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.

Stigma, Sociodemographic Factors, and Clinical Factors Associated with Psychological Distress among COVID-19 Survivors during the Convalescence Period: A Multi-Centre Study in Malaysia.

High rates of psychological distress among COVID-19 survivors and stigmatisation have been reported in both early and late convalescence. This study aimed to compare the severity of psychological distress and to determine the associations among sociodemographic and clinical characteristics, stigma, and psychological distress among COVID-19 survivors across two different cohorts at two different time points. Data were collected cross-sectionally in two groups at one month and six months post-hospitalisation among COVID-19 patient from three hospitals in Malaysia. This study assessed psychological distress and the level of stigma using the Kessler Screening Scale for Psychological Distress (K6) and the Explanatory Model Interview Catalogue (EMIC) stigma scale, respectively. At one month after discharge, significantly lower psychological distress was found among retirees (B = -2.207, 95% confidence interval [95% CI] = -4.139 to -0.068, p = 0.034), those who received up to primary education (B = -2.474, 95% CI = -4.500 to -0.521, p = 0.014), and those who had an income of more than RM 10,000 per month (B = -1.576, 95% CI = -2.714 to -0.505, p = 0.006). Moreover, those with a history of psychiatric illness [one month: (B = 6.363, 95% CI = 2.599 to 9.676, p = 0.002), six months: (B = 2.887, CI = 0.469-6.437, p = 0.038)] and sought counselling services [one month: (B = 1.737, 95% CI = 0.385 to 3.117, p = 0.016), six months: (B = 1.480, CI = 0.173-2.618, p = 0.032)] had a significantly higher severity of psychological distress at one month and six months after discharge from the hospital. The perceived stigma of being infected with COVID-19 contributed to greater severity of psychological distress. (B = 0.197, CI = 0.089-0.300, p = 0.002). Different factors may affect psychological distress at different periods of convalescence after a COVID-19 infection. A persistent stigma contributed to psychological distress later in the convalescence period.

Brief Virtual Reality Exposure Therapy and Its Effects on Negative and Positive Emotions Among Healthy Working Adults: A Feasibility Study.

Background: The primary purpose of this study is to examine the feasibility of a short-term virtual reality exposure therapy among healthy working adults sample. The secondary aim is to measure the effect of virtual reality exposure therapy on negative and positive emotions by comparing it to the standard stress management program and the wait-list groups. Methods: We enrolled 67 participants allocated into 3 groups to receive virtual reality exposure therapy, standard stress management, or wait-list group. The virtual reality exposure therapy group received a total of a 30-minute exposure to a virtual reality environment over 2 weeks. The standard stress management group received a stress management program once during the study period. Results: The results showed a heterogeneous sample, whereby a significantly younger, less-working years, and higher anxiety baseline score were found in the virtual reality exposure therapy group compared to standard stress management and wait-list groups. Nonetheless, the virtual reality exposure therapy group showed a reduction in depression, anxiety, and stress score (P < .001). The standard stress management group showed a reduction in anxiety score only (P = .002), whereas no significant changes were observed in the wait-list group. For positive emotion, all 3 groups showed significant improvement. Conclusion: Short-term virtual reality exposure therapy is a feasible intervention for the negative and positive emotions; however, cautious interpretation is needed due to significant heterogeneous sample. Replication of study with comparable groups is recommended.

Case report: Effectiveness of brexpiprazole and esketamine/ketamine combination: A novel therapeutic strategy in five cases of treatment-resistant depression.

A significant proportion of patients with treatment-resistant depression do not attain functional recovery despite administration of multiple steps of pharmacotherapeutic strategies. This highlights the elusiveness of meeting unmet needs in existing pharmacotherapies for treatment-resistant depression. There is accumulating evidence that antidepressant agents involving the glutamatergic system such as brexpiprazole and esketamine/ketamine have more rapid onset of action and potentially improved effectiveness as an augmentation therapy in treatment-resistant depression. This case series aimed to report five complex cases of unipolar and bipolar treatment-resistant depression where conventional treatment strategies were inadequate in managing high risk suicidal behavior and achieving functional recovery. We discussed further the possible synergistic mechanisms of the novel combination strategy of brexpiprazole and esketamine/ketamine, clinical and patient factors that influenced treatment response, challenges with this combination strategy and implications for future practice and research.

The Role of Bupropion in the Treatment of Women with Sexual Desire Disorder: A Systematic Review and Meta-Analysis.

