Displaying publications 21 - 40 of 74 in total

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  1. Lew B, Kõlves K, Lester D, Chen WS, Ibrahim NB, Khamal NRB, et al.
    Front Psychiatry, 2021;12:770252.
    PMID: 35069279 DOI: 10.3389/fpsyt.2021.770252
    Background: Suicide is a preventable cause of death. Examining suicide rates and trends are important in shaping national suicide prevention strategies. Therefore, the objectives of this study were to analyze age-standardized suicide trends of Malaysia between 2000 and 2019 using the WHO Global Health Estimates data, and to compare the 2019 rate with countries from the Association of South-East Asian Nations (ASEAN), Muslim majority countries, and the Group of Seven (G7). Methods: The age-standardized suicide rates data were extracted from the WHO Global Health Estimates. We calculated the average age-standardized suicide rates of the last 3 years from 2017 to 2019. Joinpoint regression analysis was conducted to calculate the average annual percentage change (APC) of the age-standardized suicide rates in Malaysia from 2000 to 2019. Results: Between 2000 and 2019, the minimum and maximum suicide rates for both sexes in Malaysia were 4.9 and 6.1 per 100,000 population respectively, whilst the past 3-year (2017-2019) average rates were 5.6, 8.8, and 2.4 for both sexes, males, and females, respectively. The suicide rates decreased significantly for both sexes between 2000 and 2013. Between 2014 and 2019, the suicide rates increased significantly for males. In 2019, Malaysia recorded the rate of 5.8 per 100,000 population, with an estimated 1,841 suicide deaths, i.e., ~5 deaths per day. The Malaysian suicide rate was the second highest amongst selected Muslim majority countries, in the middle range amongst ASEAN countries, and lower than all G7 countries except Italy. Conclusions: There is a need to further explore factors contributing to the higher suicide rates among Malaysian males. In light of the rising suicide rates in Malaysia, national mental health and suicide prevention initiatives are discussed and the importance of high-quality suicide surveillance data is emphasized.
  2. Speciani M, Barak Y, Damanhuri H, De Ronchi D, Panariello F, Atti AR
    Front Psychiatry, 2021;12:756669.
    PMID: 34777061 DOI: 10.3389/fpsyt.2021.756669
    Anorexia Nervosa (AN) is a severe eating disorder which typically develops in younger females. Many studies focus on this specific population, a majority of which will eventually partially or fully recover. A minority will become chronic despite extensive treatment. These patients are treatment-resistant and may not necessarily benefit from usual treatment. In this article we will reflect on possible mechanisms which may explain the maintenance of disease, and especially on the possible role of affective and anxiety disturbances. We will use, due to the lack of large-scale studies, data from risk and prognostic factors, treatment options and neurobiological correlates in chronic AN patients. Lastly, we will propose how these elements may advise further research and treatments.
  3. Hassan Z, Bosch OG, Singh D, Narayanan S, Kasinather BV, Seifritz E, et al.
    Front Psychiatry, 2017;8:152.
    PMID: 28868040 DOI: 10.3389/fpsyt.2017.00152
    A feature of human culture is that we can learn to consume chemical compounds, derived from natural plants or synthetic fabrication, for their psychoactive effects. These drugs change the mental state and/or the behavioral performance of an individual and can be instrumentalized for various purposes. After the emergence of a novel psychoactive substance (NPS) and a period of experimental consumption, personal and medical benefits and harm potential of the NPS can be estimated on evidence base. This may lead to a legal classification of the NPS, which may range from limited medical use, controlled availability up to a complete ban of the drug form publically accepted use. With these measures, however, a drug does not disappear, but frequently continues to be used, which eventually allows an even better estimate of the drug's properties. Thus, only in rare cases, there is a final verdict that is no more questioned. Instead, the view on a drug can change from tolerable to harmful but may also involve the new establishment of a desired medical application to a previously harmful drug. Here, we provide a summary review on a number of NPS for which the neuropharmacological evaluation has made important progress in recent years. They include mitragynine ("Kratom"), synthetic cannabinoids (e.g., "Spice"), dimethyltryptamine and novel serotonergic hallucinogens, the cathinones mephedrone and methylone, ketamine and novel dissociative drugs, γ-hydroxybutyrate, γ-butyrolactone, and 1,4-butanediol. This review shows not only emerging harm potentials but also some potential medical applications.
  4. Nair AS, Priya RS, Rajagopal P, Pradeepa C, Senthil R, Dhanalakshmi S, et al.
    Front Psychiatry, 2022;13:1042641.
    PMID: 36532166 DOI: 10.3389/fpsyt.2022.1042641
    BACKGROUND: The importance of strategies and services by caregivers and family members substantially impact the psychological and emotional wellbeing of autistic children. The rapid research developments in clinical and non-clinical methods benefit the features of autistic children. Among various internal and external factors, the influence of the built environment also impacts the characteristics of autistic children. This study investigates primarily the psychological effect of light and colors on the mood and behavior of autistic children to identify the most favorable and preferred indoor lights and color shades.

