Dissociative identity disorder (DID) previously known as multiple personality disorder is associated with depression and traumatic childhood which can be either physically or sexually abuse. It is hard to establish diagnosis of DID because of the complexity and controversies that surrounding it. We report a case of a young man who has DID and Major Depressive Disorder in the background of traumatic childhood experience who was recently admitted to our inpatient psychiatric unit and demonstrated transitions to other distinct personality state.
Huntington disease (HD) is a neurodegenerative disorder with psychiatric, cognitive, and motor symptoms. Psychiatric symptoms often manifest years before neurologic signs in HD patients. The present of psychiatric symptoms might increase risk of suicide in HD patient. We presented a case of HD who admitted to Psychiatry ward due to suicidal attempt and shows improvement with low dose of Olanzapine.
The escalating problem of opiate dependence in Malaysia and the limitations of regimental approach of forced admission to rehabilitation centres had triggered the government to expand the methadone maintenance therapy to become a national programme. This study aimed to evaluate the short-term outcomes of the Methadone Maintenance Therapy programme in one of the busiest hospital in east coast Malaysia. We also explored the prevalence on non-compliance and factors associated to it. A total of 172 patient case notes at Methadone Clinic Hospital Tengku Ampuan Afzan (HTAA) were retrieved for relevant data. A short survey was also conducted to determine the subjects' current employment and marital status. The programme's retention rate was 62% and factors associated with poor compliance were unemployment, low quality of life scores and low dose of methadone. A special attention on the patients with these three risk factors may improve their compliance to MMT. The short-term evaluation of MMT at HTAA revealed favourable findings.
Study site: Psychiatric clinic, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
BACKGROUND: High prevalence of high-risk behaviours and concurrent medical illnesses among opioid drug users would influence the outcome of Methadone Maintenance Programme. It would also require a special medical attention to contain these issues.
OBJECTIVES: This study explored patients' characteristics and their high-risk behaviours in order to understand more about opioid dependent users in Malaysia.
METHODS: A total of 172 patient case notes at Methadone Clinic Hospital Tengku Ampuan Afzan (HTAA) were retrieved for relevant data.
RESULTS: Many of the patients were engaged in high-risk behaviours such as needle sharing, unsafe sex and criminal activities. A large number of the subjects had contracted blood-borne diseases such as HIV and hepatitis infections.
CONCLUSIONS: Education on the issue of medical and psychosocial complications related to high risk behaviours is essential. Medical professionals dealing with this group have to pay attention and update their knowledge on the medical issue.
KEYWORDS: Methadone therapy; high-risk behaviours; opioid dependence
Study site: Methadone clinic, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
OBJECTIVE: The purposes of this study were to investigate the documentation of the DSM-IV-TR- Criteria A in diagnoses of schizophrenia and to identify the symptoms associated with over diagnosis of schizophrenia.
METHOD: This study involved a retrospective review and analysis of data from case notes.
RESULTS: Data of 107 newly diagnosed patients with schizophrenia were keyed in and analyzed using SPSS v 19. The cases were then evaluated for the use of the DSM-IV-TR- Criteria A. Over diagnosis was noted in 37.39% of the patients. Disorganised behaviour (12.5%), affective flattening (12.5%), hallucination (16%) and non-bizarre delusion (18.3%) significantly contributed to the over-diagnosis of schizophrenia. Symptoms such as non-bizarre delusion and hallucination were the most commonly used in over-diagnosing schizophrenia and were statistically significant with p ≤0.05.
CONCLUSIONS: There was a significant lack of DSM-IV-TR Criteria A among the data documented to diagnose schizophrenia and non-bizarre delusion and hallucination were the most commonly used in over-diagnosing schizophrenia. This key problem needs to be addressed. The reliability of a diagnosis is indispensable and achievable with the proper clinical application of DSM-IV-TR Criteria A. The DSM-IV-TR Criteria have been perceived to be useful and reliable and is most widely used throughout the world.