Objective: ADHD is a complex neurobiological disorder, which required tactful
intervention. Besides pharmacotherapy, there is still limited information in
addressing the efficacy of cognitive behavior therapy (CBT) for treating this
developmental disorder.
Methods: We report a case of late diagnosed of ADHD
whose facing difficulty to cope with her undergraduate degree. She has to repeat
her semester examination due to lack of attention. Denial was seen in both
patient and family in accepting the diagnoses, and posed roadblock for
successful intervention.
Results: Six sessions of CBT were conducted, coupled
with psycho education for both the family and patient. Consultation from the
university’s management helped her to accept and cope with her ADHD
symptoms, i.e. attention and impulsivity. The patient showed improvement
following this intensive bio-psycho-social intervention.
Conclusion: The short
duration of CBT was found suitable to be adapted and implemented in young
adult ADHD.
Objective: This case report highlights the issue of hypersexuality in persons with dementia and outlines the possible etiology and challenges associated with interventions of inappropriate sexual behaviors in dementia.
Methods: We report a 75-year-old male with vascular dementia who developed hypersexuality and aggression towards his wife. The management plans are elaborated in this paper.
Results: A combination of pharmacological and psychosocial intervention lead to the resolution of his inappropriate sexual behavior and improvement in his relationships with his wife and children.
Conclusion: Inappropriate sexual behaviors need to be recognized and managed without compromising the fulfillment of the human's basic need of sexuality.
Objective: The fact that childhood sexual abuse is associated with depression is well-known. To date, there is no proper study done on screening for depression and coping strategies among sexually abused children in Malaysia. This study aimed to determine the prevalence of depression and examine the association of depression with the socio-demographics and
coping strategies used by sexually abused children. Methods: Sixty-five sexually abused children who attended the One Stop Crisis Centre (OSCC) services at Hospital Universiti Sains Malaysia and fulfilled the study criteria were screened for depression using a validated Malay version of Children Depression Inventory (CDI).Depression was determined by a positive score of the Malay-CDI with depression being indicated in scores of more than 18.
Results: In the study sample, 16 (24.6 %) participants had been depressed and 49 (75.4 %) participants had not been depressed. Having a confidante was a protective factor against depression. Short duration of time between the abuse incident and the clinical interview was significantly associated with depression. With respect to coping strategies, 59 (90.8 %) used emotionfocused strategies and 6 (9.2 %) used problem or task-focused strategies. Among emotion-focused coping strategies, participants did the following: deciding that nothing could be done to change things, were in denial, and suppressed their feelings. Conclusion: Twenty five percent of the sample suffered from depression. The screening of depression in the vulnerable group such as sexually abused children is important, particularly for early
detection and treatment. By recognizing the coping strategies used in sexually abused children, the clinician could understand them better and plan for their psychological management.
Objective: This case reported highlighted psychotic disorder due to dengue fever
is rare. Hence we describe a case which clearly presented with psychotic
symptoms during the illness.
Methods: We reported a case of psychotic disorder
due to dengue fever who presented with psychotic symptoms of auditory and
visual hallucination, and persecutory delusion, which had significant temporal
correlation with dengue fever symptoms. There were no neurological deficits
noted, no altered sensorium and cognitive impairment during the episode. He
has no past and family history of mental illness and there was no evidence of
encephalitis and metabolic disturbances.
Results: Our case suggests that
prominent psychotic symptoms can occur during an episode of dengue fever,
which remitted when one recovering from dengue fever.
Conclusion: We
demonstrated that patients who presented with the acute onset of psychosis
accompanied by symptoms of viral fever should be screened for dengue fever,
particularly if the person lived in or visited the area where dengue fever is
endemic.
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.
Objective: To investigate the prevalence of parental stress and psychological wellbeing among parents with autistic children and their associations with dimensions of support system.
