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Editorial

Sulaiman AH, Musa R

Curr Drug Targets, 2019;20(2):145.
PMID: 30648501 DOI: 10.2174/138945012002181203145147
Editorial: Advances in Psychopharmacological Treatment

Sulaiman AH, Musa R

Curr Drug Targets, 2018;19(8):855.
PMID: 29792134 DOI: 10.2174/138945011908180518113546
The Therapeutic and Psychosocial Interaction in Enhancing Drug Targets

Musa R, Sulaiman AH

Curr Drug Targets, 2018;19(12):1351.
PMID: 30191775 DOI: 10.2174/138945011912180723102630
Evaluation of early hearing damage in personal listening device users using extended high-frequency audiometry and otoacoustic emissions

Sulaiman AH, Husain R, Seluakumaran K

Eur Arch Otorhinolaryngol, 2014 Jun;271(6):1463-70.
PMID: 23812554 DOI: 10.1007/s00405-013-2612-z

Although sound exposure from personal listening devices (PLDs) could potentially lead to noise-induced hearing loss (NIHL), the actual hearing risk associated with the use of these devices is still unclear. In this study, early hearing effects related to PLD usage were evaluated in 35 young adult PLD users (listening for >1 h/day, at >50% of the maximum volume setting of their devices) and their age- and sex-matched controls using a combination of conventional and extended high-frequency audiometry as well as transient-evoked otoacoustic emission (TEOAE) and distortion product of otoacoustic emission (DPOAE) measurements. The mean listening duration of the PLD users was 2.7 ± 1.0 h/day while their estimated average listening volume was 81.3 ± 9.0 dBA (free-field corrected). Typical signs of NIHL were not detected in the audiogram of PLD users and their audiometric thresholds at most of the conventional test frequencies (0.25-8 kHz) were comparable with those obtained from controls. However, compared with the controls, mean hearing thresholds of PLD users at many of the extended high-frequencies (9-16 kHz) were significantly higher. In addition, TEOAE and DPOAE amplitudes in users were reduced compared with controls. The deterioration of extended high-frequency thresholds and the decrease in DPOAE amplitudes were more evident in the users' right ears. These results indicate the presence of an early stage of hearing damage in the PLD user group. Preventive steps should be taken as the initial hearing damage in these users could eventually progress into permanent NIHL after many years of PLD use.
Hearing risk associated with the usage of personal listening devices among urban high school students in Malaysia

Sulaiman AH, Seluakumaran K, Husain R

Public Health, 2013 Aug;127(8):710-5.
PMID: 23474376 DOI: 10.1016/j.puhe.2013.01.007

To investigate listening habits and hearing risks associated with the use of personal listening devices among urban high school students in Malaysia.
Fulltext Hearing Risk among Young Personal Listening Device Users: Effects at High-Frequency and Extended High-Frequency Audiogram Thresholds

Sulaiman AH, Husain R, Seluakumaran K

J Int Adv Otol, 2015 Aug;11(2):104-9.
PMID: 26380997 DOI: 10.5152/iao.2015.699

The usage of personal listening devices (PLDs) is associated with risks of hearing loss. The aim of this study is to evaluate the effects of music exposure from these devices on high-frequency hearing thresholds of PLD users.
Depressive symptoms in residents of a tertiary training hospital in Malaysia: The prevalence and associated factors

Nair N, Ng CG, Sulaiman AH

Asian J Psychiatr, 2021 Feb;56:102548.
PMID: 33454562 DOI: 10.1016/j.ajp.2021.102548

The mental wellbeing of doctors is becoming an increasing concern in the world today. In Malaysia, residency is a challenging period in a doctor's life, with many changes professionally and possibly in their personal lives as well. This study aims to determine the prevalence of depressive symptoms and the socio-demographic correlates among residents in a tertiary training hospital in Malaysia. It is a cross sectional study and all residents were approached to participate in the study. The instruments used were a socio-demographic questionnaire and the Patient Health Questionnaire 9 (PHQ-9). Chi-square test was used to explore the association between the socio-demographic correlates, and those that were found to have significant associations were further tested using multivariate logistic regression. The prevalence of depression among residents was 25.1 %. Longer working hours, missing meals, and working in Department of Surgery and Department of Anaesthesia was significantly positively associated while having protected study time, CME/lectures, leisure/hobbies and exercise were negatively associated with depression. The Department of Rehabilitation Medicine had a significantly negative association with depression. After logistic regression, longer working hours and a lack of protected study time was significantly associated with depression in the respective departments. In summary, the prevalence of depression among residents is high and is associated with longer working hours, missing meals and a lack of protected study time are significantly associated with depression. Remedial steps should be taken to improve the mental health among residents.
Fulltext The Pattern of Substance Use among People Who Use Drugs (PWUD) Receiving Treatment at University Malaya Medical Centre (UMMC) during the COVID-19 Pandemic and the Associated Factors

