Displaying publications 1 - 20 of 25 in total

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  1. Navigating cultural diversity: harnessing AI for mental health diagnosis despite value-laden judgements
    Razali HYH, Yusof ANM
    J Med Ethics, 2024 Aug 21;50(9):598-599.
    PMID: 38802139 DOI: 10.1136/jme-2024-110086
    Matched MeSH terms: Mental Disorders/diagnosis
  2. Fulltext Don't give up on GWAS
    Sullivan P, 96 Psychiatric Genetics Investigators
    Mol Psychiatry, 2012 Jan;17(1):2-3.
    PMID: 21826059 DOI: 10.1038/mp.2011.94
    Matched MeSH terms: Mental Disorders/diagnosis
  3. The expert consensus guideline series: adherence problems in patients with serious and persistent mental illness
    Velligan DI, Weiden PJ, Sajatovic M, Scott J, Carpenter D, Ross R, et al.
    J Clin Psychiatry, 2009;70 Suppl 4:1-46; quiz 47-8.
    PMID: 19686636
    OBJECTIVES: Poor adherence to medication treatment can have devastating consequences for patients with mental illness. The goal of this project was to develop recommendations for addressing adherence problems to improve patient outcomes.
    METHODS: The editors identified important topics and questions concerning medication adherence problems in serious mental illness that are not fully addressed in the literature. A survey was developed containing 39 questions (521 options) asking about defining nonadherence, extent of adherence problems in schizophrenia and bipolar disorder, risk factors for nonadherence, assessment methods, and interventions for specific types of adherence problems. The survey was completed by 41 (85%) of the 48 experts to whom it was sent. Results of the literature review and survey were used to develop recommendations for assessing and improving adherence in patients with serious mental illness.
    RESULTS: ASSESSING ADHERENCE: The experts endorsed percentage of medication not taken as the preferred method of defining adherence, with 80% or more of medication taken endorsed as an appropriate cut-off for adherence in bipolar disorder and schizophrenia. Although self- and physician report are the most common methods used to assess adherence in clinical settings, they are often inaccurate and may underestimate nonadherence. The experts recommend that, if possible, clinicians also use more objective measures (e.g., pill counts, pharmacy records, and, when appropriate, serum levels such as are used for lithium). Use of a validated self-report scale may help improve accuracy.
    SCOPE OF THE PROBLEM: The majority of the experts believed the average patient with schizophrenia or bipolar disorder in their practices takes only 51%-70% of prescribed medication. FACTORS ASSOCIATED WITH NONADHERENCE: The experts endorsed poor insight and lack of illness awareness, distress associated with specific side effects or a general fear of side effects, inadequate efficacy with persistent symptoms, and believing medications are no longer needed as the most important factors leading to adherence problems in schizophrenia and bipolar disorder. The experts considered weight gain a side effect that is very likely to lead to adherence problems in patients with schizophrenia and bipolar disorder; sedation was considered a more important contributor to adherence problems in bipolar disorder than schizophrenia. The experts rated persistent positive or negative symptoms in schizophrenia and persistent grandiosity and manic symptoms in bipolar disorder as the most important symptomatic contributors to adherence problems in these illnesses.
    INTERVENTIONS: It is important to identify the specific factors that may be contributing to a patient's adherence problems in order to customize interventions to target those problems. Multiple problems may be involved, requiring a combination of interventions.
    CONCLUSIONS: Adherence problems are complex and multidetermined. The experts recommended customized interventions focused on the underlying causes.
    Matched MeSH terms: Mental Disorders/diagnosis
  4. Topical Review: Mind Your Language-Translation Matters (A Narrative Review of Translation Challenges)
    Kiing JS, Rajgor D, Toh TH
    J Pediatr Psychol, 2016 11;41(10):1110-1119.
    PMID: 27189689
    OBJECTIVE: Translation of developmental-behavioral screening tools for use worldwide can be daunting. We summarize issues in translating these tools.  METHODS:  Instead of a theoretical framework of "equivalence" by Pena and International Test Commission guidelines, we decided upon a practical approach used by the American Association of Orthopedic Surgeons (AAOS). We derived vignettes from the Parents' Evaluation of Developmental Status manual and published literature and mapped them to AAOS.  RESULTS:  We found that a systematic approach to planning and translating developmental-behavioral screeners is essential to ensure "equivalence" and encourage wide consultation with experts.  CONCLUSION:  Our narrative highlights how translations can result in many challenges and needed revisions to achieve "equivalence" such that the items remain consistent, valid, and meaningful in the new language for use in different cultures. Information sharing across the community of researchers is encouraged. This narrative may be helpful to novice researchers.
