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Postpartum obsessive-compulsive symptoms in a case of peripartum-onset depression and infanticide

Lee KKS, Yahya B

Asian J Psychiatr, 2019 Jan;39:10-11.
PMID: 30466055 DOI: 10.1016/j.ajp.2018.11.004
Analysis of variants of AKT1 in schizophrenia multiplex families

Chow TJ, Tee SF, Loh SY, Yong HS, Abu Bakar AK, Tang PY

Asian J Psychiatr, 2020 Mar;49:101957.
PMID: 32078952 DOI: 10.1016/j.ajp.2020.101957
Functional characterization of two variants in the 3'-untranslated region (UTR) of transcription factor 4 gene and their association with schizophrenia in sib-pairs from multiplex families

Mohamed ZI, Tee SF, Chow TJ, Loh SY, Yong HS, Bakar AKA, et al.

Asian J Psychiatr, 2019 Feb;40:76-81.
PMID: 30771755 DOI: 10.1016/j.ajp.2019.02.001

Transcription factor 4 (TCF4) gene plays an important role in nervous system development and it always associated with the risk of schizophrenia. Since miRNAs regulate targetgenes by binding to 3'UTRs of target mRNAs, the functional variants located in 3'UTR of TCF4 are highly suggested to affect the gene expressions in schizophrenia. To test the hypothesis regarding the effects of the variants located in 3'UTR of TCF4, we conducted an in silico analysis to identify the functional variants and their predicted functions. In this study, we sequenced the 3'UTR of TCF4 in 13 multiplex schizophrenia families and 14 control families. We found two functional variants carried by three unrelated patients. We determined that the C allele of rs1272363 and the TC insert of rs373174214 might suppress post- transcriptional expression. Secondly, we cloned the region that flanked these two variants into a dual luciferase reporter system and compared the luciferase activities between the pmirGLO-TCF4 (control), pmirGLO-TCF4-rs373174214 and pmirGLO-TCF4-rs1273263. Both pmirGLO-TCF4-rs373174214 and pmirGLO-TCF4-rs1273263 caused lower reporter gene activities, as compared to the control. However, only the C allele of rs1272363 reduced the luciferase activity significantly (p = 0.0231). Our results suggested that rs1273263 is a potential regulator of TCF4 expression, and might be associated with schizophrenia.
Fulltext A "good enough" remote psychodynamic psychotherapy - A psychiatry trainee's novice experience during Coronavirus pandemic

Chong SC, Ang JK, Tan KP

Asian J Psychiatr, 2021 Nov;65:102835.
PMID: 34534918 DOI: 10.1016/j.ajp.2021.102835

Covid-19 pandemic and the public health measure have forced an en masse transition to remote therapy from physical sessions. Remote psychodynamic psychotherapy is not a new treatment modality, but its effectiveness in holding the analytic frame has been concerned by some therapists. We would like to highlight some of the therapeutic processes involved with remote psychodynamic psychotherapy, via the help of a narrative experience of a psychiatry trainee who was novice to this delivery method of therapy. Reflections on these concerns have been made in line with the experiences highlighted.
Insights from an infodemiological study of mental health in Malaysia, the Philippines, Singapore, and Thailand from 2004 to 2021

Alibudbud R

Asian J Psychiatr, 2022 Dec;78:103311.
PMID: 36335844 DOI: 10.1016/j.ajp.2022.103311

This infodemiological study utilized Relative Search Volumes (RSV) from Google Trends. It determined changes in public interest in mental health after the implementation of the mental health laws of Malaysia, the Philippines, Singapore, and Thailand using search volumes from 2004 to 2021. It found that public interest in mental health increased in Malaysia, the Philippines, and Singapore after implementing their mental health laws. On the contrary, public interest in mental health continued to decrease in Thailand despite its mental health law implementation. This can be explained by the unequal prioritization of mental health among these countries.
Blood-based oxidation markers in medicated and unmedicated schizophrenia patients: A meta-analysis

Goh XX, Tang PY, Tee SF

Asian J Psychiatr, 2022 Jan;67:102932.
PMID: 34839098 DOI: 10.1016/j.ajp.2021.102932

