Posttraumatic growth, depression and anxiety in head and neck cancer patients: examining their patterns and correlations in a prospective study.

BACKGROUND: Positive and negative psychological reactions have been described in head and neck cancer patients. Nevertheless, the relationships between these responses across time need to be studied to understand the patients' strengths and vulnerabilities. OBJECTIVES: The aim of this study is to determine the changes in posttraumatic growth (PTG), depression and anxiety longitudinally and the correlations between PTG and depression and anxiety in head and neck cancer patients. METHODS: A prospective study was conducted on 60 head and neck cancer patients within a year of diagnosis recruited from an oncology referral centre in Malaysia with 50 patients completing the study. The PTG Inventory-Short Form (PTGI-SF) and Hospital Anxiety and Depression Scale (HADS) were used at baseline and at 6 months follow-up. RESULTS: There were significant reductions in the scores of PTGI-SF (mean difference = -5.5, p = 0.014), HADS (Depression) (mean difference = -2.0, p < 0.05) and HADS (Anxiety) (mean difference = -2.0, p < 0.05) from baseline to follow-up. However, their correlations were not significant. HADS (Depression) score at baseline showed weak inverse correlation with PTGI-SF score (rho = -0.147, p = 0.309), whereas PTGI-SF score had weak positive correlations with HADS (Anxiety) at baseline (rho = 0.261, p = 0.067), HADS (Depression) at follow-up (rho = 0.083, p = 0.566) and HADS (Anxiety) at follow-up (rho = 0.111, p = 0.445). HADS scores also did not predict total PTGI-SF score longitudinally. CONCLUSION: There were reductions in PTG, depression and anxiety within a year of cancer diagnosis and 6 months later with no significant correlations between PTG with depression and anxiety.

Female sexual dysfunction in patients with major depressive disorder (MDD) treated with selective serotonin reuptake inhibitor (SSRI) and its association with serotonin 2A-1438 G/A single nucleotide polymorphisms.

INTRODUCTION: Selective serotonin reuptake inhibitors (SSRIs) are known for their sexual side effects. Different SSRIs may affect different areas of sexual function at different rates. AIMS: The study aimed to determine the prevalence of female sexual dysfunction (FSD), its clinical correlates, and association with 5HT2A (rs6311) single nucleotide polymorphisms (SNPs) in patients with major depressive disorder (MDD) who were on SSRI therapy. METHODS: This was a cross-sectional study on 95 female outpatients with MDD treated with SSRI. The patients were in remission as determined by Montgomery-Asberg Depression Rating Scale. Genomic DNA was isolated from buccal swabs and samples were processed using a real time polymerase chain reaction. MAIN OUTCOME MEASURES: The presence or absence of FSD as measured by the Malay Version of Female Sexual Function Index and 5HT2A-1438 G/A (rs6311) SNP. RESULTS: The overall prevalence of FSD was 32.6%. After controlling for age, number of children, education level, total monthly income, SSRI types, and SSRI dosing, being employed significantly enhanced FSD by 4.5 times (odds ratio [OR] = 4.51; 95% confidence interval [CI] 1.00, 20.30; P = 0.05). Those having marital problems were 6.7 times more likely to have FSD (OR = 6.67; 95% CI 1.57, 28.34). 5HT2A-1438 G/A (rs6311) SNP was not significantly associated with FSD. CONCLUSION: There was no significant association between FSD and the 5HT2A (rs6311) SNP in patients with MDD on SSRI therapy. Employment status and marital state were significantly associated with FSD among these patients.

Psychometric properties and validation of the Satisfaction with Life Scale in psychiatric and medical outpatients in Malaysia.

