Introduction: Cases of amphetamine-type stimulants (ATS) use have been increasing over the past decade. Cravings are considered a causal factor for recurrent relapses in ATS use cases. The absence of questionnaires measuring cravings for ATS in the local population necessitates the creation of one, especially considering the rising number of cases. Objective: This study aimed to adapt and validate the Cocaine Cravings Questionnaire into a questionnaire suitable for measuring cravings for ATS in the local population. Methodology: The original questionnaire was adapted by substituting "cocaine" with "ATS". The process involved a back-to-back translation, followed by a round of face and content validation. The participants included people who use drugs (PWUD) with a history of ATS use recruited from rehabilitation centers in Malaysia. A set of questionnaires consisting of demographic items and the adapted ATS Cravings Questionnaire (ATS-CQ) were given. Results: This cross-sectional study recruited a total of 205 PWUD, mostly single men, with a mean age of 33.32 (s.d.=13.14). The mean age of ATS initiation was 22.89 (s.d.=9.39), with a median duration of ATS use of 60 months (IQR=24.00, 120.00). The adapted questionnaire received a good score for content validation. Unlike the original, this adapted version was found to have only three factors showing good internal consistency, ranging from 0.707 to 0.918 for all three factors. Test-retest reliability also showed good results, with an interclass correlation coefficient of 0.875 (95% CI=0.835, 0.905). Conclusion: The translated ATS-CQ has been finalized and deemed valid and reliable for use among Malaysian substance users to measure ATS cravings.
This study explored the pressing issue of drug and substance abuse (DSA) among adolescents in drug hotspots in Malaysia. The Malaysian Anti-drug Agency (AADK) has identified 155 hotspot areas across Malaysia, of which 78 were randomly selected as the study sites. These areas were identified as having extreme drug-related activities such as drug trafficking and drug-related crimes. According to the literature, several factors influence adolescents to be involved in DSA. Therefore, understanding the risk factors in the context of Malaysian school-going adolescents is of utmost importance. The study examined, in particular, a wide range of potential predictors, including socioeconomic factors, peer influence, family dynamics, educational experiences, drug access, and community characteristics. Adolescents in the hotspot areas were selected by means of a cross-sectional survey design with a cluster sampling method. The sample comprised 3382 school-going adolescents, and the data were collected through face-to-face interviews. The logit model method with STATA software was used to analyse the data. The findings of the study revealed that school-going adolescents with disciplinary issues face a two-fold increase in the risk of becoming current drug users compared to their peers. Further, those exhibiting externalising behaviours, such as aggression and rule-breaking, also face greater odds of becoming involved in DSA. Drug pushers were identified as the most significant risk factor, with adolescents exposed to them being 46 times more likely to become current drug users. The factors of friends and family also contribute significantly to adolescent drug involvement. However, adolescents with academic-related issues may be less involved if they have the protective factor of better coping skills. These findings will contribute to efforts to mitigate drug addiction and drug-related activities, particularly in high-risk communities, as well as help policymakers and healthcare professionals develop targeted interventions and generally promote the well-being of adolescents.
Substance-Related Disorders , Humans , Malaysia/epidemiology , Adolescent , Substance-Related Disorders/epidemiology , Substance-Related Disorders/psychology , Male , Female , Cross-Sectional Studies , Risk Factors , Schools , Adolescent Behavior/psychology , Drug Trafficking , Socioeconomic Factors
The dataset represents the socioeconomic demographic of drug-free families living in a high-risk drug environment in East Coast states of Peninsular Malaysia. The purposive sampling technique was used to choose among drug free families living in high drug environment, have children aged between 13 and 17 and none of the family members involved in any substance abuse cases via face-to-face interview questionnaires between 3rd April 2021 and 8th April 2021, gathering a total of 200 responses. The survey assessing socioeconomic demographic information (14 items) and involvement in drug prevention programs (8 items). The survey data was analyzed using descriptive analysis through frequencies and percentages. The data will assist the government, policymakers, and researchers to improve the content and delivery of family-based drug prevention programs and improve family awareness on risk and protective factors towards preventing drug abuse among youths.
