Displaying publications 1 - 20 of 42 in total

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  1. Guan NC, Ann AY
    PMID: 23082572
    We studied the use of exhaled carbon monoxide (CO) to identify nicotine dependence among adult Malaysian male smokers. We conducted a cross-sectional study among 107 male smoking staff at a university hospital. We measured their exhaled CO using a piCO+ Smokerlyzer and diagnosed nicotine dependence using a Mini-International Neuropsychiatric Interview (MINI). The optimal cut-off value for exhaled CO was determined. The correlation between exhaled CO level and the Fagerstrom Test for Nicotine Dependence (FTND) was also assessed. The mean exhaled CO level among subjects with nicotine dependence (15.78 ppm) was significantly higher than subjects without nicotine dependence (9.62 ppm). The cut-off value used to identify smokers with nicotine dependence was set at 10 ppm (specificity = 0.721, sensitivity = 0.731, positive predictive value = 0.817 and negative predictive value = 0.617). Psychometric properties were stable with various durations of smoking. Exhaled CO correlated positively with FTND scores (Pearson's rho = 0.398, p = 0.01). Our findings show exhaled CO can be used to identify nicotine dependence among adult Malaysian male smokers.
  2. Tan CH, Abd Rashid R, Guan NC
    Malays J Med Sci, 2020 Jul;27(4):51-63.
    PMID: 32863745 MyJurnal DOI: 10.21315/mjms2020.27.4.5
    BACKGROUND: Amphetamine-type stimulant (ATS) use brings severe adverse effects to the mental well-being of an individual and it is an essential contributor to the global disease burden. Meanwhile, religiosity and religious coping might improve one's conduct, physical and mental well-being. Hence, this study aims to determine the prevalence of anxiety and depression in ATS user and their association with religiosity and religious coping.

    METHODS: It is a cross-sectional study conducted at the Department of Psychological Medicine, Universiti Malaya Medical Centre, Malaysia. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression among ATS users. Religiosity and religious coping were measured with Duke University Religious Index and Brief RCOPE.

    RESULTS: This study involved 215 ATS users. Almost half of the ATS users had either anxiety (n = 96; 44.6%) or depression (n = 108; 50.2%), which were associated with polysubstance use or having an existing psychiatric disorder. Subjects with higher religiosity and positive religious coping were less anxious or depressed. However, negative religious coping was significantly associated with anxiety and depression in ATS users.

    CONCLUSION: Anxiety and depression are prevalent in ATS users. Integrating religiosity and religious coping into the ATS users' treatment plan helps to improve their mental well-being.

  3. Beng TS, Guan NC, Jane LE, Chin LE
    Am J Hosp Palliat Care, 2014 May;31(3):307-14.
    PMID: 23689367 DOI: 10.1177/1049909113490065
    A secondary analysis of 2 qualitative studies was conducted to explore the experiences of suffering caused by interactions with health care providers in the hospital setting. Interview transcripts from 20 palliative care patients and 15 palliative care informal caregivers in University Malaya Medical Centre were thematically analyzed. The results of health care interactional suffering were associated with themes of attention, understanding, communication, competence, and limitation. These 5 themes may serve as a framework for the improvement in interaction skills of health care providers in palliative care.
  4. Sidi H, Asmidar D, Hod R, Guan NC
    J Sex Med, 2012 May;9(5):1392-9.
    PMID: 21477024 DOI: 10.1111/j.1743-6109.2011.02256.x
    Selective serotonin reuptake inhibitor is one of the most widely used antidepressant and commonly associated with female sexual dysfunction (FSD).
  5. Guan NC, Seng LH, Hway Ann AY, Hui KO
    Asia Pac J Public Health, 2015 Mar;27(2):225-31.
    PMID: 23449622 DOI: 10.1177/1010539513477684
    This study was aimed at validating the simplified Chinese version of the Multidimensional Scale of Perceived Support (MSPSS-SCV) among a group of medical and dental students in University Malaya. Two hundred and two students who took part in this study were given the MSPSS-SCV, the Medical Outcome Study social support survey, the Malay version of the Beck Depression Inventory, the Malay version of the General Health Questionnaire, and the English version of the MSPSS. After 1 week, these students were again required to complete the MSPSS-SCV but with the item sequences shuffled. This scale displayed excellent internal consistency (Cronbach's α = .924), high test-retest reliability (.71), parallel form reliability (.92; Spearman's ρ, P < .01), and validity. In conclusion, the MSPSS-SCV demonstrated sound psychometric properties in measuring social support among a group of medical and dental students. It could therefore be used as a simple screening tool among young educated Malaysian adolescents.
  6. Guan NC, Beng TS, Sue-Yin L, Kanagasundram S
    Indian J Palliat Care, 2021 02 17;27(1):83-88.
    PMID: 34035622 DOI: 10.4103/IJPC.IJPC_122_20
    Context: While pain is a common complaint among palliative cancer patients, there is little research looking into nonpharmacological methods for the reduction of pain in the palliative setting.