    METHODS: A questionnaire survey was conducted at an autism center among autistic children and their parents. This study included autistic children aged between 6 and 16 (45 males, 42 females, mean age 8.7 years, standard deviation 2.3). Eighty-seven participants were involved in the survey to determine the sensory perceptions, intolerance, preferences, and sensitivities of children with an autism spectrum disorder toward colors and lighting. The margin of error at the statistical analysis's 95% confidence level is ± 0.481.

    RESULTS: As per this case report, the children have various color preferences and respond differently to different shades. Different hues have varying effects on autistic children, with many neutral tones and mellow shades proven to be autistic-friendly with their calming and soothing effect, while bright, bold, and intense colors are refreshing and stimulating. The stimulus of bright-lighting causes behavioral changes in autistic children prone to light sensitivity.

    CONCLUSION: The insights gained from this interaction with parents and caretakers of autistic children could be helpful for designers to incorporate specific autistic-friendly design elements that make productive interior spaces. A complete understanding of the effect of factors like color and lighting on the learning ability and engagement of autistic children in an indoor environment is essential for designers and clinicians. The main findings of this study could be helpful for a designer and clinicians to address designing an autism-friendly built environment with a color palette and lighting scheme conducive to their wellbeing and to maximize their cognitive functioning.

  5. Rahman MA, Rahman S, Wazib A, Arafat SMY, Chowdhury ZZ, Uddin BMM, et al.
    Front Psychiatry, 2021;12:718654.
    PMID: 34484005 DOI: 10.3389/fpsyt.2021.718654
    Background: The COVID-19 pandemic has imposed psychological distress and fear across the globe; however, factors associated with those issues or the ways people cope may vary by country or context. This study aimed to investigate the factors associated with psychological distress, fear, and coping strategies for people living in Bangladesh during the COVID-19 pandemic. Methods: A cross-sectional study conducted in August-September 2020 using online platforms in Bangladesh. People residing in Bangladesh, aged ≥18 years, who were proficient in English and able to respond to online questionnaire. The Kessler Psychological Distress Scale was used to assess the psychological stress. Level of fear was assessed using the Fear of COVID-19 Scale, and strategies to cope were assessed using the Brief Resilient Coping Scale. Results: Of the 962 participants, half of them were aged between 30 and 59 years. Being born in Bangladesh, having graduate education, perceived distress due to employment change, effect of COVID-19 on financial situation, having multiple comorbidities, and visiting a healthcare provider in the last 4 weeks were associated with higher levels of both psychological distress and fear of COVID-19. Furthermore, higher psychological distress was associated with being a female (AOR 1.81, 95% CI 1.33-2.47, p < 0.001), being a frontline worker (AOR 1.50, 95% CI 1.04-2.15, p < 0.05), having pre-existing psychiatric problems (AOR 4.03, 95% CI 1.19-13.7, p < 0.05), being a smoker (AOR 2.02, 95% CI 1.32-3.09, p < 0.01), providing care to a known/suspected COVID-19 patient (AOR 1.96, 95% CI 1.40-2.72, p < 0.001), having a recent overseas travel history