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Fulltext Features of parasuicide cases presented to Hospital Melaka in year 2015 - "a wake-up call"

Kumar, P.R., Vincent, S.D.

Malaysian Journal of Psychiatry, 2016;25(1):0-0.
MyJurnal

Objective: This study aimed to collect data on features of parasuicide cases
presented to Hospital Melaka from January to December 2015. Methods:
This was a descriptive study with retrospective review of medical records of
parasuicide cases that were warded for observation in Hospital Melaka from
January to December 2015. Data collected included sociodemographic factors,
previous attempts, methods implicated and reasons for parasuicide which
were presented in descriptive statistics. Results: A total of 88 parasuicide
cases were studied. The median age was 25.6 (17.7) with a majority in age
group between 15-24 years old (43.2%). Females were the highest with 58
cases (65.9%). In terms of ethnicity, the Malays was the highest at 38 cases
(43.2 %). However, after corrected to proportion of ethnicity in Melaka,
Indians yield the highest cases. Those who were single (50.0%) and
unemployed (64.8%) contributed to higher number of cases. About 40 cases
(45.5%) had underlying psychiatry illness and majority of them were those
diagnosed with major depressive disorder (47.5%). In general, the most
common method used was self poisoning with anti-epileptics,
sedative-hypnotic, psychotropics (22.1%). Among male cases, pesticide
ingestion (37%) was more common while among female, medication overdose
(53%) was preferred. In terms of reasons for parasuicide, individuals with
interpersonal conflicts contributed to the highest percentage of cases (57.7%).
Conclusion: Data gathered in this study is useful to reflect the current
situation of parasuicide in Melaka and could serve as a foundation in
designing future studies on preventive and intervention programs in Hospital
Melaka.

Matched MeSH terms: Depressive Disorder, Major
Fulltext Dissociative identity disorder with depression in a man with traumatic childhood: a case report

Saifuddin, T.M., Amilin, N., Zafri, A.

Malaysian Journal of Psychiatry, 2016;25(2):0-0.
MyJurnal

Dissociative identity disorder (DID) previously known as multiple personality disorder is associated with depression and traumatic childhood which can be either physically or sexually abuse. It is hard to establish diagnosis of DID because of the complexity and controversies that surrounding it. We report a case of a young man who has DID and Major Depressive Disorder in the background of traumatic childhood experience who was recently admitted to our inpatient psychiatric unit and demonstrated transitions to other distinct personality state.

Matched MeSH terms: Depressive Disorder, Major
Fulltext Understanding trypophobia: the fear of holes

Aminuddin, I., Lotfi, H.A.

Malaysian Journal of Psychiatry, 2016;25(2):0-0.
MyJurnal

The sight of clustered holes can bring about uneasiness in people, and the disgust response towards it is called trypophobia. Reactions in humans vary from nausea to severe depression. We explore the possible causes of this unique phenomenon, such as evolutionary adaptation and spectral features. We also uncover the clinical features and its relationship to other psychological conditions for example, obsessive-compulsive disorder.

Matched MeSH terms: Depressive Disorder, Major
Which somatic symptoms are associated with an unfavorable course in Chinese patients with major depressive disorder?

Novick D, Montgomery WS, Aguado J, Peng X, Brugnoli R, Haro JM

Asia Pac Psychiatry, 2015 Dec;7(4):427-35.
PMID: 26047023 DOI: 10.1111/appy.12189

This was an analysis of the impact of somatic symptoms on the severity and course of depression in Chinese patients treated for an acute episode of major depressive disorder (MDD).

Matched MeSH terms: Depressive Disorder, Major/epidemiology*; Depressive Disorder, Major/therapy
Clinical and sociodemographic correlates of severe insomnia in psychotropic drug-free, Asian outpatients with major depressive disorder

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

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

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

Matched MeSH terms: Depressive Disorder, Major/complications*; Depressive Disorder, Major/psychology
Gender differences in depressive symptom profiles and patterns of psychotropic drug usage in Asian patients with depression: Findings from the Research on Asian Psychotropic Prescription Patterns for Antidepressants study

Park SC, Lee MS, Shinfuku N, Sartorius N, Park YC

Aust N Z J Psychiatry, 2015 Sep;49(9):833-41.
PMID: 25829482 DOI: 10.1177/0004867415579464

The purpose of this study was to investigate whether there were gender-specific depressive symptom profiles or gender-specific patterns of psychotropic agent usage in Asian patients with depression.

