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Fulltext Psychiatric morbidity among adult patients in a semi-urban primary care setting in Malaysia

ZamZam R, Thambu M, Midin M, Omar K, Kaur P

Int J Ment Health Syst, 2009 Jun 18;3(1):13.
PMID: 19538711 DOI: 10.1186/1752-4458-3-13

BACKGROUND: Screening for psychiatric disorders in primary care can improve the detection rate and helps in preventing grave consequences of unrecognised and untreated psychiatric morbidity. This is relevant to the Malaysian setting where mental health care is now also being provided at primary care level. The aim of this paper is to report the prevalence of psychiatric illness in a semi-urban primary care setting in Malaysia using the screening tool Patient Health Questionnaire (PHQ).
METHODS: This is a cross-sectional study carried out in a semi-urban primary healthcare centre located south of Kuala Lumpur. Systematic random sampling was carried out and a total of 267 subjects completed the PHQ during the study period.
RESULTS: The proportion of respondents who had at least one PHQ positive diagnosis was 24.7% and some respondents had more than one diagnosis. Diagnoses included depressive illness (n = 38, 14.4%), somatoform disorder (n = 32, 12.2%), panic and anxiety disorders (n = 17, 6.5%), binge eating disorder (n = 9, 3.4%) and alcohol abuse (n = 6, 2.3%). Younger age (18 to 29 years) and having a history of stressors in the previous four weeks were found to be significantly associated (p = 0.036 and p = 0.044 respectively) with PHQ positive scores.
CONCLUSION: These findings are broadly similar to the findings of studies done in other countries and are a useful guide to the probable prevalence of psychiatric morbidity in primary care in other similar settings in Malaysia.
Fulltext Schizophrenia in Malaysian families: A study on factors associated with quality of life of primary family caregivers

ZamZam R, Midin M, Hooi LS, Yi EJ, Ahmad SN, Azman SF, et al.

Int J Ment Health Syst, 2011 Jun 08;5(1):16.
PMID: 21651770 DOI: 10.1186/1752-4458-5-16

BACKGROUND: Schizophrenia is a chronic illness which brings detrimental effects in the caregivers' health. This study was aimed at highlighting the socio-demographic, clinical and psychosocial factors associated with the subjective Quality of Life (QOL) of Malaysian of primary family caregivers of subjects with schizophrenia attending an urban tertiary care outpatient clinic in Malaysia.
METHODS: A cross-sectional study was performed to study patient, caregiver and illness factors associated with the QOL among 117 individuals involved with caregiving for schizophrenia patients. The study used WHOQOL-BREF to assess caregivers' QOL and Brief Psychiatric Rating Scale (BPRS) to assess the severity of patients' symptoms. Social Readjustment Rating Scale (SRRS) assessed the stress level due to life events.
RESULTS: The mean scores of WHOQOL-BREF in physical, psychological, social and environmental domains were 66.62 (14.36), 61.32 (15.52), 62.77 (17.33), 64.02 (14.86) consecutively. From multiple regression analysis, factors found to be significantly associated with higher QOL were higher educational level among caregivers in social and environmental domains; caregivers not having medical problem/s in physical and psychological domains; later onset and longer illness duration of illness in social domains; patients not attending day care program in environmental domain; lower BPRS score in physical and environmental domains. SRRS score of caregivers was also found to have a significant negative correlation with QOL in environmental and psychological domains. Other factors were not significantly associated with QOL.
CONCLUSION: Caregivers with more social advantages such as higher educational level and physically healthier and dealing with less severe illness had significantly higher QOL in various aspects. Supporting the caregivers in some of these modifiable factors in clinical practice is important to achieve their higher level QOL.
Fulltext Creation of consensus recommendations for collaborative practice in the Malaysian psychiatric system: a modified Delphi study

Shoesmith W, Chua SH, Giridharan B, Forman D, Fyfe S

Int J Ment Health Syst, 2020;14:45.
PMID: 32577126 DOI: 10.1186/s13033-020-00374-7

