Objective: The objective of this study was to determine the prevalence of the most common phobias and associated factors among university students. Methods: This cross-sectional study was carried out at Management and Science University (MSU). Random sampling was performed throughout all faculties. The questionnaires were distributed randomly at classes, library and university cafe within MSU. Diagnosis of anxiety disorders were established according to DSM-IV criteria. These criteria are included in Liebowitz Social Anxiety Scale (LSAS). The questionnaire consists of two sections. The first section consists of socio-demographic characteristics such as (age, sex, race, type of faculty and income); the second section is LSAS standard questionnaire. Multiple linear regression using backward analysis was performed to obtain the associated factors. Results: A total number of four hundred sixty eight (468) students participated in this study. The majority of them were older than 20
years old, female, Malay and from non-medical and heath faculties (59.6%, 69.6%, 77.8%, 68.8%; respectively). Regarding history of abuse during childhood, the majority of the university students reported that there was no sexual, physical and emotional abuse during childhood (98.5%, 97.4%, 82.1%; respectively). The majority of the students (53.85%) reported that they have phobia. The highest type of phobia reported among university students was phobia from snake (11.5%), followed by speaking in front of crowd (9.2%) and the lowest were phobia of speed, dolls phobia, ropes phobia. Types of faculty, smoking status and history of physical abuse during childhood were the factors that significantly influence the social anxiety among university students in univariate and multivariate analysis. Conclusion: The prevalence of phobic symptoms among university students was
high types of faculty; smoking status and history of physical abuse during childhood significantly influenced social anxiety among university students. Education and counseling university students is necessary to educate the students who suffer from phobia to cope with different situations during study period.
Objective: This case report highlights folie a duex of a caregiver that complicate the management of a case of childhood onset schizophrenia.
Methods: We report a case of a young Malay girl with symptoms of schizophrenia and her caregiver who share her delusion.
Result: Folie a duex in the caregiver caused difficulty in the initiation and maintenance of treatment of a child with schizophrenia.
Conclusion: Treating children with schizophrenia is not easy and could be complicated by the folie a duex in caregiver. Although Child Act 2001 can be applied in order to deliver appropriate treatment to this group of patients, one must be cautious about the implication in therapeutic alliance.
Objective: Despite the availability of modern anti-emetics, chemotherapy-induced nausea and vomiting (CINV) symptoms remain distressing to a high number of cancer patients. This study intended to (1) describe the incidence of CINV and antiemetic usage; (2) assess the health-related quality of life (HRQoL) and correlate its components with Global Health Status; (3) evaluate HRQoL status in relation to CINV among breast cancer patients receiving chemotherapy. Methods: A cross sectional study was conducted in two government hospitals located in the East Coast of Peninsular Malaysia (Terengganu, Kelantan). The Morrow Assessment of Nausea and Emesis Follow-up (MANE-FU) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were administered. Descriptive statistics and non-parametric tests were employed (SPSS 16). Results: Respondents included 41 female patients (age = 49 ± 9.6 years; Malay = 92.7%; no family history of breast cancer = 68.3% and on moderately emetogenic chemotherapy = 97.6%). Majority of patients experienced nausea during or after chemotherapy (90.2%) and rated it as ‘severe’. Most patients had taken anti-emetic
(87.8%) and considered it ‘somewhat useful’. The median score for Global Health Status was 50 (IqR= 16.7). Emotional Functioning, Fatigue and Pain correlated fairly with HRQoL (rs= +0.435; -0.417; -0.387 respectively). Patients with ‘a lot’ and ‘moderate’ nausea displayed significantly more fatigue compared to those with little nausea (p=0.029). Those who experienced vomiting reported worse HRQoL profile compared to those who did not (p=0.011). Conclusion: These findings generally ascertained that CINV remains poorly controlled and significantly interferes with HRQoL, providing rooms for improvements in therapeutic intervention.
Objective: The objective of this study is to identify the correlation between psychological factors and insomnia and the impact of insomnia on daytime sleepiness. Methods and Results: The participants were recruited through convenient sampling and consist of 173 working adults in Georgetown, Penang, aged 20 to 60 years. Participants completed the General Health Questionnaire (GHQ), Athens Insomnia Scale (AIS) and Epworth Sleepiness Scale (ESS). The results revealed that the prevalent of insomnia was 34.7%. There was a positive correlation between psychological distress and insomnia r = .481, p < .001 and also a positive correlation between insomnia and daytime sleepiness r = .334, p < .001. Conclusion: It is concluded that psychological distress typically causes sleep difficulties, and sleep deprivation leads to daytime sleepiness.
