MyMedR

Fulltext Neuroleptic drug utilisation for acute schizophrenia

Razali MS, Hasanah CI

Singapore Med J, 1996 Dec;37(6):611-3.

The aim of this study was to find the dosage and pattern of neuroleptic drug utilisation for the treatment of acute schizophrenia in a general psychiatry ward. This is an uncontrolled study involving 112 schizophrenic inpatients. Patients' socio-demographic variables, the type and peak daily doses of neuroleptics prescribed to them were analysed. Chlorpromazine was the most commonly prescribed drug. The peak mean daily dose required by the patients was equivalent to 537 mg of chlorpromazine; and 400 to 600 mg/ day of chlorpromazine or its equivalent was generally sufficient to treat acute psychosis. The majority of the patients received neuroleptics within this dose range. Low potency drugs were prescribed in lower doses than high potency drugs. Patients treated with depot preparation tended to receive higher doses of medication than those prescribed oral medication alone. The doses of neuroleptics were significantly correlated with duration of admission.

Matched MeSH terms: Schizophrenia/drug therapy*

Fulltext Phenomenological differences of delusions between schizophrenic patients of two cultures of Malaysia

Azhar MZ, Varma SL, Hakim HR

Singapore Med J, 1995 Jun;36(3):273-5.

PMID: 8553090

Two hundred and seventy schizophrenia patients were interviewed using the Present State Examination to elicit the phenomenological symptoms of the illness. Cultural factors and ethnicity were found to be significant variables associated with the symptoms. Higher prevalence of religious and other subculturally related delusions were common in Kelantan patients. Our general belief that Malaysian culture influences symptomatology of mental illness seems to be proven.

Matched MeSH terms: Schizophrenia/ethnology*

Fulltext Schizophrenia in the university students

Kadri ZN

Singapore Med J, 1963 Sep;4(3):113-8.

PMID: 14075734

Matched MeSH terms: Schizophrenia*

Schizophrenia, but not depression or bipolar affective disorder, adds additional risk of aspiration pneumonia among stroke survivors: A national cohort study in Taiwan

Hou WH, Moo CC, Kuo TL, Kuo CL, Chu SY, Wu KF, et al.

J Psychosom Res, 2022 Nov;162:111033.

PMID: 36115193 DOI: 10.1016/j.jpsychores.2022.111033

OBJECTIVE: Few studies have assessed the sex-specific and age-specific risk of aspiration pneumonia (AP) in patients with stroke and evaluated whether mental disorders may increase this risk. In this population-based cohort study, we investigated the sex-specific and age-specific risk of AP in association with stroke and the joint effects of stroke and mental disorders on the risk of AP.

METHODS: We included 23,288 patients with incident stroke admitted between 2005 and 2017 and 68,675 matched nonstroke controls. Information on mental disorders was obtained from medical claims data within the 3 years before the stroke incidence. Cox proportional hazards models considering death as a competing risk event were constructed to estimate the hazard ratio of AP incidence by the end of 2018 associated with stroke and selected mental disorders.

RESULTS: After ≤14 years of follow-up, AP incidence was higher in the patients with stroke than in the controls (11.30/1000 vs. 1.51/1000 person-years), representing a covariate-adjusted subdistribution hazard ratio (sHR) of 3.64, with no significant sex difference. The sHR significantly decreased with increasing age in both sexes. Stratified analyses indicated schizophrenia but not depression or bipolar affective disorder increased the risk of AP in the patients with stroke.

CONCLUSION: Compared with their corresponding counterparts, the patients with schizophrenia only, stroke only, and both stroke and schizophrenia had a significantly higher sHR of 4.01, 5.16, and 8.01, respectively. The risk of AP was higher in younger stroke patients than those older than 60 years. Moreover, schizophrenia was found to increase the risk of AP in patients with stroke.

Matched MeSH terms: Schizophrenia*

Fulltext A review of schizophrenia research in Malaysia

Chee KY, Salina AA

Med J Malaysia, 2014 Aug;69 Suppl A:46-54.

