Cyber Bullying - A New Social Menace

jective: Cyber bullying is a combination of the word cyber and bullying where cyber basically means the Internet or on-line. In this case, cyber bullying will focus on getting in action with bullying by using the Internet or modern technologies such as on-line chats, online media and short messaging texts through social media. The current review aims to compile and summarize the results of relevant publications related to “cyber bullying." The review also includes discussing on relevant variables related to cyber bullying. Methods: Information from relevant publications addresses the demographics, prevalence, differences between cyber bullying and traditional bullying, bullying motivation, avenues to overcome it, preventions, coping mechanisms in relation to “cyber bullying” were retrieved and summarized. Results: The prevalence of cyber bullying ranges from 30% - 55% and the contributing risk factors include positive association with perpetration, non-supportive school environment, and Internet risky behaviors. Both males and females have been equal weigh on being perpetrators and victims. The older groups with more technology exposures are more prone to be exposed to cyber bullying. With respect to individual components of bullying, repetition is less evident in cyber bullying and power imbalance is not measured by physicality but in terms of popularity and technical knowledge of the perpetrator. Conclusion: Due to the limited efforts centralized on the intervention, future researchers should focus on testing the efficacy of possible interventional programs and the effects of different roles in the intervention in ord

A Review of Depression Research in Malaysia

Depression is a debilitating illness and has become a leading cause of morbidity globally. We aim to summarise the evidence available in regard to the prevalence, type of assessment tools used and treatment options for depression in Malaysia. Two hundred and forty seven articles related to depression were found in a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. Fifty seven articles were selected and reviewed on the basis of clinical relevance and future research implications. Findings were summarised, categorised and presented according to prevalence of depression, depression in women, depression in clinical condition, assessment tools, and treatment of depression. The prevalence of depression in Malaysia was estimated to be between 8 and 12%. The figures were higher among women of low socio-economic background or those with comorbid medical condition. The common assessment tools used in Malaysia include Beck Depression Inventory (BDI), Depression, Anxiety and Stress Scale (DASS), Patient Health Questionnaire 9 (PHQ-9) and Hospital Anxiety and Depression Scale (HADS). They were translated into the Malay language and their psychometric properties were established. Both pharmacological treatment and psychotherapy were commonly used in Malaysia, and were highly recommended in local clinical practice guidelines. There are discrepancies in the reported rates of depression in Malaysia and this needs to be addressed. There were lack of studies looking into the depression among subgroups in Malaysia especially in the male population. There were several instruments available for assessment of depression in Malaysia but their suitability for the local setting need further research. Both pharmacotherapy and psychotherapy were recommended in the local treatment guideline in Malaysia. With the emergence of generic medication, we need to compare their clinical efficacy and tolerability with original products. KEY WORDS: Depression; prevalence; instrument; treatment; Malaysia

Sexual Pain Disorders Among Malay Women With Type 2 Diabetes Mellitus In Malaysia

This study aims to determine the prevalence and associated factors of sexual pain disorders among Malay women in Malaysia with type 2 diabetes mellitus. Methods: This is a cross-sectional study involving 347 women (174 nondiabetic and 173 diabetic subjects) who attended the diabetic clinic in a university hospital. Sexual pain disorders were assessed using the Pain sub scale of Malay Version of the Female Sexual Function Index (MVFSFI). Sociodemographic information of the subjects was collected with a pre-designed questionnaire. Results: Prevalence of sexual pain disorders among Malay women with type 2 diabetes mellitus was 10.4% and the control group was 9.2% but the difference was not statistically significant (p > 0.05). Multivariate logistic regression analysis did not find any relevant associated factor with sexual pain disorder. Conclusion: Sexual pain disorders among Malay women were not dependent on the diabetic status. Further studies with different population of diabetic patients are needed to confirm the results.

Model answer for critical review paper: conjoint examination for Malaysian master of medicine (Psychiatry) and MPM June 2012

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.

