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Depression in male patients on methadone maintenance therapy

Baharudin A, Mislan N, Ibrahim N, Sidi H, Nik Jaafar NR

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:67-73.
PMID: 23857840 DOI: 10.1111/appy.12069

INTRODUCTION: Depression is one of the most common psychiatric conditions in men. The aim of the study was to determine the depressive symptoms and associated factors among men on methadone maintenance therapy (MMT).
METHODS: A cross-sectional study was conducted involving 108 subjects who attended the Drug Clinic at Hospital Kuala Lumpur. The instruments used include the Structured Clinical Interview for Diagnostic and Statistical Manual, Fourth Edition Axis-I Disorder, Beck Depression Inventory and the 15-item International Index of Erectile Function.
RESULTS: The rate of depression was 44.4%. There were significant associations between Malay ethnicity, secondary education level and concurrent illicit cannabis use with depression (P
Is increased libido an atypical symptom of bipolar depression? An interesting case

Mahadevan R, Nik Jaafar NR, Sidi H, Midin M, Das S

J Sex Med, 2013 Mar;10(3):883-6.
PMID: 23036068 DOI: 10.1111/j.1743-6109.2012.02949.x

Decreased libido is recognized as one of the vegetative symptoms of depression. Increased libido has not been acknowledged as one of its symptoms, neither has it been reported, particularly in depressed bipolar patients.
The female sexual response cycle: do Malaysian women conform to the circular model?

Sidi H, Naing L, Midin M, Nik Jaafar NR

J Sex Med, 2008 Oct;5(10):2359-66.
PMID: 18086161

The concept of a sexual response cycle (SRC) for women has gained interest lately with the reintroduction of terms with new definitions and a new model for the sexual response, especially the Basson's circular model.
Fulltext Sexual desire and sexual arousal in Malaysian women: are they of the same entity?

Nik Jaafar NR, Midin M, Wan Puteh SE, Musa R

ASEAN Journal of Psychiatry, 2009;10(1):43-53.
MyJurnal

Objective: To investigate the correlation between sexual desire and sexual arousal among Malaysian women in a primary care setting. Methods: The Malay Version of Female Sexual Function Index (MVFSI) was used to assess low sexual desire and lack of sexual arousal among the respondents. A total of 230 married women aged 18 – 70 years old participated in this study. Their sociodemographic, marital profiles and correlation between low sexual desire and lack of sexual arousal were examined. Results: More than 60% respondents with low sexual desire have co-exist low sexual arousal and 94.4% respondents with high sexual desire do have high sexual arousal ( χ²= 79.6, p
Risk and associated factors of female sexual orgasmic disorder in women with hypertension in Malaysia

Abdul Latif R, Muhamad R, Kanagasundram S, Sidi H, Nik Jaafar NR, Midin M, et al.

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:21-6.
PMID: 23857833 DOI: 10.1111/appy.12039

The objective of this study was to examine the risk of female sexual orgasmic disorder among a group of women with hypertension in Malaysia. The associated factors were also examined.
Phases of female sexual response cycle among Malaysian women with infertility: a factor analysis study

Seen Heng Y, Sidi H, Nik Jaafar NR, Razali R, Ram H

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:50-4.
PMID: 23857837 DOI: 10.1111/appy.12044

This cross-sectional study aimed to determine the construct of the phases of the female sexual response cycle (SRC) among women attending an infertility clinic in a Malaysian tertiary center.
Association between 5HT2A polymorphism and selective serotonin re-uptake inhibitor (SSRI)-induced sexual desire disorder (SDD) among Malaysian women

Masiran R, Sidi H, Mohamed Z, Mohamed Saini S, Nik Jaafar NR

Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:41-9.
PMID: 23857836 DOI: 10.1111/appy.12043

SSRIs are known for their sexual side-effects with a variable rate of sexual dysfunction (SD). 5HT2A (rs6311) single nucleotide polymorphism (SNP) was found to have significant association with SD. The purpose of this study was to determine the prevalence of female SDD, its clinical correlates and association with 5HT2A (rs6311) SNP in patients with major depressive disorder (MDD) treated with SSRIs.
Why do young adolescents bully? Experience in Malaysian schools

Wan Ismail WS, Nik Jaafar NR, Sidi H, Midin M, Shah SA

Compr Psychiatry, 2014 Jan;55 Suppl 1:S114-20.
PMID: 23763872 DOI: 10.1016/j.comppsych.2013.05.002