Matched MeSH terms: Depressive Disorder, Major/drug therapy; Depressive Disorder, Major/epidemiology; Depressive Disorder, Major/psychology*
The association of suicide risk with negative life events and social support according to gender in Asian patients with major depressive disorder

Park S, Hatim Sulaiman A, Srisurapanont M, Chang SM, Liu CY, Bautista D, et al.

Psychiatry Res, 2015 Aug 30;228(3):277-82.
PMID: 26160206 DOI: 10.1016/j.psychres.2015.06.032

We investigated the associations between negative life events, social support, depressive and hostile symptoms, and suicide risk according to gender in multinational Asian patients with major depressive disorder (MDD). A total of 547 outpatients with MDD (352 women and 195 men, mean age of 39.58±13.21 years) were recruited in China, South Korea, Malaysia, Singapore, Thailand, and Taiwan. All patients were assessed with the Mini-International Neuropsychiatric Interview, the Montgomery-Asberg Depression Rating Scale, the Symptoms Checklist 90-Revised, the Multidimensional Scale of Perceived Social Support, and the List of Threatening Experiences. Negative life events, social support, depressive symptoms, and hostility were all significantly associated with suicidality in female MDD patients. However, only depressive symptoms and hostility were significantly associated with suicidality in male patients. Depression severity and hostility only partially mediated the association of negative life events and poor social support with suicidality in female patients. In contrast, hostility fully mediated the association of negative life events and poor social support with suicidality in male patients. Our results highlight the need of in-depth assessment of suicide risk for depressed female patients who report a number of negative life events and poor social supports, even if they do not show severe psychopathology.

Matched MeSH terms: Depressive Disorder, Major/ethnology; Depressive Disorder, Major/psychology*
Emotional intelligence as a mediator between rumination and suicidal ideation among depressed inpatients: The moderating role of suicidal history

Abdollahi A, Talib MA

Psychiatry Res, 2015 Aug 30;228(3):591-7.
PMID: 26117250 DOI: 10.1016/j.psychres.2015.05.046

Suicide is a substantial public health problem, and it remains a serious cause of death in the world. Therefore, this study was designed to examine the relationships between brooding, reflection, emotional intelligence (assessed by performance-based test), and suicidal ideation; the mediation role of emotional intelligence on the relationships between brooding and reflection with suicidal ideation; and the moderating role of suicidal history on the relationships between brooding, reflection, and emotional intelligence with suicidal ideation among Iranian depressed adolescents. The study consisted of a cross-sectional sample of 202 depressed adolescent inpatients from five public hospitals in Tehran, Iran completed measures of depression, rumination, emotional intelligence, and suicide attempt history as indices of suicidal ideation. Structural Equation Modelling estimated that depressed adolescent inpatients with high levels of brooding and reflective rumination, and low levels of emotional intelligence were more likely to report suicidal ideation. Moreover, emotional intelligence partially mediated the relationships between brooding and reflective rumination with suicidal ideation. Suicidal history moderated the relationships between brooding, reflection, and emotional intelligence with suicidal ideation. These findings reinforce the importance of emotional intelligence as an influencing factor against the deleterious effects of rumination styles and suicidal ideation. The results indicate that brooding and reflection have detrimental effects on suicidal ideation in depressed inpatients.

Matched MeSH terms: Depressive Disorder, Major/diagnosis; Depressive Disorder, Major/psychology*
Effects of depression and anxiety on mortality in a mixed cancer group: a longitudinal approach using standardised diagnostic interviews

Chan CM, Wan Ahmad WA, Yusof MM, Ho GF, Krupat E

Psychooncology, 2015 Jun;24(6):718-25.
PMID: 25345781 DOI: 10.1002/pon.3714

Distress and psychiatric morbidity in cancer patients are associated with poorer outcomes including mortality. In this study, we examined the prevalence of psychiatric morbidity and its association with cancer survival over time.