Increased reactive species due to the effect of antipsychotics on oxidative stress may be involved in the development of schizophrenia. However, antipsychotics may have different direct antioxidant effects due to their chemical structures. The present meta-analysis aimed to investigate whether the cause increased oxidant status in schizophrenia patients is due to the illness or induction by antipsychotics. Studies published from 1964 to 2021 were selected from Pubmed and Scopus databases. Data were analysed using Comprehensive Meta-Analysis version 2. Effect sizes were calculated and compared between unmedicated and medicated patients and healthy controls. Heterogeneity and publication bias were assessed. Subgroup analyses were conducted on drug-free and drug-naïve patients, and patients treated with atypical and typical antipsychotics. We found that medicated patients had significantly higher malondialdehyde (MDA), thiobarbituric acid reactive substances (TBARS) and total oxidant status (TOS). Meanwhile, significantly increased plasma/serum MDA and nitric oxide (NO) were observed in unmedicated patients only. Higher lipid peroxidation in the drug-naïve group may be associated schizophrenia. However, both atypical and typical antipsychotics may worsen lipid peroxidation. Antipsychotic discontinuation in the drug-free group led to significantly increased plasma/serum NO, with larger effect size than the atypical antipsychotic group. In conclusion, medicated schizophrenia patients were more suffered from increased oxidative stress. Therefore, future study may focus on the mechanism of action of specific antipsychotic on oxidative stress.
Preliminary evidence for behavioral and electrophysiological validity of an emoji dot-probe paradigm for young adults with depression

Wong MY, Croarkin PE, Lee PF

Asian J Psychiatr, 2022 Feb;68:102968.
PMID: 34954613 DOI: 10.1016/j.ajp.2021.102968
The cascade to a serendipitous discovery of lithium-induced nephrogenic diabetes insipidus

Chandrasekaran PK, Yan Qi OW, O Brien FM

Asian J Psychiatr, 2021 Dec;66:102884.
PMID: 34740125 DOI: 10.1016/j.ajp.2021.102884

Lithium therapy is a common treatment for affective disorders and is widely regarded as a lifesaving drug. However, because its elimination is almost wholly unchanged via the kidneys, both acute and long-term adverse effects relating to toxicity may occur, including declining renal function and nephrogenic diabetes insipidus (DI). DI may be difficult to detect and is frequently preceded by dehydration and which, in our patient, was discovered by chance. We describe a case of an elderly woman on chronic lithium therapy for bipolar affective disorder who initially presented with dehydration from vomiting but possibly developed extra-pontine myelinolysis (EPM) after over-zealous correction of hyponatraemia. Steroids administered appeared to have prevented further progression but a persisting hyperosmolar state then alerted us to the presence of nephrogenic DI. Although both conditions were later successfully reversed with no obvious chronic sequelae, the recovery of the patient was protracted. Clinicians should be vigilant for complications of managing dehydration states in people prescribed with lithium.
Delusional infestation successfully controlled with typical antipsychotic depot injection: An illustrative case report

Jamaluddin R

Asian J Psychiatr, 2018 Jan;31:69-70.
PMID: 29438922 DOI: 10.1016/j.ajp.2018.02.002
Emotional health and coping mechanisms among adolescents in Malaysian residential foster care homes: A comparative study with adolescents living with families

Mohammadzadeh M, Tajik E, Awang H, Latiff LA

Asian J Psychiatr, 2018 Feb;32:156-158.
PMID: 29278817 DOI: 10.1016/j.ajp.2017.12.011
A systematic review of anxiety prevalence in adults within primary care and community settings in Malaysia

Wong CH, Sultan Shah ZU, Teng CL, Lin TQ, Majeed ZA, Chan CW

Asian J Psychiatr, 2016 Dec;24:110-117.
PMID: 27931891 DOI: 10.1016/j.ajp.2016.08.020