Although few clinical trials examined the efficacy of bupropion to treat sexual dysfunction among female patients, a comprehensive and objective synthesis of the best available evidence is still lacking. To date, to the best of our knowledge, there are no published systematic reviews or meta-analyses specifically focusing on the role of bupropion in the treatment of female sexual dysfunction. The main objective of the present study was to evaluate the efficacy of bupropion in the treatment of female sexual dysfunction, and we hypothesized that bupropion is efficient in treating female patients with sexual dysfunction. This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search for published literature was performed using Ovid, Medline, Scopus, Cochrane Library, Science Direct, and PubMed databases. In our study, we found that bupropion was almost three-fold more favorable in improving problems with sexual desire (pool estimate 2.845, 95% CI: 0.215 to 5.475, I2= 95.6%, p=0.034). A meta-regression was performed to explore heterogeneity and we found that only the dosage of bupropion was statistically significant in explaining the variance, i.e., the lower the dosage (150 mg vs. 300 mg), the better the improvement in the sexual desire of women with hypoactive sexual desire disorder (HSDD). Based on the results of this systematic review and metaanalysis, there is a potential role of bupropion as an effective treatment for women with HSDD.

The Relationship between Internet Addiction, Internet Gaming and Anxiety among Medical Students in a Malaysian Public University during COVID-19 Pandemic.

The internet has become an important medium for learning and communication during the COVID-19 pandemic, particularly for university students. Nevertheless, an increase in internet usage could predispose people to internet addiction (IA) and internet gaming (IG). Equally, there is concern that anxiety levels have increased during the pandemic. The aim of this study is to determine the prevalence of IA and IG, and their associations with anxiety among medical students during the pandemic. Data were collected during the second wave of the "Conditional Movement Control Order" (CMCO) in Malaysia between 12 November and 10 December 2020. A total of 237 students participated through proportionate stratified random sampling in this cross-sectional study. They completed a set of online questionnaires which consisted of a sociodemographic profile, the Malay version of the internet addiction test (MVIAT), the Malay version of the internet gaming disorder-short form (IGDS9-SF) and the Malay version of the depression, anxiety and stress scale (DASS-21). The prevalence of IA and internet gaming disorder (IGD) were 83.5% and 2.5%, respectively. A multiple logistic regression showed that those in pre-clinical years had a greater risk of anxiety than those in clinical years [(AOR) = 2.49, p-value 0.01, 95% CI = 1.22-5.07]. In contrast, those who scored high on IA were protected against anxiety [AOR = 0.100, p-value 0.03, 95% CI = 0.01-0.76)]. In conclusion, IA was highly prevalent during the COVID-19 pandemic and its high usage might serve as a protective factor against anxiety among the medical students in this study sample.

Prevalence and associated risk factors of undiagnosed depression among people with epilepsy in a multiethnic society.

BACKGROUND: Depression is the most frequent psychiatric comorbidity of epilepsy. However, clinicians often neglect to screen for depressive symptoms among patients with epilepsy and, therefore, fail to detect depression. Many studies have described the risks associated with depression in patients with epilepsy, but few studies have elaborated whether these risks are similar in those with undiagnosed depression, especially in a multiethnic community. METHODS: In the present cross-sectional study conducted at a tertiary teaching hospital, we aimed to investigate the prevalence and associated risk factors of undiagnosed depression in patients with epilepsy. We recruited patients with epilepsy aged 18-65 years after excluding those with background illnesses that may have contributed to the depressive symptoms. In total, 129 participants were recruited. We collected their demographic and clinical details before interviewing them using two questionnaires-the Neurological Disorders Depression Inventory for Epilepsy and Beck's Depression Inventory-II. Subsequently, if a participant screened positive for depression, the diagnosis was confirmed using the Diagnostic and Statistical Manual of Mental Disorders questionnaire, and a psychiatric clinic referral was offered. RESULTS: Among the 129 participants, 9.3 % had undiagnosed major depressive disorder, and there was a female preponderance (66.7 %). The risk factors for undiagnosed depression among patients with epilepsy included low socioeconomic background (p = 0.026), generalized epilepsy (p = 0.036), and temporal lobe epilepsy (p = 0.010). Other variables such as being underweight and unmarried were more common among patients diagnosed with depression than without but no statistically significant relationship was found. CONCLUSION: The prevalence of undiagnosed depression among patients with epilepsy was higher than that in population-based studies conducted in Western countries. Although questionnaires to screen for depression are widely available, some clinicians rarely use them and, therefore, fail to identify patients who may benefit from psychosocial support and treatment that would improve their disease outcomes and quality of life. The present study indicated that clinicians should use screening questionnaires to identify undiagnosed depression in people with epilepsy.

