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The purpose of this study was to evaluate the psychometric properties of the Malay version of the Beck Youth Inventories-Second Edition (BYI-2 Malay) in a sample of adolescents living in the nongovernment-run sheltered homes. In this study, 300 adolescents completed the BYI-2 Malay, the Beck Depression Inventory-Malay (BDI-Malay), the Beck Anxiety Inventory-Malay (BAI-Malay), the Automatic Thoughts Questionnaire-Malay (ATQMalay), and the Rosenberg Self-Esteem Scale-Malay (RSES-Malay). The internal consistency estimates for the BYI-2 Malay scales, as measured by Cronbach’s alpha, were excellent: .86 for self-concept, .89 for anxiety, .92 for depression, .92 for anger, and .92 for disruptive behaviours. The five-factor model of the BYI-2 Malay (i.e., Self-Concept, Anxiety, Depression, Anger, and Disruptive Behaviour) showed a good fit to the data. Evidence for concurrent validity was established between the BYI-2 Malay Self-Concept scale and the RSES-Malay (r = .41), between the BYI-2 Malay Anxiety scale and the BAI-Malay (r = .60), and between the BYI-2 Malay Depression scale and the BDI-Malay (r = .69). The evidence for convergent validity was established between the BYI-2 Malay Anger scale and the ATQ-Malay (r = .71), and between BYI2 Malay Disruptive Behaviour scale and the ATQ Malay (r =.52). The present findings shed light on the utility of the BYI-2 Malay in aiding clinicians as well as therapists for identifying multiple symptoms of social and emotional problems in adolescents.

The polymorphisms of the 5HTR1A and 5HTR2A receptor genes (rs6295C/G and rs6311G/A) have been evaluated for association with SSRI treatment outcome in various populations with different results. The present study was carried out to determine the association between genotypes of HTR1A-rs6295 and HTR2A-rs6311 with SSRI treatment outcome among the ethnic Malay patients diagnosed with first-episode major depressive disorder (MDD). The patients were recruited from four tertiary hospitals in the Klang Valley region of Malaysia. Predefined efficacy phenotypes based on 25% (partial early response) and 50% (clinical efficacy response) reduction in Montgomery Asberg Depression Rating Scale-self Rated score (MADRS-S) were adopted for assessment of treatment efficacy in this study. Self-reporting for adverse effects (AE) was documented using the Patient Rated Inventory of Side Effect (PRISE) after treatment with SSRI for up to 6 weeks. Adjusted binary logistic regression between genotypes of the polymorphism obtained using sequencing technique with the treatment outcome phenotypes was performed. The 142 patients recruited were made up of 96 females (67.6%) and 46 males (32.4%). Clinical efficacy and Partial early response phenotypes were not significantly associated with genotypes of HTR1A and HTR2A polymorphism. The GG genotype of HTR2A polymorphism has decreased odds for dizziness (CNS) and increased odds for poor concentration. The GA genotype increases the odd for excessive sweating, diarrhoea, constipation and blurred vision. The CC genotype of HTR1A-rs6295 decreases the odd for nausea/vomiting and increases the odd for anxiety. Thus, some genotypes of HTR1A and HTR2A polymorphism were associated with SSRI treatment outcomes in ethnic Malay MDD patients.

This study aimed to determine the prevalence of depression, anxiety, and the associated factors among 632 adolescents (age range: 13-17 years, Mage = 14.47, SD = 1.32) staying in sheltered homes in Malaysia. The Malay versions of the Beck Depression Inventory, Beck Anxiety Inventory, Automatic Thoughts Questionnaire, and Rosenberg Self-Esteem Scale were applied. The overall prevalence of mild to severe depression and anxiety in this study was 70.9% and 82.3% respectively, with 64.1% for comorbidity of both symptoms. Specifically, the prevalence rates of minimal, mild, moderate, and severe depressive symptoms were 29.1%, 38.4%, 22.4%, and 10.1% respectively whereas the prevalence rates of minimal, mild, moderate, and severe anxiety symptoms were 17.7%, 27.7%, 33.2%, and 21.4% respectively. The severity of negative automatic thoughts increased with the severity of depression and anxiety. Age, anxiety, negative automatic thoughts, and self-esteem were significantly associated with depression while depression, negative automatic thought, and anger were significantly associated with anxiety. The high rates of depression and anxiety among adolescents residing in the sheltered homes indicate the need to identify these at-risk populations and provide trained personnel who can deliver psychiatric and psychological services at sheltered homes.

The objective of this study was to evaluate the effect of a family-based intervention program (REDUCE) on children’s eating behaviors and dietary intake. A two-arm randomized controlled field trial was conducted among parents and children of 7 to 10 years old who were either overweight or obese. The intervention was conducted via face-to-face sessions and social media. The child eating behaviors were assessed using the child eating behaviors questionnaire (CEBQ), while their dietary consumption of vegetables and unhealthy snacks was assessed using a parental report of three days unweighted food. The generalized linear mixed modelling adjusted for covariates was used to estimate the intervention effects with alpha of 0.05. A total of 122 parents (91% response rate) completed this study. At the six-month post-training, there were statistically significant mean differences in the enjoyment of food (F(6481) = 4.653, p < 0.001), fruit and vegetable intake (F(6480) = 4.165, p < 0.001) and unhealthy snack intake (F(6480) = 5.062, p < 0.001) between the intervention and wait-list groups; however, it was not clinically meaningful. This study added to the body of knowledge of family-based intervention that utilized social media and assessed the effect in children’s eating behavior using the CEBQ and children’s dietary intake.

