Hatta Sidi

The Female Sexual Response Cycle: Do Malaysian Women Conform to the Circular Model?

INTRODUCTION The concept of a sexual response cycle (SRC) for women has gained interest lately with the reintroduction of terms with new definitions and a new model for the sexual response, especially the Bassons circular model. AIM To determine the correlations among the SRCs phases (i.e., sexual desire, sexual arousal, orgasm, sexual satisfaction, and sexual pain) in Malaysian women, in order to validate the circular model of womens SRC. METHODS Principal component analysis (PCA), a factor analysis technique with varimax rotation method, was used to explore the correlation structure of items in female respondents who scored on the Malay version of Female Sexual Function Index (FSFI). The number of factors or components to obtain was decided using Kaisers criteria. MAIN OUTCOME MEASURE To measure the correlation between female SRCs domain. RESULTS A total of 230 married women aged 18-70 years old participated in this study. Factor loadings using PCA with varimax rotation divided the sexual domains into three components based on Kaisers criteria with eigenvalues of 6.11, 5.59, and 3.50, respectively. Sexual desire, sexual arousal, and lubrication were highly correlated, and therefore, they fall in one component, reflecting one construct, whereas orgasm and sexual satisfaction fall in another component. The third component was formed by the pain items. CONCLUSION The strong correlation between sexual desire/arousal/lubrication means that they were the same and may support the contemporary theory of circular model of SRC in women.

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.

A preliminary study of the psychological differences in infertile couples and their relation to the coping styles

BACKGROUND Studies from Western countries have observed that couples undergoing infertility treatment suffer various physical and psychological difficulties at a higher frequency than the comparable general population. These relate to treatment challenges and other psychosocial stressors, often influenced by coping style, personality factors and available support systems. There is paucity of studies in non-Western populations. OBJECTIVE The aim of this pilot investigation was to evaluate characteristics and gender differences in perceived psychological difficulties reported by infertile Malaysian couples. In particular, depression, anxiety and stress, along with correlated coping styles, were examined between spouses. METHODS Demographic information, including age, ethnicity and duration and causes of infertility, were collected from participants treated within a fertility clinic. The Depression, Anxiety and Stress Scale (DASS) and Coping Inventory for Stressful Situation (CISS) were completed to measure psychological distress and coping styles. RESULTS Depression, anxiety and stress-related difficulties were reported at significantly higher frequency by wives than husbands (p<0.05). There were no significant differences in coping styles between wives and husbands. However, emotional-oriented coping style was associated with significantly higher levels of depression, anxiety and stress (p<0.05) within the overall sample with odds ratios of 2.5, 3.0 and 1.5, respectively. CONCLUSION The study confirms that, as with Western subjects, Malaysian infertile couples demonstrate the vulnerability to psychological distress that occurs more frequently among wives than husbands. As anticipated, emotional coping style was associated with greater distress in both genders.

The risk and associated factors of methamphetamine psychosis in methamphetamine-dependent patients in Malaysia

OBJECTIVE The objective of this study was to determine the risk of lifetime and current methamphetamine-induced psychosis in patients with methamphetamine dependence. The association between psychiatric co-morbidity and methamphetamine-induced psychosis was also studied. METHODS This was a cross-sectional study conducted concurrently at a teaching hospital and a drug rehabilitation center in Malaysia. Patients with the diagnosis of methamphetamine based on DSM-IV were interviewed using the Mini International Neuropsychiatric Interview (M.I.N.I.) for methamphetamine-induced psychosis and other Axis I psychiatric disorders. The information on sociodemographic background and drug use history was obtained from interview or medical records. RESULTS Of 292 subjects, 47.9% of the subjects had a past history of psychotic symptoms and 13.0% of the patients were having current psychotic symptoms. Co-morbid major depressive disorder (OR=7.18, 95 CI=2.612-19.708), bipolar disorder (OR=13.807, 95 CI=5.194-36.706), antisocial personality disorder (OR=12.619, 95 CI=6.702-23.759) and heavy methamphetamine uses were significantly associated with lifetime methamphetamine-induced psychosis after adjusted for other factors. Major depressive disorder (OR=2.870, CI=1.154-7.142) and antisocial personality disorder (OR=3.299, 95 CI=1.375-7.914) were the only factors associated with current psychosis. CONCLUSION There was a high risk of psychosis in patients with methamphetamine dependence. It was associated with co-morbid affective disorder, antisocial personality, and heavy methamphetamine use. It is recommended that all cases of methamphetamine dependence should be screened for psychotic symptoms.

