Objective: This study validates The Malay Version of The Inventory of Socially Supportive Behaviour. Methods: The psychometric properties of the ISSB- Malay Version were examined on sixty-eight women who were Malay native speakers and diagnosed with breast cancer. Respondents answered the questionnaire at three weeks and ten weeks following surgery for breast cancer. Results: The Malay Version of ISSB showed excellent internal consistency (Cronbach’s alpha=0.96). Test-retest Intraclass Correlation Coefficient (ICC) was 0.03. Small mean differences were observed at test-retest measurement with Effect Size Index 0.18. Conclusion: The Malay Version of the ISSB could be an appropriate tool to measure the supportive behavior of the Malaysian population. ASEAN Journal of Psychiatry, Vol. 15 (1): January – June 2014: 23-29.
Objective: This case report highlights the issue of hypersexuality in persons with dementia and outlines the possible etiology and challenges associated with interventions of inappropriate sexual behaviors in dementia.
Methods: We report a 75-year-old male with vascular dementia who developed hypersexuality and aggression towards his wife. The management plans are elaborated in this paper.
Results: A combination of pharmacological and psychosocial intervention lead to the resolution of his inappropriate sexual behavior and improvement in his relationships with his wife and children.
Conclusion: Inappropriate sexual behaviors need to be recognized and managed without compromising the fulfillment of the human's basic need of sexuality.
Objective: This case report highlights psychosis post craniopharyngioma surgery.
Methods: We report a case of a young Malay lady who presented with psychotic symptoms after she underwent craniotomy for craniopharyngioma.
Results: Presence of prominent hallucinations and delusions after removal of the tumour and the symptoms lasted more than a month. The psychosis subsided with antipsychotic.
Conclusion: Psychosis post craniopharyngioma surgery is still possible whether possibly due to the residual tumour or as a result of treatment sequealae.
Objective: This case report aims to highlight the importance of parental contribution to the school refusal problem. Methods: We report a case of a 9- year old boy who presented with school refusal behaviour. Results: There was no psychiatry diagnosis made in this patient. Parental issues such as ineffective and inconsistent parenting, and parental marital disharmony contribute significantly to the school refusal behaviour. Conclusion: Parents in particular are important team players in the management of school refusal. Parental issues need to be explored and managed accordingly to ensure good outcome. ASEAN Journal of Psychiatry, Vol. 15 (1): January - June 2014: 83-85.
Objectives: This paper aims to report on a case in which re-challenging with clozapine in combination with lithium in a patient who developed neutropenia was carried out. Methods: The patient was treated with clozapine for treatment- resistant schizophrenia. After five weeks he showed much improvement but developed neutropenia. Withdrawal of clozapine brought on a relapse of psychotic symptoms. Subsequently, clozapine was reintroduced along with Lithium. The neutrophil count was monitored closely. Results: The neutrophil and white blood cell count were noted to return to normal upon re-challenging, and the patient’s clinical condition also improved. Conclusion: Simultaneous administration of lithium and clozapine to patients experiencing neutropenia on clozapine is a possible strategy. However, very close monitoring of the white count is needed. ASEAN Journal of Psychiatry, Vol. 15 (1): January - June 2014: 90-92.
Mental illness accounts for 12% of the global burden of disease with a reported 1 in 5 Malaysians suffering from a psychological disorder. Sufferers have been long plagued by stigma, which results in social isolation, low-selfesteem, lower opportunities for employment, housing, and ability to achieve life goals. This essay aims to suggest strategies to overcome such stigma in the local setting. Methods: Literature search was conducted through PubMed (http://www.ncbi.nlm.nih.gov/pubmed) and Google Scholar (http://scholar.google.com.my). Data obtained was compiled as an opinion piece. Results: Thefactors contributing to stigma in Malaysia include a lack of public knowledge, language and cultural influences, inaccurate media portrayal, doctors’ attitudes towards the field of psychiatry, and psychiatrists themselves. Stigma can be tackled in four areas: society, media, medical education, and the field of psychiatry. Firstly, psychiatric terminology can be adapted to local languages and cultural beliefs in order to avoid misconceptions. Secondly, public education is more effective if focused to targeted key groups. The media is crucial in influencing the public mind-set, and needs to be creatively engaged. Thirdly, more positive medical practitioner attitudes to mental illness can be moulded through early psychiatric postings during medical school. Finally, psychiatrists play a role in correcting misconceptions, avoiding misdiagnosis and ineffective treatments. Cultural competency leads to better management of patients by awareness towards socio-cultural and religious influences. Conclusion: A multifaceted, united coalition of effort is needed in order to tackle stigma in different contexts, and will require concerted leadership from different parties.