    Aim: This study aims to study the efficacy of 5-min mindful breathing for rapid reduction of pain in a palliative care setting.

    Methods: This is a sub-analysis of the previous randomized controlled study on distress reduction. Sixty patients were recruited and randomly assigned to either the intervention (5-min mindful breathing) or the control (5-min normal listening) group. Participants reported their pain on a 10-item analog scale at baseline, immediately after intervention and 10 min postintervention. Changes in pain scores were further analyzed.

    Results: Pain scores decreased for both the intervention and control groups. However, the reduction of pain did not reach statistical difference in both groups (P > 0.05).

    Conclusion: Five-minute mindful breathing is a quick and easy to administer therapy but does not have significant effects in terms of pain reduction in palliative settings. Future research and directions are nonetheless suggested and encouraged to look for short-term mindfulness-based therapies on pain reduction for this population.

  7. Andrew BN, Guan NC, Jaafar NRN
    Curr Drug Targets, 2018;19(8):877-887.
    PMID: 28322161 DOI: 10.2174/1389450118666170317162603
    BACKGROUND: One of the goals of cancer treatment is symptoms management especially at the end stage. The common symptoms in cancer include pain, fatigue, depression and cognitive dysfunction. The available treatment options for symptom management are limited. Methylphenidate, a psychostimulant, may be of benefit for these patients. In this report, we review the use of methylphenidate for symptoms control in cancer patients.

    METHOD: Electronic literature search on PubMed was conducted using the following keywords: methylphenidate, cancer, carcinoma, oncology, oncological and tumour. We identified forty two relevant studies and publications on the use of methylphenidate in cancer patients to be included in this review.

    RESULTS: Methylphenidate was found to have some evidence in reducing opioid-induced sedation, improving cognitive symptoms and reduction of fatigue in cancer patients. Nevertheless, the results were inconsistent due to variations in the study populations, study design and outcome measures, among others. There was minimal evidence on its use in treating depression. Otherwise, methylphenidate was generally well-tolerated by patients.

    CONCLUSION: This review potentially supports the use of methylphenidate for opioid-induced sedation, cognitive decline and fatigue in cancer patients. Further placebo-controlled trials would help in strengthening the evidence for this treatment.

  8. Chow MISP, Hashim AH, Guan NC
    Int J Soc Psychiatry, 2021 Jun;67(4):376-385.
    PMID: 32924726 DOI: 10.1177/0020764020957362
    BACKGROUND: Until now, there is scarcity of information regarding resilience, religiosity and religious coping among adolescent refugees. Currently, most researches emphasize on the physical, psychological and social distresses experienced by refugees while overlooking these crucial aspects, that is, resilience and coping.

    AIM: The study aimed to examine resilience and its association with religiosity and religious coping among adolescent refugees living in Malaysia.

    METHODS: This is a cross-sectional study conducted in five community-based learning centres in Malaysia from July 2019 till December 2019. A total of 152 refugees, aged 13 to 19-years-old, were recruited. The study gauged resilience using the 14-Item Resilience Scale (RS-14), the Duke University Religion Index (DUREL) for religiosity and the Brief Religious Coping Scale (Brief RCOPE) for religious coping.

    RESULTS: The majority of adolescent refugees portrayed moderate levels of resilience (43.5%). The study highlighted the interconnectedness between resilience and intrinsic religiosity (IR) (p 

  9. Zulkifli NA, Guan NC, Zainal NZ, Ling TS
    Alpha Psychiatry, 2021 Jul;22(4):185-193.
    PMID: 36424937 DOI: 10.5152/alphapsychiatry.2021.21107
    OBJECTIVE: Long-term social distancing, isolation, and economic fallout may be significant psychological triggers during pandemic, such as COVID-19, especially for those with underlying psychiatric illness. This study was conducted to address the psychological impact of COVID-19 pandemic among patients with depression based at a teaching hospital in Malaysia.

