MyMedR

Fulltext Remote Psychological First Aid (rPFA) in the time of Covid-19: A preliminary report of the Malaysian experience

Francis B, Juares Rizal A, Ahmad Sabki Z, Sulaiman AH

Asian J Psychiatr, 2020 Dec;54:102240.

PMID: 32593120 DOI: 10.1016/j.ajp.2020.102240

Electroconvulsive therapy in a 91-year old Asian lady with late onset bipolar mania

Francis B, Petrus CF, Wong HH

Asian J Psychiatr, 2020 Apr;50:101986.

PMID: 32135484 DOI: 10.1016/j.ajp.2020.101986

BACKGROUND: Electroconvulsive therapy (ECT) is safe and efficacious in the elderly population. However, clinicians are still weary to use it among the old-old population, citing safety concerns. Our case report highlights the use of ECT in a 91 year old lady with late onset Bipolar Mania.

CASE REPORT: A 91 year old lady presented with an acute manic relapse for the past 2 weeks. She was previously on oral Sodium Valproate, and during this current admission was augmented with oral Quetiapine IR 100 mg bd. She remained unwell and was planned for right unilateral ECT with age-based dosing stimuli. After only 4 sessions, she showed complete resolution of her manic symptoms.

RESULT: In our case study, the patient showed rapid response to right unilateral ECT. Even though the Post Suppression Index (PSI) was not significant, there is some evidence that in elderly patients, burst suppression (not measured in this case) may be more accurate measure of ECT efficacy. The transient treatment emergent delirium was short lived and ECT was very tolerated in this patient.

CONCLUSION: Clinicians should not delay ECT in old-old patients who do not respond to pharmacologic treatment, as early switch to ECT results in rapid response with good safety profile.

Preliminary findings on lifetime trauma prevalence and PTSD symptoms among adolescents in Sarawak Malaysia

Ghazali SR, Elklit A, Balang RV, Sultan MA, Kana K

Asian J Psychiatr, 2014 Oct;11:45-9.

PMID: 25453696 DOI: 10.1016/j.ajp.2014.05.008

The objective of this study is to determine the prevalence of lifetime exposure to traumatic events and its relation to PTSD symptoms.

Blood-based oxidation markers in medicated and unmedicated schizophrenia patients: A meta-analysis

Goh XX, Tang PY, Tee SF

Asian J Psychiatr, 2022 Jan;67:102932.

PMID: 34839098 DOI: 10.1016/j.ajp.2021.102932

Increased reactive species due to the effect of antipsychotics on oxidative stress may be involved in the development of schizophrenia. However, antipsychotics may have different direct antioxidant effects due to their chemical structures. The present meta-analysis aimed to investigate whether the cause increased oxidant status in schizophrenia patients is due to the illness or induction by antipsychotics. Studies published from 1964 to 2021 were selected from Pubmed and Scopus databases. Data were analysed using Comprehensive Meta-Analysis version 2. Effect sizes were calculated and compared between unmedicated and medicated patients and healthy controls. Heterogeneity and publication bias were assessed. Subgroup analyses were conducted on drug-free and drug-naïve patients, and patients treated with atypical and typical antipsychotics. We found that medicated patients had significantly higher malondialdehyde (MDA), thiobarbituric acid reactive substances (TBARS) and total oxidant status (TOS). Meanwhile, significantly increased plasma/serum MDA and nitric oxide (NO) were observed in unmedicated patients only. Higher lipid peroxidation in the drug-naïve group may be associated schizophrenia. However, both atypical and typical antipsychotics may worsen lipid peroxidation. Antipsychotic discontinuation in the drug-free group led to significantly increased plasma/serum NO, with larger effect size than the atypical antipsychotic group. In conclusion, medicated schizophrenia patients were more suffered from increased oxidative stress. Therefore, future study may focus on the mechanism of action of specific antipsychotic on oxidative stress.

Malaysian parent and teacher ratings of the oppositional defiant disorder symptoms: measurement invariance and parent-teacher agreement

Gomez R

Asian J Psychiatr, 2014 Oct;11:35-8.

PMID: 25453694 DOI: 10.1016/j.ajp.2014.05.002

This study evaluated the measurement invariance and agreement across parent and teacher ratings of the DSM-IV-TR oppositional defiant disorder (ODD) symptoms.

Teacher ratings of ODD symptoms: measurement equivalence across Malaysian Malay, Chinese and Indian children

Gomez R

Asian J Psychiatr, 2014 Apr;8:52-5.

PMID: 24655627 DOI: 10.1016/j.ajp.2013.10.017

The study examined the measurement equivalence for teacher ratings across Malaysian Malay, Chinese and Indian children.

