The vital importance of the mental health of a nation for the overall well being of the population and socioeconomic development is increasingly recognized. In Malaysia, psychiatric disorders were responsible for 8.6% of the total Disability Adjusted Life Years and were ranked fourth as the leading cause of burden of disease by disease categories. More and more evidence shows that physical illnesses are strongly associated with psychiatric disorders. Those with physical illnesses have much higher risk of developing psychiatric disorders compared to that without. The mechanisms of co-morbidity of psychiatric and physical illness are complex. It is a two-way interaction and there are five different possible ways to describe this.
Distress has become a major issue in cancer population. Patients may suffer from either physical,psychological distress or both. Cancer patients who are undergoing chemotherapy are more likely to experience psychological distress. This could be due to the negative effects of chemotherapy agents, the uncertainty of post-treatment, and the occurrence of psychosocial problems. As a result, the patient may experience a normal reaction such as sadness or may develop common psychiatric disorders such as depression and anxiety.
We report a 35 year-old Iranian female who presented with a sudden onset of left sided hemiparesis associated with temporary loss of consciousness of about 3 minutes. Neurological examination revealed a power of 0/5 over the left upper/lower limbs but reflexes were normal and plantar reflex was downgoing and equivocal. A computed tomography scan was done and it revealed mild bilateral frontal atrophy and a temporal arachnoid cyst which was decidedly an incidental finding and it did not have any relation to the clinical presentation. Electroencephalogram and other laboratory findings were all normal. When the psychiatric team interviewed her, it was revealed that the patient had recently experienced a major stressful event just prior to the hemiparesis. On further interview, the patient had complained of delusions of persecution, delusions of reference and also auditory hallucinations for approximately a year prior to admission. There have been only a spatter of reports of conversion symptoms seen in patients with schizophrenia and this is such a case.
Pathological laughing or crying (PLC) were recognized after the occurrence of stroke, with a prevalence of 15% to 18%. There is no apparent triggering stimulus, and is often misdiagnosed as a mood disorder as it is a disorder of emotional expression rather than a primary disturbance of feeling. We reported a case of a 32 year old lady, who presented with giddiness and altered consciousness progressing to fever and neck stiffness, who’s CT showed a massive left cerebellar infarct. No risk factors were identified. Psychiatrically, she developed sudden crying spells after one month and a diagnosis of Major Depressive Disorder was made with subsequent commencement of anti-depressants. A week later, she developed continuous inappropriate laughter without the feeling of elation, which was beyond her control. There were no symptoms of mania or psychosis.
The functional behavior of the thyroid is fundamental in most diseases and represents the basis for diagnosis and therapy. The status can be euthyroidism, hypothyroidism or hyperthyroidism. The psychiatric manifestation varies in different thyroid status. Those with hypothyroidism were described to have depression, psychosis and cognitive dysfunction. Meanwhile, those with hyperthyroidism were found to have psychosis, aggression, anxiety as well as cognitive impairment.
Objective: The aim of this study is to translate the original English version of List of Threatening Experiences (LTE) into Malay and to test the reliability on a group of medical students. Method: The LTE was translated into Malay and back-translated. The Malay LTE (LTE-M) was then tested on a total of 237 medical students. They were given LTE-M, General Health Questionnaire (GHQ), Beck Depression Inventory (BDI) and English version of LTE. A week later, these students were again given the LTE-M. Results: The parallel and test-retest reliability were satisfactory for 7 out of the 12 event categories (Kappa=0.67- 0.88). However 3 event categories were not reported. There was no statistical significant difference in the BDI and GHQ scores between the students with and without threatening experiences. Conclusion: The parallel and test-retest reliability of the LTE-M were acceptable. An association between the threatening experiences and increased disorders was not established.
Recent innovations in the treatment of schizophrenia reflect a growing trend towards community-based care. Malaysia had in the past few years attempted to deinstitutionalise mental patients in the mental hospitals. Therefore it is important to conduct research to compare the two groups of schizophrenia patients (community-based patients against chronic hospitalised patients) to ascertain if deinstitutionalisation has been beneficial. The main objective of the study was to compare levels of depression and function in community-based patients against chronic hospitalised patients as depression is prevalent among schizophrenia patients. This study was cross sectional in nature where data was collected from 51 inpatients in Hospital Bahagia Ulu Kinta (HBUK) and 23 community-based patients. Calgary Depression Scale for Schizophrenia (CDSS) and Global Assessment of Functioning scale (GAF) were the assessment tools used. Community-based patients were found to have significantly lower scores in the CDSS scale (1.96) as compared to chronic hospitalised patients (4.04); p < 0.01). They also showed higher functional capability between community-based and hospitalised patients respectively (74.04 vs 57.92) respectively. (p < 0.001). Community services appeared to be more effective than long stay in-patient services in preventing depression and promoting better functional levels.
Background: Vertigo Symptom Scale (VSS) by Yardley et al. (1992) is one of the disease specific
questionnaires used widely in clinical settings. It is conducted in English and had been translated into six languages including Dutch, French, German, Spanish, Swedish, and Turkish. It has been acknowledged as a good subjective tool to determine the severity of balance disorders. Objective: To develop a valid Malay version of VSS (MVVSS) using appropriate translation methods and validation technique. Method: Forward and backward translation was performed by four professionals from different fields. The translated questionnaire was then assessed for its test reliability based on an experiment on 30 normal subjects. Further, to determine the cultural adaptation issues, the face validity of MVVSS was assessed from 32 normal subjects. They were asked to fill in the MVVSS questionnaire accordingly and give opinions regarding its language, understanding and overall format of questionnaire. Results: Final results of the translation process showed sufficient concurrence among the professionals involved. The reliability test among the normal subjects also showed a high Cronbach’s alpha value (0.90). The face validity method on 32 subjects (mean age of 29.9 ± 9.2 years) showed good feedbacks in terms of language, understanding and overall format of the MVVSS. Conclusion: The translation process was successful and the further validation showed an adequate face validity response. This suggests that our MVVSS has been culturally adapted and can be used in all Malay conversing patients.
INTRODUCTION: The aim of this article was to review the types of psychological interventions for patients with tinnitus, professionals involved in giving the intervention, the effectiveness of each method of interventions and comparisons with non-psychological approaches in treating tinnitus.
MATERIALS AND METHODS: PubMed database searched.
RESULTS: Twenty one articles that employed randomized controlled trials design were included. Cognitive behavioural therapy (CBT) was the most common intervention conducted by the researchers. Clinical psychologists and trainee psychologists were the most professionals involved in the therapy. The length of therapy ranged from six weeks to three months.
DISCUSSION: Psychological interventions were more effective in reducing psychological impacts of tinnitus than non-psychological interventions such as the use of tinnitus maskers. Nevertheless, the combination of the treatments yielded more superior outcomes.
CONCLUSION: A simplified version of psychological intervention that can be implemented by other clinical professionals should be developed to treat tinnitus holistically to overcome the shortage number of clinical psychologists.