1.A Review of Depression Research in Malaysia
The Medical Journal of Malaysia 2014;69(Supplement A):42-45
Depression is a debilitating illness and has become a leading
cause of morbidity globally. We aim to summarise the
evidence available in regard to the prevalence, type of
assessment tools used and treatment options for depression
in Malaysia. Two hundred and forty seven articles related to
depression were found in a search through a database
dedicated to indexing all original data relevant to medicine
published in Malaysia between the years 2000-2013. Fifty
seven articles were selected and reviewed on the basis of
clinical relevance and future research implications. Findings
were summarised, categorised and presented according to
prevalence of depression, depression in women, depression
in clinical condition, assessment tools, and treatment of
depression. The prevalence of depression in Malaysia was
estimated to be between 8 and 12%. The figures were higher
among women of low socio-economic background or those
with comorbid medical condition. The common assessment
tools used in Malaysia include Beck Depression Inventory
(BDI), Depression, Anxiety and Stress Scale (DASS), Patient
Health Questionnaire 9 (PHQ-9) and Hospital Anxiety and
Depression Scale (HADS). They were translated into the Malay
language and their psychometric properties were established.
Both pharmacological treatment and psychotherapy were
commonly used in Malaysia, and were highly recommended
in local clinical practice guidelines. There are discrepancies
in the reported rates of depression in Malaysia and this needs
to be addressed. There were lack of studies looking into the
depression among subgroups in Malaysia especially in the
male population. There were several instruments available for
assessment of depression in Malaysia but their suitability for
the local setting need further research. Both pharmacotherapy
and psychotherapy were recommended in the local treatment
guideline in Malaysia. With the emergence of generic
medication, we need to compare their clinical efficacy and
tolerability with original products.
KEY WORDS: Depression; prevalence; instrument; treatment;
Malaysia
2.Model answer for critical review paper: conjoint examination for Malaysian master of medicine (Psychiatry) and MPM June 2012
Suzaily Wahab ; Hatta Sidi ; Ng Chong Guan
ASEAN Journal of Psychiatry 2013;14(1):1-6
This paper aims to discuss the answers to Review Paper Exam for the
Malaysian Master of Medicine (Psychiatry) May 2012 theory examination. The
paper studied the psychotropic prescription practice in cancer patients using a
health care registration database. Methods: One of the papers presented during the
journal club presentation was picked-up for evaluation of student’s critical
appraisal. Results: Model answers were provided at the end of the Critical Review
Paper. Conclusion: This review paper evaluates students’ understanding and critical
thinking on the topic of Psychotropic Drugs in cancer patients. This paper may
serve as a guideline to teach students how to critically appraise topic related to
psychiatry.
3.The Prevalence Of Orgasmic Dysfunction Among Malaysian Women Receiving Antidepressant: A Comparison Between Escitalopram And Fluoxetine
Rozita Hod ; Duni Asmindar Ahmad ; Ng Chong Guan ; Hatta Sidi
ASEAN Journal of Psychiatry 2011;12(1):1-11
Objective: To investigate the prevalence of Female Orgasmic Dysfunction (FOD) focusing on
the orgasm domain among female patients attending PPUKM Psychiatric clinic. To compare the
prevalence of orgasmic dysfunction between female patients on Escitalopram and on Fluoxetine
therapy. Methods: A validated questionnaire for sexual function was used to assess orgasmic
function. A total of 112 women aged between 24 and 57 participated in this study. The orgasmic
dysfunction was compared between patients on selective serotonin reuptake inhibitors (SSRIs)
fluoxetine and escitalopram. Results: The prevalence of female orgasmic dysfunction was 58.9%
(33/56) among patients treated with Fluoxetine and 41.1% (23/56) among patients treated with
Escitalopram. However, there was no statistically significant difference between these two
treatment groups (p=0.059). The odds to have FOD among patients on higher dose of
antidepressants was found to be higher compared to those patients who were on lower dose of
antidepressants (Odds ratio 5.32, p= 0.001). Conclusion: There was no significant difference of
Female Orgasmic Dysfunction between patients on Fluoxetine and Escitalopram
4.A journey from the known to the unknown: A qualitative study approach
Helenna M Hisham Hashim ; Lee Mei-Li ; Ng Chong Guan
ASEAN Journal of Psychiatry 2013;14(1):1-6
Individuals deal with dying and death differently and may not experience the same journey. We investigated Kübler-Ross’ Five Stages of Grief on terminally
ill patients to review the current applicability of the model among this population.