ADHD bifactor model based on parent and teacher ratings of Malaysian children

Gomez R

Asian J Psychiatr, 2014 Apr;8:47-51.

PMID: 24655626 DOI: 10.1016/j.ajp.2013.10.009

The study used confirmatory factor analysis to ascertain support for the bifactor model of the Attention Deficit/Hyperactivity Disorder (ADHD) symptoms, based on parent and teacher ratings for a group of Malaysian children.

Incidence rates of emotional and behavioural problems in Malaysian children as measured by parent ratings of the Strengths and Difficulties Questionnaire

Gomez R, Suhaimi AF

Asian J Psychiatr, 2013 Dec;6(6):528-31.

PMID: 24309866 DOI: 10.1016/j.ajp.2013.06.009

The aim of this study was to ascertain the rates of emotional and behavioural problems (emotional problems, conduct problems, hyperactivity, peer problems, and low prosocial behaviour) of Malaysian children.

Oppositional Defiant Disorder: prevalence based on parent and teacher ratings of Malaysian primary school children

Gomez R, Hafetz N, Gomez RM

Asian J Psychiatr, 2013 Aug;6(4):299-302.

PMID: 23810136 DOI: 10.1016/j.ajp.2013.01.008

BACKGROUND: This study examined the prevalence rate of Oppositional Defiant Disorder (ODD) in Malaysian primary school children.
METHODS: In all 934 Malaysian parents and teachers completed ratings of their children using a scale comprising DSM-IV-TR ODD symptoms.
RESULTS: Results showed rates of 3.10%, 3.85%, 7.49% and 0.64% for parent, teacher, parent or teacher ("or-rule"), and parent and teacher ("and-rule") ratings, respectively. When the functional impairment criterion was not considered, the rate reported by parents was higher at 13.28%.
DISCUSSION: The theoretical, diagnostic and cultural implications of the findings are discussed

Factor structure of parent and teacher ratings of the ODD symptoms for Malaysian primary school children

Gomez R

Asian J Psychiatr, 2017 Feb;25:22-26.

PMID: 28262156 DOI: 10.1016/j.ajp.2016.10.013

This present study used confirmatory factor analysis (CFA) to examine the applicability of one-, two- three- and second order Oppositional Defiant Disorder (ODD) factor models, proposed in previous studies, in a group of Malaysian primary school children. These models were primarily based on parent reports. In the current study, parent and teacher ratings of the ODD symptoms were obtained for 934 children. For both groups of respondents, the findings showing some support for all models examined, with most support for a second order model with Burke et al. (2010) three factors (oppositional, antagonistic, and negative affect) as the primary factors. The diagnostic implications of the findings are discussed.

Psychological health and menopause-specific quality of life of Malaysian women with type 2 diabetes

Hasan SS, Thiruchelvam K, Ahmed SI, Clavarino AM, Mamun AA, Kairuz T

Asian J Psychiatr, 2016 Oct;23:56-63.

PMID: 27969080 DOI: 10.1016/j.ajp.2016.07.005

Anxiety and depression are more common among females and those experiencing diabetes and menopause. Menopausal symptoms experienced by women can vary tremendously from population to population; therefore, there is a need to investigate these symptoms and associated risk factors in different communities. This study investigated the differences in psychological health and menopause-specific quality of life (MENQOL) between women with and without diabetes type 2 (T2DM) in Malaysia. Women with T2DM (n=320) were matched by age range to controls without T2DM (n=320). Data were collected from March 2012 to January 2013. Delusions Symptoms States Inventory (DSSI) instrument was used to identify symptoms of depression and anxiety. Women with diabetes had higher depressive (11.8% versus 8.4%) and anxiety (8.4% versus 6.6%) symptoms compared to women without diabetes. In both groups, the most common menopausal symptom was aches (muscles and joints). Women without diabetes had significantly higher scores for the sexual domain compared to women with diabetes (4.20 versus 3.21, p=0.001). The odds that a postmenopausal woman with diabetes was depressed or anxious on the DSSI scale increased significantly when the MENQOL score on the physical, vasomotor, and psychosocial domains increased by one unit. Both diabetes and psychological problems have negative impact on MENQOL. Our findings support the view of screening postmenopausal women with diabetes for depressive and anxiety, to improve overall quality of life.

Fulltext Adherence to the Malaysian clinical practice guideline for depression by general practitioners in private practice in Penang

Ho KC, Russell V, Nyanti L, Chan MW, Hassali MA, Dawood OT, et al.

Asian J Psychiatr, 2020 Feb;48:101899.

PMID: 31901584 DOI: 10.1016/j.ajp.2019.101899

INTRODUCTION: Most primary care in Malaysia is provided by general practitioners in private practice. To date, little is known about how Malaysian General Practitioners (GPs) manage patients with depression. We surveyed privately practising primary care physicians in the state of Penang, Malaysia, in relation to their experience of the Malaysian Clinical Practice Guideline (CPG) in Major Depressive Disorder, their current practice and perceived barriers in managing depression effectively.

