A randomised controlled trial to examine the effectiveness of group cognitive behavioural therapy for the treatment of unipolar depression in Malaysia

Malaysia has been experiencing a dearth in mental health resources. Group Cognitive Behavioural Therapy (GCBT) has been an established form of treatment for unipolar depression. The objectives of the current study were to examine the effectiveness of using GCBT for the treatment of depression in Malaysia. A total of 174 participants suffering from unipolar depression were recruited and randomly allocated to one of GCBT+Treatment as Usual (TAU), Relaxation training+TAU, or TAU only treatment groups. The participants were between 18-60 years of age. The participants in the GCBT+TAU group received eight Group CBT sessions of over a span of two months. The participants receiving Relaxation+TAU treatment received eight relaxation training sessions over a span of two months. The participants in the TAU only treatment group received treatment as usual from their psychiatrists. The BDI-M, ATQ-M, ATQP-M and DAS-M were administered at pre-treatment, mid-treatment (week 4) and post-treatment. Repeated Measures MANOVA showed a significant interaction effect between treatment group and time for BDI-M, ATQ-M, ATQP-M and DAS-M. Results showed that GCBT+TAU was able to significantly reduce depressive symptoms, negative cognitions and beliefs. Moderate effect sizes for the BDI-M scores, as well as significantly reliable and clinical change, were also found. The current study was limited by geographical boundaries, where only hospitals in and around the greater Klang Valley area were sampled. Results from the current study suggest that GCBT is effective in reducing the symptoms of depression in a Malaysian setting

The stress of caregiving: a study of family caregivers of breast cancer patients receiving oncologic treatment at a Malaysian General Hospital

Many studies among caregivers of breast cancer patients have revealed that stress affects a significant proportion of this particular group. The situation among caregivers of breast cancer patients in Malaysia was however not known. This cross-sectional study aimed to determine the proportion of the family caregivers who experienced stress while caring for the breast cancer patients who were on oncologic treatment in Kuala Lumpur Hospital and factors which predict the stress among these caregivers. A total of 130 family caregiver-breast cancer patient dyads who were attending the Institute of Radiotherapy & Oncology, Kuala Lumpur Hospital during a 3-month study period were recruited by non-random sampling method. The caregivers’ stress was measured using the stress domain of the depression, anxiety, stress scale (DASS-21) while other data obtained included the patients’ and caregivers’ socio demographic status, the patients’ illness characteristics and the caregiving factors and the caregivers’ perceived social support. About 1 in 4 (24.6%; n=32) caregivers of breast cancer patients were stressed. Duration of caregiving, sharing of caregiving burden, patients’ age and patients’ functionality were found to be significantly associated with stress (p value <0.05). All these factors, except for duration of caregiving, continue to be significant in the logistic regression analysis (p value <0.05). This study found that a high proportion of the family caregivers experienced stress. Identification of the predictors of stress among the caregivers may help in the prevention strategies of stress in this group of caregivers

Prevalence Of Depressive Disorder And Its Association With Perceived Social Support Among Patients With Human Immunodeficiency Virus (HIV) In Hospital Tuanku Jaafar, Seremban (HTJS), Malaysia