This scoping review aims to provide a comprehensive overview of studies that explore the use of hypnotherapy as a treatment for depression, adhering to the PRISMA-ScR guidelines. A total of 232 articles were identified through systematic search strategies in four databases. Following rigorous screening, 14 studies, varying from case studies to randomized controlled trials, were included in the final review. The age range of participants spanned from 18 to 70 years, and the number of female participants generally exceeded that of males in these studies. Hypnotherapy was found to be frequently used as an adjunct treatment alongside various types of psychotherapy such as cognitive behavioral therapy and often included techniques like hypnotic induction, ego strengthening, and self-hypnosis. The treatment duration varied from 3 sessions to as long as 20 weekly sessions. Most importantly, the majority of the studies found hypnotherapy to be effective in reducing symptoms of depression, with some studies suggesting it has superior effects to antidepressant treatment in areas such as overall health and vitality. This review highlights the potential of hypnotherapy as a viable treatment option for depression and highlights the need for further controlled studies to establish its efficacy.
Cognitive Behavioral Therapy , Hypnosis , Male , Humans , Female , Adolescent , Young Adult , Adult , Middle Aged , Aged , Hypnosis/methods , Depression/therapy , Psychotherapy/methods , Cognitive Behavioral Therapy/methods
BACKGROUND: The emergence of New Psychoactive Substances (NPS), including synthetic psilocybin, has raised concern among health experts due to the numerous health and socioeconomic consequences. The current trend is shifting to the hazardous use of synthetic psilocybin in vaping, and little is known about the prevalence of use, specifically among amphetamine-type stimulants (ATS) users. METHODS: Interviewer-administered questionnaires were conducted in drug detention centers between March and October 2022. The study was conducted using ASSIST 3.0 and obtained information on the respondents' socio-demographic characteristics and clinical profiles. N = 355 ATS users were enrolled in this study. RESULTS: The results show a high prevalence of psilocybin vaping among ATS users (182/355, 53.1%). Most of the respondents were males (85.1%) and unmarried (69.3%), with a mean age of 29.2 (SD = 7.3). Across all respondents, five factors were associated with psilocybin vaping: tobacco smoking, aOR =5.790 (95% CI: 1.723, 8.183); cannabis uses, aOR= 9.152 (95% CI: 2.693, 10.396); and alcohol use, aOR= 3.137 (95% CI: 1.461, 5.817). Respondents of the Malay race had higher odds of being involved in psilocybin vaping compared to other races, with aOR= 1.638 (0.043, 2.459). Meanwhile, a reduction in age by 1.9 will increase the likelihood of involvement in psilocybin vaping with aOR = 1.897 (95% CI: 0.857, 1.938). CONCLUSION: Psilocybin in vaping is growing among ATS users and across all populations. Unfortunately, knowledge regarding the long-term effects on health is limited. Further studies should highlight the harmful effects of psilocybin and the potential risk of psilocybin vaping among the younger population.
Electroconvulsive therapy (ECT) is a long-standing treatment choice for disorders such as depression when pharmacological treatments have failed. However, a major drawback of ECT is its cognitive side effects. While numerous studies have investigated the therapeutic effects of ECT and its mechanism, much less research has been conducted regarding the mechanism behind the cognitive side effects of ECT. As both clinical remission and cognitive deficits occur after ECT, it is possible that both may share a common mechanism. This review highlights studies related to ECT as well as those investigating the mechanism of its outcomes. The process underlying these effects may lie within BDNF and NMDA signaling. Edema in the astrocytes may also be responsible for the adverse cognitive effects and is mediated by metabotropic glutamate receptor 5 and the protein Homer1a.