INTRODUCTION: To determine sociodemographic and psychological factors associated with bullying behavior among young adolescents in Malaysia.
METHODS: This is a cross-sectional study of four hundred ten 12-year-old adolescents from seven randomly sampled schools in the Federal Territory of Kuala Lumpur, Malaysia. Sociodemographic features of the adolescents and their parents, bullying behavior (Malaysian Bullying Questionnaire), ADHD symptoms (Conners Rating Scales), and internalizing and externalizing behavior (Child Behaviour Checklist) were obtained from adolescents, parents and teachers, respectively.
RESULTS: Only male gender (OR=7.071, p=0.01*, CI=1.642-30.446) was a significant sociodemographic factor among bullies. Predominantly hyperactive (OR=2.285, p=0.00*, CI=1.507-3.467) and inattentive ADHD symptoms reported by teachers (OR=1.829, p=0.03*, CI=1.060-3.154) and parents (OR=1.709, p=0.03*, CI=1.046-2.793) were significant risk factors for bullying behavior while combined symptoms reported by young adolescents (OR=0.729, p=0.01*, CI=0.580-0.915) and teachers (OR=0.643, p=0.02*, CI=0.440-0.938) were protective against bullying behavior despite the influence of conduct behavior (OR=3.160, p=0.00*, CI=1.600-6.241). Internalizing behavior, that is, withdrawn (OR=0.653, p=0.04*, CI=0.436-0.977) and somatic complaints (OR=0.619, p=0.01*, CI=0.430-0.889) significantly protect against bullying behavior.
DISCUSSIONS: Recognizing factors associated with bullying behavior, in particular factors distinctive to the local population, facilitates in strategizing effective interventions for school bullying among young adolescents in Malaysian schools.
Psychometric properties and validation of the Satisfaction with Life Scale in psychiatric and medical outpatients in Malaysia

Aishvarya S, Maniam T, Karuthan C, Sidi H, Nik Jaafar NR, Oei TP

Compr Psychiatry, 2014 Jan;55 Suppl 1:S101-6.
PMID: 23602389 DOI: 10.1016/j.comppsych.2013.03.010

The present study evaluated the psychometric properties and factor structure of the Satisfaction With Life Scale (SWLS) in a sample of clinical outpatients in Malaysia. The SWLS is a measure designed to assess subjective life satisfaction. Four hundred eighty-three participants (283 with psychiatric illnesses and 200 with other medical illnesses) completed the SWLS and other self-report instruments. Results of the EFA and CFA supported the fit for the one-factor model as the best-fitting model. The internal consistency of the SWLS (α=0.86) was found to be high. Correlational analyses showed that SWLS had adequate concurrent validity. Scores on SWLS, which differentiated psychiatric patients and medical patients, supported criterion validity. The logistic regression analyses showed good discriminative validity of SWLS. The SWLS is a reliable and valid instrument to measure the satisfaction with life among psychiatry and clinical outpatients in Malaysia.
Study site: medical and psychiatric clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Employment program for patients with severe mental illness in Malaysia: a 3-month outcome

Wan Kasim SH, Midin M, Abu Bakar AK, Sidi H, Nik Jaafar NR, Das S

Compr Psychiatry, 2014 Jan;55 Suppl 1:S38-45.
PMID: 23602390 DOI: 10.1016/j.comppsych.2013.03.011

OBJECTIVE: This study aimed to examine the rate and predictive factors of successful employment at 3 months upon enrolment into an employment program among patients with severe mental illness (SMI).
METHODS: A cross-sectional study using universal sampling technique was conducted on patients with SMI who completed a 3-month period of being employed at Hospital Permai, Malaysia. A total of 147 patients were approached and 126 were finally included in the statistical analyses. Successful employment was defined as the ability to work 40 or more hours per month. Factors significantly associated with successful employment from bivariate analyses were entered into a multiple logistic regression analysis to identify predictors of successful employment.
RESULTS: The rate of successful employment at 3 months was 68.3% (n=81). Significant factors associated with successful employment from bivariate analyses were having past history of working, good family support, less number of psychiatric admissions, good compliance to medicine, good interest in work, living in hostel, being motivated to work, satisfied with the job or salary, getting a preferred job, being in competitive or supported employment and having higher than median scores of PANNS on the positive, negative and general psychopathology. Significant predictors of employment, from a logistic regression model were having good past history of working (p<0.021; OR 6.12; [95% CI 2.1-11.9]) and getting a preferred job (p<0.032; [OR 4.021; 95% CI 1.83-12.1]).
CONCLUSION: Results showed a high employment rate among patients with SMI. Good past history of working and getting a preferred job were significant predictors of successful employment.
Pre-marital sex and its predicting factors among Malaysian youths

Manaf MR, Tahir MM, Sidi H, Midin M, Nik Jaafar NR, Das S, et al.

