Displaying publications 1 - 20 of 32 in total

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  1. Sharif Nia H, Lehto RH, Pahlevan Sharif S, Mashrouteh M, Goudarzian AH, Rahmatpour P, et al.
    Omega (Westport), 2021 Sep;83(4):760-776.
    PMID: 31366310 DOI: 10.1177/0030222819865407
    Ensuring use of valid and reliable scales for evaluating death anxiety that are relevant to the cultural context where they are applied is essential. The purpose of the study was to conduct a systematic review of the psychometric properties of Templer's Death Anxiety Scale (DAS) across cultures. PubMed, Scopus, Web of Knowledge, SID, and Magiran databases were systematically searched for studies published between 1970 and 2017 using Mesh terms. Two independent researchers used Quality Assessment of Diagnostic Accuracy Studies and Checklist of Standards for Reporting of Diagnostic Accuracy to evaluate study quality. Included studies were conducted in Iran, United States, Italy, China, Egypt, Spain, and Australia. Overall study quality was acceptable in 15 evaluated articles. However, findings demonstrated that two (one study), three (seven studies), four (four studies), and five factors (three studies) were extracted across the respective studies. Confirmatory concurrent validity was assessed in two studies. While Templer's DAS has stood the test of time as a commonly used index of capturing the conscious experience of death anxiety, there are psychometric inconsistencies in identified factor solutions across cultures. Findings emphasize the need for continued evaluation of how the DAS is translated in specific countries with assessment in relation to other death construct tools.
    Matched MeSH terms: Anxiety/diagnosis
  2. Pachaiappan S, Tee MY, Low WY
    Int J Clin Exp Hypn, 2023;71(4):338-349.
    PMID: 37611140 DOI: 10.1080/00207144.2023.2246512
    Test anxiety comprises cognitive, physiological, and behavioral reactions due to anxiety about failure or a lower academic performance score on an exam or evaluation. This study examined the effect of self-hypnosis on reducing test anxiety among upper secondary school students using a quantitative methodology with a pre-experimental design. The prevalence of test anxiety was measured using the Friedben Test Anxiety Scale (FTAS) and students' demographic data were collected. Twenty-two 16-year-old students with moderate to high test anxiety were selected for a self-hypnosis intervention over a period of 5 weeks. The FTAS questionnaire was administered 4 times: at baseline, 3rd week, 5th week, and at follow-up (3 weeks after the intervention). Students' test anxiety differences were statistically significant across 4 time points. Self-hypnosis intervention decreased students' overall test anxiety scores and in the 3 constructs: social, cognitive, and tenseness. The outcomes indicate that self-hypnosis training can help students cope with test anxiety and should be further explored for managing test anxiety in school settings.
    Matched MeSH terms: Anxiety/diagnosis
  3. Pheh KS, Tan CS, Lee KW, Tay KW, Ong HT, Yap SF
    PLoS One, 2023;18(5):e0285435.
    PMID: 37167230 DOI: 10.1371/journal.pone.0285435
    Generalized anxiety disorder (GAD) is one of the most common mental disorders in Malaysia. Psychometrically sound measurements are urgently needed to assess anxiety symptoms. The extensively used Generalized Anxiety Disorder 7-item (GAD-7) is a promising candidate. However, studies on its factorial validity show mixed findings. While the one-factor solution has been replicated in different cultural contexts, some studies found different factorial structures instead. This study aimed to clarify the factorial validity of the English version of the GAD-7 in the Malaysian context. The responses collected from 1272 emerging to older adults in Malaysia were randomly divided into two halves and submitted to exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) respectively. Four acceptable models were explored in EFA ranging from unidimensional factor with 7 items to 3-factor models with 6 items. The four models revealed in EFA and the other competing models found in past studies were then examined and compared using CFA. The 6-item second-order model with a general factor of anxiety and three first-order factors with two items respectively (i.e., GAD-6) showed a more harmonic result and hence, is preferable. Moreover, the GAD-6 and its three subscales also showed satisfactory internal consistency and construct validity. This study uncovers a new and unique factorial structure of the GAD screening tool that fits in the Malaysian context. The scale may reveal GAD symptomatic dimensions that guide clinical interventions.
