MyMedR

Fulltext Comparing schizophrenia symptoms in the Iban of Sarawak with other populations to elucidate clinical heterogeneity

McLean D, Barrett R, Loa P, Thara R, John S, McGrath J, et al.

Asia Pac Psychiatry, 2015 Mar;7(1):36-44.

PMID: 24038814 DOI: 10.1111/appy.12093

INTRODUCTION: The symptom profile of schizophrenia can vary between ethnic groups. We explored selected symptom variables previously reported to be characteristic of schizophrenia in the Iban of Sarawak in transethnic populations from Australia, India, and Sarawak, Malaysia. We tested site differences to confirm previous research, and to explore implications of differences across populations for future investigations.

METHODS: We recruited schizophrenia samples in Australia (n = 609), India (n = 310) and Sarawak (n = 205) primarily for the purposes of genetic studies. We analyzed seven identified variables and their relationship to site using logistic regression, including: global delusions, bizarre delusions, thought broadcast/insertion/withdrawal delusions, global hallucinations, auditory hallucinations, disorganized behavior, and prodromal duration.

RESULTS: We identified a distinct symptom profile in our Sarawak sample. Specifically, the Iban exhibit: low frequency of thought broadcast/insertion/withdrawal delusions, high frequency of auditory hallucinations and disorganized behavior, with a comparatively short prodrome when compared with Australian and Indian populations.

DISCUSSION: Understanding between-site variation in symptom profile may complement future transethnic genetic studies, and provide important clues as to the nature of differing schizophrenia expression across ethnically distinct groups. A comprehensive approach to subtyping schizophrenia is warranted, utilizing comprehensively ascertained transethnic samples to inform both schizophrenia genetics and nosology.

Matched MeSH terms: Delusions/diagnosis*; Delusions/ethnology

Fulltext A case of psychotic disorder due to dengue fever

Mohammad Farris Iman Leong Abdullah, Rizal Abu Bakar

ASEAN Journal of Psychiatry, 2017;18(1):0-0.

MyJurnal

Objective: This case reported highlighted psychotic disorder due to dengue fever
is rare. Hence we describe a case which clearly presented with psychotic
symptoms during the illness.

Methods: We reported a case of psychotic disorder
due to dengue fever who presented with psychotic symptoms of auditory and
visual hallucination, and persecutory delusion, which had significant temporal
correlation with dengue fever symptoms. There were no neurological deficits
noted, no altered sensorium and cognitive impairment during the episode. He
has no past and family history of mental illness and there was no evidence of
encephalitis and metabolic disturbances.

Results: Our case suggests that
prominent psychotic symptoms can occur during an episode of dengue fever,
which remitted when one recovering from dengue fever.

Conclusion: We
demonstrated that patients who presented with the acute onset of psychosis
accompanied by symptoms of viral fever should be screened for dengue fever,
particularly if the person lived in or visited the area where dengue fever is
endemic.

Matched MeSH terms: Delusions

Fulltext Phenomenological differences of delusions between schizophrenic patients of two cultures of Malaysia

Azhar MZ, Varma SL, Hakim HR

Singapore Med J, 1995 Jun;36(3):273-5.

PMID: 8553090

Two hundred and seventy schizophrenia patients were interviewed using the Present State Examination to elicit the phenomenological symptoms of the illness. Cultural factors and ethnicity were found to be significant variables associated with the symptoms. Higher prevalence of religious and other subculturally related delusions were common in Kelantan patients. Our general belief that Malaysian culture influences symptomatology of mental illness seems to be proven.

Matched MeSH terms: Delusions/ethnology*

Fulltext Folie a deux complicate management of a childhood onset schizophrenia

Seen, Heng Yeoh, Kok, Wei Wee, Maryam Amaran, Hazura Hamzah

ASEAN Journal of Psychiatry, 2012;13(2):0-0.

