Ramli Musa

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.

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.

Two-year outcomes of methadone maintenance therapy at a clinic in Malaysia.

Background. The commencement of methadone maintenance therapy (MMT) in 2005 represents a quantum leap in the management of heroin dependence in Malaysia. Objective. To examine the 2-year outcomes of this modality in the treatment of heroin dependence with respect to the quality of life (QOL), heroin abstinence, and rate of employment among heroin dependants attending the Tengku Ampuan Afzan Hospital (HTAA) MMT clinic. Method. This was an experimental study in which the second QOL assessment was conducted 2 years after treatment initiation. Results. A total of 172 patients enrolled at the point of entry to the MMT program. The authors examined 107 patients who remained in the program 2 years later (62.6% retention rate). A paired t test demonstrated sigsnificant improvements in all 4 domains of QOL (physical, psychological, social relationships, and environment; P < .001). The most marked improvement was noted in the psychological domain. Conclusion. The MMT program at HTAA is effective in improving the QOL among heroin dependants.

Depression, anxiety and stress among patients with dialysis and the association with quality of life

Studies addressing the nature of relationship between psychological symptoms and quality of life among dialysis patients in Malaysia are scarce. Hence, this study is intended to investigate the association between psychological symptoms such as depression, anxiety and stress on the quality of life in dialysis patients. A cross sectional multicentre study was conducted from May to October 2012 at 15 centres that provide haemodialysis and/or peritoneal dialysis. Apart from socio-demographic profile data collection, WHOQOL-BREF and DASS21 questionnaires were administered to study subjects. All three psychological symptoms had significant impact on quality of life domains of physical health, psychological health, social impact, perceived environment and overall quality of life. These findings suggest that subjects with symptoms of depression, anxiety and stress had poorer quality of life than those without, highlighting the negative impact of psychological symptoms.

Quality of life in dialysis: A Malaysian perspective

There is a growing interest to use quality of life as one of the dialysis outcome measurement. Based on the Malaysian National Renal Registry data on 15 participating sites, 1569 adult subjects who were alive at December 31, 2012, aged 18 years old and above were screened. Demographic and medical data of 1332 eligible subjects were collected during the administration of the short form of World Health Organization Quality of Life questionnaire (WHOQOL‐BREF) in Malay, English, and Chinese language, respectively. The primary objective is to evaluate the quality of life among dialysis patients using WHOQOL‐BREF. The secondary objective is to examine significant factors that affect quality of life score. Mean (SD) transformed quality of life scores were 56.2 (15.8), 59.8 (16.8), 58.2 (18.5), 59.5 (14.6), 61.0 (18.5) for (1) physical, (2) psychological, (3) social relations, (4) environment domains, and (5) combined overall quality of life and general health, respectively. Peritoneal dialysis group scored significantly higher than hemodialysis group in the mean combined overall quality of life and general health score (63.0 vs. 60.0, P < 0.001). Independent factors that were associated significantly with quality of life score in different domains include gender, body mass index, religion, education, marital status, occupation, income, mode of dialysis, hemoglobin, diabetes mellitus, coronary heart disease, cerebral vascular accident and leg amputation. Subjects on peritoneal dialysis modality achieved higher combined overall quality of life and general health score than those on hemodialysis. Religion and cerebral vascular accident were significantly associated with all domains and combined overall quality of life and general health.

Disrupted-in-Schizophrenia-1 (DISC1) gene as genetic markers of schizophrenia susceptibility

Abstract Introduction There are substantial evidences that suggest DISC1 function in neurodevelopment thus support the locus as candidate gene of schizophrenia and potential target for the treatment of schizophrenia. Objectives: The aim of the study is to assess the association of DISC1 gene as genetic susceptibility marker of schizophrenia. Methods This is an unmatched case control study with the total of 225 unrelated schizophrenia patients and 350 control healthy individuals. Seventeenth SNPs within DISC1 gene were selected based on HapMap data constructed using the Haploview. The SNPs were genotyped using PCR-RFLP assay. Results & Discussion We found significant differences in genotypes and allele frequencies between patients and controls for two SNPs, rs4658971 [p=0.0303,OR=1.435(1.035–1.990)] and rs1538979 [p=0.036, OR=1.351(1.02–1.79)]. Conclusion The study provided significant evidence of DISC1 gene as a marker of schizophrenia susceptibility.

