MyMedR

Alternative systems in Malaysian drug rehabilitation: organization and control in comparative perspective

Lee RL

Soc Sci Med, 1985;21(11):1289-96.

This paper examines four drug rehabilitation systems in Malaysia from an organizational perspective. It focuses on authority structures in rehabilitation centres and their impact on rehabilitees' identities. The findings show that there are important differences between government-run and private centres in terms of administration and approach to therapy. Some policy implications are derived from a comparison of these systems.

Matched MeSH terms: Community Mental Health Services/organization & administration

Evaluation and validation of a measure profiling needs and problems of psychiatric patients in the community: a Malaysian study

Cheah YC, Parker G, Roy K

Soc Psychiatry Psychiatr Epidemiol, 2000 Apr;35(4):170-6.

PMID: 10868082

The Profile of Community Psychiatry Clients (PCPC) was developed in a Sydney-based sample of those with a mental illness as a 35-item measure of likely need for service recognition, review and possible assistance.

Matched MeSH terms: Community Mental Health Services/standards*; Community Mental Health Services/supply & distribution*

Fulltext Modified assertive community treatment (ACT) in the management of comorbid mental and physical illnesses: a case report

Lai, M.H., Marhani, M.

Malaysian Journal of Psychiatry, 2013;22(1):1-4.

MyJurnal

The holistic approach of assertive community treatment (ACT) may provide better care and lead to better outcomes in populations with difficult-to-treat comorbid mental and physical illnesses. This paper describes the complex issues in managing a person with multiple chronic medical illnesses who also
had comorbid treatment-resistant depression and poor social support. The patient achieved improvement after the implementation of the therapeutic ingredients of ACT.

Matched MeSH terms: Community Mental Health Services

Quality of life of community-based chronic schizophrenia patients in Penang, Malaysia

Mubarak AR, Baba I, Chin LH, Hoe QS

Aust N Z J Psychiatry, 2003 Oct;37(5):577-85.

PMID: 14511086

This is a study of the quality of life (QOL) of 174 community-based chronic schizophrenia patients in Penang, Malaysia.

Matched MeSH terms: Community Mental Health Services*

Development of a measure profiling problems and needs of psychiatric patients in the community

Cheah YC, Parker G, Hadzi-Pavlovic D, Gladstone G, Eyers K

Soc Psychiatry Psychiatr Epidemiol, 1998 Jul;33(7):337-44.

PMID: 9689896

We argue the advantages of a measure profiling common problems faced by psychiatric patients in the community and indicating a likely need for service recognition, review and possible assistance. We describe the development of such a measure, the 35-item Profile of Community Psychiatry Clients (PCPC), and the identification of four relevant domains. Component scales assess coping limitations, behavioural problems, levels of social support and organic problems. High test-retest reliability was established, and a number of tests of the measure's validity were undertaken. Discriminant validity was established by demonstrating that those case managed by a community mental health service returned significantly higher scale scores than a comparison group who, while having a similar diagnostic profile, were not case managed. Additionally, scale scores were associated with a number of categorical and dimensional validators reflecting aspects of service need, and distinctly with service costs. We demonstrate that PCPC scores correspond with scores generated by the Life Skills Profile (LSP), a measure of disability, and examine the extent to which PCPC scales correspond to those contained in the Health of the Nation Outcome Scales (HoNOS). We argue for the scale's capacity to provide both a profile of central problems faced by patients and their likely need for community-based service assistance.

Matched MeSH terms: Community Mental Health Services/organization & administration*

Some clinical problems of a psychiatric day centre

Teoh CL, Woon TH, Sim SH

Med J Malaysia, 1973 Dec;28(2):80-3.

PMID: 4276264

Matched MeSH terms: Community Mental Health Services*

Referrals to a psychiatric clinic in West Malaysia

Teoh JI, Kinzie JD, Tan ES

Int J Soc Psychiatry, 1973;18(4):301-7.

PMID: 4720845

Matched MeSH terms: Community Mental Health Services*

A systematic review of anxiety prevalence in adults within primary care and community settings in Malaysia

Wong CH, Sultan Shah ZU, Teng CL, Lin TQ, Majeed ZA, Chan CW

Asian J Psychiatr, 2016 Dec;24:110-117.