A journey from the known to the unknown: A qualitative study approach

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.

The Prevalence Of Orgasmic Dysfunction Among Malaysian Women Receiving Antidepressant: A Comparison Between Escitalopram And Fluoxetine

Objective: To investigate the prevalence of Female Orgasmic Dysfunction (FOD) focusing on the orgasm domain among female patients attending PPUKM Psychiatric clinic. To compare the prevalence of orgasmic dysfunction between female patients on Escitalopram and on Fluoxetine therapy. Methods: A validated questionnaire for sexual function was used to assess orgasmic function. A total of 112 women aged between 24 and 57 participated in this study. The orgasmic dysfunction was compared between patients on selective serotonin reuptake inhibitors (SSRIs) fluoxetine and escitalopram. Results: The prevalence of female orgasmic dysfunction was 58.9% (33/56) among patients treated with Fluoxetine and 41.1% (23/56) among patients treated with Escitalopram. However, there was no statistically significant difference between these two treatment groups (p=0.059). The odds to have FOD among patients on higher dose of antidepressants was found to be higher compared to those patients who were on lower dose of antidepressants (Odds ratio 5.32, p= 0.001). Conclusion: There was no significant difference of Female Orgasmic Dysfunction between patients on Fluoxetine and Escitalopram

Identifying Depression Among The Human Immunodeficiency Virus (HIV) Patients In University Malaya Medical Centre, Kuala Lumpur, Malaysia

Objective: The aim of this study was to identify depression among HIV- infected patients attending Infectious Disease Clinic in University Malaya Medical Centre (UMMC). Methods: This is a cross sectional study on HIV- infected patients attending Infectious Disease Clinic, UMMC. Those who fulfilled inclusion criteria were recruited and interviewed. Socio- demographic characteristics and clinical conditions such as mode of transmission, year of diagnosis, CD4+ counts, drug treatment and clinical stage were collected. The patients were then subjected to self-administered questionnaires, Patient Health Questionnaire, (PHQ-9) and Hospital Anxiety & Depression Scale (HADS). Results: 89 patients were recruited. Scores from PHQ9 showed 32% of depression rate while scores from HADS showed 19% of depression rate among the respondents. Non-self financial supporter, non- alcoholic drinkers and females were more likely to be depressed (P<0.05). All clinical characteristics showed no statistical differences. Conclusion: The depression rate was lower compared to those from the studies in western countries. The risk factors for depression were different from those found in other studies as well.

Quality of Life Assessment Of Opioid Substance Abuser On Methadone Maintenance Therapy (MMT) University Malaya Medical Centre

Objective: In Malaysia, opioid abuse is an acknowledged problem with severe health and economic repercussions. Until recently, drug addicts were mainly criminalised and forcefully rehabilitated in correctional facilities. However, the high relapse rates of this approach, coupled with the high rates of blood borne infections among drug users, led to increasing acceptance of a healthcare-based approach in the rehabilitation of drug addicts. Methadone was among the medications introduced as substitution maintenance therapy in 2005 and Universiti Malaya Medical Centre (UMMC) is a centre for MMT. This study aimed to determine the effects of MMT on quality of life in patients here. Methods: The sample was 46 patients who attended the Psychiatric outpatient clinic in fill in UMMC. The instrument used to assess quality of life was the WHOQOL-BREF. Results: The study design was cross-sectional with retrospective elements. Baseline QOL scores were obtained from case records and follow-up scores from the month of September 2007. Statistically significant improvements in all four domains of WHOQOL-BREF were found. Physical: p<0.01, C.I. 1.46-3.05. Psychological: p<0.01, C.I. 1.44-3.11. Social: p=0.03, C.I. 0.66-3.05. Environmental: p<0.01, C.I. 0.85-2.24. Conclusion: Methadone maintenance therapy substantially improves quality of life in ex-opioid abusers.