Yahaya AZB, Yee A, Sulaiman AH

Healthcare (Basel), 2022 Jul 23;10(8).
PMID: 35893189 DOI: 10.3390/healthcare10081366

There was a change in the pattern of substance usage among people who use substances during the COVID-19 pandemic period. This study aims to determine the effects of the COVID-19 pandemic on the pattern of substance usage among people who use drugs (PWUD) receiving treatment at the University Malaya Medical Centre (UMMC) as well as levels of anxiety and depression together with coping mechanisms and the factors affecting the pattern of substance use during COVID-19 pandemic period. A cross-sectional study was applied. The questionnaire used was the Mini-European Web Survey on Drugs (EWSD): COVID-19, Hospital Anxiety and Depression Scale (HADS), and Brief COPE Scale. In total, 130 PWUD were recruited. Of the participants, 36.2% of PWUD had not used/stopped the usage of illicit drugs/alcohol, 26.2% increased their usage, 20% decreased, and 14.6% used the same amount of illicit substances/alcohol during the COVID-19 pandemic period/restrictions. In addition, 28.5% of PWUD had an increased intention to seek professional support for drug counseling/treatment during the COVID-19 pandemic period. The prevalence anxiety and depression symptoms in PWUD according to HADS was 33% and 41.5%, respectively, with depression (p = 0.05) and isolation status (adjusted OR = 2.63, p < 0.05) being associated with an increase in alcohol/illicit substance use during the COVID-19 pandemic. PWUD who had increased their intention to seek professional support had significantly higher odds (adjusted OR = 4.42, p < 0.01) of reducing their alcohol/illicit substance use during the COVID-19 pandemic period. There were increased odds of maintaining alcohol/illicit substance usage among PWUD who practiced dysfunctional coping (adjusted OR = 3.87, p < 0.025) during the COVID-19 pandemic period. In conclusion, depression, isolation status, dysfunctional coping, and intention to seek professional support affected the pattern of alcohol/illicit substance use during the COVID-19 pandemic period. Strategies, substance rehabilitation/counseling, and proper mental health screening and the associated risk factors must be emphasized to prevent a further epidemic of substance use during the pandemic.
Conceptualizing and measuring youth-adult partnership in community programs: a cross national study

Zeldin S, Krauss SE, Collura J, Lucchesi M, Sulaiman AH

Am J Community Psychol, 2014 Dec;54(3-4):337-47.
PMID: 25216734 DOI: 10.1007/s10464-014-9676-9

Youth participation in program and community decision making is framed by scholars as an issue of social justice, a platform for positive youth development and effective citizenry, and a strategy for nation building. Recent literature reviews have consistently identified youth-adult partnership (Y-AP) as an effective type of youth participation across highly diverse contexts. These same reviews, however, note that indicators of Y-AP have not been conceptualized and validated for measurement purposes. The present study addresses this limitation by developing a brief measure of Y-AP that is explicitly grounded in current theory, research, and community practice. The measure was administered to youth in the United States, Malaysia, and Portugal (N = 610). Validation was assessed through factor analysis and tests of factorial, discriminant, and concurrent validity. Results confirmed the two predicted dimensions of the Y-AP measure: youth voice in decision making and supportive adult relationships. These two dimensions were also found to be distinct from other measures of program quality: safety and engagement. As predicted, they also significantly correlated with measures of agency and empowerment. It is concluded that the measure has the potential to support community efforts to maximize the quality of youth programs.
Anxiety and Depression in Cancer Patients: The Association with Religiosity and Religious Coping

Ng GC, Mohamed S, Sulaiman AH, Zainal NZ

J Relig Health, 2017 Apr;56(2):575-590.
PMID: 27287259 DOI: 10.1007/s10943-016-0267-y

There is a lack of studies looking into religiosity and religious coping in cancer patient. In this cross-sectional study, we examined the religiosity using Duke University Religion Index, religious coping using Brief Religious Coping Scale, anxiety and depression based on Hospital Anxiety and Depression Scale among 200 cancer patients. The association between religiosity and religious coping with anxiety and depression was studied. The findings showed that subjects with anxiety or depression used more negative religious coping and had lower non-organization religiosity. Hence, measurements in reducing negative religious coping and encouraging religious activities could help to reduce psychological distress in cancer patients.
Correlates of disability in Asian patients with major depressive disorder

Eurviriyanukul K, Srisurapanont M, Udomratn P, Sulaiman AH, Liu CY

Perspect Psychiatr Care, 2016 Oct;52(4):265-272.
PMID: 26031315 DOI: 10.1111/ppc.12127

PURPOSE: To examine correlates of disability in Asian patients with major depressive disorder (MDD).
DESIGN AND METHODS: Participants were outpatients with DSM-IV MDD. Global disability and three disability domains (i.e., work/school, social life/leisure, and family/home life) were key outcomes. Several socio-demographic and clinical characteristics were determined for their associations with disability.
FINDINGS: The sample was 493 MDD patients. Apart from the number of hospitalizations, the global disability was significantly associated with depression severity, fatigue, physical health, and mental health. Several clinical but only few socio-demographic characteristics associated with the other three disability domains were similar.
PRACTICE IMPLICATIONS: Disability among Asian patients with MDD correlates with the severity of psychiatric symptoms and the hospitalizations due to depression. Socio-demographic characteristics have little impact on the overall disability.
Study site: Psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Fulltext Remote Psychological First Aid (rPFA) in the time of Covid-19: A preliminary report of the Malaysian experience

Francis B, Juares Rizal A, Ahmad Sabki Z, Sulaiman AH

Asian J Psychiatr, 2020 Dec;54:102240.
PMID: 32593120 DOI: 10.1016/j.ajp.2020.102240
Fulltext Depression and associated factors in patients with type 2 diabetes mellitus

Hashim NA, Ariaratnam S, Salleh MR, Said MA, Sulaiman AH

East Asian Arch Psychiatry, 2016 Jun;26(2):77-82.
PMID: 27377489

OBJECTIVES: To determine the prevalence of major depressive disorder and its association with socio-demographic and clinical factors in patients with type 2 diabetes mellitus.

METHODS: This was a cross-sectional study of patients with type 2 diabetes mellitus who attended the hospital-based primary care clinics at the University Malaya Medical Centre, Kuala Lumpur, Malaysia. The patients were interviewed using the Mini-International Neuropsychiatric Interview to diagnose depression based on the DSM-IV criteria. The socio-demographic and clinical data were obtained by interviewing the patients and subsequently verified against their respective case notes.

RESULTS: A total of 204 patients were recruited. The prevalence of major depressive disorder was 15.7%. Major depressive disorder was significantly associated with younger age of patients (mean ± standard deviation, 57.8 ± 15.1 years, p = 0.04), younger age at diagnosis of diabetes mellitus (46.2 ± 13.0 years, p = 0.01), having secondary education (p = 0.02), and having a history of depression (p = 0.002). Multivariate analysis showed that current age (p = 0.04), duration of diabetes mellitus (p = 0.04), age at diagnosis of diabetes mellitus (p = 0.01), and secondary education (p = 0.01) were significant factors.

CONCLUSIONS: The prevalence of major depressive disorder was high among patients with type 2 diabetes mellitus. Screening of patients with type 2 diabetes mellitus for depression should be performed periodically or routinely, especially in the primary care setting.
Fulltext Sexual Desire in Opiate-Dependent Men Receiving Methadone-Assisted Treatment

Yee A, Loh HS, Ng CG, Sulaiman AH

Am J Mens Health, 2018 07;12(4):1016-1022.
PMID: 29493379 DOI: 10.1177/1557988318759197

Low sexual desire (SD) is not life threatening, but its negative impact on the quality of life and intimacy of a relationship among the patients on methadone maintenance therapy (MMT) is significant. This cross-sectional study involved 183 men on MMT who were interviewed and who completed the Malay version of the SDI-2 (SDI-2-BM), the Malay version of the self-rated Montgomery-Asberg Depression Rating Scale (MADRS-BM) and World Health Organization Quality of Life-BREF Scale (WHOQOL-BREF) questionnaires. Findings showed 32.8% ( n = 60) participants had low SD. Those who were older, had sexual partners, and were smokers achieved lower scores in both dyadic SD (≤24) and solitary SD (≤6), and suffered lower quality of life in their social relationship. MMT is very cost-effective in rehabilitating opioid dependence; however, as clinicians, we need to address and manage the issues of low SD and depression among patients on MMT, especially the older men.
Comparison of psychotropic prescriptions between oncology and cardiology inpatients: result from a pharmacy database in a teaching hospital in Malaysia

Ng CG, Mohamed S, Wern TY, Haris A, Zainal NZ, Sulaiman AH

Asian Pac J Cancer Prev, 2014;15(10):4261-4.
PMID: 24935381

OBJECTIVE: To examine the prescription rates in cancer patients of three common psychotropic drugs: anxiolytic/ hypnotic, antidepressant and antipsychotic.
MATERIALS AND METHODS: In this retrospective cohort study, data were extracted from the pharmacy database of University Malaya Medical Center (UMMC) responsible for dispensing records of patients stored in the pharmacy's Medication Management and Use System (Ascribe). We analyzed the use of psychotropics in patients from the oncology ward and cardiology from 2008 to 2012. Odds ratios (ORs) were adjusted for age, gender and ethnicity.
RESULTS: A total of 3,345 oncology patients and 8,980 cardiology patients were included. Oncology patients were significantly more often prescribed psychotropic drugs (adjusted OR: anxiolytic/hypnotic=5.55 (CI: 4.64-6.63); antidepressants=6.08 (CI: 4.83-7.64) and antipsychotics=5.41 (CI: 4.17-7.02). Non-Malay female cancer patients were at significantly higher risk of anxiolytic/hypnotic use.
CONCLUSIONS: Psychotropic drugs prescription is common in cancer patients. Anxiolytic/hypnotic prescription rates are significantly higher in non-Malay female patients in Malaysia.
Comparable efficacy and safety of 8 weeks treatment with agomelatine 25-50mg or fluoxetine 20-40mg in Asian out-patients with major depressive disorder

Shu L, Sulaiman AH, Huang YS, Fones Soon Leng C, Crutel VS, Kim YS

Asian J Psychiatr, 2014 Apr;8:26-32.
PMID: 24655622 DOI: 10.1016/j.ajp.2013.09.009

OBJECTIVE: This randomized, double-blind study evaluates the efficacy and tolerability of agomelatine, using fluoxetine as an active comparator, in Asian patients suffering from moderate to severe major depressive disorder (MDD).
METHOD: Patients were randomly assigned to receive either agomelatine (25-50mg/day, n=314) or fluoxetine (20-40mg/day, n=314) during an 8-week treatment period. The main outcome measure was the change in Hamilton Depression Rating Scale 17 items (HAM-D17) scores. Secondary efficacy criteria included scores on Clinical Global Impression Severity of illness (CGI-S) and Improvement of illness (CGI-I), patient sleeping improvement using the self-rating Leeds Sleep Evaluation Questionnaire (LSEQ) and anxiety using the Hamilton Anxiety Rating Scale (HAM-A) scores. Tolerability and safety evaluations were based on emergent adverse events.
RESULTS: Agomelatine and fluoxetine exert a comparable antidepressant efficacy in the Asian population. Mean changes over 8 weeks were clinically relevant and similar in both groups (-14.8±7.3 and -15.0±8.1 on HAM-D17 scale in agomelatine and fluoxetine groups, respectively). The between-group difference reached statistical significance on non-inferiority test (p=0.015). Clinically relevant decreases in CGI-S and CGI-I scores were observed over the treatment period in both groups. The two treatments were equally effective on the symptoms of both anxiety and sleep. The good tolerability profile and safety of both doses of agomelatine was confirmed in the Asian population.
CONCLUSIONS: Agomelatine and fluoxetine are equally effective in the treatment of MDD-associated symptoms in Asian depressed patients.
KEYWORDS: Agomelatine; Antidepressant; Asian population; Fluoxetine
Study site in Malaysia: Psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Youth–adult partnership: exploring contributions to empowerment, agency and community connections in Malaysian youth programs

