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CONTEXT: While pain is a common complaint among palliative cancer patients, there is little research looking into nonpharmacological methods for the reduction of pain in the palliative setting. AIM: This study aims to study the efficacy of 5-min mindful breathing for rapid reduction of pain in a palliative care setting. METHODS: This is a sub-analysis of the previous randomized controlled study on distress reduction. Sixty patients were recruited and randomly assigned to either the intervention (5-min mindful breathing) or the control (5-min normal listening) group. Participants reported their pain on a 10-item analog scale at baseline, immediately after intervention and 10 min postintervention. Changes in pain scores were further analyzed. RESULTS: Pain scores decreased for both the intervention and control groups. However, the reduction of pain did not reach statistical difference in both groups (P > 0.05). CONCLUSION: Five-minute mindful breathing is a quick and easy to administer therapy but does not have significant effects in terms of pain reduction in palliative settings. Future research and directions are nonetheless suggested and encouraged to look for short-term mindfulness-based therapies on pain reduction for this population.
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Although major progress has been achieved in research and development of antipsychotic medications for bipolar disorder (BPD), knowledge of the molecular mechanisms underlying this disorder and the action of atypical antipsychotics remains incomplete. The levels of microRNAs (miRNAs)-small non-coding RNA molecules that regulate gene expression, including genes involved in neuronal function and plasticity-are frequently altered in psychiatric disorders. This study aimed to examine changes in miRNA expression in bipolar mania patients after treatment with asenapine and risperidone. Using a miRNA microarray, we analyzed miRNA expression in the blood of 10 bipolar mania patients following 12 weeks of treatment with asenapine or risperidone. Selected miRNAs were validated by using real-time PCR. A total of 16 miRNAs were differentially expressed after treatment in the asenapine group, 14 of which were significantly upregulated and the other two significantly downregulated. However, all three differentially expressed miRNAs in the risperidone group were downregulated. MiRNA target gene prediction and gene ontology analysis revealed significant enrichment for pathways associated with immune system response and regulation of programmed cell death and transcription. Our results suggest that candidate miRNAs may be involved in the mechanism of action of both antipsychotics in bipolar mania. © 2016 Wiley Periodicals, Inc.
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Transtorno Bipolar/genética , MicroRNAs/genética , MicroRNAs/metabolismo , Adulto , Antipsicóticos/metabolismo , Transtorno Bipolar/metabolismo , Dibenzocicloeptenos , Feminino , Perfilação da Expressão Gênica , Compostos Heterocíclicos de 4 ou mais Anéis , Humanos , Masculino , Análise de Sequência com Séries de Oligonucleotídeos , Reação em Cadeia da Polimerase em Tempo Real , Risperidona , Transcriptoma/genéticaRESUMO
The reduced capacity for social and interpersonal interactions, social anhedonia, is an important aspect of various psychiatric disorders, especially schizophrenia-spectrum disorders. The goal of the present study was to validate a Malay translation of the adult version of the Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS; Gooding and Pflum, 2014), a relatively short and easy to administer indirect measure of social anhedonia. This cross-sectional study included 95 (47 male, 48 female) schizophrenia patients and 300 (77 male, 223 female) healthy subjects. Participants were given Malay versions of the ACIPS, Snaith Hamilton Pleasure Scale (SHAPS-M), and Beck Depression Inventory (BDI-M). The ACIPS exhibited good internal consistency (Ordinal alpha = 0.966). Total ACIPS scores were inversely correlated with the BDI-M scores, and positively correlated with total SHAPS-M scores. Factor analysis yielded a three-factor solution which accounted for 52.06% of the variance. As expected, the schizophrenia patients scored significantly lower than the healthy community participants on the ACIPS, t(130) = 4.26, p < 0.001. The Malay translation of the ACIPS showed good concurrent validity and excellent internal consistency. Taken together, these data provide further validation for the utility of the ACIPS in a cross-cultural context.
