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Psychometric properties and validation of the Reasons for Living Inventory in an outpatient clinical population in Malaysia

Aishvarya S, Maniam T, Karuthan C, Sidi H, Ruzyanei N, Oei TP

Compr Psychiatry, 2014 Jan;55 Suppl 1:S107-13.
PMID: 24230486 DOI: 10.1016/j.comppsych.2013.06.010

The Reasons For Living Inventory has been shown to have good psychometric properties in Western populations for the past three decades. The present study examined the psychometric properties and factor structure of English and Malay version of the Reasons For Living (RFL) Inventory in a sample of clinical outpatients in Malaysia. The RFL is designed to assess an individual's various reasons for not committing suicide. A total of 483 participants (283 with psychiatric illnesses and 200 with non-psychiatric medical illnesses) completed the RFL and other self-report instruments. Results of the EFA (exploratory factor analysis) and CFA (confirmatory factor analysis) supported the fit for the six-factor oblique model as the best-fitting model. The internal consistency of the RFL was α=.94 and it was found to be high with good concurrent, criterion and discriminative validities. Thus, the RFL is a reliable and valid instrument to measure the various reasons for not committing suicide among psychiatry and medical outpatients in Malaysia.
Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)

Matched MeSH terms: Mental Disorders/epidemiology; Mental Disorders/psychology*
Fulltext Psychiatric and substance abuse comorbidity among HIV seropositive and HIV seronegative prisoners in Malaysia

Zahari MM, Hwan Bae W, Zainal NZ, Habil H, Kamarulzaman A, Altice FL

Am J Drug Alcohol Abuse, 2010 Jan;36(1):31-8.
PMID: 20141394 DOI: 10.3109/00952990903544828

To examine the association between HIV infection and psychiatric disorders among prisoners, where mental illness, substance abuse, and HIV are disproportionately represented.

Matched MeSH terms: Mental Disorders/complications; Mental Disorders/epidemiology*
Fulltext The pattern of completed suicides seen in Kuala Lumpur General Hospital 1999

Hayati AN, Salina AA, Abdullah AA, Eusni RT, Mansar AH

Med J Malaysia, 2004 Jun;59(2):190-8.
PMID: 15559169 MyJurnal

A study was done on 76 suicide cases managed by the Forensic Pathology Department of Hospital Kuala Lumpur (HKL) from January till December 1999 to explore the pattern of suicide and psychiatric history. The Chinese contributed 52% (n=40) of cases followed by the Indians (29%, n=22) and the Malays (12%, n=9). After the age of sixty, 84.6% of the subjects were Chinese. The common methods of suicide were poisoning (39%), hanging (34%) and jumping from height (22%). Four out of 12 case-notes traced had documented psychiatric history i.e. schizophrenia.

Matched MeSH terms: Mental Disorders/complications; Mental Disorders/epidemiology
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*; Mental Disorders/genetics*
Belief in supernatural causes of mental illness among Malay patients: impact on treatment

Razali SM, Khan UA, Hasanah CI

Acta Psychiatr Scand, 1996 Oct;94(4):229-33.
PMID: 8911557

The concept of aetiology of mental illness in 134 Malay patients was investigated by means of a 20-item checklist. About 53% of the patients attributed their illnesses to supernatural agents. Witchcraft and possession by evil spirits were regarded as common causes of illness. The number of patients who believed in supernatural causes of their mental illness was significantly higher among those who had consulted bomohs (Malay traditional healers) than among those who had not consulted them. The belief that mental illness is caused by supernatural agents is firmly held by bomohs, who reinforce this notion in those who seek their advice. Belief in supernatural causes of mental illness was not significantly associated with age, gender, level of education or occupation of the patients. Patients who believed in supernatural causes of mental illness were also found to show poor drug compliance, and the number of such patients at 6 months follow-up was significantly lower than the corresponding figure for those who did not believe in supernatural causes. The importance of understanding the patients' cultural background when treating psychiatric patients is highlighted.

Matched MeSH terms: Mental Disorders/psychology*; Mental Disorders/therapy
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; Mental Disorders/epidemiology*
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*; Mental Disorders/psychology
Population genetic variation of SLC6A4 gene, associated with neurophysiological development

Hande SH, Krishna SM, Sahote KK, Dev N, Erl TP, Ramakrishna K, et al.