    Matched MeSH terms: Mental Disorders/diagnosis*
  5. Fulltext Diagnosis and management of Alzheimer's disease--an update
    Srinivas P
    Med J Malaysia, 1999 Dec;54(4):541-9; quiz 550.
    PMID: 11072482
    Alzheimer's disease (AD) has become recognised as a major cause of morbidity and mortality in the ageing population worldwide. Over 20 million people worldwide are affected by AD, which ensures that the disease imposes a major economic burden. Alzheimer's disease is a progressive neurodegenerative disorder with characteristic clinical and neuropathological features. Neurofibrillary tangles, neuritic plaques and amyloid angiopathy occur in varying severity in brains of patient's with Alzheimer's disease. Biological markers of AD allowing an early definitive premorbid diagnoses are currently not available. Memory loss for recent events is invariable and often the earliest prominent symptom. Language disorders, difficulties with complex tasks, depression, psychotic symptoms and behavioral changes are other common manifestations of AD. Diagnosis involves the early detection of cognitive decline and ruling out other causes of dementia like vascular dementia, Lewy body dementia, fronto-temporal degeneration or reversible causes like hypothyroidism. Acetylcholinesterase inhibitors have shown to be effective in mild to moderate AD in improving the cognitive function of patients in clinical trials. Caregiver intervention programs have considerable potential to improve both the caregiver and patient quality of life.
    Matched MeSH terms: Mental Disorders/diagnosis
  6. Fulltext Psychomotor epilepsy with rare psychiatric manifestations
    Mazumdar PK
    Med J Malaysia, 1995 Mar;50(1):114-5.
    PMID: 7752965
    A rare case of complex partial seizure (psychomotor epilepsy) with varying shades of psychiatric manifestations is presented. The highlights are multiplicity of its manifestation in the same case, its interchanging pattern and the variable durations. This gray area of psychiatry and neurology is discussed with special reference to diagnosis and management.
    Matched MeSH terms: Mental Disorders/diagnosis
  7. Fulltext Vignette method for psychiatric case detection in a rural community
    Khare CB, Upadhyaya S, Su KW
    Med J Malaysia, 1988 Jun;43(2):100-8.
    PMID: 3237125
    Matched MeSH terms: Mental Disorders/diagnosis*
  8. Psychosocial rehabilitation models in the Asia-Pacific region
    Deva MP
    Psychiatry Clin Neurosci, 1998 Dec;52 Suppl:S364-6.
    PMID: 9895195
    Mental illnesses and mental health have, out of ignorance and fear, evoked a low priority in healthcare systems the world over. The concept that all mental illnesses were synonymous with madness has its origins in the beginnings of ignorance and fear. To a large extent, these have contributed to the marginalization of psychiatry and neglect of the mentally ill. The kings of old, seeing the ill-treatment of the mentally ill, built asylums for them, but again, the prejudice soon was overwhelming and care of the mentally ill was often given to those who were not the best administrators and carers. The long and controversial tradition of mental asylum care for the mentally ill was also brought about by the lack of specific treatments for mental illnesses. With the advent of chlorpromazine in the 1950s and other psychotropics afterwards, the need for incarceration in asylums became largely redundant. However, what also became obvious soon after was the fact that the psychotropics only helped to control symptoms and not to cure diseases of the mind. Although considerable research has gone into attempts at correcting supposed defects in neurotransmission, the cure of mental illness seems some way off. The need for rehabilitating or re-housing those with mental illnesses especially those needing long-term care and those whose cure seems difficult has been recognized for a long time. It was Phillipe Pinel who almost 200 years ago unchained the mental patients at an asylum in Paris and proposed work therapy and humane care. Psychosocial rehabilitation of the mentally ill is not, therefore, a new concept. The need for methods of changing the behavior, thinking and functioning of those with severe mental illnesses using psychological, social, occupational, behavioral and medical methods is called psychosocial rehabilitation. This method, although developed in stages over the past two centuries, has undergone changes and deterioration and development in different parts of the world with different priorities and emphasis.