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Anedonia , Esquizofrenia , Adulto , Humanos , Masculino , Feminino , Voluntários Saudáveis , Estudos Transversais , Inquéritos e Questionários , PrazerRESUMO
This study aims to validate the Malay version of the Brief Resilience Scale (BRS-M) in order for the scale to be available among the Malay-speaking population. Two hundred and ninety-eight non-academic staff completed the Malay version of the Brief Resilience Scale (BRS-M), Malay Copenhagen Burnout Inventory (CBI-M), and Malay Depression, Anxiety, and Stress Scale (M-DASS-21). To explore the factor structure of BRS-M, exploratory factor analysis (EFA) with the first group of 149 participants was conducted using FACTOR (v.11) software. Confirmatory factor analysis (CFA) was conducted from the data of the second group of 149 participants using SEM_PLS software. The EFA revealed a two-factor model; Factor 1 ="Resilience" and Factor 2 = "Succumbing". The CFA indicated a sufficient internal consistency reliability (Cronbach's α = 0.806 and McDonald's omega, ω = 0.812) and a good fit with SRMR = 0.031. BRS-M, CBI-M, and M-DASS-21 displayed a satisfactory concurrent validity result. Household income and marital status had significant association with resilience level, with low household income (B40 group) being a predictor of lower resilience. The BRS-M demonstrated favourable psychometric properties in terms of reliability and validity to assess the level of resilience among non-academic staff in Malaysia.
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BACKGROUND: One of the genes suggested to play an important role in the pathophysiology of bipolar disorder (BPD) is PDLIM5, which encodes LIM domain protein. Our main objective was to examine the effect of olanzapine treatment on PDLIM5 mRNA expression in the peripheral blood leukocytes of BPD patients. METHODS: We measured the expression of PDLIM5 mRNA from 16 patients with BPD Type I after 0, 4, and 8 weeks of treatment with olanzapine using quantitative real-time PCR. The Young Mania Rating Scale was used to evaluate the severity of manic symptoms in BPD patients. We also compared PDLIM5 mRNA expression in treatment-naïve BPD patients with that in healthy control subjects. RESULTS: No significant difference was found in PDLIM5 mRNA expression between patients before olanzapine treatment and following 4 and 8 weeks of treatment (p>0.05). Although we observed a significant reduction in the severity of manic symptoms in all BPD patients (p<0.05), the effectiveness of the medication did not significantly correlate with the expression of PDLIM5 mRNA (p>0.05). Interestingly, PDLIM5 mRNA expression differed significantly between treatment-naïve BPD patients and healthy control subjects (p=0.002). CONCLUSION: PDLIM5 mRNA expression did not appear to be a reflection of the efficacy of olanzapine in reducing the manic symptoms of BPD. The significant difference in expression of PDLIM5 mRNA in the peripheral blood leukocytes of treatment-naïve BPD patients versus that of healthy control subjects, however, suggests that it may be a good biological marker for BPD.
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Proteínas Adaptadoras de Transdução de Sinal/genética , Antipsicóticos/uso terapêutico , Benzodiazepinas/uso terapêutico , Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/genética , Proteínas com Domínio LIM/genética , Adulto , Transtorno Bipolar/sangue , Estudos de Casos e Controles , Feminino , Expressão Gênica/efeitos dos fármacos , Marcadores Genéticos , Humanos , Leucócitos/efeitos dos fármacos , Leucócitos/metabolismo , Masculino , Pessoa de Meia-Idade , Olanzapina , Polimorfismo de Nucleotídeo Único , RNA Mensageiro/sangue , RNA Mensageiro/genéticaRESUMO
This is the first case report of two depressed Malay females prescribed quetiapine, the first patient developed sleep related eating disorder (SRED) on 200 mg per day and the second patient at 50 mg per day. Both resolved with discontinuation of the drug. Assessment for SRED should be done at every follow up.