The present study evaluated the psychometric properties and factor structure of the Satisfaction With Life Scale (SWLS) in a sample of clinical outpatients in Malaysia. The SWLS is a measure designed to assess subjective life satisfaction. Four hundred eighty-three participants (283 with psychiatric illnesses and 200 with other medical illnesses) completed the SWLS and other self-report instruments. Results of the EFA and CFA supported the fit for the one-factor model as the best-fitting model. The internal consistency of the SWLS (α=0.86) was found to be high. Correlational analyses showed that SWLS had adequate concurrent validity. Scores on SWLS, which differentiated psychiatric patients and medical patients, supported criterion validity. The logistic regression analyses showed good discriminative validity of SWLS. The SWLS is a reliable and valid instrument to measure the satisfaction with life among psychiatry and clinical outpatients in Malaysia.

Why do young adolescents bully? Experience in Malaysian schools.

INTRODUCTION: To determine sociodemographic and psychological factors associated with bullying behavior among young adolescents in Malaysia. METHODS: This is a cross-sectional study of four hundred ten 12-year-old adolescents from seven randomly sampled schools in the Federal Territory of Kuala Lumpur, Malaysia. Sociodemographic features of the adolescents and their parents, bullying behavior (Malaysian Bullying Questionnaire), ADHD symptoms (Conners Rating Scales), and internalizing and externalizing behavior (Child Behaviour Checklist) were obtained from adolescents, parents and teachers, respectively. RESULTS: Only male gender (OR=7.071, p=0.01*, CI=1.642-30.446) was a significant sociodemographic factor among bullies. Predominantly hyperactive (OR=2.285, p=0.00*, CI=1.507-3.467) and inattentive ADHD symptoms reported by teachers (OR=1.829, p=0.03*, CI=1.060-3.154) and parents (OR=1.709, p=0.03*, CI=1.046-2.793) were significant risk factors for bullying behavior while combined symptoms reported by young adolescents (OR=0.729, p=0.01*, CI=0.580-0.915) and teachers (OR=0.643, p=0.02*, CI=0.440-0.938) were protective against bullying behavior despite the influence of conduct behavior (OR=3.160, p=0.00*, CI=1.600-6.241). Internalizing behavior, that is, withdrawn (OR=0.653, p=0.04*, CI=0.436-0.977) and somatic complaints (OR=0.619, p=0.01*, CI=0.430-0.889) significantly protect against bullying behavior. DISCUSSIONS: Recognizing factors associated with bullying behavior, in particular factors distinctive to the local population, facilitates in strategizing effective interventions for school bullying among young adolescents in Malaysian schools.

Factor analysis study on sexual responses in women with type 2 diabetes mellitus.

AIMS: This study compared the components of sexual responses between Malaysian women with Type 2 diabetes mellitus and those without the disease. METHODS: This cross-sectional study measured sexual responses by using the validated Malay version of Female Sexual Function Index. A factor analysis with varimax rotation method was employed using principal component analysis to explore the correlation structure of the different domains of sexual responses between the two groups. Components of sexual responses were obtained using Kaiser's criteria and compared between those in the diabetic and non-diabetic groups. RESULTS: A total of 353 women (178 with diabetes and 175 without diabetes) were recruited. Three components of sexual responses emerged from the analysis in the study and control groups. Sexual pain was found to form a component together with lubrication and orgasm domains among the women with diabetes, unlike those without diabetes, where pain stood on its own. Sexual desire and arousal formed one component and satisfaction formed another in both groups. CONCLUSIONS: The domains in the sexual responses of Malaysian women were highly overlapping. It is concluded that the presence of pain as part of lubrication and orgasm component in women with diabetes indicates the importance of intact genital sensation, even though an adverse type of sensation, for vaginal congestion and orgasm to occur in this group of women.

Clinical depression while caring for loved ones with breast cancer.

