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A comparative study of sertraline dosages, plasma concentrations, efficacy and adverse reactions in Chinese versus Caucasian patients

Hong Ng C, Norman TR, Naing KO, Schweitzer I, Kong Wai Ho B, Fan A, et al.

Int Clin Psychopharmacol, 2006 Mar;21(2):87-92.
PMID: 16421459

This prospective 6-week study examined the differences in dosage and steady state plasma concentrations of sertraline in Chinese versus Caucasian depressed patients. Two groups of Chinese patients from different geographical sites and a group of Caucasian patients were evaluated with clinical measures during an initial dose of 50 mg/day, with subsequent doses adjusted clinically. The results of 17 Australian Chinese (ACHI), 13 Malaysian Chinese (MCHI) and 15 Australian Caucasians (AC) were analysed. Despite controlling for weight, the AC subjects received a significantly higher dose than both the ACHI (P = 0.002) and the MCHI groups (P = 0.012). However, the mean sertraline concentration to dose ratios at weeks 1 and 6 were not significantly different between the three groups. Sertraline was effective and well tolerated in both ethnic groups with few adverse events. Although there was a lack of difference between groups in the pharmacokinetic results, Chinese depressed patients appeared to require lower dosages with consequently lower plasma concentrations of sertraline compared to Caucasian patients to achieve clinical efficacy. Further studies of the dosages, kinetics and adverse effects of selective serotonin reuptake inhibitors linked with genotyping are necessary.

Matched MeSH terms: Depressive Disorder/drug therapy; Depressive Disorder/ethnology
Fulltext Emotional incontinence--the other poststroke phenomenon

Bharathi V, Lee FS

Med J Malaysia, 2006 Oct;61(4):490-2.
PMID: 17243530

Emotional incontinence is a disorder of emotional control following brain damage. It refers to the heightened tendency to cry or less commonly laugh, out of proportion to the underlying mood. Recognition of this phenomenon is often lacking as it is confused with other related sequelae of brain damage such as depression. This is a case report of an elderly female exhibiting poststroke emotional incontinence.

Matched MeSH terms: Depressive Disorder, Major/drug therapy; Depressive Disorder, Major/etiology*
Fulltext The prevalence of depression among elderly warded in a tertiary care centre in Wilayah Persekutuan

Mohd Sidik S, Rampal L, Hanim MA, Thong PL

Med J Malaysia, 2006 Mar;61(1):15-21.
PMID: 16708729

Depression is characterized by symptoms like disturbance in behavior, cognition and mood. This is commonly known to affect people aged 60 years and above especially those who are also afflicted with illnesses. The objectives of this study were to determine the prevalence of depression and its associated factors among the elderly in a tertiary care centre in Wilayah Persekutuan. A cross sectional study design was done. Stratified cluster sampling method was used to select the respondents. All elderly patients were selected from the orthopaedic, surgical, gynaecology and medical wards in a government hospital in Wilayah Persekutuan. A 30-item Geriatric Depression Scale questionnaire was used as a screening instrument. Out of the 246 elderly subjects, 198 were interviewed giving a response rate of 80.5%. The results showed that 54% of the elderly respondents were found to have depressive symptoms. Age (p=0.022), sex (p=0.008), ethnicity (p=0.022) and functional disabilities in bathing (p=0.001), grooming (p=0.007), dressing (p= 0.007), using the toilet (p=0.002), transferring from bed to chair and back (p=0.000), mobility (p=0.000) and climbing stairs (p=0.000) were all found to be significantly associated with depression among the elderly respondents. The outcome of this study will have an important impact on the implementation of the health policy for the elderly patients admitted to hospitals.

