Objective: This study aims to establish the validity and reliability of the Malay- translated version of the CES-D. Methods: This study employed a cross-sectional study design. The participants were female inmates (n=90) from local prisons which were selected based on purposive-selective sampling. The analyses include face validation, factor analysis, and reliability testing. A test-retest was conducted within a one-week interval. Results: The mean score for depression among the participants is 18.97 (SD=6.51). Further descriptive analysis showed that 58.9% of them scored above the mean score, which is considered high. Preliminary construct validation analysis confirmed that factor analysis was appropriate for the Malay-translated version of the CES-D. Furthermore, the factor analysis showed similar factor loadings to the original English version. The total internal consistency of the translated version, which was measured by Cronbach’s alpha coefficient, was equal to 0.75. The test-retest reliability of the total score, measured by Pearson’s correlation was equal to 0.69. Conclusions: Face validity, construct validity, and reliability analysis were found satisfactory for the Malay-translated version of the CES-D. The Malay-translated version of the CES-D was found valid and reliable to be used in future studies, with comparable properties to the original version and to previous studies. ASEAN Journal of Psychiatry, Vol. 15 (1): January - June 2014: 54-65.
Objective: The Snaith-Hamilton Pleasure Scale (SHAPS) is a self-assessment scale designed to evaluate anhedonia in various psychiatric disorders. To facilitate its use in Malaysian settings, our current study aimed to examine the validity of the Simplified-Chinese translated version of the SHAPS (SHAPS-SC) in a group of subjects at a university out-patient clinic. Method: A total of 40 depressed patients were recruited in this cross sectional study. They were given both the Simplified Chinese and Malay versions of SHAPS, General Health Questionnaire 12 (GHQ-12) and Beck Depression Inventory (BDI) to assess their hedonic state, general mental health condition and level of depression. Results: Our study showed that SHAPS-SC had impressive internal consistency (Cronbach’s alpha 0.84) and concurrent validity, and fair parallel-forms reliability (Pearson’s correlation 0.39). Conclusion: SHAPS-SC demonstrated good psychometric properties in the evaluation of hedonic state among a group of Chinese speaking depressed patients in an out-patient setting. It is easy to administer and suitable as a valid and reliable questionnaire in assessing anhedonia among depressed patients in Malaysia. ASEAN Journal of Psychiatry, Vol. 15 (1): January - June 2014: 66-71.
Study site: psychiatric out-patient clinic, University
Malaya Medical Centre (UMMC)
Objectives: This study aims to determine the prevalence and associated factors of sexual pain disorders among Malay women in Malaysia with type 2 diabetes mellitus.
Methods: This is a cross-sectional study involving 347 women (174 non- diabetic and 173 diabetic subjects) who attended the diabetic clinic in a university hospital. Sexual pain disorders were assessed using the Pain sub scale of Malay Version of the Female Sexual Function Index (MVFSFI). Socio-demographic information of the subjects was collected with a pre-designed questionnaire.
Results: Prevalence of sexual pain disorders among Malay women with type 2 diabetes mellitus was 10.4% and the control group was 9.2% but the difference was not statistically significant (p > 0.05). Multivariate logistic regression analysis did not find any relevant associated factor with sexual pain disorder.
Conclusion: Sexual pain disorders among Malay women were not dependent on the diabetic status. Further studies with different population of diabetic patients are needed to confirm the results.
Study site: Diabetic clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
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
Objectives: Prayers, spiritual healing, yoga, meditation, t'ai chi, qigong and support groups are classified as mind body complementary therapies (MBCTs). The study aimed to examine the prevalence of MBCTs use and the Health Related Quality of Life (HRQoL) in a group of Malaysian cancer patients.
Methods: This crosssectional study was conducted on 184 cancer patients at the oncology clinic of Penang general hospital, Malaysia. MBCTs was assessed using a self- administered questionnaire while the HRQoL of the participants was assessed by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30).
