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Communication problems with psychiatric patients in the multilingual society of Sarawak

Schmidt KE

Psychiatry, 1965 Aug;28:229-33.
PMID: 14318932 DOI: 10.1080/00332747.1965.11023430
Matched MeSH terms: Psychotic Disorders*
Sibling rank of Malay psychiatric patients and juvenile delinquents

Hartog J

Southeast Asian J Trop Med Public Health, 1972 Mar;3(1):124-37.
PMID: 5028858
Matched MeSH terms: Psychotic Disorders/epidemiology*
Fulltext Psychosis induced by cefuroxime and metronidazole

Zahiruddin O, Shanooha M, Mohd Azhar MY

Med J Malaysia, 2014 Feb;69(1):33-4.
PMID: 24814627 MyJurnal

We report a case 35-year-old lady who developed acute psychosis following administration of cefuroxime and metronidazole. Earliest mood changes occurred on the second day of antibiotics therapy. She developed hallucinations, delusions and bizarre behavior 1 day after the completion of the antibiotic therapy. All the relevant investigations including CT brain were normal. The psychosis resolved completely within 5 days of antipsychotic treatment.

Matched MeSH terms: Psychotic Disorders
The pathway followed by psychotic patients to a tertiary health center in a developing country: a comparison with patients with epilepsy

Razali SM, Mohd Yasin MA

Epilepsy Behav, 2008 Aug;13(2):343-9.
PMID: 18514034 DOI: 10.1016/j.yebeh.2008.04.009

The objective of this study was to describe and compare the pathways followed by Malay patients with psychoses (schizophrenia and schizophreniform disorder) and Malay patients with epilepsy to a tertiary health center in the northeastern area of peninsular Malaysia. There were 60 patients in each group. The most popular pathway for both groups was first contact with traditional or alternative healers. Consultation with Malay traditional healers (bomohs) and/or homeopathic practitioners (44.2%) was significantly higher for psychotic patients (61.7%) than for patients with epilepsy (26.7%) (chi(2)(2)=15.609, P<0.001). Direct access (24.2%) was the second most popular pathway and almost equally followed by both groups of patients. The third and last pathway was initial contact with private general practitioners and government doctors, respectively. Patients with epilepsy dominated the last two pathways. The treatment delay (TD) was significantly longer in epileptic than psychotic patients regardless of their visit to a bomoh and/or homeopathic practitioner (P<0001) or not (p<0.01). The socioeconomic status of psychotic patients also was significantly better than people with epilepsy (chi(2)=9.957, chi(2)(4), p=0.041).

Study site: Psychiatric clinic, Hospital Universiti Sains Malaysia HUSM

Matched MeSH terms: Psychotic Disorders/diagnosis; Psychotic Disorders/epidemiology*; Psychotic Disorders/therapy
Oculogyric spasm in Asian psychiatric in-patients on maintenance medication

Tan CH, Chiang PC, Ng LL, Chee KT

Br J Psychiatry, 1994 Sep;165(3):381-3.
PMID: 7994510

BACKGROUND: The objective was to investigate the occurrence and characteristics of oculogyric spasm (OGS) in an Asian country.
METHOD: All 2035 Asian (88% Chinese, 7% Malays and 5% Indonesians) psychiatric in-patients in the state psychiatric hospital in Singapore were surveyed for occurrence of oculogyric spasm (OGS) over a two-month period.
RESULTS: Thirty-four patients (1.7%) developed OGS (53% male and 47% female). All the 34 patients had been on maintenance antipsychotic drugs for more than five months. Eighteen patients had recurrent attacks. The mean chlorpromazine equivalent daily dose for those patients with recurrent OGS was 511 mg. This was significantly higher (P < 0.05) than the 277 mg daily dose received by those without recurrent OGS. Most (68%) of the attacks occurred between 1400-2000 h suggesting that OGS may have a diurnal variation.
CONCLUSIONS: OGS presenting as tardive dystonia may be due to a relative increase in cholinergic activity.

Matched MeSH terms: Psychotic Disorders/drug therapy*; Psychotic Disorders/ethnology; Psychotic Disorders/psychology
Fulltext Depression and HIV Disease Progression: A Mini-Review

Yousuf A, Mohd Arifin SR, Musa R, Md Isa ML

Clin Pract Epidemiol Ment Health, 2019;15:153-159.
PMID: 32174997 DOI: 10.2174/1745017901915010153

Background: Depression is the most common mental disorder and a leading cause of disability, which commonly presents unexplained psychological and physical symptoms. Depression and HIV/AIDS are commonly comorbid. This review provides an insight into the effect of depression on disease progression among people living with HIV.
Methods: A search for relevant articles was conducted using a database like MEDLINE, Scopus, PsycINFO and CINAHL. Peer-reviewed English journals published between 2015 and 2019 were included in the review.
Results: A total of eight studies conducted in different settings were included in the review. This review has found that psychosocial, neurohormonal and virologic factors associated with depression affect HIV disease progression. Yet, the chronicity of depression, absence of the hormones that have a buffer effect on depression and lack of examination if depression is a predictor, or an outcome of disease progression, were some of the gaps that require further investigation.
Conclusion: Considerably, more research is needed to better understand the effect of mental disorder, especially depression, on HIV disease progression to AIDS and future interventions should, therefore, concentrate on the integration of mental health screening in HIV clinical setup.

