Life events and parasuicides in Hospital Kuala Lumpur, Malaysia

Objective: The aim of this study is to compare the prevalence of life events among parasuicide patients with the prevalence of similar life events among age, sex and race matched patients with non-chronic medical illness. Methods: A hospital-based case-control study using convenience sampling method was conducted in Hospital Kuala Lumpur for a period of three and a half months. A total of 50 patients admitted consecutively after an episode of parasuicide and who fulfilled criteria for entry into the study agreed to participate. For each case one age-, sex- and race-matched control was selected from the list of patients who were admitted to the same hospital for non-chronic medical illness. Result: Statistical analysis showed that compared with medically ill patients, parasuicide patients had significantly higher prevalence of threatening life events six months (p<0.001) before their act and these life events were significantly concentrated in the last one month before the attempt (p=0.001). Among the seven categories of life events, cases had a significant excess of interpersonal problems (p<0.001) that included serious problems with a close friend, neighbour or relative, break-up of a steady relationship and separation due to marital difficulties. Conclusion: The results suggest that there is a high prevalence of life events among parasuicide patients when compared with medically ill patients especially during the month prior to their admission to the hospital. The data also indicate that there is a significant association between suicide attempts and interpersonal problems

The use of aripiprazole in early onset schizophrenia: safety and efficacy

The use of atypical antipsychotic agents in early onset schizophrenia is rising despite its limited data on efficacy, safety and tolerability. Early onset schizophrenia warrants effective pharmacological treatment that is safe and well tolerated by children and adolescent population. Existing atypical agents are not completely free of side effects. Aripiprazole has unique properties that differ from other atypical antipsychotics and fill up the missing gaps, as it is associated with minimal metabolic complications and extrapyramidal side effects that are more commonly seen in other atypical agents. It offers a better option for this population and may possibly be considered as first line treatment in future. This case report demonstrates the efficacy and safety of Aripiprazole in children and adolescent population

A case control study on personality traits and disorders among deliberate self-harm patients in Malaysian hospital

Objective: This study was conducted to compare the personality traits in deliberate self-harm (DSH) patients with a control group matched for age, sex and race. Methods: A case-control study design was used in this study. A total of 50 consecutive admissions to Kuala Lumpur Hospital following episodes of deliberate self-harm were compared with equal number of controls from the admission for minor medical illness during the same period. They were assessed on socio-demographic profile, Axis I psychiatric diagnosis and personality traits. Results: The mean age for the cases and controls was 26 years old. Seventy-eight percent of them were females, mostly unmarried and majority had completed their secondary education. The respondents were Indians (52%), Malays (40%) and Chinese (8%). A high prevalence of major depression (22%) was found among the cases compared to none among the controls. Personality disorders were present in 68% of cases as compared to 38% among the controls, while sensitivity (p<0.0005), impulsivity (p<0.0005), and worthlessness (p<0.0005) were the commonly reported personality traits. Paranoid personality disorder (p<0.05) and borderline personality disorder (p<0.05) were significantly present in deliberate self-harm subjects compared to the control group. Conclusion: Psychiatric disorder, personality traits of sensitivity, impulsivity and worthlessness, and personality disorders of paranoid and borderline were common in DSH patients

Microscopic image and text examination of conventional and digital print-outs / Muhammad Yusuf Masod, Professor Madya Hamidin Abdullah and Ridzuan Ahmad @ Awang

Wide spread of printers and computers have led to increasing use of print documents in people's common life. While mass print, automatic print quality evaluation is necessary in the fast print process to avoid the quality defect immediately when it appears. Also, in many cases print materials are direct accessories to many criminal and terrorist acts, for example forge contract, hence print identification has become more importance. With the technology that is evolving as rapidly as conventional and digital printing, however, it is easy to lose track of the many processes and the many variables in each process. Furthermore, as digital prints often appear similar to one another and to prints of traditional processes, comparing digital and conventional printouts can be confusing. This research aims to examine and characterizing digital and conventional printouts and investigate whether digital prints outs are significantly different than conventional printouts which can then be used for management and control purposes. Prior efforts to characterize digital and conventional printout have been made, however it is based on visual examination (Gascoigne 2004, Jarry 1996 and Lloyd and Taub 1988). To address this issues, In order to evaluate the print quality automatically or identify the source of the printouts intelligently, this study research will fully utilised primary examination of print with the naked eye, a magnified view of its edges and surface will render additional information. A stereomicroscope that magnifies up to approximately 20x to 50x as an instrumentation. The print identification checklist as proposed by Jurgens C. (2009) to keep track of the observations during identification. The experimental results are then presented and analyzed, showing that the results are promising and convinced

Improving emotional health and self-esteem of Malaysian adolescents living in orphanages through life skills education program: a multi-centre randomized control trial

Generally speaking, institutionalised children and adolescents are at greatly increased risk of serious mental and behavioural problems, up to seven times more than their peers. Life skills- based interventions using peer enforcement have been introduced as effective program to improve adolescents’ emotional and behavioral health. Therefore, the current randomized control study aimed to determine, if a life skills-based intervention could improve the emotional health and self-esteem among Malaysian adolescents in orphanages. Overall, 271 male and female adolescents (13–18 years old) from 8 orphanages in Klang valley, Malaysia participated in the study. Comparing the intervention to control group within 3 points of time, the finding of the study showed that immediately after finishing the interventional sessions (post-test), the mean scores of depression (F = 33.80, P<0.001, η2 = 0.11), anxiety (F = 6.28, P = 0.01, η2 = 0.02), stress (F = 32.05, P<0.001, η2 = 0.11) and selfesteem (F = 54.68, P<0.001, η2 = 0.17) were significantly decreased compared to the pretest values. However, there was no significant difference between two groups in the depression mean scores (F = 2.33, P = 0.13). Regarding to the interaction between group and test a significant change was seen in the mean score of all 4 variables including depression (F = 31.04, P0.001). These results provide preliminary approve for LSE to enhance emotional health and self-esteem in orphanages

Coping styles in patients with haematological cancer in a Malaysian hospital.

