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Fulltext Validation of a Malay Version of the Smartphone Addiction Scale among Medical Students in Malaysia

Ching SM, Yee A, Ramachandran V, Sazlly Lim SM, Wan Sulaiman WA, Foo YL, et al.

PLoS One, 2015;10(10):e0139337.
PMID: 26431511 DOI: 10.1371/journal.pone.0139337

This study was initiated to determine the psychometric properties of the Smart Phone Addiction Scale (SAS) by translating and validating this scale into the Malay language (SAS-M), which is the main language spoken in Malaysia. This study can distinguish smart phone and internet addiction among multi-ethnic Malaysian medical students. In addition, the reliability and validity of the SAS was also demonstrated.

Matched MeSH terms: Asian Continental Ancestry Group/psychology*
Subjective depressive symptoms associated with pain in patients with major depressive disorder: Findings from the study on the aspect of Asian depression

Oon-Arom A, Likhitsathian S, Maneeton B, Sulaiman AH, Shih-Yen EC, Udomratn P, et al.

Perspect Psychiatr Care, 2020 Jan;56(1):188-193.
PMID: 31148197 DOI: 10.1111/ppc.12403

PURPOSE: To examine subjective depressive symptoms associated with physical pain symptoms (PPSs) in Asian patients with major depressive disorder (MDD).
DESIGN AND METHODS: Four PPSs, including headache, chest pain, low back pain, and muscle pain, and subjective depressive symptoms were assessed using the Symptom Checklist-90-Revised.
FINDINGS: Out of 528 participants, 390 (73.9%) had at least one PPS. After adjusting for sex, depression severity, disability, fatigue, physical health status, and mental health status, PPSs were found to be associated with crying easily, blaming oneself, feeling lonely, feeling blue, and worrying too much.
PRACTICAL IMPLICATIONS: Almost three-quarters of Asian patients with MDD experience PPSs. PPSs are associated with some subjective feelings of depression.

Matched MeSH terms: Asian Continental Ancestry Group/psychology*
Sex differences on the Multitalent Perception Inventory among Malaysian students

Palaniappan AK

Percept Mot Skills, 2007 Dec;105(3 Pt 2):1052-4.
PMID: 18380099

Malaysian high school students, 142 boys and 154 girls (M age= 13.3 yr., SD = 0.3) were compared on a talent measure, the Khatena-Morse Multitalent Perception Inventory. Boys obtained significantly higher means on the overall score of Versatility and the talent areas of Artistry, Creative Imagination, Initiative, and Leadership. Further replications involving other age groups and nationalities are recommended.

Matched MeSH terms: Asian Continental Ancestry Group/psychology
Correlates of Children's Eating Attitude Test scores among primary school children

Shariff ZM, Yasin ZM

Percept Mot Skills, 2005 Apr;100(2):463-72.
PMID: 15974357

A total of 107 Malay primary school girls (8-9 yr. old) completed a set of measurements on eating behavior (ChEAT, food neophobia scales, and dieting experience), the Rosenberg Self-Esteem Scale, body shape satisfaction, dietary intake, weight, and height. About 38% of the girls scored 20 and more on the ChEAT, and 46% of them reported dieting by reducing sugar and sweets (73%), skipping meals (67%), reducing fat foods (60%) and snacks (53%) as the most frequent methods practiced. In general, those girls with higher ChEAT scores tended to have lower self-esteem (r=.39), indicating they were more unwilling to try new foods (food neophobic) (r=.29), chose a smaller figure for desired body size (r=-.25), and were more dissatisfied with their body size (r=.31).

Matched MeSH terms: Asian Continental Ancestry Group/psychology
Colour detection thresholds in faces and colour patches