Matched MeSH terms: Depressive Disorder/diagnosis; Depressive Disorder/epidemiology*
Direct and indirect effects of sociocultural influences on disordered eating among Malaysian male and female university students. A mediation analysis of psychological distress

Gan WY, Mohd Nasir MT, Zalilah MS, Hazizi AS

Appetite, 2011 Jun;56(3):778-83.
PMID: 21435366 DOI: 10.1016/j.appet.2011.03.005

This study aimed to examine the role of psychological distress in the relationships between sociocultural influences (social pressure to be thin and weight teasing) and disordered eating. Data were collected from 584 university students (59.4% females and 40.6% males), aged 18-24 years old (M=20.6, SD=1.4), selected from four universities in the Klang Valley, Malaysia. Participants completed four standardized questionnaires which measured social pressure to be thin, weight-related teasing, psychological distress and disordered eating. A good fit structural equation modeling (SEM) model was developed for both sexes. For males, the SEM model revealed that sociocultural influences showed an indirect effect on disordered eating through psychological distress. For females, the model showed an indirect effect of sociocultural influences on disordered eating through psychological distress, as well as a direct effect of sociocultural influences on disordered eating. In conclusion, psychological distress mediated the relationships between sociocultural influences and disordered eating in both males and females. Our results suggest that disordered eating intervention programs on reducing psychological distress in university students may be beneficial.

Matched MeSH terms: Depressive Disorder/complications; Depressive Disorder/psychology
Fulltext Autobiographical memory and hierarchical search strategies in depressed and non-depressed participants

Haque S, Juliana E, Khan R, Hasking P

BMC Psychiatry, 2014;14:310.
PMID: 25403551 DOI: 10.1186/s12888-014-0310-z

There is a growing body of literature showing individuals with depression and other trauma-related disorders (e.g., posttraumatic stress disorder) recall more overgeneral and less specific autobiographical memories compared to normal participants. Although the mechanisms underlying overgeneral memory are quite clear, the search strategy operated within the autobiographical knowledge base, at time of recollection, requires further exploration. The current study aimed to examine the hierarchical search sequence used to recall autobiographical memories in depressed and non-depressed participants, with a view to determining whether depressed participants exhibited truncated search strategies.

Matched MeSH terms: Depressive Disorder/physiopathology; Depressive Disorder/psychology*
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
Are predictors of future suicide attempts and the transition from suicidal ideation to suicide attempts shared or distinct: a 12-month prospective study among patients with depressive disorders

Chan LF, Shamsul AS, Maniam T

Psychiatry Res, 2014 Dec 30;220(3):867-73.
PMID: 25240940 DOI: 10.1016/j.psychres.2014.08.055

Our study aimed to examine the interplay between clinical and social predictors of future suicide attempt and the transition from suicidal ideation to suicide attempt in depressive disorders. Sixty-six Malaysian inpatients with a depressive disorder were assessed at index admission and within 1 year for suicide attempt, suicidal ideation, depression severity, life event changes, treatment history and relevant clinical and socio-demographic factors. One-fifth of suicidal ideators transitioned to a future suicide attempt. All future attempters (12/66) had prior ideation and 83% of attempters had a prior attempt. The highest risk for transitioning from ideation to attempt was 5 months post-discharge. Single predictor models showed that previous psychiatric hospitalization and ideation severity were shared predictors of future attempt and ideation to attempt transition. Substance use disorders (especially alcohol) predicted future attempt and approached significance for the transition process. Low socio-economic status predicted the transition process while major personal injury/illness predicted future suicide attempt. Past suicide attempt, subjective depression severity and medication compliance predicted only future suicide attempt. The absence of prior suicide attempt did not eliminate the risk of future attempt. Given the limited sample, future larger studies on mechanisms underlying the interactions of such predictors are needed.

Matched MeSH terms: Depressive Disorder/diagnosis*; Depressive Disorder/psychology*
Anhedonia in depressed patients on treatment with selective serotonin reuptake inhibitor anti-depressant--A two-centered study in Malaysia

Yee A, Chin SC, Hashim AH, Harbajan Singh MK, Loh HS, Sulaiman AH, et al.

Int J Psychiatry Clin Pract, 2015;19(3):182-7.
PMID: 25874350 DOI: 10.3109/13651501.2015.1031139

Anhedonia is the reduced ability to experience pleasure. It is a core symptom of depression and is particularly difficult to treat. This study aims to compare the level of anhedonia between depressed patients on anti-depressants and healthy subjects.