and being in self-quarantine (AOR 4.59, 95% CI 1.23-17.2, p < 0.05), self-isolation without COVID-19 (AOR 2.63, 95% CI 1.68-4.13, p < 0.001) or being COVID-19 positive (AOR 2.53, 95% CI 1.19-5.34, p < 0.05), and having high levels of fear of COVID-19 (AOR 3.27, 95% CI 2.29-4.66, p < 0.001). A higher level of fear was associated with moderate to high levels of psychological distress (AOR 3.29, 95% CI 2.31-4.69, p < 0.001). People with pre-existing mental health problems were less likely to be resilient (AOR 0.25, 95% CI 0.11-0.54, p < 0.01), whereas those with having an income were more likely to be resilient (AOR 1.46, 95% CI 1.02-2.11, p < 0.05). Conclusion: Effective interventions to support the vulnerable groups including improved access to mental health services are of utmost importance during the pandemic.
  6. Mohd Salleh Sahimi H, Norzan MH, Nik Jaafar NR, Sharip S, Ashraf A, Shanmugam K, et al.
    Front Psychiatry, 2022;13:956168.
    PMID: 36506446 DOI: 10.3389/fpsyt.2022.956168
    INTRODUCTION: Smartphone usage has significantly increased in the last decade among young adults has significantly increased in the last decade. While its benefits are undeniable, its negative implications are increasingly emerging. Studies are needed to investigate the effects of excessive smartphone use on a young person's life. This study aimed to determine the prevalence of excessive smartphone use among medical students and its relations with social anxiety, self-esteem, and quality of life.

    METHODS: A cross-sectional study was conducted among medical students from Universiti Kebangsaan Malaysia (UKM) in UKM Medical Center. A total of 273 students have consented to participate and completed self-reported questionnaires encompassing sociodemographic information, the Short Version Smartphone Addiction Scale (SAS-SV), the Social Interaction Anxiety Scale (SIAS), the World Health Organization Quality of Life (WHOQOL-BREF) and the Rosenberg Self-esteem Scale (RSES). Sociodemographic data, SIAS score, WHOQOL-BREF score and the Rosenberg Self-esteem Scale score were treated as independent variables. Smartphone addiction Scale score was treated as the dependent variable. Bivariate analysis was used to explore the relationship between independent and dependent variables using the Fisher exact test, Pearson Chi-Square and Pearson correlation coefficient. Multiple linear regression analysis was used to analyze the variables with a p-value of < 0.05 from the Pearson correlation coefficient test.

    RESULTS: The percentage of excessive smarphone use among UKM medical students is 48%. The bivariate analysis showed that excessive smartphone use has a small but significant positive correlation with social anxiety (r = 0.173, p = 0.004) and negative correlations with physical health (r = -0.133, p = 0.028), psychological wellbeing (r =-0.135, p = 0.026), social relationships (r = -0.232, p = 0.001), environment (r = -0.260, p = 0.001) and self-esteem (r = -0.128, p = 0.035). In the multiple regression analysis, a better environment predicted a reduced risk for smartphone addiction (β = -0.233, p = 0.013).

    CONCLUSION: Almost half of the students were found to have smartphone overdependence. Excessive smartphone use has shown a significant relationship with an increased risk for social anxiety, reduction in self-esteem, and quality of life among medical students. A closer look into the possible intervention is needed in the future to curb the negative effects arising from excessive smartphone use.

