Delusional infestation is a psychiatric condition in which a patient belief that they are infested with living organisms in the absence of any objective evidence. The objective of this case report is to highlight a rare case of delusional infestations in a patient with schizophrenia who misusing polysubstance abuse. Methods: We report a case of 36-year-old Malay gentlemen, unemployed, married with three children, known case of schizophrenia since 2013, with history of polysubstance abuse presented to the emergency department with symptoms of itching followed by a sensation of insects crawling, biting and burrowing under the skin on his head causing an ulcerated wound. Results: He was diagnosed to be suffering from schizophrenia and was successfully treated with monthly antipsychotic depot injection in view of his poor adherence to medication On examination, ulcerated scalp wound measuring 4 x 4 cm was noted at the parieto-occipital region of the scalp. Skull X-ray and computerized tomography (CT) scan of the brain were normal. Electroconvulsive therapy (ECT) was introduced in view of slow treatment response and self-inflicted injury. The symptoms were successfully controlled after eight months, and no extrapyramidal side effect was observed. Conclusion: Patients with delusional infestation often poorly adhered to his treatment medication and the usage of depot injection of antipsychotic may benefited some patients to control the psychotic symptoms. ASEAN Journal of Psychiatry, Vol. 17 (2): July – December 2016: XX XX.

Objective: The present study aims to assess verbal memory performance in patients with schizophrenia attending HUSM and determine the relationship between the patients’ verbal memory performance and their demographic/clinical factors. Methods: A cross sectional study of 114 patients with schizophrenia attending HUSM psychiatric services from December 2007 to May 2008 was conducted. The schizophrenia symptoms as well as verbal memory performance were assessed using the Brief Psychiatric Rating Scale, the Malay version of the Calgary Depression Scale (MVCDS), and the Malay version of the Auditory Verbal Learning Test (MVAVLT). The relationship between verbal memory performance and demographic/clinical symptoms was evaluated using Pearson Correlation. Results: Overall MVAVLT scores in all the trials were lowered in patients with schizophrenia compared to average healthy controls. There were significant relationships between occupational status and MVAVLT performance in Trial A1-A5 Total; between educational level and MVAVLT performance in Trial A1 and Trial A1-A5 Total and between severities of illness and MVAVLT performance in all indexes except Trial A1 after controlled for occupation and educational level. Conclusions: Patient with schizophrenia in HUSM performed significantly worse than healthy controls in verbal memory with or without interference. There were significant relationships between MVAVLT performance and patient’s occupational status, educational level and severity of the illness but not depressive symptoms.

Objective: Many studies have emphasized the significance of verbal memory for the functional outcome in schizophrenia. A preserved capability to encode and recall verbal information is essential for the long-term efficacy of psychoeducational programs and other psychological intervention to ensure the successful transfer of newly acquired skills or knowledge into everyday life. Aims of this study aimed to validate the MVALT among schizophrenia patients in HUSM. Methods: The subjects were 15 schizophrenia patients conveniently selected from the patients that attended follow up at the psychiatry clinic in HUSM or inpatients who have been admitted during the study period and 15 healthy control subjects as a comparison. Reliability and validity of the MVAVLT were analyzed. Results: The validation study showed that the Malay version Auditory Verbal Learning Test (MVAVLT) had a good validity (factor analysis 0.66 to 0.98) and test-retest reliability (pearson correlation ranged from 0.24 to 0.84) and has been shown to be sensitive in discriminating between normal and schizophrenia patients. In line with the previous research, the schizophrenia patients performed significantly worse than healthy control in all indexes measured in MVAVLT. Conclusion: The screening of deficits in verbal learning and memory among the schizophrenia patients is important, for early detection and treatment since it can be helpful for clinicians and psychologists in their counseling sessions. Subsequently, it helps patients to reduce such cognitive difficulties and their impact by using specific rehabilitation with the usage of newer antipsychotic agents.