PMID: 27931891 DOI: 10.1016/j.ajp.2016.08.020

BACKGROUND: Anxiety disorders are common mental health disorders with significant impact on the individual as well as burden on the country as a whole.
METHODS: A systematic review of databases, reference lists, internet sources, and input from content experts revealed 42 studies that documented the prevalence of anxiety symptoms or disorders. 12 of these studies specifically evaluated anxiety disorders.
RESULTS: 4 studies looked at the prevalence of anxiety disorders in the general population, whilst the remainder focused on selected population groups: university students (4 studies); substance abuse (3 studies); and victims of abuse (1 study). Studies in the general population showed that the prevalence of generalised anxiety disorder was 0.4-5.6%, mixed anxiety and depression were 3-5%, panic without agoraphobia 0.4%, phobia unspecified 0.5-%, and anxiety not-otherwise-specified 0.3-6.5%. We found significant variability in anxiety disorders in the studies in selected population groups. The variability could also have been affected by methodological factors within each study.
CONCLUSION: This study provides a broad overview of the prevalence of anxiety disorders in Malaysia. More research is required to develop diagnostic instruments that are validated for local use and comparable with international standards. Reliable prevalence estimates are lacking within certain groups, e.g. those in rural, indigenous, migrant population groups and those exposed to natural disasters.

Matched MeSH terms: Community Mental Health Services/statistics & numerical data*

Fulltext Managing ‘schizophrenia in the midst of schizophrenia’- the role of assertive community treatment

Ahmad Nabil, M.R., Marhani, M., Azlin, B.

Medicine & Health, 2014;9(2):139-142.

MyJurnal

This case report emphasizes the role of Assertive Community Treatment (ACT) in managing a family with four members suffering from mental illness, mainly schizophrenia. We report a case of middle-aged lady who was diagnosed with treatment resistant schizophrenia (TRS) living with two other family members with the same illness and their carer who developed major depression from shouldering the burden of caring for mentally ill family members. ACT, through its holistic approach, proved to have reduced hospitalizations and improve symptom control and quality of life in this family.

Matched MeSH terms: Community Mental Health Services

Fulltext Remission of symptoms among schizophrenia patients receiving assertive community treatment (ACT) in Malaysia: one year follow-up

Rahima Dahlan, Marhani Midin, Hatta Sidi

Sains Malaysiana, 2013;42:389-397.

Assertive community treatment (ACT) is one of the most important elements of mental health care reform in Malaysia. Many studies worldwide have reliably found that ACT has positive impact on several outcome domains such as reduced hospitalization rate, improvement of symptoms and quality of life. This study aimed to assess the outcome of ACT in the aspect of symptom remission and its influencing factors among patients with schizophrenia in the urban city of Kuala Lumpur. A cross sectional study was conducted on 155 patients with schizophrenia who received ACT in Hospital Kuala Lumpur (HKL). The selection was made by simple random sampling. The abbreviated Brief Psychiatric Rating Scale (BPRS) was used to determine the status of symptom remission. The socio demographic and relevant clinical data were also assessed. A total of 76% (118) was noted to be in remission. According to logistic regression, the strongest predictor of patients receiving ACT with symptom remission was having good social support (p<0.001) and with higher educational level (p=0.024). The study revealed the effectiveness of ACT in terms of high prevalence of patients with symptom remission. This was despite the model of ACT being studied not fulfilling all fidelity measurements of the standard version of the service. The finding would hopefully act as a propeller for further development in this service area. However, the study
needs to be replicated through studies with better designs and involving more psychiatric centers.

Matched MeSH terms: Community Mental Health Services

Modified assertive community treatment: effectiveness on hospitalization and length of stay

Razali SM, Hashim MA

Community Ment Health J, 2015 Feb;51(2):171-4.

PMID: 25056686 DOI: 10.1007/s10597-014-9757-0

The objective is to assess the efficacy of a modified Assertive Community treatment (ACT). This is a retrospective cross-sectional study with a comparative group. The study group was patients with schizophrenia who had completed modified ACT, while the control group was those who did not receive modified ACT. The final sample comprises 44 patients in each group. There was no significant difference between both groups in number of admissions and average length of stay. However, in the modified ACT group there was a significant reduction in the number of admissions after the intervention. In conclusion readmission rate was significantly reduced following modified ACT intervention.

