A review of schizophrenia research in malaysia.

Research in schizophrenia has advanced tremendously. One hundred and seventy five articles related to Schizophrenia were found from a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. This project aims to examine published research articles, in local and international journals in order to provide a glimpse of the research interest in Malaysia with regards to schizophrenia. Single case study, case series report, reviews and registry reports were not included in this review. Medication trial, unless it concerned a wider scope of psychopharmacology was also excluded from this review. A total of 105 articles were included in this review. Despite numerous genetics studies conducted and published, a definitive conclusion on the aetiology or mechanism underlying schizophrenia remains elusive. The National Mental Health - Schizophrenia Registry (NMHR) proved to be an important platform for many studies and publications. Studies stemmed from NMHR have provided significant insight into the baseline characteristic of patients with schizophrenia, pathway to care, and outcomes of the illness. International and regional collaborations have also encouraged important work involving stigma and discrimination in schizophrenia. Ministry of Health's hospitals (MOH) are the main research sites in the country with regards to schizophrenia research. Numbers of schizophrenia research are still low in relation to the number of universities and hospitals in the country. Some of the weaknesses include duplication of studies, over-emphasising clinical trials and ignoring basic clinical research, and the lack of publications in international and regional journals.

Risk factors for suicidal ideation, plans and attempts in Malaysia--results of an epidemiological survey.

OBJECTIVE: This is an epidemiological study to determine the prevalence of suicidal behavior and its association with generalised anxiety disorder (GAD) and major depressive disorder (MDD) in a nationally representative sample. METHOD: Suicidal ideation, plans and attempts were assessed in face-to-face interviews of respondents selected by a multistage probability sampling using items on suicidality from the WHO SUPRE-MISS questionnaire. The Mini International Neuropsychiatric Interview (MINI) was used to generate DSM-IV diagnoses of GAD and MDD. A total of 19309 subjects were studied. Multivariate regression analysis was conducted controlling for demographic characteristics such as age, gender and ethnicity. RESULTS: The prevalence estimates for suicide ideation, plans and attempts were 1.7% (95% CI: 1.4-1.9), 0.9% (CI: 0.7-1.1) and 0.5% (CI: 0.4-0.7) respectively. Younger people (16-24 years) had higher risk of suicidal behavior (OR: 2.6, CI: 1.08-6.2). Females (OR: 1.6, CI: 1.2-2.1) and Indians (OR: 3.3, CI: 2.2-4.9) also had higher risk. CONCLUSION: The prevalence of suicidal behavior in Malaysia is low, but it broadly corresponds to the pattern described in other countries. This national study confirms that Malaysians of Indian descent have much higher rates of suicidal behavior than other groups. The younger age group, females and the Indian ethnic group would need focused preventive efforts.

Suicide prevention program for at-risk groups: pointers from an epidemiological study.

OBJECTIVES: The aim of this paper is to identify at-risk groups for a focused suicide prevention program for Malaysia. METHODS: Data from 20,552 persons aged 16 years and above (males 45.9%), was obtained using stratified, random sampling in a national survey of psychiatric morbidity using locally validated General Health Questionnaire (GHQ-28) which included questions on suicidal ideation. RESULTS: The overall prevalence of suicidal ideation (SI) was 6.3%, CI 6.1-6.8 (n=1288). Logistic regression analysis was performed with age, ethnicity, gender, urban/rural residence, age group, marital status, household income, type of household, presence of chronic pain, social dysfunction, somatic, anxiety or depressive symptoms, obesity, and chronic medical illnesses as independent variables. Only Insomnia, Religion, Marital Status, Depression, Social Dysfunction and Anxiety were seen to be significant predictors. Prevalence of SI was significantly higher among Indians (11.0%, CI 9.5-12.5), especially those of the Hindu faith (12.2%, CI 10.5-14.0), Chinese (9.7%, CI 8.8-10.7) and those having depressive symptoms. CONCLUSION: In a developing country with competing priorities, prudent allocation of resources requires focusing suicide prevention efforts on treating depression in vulnerable groups.

The National Mental Health Registry (NMHR).

The National Mental Health Registry (NMHR) collects information about patients with mental disorder in Malaysia. This information allows us to estimate the incidence of selected mental disorders, and to evaluate risk factors and treatment in the country. The National Mental Health Registry (NMHR) presented its first report in 2004, a year after its establishment. The report focused on schizophrenia as a pioneer project for the National Mental Health Registry. The development of the registry has progressed with data collected from government-based facilities, the academia and the private sector. The 2003-2005 report was recently published and distributed. Since then the registry has progressed to include suicides and other mental illnesses such as depression. The NMHR Report 2003-2005 provides detailed information about the profile of persons with Schizophrenia who presented for the first time to various psychiatry and mental health providers throughout Malaysia. More detailed description regarding pharmacotherapy is reported and few cross tabulations done in an effort to provide better understanding and more clinically meaningful reports.

The pattern of completed suicides seen in Kuala Lumpur General Hospital 1999.

UNLABELLED: A study was done on 76 suicide cases managed by the Forensic Pathology Department of Hospital Kuala Lumpur (HKL) from January till December 1999 to explore the pattern of suicide and psychiatric history. The Chinese contributed 52% (n=40) of cases followed by the Indians (29%, n=22) and the Malays (12%, n=9). After the age of sixty, 84.6% of the subjects were Chinese. The common methods of suicide were poisoning (39%), hanging (34%) and jumping from height (22%). Four out of 12 case-notes traced had documented psychiatric history i.e. schizophrenia. CONCLUSION: the suicide rate for Kuala Lumpur is estimated at 7.4 per 100,000. The Indians has the highest suicide rate of 21.1 per 100,000 in keeping with other local studies. The suicide rate for the Chinese is 8.6 per 100,000, but it increased to 23 per 100,000 among the elderly Chinese. The suicide rate for Malays is 2.6 per 100,000, higher than what was cited in previous local studies. The incidence of jumping from height as a suicide method had doubled over the last 2 decades.