of psoriasis. The socio-demographic and clinical characteristics of the subjects were compared between the women with and without sexual dysfunction. The subjects were interviewed using Mini International Neuropsychiatric Interview (M.I.N.I.) to exclude any existing psychiatric illness. Sexual dysfunction was assessed using a validated questionnaire on sexual function and the severity of psoriasis was assessed using Psoriasis Area and Severity Index (PASI).
    Results: The prevalence of FSD in the patients with psoriasis was 20.3%, with hypoactive sexual desire being the most prevalent problem (44.3%). Sexual dysfunction was associated with older age, menopause, low body mass index, longer duration of marriage and presence of psoriasis in the genital area. Female sexual dysfunction was highly prevalent in patients with psoriasis.
    Conclusion: Management of psoriasis should include assessment in patients’ sexual health. Genital area involvement with psoriasis should not be overlooked as it can cause significant psychosexual distress.
    Keywords: Psoriasis, female, sexual dysfunction, prevalence, risk factor, Malaysia
    Study site: Dermatology clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
  20. Gan GG, Tey KWF, Mat S, Saad M, Bee PC, Abdul Malik R, et al.
    Asian Pac J Cancer Prev, 2022 Nov 01;23(11):3905-3914.
    PMID: 36444604 DOI: 10.31557/APJCP.2022.23.11.3905
    BACKGROUND: Quality of life (QOL) of family caregivers of cancer patients is usually affected due to increase in caregiver burden. Their QOL has not garnered much attention by many including the health professionals and community. This study aims to explore the QOL of family caregivers of cancer patients in a multi-ethnic country in Asia and to investigate its associate factors.

    METHODS: This is a cross-sectional study where family caregivers and patients who were diagnosed of cancers within 12 months were recruited. QOL of caregivers were measured using The Caregiver Quality of Life Index-Cancer (CQOLC). Psychological distress was measured using Hospital anxiety and depressive scale. Logistic regression analysis was performed to determine the related factors of QOL of caregivers.

    RESULTS: A total of 458 patients/caregiver pairs were included. Symptoms of anxiety and depression reported by caregivers were 24.9% and 24.2% respectively. Caregivers of patients with solid tumors have better CQOLC score compared to those who cared for patients with hematological cancers (91.25 vs 86.75). Caregivers of non-Malay ethnicity, those caring for patients with advanced stage cancer and with hematological cancers had significantly poorer QOL. QOL of caregivers are also significantly affected when patients demonstrated anxiety symptoms.

    CONCLUSION: This study provides detailed evaluation of the QOL of caregivers of cancer patients in Malaysia. The significant psychological distress and low caregiver QOL indicate the urgent need for comprehensive supports for caregivers with cancer patients, especially those caring for patients with haematological cancers.

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