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Background and Objectives: This study was done to validate the Tamil version of Multidimensional Scale of Perceived Social Support (MSPSS-TV) among a group of Indian participants in University Malaya. Materials and Methods: Ninety-four people who took part in this study were given MSPSS-TV, Medical Outcome Study (MOS) social support survey, Malay version of Beck Depression Inventory (BDI), Malay version of General Health Questionnaire (GHQ), and English version of MSPSS. After a week, these participants were again required to complete the MSPSS-TV, but with the item sequences shuffled. Results: Internal consistency of this scale was excellent (Cronbach's alpha = 0.924), and both test-retest reliability (0.71) and parallel form reliability (0.92) were high (Spearman's rho, P<0.01). MSPSS-TV was negatively correlated with GHQ and BDI. Interpretation and Conclusions: The MSPSS-TV demonstrated sound psychometric properties in gauging the social support among a group of participants. It could therefore be used as a simple screening tool among the young educated Malaysians [ABSTRACT FROM AUTHOR]

Objective: To determine the reliability and factorial validity of the Malay version of Substance Abuse and Sexual Behaviour Survey (SUSBS-MV) questionnaire among a group of heroin users. Design: A cross-sectional study. Materials and Methods: 51 subjects participated in the study. They were given the Malay version of the SUSBS, FASTLANE study questionnaire regarding sexual behaviour when high on substance and the English version of SUSBS. Results: The instrument displayed good internal consistency (Cronbach's alpha = 0.87), test-retest reliability (0.81) and fair parallel form reliability (0.43) (Spearman's rho, p < 0.01). The positive correlation of the questionnaire with the FASTLANE study questionnaire regarding sexual behaviour confirmed its validity. Extraction method of the 19 items SUSBS-MV using principle component analysis with varimax rotation converged into six components (enjoyment, risky behaviours, precipitation, obstacles, after-effect and insight). Conclusion: The SUSBS-MV demonstrated good psychometric properties to assess sexual behaviour among heroin abuser and it could be used as a simple instrument for patients with other substance use. [ABSTRACT FROM AUTHOR]

Objectives. The objectives of this study were to determine the efficacy and safety of aripiprazole for treatment of psychosis, retention and abstinence in patients with methamphetamine dependence. Methods. This was a double-blind study where 37 methamphetamine dependent patients with history of psychosis were randomly assigned to receive aripiprazole (5-10 mg daily, N = 19) or placebo ( N = 18) for 8 weeks. Follow-up evaluation was scheduled on day 7, 14, 28, 42 day 56 after enrolment. Results. Participants on aripiprazole were retained significantly longer in treatment (48.7 days, SD =4.0) compared to placebo (37.1 days, SD =5.0). The Kaplan-Meier survival analysis showed that participants on aripiprazole were less likely to drop out of the study than the placebo group ( P =0.02, χ2 =5.3). Psychotic symptoms significantly decreased among those on aripiprazole as compared to placebo ( P < 0.05). However, no statistically significance was found between the two groups in maintaining abstinence (generalised estimation equation (GEE) analysis, P = 0.41). No serious adverse events were reported in either group. Conclusion. Aripiprazole was no more effective than placebo in maintaining abstinence from methamphetamine use. However, it facilitated treatment retention and reduced the severity of psychotic symptoms. Aripiprazole was found to be generally safe and well tolerated. [ABSTRACT FROM AUTHOR]

Objective: This paper aims to discuss the answers to Review Paper Exam for the Malaysian Master of Medicine (Psychiatry) May 2012 theory examination. The paper studied the psychotropic prescription practice in cancer patients using a health care registration database. Methods: One of the papers presented during the journal club presentation was picked-up for evaluation of student's critical appraisal. Results: Model answers were provided at the end of the Critical Review Paper. Conclusion: This review paper evaluates students' understanding and critical thinking on the topic of Psychotropic Drugs in cancer patients. This paper may serve as a guideline to teach students how to critically appraise topic related to psychiatry. [ABSTRACT FROM AUTHOR]

Objective: Individuals deal with dying and death differently and may not experience the same journey. We investigated Kübler-Ross' Five Stages of Grief on terminally ill patients to review the current applicability of the model among this population. The aims of this paper is to share information regarding the Five Stages of Grief, the emotions associated with the stages, and the challenges that terminally ill patients, namely those diagnosed with cancer, experience. Methods: Non-structured interviews were conducted among terminally ill patients located at the palliative ward for two years. Results: We found that terminally ill patients at the palliative ward were undergoing the Five Stages of Grief, and that the emotions associated with the stages were reported to be similar to the emotions proposed in the model and among the patients. Conclusion: Kübler-Ross' Five Stages of Grief is still applicable among terminally ill patients. The thoughts regarding dying and death still remain negative, therefore, the change in the myths of dying and death are required to help improve the journey towards death. [ABSTRACT FROM AUTHOR]