Background: There is strong evidence that collaborative practice in mental healthcare improves outcomes for patients. The concept of collaborative practice can include collaboration between healthcare workers of different professional backgrounds and collaboration with patients, families and communities. Most models of collaborative practice were developed in Western and high-income countries and are not easily translatable to settings which are culturally diverse and lower in resources. This project aimed to develop a set of recommendations to improve collaborative practice in Malaysia.
Methods: In the first phase, qualitative research was conducted to better understand collaboration in a psychiatric hospital (previously published). In the second phase a local hospital level committee from the same hospital was created to act on the qualitative research and create a set of recommendations to improve collaborative practice at the hospital for the hospital. Some of these recommendations were implemented, where feasible and the outcomes discussed. These recommendations were then sent to a nationwide Delphi panel. These committees consisted of healthcare staff of various professions, patients and carers.
Results: The Delphi panel reached consensus after three rounds. The recommendations include ways to improve collaborative problem solving and decision making in the hospital, ways to improve the autonomy and relatedness of patients, carers and staff and ways to improve the levels of resources (e.g. skills training in staff, allowing people with lived experience of mental disorder to contribute).
Conclusions: This study showed that the Delphi method is a feasible method of developing recommendations and guidelines in Malaysia and allowed a wider range of stakeholders to contribute than traditional methods of developing guidelines and recommendations.Trial registration Registered in the National Medical Research Register, Malaysia, NMRR-13-308-14792.
Fulltext Beyond the crisis: building back better mental health care in 10 emergency-affected areas using a longer-term perspective

Epping-Jordan JE, van Ommeren M, Ashour HN, Maramis A, Marini A, Mohanraj A, et al.

Int J Ment Health Syst, 2015;9:15.
PMID: 25904981 DOI: 10.1186/s13033-015-0007-9

BACKGROUND: Major gaps remain - especially in low- and middle-income countries - in the realization of comprehensive, community-based mental health care. One potentially important yet overlooked opportunity for accelerating mental health reform lies within emergency situations, such as armed conflicts or natural disasters. Despite their adverse impacts on affected populations' mental health and well being, emergencies also draw attention and resources to these issues and provide openings for mental health service development.
CASE DESCRIPTION: Cases were considered if they represented a low- or middle-income country or territory affected by an emergency, were initiated between 2000 and 2010, succeeded in making changes to the mental health system, and were able to be documented by an expert involved directly with the case. Based on these criteria, 10 case examples from diverse emergency-affected settings were included: Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, occupied Palestinian territory, Somalia, Sri Lanka, and Timor-Leste.
DISCUSSION AND EVALUATION: These cases demonstrate generally that emergency contexts can be tapped to make substantial and sustainable improvements in mental health systems. From these experiences, 10 common lessons learnt were identified on how to make this happen. These lessons include the importance of adopting a longer-term perspective for mental health reform from the outset, and focusing on system-wide reform that addresses both new-onset and pre-existing mental disorders.
CONCLUSIONS: Global progress in mental health care would happen more quickly if, in every crisis, strategic efforts were made to convert short-term interest in mental health problems into momentum for mental health reform.
Fulltext Comprehensive SDG goal and targets for non-communicable diseases and mental health

Minas H, Tsutsumi A, Izutsu T, Goetzke K, Thornicroft G

Int J Ment Health Syst, 2015;9:12.
PMID: 25774216 DOI: 10.1186/s13033-015-0003-0

The negotiations on the SDG goals and targets, leading to the sustainable development Declaration in September 2015, are now in the final stages. Ensuring that people with mental disorders are not left behind in the global development program from 2015 to 2030 will require specific and explicit commitments and targets against which progress in mental health can be measured and reported. The arguments for inclusion of explicit mental health targets in the SDGs are compelling. The final negotiations on the SDG goals and targets will now determine whether people with mental illness and psychosocial disabilities will continue to be neglected or will benefit equitably from inclusion in the post-2015 development program.
Fulltext First aid guidelines for psychosis in Asian countries: A Delphi consensus study

Jorm AF, Minas H, Langlands RL, Kelly CM

Int J Ment Health Syst, 2008;2(1):2.
PMID: 18291042 DOI: 10.1186/1752-4458-2-2

Guidelines for how a member of the public should give first aid to a person who is becoming psychotic have been developed for English-speaking countries. However, these guidelines may not be appropriate for use in other cultures. A study was therefore carried out to examine whether it was possible to achieve consensus on guidelines that could apply in a range of Asian countries.
Fulltext Global trends in research related to social media in psychology: mapping and bibliometric analysis

Zyoud SH, Sweileh WM, Awang R, Al-Jabi SW

Int J Ment Health Syst, 2018;12:4.
PMID: 29387147 DOI: 10.1186/s13033-018-0182-6

Background: Social media, defined as interactive Web applications, have been on the rise globally, particularly among adults. The objective of this study was to investigate the trend of the literature related to the most used social network worldwide (i.e. Facebook, Twitter, LinkedIn, Snapchat, and Instagram) in the field of psychology. Specifically, this study will assess the growth in publications, citation analysis, international collaboration, author productivity, emerging topics and the mapping of frequent terms in publications pertaining to social media in the field of psychology.

