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Background: Mental health problems in Malaysia are on a rise. This study aimed at performing a systematic review of mental health literacy (MHL) in Malaysia. Methods: Medline, Embase, ERIC/Proquest, ScienceDirect, Pubmed, PsycINFO, CINAHL, Scopus, EBM Reviews - Cochrane Central Register of Controlled Trials, Ovid Emcare and reference lists of included studies were searched in February 2020. Studies that evaluated at least one of the main components of MHL, including (1) knowledge related to mental health issues, and (2) stigma, were included irrespective of study design. As secondary findings, the review also synthesized results related to facilitators and barriers to seeking mental health services. Depending on the research design, the quality of each study was assessed through checklists. Results: Forty six studies published between 1995 to 2019 were included. Most studies used cross-sectional designs to investigate MHL. Findings indicate that most Malaysians have stigmatizing attitudes towards mental health problems. Participants in the included studies endorsed multifactorial explanations of mental health issues with a dominance of supernatural and religious aetiologies. Likewise, the commonest barrier was considering sources other than professional sources of mental-health services. Presence of adequate knowledge and considering providers as competent facilitated help-seeking. Additionally, there was considerable heterogeneity in studies and a lack of standardized measures assessing MHL. Conclusions: There is an increase in studies on MHL in Malaysia. A few of these studies, based on experimental design, have shown positive effects. Researchers, practitioners, and policymakers should develop standardized measures and interventional studies based on all the components of MHL

Background\ud A social recovery approach to youth mental health focuses on increasing the time spent in valuable and meaningful structured activities, with a view to preventing enduring mental health problems and social disability. In Malaysia, access to mental health care is particularly limited and little research has focused on identifying young people at risk of serious socially disabling mental health problems such as psychosis. We provide preliminary evidence for the feasibility and acceptability of core social recovery assessment tools in a Malaysian context, comparing the experiential process of engaging young Malaysian participants in social recovery assessments with prior accounts from a UK sample.\ud \ud Methods\ud Nine vulnerable young people from low-income backgrounds were recruited from a non-government social enterprise and partner organisations in Peninsular Malaysia. Participants completed a battery of social recovery assessment tools (including time use, unusual experiences, self-schematic beliefs and values). Time for completion and completion rates were used as indices of feasibility. Acceptability was examined using qualitative interviews in which participants were asked to reflect on the experience of completing the assessment tools. Following a deductive approach, the themes were examined for fit with previous UK qualitative accounts of social recovery assessments.\ud \ud Results\ud Feasibility was indicated by relatively efficient completion time and high completion rates. Qualitative interviews highlighted the perceived benefits of social recovery assessments, such as providing psychoeducation, aiding in self-reflection and stimulating goal setting, in line with findings from UK youth samples.\ud \ud Conclusions\ud We provide preliminary evidence for the feasibility and acceptability of social recovery assessment tools in a low-resource context, comparing the experiential process of engaging young Malaysian participants in social recovery assessments with prior accounts from a UK sample. We also suggest that respondents may derive some personal and psychoeducational benefits from participating in assessments (e.g. of their time use and mental health) within a social recovery framework.

Educational modules can be effective in educating and motivating adolescents to participate in physical activity (PA). This paper describes the development and validation of a PA educational module for use in an obesity intervention programme, CEria Respek Gigih Aktif Sihat (CERGAS). The present study was conducted in three phases: Phase I was composed of needs assessments with four focus group discussions to elicit adolescents&rsquo, opinions regarding module content and design, Phase II was the development of the PA module, while Phase III was content and face validation. A content validity index (CVI) was used to assess content validity quantitatively, with a CVI of more than 0.79 being considered appropriate. The needs assessments indicated that content of interest to adolescents included: the benefits of exercise, exercise techniques, ways to increase PA and how to stay motivated. Attractive graphic design was determined as a way to draw the adolescents&rsquo, attention. The module covered five topics: &ldquo, Let&rsquo, s Be Active&rdquo, &ldquo, Exercise and Fitness&rdquo, Staying Safe during Exercise and Physical Activity&rdquo, Planning for Success&rdquo, and &ldquo, How to Overcome Sedentariness and Get Moving&rdquo, The module was found to have good content validity (mean CVI = 0.85). Expert members made suggestions to improve the module. These suggestions were then accepted, and the module was modified accordingly. We concluded that the module has good content validity and can be used to improve PA knowledge amongst CERGAS participants.