Objective. To determine the risk of hypoactive sexual desire (HSD) in depressed female patients treated with selective serotonin reuptake inhibitors, comparing escitalopram and fluoxetine. The associated factors were also examined. Methods. This cross-sectional study involved 112 female patients (56 in each group) diagnosed to have major depressive disorder who were in remission (as defined by the Diagnostic and Statistical Manual-IV (DSM-IV) in the past 2 months and the Montgomery-Asberg Depression Rating Scale (MADRS) score of ≤ 10) from the psychiatric clinic, University Kebangsaan Malaysia Medical Centre (UKMMC). They were interviewed using the Structured Clinical Interview for DSM-IV (SCID). Hypoactive sexual desire was assessed using the Desire subscale of the Malay Version of the Female Sexual Function Index (MVFSFI). Results. The risk of hypoactive sexual desire was 50.9% for all patients; 64.3% for the fluoxetine group and 37.5% for the escitalopram group. Multivariate logistic regression analysis showed fluoxetine therapy (adjusted OR == 3.08, CI == 1.23, 7.73) and moderate to high dosage of antidepressant (adjusted OR == 4.27, CI == 1.66, 10.95) were significantly associated with hypoactive sexual desire. Conclusion. Those treated with fluoxetine had significantly higher rates of HSD than those on escitalopram. Moderate to high antidepressant dosage is another significant predictor of HSD in depressed women treated with SSRIs. [ABSTRACT FROM AUTHOR]

Objective: Long-term social distancing, isolation, and economic fallout may be significant psychological triggers during pandemic, such as COVID-19, especially for those with underlying psychiatric illness. This study was conducted to address the psychological impact of COVID-19 pandemic among patients with depression based at a teaching hospital in Malaysia., Methods: This is a cross-sectional online study among patients with depression from University Malaya Medical Centre, using Generalized Anxiety Disorder-7 (GAD-7), Montgomery-Åsberg Depression Rating Scale-Self Assessment (MADRS-S), Insomnia Severity Index (ISI), Multidimensional Scale of Perceived Social Support (MSPSS), Knowledge, Attitudes, and Practices (KAP), and Social Media Addiction during COVID-19 Pandemic (SMACOP)., Results: One hundred seventy-eight patients participated in this study. The mean total of the KAP score is 12.65 (SD = 2.65), with knowledge section (mean = 7.34 [SD = 2.13]), attitudes section (mean = 2.63 [SD = 0.58]), and practices section (mean = 2.69 [SD = 1.00]). They scored moderately on the MADRS-S (mean = 21.03 [SD = 4.62]) and ISI (mean = 20.25 [SD = 4.62]) but had high GAD-7 scores (mean = 16.8 (SD = 6.27]). From the multiple logistic regression analyses, depressive symptoms of greater severity (MADRS-S 18-34) are significantly associated with more severe insomnia ( P < .001, adjusted OR = 9.101, 95% CI: 3.613-22.924). Furthermore, the high anxiety level is associated with the younger age group ( P = .029, Adjusted OR = 2.274, 95% CI: 1.090-4.746), greater severity of insomnia ( P < .001, Adjusted OR = 22.9, 95% CI: 6.145-85.343), and higher risk of COVID-19 related social media addiction ( P = .011, adjusted OR = 2.637, 95% CI: 1.253-5.550)., Conclusion: This study demonstrates the high levels of sleep disturbances and anxiety symptoms experienced by outpatients with depression during the COVID-19 pandemic. These are closely linked to the younger age group and at-risk social media addiction related to COVID-19., Competing Interests: Conflict of Interest: The authors have no conflict of interest to declare., (© Copyright 2021 authors.)

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., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Indian Journal of Palliative Care.)

Background: Amphetamine-type stimulant (ATS) use brings severe adverse effects to the mental well-being of an individual and it is an essential contributor to the global disease burden. Meanwhile, religiosity and religious coping might improve one's conduct, physical and mental well-being. Hence, this study aims to determine the prevalence of anxiety and depression in ATS user and their association with religiosity and religious coping., Methods: It is a cross-sectional study conducted at the Department of Psychological Medicine, Universiti Malaya Medical Centre, Malaysia. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression among ATS users. Religiosity and religious coping were measured with Duke University Religious Index and Brief RCOPE., Results: This study involved 215 ATS users. Almost half of the ATS users had either anxiety ( n = 96; 44.6%) or depression ( n = 108; 50.2%), which were associated with polysubstance use or having an existing psychiatric disorder. Subjects with higher religiosity and positive religious coping were less anxious or depressed. However, negative religious coping was significantly associated with anxiety and depression in ATS users., Conclusion: Anxiety and depression are prevalent in ATS users. Integrating religiosity and religious coping into the ATS users' treatment plan helps to improve their mental well-being., Competing Interests: Conflict of Interest None., (© Penerbit Universiti Sains Malaysia, 2020.)

