Objective: To study the demographic data of patients and the pattern of crime in the study group, to look at the outcome of assessment by psychiatrist on fitness to plea and insanity at time of offense and to assess association between the nature of crime with presence of psychopathology during the crime. Method: This is a retrospective study. All available case notes for 342 forensic admissions from January 2007 until March 2010 were reviewed. All related information on 135 patients that committed violent crime was taken for analysis. Result: Majority of patients were male, Malay, single, education up to secondary school and unemployed. Only 38% of patients had encountered psychiatric services, 20% had previous imprisonment and 49% had history of substance usage. In cases involving victims (87%), 64% the victims were known to the patient, 53% had hallucination or delusion or both at the time of crime and 90% was found to have some diagnosis of mental illness after psychiatrist assessment. Only 81% of formal forensic reports were available in the case note and it showed 94% were fit to plea and 82% were at sound mind at the time of offense. Conclusion: Substance abuse had high prevalence among the patient. Almost 2/3 never had any encounter with psychiatric services before the admission. Even with the high percentage of patient diagnosed with mental illness, they were still found to be fit to plea in court and are at sound mind at the time of offense
Floods are natural disasters that occur without much warning. Natural disasters can result in negative impact due to highly stressful event. Floods can cause mental and emotional disorders to the victims and could also induce stress and trauma either in the short or long terms. This research was carried out to recognize the psychological sequelae of floods and how to overcome them. This study describes the cross sectional descriptive pattern of flood victims in Johor. The DASS Test Questionnaire which is a measurement tool endorsed by the Family Development Institute, Ministry of Health Malaysia was used. We carried out the research in 3 districts of Johor which were the worst hit areas by the flood disaster. Twenty-three percent of the participants were males while 77% were females. The DASS Test Questionnaire showed that 13% were mildly depressed, 7% moderately depressed and 3% were severely depressed. It also revealed that 22% were mildly anxious, 19% moderately anxious, 5% severely anxious and 4% had very severe anxiety. On the stress scores, 15% suffered mild stress, 11% were moderately stressed while 2% were severely stressed. A committee to conduct the motivation programme for the state of Johor was formed by Jabatan Kesihatan Negeri Johor with the cooperation of the PROKEM committee from Hospital Permai, Johor Bahru. This committee headed by the Deputy Director of Health (Medical Division) attempted to overcome the psychological sequelae suffered by flood victims. The activities conducted by the PROKEM staff and staff from the Ministry of Health were monitored by the committee based at Hospital Permai, Johor Bahru. The Bilik Gerakan was in operation for 24 hours a day with meetings conducted every morning and evening to brief and debrief members of staff who were going to carry out the motivation programme. Feedback was also obtained from staff on their return from the various relief centres.
The National Mental Health Registry (NMHR) collects information about patients with mental disorder in Malaysia. This information allows us to estimate the incidence of selected mental disorders, and to evaluate risk factors and treatment in the country. The National Mental Health Registry (NMHR) presented its first report in 2004, a year after its establishment. The report focused on schizophrenia as a pioneer project for the National Mental Health Registry. The development of the registry has progressed with data collected from government-based facilities, the academia and the private sector. The 2003-2005 report was recently published and distributed. Since then the registry has progressed to include suicides and other mental illnesses such as depression. The NMHR Report 2003-2005 provides detailed information about the profile of persons with Schizophrenia who presented for the first time to various psychiatry and mental health providers throughout Malaysia. More detailed description regarding pharmacotherapy is reported and few cross tabulations done in an effort to provide better understanding and more clinically meaningful reports.
OBJECTIVE: The objective of this study is to determine the prevalence of metabolic syndrome among schizophrenia patients receiving antipsychotic monotherapy in Malaysia.
METHOD: A cross-sectional study was conducted at multiple centres between June 2008 and September 2011. Two hundred and five patients who fulfilled the DSM IV-TR diagnostic criteria for schizophrenia and who had been on antipsychotic medication for at least one year, were screened for metabolic syndrome. Patients receiving a mood stabilizer were excluded from the study. Metabolic syndrome was defined by using the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults Treatment Panel III (ATP III) modified for Asian waist circumference.
RESULTS: In the first-generation antipsychotic (FGA) group, the highest prevalence of metabolic syndrome was among patients treated with trifluoperazine and flupenthixol decanoate (66.7% each). For the second-generation antipsychotic (SGA) group, the highest prevalence of metabolic syndrome was among patients treated with clozapine (66.7%). The component with the highest prevalence in metabolic syndrome was waist circumference in both FGA and SGA groups except for aripiprazole in SGA.
CONCLUSION: The prevalence of metabolic syndrome in schizophrenia patients receiving antipsychotic monotherapy in Malaysia was very high. Intervention measures are urgently needed to combat these problems.
KEYWORDS: Antipsychotics; Metabolic syndrome; Monotherapy; Prevalence; Schizophrenia