Matched MeSH terms: Depressive Disorder, Major/epidemiology*; Depressive Disorder, Major/psychology
Lack of association between TPH2 gene polymorphisms with major depressive disorder in multiethnic Malaysian population

Nazree NE, Loke AC, Zainal NZ, Mohamed Z

Asia Pac Psychiatry, 2015 Mar;7(1):72-7.
PMID: 24376086 DOI: 10.1111/appy.12118

Numerous association studies of candidate genes studies with major depressive disorder (MDD) have been conducted for many years; however, the evidence of association between genes and the risk of developing MDD still remains inconclusive. In this study, we aimed to investigate the association between the tryptophan hydroxylase 2 (TPH2) gene and MDD in three ethnic groups (Malay, Chinese and Indian) within the Malaysian population.

Matched MeSH terms: Depressive Disorder, Major/genetics*
Fulltext Joint analysis of psychiatric disorders increases accuracy of risk prediction for schizophrenia, bipolar disorder, and major depressive disorder

Maier R, Moser G, Chen GB, Ripke S, Cross-Disorder Working Group of the Psychiatric Genomics Consortium, Coryell W, et al.

Am J Hum Genet, 2015 Feb 05;96(2):283-94.
PMID: 25640677 DOI: 10.1016/j.ajhg.2014.12.006

Genetic risk prediction has several potential applications in medical research and clinical practice and could be used, for example, to stratify a heterogeneous population of patients by their predicted genetic risk. However, for polygenic traits, such as psychiatric disorders, the accuracy of risk prediction is low. Here we use a multivariate linear mixed model and apply multi-trait genomic best linear unbiased prediction for genetic risk prediction. This method exploits correlations between disorders and simultaneously evaluates individual risk for each disorder. We show that the multivariate approach significantly increases the prediction accuracy for schizophrenia, bipolar disorder, and major depressive disorder in the discovery as well as in independent validation datasets. By grouping SNPs based on genome annotation and fitting multiple random effects, we show that the prediction accuracy could be further improved. The gain in prediction accuracy of the multivariate approach is equivalent to an increase in sample size of 34% for schizophrenia, 68% for bipolar disorder, and 76% for major depressive disorders using single trait models. Because our approach can be readily applied to any number of GWAS datasets of correlated traits, it is a flexible and powerful tool to maximize prediction accuracy. With current sample size, risk predictors are not useful in a clinical setting but already are a valuable research tool, for example in experimental designs comparing cases with high and low polygenic risk.

Matched MeSH terms: Depressive Disorder, Major/genetics
Fulltext Seasonality shows evidence for polygenic architecture and genetic correlation with schizophrenia and bipolar disorder

Byrne EM, Psychiatric Genetics Consortium Major Depressive Disorder Working Group, Raheja UK, Stephens SH, Heath AC, Madden PA, et al.

J Clin Psychiatry, 2015 Feb;76(2):128-34.
PMID: 25562672 DOI: 10.4088/JCP.14m08981

OBJECTIVE: To test common genetic variants for association with seasonality (seasonal changes in mood and behavior) and to investigate whether there are shared genetic risk factors between psychiatric disorders and seasonality.
METHOD: Genome-wide association studies (GWASs) were conducted in Australian (between 1988 and 1990 and between 2010 and 2013) and Amish (between May 2010 and December 2011) samples in whom the Seasonal Pattern Assessment Questionnaire (SPAQ) had been administered, and the results were meta-analyzed in a total sample of 4,156 individuals. Genetic risk scores based on results from prior large GWAS studies of bipolar disorder, major depressive disorder (MDD), and schizophrenia were calculated to test for overlap in risk between psychiatric disorders and seasonality.
RESULTS: The most significant association was with rs11825064 (P = 1.7 × 10⁻⁶, β = 0.64, standard error = 0.13), an intergenic single nucleotide polymorphism (SNP) found on chromosome 11. The evidence for overlap in risk factors was strongest for schizophrenia and seasonality, with the schizophrenia genetic profile scores explaining 3% of the variance in log-transformed global seasonality scores. Bipolar disorder genetic profile scores were also associated with seasonality, although at much weaker levels (minimum P value = 3.4 × 10⁻³), and no evidence for overlap in risk was detected between MDD and seasonality.
CONCLUSIONS: Common SNPs of large effect most likely do not exist for seasonality in the populations examined. As expected, there were overlapping genetic risk factors for bipolar disorder (but not MDD) with seasonality. Unexpectedly, the risk for schizophrenia and seasonality had the largest overlap, an unprecedented finding that requires replication in other populations and has potential clinical implications considering overlapping cognitive deficits in seasonal affective disorders and schizophrenia.