  7. Sovey S, Osman K, Matore MEEM
    Front Psychiatry, 2022;13:1022304.
    PMID: 36506434 DOI: 10.3389/fpsyt.2022.1022304
    Computational thinking refers to the cognitive processes underpinning the application of computer science concepts and methodologies to the methodical approach and creation of a solution to a problem. The study aims to determine how students' cognitive, affective, and conative dispositions in using computational thinking are influenced by a gender. This study used a survey research design with quantitative approach. Five hundred thirty-five secondary school students were sampled using probability sampling with the Computational Thinking Disposition Instrument (CTDI). WINSTEPS version 3.71.0 software was subsequently employed to assess the Gender Differential item functioning (GDIF) including reliability and validity with descriptive statistics were employed to assess students' disposition toward practicing computational thinking. In addition to providing implications for the theory, the data give verifiable research that the CT disposition profile consists of three constructs. In addition, the demonstrated CTDI has good GDIF features, which may be employed to evaluate the efficacy of the application of CT in the Malaysian curriculum by measuring the level of CT in terms of the disposition profile of students.
  8. Razali NA, Mohd Daud TI, Woon LS, Mohamed Saini S, Muhammad NA, Sharip S
    Front Psychiatry, 2022;13:1080698.
    PMID: 36713919 DOI: 10.3389/fpsyt.2022.1080698
    48,XXYY syndrome is a rare condition. The presentations of impulsive and aggressive behavior have been reported in several case reports among patients with 48,XXYY syndrome. The management of the psychological impact and neuropsychiatric sequela of this condition is a significant issue faced by families, carers, and healthcare professionals. We report a patient, 21-year-old Malay male, with underlying 48,XXYY syndrome with attention deficit hyperactivity disorder (ADHD) and intellectual disability, diagnosed later in adulthood with a bipolar mood disorder and benefited after being started on lithium. We describe the key clinical features and diagnostic workouts that allowed the arrival of the correct psychiatric diagnosis. Challenges in psychopharmacotherapy, including the risks of metabolic syndrome and deep vein thrombosis associated with 48,XXYY syndrome, are also considered. We suggest that for patients with 48,XXYY syndrome, routine psychological screening for mood symptoms such as mania and depression should be done by healthcare professionals with early involvement of psychiatrist in the multidisciplinary team due to the challenges in the management of these patients.
  9. Wahab S, Sivarajah R, Azmi AD, Chemi N, Mahadevan R
    Front Psychiatry, 2022;13:994324.
    PMID: 36684009 DOI: 10.3389/fpsyt.2022.994324
    INTRODUCTION: This cross-sectional study examines the correlation between childhood trauma, intimate partner violence (IPV), and parenting self-efficacy among women who reported using amphetamine-type stimulants (ATS) in an institutional drug rehabilitation center.

    METHODS: A total of 106 participants were recruited by purposive sampling, of which 88 were mothers. Questionnaires were used to collect sociodemographic data and study variables.

    RESULTS: Most of these women had experienced emotional abuse, sexual abuse, and physical neglect in their childhood. IPV assessments revealed that 70.5% (n = 74) and 30.5% (n = 32) had experienced physical and sexual violence, respectively. In terms of parenting competency, they scored 79.5% for self-efficacy and 54.4% for parenting satisfaction. Childhood emotional abuse significantly increases the odds of individuals experiencing sexual violence by 20.9%.

    DISCUSSION: We found that childhood trauma and IPV did not have a significant relationship with parenting efficacy. Conversely, childhood emotional abuse and physical abuse were negatively correlated to parenting satisfaction. It is imperative that any form of childhood abuse be recognized and stopped early to reduce the harm it brings to women later in life.