Tan KW, Stephen ID

Perception, 2013;42(7):733-41.
PMID: 24344549

Human facial skin colour reflects individuals' underlying health (Stephen et al 2011 Evolution & Human Behavior 32 216-227); and enhanced facial skin CIELab b* (yellowness), a* (redness), and L* (lightness) are perceived as healthy (also Stephen et al 2009a International Journal of Primatology 30 845-857). Here, we examine Malaysian Chinese participants' detection thresholds for CIELab L* (lightness), a* (redness), and b* (yellowness) colour changes in Asian, African, and Caucasian faces and skin coloured patches. Twelve face photos and three skin coloured patches were transformed to produce four pairs of images of each individual face and colour patch with different amounts of red, yellow, or lightness, from very subtle (deltaE = 1.2) to quite large differences (deltaE = 9.6). Participants were asked to decide which of sequentially displayed, paired same-face images or colour patches were lighter, redder, or yellower. Changes in facial redness, followed by changes in yellowness, were more easily discriminated than changes in luminance. However, visual sensitivity was not greater for redness and yellowness in nonface stimuli, suggesting red facial skin colour special salience. Participants were also significantly better at recognizing colour differences in own-race (Asian) and Caucasian faces than in African faces, suggesting the existence of cross-race effect in discriminating facial colours. Humans' colour vision may have been selected for skin colour signalling (Changizi et al 2006 Biology Letters 2 217-221), enabling individuals to perceive subtle changes in skin colour, reflecting health and emotional status.

Matched MeSH terms: Asian Continental Ancestry Group/psychology
Investigating the mediating role of self-construal on the relationship between cultural group (Malay and Australian) and the characteristics and functional use of autobiographical memory

Jobson L, Whittles N, Tsecoutanis E, Raj S, Yew RY, Haque S

Memory, 2019 09;27(8):1054-1062.
PMID: 31104591 DOI: 10.1080/09658211.2019.1619776

Cultural differences in autobiographical memory characteristics and function have often been presumed to be associated with different cultural beliefs related to the self. The current research aimed to investigate whether self-construal mediated the relationship between cultural group and the characteristics and functional use of autobiographical memory. Caucasian Australians (n = 71) and Malay Malaysians (n = 50) completed an online questionnaire that included the Self-Defining Memory task, the Thinking About Life Experiences Revised Questionnaire and the Self Construal Scale. As expected, the Australian group provided longer, more autonomously oriented, specific memories than the Malay group. However, contrary to our predictions, self-construal did not mediate the relationships between cultural group and memory characteristics. The Malay group reported more frequently using autobiographical memories for self-continuity than the Australian group. Finally, there was support for an indirect pathway between cultural group and use of autobiographical memories for self-continuity and social-bonding through self-construal (i.e. independent self relative to interdependent self). The findings highlight the importance of explicitly examining values assumed to be associated with autobiographical remembering, and relating these values to memory characteristics and function.

Matched MeSH terms: Asian Continental Ancestry Group/psychology*
Fulltext Asian medical students' attitudes towards professionalism

Parthiban N, Boland F, Fadil Azim DH, Pawlikowska T, O'Shea MT, Jaafar MH, et al.

Med Educ Online, 2021 Dec;26(1):1927466.
PMID: 33999787 DOI: 10.1080/10872981.2021.1927466

Background: Professionalism is the basis of trust in patient-physician relationships; however, there is very limited evidence focusing on attitudes towards professionalism among medical students. Hence, the main aim of our study was to investigate Malaysian medical students' attitudes towards professionalism with specific emphasis on the comparison between pre-clinical and clinical students. Our secondary aim was to compare the differences in perception of medical students in Malaysia (pre-clinical and clinical) with Asian medical students studying in Dublin, IrelandMethods: This study utilized the Professionalism Mini-Evaluation Exercise (P-MEX) instrument which consists of 25 items that represent four skill categories: Doctor-Patient Relationship skills, Reflective skills, Time Management and Inter-Professional Relationship skills. Descriptive statistics were used to describe the demographic information of students and given the ordinal nature of the data, Mann-Whitney U-tests were used.Results: Overall, students have positive attitudes to all the professionalism items with more than 80% of the students agreeing that each of the professionalism attributes is important or very important. There was evidence of a significant difference between Malaysian pre-clinical and clinical students in relation to 'avoiding derogatory language' only (p = 0.015). When comparing between Malaysian and Dublin Asian students, there was a statistically significant difference in relation to 'show interest in patient as a person' (p

Matched MeSH terms: Asian Continental Ancestry Group/psychology*
Clinical Characteristics, Pain, and Quality of Life Experiences of Trigeminal Neuralgia in a Multi-Ethnic Asian Cohort

Tan CY, Shahrizaila N, Goh KJ

J Oral Facial Pain Headache, 2017 10 27;31(4):e15-e20.
PMID: 29073667 DOI: 10.11607/ofph.1793

