The Association of South East Asian Nations (ASEAN) was formed in 1971, and 10 years
later the ASEAN Federation for Psychiatry and Mental Health (AFPMH) was formally
launched. This article reviews the objectives, structure, membership, and the principles of
rotational participation and responsibility of the AFPMH, which has just celebrated its jubilee anniversary last year. Twenty-six years have passed, and the AFPMH has achieved many successes, including the congress, which is currently held every two years, and the ASEAN Journal of Psychiatry, which may be the oldest regional journal in the Asian continent. The bright future of ASEAN psychiatry is expected but relies heavily on the unity and commitment of all individual psychiatric associations within the ASEAN.
Depression as a symptom and a disease has been recognized from antiquity. While numerous references to melancholia, illnesses of the heart broken, and delusions of guilt are found in Shakespearean literature, world literature, stories, and dramas the world over, yet the development of modern western medicine has by and large tended to ignore all things psychological in the process of disease recognition and understanding. Even the face of a depressed patient, so obvious to the initiated, is a rarely taught and recognized sign of ill health by non- psychiatrists. The long association of psychiatry with severe psychoses in the minds of medical teachers has dulled the sense of astuteness in the picking up of anxiety and depression. It has also dulled the medical profession into the delusion that mental illnesses do not occur in general hospitals. Thus the fairly large number of mental problems in every day clinical practice remains an area of darkness. In practice, the pick up rate of all mental illnesses in primary care remains very low at less than 5% of all mental illnesses while studies show that about 25% of all primary care patients have significant mental problems that necessitate their attendance in the primary care clinics.
Malaysia is a tropical country in the heart of South East Asia, at the crossroads of the ancient east-west sea trade routes. Although independent from British colonial rule only in 1957, it has a recorded history dating back to at least the first century CE, when the region was already the source of valuable mineral and forest produce that found markets in China, India and further west.
The management of schizophrenias has undergone a revolution with the advent of Electroconvulsive Therapy (ECT) and a whole range of psycho-pharmaceuticals this century. Along with these, the newer trends towards more humane, and psycho-oriented patient-care have resulted in the management of patients in srnall general hospital units hardly different from a surgical or medical ward. The different areas of treatment of the schizophrenic cannot all be accomplished in a general practice clinic but a surprising number of these patients are successfully managed as out-patients. This paper aims to outline the modern methods used in the management of the schizophrenias and their suitability in general practice.