Nor Zuraida Zainal

The efficacy of mindfulness-based stress reduction on mental health of breast cancer patients: a meta-analysis

This study aims to investigate the evidence of the efficacy of mindfulness‐based stress reduction (MBSR) in improving stress, depression and anxiety in breast cancer patients.

The prevalence and pharmacotherapy of depression in cancer patients

BACKGROUND Depression is a frequent and serious comorbid condition in cancer patients that may require special attention. We investigate the prevalence of depression in cancer and review the current state of evidence regarding the effectiveness of drug treatment of depression in this group. METHODS We conducted a literature search for reports of prevalence rate of Major Depressive Disorder (MDD) in cancer patients based on Structured Clinical Interview based on DSM (SCID). We estimated the prevalence rate by combining the data of all reports. In addition we identified controlled trials studying the effect of psychotropic drugs in depressed cancer patients. RESULTS Based on the 31 reports, the estimated prevalence rate of depression in cancer patients is 10.8% (996/9248). There were 8 trials comparing antidepressant with other active treatment in cancer patients. Only mianserin and alprazolam demonstrated to improve the depressive symptoms. LIMITATIONS This literature review cannot resolve the challenge of diagnosing depression in severely ill and is subject to publication bias. CONCLUSION Despite the high prevalence of depression in cancer patients, studies on effective pharmacotherapy are relatively scarce. The evidence for the efficacy of conventional medication used for the treatment of depression such as tricyclics antidepressants and selective serotonin reuptake inhibitors is very limited. It is possible that they may be less suitable in this setting because of their relatively late onset of action. The use of psychostimulants which have a rapid onset of action therefore deserves more attention.

Prevalence of Depression in Breast Cancer Survivors: a Systematic Review of Observational Studies

BACKGROUND Depression is common in breast cancer patients. The aim of this paper was to make a systematic review of its prevalence and associated factors oin breast cancer survivors. MATERIALS AND METHODS An extensive systematic electronic review (PUBMED, CINAHL, PsyINFO and Ovid) and handsearch were carried out to retrieve published articles up to November 2012, using Depression OR Dysthymia AND (Cancer OR Tumor OR Neoplasms as the keywords. Information about the design of the studies, measuring scale, characteristics of the participants, prevalence of depression and its associated factors from the included studies were extracted and summarized. RESULTS We identified 32 eligible studies that recruited 10,826 breast cancer survivors. Most were cross-sectional or prospective designed. The most frequent instrument used to screen depression was the Center for Epidemiological Studies for Depression (CES-D, n=11 studies) followed by the Beck Depression Inventory (BDI, n=6 studies) and the Hospital Anxiety and Depression Scale (HADS, n=6 studies). CES-D returned about similar prevalence of depression (median=22%, range=13-56%) with BDI (median=22%, range=17-48%) but higher than HADS (median=10%, range=1-22%). Depression was associated with several socio-demographic variables, cancer-related factors, treatment-related factors, subject psychological factors, lifestyle factors, social support and quality of life. CONCLUSIONS Breast cancer survivors are at risk for depression so that detection of associated factors is important in clinical practice.

Psychiatric and Substance Abuse Comorbidity among HIV Seropositive and HIV Seronegative Prisoners in Malaysia

Objective: To examine the association between HIV infection and psychiatric disorders among prisoners, where mental illness, substance abuse, and HIV are disproportionately represented. Design: Cross-sectional study. Methods: Using a sequential randomization scheme, 200 HIV-seropositive and 200 HIV-seronegative prisoners were selected for evaluation of psychiatric illnesses with the Structured Clinical Interview for Diagnostic Statistical Manual of Mental Disorders-IV (SCID-I). Results: The prevalence of mental illness and substance use disorders, particularly opioid dependence, was extremely high. HIV infection was significantly correlated with age, ethnicity, marital status, history of injection drug use, lifetime duration of incarceration, substance abuse, and polysubstance drug use. After controlling for potential confounders, HIV infection was significantly associated with non-substance-induced psychiatric disorders (AOR = 1.92; 95% CI: 1.03–3.59). While prisoners with a triple diagnosis (psychiatric disorders, substance use disorders, and HIV) spent 46.7 more cumulative lifetime months in prison than those with only a psychiatric diagnosis (p < .01), those with a dual diagnosis (psychiatric plus substance use disorders) were comparable to those with one psychiatric diagnosis only. Neither HIV infection nor triple diagnosis was associated with violent offenses. Conclusion: These findings suggest that a public health approach that simultaneously addresses psychiatric illnesses, substance abuse, and HIV infection is needed in both the correctional and the community settings in order to provide adequate care for triply-diagnosed patients and prevent them from returning to prison.