    Matched MeSH terms: Anxiety/diagnosis
  4. Wu Y, Levis B, Daray FM, Ioannidis JPA, Patten SB, Cuijpers P, et al.
    Psychol Assess, 2023 Feb;35(2):95-114.
    PMID: 36689386 DOI: 10.1037/pas0001181
    The seven-item Hospital Anxiety and Depression Scale Depression subscale (HADS-D) and the total score of the 14-item HADS (HADS-T) are both used for major depression screening. Compared to the HADS-D, the HADS-T includes anxiety items and requires more time to complete. We compared the screening accuracy of the HADS-D and HADS-T for major depression detection. We conducted an individual participant data meta-analysis and fit bivariate random effects models to assess diagnostic accuracy among participants with both HADS-D and HADS-T scores. We identified optimal cutoffs, estimated sensitivity and specificity with 95% confidence intervals, and compared screening accuracy across paired cutoffs via two-stage and individual-level models. We used a 0.05 equivalence margin to assess equivalency in sensitivity and specificity. 20,700 participants (2,285 major depression cases) from 98 studies were included. Cutoffs of ≥7 for the HADS-D (sensitivity 0.79 [0.75, 0.83], specificity 0.78 [0.75, 0.80]) and ≥15 for the HADS-T (sensitivity 0.79 [0.76, 0.82], specificity 0.81 [0.78, 0.83]) minimized the distance to the top-left corner of the receiver operating characteristic curve. Across all sets of paired cutoffs evaluated, differences of sensitivity between HADS-T and HADS-D ranged from -0.05 to 0.01 (0.00 at paired optimal cutoffs), and differences of specificity were within 0.03 for all cutoffs (0.02-0.03). The pattern was similar among outpatients, although the HADS-T was slightly (not nonequivalently) more specific among inpatients. The accuracy of HADS-T was equivalent to the HADS-D for detecting major depression. In most settings, the shorter HADS-D would be preferred. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
    Matched MeSH terms: Anxiety/diagnosis
  5. Wasimin FS, Thum SCC, Tseu MWL, Kamu A, Ho CM, Pang NTP, et al.
    Int J Environ Res Public Health, 2022 Aug 27;19(17).
    PMID: 36078389 DOI: 10.3390/ijerph191710673
    Viral epidemics have surfaced frequently over the past quarter-century, with multiple manifestations of psychological distress. This study sought to establish the psychometric properties of the Malay version of SAVE-9 among healthcare workers. A total of 203 healthcare workers across Malaysia participated in the research. The Malay version of SAVE-9 was translated and back-translated using the WHO instrument validation protocols. Classical Test Theory (CTT) and Rasch analysis were used to assess the validity and reliability of the Malay version of the SAVE-9 scale. The analysis was run using IBM SPSS 26.0 and JAPS. Cronbach's alpha was used to measure the internal consistency of SAVE-9, which was found to be satisfactory (Cronbach's α = 0.795). The correlations between the SAVE-9 and other measured scales (GAD-7 and PHQ-9) were statistically significant. A score of 22 was defined as a cut-off point with good sensitivity (0.578) and specificity (0.165). The Malay version of the Stress and Anxiety to Viral Epidemics-9 (SAVE-9) scale is valid and reliable after testing among healthcare workers. It is psychometrically suitable to be used in assessing healthcare workers' stress and anxiety specific to viral epidemics.
    Matched MeSH terms: Anxiety/diagnosis
  6. Li C, Yang M, Zhang Y, Lai KW
    Int J Environ Res Public Health, 2022 Nov 14;19(22).
    PMID: 36429697 DOI: 10.3390/ijerph192214976
    PURPOSE: Mental health assessments that combine patients' facial expressions and behaviors have been proven effective, but screening large-scale student populations for mental health problems is time-consuming and labor-intensive. This study aims to provide an efficient and accurate intelligent method for further psychological diagnosis and treatment, which combines artificial intelligence technologies to assist in evaluating the mental health problems of college students.

