Completers Versus Dropouts of A Parent Training Programme and Child Behaviour Improvement In Malaysia

@#Introduction: There is a strong body of evidence advocating parent training programmes in the management of behavioral problems in children. In these programmes, attrition is a major challenge. We aimed to examine the sociodemographic and clinical profiles, parental motivation, and pre-intervention severity of children’s behavioural problems as rated by mothers who completed (PC) and mothers who dropped out (PD) of a parent training programme. We also aimed to determine whether there was any change in their children’s behaviour scores before and after intervention. We hypothesized that parent and child sociodemographic and clinical profiles, parental motivation, and pre-intervention severity of children’s behavioural problems would be different between PC and PD, and that children of PC would experience significant improvements in their behaviour. Methods: Data from a randomised controlled trial (RCT) involving 35 mothers and children aged 6–12 years old with behavioural problems who were enrolled in a parent training programme were examined. Child behaviour was measured using the Strength and Difficulties Questionnaire. Results: No significant differences were found between PC and PD in terms of the sociodemographic and clinical profiles, parental motivation, and pre- or post-intervention child behaviour. After programme completion, PC (n=27) reported improvements in all the behaviour subscales; total difficulties (p<0.001), emotional problem (p=0.004), conduct problem (p=0.001), hyperactivity symptoms (p<0.001), peer problems (p=0.036), and prosocial behaviour (p=0.001). Conclusion: The parent training programme produces significant child behaviour improvements in mothers who complete the programme. Nonetheless, the study has some limitations which restrict the generalizability of these findings.

Prevalence and Predictors of Anxiety and Depressive Symptoms among Adult Patients with Atopic Dermatitis in Malaysia Tertiary Referral Hospital

@#Introduction: Atopic dermatitis (AD) is not only a cosmetic nuisance but is also associated with a significant impact on mental health and quality of life. Psychological symptoms are highly related to poor treatment adherence and recovery, more comorbidities, and a significant overall socioeconomic burden. Identifying the factors associated with anxiety and depression among patients with AD is important to modify and reduce the risk of developing these psychiatric complications. Methods: This was correlational research conducted in the dermatology clinic of four hospitals in Klang Valley, namely Hospital Kuala Lumpur, Hospital Tengku Ampuan Rahimah Klang, Hospital Selayang, and Hospital Ampang. By using a purposive sampling method, 128 samples (n=128) of adult patients with AD aged 18-65 were included. A questionnaire was administered regarding sociodemographic background, illness characteristics of AD, the Investigator’s Global Assessment (IGA), Malay version of the Automatic Thought Questionnaire-17, GAD-7, and PHQ-9. Results: The prevalence of anxiety and depressive symptoms among adult patients with AD is 31.3% and 46.9% respectively. Multivariable logistic regression analysis revealed that age and personal maladjustment (PM) predict anxiety symptoms, while only negative self-concept/expectation (NSNE) predicts depressive symptoms. The hierarchical logistic regression model explained 51% (Nagelkerke’s R2) of the variance in anxiety symptoms and 56% (Nagelkerke’s R2) of depressive symptoms. Conclusion: There is a high proportion of anxiety and depressive symptoms among adult patients with AD which is associated with negative automatic thoughts. In the management of adult patients with AD, clinicians should consider mental health symptom screening and monitoring.

Effectiveness of an integrated-Weight Management Programme (i-WMP) in Reducing Body Weight among Noncommunicable Disease Patients in Malaysian Government Primary Care Clinics: A Randomised Controlled Trial