INTRODUCTION: The period of the cancer patients undergoing treatment is also the most stressful time for their family caregivers. This study aimed to determine the rates of major depressive disorder and dysthymia; and their associated factors in the caregivers during this time. METHODS: One hundred and thirty caregiver-patient dyads attending the oncology centre for breast cancer treatment participated in this cross-sectional study. While the data on the patients' socio-demographic and illness characteristics were obtained from their medical record, the caregivers completed three self-report measures: 1) socio-demography and the caregiving factor questionnaire, 2) Multi-dimensional Perceived Social Support (MSPSS) and 3) Depression, Anxiety and Stress Scale (DASS-21). Subsequently, those with "probable depression" identified from the DASS-21 score were interviewed using The Mini-International Neuropsychiatric Interview (MINI) to obtain the diagnoses of depressive disorders. RESULTS: Twenty-three of the 130 caregivers (17.69%) were diagnosed to have depressive disorders, where 12.31% (n=16) had major depressive disorder and 5.38% (n=7) had dysthymic disorder. Factors associated with depression include ethnicity, duration of caregiving, the patients' functional status and the caregivers' education level. Logistic regression analysis showed that the patients' functional status (p<0.05, OR=0.23, CI=0.06-0.86) and the caregivers' education level (p<0.05, CI=9.30, CI=1.82-47.57) were significantly associated with depression in the caregivers attending to breast cancer patients on oncology treatment. CONCLUSIONS: A significant proportion of family caregivers were clinically depressed while caring for their loved ones. Depression in this population is a complex interplay between the patients' factors and the caregivers' factors.

Orgasmic dysfunction among Malay diabetic women in Malaysia.

OBJECTIVES: The present study aimed to determine the prevalence and associated factors of orgasmic dysfunction among Malay women with type 2 diabetes mellitus in Malaysia. METHODS: This cross-sectional study involved 347 women (174 non diabetic and 173 diabetic subjects) who attended the diabetic clinic in a university hospital. Orgasmic dysfunction was assessed using the orgasmic subscale of Malay Version of the Female Sexual Function Index (MVFSFI). Sociodemographic information of the subjects was collected with a pre-designed questionnaire. RESULTS: Prevalence of orgasmic dysfunction among Malay women was 13.3% and 10.3% in type 2 diabetes mellitus and control group, respectively. However, the difference was not statistically significant. Multivariate logistic regression analysis showed that unemployment (Adjusted Odds Ratio, AOR=2.69, 95% CI=1.22, 5.97) and lower academic status (AOR=0.35, 95% CI=0.17, 0.72) were significantly associated with sexual orgasmic dysfunction in diabetic women. CONCLUSION: Orgasmic dysfunction was highly prevalent among the Malay women regardless of the diabetic state. It is recommended that orgasmic dysfunction in women with diabetes should be assessed during routine clinical health visit to the hospital for early treatment.

Pre-marital sex and its predicting factors among Malaysian youths.

INTRODUCTION: This study aimed to examine the prevalence of pre-marital sex and its predicting factors among youth trainees undergoing a national skill training programme in the state of Malaysia. METHODS: Participants filled up health screening surveys at the beginning of their training period. A total of 1328 out of 1377 trainees were included in the study. Logistic regression was done to determine the potential predicting factors of pre-marital sex among the trainees. RESULTS: Most trainees were 18 years old (97.1%) and 56% were female and 44% were male. The prevalence of pre-marital sex among trainees of these youths was 4.6%. A total of 6.2% of the female trainees as compared to 2.6% of their male counterpart had had pre-marital sex. Analysis using multiple logistic regression revealed only six significant predictor variables which were religion, race, lover, reading or watching porn, masturbation and bullying. CONCLUSION: The prevalence of pre-marital sex amongst Malaysian youths is low as compared to those in developed countries. However, as pre-marital sex and pregnancy outside wedlock are largely socially unacceptable in Malaysia and may be kept hidden from others, the complications and social problems that may follow from this behaviour should be taken into consideration. Measures such as sex education and awareness programmes are needed among youth to curb this phenomenon from becoming a social as well as a public health concern.

Employment program for patients with severe mental illness in Malaysia: a 3-month outcome.

