Objective: In the process of growing, adolescents experience stress either good or bad depending on how they cope. School training further adds to this stressful situation. It is noteworthy that persistent over stress will impair students’ academic achievement, personal and professional development. This preliminary study is meant to obtain initial data on the stress prevalence, stressors, and coping strategies among secondary school children in Malaysia. Data gained from this preliminary study provides valuable data for subsequence research in the future. Methods: This is a cross-sectional study involving 100 secondary school students from a Malaysian government secondary school. The validated Malay version 12-item General Health Questionnaire (GHQ-12), Soalselidik Stressor Sekolah Menengah (SSSM) and Malay version of Brief COPE were used to identify stress level, stressors, and coping strategies. Results: A number of 90 (90%) students participated in this study. The prevalence of stress among secondary school students was 26.1%. It was found that the main stressors were related to academic. The top five coping strategies were religion, positive reinterpretation, active coping, planning, and use of instrumental support. Conclusion: The prevalence of stress among secondary school students in a Malaysian
stressor among the students. The most frequent coping strategies being used by the students were positive coping strategies.
Objective: Smart phones have become an important part of human’s life, including the healthcare population and medical students. However, pathological use of smart phones could lead to smart phones addiction. The aim of this study is to observe a pattern of usage of smart phones among the medical students and staffs in the Faculty of Medicine Universiti Teknologi MARA (UiTM) and screen for smart phone addiction among the respondents.
Methods: A cross sectional, quasi-experimental study design involving medical students and staffs in the Faculty of Medicine Universiti Teknologi MARA (UiTM) was employed. A total of 598 respondents was approached to participate, and all consented to this study. Measurements used in the study include a self-developed questionnaire to measure pattern of smart phone usage and Smart phone addiction scale (Malay version).
Result: We found that 65.9% of the respondents were heavy users of the smart phone (more than 3 hours daily) and majority of them were using it for social networking. More than half of the respondents (52.2%) were at risk of developing smart phone addiction based on Smart phone Addiction Scale (Malay Version).
Conclusion: This study revealed that medical students, and the faculty staffs were heavy users of smart phones, and they were at risk to develop smart phone addiction.
Objective: Mental health is often stigmatized in Asia, and electroconvulsive therapy (ECT) is portrayed negatively in the media. The objective of this short report is to obtain an insight on Asian countries’ perception on Electroconvulsive Therapy, mainly through the media.
Methods: Several online movie databases were searched, with emphasis on Asian movies’ portrayal of Electroconvulsive Therapy.
Results: Electroconvulsive Therapy (ECT) was portrayed in 9 television programme, 4 in films and 2 on Youtube. All patients (15) had no proper information given on possible side effects and consent not taken in all of them. 5 patients (33%) were tortured via ECT, 3(20%) of them had, ECT for Schizophrenia. In all scenes (15/15, 100%) ECT were given without general anaesthesia and the patients were fully awake. Basic monitoring (2/15, 13%) was performed, and all patients had no oxygenation. Tonic Clonic seizures were visible because all patients received no muscle relaxant. Bilateral electrode's placements (13/15, 87%) were common. One (6.6%) patient had a trilateral electrode placement. Most patients (9/15, 60%) received one shock, 4 patients (27%) received 2 shocks. One patient (6.6%) received 3 and 1 patient (6.6%) 4 shocks. 100% of patients were in obvious discomfort and ECT was portrayed as barbaric. There was no death depicted post ECT.
Conclusion: ECT is under portrayed in the Asian media. Only the Indian and Pakistani medium broached the subject. In the majority of the scenes, ECT was portrayed
negatively. This shows a total lack of knowledge of ECT among the Asian population. Alarmingly, ECT was used as a torture device in 5 mediums. This only adds to the stigma of ECT in Asia. More needs to be done to correct the misconceptions of ECT in Asia.
