The characteristics of 74 patients who attempted suicide in Penang are described. Differences in the incidence and reasons for and methods of attempting were observed among the ethnic groups. There was a higher incidence in females and patients of single status. The majority of patients did not suffer from severe psychiatric disorders, but did encounter chronic inter-personal and intra-familial conflicts. Conflicts with elders were more frequent among female patients, and this finding suggested that young females were faced with a greater degree of role conflicts. Rural to urban shift among the Chinese patients was observed to be associated with a high incidence of attempts. Dwellers of high-rise flat complexes were not over-represented. In view of antecedent social factors, professionals and others besides psychiatrists have a role in the prevention and management of para-suicidal behaviours.
This paper describes the characteristics of Malay psychiatric inpatients, their attitudes towards hospitalisation and their practice of consulting traditional healers (bomohs). The behaviour patterns which prompted hospitalisation were: acute disorganised behaviour directed at the community, behaviour of a less acute nature distressing the family and life-threatening crises. The social interaction life styles of urban and rural Malays are discussed in relation to the differences observed between urban and rural hospitalised patients. When the traditional healers were consulted there was a delay before hospitalisation, but there was an awareness of the need for hospitalisation shown by a small number of the traditional healers. Some patients who had consulted the traditional healers had the tendency to continue the consultations after leaving the hospital, but this practice became less frequent after each discharge from hospital.
This study show that within a general hospital outpatient setting, the prescription of psychotropic medication is mainly confined to the anti-anxiety drugs and and secondarily to the hypnotics. There is a conspicuous absence of prescription for antipsychotic drugs and negligible use of antidepressants. The use of anti-anxiety drugs and hypnotics was higher in the general outpatient clinic than in the psychiatric outpatient clinic in the same hospital. This finding is in the trend of similar findings by others that non-psychiatrists prescribe more psychotropic medication including an-anxiety and hypnotic medication. In this study the use of psychotropic medication for patient generated psychiatric symptomalogy was only in 14.5% of cases prescribed these medication. The anti-anxiety drugs were prescribed as adjuncts in non-psychiatric conditions as well. Frequent use as adjuncts were in the treatment of muscular tension and in chronic cardiovascular disorders. There is a core of patients (20%) that had been continuously prescribed medication up to a period of 5 years. Half of these were chronic cardiovascular patients and half presented with no demonstrable systemic organicity. None had been referred to psychiatrist.
Study site: Outpatient clinic, general hospital, Malaysia