OBJECTIVE: This study aimed to examine the rate and predictive factors of successful employment at 3 months upon enrolment into an employment program among patients with severe mental illness (SMI). METHODS: A cross-sectional study using universal sampling technique was conducted on patients with SMI who completed a 3-month period of being employed at Hospital Permai, Malaysia. A total of 147 patients were approached and 126 were finally included in the statistical analyses. Successful employment was defined as the ability to work 40 or more hours per month. Factors significantly associated with successful employment from bivariate analyses were entered into a multiple logistic regression analysis to identify predictors of successful employment. RESULTS: The rate of successful employment at 3 months was 68.3% (n=81). Significant factors associated with successful employment from bivariate analyses were having past history of working, good family support, less number of psychiatric admissions, good compliance to medicine, good interest in work, living in hostel, being motivated to work, satisfied with the job or salary, getting a preferred job, being in competitive or supported employment and having higher than median scores of PANNS on the positive, negative and general psychopathology. Significant predictors of employment, from a logistic regression model were having good past history of working (p<0.021; OR 6.12; [95% CI 2.1-11.9]) and getting a preferred job (p<0.032; [OR 4.021; 95% CI 1.83-12.1]). CONCLUSION: Results showed a high employment rate among patients with SMI. Good past history of working and getting a preferred job were significant predictors of successful employment.

Functional remission and employment among patients with schizophrenia in Malaysia.

OBJECTIVE: The study aimed to determine the rates of functional remission and employment as well as the factors associated with functional remission among patients with Schizophrenia, receiving community psychiatric service in an urban setting in Malaysia. METHODS: From a total of 250 patients randomly selected, 155 fulfilled the study requirement and were assessed on their functional remission status using the Personal and Social Performance Scale. The relationships between functional remission and socio-demographic factors, clinical factors, social support, symptom remission and rates of hospitalization were examined. RESULTS: The results revealed that 74% (n=115) of the respondents had functional remission with only 20% (n=31) currently employed. Functional remission was found to be significantly associated with good social support (84.4% versus 36.4% p<0.001, OR=9.487 [95% CI=4.008-22.457]); shorter illness duration of less than 10 years (81.2% versus 66.7% p=0.038, OR=2.167 [95% CI=1.035-4.535]); good medication compliance (79.1% versus 50.0% p=0.002, OR=3.778 [95% CI=1.570-9.090]); hospital admissions of lower than 3 per year (80.5% versus 44.4% p<0.001 OR=5.150 [95% CI=2.145-12.365]) and; symptomatic remission (87.3% versus 37.4% p<0.001 [95% CI=0.070 (0.029-0.168]). A multiple regression analysis revealed only social support, lower hospitalization rate and symptom remission, as significant predictors of functional remission. CONCLUSION: A majority of patients with Schizophrenia in this study achieved functional remission, however, only a small percentage of them were employed. Functional remission was influenced by severity of illness and levels of social support in these patients.

Duration of hypertension and antihypertensive agents in correlation with the phases of female sexual response cycle.

OBJECTIVE: This cross-sectional study aimed to determine the construct of the phases of the female sexual response cycle (SRC) in women with hypertension and their association with the duration of hypertension and types of antihypertensive agents. METHODS: The sexual response phases were measured with a validated Malay version of the Female Sexual Function Index (FSFI). The correlations structure of the items of the SRC's phases (i.e. desire, arousal, orgasm, satisfaction and pain) was determined using principal component analysis (PCA), with varimax rotation method. The number of factors obtained was decided using Kaiser's criteria. A total of 348 hypertensive women were recruited for this study. Four constructs were extracted in the analysis of all subjects. RESULTS: Using the factor analysis, the six domains (i.e. sexual desire, arousal, etc.) of the women's SRC among hypertensive women merged into 4 constructs. They were composed of (i) sexual desire and arousal, (ii) orgasm and sexual satisfaction, (iii) vaginal lubrication and (iv) sexual pain. Interestingly, vaginal lubrication stood out alone as one construct, compared to the non-hypertensive women. It was also observed that the duration of hypertension, beta blocker and diuretic antihypertensive medications had different influence on the SCR (in terms of constructs). CONCLUSION: Duration of hypertension and types of antihypertensive drugs may affect the components of the SRC. A clear understanding would help the clinician in strategizing the treatment approach of sexual dysfunction in women with hypertension.

Serotonin transporter gene polymorphism and its association with bipolar disorder across different ethnic groups in Malaysia.