Methods: This is a preliminary cross sectional study which randomly selected parents with clinically diagnosed autistic children. Those parents who attended psycho-education session on management of autistic children at Health Psychology Unit were randomly selected to enroll in the study. Psychological wellbeing, parental stress and dimensions of support system were assessed by using the General Health Questionnaire (GHQ-28), the Parenting Stress Index (PSI) and the Provision Social Relation (PSR), respectively.
Results: Of 52 parents with autistic children (34 female and 18 male), about 90.4% of parents had significant parenting stress, and 53.8% of parents showed clinical disturbance in psychological wellbeing. Gender (t=1.67, p=0.02) and occupation (F=4.78, p=0.01) showed statistically significant association with psychological wellbeing. No association found between other socio-demographic factors, parental stress and psychological wellbeing with dimensions of support system among parents with autistic children.
Conclusion: Parents with autistic children have high prevalence of stress and psychological disturbances. Interactions of various factors need to be acknowledged and considered in order to reduce the burden of parents with autistic children.
Objective: To study the effect of depressive disorders, severity of depression and, sociodemographic factors on drug compliance among hypertensive patients at primary care clinics. Methods: A total of 201 hypertensive patients on treatment for at least 3 months who attended the HUKM Primary Care Clinic and Salak Polyclinic were selected for this study. Patients were screened for depressive disorders using the Hospital Anxiety Depression Scale (HADS) and those who scored 8 and more were further interviewed to establish a diagnosis using the Mini International Neuropsychiatric Interview (MINI). Patients who were diagnosed to have depressive disorders were further rated for the severity of the illness by using Hamilton Rating Scale for Depression (HAMD). Drug compliance was assessed during a 2 month follow up using the pill counting method (ratio 0.8 – 1.2 considered as compliant). Results: The prevalence of non-compliance among hypertensive patients was 38.3%. There was no association between the diagnosis of depressive disorders and drug compliance. Among the 12 patients who had depressive disorders, severity of depression as rated by HAMD, showed significant association with drug compliance (Mann-Whitney test z = -2.083, p
Objectives: This study aimed to determine the prevalence of depressive disorder
and its association with perceived social support among patients with HIV
attending the Infectious Disease Clinic in HTJS.
Methods: A cross-sectional
study was conducted, and systematic random sampling method was employed
for the selection of participants. Socio-demographic and clinical details were
obtained through a self-rated questionnaire and participants’ medical records.
Depressive disorder was screened and diagnosed using the Mini International
Neuropsychiatric Interview (M.I.N.I.) and perceived social support was
determined using the Multidimensional Scale of Perceived Social Support
(MSPSS). Appropriate statistical analyses were used to determine the prevalence
of depressive disorder and its association with perceived social support.
Results:
A total of 99 patients participated in this study. The mean age of participants
was 38.16 ± 1.01 years, and the majority of participants were male (69.7%). Most
of the participants were Malay (58.6%), followed by Indians (20.2%), Chinese
(17.2%) and others (4.0%). The majority had completed secondary education
(54%), and most were employed (79.8%). Most of the participants were single
(45.5%) or married (45.5%). The lifetime and point prevalence of depressive
disorder was 24.2% and 17.2%, respectively. About 64.7% of patients with
depressive disorder were undiagnosed. Out of the 3 sources of perceived social
support, perceived social support from a significant other (OR=0.53, p=0.042,
Cl=0.29, 0.98) and perceived social support from friends (OR=0.49, p=0.015,
Cl=0.27, 0.87) were found to be negative predictors for depressive disorder.
Conclusion: This study reports that the prevalence disorder among patients with
HIV in HTJS is higher than that of the general population. Patients without
depressive disorder reported significantly higher perceived social support scores.
Perceived social supports from significant others and friends were found to be
important associated factors for lower depressive disorder vulnerability. Hence,
physicians should routinely screen for depressive disorder in this vulnerable
group and explore and mobilize their social support to reduce patients’
vulnerability to develop depressive disorder.