Matched MeSH terms: Depressive Disorder, Major/diagnosis; Depressive Disorder, Major/genetics*; Depressive Disorder, Major/psychology
Subjective memory and concentration deficits in medication-free, non-elderly Asians with major depressive disorder: prevalence and their correlates

Srisurapanont M, Bautista D, Chen CH, Wang G, Udomratn P, Eurviriyanukul K

J Affect Disord, 2015 Jan 15;171:105-10.
PMID: 25303026 DOI: 10.1016/j.jad.2014.09.007

BACKGROUND: Subjective cognitive impairment (SCI) in major depressive disorder (MDD) is prevalent and correlated with disability. This study aimed to examine the prevalence rates and correlates of subjective memory deficit (SMD) and subjective concentration deficit (SCD) in medication-free, non-elderly Asians with MDD.
METHODS: The SMD and SCD were assessed by using two items of the Symptom Checklist-90-Revised (SCL-90-R). Other measurements of interest included the Montgomery-Asberg Depression Rating Scale (MADRS), the Fatigue Severity Scale (FSS), the Sheehan Disability Scale (SDS), and the Short Form Health Survey (SF-36). Adjusted odds ratios with 95% confidence intervals were calculated.
RESULTS: Of 515 participants from China, Korea, Malaysia, Singapore, Taiwan, and Thailand, 347 (67.4%) and 377 (73.2%) had SMD and SCD, respectively. In total, 420 participants (81.6%) had SMD alone, SCD alone, and both deficits. Severe depression and poor mental health were significant correlates of SMD. Severe depression, clinically significant disability, poor physical health, and poor mental health were significantly independent correlates of SCD. Compared with young adults (18-34 years), older adults aged 50-65 years had a significantly lower risk of SCD (OR=.33, 95% CI: .19-.57).
LIMITATIONS: Only two SCL-90-R items were used to assess the SMD and SCD. The exclusion of MDD patients treated with psychotropic medications eliminated many patients commonly seen in typical clinic settings.
CONCLUSION: SMD and SCD are prevalent in medication-free, non-elderly Asians with MDD. Both deficits are correlated with depression and mental health status. The independent correlation between SCD and disability underscores the crucial role of SCI in MDD.
KEYWORDS: Asian; Cognitive impairment; Depressive disorders; SCL-90-R; Subjective

Matched MeSH terms: Depressive Disorder, Major/ethnology*; Depressive Disorder, Major/psychology
Fulltext Impact of pharmacist intervention on adherence and measurable patient outcomes among depressed patients: a randomised controlled study

Aljumah K, Hassali MA

BMC Psychiatry, 2015;15:219.
PMID: 26376830 DOI: 10.1186/s12888-015-0605-8

Adherence to antidepressant treatment is essential for the effective management of patients with major depressive disorder. Adherence to medication is a dynamic decision-making process, and pharmacists play an important role in improving adherence to antidepressant treatment in different settings within the healthcare system. The aim of this study was to assess whether pharmacist interventions based on shared decision making improved adherence and patient-related outcomes.

Matched MeSH terms: Depressive Disorder, Major/drug therapy*
Fulltext A case report of a patient involved in an alleged homicide-attempted suicide case - a theoretical discussion on the theory of homicide-suicide

Ahmad Nabil, M.R., Suarn, S.