Results: Among the complementary and alternative medicines (CAM) users, 75(40.7%) patients self-reported using MBCTs while having cancer. Majority of MBCTs users were female 60(80%, p=0.01), aged between 38 and 57 (58%), and were of Malay ethnicity (61%). Socio-demographic factors including age (r=0.15, p=0.03) and monthly house-hold income (r= -0.25, p<0.001) were significantly correlated with MBCTs use. Prayers for health reasons was the most frequently practised MBCTs modality, followed by spiritual practices 20(10.8%), meditation 7(5.9%), t'ai chi 7(3.8%), music therapy 4(2.1%), qigong 1(0.5%), hypnotherapy 1(0.5%), and reiki 1(0.5%). Recommendations from friends and family members 53(70%) were the most common reasons of MBCTs use followed by patient's own will 22(29.3%). Health related Quality of Life (HRQoL) scores showed significant difference in all functional and symptoms scores among MBCTs users and non-users (p<0.05). Conclusion: The study helps to identify numerous MBCTs commonly practised by a group of Malaysian cancer patients. Prayers specifically for health reasons and spiritual practices were somewhat common among patients. Viewing MBCTs, not as alternative but to complement conventional cancer therapies may help to address cancer patients' emotional and psychological needs.
Study site: Oncology clinic, Hospital Pulau Pinang, Malaysia
Objective: The family caregiver has a pivotal role in the management of HIV/AIDS patients and their well-being is consequently crucial as it could impact negatively on the quality of caregiving. This preliminary qualitative investigation intended to explore and describe the challenges and experiences of HIV/AIDS family caregivers in Terengganu, Malaysia. Methods: A convenient sample of family caregivers of HIV/AIDS patients who were aware of the diagnosis was enrolled. Recruitment was conducted in Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia and semi-structured interviews were used. Results: Results were transcribed into verbatim before being subjected to analysis. Twelve Muslim caregivers consented participation (age range = 18.0 - 81.0; female = 75.0%, mother/wife = 50.0%; married = 83.3%; ≤ primary school
= 50.0%; and self-employed = 66.7%). The four major themes that emerged were challenges of caregiving, financial issues, stigma and discrimination, and support for caregivers. Additionally, caregivers did mention several positive aspects of their caregiving role including satisfaction from helping family member and improved family relationships. Conclusion: A variety of life aspects were negatively affected by caring for HIV patients, thus requiring a multidisciplinary approach to address such issues. ASEAN Journal of Psychiatry, Vol. 15 (2): July - December 2014: 120-130.
Objective: This study aimed to assess the concurrent validity of the Malay version of the Perceived Stress Scale (PSS-10) PSS-10 item.
Methods: A cross-sectional study was conducted among all students in a medical faculty in Malaysia. The questionnaire included three parts; socio-demographic correlates, PSS-10 and the validated Malay version of Depression Anxiety and Stress Scale-21 item (DASS-21). Spearman's correlation coefficient was used in the analysis.
Results: Stress subscale of DASS -21 correlated positively with the total score of PSS-10 (r= +0.50, p<0.001), positively with the negative subscale of PSS-10 (r=+0.36, p<0.001) and negatively with the positive subscale of PSS-10 (perceived coping) (r= -0.33, p<0.001).
Conclusion: The Malay Version of PSS-10 has fair correlation with the stress subscale of DASS-21. This confirmed the concurrent validity of this scale, which further strengthened the previous evidence that the Malay version of PSS-10 was a valid tool to measure stress in Malaysian university students.
Keywords: Malay, Version, Stress, Medical, Students, Psychological Distress
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.
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.
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
Objective: Pathological laughter, pseudobulbar affect or a myriad of its other synonyms, is a condition common secondary to neurological injury, presenting with uncontrolled laughing or crying, appearing to be mood-incongruent and significantly debilitating. The objective of this case report is to highlight a rare case of pathological laughter associated with Cerebral Lupus.
Methods: We report a case of a 27-year-old lady presenting with signs and symptoms of stroke with dysarthria progressing to aphasia and then pathological laughter, with an underlying poorly controlled Systemic Lupus Erythematosus, manifesting as Cerebral Lupus.
Results: An improvement in affect congruency followed by decreased frequency of outbreaks among bouts of pathological laughter.
Conclusion: The combination of Escitalopram and Topiramate is effective in the symptomatic treatment of Pathological Laughter.
Objective: Pritchard Criteria are adopted in a Malaysian criminal-justice system while assessing fitness to plead. There is limited data on the reason of unfitness to plead for female offenders in Malaysia.