ATS dependence in Malaysia is growing tremendously across multiracial Malaysian groups, increasing concerns among public health experts and the community. This study highlighted the chronicity of ATS dependence and factors associated with ATS use. Interviewer-administered questionnaires were administered using ASSIST 3.0. A total of N = 327 multiracial people who use ATS were enrolled in this study. The study findings show that 190/327 (58.1%) respondents were ATS dependent. Malays reported the highest number of ATS-dependent (55.8%), followed by Bajau (21.6%) and Kadazan-Dusun (16.8%) ethnic. Across all races, three factors were significantly associated with the ATS dependence: respondents who had a lifetime history of needle sharing aOR = 0.023 (95% CI: 0.003, 0.183) and a lifetime history of heroin use aOR = 0.192 (95% CI: 0.093, 0.396) were at a reduced odd of ATS dependent. Meanwhile, being married reduced the likelihood of becoming dependent on ATS with aOR = 0.378 (95% CI: 0.206, 0.693) compared to being single or divorced. This study revealed that the use of ATS among multiracial Malaysians is alarmingly high, including those in detention centers. Comprehensive harm reduction strategies are urgently needed to prevent the spreading of infectious diseases and other negative health consequences associated with ATS use.
We examined whether burnout, depression, anxiety, stress, lifetime suicidal ideation, self-efficacy in preventing suicide and demographic factors predicted the understanding of and willingness to help suicidal patients among hospital healthcare workers. A total of 368 healthcare workers from the major surgical and medical departments in a general hospital setting were recruited. Participants responded to the Depression Anxiety and Stress Scale-21, Self-efficacy in Suicide Prevention, and Understanding Suicide Attempt Patient Scale. Those from the psychiatric department, with higher suicide prevention self-efficacy, and lower personal accomplishment indicated more understanding and helpful attitudes; doctors, depressed and anxious healthcare workers reported less understanding and helpful attitudes. Suicide prevention efforts must be conducted in tandem with equipping and supporting the healthcare workers who manage suicidal patients.
Depression , Suicide, Attempted , Humans , Suicide, Attempted/psychology , Depression/psychology , Anxiety/psychology , Suicidal Ideation , Health Personnel , Risk Factors
Cotard's syndrome is uncommon psychopathology among patients with psychotic illnesses. Limited cases had been reported regarding the occurrence of this syndrome in anti-NMDAR encephalitis which itself is a relatively new disease that often presents with florid psychotic symptoms. This poses difficulties in differentiating it from a primary psychiatric illness. Late recognition of anti-NMDAR encephalitis can lead to death as it can progress to autonomic instability in its natural course of illness. We report a patient who first presented with psychotic symptoms with initial negative findings from baseline investigations. Further investigation revealed anti NMDAR antibodies in the cerebrospinal fluid. Prompt treatment was initiated and despite early poor response to the first-line treatment with the development of allergic reaction, our patient recovered completely after 1 month of hospitalization. This case report aims to highlight the importance of early detection of anti-NMDAR encephalitis and the possibility of uncommon psychopathology such as Cotard's syndrome occurring in this disease.
Major depressive disorder (MDD) is a common but complex illness that is frequently presented in the primary care setting. Managing this disorder in primary care can be difficult, and many patients are underdiagnosed and/or undertreated. The Malaysian Clinical Practice Guidelines (CPG) on the Management of Major Depressive Disorder (MDD) (2nd ed.), published in 2019, covers screening, diagnosis, treatment and referral (which frequently pose a challenge in the primary care setting) while minimising variation in clinical practice.
Background: Suicidal behavior (SB) among elderly inpatients has exhibited a growing global drift. This study aimed to establish the prevalence of SB among elderly inpatients and identify the relationship between SB and depression and functional disability. Methods: This cross-sectional study included 136 randomly selected elderly inpatients aged 60 years and older who were hospitalized in a tertiary referral center in Kuala Lumpur, Malaysia. The study utilized the following scales as the assessment tools: The Columbia Suicide Severity Rating Scale (CSSRS), Geriatric Depression Scale (GDS-15), Mini International Neuropsychiatric Interview (M.I.N.I.), the Modified Barthel Index (Shah version) (MBI), and visual analog scale. Results: The rates of current major depressive disorder (MDD), recurrent MDD, passive suicidal ideation (SI), and active SI were 24.3%, 8.8%, 27.9%, and 5.9%, respectively. Depressed elderly had 6 to 17 times higher risk of developing passive or active SI. "Wish to be dead," ie, passive SI was associated with admission to oncology or surgical ward and the presence of current MDD. The findings of the study revealed that active SI was associated with being over 80 years old (p = 0.027), being single (p = 0.042), admission to the oncology ward (p = 0.012) or orthopedic ward (p = 0.032), having positive GDS (p = 0.049), and the presence of current MDD (p = 0.019) or recurrent MDD (p = 0.010). According to the study findings, no association has been observed between passive and active SI and level of independence and acute pain. Conclusion: The risk of depressed elderly inpatients having passive and active SI is high. Hence, screening for depression and SI is crucial for prompt treatment and management.