OBJECTIVES: The risk variants have been shown to vary substantially across populations and a genetic study in a heterogeneous population might shed a new light in the disease mechanism. This preliminary study aims to determine the frequency of the serotonin transporter gene polymorphism (5-HTTLPR) in the three main ethnic groups in Malaysia and its association with bipolar disorder. METHODS: This is a candidate gene association study of randomly selected forty five unrelated bipolar disorder probands and sixty six controls. Diagnosis was evaluated using the Mini International Neuropsychiatric Interview (M.I.N.I). The control group consisted of healthy volunteers without personal psychiatric history and family history of mood disorder. Patients' whole blood was collected for genotyping. RESULTS: This study revealed that the frequency of the short variant of 5-HTTLPR in healthy control group was highest in Indians (42.9%) followed by Malays (23.5%) and was absent in Chinese. The association between the homozygous ss genotype of the 5-HTTLPR polymorphism with bipolar disorder was not found in the pooled subjects (χ(2)=1.52, d.f.=1, p=0.218, OR=4.67, 95% C.I.=0.69-7.58) and after stratification into Malays (p=0.315, OR=2.03, 95% CI=0.50-8.17), Indians (p=0.310; OR=0.44, 95% CI=0.21-0.92) and Chinese. CONCLUSION: The differences in the frequency of the short allele of 5-HTTLPR across the three main ethnic groups in Malaysia were noteworthy. The present study showed no significant association between the homozygous short variant of the 5-HTTLPR and bipolar disorder in the pooled subject and after stratification into the three main ethnic groups in Malaysia.

Prevalence and risk factors of female sexual dysfunction among healthcare personnel in Malaysia.

OBJECTIVE: To determine the prevalence and risk factors of female sexual dysfunction (FSD) among healthcare personnel in selected healthcare facilities in Malaysia. METHODS: This was a cross-sectional study carried out at three large healthcare facilities that were selected by convenience sampling. Within each facility, stratified random sampling was used to select suitable candidates to participate in the study (n=201). Validated questionnaires were used to assess depression, anxiety, sexual function in women and erectile dysfunction (ED) in their partners. RESULTS: The prevalence of FSD was 5.5%. Women with sexual dysfunction were more likely to be married longer (OR=4.08; 95% CI; 1.15-4.50), had lower frequency of sexual intercourse (OR=5.00; 95% C; 1.05-23.76) and had a spouse with ED (OR=24.35; 95% CI; 4.55-130.37). Multivariate analysis showed that ED was the strongest predictor for FSD (AOR=27.30; 95% CI; 4.706-159.08). CONCLUSION: One in eighteen female healthcare personnel suffered from FSD and presence of ED in the partner strongly impacted her sexual function, negatively. The findings highlight the importance of including the male partner in clinical assessment of FSD.

Socio-demographic and psychosocial correlates of erectile dysfunction among hypertensive patients.

OBJECTIVE: The main aim of the study was to estimate the prevalence of ED and the associated socio-demographic and psychological correlates among hypertensive patients from a rural multiethnic community in Malaysia. METHODS: A cross-sectional study was conducted among hypertensive patients attending rural primary care clinics. The socio-demographic, health characteristics, erectile function and levels of depression, anxiety and stress were recorded and analysed. The International Index of ErectileFunction-5 (IIEF-5) questionnaire and the Depression, Anxiety and Stress Scale (DASS-21) were used to assess erectile function and the levels of depression, anxiety and stress, respectively. RESULTS: A total of 253 hypertensive patients comprising 178 (70.4%) Malays, 56 (22.1%) Chinese and 18 (7.5%) Indians participated. The mean age of participants was 59.8 ± 10.62 years. Overall, the prevalence rate of ED was 62%: 90 (35%) with moderate and 69 (27%) with severe ED. The prevalence rate of ED among those aged 65 years or older (83.1%) was significantly higher than those less than 65 years (51.8%), (p<0.001). Higher prevalence rates were also noted among the Chinese (78.6%) compared to Malays (59.6%) and Indians (50%) (p=0.021); lower education level (69.1%) (p=0.026), among hypertensive patients with concomitant diabetes mellitus (70.6%) (p=0.026) and WHR ≥ 0.9 (31.3%) (p=0.021). However, no significant association was found between depression, anxiety and stress scores with IIEF-5 score. CONCLUSION: The prevalence rate of ED among Malaysian hypertensive patients is high. The rate increases significantly with age, Chinese ethnicity, concomitant diabetes mellitus, lower education level, WHR and the number of pack years of smoking. ED should be properly recognized and managed in hypertensive patients.