@#Introduction: Obesity is a global issue called as “globesity”. Overweight and obesity may lead to many noncommunicable diseases (NCDs). Primary care is the first centre to monitor and follow-up the progress of NCD patients. Therefore, the objective of this study was to determine the effectiveness of an integrated-Weight Management Programme (i-WMP) to reduce body weight among NCD patients from two Government primary care clinics from Hulu Langat District. Methods: This study was single-blinded randomised controlled trial by design. There were 244 eligible patients were randomised into intervention (n = 122) or wait-list control group (n = 122). The i-WMP was developed based on the behaviour change wheel through the operationalization of behaviour change techniques. The duration of this intervention programme was four weeks. Data collected at week 0, week 4, and week 12. The software IBM SPSS was used to analyse the data. Generalized linear mixed model analysis with intention-to-treat principle was applied. Results: The retention rate was 74.2%. Findings showed that the i-WMP was significantly effective in reducing not only body weight as primary outcome but also secondary outcomes such as waist-to-height ratio, waist circumference, body mass index, and total sitting time. It also improved effectively other secondary outcomes such as participants’ knowledge, attitude, and practice towards dietary and towards physical activity. However, no significant changes were reported for body fat percentage and total physical activity metabolic equivalent of task-minutes/week. Conclusion: Implications surrounding the implementation of i-WMP in the primary care clinics are recommended.

A Case of Unrecognized Psychogenic Polydipsia

@#Psychogenic polydipsia is prevalent among people with schizophrenia. Although its pathophysiology is relatively unknown, it causes life threatening complications due to acute or severe hyponatraemia.. This report illustrates a patient with schizophrenia who had unrecognized psychogenic polydipsia and developed severe complication. It also highlights the clinical salience of its management.

Development and Validation of High Resolution Melting Assays for High-Throughput Screening of BDNF rs6265 and DAT1 rs40184

@#Introduction: One of the commonly used techniques for mutation screening is High Resolution Melting (HRM) analysis. HRM is a post PCR method that relies on the detection of the fluorescent signals acquired due to the release of DNA intercalated dyes upon the melting of dsDNA to ssDNA. The method is simple, inexpensive and does not require post PCR-handling, making it suitable for high throughput screening. Methods: This study aimed to develop and validate HRM technique for the screening of two disease-associated single nucleotide polymorphisms (SNPs) namely BDNF rs6265 and DAT1 rs40184 using a total of 30 gDNA samples. The obtained results were confirmed and validated by sequencing. Results: HRM analysis showed that the predicted genotypes of BDNF rs6265 and DAT1 rs40184 among all the gDNA samples were in 100% concordance with the sequencing results, making it an accurate and sensitive method for the detection of SNPs. Conclusions: The application of HRM can accurately determine the genotype of BDNF rs6265 and DAT1 rs40184 SNPs, making it a promising tool for rapid and high-throughput screening of targeted SNPs in a large population study.

Prevalence and Predictors of Water Pipe (Shisha) use among Iranian High School Children

Introduction: Water pipe use is becoming increasingly common among Iranian adolescents. This study examined the prevalence and predictors of water pipe use among public high schoolchildren aged 14-17 in Iran. Methods: A cross-sectional study was conducted among 1st, 2nd and 3rd grade public high schoolchildren in Sanadaj City, capital of Kurdistan province of Iran during the academic year 2012-2013. Cluster sampling was used to select a sample from 8 public high schools. The data were collected using validated self-administrated questionnaire that included questions on water pipe use, socio-demographic characteristics, smoking-related knowledge, attitude toward smoking, normative believes regards perceived prevalence water pipe use among peer and adults, perception of harm, self-esteem and refusal skill. A multivariate logistic regression analysis was performed to assess predictors of water pipe use. Results: A total of 1837 students participated in this study. Students’ ages ranged from 14 to 17 years (mean age±15.09; SD±0.82 years). The overall prevalence of ever water pipe use was 36.2% (43.1% in male and 29.2% in female, (p<0.001). Age, gender, living arrangement, pocket money, academic grade, parental history of smoking, attitude, and normative believes regards perceived prevalence water pipe use among peer and adults were predictors of water pipe use among study participants. Conclusions: The overall prevalence of water pipe is high among high school children in Sanandaj. Age, gender, pocket money, academic grade, parents smoking, attitude toward smoking and normative believes were identified as the most important predictors increasing the risk of water pipe use in the studied students.