Compr Psychiatry, 2014 Jan;55 Suppl 1:S82-8.
PMID: 23587530 DOI: 10.1016/j.comppsych.2013.03.008

This study aimed to examine the prevalence of pre-marital sex and its predicting factors among youth trainees undergoing a national skill training programme in the state of Malaysia.
The relationship between sexual functioning among couples undergoing infertility treatment: a pair of perfect gloves

Yeoh SH, Razali R, Sidi H, Razi ZR, Midin M, Nik Jaafar NR, et al.

Compr Psychiatry, 2014 Jan;55 Suppl 1:S1-6.
PMID: 23116967 DOI: 10.1016/j.comppsych.2012.09.002

The study aimed to measure the relationship of sexual functioning between male and female partners, who sought infertility treatment in a university hospital setting in Malaysia.
Serotonin transporter gene polymorphism and its association with bipolar disorder across different ethnic groups in Malaysia

Mohamed Saini S, Nik Jaafar NR, Sidi H, Midin M, Mohd Radzi A, Abdul Rahman AH

Compr Psychiatry, 2014 Jan;55 Suppl 1:S76-81.
PMID: 23410635 DOI: 10.1016/j.comppsych.2012.12.005

The risk variants have been shown to vary substantially across populations and a genetic study in a heterogeneous population might shed a new light in the disease mechanism. This preliminary study aims to determine the frequency of the serotonin transporter gene polymorphism (5-HTTLPR) in the three main ethnic groups in Malaysia and its association with bipolar disorder.
Risk factors of erectile dysfunction in patients receiving methadone maintenance therapy

Nik Jaafar NR, Mislan N, Abdul Aziz S, Baharudin A, Ibrahim N, Midin M, et al.

J Sex Med, 2013 Aug;10(8):2069-76.
PMID: 23445463 DOI: 10.1111/jsm.12105

INTRODUCTION: While methadone effectively treats opiate dependence, the side effect of erectile dysfunction (ED) may interfere with treatment adherence and benefits.
AIM:To determine the rate of ED and the associated factors which predict ED in male patients on methadone maintenance therapy (MMT) in a Malaysian population.
MAIN OUTCOME MEASURES: The main outcome measures were the International Index of Erectile Function-15 (IIEF-15) and the Beck Depression Inventory (BDI).
METHODS: A total of 108 participants diagnosed with heroin dependence were assessed. We used the Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I) on subjects who received MMT, and they were assessed using the IIEF-15, the BDI, and measures of other clinical and sociodemographic variables.
RESULTS: The rate of ED among men on MMT was 68.5% (mild ED, 36.1%; mild to moderate ED, 22.2%; severe ED, 3.7%). The mean age of the participants was 43.45 years. Older age (P = 0.002), concurrent illicit heroin use (P = 0.024), and having an older partner (P = 0.039) were significantly associated with ED. Following multivariate analysis, it was found that older age was the only significant predictor of ED, with an adjusted odds ratio of 1.07 (95% CI = 1.02-1.16). Methadone dose and duration of methadone treatment were not significantly associated with ED.
CONCLUSION: ED was highly prevalent among male patients on MMT. This suggests that there is a need for routine assessment of sexual function in patients on methadone. Among the risk factors, age was the only factor that was significantly associated with ED. The current use of MMT in Malaysia in terms of dosage and duration did not pose a significant risk for ED.
KEYWORDS: Erectile Dysfunction; Methadone Therapy; Opiate Dependence
Study site: outpatient clinic for opiate substitution therapy, Hospital Kuala Lumpur (HKL), Malaysia
Fulltext Structured Walking and Chronic Institutionalized Schizophrenia Inmates: A pilot RCT Study on Quality of Life

Loh SY, Abdullah A, Abu Bakar AK, Thambu M, Nik Jaafar NR

Glob J Health Sci, 2016;8(1):238-48.
PMID: 26234968 DOI: 10.5539/gjhs.v8n1p238

Lifestyle moderate-intensity physical activity can lower the risk of over twenty chronic health conditions, whilst inactivity reduces daily functioning and physical health of individuals living with schizophrenia. This study conducted in 2014 examines the effect of structured walking participation on QOL, psychosocial functioning and symptoms in Hospital Permai, one of the largest psychiatry institution in Asia
Fulltext Psychometric Properties of the Malay Version of the Internet Gaming Disorder Scale-Short Form (IGDS9-SF-M): Evidence from a Sample of Malaysian Undergraduates

Ling SL, Nik Jaafar NR, Tan KA, Bahar N, Baharudin A, Ahmad Tajjudin AI

Int J Environ Res Public Health, 2021 03 05;18(5).
PMID: 33807598 DOI: 10.3390/ijerph18052592