The relationship between sexual functioning among couples undergoing infertility treatment: a pair of perfect gloves.

OBJECTIVE: The study aimed to measure the relationship of sexual functioning between male and female partners, who sought infertility treatment in a university hospital setting in Malaysia. METHODS: This cross-sectional study was conducted on couples with infertility problems attending the Medically Assisted Conception Center (MACC). The female and male sexual functioning was measured using the Malay Version of Female Sexual Function Index (MVFSFI) and Malay Version of International Index of Erectile Function (IIEF), respectively. The relationship between the female and male sexual functioning was measured using correlation statistical analyses. A total of 269 subjects (150 females and 119 males) who met the requirement of the study, were recruited. RESULTS: The female and male sexual functioning was moderately correlated (r=0.574). Female sexual arousal and sexual satisfaction domains scores had the largest correlation (r=0.522 and r=0.507 respectively) to IIEF total score. On the other hand, male intercourse satisfaction (IS) domain score had the highest correlation (r=0.574) to FSFI total score. A strong correlation between male and female sexual function was observed. CONCLUSION: It is speculated that possible interaction of male and female sexual functioning may be multifactorial and complex.

Waist circumference and not body mass index as the outcome of a group weight intervention for patients with severe mental illness.

OBJECTIVE: Most weight interventions among patients with severe mental illness (SMI) used body mass index (BMI) as outcome measure but excluded waist circumference (WC) although the latter is a stronger predictor of obesity complications. This study aimed to assess a weight-management program consisting of education, exercise and behavioural techniques for patients with SMI using weight parameters including WC as the outcome measures. METHODS: A group intervention was carried out as part of psychiatric outpatient community service. It used structured modules on diet, exercise and related topics comprising of education and exercises sessions with a total of 12-week duration. The participants were outpatients with SMI recruited through referrals to the program by the treating doctor. The participants' body weight, BMI and WC were measured at the baseline, fortnightly and at the end of the program. RESULTS: A total of 27 patients participated in the program which was carried out in 6 cycles. The pre- and post-intervention comparisons analysis of the weight parameters found a significant reduction in the WC (mean=3.878 cm+5.165, p=0.001) while no significant changes were recorded in body weight and BMI. CONCLUSION: Small but significant loss in WC and possibly weight maintenance were achieved using this non-pharmacological intervention. Modest loss in WC may have an impact on reducing the risk of obesity-related health risks.

A preliminary study of the psychological differences in infertile couples and their relation to the coping styles.

BACKGROUND: Studies from Western countries have observed that couples undergoing infertility treatment suffer various physical and psychological difficulties at a higher frequency than the comparable general population. These relate to treatment challenges and other psychosocial stressors, often influenced by coping style, personality factors and available support systems. There is paucity of studies in non-Western populations. OBJECTIVE: The aim of this pilot investigation was to evaluate characteristics and gender differences in perceived psychological difficulties reported by infertile Malaysian couples. In particular, depression, anxiety and stress, along with correlated coping styles, were examined between spouses. METHODS: Demographic information, including age, ethnicity and duration and causes of infertility, were collected from participants treated within a fertility clinic. The Depression, Anxiety and Stress Scale (DASS) and Coping Inventory for Stressful Situation (CISS) were completed to measure psychological distress and coping styles. RESULTS: Depression, anxiety and stress-related difficulties were reported at significantly higher frequency by wives than husbands (p<0.05). There were no significant differences in coping styles between wives and husbands. However, emotional-oriented coping style was associated with significantly higher levels of depression, anxiety and stress (p<0.05) within the overall sample with odds ratios of 2.5, 3.0 and 1.5, respectively. CONCLUSION: The study confirms that, as with Western subjects, Malaysian infertile couples demonstrate the vulnerability to psychological distress that occurs more frequently among wives than husbands. As anticipated, emotional coping style was associated with greater distress in both genders.