BACKGROUND: Anxiety disorders are common mental health disorders with significant impact on the individual as well as burden on the country as a whole.
METHODS: A systematic review of databases, reference lists, internet sources, and input from content experts revealed 42 studies that documented the prevalence of anxiety symptoms or disorders. 12 of these studies specifically evaluated anxiety disorders.
RESULTS: 4 studies looked at the prevalence of anxiety disorders in the general population, whilst the remainder focused on selected population groups: university students (4 studies); substance abuse (3 studies); and victims of abuse (1 study). Studies in the general population showed that the prevalence of generalised anxiety disorder was 0.4-5.6%, mixed anxiety and depression were 3-5%, panic without agoraphobia 0.4%, phobia unspecified 0.5-%, and anxiety not-otherwise-specified 0.3-6.5%. We found significant variability in anxiety disorders in the studies in selected population groups. The variability could also have been affected by methodological factors within each study.
CONCLUSION: This study provides a broad overview of the prevalence of anxiety disorders in Malaysia. More research is required to develop diagnostic instruments that are validated for local use and comparable with international standards. Reliable prevalence estimates are lacking within certain groups, e.g. those in rural, indigenous, migrant population groups and those exposed to natural disasters.
Fulltext Experiences and challenges in mental health research and practice during COVID-19: Perspectives from emerging psychologists across five countries

Simon PD, Adams C, Goh MCW, Suhaimi AF, Hassem T

Asian J Psychiatr, 2021 Nov;65:102813.
PMID: 34419720 DOI: 10.1016/j.ajp.2021.102813
Fulltext Psychological first aid training as a tool to address mental health problems during COVID-19

Kurniawan L, Sutanti N, Ningsih R, Wulandari NY, Ahmad AB, Kee P, et al.

Asian J Psychiatr, 2022 Sep;75:103226.
PMID: 35926297 DOI: 10.1016/j.ajp.2022.103226
Social anhedonia in Malaysian schizophrenia patients and healthy participants

Balasingam K, Kanagasundram S, Ann AYH, Kasmuri K, Gooding DC

Asian J Psychiatr, 2023 Jan;79:103350.
PMID: 36462388 DOI: 10.1016/j.ajp.2022.103350

The reduced capacity for social and interpersonal interactions, social anhedonia, is an important aspect of various psychiatric disorders, especially schizophrenia-spectrum disorders. The goal of the present study was to validate a Malay translation of the adult version of the Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS; Gooding and Pflum, 2014), a relatively short and easy to administer indirect measure of social anhedonia. This cross-sectional study included 95 (47 male, 48 female) schizophrenia patients and 300 (77 male, 223 female) healthy subjects. Participants were given Malay versions of the ACIPS, Snaith Hamilton Pleasure Scale (SHAPS-M), and Beck Depression Inventory (BDI-M). The ACIPS exhibited good internal consistency (Ordinal alpha = 0.966). Total ACIPS scores were inversely correlated with the BDI-M scores, and positively correlated with total SHAPS-M scores. Factor analysis yielded a three-factor solution which accounted for 52.06% of the variance. As expected, the schizophrenia patients scored significantly lower than the healthy community participants on the ACIPS, t(130) = 4.26, p
An explainable predictive model for suicide attempt risk using an ensemble learning and Shapley Additive Explanations (SHAP) approach

Nordin N, Zainol Z, Mohd Noor MH, Chan LF

Asian J Psychiatr, 2023 Jan;79:103316.
PMID: 36395702 DOI: 10.1016/j.ajp.2022.103316

Machine learning approaches have been used to develop suicide attempt predictive models recently and have been shown to have a good performance. However, those proposed models have difficulty interpreting and understanding why an individual has suicidal attempts. To overcome this issue, the identification of features such as risk factors in predicting suicide attempts is important for clinicians to make decisions. Therefore, the aim of this study is to propose an explainable predictive model to predict and analyse the importance of features for suicide attempts. This model can also provide explanations to improve the clinical understanding of suicide attempts. Two complex ensemble learning models, namely Random Forest and Gradient Boosting with an explanatory model (SHapley Additive exPlanations (SHAP)) have been constructed. The models are used for predictive interpretation and understanding of the importance of the features. The experiment shows that both models with SHAP are able to interpret and understand the nature of an individual's predictions with suicide attempts. However, compared with Random Forest, the results show that Gradient Boosting with SHAP achieves higher accuracy and the analyses found that history of suicide attempts, suicidal ideation, and ethnicity as the main predictors for suicide attempts.
Prevalence and risk factors contributing to recidivism among patients admitted to Forensic Unit Hospital Permai Johor Bahru Malaysia

