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.

Burnout and psychological distress were reported at higher rates among hospital healthcare workers. Despite this, there is a paucity of research examining the associated risk factors among workers across specialties and occupations in Asia. This paper aimed to examine the risk factors associated with burnout and psychological distress among Malaysian hospital healthcare workers from diverse medical specialties and occupations. A total of 368 doctors, nurses, assistant medical officers and hospital attendants were recruited from major medical and surgery departments in an urban general hospital. The participants were self-administered a questionnaire consisting of demographic information, Maslach Burnout Inventory-Human Services Survey and Depression Anxiety and Stress Scale. In the fully adjusted multivariate analyses, doctors were about four to five times more likely to be emotionally exhausted (aOR [adjusted Odds Ratio], 4.826; 95% CI [Confidence Interval]: 1.492-15.604, p<0.01), depressed (aOR, 5.221; 95% CI: 1.995-13.661, p<0.01) and stressed (aOR, 3.990; 95% CI: 1.473-10.809, p<0.01). Paediatric workers demonstrated three to five times higher risks of depression (aOR, 3.105, 95% CI: 1.043-9.243, p<0.05), anxiety (aOR, 3.517, 95% CI: 1.194- 10.356, p<0.05) and stress (aOR, 5.404, 95% CI: .1.628-17.942, p<0.01). Emotional exhaustion (aOR, 1.046, 95% CI: .1.013-1.079, p<0.01) and depersonalization (aOR, 1.078, 95% CI: .1.015-1.145, p<0.05) led to higher risks of psychological distress, while stress predicted higher risks of burnout (aOR, 1.153, 95% CI: 1.062-1.251, p<0.01). There were occupational and departmental differences in susceptibility to burnout and psychological distress, requiring further investigation into the unique working environments and roles of hospital healthcare workers.
Burnout ; psychological distress ; healthcare worker ; healthcare personnel ; hospital ; Malaysia