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Fulltext Mental health difficulties in children: a University Hospital experience

Norhaniza, I., Abdullah, A., Aili, H.H., Manveen, K.S., Pillai, S.K.

Malaysian Journal of Psychiatry, 2010;19(2):1-8.
MyJurnal

Mental health difficulties in children are often missed or dismissed. Adults too are often wary of bringing their children to such a facility. This paper is a descriptive study of a child mental health service utilization in Kuala Lumpur. Methods: The cases consisted of new cases from the month of January to December 2007 who attended the Psychiatry Adolescent and Child (PAC) Unit, University Malaya Medical Center (UMMC). Results: The children presented with a range of development, academic, behavior and emotional difficulties. There were 373 new cases of which the highest number of children were in the primary school-going age group (54.7%) and males (65.4%). Sixty percent of the cases had one single diagnosis. Children with Attention Deficit Hyperactive Disorder (ADHD) were the highest disorder seen in the single diagnosis group (27.3%) as well as in those with more than one diagnosis (61.5%). Primary support group difficulties were the most common co-morbid condition noted. Conclusion: It is essential that extensive screening of children and their families be done to detect family difficulties and co- morbid conditions, which would be necessary for favorable outcomes to be met.

Matched MeSH terms: Psychiatry
Fulltext Bio-psychological perspectives of eating disorders and obesity: a revisited

Ainsah Omar, Osman Che Bakar

ASEAN Journal of Psychiatry, 2008;9(1):33-41.
MyJurnal

Food is closely related with emotion. It often provides comfort and satisfaction. Some individuals choose to turn to food to curb their negative emotion, resulting in disturbances in
eating patterns, such as overeating which lead to obesity and severely controlling food intake, which culminate in eating disorders like anorexia nervosa, bulimia nervosa and binge eating. These disorders are not related to the eating problems per se but often due to underlying or complicated by psychological factors, namely depression, anxiety, impulse control problems and personality. The roles of psychological factors in eating disorders and obesity should therefore not be downplayed. These disorders should be managed comprehensively involving multiple approaches, including not only biological but also psychological interventions provided by a professional team comprising endocrinologists, psychiatrists, dietitians, exercise physicians and surgeons.

Matched MeSH terms: Psychiatry
Fulltext Development of clinical pathway for Mild Cognitive Impairment and Dementia to quantify cost of age-related cognitive disorders in Malaysia

Syed Mohamed Aljunid, Namaitijiang Maimaiti, Zafar Ahmed, Amrizal Muhammad Nur, Norashidah Mohamed Nor, Normazwana Ismail, et al.

Malaysian Journal of Public Health Medicine, 2014;14(3):0-0.
MyJurnal

As the Malaysian population ages, the burden of age-related cognitive disorders such as dementia and Alzheimer’s disease will increase concomitantly. This is one of the sub-study under a research project titled by quantify the cost of age-related cognitive impairment in Malaysia, which was undertaken to develop a clinical pathway for Mild Cognitive Impairment (MCI) and Dementia. The clinical pathway (CP) will be used to support the costing studies of MCI and Dementia. An expert group discussion (EGD) was conducted among selected experts from six (6) government hospitals from different states of Malaysia, Ministry of Health, and United Nations University, International Institute for Global Health, UKM and UPM. The expert group includes psychiatrist specialists and public health medicine specialists. A total of 15 participants took part in the EGD. The group was presented with the different approach in managing MCI and Dementia. Finally, the group came to the consensus agreement on the most appropriate and efficient ways of managing the two conditions. In the EGD, an operational definition for MCI and Dementia was agreed upon and a pathway was developed for the usual practice in the Malaysian health system. A typical case used, as a reference is a 60-year-old patient referred to a memory clinic with complaint of “forgetfulness”. After three outpatient visits in the clinic, the diagnosis of MCI and Dementia could be clinically established. The clinical pathways covered all active clinical and non-clinical management of the patient over a period of one year. The experts identified the additional resources required to manage these patients for the whole spectrum of lifetime based on the expected life expectancy. The Clinical pathway (CP) for MCI and Dementia was successfully developed in EGD with strong support from practitioners in the health system. The findings will help the researchers to identify all-important clinical activities and interventions that will be included in the costing study.