A total of 201 patients with major depressive disorder from four hospitals in Malaysia were followed up for 5 years to determine the prognostic factors of recurrent major depressive disorder that could potentially contribute to improving the management of MDD patients. For each individual patient, at the time of recruitment as part of a case-control study, information was collected on recent threatening life events, personality and social and occupational functioning, while blood samples were collected to genotype single nucleotide polymorphisms of vitamin D receptor (VDR), zinc transporter-3 (ZnT3), dopamine transporter-1 (DAT1), brain-derived neurotropic factor (BDNF), serotonin receptor 1A (HT1A) and 2A (HT2A) genes. Kaplan-Meier and Cox-regression were used to estimate hazard functions for recurrence of major depressive disorder. Individuals with severe MDD in previous major depressive episodes had five and a half times higher hazard of developing recurrence compared to mild and moderate MDD (HR = 5.565, 95% CI = 1.631–18.994, p = 0.006). Individuals who scored higher on social avoidance had three and a half times higher hazard of recurrence of MDD (HR = 3.525, 95% CI = 1.349–9.209; p = 0.010). There was significant interaction between ApaI +64978C>A single nucleotide polymorphism and severity. The hazard ratio increased by 6.4 times from mild and moderate to severe MDD for A/A genotype while that for C/A genotype increased by 11.3 times. Social avoidance and severity of depression at first episode were prognostic of recurrence. Screening for personality factors at first encounter with MDD patients needs to be considered as part of the clinical practice. For those at risk of recurrence in relation to social avoidance, the psychological intervention prescribed should be customized to focus on this modifiable factor. Prompt and appropriate management of severe MDD is recommended to reduce risk of recurrence.

Major depressive disorder (MDD) is primarily hinged on the presence of either low mood and/or anhedonia to previously pleasurable events for a minimum of 2 weeks. Other clinical features that characterize MDD include disturbances in sleep, appetite, concentration and thoughts. The combination of any/both of the primary MDD symptoms as well as any four of the other clinical features has been referred to as MDD. The challenge for replicating gene association findings with phenotypes of MDD as well as its treatment outcome is putatively due to stratification of MDD patients. Likelihood for replication of gene association findings is hypothesized with specificity in symptoms profile (homogenous clusters of symptom/individual symptoms) evaluated. The current review elucidates the genetic factors that have been associated with insomnia symptom of MDD phenotype, insomnia symptom as a constellation of neuro-vegetative cluster of MDD symptom, insomnia symptom of MDD as an individual entity and insomnia feature of treatment outcome. Homozygous CC genotype of 3111T/C, GSK3B-AT/TT genotype of rs33458 and haplotype of TPH1 218A/C were associated with insomnia symptom of MDD. Insomnia symptom of MDD was not resolved in patients with the A/A genotype of HTR2A-rs6311 when treated with SSRI. Homozygous short (SS) genotype-HTTLPR, GG genotype of HTR2A-rs6311 and CC genotype of HTR2A-rs6313 were associated with AD treatment-induced insomnia, while val/met genotype of BDNF-rs6265 and the TT genotype of GSK-3beta-rs5443 reduced it. Dearth of association studies may remain the bane for the identification of robust genetic endophenotypes in line with findings for genotypes of HTR2A-rs6311.

Major depressive disorder (MDD) compromises the individual’s capacity for self-care and productivity. Single nucleotide polymorphisms (SNP) of a number of genes have been associated with MDD. The zinc transporter-3 protein, encoded by the ZnT3 (SLC30A3) gene, maintains zinc-glutamate homeostasis at the glutamatergic synapse, a disruption of which increases risk of MDD. We hypothesise that variation in SLC30A3 (rs11126936) SNP increases risk of MDD. We recruited 300 MDD cases and 300 controls, matched in the ratio of 1:1 by age, gender and ethnicity. PCR-restriction fragment length polymorphism analysis was used in DNA genotyping, validated by sequencing 10% of samples. Deviation from the Hardy-Weinberg equilibrium was tested using the chi-square test. Conditional logistic regression was used to estimate adjusted odds ratios, controlling for age, gender, ethnicity, occupation and family monthly income. Genotypes G/G and G/T showed two times greater odds of developing MDD compared to variant genotype T/T (OR=1.983, 95% CI=1.031-3.815; p=0.040 and OR=2.232, 95% CI=1.100-4.533; p=0.026 respectively). Carriers of genotypes G/G and G/T of the SNP rs11126936 in SLC30A3 are associated with increased risk of MDD.