    MATERIALS AND METHODS: We propose a mixed-method study of mental health assessment that combines psychological questionnaires with facial emotion analysis to comprehensively evaluate the mental health of students on a large scale. The Depression Anxiety and Stress Scale-21(DASS-21) is used for the psychological questionnaire. The facial emotion recognition model is implemented by transfer learning based on neural networks, and the model is pre-trained using FER2013 and CFEE datasets. Among them, the FER2013 dataset consists of 48 × 48-pixel face gray images, a total of 35,887 face images. The CFEE dataset contains 950,000 facial images with annotated action units (au). Using a random sampling strategy, we sent online questionnaires to 400 college students and received 374 responses, and the response rate was 93.5%. After pre-processing, 350 results were available, including 187 male and 153 female students. First, the facial emotion data of students were collected in an online questionnaire test. Then, a pre-trained model was used for emotion recognition. Finally, the online psychological questionnaire scores and the facial emotion recognition model scores were collated to give a comprehensive psychological evaluation score.

    RESULTS: The experimental results of the facial emotion recognition model proposed to show that its classification results are broadly consistent with the mental health survey results. This model can be used to improve efficiency. In particular, the accuracy of the facial emotion recognition model proposed in this paper is higher than that of the general mental health model, which only uses the traditional single questionnaire. Furthermore, the absolute errors of this study in the three symptoms of depression, anxiety, and stress are lower than other mental health survey results and are only 0.8%, 8.1%, 3.5%, and 1.8%, respectively.

    CONCLUSION: The mixed method combining intelligent methods and scales for mental health assessment has high recognition accuracy. Therefore, it can support efficient large-scale screening of students' psychological problems.

    Matched MeSH terms: Anxiety/diagnosis
  7. Zakaria H, Hussain I, Zulkifli NS, Ibrahim N, Noriza NJ, Wong M, et al.
    PLoS One, 2023;18(7):e0283862.
    PMID: 37506072 DOI: 10.1371/journal.pone.0283862
    BACKGROUND AND AIMS: There is growing evidence on the contribution of psychological factors to internet addiction; yet it remains inconsistent and deserves further exploration. The aim of this study was to determine the relationship between the psychological symptoms (Attention Deficit Hyperactivity Disorder (ADHD) symptoms, stress, depression, anxiety and loneliness) and internet addiction (IA) among the university students in Malaysia.

    MATERIALS AND METHODS: A total of 480 students from different faculties in a Malaysian public university participated in this study. They were selected by simple random sampling method. They completed self-administered questionnaires including the Malay Version of Internet Addiction Test (MVIAT)) to measure internet addiction and Adult Self-Report Scale (ASRS) Symptom Checklist, Depression Anxiety Stress Scales (DASS) and UCLA Loneliness Scale (Version 3) to assess for ADHD symptoms, depression, anxiety, stress, and loneliness respectively.

    RESULTS: The prevalence of IA among university students was 33.33% (n = 160). The respondents' mean age was 21.01 ± 1.29 years old and they were predominantly females (73.1%) and Malays (59.4%). Binary logistic regression showed that gender (p = 0.002; OR = 0.463, CI = 0.284-0.754), ADHD inattention (p = 0.003; OR = 2.063, CI = 1.273-3.345), ADHD hyperactivity (p<0.0001; OR = 2.427, CI = 1.495-3.939), stress (p = 0.048; OR = 1.795, CI = 1.004-3.210) and loneliness (p = 0.022; OR = 1.741, CI = 1.084-2.794) were significantly associated with IA.

    CONCLUSION: A third of university students had IA. In addition, we found that those who were at risk of IA were males, with ADHD symptoms of inattention and hyperactivity, who reported stress and loneliness. Preventive strategy to curb internet addiction and its negative sequelae may consider these factors in its development and implementation.