Introduction: This cross-sectional study examines the correlation between childhood trauma, intimate partner violence (IPV), and parenting self-efficacy among women who reported using amphetamine-type stimulants (ATS) in an institutional drug rehabilitation center. Methods: A total of 106 participants were recruited by purposive sampling, of which 88 were mothers. Questionnaires were used to collect sociodemographic data and study variables. Results: Most of these women had experienced emotional abuse, sexual abuse, and physical neglect in their childhood. IPV assessments revealed that 70.5% (n = 74) and 30.5% (n = 32) had experienced physical and sexual violence, respectively. In terms of parenting competency, they scored 79.5% for self-efficacy and 54.4% for parenting satisfaction. Childhood emotional abuse significantly increases the odds of individuals experiencing sexual violence by 20.9%. Discussion: We found that childhood trauma and IPV did not have a significant relationship with parenting efficacy. Conversely, childhood emotional abuse and physical abuse were negatively correlated to parenting satisfaction. It is imperative that any form of childhood abuse be recognized and stopped early to reduce the harm it brings to women later in life.
Background: Natural disasters may physically and psychologically affect individuals and their surrounding community. This study determines the prevalence of post-traumatic stress (PTS) symptoms and its association with maladaptive trauma-related cognition and resilience among adolescents post-earthquake. Materials and Methods: Data were collected, in this cross-sectional study, during an intervention program post-earthquake held in a state high school located at Lombok, Indonesia. The study sample engaged students 14-19 years of age using the purposive sampling method. The questionnaires used to measure PTS symptoms, maladaptive trauma-related cognition, and resilience were Children's Revised Impact of Event Scale-13 (CRIES-13), Child Post-Traumatic Cognitions Inventory (CPTCI), and Child and Youth Resilience Measure-Revised (CYRM-R), respectively. Results: The prevalence of PTS symptoms was 69.9%. Among the respondents, 61.37% were female and 56.48% had mothers with lower educational levels. Using multiple linear regression, the final predictors of PTS symptoms were excessive reactions (e.g., wailing loudly, miserable shrieking) of proxy during earthquake (ß = 3.283, p = 0.005), maladaptive trauma-related cognition (ß = 0.224, p = 0.002), and resilience (ß = 0.192, p < 0.001) with female gender (ß = 7.350, p < 0.001) as a control variable. Through simple linear regression, victims who witnessed injury or death during the earthquake (p = 0.003), had a proxy died during the earthquake (p = 0.01), and trapped victims or those who had difficulty escaping (p = 0.01) were identified to potentially predict the occurrence of PTS symptoms, warranting further study. Conclusion: The presence of excessive proxy reactions during the earthquake, maladaptive trauma-related cognition, and resilience in adolescents exposed to a natural disaster are worth targeting and prioritizing in future post-disaster interventions.
INTRODUCTION: Patients receiving methadone maintenance therapy (MMT) experience higher level of stress and are at greater risk of developing mental health problems such as depression which could potentially affect both quality of life and treatment outcomes. This cross-sectional study is aimed at understanding the relationship between psychosocial factors such as social support, coping, and depression among patients receiving MMT in a Malaysian Hospital. METHODS: One hundred and ninety-six patients attending MMT program were recruited. The Patient Health Questionnaire-9 (PHQ-9) was used to screen for depression, Multidimensional Scale of Perceived Social Support (MSPSS) was used to assess participants' perceived social support, and the Brief COPE questionnaire was used to assess coping strategies. The diagnosis of depression was made using Mini-International Neuropsychiatric Interview (MINI). RESULTS: About 13.8% of our sample were diagnosed with depression. From our analysis, it was found that having higher levels of perceived social support (OR = 0.462, 95% CI 0.238-0.899, P < .05), the use of active and emotion focused coping mechanism (OR = 0.231, 95% CI 0.095-0.565, P < .005), and support seeking and self-distraction coping mechanism (OR = 0.196, 95% CI 0.074-0.521, P < .001) was associated with lower likelihood of depression. On the contrary, the use of dysfunctional coping strategies such as denial, behavioral disengagement, and self-blame was associated with increased likelihood of depression (OR = 9.384, 95% CI 3.081-28.581, P < .001). CONCLUSION: Active and emotion focused along with support and self-distraction coping strategies, and higher levels of perceived social support may serve as a buffer against depression in patients receiving MMT.