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: This study aimed to assess the concurrent validity of the Malay version of the Perceived Stress Scale (PSS-10) PSS-10 item.
Methods: A cross-sectional study was conducted among all students in a medical faculty in Malaysia. The questionnaire included three parts; socio-demographic correlates, PSS-10 and the validated Malay version of Depression Anxiety and Stress Scale-21 item (DASS-21). Spearman's correlation coefficient was used in the analysis.
Results: Stress subscale of DASS -21 correlated positively with the total score of PSS-10 (r= +0.50, p<0.001), positively with the negative subscale of PSS-10 (r=+0.36, p<0.001) and negatively with the positive subscale of PSS-10 (perceived coping) (r= -0.33, p<0.001).
Conclusion: The Malay Version of PSS-10 has fair correlation with the stress subscale of DASS-21. This confirmed the concurrent validity of this scale, which further strengthened the previous evidence that the Malay version of PSS-10 was a valid tool to measure stress in Malaysian university students.
Keywords: Malay, Version, Stress, Medical, Students, Psychological Distress
Objective: This paper aimed to determine the prevalence of sleeping pills use among university students and its associated factors in Malaysia. Methods: This cross-sectional study was conducted in January 2010 among 200 Malaysia. The survey was conducted by distributing self-administered questionnaires. The questionnaire was developed based on the literature review. The students were chosen randomly using convenience sampling.
Results: A total of 200 university students participated in this study. The prevalence of using sleeping pills among university students is 7.5%. The majority of the participants were Malay 146 (73.0%), from urban area 169 (84.5%), from medical and health sciences background 101 (50.5%). This study showed that there is a significant relationship between using sleeping pills and depression (p= 0.03). There is also a significant relationship between
using sleeping pills and inducing sleep by reading (p=0.04). Conclusion: The prevalence of sleeping pills usage among university students is relatively high. This study showed that there is a significant relationship between using sleeping pills and depression.
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.
Objectives: The objective of the study is to determine the prevalence of substance abuse for alcohol, cannabis, opiates, stimulants, solvent and other substances among patients with schizophrenia in Hospital Bahagia Ulu Kinta (HBUK), Perak , Central Peninsular of Malaysia. This study also aims to determine the association of substance abuse with aggression, the demographic characteristics and total duration of hospitalization.
Methods: This was a retrospective cross-sectional study whereby the first 194 subjects diagnosed to have schizophrenia based on International Classification of Disease, 10th edition (ICD-10) criteria were taken from data registry of patients admitted to HBUK from January until February 2004. The subjects’ medical files were examined for documentation of substances abuse, aggression and accumulative duration of hospitalization.
Results: The results showed the prevalence of substances misuse among patients with schizophrenia in general (including alcohol) was 24.7%. Cannabis 16.7%, alcohol 13.4%, opiates(heroin) 6.7%, Amphetamine type stimulants (amphetamine, metamphetamine, ecstacy) 5.7%, and other substances (benzodiazepine, solvents) 1.5%.
Conclusion: There is higher prevalence of substance misuse in patients with schizophrenia as compared to general population. Male patients with history of substance misuse are more likely to have aggression than female. This group needs special precaution and probably in need of specialist help.
Objective: According to Malaysian law, defendants found not guilty by reason of insanity may be admitted to a psychiatric hospital and discharge is subject to the state ruler’s assent. The objective of this study is to examine the clinical, socio-demographic and forensic factors that influence inpatient duration of insanity acquittees in a Malaysian mental institution. Methods:This is a cross-sectional study of one hundred and twelve insanity acquittee inpatients in Hospital Bahagia Ulu Kinta from January 2007 to February 2007. Patients with a clinical diagnosis of schizophrenia, major depressive disorder and bipolar disorder were assessed using the Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HAMD) and Young Mania Rating Scale (YMRS) respectively. Other relevant sociodemographic, clinical and forensic factors were also assessed. Results: The inpatient duration varied widely from three months to forty-seven years with a median of seven years. Seventy five percent of patients were in remission. According to the multiple linear regression model, the strongest predictor of a longer duration of hospital stay for insanity acquittees was older age (p
Objective: Bradycardia due to the combination of amisulpride and fluvoxamine is not commonly known in the literature.