This study aims to assess the factor structure and reliability of the General Health Questionnaire (GHQ-12). Additionally, the study also attempts to evaluate the psychological well-being among university students using the GHQ-12 scale and thereby determine a relationship between select demographic variables and well-being. Methods: An exploratory cross-sectional survey was conducted among undergraduate students of a public university in Sarawak, Malaysia. A self administered questionnaire consisting of the demographic aspects and the GHQ 12 scale were utilized to assess the well-being of students, who were selected by convenience sampling technique. Results: Factorability of the GHQ-12 was examined and a three-factor model explaining 55% total variance was found to be the best fit. Internal consistency of the scale was 0.78, which is within the acceptable range. The results also suggest that considerable proportion (57%) of students had psychological distress. Participants who were susceptible to psychological distress in the present study were identified as students from low income families, with poor social support, in a relationship with partner as well as the student with Hindu’s religion and male students. By multiple regression analysis, variables that significantly predicted psychological distress were gender; income; area of residence; relationship with parents; negative life events; smoking; drinking and event with the overall model fit were 34%. Conclusion: Based on these findings, it may be foreseen that if prompt intervention is not provided to students in distress, they may be susceptible to depression, anxiety and stress. The findings have implications for teachers and counsellors, who are in a position to influence a wide range of students and provide support to improve the psychological well-being of students.
The incidence of benzodiazepine paradoxical reaction is uncommon. It may be implicated with crime as will be described in this case report. Method: We report a 37 year-old schizophrenia patient who was detained by the authority under Section 392/397 of Penal Code assaulting a lady using sharp weapon. He had history of illicit substance abuse and benzodiazepine dependence with significant history of aggression associated with benzodiazepine. Just prior to the incident, he took a significant amount of various types of benzodiazepine and suffered from amnesia of that event. During the time of the offense, he was in remission as far as schizophrenia is concerned. Result: He was under the forensic psychiatric care and observation at Hospital Bahagia Ulu Kinta (HBUK). He developed withdrawal symptoms of benzodiazepine in the ward. Conclusion: He was found by the expert team to be under the influence of benzodiazepine during the offence. The role of benzodiazepine and relevant factors leading to aggression will be discussed in this manuscript.
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.
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.
Objective: ADHD is a complex neurobiological disorder, which required tactful
intervention. Besides pharmacotherapy, there is still limited information in
addressing the efficacy of cognitive behavior therapy (CBT) for treating this
developmental disorder.
Methods: We report a case of late diagnosed of ADHD
whose facing difficulty to cope with her undergraduate degree. She has to repeat
her semester examination due to lack of attention. Denial was seen in both
patient and family in accepting the diagnoses, and posed roadblock for
successful intervention.
Results: Six sessions of CBT were conducted, coupled
with psycho education for both the family and patient. Consultation from the
university’s management helped her to accept and cope with her ADHD
symptoms, i.e. attention and impulsivity. The patient showed improvement
following this intensive bio-psycho-social intervention.
Conclusion: The short
duration of CBT was found suitable to be adapted and implemented in young
adult ADHD.
Objective: Mental health is often stigmatized in Asia, and electroconvulsive therapy (ECT) is portrayed negatively in the media. The objective of this short report is to obtain an insight on Asian countries’ perception on Electroconvulsive Therapy, mainly through the media.