Are Malaysian Youths Overdependent on the Internet?: A Narrative Review.

Overdependence on the internet is a grave concern that has enveloped Malaysian youths which could lead to a variety of sequelae. This narrative review aims to determine the definition of internet overdependence and its associated factors, as well as the potential preventive and treatment strategies for internet overdependence. From the literature, internet overdependence is regarded as a 3-factor model encompassing salience, self-control failure, and serious consequences. Sociodemographic factors such as age, gender, and ethnicity, as well as psychosocial factors such as depression, anxiety, stress, and loneliness, were found to be associated with internet overdependence among Malaysian youths. A multimodal treatment approach is recommended by the implementation of various types of treatments, integrating disciplines such as pharmacology, psychotherapy, and family counseling. Despite various terminologies being used and unclear conceptualization of its nomenclature, overdependence on the internet is prevalent among youths in Malaysia. Future research should go toward establishing a clear definition of its terminology and attaining more robust evidence on treatment strategies.

Health Anxiety and Its Correlations with Self-Perceived Risk and Attitude on COVID-19 among Malaysian Healthcare Workers during the Pandemic.

Healthcare workers (HCW) are exposed to health-related anxiety in times of pandemic as they are considered to have a high risk of being infected whilst being the vital workforce to manage the outbreak. This study determined the factors that influence health anxiety and its extent in correlations with perceived risk, knowledge, attitude, and practice of HCW. A cross-sectional online survey was conducted on a total of 709 HCW from both public and private healthcare facilities who completed a set of questionnaires on sociodemographic data, knowledge, attitude, and practice of HCW on COVID-19, and health anxiety traits assessed using the short version Health Anxiety Inventory (HAI). Multiple linear regression (adjusted R2 = 0.06) revealed respondents with higher perceived risk for COVID-19 significantly predicted higher HAI scores (beta 1.281, p < 0.001, 95%, CI: 0.64, 1.92), and those with a higher cautious attitude towards COVID-19 significantly predicted higher HAI scores (beta 0.686, p < 0.001, 95%CI: 0.35, 1.02). Healthcare workers' perceived risk and cautious attitude towards COVID-19 might be potentially influenced by management of the sources and approaches to the dissemination of information of the pandemic. The implementation of certain measures that minimize the infection risk and its related anxiety is important to preserve both their physical and psychological wellbeing.

Psychometric Properties of the Malay Version of the Internet Gaming Disorder Scale-Short Form (IGDS9-SF-M): Evidence from a Sample of Malaysian Undergraduates.

In recent years, increased interest in Internet Gaming Disorder has led to the development of the Internet Gaming Disorder Scale-Short Form. Translation and subsequent validation of such a scale are important for cross-cultural use. The aim of the present study was to examine the psychometric properties (factor structure, reliability, and validity) of the Malay Version of the Internet Gaming Disorder Scale-Short Form using a sample of Malaysian undergraduates. The present sample included 137 Malaysian undergraduates. Participants completed a self-administered online survey containing demographic items, the Malay Version of the Internet Gaming Disorder Scale-Short Form, the Problematic Online Gaming Questionnaire-Short Form, and the Malay Version of the Internet Addiction Test. The present findings confirm the one-factor model of the Malay Version of the Internet Gaming Disorder Scale-Short Form. Good reliability, as measured by Cronbach alpha, was found for the Malay Version of the Internet Gaming Disorder Scale-Short Form. The Malay Version of the Internet Gaming Disorder Scale-Short Form has demonstrated concurrent validity by significantly correlating with the Problematic Online Gaming Questionnaire-Short Form as well as demonstrated convergent validity with respect to the Malay Version of the Internet Addiction Test. The Malay Version of the Internet Gaming Disorder Scale-Short Form is a reliable and valid tool for assessing Internet Gaming Disorder in Malaysian undergraduates. As more research is still needed to confirm the status of Internet Gaming Disorder as a formal disorder, it is hoped that the Malay Version of the Internet Gaming Disorder Scale-Short Form can facilitate future research examining antecedents and consequences of Internet Gaming Disorder in a Malaysian setting.