AIMS: To describe the clinical characteristics of trigeminal neuralgia (TN) in a multi-ethnic Malaysian population and to relate them to standardized measures of pain severity, anxiety, depression, and quality of life (QoL).
METHODS: Patients fulfilling the International Headache Society (IHS) criteria for TN were prospectively interviewed for their demographic and clinical data. Pain intensity was rated with a visual analog scale (VAS), anxiety and depression were determined by the Hospital Anxiety and Depression Scale (HADS), and QoL was assessed by the Short-Form 36 (SF-36) questionnaire. Chi-square, Mann-Whitney U, and Spearman correlation tests were used to test for differences considering a significance level of P < .05.
RESULTS: Of the 75 included patients, 52 (69.3%) were women with a mean ± standard deviation (SD) onset age of 52.0 ± 12.7 years, and 57.3% were Chinese, 24.0% Malay, and 18.7% Indian. Pain was more common on the right side (69.3%) and in the maxillary and mandibular divisions. VAS scores for pain at its worst were higher in anxious/borderline anxious patients compared to non-anxious patients (89.5 ± 15.9 vs 80.9 ± 17.2, respectively; P < .05), and VAS scores for pain at its least were higher in depressed/borderline depressed subjects compared to non-depressed subjects (38.4 ± 25.8 vs 23.0 ± 19.2, respectively; P < .05). Chinese patients had lower VAS scores for pain at its least compared to Indian patients (19.7 ± 16.1 vs 39.9 ± 24.7; P < .01). TN patients scored lower in all eight domains of the SF-36 compared to the general population. Indian patients had lower scores in role limitations due to physical health (8.9 ± 23.2 vs 49.4 ± 43.8; P < .01) and social function (56.3 ± 13.6 vs 76.5 ± 23.6; P < .01) than Chinese patients, and Malay patients had lower mental health scores compared to Chinese patients (59.1 ± 19.5 vs 73.0 ± 21.0; P < .01).
CONCLUSION: Clinical characteristics of TN patients were similar to those of other populations. There were differences in pain ratings and QoL between TN patients of different ethnicities, as well as between those with anxiety and depression.

Matched MeSH terms: Asian Continental Ancestry Group/psychology*
Mammographic screening practices among Chinese-Australian women

Kwok C, Fethney J, White K

J Nurs Scholarsh, 2012 Mar;44(1):11-8.
PMID: 22151348 DOI: 10.1111/j.1547-5069.2011.01429.x

To report mammographic screening practice among Chinese-Australian women, and to examine the relationship between demographic characteristics, acculturation factors (English proficiency and length of stay in Australia), cultural beliefs, and having a mammogram as recommended.

Matched MeSH terms: Asian Continental Ancestry Group/psychology*
Psychometric Properties of the Iowa Infant Feeding Attitude Scale among a Multiethnic Population during Pregnancy

Lau Y, Htun TP, Lim PI, Ho-Lim SS, Klainin-Yobas P

J Hum Lact, 2016 May;32(2):315-23.
PMID: 26151966 DOI: 10.1177/0890334415591813

BACKGROUND: The Iowa Infant Feeding Attitude Scale (IIFAS) was developed to measure maternal attitudes toward infant feeding, but a number of validated studies on the IIFAS found that it was subject to methodological limitations.
OBJECTIVE: The purpose of this study was to evaluate the psychometric properties of the IIFAS among a multiethnic population in Singapore.
METHODS: A cross-sectional research design was used on a sample of 417 antenatal women. The internal consistency and stability of the IIFAS were evaluated using Cronbach's α and test-retest reliability. Known-group comparisons discriminated certain group differences in a predictable way. A series of exploratory factor analyses (EFAs) was conducted to test the factor structure of the IIFAS using the maximum likelihood and principal axis factoring. The number of factors was selected according to theoretical and statistical considerations. A confirmatory factor analysis (CFA) was further performed to validate the factor structure constructed in the prior EFA.
RESULTS: The IIFAS had a Cronbach's α and Pearson correlation of 0.79 and 0.85, respectively. The known-group comparisons among certain groups were supported. The EFA results showed that the 3-factor structure produced the most interpretable and theoretical sense. A second-order CFA was conducted to confirm the construct dimensionality of the 15-item IIFAS, with satisfactory fit indices found.
CONCLUSION: The 15-item IIFAS is a psychometrically sound measurement tool that health care professionals can use to understand the diverse infant feeding attitudes and knowledge among different ethnic groups in order to provide breastfeeding interventions that are culturally sensitive.