Methods: Several online movie databases were searched, with emphasis on Asian movies’ portrayal of Electroconvulsive Therapy.
Results: Electroconvulsive Therapy (ECT) was portrayed in 9 television programme, 4 in films and 2 on Youtube. All patients (15) had no proper information given on possible side effects and consent not taken in all of them. 5 patients (33%) were tortured via ECT, 3(20%) of them had, ECT for Schizophrenia. In all scenes (15/15, 100%) ECT were given without general anaesthesia and the patients were fully awake. Basic monitoring (2/15, 13%) was performed, and all patients had no oxygenation. Tonic Clonic seizures were visible because all patients received no muscle relaxant. Bilateral electrode's placements (13/15, 87%) were common. One (6.6%) patient had a trilateral electrode placement. Most patients (9/15, 60%) received one shock, 4 patients (27%) received 2 shocks. One patient (6.6%) received 3 and 1 patient (6.6%) 4 shocks. 100% of patients were in obvious discomfort and ECT was portrayed as barbaric. There was no death depicted post ECT.
Conclusion: ECT is under portrayed in the Asian media. Only the Indian and Pakistani medium broached the subject. In the majority of the scenes, ECT was portrayed
negatively. This shows a total lack of knowledge of ECT among the Asian population. Alarmingly, ECT was used as a torture device in 5 mediums. This only adds to the stigma of ECT in Asia. More needs to be done to correct the misconceptions of ECT in Asia.
Objective: It is important to investigate the association between spousal support
and psychology of cancer patients, thus a validated instrument to measure the
degree of perceived spousal support is required. We translated and evaluated the
psychometric properties of the Sources of Social Support Scale-Malay version
(SSSS-Malay) among Malaysian cancer patients.
Methods: In this study, the
SSSS-Malay and Hope Scale-Malay [used to compare with the SSSS-Malay to
assess discriminant validity] were administered to 195 Malaysian cancer patients
during baseline assessment. The SSSS-Malay was re-administered 2 months
after the baseline assessment during follow-up.
Results: The SSSS-Malay total
score (Cronbach’s α = 0.70, intraclass correlation coefficient (ICC) = 0.72) and
its domains (Cronbach’s α ranging from 0.70 to 0.83, intraclass correlation
coefficient ranging from 0.6 to 0.76) exhibited good internal consistencies and
good test-retest reliability. The SSSS-Malay also demonstrated good convergent
and discriminant validities. However, confirmatory factor analysis of the SSSSMalay
showed that it was best fit into a 3-factor model instead of the 4-factor
model of the original English version.
Conclusion: The SSSS-Malay
demonstrated good psychometric properties for use in Malaysian cancer
patients.
Introduction: Posttraumatic growth (PTG) is a positive psychological change in
life that occurs as a result of struggle with highly challenging life crises. There is
a growing need to explore posttraumatic growth (PTG) in cancer patients, as
higher PTG may enhance well-being of patients.
Objectives: The aim of this
study was to translate the Posttraumatic Growth Inventory-Short Form (PTGISF)
into the Malay language and evaluate its psychometric properties for
assessing Malaysian cancer patients in future studies.
Methods: Two parallels
forward and backward translations of the PTGI-SF into the Malay language
were conducted. The test was administered to 195 cancer patients. Reliability
was evaluated by testing internal consistency (Cronbach’s α) and calculating the
test-retest intra-class correlation coefficient, and validity was examined by
determining face, convergent, and discriminant validities and using
confirmatory factor analysis (CFA).
Results: The Malay version of the PTGI-SF
and its five domains demonstrated good internal consistencies and acceptable
test-retest reliability. All 10 items of this version were highly correlated with
their own domains and thus exhibited convergent validity. Discriminant validity
was achieved, as all domains of the Malay PTGI-SF was not highly correlated
with the domains of the Source of Social Support Scale. CFA resulted in a bestfitting
5-factor model.
Conclusion: The Malay version of the PTGI-SF is a
suitable tool for measuring PTG in Malaysian cancer patients.
