Prevalence & experience of contact with traditional healers among patients with first-episode psychosis in Hospital Kuala Lumpur.

Introduction: Patients with mental disorders in Malaysia often seek help from traditional healers prior to consulting psychiatric service. The objective of the study is to determine the prevalence and experience of contact with traditional healers among patients with first-episode psychosis in Hospital Kuala Lumpur (HKL). Methods: This is a hospital-based cross-sectional descriptive study of 50 in-patients with first-episode psychosis in HKL. Structured Clinical Interview for DSM-IV Clinical Version for Axis I Disorders (SCID-CV) was used for establishing diagnosis. Socio-demographic data, information on help-seeking pathways, and experience of contact with traditional healers were determined through face-to-face interview and semi-structured questionnaires. Results: Twenty seven (54%) of the patients had at least one contact with traditional healers prior to consulting psychiatric service, and it was the most popular first point of non-psychiatric help-seeking contact (48%). About a quarter of them (24%) had 3 or more contacts with traditional healers prior to consulting psychiatric service. The most common type of traditional treatment received was prayer (25, 96.3%). Only 2 patients (7.41%) reported having some beneficial effects from traditional treatments. There were two patients who reported having adverse experience with traditional healers. Among those who had sought help from traditional healers, one third was recommended by at least one of their traditional healers to seek medical help. Conclusion: History of contact with traditional healers prior to consulting psychiatric service was common among inpatients with first-episode psychosis in HKL. There may be potential meaningful collaborations between psychiatrists and traditional healers for better management of patients

A case of clinical vampirism in Asia

Clinical vampirism in psychiatric practice is very rare and usually associated with schizophrenia, antisocial personality disorder or paraphilia. An Asian case of clinical vampirism is described. It is about a 24-year-old Malay female, paramedic student, who craved for blood since childhood. She injured her sister and herself so that she could access and drink blood. There was no associated psychosis or medical problems. The craving for blood may represent her underlying craving for parental love and attention

The prevalence and risk factors of major depressive disorders in gynaecological cancer patients

Major Depressive Disorder (MDD) in gynaecological cancer patients is a disabling illness with significant mental and physical suffering. Determining the risk factors of MDD in cancer patients enables us to pay more attention to those who are vulnerable and to device effective strategies for prevention, early detection, and treatment. The objective of the study is to determine the prevalence of MDD and its associated risk factors in gynaecological cancer patients at Hospital Sultanah Bahiyah, Alor Star. This is a hospital-based cross-sectional descriptive study of 120 gynaecological cancer patients in Gynae-Oncology Unit in Hospital Sultanah Bahiyah, Alor Star. Mini International Neuropsychiatry Interview (MINI) was used for diagnosis of MDD. Socio-demographic data and clinical variables were collected. MVFSFI (Malay version Female Sexual Function Index) was used to determine sexual dysfunction, and WHOQOL-BREF (World Health Organization – Quality of Life-26) was performed to assess quality of life. The prevalence of MDD in gynaecological cancer patients in the study was 18%. The variables found to be significantly associated with MDD were lack of perceived social support, greater physical pain perception, presence of past psychiatric history, and poorer quality of life. Meanwhile, sexual dysfunction was not associated with MDD. Logistic regression analysis revealed that only the psychological health domain of QOL was significantly associated with MDD, and contributed to 60% of the variation in MDD. The prevalence of MDD in gynaecological cancer patients is higher than those in the general population. In view that MDD can compromise cancer prognosis and patient’s well-being, psychosocial intervention is recommended as a part of multi- disciplinary and comprehensive management of gynaecological cancer

Reliability and factor structure of the General Health Questionnaire-12 among university students

The 12- item General Health Questionnaire (GHQ-12) has been translated into many languages and widely used in different settings and countries. Its reliability and psychometric properties were extensively studied in many population groups which suggested that it measures psychological distress in multidimensional construct. Objective: The objective of this study was to assess the reliability and factor structure of the Bahasa Malaysia version of the GHQ-12 among university students attending a health program at a Malaysian public university. Method: The cross sectional survey was conducted on 306 undergraduate students aged between 18 to 27 years old who visited the booth set up for mental health screening at a health program. The screening was conducted using a self-administered, validated Bahasa Malaysia version of GHQ-12 questionnaire. Results: Using exploratory factor analysis, the Bahasa Malaysia version of GHQ-12 was found to have a three factor structures namely depressive symptoms, self-esteem and perceived abilities which accounted for 58% of the item variance. The overall Cronbach’s alpha coefficient of the scale was found to be high (0.84) with each factor having acceptable inter-item consistency ranging from 0.61 to 0.82. Conclusion: The findings of the study show that the Bahasa Malaysia version GHQ-12 is reliable and has good structural characteristics. It can assess a few domains of the psychological status of university students. It also helps in providing more information on the domain which may become a focus target of intervention in the prevention of mental illness

Prevalence of psychological stress among undergraduate students attending a health programme in a Malaysian University