Matched MeSH terms: Asian Continental Ancestry Group/psychology*
The role of complementary indigenous Malay therapies: perspectives from palliative care patients

Lua PL

J Complement Integr Med, 2011 Jan;8.
PMID: 22754943 DOI: 10.2202/1553-3840.1369

Although the popularity of complementary indigenous Malay therapies (CIMT) in general healthcare is undeniable in the Malaysian context today, their usage within the palliative care scenarios remains unexplored. Our study was specifically embarked to determine CIMT’s usage pattern, reasons, attitudes, beliefs, perceptions and health-related quality of life (HRQoL) differences (users vs. non-users) in a sample of hospice-based palliative patients in Selangor, Malaysia. From the 39 consenting patients (mean age = 56 years; female = 56.4 percent; Malay = 53.8 percent), 38.5 percent were users of CIMT. Dried medicinal roots, herbs and sea cucumber products were the most preferred types of CIMT (53.3 percent). The most common reason cited for usage was because these were "easier and simpler to be administered" (46.7 percent). Although users' attitudes, beliefs and perceptions were more favourable than the non-users, between 30.0-73.3 percent of users remained unsure or had no knowledge regarding CIMT. They also exhibited significantly poorer Physical Symptoms than the non-users (p=0.006), a probable motive for seeking CIMT in the first place. Despite the small sample size, the findings provided some insight into the role of CIMT especially with regard to usage trends and overall well-being among the terminally-ill, of which healthcare professionals should constantly be vigilant of amidst their routine care responsibilities.

Matched MeSH terms: Asian Continental Ancestry Group/psychology
The cultural, family and community factors for resilience in southeast asian indigenous communities: A systematic review

Chua RY, Kadirvelu A, Yasin S, Choudhry FR, Park MS

J Community Psychol, 2019 09;47(7):1750-1771.
PMID: 31374592 DOI: 10.1002/jcop.22224

Although faced with historical and ongoing hardships, many indigenous communities in Southeast Asia have managed to survive and thrive. The identification of factors that assist these communities in coping with the challenges experienced would help enhance their overall psychological well-being and resilience. The current review outlines types of protective factors for the indigenous communities in Southeast Asia focusing on the cultural, family and community elements linked to their psychological well-being. Four themes of protective factors were identified strong connection to the land and the environment, embracing cultural norms and traditions, passing down and keeping indigenous knowledge across generations, and emphasis on community and social cohesion. Findings suggest that the value of interconnectedness serves as an overarching theme that forms the worldview of the indigenous communities in Southeast Asia. Interconnectedness was important to the indigenous peoples as they considered themselves to be extensions of their family, community, ancestors, future descendants, the land and to all living things and creations that reside on their lands. Future intervention attempts to promote resilience among these communities should take these factors into account, and pay closer attention to community-level factors that seem to have a profound impact on the indigenous construction of resilience.

Matched MeSH terms: Asian Continental Ancestry Group/psychology*
Invariance of parent ratings of the ADHD symptoms in Australian and Malaysian, and north European Australian and Malay Malaysia children: a mean and covariance structures analysis approach

Gomez R

J Atten Disord, 2009 Mar;12(5):422-33.
PMID: 18367758 DOI: 10.1177/1087054708315171

This study used the mean and covariance structures analysis approach to examine the equality or invariance of ratings of the 18 ADHD symptoms.

Matched MeSH terms: Asian Continental Ancestry Group/psychology*
Clinical and sociodemographic correlates of severe insomnia in psychotropic drug-free, Asian outpatients with major depressive disorder

Srisurapanont M, Likhitsathian S, Chua HC, Udomratn P, Chang S, Maneeton N, et al.