The risk and associated factors of methamphetamine psychosis in methamphetamine-dependent patients in Malaysia.

OBJECTIVE: The objective of this study was to determine the risk of lifetime and current methamphetamine-induced psychosis in patients with methamphetamine dependence. The association between psychiatric co-morbidity and methamphetamine-induced psychosis was also studied. METHODS: This was a cross-sectional study conducted concurrently at a teaching hospital and a drug rehabilitation center in Malaysia. Patients with the diagnosis of methamphetamine based on DSM-IV were interviewed using the Mini International Neuropsychiatric Interview (M.I.N.I.) for methamphetamine-induced psychosis and other Axis I psychiatric disorders. The information on sociodemographic background and drug use history was obtained from interview or medical records. RESULTS: Of 292 subjects, 47.9% of the subjects had a past history of psychotic symptoms and 13.0% of the patients were having current psychotic symptoms. Co-morbid major depressive disorder (OR=7.18, 95 CI=2.612-19.708), bipolar disorder (OR=13.807, 95 CI=5.194-36.706), antisocial personality disorder (OR=12.619, 95 CI=6.702-23.759) and heavy methamphetamine uses were significantly associated with lifetime methamphetamine-induced psychosis after adjusted for other factors. Major depressive disorder (OR=2.870, CI=1.154-7.142) and antisocial personality disorder (OR=3.299, 95 CI=1.375-7.914) were the only factors associated with current psychosis. CONCLUSION: There was a high risk of psychosis in patients with methamphetamine dependence. It was associated with co-morbid affective disorder, antisocial personality, and heavy methamphetamine use. It is recommended that all cases of methamphetamine dependence should be screened for psychotic symptoms.

Post tsunami psychological impact among survivors in Aceh and West Sumatra, Indonesia.

OBJECTIVE: In 2004, the province of Aceh, Indonesia was rocked by tsunami and in September 2009, West Sumatra, Indonesia was hit by an earthquake. The aim of this study was to determine the long-term psychological impact on the residents inhabiting these regions and to identify factors associated with it. METHODS: A cross-sectional study was conducted among the residents. The Depression, Anxiety and Stress Scale (DASS) was used to measure their psychological well-being. RESULTS: Out of 200 respondents, 1 in 5 (19%) was found to suffer from a high level of depression, 1 in 2 (51%) had anxiety and 1 in 5 (22%) experienced stress. Factors found to be significantly associated with depression, anxiety and stress were female, young age, unemployed, and single (p<0.05). CONCLUSION: The psychological impact following the tsunami persisted in the population after many years post-disaster. It is recommended that the psychological profile of the population be evaluated for the vulnerable group following any natural disaster.

The Dual Systems Model-Impulsivity and Narcissism as the Reflexive System and Self-Regulation as the Reflective System-of Smartphone Addiction.

The exploration of underlying mechanisms leading to the development of smartphone addiction has been limited, with only a few studies incorporating theories to provide explanations. Drawing upon the Dual Systems Model, this study tested the hypothesis that the reflective system of self-regulation would mediate the relation between the reflexive system of impulsivity and narcissism, and smartphone addiction in a sample of 298 undergraduate students. Participants completed a self-administrated web-based questionnaire containing measures of impulsivity (the Barratt Impulsiveness Scale), narcissism (the Narcissistic Personality Inventory), self-regulation (the Self-Regulation Scale), and smartphone addiction (the Smartphone Addiction Inventory). The findings from structural equation modeling revealed that self-regulation served as a significant mediator between impulsivity and smartphone addiction, as well as between narcissism and smartphone addiction. These findings offer insights that can contribute to the development of interventions and strategies that target impulsivity and narcissism by enhancing self-regulation skills.