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PURPOSE: Polycystic ovarian syndrome (PCOS) is a common disorder characterized by clinical or biochemical hyperandrogenism and ovulary dysfunction. Female sexual dysfunction (FSD) adversely affects quality of life and interpersonal relationships. We aimed to compare the prevalence of FSD in women with and without PCOS. METHODS: We pooled data from 28 observational studies involving 6256 women. Apart from the total prevalence of FSD, subgroup analyses based on different PCOS diagnostic criteria and obesity status (body mass index [BMI] ≥ 25 kg/m2) were performed. The differences in total and subscale scores of the Female Sexual Function Index (FSFI) among women with and without PCOS were also compared. RESULTS: Women with PCOS were younger (mean ± SD 28.56 ± 3.0 vs 31.5 ± 3.2 years, p < 0.001) with higher BMI (28.5 ± 4.2 vs 27.0 ± 6.1 kg/m2, p < 0.001), Ferriman-Gallwey score (10.0 ± 3.2 vs 4.0 ± 2.1, p < 0.001), and serum total testosterone level (2.34 ± 0.58 nmol/L vs 1.57 ± 0.60 nmol/L, p < 0.001) compared with women without PCOS. The prevalence of FSD among women with and without PCOS was 35% and 29.6%, respectively. There was no significant difference in total FSFI score (24.59 ± 3.97 vs 26.04 ± 3.05, p = 0.237) between the two groups. Women with PCOS, however, had significantly lower scores in the pain (p < 0.001) and satisfaction subscales (p = 0.010) compared with women without PCOS. Women with PCOS had 1.32 higher odds (95% CI 1.07, 1.61) of having FSD than women without PCOS. CONCLUSION: Women with PCOS have a higher risk of FSD than those without PCOS. Although total FSFI scores were not significantly different, women with PCOS tended to report dyspareunia and lack of sexual satisfaction.
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Síndrome do Ovário Policístico/epidemiologia , Disfunções Sexuais Fisiológicas/epidemiologia , Adulto , Feminino , Humanos , Síndrome do Ovário Policístico/complicações , Disfunções Sexuais Fisiológicas/etiologiaRESUMO
BACKGROUND: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) can cure leukaemia. However, long term complications of post transplantation interfere with the patients' full recovery. The objective of this review was to identify the various long term complications and to assess their individual prevalences. METHODS: Electronic databases including PubMed, Google Scholar and Cochrane were searched for years 2004-2017. The keywords used were leukaemia, allogenic stem cell transplantation, prevalence, side effects, long term, delayed, adverse effects, complications and outcome. RESULTS: A total of ten articles were included for analysis. There were 5 prospective studies, 3 retrospective studies and 2 cross sectional studies. A total of 40,069 patients, (20,189 males and 17,191 females) participated in these 10 studies. The gender of 2689 patients were not disclosed. Most common late complications and prevalence were chronic graft versus host disease (43% at 5 years post HSCT), secondary tumor (21% at 20 years post HSCT), hypothyroidism (11% at 15 years), bronchiolitis obliterans (9.7% at 122 days), cardiovascular disease (7.5% at 15 years) and avascular necrosis (5.4% at 10 years). The prevalence of azoospermia was 71.1% and depression, 18%. For the latter two conditions no time limit was available. Follow up duration ranged from 2 years till 30 years post HSCT. CONCLUSION: While allogenic stem cell transplantation is an effective cure for leukaemia, the procedure is associated with complications that can have their onset many years after the procedure.
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Objective: This study was conducted to assess the prevalence, pattern of smoking and sociodemographic factors among Kerinchi residents in Kuala Lumpur, as well as to identify the association between smoking, stress, anxiety and depression. Methods: This study was carried out at four community housing projects in the Lembah Pantai area in Kuala Lumpur. Data was collected between 3 February 2012, and 29 November 2012. Data collectors made house visits and used interviewer administered questionnaires containing questions on demographic data and smoking patterns. Depression anxiety stress scale (DASS) was used to assess psychological symptoms. Alcohol smoking and substance involvement screening tool (ASSIST) scale was used to assess nicotine use. Results: Data from 1989 individuals (833 households) showed the age of respondents ranged from 18 to 89 years and the mean age was 39.12 years. There were 316 smokers indicating the prevalence of smoking was 15.85%, with 35.5% among males and 1.8% among females. Further, 86.6% of smokers were Malay and 87% were Muslims. Divorce was associated with smoking. Unemployment and housewives were less associated with smoking. Depression and anxiety were significantly associated with smoking (OR = 1.347. 95% CI: 1.042-1.741) and (OR = 1.401. 95% CI: 1.095-1.793) respectively. Conclusion: Screening for depression and anxiety should be routinely performed in the primary care setting and in population-based health screening to intervene early in patients who smoke.