    Matched MeSH terms: Anxiety/diagnosis
  8. Mat Hassan N, Salim HS, Amaran S, Yunus NI, Yusof NA, Daud N, et al.
    PLoS One, 2023;18(5):e0282538.
    PMID: 37195978 DOI: 10.1371/journal.pone.0282538
    INTRODUCTION: The number of children with mental health problems has more than doubled since the COVID-19 pandemic. However, the effect of long Covid on children's mental health is still debatable. Recognising long Covid as a risk factor for mental health problems in children will increase awareness and screening for mental health problems following COVID-19 infection, resulting in earlier intervention and lower morbidity. Therefore, this study aimed to determine the proportion of mental health problems post-COVID-19 infection in children and adolescents, and to compare them with the population with no previous COVID-19 infection.

    METHODOLOGY: A systematic search was done in seven databases using pre-defined search terms. Cross-sectional, cohort and interventional studies reporting the proportion of mental health problems among children with long COVID in the English language from 2019 to May 2022 were included. Selection of papers, extraction of data and quality assessment were done independently by two reviewers. Studies with satisfactory quality were included in meta-analysis using R and Revman software programmes.

    RESULTS: The initial search retrieved 1848 studies. After screening, 13 studies were included in the quality assessments. Meta-analysis showed children who had previous COVID-19 infection had more than two times higher odds of having anxiety or depression, and 14% higher odds of having appetite problems, compared to children with no previous infection. The pooled prevalence of mental health problems among the population were as follows; anxiety: 9%(95% CI:1, 23), depression: 15%(95% CI:0.4, 47), concentration problems: 6%(95% CI: 3, 11), sleep problems: 9%(95% CI:5, 13), mood swings: 13% (95%CI:5, 23) and appetite loss: 5%(95% CI:1, 13). However, studies were heterogenous and lack data from low- and middle-income countries.

    CONCLUSION: Anxiety, depression and appetite problems were significantly increased among post-COVID-19 infected children, compared to those without a previous infection, which may be attributed to long COVID. The findings underscore the importance of screening and early intervention of children post-COVID-19 infection at one month and between three to four months.

    Matched MeSH terms: Anxiety/diagnosis
  9. Quintana GR, Ponce FP, Escudero-Pastén JI, Santibáñez-Palma JF, Nagy L, Koós M, et al.
    J Affect Disord, 2024 Apr 01;350:991-1006.
    PMID: 38244805 DOI: 10.1016/j.jad.2024.01.127
    BACKGROUND: Depression and anxiety are among the most prevalent mental health issues experienced worldwide. However, whereas cross-cultural studies utilize psychometrically valid and reliable scales, fewer can meaningfully compare these conditions across different groups. To address this gap, the current study aimed to psychometrically assess the Brief Symptomatology Index (BSI) in 42 countries.

    METHODS: Using data from the International Sex Survey (N = 82,243; Mage = 32.39; SDage = 12.52; women: n = 46,874; 57 %), we examined the reliability of depression and anxiety symptom scores of the BSI-18, as well as evaluated evidence of construct, invariance, and criterion-related validity in predicting clinically relevant variables across countries, languages, genders, and sexual orientations.

    RESULTS: Results corroborated an invariant, two-factor structure across all groups tested, exhibiting excellent reliability estimates for both subscales. The 'caseness' criterion effectively discriminated among those at low and high risk of depression and anxiety, yielding differential effects on the clinical criteria examined.

    LIMITATIONS: The predictive validation was not made against a clinical diagnosis, and the full BSI-18 scale was not examined (excluding the somatization sub-dimension), limiting the validation scope of the BSI-18. Finally, the study was conducted online, mainly by advertisements through social media, ultimately skewing our sample towards women, younger, and highly educated populations.

    CONCLUSIONS: The results support that the BSI-12 is a valid and reliable assessment tool for assessing depression and anxiety symptoms across countries, languages, genders, and sexual orientations. Further, its caseness criterion can discriminate well between participants at high and low risk of depression and anxiety.