MyJurnal

Objective: This case report highlights folie a duex of a caregiver that complicate the management of a case of childhood onset schizophrenia.
Methods: We report a case of a young Malay girl with symptoms of schizophrenia and her caregiver who share her delusion.
Result: Folie a duex in the caregiver caused difficulty in the initiation and maintenance of treatment of a child with schizophrenia.
Conclusion: Treating children with schizophrenia is not easy and could be complicated by the folie a duex in caregiver. Although Child Act 2001 can be applied in order to deliver appropriate treatment to this group of patients, one must be cautious about the implication in therapeutic alliance.

Matched MeSH terms: Delusions

Common cultural medical complaint presenting as a delusion

George P, Ramasamy P

Malaysian Journal of Psychiatry, 2006;14(1):41-42.

MyJurnal

Symptoms presented by patients suffering from Schizophrenia can be influenced by cultural factors. A case of Schizophrenia presenting with a common cultural medical complaint as a delusion, is described here. The appropriate assessment, identification and treatment have led to an improved out.

Matched MeSH terms: Delusions

Fulltext A case series on the use of atypical long acting injectable as first-line antipsychotic treatment in Malaysia: who benefits and how?

Nik Ruzyanei, N.J., Hazli, Z., Chong, Y.S.

Malaysian Journal of Psychiatry, 2013;22(1):1-5.

MyJurnal

Introduction: The use of long acting injectable (LAI) antipsychotics is mainly reserved as the second line treatment when all efforts to ensure patients’ adherence to regular oral medication failed. We aim to describe the common clinical features of patients with schizophrenia who benefited from the use of LAI early in the course of illness. Methods: We report four patients with first presentation of schizophrenia, all of whom were started with atypical LAI antipsychotics without prior history of oral antipsychotic. Results: In all of the cases, short acting major tranquilizers were not administered in the acute phase of psychosis because the patients were not agitated. Beside absence of agitation, other common clinical features observed in the four patients were prominent delusion (rather than hallucination), obstinate refusal of oral medication, good pre-morbid functioning and very poor insight. Interestingly, following the remission of the acute psychotic phase, all showed marked improvement in their insight and had better than expected therapeutic alliance. Discussion: LAI may improve the doctor-patient therapeutic alliance due to its minimal side effects and by ways of increasing the patients’ sense of control and allowing psychoeducation to take place when the patient is ready. We conclude that LAI may be used as the first line antipsychotic treatment in the acute psychotic phase in patients who are nonagitated but have prominent symptom of delusions with poor insight.

Matched MeSH terms: Delusions

Fulltext Alcohol-induced psychotic disorder with suicidal attempt: a case report

Tengku Mohd Saifuddin, Chong Wei Wei, Aida Farina Ismail, Noorul Amilin Harun

Malaysian Journal of Psychiatry, 2018;27(1):0-0.

MyJurnal

Alcohol-induced psychotic disorder (AIPD) is a rare complication of alcohol
abuse which is characterized by an acute onset of auditory or visual
hallucinations that occur either during or after a period of heavy alcohol
consumption. Other symptoms include delusions, thought disorder,
psychomotor disturbances, and abnormal affect. To establish the diagnosis,
one must rule out other disorders such as alcohol withdrawal delirium or
other psychotic disorders. Although it is well recognised, relatively little is
known about the condition. Moreover, the pathogenesis and treatment of
AIPD are still unclear despite high co-morbidity with other psychiatric
disorders, high re-hospitalization as well as mortality rates and suicidal
behaviour. Therefore, the prognosis appears less favourable. We present a
case of young man with AIPD with suicidal attempt secondary to auditory
hallucination.

Matched MeSH terms: Delusions

Fulltext Retrospective review on patients admitted for violent crime in Permai Hospital, Malaysia

Najwa Hanim, M.R., Abdul Kadir, A.B., Badiah, Y.

Malaysian Journal of Psychiatry, 2011;20(1):1-8.