Krauss SE, Collura J, Zeldin S, Ortega A, Abdullah H, Sulaiman AH

J Youth Adolesc, 2014 Sep;43(9):1550-62.
PMID: 24122395

Youth–adult partnership (Y–AP) has emerged as a key practice for enacting two features of effective developmental settings: supportive adult relationships and support for efficacy and mattering. Previous studies have shown that when youth, supported by adults, actively participate in organizational and community decision making they are likely to show greater confidence and agency, empowerment and critical consciousness, and community connections. Most of the extant research on Y–AP is limited to qualitative studies and the identification of organizational best practices. Almost all research focuses on Western sociocultural settings. To address these gaps, 299 youth, age 15 to 24, were sampled from established afterschool and community programs in Malaysia to explore the contribution of Y–AP (operationalized as having two components: youth voice in decision-making and supportive adult relationships) to empowerment, agency and community connections. As hypothesized, hierarchical regressions indicated that program quality (Y–AP, safe environment and program engagement) contributed to agency, empowerment and community connections beyond the contribution of family, school and religion. Additionally, the Y–AP measures contributed substantially more variance than the other measures of program quality on each outcome. Interaction effects indicated differences by age for empowerment and agency but not for community connections. The primary findings in this inquiry replicate those found in previous interview and observational-oriented studies. The data suggests fertile ground for future research while demonstrating that Y–AP may be an effective practice for positive youth development outside of Western settings.
A randomized, placebo-controlled trial of aripiprazole for the treatment of methamphetamine dependence and associated psychosis

Sulaiman AH, Gill JS, Said MA, Zainal NZ, Hussein HM, Guan NC

Int J Psychiatry Clin Pract, 2013 Jun;17(2):131-8.
PMID: 22486597 DOI: 10.3109/13651501.2012.667116

The objectives of this study were to determine the efficacy and safety of aripiprazole for treatment of psychosis, retention and abstinence in patients with methamphetamine dependence.
The Effect of 5 Minutes of Mindful Breathing to the Perception of Distress and Physiological Responses in Palliative Care Cancer Patients: A Randomized Controlled Study

Ng CG, Lai KT, Tan SB, Sulaiman AH, Zainal NZ

J Palliat Med, 2016 09;19(9):917-24.
PMID: 27110900 DOI: 10.1089/jpm.2016.0046

BACKGROUND: Palliative cancer patients suffer from high levels of distress. There are physiological changes in relation to the level of perceived distress.
OBJECTIVE: To study the efficacy of 5 minutes of mindful breathing (MB) for rapid reduction of distress in a palliative setting. Its effect to the physiological changes of the palliative cancer patients was also examined.
METHODS: This is a randomized controlled trial. Sixty palliative cancer patients were recruited. They were randomly assigned to either 5 minutes of MB or normal listening arms. The changes of perceived distress, blood pressure, pulse rate, breathing rate, galvanic skin response, and skin surface temperature of the patients were measured at baseline, after intervention, and 10 minutes post-intervention.
RESULTS: There was significant reduction of perceived distress, blood pressure, pulse rate, breathing rate, and galvanic skin response; also, significant increment of skin surface temperature in the 5-minute MB group. The changes in the 5-minute breathing group were significantly higher than the normal listening group.
CONCLUSION: Five-minute MB is a quick, easy to administer, and effective therapy for rapid reduction of distress in palliative setting. There is a need for future study to establish the long-term efficacy of the therapy.
Erectile dysfunction among patients on methadone maintenance therapy and its association with quality of life

Teoh JB, Yee A, Danaee M, Ng CG, Sulaiman AH

J Addict Med, 2017 Jan-Feb 6;11(1):40-46.
PMID: 27753719 DOI: 10.1097/ADM.0000000000000267

OBJECTIVES: Erectile dysfunction (ED) is a problem commonly encountered by patients on methadone maintenance therapy (MMT). This study aimed to assess the prevalence of ED among this group of patients along with its risk factors and association with quality of life (QOL).
METHODS: Male patients on MMT in a tertiary hospital in Malaysia were included in the study. A total of 134 patients with sexual partners were assessed for ED using the International Index of Erectile Function. Patients were assessed for substance use using Opiate Treatment Index (OTI) and depression using the Malay version of the self-rated Montgomery-Asberg Depression Rating Scale (MADRS-BM). QOL was evaluated using World Health Organisation Quality of Life (WHOQOL)-BREF.
RESULTS: The prevalence of ED among patients on MMT was 67%, with 26.1% having mild ED, 30.4% having mild-to-moderate ED, 7.0% having moderate ED, and 17.2% having severe ED. Patients with depression were 4 times more likely to have ED compared with patients without depression, whereas increasing age significantly correlated with the severity of ED. Having ED predicted a poorer QOL in the social relationships domain.
CONCLUSION: Depression is highly associated with ED, which negatively influences the social aspect of QOL among patients on methadone maintenance therapy.
Study site: outpatient addiction psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

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