Matched MeSH terms: Depressive Disorder/drug therapy; Depressive Disorder/epidemiology*
Use of antidepressants in the treatment of depression in Asia: guidelines, clinical evidence, and experience revisited

Treuer T, Liu CY, Salazar G, Kongsakon R, Jia F, Habil H, et al.

Asia Pac Psychiatry, 2013 Dec;5(4):219-30.
PMID: 23857712 DOI: 10.1111/appy.12090

Major depressive disorder is prevalent worldwide, and only about half of those affected will experience no further episodes or symptoms. Additionally, depressive symptoms can be challenging to identify, with many patients going undiagnosed despite a wide variety of available treatment options. Antidepressants are the cornerstone of depression treatment; however, a large number of factors must be considered in selecting the treatment best suited to the individual. To help support physicians in this process, international and national treatment guidelines have been developed. This review evaluates the current use of antidepressant treatment for major depressive disorder in six Asian countries (China, Korea, Malaysia, Philippines, Taiwan, and Thailand). No remarkable differences were noted between Asian and international treatment guidelines or among those from within Asia as these are adapted from western guidelines, although there were some local variations. Importantly, a shortage of evidence-based information at a country level is the primary problem in developing guidelines appropriate for Asia, so most of the guidelines are consensus opinions derived from western research data utilized in western guidelines. Treatment guidelines need to evolve from being consensus based to evidence based when evidence is available, taking into consideration cost/effectiveness or cost/benefit with an evidence-based approach that more accurately reflects clinical experience as well as the attributes of each antidepressant. In everyday practice, physicians must tailor their treatment to the patient's clinical needs while considering associated external factors; better tools are needed to help them reach the best possible prescribing decisions which are of maximum benefit to patients.

Matched MeSH terms: Depressive Disorder, Major/drug therapy*; Depressive Disorder, Major/economics
Correlates of depression, anxiety and stress among Malaysian university students

Shamsuddin K, Fadzil F, Ismail WS, Shah SA, Omar K, Muhammad NA, et al.

Asian J Psychiatr, 2013 Aug;6(4):318-23.
PMID: 23810140 DOI: 10.1016/j.ajp.2013.01.014

University students face not only challenges related with independent living, but also academic challenges. This predisposes them to depression, anxiety and stress, which are fairly common.

Matched MeSH terms: Depressive Disorder/diagnosis*; Depressive Disorder/epidemiology
Fulltext Factors Influencing the Prevalence of Mental Health Problems among Malay Elderly Residing in a Rural Community: A Cross-Sectional Study

Abdul Manaf MR, Mustafa M, Abdul Rahman MR, Yusof KH, Abd Aziz NA

PLoS One, 2016;11(6):e0156937.
PMID: 27280529 DOI: 10.1371/journal.pone.0156937

BACKGROUND AND PURPOSE: Mental health problems are common in old age, but frequently remain undetected and untreated. Mental health problems in the elderly are the result of a complex interaction of social, psychological and biological factors. The aim of this study is to determine the prevalence of mental health problems (depression, anxiety, and emotional stress) and their associated factors among the Malay elderly in a rural community of Perak, Malaysia.
METHODS: It was a cross-sectional study. The Malay elderly aged 60 years and above were selected through convenient sampling to give a total of 230 respondents. The Depression, Anxiety, and Stress Scale (DASS-21) was used to assess the symptoms of depression, anxiety, and stress. Bivariate analyses were performed using chi-square tests and multiple logistic regression analyses were conducted to determine the association between the factors and each of the mental health statuses assessed.
RESULTS: The results showed that the prevalence of depression, anxiety, and stress among the elderly respondents was 27.8%, 22.6%, and 8.7%, respectively. The significant factors for depression were single elderly (Adjusted OR = 3.27, 95%CI 1.66, 6.44), living with family (Adjusted OR = 4.98, 95%CI 2.05, 12.10), and poor general health status (Adjusted OR = 2.28, 95%CI 1.20, 4.36). Living with family was the only significant factor for anxiety (Adjusted OR = 2.68, 95%CI 1.09, 6.57). There was no significant factor for stress.
CONCLUSIONS: Depression and anxiety among the Malay elderly in the rural community were very worrying. More equity in health should be created or strengthened in order to intensify the opportunity to identify, diagnose, and treat those with mental health problems. Living arrangement in the rural community was an important factor that had influenced depression and anxiety. Therefore, further research is recommended for more comprehensive information, as a result of which appropriate intervention can be made.