    Matched MeSH terms: Mental Disorders/diagnosis
  9. A clinical and survey study of latah in Sarawak, Malaysia
    Chiu TL, Tong JE, Schmidt KE
    Psychol Med, 1972 May;2(2):155-65.
    PMID: 5034110 DOI: 10.1017/S0033291700040629
    During a psychiatric survey in Sarawak, subjects demonstrating latah were examined separately, both clinically and with a questionnaire. Latah occurred only in females, mainly Malays, occasionally Ibans, and never Chinese. Fifty latah subjects were examined, seven were firmly diagnosed as being mentally ill, and another 13 demonstrated mild psychiatric disorders. Dream content indicated an overt sexual component
    Matched MeSH terms: Mental Disorders/diagnosis
  10. Adaptation problems of asian migrants
    Hastings J
    Aust N Z J Psychiatry, 1977 Dec;11(4):219-21.
    PMID: 272878
    Matched MeSH terms: Mental Disorders/diagnosis*
  11. Fulltext Behaviour therapy in psychiatric outpatients
    Ko SM, Tan SL, Leong B
    Singapore Med J, 1996 Apr;37(2):168-71.
    PMID: 8942256
    In a prospective study of fifty consecutive outpatients (30 men and 20 women) attending the Behaviour Therapy Clinic at a general hospital, the commonest conditions were obsessive compulsive disorders (n = 16), phobic disorders (n = 11) and generalised anxiety disorders (n = 9). Three-quarters of the referrals were from psychiatrists and family physicians. The patients received between 2 to 10 sessions of behaviour treatment; most had 4 to 6 sessions with a mean of 4.7, SD 1.82. The commonest behavioural techniques administered were exposure therapy with response prevention and relaxation therapy. Initially, treatment was therapist-aided, but subsequently self-help was encouraged with regular reviews of the patient's homework. After one month, 42 patients (84%) were assessed to have improved somewhat, with 20 (40%) showing moderate improvement. After three months, 41 (82%) continued to improve, with 33 (66%) showing moderate to great improvement. Nine patients were considered to have failed in therapy-six defaulted and three were non-responders. The reasons for defaulting treatment were unwillingness to bear with the discomfort involved in exposure therapy, lack of motivation or returning to own hometown in Malaysia. Sixteen patients (n = 32%) were treated solely with behavioural techniques while the rest had a combination of behaviour therapy and drugs, especially anxiolytics and antidepressants. However, at the end of treatment, the dosages of most medications were reduced or else discontinued completely.

    Study site: Behavior therapy clinic at a general hospital
    Matched MeSH terms: Mental Disorders/diagnosis
  12. The burden of psychiatric morbidity in Multiple Sclerosis, AQP4-antibody NMOSD and MOGAD before and after neurological diagnosis
    Tan YY, Saffari SE, Tye JSN, Peng X, Koh MJ, Mahmood ABSB, et al.
    Mult Scler Relat Disord, 2024 Sep;89:105775.
    PMID: 39053396 DOI: 10.1016/j.msard.2024.105775
    BACKGROUND: Psychiatric comorbidities are common in Multiple Sclerosis (MS) and are increasingly recognised in Aquaporin-4-Antibody Neuromyelitis Optica Spectrum Disorders (AQP4-Ab NMOSD) and Myelin Oligodendrocyte Glycoprotein-Antibody Associated Disease (MOGAD). However, it is unclear if these psychiatric comorbidities predate neurological diagnosis or classical neurological symptoms that are conventionally used to establish the onset of these central nervous system inflammatory demyelinating diseases. We sought to: (1) assess the frequency and incidence of psychiatrist-diagnosed psychiatric disorders before and after formal MS, AQP4-Ab NMOSD, and MOGAD diagnosis, and (2) identify potential factors associated with the presence of pre-existing psychiatric morbidity and depression severity at the first clinical visit for MS patients.