Objectives: This study aimed to determine the prevalence of depressive disorder and its association with perceived social support among patients with HIV attending the Infectious Disease Clinic in HTJS. Methods: A cross-sectional study was conducted, and systematic random sampling method was employed for the selection of participants. Socio-demographic and clinical details were obtained through a self-rated questionnaire and participants’ medical records. Depressive disorder was screened and diagnosed using the Mini International Neuropsychiatric Interview (M.I.N.I.) and perceived social support was determined using the Multidimensional Scale of Perceived Social Support (MSPSS). Appropriate statistical analyses were used to determine the prevalence of depressive disorder and its association with perceived social support.Results: A total of 99 patients participated in this study. The mean age of participants was 38.16 ± 1.01 years, and the majority of participants were male (69.7%). Most of the participants were Malay (58.6%), followed by Indians (20.2%), Chinese (17.2%) and others (4.0%). The majority had completed secondary education (54%), and most were employed (79.8%). Most of the participants were single (45.5%) or married (45.5%). The lifetime and point prevalence of depressive disorder was 24.2% and 17.2%, respectively. About 64.7% of patients with depressive disorder were undiagnosed. Out of the 3 sources of perceived social support, perceived social support from a significant other (OR=0.53, p=0.042, Cl=0.29, 0.98) and perceived social support from friends (OR=0.49, p=0.015, Cl=0.27, 0.87) were found to be negative predictors for depressive disorder. Conclusion: This study reports that the prevalence disorder among patients with HIV in HTJS is higher than that of the general population. Patients without depressive disorder reported significantly higher perceived social support scores. Perceived social supports from significant others and friends were found to be important associated factors for lower depressive disorder vulnerability. Hence, physicians should routinely screen for depressive disorder in this vulnerable group and explore and mobilize their social support to reduce patients’ vulnerability to develop depressive disorder.Please click PDF below to download the full paper...Â

Knowledge and attitude on sex among medical students of a Malaysian university: a comparison study

Introduction: The objective of this study was to determine the relationship between clinical/socio-demographic factors with knowledge and attitude on sex among medical students of the National University of Malaysia (UKM). Methods: A cross-sectional study assessing 452 students using a self-administered questionnaire of knowledge and attitude was performed and had a response rate of 80%. Results: The majority of respondents were Malays (56%), females (57.5%), lived in urban areas (66.4%), had a median family income of RM3000 and perceived themselves as moderately religious (60%). The overall score on knowledge about sex was 21.7 of 35 (a higher score indicates better knowledge about sex). It was noted that 73.2% of students felt that they did not receive adequate training in medical school to deal with patients' sexuality and sexual problems, while 51.5% felt uncomfortable talking to patients about these issues. Students in the clinical year were more knowledgeable than those in pre-clinical years (22.67 versus 20.71, P22 marks [median score]). Discussion: The students' attitude on sex was considered conservative as the majority of them disagreed on premarital sex, masturbation, abortion, homosexuality and oral sex. Gender and religiosity have a large influence on attitudes on controversial sexual issues, whereas clinical status plays a small role. Knowledge on sex among UKM medical students is inadequate and their attitudes on sex are considered conservative. Integration of sexual medicine and health modules in the medical curriculum is crucial for students to more effectively address patients' sexual problems and promote non-judgmental attitudes towards patients. Copyright © 2013 Wiley Publishing Asia Pty Ltd

Validation of the Malay Self-Report Quick Inventory of Depressive Symptomatology in a Malaysian Sample

Depression is ranked as the second-leading cause for years lived with disability worldwide. Objective monitoring with a standardized scale for depressive symptoms can improve treatment outcomes. This study evaluates the construct and concurrent validity of the Malay Self-Report Quick Inventory of Depressive Symptomatology (QIDS-SR16) among Malaysian clinical and community samples. This cross-sectional study was based on 277 participants, i.e., patients with current major depressive episode (MDE), n = 104, and participants without current MDE, n = 173. Participants answered the Malay QIDS-SR16 and were administered the validated Malay Mini-International Neuropsychiatric Interview (MINI) for DSM-IV-TR. Factor analysis was used to determine construct validity, alpha statistic for internal consistency, and receiver operating characteristic (ROC) analysis for concurrent validity with MINI to determine the optimal threshold to identify MDE. Data analysis provided evidence for the unidimensionality of the Malay QIDS-SR16 with good internal consistency (Cronbach&rsquo;s &alpha; = 0.88). Based on ROC analysis, the questionnaire demonstrated good validity with a robust area under the curve of 0.916 (p &lt; 0.000, 95% CI 0.884&ndash;0.948). A cut-off score of nine provided the best balance between sensitivity (88.5%) and specificity (83.2%). The Malay QIDS-SR16 is a reliable and valid instrument for identifying MDE in unipolar or bipolar depression