MyJurnal

Objective: To study the demographic data of patients and the pattern of crime in the study group, to look at the outcome of assessment by psychiatrist on fitness to plea and insanity at time of offense and to assess association between the nature of crime with presence of psychopathology during the crime. Method: This is a retrospective study. All available case notes for 342 forensic admissions from January 2007 until March 2010 were reviewed. All related information on 135 patients that committed violent crime was taken for analysis. Result: Majority of patients were male, Malay, single, education up to secondary school and unemployed. Only 38% of patients had encountered psychiatric services, 20% had previous imprisonment and 49% had history of substance usage. In cases involving victims (87%), 64% the victims were known to the patient, 53% had hallucination or delusion or both at the time of crime and 90% was found to have some diagnosis of mental illness after psychiatrist assessment. Only 81% of formal forensic reports were available in the case note and it showed 94% were fit to plea and 82% were at sound mind at the time of offense. Conclusion: Substance abuse had high prevalence among the patient. Almost 2/3 never had any encounter with psychiatric services before the admission. Even with the high percentage of patient diagnosed with mental illness, they were still found to be fit to plea in court and are at sound mind at the time of offense

Matched MeSH terms: Delusions

Fulltext Psychosis post craniotomy for craniopharyngioma

Siti Rohana Abdul Hadi, Saminah Md Kassim, Suriati Mohamed Saini

ASEAN Journal of Psychiatry, 2013;14(2):183-186.

MyJurnal

Objective: This case report highlights psychosis post craniopharyngioma surgery.

Methods: We report a case of a young Malay lady who presented with psychotic symptoms after she underwent craniotomy for craniopharyngioma.

Results: Presence of prominent hallucinations and delusions after removal of the tumour and the symptoms lasted more than a month. The psychosis subsided with antipsychotic.

Conclusion: Psychosis post craniopharyngioma surgery is still possible whether possibly due to the residual tumour or as a result of treatment sequealae.

Matched MeSH terms: Delusions

Fulltext Recollections Expressed by Mechanically Ventilated Patients of Intensive Care Unit (ICU), Hospital Universiti Kebangsaan Malaysia (HUKM)

Ho, Siew Eng, Hamidah Hassan, Sanisah Saidi, Syed Zulkfli

Medicine & Health, 2008;3(1):46-53.

MyJurnal

Ventilated patients who require intensive care unit (ICU) treatment may encounter unpleasant experiences. These experiences may include factual incidents and delusional memories of ICU such as dreams, hallucinations and frightening experiences. A cross sectional study using “Intensive Care Experience Questionnaire” consisted of four domains: awareness of surrounding, frightening experiences, recall of experience and satisfaction with nursing care. Forty five participants who fulfilled the inclusion criteria were recruited in this study. This study was conducted in ICU of HUKM from January to March 2006. Results showed that 20 respondents (44%) were aware of their surrounding and 31 respondents (69%) reported frightening experiences. Majority of respondents (43 respondents, 96%) reported satisfaction with the delivery of nursing care. There was positive correlation between awareness of surrounding and their abilities to recall their experiences (p

Matched MeSH terms: Delusions

Fulltext Love tragedy, she wrote

Mat Esa MS, Othman Z, Jamil Yaacob M

Malays J Med Sci, 2004 Jan;11(1):86-9.

PMID: 22977365

A case of a 53-year old-single, Kelantanese lady with a diagnosis of paranoid schizophrenia for 28 years is reported with aims to illustrate the influence of life experiences particularly based on education and intelligent on delusion illustrate the evolving nature of the complexity of delusions as well as to show the importance of documentation in psychiatric practice. We concluded that this patient had used defense mechanism of suppression, reaction formation and persecution throughout her delusion. The final persecutory delusion evolved through series of transformation via object of admirations. We postulated that in-depth emotional insight about effects of schizophrenia might have contributed to her self-reflection that have made her frustrated with her poor achievement in life.

Matched MeSH terms: Delusions

Fulltext DSM-IV "criterion A" schizophrenia symptoms across ethnically different populations: evidence for differing psychotic symptom content or structural organization?

McLean D, Thara R, John S, Barrett R, Loa P, McGrath J, et al.

Cult Med Psychiatry, 2014 Sep;38(3):408-26.