Objective: Sexual problems are common among patients who are on antidepressants treatment. The objective of this study is to determine the prevalence of PE and ED, and their potential risk factors that may impair their sexual function in a TH
Methods: A cross-sectional study using simple random sampling was conducted among adult male patients who are on antidepressant treatment in the TH psychiatric outpatient clinic. Respondents’ sociodemographic data were obtained. Participants were interviewed using a structured self-report questionnaire with 15-item International Index of Erectile Function (IIEF-15)where the scores lesser than 25 were indicative for having an ED. A validated Malay Premature Ejaculation Diagnostic Tool (MAPET) was used to assess PE and those with a score ≥ 23 were considered to have PE.
Results: Hundred respondents were participated, and the prevalence of PE and ED was 66% and 85%, respectively. Using multivariate binary logistic regression, the potential risk factors of PE were race, i.e. being non-Malay (p=0.044), lesser in the frequency of sexual activity (p=0.03) and also an ED (p=0.03), respectively. The only risk factor for ED was PE (p=0.026). No significant association was noted for the other factors, including type of the antidepressant, dose and duration of antidepressant used (p>0.05). There was a strong correlation of MAPET and IIEF-15 (r=-0.345, p < 0.01) signifying patient with more severe PE had more severe ED.
Conclusions: Due to very high rate of ED and PE in this group of respondents, it is pivotal to screen for sexual problem among patients who are taking an antidepressant in a psychiatric setup.
Study site: Psychiatric clinic, Pusat Perubatan University Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia.
Objective: This case report highlights a case of young male referred for psychiatric evaluation due to paraphilic disorder. This 27-year old single male working as an assistant accountant was noted to have voyeuristic behaviour and presented with depressive symptoms since his teenage age. He has poor coping whenever he experiences stress in life. He started to watch pornographic videos and subsequently get involved by peeping pre-pubescent’s undergarments. These activities are followed by a compulsive behaviour such as masturbation to gratify his sexual arousal.
Results: The patient undergone several psychotherapy sessions, and medical report was furnished for the court's purpose. Our assessment revealed that he was suffering from a lifetime major depressive disorder,and he was prescribed with Tablet Sertraline 50mg/daily.He also has premature ejaculation, severe in nature. He regretted his voyeuristic urge and psychotherapyfocused on how to channel his sexual needs.
Conclusion: Mood disorder is seen in paraphilic disorder and has to be dealt with in order to establish good management care.
Objectives: With the explosion in the use of WhatsApp Messenger globally, the revalence of late-night WhatsApping is poised to show a commensurate increase. This has sparked debates on a possible new wave of technological addiction that could cause serious psycho-behavioral repercussions. Acknowledging the ubiquity of WhatsApp, healthcare professionals have adopted it as a preferred communication tool in clinical practice. This preliminary cross-sectional study aimed to explore the prevalence of and psycho-behavioral factors associated with late-night WhatsApping.
Methods: It was conducted on a universal sample of 307 healthcare professionals across medical and casualty departments in a Malaysian public hospital. The self-administered questionnaire consisted of items on socio-demographics, WhatsApp usage characteristics, and psycho-behavioral attributes.
Results: Majority of respondents (72.9%) reported late-night WhatsApping habits. In multivariate analyses, late-night WhatsApping was significantly higher among those who used WhatsApp for more than 12 months (Adjusted odds ratio, AOR = 4.4, 95% Confidence interval, CI 2.2–8.8, p < 0.001), those who frequently kept
mobile data on to avoid missing WhatsApp messages (AOR = 3.2, 95% CI 1.3–5.8, p = 0.006), those with frequent social connections (AOR = 3.0, 95% CI 1.4–6.4, p = 0.003), and those living alone (AOR = 2.3, 95% CI 1.1–5.2, p = 0.038).
Conclusion: Late-night WhatsApping was significantly associated with usage characteristics and psycho-behavioral attributes.
Objectives: This study investigated the relationship between coping skills and
psychosocial adjustments among parents of children with LD.
