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Does Cannabis Consumption Negatively Affect Cognition? A Review Of The Scientific Evidence

Attilio Rapisarda ; Keane Lim ; Jimmy Lee

ASEAN Journal of Psychiatry.2017;18(2):82-93.

Objective: This review summarises the existing evidence on the effects that recreational and medical use of cannabis and cannabinoids have on cognitive performance. Methods: Databases (PubMed, Medline, and Google Scholar) were searched from inception to March 2017 by adopting the following key terms: dronabinol, nabilone, nabiximols, cannabis, marijuana, cognition, neurology, and neuropsychology. A total of 94 documents, including reviews, preclinical and clinical studies, industrial and government agencies reports were included in this review. Results: We found that recreational use of cannabis doubles the risk of a fatal traffic accident by impairing attention and lengthening reaction time. Short-term use lowers performance in working memory, attention, executive functions and visual perception tasks. Chronic recreational use in adolescents also doubles the risk of early school-leaving, cognitive impairment and psychoses in adulthood. Adverse effects of cannabis-based medication – dronabinol, nabiximol and nabilone – and ingestion/inhalation of marijuana allowed for medical use include dizziness, drowsiness and short-term memory impairment. Conclusion: Cannabis consumption is associated with significant impairments in a range of cognitive abilities. Of particular concern, early and chronic exposure to cannabis, especially in the adolescence, seems to be associated with irreversible cognitive impairments.

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Anxiety-Depression Psychopathology Of A Patient With Voyeurism, Major Depression And Premature Ejaculation

Nurazah Ismail ; Rohayah Husain ; Hatta Sidi

ASEAN Journal of Psychiatry.2017;18(2):94-96.

Objective: This case report highlights a case of young male referred for psychiatric evaluation due to paraphilic disorder. This 27-year old single male working as an assistant accountantwas noted to have voyeuristic behaviour andpresented with depressive symptoms since his teenage age. He has poor coping whenever he experiences stress in life. He started to watch pornographic videosand subsequently get involved by peeping pre-pubescent’s undergarments. These activities are followed by a compulsive behavioursuch as masturbation to gratify his sexual arousal. Results: The patient undergone several psychotherapy sessions, and medical report was furnished for the court's purpose. Our assessment revealed that he was suffering from a lifetime major depressive disorder,and he was prescribed with Tablet Sertraline 50mg/daily.He also has premature ejaculation, severe in nature. He regretted his voyeuristic urge and psychotherapyfocused on how to channel his sexual needs. Conclusion: Mood disorder is seen in paraphilic disorder and has to be dealt with in order to establish good management care.

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Anxiety and Depression Symptoms And Health-related Quality of Life Status Among Patients With Cancer In Terengganu, Malaysia

Lua Pei Lin ; Wong Sok Yee ; Neni Widiasmoro Selamat

ASEAN Journal of Psychiatry.2011;12(1):1-15.

Objective: This study was aimed to determine the prevalence of anxiety and depressive symptoms , to examine their association with health-related quality of life (HRQoL) profiles and to determine the predictors on overall HRQoL. Methods: This was a cross-sectional study conducted in Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia. The Malay Hospital Anxiety and Depression Scale (HADS) and McGill Quality of Life Questionnaire (MMQoL) were administered to a sample of 150 cancer patients (mean age = 50.4 years). Chi-square test, correlation and multiple regression were utilised for data analysis. Results: The prevalence for mild anxiety and depressive symptoms was 30.7% and 23.3% respectively. The HADS-A correlated strongest with Total MMQoL Score (r = - 0.578) and Psychological Well-Being (r = -0.526). Only HADS-A (beta = - 0.486), and HADS-D (beta = -0.173) were significant in predicting overall health-related quality of life. Conclusion: Findings in our study indicated that the prevalence of anxiety and depressive symptoms in Terengganu cancer patients are moderate. If anxiety and depression are identified and treated, health-related quality of life among oncology patients appropriately could significantly be improved.

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A Randomized Trial of Oral Risperidone Versus Intramuscular Haloperidol In The Emergency Treatment Of Acute Psychotic Agitation

Bernardo L. Conde ; Eufemio E. Sobreveg ; Michael P. Sionzon

ASEAN Journal of Psychiatry.2011;12(1):1-8.

Objective: The study aimed to compare the efficacy and tolerability of oral risperidone and oral clonazepam with intramuscular haloperidol and oral clonazepam in Filipino patients with acute psychotic agitation. Methods: This study used a prospective randomized design targeting patients who were referred to the emergency department or hospital inpatients exhibiting both psychosis and agitation. Patients were randomized into oral risperidone group or intramuscular haloperidol group. Both groups received oral clonazepam as part of treatment. Patients were observed for 24 hours. The main efficacy parameter was the PANSS agitation cluster score. Other parameters were total PANSS, other PANSS subscale scores, time and incidence of additional clonazepam usage. The safety parameter measured as incidence of adverse events. Results: There were 99 subjects enrolled in the study: 49 in the oral risperidone arm and 50 in the intramuscular haloperidol arm. There were significant reductions in the mean PANSS agitation cluster scores for both groups: -7.6+4.7 for oral risperidone group (p<0.0001) and -6.7+5.0 for intramuscular haloperidol group (p<0.0001). There was no statistical difference observed in the mean change in PANSS agitation cluster scores among the two groups (p=0.3928). Similar trends were observed in the total PANSS and other subscale scores. The incidence of additional clonazepam use is numerically higher in the oral risperidone arm than the intramuscular haloperidol arm (33% vs. 20%), but the difference did not attain statistical significance (p=0.1370). At the end of the study, 17 (33 %) and 18 (36%) of patients in the risperidone and haloperidol groups experienced varying degrees of sedation. No serious adverse event was reported. Conclusion: Oral risperidone is comparable to intramuscular haloperidol in the treatment of acute psychotic agitation in terms of efficacy and safety.

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Concurrent Validity Of The Depression And Anxiety Components In The Bahasa Malaysia Version of The Depression Anxiety and Stress Scales (DASS)

Ramli Musa ; Roszaman Ramli ; Kartini Abdullah ; Rosnani Sarkarsi

ASEAN Journal of Psychiatry.2011;12(1):1-5.

Scales 21-item (DASS-21) has been widely used ever since the establishment of its validity. To consolidate the evidence of the BM DASS-21 validity by examining its concurrent validity. Methods: The BM DASS was administered together with the Hospital Anxiety and Depressive Scale (HADS) to a total of 246 patients at International Islamic University Malaysia (IIUM) Infertility Centre. Results: The anxiety domain of BM DASS-21 had good correlation with anxiety domain in HADS (0.61) but for DASS depressive domain, it had modest correlation with its respective domain in HADS (0.49). Conclusions: The results of this study further ensconced the evidence that the BM DASS-21 had relatively satisfactory psychometric properties for clinical subjects in Malaysia.

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Stress, Stressors And Coping Strategies Among House Officers In A Malaysian Hospital

Muhamad Saiful Bahri Yusoff ; Tan Ying Jie ; Ab Rahman Esa

ASEAN Journal of Psychiatry.2011;12(1):1-10.

highly stressful environment to doctors. This article described findings on stress, stressors and coping strategies among house officers in a Malaysian hospital. Methods: A cross-sectional study was conducted on house officers in a Malaysian hospital. The 12 items General Health Questionnaire (GHQ-12), General Stressors Questionnaire (GSQ) and Brief COPE inventory were administered to measure perceived stress, sources of stress and coping strategies among house officers respectively. Data was analysed using SPSS version 12. Results: Forty two house officers participated in this study. This study found that approximately 31% of the house officers were in distress. The top five stressors were fears of making mistakes that can lead to serious consequences, work overload, working with uncooperative colleagues, doing work that mentally straining and feeling of being underpaid. The most frequent coping strategies used by house officers were religion, acceptance and self-distraction. Conclusion: This study found that there was a high percentage of distressed house officers. It also found that major stressors were related to performance pressure. The main coping strategy used by house officer was emotion-focused copin

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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

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Development And Validation Of The Brain Fag Propensity Scale

David O. Igbokwe ; Bolanle A. Ola

ASEAN Journal of Psychiatry.2011;12(1):1-13.

Objective: Brain Fag Syndrome (BFS) is a psychiatric disorder associated with study among African students. Among secondary school students, it affects two to four out of every ten students. One of the consequences of this illness is early foreclosure of education in affected students. However, clinical experience suggests that many students have sub-threshold symptoms of brain fag and are at risk for developing brain fag syndrome. This study aimed to develop a valid and reliable psychometric instrument that measures brain fag syndrome propensity. Methods: External and internal expert panels as well as a patient focus group evaluated a large pool of potential item stems gathered from the psychological and psychiatric literature. Potential scale items were then administered to 250 students along with a set of validating questionnaires. Final item selection was based upon rigorous empirical criteria and the psychometric properties of the final scale were examined. Results: A final four dimensional 20-item scale, the Brain Fag Syndrome Propensity Scale, has a Cronbach’s alpha of 0.795, split half reliability of 0.813 for the part 1 (10 items) and 0.585 for the part 2 (10 items), and Spearman-Brown coefficient of 0.557. The intrinsic validity yielded a coefficient of 0.892. Conclusion: The current results indicate the BFPS has an excellent internal consistency as well as good content and concurrent validity and should have significant utility as a brief, valid measure of propensity to develop brain fag syndrome or sub-threshold cases of BFS.

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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.

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Effects of A Brief Stress Reduction Intervention On Medical Students' Depression, Anxiety And Stress Level During Stressful Period

Muhamad Saiful Bahri Yusoff

ASEAN Journal of Psychiatry.2011;12(1):1-14.

Objective: The objective of this study was to evaluate whether students exposed to a brief stress reduction intervention would have lesser stress, anxiety and depression levels compared to their non-exposed classmates during stressful events. Methods: The Ex Post Facto design was applied in this study. Students who were exposed and not exposed to a brief stress reduction intervention were surveyed during a continuous examination and during the final examination. The Depression Anxiety Stress Scales (DASS) was used to examine effects on anxiety, stress, and depression levels. Results: The exposed students statistically had lower anxiety and depression scores than the non-exposed students during the stressful period. Reduction of stress, anxiety and depression scores was sustained during the stressful period. Conclusion: The significant reduction of anxiety and depression scores suggested that brief intervention was effective in the enhancement of the psychological wellbeing of exposed medical students during stressful period.

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