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Fulltext Depressive illness--the need for a paradigm shift in its understanding and management

Deva MP

Med J Malaysia, 2006 Mar;61(1):4-6.
PMID: 16708727

Depression as a symptom and a disease has been recognized from antiquity. While numerous references to melancholia, illnesses of the heart broken, and delusions of guilt are found in Shakespearean literature, world literature, stories, and dramas the world over, yet the development of modern western medicine has by and large tended to ignore all things psychological in the process of disease recognition and understanding. Even the face of a depressed patient, so obvious to the initiated, is a rarely taught and recognized sign of ill health by non- psychiatrists. The long association of psychiatry with severe psychoses in the minds of medical teachers has dulled the sense of astuteness in the picking up of anxiety and depression. It has also dulled the medical profession into the delusion that mental illnesses do not occur in general hospitals. Thus the fairly large number of mental problems in every day clinical practice remains an area of darkness. In practice, the pick up rate of all mental illnesses in primary care remains very low at less than 5% of all mental illnesses while studies show that about 25% of all primary care patients have significant mental problems that necessitate their attendance in the primary care clinics.

Matched MeSH terms: Depressive Disorder/therapy*
Fulltext Exorcism and psychiatric illness. Two case reports

Maniam T

Med J Malaysia, 1987 Dec;42(4):317-9.
PMID: 3454406

Traditional methods of treatment are extremely popular with Malaysians especially for psychiatric illnesses. Those who seek such treatment come from all cultures, social classes and different educational levels in this country. In one hospital as much as 49% of psychiatric patients had been to traditional healers . Some receive simultaneously traditional and modern modes of treatment. While many reports have been written on traditional healers such as the bomoh and spirit mediums, relatively less is written about Christian healers who practise exorcism. This paper describes two patients who had received psychiatric diagnoses of major illnesses, and who subsequently underwent Christian exorcism. The process of exorcism and the short-term and long-term outcome are reported.

Matched MeSH terms: Depressive Disorder/therapy*
Systematic review of universal and targeted workplace interventions for depression

Wan Mohd Yunus WMA, Musiat P, Brown JSL

Occup Environ Med, 2018 01;75(1):66-75.
PMID: 29074553 DOI: 10.1136/oemed-2017-104532

Depression is increasingly being recognised as a significant mental health problem in the workplace contributing to productivity loss and economic burden to organisations. This paper reviews recently published randomised controlled trials (RCTs) of universal and targeted interventions to reduce depression in the workplace. Studies were identified through searches of EMBASE, MEDLINE/PubMed, PsycINFO, PsycARTICLES Full Text, and Global Health and Social Policy and Practice databases. Studies were included if they included an RCT of a workplace intervention for employees targeting depression as the primary outcome. Twenty-two published RCTs investigating interventions utilising various therapeutic approaches were identified. The cognitive behavioural therapy (CBT) approach is the most frequently used in the workplace, while interventions that combine different therapeutic approaches showed the most promising results. A universal intervention in the workplace that combines CBT and coping flexibility recorded the highest effect size (d=1.45 at 4 months' follow-up). Most interventions were delivered in group format and showed low attrition rates compared with other delivery formats. Although all studies reviewed were RCTs, the quality of reporting is low. Interventions using different therapeutic approaches with different modes of delivery have been used. Most of these interventions were shown to reduce depression levels among employees in the workplace, particularly those that combine more than one therapeutic approaches.

Matched MeSH terms: Depressive Disorder/therapy*
Spirituality Moderates Hopelessness, Depression, and Suicidal Behavior among Malaysian Adolescents

Talib MA, Abdollahi A

J Relig Health, 2017 Jun;56(3):784-795.
PMID: 26429729 DOI: 10.1007/s10943-015-0133-3

Suicide is an important public health problem for adolescents, and it is essential to increase our knowledge concerning the etiology of suicide among adolescent students. Therefore, this study was designed to examine the associations between hopelessness, depression, spirituality, and suicidal behavior, and to examine spirituality as a moderator between hopelessness, depression, and suicidal behavior among 1376 Malaysian adolescent students. The participants completed measures of depression, hopelessness, daily spiritual experience, and suicidal behavior. Structural equation modeling indicated that adolescent students high in hopelessness and depression, but also high in spirituality, had less suicidal behavior than others. These findings reinforce the importance of spirituality as a protective factor against hopelessness, depression, and suicidal behavior among Malaysian adolescent students.