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Ansiedade/epidemiologia , Depressão/epidemiologia , Fumar/epidemiologia , Adulto , Estudos Transversais , Feminino , Habitação , Humanos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fumantes , Inquéritos e Questionários , DesempregoRESUMO
Recent studies have shown that bipolar disorder (BPD) and schizophrenia (SZ) share some common genetic risk factors. This study aimed to examine the association between candidate single nucleotide polymorphisms (SNPs) identified from genome-wide association studies (GWAS) and risk of BPD and SZ. A total of 715 patients (244 BPD and 471 SZ) and 593 controls were genotyped using the Sequenom MassARRAY platform. We showed a positive association between LMAN2L (rs6746896) and risk of both BPD and SZ in a pooled population (P-value=0.001 and 0.009, respectively). Following stratification by ethnicity, variants of the ANK3 gene (rs1938516 and rs10994336) were found to be associated with BPD in Malays (P-value=0.001 and 0.006, respectively). Furthermore, an association exists between another variant of LMAN2L (rs2271893) and SZ in the Malay and Indian ethnic groups (P-value=0.003 and 0.002, respectively). Gene-gene interaction analysis revealed a significant interaction between the ANK3 and LMAN2L genes (empirical P=0.0107). Significant differences were shown between patients and controls for two haplotype frequencies of LMAN2L: GA (P=0.015 and P=0.010, for BPD and SZ, respectively) and GG (P=0.013 for BPD). Our study showed a significant association between LMAN2L and risk of both BPD and SZ.
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Anquirinas/genética , Transtorno Bipolar/genética , Lectinas/genética , Proteínas de Membrana Transportadoras/genética , Polimorfismo de Nucleotídeo Único , Esquizofrenia/genética , Adulto , Povo Asiático/genética , Transtorno Bipolar/etnologia , Estudos de Casos e Controles , Feminino , Estudos de Associação Genética , Predisposição Genética para Doença , Haplótipos , Humanos , Masculino , Esquizofrenia/etnologiaRESUMO
Two single nucleotide polymorphisms of PDLIM5, rs7690296 and rs11097431, were genotyped using Mass-Array SNP genotyping by Sequenom technology in 244 bipolar disorder patients, 471 schizophrenia patients, and 601 control individuals who were Malay, Chinese, and Indian ethnic groups in the Malaysian population. A significant association was observed in allele frequency between the rs7690296 polymorphism and bipolar disorder in the Indian ethnic group [P=0.02, adjusted odds ratio (OR) 0.058, 95% confidence interval (CI) 0.36-0.93]. A significant association was also observed between the rs7690296 polymorphism and schizophrenia under the recessive model for both Malay (P=0.02, adjusted OR 1.86, 95% CI 1.12-3.10) and Indian (P=0.02, adjusted OR 1.92, 95% CI 1.10-3.37) ethnic groups. However, no association was detected between the rs11097431 polymorphism either with bipolar disorder or with schizophrenia. Therefore, it can be deduced that the nonsynonymous rs7690296 polymorphism could play an important role in the pathophysiology of both bipolar disorder and schizophrenia.
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Proteínas Adaptadoras de Transdução de Sinal/genética , Transtorno Bipolar/genética , Estudos de Associação Genética , Predisposição Genética para Doença , Proteínas com Domínio LIM/genética , Polimorfismo de Nucleotídeo Único/genética , Esquizofrenia/genética , Adulto , Estudos de Casos e Controles , Etnicidade/genética , Feminino , Frequência do Gene/genética , Humanos , Masculino , Pessoa de Meia-Idade , Modelos GenéticosRESUMO
INTRODUCTION: The objective of this study was to examine the risk of female sexual orgasmic disorder among a group of women with hypertension in Malaysia. The associated factors were also examined. METHODS: This cross-sectional study involved 348 hypertensive women attending the primary care or hypertension clinic in a teaching hospital in Malaysia. Female sexual orgasmic disorder was assessed using the Orgasmic subscale of the Malay Version of the Female Sexual Function Index (MVFSFI). Basic socio-demographic data of the subjects was collected using a predesigned questionnaire. Medical records were reviewed to gather patients' medical information. RESULTS: The risk of female sexual orgasmic disorder among hypertensive women was 14.1%. Univariate analysis found that older age, longer duration of marriage, lower educational level, and menopause were associated with higher risk of female sexual orgasmic disorder. These factors were not significant in multivariate analysis. DISCUSSION: The risk of female sexual orgasmic disorder was relatively low in Malaysian women with hypertension. No risk factors were associated with female sexual orgasmic disorder in the current study.