    METHODS: A retrospective observational study was performed on MS, AQP4-Ab NMOSD, and MOGAD patients seen at the National Neuroscience Institute (NNI) Singapore. Individuals with psychiatrist-diagnosed psychiatric disorders before and after neurological diagnosis were identified. Demographic, clinical data, and Patient Health Questionnaire (PHQ)-9 score at first clinic visit were collected and analysed.

    RESULTS: Three hundred and ninety-nine patients (249 MS, 102 AQP4-Ab NMOSD, 48 MOGAD) were included. A higher proportion of MS patients (13/249, 5.2%) had psychiatric disorders before neurological diagnosis, compared to AQP4-Ab NMOSD (1/102, 1.0%) and MOGAD (0/48, 0.0%) (p = 0.054). Within MS patients, univariate logistic regression revealed that age, sex, race, MS subtype, initial MRI lesion load, and interval between classical MS symptom onset to MS diagnosis were not associated with pre-existing psychiatric disorders. Mean PHQ-9 score for MS patients at their first MS consult was 4.4 (cut-off for no/minimal depression is ≤4); no clinical factors were predictive of higher PHQ-9 scores on univariate linear regression. The proportion of MS patients (29/236, 12.2%) who developed psychiatric illness after neurological diagnosis was not different from AQP4-Ab NMOSD (9/101, 8.9%) (p > 0.999), while this was significantly higher compared to MOGAD (0/48, 0.0%) (p = 0.021). The incidence rate of psychiatric diseases after neurological diagnosis, accounting for follow up time, was also similar between MS and AQP4-Ab NMOSD (incidence rate ratio 1.2; 95% confidence interval 0.54 - 2.8; p = 0.689).

    CONCLUSION: There is a significant psychiatric burden prior to MS diagnosis compared to AQP4-Ab NMOSD and MOGAD. The increased frequency of psychiatric comorbidity after NMOSD diagnosis merits further study to investigate the determinants of this phenomenon.

    Matched MeSH terms: Mental Disorders/diagnosis
  13. Fulltext The positive mental health instrument: development and validation of a culturally relevant scale in a multi-ethnic Asian population
    Vaingankar JA, Subramaniam M, Chong SA, Abdin E, Orlando Edelen M, Picco L, et al.
    Health Qual Life Outcomes, 2011;9:92.
    PMID: 22040157 DOI: 10.1186/1477-7525-9-92
    Instruments to measure mental health and well-being are largely developed and often used within Western populations and this compromises their validity in other cultures. A previous qualitative study in Singapore demonstrated the relevance of spiritual and religious practices to mental health, a dimension currently not included in exiting multi-dimensional measures. The objective of this study was to develop a self-administered measure that covers all key and culturally appropriate domains of mental health, which can be applied to compare levels of mental health across different age, gender and ethnic groups. We present the item reduction and validation of the Positive Mental Health (PMH) instrument in a community-based adult sample in Singapore.
    Matched MeSH terms: Mental Disorders/diagnosis*
  14. Fulltext Genetic Differences in the Immediate Transcriptome Response to Stress Predict Risk-Related Brain Function and Psychiatric Disorders
    Arloth J, Bogdan R, Weber P, Frishman G, Menke A, Wagner KV, et al.
    Neuron, 2015 Jun 03;86(5):1189-202.
    PMID: 26050039 DOI: 10.1016/j.neuron.2015.05.034
    Depression risk is exacerbated by genetic factors and stress exposure; however, the biological mechanisms through which these factors interact to confer depression risk are poorly understood. One putative biological mechanism implicates variability in the ability of cortisol, released in response to stress, to trigger a cascade of adaptive genomic and non-genomic processes through glucocorticoid receptor (GR) activation. Here, we demonstrate that common genetic variants in long-range enhancer elements modulate the immediate transcriptional response to GR activation in human blood cells. These functional genetic variants increase risk for depression and co-heritable psychiatric disorders. Moreover, these risk variants are associated with inappropriate amygdala reactivity, a transdiagnostic psychiatric endophenotype and an important stress hormone response trigger. Network modeling and animal experiments suggest that these genetic differences in GR-induced transcriptional activation may mediate the risk for depression and other psychiatric disorders by altering a network of functionally related stress-sensitive genes in blood and brain.