Objective: Truancy is a disciplinary problem, which frequently occurs among school students and it has many contributory as well as inter-related factors. It is a growing problem in this country and it often becomes a prelude to other delinquent behaviours. The study objective is to determine the prevalence of truancy as well as factors related to it including psycho-behavioural factors. Methods: A cross-sectional study involving 556 Malay student’s selected using multi-stage sampling was conducted. Results: The overall prevalence of truancy is 30.2%. The predictors to truancy are age, students who frequenting entertainment centre, students who have not completed Quran recital, coping strategies using problems solving methods and time spent watching television/video. There is a significant association between truancy and psycho-behaviour such as watching video/internet pornography, frequenting entertainment centre, smoking, motorcycle racing and dating a special friend. Conclusion: Truancy is a social issue, which must be given serious attention by all concerned components of the society.
Objective: Emotional Intelligence (EI) is described as the ability to perceive, express,
understand, motivate, control and regulate emotion. The USM Emotional Quotient Inventory (USMEQ-i) was designed to measure EI and it was found to be a reliable and valid tool in a sample of prospective medical students. The objective of this study is to determine stability of the USMEQ-i to measure EI at different time and occasions. Methods: A prospective cohort study was done on 196 first year medical students. It was administered to the medical students at four different intervals. The Cronbach’s alpha and intra-class correlation analysis were applied to measure the internal consistency and agreement level across the intervals. The analysis was done using Statistical Package for Social Sciences (SPSS) version 18. Results: A total of 196 first year medical students participated in this study. Its overall Cronbach’s alpha value across intervals ranged between 0.94 and 0.97. The Cronbach’s alpha values of emotional control, emotional maturity, emotional conscientiousness, emotional awareness, emotional commitment, emotional fortitude, and emotional expression scale ranged between 0.59 and 0.91. The Cronbach’s alpha value for the faking index scale ranged from 0.76 to 0.89. The ICC coefficient values for EI total score was 0.83, EI domain score ranged between 0.62 and 0.76 and the faking index score was 0.76. Conclusion: The USMEQ-i has demonstrated a good level of stability and internal consistency to measure EI at different time and occasions. It is a promising psychometric instrument that can be used to measure EI.
Objective: The objective of the present study was to determine the prevalence and factors contributing to psychological morbidity among doctors in Sana’a city, Yemen. Methods: A cross sectional study was conducted among 442 Yemeni doctors. The (GHQ12) was used as a measure of psychological morbidity. Sources of job stress were determined using a 37-item scale questionnaire. Results: The prevalence of psychological morbidity was 68.1 %. Gender, age range of 30 – 39 years old, chewing Khat, type of residence and income were significantly associated with psychological morbidity (p
Objective: The objective of this case report is to highlight some learning points
behind the reasoning of the Appellate Court in a case where there were two
different expert opinions by two forensic psychiatrists from two distinctive
Malaysian Approved Psychiatric Hospital in regard to the soundness of mind of
Mr. A for an alleged offence punishable by a death penalty. Methods: This case
report is based on the reasoning of the Appellate Court in rejecting the plea of
the prosecutor. Results: The High Court order remained in which the defendant
was found not guilty due to reason of insanity (NGRI) provided by the
Malaysian Law under Section 84 of Penal Code for the charge of dangerous drug
trafficking, and he was ordered by court to undergo treatment for his underlying
mental illness in a Psychiatric Institution under Section 348(1) of the Malaysian
Criminal Procedure Code. Conclusion: In writing expert report, it is preferable
to use a singular first-person pronoun in stating the conclusion. If there are other
experts involved in either current or previous assessment, it would be beneficial
to address their different opinions in the expert report. However, expert opinion
is still an ‘opinion',’ and the court would be perfectly entitled to reject or differ
from any of the expert opinions when there are proper grounds to do so.
Objective: Delusional infestation is a psychiatric condition in which a patient
belief that they are infested with living organisms in the absence of any objective
evidence. The objective of this case report is to highlight a rare case of delusional
infestations in a patient with schizophrenia who misusing polysubstance abuse.
Methods: We report a case of 36-year-old Malay gentlemen, unemployed,
married with three children, known case of schizophrenia since 2013, with
history of polysubstance abuse presented to the emergency department with
symptoms of itching followed by a sensation of insects crawling, biting and
burrowing under the skin on his head causing an ulcerated wound. Results: He
was diagnosed to be suffering from schizophrenia and was successfully treated
with monthly antipsychotic depot injection in view of his poor adherence to
medication On examination, ulcerated scalp wound measuring 4 x 4 cm was
noted at the parieto-occipital region of the scalp. Skull X-ray and computerized
tomography (CT) scan of the brain were normal. Electroconvulsive therapy
(ECT) was introduced in view of slow treatment response and self-inflicted
injury. The symptoms were successfully controlled after eight months, and no
extrapyramidal side effect was observed. Conclusion: Patients with delusional
infestation often poorly adhered to his treatment medication and the usage of
depot injection of antipsychotic may benefited some patients to control the
psychotic symptoms.
