Medicine

BackgroundIt is essential for caregivers of schizophrenia patients to have effective coping mechanisms to deal with their own mental health. However, research on the factors that contribute to the coping mechanisms of caregivers is limited. The purpose of this study is to investigate the use of coping strategies and their correlations to socio-demographic features, psychological distress, and social support among the caregivers of patients with schizophrenia.MethodThrough the convenience sampling method, 331 caregivers of patients with schizophrenia participated in this cross-sectional study. The respondents comprised caregivers who had attended an outpatient psychiatric clinic, providing the socio-demographic data. The study involves three instruments: the Kessler's Psychological Distress (K10); the Multidimensional Scale of Perceived Social Support (MSPSS); and the Brief-COPE.FindingsUsing multivariable analysis, psychological distress was identified as a substantial independe...

Borderline personality disorder (BPD) dikategorikan
sebagai gangguan personaliti mengikut Manual
Diagnostik dan Statistik Gangguan Mental edisi ke
lima atau DSM-5. Menurut DSM-5, ciri-ciri utama
gangguan personaliti BPD adalah ketidakstabilan
emosi dan hubungan dengan individu-individu lain
serta masalah imej diri dan tingkah laku yang
impulsif. Antara ciri-ciri utama BPD berkaitan
permasalahan hubungan dengan orang lain adalah
mereka takut ditinggalkan, takut keseorangan serta
takut ditolak. Ciri-ciri yang lain adalah emosi marah
yang berlebihan dan juga mencederakan diri sendiri.
Di negara barat jumlah pesakit BPD yang
mengunjungi jabatan kecemasan adalah sangat
kerap. Mereka biasanya datang dengan masalah
tingkah-laku mencederakan diri dan mengambil ubat
dengan kadar yang berlebihan atas dasar untuk
melegakan kesakitan emosi mereka. Sebahagian
mereka tidak mempunyai niat untuk mati.
Walaubagaimanapun, perbuatan mencederakan diri
merupakan suatu yang tidak harus dipandang
enteng.

Sibutramine is a prohibited weight-reducing agent used in many weight-loss products, which has been banned in many countries since 2010 including Malaysia due to it toxicities and mortality effect. The widespread use of these sibutramine-containing products has raised concerns regarding their side effects, which include psychological symptoms. In this case report, we highlight a case of psychosis induced by the use of this product. We present a case of 36-year-old Burmese lady who has three admissions to psychiatry ward with psychotic presentation after ongoing consumption of weight-loss product containing sibutramine.

Sibutramine is a prohibited weight-reducing agent used in many weight-loss products, which has been banned in many countries since 2010 including Malaysia due to it toxicities and mortality effect. The widespread use of these sibutramine-containing products has raised concerns regarding their side effects, which include psychological symptoms. In this case report, we highlight a case of psychosis induced by the use of this product. We present a case of 36-year-old Burmese lady who has three admissions to psychiatry ward with psychotic presentation after on-going consumption of weight-loss product containing sibutramine. Please click PDF below to download the full paper...

Manic symptoms secondary to post dengue fever are rare or might be under-reported. Awareness of this phenomenon is important for therapeutic considerations of patients. We present a case of late onset mania in an elderly gentleman who developed manic symptoms post dengue fever. Please click PDF below to download the full paper...

Islam places significant emphasis on mental health, urging Muslims to approach it holistically. Until now, this characterization serves as a starting point for discussing the definition and scope of Islamic spiritual care. This research aimed to provide a comprehensive overview of al-Balkhi's contributions to Islamic psychology and their relevance to modern mental health practice. The methodology utilized in this research is a literature review that synthesized information from scientific texts, research reports, and historical accounts related to al-Balkhi's work. This review synthesizes Abu Zayd al-Balkhi's pioneering contributions to Islamic mental health principles, focusing on his seminal work Masalih al-Abdan Wa al-Anfus (Sustenance of the Body and Soul). This review highlights the enduring relevance of al-Balkhi's insights in mental health care, advocating for a holistic approach rooted in Islamic principles. His classifications of depressive states and therapeutic methods, like exposure-based treatments, still influence modern psychotherapy. Al-Balkhi's holistic view emphasizes the link between spiritual and physical well-being. Analyzing his theories alongside current knowledge aids in diagnosing consistently and guiding therapy effectively. Integrating historical perspectives can enhance culturally sensitive mental health interventions within Muslim communities, respecting diverse cultural contexts.