  10. Pedersen CJ, Wickersham JA, Altice FL, Kamarulzaman A, Khoshnood K, Gibson BA, et al.
    Front Psychiatry, 2022;13:879479.
    PMID: 35774093 DOI: 10.3389/fpsyt.2022.879479
    The use of amphetamine-type stimulants (ATS) has been associated with increased sexual risk behaviors and HIV transmission, among other adverse health outcomes. However, ATS use among female sex workers (FSWs) in Malaysia has not yet been characterized. We examined the prevalence and correlates associated with ATS use among Malaysian FSW. Between February and December 2016, 492 FSWs, including cisgender (n = 299) and transgender (n = 193) women, were recruited using respondent-driven sampling in Greater Kuala Lumpur, Malaysia. A structured questionnaire was used to collect demographic characteristics, sexual behaviors, ATS and other substance use, behavioral health issues, involvement in criminal justice, and experience of physical and sexual trauma. Logistic regression analyses were conducted to determine factors associated with active ATS use, defined as ATS use in the last 30 days. Nearly one-third (32.3%) of participants reported active ATS use. In the multivariable model, ATS use was associated with drug use during sex work (aOR = 17.10; 8.32-35.15), having moderate to severe level of substance use disorder (aOR = 3.38; 1.48-7.70), and engaging in sex work with multiple clients per day (two clients: aOR = 3.39; 1.36-8.46; three clients: aOR = 5.06; 1.81-14.10). A high prevalence of ATS use was documented in our sample. The presence of moderate to severe substance use disorder, the use of drugs during sex work activity, and having multiple sex work clients per day were significantly associated with active ATS use. Given these findings, prevention and harm reduction strategies need to be tailored to address the increasing ATS use and the associated adverse health consequences among FSWs in Malaysia.
  11. Roslan AF, Pheh KS, Mahadevan R, Bujang SM, Subramaniam P, Yahya HF, et al.
    Front Psychiatry, 2023;14:1009754.
    PMID: 36741120 DOI: 10.3389/fpsyt.2023.1009754
    BACKGROUND: Suicide is a major cause of death among adolescents and young adults, especially students. This is particularly true for healthcare students with a higher risk and more access to lethal means. Thus, it is vital for healthcare educators who have regular contact with these healthcare students to be trained as gatekeepers in preventing suicide. Evidence of the effectiveness of such gatekeeper training, mainly using an online module, is lacking predominantly in Malaysia. This study aims to investigate the effectiveness of an online gatekeeper suicide prevention training program that is conducted for healthcare lecturers.

    METHODS: A single-arm interventional pre-and post-pilot study was conducted on a sample of healthcare lecturers and workers who are involved in supervising healthcare students. A purposive sampling technique was used to recruit 50 healthcare educators in Malaysia. The program was conducted by trained facilitators and 31 participants completed a locally validated self-rated questionnaire to measure their self-efficacy and declarative knowledge in preventing suicide; immediately before and after the intervention.

    RESULTS: Significant improvement was seen in the overall outcome following the intervention, mostly in the self-efficacy domain. No significant improvement was seen in the domain of declarative knowledge possibly due to ceiling effects; an already high baseline knowledge about suicide among healthcare workers. This is an exception in a single item that assesses a common misperception in assessing suicide risk where significant improvement was seen following the program.

    CONCLUSION: The online Advanced C.A.R.E. Suicide Prevention Gatekeeper Training Program is promising in the short-term overall improvement in suicide prevention, primarily in self-efficacy.

  12. Ismail NH, Nik Jaafar NR, Woon LS, Mohd Ali M, Dahlan R, Baharuddin ANAP
    Front Psychiatry, 2022;13:989079.
    PMID: 36762292 DOI: 10.3389/fpsyt.2022.989079
    BACKGROUND: The Beck Anxiety Inventory (BAI) is a common tool for screening anxiety symptoms. In Malaysia, the Malay-version 21-item BAI has been previously validated in the Malaysian adult population. However, information regarding its reliability and validity among adolescents below 18 years old is still lacking. The objective of this study is to investigate the psychometric properties of the Malay-version BAI in this population.

    METHODS: The Malay versions of the BAI and the Depression, Anxiety, and Stress Scale (DASS) were administered among a sample of lower secondary school students (n = 329, age range: 13-14 years) in Selangor, Malaysia. Cronbach's alpha value for the internal consistency of the Malay-version BAI was determined. The correlation coefficient between the BAI score and DASS anxiety subscale score was calculated to examine convergent validity. The factor structure of the Malay-version BAI was identified by exploratory factor analysis (EFA) using principal axis factoring.