    Matched MeSH terms: Mental Disorders/diagnosis*
  15. New admissions to Woodbridge Hospital 1975 with special reference to schizophrenia
    Tsoi WF, Chen AJ
    Ann Acad Med Singap, 1979 Jul;8(3):275-9.
    PMID: 547870
    Woodbrige Hospital had 2,257 patients in 1975. Of these 75 percent were suffering from Schizophrenia. This pattern was similar to that of developing countries like Padistan and Malaya. A study was carried out on all new admissions in 1975. There were 1,068 patients whose age ranged from 10 to 89. Schizophrenia which constituted 62% of the cases was analysed in detail. They were mainly in the age range 10-29 (64%). The sex ratio was 3 males to 2 females. Their distribution by their type of housing was similar to that of the general populations. They were better educated. The most common presentation were reports of aggressive, violent, disturbed, abnormal or withdrawn behaviour. The 10 most common symptoms were paranoid ideas, hearing of voices, talking to oneself, insomnia, aggression, abnormal behaviour, laughing to oneself, disturbed behaviour, crying to oneself and withdrawn behaviour. The most common drugs used were trifluoperazine (47%) and chlorpromazine (45%). Electroconvulsive therapy was given to 25% of the patients. Most of the patients (63%) stayed less than 20 days.
    Matched MeSH terms: Mental Disorders/diagnosis
  16. Fulltext Functional impairment as a proxy measure indicating high rates of trauma exposure, post-migration living difficulties, common mental disorders, and poor health amongst Rohingya refugees in Malaysia
    Tay AK, Rees S, Miah MAA, Khan S, Badrudduza M, Morgan K, et al.
    Transl Psychiatry, 2019 09 02;9(1):213.
    PMID: 31477686 DOI: 10.1038/s41398-019-0537-z
    A major challenge in the refugee field is to ensure that scarce mental health resources are directed to those in greatest need. Based on data from an epidemiological survey of 959 adult Rohingya refugees in Malaysia (response rate: 83%), we examine whether a brief screening instrument of functional impairment, the WHO Disability Assessment Schedule (WHODAS), prove useful as a proxy measure to identify refugees who typically attend community mental health services. Based on estimates of mental disorder requiring interventions from analyses of epidemiological studies conducted worldwide, we selected a WHODAS cutoff that identified the top one-fifth of refugees according to severity of functional impairment, the remainder being distributed to moderate and lower impairment groupings, respectively. Compared to the lower impairment grouping, the severe impairment category comprised more boat arrivals (AOR: 5.96 [95% CI 1.34-26.43); stateless persons (A20·11 [95% CI 7.14-10); those with high exposure to pre-migration traumas (AOR: 4.76 [95% CI 1.64-13.73), peri-migration stressors (AOR: 1.26 [95% CI 1.14-1.39]) and postmigration living difficulties (AOR: 1.43 [95% CI 1.32-1.55); persons with single (AOR: 7.48 [95% CI 4.25-13.17]) and comorbid (AOR: 13.54 [95% CI 6.22-29.45]) common mental disorders; and those reporting poorer general health (AOR: 2.23 [95% CI 1-5.02]). In addition, half of the severe impairment grouping (50.6%) expressed suicidal ideas compared to one in six (16.2 percent) of the lower impairment grouping (OR: 2.39 [95% CI 1.94-2.93]). Differences between the severe and moderate impairment groups were similar but less extreme. In settings where large-scale epidemiological studies are not feasible, the WHODAS may serve as readily administered and brief public health screening tool that assists in stratifying the population according to urgency of mental health needs.
    Matched MeSH terms: Mental Disorders/diagnosis*
  17. Research on culture-bound syndromes: new directions
    Guarnaccia PJ, Rogler LH
    Am J Psychiatry, 1999 Sep;156(9):1322-7.