Methods: We report a case of asymptomatic sinus bradycardia that occurred when amisulpride and fluvoxamine were given concurrently and resolved after cessation of both these two medications. The Naranjo scale for Adverse Drug Reaction was used to determine the likelihood of medications’ in causing bradycardia. Other possible causes were also assessed and ruled out through medical consultations.
Results: This case strongly suggests that the bradycardia occurred due to the combined effect of these medications’ independent risk in causing this potentially harmful cardiac event.
Conclusion: Therefore, it is important to monitor for bradycardia whenever both these medications are prescribed even at therapeutic dosages.
Objectives: With the explosion in the use of WhatsApp Messenger globally, the revalence of late-night WhatsApping is poised to show a commensurate increase. This has sparked debates on a possible new wave of technological addiction that could cause serious psycho-behavioral repercussions. Acknowledging the ubiquity of WhatsApp, healthcare professionals have adopted it as a preferred communication tool in clinical practice. This preliminary cross-sectional study aimed to explore the prevalence of and psycho-behavioral factors associated with late-night WhatsApping.
Methods: It was conducted on a universal sample of 307 healthcare professionals across medical and casualty departments in a Malaysian public hospital. The self-administered questionnaire consisted of items on socio-demographics, WhatsApp usage characteristics, and psycho-behavioral attributes.
Results: Majority of respondents (72.9%) reported late-night WhatsApping habits. In multivariate analyses, late-night WhatsApping was significantly higher among those who used WhatsApp for more than 12 months (Adjusted odds ratio, AOR = 4.4, 95% Confidence interval, CI 2.2–8.8, p < 0.001), those who frequently kept
mobile data on to avoid missing WhatsApp messages (AOR = 3.2, 95% CI 1.3–5.8, p = 0.006), those with frequent social connections (AOR = 3.0, 95% CI 1.4–6.4, p = 0.003), and those living alone (AOR = 2.3, 95% CI 1.1–5.2, p = 0.038).
Conclusion: Late-night WhatsApping was significantly associated with usage characteristics and psycho-behavioral attributes.
Objective: Mental health services in Malaysia often face competition from traditional healers especially among patients with psychosis. The objective of the study is to determine whether patients who sought help earlier from traditional healers had longer duration of untreated psychosis (DUP), and more adverse experiences in pathways to psychiatric care. Methods: This is a hospital-based cross-sectional study of 50 inpatients with first-episode
psychosis in Hospital Kuala Lumpur. Structured Clinical Interview for DSM-IV (Diagnostic and statistical manual, 4th edition) Clinical Version for Axis I Disorders (SCID-CV) was used for establishing diagnosis. Onset of psychosis was defined as any one positive symptom with a score of >3 on the Positive and Negative Syndrome Scale (PANSS). Socio-demographic
data, information on pathways and treatment delaying factors were determined through face-to-face interview and semi-structured questionnaire. Results: Fifty-four percent of the patients had at least one contact with traditional healers prior to consulting psychiatric service, and it was the most popular first point of non-psychiatric help-seeking contact
(48%). Contact with traditional healers was not associated with age, gender, ethnic, education level, longer DUP or treatment delay, and admissions with violent behaviour or police assistance. Of those who had sought help from traditional healers, one third were recommended by at least one of their traditional healers to seek medical help. Conclusion:
Consultation involving traditional healers was a popular choice, and not associated with treatment delay. Traditional healers in an urban setting may be potential collaborators in managing patients with first-episode psychosis. Future research should explore the frontiers of such collaborative work.