PMID: 24981830 DOI: 10.1007/s11013-014-9385-8

There is significant variation in the expression of schizophrenia across ethnically different populations, and the optimal structural and diagnostic representation of schizophrenia are contested. We contrasted both lifetime frequencies of DSM-IV criterion A (the core symptom criterion of the internationally recognized DSM classification system) symptoms and types/content of delusions and hallucinations in transethnic schizophrenia populations from Australia (n = 776), India (n = 504) and Sarawak, Malaysia (n = 259), to elucidate clinical heterogeneity. Differences in both criterion A symptom composition and symptom content were apparent. Indian individuals with schizophrenia reported negative symptoms more frequently than other sites, whereas individuals from Sarawak reported disorganized symptoms more frequently. Delusions of control and thought broadcast, insertion, or withdrawal were less frequent in Sarawak than Australia. Curiously, a subgroup of 20 Indian individuals with schizophrenia reported no lifetime delusions or hallucinations. These findings potentially challenge the long-held view in psychiatry that schizophrenia is fundamentally similar across cultural groups, with differences in only the content of psychotic symptoms, but equivalence in structural form.

Matched MeSH terms: Delusions/ethnology*

Fulltext Psychosis induced by cefuroxime and metronidazole

Zahiruddin O, Shanooha M, Mohd Azhar MY

Med J Malaysia, 2014 Feb;69(1):33-4.

PMID: 24814627 MyJurnal

We report a case 35-year-old lady who developed acute psychosis following administration of cefuroxime and metronidazole. Earliest mood changes occurred on the second day of antibiotics therapy. She developed hallucinations, delusions and bizarre behavior 1 day after the completion of the antibiotic therapy. All the relevant investigations including CT brain were normal. The psychosis resolved completely within 5 days of antipsychotic treatment.

Matched MeSH terms: Delusions

Fulltext Antidepressant induced Mania and Steroid Psychosis in a Patient with Bell’s Palsy

Tan, C.L., Anne Yee, H.A., Majid, S.M., Koh, O.H., Ng, C.G.

Malaysian Journal of Psychiatry, 2010;19(2):1-5.

MyJurnal

Steroid is commonly used for various connective tissue diseases and immunological related disorders. Psychiatric side effects are common in patient with systematic treatment of steroid. The reported prevalence ranges from 6% to 28%. Antidepressant-induced mania occurs when the mood of a patient switches to manic or hypomanic from depression after the use of antidepressant. We reported a case of a 55 year old lady, who presented with agitation and grandiosity after the treatment with antidepressant. She was initially diagnosed as having Bell’s palsy with unilateral facial muscle weakness. Oral prednisolone was prescribed for seven days where she became depressed, having auditory hallucination and delusion of guilt. She was then started on antidepressant where she became irritable, agitated and developed grandiose delusion. The antidepressant was withheld and she was started on atypical antipsychotic. Her condition improved and discharged well after three days of stay in the ward.

Matched MeSH terms: Delusions

Fulltext Conversion Symptoms In Schizophrenia: A Case Report

Ting, J.H., Nor Zuraida, Z., Sharmilla, K., Salina, M.

Malaysian Journal of Psychiatry, 2009;18(2):1-5.

MyJurnal

We report a 35 year-old Iranian female who presented with a sudden onset of left sided hemiparesis associated with temporary loss of consciousness of about 3 minutes. Neurological examination revealed a power of 0/5 over the left upper/lower limbs but reflexes were normal and plantar reflex was downgoing and equivocal. A computed tomography scan was done and it revealed mild bilateral frontal atrophy and a temporal arachnoid cyst which was decidedly an incidental finding and it did not have any relation to the clinical presentation. Electroencephalogram and other laboratory findings were all normal. When the psychiatric team interviewed her, it was revealed that the patient had recently experienced a major stressful event just prior to the hemiparesis. On further interview, the patient had complained of delusions of persecution, delusions of reference and also auditory hallucinations for approximately a year prior to admission. There have been only a spatter of reports of conversion symptoms seen in patients with schizophrenia and this is such a case.