Matched MeSH terms: Community Mental Health Services*

Malaysian child psychiatric practice: a pragmatic and rational approach

Yeoh KL, Ong SB

Aust N Z J Psychiatry, 1982 Jun;16(2):61-6.

PMID: 6957184

A pragmatic and rational approach to the management of five child psychiatric cases in Malaysia is briefly reviewed. The significance of sociocultural factors in treating these cases within the context of a rapidly developing plural society is emphasized. The implications of overemphasis on educational and material achievements are noted.

Matched MeSH terms: Community Mental Health Services/utilization

Transcultural aspects of community psychiatry

Hartog J

Ment Hyg, 1971 Jan;55(1):35-44.

PMID: 5549644

Matched MeSH terms: Community Mental Health Services*

Association of social support and quality of life among people with schizophrenia receiving community psychiatric service: A cross-sectional study

Munikanan T, Midin M, Daud TIM, Rahim RA, Bakar AKA, Jaafar NRN, et al.

Compr Psychiatry, 2017 05;75:94-102.

PMID: 28342379 DOI: 10.1016/j.comppsych.2017.02.009

OBJECTIVE: To understand the needs of patients with schizophrenia for recovery, this study examined the type and level of social support and its association with quality of life (QOL) among this group of patients in the city of Kuala Lumpur.

METHOD: A cross-sectional study was conducted on 160 individuals with schizophrenia receiving community psychiatric services in Hospital Kuala Lumpur (HKL). The WHOQOL-BREF, Brief Psychiatric Rating Scale (BPRS) and Multidimensional Scale of Perceived Social Support (MSPSS) were used to assess QOL, severity of symptoms and social support, respectively. The study respondents were predominantly Malay, aged less than 40, males, single, unmarried, had lower education levels and unemployed.

RESULTS: About 72% of the respondents had poor perceived social support, with support from significant others being the lowest, followed by friends and family. From multiple regression analysis, social support (total, friend and family) significantly predicted better QOL in all domains; [B=0.315 (p<0.001), B=0.670 (p<0.001), B=0.257 (p<0.031)] respectively in Physical Domain; [B=0.491 (p<0.001), B=0.735 (p<0.001), B=0.631 (p<0.001)] in Psychological Domain; [B=1.065 (p<0.001), B=0.670 (p<0.017), B=2.076 (p<0.001)] in Social Domain and; [B=0.652 (p<0.001), B=1.199 (p<0.001), B=0.678 (p<0.001)] in Environmental Domain. Being married and having shorter duration of illness, lower BPRS (total) scores, female gender and smoking, were also found to significantly predict higher QOL.

CONCLUSION: Social support is an important missing component among people with schizophrenia who are already receiving formal psychiatric services in Malaysia.

Matched MeSH terms: Community Mental Health Services/statistics & numerical data*

Fulltext Role of modified assertive community treatment (ACT) in maintaining stability in patients with dual diagnosis: a case report

Siti Rohana, A.H., Marhani, M.

Malaysian Journal of Psychiatry, 2013;22(2):80-83.

MyJurnal

This case report highlights the role of hospital-based modified assertive community treatment (ACT) in maintaining stability in a patient with dual diagnosis. We report a case of a middle-aged Indian gentleman who had schizophrenia with co-morbid alcohol abuse presented with multiple relapses, with recurrent suicidal attempts and criminal behaviour during his relapse episodes. After stabilisation of his most recent acute episode in hospital, the patient was followed-up by the community mental health team (CMHT). He was able to maintain in remission and stay free from alcohol, suicidality and criminal behaviour when provided ACT. The hospital-based modified ACT is proven to be effective in the management of this patient with co-morbidities and complications to sustain remission and prevent relapses.

Matched MeSH terms: Community Mental Health Services

Functional remission and employment among patients with schizophrenia in Malaysia

Dahlan R, Midin M, Shah SA, Nik Jaafar NR, Abdul Rahman FN, Baharudin A, et al.

Compr Psychiatry, 2014 Jan;55 Suppl 1:S46-51.

PMID: 23679983 DOI: 10.1016/j.comppsych.2013.03.007

The study aimed to determine the rates of functional remission and employment as well as the factors associated with functional remission among patients with Schizophrenia, receiving community psychiatric service in an urban setting in Malaysia.

Matched MeSH terms: Community Mental Health Services

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