Mindfulness practices have beneficial effects on physical as well as mental health. However, the concept of mindfulness from the Islamic perspective is not widely discussed. This paper explores the concept of mindfulness from the Islamic point of view focussing on the mental health issue and described the promising benefits of the concept of mindfulness practiced integrated with Islamic values especially for mental health. There is limited research on the effects of mindfulness practices integrated with Islamic values for individuals with mental health issues due to the limitation of the relevant studies. This paper recommended for further study to establish the concept of mindfulness according to Islamic values by conducting more qualitative and quantitative studies.

Internet addiction is increasingly recognized as a significant mental health concern, and is now included in DSM-5 TR as internet gaming disorder. Cybersexual addiction, a subtype of internet addiction, presents unique treatment challenges due to the pervasive need for online activities. This paper examines the incorporation of Islamic principles in the treatment of internet addiction among Muslim patients. The aim is to explore culturally sensitive approaches that align with Islamic practices to effectively address internet addiction. To highlight the specific challenges and benefits of integrating Islamic principles in managing internet addiction, a review of various databases was conducted. Key search terms included "internet addiction," "Islamic principles," "religious therapy," and "psychospiritual treatment." A detailed case vignette was included to demonstrate the practical application of integrating Islamic principles in treatment, highlighting the psychospiritual aspects and their impact on patients' emotional well-being. This paper discusses the principles of treatment, patient suitability, therapist preparedness, and potential limitations. Integrating religious principles as part of a psychospiritual approach shows promise in behaviour therapy for Muslim individuals suffering from internet addiction

Mindfulness-based therapy has beneficial effects for individuals with health issues, especially in mental health. However, the potential benefits of mindfulness therapy integrated with Islamic values are unclear. This paper provides a scoping review of the effects of mindfulnesspractices integrated with Islamic values for individuals with a mental health issue. Materials and method: Five electronic databases (Web of Science, Scopus, MEDLINE, PubMed, and CINAHL) were searched for relevant published literature. Titles, abstracts, and full-text articles were screened for the selection of relevant papers. Results: This article described the potential promising benefits of mindfulness therapy integrated with Islamic values for individuals with a mental health issue. Conclusion: There is a scarcity of research on the effects of mindfulness practices integrated with Islamic values for individuals with mental health issues due to the limitation of the number and methodology of the relevant studies. This paper recommended further study to establish the content and efficacy of mindfulness practices integrated with Islamic values.

The identification and management of Autism Spectrum Disorder (ASD) and its associated psychiatric comorbidities pose significant clinical challenges. This comprehensive review explores the multifaceted relationship between ASD and depression, suicidality, and borderline personality disorder (BPD), highlighting the intricate interplay between these mental health conditions. The unique complexities of diagnosing and managing comorbid depression and suicidality in individuals with ASD are discussed, including the heightened risks of non-suicidal self-injury and suicidality. Moreover, the review emphasizes the necessity of personalized, innovative treatment approaches, with a focus on the role of antidepressants, cognitive-behavioral therapy (CBT), and the application of electroconvulsive therapy (ECT) in managing treatment-resistant depression. The complexities of co-occurring borderline personality disorder in individuals with ASD are also examined, further underscoring the need for comprehensive, individualized care strategies. This review advocates for multidimensional therapeutic approaches that consider the interplay of psychiatric comorbidities and neurodevelopmental factors, to optimize outcomes and improve the quality of life for individuals with ASD. The findings stress the importance of early diagnosis, tailored interventions, and ongoing research into novel therapeutic modalities to better address the persistent and diverse nature of mental health challenges within the ASD population.