The relations of internet and smartphone addictions to depression, anxiety, stress, and suicidality among public university students in Klang Valley, Malaysia.

PURPOSE: This cross-sectional study examined the cyber-psychological correlates of depression, anxiety, stress, and suicidality among public university students in Klang Valley, Malaysia. DESIGN AND METHODS: Participants were randomly selected using multi-stage sampling methods from three public universities in the study location. Participants completed measures of internet and smartphone addictions, depression, anxiety, stress, and suicidality, along with sociodemographic items. FINDINGS: At bivariate level, both internet and smartphone addictions were found to have significant positive correlations with depression, anxiety, stress, and suicidality. At multivariate level, only internet addiction emerged as a consistent significant predictor for depression, anxiety, stress, and suicidality. PRACTICE IMPLICATIONS: The present findings have implications for mental health professionals to routinely screen for psychological disturbance in young adults who have potential risks for internet addiction.

Association between insight and internalized stigma and other clinical factors among patients with depression: A cross-sectional study.

BACKGROUND: Insight influences treatment adherence among patients with depression. These patients also experience considerable social and self-stigma. The relationship between insight and internalized stigma has been extensively studied among patients with schizophrenia but not patients with depression. AIM: This study aimed to determine the relationship between the level of insight in illness and internalized stigma among patients with depression and to identify the clinical factors associated with impaired insight. MATERIALS AND METHODS: A cross-sectional survey was conducted among adult psychiatric outpatients with depressive disorders at a teaching hospital in Kuala Lumpur for 10 months. Sociodemographic and illness-related data were gathered. Two questionnaires, Mood Disorder Insight Scale (MDIS) and Internalized Stigma of Mental Illness Scale (ISMI), were administered. RESULTS: Ninety-nine respondents participated in the study (female: 63.6%; Malay: 41.4%; mean age: 46.4 years). The median duration of illness was 6.0 years. More respondents were taking combination therapy (59.6%). There was a statistically significant correlation between ISMI and MDIS scores (r s = 0.339, P = 0.001). On bivariate analyses, intact insight was associated with non-Malay race, combination therapy, higher average ISMI scores and subscores for alienation, stereotype endorsement, discrimination experience, and social withdrawal. Combination therapy, higher scores for alienation, and social withdrawal subscales were associated with a greater likelihood for intact insight in logistic regression model. CONCLUSIONS: Significant association exists between insight and internalized stigma in patients with depression. Interventions to reduce the impact of internalized stigma while improving patients' insight are required.

Excessive internet use in young women: What are the implications?

PURPOSE OF REVIEW: There are considerable gender differences in youth engaging in excessive internet use (EIU). This review provides updates based on the recent literature focusing on the EIU in young women to describe its implications including what it constitutes of, its correlates, sequelae and preventive and/or treatment strategies. RECENT FINDINGS: Definition of EIU and its conceptualization still requires refinement. Recent studies indicate a changing trend towards female predominance of EIU. Women also differ in their internet use compared with men regarding their preference in the internet content and online activities, motives of use and factors related to access to the internet, including the device, sociocultural restrictions, etc. The correlates and sequelae of EIU encompass psychological, physical, biological, family and social domains that could form the basis of identifying individuals at risk and strategizing treatment. SUMMARY: The findings indicate the need for standardization in definition and measures of EIU for better recognition of EIU and identification of its at-higher-risk females. Effective preventive and treatment measures are still limited by various methodology flaws outlined here.

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.

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.

Attention deficit hyperactivity disorder symptoms reporting in Malaysian adolescents: do adolescents, parents and teachers agree with each other?

Attention Deficit Hyperactivity Disorder (ADHD) is a clinical diagnosis relying on persistence of symptoms across different settings. Information are gathered from different informants including adolescents, parents and teachers. In this cross-sectional study involving 410 twelve-year old adolescents, 37 teachers and 367 parents from seven schools in the Federal Territory of Kuala Lumpur, reliability of ADHD symptoms among the various informants were reported. ADHD symptoms (i.e. predominantly hyperactive, predominantly inattentive and combined symptoms) were assessed by adolescents, teachers and parents, using Conners-Wells' Adolescent Self-report Scale (CASS), Conner's Teachers Rating Scale (CTRS) and Conner's Parents Rating Scale (CPRS) respectively. For predominantly hyperactive symptoms, there were statistically significant, weak positive correlations between parents and teachers reporting (r=0.241, p<0.01). Statistically significant, weak positive correlations were found between adolescents and parents for predominantly inattentive symptoms (r=0.283, p<0.01). Correlations between adolescents and parents reporting were statistically significant but weak (r=0.294, p<0.01). Weak correlations exist between the different informants reporting ADHD symptoms among Malaysian adolescents. While multiple informant ratings are required to facilitate the diagnosis of ADHD, effort should be taken to minimize the disagreement in reporting and better utilize the information.