Psychosocial Problem and its Associated Factors Among Adolescents in the Secondary Schools in Pasir Gudang, Johor

Introduction: Adolescence is a crucial period with impressive emotional changes. Emotional disorders such as depression, anxiety and stress are high among adolescents worldwide; however the psychosocial changes are often neglected. The aim of the current study was to determine the depression, anxiety and stress symptoms and their associated factors among adolescents. Methods: A cross-sectional study using cluster sampling was carried out among school-going adolescents in 10 secondary schools in Pasir Gudang, Johor, Malaysia. Respondents answered a self-administered questionnaire including socio-demographic, Inventory of Parent and Peer Attachment (IPPA), Depression Anxiety Stress Scale-21 (DASS-21) and Strength and Difficulties Questionnaire (SDQ). Using SPSS-21, chi-square test and binomial logistic regression were conducted to examine the associations between dependent and independent variables. Results: Respondents (52.6% female and 53.9% Malay) had 46.0% prevalence of depression symptoms, 59.1% anxiety, 38.1% stress and 45.6% psychosocial status (internalizing and externalizing problems). Age, father occupation and parental bonding were significantly predicted having moderate to extremely severe depression symptom (p<0.05). Younger adolescents (13-14 years old) were 1.42 times more likely to have anxiety symptom. In addition, respondents with insecure father attachment were 1.5 times more likely to have stress symptom (p<0.05). Respondents with insecure parental attachment were more likely to have psychosocial problem (p<0.05). Conclusions: Depression, anxiety and stress of adolescents were influenced by the sociodemographic of adoleascents and their parents. Age, gender and parental attachment were the significant predictors in the current study which should be the center of attention for the future studies to reduce the psychological disorders among adolescents.

Prevalence and Predictors of Suicidality Among Medical Students in A Public University

Background: Undergraduate medical students have been the most distressed group among the student population. Depression and anxiety have been found to be more prevalent in this group of students compared to others. Objective: This study was conducted to determine the prevalence and predictors of suicidality among undergraduate medical students in a public university. Methods: This was an analytical cross-sectional study, conducted in a public university in Selangor, Malaysia. Data were collected using self-administered questionnaires from January to February 2013, and analysed using the Statistical Package for Social Sciences Software (version 21). Results: Out of 625 undergraduate medical students, 537 (85.9%) participated in the study. The prevalence of the suicidality among undergraduate medical students was 7.0%. The significant predictors of suicidality based on multiple logistic regression were the respondent’s lifetime suicide attempts (Adjusted Odds Ratio, AOR 10.4, 95% CI 2.7 to 40.9); depression (AOR 5.9, 95% CI 1.5 to 23.0); breaking off a steady love relationship (AOR 5.4, 95% CI 1.3 to 22.4); hopelessness (AOR 4.9, 95% CI 1.1 to 21.6); and something valued being lost or stolen (AOR 4.4, 95% CI 1.2 to 15.9). Conclusion: These findings indicate that mental health care services should be strengthened at university level. The results show a need for an intervention programme to reduce suicidality among the undergraduate medical students.

Prevalence of Tobacco Use and its Socio-demographic Determinants among Saudi Female School Adolescents in Jeddah

Tobacco use among females is a rising public health issue. Further insight into the smoking epidemic can be gained from studying a specific subgroup of interest within the population. Determining predictors of each tobacco smoking type is necessary for planning tobacco specific intervention programmes. The aim of this study was to determine the prevalence of ever tobacco use and its associated socio-demographic factors among Saudi female adolescents aged 12 to 19 in Jeddah. A cross-sectional analytical study was conducted among female students from intermediate and high secondary schools in Jeddah during the academic year 2012-2013. Sampling with probability proportionate to size was used to select a sample of 5,150 students from 40 schools. The data were collected using validated self-administrated questionnaire that required information on tobacco use behaviours and selected socio-demographic characteristics. A total of 5,073 students participated in this study of whom 51.6% were from intermediate grades, and 83.1% from public schools. The prevalence of ever tobacco use was 44.2% (36.2% water pipe and 30.9% cigarettes). The significant predictors of ever tobacco use were student’s age, mother’s education, family structure, residence location and monthly student’s allowance. In conclusion, ever tobacco used is highly prevalent among female adolescents in Jeddah. Designing intervention programmes aimed at preventing Saudi female adolescents from smoking should include all forms of tobacco use.