In recent years, increased interest in Internet Gaming Disorder has led to the development of the Internet Gaming Disorder Scale-Short Form. Translation and subsequent validation of such a scale are important for cross-cultural use. The aim of the present study was to examine the psychometric properties (factor structure, reliability, and validity) of the Malay Version of the Internet Gaming Disorder Scale-Short Form using a sample of Malaysian undergraduates. The present sample included 137 Malaysian undergraduates. Participants completed a self-administered online survey containing demographic items, the Malay Version of the Internet Gaming Disorder Scale-Short Form, the Problematic Online Gaming Questionnaire-Short Form, and the Malay Version of the Internet Addiction Test. The present findings confirm the one-factor model of the Malay Version of the Internet Gaming Disorder Scale-Short Form. Good reliability, as measured by Cronbach alpha, was found for the Malay Version of the Internet Gaming Disorder Scale-Short Form. The Malay Version of the Internet Gaming Disorder Scale-Short Form has demonstrated concurrent validity by significantly correlating with the Problematic Online Gaming Questionnaire-Short Form as well as demonstrated convergent validity with respect to the Malay Version of the Internet Addiction Test. The Malay Version of the Internet Gaming Disorder Scale-Short Form is a reliable and valid tool for assessing Internet Gaming Disorder in Malaysian undergraduates. As more research is still needed to confirm the status of Internet Gaming Disorder as a formal disorder, it is hoped that the Malay Version of the Internet Gaming Disorder Scale-Short Form can facilitate future research examining antecedents and consequences of Internet Gaming Disorder in a Malaysian setting.
Fulltext The association between the attention deficit hyperactivity disorder(ADHD) symptoms and bully/victim problem among malaysian sixth-graders

Wan Ismail WS, Nik Jaafar NR, Mohd Daud TI, Shah SA, Ismail A, Shafiee Z

ASEAN Journal of Psychiatry, 2010;11(1):79-86.
MyJurnal

Objective: School bullying in Malaysia is on the rise. While efforts are put together to combat the problem, the psychiatric aspect has been neglected. This is a cross-sectional study aimed to determine the association between the symptoms of ADHD and bully/victim problems among Malaysian sixthgraders attending primary schools in Kuala Lumpur.
Methods: A total of 410 sixth-graders from seven randomly selected schools were assessed with regards to bully/victim problems and ADHD symptoms using self-reported questionnaires. Malaysian Bullying Questionnaire was used to rate bully/victim problems while ADHD symptoms were assessed using ConnersWells’ Adolescent Self-report Scale (CASS). Teachers and parents also assessed students’ ADHD symptoms using Conner’s Teachers Rating Scale (CTRS) and Conner’s Parents Rating Scale (CPRS), respectively.
Results: Self-reported questionnaires showed that 61.2% of the children were involved in bully/victim problems. The ADHD symptoms were found significant in relation to bully/victim problems as tested by multiple logistic regression. Only students and parents reported significant ADHD symptoms among the bully/victim groups. The ADHD symptoms reported by students were significant among bullies(OR=0.59,CI=0.42-0.83, p
Prevalence of cognitive impairment using the Montreal Cognitive Assessment questionnaire among patients with systemic lupus erythematosus: a cross-sectional study at two tertiary centres in Malaysia