Matched MeSH terms: Psychotic Disorders
Fulltext A case of clinical vampirism in asia

Phang, C.K., Kayatri, S., Ang, J.K.

Malaysian Journal of Medicine and Health Sciences, 2013;9(1):87-89.
MyJurnal

Clinical vampirism in psychiatric practice is very rare and usually associated with schizophrenia, antisocial personality disorder or paraphilia. An Asian case of clinical vampirism is described. It is about a 24-year-old Malay female, paramedic student, who craved for blood since childhood. She injured her sister and herself so that she could access and drink blood. There was no associated psychosis or medical problems. The craving for blood may represent her underlying craving for parental love and attention.

Matched MeSH terms: Psychotic Disorders
Fulltext Factors influencing inpatient duration among insanity acquittees in a Malaysian mental institution

Chan, Lai Fong, Tuti Iryani Mohd Daud, Hazli Zakaria, Phang, Cheng Kar, Loo, Tsui Huei, Ong, Lieh Yan, et al.

ASEAN Journal of Psychiatry, 2010;11(1):25-35.
MyJurnal

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

Matched MeSH terms: Psychotic Disorders
Fulltext Traditional healers are causing treatment delay among patients with psychosis in Hospital Kuala Lumpur: fact or fallacy?

Marhani Midin, Salina Abdul Aziz, Phang, Cheng-Kar

ASEAN Journal of Psychiatry, 2010;11(2):206-215.
MyJurnal

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.

Matched MeSH terms: Psychotic Disorders
Fulltext Obsessive-Compulsive Disorder in Schizophrenia: Clinical and Neurocognitive Correlates

Abdul Hamid, A.R., Abdul Razak, O.

Malaysian Journal of Psychiatry, 2010;19(2):1-9.
MyJurnal

This study aims to determine the prevalence of obsessive compulsive disorder (OCD) among schizophrenic patients and the association of this condition with clinical and selected neurocognitive factors. This is a cross sectional study on one hundred schizophrenic patients who attended psychiatric clinic in National University Hospital and Kuala Lumpur Hospital over a four-months period. All patients diagnosed as schizophrenia according to DSM 1V were assessed using Mini International Neuropsychiatric Interview (MINI) Version 5 for the presence of Obsessive Compulsive Disorder, Brief Psychiatric rating Scale (BPRS) for severity of psychosis and Yale Brown Obsessive Compulsive Scale (YBOCS) for severity of obsessive compulsive (OC) symptoms. Socio-demographic data were obtained by direct interview. The neurocognitive assessment were done using Mini Mental State Examination , Rey Auditory Verbal Learning Test (RAVLT) and Digit Span. Fifteen percent of schizophrenic patients (15%) in this sample were found to have a diagnosis of Obsessive compulsive Disorder (OCD). The OCD and non-OCD schizophrenic patients did not differ significantly in term of age ,gender, race and family history of mental illness. However they differ significantly on employment, type of treatment medication and the presence or severity of current psychosis. Schizophrenic patients with OCD also showed no significant different in selected neurocognitive functions.

Matched MeSH terms: Psychotic Disorders
Fulltext Prevalence & Experience Of Contact With Traditional Healers Among Patients With First-Episode Psychosis In Hospital Kuala Lumpur

Phang, C.K., Marhani, M., Salina, A.A.

Malaysian Journal of Psychiatry, 2010;19(2):1-9.
MyJurnal

Introduction: Patients with mental disorders in Malaysia often seek help from traditional healers prior to consulting psychiatric service. The objective of the study is to determine the prevalence and experience of contact with traditional healers among patients with first-episode psychosis in Hospital Kuala Lumpur (HKL). Methods: This is a hospital-based cross-sectional descriptive study of 50 in-patients with first-episode psychosis in HKL. Structured Clinical Interview for DSM-IV Clinical Version for Axis I Disorders (SCID-CV) was used for establishing diagnosis. Socio-demographic data, information on help-seeking pathways, and experience of contact with traditional healers were determined through face-to-face interview and semi-structured questionnaires. Results: Twenty seven (54%) 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%). About a quarter of them (24%) had 3 or more contacts with traditional healers prior to consulting psychiatric service. The most common type of traditional treatment received was prayer (25, 96.3%). Only 2 patients (7.41%) reported having some beneficial effects from traditional treatments. There were two patients who reported having adverse experience with traditional healers. Among those who had sought help from traditional healers, one third was recommended by at least one of their traditional healers to seek medical help. Conclusion: History of contact with traditional healers prior to consulting psychiatric service was common among inpatients with first-episode psychosis in HKL. There may be potential meaningful collaborations between psychiatrists and traditional healers for better management of patients.