    Matched MeSH terms: Anxiety/diagnosis
  10. Osman ZJ, Mukhtar F, Hashim HA, Abdul Latiff L, Mohd Sidik S, Awang H, et al.
    Compr Psychiatry, 2014 Oct;55(7):1720-5.
    PMID: 24952938 DOI: 10.1016/j.comppsych.2014.04.011
    OBJECTIVE: The 21-item Depression, Anxiety and Stress Scale (DASS-21) is frequently used in non-clinical research to measure mental health factors among adults. However, previous studies have concluded that the 21 items are not stable for utilization among the adolescent population. Thus, the aims of this study are to examine the structure of the factors and to report on the reliability of the refined version of the DASS that consists of 12 items.
    METHOD: A total of 2850 students (aged 13 to 17 years old) from three major ethnic in Malaysia completed the DASS-21. The study was conducted at 10 randomly selected secondary schools in the northern state of Peninsular Malaysia. The study population comprised secondary school students (Forms 1, 2 and 4) from the selected schools.
    RESULTS: Based on the results of the EFA stage, 12 items were included in a final CFA to test the fit of the model. Using maximum likelihood procedures to estimate the model, the selected fit indices indicated a close model fit (χ(2)=132.94, df=57, p=.000; CFI=.96; RMR=.02; RMSEA=.04). Moreover, significant loadings of all the unstandardized regression weights implied an acceptable convergent validity. Besides the convergent validity of the item, a discriminant validity of the subscales was also evident from the moderate latent factor inter-correlations, which ranged from .62 to .75. The subscale reliability was further estimated using Cronbach's alpha and the adequate reliability of the subscales was obtained (Total=76; Depression=.68; Anxiety=.53; Stress=.52).
    CONCLUSION: The new version of the 12-item DASS for adolescents in Malaysia (DASS-12) is reliable and has a stable factor structure, and thus it is a useful instrument for distinguishing between depression, anxiety and stress.
    Matched MeSH terms: Anxiety/diagnosis*
  11. Kaur S, Zainal NZ, Low WY, Ramasamy R, Sidhu JS
    Asia Pac J Public Health, 2015 May;27(4):450-60.
    PMID: 24807887 DOI: 10.1177/1010539514533719
    The Hospital Anxiety and Depression Scale (HADS) is a common screening instrument used to determine the levels of anxiety and depression experienced by a patient and has been extensively used in patients with coronary artery disease (CAD). This study aimed to establish the factor structure of HADS in a Malaysian sample of 189 patients with CAD. Factor analysis of HADS using principal component analysis with varimax rotation yielded 3 factors. Confirmatory factor analysis supported the use of HADS in assessing 3 distinct dimensions of psychological distress--namely, anxiety, anhedonia, and psychomotor retardation. The HADS showed good internal consistency and was found to be a valid measure of psychological distress among Malaysian patients with CAD. However, low mean scores on the original 2 factors--that is, anxiety and depression--and also on the 2 depression subscales--anhedonia and psychomotor retardation--suggests that the recommended cutoff score to screen for psychological distress among CAD patients be reevaluated. Further research to determine the generalizability and consistency for the tridimensional structure of the HADS in Malaysia is recommended.
    Matched MeSH terms: Anxiety/diagnosis*
  12. Chin YW, Lai PS, Chia YC
    BMC Fam Pract, 2017 02 20;18(1):25.
    PMID: 28219325 DOI: 10.1186/s12875-017-0601-9
    BACKGROUND: Several disease specific instruments have been developed to identify and assess diabetes distress. In Malaysia, the Problem Areas in Diabetes Scale has been validated in Malay, but it does not have specific domains to assess the different areas of diabetes-related distress. Hence, we decided to use the Diabetes Distress Scale instead. To date, only the Malay version of the Diabetes Distress Scale has been validated in Malaysia. However, English is widely spoken by Malaysians, and is an important second language in Malaysia. Therefore, our aim was to determine the validity and reliability of the English version of the Diabetes Distress Scale among patients with type 2 diabetes in Malaysia.