Method: A
cross-sectional study with a convenience sampling method was applied to a total
of 87 parents of children with LD from four non-government community
rehabilitation centers. They were measured using a validated Malay version of
the Family Crisis Oriented Personal Evaluation Scale (F-COPES) for coping
skills. The Modified Psychosocial Adjustment to Illness Scale-Self-Report
(PAIS-SR) was used to measure parents’ psychosocial adjustments.
Results: A
Spearman’s rho showed a correlation between total coping skills and
psychosocial adjustments scores among parents (rs= -0.43, p
Objectives: This study aimed to determine the prevalence of depressive disorder
and its association with perceived social support among patients with HIV
attending the Infectious Disease Clinic in HTJS.
Methods: A cross-sectional
study was conducted, and systematic random sampling method was employed
for the selection of participants. Socio-demographic and clinical details were
obtained through a self-rated questionnaire and participants’ medical records.
Depressive disorder was screened and diagnosed using the Mini International
Neuropsychiatric Interview (M.I.N.I.) and perceived social support was
determined using the Multidimensional Scale of Perceived Social Support
(MSPSS). Appropriate statistical analyses were used to determine the prevalence
of depressive disorder and its association with perceived social support.
Results:
A total of 99 patients participated in this study. The mean age of participants
was 38.16 ± 1.01 years, and the majority of participants were male (69.7%). Most
of the participants were Malay (58.6%), followed by Indians (20.2%), Chinese
(17.2%) and others (4.0%). The majority had completed secondary education
(54%), and most were employed (79.8%). Most of the participants were single
(45.5%) or married (45.5%). The lifetime and point prevalence of depressive
disorder was 24.2% and 17.2%, respectively. About 64.7% of patients with
depressive disorder were undiagnosed. Out of the 3 sources of perceived social
support, perceived social support from a significant other (OR=0.53, p=0.042,
Cl=0.29, 0.98) and perceived social support from friends (OR=0.49, p=0.015,
Cl=0.27, 0.87) were found to be negative predictors for depressive disorder.
Conclusion: This study reports that the prevalence disorder among patients with
HIV in HTJS is higher than that of the general population. Patients without
depressive disorder reported significantly higher perceived social support scores.
Perceived social supports from significant others and friends were found to be
important associated factors for lower depressive disorder vulnerability. Hence,
physicians should routinely screen for depressive disorder in this vulnerable
group and explore and mobilize their social support to reduce patients’
vulnerability to develop depressive disorder.
Objective: The psychological impact of care giving responsibility for dementia patients is significant regardless of the cultural background. Most of the current advanced caregivers’ interventions, originating from developed western countries, do not necessarily apply to local settings. Hence, there is a need for an effective culturally competent psychological intervention for these caregivers. The aim of the study is to assess the effectiveness of the cultural-based support group for Malay caregivers of dementia patients in Kelantan towards their burden, anxiety and depression level, and quality of life.
Methods: This was an experimental study, without control, investigating pre and post support group intervention effectiveness in reducing caregiver burden, anxiety and depression, and improving the quality of life. Sixteen caregivers completed the program, which involved seven fortnightly support group sessions with duration of 2 hours each, conducted over twelve weeks. Caregivers’ burden was assessed using Caregiver Strain Index (CSI) while their psychological well-being was objectively assessed using Hospital Anxiety and Depression Scale (HADS). WHO Quality of Life questionnaire (WHOQOL-BREF) was used to measure the quality of life. The validated Malay versions of the questionnaires were used.
Results: There was a statistically significant reduction in the level of caregiver burden (p = or < 0.001). Measurement of both scores of anxiety and depression comparing pre and post intervention also showed improvement, but statistically were not significant. Assessment of caregivers’ quality of life showed statistically significant improvement in the domains of social, psychological and physical (all with the p-value <0.05). Discussion: Our cultural-based support group is an effective intervention to improve burden, psychological well-being and quality of life among local caregivers of dementia patients.
Keyword: Dementia Caregivers, Support Group, Malay, Burden, Quality of Life
Study site: Memory clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia