Psychogenic polydipsia is prevalent among people with schizophrenia. Although its pathophysiology is relatively unknown, it causes life threatening complications due to acute or severe hyponatraemia.. This report illustrates a patient with schizophrenia who had unrecognized psychogenic polydipsia and developed severe complication. It also highlights the clinical salience of its management.
The increasing trend of Chronic Kidney Disease (CKD) prevalence in Indonesia is a public health concern as it increases mortality, morbidity and burden of disease that has great implication on the health economic. In addition, CKD patients who are more likely to undergo hemodialysis is commonly associated with psychological problems such as depression, anxiety and stress and these have added more to the disease burden. Immediate measures such as progressive muscle relaxation (PMR) to reduce the psychological symptoms is of great importance before the symptoms progress into psychiatric disorders. The study was aimed to evaluate the effectiveness of PMR in reducing symptoms of depression, anxiety and stress among patients undergoing hemodialysis. It was a quasi-experimental, pretest-posttest control study that recruited 60 eligible respondents who underwent hemodialysis and was randomly allocated into intervention and wait-list control groups. Respondents in the intervention group performed PMR twice a day for two weeks. Mean scores of depression, anxiety and stress of respondents were examined before and after intervention using Depression, Anxiety and Stress Scale–21 questionnaire (DASS-21). Results showed that mean scores of depression, anxiety and stress differed significantly before and after intervention between groups and within the intervention group (p
Objective: The study aims to determine pattern of verbal memory and learning impairment and its associated factors among patients with bipolar I disorder in a psychiatric clinic of a university hospital. Methods: A case control study comparing verbal memory test
performance in 40 patients with bipolar I disorder to that of 40 healthy normal subjects using Rey Auditory Verbal Learning Test (RAVLT). The association between demographic, clinical
characteristics and poor verbal memory performance were examined. Results: Up to 92% of patients with bipolar I disorder have impaired short term working memory in this hospital-based study. They also recalled fewer words in all the RAVLT trials and had difficulties
learning the word list in comparison to that of normal healthy individuals. Verbal memory and learning impairment are observed in bipolar illness in the absence of active mood symptoms while duration and severity of illness are not found to have any effect on verbal memory and learning. Conclusion: There is consistent verbal memory and learning problems in individuals with bipolar I disorder and their presence in the absence of mania, depression and mixed symptoms during the course of the illness suggests a trait related deficit.
Study site: Psychiatric Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
The use of atypical antipsychotic agents in early onset schizophrenia is rising despite its limited data on efficacy, safety and tolerability. Early onset schizophrenia warrants effective pharmacological treatment that is safe and well tolerated by children and adolescent population. Existing atypical agents are not completely free of side effects. Aripiprazole has unique properties that differ from other atypical antipsychotics and fill up the missing gaps, as it is associated with minimal metabolic complications and extrapyramidal side effects that are more commonly seen in other atypical agents. It offers a better option for this population and may possibly be considered as first line treatment in future. This case report demonstrates the efficacy and safety of Aripiprazole in children and adolescent population.
Overweight and obesity have become a serious health issue in worldwide and Malaysia is no exception. In view that obesity is one of the leading causes of non-communicable diseases, this systematic review aimed to explore whether Malaysian are getting fatter (overweight or obesity) and rounder (abdominal obesity). Searches of the published literature were conducted using 3 databases including EMBASE, MEDLINE, and PubMed. These were limited to cross-sectional or cohort studies in Malaysia. The databases provided the prevalence of overweight, obesity, and abdominal obesity among 15 years old and above Malaysian population from 2009 to 2015. In total, 47 articles were included in this review. Findings exhibit that the prevalence rates of overweight, obesity, and abdominal obesity range from 9.5% to 43.5%, 1.77% to 26.4% and 11.4% to 57.4%, respectively. Overweight is more predominant among males. However, obesity and abdominal obesity are more predominant among females. This means that more females are getting fatter and “rounder” as compared to males in Malaysia. The findings imply a lack of intervention programmes based on proper randomized controlled trials which are needed to adequately address the problem of obesity in Malaysia.
Major depressive disorder (MDD) is a serious mental illness with a multifactorial aetiology that was shown to influence behaviour and affect cognition. Previous research has favoured the involvement of dopamine in the aetiology of the disorder, and since one of the critical regulators of the dopamine levels and activity in the brain is DAT1, the present study investigated the association of a single nucleotide polymorphism in the DAT1gene (rs40184) and MDD in the Malaysian population. A total of 300cases and 300 matched controls were recruited from four Klang valley hospitals and were screened for DAT1rs40184 using high resolution melting assays. The allele and genotype frequencies were analysed by using Chi-square. Hardy Weinberg equilibrium for the distribution of alleles and genotypes was tested by using Chi-square. Determination of the association between rs40184 and MDD was achieved by conditional logistic regression using SPSS. In the present study, no significant association was obtained between DAT1and MDD in the Malaysianpopulation.
The aim of this study was to evaluate the effects of a DVDdelivered mindfulness-based intervention for reducing stress among medical students in a Malaysian university. Methods: A total of 76 medical students participated in the intervention program (Mindful-Gym DVD). They were stratified according to year of studies and randomly allocated to intervention (N = 38) and control groups (N = 38). The following outcome variables were measured at pre- and post-intervention: mindfulness (with Mindful Attention Awareness Scale, MAAS); perceived stress (with Perceived Stress Scale, PSS); mental distress (with Depression, Anxiety and Stress Scale, DASS); and self-efficacy (with General Selfefficacy Scale, GSE). Hierarchical multiple regression analyses were used to analyse the effect of group (Intervention vs. Control) on changes in the outcome variables. Results: One week after the intervention, participants in the intervention group reported significantly greater improvements with small to medium effect sizes in self-reported levels of mindfulness (β =0.19, ∆R2= 0.04, p = 0.028, f2= 0.07), perceived stress (β = -0.25, ∆R2=0.06, p = 0.006, f2= 0.11), mental distress (β = -0.27, ∆R2= 0.07, p =0.003, f2= 0.13), and self-efficacy (β = 0.27, ∆R2= 0.07, p = 0.003, f2= 0.13), compared to participants in the control group. The number needed to treat (NNT) to achieve ‘normal’ levels of depressive, anxiety, and stress symptoms (as indicated by the DASS scores) were 5, 8, and 6 respectively. Conclusions: This study found that the DVD-delivered mindfulness-based program is potentially a labour- and cost-effective and easily accessible stress reduction program for medical students.
Introduction: Water pipe use is becoming increasingly common among Iranian adolescents. This study examined the prevalence and predictors of water pipe use among public high schoolchildren aged 14-17 in Iran.
Methods: A cross-sectional study was conducted among 1st, 2nd and 3rd grade public high schoolchildren in Sanadaj City, capital of Kurdistan province of Iran during the academic year 2012-2013. Cluster sampling was used to select a sample from 8 public high schools. The data were collected using validated self-administrated questionnaire that included questions on water pipe use, socio-demographic characteristics, smoking-related knowledge, attitude toward smoking, normative believes regards perceived prevalence water pipe use among peer and adults, perception of harm, self-esteem and refusal skill. A multivariate logistic regression analysis was performed to assess predictors of water pipe use.
Results: A total of 1837 students participated in this study. Students’ ages ranged from 14 to 17 years (mean age±15.09; SD±0.82 years). The overall prevalence of ever water pipe use was 36.2% (43.1% in male and 29.2% in female, (p<0.001). Age, gender, living arrangement, pocket money, academic grade, parental history of smoking, attitude, and normative believes regards perceived prevalence water pipe use among peer and adults were predictors of water pipe use among study participants.
Conclusions: The overall prevalence of water pipe is high among high school children in Sanandaj. Age, gender, pocket money, academic grade, parents smoking, attitude toward smoking and normative believes were identified as the most important predictors increasing the risk of water pipe use in the studied students.
Keywords: Water pipe use, Prevalence, Predictors of Water Pipe, High school children
Introduction: Adolescence is a crucial period with impressive emotional changes. Emotional disorders such as
depression, anxiety and stress are high among adolescents worldwide; however the psychosocial changes are often
neglected. The aim of the current study was to determine the depression, anxiety and stress symptoms and their
associated factors among adolescents. Methods: A cross-sectional study using cluster sampling was carried out
among school-going adolescents in 10 secondary schools in Pasir Gudang, Johor, Malaysia. Respondents answered
a self-administered questionnaire including socio-demographic, Inventory of Parent and Peer Attachment (IPPA),
Depression Anxiety Stress Scale-21 (DASS-21) and Strength and Difficulties Questionnaire (SDQ). Using SPSS-21,
chi-square test and binomial logistic regression were conducted to examine the associations between dependent and
independent variables. Results: Respondents (52.6% female and 53.9% Malay) had 46.0% prevalence of depression
symptoms, 59.1% anxiety, 38.1% stress and 45.6% psychosocial status (internalizing and externalizing problems).
Age, father occupation and parental bonding were significantly predicted having moderate to extremely severe
depression symptom (p
As reported by the World Health Organisation (2014), Malaysia is the fattest country among the Southeast Asia. Among others, obesity is a leading contributor of non-communicable diseases (e.g., type II diabetes, metabolic syndrome, and cancer). This article aims to review the exiting weight management programmes targeting overweight and obesity in Malaysia from 2005 to 2015. The findings from this review could be useful for future intervention efforts in an attempt to address such issues in Malaysia.