    METHODS: This is a cross-sectional online study among patients with depression from University Malaya Medical Centre, using Generalized Anxiety Disorder-7 (GAD-7), Montgomery-Åsberg Depression Rating Scale-Self Assessment (MADRS-S), Insomnia Severity Index (ISI), Multidimensional Scale of Perceived Social Support (MSPSS), Knowledge, Attitudes, and Practices (KAP), and Social Media Addiction during COVID-19 Pandemic (SMACOP).

    RESULTS: One hundred seventy-eight patients participated in this study. The mean total of the KAP score is 12.65 (SD = 2.65), with knowledge section (mean = 7.34 [SD = 2.13]), attitudes section (mean = 2.63 [SD = 0.58]), and practices section (mean = 2.69 [SD = 1.00]). They scored moderately on the MADRS-S (mean = 21.03 [SD = 4.62]) and ISI (mean = 20.25 [SD = 4.62]) but had high GAD-7 scores (mean = 16.8 (SD = 6.27]). From the multiple logistic regression analyses, depressive symptoms of greater severity (MADRS-S 18-34) are significantly associated with more severe insomnia (P < .001, adjusted OR = 9.101, 95% CI: 3.613-22.924). Furthermore, the high anxiety level is associated with the younger age group (P = .029, Adjusted OR = 2.274, 95% CI: 1.090-4.746), greater severity of insomnia (P < .001, Adjusted OR = 22.9, 95% CI: 6.145-85.343), and higher risk of COVID-19 related social media addiction (P = .011, adjusted OR = 2.637, 95% CI: 1.253-5.550).

    CONCLUSION: This study demonstrates the high levels of sleep disturbances and anxiety symptoms experienced by outpatients with depression during the COVID-19 pandemic. These are closely linked to the younger age group and at-risk social media addiction related to COVID-19.

  10. Beng TS, Chin LE, Guan NC, Yee A, Wu C, Jane LE, et al.
    Am J Hosp Palliat Care, 2015 Mar;32(2):144-60.
    PMID: 24142593 DOI: 10.1177/1049909113508640
    To develop a mindfulness-based palliative psychotherapy to address psychoexistential suffering in palliative care.
  11. Midi M, Kanagasundram S, Sidi H, Asmidar D, Naing L, Guan NC
    Int J Psychiatry Med, 2012;43(4):405-18.
    PMID: 23094470
    To compare the risk of sexual arousal difficulties between two groups of depressed female patients in remission who were treated with either escitalopram or fluoxetine. Associated factors were also examined.
  12. Sulaiman AH, Gill JS, Said MA, Zainal NZ, Hussein HM, Guan NC
    Int J Psychiatry Clin Pract, 2013 Jun;17(2):131-8.
    PMID: 22486597 DOI: 10.3109/13651501.2012.667116
    The objectives of this study were to determine the efficacy and safety of aripiprazole for treatment of psychosis, retention and abstinence in patients with methamphetamine dependence.
  13. Guan NC, Isa SM, Hashim AH, Pillai SK, Harbajan Singh MK
    Asia Pac J Public Health, 2015 Mar;27(2):NP2210-9.
    PMID: 22652253 DOI: 10.1177/1010539512447808
    The use of the Internet has been increasing dramatically over the decade in Malaysia. Excessive usage of the Internet has lead to a phenomenon called Internet addiction. There is a need for a reliable, valid, and simple-to-use scale to measure Internet addiction in the Malaysian population for clinical practice and research purposes. The aim of this study was to validate the Malay version of the Internet Addiction Test, using a sample of 162 medical students. The instrument displayed good internal consistency (Cronbach's α = .91), parallel reliability (intraclass coefficient = .88, P < .001), and concurrent validity with the Compulsive Internet Use Scale (Pearson's correlation = .84, P < .001). Receiver operating characteristic analysis showed that 43 was the optimal cutoff score to discriminate students with and without Internet dependence. Principal component analysis with varimax rotation identified a 5-factor model. The Malay version of the Internet Addiction Test appeared to be a valid instrument for assessing Internet addiction in Malaysian university students.
  14. Sidi H, Asmidar D, Hod R, Jaafar NR, Guan NC
    Int J Psychiatry Clin Pract, 2012 Mar;16(1):41-7.
    PMID: 22122658 DOI: 10.3109/13651501.2011.617457
    To determine the risk of hypoactive sexual desire (HSD) in depressed female patients treated with selective serotonin reuptake inhibitors, comparing escitalopram and fluoxetine. The associated factors were also examined.
  15. Sidi H, Asmidar D, Seng LH, Jaafar NR, Midi M, Guan NC
    Psychopharmacol Bull, 2016 Mar 1;46(1):24-35.
    PMID: 27738371
    OBJECTIVES: The current study compares the risk of sexual pain in depressed female patients in remission between those who were treated with Escitalopram and Fluoxetine. The associated factors were also examined.
    METHODS: This is a cross-sectional study involved 112 depressed female patients (56 treated with Escitalopram and 56 treated with Fluoxetine) who were in remission (as defined by Diagnostic and Statistical Manual-IV (DSM-IV) in the past 2 months and Montgomery-Asberg Depression Rating Scale (MADRS) score of ≤ 10) from the psychiatric clinic, University Kebangsaan Malaysia Medical Centre (UKMMC). They were interviewed using Structured Clinical Interview for DSM-IV (SCID). Hypoactive sexual desire was assessed using the Pain subscale of Malay Version of the Female Sexual Function Index (MVFSFI).
    RESULTS: The results show that risk of sexual pain was relatively low (16.07% for all patients), with no statistical significant between the two groups (17.86% for fluoxetine group, 14.29% for escitalopram group). Older age (adjusted odds ratio = 1.524, 95% CI = 1.199, 1.938) was the only factor significantly associated with sexual pain disorder.
    CONCLUSIONS: There should not be any barrier when continuing the use of escitalopram or fluoxetine as antidepressants amongst the female patients.
    KEYWORDS: depression; escitalopram; female; fluoxetine; sexual pain