Matched MeSH terms: Depressive Disorder/epidemiology*; Depressive Disorder/psychology
Fulltext Diabetes-related distress, depression and distress-depression among adults with type 2 diabetes mellitus in Malaysia

Chew BH, Vos R, Mohd-Sidik S, Rutten GE

PLoS One, 2016;11(3):e0152095.
PMID: 27002728 DOI: 10.1371/journal.pone.0152095

Type 2 diabetes mellitus (T2DM) brings about an increasing psychosocial problem in adult patients. Prevalence data on and associated factors of diabetes related distress (DRD) and depression have been lacking in Asia. This study aimed to examine the prevalence of DRD and depression, and their associated factors in Asian adult T2DM patients. This study was conducted in three public health clinics measuring DRD (Diabetes Distress Scale, DDS), and depression (Patient Health Questionnaire, PHQ). Patients who were at least 30 years of age, had T2DM for more than one year, with regular follow-up and recent laboratory results (< 3 months) were consecutively recruited. Associations between DRD, depression and the combination DRD-depression with demographic and clinical characteristics were analysed using generalized linear models. From 752 invited people, 700 participated (mean age 56.9 years, 52.8% female, 52.9% Malay, 79.1% married). Prevalence of DRD and depression were 49.2% and 41.7%, respectively. Distress and depression were correlated, spearman's r = 0.50. Patients with higher DRD were younger (OR 0.995, 95% CI 0.996 to 0.991), Chinese (OR 1.2, 95% CI 1.04 to 1.29), attending Dengkil health clinic (OR 1.1, 95% CI 1.00 to 1.22) and had higher scores on the PHQ (OR 1.1, 95% CI 1.04 to 1.06). Depression was less likely in the unmarried compared to divorced/separately living and those attending Dengkil health clinic, but more likely in patients with microvascular complications (OR 1.4, 95% CI 1.06 to 1.73) and higher DDS (OR 1.03, 95% CI 1.02 to 1.03). For the combination of DRD and depression, unemployment (OR 4.7, 95% CI 1.02 to 21.20) had positive association, whereas those under medical care at the Salak health clinics (OR 0.28, 95% CI 0.12 to 0.63), and those with a blood pressure > 130/80 mmHg (OR 0.53, 95% CI 0.32 to 0.89) were less likely to experience both DRD and depression. DRD and depression were common and correlated in Asian adults with T2DM at primary care level. Socio-demographic more than clinical characteristics were related to DRD and depression.

Matched MeSH terms: Depressive Disorder/etiology*; Depressive Disorder/epidemiology*
Fulltext Genome-wide gene-environment analyses of major depressive disorder and reported lifetime traumatic experiences in UK Biobank

Coleman JRI, Peyrot WJ, Purves KL, Davis KAS, Rayner C, Choi SW, et al.