    RESULTS: The study included 329 respondents, who were predominantly female (58.7%) and Malay (79.9%). The mean Malay-version BAI score was 14.46 (SD = 12.39). The Malay-version BAI showed a high level of internal consistency (Cronbach's alpha = 0.948) and convergent validity with the DASS anxiety subscale score (r = 0.80, p < 0.001). The EFA suggested a one-factor solution, with the factor loading of all items on the single factor ranging between 0.48 and 0.81.

    CONCLUSION: The Malay-version BAI demonstrated good psychometric properties. It can be a valid and reliable screening instrument for anxiety among Malaysian adolescents.

  13. Jaafar Sidek MA, Amajid K, Loh YS, Rosli MA, Hashim IS, Mohd Suffian NA, et al.
    Front Psychiatry, 2023;14:1085115.
    PMID: 37791131 DOI: 10.3389/fpsyt.2023.1085115
    BACKGROUND: Breast cancer is the most common cancer among women in Malaysia. Anxiety is one factor that deters women from participating in mammography. This study aimed to assess the anxiety level and its associated factors in women undergoing mammography.

    METHODS: A three-month cross-sectional study was conducted using self-administered questionnaires, encompassing socio-demographic details, clinical characteristics, and the State-Trait Anxiety Inventory.

    RESULTS: The mean age of the participants was 57 years old (SD ±10.098). Repeat mammograms consisted of 48.8% of the participants. One-third (35.7%) of them had a history of breast disease. Most participants (84.5%) did not have a positive family history of breast cancer. The proportion of participants with moderate and high anxiety levels was 41.8%. The cause of anxiety was mainly due to the fear of the results (69%), while familiarity with the procedure reduced anxiety among respondents. Socio-demographic and clinical factors were not significantly associated with anxiety levels. However, a statistically significant positive correlation was found between state and trait anxiety scores (r = 0.568, p = 0.001, n = 213).

    LIMITATIONS: The urban setting and absence of questions on the location of origin in the study may have excluded data from the rural population. This may have prevented a true representation of the Malaysian population.

    CONCLUSION: The findings suggest a better understanding of the procedures involved as well as the subsequent disease management would be beneficial in alleviating anxiety prior to, during, and post-mammogram.