Matched MeSH terms: Psychiatry
Fulltext Varenicline - a new pharmacotherapy for smoking cessation: implication for smokers with mental health problems

Rusdi Abdul Rashid, Muhammad Muhsin Ahmad Zahari, Mohammad Hussain Habil, Noor Zurani Md Haris Robson

ASEAN Journal of Psychiatry, 2009;10(2):202-209.
MyJurnal

Objective: The smoking rate among patients with mental health problem is higher than in the general population. Effective pharmacotherapy to treat nicotine addiction is thus needed to reduce the morbidity and mortality associated with cigarette smoking among these patients. This article reviews the literature on the suitability of varenicline for smokers with mental health problems.
Methods: A search of the literature was conducted using PubMed from year 2001 to July 2009 using key words varenicline alone and varenicline and mental health. Articles chosen were narrowed to those published in English. The type of articles chosen included clinical trials, metaanalyses, case reports, and review articles.
Results: The search produced a total of 322 articles on varenicline and 14 articles on varenicline and mental health. Varenicline, a new drug for smoking cessation is an α4β2 partial agonist and partial antagonist at nicotinic acetylcholine receptor. As a partial agonist, varenicline relieves craving and withdrawal symptoms that occur during smoking abstinence and also reduce the rewarding effects of smoking in patients who relapse. However, at present, there is concern regarding the neuropsychiatric side effects such as aggressive behaviour, suicidal ideation, mania and depression associated with varenicline use in patients with mental health problems, but these reports did not show a causal-link or lack of link between these symptoms and varenicline.
Conclusion: Current available data support the effectiveness of varenicline to treat nicotine dependence. However its safety among smokers with mental health problems remains to be elucidated. At present, further safety assessment is needed in this patient population. Until new data is available regarding the safety of varenicline in these populations, psychiatrists and physicians prescribing this medication should be extra cautious and monitor for possible psychiatric side effects when prescribing this medication to patients with pre-existing psychiatric disorders or have vulnerability to psychoses.

Matched MeSH terms: Psychiatry
Fulltext Factor structure of type D scale in Malaysian patients with coronary artery disease

Kaur, Satpal, Nor Zuraida Zainal, Wah, Yun Low, Ramasamy, Ravindran, Sidhu, Jaideep Singh

ASEAN Journal of Psychiatry, 2014;15(2):186-195.
MyJurnal

Objective: Type D personality, tendency trait to experience increased NA (Negative Affect) and SI (Social Inhibition) has been associated with negative psychological conditions linked to heart disease. This study aimed to examine the psychometric properties of the Malay version of Type D personality scale (DS14) among Malaysian patients with coronary artery disease (CAD). Methods: In this cross-sectional study 195 patients diagnosed with CAD were selected from National Heart Institute, Kuala Lumpur. They completed the questionnaire including demographic information and the Malay version of DS14 and Hospital Anxiety and Depression Scale (HADS). Results: The structural validity, as demonstrated by exploratory factor analysis of the DS14 was acceptable. The Cronbach's α coefficient for the NA and SI subscales were 0.876 and 0.732, respectively. With the standardized cut-off of NA ≥ 10 and SI ≥ 10, 28.2% of the patients with CAD were defined as having a Type D personality. Anxiety was significantly higher among patients with Type D personality. Conclusion: The results indicate that the Type D personality (DS14) questionnaire is a valid and reliable tool in the Malaysian population. The prevalence of Type D personality in Malaysia falls close to what has been found in Western countries, at least for CAD patients. This study indicates also that it is possible to use the DS14 among the Malaysian population in future cross-cultural studies. ASEAN Journal of Psychiatry, Vol. 15 (2): July - December 2014: 186-195.

Matched MeSH terms: Psychiatry
Fulltext Factorial validity and reliability of the simplified-Chinese version of Snaith-Hamilton pleasure scale: a study among depressed patients at an out-patient clinic in Malaysia

Anne, Yee, Huai, Seng Loh, Chong, Guan Ng

ASEAN Journal of Psychiatry, 2014;15(1):66-71.
MyJurnal

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)

Matched MeSH terms: Psychiatry
Fulltext Memantine augmentation in the treatment of frontal lobe syndrome in patients with end-stage renal disease: a case report

Aida Abdul Razak, Maniam, T., Hatta Sidi, Shalisah Sharip, Suriati Mohamed Saini

ASEAN Journal of Psychiatry, 2014;15(1):93-96.
MyJurnal

Objective: This case report highlights the challenges in managing Frontal Lobe Syndrome (FLS) in a patient with end-stage renal disease. Methods: This is a case description of a 58 year-old gentleman who presented with behavioural changes: irritability, mood lability, aggression, psychosis, and overfamiliarity. His presenting symptoms were in keeping with (FLS) with positive findings on Computed Tomography (CT) scan of the brain and also neuropsychological assessments. Difficulties arose in attempts to control his aggression without further compromising his renal function. Results: The usage of the commonly used antipsychotics in controlling aggression was restricted in view of the patient’s renal impairment. Augmentation with low dose memantine proved to be beneficial in this case, without causing further deterioration in renal function. Conclusion: The use of memantine to augment the effect of risperidone was observed to be safe and successful in managing the behavioural changes associated with FLS in adults with end-stage renal disease. ASEAN Journal of Psychiatry, Vol. 15 (1): January - June 2014: 93-96.

Matched MeSH terms: Psychiatry
Fulltext Coping Styles and Clinical Factors in Relation to Quality of Life among Patients with Schizophrenia

Mohd Badi, M., Osman, C.B., Anisah, O.

Medicine & Health, 2008;3(1):14-21.
MyJurnal

This is a cross sectional study examining quality of life in relation to coping styles among patients with Schizophrenia (N=92) in remission, from June 2002 to December 2002.Remission state is determined by Brief Psychiatric Rating Scale (BPRS). The psychiatric diagnosis was made by treating psychiatrist using the Clinical Interview Schedule for the DSM-IV Diagnosis. They are subsequently asked to complete demographic and clinical data questionnaire and followed by 36-item short-form health survey (SF-36) of the Medical Outcome Study (MOS) for the assessment of quality of life and the Coping Inventory for Stressful Situation (CISS). The QOL in term of overall mental health among patients with schizophrenia was significantly and positively associated with ethnic group (p

Matched MeSH terms: Psychiatry
Fulltext Role of modified assertive community treatment (ACT) in maintaining stability in patients with dual diagnosis: a case report

Siti Rohana, A.H., Marhani, M.

Malaysian Journal of Psychiatry, 2013;22(2):80-83.
MyJurnal

This case report highlights the role of hospital-based modified assertive community treatment (ACT) in maintaining stability in a patient with dual diagnosis. We report a case of a middle-aged Indian gentleman who had schizophrenia with co-morbid alcohol abuse presented with multiple relapses, with recurrent suicidal attempts and criminal behaviour during his relapse episodes. After stabilisation of his most recent acute episode in hospital, the patient was followed-up by the community mental health team (CMHT). He was able to maintain in remission and stay free from alcohol, suicidality and criminal behaviour when provided ACT. The hospital-based modified ACT is proven to be effective in the management of this patient with co-morbidities and complications to sustain remission and prevent relapses.
Fulltext Reducing stigma towards people with mental illness in Malaysia

Lim, Sheri

ASEAN Journal of Psychiatry, 2015;16(2):261-264.
MyJurnal

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.

Matched MeSH terms: Psychiatry
Fulltext Features of parasuicide cases presented to Hospital Melaka in year 2015 - "a wake-up call"

Kumar, P.R., Vincent, S.D.

Malaysian Journal of Psychiatry, 2016;25(1):0-0.
MyJurnal

Objective: This study aimed to collect data on features of parasuicide cases
presented to Hospital Melaka from January to December 2015. Methods:
This was a descriptive study with retrospective review of medical records of
parasuicide cases that were warded for observation in Hospital Melaka from
January to December 2015. Data collected included sociodemographic factors,
previous attempts, methods implicated and reasons for parasuicide which
were presented in descriptive statistics. Results: A total of 88 parasuicide
cases were studied. The median age was 25.6 (17.7) with a majority in age
group between 15-24 years old (43.2%). Females were the highest with 58
cases (65.9%). In terms of ethnicity, the Malays was the highest at 38 cases
(43.2 %). However, after corrected to proportion of ethnicity in Melaka,
Indians yield the highest cases. Those who were single (50.0%) and
unemployed (64.8%) contributed to higher number of cases. About 40 cases
(45.5%) had underlying psychiatry illness and majority of them were those
diagnosed with major depressive disorder (47.5%). In general, the most
common method used was self poisoning with anti-epileptics,
sedative-hypnotic, psychotropics (22.1%). Among male cases, pesticide
ingestion (37%) was more common while among female, medication overdose
(53%) was preferred. In terms of reasons for parasuicide, individuals with
interpersonal conflicts contributed to the highest percentage of cases (57.7%).
Conclusion: Data gathered in this study is useful to reflect the current
situation of parasuicide in Melaka and could serve as a foundation in
designing future studies on preventive and intervention programs in Hospital
Melaka.

Matched MeSH terms: Psychiatry
Fulltext A better mental health for all

Jasraj, S., Viknesh, N.

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

Psychiatric services have progressed well throughout history, marked by a shift from heavily inpatient asylums to outpatient management via deinstitutionalization, and advances in psychopharmacology. An overview of important themes is discussed at public mental health level. Firstly, differences between sexes are touched upon from theoretical and societal perspectives. Next, among the disabled, the phenomenon of diagnostic overshadowing, attributing apparent mental health problems to learning disability, contributes to their overall poorer quality of life. Mental health at both extremes of age is another important theme, whereby dementia and depression are keenly observed in the older age group, while maternal risk factors and parenting play a role in the mental well-being of the younger age group. Fourthly, inequalities, stigma and discrimination, are rife among people living with mental illness, and thereby detrimental in their road to recovery. Deinstitutionalization is explained as being more than just downsizing the inpatient load, gaining prominence with the emergence of community psychiatry services, and found to be helpful in overcoming stigma. Demographically, it was demonstrated that developing countries, as opposed to developed countries, have advantages in their approaches to psychiatric services, including better integration of people living with mental illness into society. Lastly, the psychological well-being of mental health workers should not be discounted, with measures such as stress management and resilience training proving to be key in combating burnout.

Matched MeSH terms: Community Psychiatry
Validation of the Malay Version of the De Jong Gierveld Loneliness Scale

Jaafar MH, Villiers-Tuthill A, Lim MA, Ragunathan D, Morgan K

Australas J Ageing, 2020 Mar;39(1):e9-e15.
PMID: 31115154 DOI: 10.1111/ajag.12672

OBJECTIVE: This study aims to determine the psychometric properties of the Bahasa Malaysia (BM) version of the 6-item De Jong Gierveld Loneliness Scale (DJGLS) among older adults in Malaysia.
METHODS: A total of 200 participants aged 50 years and older completed the questionnaire in which 81 participants completed in BM. A subsample of 30 participants was retested after a period of 2 weeks.
RESULTS: The DJGLS showed good internal consistency (Cronbach's alpha 0.71) and high test-retest reliability (r = 0.93). Convergent validity was demonstrated by moderate positive correlation between total DJGLS loneliness score and UCLA loneliness scale (ULS-8) (r = 0.56, n = 81, P

Matched MeSH terms: Geriatric Psychiatry
Fulltext Role of the husband's knowledge and behaviour in postnatal depression: a case study of an immigrant Pakistani woman

Khan TM, Arif NH, Tahir H, Anwar M

Ment Health Fam Med, 2009 Dec;6(4):195-201.
PMID: 22477910

Objective. This study aims to highlight the subjective experience of an immigrant Pakistani woman during postnatal depression (PND), with a special emphasis on the husband's knowledge and behaviour towards PND.
Methods. A face-to-face interview was conducted with a woman reporting symptoms of depression on the fourth day after delivery. She was evaluated using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV)(1) and the Edinburgh Postnatal Depression Rating Scale (EPDRS).(2) The evaluations were completed by a qualified psychiatrist. The demographic information, personal and family medical history and attitude towards the child were the principal issues recorded. In addition, five items were used to evaluate the husband's knowledge about PND. The EPDRS differences before and after counselling were evaluated using a student t-test.
Results. The patient was 32 years old and this was her first experience of delivery by Caesarean section. The evaluation for depression confirmed the diagnosis of PND and she scored 16 on the EPDRS. The husband's knowledge of PND was poor.
Conclusion. This case study suggests that lack of social support and understanding appear to play a vital role in the persistence of symptoms of PND among new mothers. Therefore, counselling of couples may be an effective additional tool in treating PND.

Matched MeSH terms: Psychiatry
Using decision support tools for treatment decision making about antidepressants in outpatient psychiatric consultations

Mat Lazim NH, Syed A, Lee C, Ahmed Abousheishaa A, Chong Guan N

Patient Educ Couns, 2024 Jul;124:108266.
PMID: 38565074 DOI: 10.1016/j.pec.2024.108266

OBJECTIVE: To examine the use of decision support tools in decision making about antidepressants during conversations between patients with major depressive disorder (MDD) and their psychiatrists.
METHODS: Theme-oriented discourse analysis of two psychiatric consultation groups: control (n = 17) and intervention (n = 16). In the control group, only a doctor's conversation guide was used; in the intervention group, the conversation guide and a patient decision aid (PDA) were used.
RESULTS: Psychiatrists mainly dominated conversations in both consultation groups. They were less likely to elicit patient treatment-related perspectives in the intervention group as they focused more on delivering the information than obtaining patient perspectives. However, using PDA in the intervention group slightly encouraged patients to participate in decisional talk.
CONCLUSION: The decision support tools did promote SDM performance. Using the conversation guide in both consultation groups encouraged the elicitation of patient perspectives, which helped the psychiatrists in tailoring their recommendations of options based on patient preferences and concerns. Using the PDA in the intervention group created space for treatment discussion and fostered active collaboration in treatment decision making.
PRACTICE IMPLICATIONS: Our findings have implications for SDM communication skills training and critical reflection on SDM practice.

Matched MeSH terms: Psychiatry
Fulltext Patterns of Referral to Clinical Psychology Services in the Ministry of Health Malaysia

Martadza M, Saedon UI, Darus N, Badli TST, Ghazalan SA, Yunus WMAWM

Malays J Med Sci, 2019 Nov;26(6):111-119.
PMID: 31908592 MyJurnal DOI: 10.21315/mjms2019.26.6.11

Background: This descriptive study identifies the demographic characteristics and patterns of referral to clinical psychology services, which include types of diagnosis, types of referral and source of referrals in child, adolescent, adult and geriatric cases in Malaysia.
Methods: We utilised 2,179 referrals between January and December 2015 from six general hospitals and three mental health institutions that provide clinical psychology services.
Results: The percentage of male referrals (60.3%) is higher than that of female referrals (39.7%). Adult cases had the highest percentage of referrals (48.2%). Children (48.8%) and adolescent (28.1%) cases were mainly referred for psychological assessment. Meanwhile, adult cases (74.8%) were mainly referred for psychological intervention. Neurodevelopmental disorders was the diagnosis with the highest percentage of referrals recorded (41.4%), followed by depressive disorders (13.3%) and anxiety disorders (12.7%), and the combination of other disorders. Psychiatrists provided the highest number of referrals (82.2%), which is unsurprising as both fields are closely related.
Conclusion: Clinical psychology services within the Ministry of Health (MOH) Malaysia play an important role in mental health care.

