About 60% of people with mental illness developed co-morbid medical and physical illness that invariably worsens their lives. However, most of the studies regarding this issue were done either in the out-patient or community settings, ignoring long stay inpatients. Locally, no data exists among long stay patients in psychiatric institutions. The aim of this retrospective study was to look at the prevalence of physical illness among long-stay patients and to compare the occurrence of physical illness before and after admission to the psychiatric institution. We found that 85 (63.4%) out of 134 subjects there was suffering with co-morbid physical and medical illnesses. There were 33 (24.6%) subjects with hyperlipidaemia, 22 (16.4%) subjects with hypertension and 17 (12.7%) subjects with diabetes. Approximately 75 (55.9%) subjects developed medical illness after admission. In conclusion, long-stay psychiatric patients are at a high risk of developing medical problems that tends to begin after admission to the psychiatric institution.
Study site: Hospital Bahagia, Ulu Kinta, Perak, Malaysia
Alot has been said and debated about evidence-based clinical practice. What is it really and why so much of significance is attached to it? Is all the evidence from clinical trials relevant and reliable? How about experience-based clinical practice? How much of our practice is influenced by clinical data and how much of it by years of practice and number of patients managed? The clinician will still need to exercise common sense when treating patients and they must always remember that each individual patient is unique and a clinician’s approach will have to be catered to their needs. After all, the caveat is that we are treating individuals with feelings and emotions and not textbooks or journal articles.
The problem of illicit drug use has been a long standing problem in Malaysia. It is well recognized that drug mis-use is associated with many social, economic and health problems, including mental health problems. Anxiety disorders have consistently been cited as the commonest type of psychiatric disorder in drug users. In Malaysia, many drug users are incarcerated in rehabilitation centres and prison. They form a different type of population as compared to the drug user in the general population, due to the effects of incarceration. With this in mind, a study was carried out in a rehabilitation centre, looking at anxiety disorders. Utilizing the SCID, we found current and lifetime diagnoses for anxiety disorders at 63.4% and 67.6% respectively. Suggestions are made in regards to our findings.
It has been long known that affective disorders as a result of organic brain diseases are not uncommon. Neurological disorders seem to be significant as risk factors for newly diagnosed mania in the elderly. It has been theorized that lesions in the right cerebral hemisphere and limbic structures may produce symptoms suggestive of mania. Even though specific areas of involvement had not been determined, this case discussed below clearly reports a right sided lesion. One of the reasons why not much is known yet about this clinical entity is the rarity of this occurrence. In fact, in one large scale study, only 2 patients out of 700 were identified with mania.
Objective: This systematic review is aimed to quantitatively summarise the
prevalence of sexual dysfunction among non-SSRI second generation
antidepressants namely agomelatine, bupropion, duloxetine, venlafaxine, and
mirtazapine.
Methods: Relevant studies published from inception till
December 2012 were identified by searching PubMed, OVID and Embase.
We included all literatures encompassing randomized controlled, cohort,
case-controlled and cross-sectional studies, which contained quantitative data
for prevalence on all aspects of sexual dysfunction in depressive patients who
were older than 18 years of age. Heterogeneity, publication bias and odds
ratio were assessed thoroughly.
Results: In the non-SSRI second generation
antidepressant group which consisted of 17,316 subjects, various studies
showed the range of sexual dysfunction prevalence between 0% and 67%.
Sexual dysfunction in patients who took non-SSRI second generation
antidepressants constituted a meta-analytical pooled prevalence of 15%, and
36% in those who took SSRIs. The combined relative risk of sexual
dysfunction in the non-SSRI second generation antidepressant group when
compared with SSRI was 0.57.
Conclusions: The pooled prevalence of sexual
dysfunction in non-SSRI second generation antidepressant is lower than in
SSRI antidepressants.
Objective: To study the prevalence of social anxiety problem and potential risk factors that may be associated with social anxiety among medical students. Methods: Social Phobia Inventory (SPIN) and a questionnaire assessing gender, religion, number of siblings, type of school and partner status were given to 167 final year medical students. Results: There were 101 respondents of which 56% of the medical students scored > 19 in the Social Phobia Inventory (SPIN) suggesting that they were having social anxiety problem. None of the variables analysed were significantly associated with social anxiety. Conclusion: More than half of the medical students have significant social anxiety symptoms. No specific variables were found to be significantly associated with those at risk of developing social anxiety disorder.