  14. Sun Y, Chen G, Wang L, Li N, Srisurapanont M, Hong JP, et al.
    Front Psychiatry, 2019;10:321.
    PMID: 31156476 DOI: 10.3389/fpsyt.2019.00321
    Stigma of major depressive disorder (MDD) is an important public health problem. This study aimed to examine the level of perceived stigma and its associated factors in MDD patients in five Asian countries, including China, Korea, Malaysia, Singapore, and Thailand. A total of 547 outpatients with MDD were included from Asian countries. We used the stigma scale of the Explanatory Model Interview Catalogue (EMIC) to assess stigma. The Montgomery-Asberg Depression Rating Scale (MADRS), Symptoms Checklist 90-Revised (SCL-90-R), Fatigue Severity Scale (FSS), Sheehan Disability Scale (SDS), 36-Item Short-Form Health Survey (SF-36), and Multidimensional Scale of Perceived Social Support (MSPSS) were used to assess symptoms, clinical features, functional impairment, health status, and social support. The stigma scores of patients under 55 years old were significantly higher than those equal to or greater than 55 years old (P < 0.001). The stigma scores exhibited significant negative correlation with age; MSPSS scores of family, friends, and others; and SF-36 subscale of mental health, but significant positive correlation with MADRS, FSS, SDS, and SCL-90-R subscale scores of depression, interpersonal sensitivity, obsession-compulsion, psychoticism, and somatization. Multivariate regression analysis revealed that age, SCL-90-R interpersonal sensitivity, obsession-compulsion, psychoticism, MSPSS scores of friends and others, and SF-36 of mental health were significantly associated with the level of perceived stigma. These findings suggest that MDD patients who are young, have a high degree of interpersonal sensitivity and psychoticism, have low health-related quality of life, and have low social support are the target population for stigma interventions in Asia.
  15. Wong DTL, Tong SF, Daud TIM, Aziz SA, Midin M
    Front Psychiatry, 2019;10:962.
    PMID: 32116809 DOI: 10.3389/fpsyt.2019.00962
    Schizophrenia is a severe mental illness that leads to significant productivity loss and is listed in the top 15 global burdens of disease. One important contributor to the high disease burden is duration of untreated psychosis (DUP) which can be shortened with promotion of professional help-seeking behavior. This study explored caregivers' perspective on factors influencing professional help-seeking behavior during first episode psychosis (FEP) in schizophrenia in Malaysia. The results of this study would inform the development of intervention strategies targeted at promoting professional help-seeking behavior in caregivers of individuals experiencing first episode psychosis (FEP). This is a thematic exploratory study which employed purposive sampling using focus group discussion (FGD). These interviews were audio recorded and transcribed verbatim. Basic thematic approach was used in analyzing the transcribed interviews. Two main themes identified were adequacy of knowledge and stigma. These two factors were found to co-influence each other. Stigma undermined the impact of knowledge on professional help-seeking; likewise, the reverse was also observed. Intervention strategies for promoting help-seeking behavior during FEP should simultaneously focus on improving knowledge about schizophrenia and reducing the stigma attached to it.
  16. Chua SY, Abd Rahman FN, Ratnasingam S
    Front Psychiatry, 2023;14:1244164.
    PMID: 37965356 DOI: 10.3389/fpsyt.2023.1244164
    OBJECTIVE: Caregivers of children with Autism Spectrum Disorder (ASD) often experience emotional and psychological distress, as well as disruptions to family life and employment due to the challenges of caring for children with ASD. This study examines the relationship between problem behaviours and caregiver burden among children with ASD.

    METHOD: A cross-sectional study using convenience sampling recruited 230 caregivers of children with ASD aged 4 to 18 years from selected autism centres in Kuching, Sarawak. The caregivers completed the Aberrant Behaviour Checklist-2 and the Zarit Burden Interview.

    RESULTS: Univariate analysis revealed a significant difference in caregiver burden for children with ASD receiving medications (p = 0.013), registered with the Social Welfare Department (p = 0.036), and having siblings with ASD (p = 0.046). About 40% of the children exhibited at least one domain of problem behaviour. More than half of the caregivers (53.9%) experienced burden, with the majority experiencing mild burden. Positive associations were seen between irritability (r = 0.458, p 

  17. Seng Choi C
    Front Psychiatry, 2023;14:1170924.
    PMID: 37229395 DOI: 10.3389/fpsyt.2023.1170924
    Suicide has been the subject of exploration in psychoanalysis. From Freud's internalized aggression and self-objectification in melancholic depression to contributions from object relation and self-psychology theorists, several of these central clinical concepts seem to share the commonality that one encounters an inhibition of thinking in a suicidal state of mind. Their freedom of thought is inhibited unswervingly despite the notion that we are born to think. Most psychopathologies, including suicide, relate to how we are often stuck with our thoughts. Thinking beyond this sense comes with significant emotional resistance. This case report follows through an attempt to integrate the hypothesized inhibitions on one's capability to think, involving one's own core conflicts and dysfunctional mental processing from the traditional psychoanalytic and mentalizing perspectives. The author hopes that further conceptualizations and research will empirically investigate these assumptions, potentially improving suicide risk assessment and prevention and enhancing psychotherapeutic outcomes.
  18. Tan HJ, Shahren AAH, Khoo CS, Ng CF, Zaidi WAW, Kori N, et al.
    Front Psychiatry, 2023;14:1148019.
    PMID: 37275980 DOI: 10.3389/fpsyt.2023.1148019
    INTRODUCTION: Anxiety has been increasingly recognized as part of the psychosocial health issues in COVID-19 patients. However, the impact of this topic may be underestimated in low- and middle-income countries. This study aimed to estimate the prevalence of and risk factors of anxiety in COVID-19 patients compared to controls in a local tertiary teaching hospital in Malaysia.