It has been widely reported that medical students face considerable stress in medical school. In Malaysia, a brief (four-session, 2 h per week) group Mindfulness-based Cognitive Therapy (b-GMBCT/Mindful-Gym) was developed to help medical students cope with stress. The aim of this study was to evaluate the feasibility and effectiveness of the program in reducing stress among medical students in a Malaysian university. This was a single-group, prospective study. A total of 135 year-four medical students in psychiatric postings participated in the program (conducted in seven batches over 2 years). The following outcome variables were measured pre- and post-intervention: mindfulness, perceived stress, and general psychological distress. Intention-to-treat analyses showed significant reductions in perceived stress (M = −3.85, SD = 5.70, 95 % CI, -2.88 to −4.82, p

Psychiatric screening and diagnostic assessments in Malaysia are generally translated versions of existing tools from the West due to the lack of research on indigenous mental health concepts for diagnostic and treatment purposes. This study examined the syndromes of psychotic disorder based on Western constructs within the local context to see its applicability in Malaysia. Knowledge of this investigation would help in determining the extent of adapted tools in Malaysia with regards to validity of use. Concurrently, this study aimed to develop a Malaysian Psychotic Symptoms Screening Inventory as a primary-care-level psychiatric screener. A total of 344 respondents (174 psychotic and 170 non-psychotic respondents) were recruited. Items in the instrument were derived from commonly used Western-based inventories. The generated inventory was self-administered and data collected from the respondents were factor analysed using Principle Component Analysis. Results revealed four factors, of which three indicat...

Nutrition is an important factor in mental development and, as a consequence, in cognitive performance. Malnutrition is reflected in children's weight, height and BMI curves. The present cross-sectional study aimed to evaluate the association between anthropometric indices and cognitive performance in 6746 school-aged children (aged 6–12 years) of four Southeast Asian countries: Indonesia; Malaysia; Thailand; Vietnam. Cognitive performance (non-verbal intelligence quotient (IQ)) was measured using Raven's Progressive Matrices test or Test of Non-Verbal Intelligence, third edition (TONI-3). Height-for-age z-scores (HAZ), weight-for-age z-scores (WAZ) and BMI-for-age z-scores (BAZ) were used as anthropometric nutritional status indices. Data were weighted using age, sex and urban/rural weight factors to resemble the total primary school-aged population per country. Overall, 21 % of the children in the four countries were underweight and 19 % were stunted. Children with low WAZ were 3·5 times more likely to have a non-verbal IQ

The dual burden of malnutrition reportedly coexists in Malaysia; however, existing data are scarce and do not adequately represent the nutritional status of Malaysian children. The Nutrition Survey of Malaysian Children was carried out with the aim of assessing the nutritional status in a sample of nationally representative population of children aged 6 months to 12 years. A total of 3542 children were recruited using a stratified random sampling method. Anthropometric measurements included weight, height, mid-upper arm circumference, and waist and hip circumferences. Blood biochemical assessment involved analyses of Hb, serum ferritin, and vitamins A and D. Dietary intake was assessed using semi-quantitative FFQ, and nutrient intakes were compared with the Malaysian Recommended Nutrient Intakes (RNI). The prevalence of overweight (9·8 %) and obesity (11·8 %) was higher than that of thinness (5·4 %) and stunting (8·4 %). Only a small proportion of children had low levels of Hb (6·6 %), serum ferritin (4·4 %) and vitamin A (4·4 %), but almost half the children (47·5 %) had vitamin D insufficiency. Dietary intake of the children was not compatible with the recommendations, where more than one-third did not achieve the Malaysian RNI for energy, Ca and vitamin D. The present study revealed that overnutrition was more prevalent than undernutrition. The presence of high prevalence of vitamin D insufficiency and the inadequate intake of Ca and vitamin D are of concern. Hence, strategies for improving the nutritional status of Malaysian children need to consider both sides of malnutrition and also put emphasis on approaches for the prevention of overweight and obesity as well as vitamin D insufficiency.