PMID: 25417951 MyJurnal

Research in schizophrenia has advanced tremendously. One hundred and seventy five articles related to Schizophrenia were found from a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. This project aims to examine published research articles, in local and international journals in order to provide a glimpse of the research interest in Malaysia with regards to schizophrenia. Single case study, case series report, reviews and registry reports were not included in this review. Medication trial, unless it concerned a wider scope of psychopharmacology was also excluded from this review. A total of 105 articles were included in this review. Despite numerous genetics studies conducted and published, a definitive conclusion on the aetiology or mechanism underlying schizophrenia remains elusive. The National Mental Health - Schizophrenia Registry (NMHR) proved to be an important platform for many studies and publications. Studies stemmed from NMHR have provided significant insight into the baseline characteristic of patients with schizophrenia, pathway to care, and outcomes of the illness. International and regional collaborations have also encouraged important work involving stigma and discrimination in schizophrenia. Ministry of Health's hospitals (MOH) are the main research sites in the country with regards to schizophrenia research. Numbers of schizophrenia research are still low in relation to the number of universities and hospitals in the country. Some of the weaknesses include duplication of studies, over-emphasising clinical trials and ignoring basic clinical research, and the lack of publications in international and regional journals.

Matched MeSH terms: Schizophrenia

Rates of treated schizophrenia and its clinical and cultural features in the population isolate of the Iban of Sarawak: a tri-diagnostic approach

Barrett R, Loa P, Jerah E, Nancarrow D, Chant D, Mowry B

Psychol Med, 2005 Feb;35(2):281-93.

PMID: 15841685

We present results of a study of treated rates of schizophrenia among the Iban of Sarawak, Malaysia. Most Iban live in longhouses, each comprising a kindred group of up to 300 individuals. Cultural practices such as minimal intermarriage with members of adjacent ethnic groups and in-depth genealogical knowledge make them a population suitable for genetic investigation. Iban culture is conducive to a focus on symptoms and illness, and to patterns of treatment-seeking behaviour that are enthusiastic and persistent.

Matched MeSH terms: Schizophrenia/complications; Schizophrenia/epidemiology*; Schizophrenia/therapy*

Screening for schizophrenia in initial prodromal phase: Detecting the sub-threshold psychosis

Razali SM, Abidin ZZ, Othman Z, Yassin MA

Asian J Psychiatr, 2015 Aug;16:26-31.

PMID: 26182843 DOI: 10.1016/j.ajp.2015.06.011

The aim of the study is to screen and evaluate the efficacy of the screening tools in detecting subjects with sub-threshold psychosis among asymptomatic individuals at genetic risk, as compared with persons in the general public.

Matched MeSH terms: Schizophrenia/diagnosis*; Schizophrenia/genetics; Schizophrenia/epidemiology

Factors associated with sexual dysfunction among schizophrenia men with nicotine dependency and non-smoking schizophrenia men

Ong KY, Muhd Ramli ER, Che Ismail H

Mental Health and Substance Use: Dual Diagnosis, 2014;7:370-80.

DOI: 10.1080/17523281.2014.940370

Cigarette-smoking in schizophrenia and its associations with sexual functioning have been relatively under-examined. The study purpose was to determine the factors associated with sexual dysfunction among schizophrenia men with nicotine dependency and those non-smokers. A retrospective study was conducted in a local hospital in Malaysia over a two-year period from 2011 to 2012. There were 54 schizophrenia men with nicotine dependency and 57 non-smokers. Sexual functioning was assessed using the Malay version of the International Index of Erectile Function-15. Logistic regression analysis was employed. All the 111 schizophrenia men had at least one sexual dysfunction domain. For the group with nicotine dependency, Positive and Negative Syndrome Scale (PANSS)-positive was positively associated with the ability to achieve orgasm and ejaculation. However, age of schizophrenia onset was negatively associated with the confidence to attain and keep an erection. For the non-smoker group, married status and duration of schizophrenia were positively associated with the ability to attain erection and overall sex life satisfaction, respectively, while age of schizophrenia onset was negatively associated with the ability to attain erection and erectile sustainability during intercourse. Among the domains, only orgasmic dysfunction was significantly associated with PANSS-positive, i.e. higher PANSS-positive score was a protective factor for orgasmic dysfunction (odds ratio = 0.37; 95% confidence interval: 0.17, 0.80; p =.012). Schizophrenia men may apparently attempt to treat their orgasmic impairment due to effect from antipsychotics through smoking cigarettes. Sexual impairment among the non-smokers may be attributed mostly to relationship issues with their partner. © 2014 Taylor & Francis.