Methods: A case series of five patients hospitalized to Hospital Bahagia Ulu Kinta, Malaysia due to unfitness to plead was presented and discussed.
Result: The offences include three homicides, one assault, and one stealing. All of them were diagnosed to have schizophrenia with prominent looseness of association. Four of them subsequently treated as Treatment-Resistant Schizophrenia (TRS) with a minimal response toward clozapine.
Conclusion: Looseness of association may be a contributing factor for unfitness to plead among Malaysian female offenders, which can result in indeterminate hospitalization. This should be confirmed in a larger prospective study.
Introduction: Psychotherapy is a form of treatment intervention targeting problematical human behaviour, emotion, and cognition using various psychological techniques and approaches. In Malaysia, the application of psychotherapy in ameliorating criminality among forensic populations is developing and evidence shows that some therapies like Cognitive-Behavioural Therapy and Reality Therapy have been practiced in many correctional institutions.
Objective: This paper aims to review the role of psychotherapy for help in correctional settings as a means to ameliorate criminal behaviour and reduce recidivism rates.
Method: An archival research was utilised, where articles and books regardless of the year of publication from different countries, including Malaysia were examined. Several keywords were used for the purpose of retrieval of related articles.
Results and Discussion: Three different approaches of psychotherapies, i.e. Behavioural Therapy, Cognitive Therapy and Cognitive-Behavioural Therapy and their principles and effectiveness in rehabilitating the forensic populations were elaborated in this review. The principle behind the effectiveness of the psychotherapy was different, and this influences the choice of treatment that should be used in dealing with the forensic populations.
Conclusion: Forensic populations have rights to obtain treatment, and the choice of therapy has to be relevant within the context of cost-effectiveness to ensure optimum effectiveness in ameliorating criminal tendencies.
The laser technology laboratory (LTL) of the Physics Department, University of Technology Malaysia was established in 1989 to support research and development activities. The laboratory provides activities for short- and long-term projects to serve final year undergraduate and post-graduate students in masters and PhD programmes.
The Nipah virus was first discovered in 1999, following a severe outbreak of viral encephalitis among pig farm workers in Malaysia. The virus was thought to have spread from Pteropus bats to pigs, then from infected pigs to humans by close contact. Mortality of the disease was high at about 40%. The main necropsy finding was disseminated microinfarction associated with vasculitis and direct neuronal involvement. Relapsed encephalitis was seen in approximately 10% of those who survived the initial illness. Since its first recorded emergence in peninsular Malaysia, 10 outbreaks of Nipah virus encephalitis have been reported in Bangladesh and West Bengal in India. The outbreaks occurred from January to May, with Pteropus giganteus as the reservoir of the virus. In Bangladesh, evidence indicated that the virus transmitted directly from bats to human, with human to human transmission as an important mode of spread. The mortality of the illness was higher in Bangladesh which stood at around 70%. This was likely to be due to genetic variation of the virus.
Research and development trends will continue to design innovative composite foods in which muscle proteins are combined with non-conventional animal products, non-meat proteins and functional food additives, many of which have lost their original inherent properties and characteristics. Composite food are products with meat, non-meat proteins, fats, carbohydrates and functional ingredients such as pre-emulsion, probiotics, enzymes, bioactives, peptides, hormones, emulsifiers, gelatin, animal fats/oils, alcohol and visceral tissues. Traceability of halal meat raw materials should start at the point of animal breeding, production to the stage of halal slaughter, processing operations and final point of consumption. Traceability of food additives used in the food industry remains a major hurdle for the Muslim community seeking halal food. The processes and technological advancements made in raw material processing, ingredient extractions, modifications, purification and resynthesized into many food ingredients make the question of traceability and solving of the materials and processes that are halal a monumental task. Food is only halal if the entire food chain from farm to table, is processed, handled and stored in accordance with the syariah and/or halal standards or guidelines, such as in the Jabatan Kemajuan Islam Malaysia (JAKIM): General guidelines, Malaysia Standards MS 1500:2009 and Codex Alimentarius (Food Labeling). Here lies the challenge and importance of traceability to verify the ‘wholesomeness’ of the sources of halal raw materials and final meat-based food products.