Objective: This case report highlights psychosis post craniopharyngioma surgery.
Methods: We report a case of a young Malay lady who presented with psychotic symptoms after she underwent craniotomy for craniopharyngioma.
Results: Presence of prominent hallucinations and delusions after removal of the tumour and the symptoms lasted more than a month. The psychosis subsided with antipsychotic.
Conclusion: Psychosis post craniopharyngioma surgery is still possible whether possibly due to the residual tumour or as a result of treatment sequealae.
The objective of this study is to determine the prevalence and factors associated with psychosis in Parkinson’s disease (PD) patients.
Method: This is a cross-sectional study of 108 PD patients from neurological clinic UKM Medical Centre and Kuala Lumpur Hospital. The patients were recruited from August to December 2004. Psychosis was determined using SCID, the severity of psychosis was rated using BPRS. The cognitive functions were evaluated with MMSE and the severity of depression was assessed with HAM-D.
Results: The result shows that the prevalence of psychosis in Parkinson's disease patients in this sample was 13%. The psychosis was found to be significantly associated with advancing age, duration of illness, severity of depression and cognitive impairment. Multivariate analysis demonstrates that severity of depression (OR = 1.08, 95% C.I. = 1.01 - 1.16) and advancing age (OR = 4.72, 95% C.I. = 1.37 - 16.29) increased risk of psychosis in PD patients.
Conclusion: We found that advancing age and severity of depression increase risk to develop psychosis in patients with PD.
Study site: neurological clinic UKM Medical Centre and Kuala Lumpur Hospita
Objective: This study validates The Malay Version of The Inventory of Socially Supportive Behaviour. Methods: The psychometric properties of the ISSB- Malay Version were examined on sixty-eight women who were Malay native speakers and diagnosed with breast cancer. Respondents answered the questionnaire at three weeks and ten weeks following surgery for breast cancer. Results: The Malay Version of ISSB showed excellent internal consistency (Cronbach’s alpha=0.96). Test-retest Intraclass Correlation Coefficient (ICC) was 0.03. Small mean differences were observed at test-retest measurement with Effect Size Index 0.18. Conclusion: The Malay Version of the ISSB could be an appropriate tool to measure the supportive behavior of the Malaysian population. ASEAN Journal of Psychiatry, Vol. 15 (1): January – June 2014: 23-29.
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: 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: Smoking is a prevalent problem globally but more so among most ASEAN countries. Worldwide, six million lives are lost annually and this number is expected to grow. In light of this, the World Health Organization recognises the 31st of May to be World No Tobacco Day. For 2013, the theme is "Ban Tobacco Advertising, Promotion and Sponsorship". This article aims to increase awareness among mental health workers, in particular psychiatrists, on the dangers of smoking, the tactics of the tobacco industry, and simple measures to address these problems within their daily activities.
Method: A brief review of recent relevant literature in the field and actual experience from the field were highlighted in this opinion section.
Results and Conclusion: Mental health workers are at an advantage as they have training in both psychological treatments such as brief intervention, cognitive behavioural therapy or counselling skills and for some others, pharmacological treatments. It is timely that health workers in the region take up this challenging but meaningful opportunity to help those with mental illness to stop their dependence for tobacco.
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
Objective: This descriptive cross-section, community-based study examined the prevalence of psychiatric morbidity and quality of life (QOL) and the associated factors among family caregivers of hospice patients with cancer. Methods: Subjects were 50 family caregivers of cancer patients under the care of Hospice Malaysia homecare. Home visits were done in Klang Valley. Psychiatric morbidity was detected using GHQ-30 English and Bahasa Malaysia versions, and the QOL was assessed by the Short Form 36 items (SF-36) questionnaire. Results:The study results showed that 54% of respondents had psychiatric morbidity. The educational status and the relationship between family caregivers and the cancer patients were statistically significant (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: Postgraduate medical training has always been regarded as a highly stressful environment to students. This article described an initial finding on prevalence and sources of stress among postgraduate students. Method: This is a cross-sectional study conducted on postgraduate students in the School of Medical Sciences, Universiti Sains Malaysia. Sample size as calculated for this preliminary study was 38 and convenient sampling method was applied. The 12 items General Health Questionnaire (GHQ-12) and Postgraduate Stressors Questionnaire (PSQ) were administered during a workshop involving postgraduate students. Data was analysed using SPSS version 12. Results: Thirty three participants participated in this study. This study found that the prevalence of distressed postgraduate students was 36.4%. The top ten stressors were tests and examinations, large amount of content to be learnt, time pressure to meet deadlines, doing work beyond
ability, work overload, unfair assessment by superior, fears of making mistakes that can lead to serious consequences, doing work that mentally straining, work demands affect my personal and home life, and lack of time to review what have been learnt. Conclusion: This study found that there was a high prevalence of distressed postgraduate students. It also found that the major stressors were related to academic and performance pressure.
