Critical review paper is one of the components in the theory examination for master of medicine (psychiatry) and master of psychological medicine part II. Majority of the students find critical review paper is difficult to pass. Thus this article is useful to help them. The paper discussed below is aimed to determine the validity and examine the reliability of the Malay version of Auditory Verbal Learning Test (MVAVLT) for Malaysian population use. They also wanted to determine the level of performance of the test among schizophrenia patients. The data were subjected to the principal component factor analysis (PCA) with varimax rotation using a single factor. Questions for this paper mainly discussed the validity and factor analysis concept.

Objective: Critical appraisal is a process of systematically examining research evidence to assess its validity, results and relevance before using it to form a decision. A basic knowledge in statistic and epidemiology is important among postgraduate students in psychiatry to acquire the skills for appraising clinical research evidence. This is a descriptive study that attempts to look into the level of knowledge among the postgraduate psychiatry students in terms of statistic and epidemiology. Methods: A total of 31 postgraduate students in their second (N= 26) and third year (N=5) Master of Medicine (Psychiatry) and Master of Psychological Medicine from three different universities, namely: Universiti Kebangsaan Malaysia, Universiti Malaya and Universiti Sains Malaysia participated in this research. The participants were asked to answer 7 questions within 30 minutes. The passing mark for this critical review paper is set at 25 out of 50. Results: Overall, only 32.3% passed the mock critical review paper. About 67.7% of the students passed their epidemiology component and only 19.4% passed the statistic component. Conclusion: We found poor performance in basic statistics among psychiatric trainees which highlights the need for further improvement in the subject’s training.

Objective: This is a case report discussing the comorbidity of obsessive compulsive disorder (OCD) and schizophrenia. Such clinical phenomenon merits recognition as a distinct subgroup of schizophrenia with unique challenges and treatment needs. Method: A case report presenting schizophrenia with preceding obsessive-compulsive disorder over five years. Results: This report describes the clinical course and treatment challenges of a patient with obsessive compulsive schizophrenia (OCS). Conclusion: This case illustrates that OCS is a complex disorder with atypical clinical characteristics. In managing this patient, several clinical dilemmas including diagnostic ambiguity, problems with pharmacotherapy and difficulties in his rehabilitation were highlighted.

Objective: To describe the setting up of a pilot project on weight management programme for patients with severe mental illness (SMI) in a general hospital setting, the effectiveness of the programme on 5 patients and the feasibility of such programme to be developed in our local setting. Methods: Key staff members from relevant disciplines were involved through out the programme, which was based on dietary education, exercise and behavioural techniques. It was conducted weekly for physical exercise and biweekly for topic discussion with a total duration of 16 weeks. Results: Patients achieved means (SDs) weight loss of 1.78 (2.83) kg; BMI reduction of 0.92 (1.41) kg/m2 ; and reduction of waist circumference of 6.8 (4.97) cm. Factors associated with positive health outcome were high baseline BMI, high educational level and committed family members. Conclusion: The programme appears to be effective for patients and is feasible to be developed in Malaysian hospitals.

Objectives: To determine the association of students’ perception of schooling with externalizing/internalizing scores; and to examine the different perceptions related to truancy. Methods: A total of 373 predominantly 16 year-old students attending three high risk schools in Pudu, Kuala Lumpur completed the questionnaires on schooling variables (four items) and externalizing/internalizing syndromes (Youth Self-Report, 112 items). Results: Certain negative perceptions (uncertainty of the schooling purpose, thinking schooling as time wasting) were significantly associated with higher internalizing (p<0.05), externalizing (p<0.005) and total problem (p<0.005) scores. Truants were significantly associated with disliking school (OR=2.52, 95% CI=1.01-6.20), lower educational goals (OR=2.03, 95% CI=1.18-3.49) and uncertainty of the schooling purpose (OR=3.14, 95% CI=1.47-6.67). Among truants, those who thought schooling as time wasting scored significantly higher on externalizing (p<0.005) and total problems (p<0.005). Conclusions: Certain negative perceptions of schooling are associated with self-reported emotional/behavioral problems and truancy. Positive schooling experience may correct schooling misperceptions and solve related emotional and behavioural problems.

Objective: To investigate the correlation between sexual desire and sexual arousal among Malaysian women in a primary care setting. Methods: The Malay Version of Female Sexual Function Index (MVFSI) was used to assess low sexual desire and lack of sexual arousal among the respondents. A total of 230 married women aged 18 – 70 years old participated in this study. Their sociodemographic, marital profiles and correlation between low sexual desire and lack of sexual arousal were examined. Results: More than 60% respondents with low sexual desire have co-exist low sexual arousal and 94.4% respondents with high sexual desire do have high sexual arousal ( χ²= 79.6, p <0.001 ), with correlation of r = 0.852. Conclusions: The strong correlation between sexual desire and arousal has both diagnostic and therapeutic indications, and may also strongly support the circular model (Basson-inspired model) of sexual response among women.