    METHODS: The Diabetes Distress Scale was administered to 114 patients with type 2 diabetes, who could understand English, at baseline and 4 weeks later, at a primary care clinic in Malaysia. To assess for convergent validity, the Depression Anxiety Stress Scale was administered at baseline. Discriminative validity was assessed by analysing the total diabetes distress scores of participants with poor (HbA1c > 7.0%) and good glycaemic control (HbA1c ≤ 7.0%).
    RESULTS: The majority of our participants were male 65(57.0%), with a median duration of diabetes of 9.5 years. Exploratory factor analysis showed that the Diabetes Distress Scale had 4 subscales, as per the original Diabetes Distress Scale. The overall Cronbach's α was 0.920 (range = 0.784-0.859 for each subscale). The intraclass correlation ranged from 0.436 to 0.643 for test-retest. The Diabetes Distress Scale subscales were significantly correlated with the different subscales of the Depression Anxiety Stress Scale (spearman's rho range = 0.427-0.509, p 
    Matched MeSH terms: Anxiety/diagnosis*
  13. Soleimani MA, Yaghoobzadeh A, Bahrami N, Sharif SP, Sharif Nia H
    Death Stud, 2016 10;40(9):547-557.
    PMID: 27259574 DOI: 10.1080/07481187.2016.1187688
    In this study, 398 Iranian cancer patients completed the 15-item Templer's Death Anxiety Scale (TDAS). Tests of internal consistency, principal components analysis, and confirmatory factor analysis were conducted to assess the internal consistency and factorial validity of the Persian TDAS. The construct reliability statistic and average variance extracted were also calculated to measure construct reliability, convergent validity, and discriminant validity. Principal components analysis indicated a 3-component solution, which was generally supported in the confirmatory analysis. However, acceptable cutoffs for construct reliability, convergent validity, and discriminant validity were not fulfilled for the three subscales that were derived from the principal component analysis. This study demonstrated both the advantages and potential limitations of using the TDAS with Persian-speaking cancer patients.
    Matched MeSH terms: Anxiety/diagnosis*
  14. Quek KF, Atiya AS, Heng NGC, Beng CC
    Int J Impot Res, 2007 May-Jun;19(3):321-5.
    PMID: 17136103 DOI: 10.1038/sj.ijir.3901528
    Premature ejaculation (PE) is a common sexual dysfunction among the general population. PE has often been associated with a psychological state of mind. Hospital Anxiety and Depression Scale (HADS) can be used as an instrument to assess the emotional and psychological state. The present study was designed to assess the reliability and validity of the HADS in a Malaysian population. The validity and reliability were studied in subjects with and without PE. Test-retest methodology was used to assess the reliability whereas Cronbach's alpha was used to assess the internal consistency. In the control and the PE groups, the internal consistency was good and a high degree of internal consistency was observed for all 14 items. In the control group, the Cronbach's alpha values at baseline were from 0.811 to 0.834, whereas for retest, the Cronbach's alpha values were from 0.821-0.838 items. Intraclass correlation coefficient (ICC) was high for the control (0.797-0.868: baseline and 0.805-0.872: retest) and PE group (0.822-0.906: baseline and 0.785-0.887: retest). The high value of ICC and the internal consistency was due to high reliability and consistency of the items at 2-week interval. A degree of significance between the baseline and week-2 scores was observed across all items in the PE group but not in the control group. The HADS is a suitable, reliable, valid and sensitive instrument to measure the clinical change for anxiety and depression in the Malaysian population.
    Matched MeSH terms: Anxiety/diagnosis*
  15. Yusof KM, Mohd Sidik S, Mahmud R, Abdullah M, Avery-Kiejda KA, Rosli R
    Breast Cancer, 2023 Sep;30(5):810-819.
    PMID: 37306933 DOI: 10.1007/s12282-023-01475-0
    BACKGROUND: Although higher survival rates of breast cancer are achieved these days, breast cancer survivors are challenged with unwanted side effects from treatment or management that affect physical, functional, and psychological well-being of an individual. This study aimed to assess psychological distress status in Malaysian breast cancer survivors and factors that affected the condition.