OBJECTIVE: The attitude of medical personnel towards suicide may influence the outcome of suicidal-patients management. This study aimed to determine the attitudes of medical undergraduates towards suicide and its association with their help-seeking behavior. METHODS: A cross-sectional study involving 290 medical undergraduates was conducted in a Malaysian university. The questionnaires on the attitude towards suicide and general help-seeking behavior were used as research instruments. RESULTS: The mean age of the participants was 22.4 years. Participants who did psychiatry posting indicated a greater tendency to agree on suicide as a way of communication (p = 0.008) than those who did not. Participants previously diagnosed with a psychiatric illness indicated a greater ability to understand and accept suicide (p < 0.001) as well as a greater tendency to agree on the normality of suicide (p = 0.019) than those without a previous diagnosis. Those who attended a suicide prevention program also indicated a greater tendency to agree that loneliness and avoidance could be triggers to suicide (p = 0.037) than those who did not. No correlation was found between the "attitude towards suicide" and "general help-seeking behavior" variable. CONCLUSION: Education programs in suicide prevention and management need to be incorporated early into the undergraduate medical curriculum to cultivate a more positive attitude towards suicide and help-seeking behavior.
Help-Seeking Behavior , Suicide Prevention , Adult , Attitude , Cross-Sectional Studies , Humans , Surveys and Questionnaires , Universities , Young Adult
INTRODUCTION: Adolescent substance use is a multifactorial social issue that leads to detrimental outcomes. The aim of this study is to understand the association of a lifetime history of substance abuse or dependence with family functioning, childhood victimisation, and depression, among adolescent male inmates in a juvenile detention centre in Malaysia. METHODS: This study was cross-sectional involving 230 inmates and was conducted in a juvenile detention centre in Malaysia. The mean age of the participants was 16.65 years, with the highest percentage from the Malay ethnicity (87.8% where n = 202). The Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID), Adolescent Alcohol and Drug Involvement Scale (AADIS), Family Adaptability and Cohesion Evaluation Scale (FACES) IV and Juvenile Victimization Questionnaire Second Revision (JVQ-R2) were used as instruments. RESULTS: The prevalence of a lifetime history of substance abuse and substance dependence is 72.6% and 58.3%, respectively. A lifetime history of substance abuse and dependence had a significant association with age, race, religion, and peer/sibling victimisation. Further analysis reveals that an increase in age can be a predictor of both lifetime history of substance abuse and dependence while peer/sibling victimisation may predict lifetime history of substance abuse. There was no significant association of lifetime substance-use disorder with family functioning and depression in the juvenile offenders. CONCLUSIONS: Adolescents exposed to peer/sibling victimisation might be at a higher risk of developing a substance-use disorder. At-risk groups need to be identified, assessed, and have intervention early to prevent adverse outcomes.
The escalating trend of murder victim concealment worldwide appears worrying, and literature does not reveal any specific study focusing on victim concealment amongst convicted male Malaysian murderers. Therefore, this study was aimed at investigating the psychological traits that may underlie the act of murder concealment in Malaysia via mixed method approaches. Male murderers (n = 71) from 11 prisons were selected via purposive sampling technique. In the quantitative analysis, a cross-sectional study design using the validated questionnaire was used. The questionnaire contained murder concealment variables and four Malay validated psychometric instruments measuring: personality traits, self-control, aggression, and cognitive distortion. The independent sample t-tests revealed the significantly higher level of anger in murderers who did not commit concealment acts (8.55 ± 2.85, p < 0.05) when compared with those who did so (6.40 ± 2.64). Meanwhile, the Kruskal-Wallis H test revealed that anger and the personality trait of aggressiveness-hostility significantly varied across the different groups of murder concealment acts (p < 0.05). The qualitative data obtained via the in-depth interviews revealed two important themes for the murderers to commit murder concealment acts: (1) fear of discovery and punishment and (2) blaming others. These findings discussed from the perspectives of the murderers within the context of criminology and psychology may provide the first ever insight into the murder concealment acts in Malaysia that can benefit the relevant authorities for crime prevention and investigation efforts.