Jacob MFF, Razali S, Ali NF, Khamis J, Ahmad Y

Asian J Psychiatr, 2023 Jan;79:103325.
PMID: 36395701 DOI: 10.1016/j.ajp.2022.103325
The utility and cultural specificity of cognitive-based interventions in preventing cognitive decline among healthy older adults in Asia: A systematic review

Vasantha Kumar P, Subramaniam P, Che Din N

Asian J Psychiatr, 2021 Jun;60:102646.
PMID: 33873045 DOI: 10.1016/j.ajp.2021.102646

BACKGROUND: The effects of aging and its associated cognitive decline is particularly acute in Asia given the exponential growth of older adults as a proportion of the population as a whole. Many structured cognitive interventions have been proposed to prevent the cognitive decline typically seen in older age, but their utility as a viable means of achieving these goals is questionable.
OBJECTIVES: To summarize and synthesize evidence on the utility and methodological quality of cognitive-based interventions on cognitive performance and associated secondary outcomes among healthy older adults in Asia, as well as novel, culture-specific components of cognitive interventions across the region.
DATA SOURCES: The PubMed/Medline, Web of Science, Scopus, and ScienceDirect databases were searched through May 2020.
ELIGIBILITY: Studies including individuals aged 60 years and above, who had no previous history of physical and/or mental illness. Few restrictions placed on intervention design, duration and mode of delivery, provided that participants were randomized to study conditions, and intervention included components addressing at least one cognitive domain.
RESULTS: A total of 17 studies from six countries met the eligibility criteria and were included in the final review. Evidence from those studies indicated that cognitive interventions may be most effective when the design and aims were directed towards improvement in specific cognitive domains, but evidence regarding long-term effectiveness in preventing progression to clinical-level cognitive deficits is still unclear. Several studies highlighted culture-specific activities as components of their interventions, though these will need to be further outlined and standardized clearly in future research.
Psychometric validation of revised Olweus Bully/Victim Questionnaire (OBVQ-R) among adolescents in Bangladesh

Mahmood S, Siraji MA, Naher R, Arató N, Kaló Z

Asian J Psychiatr, 2023 Feb 17;83:103514.
PMID: 36906995 DOI: 10.1016/j.ajp.2023.103514

BACKGROUND: The assessment of bullying-related attributes is vital in developing anti-bullying intervention and prevention programs. The revised Olweus Bully/Victim Questionnaire (OBVQ-R) is one tool that has been widely used for this purpose. Thus, as we noticed a rising interest in research on bullying and there is a scarcity of proper psychometric tools to assess bullying-related attributes in Bangladesh, our study aimed to translate the OBVQ-R and test the psychometric properties of the Bangla version of this questionnaire on a large Bangladeshi adolescent sample.
METHOD: In Bangladesh, we collected data from grade 8-10 students (N = 567, 309 females, 258 males, AgeMean±SD=15.12 ± 0.81). The participants completed Bangla OBVQ-R, Beck Youth Inventory (BYI), and Children's Revised Impact of Events Scale-13 (CRIES-13).
RESULTS: The item response theory (IRT) analysis discarded five items and retained 15 items (Victimization=8, Perpetration=7). Both subscales had items with high discrimination (Victimization: 3.14 ± 0.67; Perpetration: 3.40 ± 1.04). Confirmatory factor analysis supported a correlated two-factor model (CFI=0.99; TLI=0.99). Both subscales (Victimization and Perpetration) and the 15-item full scale exhibited satisfactory reliability (>0.80). In line with our predictions, both subscales demonstrated significant positive correlations with BYI and CRIES-13, indicating satisfactory concurrent validity.
CONCLUSION: The results of the psychometric analyses supported the reliability and validity of the 15-item Bangla-version OBVQ-R to assess bullying involvement. Hence, this new, adapted measurement can facilitate further bullying research in Bangladesh and, thus, the development of prevention and intervention programs.
Validation of the Bangla Communication Scale among Bangladeshi adolescents: A Classical Test Theory and Item Response Theory approach