Matched MeSH terms: Depressive Disorder/therapy*
The clinical effectiveness of cognitive behavior therapy and an alternative medicine approach in reducing symptoms of depression in adolescents

Charkhandeh M, Talib MA, Hunt CJ

Psychiatry Res, 2016 05 30;239:325-30.
PMID: 27058159 DOI: 10.1016/j.psychres.2016.03.044

The main aim of the study was to investigate the effectiveness of two psychotherapeutic approaches, cognitive behavioral therapy (CBT) and a complementary medicine method Reiki, in reducing depression scores in adolescents. We recruited 188 adolescent patients who were 12-17 years old. Participants were randomly assigned to CBT, Reiki or wait-list. Depression scores were assessed before and after the 12 week interventions or wait-list. CBT showed a significantly greater decrease in Child Depression Inventory (CDI) scores across treatment than both Reiki (p

Matched MeSH terms: Depressive Disorder/therapy*
Religious psychotherapy in depressive patients

Azhar MZ, Varma SL

Psychother Psychosom, 1995;63(3-4):165-8.
PMID: 7624461

This study was conducted to explore the outcome of psychotherapy in ethnic Malays with strong religious and cultural background. The patients were divided into two groups. The study and control groups consisted of 32 depressed patient each. In the study group brief psychotherapy of 15-20 sessions was attempted with the addition of a religious perspective, while in the control group the religious perspective was omitted. Patients in the study group showed more rapid improvement in the initial 3 months of the study period than those in the control group, but at the end of the 6 months the difference became nonsignificant.

Matched MeSH terms: Depressive Disorder/therapy*
The effects of brief individual cognitive behavioural therapy for depression and homesickness among international students in Malaysia

Saravanan C, Alias A, Mohamad M

J Affect Disord, 2017 10 01;220:108-116.
PMID: 28618312 DOI: 10.1016/j.jad.2017.05.037

BACKGROUND: Students who go to other countries for higher education face various psychological problems, particularly homesickness and depression. The objectives of this study were to: (a) identify differences between students who did and did not receive brief individual cognitive behavioural therapy (CBT) for depression to reduce homesickness; (b) identify whether brief individual CBT for depression reduces the level of homesickness in students between pre-, post- and follow-up assessment; and (c) compare the scores of students experiencing only homesickness and those experiencing both homesickness and depression.
METHOD: The sample consisted of 520 first-year undergraduate international students. The experimental group contained students who were diagnosed with depression and homesickness and received seven sessions of brief individual CBT for depression to reduce homesickness. The control group contained students who were diagnosed with depression and homesickness and received one session of advice and suggestions. The comparison group contained students who experienced only homesickness and did not receive any interventions. The study used the comparison group to determine if an interaction effect existed between students experiencing only homesickness and students experiencing both homesickness and depression.
RESULTS: Students who received brief individual CBT displayed a significant reduction in their homesickness and depression scores compared to the scores of students in the control group. Students who experienced only homesickness exhibited a significant reduction in the scores on homesickness in the post-assessment compared to the control group's post-assessment homesickness scores.
LIMITATION: The results of this study cannot be generalized as data were collected from three universities in Malaysia. The follow-up assessment was conducted six months after the post-assessment, which also limits generalizability beyond six months.
CONCLUSION: Overall, homesickness is considered a normal reaction. Brief individual CBT for depression is effective in reducing homesickness and depression among international students.

Matched MeSH terms: Depressive Disorder/therapy*
Fulltext Neuroprotective Effects and Therapeutic Potential of Transcorneal Electrical Stimulation for Depression

Yu WS, Kwon SH, Agadagba SK, Chan LL, Wong KH, Lim LW

Cells, 2021 09 21;10(9).
PMID: 34572141 DOI: 10.3390/cells10092492

Transcorneal electrical stimulation (TES) has emerged as a non-invasive neuromodulation approach that exerts neuroprotection via diverse mechanisms, including neurotrophic, neuroplastic, anti-inflammatory, anti-apoptotic, anti-glutamatergic, and vasodilation mechanisms. Although current studies of TES have mainly focused on its applications in ophthalmology, several lines of evidence point towards its putative use in treating depression. Apart from stimulating visual-related structures and promoting visual restoration, TES has also been shown to activate brain regions that are involved in mood alterations and can induce antidepressant-like behaviour in animals. The beneficial effects of TES in depression were further supported by its shared mechanisms with FDA-approved antidepressant treatments, including its neuroprotective properties against apoptosis and inflammation, and its ability to enhance the neurotrophic expression. This article critically reviews the current findings on the neuroprotective effects of TES and provides evidence to support our hypothesis that TES possesses antidepressant effects.

Matched MeSH terms: Depressive Disorder/therapy
Religious--sociocultural psychotherapy in patients with anxiety and depression

Razali SM, Hasanah CI, Aminah K, Subramaniam M

Aust N Z J Psychiatry, 1998 Dec;32(6):867-72.
PMID: 10084352

To show the effectiveness of incorporating religious-sociocultural components in the management of patients with generalised anxiety disorders and major depression who have strong religious and cultural backgrounds as compared with a normal psychotherapeutic approach.