Prevalence of Job stress and its Associated Factors among Universiti Putra Malaysia Staff

Introduction: Stress in the work place is a global major risk factor to worker’s health, which triggers the workers to be poorly motivated and less productive. Objectives: The objective of the study was to determine the prevalence of job stress and its associated factors among Universiti Putra Malaysia staff. Methods: This is a cross sectional study involving 511 academic and non-academic staff of Universiti Putra Malaysia in Serdang. Probability proportionate to size was used for calculating the required sample size. Results: The overall prevalence of stress was 21.7% (21.0% among male and 23.0% among female). The variables found to be significantly associated with stress were: Job demand, coworker support, depression, anxiety, focus and venting of emotion and self-blame (p<0.05). The findings revealed that UPM staffs are exposed to a range of specific stressors such as work stressor: job demand, lack of social support such as co-worker support and supervisor support, psychological stressors such as depression and anxiety, coping such as focus and venting of emotion and self-blame. Work stressor such as job demand was the main predictor of stress (p value = 0.001). Conclusion: The overall prevalence of job stress was 21.7%. The predictors job stress were job demand, lack of support from co-worker and supervisor, depression, anxiety and use of avoidance focused coping.

Reliability and Factor structure of the General Health Questionnaire-12 among university students

Introduction: The 12- item General Health Questionnaire (GHQ-12) has been translated into many languages and widely used in different settings and countries. Its reliability and psychometric properties were extensively studied in many population groups which suggested that it measures psychological distress in multidimensional construct. Objective: The objective of this study was to assess the reliability and factor structure of the Bahasa Malaysia version of the GHQ-12 among university students attending a health program at a Malaysian public university. Method: The cross sectional survey was conducted on 306 undergraduate students aged between 18 to 27 years old who visited the booth set up for mental health screening at a health program. The screening was conducted using a self-administered, validated Bahasa Malaysia version of GHQ-12 questionnaire. Results: Using exploratory factor analysis, the Bahasa Malaysia version of GHQ-12 was found to have a three factor structures namely depressive symptoms, self-esteem and perceived abilities which accounted for 58% of the item variance. The overall Cronbach’s alpha coefficient of the scale was found to be high (0.84) with each factor having acceptable inter-item consistency ranging from 0.61 to 0.82. Conclusion: The findings of the study show that the Bahasa Malaysia version GHQ-12 is reliable and has good structural characteristics. It can assess a few domains of the psychological status of university students. It also helps in providing more information on the domain which may become a focus target of intervention in the prevention of mental illness.

Verbal Memory Test Performance In Patients With Bipolar I Disorder Attending A Psychiatric Clinic Of A University Hospital In Kuala Lumpur, Malaysia

Objective: The study aims to determine pattern of verbal memory and learning impairment and its associated factors among patients with bipolar I disorder in a psychiatric clinic of a university hospital. Methods: A case control study comparing verbal memory test performance in 40 patients with bipolar I disorder to that of 40 healthy normal subjects using Rey Auditory Verbal Learning Test (RAVLT). The association between demographic, clinical characteristics and poor verbal memory performance were examined. Results: Up to 92% of patients with bipolar I disorder have impaired short term working memory in this hospital-based study. They also recalled fewer words in all the RAVLT trials and had difficulties learning the word list in comparison to that of normal healthy individuals. Verbal memory and learning impairment are observed in bipolar illness in the absence of active mood symptoms while duration and severity of illness are not found to have any effect on verbal memory and learning. Conclusion: There is consistent verbal memory and learning problems in individuals with bipolar I disorder and their presence in the absence of mania, depression and mixed symptoms during the course of the illness suggests a trait related deficit.