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  1. Abdollahi F, Zarghami M, Sazlina SG, Lye MS
    Early intervention in psychiatry, 2017 Feb;11(1):57-62.
    PMID: 25582677 DOI: 10.1111/eip.12215
    AIM: Prolonged depression during the post-partum period is associated with maternal and infant mortality and morbidity. Less attention has been given to factors that predict the persistence of depression beyond the first 3 months post-partum.
    METHODS: From a longitudinal cohort of 2279 women who attended Mazandaran's primary health centres in 2009, 478 women with an Edinburgh Postnatal Depression Scale (EPDS) score of 12 or greater in the third trimester of pregnancy were recruited. Persistently depressed women (depressed at all three occasions: during pregnancy, and at 2 and 12 weeks post-partum) were compared with those without depression to determine demographic, cultural, obstetric and biopsychosocial predictors for persistence of depression. Data were analysed using chi-square test, t-test and logistic regression models.
    RESULTS: The stability of depression was found in 193 (46.2 %) of 418 depressed cases who were followed up over the study period. Of those mothers who scored more than the threshold of 12 during the third trimester of pregnancy, 277 (66.3%) and 221 (52.9%) had high EPDS at 2 and 12 weeks post-partum. Psychological distress (based upon the General Health Questionnaire), low maternal parental self-efficacy (based upon the Parental Expectation Survey) and perceived social isolation (based upon the Network Orientation Scale) were independent predictors of persistent depression.
    CONCLUSION: Fewer depressed mothers in this study were found to recover during the first 3 months after giving birth. Psychosocial factors predicted sustained depression from pregnancy to 3 months post-partum. The findings highlight the significance of support in enhancing maternal mental health.
  2. Chee KY
    Early intervention in psychiatry, 2010 May;4(2):111-8.
    PMID: 20536966 DOI: 10.1111/j.1751-7893.2010.00176.x
    This study sought to examine the determinants of subjective quality of life among patients with first-episode schizophrenia in a developing country.
  3. Berry C, Michelson D, Othman E, Tan JC, Gee B, Hodgekins J, et al.
    Early intervention in psychiatry, 2020 02;14(1):115-123.
    PMID: 31111672 DOI: 10.1111/eip.12832
    AIM: Mental health problems are prevalent among young people in Malaysia yet access to specialist mental health care is extremely limited. More context-specific research is needed to understand the factors affecting help-seeking in youth, when mental health problems typically have first onset. We aimed to explore the attitudes of vulnerable young Malaysians regarding mental health problems including unusual psychological experiences, help-seeking and mental health treatment.

    METHODS: In the present study, nine young people (aged 16-23 years) from low-income backgrounds participated in a semi-structured interview about their perspectives on mental health problems, unusual psychological experiences and help-seeking.

    RESULTS: Four themes were developed using thematic analysis. "Is it that they [have] family problems?" reflected participants' explanatory models of mental health problems. "Maybe in Malaysia" was concerned with perceptions of Malaysian culture as both encouraging of open sharing of problems and experiences, but also potentially stigmatizing. "You have to ask for help" emphasized the importance of mental health help-seeking despite potential stigma. "It depends on the person" addressed the challenges of engaging with psychological therapy.

    CONCLUSIONS: We conclude that young people in Malaysia may hold compassionate, non-stigmatizing views towards people experiencing mental health problems and a desire to increase their knowledge and understandings. Yet societal stigma is a perceived reputational risk that may affect mental health problem disclosure and help-seeking. We suggest that efforts to improve mental health literacy would be valued by young Malaysians and could support reduced stigma and earlier help-seeking.

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