Background: Up to date, there are handful questionnaires that have been validated in Bahasa Malaysia (BM). This study aimed to translate the Depression Anxiety Stress Scales 21-item (DASS-21) and measure its psychometric properties. Objectives: To determine the construct validity and acceptability of the DASS, BM. Methods: Two forward and backward translations were done in BM in accordance to guideline, and its validation was determined by using confirmatory factor analysis. A total of 263 subjects were selected by systematic random sampling to represent Malaysian population for reliability and validity purposes. Results: The BM DASS-21 had very good Cronbach’s alpha values of .84, .74 and .79, respectively, for depression, anxiety and stress. In addition, it had good factor loading values for most items (.39 to .73). Correlations among scales were between .54 and .68. Conclusions: BM DASS-21 is correctly and adequately translated to Bahasa Malaysia with high psychometric properties. Further studies are required to support these findings.
Objective: This study aimed to determine the prevalence of obesity among patients with schizophrenia and its association with the demographic profile. Methods: This is a cross sectional study. Subjects were selected using systematic sampling. Patients attending the out patient psychiatric clinic, Hospital Universiti Kebangsaan Malaysia, who fulfilled the criteria and able to give consent were included in this study. Diagnosis of schizophrenia was made using Structured Clinical Interview (SCID) for DSM-IV. Demographic profiles of the patients were obtained and anthropometric measurements were measured and classified according to Body Mass Index (BMI) and Waist Circumference (WC) of Asian population. Results: A total of 97 patients were included. The prevalence of overweight (BMI: 23.0- 27.4 kg/m2) was 39.2% (n=38), and the prevalence of obesity (BMI: >27.0 kg/m2) was 35.1% (n=34). BMI was higher among non-Chinese (Malay and Indian, p=.03) and those who had low total household income (p=.03). Sixty-two patients (63.9%) had high WC, which was associated with male (p=.003) and non-Chinese (p=.03). Conclusions: Obesity is highly prevalent among patients with schizophrenia. The risk factors for obesity include male, non-Chinese and those with low total income. The high WC among non-Chinese and male patients suggests that they are at a higher risk of developing obesity-related physical illnesses. These findings support that obesity is a common critical issue among schizophrenic patients, and it warrants serious clinical interventions.
Study site: Psychiatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
Objective: This study aimed to determine the association between the personality traits and
social factors with compliance to anti-hypertensive pharmachotherapy. Methods: This cross
sectional study was conducted from 1st of June until 31st of December 2004, which involved
Hospital Universiti Kebangsaan Malaysia Primary Polyclinic in Bandar Tasik Selatan,
Cheras and Salak Polyclinic in Sepang, Selangor. A total of 200 patients who fulfilled all the inclusion criteria, were selected as respondents. This study used the Mini International Neuropsychiatric Interview (M.I.N.I) for the psychiatric diagnoses and personality characteristics were assessed by using Personality Assessment Schedule (PAS) Results: The prevalence rate of non-compliance was 38.5%. Paranoid personality trait (27.3%) was the most common type of personality traits that associated with non-compliance to the medications prescribed. The results of this study revealed a statistically significant difference between drug compliance and age, race, gender and the site where the study was conducted. No association was found between patients’ education level, occupation, income, marital status, family history of hypertension and personality traits and drug compliance. Conclusion: This study suggested that drug compliance among hypertensive patients was influenced by the presence of psychosocial factors. Hence, it is important for medical practitioners to understand these factors and administer treatment more individual.
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: To assess postgraduate candidates’ knowledge on basic sciences and to compare
their achievement based on two years study in the Department of Psychiatry, National University of Malaysia (UKM), Kuala Lumpur, Malaysia. Methods: This is a study assessing
areas of difficulties in basic sciences for the Malaysian postgraduate candidates sitting for
mock MCQ examination papers in two consecutive years. Results: The candidates in both
years failed on MCQ papers (scoring marks are only 43% and 40% for the year 2006 and
2005 respectively), which is consistent with their final examination outcomes. The candidates in the year 2006 were much superior in neuroanatomy (percentages of median scores: 47% vs. 31%, p
Food is closely related with emotion. It often provides comfort and satisfaction. Some individuals choose to turn to food to curb their negative emotion, resulting in disturbances in
eating patterns, such as overeating which lead to obesity and severely controlling food intake, which culminate in eating disorders like anorexia nervosa, bulimia nervosa and binge eating. These disorders are not related to the eating problems per se but often due to underlying or complicated by psychological factors, namely depression, anxiety, impulse control problems and personality. The roles of psychological factors in eating disorders and obesity should therefore not be downplayed. These disorders should be managed comprehensively involving multiple approaches, including not only biological but also psychological interventions provided by a professional team comprising endocrinologists, psychiatrists, dietitians, exercise physicians and surgeons.