Objective: To determine the sensitivity, specificity and internal consistency of the Malay version GHQ-12 among medical student population. This study determined the appropriate GHQ-12 score to detect distressed medical students. Methods: The Malay version of GHQ-12 was derived based on two sources which were the original version GHQ-12 and the validated Malay version 30-items GHQ. The GHQ-12 and the Malay version Beck Depression Inventory-II (BDI-II) were administered to a total of 141 medical students. Distress diagnoses were made based on the Malay version BDI-II. ROC curve analysis was applied to determine the sensitivity and specificity of the GHQ-12 by testing against the BDI-II. Reliability analysis (Cronbach’s alpha and item total correlation) was applied to test internal consistency of the
GHQ-12. The analysis was done using SPSS version 12.Results: The GHQ-12 sensitivity and specificity at cut-off point of 3/4 was 81.3% and 75.3% respectively with positive predictive value (PPV) of 62.9% as well as area under ROC curve more than 0.7. The Cronbach’s alpha value of the GHQ-12 was 0.85.Conclusion: This study showed the Malay version GHQ-12 is a valid and reliable screening tool in detecting distressed medical students. The
GHQ-12 score equal to or more than 4 was considered as significant distress.
Introduction and Objective: Tobacco use is a significant risk factor for oral diseases. Periodontal disease has been known to be associated with tobacco use for over twenty years. Despite that, dentists and particularly periodontist does not include tobacco use cessation as part of their initial treatment in treating periodontal disease or placing implants in patients who use tobacco. The increase in prevalence and severity of periodontitis among smokers
cannot be explained by differences in the amount of plaque between smokers and nonsmokers. A possible explanation is that smoking may alter the quality of the flora. Dental professionals also have a crucial role to play in tobacco cessation counseling, particularly for patients with chronic periodontitis. More patients will be affected by periodontitis than will ever be affected by oral cancer. Methods and Results: Reviews of literatures were
done on a clearly formulated question on the need of smoking cessation intervention to increase positive outcome of treatment on periodontal disease. Conclusion: Various epidemiological studies strongly suggest that tobacco use cessation is beneficial to patients following periodontal treatments for a better outcome.
This paper discusses the evolution of PSR development for people with severe mental illness since the early 20th century in Malaysia. The various aspects of PSR include the activities, service target, the treatment settings, factors contributed to the development and the challenges that have been faced are also described along with the evolution, comparing the past and
present. It is learned that despite of many challenges, PSR in Malaysia has now continued to progress with increasing supports from the stakeholders and is in keeping with the current PSR concept.
Objective: To investigate the prevalence of Female Orgasmic Dysfunction (FOD) focusing on the orgasm domain among female patients attending PPUKM Psychiatric clinic. To compare the prevalence of orgasmic dysfunction between female patients on Escitalopram and on Fluoxetine therapy.
Methods: A validated questionnaire for sexual function was used to assess orgasmic function. A total of 112 women aged between 24 and 57 participated in this study. The orgasmic dysfunction was compared between patients on selective serotonin reuptake inhibitors (SSRIs) fluoxetine and escitalopram.
Results: The prevalence of female orgasmic dysfunction was 58.9% (33/56) among patients treated with Fluoxetine and 41.1% (23/56) among patients treated with Escitalopram. However, there was no statistically significant difference between these two treatment groups (p=0.059). The odds to have FOD among patients on higher dose of antidepressants was found to be higher compared to those patients who were on lower dose of antidepressants (Odds ratio 5.32, p= 0.001).
Conclusion: There was no significant difference of Female Orgasmic Dysfunction between patients on Fluoxetine and Escitalopram.
Study site: Psychiatric clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Objective: To investigate the prevalence of genital arousal disorder and the potential risk
factors that may impair genital arousal among women at a primary care setting in Malaysia.
Methods: A validated questionnaire for sexual function was used to assess genital arousal
function. A total of 230 married women aged 18–70 years old participated in this study. Their sociodemographic and marital profiles were compared between those who had genital arousal disorder and those who did not. The risk factors were examined. Results: The prevalence of genital arousal disorder in the primary care population was 50.4% (116/230). Women with genital arousal disorder were found to be significantly higher in groups of more than 45 years old (p55) (p=.001), those having 4 children or more (p=.028), those having less sexual intercourse (less than 1–2 times a week) (p=.001), and those at post-menopausal state (p=.002). There was no significant difference between these two groups in term of salary (p=.29), suffering from medical problems (p=.32), dysmenorrhea (p=.95), menarche (p=.5) and hormonal replacement therapy (p=.6). Conclusion: Women with infrequent sexual intercourse are less likely to be sexually aroused (OR=0.29, 95% CI: 0.11-0.74).