Medicine & Health, 2015;10(2):141-145.
MyJurnal

This case report stresses the role of depression in the manifestation of a homicide-attempted suicide. We report the case of a man who allegedly murdered his partner and then attempted suicide. Previously, he had several failures and rejections in relationships in addition to work-related stress. He was diagnosed with major depressive disorder and treated with antidepressant. The scarcity of homicide-attempted suicide as exemplified in this case could give an insight to the Psychiatrist for better understading and possible prevention.

Matched MeSH terms: Depressive Disorder, Major
Fulltext The psychological impact of diabetic limb problems

Bahari R

International Medical Journal Malaysia, 2015;14(2):3-8.
MyJurnal

Limb problem is a common complication for patients with diabetes. While the impact of diabetic limb problems
on physical health is well known, the psychological impact of the condition is still largely unknown. People with
diabetes with or without foot ulcers frequently suffer from major depressive disorder, and this is made worse
by the presence of limb complications. Furthermore, depression itself can have negative consequences on the
person’s diabetes. Hence, in caring for people with diabetic foot problem, the psychological sequelae must not
be overlooked but managed accordingly

Matched MeSH terms: Depressive Disorder, Major
Meta-analysis of polymorphisms in TPH2 gene and suicidal behavior

Choong MY, Tee SF, Tang PY

Psychiatry Res, 2014 Dec 30;220(3):1163-6.
PMID: 25219619 DOI: 10.1016/j.psychres.2014.07.076
Matched MeSH terms: Depressive Disorder, Major/genetics*; Depressive Disorder, Major/psychology
Comparable efficacy and safety of 8 weeks treatment with agomelatine 25-50mg or fluoxetine 20-40mg in Asian out-patients with major depressive disorder

Shu L, Sulaiman AH, Huang YS, Fones Soon Leng C, Crutel VS, Kim YS

Asian J Psychiatr, 2014 Apr;8:26-32.
PMID: 24655622 DOI: 10.1016/j.ajp.2013.09.009

OBJECTIVE: This randomized, double-blind study evaluates the efficacy and tolerability of agomelatine, using fluoxetine as an active comparator, in Asian patients suffering from moderate to severe major depressive disorder (MDD).
METHOD: Patients were randomly assigned to receive either agomelatine (25-50mg/day, n=314) or fluoxetine (20-40mg/day, n=314) during an 8-week treatment period. The main outcome measure was the change in Hamilton Depression Rating Scale 17 items (HAM-D17) scores. Secondary efficacy criteria included scores on Clinical Global Impression Severity of illness (CGI-S) and Improvement of illness (CGI-I), patient sleeping improvement using the self-rating Leeds Sleep Evaluation Questionnaire (LSEQ) and anxiety using the Hamilton Anxiety Rating Scale (HAM-A) scores. Tolerability and safety evaluations were based on emergent adverse events.
RESULTS: Agomelatine and fluoxetine exert a comparable antidepressant efficacy in the Asian population. Mean changes over 8 weeks were clinically relevant and similar in both groups (-14.8±7.3 and -15.0±8.1 on HAM-D17 scale in agomelatine and fluoxetine groups, respectively). The between-group difference reached statistical significance on non-inferiority test (p=0.015). Clinically relevant decreases in CGI-S and CGI-I scores were observed over the treatment period in both groups. The two treatments were equally effective on the symptoms of both anxiety and sleep. The good tolerability profile and safety of both doses of agomelatine was confirmed in the Asian population.
CONCLUSIONS: Agomelatine and fluoxetine are equally effective in the treatment of MDD-associated symptoms in Asian depressed patients.
KEYWORDS: Agomelatine; Antidepressant; Asian population; Fluoxetine
Study site in Malaysia: Psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Depressive Disorder, Major/drug therapy*
Rapid response to methylphenidate as an add-on therapy to mirtazapine in the treatment of major depressive disorder in terminally ill cancer patients: a four-week, randomized, double-blinded, placebo-controlled study

Ng CG, Boks MP, Roes KC, Zainal NZ, Sulaiman AH, Tan SB, et al.

