Extract: In 1910 I was holding the appointment of Medical Officer and Magistrate at Anguilla in the St. Kits presidency of the Leeward Islands, British West Indies, when the Administrator one day handed me a cable, asking if I would accept the Medical Superintendency of the “Central Lunatic Asylum,” Tanjong Rambutan, Perak, Federated Malay States. Fortunately the cable explained that Tanjong Rambutan was in the Federated Malay States, as neither he nor I had the slightest idea where it was.
Tujuan menjalankan kajian ini adalah untuk mengetahui tahap kekerapan penyelidikan yang berkaitan dengan kesihatan mental yang dijalankan di fasiliti Kementerian Kesihatan Malaysia. Sebanyak 258 fasiliti Kementerian Kesihatan yang terlibat dalam kajian ini meliputi Hospital Mental, Hospital dengan perkhidmatan Pakar Psikiatri, Hospital tanpa perkhidmatan Pakar Psikiatri dan Pejabat Kesihatan Daerah. Borang kajiselidik telah dihantar melalui pos kepada Pengarah Hospital dan Pegawai Kesihatan Daerah dengan kadar maklumbalas 70.2%. Hasil kajian mendapati hanya 23(13.1%) fasiliti sahaja yang menjalankan kajian mengenai kesihatan mental. Sebanyak 37 kajian berkaitan kesihatan mental telah dijalankan bagi tahun 2003-2004. Penyebab utama penyelidikan kurang dijalankan disebabkan oieh peruntukan yang tidak mencukupi dan tiada kepakaran untuk menjalankan penyelidikan yang berkaitan dengan kesihatan mental. Antara penyebab lain adalah kekurangan anggota, NGO tidak berminat dan tiada latihan. Kesimpulannya menunjukkan tahap penyelidikan kesihatan mental di fasiliti Kementerian Kesihatan masih rendah.
The British government in Malaya conducted treatment for women suffering mental illness in an effort to deal with the increasing number of cases in the Federated Malay States in 1930-57. This paper explores the role of mental asylums and society in contributing to methods of treatment during the twentieth century.
The main aim of the study was to determine the effect of psychoeducation program on insight of patients with schizophrenia and to determine other factors associated with the change of the insight. This was an interventional study of 70 patients with schizophrenia who underwent a psychoeducation program. Diagnosis was confirmed using Mini International Neuropsychiatric Interview (M.I.N.I). Insight was assessed using the Schedule for the Assessment of Insight (SAI) before and after the psychoeducation programme. Effect on insight was measured as the change in SAI scores. There was an improvement in insight after the psychoeducation programme which was significant (p< 0.001). Patient’s age, shorter duration of illness and no previous history of admission to mental institution were significantly related to the improvement of insight (p< 0.05). Conclusion: Psychoeducation is an important tool in improving insight into illness among patients with schizophrenia. It needs to be given as early as possible during the course of the illness.
Objective: To determine the prevalence of depressive disorders among caregivers of patients with schizophrenia, its association with patient’s and caregiver’s socio-demographic characteristics and family functioning.
Methods: This was a cross-sectional study of caregivers of patients with schizophrenia at the outpatient clinic, Hospital Permai Johor Bahru, Malaysia. The study was conducted between August and October 2008. A total of 243 caregivers who fulfilled the inclusion criteria were enrolled, of whom 232 completed the self-administered socio-demographic questionnaire, the General Health Questionnaire (GHQ-30) and the McMaster Family Assessment Device. A total of 33 caregivers with the GHQ-30 cut-off point of 7/8 were assessed further by the Mini International Neuropsychiatric Interview to diagnose depressive disorder.
Results: The prevalence of psychological distress in our study sample was 14% (n = 33) and that of depressive disorders was 6% (n = 14). There was no association between patients’ and caregivers’ sociodemographic characteristics with depressive disorders, but there were significant associations between depressive disorders and family functioning dimensions in terms of Communication and Roles.
Conclusion: Although the causal link was not established, the results suggested that depression had a significant association with family functioning among caregivers of patients with schizophrenia.
Key words: Caregivers; Depressive disorder; Schizophrenia
Study site: outpatient clinic, Hospital Permai Johor Bahru, Malaysia.
The Malaysian Mental Health Act 2001 did not come into effect until the Mental Health Regulations 2010 came into force. The Act provides a framework for the delivery of comprehensive care, treatment, control, protection and rehabilitation of those with mental disorders. The Act governs the establishment of private and government psychiatric hospitals, psychiatric nursing homes and community mental health centres. This paper outlines the provisions of the Act and the Regulations.
We used medical record abstraction to conduct research in a psychiatric hospital with paper-based medical records. The challenges we encountered included: the difficulty in retrieving files; the extensive effort and time needed to extract clinical information; the lack of a standardised documentation system of medical records; and the need for advanced computer literacy. To promote future research using electronic medical records, potential solutions include creating a registry of all patients receiving treatment, as well as equipping busy clinicians with computer skills.
About 60% of people with mental illness developed co-morbid medical and physical illness that invariably worsens their lives. However, most of the studies regarding this issue were done either in the out-patient or community settings, ignoring long stay inpatients. Locally, no data exists among long stay patients in psychiatric institutions. The aim of this retrospective study was to look at the prevalence of physical illness among long-stay patients and to compare the occurrence of physical illness before and after admission to the psychiatric institution. We found that 85 (63.4%) out of 134 subjects there was suffering with co-morbid physical and medical illnesses. There were 33 (24.6%) subjects with hyperlipidaemia, 22 (16.4%) subjects with hypertension and 17 (12.7%) subjects with diabetes. Approximately 75 (55.9%) subjects developed medical illness after admission. In conclusion, long-stay psychiatric patients are at a high risk of developing medical problems that tends to begin after admission to the psychiatric institution.
Study site: Hospital Bahagia, Ulu Kinta, Perak, Malaysia