Few randomized controlled trials (RCTs) of interventions for the treatment of childhood obesity have taken place outside the Western world.To test whether a good practice intervention for the treatment of childhood obesity would have a greater impact on weight status and other outcomes than a control condition in Kuala Lumpur, Malaysia.Assessor-blinded RCT of a treatment intervention in 107 obese 7- to 11-year olds. The intervention was relatively low intensity (8 hours contact over 26 weeks, group based), aiming to change child sedentary behavior, physical activity, and diet using behavior change counselling. Outcomes were measured at baseline and six months after the start of the intervention. Primary outcome was BMI z-score, other outcomes were weight change, health-related quality of life (Peds QL), objectively measured physical activity and sedentary behavior (Actigraph accelerometry over 5 days).The intervention had no significant effect on BMI z score relative to control. Weight gain was reduced significantly in the intervention group compared to the control group (+1.5 kg vs. +3.5 kg, respectively, t-test p0.01). Changes in health-related quality of life and objectively measured physical activity and sedentary behavior favored the intervention group.Treatment was associated with reduced rate of weight gain, and improvements in physical activity and quality of life. More substantial benefits may require longer term and more intensive interventions which aim for more substantive lifestyle changes.

This paper highlights the integration of spiritual and religious approaches in psychotherapy using the three major religions (Taoism, Buddhism, and Christianity) of the Chinese community in Malaysia (CIM) as an example. The authors explore the underlying therapeutic dimensions that exist among CIM. The distinctive practices of religion among CIM include: 1) the blending of religion, folklore, and superstitious practices; 2) loyalty to the religious tradition of one’s family; and 3) common belief in a spiritual reality. Due to the particularity of religiosity within this population, the authors propose a tradition-sensitive approach to integrative therapy and religion. Lastly, four clinical cases are discussed to demonstrate an integrative approach in therapy sessions. The themes that emerge from the cases are viewed as a dynamic process, including 1) exploration of the client’s religious beliefs and beliefs concerning the spiritual realm, 2) affirming the client’s religious resources and social duties, 3) returning to the client’s basic religious teachings and rituals, 4) expanding religious support from the client’s family and community, and 5) personal growth and healing in the client’s relationships. In the conclusion, both the benefits and potential weaknesses of this approach are discussed in order to address the complexity of such an endeavour in an Asian setting.

Women participating in a wide range of competitive sports are at higher risk of developing eating disorders, menstrual irregularities and osteoporosis, which are generally referred to as the 'female athlete triad'. The objective of this study was to determine the prevalence of female athlete triad and factors associated with this condition among athletes participating in different sports. A total of 67 elite female athletes aged between 13-30 years participated in the study and were subdivided into the 'leanness' and 'non-leanness' groups. Eating disorders were assessed using a body image figure rating and the Eating Disorder Inventory (EDI) with body dissatisfaction (BD), drive for thinness (DT), bulimia (B) and perfectionism (P) subscales. Menstrual irregularity was assessed with a self-reported menstrual history questionnaire. Bone quality was measured using a quantitative ultrasound device at one-third distal radius. Prevalence of the female athlete triad was low (1.9%), but the prevalence for individual triad component was high, especially in the leanness group. The prevalence of subjects who were at risk of menstrual irregularity, poor bone quality and eating disorders were 47.6%, 13.3% and 89.2%, respectively, in the leanness group; and 14.3%, 8.3% and 89.2%, respectively, in the non-leanness group. Since the components of the triad are interrelated, identification of athletes at risk of having any one component of the triad, especially those participating in sports that emphasise a lean physique, is an important aid for further diagnosis.