1.Effectiveness of Group Cognitive Behaviour Therapy Augmentation In Reducing Negative Cognitions In The Treatment Of Depression In Malaysia
Firdaus Mukhtar ; Tian PS Oei ; Mohd Jamil Mohd Yaacob
ASEAN Journal of Psychiatry 2011;12(1):1-16
Objective: Cognitive Behaviour Therapy (CBT) for depression is popular in Western countries. In the context of Malaysia, CBT has been applied as an individual session in a clinical setting. However, there is limited research in the area of group CBT for depression among Malays. The aim of this study is to investigate the effectiveness of Group Cognitive Behavioural Therapy (GCBT) in reducing the negative cognitions that are related to depression in a group of Malay patients. Methods: One hundred and thirteen patients, diagnosed with depression, were randomly allocated to either a Treatment As Usual (TAU) group (n = 55), or a TAU plus GCBT group (n = 58). All participants completed two questionnaires that measured maladaptive cognitions at pre-treatment, midway through treatment, post-treatment (week 4), and at follow-ups after three (week 16) and six months (week 28). Results: The TAU+GCBT patients improved significantly more, and at a faster rate, than the TAU group; which showed minimal improvement. The effect size (Cohen’s d) of the treatment group was 0.93 and 96.55% of the treatment group achieved a clinically significant change. Conclusions: The findings suggest that GCBT, when used in addition to the TAU, is effective in reducing negative thoughts and maladaptive attitudes of Malaysian patients suffering from depression.
2.Depression and Coping Strategies Among Sexually Abused Children In A Malay Community In Malaysia
Rohayah Husain ; Rosliwati Md Yusoff ; Mohd Jamil Yaacob ; Zaharah Sulaiman
ASEAN Journal of Psychiatry 2009;10(2):169-180
Objective: The fact that childhood sexual abuse is associated with depression is well-known. To date, there is no proper study done on screening for depression and coping strategies among sexually abused children in Malaysia. This study aimed to determine the prevalence of depression and examine the association of depression with the socio-demographics and coping strategies used by sexually abused children. Methods: Sixty-five sexually abused children who attended the One Stop Crisis Centre (OSCC) services at Hospital Universiti Sains Malaysia and fulfilled the study criteria were screened for depression using a validated Malay version of Children Depression Inventory (CDI).Depression was determined by a positive score of the Malay-CDI with depression being indicated in scores of more than 18. Results: In the study sample, 16 (24.6 %) participants had been depressed and 49 (75.4 %) participants had not been depressed. Having a confidante was a protective factor against depression. Short duration of time between the abuse incident and the clinical interview was significantly associated with depression. With respect to coping strategies, 59 (90.8 %) used emotion-focused strategies and 6 (9.2 %) used problem or task-focused strategies. Among emotion-focused coping strategies, participants did the following: deciding that nothing could be done to change things, were in denial, and suppressed their feelings. Conclusion: Twenty five percent of the sample suffered from depression. The screening of depression in the vulnerable group such as sexually abused children is important, particularly for early detection and treatment. By recognizing the coping strategies used in sexually abused children, the clinician could understand them better and plan for their psychological management.
3.The Effectiveness Of Paliperidone For Adolescents With Atypical Presentation Of Bipolar Disorder In Manic Phase: A Case Report
Norzila Zakaria ; Mohd Jamil Yaacob ; Van Rostenberghe Hans
ASEAN Journal of Psychiatry 2009;10(2):199-201
Objective: To report the use of Paliperidone in an adolescent with bipolar disorder primarily concerning its effectiveness and safety. Method: We present a case report of an adolescent with atypical presentation of bipolar disorder. The problem was complicated by poor liver function and poor compliance. Progress of the patient was recorded. Results: The patient showed dramatic improvement after 2 weeks on Paliperidone and has achieved the best level of functioning after almost 4 years on other treatment. Conclusion: The usage of Paliperidone was effective and safe in an adolescent
with atypical bipolar disorder.