    METHODS: A cross-sectional study design was conducted on 162 breast cancer survivors from various breast cancer support groups in Malaysia. Psychological distress status was assessed based on depression and anxiety scores by applying the Malay version of Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7). Both instruments were self-administered along with a set of questionnaires comprising demographic, medical history, quality of life, and upper extremity function assessment. Outcomes from the PHQ-9 and GAD-7 were analyzed for severity level of psychological distress, and its association with relevant variables, arm morbidity symptoms, as well as the duration of cancer survivorship.

    RESULTS: The univariate analysis showed that breast cancer survivors with arm morbidities after breast surgery had a higher score of depression (5.0 vs 4.0, p = 0.011) and anxiety (3.0 vs 1.0, p = 0.026) than those who did not. Besides that, receiving fewer post-rehabilitation treatments (p = 0.049) and having a family history of cancer (p = 0.022) were correlated with higher anxiety level. The level of depression and anxiety was inversely proportionate with quality of life and positively correlated with greater disability of the arm function (p 

    Matched MeSH terms: Anxiety/diagnosis
  16. Mohammad Redzuan SA, Suntharalingam P, Palaniyappan T, Ganasan V, Megat Abu Bakar PN, Kaur P, et al.
    BMJ Open, 2020 Jun 21;10(6):e034458.
    PMID: 32565453 DOI: 10.1136/bmjopen-2019-034458
    INTRODUCTION: Postpartum depression, general depressive symptoms, anxiety and stress (PODSAS) are often overlooked, and may cause morbidity to new mothers, their babies and families. This study aims to determine the point prevalence of depression (post partum and general), anxiety and stress among mothers in five public health clinics in Perak at 4 weeks postdelivery and identify their associated risk factors. Findings from this study will be used to identify the needs for early screening and detection, encourage development of interventions to reduce its occurrence and support mothers with PODSAS.

    METHODS AND ANALYSIS: This cross-sectional study will recruit 459 postpartum mothers during their 4-week postnatal follow-up in five selected public health clinics in Perak from September 2019 to May 2020. Participants will be mothers aged 18 years and above at 4 weeks postdelivery who are able to understand the English and Malay languages. Non-Malaysians and mothers with known diagnosis of psychotic disorders will be excluded from the study. Sociodemographic information and possible risk factors of the participants will be captured via a set of validated questionnaires, postpartum depression (PPD) will be measured using the Edinburgh Postpartum Depression Scale questionnaire and general depressive symptoms, anxiety and stress will be measured using the 21-item Depression, Anxiety and Stress Scale. Data analysis will be conducted using SPSS V.25.0 (IBM). Besides descriptive statistics, multivariable regression analyses will be done to identify possible risk factors and their independent associations with depression (PPD and general depressive symptoms, combined and separately), anxiety and stress.

    ETHICS AND DISSEMINATION: The study protocol was reviewed and approved by the Medical Research Ethics Committee, Ministry of Health Malaysia on 7 August 2019. Results of this study will be reported and shared with the local health stakeholders and disseminated through conference proceedings and journal publications.

    REGISTRATION NUMBER: This study is registered in the Malaysian National Medical Research Register with the ID: NMRR-19-868-47647.

    Matched MeSH terms: Anxiety/diagnosis
  17. Shamsuddin K, Fadzil F, Ismail WS, Shah SA, Omar K, Muhammad NA, et al.
    Asian J Psychiatr, 2013 Aug;6(4):318-23.
    PMID: 23810140 DOI: 10.1016/j.ajp.2013.01.014
    University students face not only challenges related with independent living, but also academic challenges. This predisposes them to depression, anxiety and stress, which are fairly common.
    Matched MeSH terms: Anxiety/diagnosis*
  18. Isa MR, Moy FM, Abdul Razack AH, Zainuddin ZM, Zainal NZ
    Asian Pac J Cancer Prev, 2013;14(4):2237-42.
    PMID: 23725119
    BACKGROUND: The aim of this study was to determine the impact of applied progressive muscle relaxation training on the levels of depression, anxiety and stress among prostate cancer patients.