    Study site: Psychiatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
  16. Choy CL, Sidi H, Koon CS, Ming OS, Mohamed IN, Guan NC, et al.
    J Sex Med, 2019 Jul;16(7):1029-1048.
    PMID: 31113742 DOI: 10.1016/j.jsxm.2019.04.007
    INTRODUCTION: Sexual dysfunction in hypertensive women is an often-neglected subject despite a reported prevalence of 42.1%. Although few reviews exist, a definitive relationship between hypertension and sexual dysfunction in women has not been clearly established.

    AIM: To review the existing literature to definitively examine sexual dysfunction in women with hypertension, in both treated and untreated subjects.

    METHODS: We performed a systematic search for published literature of 3 electronic databases (Scopus, EBSCOhost Medline Complete, and Cochrane Library) in August 2018. The search terms with relevant truncation and Boolean were developed according to a population exposure-comparator-outcome model combining pilot searches. The quality of included studies was assessed with the McMaster Critical Review Form for Quantitative Studies. Initial search, limited to the English language, included a total of 2,198 studies. 31 studies (18,260 subjects) met our inclusion criteria and were included in the review. Sexual dysfunction in these studies was measured using different tools. We extracted information of study setting, country, number of subjects, participants' age and blood pressure, comparators, and outcome. We ran a meta-analysis on the presence of sexual dysfunction as an outcome from the following comparisons: (i) hypertensive vs normotensive (ii) treated vs untreated hypertension, and (iii) exposure vs absence of specific class of anti-hypertensive drug.

    MAIN OUTCOME MEASURES: Women with sexual dysfunction and hypertension were included.

    RESULTS: We found significant sexual dysfunction in women with hypertension compared with the normotensive group (pooled odds ratio [OR] = 2.789, 95% CI = 1.452-5.357, P = .002). However, there was no statistical difference of sexual dysfunction in women with treated or untreated hypertension (OR = 1.229, 95% CI = 0.675-2.236, P = .5). Treatment with alpha-/beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers, and diuretics resulted in no statistical difference in sexual dysfunction in hypertensive women.

    CLINICAL IMPLICATIONS: Because sexual dysfunction is prevalent in women with hypertension, it is imperative to address the underlying medical condition to manage this important clinical problem.

    STRENGTH & LIMITATIONS: Many studies had to be excluded from the meta-analysis, due to unavailability and incompleteness of data. Nevertheless, results of the review are useful to derive recommendations for alerting physicians of the need to routinely assess the sexual functioning of women with hypertension.

    CONCLUSION: We conclude that women with hypertension are at increased risk for sexual dysfunction, and our findings imply that evaluation for sexual dysfunction needs to be part of the clinical management guidelines for women with hypertension. Choy CL, Sidi H, Koon CS, et al. Systematic Review and Meta-Analysis for Sexual Dysfunction in Women With Hypertension. J Sex Med 2019;16:1029-1048.

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