Matched MeSH terms: Schizophrenia

Fulltext Epigenetic changes of DRD2 gene in Pathogenesis of Schizophrenia

Nour El Huda Abd Rahim, Mohd Nabil Fikri Rahim, Norsidah Ku Zaifah, Hanisah Mohd Noor, Kartini Abdullah, Norlelawati A. Talib

International Medical Journal Malaysia, 2017;16(11):3-3.

MyJurnal

The dopamine hypothesis has earlier dominated the theories for the
development of schizophrenia based on the early pharmacologic evidence. The
antipsychotic drugs, among others, is thought to interfere with the function of the
dopamine D2 receptor (DRD2) resulting in clinical improvement. Accumulating evidence
suggest the role of epigenetic mechanisms in the pathophysiology of schizophrenia.
Despite this, specific evidence linking the DRD2 DNA methylation with schizophrenia is
insufficient mainly due to the poor accessibility and limited brain samples. Of late, new
data has suggested the global impact of DNA methylation in the development of
schizophrenia, thus methylation in the peripheral blood could infer changes in the brain.
The aim of this study was to assess the DRD2 DNA methylation in the peripheral blood of
schizophrenia.

Matched MeSH terms: Schizophrenia

DNA methylation of membrane-bound catechol-O-methyltransferase in Malaysian schizophrenia patients

Nour El Huda AR, Norsidah KZ, Nabil Fikri MR, Hanisah MN, Kartini A, Norlelawati AT

Psychiatry Clin Neurosci, 2018 Apr;72(4):266-279.

PMID: 29160620 DOI: 10.1111/pcn.12622

AIM: This study examined catechol-O-methyltransferase (COMT) DNA methylation in the peripheral blood of schizophrenia patients and also in healthy controls to investigate its potential use as a peripheral biomarker of schizophrenia and its relations with the clinical variables of schizophrenia patients.

METHODS: We examined the DNA methylation levels of COMT using genomic DNA from the peripheral blood of schizophrenia patients (n = 138) and healthy control participants (n = 132); all were Malaysian Malays. The extracted DNA was bisulfite converted, and the percentage methylation ratio value was calculated based on the results following a MethyLight protocol analysis.

RESULTS: The percentage methylation ratio of COMT was lower in schizophrenia than it was in the healthy controls (P schizophrenia and might also be influenced by pharmacological treatment. The epigenetic alteration of COMT in the peripheral blood could be a potential peripheral biomarker of schizophrenia.

Matched MeSH terms: Schizophrenia/blood*; Schizophrenia/drug therapy; Schizophrenia/physiopathology*

Fulltext Anorexia Nervosa in Schizophrenia: a starving mind within a susceptible brain

Nik Ruzyanei, N.J., Wan Salwina, W.I., Choo, S.P., Rosdinom, R.

Malaysian Journal of Psychiatry, 2011;20(1):1-5.

MyJurnal

Schizophrenia poses challenges in diagnosis and treatment strategies when the predominant clinical features represent another spectrum of disorder like eating disorders. Nevertheless, symptoms of eating disorder in schizophrenia are not entirely uncommon although never included in the diagnostic criteria. We reported a case of a woman who first presented at seventeen years old with food refusal and underlying psychosis resulting in severe weight loss, but defaulted treatment for almost a decade. In 2009, she presented again with sinus bradycardia and secondary amenorrhoea. In this report, we discussed about the patient’s vulnerability for psychosis and its psychodynamic drive which led to a complex symptoms manifestation. Our aim is to highlight its diagnostic dilemma and suggestions to treatment strategies unique to this presentation.

Matched MeSH terms: Schizophrenia

Common cultural medical complaint presenting as a delusion

George P, Ramasamy P

Malaysian Journal of Psychiatry, 2006;14(1):41-42.