Eur Neuropsychopharmacol, 2014 Apr;24(4):491-8.
PMID: 24503279 DOI: 10.1016/j.euroneuro.2014.01.016

This is a 4 week, randomized, double-blind, placebo-controlled study to examine the effects of methylphenidate as add-on therapy to mirtazapine compared to placebo for treatment of depression in terminally ill cancer patients. It involved 88 terminally ill cancer patients from University of Malaya Medical Centre, Kuala Lumpur, Malaysia. They were randomized and treated with either methylphenidate or placebo as add on to mirtazapine. The change in Montgomery-Åsberg Depression Rating Scale (MADRS) score from baseline to day 3 was analyzed by linear regression. Changes of MADRS and Clinical Global Impression-Severity Scale (CGI-S) over 28 days were analyzed using mixed model repeated measures (MMRM). Secondary analysis of MADRS response rates, defined as 50% or more reduction from baseline score. A significantly larger reduction of Montgomery-Åsberg Depression Rating Scale (MADRS) score in the methylphenidate group was observed from day 3 (B=4.14; 95% CI=1.83-6.45). Response rate (defined as 50% or more reduction from baseline MADRS score) in the methylphenidate treated group was superior from day 14. Improvement in Clinical Global Impression-Severity Scale (CGI-S) was greater in the methylphenidate treated group from day 3 until day 28. The drop-out rates were 52.3% in the methylphenidate group and 59.1% in the placebo group (relative risk=0.86, 95%CI=0.54-1.37) due to cancer progression. Nervous system adverse events were more common in methylphenidate treated subjects (20.5% vs 9.1%, p=0.13). In conclusions, methylphenidate as add on therapy to mirtazapine demonstrated an earlier antidepressant response in terminally ill cancer patients, although at an increased risk of the nervous system side effects.

Matched MeSH terms: Depressive Disorder, Major/drug therapy*
Female sexual dysfunction in patients with major depressive disorder (MDD) treated with selective serotonin reuptake inhibitor (SSRI) and its association with serotonin 2A-1438 G/A single nucleotide polymorphisms

Masiran R, Sidi H, Mohamed Z, Mohd Nazree NE, Nik Jaafar NR, Midin M, et al.

J Sex Med, 2014 Apr;11(4):1047-1055.
PMID: 24533444 DOI: 10.1111/jsm.12452

INTRODUCTION: Selective serotonin reuptake inhibitors (SSRIs) are known for their sexual side effects. Different SSRIs may affect different areas of sexual function at different rates.
AIMS: The study aimed to determine the prevalence of female sexual dysfunction (FSD), its clinical correlates, and association with 5HT2A (rs6311) single nucleotide polymorphisms (SNPs) in patients with major depressive disorder (MDD) who were on SSRI therapy.
METHODS: This was a cross-sectional study on 95 female outpatients with MDD treated with SSRI. The patients were in remission as determined by Montgomery-Asberg Depression Rating Scale. Genomic DNA was isolated from buccal swabs and samples were processed using a real time polymerase chain reaction.
MAIN OUTCOME MEASURES: The presence or absence of FSD as measured by the Malay Version of Female Sexual Function Index and 5HT2A-1438 G/A (rs6311) SNP.
RESULTS: The overall prevalence of FSD was 32.6%. After controlling for age, number of children, education level, total monthly income, SSRI types, and SSRI dosing, being employed significantly enhanced FSD by 4.5 times (odds ratio [OR] = 4.51; 95% confidence interval [CI] 1.00, 20.30; P = 0.05). Those having marital problems were 6.7 times more likely to have FSD (OR = 6.67; 95% CI 1.57, 28.34). 5HT2A-1438 G/A (rs6311) SNP was not significantly associated with FSD.
CONCLUSION: There was no significant association between FSD and the 5HT2A (rs6311) SNP in patients with MDD on SSRI therapy. Employment status and marital state were significantly associated with FSD among these patients.
Study site: Psychiatry clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Depressive Disorder, Major/drug therapy*; Depressive Disorder, Major/genetics

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