Matched MeSH terms: Psychotic Disorders
Fulltext Post Stroke Laughter – A Case Report

Amarpreet, K., Nor Zuraida, Z., Ng, C.G., Aida, S.A.

Malaysian Journal of Psychiatry, 2008;17(2):1-5.
MyJurnal

Pathological laughing or crying (PLC) were recognized after the occurrence of stroke, with a prevalence of 15% to 18%. There is no apparent triggering stimulus, and is often misdiagnosed as a mood disorder as it is a disorder of emotional expression rather than a primary disturbance of feeling. We reported a case of a 32 year old lady, who presented with giddiness and altered consciousness progressing to fever and neck stiffness, who’s CT showed a massive left cerebellar infarct. No risk factors were identified. Psychiatrically, she developed sudden crying spells after one month and a diagnosis of Major Depressive Disorder was made with subsequent commencement of anti-depressants. A week later, she developed continuous inappropriate laughter without the feeling of elation, which was beyond her control. There were no symptoms of mania or psychosis.

Matched MeSH terms: Psychotic Disorders
Fulltext Methamphetamine abuse in sexual minorities: a case report

Lai, M.H., Norliza, C.M., Marhani, M.

Malaysian Journal of Psychiatry, 2012;21(2):57-60.
MyJurnal

Methamphetamine production and abuse increased significantly in Malaysia. Lesbian, gay, bisexual and transgender (LGBT) populations have higher prevalence of substance abuse compared to general population. Their unmet needs pose greater challenges in managing their substance related disorders. This paper described the agony of a Malaysian lesbian with gender identity disorder who abused substances and developed amphetamine-induced psychosis. Her sexual identity issue was explored in managing her substance related disorders to improve her outcome.

Matched MeSH terms: Psychotic Disorders
Fulltext Psychosis in Parkinson's disease patients

Abdul Hamid Abdul Rahman, Suriati Mohamed Saini, Ibrahim Abu Samah

ASEAN Journal of Psychiatry, 2013;14(2):96-102.
MyJurnal

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

Matched MeSH terms: Psychotic Disorders
Fulltext Inhalant dependence: is there a role of achieving abstinent through supported employment? A case report

Radhiahtul Akmal Razali, Ahmad Faizal Shamsuddin, Suzaily Wahab, Abdul Kadir Abu Bakar

ASEAN Journal of Psychiatry, 2015;16(2):249-252.
MyJurnal

This case report highlights the success of community services and supported employment program that may be of help to a woman with chronic inhalant use to achieve a complete abstinence. Methods: We report the case of a 45 year old lady who chronically abused glue, presented after 10 years with substance induced psychosis and comorbid mood disorder. Results: Abstinent from inhalant dependence was achieved after series of home treatment services and supported employment program. Conclusion: Provision of acute community service and incorporating this patient in supported employment program contribute to her successful journey in achieving abstinence from inhalant dependence.

Matched MeSH terms: Psychotic Disorders
Fulltext Organic disorder with neuropsychiatric symptoms - case report of anti-NMDA receptor encephalitis with neuropsychiatric manifestations

Sivarooban, V., Yogitagavari, Y., Che, C.K., Lee, C.W.

Malaysian Journal of Psychiatry, 2017;26(1):0-0.
MyJurnal

Neuropsychiatric symptoms are symptoms that caused by organic brain
disorders. Multiple neuropsychiatric symptoms can occur concurrently in the
course of brain related organic disorders. Two main components of
neuropsychiatric symptoms are cognitive impairment and disturbance of
consciousness while other neuropsychiatric symptoms, such as hallucinations,
delusions, mood disorders, anxiety, apathy, behavioural and personality
changes also commonly occur. Some of the mild neuropsychiatric symptoms
could possibly be the earliest manifestations of brain related organic
disorders. Clinicians should carefully evaluate organic factors in the
treatment of psychosis, especially in patients of very young age or older age.
They should have enough knowledge and experience in the integrating
neuroscience, that is, neuropsychiatry. The present report illustrates a case of
organic disorder with neuropsychiatric manifestations. It is about a young
male patient who was diagnosed with anti-NMDA receptor encephalitis and
subsequently developed acute delirium secondary to the illness.