Matched MeSH terms: Psychiatry
The Clinical Interview Schedule-Revised (CIS-R)-Malay Version, Clinical Validation

Subramaniam K, Krishnaswamy S, Jemain AA, Hamid A, Patel V

Malays J Med Sci, 2006 Jan;13(1):58-62.
PMID: 22589592

Use of instruments or questionnaires in different cultural settings without proper validation can result in inaccurate results. Issues like reliability, validity, feasibility and acceptability should be considered in the use of an instrument. The study aims to determine the usefulness of the CIS-R Malay version in detecting common mental health problems specifically to establish the validity. The CIS-R instrument (PROQSY* format) was translated through the back translation process into Malay. Inter rater reliability was established for raters who were medical students. Cases and controls for the study were psychiatric in patients, out patient and relatives or friends accompanying the patients to the clinic or visiting the inpatients. The Malay version of CIS-R was administered to all cases and controls. All cases and controls involved in the study were rated by psychiatrists for psychiatric morbidity using the SCID as a guideline. Specificity and sensitivity of the CIS-R to the assessment by the psychiatrist were determined. The Malay version of CIS-R showed 100% sensitivity and 96.15% specificity at a cut off score of 9. The CIS-R can be a useful instrument for clinical and research use in the Malaysian population for diagnosing common mental disorders like depression and anxiety.

Matched MeSH terms: Psychiatry
Fulltext Psychiatric and substance abuse comorbidity among HIV seropositive and HIV seronegative prisoners in Malaysia

Zahari MM, Hwan Bae W, Zainal NZ, Habil H, Kamarulzaman A, Altice FL

Am J Drug Alcohol Abuse, 2010 Jan;36(1):31-8.
PMID: 20141394 DOI: 10.3109/00952990903544828

To examine the association between HIV infection and psychiatric disorders among prisoners, where mental illness, substance abuse, and HIV are disproportionately represented.
Fulltext Polypharmacy and psychotropic drug loading in patients with schizophrenia in Asian countries: Fourth survey of Research on Asian Prescription Patterns on antipsychotics

Yang SY, Chen LY, Najoan E, Kallivayalil RA, Viboonma K, Jamaluddin R, et al.

Psychiatry Clin Neurosci, 2018 Aug;72(8):572-579.
PMID: 29761577 DOI: 10.1111/pcn.12676

AIM: The aim of the present study was to survey the prevalence of antipsychotic polypharmacy and combined medication use across 15 Asian countries and areas in 2016.
METHODS: By using the results from the fourth survey of Research on Asian Prescription Patterns on antipsychotics, the rates of polypharmacy and combined medication use in each country were analyzed. Daily medications prescribed for the treatment of inpatients or outpatients with schizophrenia, including antipsychotics, mood stabilizers, anxiolytics, hypnotics, and antiparkinson agents, were collected. Fifteen countries from Asia participated in this study.
RESULTS: A total of 3744 patients' prescription forms were examined. The prescription patterns differed across these Asian countries, with the highest rate of polypharmacy noted in Vietnam (59.1%) and the lowest in Myanmar (22.0%). Furthermore, the combined use of other medications, expressed as highest and lowest rate, respectively, was as follows: mood stabilizers, China (35.0%) and Bangladesh (1.0%); antidepressants, South Korea (36.6%) and Bangladesh (0%); anxiolytics, Pakistan (55.7%) and Myanmar (8.5%); hypnotics, Japan (61.1%) and, equally, Myanmar (0%) and Sri Lanka (0%); and antiparkinson agents, Bangladesh (87.9%) and Vietnam (10.9%). The average psychotropic drug loading of all patients was 2.01 ± 1.64, with the highest and lowest loadings noted in Japan (4.13 ± 3.13) and Indonesia (1.16 ± 0.68), respectively.
CONCLUSION: Differences in psychiatrist training as well as the civil culture and health insurance system of each country may have contributed to the differences in these rates. The concept of drug loading can be applied to other medical fields.

Matched MeSH terms: Psychiatry

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