Knowledge and attitude on sex among medical students of a Malaysian university

The objective of this study was to determine the relationship between clinical/socio‐demographic factors with knowledge and attitude on sex among medical students of the National University of Malaysia (UKM).

Knowledge and attitude on sex among medical students of a Malaysian university: A comparison study

The objective of this study was to determine the relationship between clinical/socio‐demographic factors with knowledge and attitude on sex among medical students of the National University of Malaysia (UKM).

Emotional disturbances among adult diabetic patients attending diabetic clinic in a Malaysian General Hospital

Introduction: Emotional disturbances such as depression, anxiety and stress play an important role in the management of diabetes mellitus since their presence can adversely affect glycemic control, quality of life and compliance with medications. Despite this, emotional disturbances are consistently under-diagnosed and undertreated by physicians in general practice. Objectives: This study aims to determine the prevalence and severity of emotional disturbances among diabetic patients Methodology: This is a cross sectional study conducted on a sample of 200 patients with diabetes mellitus attending the diabetic clinic at the Hospital Tengku Ampuan Afzan, Pahang state, Malaysia. The prevalence and severity of depressive, anxiety and stress symptoms were assessed in those diabetic patients by using the self-rating Bahasa Malaysia version of the Depression, Anxiety and Stress Scales (DASS-42). Results: The prevalence of depression, anxiety, and stress among diabetic patients was 13.5%, 28%, 11% respectively. Most of the patients with emotional disturbances had moderate depression and anxiety symptoms. However, stress symptoms were mild. Although females showed higher prevalence of emotional disturbances, only anxiety was significantly higher than males. Conclusion: Diabetic patients are at risk to develop psychiatric illnesses in the form of depression, anxiety and stress. Anxiety symptoms were more prominent than depression and stress in diabetic patients.

The Therapeutic and Psychosocial Interaction in Enhancing Drug Targets

The holistic standpoint of biopsychosocial importance of mediation is crucial in the perception regarding on how the psychopharmacological agent acts. This understanding is indeed important when dealing with patients expectation and hope, specifically during their illness and recovery process. In clinical setting, the fundamental knowledge on know-how art of prescribing medication and dietary advice can be of great help in the real-world practice of medicine. Subsequently, this manoeuvre may influence the choice of the pharmacological agents, dietary choice of intake and managing the adverse-effect of the existing drug intervention routine. The relationship between the mind-body is well described in the literature especially in the context of pharmacological therapy. The relationship is important in order to be understood for the management of patients in the clinical settings. Research studies have been done to ascertain the role of the psychosocial contributing factors, and how they may influence an individual’s experience of drug targets. In this thematic issue, the articles focussed on the role of drug targets, which was augmented by the emotional-cognitive and behavioral mediation in enhancing the effects of biological therapy. Emotionalcognitive determinants may influence the processing of neurochemical actions, e.g. the dopamine-oxytocin-nitric oxide neural pathway in patients who were given treatment in order to improve their sexual intimacy with his or her partner. These determinants are also relevant while elaborating the role of psychopharmacological agents in alleviating the patient’s somatic symptoms. Behavioural modification advice may help patients regain their self-confidence in their journey to recovery, despite petite guidance given by the clinician. The purpose of biopsychopsychological input, i.e. intimacy-relationship, cognition and emotional states are important in helping the patient’s self-esteem with successful treatment of the PDE-5 inhibitors. Selecting the right psychopharmacological agents to reduce the sexual-adverse effect of drugs is essential in patients with both depression and schizophrenia. The roles of new novel antidepressants are portrayed in its multi-modality function of treating depression. Antidepressant’s effect in managing physical symptoms is important. The stress model diathesis of alcohol in mental health was underlined in the perspective of neuronal basis of cognition memory. In the present thematic issue, the association of serotonin selective reuptake inhibitors and female sexual dysfunction was discussed with special emphasis on its treatment. Interesting articles on the antinociceptive effect of Mitragyna speciosa, the phosphodiasterase 5-inhibitors (PDE-5i) for erectile dysfunction, the recent approaches on treatment of alcohol addiction, the neurobiology of hypersexuality and its treatment, role of atypical antipsychotics in sexuality, treatment of anxiety disorders with Vortioxetine and the role of dietary compounds in the treatment for anxiety disorders were highlighted. Last but not the least, the present issue also focussed on the use of antidepressants for physical and psychological symptoms in cancer and discussed the dietary issue in the biopsychopsychological context of treatment, which included tocopherol and tocotrienol.