Objective: The aim of the study is to examine the prevalence and factors influencing PTSD among a sample of help-seeking women experiencing domestic violence. Methods: This was a cross-sectional survey study of 40 women in two shelters in Malaysia from 2007 to 2008. Measures include the Detailed Assessment of Posttraumatic Stress; the Measure of Wife Abuse; the Posttraumatic Cognitions Inventory; the Coping Scale for Adults; and the Provision of Social Relations. Results: Results showed that 60% of subjects
exhibited patterns of symptoms consistent with the diagnosis of PTSD. The most prominent posttraumatic symptoms reported were re-experience, avoidance, dissociative responses, and symptoms of increased arousal. Both negative appraisals about themselves and self blame for the abusive situations were positively associated with increased tendency to develop PTSD. The greater use of optimism coping style and the higher quality social
support appeared to lead to a significantly reduced tendency of developing PTSD. Negative appraisals about themselves were found to be the strongest positive predictor of PTSD [R² = 0.32, F(1,38)=17.67, p
Objective: Sexual problems are common among patients who are on antidepressants treatment. The objective of this study is to determine the prevalence of PE and ED, and their potential risk factors that may impair their sexual function in a TH
Methods: A cross-sectional study using simple random sampling was conducted among adult male patients who are on antidepressant treatment in the TH psychiatric outpatient clinic. Respondents’ sociodemographic data were obtained. Participants were interviewed using a structured self-report questionnaire with 15-item International Index of Erectile Function (IIEF-15)where the scores lesser than 25 were indicative for having an ED. A validated Malay Premature Ejaculation Diagnostic Tool (MAPET) was used to assess PE and those with a score ≥ 23 were considered to have PE.
Results: Hundred respondents were participated, and the prevalence of PE and ED was 66% and 85%, respectively. Using multivariate binary logistic regression, the potential risk factors of PE were race, i.e. being non-Malay (p=0.044), lesser in the frequency of sexual activity (p=0.03) and also an ED (p=0.03), respectively. The only risk factor for ED was PE (p=0.026). No significant association was noted for the other factors, including type of the antidepressant, dose and duration of antidepressant used (p>0.05). There was a strong correlation of MAPET and IIEF-15 (r=-0.345, p < 0.01) signifying patient with more severe PE had more severe ED.
Conclusions: Due to very high rate of ED and PE in this group of respondents, it is pivotal to screen for sexual problem among patients who are taking an antidepressant in a psychiatric setup.
Study site: Psychiatric clinic, Pusat Perubatan University Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia.
Objective: Living with epilepsy imposes great challenges on both patients and their family caregivers but most researchers only explored the impact on patients, with less attention given to family caregivers. Our study intended to explore the needs and problems of epilepsy family caregivers of epilepsy patients encountered during the caregiving process. Methods: Respondents were recruited from the Neurology Clinic of Hospital Sultanah Nur Zahirah (HSNZ), Kuala Terengganu. A semi-structured interview was conducted using openended and broad questions asking about their general experience in caregiving, daily routine activities, caregiving effects, caregiving difficulties and caregivers’ needs. The interviewed data were later transcribed into verbatim before further analysis using the QSR International’s NVivo10 software. Results: Fifteen Malay Muslim family caregivers between the age of 19 and 66 years participated. Most were females (53%), married (67%), with education level at secondary school or equivalent (73%) and were homemakers (40%). In particular, respondents expressed the need for extra support from their family members and experts in terms of physical (care relief), mental, and financial aspects. In addition, the major caregiving problems identified included: (i) emotional disturbances (sad, angry, depressed, and anxious); (ii) care giving challenges (family adjustments, physical burden, psychological burden, and time management); and (iii) financial issues (not working and limited family income). Some advantages in caregiving were also reported. Conclusion: In conclusion, their experiences while taking care of their loved ones in terms of feelings, beliefs and needs exposed the difficulties in caregiving, causing substantial emotional pressure which could later lead to poor quality of caregiving. ASEAN Journal of Psychiatry, Vol. 16 (1): Januray – June 2015: XX XX.
Study site: Neurology Clinic of Hospital Sultanah Nur Zahirah (HSNZ), Kuala Terengganu.
This is a cross-sectional, two-year follow up study. The authors determined the varied presentations of delirium, dementia and other organic disorders to assess their mortality and outcome. They described the diagnosis of patients suffering from the psychiatric effects of those organic states and compared their symptom resolution and mortality between those with the acute and chronic varieties during their index hospitalization and again, 24 months later. Although mortality rates did not differ, patients with the acute syndrome had significantly better outcomes in terms of symptom resolution as compared to those with the chronic syndrome (p=0.001). Patients with symptom resolution upon discharge did not show statistically significant lower mortality rates.