OBJECTIVE: To assess coping styles of haematological cancer patients and investigate factors (major depressive disorders, socio-demographic profiles and clinical factors) that influence them. METHODS:This was a cross-sectional study conducted at the Ampang Hospital in Kuala Lumpur, Malaysia, which is a tertiary referral centre for haematological diseases. In all, 105 patients with haematological cancer were assessed using the Brief COPE questionnaire to examine the coping styles of patients, and the Mini-International Neuropsychiatric Interview to assess major depressive disorder. RESULTS:The response rate was 83%. The coping strategies used by haematological cancer patients in descending order of frequency were: behavioural disengagement, active coping, denial, venting, self-distraction, substance use, acceptance, humour, use of emotional support, use of instrumental support, religion, positive reframing, planning, and self-blame. The coping styles were found to be associated with major depressive disorder, socio-demographic profiles, and clinical factors. Self-distraction and positive reframing coping styles were significant predictors and related to major depressive disorder. CONCLUSION:The early identification of poor coping styles in cancer patients is important, in order to enhance their survival and prevent relapses

The effects of a life skills-based intervention on emotional health, self-esteem and coping mechanisms in Malaysian institutionalised adolescents: protocol of a multi-centre randomized controlled trial

The aim of the current study was to determine if a life skills-based intervention programme could improve the emotional health, self-esteem and coping skills of Malaysian institutionalised adolescents. This study was a randomized controlled trial with pre-, post- and four-month follow-up tests comprising intervention and control groups which were randomly selected to receive the intervention programme (life skills education) or the placebo education programme (COMBI programme). Overall, 271 adolescents, who experienced a mild to extra severe score in one of the objectives of the DASS21 questionnaire were selected to participate in the study. The findings of this study can be the starting point of continuous, systematic life skills education for Malaysian children and adolescents, and can be used by researchers and educational planners across the country

Emotional health and self-esteem among adolescents in Malaysian orphanages

This study aimed to assess the prevalence and risk factors of depression, anxiety, stress and low self-esteem among institutional Malaysian adolescents. This cross-sectional descriptive study included 287 adolescents aged 12-18 years living in six selected orphan homes. Study's instruments included Socio-demographic questionnaire, validated Malay version of Depression Anxiety Stress Scale-21 and Rosenberg Self-Esteem Scale. The findings revealed that 85.2, 80.1 and 84.7% of participants had depression, anxiety and stress respectively. Females were more likely to be depressed. Furthermore, anxiety was significantly associated with race and age but no significant associations between stress and the demographic factors were found. The study also showed that 70.8% of males and 69.2% of females had low self-esteem and the self-esteem was associated with depression, anxiety and stress.Therefore, mental health problems are very common among adolescents in Malaysian orphanages. Results reveal the urgency of immediate actions to reduce the mental health problems among Malaysian institutional adolescents

Improving coping mechanisms of Malaysian adolescents living in orphanages through a life skills education program: a multicentre randomized controlled trial

The current study amid to determine whether a life skills-based education could improve coping skills among adolescents in Malaysian orphanages. It was a randomized controlled trial comprising intervention and control groups which were randomly selected to receive the life skills, or the Placebo education programmes. The DASS21 and Brief COPE were used as the study instruments. Results showed the mean scores of self-distraction, active coping, use of emotional support, use of instrumental support, positive reinterpretation, planning and acceptance, at post-test, were significantly increased compared to the pre-test values. Denial, substance abuse, behavioural disengagement and self-blame significantly decreased. The findings provide an opportunity to assess the effects of participation in a life skills education programme on behavioural health in Malaysia orphanages

Assessment of depression and anxiety in hematological cancer patients and their relationship with quality of life.

OBJECTIVES:To determine the relationship between major depressive disorder, anxiety disorders and the quality of life of haematological cancer patients. METHODS: This cross-sectional study was conducted at Ampang Hospital Kuala Lumpur, Malaysia, a tertiary referral centre hospital for haematological cancer. The Mini-International Neuropsychiatric Interview was used for the diagnosis of major depressive disorder and anxiety disorders. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire was utilised to measure patients' quality of life. RESULTS: A total of 105 haematological cancer patients were included in the study with response rate of 100%. Major depressive disorder correlated with almost all domains of the quality of life, except the pain scores. Logistic regression showed that insomnia and financial difficulties were related to major depressive disorder. Different anxiety disorders also correlated with quality of life in specific domains. The leading anxiety disorders that correlated mostly with quality-of-life scales were generalised anxiety disorder, followed by obsessive-compulsive disorder, social anxiety disorder, as well as post-traumatic stress disorder and panic disorder with agoraphobia (p<0.05). CONCLUSIONS: Psychological treatment along with medication and intervention should be implemented to improve the overall quality of life and psychiatric disorder symptoms among the haematological cancer patients