HIV-associated neurocognitive disorder incurs a significant burden on HIV patients in Asia-Pacific countries; however, the incidence is difficult to estimate due to a lack of local epidemiological data. The impact of neurocognitive impairment in HIV patients is often underestimated due to a lack of education and awareness, and there are consequently gaps in the provision of screening and diagnosis to enable earlier intervention to limit neurocognitive impairment.
Studies addressing the nature of relationship between psychological symptoms and quality of life among dialysis patients in Malaysia are scarce. Hence, this study is intended to investigate the association between psychological symptoms such as depression, anxiety and stress on the quality of life in dialysis patients. A cross sectional multicentre study was conducted from May to October 2012 at 15 centres that provide haemodialysis and/or peritoneal dialysis. Apart from socio-demographic profile data collection, WHOQOL-BREF and DASS21 questionnaires were administered to study subjects. All three psychological symptoms had significant impact on quality of life domains of physical health, psychological health, social impact, perceived environment and overall quality of life. These findings suggest that subjects with symptoms of depression, anxiety and stress had poorer quality of life than those without, highlighting the negative impact of psychological symptoms.
A recent article in this journal (Razali et al., 2015) reports the results of a 2-stage study screening for psychosis risk in Malaysia. The researchers incorporated both selective and indicated prevention strategies and included self-report items probing non-specific "early" experiences as well as attenuated psychotic symptoms associated with the prodromal phase of schizophrenia. Given that increased stigma and reduced services may reduce help-seeking in many Asian countries, population screening may be more important to early detection of individuals at risk for psychosis. In fact, the availability of large population centers and greater trust of providers may make Asian research centers uniquely suited for conducting badly needed research on screening strategies and the role of cultural factors in the emergence of psychosis.
The aim of the study is to screen and evaluate the efficacy of the screening tools in detecting subjects with sub-threshold psychosis among asymptomatic individuals at genetic risk, as compared with persons in the general public.
Cambodia had suffered enormously due to war and internecine conflict during the latter half of the twentieth century, more so during the Vietnam War. Total collapse of education and health systems during the Pol Pot era continues to be a challenge for developing the necessary infrastructure and human resources to provide basic minimum mental health care which is compounded by the prevailing cultural belief and stigma over mental, neurological and substance abuse disorders (MNSDs). The mental health research and services in Cambodia had been predominantly 'trauma focused', a legacy of war, and there is a need to move toward epidemiologically sound public health oriented mental health policy and service development. Integrating mental health program with primary health care services with specifically stated minimum package of activities at primary level and complementary package of activities at secondary level is an opportunity to meet the needs and rights of persons with mental, neurological and substance abuse disorders (PWMNSDs) in Cambodia, provided there is mental health leadership, government commitment and political will.
The study compared knowledge and beliefs about depression among urban and rural Chinese in a Malaysian sample. A total of 409 participants were asked to identify cases of depression varying in intensity from two vignettes and rate their beliefs regarding a list of possible causes and treatments for depression. The urban Chinese were more likely to identify depression as the problem in the vignette. Beliefs about causes of depression were factored into five components, whereas beliefs about treatment for depression factored into four components. The results indicated that the causes most strongly endorsed were stress and pressure, and standard treatments rated the highest as treatments for depression. Overall, depression literacy was moderate for Chinese Malaysians. The results are discussed in relation to Chinese cultural beliefs about depression. Limitations of this preliminary study were acknowledged.
Distress thermometer (DT) is a single-item measure generated to assess the psychological distress among cancer patients. The aim of this study was to validate the translated DT as a tool to determine the psychological distress level and assess the factors associated with distress among the working breast cancer survivors and also to compare with the Hospital Anxiety and Depression Scale (HADS).