Siraji MA, Jahan N, Borak Z

Asian J Psychiatr, 2023 Jun;84:103586.
PMID: 37079986 DOI: 10.1016/j.ajp.2023.103586

BACKGROUND: Assessing communication skills is necessary to facilitate pro-communication skills development programs. The 23-item Communication Scale (CS) is the most widely used tool for this purpose. Since there is a scarcity of validated tools to assess communication skills among Bangladeshi adolescents, we translated this questionnaire into Bangla and validated it on a Bangladeshi adolescent sample.
METHODS: We conducted two independent rounds of large-scale surveys that yielded data from 621 Bangladeshi adolescents (AgeMean ± SD = 16.44 ± 1.32), of which 378 were males, and 244 were females. The participants completed the Bangla CS. A subset of the participants (n = 160) also completed the Bangla Beck's Hopelessness Scale (BBHS)-a measure of hopelessness.
RESULTS: Exploratory factor analysis on the first-round data (n = 340) discarded six items and retained 17 items and revealed a unidimensional factor structure. Confirmatory Factor Analysis on the second-round data (n = 281) supported the unidimensional structure (CFI = 0.94, TLI = 0.93). Measurement invariance analysis indicated that the unidimensional structure was robust across gender (143 males vs 139 females). The scale exhibited a negative correlation with BBHS revealing the scale's concurrent validity (r = - 0.16, p 0.70) across a sizable range of communication skills continuum (θ = - 5.3 to 2.3) and had excellent marginal reliability (0.80). All items had adequate discriminating power (0.90 ± 0.20).
CONCLUSION: The psychometric analysis of the 17-item Bangla-CS indicated that the scale is reliable and valid. We recommend that researchers and mental health practitioners utilize this scale to evaluate communication skills among Bangladeshi adolescents.
Clinical benefit of second-generation long-acting injectable antipsychotics in preventing re-hospitalization in patients with schizophrenia: A real-world study in Japan

Kasahara-Kiritani M, Saga Y, Wakamatsu A, Wu DB, Tsai IC

Asian J Psychiatr, 2023 Aug;86:103671.
PMID: 37311333 DOI: 10.1016/j.ajp.2023.103671

BACKGROUND: Real-world evidence on the benefits of long-acting injectable (LAI) antipsychotics (AP) in patients with schizophrenia is limited, especially in the employed population in Japan. This study evaluates the effectiveness of LAI AP in preventing re-hospitalization in patients with schizophrenia, including the employed population.
METHODS: This retrospective, observational, population-based study used the Japan Medical Data Center (JMDC) health insurance claims database to identify patients having schizophrenia before or on the day of the first LAI AP prescription (index date), and receiving LAI AP between April 1, 2012 and December 31, 2019. The number of all-cause, psychiatric-, and schizophrenia-related hospitalizations at baseline (365 days before index date) and during the 1-year follow-up period were evaluated.
RESULTS: Of the 1692 patients who received LAI AP during the study period, 146 were included (employed: 55 [37.7 %]; dependent: 91 [62.3 %]). The mean age was 37 years; 50.7 % (n = 74) were females. During baseline period, 61 (41.8 %) patients were not hospitalized. During the follow-up period, 67 (45.9 %) patients underwent hospitalization ≤ 7 days; all-cause: 100 (68.7 %); psychiatry-related: 104 (76.2 %); schizophrenia-related: 114 (78.1 %). A higher proportion of patients were hospitalization-free during the follow-up in the employed vs. dependent population: all cause: 69.1 % vs. 61.5 %; psychiatric-related 76.4 % vs. 67.0 %, schizophrenia-related: 87.3 % vs. 71.4 %.
CONCLUSION: This study demonstrated the effectiveness of LAI AP in preventing hospitalization in Japan. During the follow-up period, patients with schizophrenia receiving LAI AP, including the employed population, had a significant decrease in hospitalization length and re-hospitalization rate compared to baseline.

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