MyJurnal

Symptoms presented by patients suffering from Schizophrenia can be influenced by cultural factors. A case of Schizophrenia presenting with a common cultural medical complaint as a delusion, is described here. The appropriate assessment, identification and treatment have led to an improved out.

Matched MeSH terms: Schizophrenia

Fulltext A case series on the use of atypical long acting injectable as first-line antipsychotic treatment in Malaysia: who benefits and how?

Nik Ruzyanei, N.J., Hazli, Z., Chong, Y.S.

Malaysian Journal of Psychiatry, 2013;22(1):1-5.

MyJurnal

Introduction: The use of long acting injectable (LAI) antipsychotics is mainly reserved as the second line treatment when all efforts to ensure patients’ adherence to regular oral medication failed. We aim to describe the common clinical features of patients with schizophrenia who benefited from the use of LAI early in the course of illness. Methods: We report four patients with first presentation of schizophrenia, all of whom were started with atypical LAI antipsychotics without prior history of oral antipsychotic. Results: In all of the cases, short acting major tranquilizers were not administered in the acute phase of psychosis because the patients were not agitated. Beside absence of agitation, other common clinical features observed in the four patients were prominent delusion (rather than hallucination), obstinate refusal of oral medication, good pre-morbid functioning and very poor insight. Interestingly, following the remission of the acute psychotic phase, all showed marked improvement in their insight and had better than expected therapeutic alliance. Discussion: LAI may improve the doctor-patient therapeutic alliance due to its minimal side effects and by ways of increasing the patients’ sense of control and allowing psychoeducation to take place when the patient is ready. We conclude that LAI may be used as the first line antipsychotic treatment in the acute psychotic phase in patients who are nonagitated but have prominent symptom of delusions with poor insight.

Matched MeSH terms: Schizophrenia

Fulltext Insulinoma aggravating or masquerading as late-onset schizophrenia?

Chien, K.Y.

Malaysian Journal of Psychiatry, 2013;22(2):72-75.

MyJurnal

A 76 year-old lady with late-onset schizophrenia was admitted with hypoglycaemia. She was later found to have a pancreatic tail insulinoma, confirmed biochemically and radiologically. She is treated medically with Diazoxide while awating laparascopic enucleation of the pancreatic tumour. The question remains if neuroglycopenia aggravates co-existing schizophrenia or if insulinoma-induced neuroglycopenia had been misdiagnosed as schizophrenia.

Matched MeSH terms: Schizophrenia

Fulltext Paliperidone palmitate in adolescents, is there a role?: a case report

Janaki Venkatasalam, Fairuz Nazri Abd Rahman

ASEAN Journal of Psychiatry, 2015;16(2):253-255.

MyJurnal

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.

Matched MeSH terms: Schizophrenia

Fulltext Clozapine induced priapism: case series

Thangam, N., Farah Radhiah, H., Sashitharan, D., Abdul Kadir, A.K.

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

MyJurnal

Clozapine is effective in treatment resistant schizophrenia. Priaprism is a rare side effect of Clozapine. It is a urological emergency and can lead to permanent damage to the penis. We present two cases two cases of clozapine induced priapism. Both patients were started on Clozapine in view of treatment resistant. For the first patient, priapism was noted after 2 years on Clozapine and treated conservatively. Clozapine was rechallenged in this patient but in a lower dosage and was augmented with amisulpride. He did not develop priaprism until date. In the second case, patient developed priaprism after 7 months on clozapine and required urological intervention. He redeveloped recurrent episode of priaprism as clozapine was restarted on the previous dose. In conclusion, priaprism is not related to dosage or duration of treatment of Clozapine. Thus, a careful risk-benefit assessment need to done as there is always a risk of priapism to recur when clozapine rechallenged.

Matched MeSH terms: Schizophrenia

Genderwise clinical response of antipsychotics among schizophrenic patients: a prospective observational study from Lahore, Pakistan

Asif U, Saleem Z, Yousaf M, Saeed H, Hashmi FK, Islam M, et al.

Int J Psychiatry Clin Pract, 2018 Sep;22(3):177-183.