J Affect Disord, 2015 Nov 1;186:26-31.
PMID: 26226430 DOI: 10.1016/j.jad.2015.06.032

BACKGROUND: Little has been known regarding the correlates of severe insomnia in major depressive disorder (MDD). This post-hoc analysis aimed to examine the sociodemographic and clinical correlates of severe insomnia in psychotropic drug-free, Asian adult outpatients with MDD.
METHODS: Participants were psychotropic drug-free patients with MDD, aged 18-65 years. By using the Symptom Checklist-90 Items, Revised (SCL-90-R), a score of 4 (severe distress) on any one of three insomnia items was defined as severe insomnia. Other measures included the Montgomery-Asberg Depression Rating Scale (MADRS), the Fatigue Severity Scale (FSS), the nine psychopathology subscales of SCL-90-R, the Physical and Mental Component Summaries of Short Form Health Survey (SF-36 PCS and SF-36 MCS), and the Sheehan Disability Scale (SDS).
RESULTS: Of 528 participants, their mean age being 39.5 (SD=13.26) years, 64.2% were females, and 239 (45.3%) had severe insomnia. The logistic regression model revealed that low educational qualifications (less than secondary school completion), high SCL-90-R Depression scores, high SCL-90-R Anxiety scores, and low SF-36 PCS scores were independently correlated with severe insomnia (p'sAsian; Depressive disorders; Insomnia; SCL-90-R; Subjective

Matched MeSH terms: Asian Continental Ancestry Group/psychology*
Cognitive complaints and predictors of perceived cognitive dysfunction in adults with major depressive disorder: Findings from the Cognitive Dysfunction in Asians with Depression (CogDAD) study

Srisurapanont M, Mok YM, Yang YK, Chan HN, Della CD, Zainal NZ, et al.

J Affect Disord, 2018 05;232:237-242.
PMID: 29499506 DOI: 10.1016/j.jad.2018.02.014

BACKGROUND: Several studies have described the presence of perceived cognitive dysfunction amongst Asian patients with major depressive disorder (MDD). To date, no study has been conducted investigating the predictors of perceived cognitive dysfunction amongst Asian MDD patients.
METHODS: This was a post-hoc analysis of the Cognitive Dysfunction in Asian patients with Depression (CogDAD) study. Descriptive statistics were used to describe the most common cognitive complaints by patients. Univariate and multivariate analyses were performed to determine variables associated with perceived cognitive dysfunction (Perceived Deficit Questionnaire-Depression, PDQ-D).
RESULTS: The CogDAD study population is comprised of MDD patients with mild-to-moderate depression (Patient Health Questionnaire 9-item [PHQ-9]: 11.3 ± 6.9) who reported perceived cognitive dysfunction (PDQ-D = 22.6 ± 16.2). The most common cognitive complaints were: mind drifting (42.3%), trouble making decision (39.6%) and trouble concentrating (38.0%). Predictors of perceived cognitive dysfunction were: being Southeast Asians (vs. Taiwanese) (p 

Matched MeSH terms: Asian Continental Ancestry Group/psychology*
Genetic polymorphism in DTNBP1 gene is associated with methamphetamine-induced panic disorder

Sim MS, Hatim A, Diong SH, Mohamed Z

J Addict Med, 2014 Nov-Dec;8(6):431-7.
PMID: 25303981 DOI: 10.1097/ADM.0000000000000075

The dysbindin-1 (dystrobrevin-binding protein-1 [DTNBP-1]) gene has repeatedly been shown to be associated with psychotic disorder across diverse populations. In this study, we attempted to investigate the association of the rs3213207 (P1635) genetic polymorphism of the DTNBP1 gene with methamphetamine dependence and with methamphetamine-induced psychosis, manic episodes, and panic disorder in a male Malaysian population.

Matched MeSH terms: Asian Continental Ancestry Group/psychology
Worry about performance: a unique dimension of caregiver burden

Lim WS, Cheah WK, Ali N, Han HC, Anthony PV, Chan M, et al.

Int Psychogeriatr, 2014 Apr;26(4):677-86.
PMID: 24382159 DOI: 10.1017/S1041610213002445

Recent studies that describe the multidimensionality of the Zarit Burden Interview (ZBI) challenge the traditional dual-factor paradigm of personal and role strains (Whitlatch et al., 1991). These studies consistently reported a distinct dimension of worry about caregiver performance (WaP) comprising items 20 and 21.The present study aims to compare WaP against conventional ZBI domains in a predominantly Chinese multi-ethnic Asian population.

Matched MeSH terms: Asian Continental Ancestry Group/psychology
Fulltext Sex among Asian men and women: the Global Better Sex Survey in Asia

Tan HM, Marumo K, Yang DY, Hwang TI, Ong ML

Int J Urol, 2009 May;16(5):507-14; discussion 514-5.
PMID: 19467120 DOI: 10.1111/j.1442-2042.2009.02283.x

OBJECTIVES:
To explore by a pooled subanalysis of the Global Better Sex Survey sexual aspirations and unmet needs of men and women from Hong Kong, Indonesia, Japan, Malaysia, Singapore, South Korea, Taiwan, and Thailand.