Psychological stress among undergraduate students is associated with poor academic results, physical ill-health and psychiatric disorders. The objectives of the study were to determine the prevalence of psychological stress and its associated factors among undergraduate students attending a health programme in a local university. This is a cross-sectional study among undergraduate students attending a health programme in a local university. The 12-item General Health Questionnaire (GHQ-12) was used to determine the presence of psychological stress at a cut-off point of 4 and above. Analysis was conducted to determine any association between gender, ethnicity, year of study in the university, recent health-seeking contact with a doctor, and psychological stress among the participants. The prevalence of psychological stress among undergraduate students attending a health program in a Malaysian University was 49.3%. There was no significant association with any of the socio-demographic factors studied (p>0.05). The prevalence of psychological stress in this study was significantly high, and irrespective of gender, ethnicity, year of study in the university, and recent health-seeking contact with a doctor. Hence, the findings of this study show that it may be a useful strategy to integrate such health programs regularly in activities of colleges and universities, with the aim of promoting mental health and wellness among the students

Factors influencing inpatient duration among insanity acquittees in a Malaysian mental institution

Objective: According to Malaysian law, defendants found not guilty by reason of insanity may be admitted to a psychiatric hospital and discharge is subject to the state ruler’s assent. The objective of this study is to examine the clinical, socio-demographic and forensic factors that influence inpatient duration of insanity acquittees in a Malaysian mental institution. Methods: This is a cross-sectional study of one hundred and twelve insanity acquittee inpatients in Hospital Bahagia Ulu Kinta from January 2007 to February 2007. Patients with a clinical diagnosis of schizophrenia, major depressive disorder and bipolar disorder were assessed using the Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HAMD) and Young Mania Rating Scale (YMRS) respectively. Other relevant socio- demographic, clinical and forensic factors were also assessed. Results: The inpatient duration varied widely from three months to forty-seven years with a median of seven years. Seventy five percent of patients were in remission. According to the multiple linear regression model, the strongest predictor of a longer duration of hospital stay for insanity acquittees was older age (p<0.001) followed by murder as the index offence (p=0.005). Good family support predicted a shorter inpatient duration. This model explains 56% of the variance in the inpatient duration. Conclusion: Social factors such as family support may be increasingly important in determining the discharge process of insanity acquittees besides clinical rehabilitation. Issues such as stigma of violent forensic patients and the role of community forensic rehabilitation services need to be further explored

t-test using STATA software

Students-t test is the most popular statistical test. The test compares two mean values to judge if they are different or not. For small data it is possible to conduct it using manual calculation – however that is not the case. Researchers would need to use statistical software and packages to conduct their analysis. This guide will help the junior researchers to conduct independent- and paired-t test using STATA software

Prevalence of psychological stress among undergraduate students attending a health program in a Malaysian university

Psychological stress among undergraduate students is associated with poor academic results, physical ill-health and psychiatric disorders. The objectives of the study were to determine the prevalence of psychological stress and its associated factors among undergraduate students attending a health programme in a local university. This is a cross-sectional study among undergraduate students attending a health programme in a local university. The 12-item General Health Questionnaire (GHQ-12) was used to determine the presence of psychological stress at a cut-off point of 4 and above. Analysis was conducted to determine any association between gender, ethnicity, year of study in the university, recent health-seeking contact with a doctor, and psychological stress among the participants. The prevalence of psychological stress among undergraduate students attending a health program in a Malaysian University was 49.3%. There was no significant association with any of the socio-demographic factors studied (p>0.05). The prevalence of psychological stress in this study was significantly high, and irrespective of gender, ethnicity, year of study in the university, and recent health-seeking contact with a doctor. Hence, the findings of this study show that it may be a useful strategy to integrate such health programs regularly in activities of colleges and universities, with the aim of promoting mental health and wellness among the students

ORIGINAL ARTICLE TRADITIONAL HEALERS ARE CAUSING TREATMENT DELAY AMONG PATIENTS WITH PSYCHOSIS IN HOSPITAL KUALA LUMPUR: FACT OR FALLACY?

Objective: Mental health services in Malaysia often face competition from traditional healers especially among patients with psychosis. The objective of the study is to determine whether patients who sought help earlier from traditional healers had longer duration of untreated psychosis (DUP), and more adverse experiences in pathways to psychiatric care. Methods: This is a hospital-based cross-sectional study of 50 inpatients with first-episode psychosis in Hospital Kuala Lumpur. Structured Clinical Interview for DSM-IV (Diagnostic and statistical manual, 4 th edition) Clinical Version for Axis I Disorders (SCID-CV) was used for establishing diagnosis. Onset of psychosis was defined as any one positive symptom with a score of&gt;3 on the Positive and Negative Syndrome Scale (PANSS). Socio-demographic data, information on pathways and treatment delaying factors were determined through face-to-face interview and semi-structured questionnaire. Results: Fifty-four percent of the patients had at least on

Effects of a brief mindfulness-based intervention program on psychological symptoms and well-being among medical students in Malaysia: a controlled study

Medical students often experience heightened psychological distress that may undermine their training experience. This study evaluated the effects of a 4-week mindfulness-based intervention program on psychological health among medical students and whether the effects were mediated by changes in mindfulness. The study also examined whether trait mindfulness moderated the effectiveness of the intervention. One hundred thirty-nine medical students participated in the study. They completed measures of mindfulness and psychological symptoms at pre- and post-intervention. Analysis showed that the intervention group reported significantly greater improvements in depressive symptoms, anxiety, general psychiatric symptoms, perceived stress, subjective happiness, and satisfaction with life compared to the control group. Low trait mindfulness at baseline predicted greater improvements on depressive and anxiety symptoms. Changes in mindfulness mediated several outcomes. The findings show that a brief mindfulness-based intervention program is efficacious in reducing psychological symptoms among medical students. Mindfulness may be a key mechanism of change of the intervention