    MATERIALS AND METHODS: A quasi-experimental study was conducted at the University Malaya Medical Centre (UMMC) and Universiti Kebangsaan Malaysia Medical Centre (UKMMC) over six months. Prostate cancer patients from UMMC received the intervention and patients from UKMMC were taken as controls. The level of depression, anxiety and stress were measured using Depression, Anxiety Stress Scales - 21 (DASS-21).

    RESULTS: A total of 77 patients from the UMMC and 78 patients from the UKMMC participated. At the end of the study, 90.9% and 87.2% of patients from the UMMC and UKMMC groups completed the study respectively. There were significant improvements in anxiety (p<0.001, partial ?2=0.198) and stress (p<0.001, partial ?2=0.103) at the end of the study in those receiving muscle training. However, there was no improvement in depression (p=0.956).

    CONCLUSIONS: The improvement in anxiety and stress showed the potential of APMRT in the management of prostate cancer patients. Future studies should be carried out over a longer duration to provide stronger evidence for the introduction of relaxation therapy among prostate cancer patients as a coping strategy to improve their anxiety and stress.

    Matched MeSH terms: Anxiety/diagnosis
  19. Yusoff N, Low WY, Yip CH
    Asian Pac J Cancer Prev, 2011;12(4):915-7.
    PMID: 21790225
    The main objective of this paper is to examine the psychometric properties of the Malay Version of the Hospital Anxiety and Depression Scale (HADS), tested on 67 husbands of the women who were diagnosed with breast cancer. The eligible husbands were retrieved from the Clinical Oncology Clinic at three hospitals in Kuala Lumpur, Malaysia. Data was collected at three weeks and ten weeks following surgery for breast cancer of their wives. The psychometric properties of the HADS were reported based on Cronbach' alpha, Intraclass Correlation Coefficients (ICC), Effect Size Index (ESI), sensitivity and discriminity of the scale. Internal consistency of the scale is excellent, with Cronbach's alpha of 0.88 for Anxiety subscale and 0.79 for Depression subscale. Test-retest Intraclass Correlation Coefficient (ICC) is 0.35 and 0.42 for Anxiety and Depression Subscale, respectively. Small mean differences were observed at test-retest measurement with ESI of 0.21 for Anxiety and 0.19 for Depression. Non-significant result was revealed for the discriminant validity (mastectomy vs lumpectomy). The Malay Version of the HADS is appropriate to measure the anxiety and depression among the husbands of the women with breast cancer in Malaysia.
    Study site: Oncology clinic, University of Malaya Medical Centre (UMMC), Hospital Kuala Lumpur, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Anxiety/diagnosis*
  20. Quek KF, Low WY, Razack AH, Loh CS, Chua CB
    Med J Malaysia, 2004 Jun;59(2):258-67.
    PMID: 15559178 MyJurnal
    To validate the English version of the Spielberger State-Trait Anxiety Inventory (STAI) in a sample of Malaysia patients with and without urinary symptoms. Validity and reliability were studied in patients with lower urinary tract symptoms (LUTS) and patients without LUTS. Reliability was evaluated using the test-retest method and internal consistency was assessed using Cronbach's alpha. Sensitivity to change was expressed as the effect size in the pre-intervention versus post-intervention score in additional patients with LUTS who underwent transurethral resection of the prostate (TURP). Internal consistency was excellent. A high degree of internal consistency was observed for each of the 40 items with Cronbach's alpha value = 0.38 to 0.89 while the Cronbach's alpha for the total scores was 0.86. Test-retest correlation coefficients for the 40 items score were highly significant. Intraclass correlation coefficient was high (ICC=0.39 to 0.89). A high degree of sensitivity and specificity to the effects of treatment was observed. A high degree of significant level between baseline and post-treatment scores was observed across nearly half of the items in surgical group but not in the non-LUTS group (control subjects). The STAI is reliable, valid and sensitive to clinical change in a sample of Malaysian patients with and without urinary symptoms.
    Matched MeSH terms: Anxiety/diagnosis*
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