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Hipertensão/complicações , Disfunções Sexuais Psicogênicas/etiologia , Adulto , Fatores Etários , Idoso , Estudos Transversais , Escolaridade , Feminino , Humanos , Malásia/epidemiologia , Menopausa , Pessoa de Meia-Idade , Fatores de Risco , Disfunções Sexuais Psicogênicas/epidemiologia , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To compare the risk of sexual arousal difficulties between two groups of depressed female patients in remission who were treated with either escitalopram or fluoxetine. Associated factors were also examined. METHODS: This was a cross-sectional study involving 112 female patients attending the psychiatric clinic, University Kebangsaan Malaysia Medical Centre (UKMMC) with depressive disorders as assessed by using the Structured Clinical Interview for DSM-IV (SCID), who had been in remission for the previous 2 months as defined by a score of < or = 10 from an assessment using the Montgomery-Asberg Depression Rating Scale (MADRS) and were treated with either fluoxetine or escitalopram. Sexual arousal difficulties were assessed using the arousal subscale of Malay Version of the Female Sexual Function Index (MVFSFI). RESULTS: The rate of sexual arousal difficulties was 41.1% for all subjects. Sexual arousal difficulties occurred in 50.0% of subjects treated with fluoxetine and 32.1% with escitalopram. However, this difference was not statistically significant (p = 0.055). Multivariate logistic regression analysis showed that higher dose of antidepressant (adjusted OR = 4.08, 95 CI = 1.70-9.81) was significantly associated with female sexual arousal difficulties. CONCLUSION: The risk of sexual arousal difficulties was higher in female patients who were treated with higher doses of either fluoxetine or escitalopram.
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Antidepressivos/efeitos adversos , Citalopram/efeitos adversos , Transtorno Depressivo Maior/tratamento farmacológico , Fluoxetina/efeitos adversos , Disfunções Sexuais Psicogênicas/induzido quimicamente , Adulto , Antidepressivos/uso terapêutico , Citalopram/uso terapêutico , Estudos Transversais , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Relação Dose-Resposta a Droga , Feminino , Fluoxetina/uso terapêutico , Humanos , Malásia , Pessoa de Meia-Idade , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/epidemiologia , Inquéritos e QuestionáriosRESUMO
Frontotemporal dementia (FTD) is now increasingly being recognized as one of the causes of young onset dementia (YOD). The presentation of FTD can be subtle with a broad range of symptoms. This frequently causes misdiagnosis and a delay in initiating the correct treatment. While subtle personality changes, disinhibition and problems in executive functioning are frequently encountered in FTD, frank psychotic symptoms resembling schizophrenia are unusual. This is a case of a 38 year old Chinese female that highlights how obsessive compulsive symptoms which progressed to florid psychosis and disorganized speech and behavior can be a presenting picture in FTD. For seven years, this patient was treated as a case of schizophrenia and was thought to have poor response to electroconvulsive therapy (ECT) as well as antipsychotic medication. Her blood work and electroencephalogram (EEG) were normal. Magnetic resonance imaging (MRI) showed progressive cerebral atrophy. This case report suggests that psychosis should be investigated in detail especially when the clinical presentation is not typical of a functional disorder and more so when the patient is not responsive to conventional treatment. This report also highlights the importance of eliciting symptoms suggestive of an "organic" etiology, such as incontinence and disorientation. In addition, the usefulness of repeated imaging to show the rapidly progressive course of FTD has been illustrated. Other possible differential diagnoses of this patient are also discussed.