Female Sexual Dysfunction in Patients Treated with Antidepressant—Comparison between Escitalopram and Fluoxetine

INTRODUCTION Selective serotonin reuptake inhibitor is one of the most widely used antidepressant and commonly associated with female sexual dysfunction (FSD). AIMS This study compares the prevalence of FSD between patients on escitalopram and fluoxetine. The risk factors for FSD were also examined. METHODS A cross-sectional study involved 112 female depressed patients (56 each group) who were in remission (as defined in the fourth edition of Diagnostic and Statistical Manual of Mental Disorders [DSM-IV] during the past 2 months with no significant signs or symptoms of the disturbance and Montgomery-Asberg Depression Rating Scale score of ≤10) from the psychiatric clinic in a university hospital. The rates of sexual dysfunction between the two groups were compared. MAIN OUTCOME MEASURES The subjects were interviewed by using Structured Clinical Interview for DSM-IV. Sexual dysfunction was assessed with the Malay Version of the Female Sexual Function Index. RESULTS The prevalence of FSD was 44.6% for all patients, 55.4% for the fluoxetine group, and 33.9% for the escitalopram group. Multivariate logistic regression analysis showed no significant difference in the risk of FSD between the two groups. Moderate to high dosing was the only significant associated factor for FSD (odds ratio = 4.89, 95% confidence interval = 1.94-12.33). CONCLUSION There was no significant difference in the risk of having FSD between patients treated with fluoxetine or escitalopram. Patients on higher dosage of antidepressant have higher risk of having FSD.

Risk factors for depression and anxiety among pregnant women in Hospital Tuanku Bainun, Ipoh, Malaysia

Anxiety and depression are prevalent during pregnancy. Estimates of the prevalence of anxiety and depression during pregnancy vary according to the criteria used, variable methodologies and population characteristics.

Suicide ideation and intent in Malaysia: A review of the literature

The aim of this paper was to review the literature on suicide ideation and intent in Malaysia. PsyINFO, PubMed, Medline databases from 1845 to 2012 and detailed manual search of local official reports from Ministry of Health, Malaysian Psychiatric Association and unpublished dissertations from 3 local universities providing postgraduate psychiatric training, were included in the current review. A total of 13 studies on suicide ideation and intent in Malaysia were found and reviewed. The review showed that research on suicide ideation and intent in Malaysia was fragmented and limited, at best. Approximately 50% of existing research on suicide ideation and intent simply focused on sociodemographic data. Fifty-four percent of the data were obtained from hospitals. No study has been conducted on treatment and interventions for suicide ideation and intent. None of the studies used validated suicide scales. The impact of culture was rarely considered. It was clear from the review that for researchers, clinicians and public health policy makers to gain a better understanding of suicide behavior especially suicide ideation and intent in Malaysia, more systematic and empirically stringent methodologies and research frameworks need to be used.

Post tsunami psychological impact among survivors in Aceh and West Sumatra, Indonesia

OBJECTIVE In 2004, the province of Aceh, Indonesia was rocked by tsunami and in September 2009, West Sumatra, Indonesia was hit by an earthquake. The aim of this study was to determine the long-term psychological impact on the residents inhabiting these regions and to identify factors associated with it. METHODS A cross-sectional study was conducted among the residents. The Depression, Anxiety and Stress Scale (DASS) was used to measure their psychological well-being. RESULTS Out of 200 respondents, 1 in 5 (19%) was found to suffer from a high level of depression, 1 in 2 (51%) had anxiety and 1 in 5 (22%) experienced stress. Factors found to be significantly associated with depression, anxiety and stress were female, young age, unemployed, and single (p<0.05). CONCLUSION The psychological impact following the tsunami persisted in the population after many years post-disaster. It is recommended that the psychological profile of the population be evaluated for the vulnerable group following any natural disaster.

Psychometric properties and validation of the Satisfaction With Life Scale in psychiatric and medical outpatients in Malaysia

The present study evaluated the psychometric properties and factor structure of the Satisfaction With Life Scale (SWLS) in a sample of clinical outpatients in Malaysia. The SWLS is a measure designed to assess subjective life satisfaction. Four hundred eighty-three participants (283 with psychiatric illnesses and 200 with other medical illnesses) completed the SWLS and other self-report instruments. Results of the EFA and CFA supported the fit for the one-factor model as the best-fitting model. The internal consistency of the SWLS (α=0.86) was found to be high. Correlational analyses showed that SWLS had adequate concurrent validity. Scores on SWLS, which differentiated psychiatric patients and medical patients, supported criterion validity. The logistic regression analyses showed good discriminative validity of SWLS. The SWLS is a reliable and valid instrument to measure the satisfaction with life among psychiatry and clinical outpatients in Malaysia.

Prevalence and risk factors of female sexual dysfunction among healthcare personnel in Malaysia.

OBJECTIVE To determine the prevalence and risk factors of female sexual dysfunction (FSD) among healthcare personnel in selected healthcare facilities in Malaysia. METHODS This was a cross-sectional study carried out at three large healthcare facilities that were selected by convenience sampling. Within each facility, stratified random sampling was used to select suitable candidates to participate in the study (n=201). Validated questionnaires were used to assess depression, anxiety, sexual function in women and erectile dysfunction (ED) in their partners. RESULTS The prevalence of FSD was 5.5%. Women with sexual dysfunction were more likely to be married longer (OR=4.08; 95% CI; 1.15-4.50), had lower frequency of sexual intercourse (OR=5.00; 95% C; 1.05-23.76) and had a spouse with ED (OR=24.35; 95% CI; 4.55-130.37). Multivariate analysis showed that ED was the strongest predictor for FSD (AOR=27.30; 95% CI; 4.706-159.08). CONCLUSION One in eighteen female healthcare personnel suffered from FSD and presence of ED in the partner strongly impacted her sexual function, negatively. The findings highlight the importance of including the male partner in clinical assessment of FSD.