Matched MeSH terms: Psychotic Disorders
Fulltext Early readmissions and associated socio-demographic, clinical factors in a psychiatric hospital, Malaysia

Lee, Wen Jih, Ong, Lieh Yan, Koay, Siew Ni, Kwan, Zuan Er

ASEAN Journal of Psychiatry, 2017;18(1):0-0.
MyJurnal

Objective: The main aim of this study is to assess the prevalence of early
readmissions to inpatient care in Hospital Bahagia Ulu Kinta and the associated
socio-demographic and clinical factors.

Methods: This is an observational study
for all patients with readmissions within 3 months from the last discharge, dated
from 1 January 2013 to 31 December 2013. Related socio-demographic and
clinical details are obtained from the medical records and compared between the
patients who were readmitted within the first month after discharge to those who
were readmitted later in the second and third month.

Results: Total of 149
records of patients who were readmitted within 3 months of last discharge were
analyzed. Majority of them were from the same state of Perak (83.9%), male
(74.5%), single (71.1%), unemployed (85.9%), taken care by family (75.2%),
achieved secondary education level (59.7%) with mean age of 37.89 years (SD
11.53). They were discharged for a mean of 32.52 days (SD 26.48) before
readmission with a mean duration of 72.98 days in the previous admission, and
mean previous admissions of 10.17 times. 69.8% of the patients were treated for
psychotic disorders and the main reason for readmission was relapse (84.6%).
Up to 34.2% of the patients reported to have substance abuse while 25.5% had
medical co-morbidities. Most of the patients (63.8%) were not compliant to the
treatment from the last discharge. Socioeconomic and clinical factors did not
show statistical significance when the readmissions within the first month after
discharge were compared to those who were admitted later at the second and
third month.

Conclusions: Due to limitations, further studies need to be done to
identify risk factors associated with readmissions and adequate measures need to
be taken to prevent these readmissions.

Matched MeSH terms: Psychotic Disorders
Fulltext A Brief Psychotic Episode with Depressive Symptoms in Silent Right Frontal Lobe Infarct

Badrin S, Mohamad N, Yunus NA, Zulkifli MM

Korean J Fam Med, 2017 Nov;38(6):380-382.
PMID: 29209479 DOI: 10.4082/kjfm.2017.38.6.380

Psychiatric symptoms may be related to a silent cerebral infarct, a phenomenon that has been described previously in literature. Acute psychosis or other neuropsychiatric symptoms including depression may present in stroke patients and patients with lesions either within the prefrontal or occipital cortices, or in subcortical areas such as the basal ganglia, thalamus, mid-brain, and brainstem. Psychosis in clinical stroke or in silent cerebral infarction is uncommon and not well documented in the literature. Neurological deficits are the most common presentation in stroke, and nearly a third of patients that suffer a stroke may experience psychological disorders such as depression and anxiety, related to physical disability. The present case report describes an elderly female patient who presented with hallucinations and depressive symptoms, and was discovered to have a recent right frontal brain infarction, without other significant neurological deficits.

Matched MeSH terms: Psychotic Disorders
Disease Expression and HLA Types in Early and Late Onset Disease of Malaysian Patients with Systemic Lupus Erythematosus

Radzi AM, Huan KS, Yahaya N, Shahera A, Kong N, Mohd Noah R

Malays J Med Sci, 2001 Jul;8(2):32-9.
PMID: 22893758

Age has been suggested to modify systemic lupus erythematosus expression. In this study we have attempted to study 13 patients with late onset (40 years and above) and 90 with early onset disease (below 40 years) to determine whether age-related differences in disease expression exist and whether the genetic make-up influences the age of disease onset. We found that patients with late onset disease initially presented with pericarditis (31% vs 3%, P<0.005) and a lower incidence of malar rash (31% vs 57%, p<0.05). During the disease course, there was a lower incidence of mucocutaneous symptoms especially malar rash (p<0.005) and psychosis (p<0.05) in the late onset group. Serological parameters were similar in both groups. There was a prevalence of HLA-DQA1*0103 in Chinese patients with late onset disease (pcorr=0.004). These findings suggest that a subgroup of late onset patients may experience milder disease and that the risk conferred by the HLA-DQA1*0103 may be significant among these patients.

Matched MeSH terms: Psychotic Disorders
Neurosyphilis and psychosis

Wahab S, Md Rani SA, Sharis Othman S

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:90-4.
PMID: 23857843 DOI: 10.1111/appy.12050

Neurosyphilis may presents with a range of psychiatric symptoms. This report illustrates a case of neurosyphilis in a man who presented with psychosis and cognitive dysfunction. Clinical findings and investigations done in the present case showed positive results for syphilis. Reduction of symptoms was noted after treatment with antibiotic. This case further highlights the importance of having high index of suspicion for neurosyphilis in patients presenting with psychiatric symptoms.

Matched MeSH terms: Psychotic Disorders/etiology*

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