    PMID: 10484940
    The unprecedented inclusion of culture-bound syndromes in DSM-IV provides the opportunity for highlighting the need to study such syndromes and the occasion for developing a research agenda to study them. The growing ethnic and cultural diversity of the U.S. population presents a challenge to the mental health field to develop truly cross-cultural approaches to mental health research and services. In this article, the authors provide a critique of previous analyses of the relationship between culture-bound syndromes and psychiatric diagnoses. They highlight the problems in previous classificatory exercises, which tend to focus on subsuming the culture-bound syndromes into psychiatric categories and fail to fully investigate these syndromes on their own terms. A detailed research program based on four key questions is presented both to understand culture-bound syndromes within their cultural context and to analyze the relationship between these syndromes and psychiatric disorders. Results of over a decade of research on ataques de nervios, a Latino-Caribbean cultural syndrome, are used to illustrate this research program. The four questions focus on the nature of the phenomenon, the social-cultural location of sufferers, the relationship of culture-bound syndromes to psychiatric disorders, and the social and psychiatric history of the syndrome in the life course of the sufferer.
    Matched MeSH terms: Mental Disorders/diagnosis*
  18. In search of the true amok: amok as viewed with the Malay culture
    Carr JE, Tan EK
    Am J Psychiatry, 1976 Nov;133(11):1295-9.
    PMID: 984220
    In an attempt to discover how the phenomenon of amok is viewed within its indigenous culture, the authors studied and interviewed 21 subjects in West Malaysia who were labeled as amok. This investigation showed that both the subjects and the Malay culture view amok as psychopathology, that amok cases are disposed of in line with this view, and that the behavior of the amok person conforms to social expectations of the phenomenon. Despite cultural proscriptions, however, the act is purposive and motivated and is subtly sanctioned by Malay society.
    Matched MeSH terms: Mental Disorders/diagnosis*
  19. Adolescents as perpetrators of aggression within the family
    Kuay HS, Lee S, Centifanti LC, Parnis AC, Mrozik JH, Tiffin PA
    Int J Law Psychiatry, 2016 Jul-Aug;47:60-7.
    PMID: 27016774 DOI: 10.1016/j.ijlp.2016.02.035
    Although family violence perpetrated by juveniles has been acknowledged as a potentially serious form of violence for over 30years, scientific studies have been limited to examining the incidence and form of home violence. The present study examined the prevalence of family aggression as perpetrated by youths; we examined groups drawn from clinic-referred and forensic samples. Two audits of case files were conducted to systematically document aggression perpetrated by referred youths toward their family members. The purpose of the first audit was fourfold: i) to identify the incidence of the perpetration of family aggression among clinical and forensic samples; ii) to identify whether there were any reports of weapon use during aggressive episodes; iii) to identify the target of family aggression (parents or siblings); and iv) to identify the form of aggression perpetrated (verbal or physical). The second audit aimed to replicate the findings and to show that the results were not due to differences in multiple deprivation indices, clinical diagnosis of disruptive behavior disorders, and placement into alternative care. A sampling strategy was designed to audit the case notes of 25 recent forensic Child and Adolescent Mental Health Service (CAMHS) cases and 25 demographically similar clinic-referred CAMHS cases in the first audit; and 35 forensic cases and 35 demographically similar clinic-referred CAMHS cases in the second audit. Using ordinal chi-square, the forensic sample (audit 1=64%; audit 2=82.9%) had greater instances of family violence than the clinical sample (audit 1=32%; audit 2=28.6%). They were more likely to use a weapon (audit 1=69%; audit 2=65.5%) compared to the clinical sample (audit 1 and 2=0%). Examining only the aggressive groups, there was more perpetration of aggression toward parents (audit 1, forensic=92%, clinical=75%; audit 2, forensic=55.17%, clinical=40%) than toward siblings (audit 1, forensic=43%, clinical=50%; audit 2, forensic=27.58%, clinical=30%). Based on these findings, we would urge professionals who work within the child mental health, particularly the forensic area, to systematically collect reports of aggression perpetrated toward family members.

    Study conducted in England
    Matched MeSH terms: Mental Disorders/diagnosis
  20. Aspects of psychiatric admissions of migrants to hospitals in Perth, Western Australia
    Bruxner G, Burvill P, Fazio S, Febbo S
    Aust N Z J Psychiatry, 1997 Aug;31(4):532-42.
    PMID: 9272263
    Recent Australian Government initiatives have emphasised problems with service provision to the ethnic mentally ill. This study aims to address the paucity of contemporary data describing the disposition of the ethnic mentally ill in hospital settings.
    Matched MeSH terms: Mental Disorders/diagnosis
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