J Genet, 2021;100.
PMID: 33764333

The serotonin transporter 5-HTT is encoded by a single gene SLC6A4. Polymorphisms in SLC6A4 has been associated with a wide variety of neurological and psychiatric disorders including increased risk of posttraumatic stress disorder, higher likelihood for depression, obsessive-compulsive disorder (OCD), increased hostility and criminal behaviour. Genes associated with complex diseases often exhibit strong signatures of purifying selection compared to others. Further, discernible population specific variation in the signature of natural selection have been observed for several complex disease-related genes. In this project we aimed to investigate the population genetic variation of the serotonin transporter gene (SLC6A4), focussing on the single nucleotide polymorphisms (SNPs). To this end, we employed 2504 individuals around the globe available in 1000 Genome project Phase III data and classified them into five ethnic groups: Americans (AMR), Europeans (EUR), Africans (AFR), East Asians (EAS) and South Asians (SAS). Principal component analysis (PCA) performed on all annotated SNPs of SLC6A4 depicted clear clustering between Africans and the rest of the world along PC1, and East Asians and other non-African populations along PC2. Further, these SNPs were found to be under strong selection pressure especially among East Asian populations with significantly high positive cross-population extended haplotype homozygosity scores compared to Africans, indicating that SLC6A4 has likely undergone a strong selective sweep among the East Asians in the recent past. Our study can potentially explain the association between polymorphisms in SLC6A4, and major depression and suicidal tendencies among people of East Asian ancestry and the absence of such associations among people of European ancestry.

Matched MeSH terms: Mental Disorders/etiology; Mental Disorders/pathology*
The psychiatric aspects of epilepsy

Teoh JI

Med J Malaysia, 1973 Sep;28(1):8-15.
PMID: 4273788
Matched MeSH terms: Mental Disorders/complications; Mental Disorders/etiology*
Caregiver burden among caregivers of individuals with severe mental illness: testing the moderation and mediation models of resilience

Mulud ZA, McCarthy G

Arch Psychiatr Nurs, 2017 Feb;31(1):24-30.
PMID: 28104054 DOI: 10.1016/j.apnu.2016.07.019

The association between the socio-demographic characteristics of caregivers, such as gender and caregiver burden, is well documented; however, the process underlying this relationship is poorly understood. Based on the stress process model, we designed a cross-sectional study to examine the mediating and moderating effect of resilience on the relationship between gender and caregiver burden. Caregivers of individuals with severe mental illness (n=201) were recruited in two psychiatric outpatient clinics in Malaysia. The relationship between the gender of the caregiver and caregiver burden was mediated by resilience, thus supporting the stress process model. The findings from the present research contribute to the growing evidence of the interaction between socio-demographic variables of caregivers and resilience, and caregiver burden.

Study site:Two clinics in West Malaysia Clinic A is located in the Klang administrative district, while clinic B is underthe Petaling administrative district

Matched MeSH terms: Mental Disorders/nursing; Mental Disorders/psychology*
Association of co-occurring psychosocial health conditions and HIV infection among MSM in Malaysia: Implication of a syndemic effect

Ng RX, Guadamuz TE, Akbar M, Kamarulzaman A, Lim SH

Int J STD AIDS, 2020 05;31(6):568-578.
PMID: 32299293 DOI: 10.1177/0956462420913444
Matched MeSH terms: Mental Disorders/epidemiology*; Mental Disorders/psychology
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/classification; Mental Disorders/diagnosis*
Fulltext The prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients: a systematic review and meta-regression

Salari N, Khazaie H, Hosseinian-Far A, Khaledi-Paveh B, Kazeminia M, Mohammadi M, et al.

Hum Resour Health, 2020 12 17;18(1):100.
PMID: 33334335 DOI: 10.1186/s12960-020-00544-1

BACKGROUND: Stress, anxiety, and depression are some of the most important research and practice challenges for psychologists, psychiatrists, and behavioral scientists. Due to the importance of issue and the lack of general statistics on these disorders among the Hospital staff treating the COVID-19 patients, this study aims to systematically review and determine the prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients.
METHODS: In this research work, the systematic review, meta-analysis and meta-regression approaches are used to approximate the prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients. The keywords of prevalence, anxiety, stress, depression, psychopathy, mental illness, mental disorder, doctor, physician, nurse, hospital staff, 2019-nCoV, COVID-19, SARS-CoV-2 and Coronaviruses were used for searching the SID, MagIran, IranMedex, IranDoc, ScienceDirect, Embase, Scopus, PubMed, Web of Science (ISI) and Google Scholar databases. The search process was conducted in December 2019 to June 2020. In order to amalgamate and analyze the reported results within the collected studies, the random effects model is used. The heterogeneity of the studies is assessed using the I2 index. Lastly, the data analysis is performed within the Comprehensive Meta-Analysis software.
RESULTS: Of the 29 studies with a total sample size of 22,380, 21 papers have reported the prevalence of depression, 23 have reported the prevalence of anxiety, and 9 studies have reported the prevalence of stress. The prevalence of depression is 24.3% (18% CI 18.2-31.6%), the prevalence of anxiety is 25.8% (95% CI 20.5-31.9%), and the prevalence of stress is 45% (95% CI 24.3-67.5%) among the hospitals' Hospital staff caring for the COVID-19 patients. According to the results of meta-regression analysis, with increasing the sample size, the prevalence of depression and anxiety decreased, and this was statistically significant (P mental disorders in the Hospital staff.