Aggression , Homicide , Cross-Sectional Studies , Humans , Malaysia , Male , Psychometrics
Child sexual abuse is a public health issue that has been associated with a variety of negative health outcomes. Child sexual abusers constitute a heterogeneous population of individuals. This review lays out an overview of the current understanding of typologies and psychological profiles of child sexual abusers. Typologies of child sexual abusers in general and online child sexual abusers are reviewed to summarise the existing knowledge. Psychological traits including personality traits, cognitive distortion, empathy, and impulsivity are examined to provide a wider perspective of the psycho-criminogenic factors of child sexual abuse. Although past research on child sexual abusers has provided insights into the organisation and classification of different types of child sexual abusers, the classification of these typologies has drawn widespread criticisms. In this review, we discuss the challenges and limitations pertaining to the existing typologies and studies related to the psychological profile of child sexual abusers.
BACKGROUND: There has been mixed findings on whether a healthcare workers' religious beliefs contribute positively or negatively to their attitudes towards suicidal patients. AIMS: This study aims to explore qualitatively the influence of religious/spiritual beliefs on healthcare workers' attitudes towards suicide and suicidal patients in the culturally heterogeneous Malaysian population. METHODS: Thirty-one healthcare workers from diverse religious backgrounds, professions and medical disciplines were interviewed. Thematic analysis revealed the centrality of religion in determining healthcare workers' acceptability of suicide, specific religious beliefs that influenced their views on the right-to-die issue, perceptions of the suicidal patient's religiousness/spirituality, and the aspects and extent of religious relevance in professional philosophy and practice. RESULTS: Healthcare workers who could perceive the multifactorial nature of suicide causation had a more empathetic response. There were high levels of paternalism in the care of suicidal patients, involving unsolicited religious/spiritual advice practised as a form of suicide deterrent and social support. CONCLUSIONS: The formal integration of religious/spiritual practices into the professional care of suicidal patients was indicated.
PURPOSE: The shorter life expectancy and increased risk of suicide in patients with schizophrenia have been well documented. However, study outcomes on suicidality in this special population have been few to date. This study investigated the prevalence and factors associated with suicidal ideation in a population of institutionalized patients with schizophrenia. METHODS: Two hundred fifty-six patients with schizophrenia between the age of 18 and 65 years were randomly recruited. This cross-sectional study utilised the Calgary Depression Scale for Schizophrenia (CDSS), the Positive and Negative Syndrome Scale (PANSS) and the Psychotic Symptom Rating Scale (PSYRATS-AH). Univariate analysis was performed using an independent t-test or chi-square test, followed by binary logistic regression to determine the factors associated with increased suicidal risks. RESULTS: The socio-demographic factors associated with suicidal ideation included level of education (p=0.039); secondary-level education (OR=5.76, 95% CI:1.49, 22.34, p=0.011) and tertiary-level education (OR=9.30, 95% CI: 1.80, 48.12, p=0.008) posed a greater risk. A history of attempted suicide (OR=2.09, 95% CI: 1.01, 4.36, p=0.049) and the presence of co-morbid physical illnesses (OR=2.07, 95% CI: 1.02, 4.21, p=0.044) were also found to be associated with a suicidal ideation. Other significant factors associated with suicidal thoughts were concurrent depression (OR=9.68, 95% CI: 3.74, 25.05, p<0.001) and a higher PSYRATS score in emotional characteristics of auditory hallucinations (OR=1.13, 95% CI: 1.06, 1.21, p<0.001). CONCLUSION: Suicide in schizophrenia appears to be more closely associated with certain socio-demographic factors and affective symptoms. Appropriate screening and treatment addressing these challenges must be emphasized if suicidal thoughts and actions are to be reduced.