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: 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: The involvement of families in assisting health professionals in providing care for their family members who suffer a stroke during hospitalization is common in Malaysia. Family caregivers are accountable in providing for the first-ever stroke survivor’s needs, including maintaining functional improvements gained in rehabilitation and the long-term well-being of the stroke survivors. The objective of this study was to determine the predictors of life satisfaction among family caregivers of hospitalized first-ever stroke patients. Methods: This was a cross-sectional community research design study with purposive sampling. It involved 102 family caregivers of hospitalized first-ever stroke patients of two tertiary hospitals in Kelantan. The Bakas Caregiving Outcomes Score (BCOS) was used to measure life satisfaction. Multiple linear regression was used to determine the predictors of life satisfaction. Results: Out of 102 respondents, 21 were males and 81 were females with age range of 16 to 76 years. Significant predictors of life satisfaction of caregivers while caring for their hospitalized first-ever stroke family members were caregivers’ health (β: -2.875, 95%CI: -5.725, -0.025, p = 0.048), patients’ age (β: - 4.251, 95% CI: - 6.379, -2.123, p
Objective: This study examined the symptoms of PTSD among survivors of the December 26th 2004 Malaysian tsunami disaster, as well as differences among sexes in terms of coping styles and availability of social support. Methods: A total of 64 (28 males and 36 females) respondents from several affected districts of Kuala Muda and Langkawi in Kedah and Batu Maung, Pulau Pinang were recruited through purposive sampling. The Detailed Assessment of Posttraumatic Stress (DAPS) was used to measure the posttraumatic stress disorder/symptoms, while the Social Support Questionnaire and Significant Others Scale (Form A) were used to measure the quality and quantity of social support. The COPE Questionnaire was used to measure two coping styles; adaptive and maladaptive coping. Results: Fifty two (81%) respondents did not fulfill the DAPS-PTSD criteria while only 12 (19%) fulfilled the criteria. There was no significant difference between men and women in terms of posttraumatic stresstotal, and the quantity and quality of social support. However, there is a significant difference in adaptive and maladaptive coping styles among victims who fulfill the PTSD diagnosis and those who did not. It was also found that there is no relationship between PTSD symptoms and emotional support, whereas there is a significant
relationship between PTSD symptoms and practical support. Conclusion: This research showed that only a small number of respondents fulfilled the diagnosis of PTSD following their experience of a disaster. There were no difference between genders in terms of PTSD symptoms and social support. Among victims who fulfill the PTSD diagnosis and those who do not, there is a significant difference in the adaptive and maladaptive coping styles. As for the relationship between PTSD symptoms and social support, there is a significant
relationship between PTSD symptoms and practical support but not with emotional support.
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.
Objective: This study was aimed to explore the perceptions and opinions of happiness among university students. Methods: This qualitative study was conducted in January for the academic year 2010 among 33 Medical Science Students from Management and Science University (MSU), Shah Alam, Malaysia. The facilitator wrote down the conversation during the discussion. The data obtained was classified into various categories. Due to the small sample size, the data was analyzed manually. Results: All participants mentioned that the main source of happiness is money. Good relationship with friends and family is the second source of happiness among university students. Some of the students mentioned that the stability of life and good health are causes of happiness. Few participants mentioned that success in life is one of the causes of the happiness.
Objective: Pathological laughter, pseudobulbar affect or a myriad of its other synonyms, is a condition common secondary to neurological injury, presenting with uncontrolled laughing or crying, appearing to be mood-incongruent and significantly debilitating. The objective of this case report is to highlight a rare case of pathological laughter associated with Cerebral Lupus.
Methods: We report a case of a 27-year-old lady presenting with signs and symptoms of stroke with dysarthria progressing to aphasia and then pathological laughter, with an underlying poorly controlled Systemic Lupus Erythematosus, manifesting as Cerebral Lupus.
Results: An improvement in affect congruency followed by decreased frequency of outbreaks among bouts of pathological laughter.
Conclusion: The combination of Escitalopram and Topiramate is effective in the symptomatic treatment of Pathological Laughter.
Objective: This case report aims to highlight the importance of parental contribution to the school refusal problem. Methods: We report a case of a 9- year old boy who presented with school refusal behaviour. Results: There was no psychiatry diagnosis made in this patient. Parental issues such as ineffective and inconsistent parenting, and parental marital disharmony contribute significantly to the school refusal behaviour. Conclusion: Parents in particular are important team players in the management of school refusal. Parental issues need to be explored and managed accordingly to ensure good outcome. ASEAN Journal of Psychiatry, Vol. 15 (1): January - June 2014: 83-85.
Currently, paliperidone palmitate is not approved for the treatment of schizophrenia in adolescents. It is only indicated for treatment of schizophrenia and schizoaffective disorder in adults. This case report highlights the successful treatment outcome with paliperidone palmitate in an adolescent with schizophrenia. Methods: We report a case of an adolescent who presented with psychotic symptoms and marked deterioration in functioning over a period of one year. Results: She showed significant improvement in functioning, and her psychotic symptoms gradually subsided with paliperidone palmitate. Conclusions: Paliperidone palmitate could be considered as an effective treatment modality in adolescents with schizophrenia.
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.