Matched MeSH terms: Mental Disorders/etiology; Mental Disorders/epidemiology*
Paternal age and common mental disorders

Krishnaswamy S, Subramaniam K, Indran H, Ramachandran P, Indran T, Indran R, et al.

World J Biol Psychiatry, 2009;10(4 Pt 2):518-23.
PMID: 19191074 DOI: 10.1080/15622970802653691

There is evidence in the literature that there are associations between advancing paternal age and psychosis or more specifically schizophrenia, but not enough to support a strong link between advancing paternal age and common mental disorders.

Matched MeSH terms: Mental Disorders/etiology*; Mental Disorders/epidemiology
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; Mental Disorders/epidemiology; Mental Disorders/psychology
Fulltext Anti N-Methyl-D-Aspartate receptor encephalitis: An under-recognised cause of encephalitis

Rajahram GS, Nadarajah R, Lim KS, Menon J

Med J Malaysia, 2015 Dec;70(6):363-4.
PMID: 26988212 MyJurnal

Anti-N-Methyl-D-Aspartate receptor (NMDAR) encephalitis is an immune mediated condition with characteristic clinical presentation. We report the first case from Borneo, Sabah and the use of electroconvulsive therapy (ECT) in treating recalcitrant psychiatrist symptoms associated with this condition.

Matched MeSH terms: Mental Disorders
Psychological interventions in cardiovascular disease: an update

Tan MP, Morgan K

Curr Opin Psychiatry, 2015 Sep;28(5):371-7.
PMID: 26181666 DOI: 10.1097/YCO.0000000000000181

To evaluate recent literature on psychological interventions in cardiovascular disease.

Matched MeSH terms: Mental Disorders/complications; Mental Disorders/etiology; Mental Disorders/therapy*
Help-seeking pathways among Malay psychiatric patients

Razali SM, Najib MA

Int J Soc Psychiatry, 2000;46(4):281-9.
PMID: 11201349

The aim of this study is to explore the help-seeking behaviour of Malay psychiatric patients. A semi-structured interview based on a standard proforma was conducted to assess help seeking process and delays for Malay psychiatric patients attending the psychiatric clinic for the first time. Help-seeking process and delays were defined. Among 134 patients evaluated in the study, 69% had visited traditional healers (bomoh) for the present illness before consulting psychiatrists. The second popular choice of treatment was medical practitioner and only a small percentage of them had consulted homeopathic practitioners and herbalists. Patients who had consulted bomohs were significantly delayed in getting psychiatric treatment compared with those who had not consulted them. Consultation of bomohs was significantly higher among married patients, those with major psychiatric illnesses and in family who believed in supernatural causes of mental illness. However, there was no significant difference in age, gender, educational status and occupation between patients who had consulted and not consulted bomoh. We concluded that majority of the Malay psychiatric patients had sought the traditional treatment prior to psychiatric consultation. The strength of social support and the belief of the patients, friends, and/or relatives in supernatural causes of mental illness were strongly associated with the rate of traditional treatment. Deep-seated cultural beliefs were major barrier to psychiatric treatment.

Matched MeSH terms: Mental Disorders/ethnology*; Mental Disorders/epidemiology; Mental Disorders/psychology
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; Mental Disorders/ethnology*; Mental Disorders/psychology
Disease, disorder, or deception? Latah as habit in a Malay extended family

Bartholomew RE

J. Nerv. Ment. Dis., 1994 Jun;182(6):331-8; discussion 339-41.
PMID: 8201305 DOI: 10.1097/00005053-199406000-00004

Thirty-seven cases of latah are examined within the author's Malay extended family (N = 115). Based on ethnographic data collected and a literature review, cases are readily divisible into two broad categories: habitual (N = 33) and performance (N = 4). The first form represents an infrequent, culturally conditioned habit that is occasionally used as a learned coping strategy in the form of a cathartic stress response to sudden startle with limited secondary benefits (i.e., exhibiting brief verbal obscenity with impunity). In this sense, it is identical to Western swearing. Performers are engaged in conscious, ritualized social gain through the purported exploitation of a neurophysiological potential. The latter process is essentially irrelevant, akin to sneezing or yawning. It is concluded that latah is a social construction of Western-trained universalist scientists. The concept of malingering and fraud in anthropology is critically discussed.

Matched MeSH terms: Mental Disorders/diagnosis*; Mental Disorders/ethnology; Mental Disorders/epidemiology

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