PMID: 29082784 DOI: 10.1080/13651501.2017.1395055

OBJECTIVE: The study was aimed to evaluate the gender specific response to adherence and occurrence of side effects among schizophrenic patients in Lahore, Pakistan.

METHODS: A prospective study was performed for a period of 1 year among 180 newly diagnosed schizophrenics, aged 20-60 years to observe the symptoms, medication adherence and side effects. Morisky-Green-Levine Scale was used to evaluate medication adherence, LUNSER for side effects and PANSS to measure positive and negative symptoms. Data were analyzed using SPSS.

RESULTS: Positive symptoms (Male: Baseline 36.14 vs. endpoint 23.58, Female: 35.29 vs. 23.74) and negative symptoms (Males 27.9 vs. 20.05, Females 28.41 vs. 20.2) of schizophrenia were equally reduced after a follow up of 1 year in both the genders. Male population suffered more accumulative side effects (11.4 in males vs. 6.40 in females), extrapyramidal symptoms such as tardive dyskinesia and tremors (1.21 in males vs. 0.57 in females) and other side effects as compared to women (p ≤ .005). Males were found poorly adherent to antipsychotic treatment than females (93.3% in males vs. 6.7% in females (p ≤ .005).

CONCLUSIONS: Prescribing practices should not overlook sex specific factors like hormonal changes, altered brain morphology and socioeconomic factors that may be responsible for the difference in the response to the course of schizophrenia.

Matched MeSH terms: Schizophrenia/drug therapy*; Schizophrenia/epidemiology; Schizophrenia/physiopathology*

Fulltext A Nested Allele-Specific Multiplex Polymerase Chain Reaction Method for the Detection of DRD2 Polymorphisms

Zahari Z, Salleh MR, Zahri Johari MK, Musa N, Ismail R

Malays J Med Sci, 2011 Oct;18(4):44-57.

PMID: 22589672 MyJurnal

The dopamine D2 receptor gene (DRD2) plays a role in many diseases such as schizophrenia, Parkinson's disease, and addictive behaviour. Methods currently available for the detection of DRD2 polymorphisms are costly and cannot detect all 8 polymorphisms of our research interest simultaneously (Val96Ala, Leu141Leu, Val154Ile, Pro310Ser, Ser311Cys, TaqI A, A-241G, and -141C Ins/Del). Therefore, we developed a nested multiplex polymerase chain reaction (PCR) for simultaneous detection of these polymorphisms.

Matched MeSH terms: Schizophrenia

Fulltext Influence of CYP2D6 polymorphisms on symptomatology and side-effects of patients with schizophrenia in Malaysia

Zahari Z, Salleh MR, Teh LK, Ismail R

Malays J Med Sci, 2009 Jul;16(3):12-20.

PMID: 22589660 MyJurnal

Our objective was to investigate the association of CYP2D6 polymorphisms with symptoms and side-effects of patients with schizophrenia.

Matched MeSH terms: Schizophrenia

Effect of semantic coherence on episodic memory processes in schizophrenia

Battal Merlet L, Morel S, Blanchet A, Lockman H, Kostova M

Psychiatry Res, 2014 Dec 30;220(3):752-9.

PMID: 25240943 DOI: 10.1016/j.psychres.2014.08.034

Schizophrenia is associated with severe episodic retrieval impairment. The aim of this study was to investigate the possibility that schizophrenia patients could improve their familiarity and/or recollection processes by manipulating the semantic coherence of to-be-learned stimuli and using deep encoding. Twelve schizophrenia patients and 12 healthy controls of comparable age, gender, and educational level undertook an associative recognition memory task. The stimuli consisted of pairs of words that were either related or unrelated to a given semantic category. The process dissociation procedure was used to calculate the estimates of familiarity and recollection processes. Both groups showed enhanced memory performances for semantically related words. However, in healthy controls, semantic relatedness led to enhanced recollection, while in schizophrenia patients, it induced enhanced familiarity. The familiarity estimates for related words were comparable in both groups, indicating that familiarity could be used as a compensatory mechanism in schizophrenia patients.

Matched MeSH terms: Schizophrenia/diagnosis*; Schizophrenia/physiopathology*

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