Mol Psychiatry, 2020 Jul;25(7):1430-1446.
PMID: 31969693 DOI: 10.1038/s41380-019-0546-6

Depression is more frequent among individuals exposed to traumatic events. Both trauma exposure and depression are heritable. However, the relationship between these traits, including the role of genetic risk factors, is complex and poorly understood. When modelling trauma exposure as an environmental influence on depression, both gene-environment correlations and gene-environment interactions have been observed. The UK Biobank concurrently assessed Major Depressive Disorder (MDD) and self-reported lifetime exposure to traumatic events in 126,522 genotyped individuals of European ancestry. We contrasted genetic influences on MDD stratified by reported trauma exposure (final sample size range: 24,094-92,957). The SNP-based heritability of MDD with reported trauma exposure (24%) was greater than MDD without reported trauma exposure (12%). Simulations showed that this is not confounded by the strong, positive genetic correlation observed between MDD and reported trauma exposure. We also observed that the genetic correlation between MDD and waist circumference was only significant in individuals reporting trauma exposure (rg = 0.24, p = 1.8 × 10-7 versus rg = -0.05, p = 0.39 in individuals not reporting trauma exposure, difference p = 2.3 × 10-4). Our results suggest that the genetic contribution to MDD is greater when reported trauma is present, and that a complex relationship exists between reported trauma exposure, body composition, and MDD.

Matched MeSH terms: Depressive Disorder, Major/genetics*; Depressive Disorder, Major/epidemiology*
The Efficiency of a Multicomponent Training for Prospective Memory Among Healthy Older Adults: A Single-Blind, Randomized Controlled Within-Participants Cross-Over Trial

Farzin A, Ibrahim R, Madon Z, Basri H

Am J Phys Med Rehabil, 2018 09;97(9):628-635.
PMID: 29595585 DOI: 10.1097/PHM.0000000000000931

OBJECTIVE: The main objective of the present trial was to evaluate the efficiency of a preventative multicomponent prospective memory training among healthy older adults.
DESIGN: This study was a two-arm within-participants trial with 4- and 12-wk follow-ups. Allocation ratio was 1:1, and pretraining and posttraining measurements were included. A total number of 25 healthy older adults were enrolled (mean = 63.32, SD = 4.44). Participants were randomly allocated into two conditions: (a) prospective memory training: participants underwent a multicomponent prospective memory training, and (b) control: participants were not contacted during the training phase. After the training phase was finished, participants crossed over to undergo the condition they did not experience before. The differences between pretraining and posttraining measures of prospective memory, activities of daily living, negative mood (depression), and anxiety were assessed. All changes in the measurements were analyzed using general linear method. This trial is registered at https://www.isrctn.com (#ISRCTN57600070).
RESULTS: Multicomponent prospective memory training program was significantly effective on both subjective and objective prospective memory performances among healthy older adults. Moreover, the training had significant positive effects on activities of daily living (independence) among participants. In addition, negative mood and anxiety levels were reduced after the training was finished.
CONCLUSIONS: This multicomponent prospective memory training improved prospective memory performance and activities of daily living and reduce negative mood (depression) and anxiety levels among healthy older adults.

Matched MeSH terms: Depressive Disorder
Fulltext Mania secondary to hyponatremia in elderly patient: a case report

Saifuddin, T.M., Harun, N.A.

Malaysian Journal of Psychiatry, 2017;26(2):0-0.
MyJurnal

Manic symptoms secondary to hyponatremia is rare or might be underreported.
Awareness of this phenomenon is important for therapeutic
considerations of patients. We present a case of late onset mania in an elderly
gentleman who was previously diagnosed to have Major Depressive Disorder.
His manic symptoms improved without medication after sodium level was
corrected.

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 Depression, anxiety, and stress scale (dass-21) among counselling students: a preliminary study

Amalia Madihie, Mohd Saizam Said

Journal of Cognitive Sciences & Human Development, 2015;1(1):90-101.
MyJurnal

This research aimed to determine the correlation between level of depression, anxiety and stress among counselling students at Universiti Malaysia Sarawak. This research adopted a correlational study with a quantitative approach in order to observe the correlation between the variables. Eighty six (86) respondents participated in this study. The study was conducted using Depression, Anxiety and Stress Scale (DASS-21) instrument. The result showed that there was a significant relationship between the level of depression, anxiety and stress among counselling students at Universiti Malaysia Sarawak. This research also provides awareness towards the counselling students on their level of depression, anxiety and stress. For future research, it is suggested that personality test and scoring test be conducted for level of depression, anxiety and stress in order to see the correlations between variables.