Objective: To investigate patient’s perceived satisfaction and adequacy of information given by doctors on prescribed drugs in an outpatient psychiatric setting.
Methods: The sampling was done consecutively with a target sample size of 200 patients. A simple questionnaire that was developed with 10 close-ended questions and yes or no answers was administered by the interviewing team. This questionnaire assessed patients' knowledge on prescribed medications and their perception on the adequacy of information given.
Results: More than 80% of the patients were informed regarding the reasons, timing to take medication(s), duration of drug treatment and type of prescribed drugs. Half of them were informed regarding the side effect profiles of their prescribed medications. Majority of them (80%) were satisfied with the information given despite only 49% of the patients being given adequate information on their medications.
Conclusion: Patients who are adequately informed about their medications are more significantly satisfied than those inadequately informed. (χ2=4.085, p<0.05).
Key words: perceived satisfaction, adequacy of information, prescribed psychotropic drug
Study site: Psychiatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
This article highlights the issues pertaining to psychiatry and smoking as reported in a symposium on smoking cessation in Malaysia. Methods: A report on a meeting outcome of a symposium on “Making smoking free agenda for psychiatrists in Malaysia.” Results: Smoking is still the number one public health problem and those with mental illness were at a high risk. Despite that, they are often under served in service provision by those caring for them. These shortcoming are seen more and more in Malaysia, where smoking and psychiatry is under researched. Conclusion: More research are needed on the why and how psychiatrist can play a major role in ensuring that those with mental illness in Malaysia are provided equal opportunities to quit smoking.
Objective: Globally, there is growing evidence of stigmatization of people with mental illnesses and mental illness is more stigmatizing than physical illnesses. Therefore, this study aimed to determine the attitudes of university students towards persons with mental illness. Methods: A cross-sectional study was conducted among Management and Science University students during the academic year 2012. Prior ethical approval was taken for conducting the study. A total of 300 medical and health science students was recruited in this study and the response rate was 93%. The survey questionnaire was adopted from a previous study with 15 statements about attitude towards mental health illness and sociodemographic characteristics. Classes were chosen randomly and students also randomly selected. The inclusion criterion for this research was medical and health science students while the exclusion criterion was students from other faculties, staff and lecturers. Data was analyzed with the Statistical Package for the Social Sciences version 13.0. Descriptive statistics were used for the analysis of the basic demographics and survey items of the questionnaire. T-test and multiple linear regression were used to explore the relationship between the socio-demographic and the attitude. Results: A total number of 279 students participated in this study. The majority of them were female, age 20 years and above, single, Malay, from International Medical School (IMS) and from urban areas (68.5%, 88.2%, 96.4%, 58.1%, 60.2%, 77.8% respectively). In this study, the majority of the participants showed a moderate to good attitude towards people with mental illness. Univariate analysis showed that marital status influenced the attitudes of university students towards people with mental illness (p=0.015). In multivariate analysis, multiple linear regression showed that gender, marital status, smoking and drinking alcohol significantly influenced the attitude of university students towards people with mental illness (p=0.014, p=0.012; p=0.009, p=0.013; respectively). Conclusion: This study showed that the undergraduate university students had a moderate to good attitude towards people with mental illness. Gender, marital status, smoking and drinking alcohol significantly influenced the attitude of undergraduate university students towards people with mental illness. ASEAN Journal of Psychiatry, Vol. 14 (1): January - June 2013: XX XX.
Objectives: To determine the association of students’ perception of schooling with externalizing/internalizing scores; and to examine the different perceptions related to truancy. Methods:A total of 373 predominantly 16 year-old students attending three high risk schools in Pudu, Kuala Lumpur completed the questionnaires on schooling variables (four items) and externalizing/internalizing syndromes (Youth Self-Report, 112 items). Results: Certain negative perceptions (uncertainty of the schooling purpose, thinking schooling as time wasting) were significantly associated with higher internalizing (p
Dissociation, including multiple personality disorder, has long been a controversial topic. Patients with suggestive symptoms are often misdiagnosed as malingering or even having
schizophrenia. The former as a result of the overlooking of a clinician on the fact that suggestibility itself plays a key role in the emergence and perpetuation of this illness and the latter due to the lack of knowledge of the whole dissociative disorder spectrum, often resembling that of a psychotic disorder. Another contributing factor to the small number of patients with this diagnosis is due to the reluctance of a psychiatrist to do so because of his/her lack of experience and also fear of humiliation of being accused of seeking fame from diagnosing this somewhat glamorous phenomenon. In Malaysia, various culture bound syndromes often present with similar symptoms too. This article will attempt to understand this dissociation on the local context using case studies as a reference point.