MATERIAL AND METHODS: A questionnaire based on the study aims and previous literature was developed by the authors and mailed to all currently registered GPs in private clinics in Penang. Survey responses were analysed using SSPS version 21.

RESULTS: From a total of 386 questionnaires distributed, 112 (29%) were returned. Half of the respondents were unaware of the existence of any CPG for depression. One quarter reported not managing depression at all, while one third used anxiolytic monotherapy in moderate-severe depression. Almost 75 % of respondents reported making referrals to specialist psychiatric services for moderate-severe depression. Time constraints, patient non-adherence and a lack of depression management skills were perceived as the main barriers to depression care.

CONCLUSIONS: Our findings highlight the need to engage privately practising primary care physicians in Malaysia to improve their skills in the management of depression. Future revisions of the Malaysian Depression CPG should directly involve more GPs from private practices at the planning, development and implementation stages, in order to increase its impact.

The burden of HIV-associated neurocognitive disorder (HAND) in the Asia-Pacific region and recommendations for screening

Ian E, Gwen CL, Soo CT, Melissa C, Chun-Kai H, Eosu K, et al.

Asian J Psychiatr, 2016 Aug;22:182-9.

PMID: 26617385 DOI: 10.1016/j.ajp.2015.10.009

HIV-associated neurocognitive disorder incurs a significant burden on HIV patients in Asia-Pacific countries; however, the incidence is difficult to estimate due to a lack of local epidemiological data. The impact of neurocognitive impairment in HIV patients is often underestimated due to a lack of education and awareness, and there are consequently gaps in the provision of screening and diagnosis to enable earlier intervention to limit neurocognitive impairment.

Health and quality of life among the caregivers of children with disabilities: A review of literature

Isa SN, Ishak I, Ab Rahman A, Mohd Saat NZ, Che Din N, Lubis SH, et al.

Asian J Psychiatr, 2016 Oct;23:71-77.

PMID: 27969083 DOI: 10.1016/j.ajp.2016.07.007

Families caring for children with disabilities face particular challenges and demands compared to those caring for children without disabilities. Evidence suggests that there is considerable variation in how caregivers of children with disabilities adapt to their caregiving demands and stressors. The different adaptations to the children with disabilities may cause different impacts on the health and well-being of caregivers. This paper provides a brief overview of the literature on the impact of caring for children with disabilities on the health and quality of life of caregivers and the factors related to the health outcomes and quality of life. A literature search was conducted by using various electronic databases, including PsychINFO, ScienceDirect, ProQuest, and MEDLINE using specific key terms. Thirty-one articles published in peer-review journals from the last six years (2009-2014) were reviewed. Most of the studies were quantitative studies. Factors discussed that impact on caregivers' health and quality of life include the caregivers' sociodemographic background and child's disability-related factors. Several mediators and moderators including coping strategies, social support, parental stress, self-esteem and self-efficacy are described in this paper. This review highlighted the importance of these factors to better understand the complex nature of stress processes and the caregivers' adaptations to their children's disabilities.

Prevalence and risk factors contributing to recidivism among patients admitted to Forensic Unit Hospital Permai Johor Bahru Malaysia

Jacob MFF, Razali S, Ali NF, Khamis J, Ahmad Y

Asian J Psychiatr, 2023 Jan;79:103325.

PMID: 36395701 DOI: 10.1016/j.ajp.2022.103325

Delusional infestation successfully controlled with typical antipsychotic depot injection: An illustrative case report

Jamaluddin R

Asian J Psychiatr, 2018 Jan;31:69-70.

PMID: 29438922 DOI: 10.1016/j.ajp.2018.02.002

Fulltext Reducing the stigma of mental health disorders with a focus on low- and middle-income countries

Javed A, Lee C, Zakaria H, Buenaventura RD, Cetkovich-Bakmas M, Duailibi K, et al.

Asian J Psychiatr, 2021 Apr;58:102601.

