Food is closely related with emotion. It often provides comfort and satisfaction. Some individuals choose to turn to food to curb their negative emotion, resulting in disturbances in
eating patterns, such as overeating which lead to obesity and severely controlling food intake, which culminate in eating disorders like anorexia nervosa, bulimia nervosa and binge eating. These disorders are not related to the eating problems per se but often due to underlying or complicated by psychological factors, namely depression, anxiety, impulse control problems and personality. The roles of psychological factors in eating disorders and obesity should therefore not be downplayed. These disorders should be managed comprehensively involving multiple approaches, including not only biological but also psychological interventions provided by a professional team comprising endocrinologists, psychiatrists, dietitians, exercise physicians and surgeons.
We aimed to report the first case of anorexia nervosa in a young Malaysian Malay homosexual man with underlying borderline personality disorder and major depression. Patient and parents were interviewed. The Structured Clinical Interview for DSM IV was used to generate Axis-I diagnosis. The Hamilton Depressive Rating Scale was used to assess the severity of depression. His parents had marital discord. His father was overinvolved. Regarding anorexia nervosa, he had 163 cm height, 46kg weight and a body mass index (BMI) of 17 kg/m2. His four limbs had multiple scratch marks. Laboratory test results showed anemia, leukocytosis and hypoalbuminemia. Family pathology, borderline personality disorder and homosexuality could be the risk factors of anorexia nervosa in this patient.
The various shortcomings involving issues related to managing patients with mental health are compared to those with physical health which are mainly attributed to attitude, misconception and stigma attached to mental health. There is a strong need to have a comprehensive collective efforts and a paradigm shift on how to deal with these critical issues especially in the area of Primary care for mentally ill.
The burden of caring patients with Schizophrenia was extensive and mental health professionals need to be more aware of the burden of mental illness on family members. There are four main sources of burden, namely restriction on the carer’s social and leisure activities, the strain placed on finances and employment, the emotional impact and the difficulty in dealing with dysfunctional and bizarre behaviors. Effective family intervention programs need to be done including to treat the depressive disorders among the carers.
Objective: This study aimed to determine the prevalence of obesity among patients with schizophrenia and its association with the demographic profile. Methods: This is a cross sectional study. Subjects were selected using systematic sampling. Patients attending the out patient psychiatric clinic, Hospital Universiti Kebangsaan Malaysia, who fulfilled the criteria and able to give consent were included in this study. Diagnosis of schizophrenia was made using Structured Clinical Interview (SCID) for DSM-IV. Demographic profiles of the patients were obtained and anthropometric measurements were measured and classified according to Body Mass Index (BMI) and Waist Circumference (WC) of Asian population. Results: A total of 97 patients were included. The prevalence of overweight (BMI: 23.0- 27.4 kg/m2) was 39.2% (n=38), and the prevalence of obesity (BMI: >27.0 kg/m2) was 35.1% (n=34). BMI was higher among non-Chinese (Malay and Indian, p=.03) and those who had low total household income (p=.03). Sixty-two patients (63.9%) had high WC, which was associated with male (p=.003) and non-Chinese (p=.03). Conclusions: Obesity is highly prevalent among patients with schizophrenia. The risk factors for obesity include male, non-Chinese and those with low total income. The high WC among non-Chinese and male patients suggests that they are at a higher risk of developing obesity-related physical illnesses. These findings support that obesity is a common critical issue among schizophrenic patients, and it warrants serious clinical interventions.
Study site: Psychiatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
Objective: This descriptive cross-section, community-based study examined the prevalence of psychiatric morbidity and quality of life (QOL) and the associated factors among family caregivers of hospice patients with cancer. Methods: Subjects were 50 family caregivers of cancer patients under the care of Hospice Malaysia homecare. Home visits were done in Klang Valley. Psychiatric morbidity was detected using GHQ-30 English and Bahasa Malaysia versions, and the QOL was assessed by the Short Form 36 items (SF-36) questionnaire. Results:The study results showed that 54% of respondents had psychiatric morbidity. The educational status and the relationship between family caregivers and the cancer patients were statistically significant (p
Obesity is highly prevalent among patient with schizophrenia. It is therefore important to know whether lifestyle factors could contribute to obesity. The objective of this paper is to study the prevalence of overweight, obesity and high waist circumference (WC) in relation to Binge eating and lifestyle factors among patients with schizophrenia. This is a cross sectional study for a period of three and a half months which systematically selected patients with schizophrenia who fulfilled the inclusion criteria. The diagnosis of schizophrenia was made using Structured Clinical Interview for DSM-IV (SCID). The diagnosis of Binge Eating Disorder (BED) and the assessment of lifestyle factors were made using Eating Disorder, Module H of SCID and Health Promoting Lifestyle Profile II (HPLP II) respectively. The prevalence of overweight was 39.2 %, obesity was 35.1 % and high waist circumference was 63.9 %. The difference between presence of BED among patients who had normal and either overweight or obese was not significant (?2 with Yates correction 3.34, p=0.06). BED was found to be more in patients with high WC (n=11, 78.6 %) than those with normal WC (n=3, 21.4 %) but the difference was not significant (?2=1.88, p=0.21). In term of lifestyle factors, no significant different found between those who smoke and those who did not smoke in relation to BMI (?2=0.00, p=0.98) and WC (?2=0.15, p=0.90). There was no difference between total score of diet and exercise among patients who had normal weight and those who were either overweight or obese in relation to BMI (t=1.30, p=0.20) and WC (t=0.91, p=0.36) and BMI (t=0.80, p=0.43) and WC (t=0.02, p=0.98) respectively. There were also no differences between total score of all four domains of psychological lifestyle i.e. stress management, health responsibility, spiritual growth and interpersonal relationship among patients who had normal weight and those who were overweight and obese in relation to BMI and WC (p>0.05). Presence of Binge eating disorder and the lifestyle factors did not contribute to obesity among patients with schizophrenia. Keywords: Schizophrenia, obesity, lifestyle, binge eating disorder