Depression and insomnia are common psychiatric disorders among elderly people and reported to be related to several social and health factors. However, their occurrences in relation to food intake have rarely been investigated. Therefore, this study was to identify determinants of depression and insomnia, with emphasised on food intake among 71 elderly people residing in a government funded institution in Malaysia. An interview based questionnaire was used to obtain information on socio-demography, health and functional status, depression, insomnia and food intake. A total of 71.8% subjects had depression and 53% had insomnia. Subjects who had insomnia [Adjusted Odds Ratio (AOR) 19.55, 95% CI=4.04-94.64], needed help/unable to perform >4 items of IADL (AOR=16.65, 95% CI=3.95-70.22), had hypertension (AOR=7.66, 95% CI=1.37-42.76), had >50% wastage of poultry or fish (AOR=3.66, 95% CI=1.06-12.60) and wastage of vegetables (AOR 3.31, 95% CI=1.03-10.60) were more likely to have depression. Subjects who had depression (AOR 19.55, 95% CI=4.04-94.64), needed help/unable to perform >4 items of IADL (AOR 2.97, 95% CI=1.12-7.84), needed help/unable to handle financial matters (AOR 5.01, 95% CI=1.37-18.27) and had >50% wastage of vegetables (AOR 3.91, 95% CI=1.42-10.82) were at a higher risk to develop insomnia. Depression and insomnia affected more than half of the subjects, interrelated, and associated with functional inability, socioeconomic factor and high food wastage of specific foods.
The aim of this study was to identify predictors of response to treatment for depression in Malaysia, using demographic and cognitive predictors. 113 patients, that were diagnosed with depression, were randomly assigned to the Treatment-As-Usual (TAU) (n=55), or TAU plus eight sessions of Group Cognitive Behaviour Therapy (TAU+GCBT; n=58). Pre-treatment using the Beck Hopelessness Scale (BHS), the Automatic Thoughts Questionnaire-Malay (ATQ-Malay), the Dysfunctional Attitude Scale-Malay (DAS-Malay), a quality of life scale, and demographic characteristics, were used in a series of multiple regression models, as potential predictors of the Beck Depression Inventory-Malay (BDI-Malay) post-assessment scores. Regression results revealed that age, the quality of life scale, and all three cognitive measures were significant predictors of outcomes in the Group Cognitive Behaviour Therapy (GCBT) group, showing that Beck's cognitive model for depression could be applied in Malaysia.
OBJECTIVE: The aim of this study was to validate the Malay version of the Multidimensional Scale of Perceived Social Support (MSPSS-M) among a group of medical students in Faculty of Medicine, University Malaya.
METHODS: 237 students participated in the study. They were given the Malay version of MSPSS, medical outcome study (MOS) social support survey, Malay version of General Health Questionnaire (GHQ), Malay version of Beck Depression Inventory (BDI) and English version of MSPSS. A week later, these students were again given the Malay version of MSPSS.
RESULTS: The instrument displayed good internal consistency (Cronbach's alpha=0.89), parallel form reliability (0.94) and test-retest reliability (0.77) (Spearman's rho, p<0.01). The negative correlation of the total and subscales of the instrument with the Malay version of GHQ and BDI confirmed its validity. Extraction method of the 12 items MSPSS using principle axis factoring with direct oblimin rotation converged into three factors of perceived social support (Family, Friends and Significant Others) with reliability coefficients of 0.88, 0.82 and 0.94, respectively.
CONCLUSION: The Malay version of the MSPSS demonstrated good psychometric properties in measuring social support among a group of medical students from Faculty of Medicine, University Malaya and it could be used as a simple instrument on young educated Malaysian adolescents.
Cambodia is a developing south-east Asian country located in the fertile Mekong delta. Its recent past has been complicated by European colonialism and internal conflict. Health including mental health services are limited and sparse in regional and rural areas. Very constrained public mental health facilities and services are hampered by a shortage of a skilled workforce and insufficient training programs. The recent formation of the Mental Health Association of Cambodia promises to be a positive step forward in promoting mental health throughout the country.