The pharmacy profession has undergone tremendous changes over the past few decades. Pharmacists' roles have expanded their boundaries to encompass more patient-centered services. However, the degree to which these roles are practised may vary. This scoping review is aimed at describing the extent and range of the professional pharmacy services offered in hospital pharmacies across different countries and the barriers underlying inappropriate or incomplete implementation of these services. Studies published in the English language between 2015 and 2019 were retrieved from the following databases: PubMed, CINAHL, Scopus, EBSCO Discovery Service, and Web of Science. A thematic analysis across the included studies produced two main themes. "Scope of practice" comprised three subthemes: pharmaceutical care practice, clinical pharmacy practice, and public health services and "Multiple levels of influence" comprised five subthemes: individual, interpersonal, institutional, community, and public policy-related factors. The hospital pharmacy services across countries ranged from traditional drug-centered pharmacy practice to a more progressive, clinically oriented practice. In some countries, there is an apparent inadequacy in the clinical pharmacy services provided compared to other clinical settings. Understanding the current pharmacy practice culture across different health care systems is an essential step towards improving the profession., Competing Interests: The authors declare no conflict of interest.

Objectives: The current study compares the risk of sexual pain in depressed female patients in remission between those who were treated with Escitalopram and Fluoxetine. The associated factors were also examined., Methods: This is a cross-sectional study involved 112 depressed female patients (56 treated with Escitalopram and 56 treated with Fluoxetine) who were in remission (as defined by Diagnostic and Statistical Manual-IV (DSM-IV) in the past 2 months and Montgomery-Asberg Depression Rating Scale (MADRS) score of ≤ 10) from the psychiatric clinic, University Kebangsaan Malaysia Medical Centre (UKMMC). They were interviewed using Structured Clinical Interview for DSM-IV (SCID). Hypoactive sexual desire was assessed using the Pain subscale of Malay Version of the Female Sexual Function Index (MVFSFI)., Results: The results show that risk of sexual pain was relatively low (16.07% for all patients), with no statistical significant between the two groups (17.86% for fluoxetine group, 14.29% for escitalopram group). Older age (adjusted odds ratio = 1.524, 95% CI = 1.199, 1.938) was the only factor significantly associated with sexual pain disorder., Conclusions: There should not be any barrier when continuing the use of escitalopram or fluoxetine as antidepressants amongst the female patients., Competing Interests: None.

This study was aimed at validating the simplified Chinese version of the Multidimensional Scale of Perceived Support (MSPSS-SCV) among a group of medical and dental students in University Malaya. Two hundred and two students who took part in this study were given the MSPSS-SCV, the Medical Outcome Study social support survey, the Malay version of the Beck Depression Inventory, the Malay version of the General Health Questionnaire, and the English version of the MSPSS. After 1 week, these students were again required to complete the MSPSS-SCV but with the item sequences shuffled. This scale displayed excellent internal consistency (Cronbach's α = .924), high test-retest reliability (.71), parallel form reliability (.92; Spearman's ρ, P < .01), and validity. In conclusion, the MSPSS-SCV demonstrated sound psychometric properties in measuring social support among a group of medical and dental students. It could therefore be used as a simple screening tool among young educated Malaysian adolescents., (© 2013 APJPH.)

The use of the Internet has been increasing dramatically over the decade in Malaysia. Excessive usage of the Internet has lead to a phenomenon called Internet addiction. There is a need for a reliable, valid, and simple-to-use scale to measure Internet addiction in the Malaysian population for clinical practice and research purposes. The aim of this study was to validate the Malay version of the Internet Addiction Test, using a sample of 162 medical students. The instrument displayed good internal consistency (Cronbach's α = .91), parallel reliability (intraclass coefficient = .88, P < .001), and concurrent validity with the Compulsive Internet Use Scale (Pearson's correlation = .84, P < .001). Receiver operating characteristic analysis showed that 43 was the optimal cutoff score to discriminate students with and without Internet dependence. Principal component analysis with varimax rotation identified a 5-factor model. The Malay version of the Internet Addiction Test appeared to be a valid instrument for assessing Internet addiction in Malaysian university students., (© 2012 APJPH.)

We studied the use of exhaled carbon monoxide (CO) to identify nicotine dependence among adult Malaysian male smokers. We conducted a cross-sectional study among 107 male smoking staff at a university hospital. We measured their exhaled CO using a piCO+ Smokerlyzer and diagnosed nicotine dependence using a Mini-International Neuropsychiatric Interview (MINI). The optimal cut-off value for exhaled CO was determined. The correlation between exhaled CO level and the Fagerstrom Test for Nicotine Dependence (FTND) was also assessed. The mean exhaled CO level among subjects with nicotine dependence (15.78 ppm) was significantly higher than subjects without nicotine dependence (9.62 ppm). The cut-off value used to identify smokers with nicotine dependence was set at 10 ppm (specificity = 0.721, sensitivity = 0.731, positive predictive value = 0.817 and negative predictive value = 0.617). Psychometric properties were stable with various durations of smoking. Exhaled CO correlated positively with FTND scores (Pearson's rho = 0.398, p = 0.01). Our findings show exhaled CO can be used to identify nicotine dependence among adult Malaysian male smokers.