Objectives: To determine the association of students’ perception of schooling with externalizing/ internalizing scores; and to examine the different perceptions related to truancy. Methods: A total of 373 predominantly 16 year-old students attending three high risk schools in Pudu, Kuala Lumpur completed the questionnaires on schooling variables (four items) and externalizing/ internalizing syndromes (Youth Self-Report, 112 items). Results: Certain negative perceptions (uncertainty of the schooling purpose, thinking schooling as time wasting) were significantly associated with higher internalizing (p<0.05), externalizing (p<0.005) and total problem (p<0.005) scores. Truants were significantly associated with disliking school (OR=2.52, 95% CI=1.01-6.20), lower educational goals (OR=2.03, 95% CI=1.18-3.49) and uncertainty of the schooling purpose (OR=3.14, 95% CI=1.47-6.67). Among truants, those who thought schooling as time wasting scored significantly higher on externalizing (p<0.005) and total problems (p<0.005). Conclusions: Certain negative perceptions of schooling are associated with self-reported emotional/behavioral problems and truancy. Positive schooling experience may correct schooling misperceptions and solve related emotional and behavioural problems.

Objective: School bullying in Malaysia is on the rise. While efforts are put together to combat the problem, the psychiatric aspect has been neglected. This is a cross-sectional study aimed to determine the association between the symptoms of ADHD and bully/victim problems among Malaysian sixth-graders attending primary schools in Kuala Lumpur. Methods: A total of 410 sixth-graders from seven randomly selected schools were assessed with regards to bully/victim problems and ADHD symptoms using self-reported questionnaires. Malaysian Bullying Questionnaire was used to rate bully/victim problems while ADHD symptoms were assessed using Conners-Wells’ Adolescent Self-report Scale (CASS). Teachers and parents also assessed students’ ADHD symptoms using Conner’s Teachers Rating Scale (CTRS) and Conner’s Parents Rating Scale (CPRS), respectively. Results: Self-reported questionnaires showed that 61.2% of the children were involved in bully/victim problems. The ADHD symptoms were found significant in relation to bully/victim problems as tested by multiple logistic regression. Only students and parents reported significant ADHD symptoms among the bully/victim groups. The ADHD symptoms reported by students were significant among bullies(OR=0.59,CI=0.42-0.83, p<0.01) and bully-victims(OR=0.55 CI=0.37-0.81,p<0.00). Parents reported significant ADHD symptoms only in victims(OR=1.260,CI=1.02-1.56,p=0.03). Conclusion: The ADHD symptoms were significantly present among bullies, victims and bully-victims. These findings open a new perspective of managing bully/victim problems since effective treatment is available for ADHD.

Objective: This study aims to report on the process of standard settings (SS) and to compare the passing rates between the norm-reference and SS methods, for OSCE in psychiatry undergraduate examination at UKM for 2009/2010 session. Methods: In the SS method, examiners were asked to imagine the performance of a minimally competent student and gave marks using a standardized check-list. The marks in particular outliers were discussed. After the first round, the examiners went through the same process again, to rate the minimally competent students independently. The median of the marks was taken as the passing mark for the particular question. The passing rate using the passing mark of 50% in the norm-reference method was compared to the passing rate from the passing mark obtained from the settings method. Results: For question 1, the passing rate with the norm-reference method (i.e. passing mark of 50%) was 93% (106/114) and that by the SS method was 72.8% (83/114). For question 2, the pass rate with the norm-reference method was 92% (105/114) and that by the SS method was 67.5% (77/114). Conclusion: The passing rates between the two methods showed significant differences. Although OSCE is an improvement to the undergraduate psychiatry examination in Universiti Kebangsaan Malaysia, there were few limitations and challenges that need to be tackled for further improvement.

Background: Impulse control behaviours are repetitive and excessive activities that may be subsyndromal and not fulfil the criteria for impulse control disorder. These activities have potential to negatively impact on the daily lives of sufferers. We conducted a study to investigate the prevalence of impulse control behaviours and its associated features in Parkinson’s disease in our population. Methods: We conducted a prospective cross-sectional study on consecutive patients attending neurology clinic. Inclusion criteria include idiopathic Parkinson’s disease patients with Hoehn & Yahr stage I-IV. Eighty patients were enrolled and screened for impulse control behaviours using the Questionnaire for Impulsive-Compulsive Disorder for Parkinson’s disease (QUIP). Results: Prevalence of impulse control behaviours among our cohort was 11.3%; the features significantly associated with it were higher level of education (p=0.02), advanced stage of disease (p=0.03) and higher levodopa dosage (p= 0.01). The commonest impulse control behaviour in our cohort was compulsive medication use (7.5%), followed by hobbyism (6.3%), hypersexuality (5%), compulsive buying (3.75%), punding (2.5%), walkabout (2.5%), compulsive eating (1.25%) and pathological gambling (1.3%). Conclusions: There is an association between impulse control behaviour and higher levodopa dosage in a study on patients with Parkinson’s disease in Malaysia. We also found a low prevalence of pathological gambling as compared to studies performed in the West.
Disruptive, Impulse Control, and Conduct Disorders ; Parkinson Disease