Depression in male patients on methadone maintenance therapy.

INTRODUCTION: Depression is one of the most common psychiatric conditions in men. The aim of the study was to determine the depressive symptoms and associated factors among men on methadone maintenance therapy (MMT). METHODS: A cross-sectional study was conducted involving 108 subjects who attended the Drug Clinic at Hospital Kuala Lumpur. The instruments used include the Structured Clinical Interview for Diagnostic and Statistical Manual, Fourth Edition Axis-I Disorder, Beck Depression Inventory and the 15-item International Index of Erectile Function. RESULTS: The rate of depression was 44.4%. There were significant associations between Malay ethnicity, secondary education level and concurrent illicit cannabis use with depression (P < 0.05). However, there was no significant associations between depression and erectile dysfunction (P = 0.379). DISCUSSION: Even though depression is common among men on MMT, it is often missed by the treating doctors. It is important to make the treating doctors aware that depression is a serious clinical condition that has a profound impact on the individual and compliance to treatment.

Prevalence of depression in breast cancer survivors: a systematic review of observational studies.

BACKGROUND: Depression is common in breast cancer patients. The aim of this paper was to make a systematic review of its prevalence and associated factors oin breast cancer survivors. MATERIALS AND METHODS: An extensive systematic electronic review (PUBMED, CINAHL, PsyINFO and Ovid) and handsearch were carried out to retrieve published articles up to November 2012, using Depression OR Dysthymia AND (Cancer OR Tumor OR Neoplasms as the keywords. Information about the design of the studies, measuring scale, characteristics of the participants, prevalence of depression and its associated factors from the included studies were extracted and summarized. RESULTS: We identified 32 eligible studies that recruited 10,826 breast cancer survivors. Most were cross-sectional or prospective designed. The most frequent instrument used to screen depression was the Center for Epidemiological Studies for Depression (CES-D, n=11 studies) followed by the Beck Depression Inventory (BDI, n=6 studies) and the Hospital Anxiety and Depression Scale (HADS, n=6 studies). CES-D returned about similar prevalence of depression (median=22%, range=13-56%) with BDI (median=22%, range=17-48%) but higher than HADS (median=10%, range=1-22%). Depression was associated with several socio-demographic variables, cancer-related factors, treatment-related factors, subject psychological factors, lifestyle factors, social support and quality of life. CONCLUSIONS: Breast cancer survivors are at risk for depression so that detection of associated factors is important in clinical practice.

Risk factors of erectile dysfunction in patients receiving methadone maintenance therapy.

INTRODUCTION: While methadone effectively treats opiate dependence, the side effect of erectile dysfunction (ED) may interfere with treatment adherence and benefits. AIM: To determine the rate of ED and the associated factors which predict ED in male patients on methadone maintenance therapy (MMT) in a Malaysian population. MAIN OUTCOME MEASURES: The main outcome measures were the International Index of Erectile Function-15 (IIEF-15) and the Beck Depression Inventory (BDI). METHODS: A total of 108 participants diagnosed with heroin dependence were assessed. We used the Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I) on subjects who received MMT, and they were assessed using the IIEF-15, the BDI, and measures of other clinical and sociodemographic variables. RESULTS: The rate of ED among men on MMT was 68.5% (mild ED, 36.1%; mild to moderate ED, 22.2%; severe ED, 3.7%). The mean age of the participants was 43.45 years. Older age (P = 0.002), concurrent illicit heroin use (P = 0.024), and having an older partner (P = 0.039) were significantly associated with ED. Following multivariate analysis, it was found that older age was the only significant predictor of ED, with an adjusted odds ratio of 1.07 (95% CI = 1.02-1.16). Methadone dose and duration of methadone treatment were not significantly associated with ED. CONCLUSION: ED was highly prevalent among male patients on MMT. This suggests that there is a need for routine assessment of sexual function in patients on methadone. Among the risk factors, age was the only factor that was significantly associated with ED. The current use of MMT in Malaysia in terms of dosage and duration did not pose a significant risk for ED.