Depression is usually associated with changes in the endogenous hormonal system. The most important hormonal modifications are elevation of the serum cortisol level as well as the reduction of endogenous sex hormone levels. These changes have advanced side effects on a bone metabolism and bone remodelling process, which consequently, lead to the declining in bone mineral density and increase the risk of bone fractures, which is reported by current studies.
The aim of this study was to investigate the factor structure of the Malay version of the Dysfunctional Attitude Scale (DAS-Malay) in clinical and nonclinical populations. The DAS is a self-report inventory derived from Beck's cognitive theory of depression to measure beliefs constituting a predisposition to depression. The 40-item DAS-Malay was completed by 315 university students, 495 members of the general community, 167 medical patients, and 113 patients diagnosed with major depressive disorder. Through principal axis factoring, with varimax rotation, two factors were extracted; performance evaluation and self-control. Correlation with depression and other variables indicated that the DAS-Malay held good concurrent validity. In addition, sensitivity and specificity of the total scores of the DAS were evident in this study. The results showed that the DAS-Malay possesses satisfactory psychometric properties suggesting that this instrument is appropriate for use as a cognitive measure in a Malay cultural context although several issues require consideration.
Background: Psychoeducation has shown promising benefits in managing patients with schizophrenia. In Malaysia, the use of psychoeducation is rather limited and its impact indeterminate.
Aims: To assess the effectiveness of a structured psychoeducation programme for the community in improving caregiver knowledge, decreasing caregivers’ burden, reducing patients’ readmission and defaulter follow up rates.
Method: In a controlled interventional study, 109 caregivers were included, 54 and 55 in the intervention and control groups respectively. Caregivers were assessed at baseline, 3 and 6 months post-intervention for knowledge and burden. Patients were monitored for relapse and defaulting follow up in the clinic.
Results: Caregivers in the intervention group showed significant improvement in knowledge, reduction in burden in assistance in daily living (severity) and a reduced defaulter rate was seen in the patients’ follow up.
Conclusion: The findings shows that structured psychoeducation programme among caregivers has the potential to improve outcome of care for patients with schizophrenia.
Keywords: Schizophrenia; Psychoeducation; Community; Caregiver Questionnaire: Family Burden Interview Schedule–Short Form (FBIS/SF)
Free radicals are produced as part of the body immune response triggered by exogenous oxidants. In excess, they impair antioxidant defence system and cause oxidative stress. Antioxidants are hypothesised as antidotes to counteract oxidative stress and improve immune function. Carotenoids serve as a reliable indicator of overall antioxidant level in humans. This study investigated the possible relationship of carotenoid antioxidant levels in schizophrenia. A total of 351 schizophrenic subjects from Hospital Bahagia Ulu Kinta, Malaysia and 247 healthy controls were recruited. Subjects' skin carotenoid levels were measured using a non-invasive technique, Raman spectroscopy. The results showed significant (P<0.01) reduction of carotenoid level in patient compared to healthy controls, suggesting higher levels of oxidative stress in schizophrenia. Comparison between gender, age, subtypes, antipsychotic drug treatments, and duration of illness was investigated, but none was significantly associated with carotenoid score. Antipsychotics were suggested to be the possible causes of reduced antioxidant level in schizophrenia.
The Neuropsychiatry Unit Cognitive Screening Instrument (NUCOG) provides more detailed screening of cognition than most commonly available tools and was selected for translation into and validation in Bahasa Malaysia (Malay language). It was first translated to Malay, then back-translated to English until changes made were comparable to the original English version. The Malay-translated NUCOG and the Malay version of the Mini-Mental State Examination (MMSE) were delivered to Malay-speaking subjects (n=24). The Malay NUCOG version was then validated by correlating scores against the Malay version of the MMSE and the data tested for reliability of the tool. The Malay version of the NUCOG proved to be a valid (r=0.98, p<0.001) and internally consistent (Cronbach's α=0.76) tool to assess cognitive function and this multi-dimensional cognitive screening instrument is likely to be valuable in the cognitive assessment of neuropsychiatric patients in Malay.