4.Prevalence and Sources of Stress among Universiti Sains Malaysia Medical Students
Muhamad Saiful Bahri Yusoff ; Ahmad Fuad Abdul Rahim ; Mohd Jamil Yaacob
Malaysian Journal of Medical Sciences 2010;17(1):30-37
Background: Being in medical school has always been regarded as highly stressful. Excessive
stress causes physical and mental health problems. Persistent stress can impair students’ academic
achievement and personal or professional development. The aim of this study is to explore the nature
of stress among medical students by determining the prevalence, sources and pattern of stress and
the factors affecting it.
Methods: We chose a cross-sectional study design utilizing validated questionnaires, the 12
items General Health Questionnaire (GHQ-12) and Medical Student Stressor Questionnaire (MSSQ),
to evaluate stress levels and stressors. School and ethical committee clearance were obtained prior
to the study. Data were analysed using SPSS version 12.
Results: Of the medical students who were administered the questionnaire, 761 (72%)
respondents participated in this study. The prevalence of stress among the medical students was
29.6%. The top 10 stressors were academic-related. Prevalence of stress for the first, second, third,
fourth and fifth year students was 26.3%, 36.5 %, 31.4%, 35.3% and 21.9%, respectively. Year of study
was the only significant factor affecting stress among medical students (P-value < 0.05).
Conclusions: The prevalence of stress among medical students in USM is high. Academicrelated
problems were the major stressor among medical students. Year of study was the factor most
significantly associated with medical students’ stress. There was a bimodal pattern of the stress level
throughout the year of study.
5.The development and validity of the medical student stressor questionnaire (MSSQ)
Muhamad Saiful Bahri Yusoff ; Ahmad Fuad Abdul Rahim ; Mohd Jamil Yaacob
ASEAN Journal of Psychiatry 2010;11(1):13-24
Objective: To determine the construct validity and the internal consistency of the Medical Student Stressor Questionnaire (MSSQ) among medical students hence in the future it could be used as a valid and reliable instrument to identify stressors among medical students. Methods: The blueprint for the development of MSSQ was developed after a review of literature on the subject and a discussion with experts in the field. It comprised of 40 items with six hypothetical groups. The face validity of the questionnaire was established through discussion with 141 final year medical students whereas content validity was established through discussion with experts from field of Medical Education and Psychiatry. It was administered to a total of 761 medical students. Data was analysed using Statistical Package Social Sciences (SPSS) version 12. Factor analysis was applied to test construct validity of the MSSQ. Reliability analysis (Cronbach’s alpha and item total correlation) was applied to test internal consistency of the MSSQ. Results: The total Cronbach’s alpha value of the MSSQ was 0.95. All the preliminary 40 items were included in the MSSQ as the items had item total correlation value of more than 0.3. The items were loaded nicely into the six pre-determined hypothetical groups as their factor loading values were more than 0.3. Conclusion: This study showed that MSSQ had good psychometric value. It is a valid and reliable instrument in identifying stressors among medical students.
6.The sensitivity, specificity and reliability of the malay version 12-items general health questionnaire (GHQ-12) in detecting distress medical students
Muhamad Saiful Bahri Yusoff ; Ahmad Fuad Abdul Rahim ; Mohd Jamil Yaacob
ASEAN Journal of Psychiatry 2010;11(1):36-43
Objective: To determine the sensitivity, specificity and internal consistency of the Malay version GHQ-12 among medical student population. This study determined the appropriate GHQ-12 score to detect distressed medical students. Methods: The Malay version of GHQ-12 was derived based on two sources which were the original version GHQ-12 and the validated Malay version 30-items GHQ. The GHQ-12 and the Malay version Beck Depression Inventory-II (BDI-II) were administered to a total of 141 medical students. Distress diagnoses were made based on the Malay version BDI-II. ROC curve analysis was applied to determine the sensitivity and specificity of the GHQ-12 by testing against the BDI-II. Reliability analysis (Cronbach’s alpha and item total correlation) was applied to test internal consistency of the GHQ-12. The analysis was done using SPSS version 12.Results: The GHQ-12 sensitivity and specificity at cut-off point of 3/4 was 81.3% and 75.3% respectively with positive predictive value (PPV) of 62.9% as well as area under ROC curve more than 0.7. The Cronbach’s alpha value of the GHQ-12 was 0.85.Conclusion: This study showed the Malay version GHQ-12 is a valid and reliable screening tool in detecting distressed medical students. The GHQ-12 score equal to or more than 4 was considered as significant distress.