PMID: 33611083 DOI: 10.1016/j.ajp.2021.102601

Mental health disorders are a burgeoning global public health challenge, and disproportionately affect the poor. Low- and middle-income countries (LMICs) bear 80 % of the mental health disease burden. Stigma associated with mental health results in delayed help seeking, reduced access to health services, suboptimal treatment, poor outcomes and an increased risk of individuals' human rights violations. Moreover, widespread co-occurrence of physical comorbidities such as noncommunicable diseases with mental health disorders makes the treatment of both conditions challenging and worsens prognosis. This paper explores various aspects of stigma towards mental health with a focus on LMICs and assesses measures to increase help-seeking and access to and uptake of mental health services. Stigma impacts persons living with mental illness, their families and caregivers and healthcare professionals (mental health professionals, non-psychiatric specialists and general practitioners) imparting mental health care. Cultural, socio-economic and religious factors determine various aspects of mental health in LMICs, ranging from perceptions of health and illness, health seeking behavior, attitudes of the individuals and health practitioners and mental health systems. Addressing stigma requires comprehensive and inclusive mental health policies and legislations; sustainable and culturally-adapted awareness programs; capacity building of mental health workforce through task-shifting and interprofessional approaches; and improved access to mental health services by integration with primary healthcare and utilizing existing pathways of care. Future strategies targeting stigma reduction must consider the enormous physical comorbidity burden associated with mental health, prioritize workplace interventions and importantly, address the deterioration of population mental health from the COVID-19 pandemic.

Mental health services in Cambodia, challenges and opportunities in a post-conflict setting

Jegannathan B, Kullgren G, Deva P

Asian J Psychiatr, 2015 Feb;13:75-80.

PMID: 25563073 DOI: 10.1016/j.ajp.2014.12.006

Cambodia had suffered enormously due to war and internecine conflict during the latter half of the twentieth century, more so during the Vietnam War. Total collapse of education and health systems during the Pol Pot era continues to be a challenge for developing the necessary infrastructure and human resources to provide basic minimum mental health care which is compounded by the prevailing cultural belief and stigma over mental, neurological and substance abuse disorders (MNSDs). The mental health research and services in Cambodia had been predominantly 'trauma focused', a legacy of war, and there is a need to move toward epidemiologically sound public health oriented mental health policy and service development. Integrating mental health program with primary health care services with specifically stated minimum package of activities at primary level and complementary package of activities at secondary level is an opportunity to meet the needs and rights of persons with mental, neurological and substance abuse disorders (PWMNSDs) in Cambodia, provided there is mental health leadership, government commitment and political will.

Clinical benefit of second-generation long-acting injectable antipsychotics in preventing re-hospitalization in patients with schizophrenia: A real-world study in Japan

Kasahara-Kiritani M, Saga Y, Wakamatsu A, Wu DB, Tsai IC

Asian J Psychiatr, 2023 Aug;86:103671.

PMID: 37311333 DOI: 10.1016/j.ajp.2023.103671

BACKGROUND: Real-world evidence on the benefits of long-acting injectable (LAI) antipsychotics (AP) in patients with schizophrenia is limited, especially in the employed population in Japan. This study evaluates the effectiveness of LAI AP in preventing re-hospitalization in patients with schizophrenia, including the employed population.

METHODS: This retrospective, observational, population-based study used the Japan Medical Data Center (JMDC) health insurance claims database to identify patients having schizophrenia before or on the day of the first LAI AP prescription (index date), and receiving LAI AP between April 1, 2012 and December 31, 2019. The number of all-cause, psychiatric-, and schizophrenia-related hospitalizations at baseline (365 days before index date) and during the 1-year follow-up period were evaluated.

RESULTS: Of the 1692 patients who received LAI AP during the study period, 146 were included (employed: 55 [37.7 %]; dependent: 91 [62.3 %]). The mean age was 37 years; 50.7 % (n = 74) were females. During baseline period, 61 (41.8 %) patients were not hospitalized. During the follow-up period, 67 (45.9 %) patients underwent hospitalization ≤ 7 days; all-cause: 100 (68.7 %); psychiatry-related: 104 (76.2 %); schizophrenia-related: 114 (78.1 %). A higher proportion of patients were hospitalization-free during the follow-up in the employed vs. dependent population: all cause: 69.1 % vs. 61.5 %; psychiatric-related 76.4 % vs. 67.0 %, schizophrenia-related: 87.3 % vs. 71.4 %.

CONCLUSION: This study demonstrated the effectiveness of LAI AP in preventing hospitalization in Japan. During the follow-up period, patients with schizophrenia receiving LAI AP, including the employed population, had a significant decrease in hospitalization length and re-hospitalization rate compared to baseline.

Depression and low bone mineral density: The correlation among Chinese

Kurmanji JM, Sulaiman SA, Kah LK, Chandrasekaran PK

Asian J Psychiatr, 2010 Sep;3(3):134-7.

PMID: 23051571 DOI: 10.1016/j.ajp.2010.07.013

Depression is usually associated with changes in the endogenous hormonal system. The most important hormonal modifications are elevation of the serum cortisol level as well as the reduction of endogenous sex hormone levels. These changes have advanced side effects on a bone metabolism and bone remodelling process, which consequently, lead to the declining in bone mineral density and increase the risk of bone fractures, which is reported by current studies.

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