Recent studies have highlighted the significant impact of the human gut microbiota on the nervous system, correlating with various psychological and behavioral phenotypes, such as mood, cognition, sleep, and personality. This intricate bidirectional communication, known as the "Microbiota-Gut-Brain Axis" (MGBA), plays a crucial role in both the development and function of the brain in health and disease states. Dysbiosis of the gut microbiota, characterized by perturbations and alterations, has been associated with anxiety, depression, and a spectrum of neuropsychiatric disorders. This review synthesizes the clinical application of the MGBA in managing major psychiatric illnesses in adults, termed "Psychomicrobiotic." Materials and method:A scoping review was conducted through comprehensive searches of Scopus, Web of Science, and PubMed databases from inception to December 2019, yielding 12 relevant systematic reviews and meta-analyses. Herewith, the titles, abstracts, and full-text articles were screened for the selection of relevant papers. Results: The findings reveal promising effects of interventions targeting gut microbiota on anxiety and depression symptoms, albeit with limitations such as variability in study populations, methodologies, and intervention durations. Mechanistically, dysbiosis influences psychiatric pathology through neuro-immuno-endocrine pathways and epigenetic regulation. While evidence supports the efficacy of probiotics in alleviating symptoms of anxiety and depression,further research is warranted, particularly in schizophrenia and bipolar disorder. Overall, this review underscores the imperative for high-quality research to elucidate the association between psychiatric illness and the human gut microbiome, offering potential avenues for novel therapeutic strategies.

Klinefelter syndrome (KS), characterized by an additional X chromosome in males, remains an underdiagnosed condition despite its prevalence. This case report delves into the multidimensional impact of KS, particularly its often-overlooked association with psychiatric disorders, notably bipolar disorder. We present the case of a 36-year-old man initially diagnosed with Bipolar Disorder Type I during a manic phase. Despite apparent improvement with conventional pharmacotherapy, recurrent syncopal attacks led to an endocrine referral, revealing an underlying KS diagnosis. The patient exhibited typical clinical features, including gynecomastia and testicular abnormalities, alongside neuropsychiatric manifestations. The patient's history of sexual abuse and familial mental illness hints at complex etiological factors influencing his psychiatric presentation. Moreover, the co-occurrence of KS and bipolar disorder raises questions about the syndrome's psychological impact, including its implications for self-image and coping mechanisms. This case emphasizes the imperative for a comprehensive multidisciplinary approach to understand and manage complex psychiatric presentations. It highlights the necessity of considering physiological and psychological factors in comprehensive psychiatric assessments and treatment plans. Furthermore, it underscores the need for specialized multidisciplinary clinics to provide comprehensive care for individuals with KS, addressing their diverse medical, psychological, and social needs. Further research is needed to elucidate the intricate connections between genetic predispositions, psychological trauma, and mood disorders, particularly in the context of rare genetic conditions such as KS.

Klinefelter syndrome (KS) is a rare genetic disorder that may present concomitantly with autism spectrum disorder (ASD). This case report details the unique clinical presentation of a 24-year-old male diagnosed with both KS and ASD, characterized by a series of multiple suicidal attempts. This case sheds light on the underdiagnosed nature of KS, emphasizing the intricate interplay between hereditary variables and mental vulnerability. Notably, the patient’s clinical trajectory took an unexpected turn with the successful application of electroconvulsive therapy, suggesting a promising intervention for individuals facing similar challenges. This report contributes to the growing body of literature on the intersectionality of genetic conditions and psychiatric disorders, highlighting the importance of recognizing and addressing these complexities in clinical practice.

Acute psychosis, a prominent manifestation of Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, poses a diagnostic challenge as it closely mimics primary psychiatric disorders. Consequently, clinicians may inadvertently initiate antipsychotic treatment, inadvertently exacerbating the underlying pathology. We presented a mortality case of late detection of anti-NMDAR encephalitis in a young man who presented with acute psychosis which developed further deterioration after initiated anti-psychotics. This underscores the inherent risk in misdiagnosing anti-NMDAR encephalitis when acute psychosis is the primary clinical presentation. The delay in recognizing the neurological underpinnings of the symptoms resulted in a detrimental progression of the disease in the young male subject. This illuminates the critical need for heightened clinical suspicion when confronted with acute psychosis, prompting clinicians to consider alternative diagnoses beyond conventional psychiatric conditions. In conclusion, this article contributes to the ongoing discourse on the challenges associated with diagnosing anti-NMDAR encephalitis, particularly when masked by psychiatric symptomatology. It underscores the imperative for clinicians to maintain a high index of suspicion, prompting comprehensive evaluations to avert delayed diagnoses and potential fatalities in cases of this severe neurological condition.