Validation of the Malay version of the Multidimensional Scale of Perceived Social Support (MSPSS-M) among a group of medical students in Faculty of Medicine, University Malaya

OBJECTIVE The aim of this study was to validate the Malay version of the Multidimensional Scale of Perceived Social Support (MSPSS-M) among a group of medical students in Faculty of Medicine, University Malaya. METHODS 237 students participated in the study. They were given the Malay version of MSPSS, medical outcome study (MOS) social support survey, Malay version of General Health Questionnaire (GHQ), Malay version of Beck Depression Inventory (BDI) and English version of MSPSS. A week later, these students were again given the Malay version of MSPSS. RESULTS The instrument displayed good internal consistency (Cronbachs alpha=0.89), parallel form reliability (0.94) and test-retest reliability (0.77) (Spearmans rho, p<0.01). The negative correlation of the total and subscales of the instrument with the Malay version of GHQ and BDI confirmed its validity. Extraction method of the 12 items MSPSS using principle axis factoring with direct oblimin rotation converged into three factors of perceived social support (Family, Friends and Significant Others) with reliability coefficients of 0.88, 0.82 and 0.94, respectively. CONCLUSION The Malay version of the MSPSS demonstrated good psychometric properties in measuring social support among a group of medical students from Faculty of Medicine, University Malaya and it could be used as a simple instrument on young educated Malaysian adolescents.

Prescription patterns for psychotropic drugs in cancer patients; a large population study in the Netherlands

Psychotropic drugs are commonly prescribed for various psychological complaints in cancer patients. We aim to examine the prescription pattern in cancer patients of three common psychotropic drugs: benzodiazepine, antidepressant and antipsychotic.

A randomized, placebo-controlled trial of aripiprazole for the treatment of methamphetamine dependence and associated psychosis

Abstract 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.

Prevalence of distress in cancer patients undergoing chemotherapy

Aim:  Feeling distressed is often a normal reaction to the diagnosis of cancer and cancer treatment. However, if excessive, distress may lead to more disabling conditions such as depression and anxiety. The aims of the study were to determine the prevalence and level of distress in patients with cancer who were undergoing chemotherapy and to examine the associated factors related to psychological distress in these patients.

The characteristics of people with mental illness who are under treatment in traditional healer centres in Sudan

Aims: To determine the general characteristics of people with mental disorders in traditional healers centres in Sudan in terms of sociodemographic profile, common clinical presentations and diagnostic features, and to look at the treatment methods and intervention procedures used in these centres for treating people with mental illness. Methods: This is a descriptive cross-sectional study using both quantitative and qualitative research methods. All inpatients with mental illness (405) from 10 selected traditional healers centres in Sudan who gave consent were interviewed, using a specially designed questionnaire and the Mini International Neuropsychiatric Interview (MINI). Results: Most of the visitors to the centres were from central Sudan with a mean age of 31 years, illiterate or with only a primary basic education, male and jobless. The average mean duration of stay in the traditional healer centre was five months and the mean duration of untreated illness before coming to the centre was 13 months. Only 17% reported a history of alcohol abuse and only 11% of drug abuse. The most common prevalent diagnosis was psychotic disorder. Conclusion: This study improves the understanding about what types of people with mental illness are treated at these traditional healer centres and gives recommendations that can help in improving the quality of services in these centres. It can probably be used in building bridges of collaboration between these centres and the available mental health and psychiatric services in Sudan, especially at primary healthcare level.

Religiousness, religious coping methods and distress level among psychiatric patients in Malaysia.

Background: Patients having psychiatric diagnoses often experience high level of distress. Religiousness is often used by them as part of their coping mechanism and problem-solving strategies. Objective: To determine the level of religious commitment and coping methods in psychiatric patients and its relationship with distress level. Methods: Religious commitment and coping patterns were measured with the Duke University Religious Index (DUREL) and Brief RCOPE, respectively. Psychopathology was assessed using the Brief Psychiatric Rating Scale (BPRS) and distress level was assessed with the Depressive, Anxiety and Stress Scale (DASS). Social support and experiences of recent threatening events were measured with the Multidimensional Scale of Perceived Social Support (MSPSS) and Life Threatening Events (LTE). Results: A total of 228 patients were included in this study with a mean age of 40.2 years. The majority were male, Malay, Muslim, single and with psychotic disorder. The subjects had a high level of religious commitment and had used more positive coping methods. Negative religious coping, psychiatric symptoms and diagnosis of anxiety disorder or major depression were significantly associated with high distress level. Higher religious commitment was significantly associated with lower distress (p < .05). Conclusion: Psychiatric patients were religiously committed and used more positive religious coping methods. Practices of negative religious coping, severe psychiatric symptoms and anxiety/depression were associated with higher distress.