Methods: Publications related to social media in the field of psychology published between 2004 and 2014 were obtained from the Web of Science. The records extracted were analysed for bibliometric characteristics such as the growth in publications, citation analysis, international collaboration, emerging topics and the mapping of frequent terms in publications pertaining to social media in the field of psychology. VOSviewer v.1.6.5 was used to construct scientific maps.

Results: Overall, 959 publications were retrieved during the period between 2004 and 2015. The number of research publications in social media in the field of psychology showed a steady upward growth. Publications from the USA accounted for 57.14% of the total publications and the highest h-index (48).The most common document type was research articles (873; 91.03%). Over 99.06% of the publications were published in English. Computers in Human Behavior was the most prolific journal. The University of Wisconsin-Madison ranked first in terms of the total publications (n = 39). A visualisation analysis showed that personality psychology, experimental psychology, psychological risk factors, and developmental psychology were continual concerns of the research.

Conclusions: This is the first study reporting the global trends in the research related to social media in the psychology field. Based on the raw data from the Web of Science, publication characteristics such as quality and quantity were assessed using bibliometric techniques over 12 years. The USA and its institutions play a dominant role in this topic. The most preferred topics related to social media in psychology are personality psychology, experimental psychology, psychological risk factors, and developmental psychology.
Fulltext A qualitative exploration of the perspectives of mental health professionals on stigma and discrimination of mental illness in Malaysia

Hanafiah AN, Van Bortel T

Int J Ment Health Syst, 2015;9:10.
PMID: 25774215 DOI: 10.1186/s13033-015-0002-1

Stigma of mental illness has been identified as a significant barrier to help-seeking and care. Basic knowledge of mental illness - such as its nature, symptoms and impact - are neglected, leaving room for misunderstandings on mental health and 'stigma'. Numerous researches have been conducted on stigma and discrimination of people with mental disorders. However, most of the literature investigates stigma from a cultural conception point of view, experiences of patients or public attitudes towards mental illness but little to none from the standpoint of mental health professionals. In Malaysia, this research on stigma is particularly limited. Therefore, the state of stigma and discrimination of people with mental illness was investigated from the perspectives of mental health professionals in Malaysia.
Fulltext Clinical and cognitive correlates of employment among patients with schizophrenia: a cross-sectional study in Malaysia

Midin M, Razali R, Zamzam R, Fernandez A, Hum LC, Shah SA, et al.

Int J Ment Health Syst, 2011 May 30;5:14.
PMID: 21624111 DOI: 10.1186/1752-4458-5-14

BACKGROUND: Gainful employment is one major area of functioning which is becoming an important goal in psychiatric rehabilitation of patients with schizophrenia. Studies in western countries are pointing to evidence that certain sociodemographic and clinical factors may contribute to employment outcomes in this group of people. However, the area is still largely unexplored in Malaysia. The aim of this study was to examine the sociodemographic, clinical and cognitive correlates of employment status among patients with Schizophrenia.
METHODS: This was a cross-sectional study. All participants who fulfilled the requirements of the study according to the inclusion and exclusion criteria were enrolled. Study instruments included a demographic data questionnaire, Positive and Negative Symptom Scale (PANSS), Trail Making Tests, Rey's Auditory Verbal Learning Test (RAVLT) and Digit Span. Bivariate analyses were done using chi-square for categorical data and t-test for continuous data and multiple logistic regression analysis was done to identify predictors of employment status.
RESULTS: A total of 95 participants who fulfilled the inclusion criteria were enrolled into the study. Among the sociodemographic, clinical and cognitive variables studied marital status, educational level, mean scores of negative symptoms, Digit Span and RAVLT and Trail Making Tests were found to show significant association with employment status on bivariate analyses. However, when entered into a logistic regression model, only cognitive variables ie. Trail A and B, Digit Span and RAVLT were significant predictors of employment status.
CONCLUSIONS: The results from this study support the role of cognitive function, particularly, attention, working memory and executive functioning on attaining and maintaining employment in persons with schizophrenia as measured by the RAVLT, Digit Span and Trail Making Tests. These findings may act as preliminary evidence suggesting the importance of integrating cognitive rehabilitation in the psychosocial rehabilitation program for patients with schizophrenia in Malaysia.