METHODS:
To qualify, respondents must have had sexual intercourse at least once in the past 12 months. Women must have had heterosexual intercourse. Data were weighted by population size between countries.

RESULTS:
Of 3538 Asian respondents (1776 men and 1762 women), 52% were aged <40 years, 40% were aged 40-59 years, and 8% were aged >or=60 years. The majority were married or in a relationship. Men and women reported having sexual intercourse 5.1 and 4.0 times monthly, respectively. Attraction to partner, foreplay, intercourse, and achieving orgasm were important to most men and women. Two thirds were less than very satisfied with their sex life, and 36% of men were interested in improving sex. For a good sexual experience, the man's ability to get and maintain an erection and erection hardness were important to the majority of Asian men and women. Few respondents reported using a prescription erectile dysfunction medication, but many showed interest in using these medications to improve their sex lives. A comparison between individual countries suggests that attitudes about sex differ from country to country, and between men and women in each country.

CONCLUSIONS:
Sex is very important to Asian men and women, but many of them are not fully satisfied with their sex lives and want to improve them.

Matched MeSH terms: Asian Continental Ancestry Group/psychology
Psychometric properties of the Malay version of the Osteoporosis Health Belief Scale (OHBS-M) among type 2 diabetic patients

Abdulameer SA, Syed Sulaiman SA, Hassali MA, Sahib MN, Subramaniam K

Int J Rheum Dis, 2014 Jan;17(1):93-105.
PMID: 24472272 DOI: 10.1111/1756-185X.12104

The aims of this study were to translate and examine the psychometric properties of the Malaysian version of the Osteoporosis Health Belief Scale (OHBS-M) among type 2 diabetes patients (T2DM) and to assess the correlation between osteoporosis knowledge, health belief and self-efficacy scales, as well as assess the osteoporosis risk in the sample population using quantitative ultrasound measurement (QUS).

Matched MeSH terms: Asian Continental Ancestry Group/psychology*
Fulltext Domains of quality of life affecting elderly patients with hand osteoarthritis: a qualitative study in the Asian perspective

Thumboo J, Wu L, Leung YY

Int J Rheum Dis, 2017 Sep;20(9):1105-1119.
PMID: 26990791 DOI: 10.1111/1756-185X.12843

OBJECTIVES: Hand osteoarthritis (HOA) is common but little is known about how HOA has impact on disability and quality of life (QoL).We aim to identify important domains of concern among participants suffering from symptomatic HOA in Singapore, representing an Asian socio-cultural context.
METHODS: A qualitative study using a focus group technique was performed. We ran focus groups stratified by gender, ethnicity and language. Two independent, trained analysts identified relevant categories and assigned codes to text segments through open coding, with discrepancies resolved through consensus. The final lists of domains and subthemes descriptive of QoL were then compared to the following commonly used HOA specific instruments: Functional Index for Hand Osteoarthritis (FIHOA), Score for Assessment and quantification of Chronic Rheumatic Affections of the Hand (SACRAH), Australian/Canadian Hand Osteoarthritis Index (AUSCAN); and Health Assessment Questionnaire (HAQ).
RESULTS: Twenty-six patients (23 women, three men; 24 Chinese and two Malay; mean ± SD age 62.9 ± 7.5 years) with symptomatic HOA according to the American College of Rheumatology Classification Criteria participated in seven focus groups. Two and five focus groups were conducted in Chinese and English, respectively. The qualitative analysis revealed pain, stiffness and functional disability as the main domains. However, psychological consequences, aesthetic concerns, participation in leisure activities, participation in family roles were important concepts from the focus groups which were not covered by existing instruments. Impact on work productivity by HOA and the unmet health care need is revealed.
CONCLUSION: The domains of concepts important to people with HOA in an Asian socio-cultural context are not fully represented in the most commonly used instruments. Further studies on the selection of main domains relevant to HOA patients are necessary.
Study site: Rheumatology outpatient clinic, Singapore General Hospital

Matched MeSH terms: Asian Continental Ancestry Group/psychology*

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