The aims of this paper is to share information regarding the Five Stages of Grief, the emotions associated with the stages, and the challenges that terminally ill patients,
namely those diagnosed with cancer, experience. Methods: Non-structured interviews were conducted among terminally ill patients located at the palliative
ward for two years. Results: We found that terminally ill patients at the palliative ward were undergoing the Five Stages of Grief, and that the emotions associated
with the stages were reported to be similar to the emotions proposed in the model and among the patients. Conclusion: Kübler-Ross’ Five Stages of Grief is still
applicable among terminally ill patients. The thoughts regarding dying and death still remain negative, therefore, the change in the myths of dying and death are
required to help improve the journey towards death.
5.Sexual Pain Disorders Among Malay Women With Type 2 Diabetes Mellitus In Malaysia
Adibah Hanim Ismail ; Rawa Baw ; Hatta Sidi ; Ng Chong Guan
ASEAN Journal of Psychiatry 2014;15(1):1-7
This study aims to determine the prevalence and associated factors of sexual pain disorders among Malay women in Malaysia with type 2 diabetes mellitus. Methods: This is a cross-sectional study involving 347 women (174 nondiabetic
and 173 diabetic subjects) who attended the diabetic clinic in a university hospital. Sexual pain disorders were assessed using the Pain sub scale of Malay Version of the Female Sexual Function Index (MVFSFI). Sociodemographic
information of the subjects was collected with a pre-designed questionnaire. Results: Prevalence of sexual pain disorders among Malay women with type 2 diabetes mellitus was 10.4% and the control group was 9.2% but the difference was not statistically significant (p > 0.05). Multivariate logistic regression analysis did not find any relevant associated factor with sexual pain disorder. Conclusion: Sexual pain disorders among Malay women were not dependent on the diabetic status. Further studies with different population of diabetic patients are needed to confirm the results.
Diabetes Mellitus, Type 2
;
Women
;
Malaysia
6.Factorial Validity And Reliability Of The Simplified-Chinese Version Of Snaith-Hamilton Pleasure Scale : A Study Among Depressed Patients At An Out-Patient Clinic In Malaysia
Anne Yee ; Huai Seng Loh ; Chong Guan Ng
ASEAN Journal of Psychiatry 2014;15(1):66-71
The Snaith-Hamilton Pleasure Scale (SHAPS) is a self-assessment scale designed to evaluate anhedonia in various psychiatric disorders. To facilitate its use in Malaysian settings, our current study aimed to examine the
validity of the Simplified-Chinese translated version of the SHAPS (SHAPS-SC) in a group of subjects at a university out-patient clinic. Method: A total of 40
depressed patients were recruited in this cross sectional study. They were given both the Simplified Chinese and Malay versions of SHAPS, General Health Questionnaire 12 (GHQ-12) and Beck Depression Inventory (BDI) to assess their hedonic state, general mental health condition and level of depression. Results: Our study showed that SHAPS-SC had impressive internal consistency (Cronbach’s alpha 0.84) and concurrent validity, and fair parallel-forms
reliability (Pearson’s correlation 0.39). Conclusion: SHAPS-SC demonstrate good psychometric properties in the evaluation of hedonic state among a group of Chinese speaking depressed patients in an out-patient setting. It is easy to administer and suitable as a valid and reliable questionnaire in assessing anhedonia among depressed patients in Malaysia.