Objective: This review paper will be discussing on mental health of children and adolescents in Malaysia. Behavioural problems, academic failure and underachievement in school are common reasons for referral of children to the medical services. Epidemiological research has substantiated a possible seriously mismatch between the rates of child mental health problems across a broad spectrum and the number of children actually referred to existing services. These data suggest it is imperative in Malaysia to empirically investigate the present realities in the schools in regard to special education needs and their neglect. Methods: The present preliminary study is based on a literature review of epidemiological features of learning disorders and comorbidities using the Cochran library key word search. Available statistics for learning disorders from the WHO are compared with records for the
year 2007 from the Ministry of Education in Malaysia. Results: Findings of this comparison with international prevalence rates of learning disorders and related diseases show a sizable gap between real existing needs in Malaysia, and their perception. Based on quantitative estimates, the findings suggest that some 1.4 million children in Malaysia have mental health difficulties that interfere with normal functioning and development, but adequate services for intervention are largely not available. Conclusion: The present undersupply of adequate service for children with learning difficulties is aggravated by the lack of systematic developmental screening in early childhood in Malaysia. This status affects the outcomes and development of the general education system in efforts to meet challenges in the new century.
Objective: The relationships between awareness, knowledge and attitudes (AKA) and coping mechanisms among people with epilepsy (PWE) have not been well-explored particularly in Asia. This study aimed to: identify preferred coping strategies, correlate between AKA and coping mechanisms and compare coping strategies of PWE with different AKA levels. Methods: A cross-sectional sample of epilepsy outpatients was recruited from the Neurology Clinic, Hospital Sultanah Nur Zahirah, Kuala Terengganu. The participants completed the Malay AKA Epilepsy and the Malay Brief COPE instruments. The data was analysed using non-parametric statistics. Results: Sixty out of 72 patients (response rate = 83.3%) consented
participation (median age = 27.5 years; male = 53.3%; unmarried = 63.3%; Malay = 90.0%; SPM education = 54.2%; unemployed = 35.0%; rural residents = 70.0%). Religion was the most preferred coping strategy (93.3%), followed by Emotional Support (86.7%) and Instrumental Support (81.7%). Awareness was negatively correlated with Instrumental Support (rs = -0.268; p
Study site: Neurology Clinic, Hospital Sultanah Nur Zahirah, Kuala Terengganu.
Objective: The purpose of this study was to evaluate the effectiveness of nutrition education intervention among university students in terms of social, psychological factors and nutrition-related Quality of Life (NQoL) outcomes after receiving a 10-week nutrition education. Longitudinal and randomised study design was adopted for the study. Methods: A total of 417 respondents from four public universities in Terengganu were randomly assigned to either intervention group (IG = 205) or control group (CG = 212). The IG received nutrition education through three tools; 1) conventional lecture, 2) brochures and 3) text messages via short messaging system (SMS) while the CG not received any intervention. Students completed the Malay version of NQoL (6 domains; 49 items; Likert-type responses=1-5) and SF-36 (8 domains; 36 items) at pre-intervention and post-intervention. Data analysis was carried out by using SPSS 16.0 utilising descriptive and parametric statistics. Results: Ninety-one percent of participants (IG = 178; CG = 202) completed the study (age = 19.1±1.1 years; female = 87.6%; Malay = 98.2%). After controlling for possible confounders (eg. weight, waist, hip circumferences and pre-intervention scores for each domain), IG possessed relatively higher NQoL score in Food Impact (p = 0.001), Social / Interpersonal (p = 0.008), Physical Functioning (p = 0.011) and Overall NQoL (p = 0.001). However, Psychological Factors did not show any significant difference for both groups. Conclusion: Although the intervention did not generate significant impact in the psychological component over a period of 10 weeks, significant positive impacts in Social/Interpersonal aspects and NQoL were clearly shown. ASEAN Journal of Psychiatry, Vol. 15 (1): January - June 2014: 39-53.