Kanapathy A, Nik Jaafar NR, Shaharir SS, Chan LF, Rozita M, Ch'ng SS

Lupus, 2019 Jun;28(7):854-861.
PMID: 31159651 DOI: 10.1177/0961203319852153

INTRODUCTION: Cognitive impairment is a common neuropsychiatric manifestation of systemic lupus erythematosus (SLE). However, it is not routinely assessed for despite its high prevalence and significant disease burden.
AIMS: This study aimed to determine the prevalence of mild cognitive impairment (MCI) using the Montreal Cognitive Assessment (MoCA) and its associated factors among patients diagnosed with SLE in Malaysia.
METHODS: A total of 200 SLE patients were recruited prospectively from the outpatient clinics of two tertiary hospitals in Malaysia. Standardized clinical interview was utilized to obtain information on socio-demographic characteristics. All patients were then assessed using the MoCA questionnaire for presence of cognitive impairment; the Patient Health Questionnaire 9 (PHQ-9) for presence of depressive symptoms; and the Wong-Baker Faces Pain Scale (WBFPS) for severity of pain. The evaluation of disease activity and severity were performed by the treating rheumatologists and nephrologists using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborating Clinics Damage Index (SLICC DI).
RESULTS: The prevalence of MCI was 35%. The significant associated factors from the bivariate analysis were male gender (p = 0.04), educational level (p = 0.00), WBFPS score (p = 0.035) and anticardiolipin IgM (p = 0.01). Further analysis using logistic regression model found that male gender (OR = 7.43, 95% confidence interval 1.06-52.06, p = 0.04), lower educational level (OR = 4.4, 95% confidence interval 1.47-13.21, p = 0.01) and presence of anticardiolipin IgM (OR = 6.81, 95% confidence interval 1.45-32.01, p = 0.031) were associated with impaired MoCA scores. Also, increasing pain scores increased the risk of patients being affected by cognitive impairment.
CONCLUSION: Over one-third of patients with SLE in our cohort were found to have MCI. Risk factors included male gender, lower educational level, higher pain score and presence of anticardiolipin IgM. Physicians are encouraged to perform routine screening to detect cognitive dysfunction in patients with SLE in their clinical practice as part of a more comprehensive management.
Fulltext Mental Health Status of University Healthcare Workers during the COVID-19 Pandemic: A Post-Movement Lockdown Assessment

Woon LS, Sidi H, Nik Jaafar NR, Leong Bin Abdullah MFI

Int J Environ Res Public Health, 2020 12 08;17(24).
PMID: 33302410 DOI: 10.3390/ijerph17249155

This study investigated the prevalence and severity of depression, anxiety, and stress and determined the association between various factors, social support, and depression, anxiety, and stress among university healthcare workers in Malaysia after the government lifted the movement control order (MCO) put in place to curb the coronavirus disease 2019 (COVID-19) pandemic. This online, cross-sectional survey recruited 399 participants from two university hospitals, and they were administered a self-reported questionnaire on demographic, personal, and clinical characteristics, as well as COVID-19-related stressors and coping. In addition, they completed the Multidimensional Scale of Perceived Social Support (MSPSS) to measure perceived social support, as well as the 21-item Depression, Anxiety, and Stress Scale (DASS-21) to assess depression, anxiety, and stress. We found that the prevalence rates of depression, anxiety, and stress were 21.8%, 31.6%, and 29.1%, respectively. Participants with moderate to extremely severe depression, anxiety, and stress made up 13.3%, 25.8%, and 8.1% of the sample, respectively. Being single or divorced, fear of frequent exposure to COVID-19 patients, agreeing that the area of living had a high prevalence of COVID-19 cases, uncertainty regarding the prevalence of COVID-19 cases in the area of living, and a history of pre-existing psychiatric illnesses were associated with higher odds of depression, anxiety, and stress. Conversely, having more than three children and greater perceived friend support were associated with lower odds of depression, anxiety, and stress. The prevalence of depression, anxiety, and stress remained elevated even after the MCO was lifted.
Study site: Hospital Universiti Sains Malaysia (HUSM); Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
Fulltext The Relationship between Internet Addiction, Internet Gaming and Anxiety among Medical Students in a Malaysian Public University during COVID-19 Pandemic

Ismail N, Tajjudin AI, Jaafar H, Nik Jaafar NR, Baharudin A, Ibrahim N

Int J Environ Res Public Health, 2021 11 12;18(22).
PMID: 34831627 DOI: 10.3390/ijerph182211870

The internet has become an important medium for learning and communication during the COVID-19 pandemic, particularly for university students. Nevertheless, an increase in internet usage could predispose people to internet addiction (IA) and internet gaming (IG). Equally, there is concern that anxiety levels have increased during the pandemic. The aim of this study is to determine the prevalence of IA and IG, and their associations with anxiety among medical students during the pandemic. Data were collected during the second wave of the "Conditional Movement Control Order" (CMCO) in Malaysia between 12 November and 10 December 2020. A total of 237 students participated through proportionate stratified random sampling in this cross-sectional study. They completed a set of online questionnaires which consisted of a sociodemographic profile, the Malay version of the internet addiction test (MVIAT), the Malay version of the internet gaming disorder-short form (IGDS9-SF) and the Malay version of the depression, anxiety and stress scale (DASS-21). The prevalence of IA and internet gaming disorder (IGD) were 83.5% and 2.5%, respectively. A multiple logistic regression showed that those in pre-clinical years had a greater risk of anxiety than those in clinical years [(AOR) = 2.49, p-value 0.01, 95% CI = 1.22-5.07]. In contrast, those who scored high on IA were protected against anxiety [AOR = 0.100, p-value 0.03, 95% CI = 0.01-0.76)]. In conclusion, IA was highly prevalent during the COVID-19 pandemic and its high usage might serve as a protective factor against anxiety among the medical students in this study sample.

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