Neurological soft signs (NSS) are subtle indicators of brain dysfunction which are present in excess among patients with Schizophrenia. Its clinical significance remains unclear despite extensive researches in this area. The objective of this work was to determine the proportion of schizophrenia patients who have motor NSS and then to compare the clinical features between these two groups; with and without motor NSS. This cross-sectional study which utilized the brief motor scale (BMS) was used to investigate the presence of motor NSS in 80 schizophrenia patients who attended Universiti Kebangsaan Malaysia Medical Centre (UKMCC) Psychiatric clinic. The diagnosis of schizophrenia was confirmed by mini international neuropsychiatic interview (MINI). Symptomatology and abnormal motor movement were assessed using the brief psychiatric rating scale (BPRS) and abnormal involuntary movement scale (AIMS), respectively. A brief battery of cognitive tests covering aspects of attention, working memory and executive function was administered. The bivariate analyses were applied to look for any relationship between the study factors. Majority of schizophrenia patients (68.8%) in this study have motor NSS. The motor NSS were associated with ethnic group, level of education, age of onset, duration of illness and performance in cognitive assessment; verbal fluency, digit span forward, digit span backward
and trail making B (p<0.05) but not with trail making A. The assessment of motor NSS represents a brief, inexpensive and meaningful tool in assessing the cognitive functions in schizophrenia. It has the potential as an illness marker and a link between neurobiological research and clinical practice.
Students-t test is the most popular statistical test. The test compares two mean values to judge if they are different or not. For small data it is possible to conduct it using manual calculation – however that is not the case. Researchers would need to use statistical software and packages to conduct their analysis. This guide will help the junior researchers to conduct independent- and paired-t test using STATA software.
Major depressive disorder (MDD) compromises the individual’s capacity for self-care and productivity. Single nucleotide polymorphisms (SNP) of a number of genes have been associated with MDD. The zinc transporter-3 protein, encoded by the ZnT3 (SLC30A3) gene, maintains zinc-glutamate homeostasis at the glutamatergic synapse, a disruption of which increases risk of MDD. We hypothesise that variation in SLC30A3 (rs11126936)SNP increases risk of MDD. We recruited 300 MDD cases and 300 controls, matched in theratio of 1:1 by age, gender and ethnicity. PCR-restriction fragment length polymorphism analysis was used in DNA genotyping, validated by sequencing 10%of samples. Deviation from the Hardy-Weinberg equilibrium was tested using the chi-square test. Conditional logistic regression was used to estimate adjusted odds ratios, controlling for age, gender, ethnicity, occupation and family monthly income.Genotypes G/G and G/T showed two times greater odds of developing MDD compared to variant genotype T/T (OR=1.983, 95% CI=1.031-3.815; p=0.040 and OR=2.232, 95% CI=1.100-4.533; p=0.026 respectively). Carriers of genotypes G/G and G/T of the SNP rs11126936 in SLC30A3are associated with increased risk of MDD.
The 12- item General Health Questionnaire (GHQ-12) has been translated into many languages and widely used in different settings and countries. Its reliability and psychometric properties were extensively studied in many population groups which suggested that it measures psychological distress in multidimensional construct. Objective: The objective of this study was to assess the reliability and factor structure of the Bahasa Malaysia version of the GHQ-12 among university students attending a health program at a Malaysian public university. Method: The cross sectional survey was conducted on 306 undergraduate students aged between 18 to 27 years old who visited the booth set up for mental health screening at a health program. The screening was conducted using a self-administered, validated Bahasa Malaysia version of GHQ-12 questionnaire. Results: Using exploratory factor analysis, the Bahasa Malaysia version of GHQ-12 was found to have a three factor structures namely depressive symptoms, self-esteem and perceived abilities which accounted for 58% of the item variance. The overall Cronbach’s alpha coefficient of the scale was found to be high (0.84) with each factor having acceptable inter-item consistency ranging from 0.61 to 0.82. Conclusion: The findings of the study show that the Bahasa Malaysia version GHQ-12 is reliable and has good structural characteristics. It can assess a few domains of the psychological status of university students. It also helps in providing more information
on the domain which may become a focus target of intervention in the prevention of mental illness.
Introduction: One of the commonly used techniques for mutation screening is High Resolution Melting (HRM) analysis. HRM is a post PCR method that relies on the detection of the fluorescent signals acquired due to the release of DNA intercalated dyes upon the melting of dsDNA to ssDNA. The method is simple, inexpensive and does not require post PCR-handling, making it suitable for high throughput screening. Methods: This study aimed to develop and validate HRM technique for the screening of two disease-associated single nucleotide polymorphisms (SNPs) namely BDNF rs6265 and DAT1 rs40184 using a total of 30 gDNA samples. The obtained results were confirmed and validated by sequencing. Results: HRM analysis showed that the predicted genotypes of BDNF rs6265 and DAT1 rs40184 among all the gDNA samples were in 100% concordance with the sequencing results, making it an accurate and sensitive method for the detection of SNPs. Conclusions: The application of HRM can accurately determine the genotype of BDNF rs6265 and DAT1 rs40184 SNPs, making it a promising tool for rapid and high-throughput screening of targeted SNPs in a large population study.