Matched MeSH terms: Depressive Disorder
Fulltext Prevalence of loneliness, anxiety, and depression among older people living in long-term care: a review

Sharifah Munirah Syed Elias

International Journal of Care Scholars, 2018;1(1):39-43.
MyJurnal

Objective: The aim of this paper was to review prevalence rates of loneliness, anxiety, and depression among older people living in long-term care settings such as residential aged care facilities, nursing homes and assisted living facilities.

Method: A systematic search of the literature was conducted using several electronic databases including Medline, CINAHL, PsycINFO, and the Cochrane library.

Results: In total, 18 articles met the inclusion criteria for this review. The results indicated that the prevalence rates of loneliness (56% to 95.5%), anxiety (3.6% to 38%), and depression (11% to 85.5%) in older people living in long-term care settings are generally high.

Conclusion: Further research on effective methods of reducing these symptoms is recommended.

Matched MeSH terms: Depressive Disorder
Fulltext Use of complementary and alternative medicine and adherence to antiepileptic drug therapy among epilepsy patients: a systematic review

Farrukh MJ, Makmor-Bakry M, Hatah E, Tan HJ

Patient Prefer Adherence, 2018;12:2111-2121.
PMID: 30349205 DOI: 10.2147/PPA.S179031

Purpose: To identify the use pattern of complementary and alternative medicine (CAM) and its impact on antiepileptic drug (AED) adherence among patients with epilepsy.
Method: Potential studies were identified through a systematic search of Scopus, Science Direct, Google Scholar, and PubMed. The keywords used to identify relevant articles were "adherence," "AED," "epilepsy," "non-adherence," and "complementary and alternative medicine." An article was included in the review if the study met the following criteria: 1) conducted in epilepsy patients, 2) conducted in patients aged 18 years and above, 3) conducted in patients prescribed AEDs, and 4) patients' adherence to AEDs.
Results: A total of 3,330 studies were identified and 30 were included in the final analysis. The review found that the AED non-adherence rate reported in the studies was between 25% and 66%. The percentage of CAM use was found to be between 7.5% and 73.3%. The most common reason for inadequate AED therapy and higher dependence on CAM was the patients' belief that epilepsy had a spiritual or psychological cause, rather than primarily being a disease of the brain. Other factors for AED non-adherence were forgetfulness, specific beliefs about medications, depression, uncontrolled recent seizures, and frequent medication dosage.
Conclusion: The review found a high prevalence of CAM use and non-adherence to AEDs among epilepsy patients. However, a limited number of studies have investigated the association between CAM usage and AED adherence. Future studies may wish to explore the influence of CAM use on AED medication adherence.

Matched MeSH terms: Depressive Disorder
Cognitive behavioural therapy can be effective in treating anxiety and depression in persons with dementia: a systematic review

Tay KW, Subramaniam P, Oei TP

Psychogeriatrics, 2019 May;19(3):264-275.
PMID: 30548731 DOI: 10.1111/psyg.12391

Dementia is a neurocognitive disorder that affects a person's abilities in daily functioning. Anxiety and depression symptoms are common among persons with dementia. Cognitive behavioural therapy (CBT) has been tested to manage their depression and anxiety symptoms. However, the purpose of CBT in managing these symptoms is unclear. Therefore, this paper aims to clarify whether CBT can be used to reduce depression and anxiety symptoms in persons with dementia. The electronic databases PubMed, PsycINFO, MEDLINE, and CINAHL were used to locate relevant studies. Eleven studies, which involved a total of 116 older adults, were identified. The findings suggest that CBT can be effective in reducing depression and anxiety symptoms. Based on our current review, the findings from previous studies form a promising foundation on which to conduct a major randomized controlled trial with a larger sample size. This review discusses some of the most important considerations in applying CBT to persons with dementia, and these may be beneficial for future studies that explore this area and seek more conclusive evidence on the use of CBT.

Matched MeSH terms: Depressive Disorder

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