    METHODS: In this case-control study, we analyzed data on adult patients aged 18 years and above hospitalized for COVID-19 infection with matched hospitalized controls. The demographic, clinical data and anxiety measures using the Generalized Anxiety Disorder-7 questionnaire were analyzed using univariate and multivariate analysis.

    RESULTS: 86.6% in the COVID-19 group had anxiety, significantly higher than 13.4% in the control group (p = 0.001). The COVID-19 group was significantly associated with the GAD-7 severity (p = 0.001). The number of COVID-19 patients in the mild, moderate, and severe anxiety groups was 48 (84.2%), 37 (86%), and 18 (94.7%), respectively. Multiple logistic regression showed significant predictors for anxiety, including COVID-19 diagnosis and neurological symptoms. Anxiety was found 36.92 times higher in the patients with COVID-19 compared to those without COVID-19 (OR 36.92;95% CI 17.09, 79.78, p = 0.001). Patients with neurological symptoms were at risk of having anxiety (OR 2.94; 95% CI 1.03, 8.41, p = 0.044).

    DISCUSSION: COVID-19 patients experience a significant disruption in psychosocial functioning due to hospitalization. The burden of anxiety is notably high, compounded by a diagnosis of COVID-19 itself and neurological symptomatology. Early psychiatric referrals are warranted for patients at risk of developing anxiety symptoms.

  19. Ibrahim MF, Wan Ismail WS, Nik Jaafar NR, Mohd Mokhtaruddin UK, Ong HY, Abu Bakar NH, et al.
    Front Psychiatry, 2022;13:913067.
    PMID: 35757216 DOI: 10.3389/fpsyt.2022.913067
    INTRODUCTION: Depression is a prevalent mental health condition worldwide and in Malaysia. Depression among adolescents has been steadily increasing. Self-esteem has been known to be associated with depression. It has been postulated that a poor lifestyle among adolescents is associated with depression. This paper aims to study the correlation of self-esteem, lifestyle (eating behavior, physical activity, and internet usage) with depression among Malaysian youth.

    METHODOLOGY: This is a cross-sectional study among secondary school children from 5 random schools in an urban city of Kuala Lumpur, Malaysia. Those with intellectual disability and/or difficulty to comprehend Malay language, and without parental consent and assent, were excluded. Students from randomly selected classes aged 13-year-old to 17-year-old were invited to fill in these questionnaires: Socio-demographic Questionnaire, Rosenberg Self-esteem Questionnaire, Physical Activity Questionnaire (PAQ-A), Eating Disorder Examination Questionnaires (EDE-Q), Internet Addiction Test Scale (IAT), and Children's Depression Inventory (CDI).

    RESULT: 461 students participated in the study. 21.5% of the participating students were found to have depression (n = 99). Younger age and Chinese race showed significant association with adolescent depression with a p-value of 0.032 and 0.017 respectively. Other significant correlations with depression were self-esteem (p = 0.013), disordered eating (p = 0.000), lower physical activity (p = 0.014) and problematic internet usage (p = 0.000).

    DISCUSSION: The prevalence of depression among adolescents in this study (21.5%) is in line with previous prevalence studies in Malaysia. Self-esteem is postulated to be a moderating factor for depression hence explaining the significant association. A sedentary lifestyle may increase the risk of developing depression, The causal relationship between problematic internet usage and depression is complex and difficult to establish. This is similar to the relationship between problematic eating behavior and depression as well.

    CONCLUSION: There is still a need to explore the causal relationship between lifestyle factors and depression among youth. Despite that, the results from this paper have accentuated the gravity of the importance of a healthy lifestyle among adolescents. An appropriate preventive measure is governmental strategies and policies aiming at improving a healthier lifestyle in this age group.

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