Objectives: The aim of this study is to validate the Malay version of the Aggression Questionnaire (AQ) for the purpose of the future study related to aggression. Furthermore, the study seeks to identify types of aggression hold by the female inmates.
Methods: A cross-sectional study was designed involving 90 Malaysian female prisoners. The analyses include descriptive analysis, confirmatory factor analysis, and reliability testing. After one-week interval, a test-retest was conducted.
Results: The preliminary analysis confirmed that factor analysis was appropriate for the Malay-translated version of the AQ. The four factors structure was assessed but the factor loadings are remarkable different from the original versions. The total Cronbach's alpha coefficients is very high (α= 0.91). The Pearson's correlation however is low (r = 0.48) but acceptable for the instrument. Reliability of the subscales and the factors were also found satisfactory. Consequently, anger and hostility were identified as the most common types of aggression among the participants, followed by verbal aggression. In contrast, physical aggression was the least scored type of aggression.
Conclusion: The Malay-translated version of the AQ was found to be valid and reliable to be used in future studies.
Objectives: To determine the best possible programme that suits our local setting, to determine the average dose required, and to determine possible problems that can arise from implementing such a programme locally and how best to address them. Methods: The inclusion criteria were those above 18, a positive urine test, the presence of a supportive carer and willing to engage in the programme. Methadone was initiated and observations relating to dose, adverse events, relationship with carers, work performance, crime and high risk behaviours were monitored for 18 weeks. Results: Two thirds of the 45 subjects completed the trial over the 18 week period. No significant adverse events occurred and improvement in relationship with carers and work performance were noted with reduction in crime and high risk behaviours. Conclusion: Methadone is a safe and effective drug that can be used in the local Malaysian setting.
Objective: The family caregiver has a pivotal role in the management of HIV/AIDS patients and their well-being is consequently crucial as it could impact negatively on the quality of caregiving. This preliminary qualitative investigation intended to explore and describe the challenges and experiences of HIV/AIDS family caregivers in Terengganu, Malaysia. Methods: A convenient sample of family caregivers of HIV/AIDS patients who were aware of the diagnosis was enrolled. Recruitment was conducted in Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia and semi-structured interviews were used. Results: Results were transcribed into verbatim before being subjected to analysis. Twelve Muslim caregivers consented participation (age range = 18.0 - 81.0; female = 75.0%, mother/wife = 50.0%; married = 83.3%; ≤ primary school
= 50.0%; and self-employed = 66.7%). The four major themes that emerged were challenges of caregiving, financial issues, stigma and discrimination, and support for caregivers. Additionally, caregivers did mention several positive aspects of their caregiving role including satisfaction from helping family member and improved family relationships. Conclusion: A variety of life aspects were negatively affected by caring for HIV patients, thus requiring a multidisciplinary approach to address such issues. ASEAN Journal of Psychiatry, Vol. 15 (2): July - December 2014: 120-130.
Objective: To report the use of Paliperidone in an adolescent with bipolar disorder primarily concerning its effectiveness and safety. Method: We present a case report of an adolescent with atypical presentation of bipolar disorder. The problem was complicated by poor liver function and poor compliance. Progress of the patient was recorded. Results: The patient showed dramatic improvement after 2 weeks on Paliperidone and has achieved the best level of functioning after almost 4 years on other treatment. Conclusion: The usage of Paliperidone was effective and safe in an adolescent with atypical bipolar disorder.
Objectives: This review aims to compile and evaluate all available randomised controlled trials (RCTs) of auricular acupuncture (AA) treatment in drug addiction population with emphasis on the length of treatment course, needle-points, outcome measures, reported side-effects and overall outcomes.
Methods: Science Direct, Medline and EBSCOhost databases were searched. From the year 1990 until 2010, only full-length English articles incorporating RCTs related to AA studies (needle-based only) in drug addiction such as heroin, morphine, methamphetamine and cocaine were included. Studies involving the usage of various methods of electroacupuncture and investigations relating to cigarette-smoking or alcohol addiction were excluded.