Matched MeSH terms: Delusions

Fulltext Organic disorder with neuropsychiatric symptoms - case report of anti-NMDA receptor encephalitis with neuropsychiatric manifestations

Sivarooban, V., Yogitagavari, Y., Che, C.K., Lee, C.W.

Malaysian Journal of Psychiatry, 2017;26(1):0-0.

MyJurnal

Neuropsychiatric symptoms are symptoms that caused by organic brain
disorders. Multiple neuropsychiatric symptoms can occur concurrently in the
course of brain related organic disorders. Two main components of
neuropsychiatric symptoms are cognitive impairment and disturbance of
consciousness while other neuropsychiatric symptoms, such as hallucinations,
delusions, mood disorders, anxiety, apathy, behavioural and personality
changes also commonly occur. Some of the mild neuropsychiatric symptoms
could possibly be the earliest manifestations of brain related organic
disorders. Clinicians should carefully evaluate organic factors in the
treatment of psychosis, especially in patients of very young age or older age.
They should have enough knowledge and experience in the integrating
neuroscience, that is, neuropsychiatry. The present report illustrates a case of
organic disorder with neuropsychiatric manifestations. It is about a young
male patient who was diagnosed with anti-NMDA receptor encephalitis and
subsequently developed acute delirium secondary to the illness.

Matched MeSH terms: Delusions

Pisa syndrome secondary to rivastigmine: a case report

Muthupalaniappen L, Rosdinom R, Suguna M

Clin Ter, 2012;163(1):31-2.

PMID: 22362231

Pisa syndrome or pleurothotonus is the persistent flexion of the body and head to one side giving the appearance of the leaning tower of Pisa. It is most commonly caused by typical and atypical antipsychotic drugs. We report a case of Pisa Syndrome caused by prolonged use of high dose cholinesterase inhibitor, rivastigmine. Symptoms subsided when rivastigmine was withdrawn and did not reappear when a different cholinesterase inhibitor, donepezil was introduced. Physicians should be aware of Pisa syndrome and should alert patient of this possibility when starting and stepping up medications. The purpose of reporting this case is to create awareness among general practitioners as it is a reversible condition which responds to removal of the offending drug.

Matched MeSH terms: Delusions/drug therapy

The psychiatric aspects of epilepsy

Teoh JI

Med J Malaysia, 1973 Sep;28(1):8-15.

PMID: 4273788

Matched MeSH terms: Delusions/etiology

Capgras syndrome in a very late onset, treatment resistant schizophrenia

Ain MK, Rosdinom R, Raynuha M

Int Psychogeriatr, 2015 Sep;27(9):1573-5.

PMID: 25794136 DOI: 10.1017/S1041610215000332

We report a Malay man, with underlying chronic medical illnesses, presenting with positive symptoms of schizophrenia, including Capgras syndrome (CS) at the age of 73. Physical examination and blood investigations were normal and brain CT scan showed age-related cerebral atrophy. Neuropsychological assessment showed probable right hemisphere lesions but relatively intact memory and intellectual functions. Several neuroleptics including depot injections were tried but ineffective. Positive symptoms including CS eventually improved with clozapine before his death from myocardial infarction. This case report highlights the uncommon occurrence of CS in treatment resistant schizophrenia (TRS) of very late onset and its treatment challenges.

Matched MeSH terms: Delusions

Fulltext Cognitive impairment and depressive symptoms coexisting in an elderly man

Masiran R, Pang NT

BMJ Case Rep, 2017 Feb 08;2017.

PMID: 28179386 DOI: 10.1136/bcr-2016-218267

We report a case of a man aged 67 years presenting with recent depressive symptoms and paranoid ideations in addition to 1-year cognitive impairment. He has vascular risk factors and family history of memory loss. An episode of depression 2 decades ago resolved spontaneously but was followed by occupational decline. On mental state examination, he denied having depressed mood, hallucinations or delusions, but there were prominent word-finding difficulties and impaired attention and concentration.

Matched MeSH terms: Delusions

Displaying publications 1 - 20 of 23 in total