Patients
;
Depression
;
Outpatient Clinics, Hospital
7.Extracranial carotid stenosis after radiotherapy in nasopharyngeal carcinoma, a Malaysian study
Sharon Mei-Ling Tai ; Mariyam Niyaz ; Chong-Guan Ng ; Gopala Krishnan Govindasamy ; Chong-Tin Tan
Neurology Asia 2013;18(2):143-151
Background and objectives: Radiation treatment in nasopharyngeal carcinoma (NPC) is known to be
associated with increased prevalence of carotid stenosis. The objectives of the study was to determine
the prevalence of radiation-induced extracranial carotid stenosis, plaque, carotid intima thickness
(CIMT) in NPC patients; to explore whether the stenosis is due to direct effect of radiation rather
than general tendency to atherosclerosis. Methods: This was a cross-sectional study conducted in the
University Malaya Medical Centre from July 2011 to February 2012. The study subjects consisted of
47 NPC patients who were treated with radiation, and 47 healthy control. The patients and control had
carotid duplex ultrasound and transcranial Doppler (TCD). Results: The mean age of the patients was
55.1 years, the time lapse from radiation was 76.7 ± 95.3 months. Internal carotid artery (ICA) and
common carotid artery (CCA) stenosis of ≥50% was seen in 17.0% of patients vs 2.1 % of controls
(p = 0.031), with 61.7% of patients and 19.1% of controls having plaque in ICA and CCA (p=0.004).
CIMT was increased in 70.2% of patients and 44.7% of controls (p =0.022). Both the patient group
and control had similar rate of intracranial stenosis of 12.8% in TCD.
Conclusion: Extracranial internal carotid artery is the most common site of stenosis following
radiotherapy in NPC. This suggests that local trauma from irradiation is the most important factor in
predisposition to atherosclerosis following radiation therapy.
9.Identifying Depression Among The Human Immunodeficiency Virus (HIV) Patients In University Malaya Medical Centre, Kuala Lumpur, Malaysia
Tung Mun Yee ; Mary Lee Hong Gee ; Ng Chong Guan ; John Tan Jin Teong ; Adeeba Kamarulzaman
ASEAN Journal of Psychiatry 2009;10(2):135-147
Objective: The aim of this study was to identify depression among HIV-
infected patients attending Infectious Disease Clinic in University Malaya
Medical Centre (UMMC). Methods: This is a cross sectional study on HIV-
infected patients attending Infectious Disease Clinic, UMMC. Those who fulfilled inclusion criteria were recruited and interviewed. Socio-
demographic characteristics and clinical conditions such as mode of transmission, year of diagnosis, CD4+ counts, drug treatment and clinical stage were collected. The patients were then subjected to self-administered questionnaires, Patient Health Questionnaire, (PHQ-9) and Hospital Anxiety & Depression Scale (HADS). Results: 89 patients were recruited. Scores from
PHQ9 showed 32% of depression rate while scores from HADS showed 19%
of depression rate among the respondents. Non-self financial supporter, non-
alcoholic drinkers and females were more likely to be depressed (P<0.05). All clinical characteristics showed no statistical differences. Conclusion: The depression rate was lower compared to those from the studies in western countries. The risk factors for depression were different from those found in other studies as well.
10.Cyber Bullying - A New Social Menace
Ng Chong Guan ; Sharmilla Kanagasundram ; Yee Hway Ann ; Tan Loong Hui ; Teoh Kar Mun
ASEAN Journal of Psychiatry 2016;17(1):1-12
jective: Cyber bullying is a combination of the word cyber and bullying where
cyber basically means the Internet or on-line. In this case, cyber bullying will
focus on getting in action with bullying by using the Internet or modern
technologies such as on-line chats, online media and short messaging texts
through social media. The current review aims to compile and summarize the
results of relevant publications related to “cyber bullying." The review also
includes discussing on relevant variables related to cyber bullying. Methods:
Information from relevant publications addresses the demographics, prevalence,
differences between cyber bullying and traditional bullying, bullying motivation,
avenues to overcome it, preventions, coping mechanisms in relation to “cyber
bullying” were retrieved and summarized. Results: The prevalence of cyber
bullying ranges from 30% - 55% and the contributing risk factors include
positive association with perpetration, non-supportive school environment, and
Internet risky behaviors. Both males and females have been equal weigh on
being perpetrators and victims. The older groups with more technology
exposures are more prone to be exposed to cyber bullying. With respect to
individual components of bullying, repetition is less evident in cyber bullying
and power imbalance is not measured by physicality but in terms of popularity
and technical knowledge of the perpetrator. Conclusion: Due to the limited
efforts centralized on the intervention, future researchers should focus on testing
the efficacy of possible interventional programs and the effects of different roles
in the intervention in ord