Results: Eight RCTs met all inclusion criteria comprising of 1,594 respondents (age = 19 - 46 years; male = 57% - 76%). Most were involved in cocaine addiction. Overall, trials were designed with brief periods of treatment course and utilised three to five standard National Acupuncture Detoxification Association (NADA) points (Sympathetic, Lung, Liver, Kidney and Shen men), but inconsistent sham points. All trials included urine toxicology test as the main outcome measure while data on side-effects incidence was insufficient. Conclusions: Overall, four of the RCTs reported positive outcomes although at this point, AA’s effectiveness and safety could not be substantially confirmed. For the future, high-quality RCTs of AA are urgently required to provide a clearer understanding on the usefulness of this complementary therapy in drug addiction treatment.
Objective: The psychological impact of care giving responsibility for dementia patients is significant regardless of the cultural background. Most of the current advanced caregivers’ interventions, originating from developed western countries, do not necessarily apply to local settings. Hence, there is a need for an effective culturally competent psychological intervention for these caregivers. The aim of the study is to assess the effectiveness of the cultural-based support group for Malay caregivers of dementia patients in Kelantan towards their burden, anxiety and depression level, and quality of life.
Methods: This was an experimental study, without control, investigating pre and post support group intervention effectiveness in reducing caregiver burden, anxiety and depression, and improving the quality of life. Sixteen caregivers completed the program, which involved seven fortnightly support group sessions with duration of 2 hours each, conducted over twelve weeks. Caregivers’ burden was assessed using Caregiver Strain Index (CSI) while their psychological well-being was objectively assessed using Hospital Anxiety and Depression Scale (HADS). WHO Quality of Life questionnaire (WHOQOL-BREF) was used to measure the quality of life. The validated Malay versions of the questionnaires were used.
Results: There was a statistically significant reduction in the level of caregiver burden (p = or < 0.001). Measurement of both scores of anxiety and depression comparing pre and post intervention also showed improvement, but statistically were not significant. Assessment of caregivers’ quality of life showed statistically significant improvement in the domains of social, psychological and physical (all with the p-value <0.05). Discussion: Our cultural-based support group is an effective intervention to improve burden, psychological well-being and quality of life among local caregivers of dementia patients.
Keyword: Dementia Caregivers, Support Group, Malay, Burden, Quality of Life
Study site: Memory clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
Objective: To study the effect of depressive disorders, severity of depression and, sociodemographic factors on drug compliance among hypertensive patients at primary care clinics. Methods: A total of 201 hypertensive patients on treatment for at least 3 months who attended the HUKM Primary Care Clinic and Salak Polyclinic were selected for this study. Patients were screened for depressive disorders using the Hospital Anxiety Depression Scale (HADS) and those who scored 8 and more were further interviewed to establish a diagnosis using the Mini International Neuropsychiatric Interview (MINI). Patients who were diagnosed to have depressive disorders were further rated for the severity of the illness by using Hamilton Rating Scale for Depression (HAMD). Drug compliance was assessed during a 2 month follow up using the pill counting method (ratio 0.8 – 1.2 considered as compliant). Results: The prevalence of non-compliance among hypertensive patients was 38.3%. There was no association between the diagnosis of depressive disorders and drug compliance. Among the 12 patients who had depressive disorders, severity of depression as rated by HAMD, showed significant association with drug compliance (Mann-Whitney test z = -2.083, p
Objective: To determine the construct validity and the internal consistency of the Medical Student Stressor Questionnaire (MSSQ) among medical students hence in the future it could be used as a valid and reliable instrument to identify stressors among medical students. Methods: The blueprint for the development of MSSQ was developed after a review of literature on the subject and a discussion with experts in the field. It comprised of 40 items
with six hypothetical groups. The face validity of the questionnaire was established through discussion with 141 final year medical students whereas content validity was established through discussion with experts from field of Medical Education and Psychiatry. It was administered to a total of 761 medical students. Data was analysed using Statistical Package Social Sciences (SPSS) version 12. Factor analysis was applied to test construct validity of the MSSQ. Reliability analysis (Cronbach’s alpha and item total correlation) was applied to test internal consistency of the MSSQ. Results: The total Cronbach’s alpha value of the MSSQ was 0.95. All the preliminary 40 items were included in the MSSQ as the items had item total correlation value of more than 0.3. The items were loaded nicely into the six pre-determined hypothetical groups as their factor loading values were more than 0.3.
Conclusion: This study showed that MSSQ had good psychometric value. It is a valid and reliable instrument in identifying stressors among medical students.