Matched MeSH terms: Depressive Disorder/therapy*
Positive effects of Individual Cognitive Behavior Therapy for patients with unipolar mood disorders with suicidal ideation in Malaysia: A randomised controlled trial

Sinniah A, Oei TPS, Maniam T, Subramaniam P

Psychiatry Res, 2017 08;254:179-189.
PMID: 28463716 DOI: 10.1016/j.psychres.2017.04.026

The aim of this study was to investigate the effectiveness of Individual Cognitive Behavior Therapy (ICBT) in treating patients with mood disorders with suicidal ideation. A total of 69 patients (48 females, 21 males) with the diagnoses above were randomly allocated to either the group of Treatment As Usual (TAU)+ICBT (n=33) or the TAU group (n=36). All participants completed the Beck Depression Inventory (BDI), Beck Scale for Suicide Ideation (BSS), Positive and Negative Suicide Ideation Inventory (PANSI), Beck Hopelessness Scale (BHS), and Depression Anxiety Stress Scale-21 (DASS-21). These questionnaires were administered at pre-treatment, midway through treatment (week 4), post-treatment (week 8), and at follow-ups after three months (week 20) and six months (week 32). Factorial ANOVA results showed that the TAU+ICBT patients improved significantly and at faster rate as compared to the TAU group, which showed improvement only from pre to mid treatment on DASS-D and BHS-T measures. The effect size (Cohen's d), for the TAU+ICBT group showed large effect (1.47) for depressive symptoms and suicidal ideation (1.00). These findings suggest that ICBT used in addition to the TAU, was effective in enhancing treatment outcome of patients with unipolar mood disorders as well as, reducing risk for suicide behavior.

Matched MeSH terms: Depressive Disorder/therapy*
Community knowledge, attitudes, and beliefs towards depression in the state of Penang, Malaysia

Khan TM, Sulaiman SA, Hassali MA, Anwar M, Wasif G, Khan AH

Community Ment Health J, 2010 Feb;46(1):87-92.
PMID: 20146000 DOI: 10.1007/s10597-009-9262-z

This study was intended to evaluate the mental health literacy vis-à-vis depression among inhabitants of Penang state in North Malaysia. Using a clustered random sampling method, 1,855 respondents were approached to participate in the survey. A total of 1,149 respondents actually participated, for a 61.9% response rate. Face to face interviews were then conducted using a pre-validated 21-item questionnaire. The mean age of the respondents was 30 years (SD +/-11.5). The majority (n = 884; 76.9%) could recognize three or more symptoms of depression. Chinese and/or female respondents performed the best in this domain. Respondents with a personal experience of depression displayed a significantly better knowledge of symptoms of and therapies for depression than those who did not (t = -35.745, P = <0.001). Overall, a moderate knowledge level of the symptoms of depression and a cursory knowledge towards therapy were observed among the general population in Penang. Notably, respondents were generally inclined towards the use of alternative medicine. The study suggests that strong beliefs in alternative and traditional medicines could undermine the respondents' willingness and ability to seek evidence-based mental health care.

Matched MeSH terms: Depressive Disorder/therapy
Electrical Stimulation Normalizes c-Fos Expression in the Deep Cerebellar Nuclei of Depressive-like Rats: Implication of Antidepressant Activity

Huguet G, Kadar E, Temel Y, Lim LW

Cerebellum, 2017 04;16(2):398-410.
PMID: 27435250 DOI: 10.1007/s12311-016-0812-y

The electrical stimulation of specific brain targets has been shown to induce striking antidepressant effects. Despite that recent data have indicated that cerebellum is involved in emotional regulation, the mechanisms by which stimulation improved mood-related behaviors in the cerebellum remained largely obscure. Here, we investigated the stimulation effects of the ventromedial prefrontal cortex (vmPFC), nucleus accumbens (NAc), and lateral habenular nucleus on the c-Fos neuronal activity in various deep cerebellar and vestibular nuclei using the unpredictable chronic mild stress (CMS) animal model of depression. Our results showed that stressed animals had increased number of c-Fos cells in the cerebellar dentate and fastigial nuclei, as well as in the spinal vestibular nucleus. To examine the stimulation effects, we found that vmPFC stimulation significantly decreased the c-Fos activity within the cerebellar fastigial nucleus as compared to the CMS sham. Similarly, there was also a reduction of c-Fos expression in the magnocellular part of the medial vestibular nucleus in vmPFC- and NAc core-stimulated animals when compared to the CMS sham. Correlational analyses showed that the anxiety measure of home-cage emergence escape latency was positively correlated with the c-Fos neuronal activity of the cerebellar fastigial and magnocellular and parvicellular parts of the interposed nuclei in CMS vmPFC-stimulated animals. Interestingly, there was a strong correlation among activation in these cerebellar nuclei, indicating that the antidepressant-like behaviors were possibly mediated by the vmPFC stimulation-induced remodeling within the forebrain-cerebellar neurocircuitry.

Matched MeSH terms: Depressive Disorder/therapy*