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IntroductionAn estimated 13% of women in the postnatal period suffer from postnatal depression (PND) worldwide. In addition to underprivileged women, women who are exposed to violence are at higher risk of PND. This study aimed to investigate the relationship between intimate partner violence (IPV) and PND in Malaysia.MethodsThis survey was conducted as a nationwide cross-sectional study using a cluster sampling design. Probable PND was assessed using a self-administered Edinburgh Postnatal Depression Scale (EPDS). Demographic profiles and IPV were assessed using a locally validated WHO Multicountry Study on Women’s Health and Life Events Questionnaire that was administered in a face-to-face interview. An EPDS total score of 12 or more and/or a positive tendency to self-harm were used to define PND.ResultsOut of 6669 women, 5727 respondents were successfully interviewed with a response rate of 85.9%. The prevalence of probable PND was 4.4% (95% CI 2.9 to 6.7). The overall prevalence of IPV was 4.9% (95% CI 3.8 to 6.4). Among the women in this group, 3.7% (95% CI 2.7 to 5.0), 2.6% (95% CI 1.9 to 3.5) and 1.2% (95% CI 0.9 to 1.7) experienced emotional, physical and sexual violence, respectively. Logistic regression analysis revealed that women who were exposed to IPV were at 2.3 times the risk for probable PND, with an adjusted OR (aOR) of 2.34 (95% CI 1.12 to 4.87). Other factors for PND were reported emotional violence (aOR 3.79, 95% CI 1.93 to 7.45), unplanned pregnancy (aOR 3.32, 95% CI 2.35 to 4.69), lack of family support during confinement (aOR 1.79, 95% CI 1.12 to 2.87), partner’s use of alcohol (aOR 1.59, 95% CI 1.07 to 2.35) or being from a household with a low income (aOR 2.99; 95% CI 1.63 to 5.49).ConclusionsExposure to IPV was significantly associated with probable PND. Healthcare personnel should be trained to detect and manage both problems. An appropriate referral system and support should be made available.

The translation and validation process of the WHO-5 Well-Being Index (WHO-5) into Malay is still not yet available. This study is the first psychometric evaluation of the Malay version of the WHO-5 in a sample of 127 primary care patients with type 2 diabetes mellitus. We evaluated the internal consistency and 5-week test–retest reliability of the WHO-5 Malay, and three aspects of its validity—first, the factorial validity in relation to the factor structure of the WHO-5 Malay; second, the concurrent validity in relation to depression and diabetes-related distress; and third, the convergent validity in relation to diabetes management self-efficacy and diabetes self-care behaviors. This study had two phases. Phase 1 involved the translation of the WHO-5 into Malay language following established procedures, whereas Phase 2 involved the validation of the WHO-5 Malay. Excellent internal consistency and 5-week test–retest reliability estimates were obtained. The factorial validity of the WHO-5 was found to be unidimensional. As for concurrent validity, the WHO-5 Malay was found to be negatively correlated with depression and diabetes-related distress. The WHO-5 was found to be correlated with diabetes management self-efficacy and diabetes self-care behaviors, thereby establishing convergent validity. The WHO-5 Malay has reliable and valid psychometric properties and represents a promising tool that informs healthcare providers in making effective and holistic diabetes management.

BackgroundThe COVID-19 pandemic is catastrophic and caused negative psychological effects among patients, healthcare workers and their surroundings. This study aims to determine the prevalence of depression and general anxiety disorders (GAD) among stable hospitalized COVID-19 patients.MethodsA cross-sectional study via web-based online survey involving 401 patients in the main COVID-19 hospitals in Malaysia who were selected via quota sampling. The questionnaire consists of socio-demographic profile, Patient Health Questionnaire 9 items (PHQ-9), General Anxiety Disorders 7 items (GAD-7) and Brief COPE (Coping Orientation to Problems Experienced). The identified probable cases of depression, anxiety and suicidal ideation were subsequently referred to psychiatrists.ResultThe prevalence of depression and anxiety were 7.5% and 7.0%, respectively. Besides that, 4.0% of respondents were suspected as having suicidal ideation. The prediction model revealed that females [aOR=5.29 (95% CI: 1.34, 20.80)], age 35-49 years old [aOR=7.47 (95% CI: 1.78, 31.30)], adopting behavioral disengagement [aOR=1.94 (95% CI: 1.31, 2.87)] and self-blame [aOR= 1.74 (95% CI: 1.31, 2.30)] as coping strategies, were significant predictors of depression. ConclusionsThe findings estimate the mental health burden among COVID-19 patients in Malaysia. The establishment of continuous mental health surveillance is essential in managing cases of depression, anxiety and suicidal ideation.

IntroductionPeople with diabetes are often associated with multifaceted factors and comorbidities. Diabetes management frameworks need to integrate a biopsychosocial, patient-centred approach. Despite increasing efforts in promotion and diabetes education, interventions integrating both physical and mental health components are still lacking in Malaysia. The Optimal Health Programme (OHP) offers an innovative biopsychosocial framework to promote overall well-being and self-efficacy, going beyond education alone and has been identified as relevant within the primary care system. Following a comprehensive cultural adaptation process, Malaysia’s first OHP was developed under the name ‘Pohon Sihat’ (OHP). The study aims to evaluate the effectiveness of the mental health-based self-management and wellness programme in improving self-efficacy and well-being in primary care patients with diabetes mellitus.Methods and analysisThis biopsychosocial intervention randomised controlled trial will engage patients (n=156) diagnosed with type 2 diabetes mellitus (T2DM) from four primary healthcare clinics in Putrajaya. Participants will be randomised to either OHP plus treatment as usual. The 2-hour weekly sessions over five consecutive weeks, and 2-hour booster session post 3 months will be facilitated by trained mental health practitioners and diabetes educators. Primary outcomes will include self-efficacy measures, while secondary outcomes will include well-being, anxiety, depression, self-care behaviours and haemoglobin A1c glucose test. Outcome measures will be assessed at baseline, immediately postintervention, as well as at 3 months and 6 months postintervention. Where appropriate, intention-to-treat analyses will be performed.Ethics and disseminationThis study has ethics approval from the Medical Research and Ethics Committee, Ministry of Health Malaysia (NMRR-17-3426-38212). Study findings will be shared with the Ministry of Health Malaysia and participating healthcare clinics. Outcomes will also be shared through publication, conference presentations and publication in a peer-reviewed journal.Trial registration numberNCT03601884.

INTRODUCTION: Postnatal depression is a highly prevailing illness, yet underdiagnosed. Untreated, it carries a transgenerational impact, and therefore promoting awareness for it has to be of high priority. This research explored the elements of an educational tool to develop awareness for postnatal depression as preferred by stakeholders. MATERIALS AND METHOD: A descriptive qualitative approach using semi-structured face-to-face interviews were conducted, where nine participants were recruited via purposive sampling from a university hospital in Malaysia. Interviews with each participant were audio-recorded and transcribed to verbatims. Emergent themes were identified during the analysis. RESULTS: Four consistent themes regarding elements for an educational tool were derived as follows: Foundations of the tool, Illness circumstances, Support bases, and Matters of perspective. CONCLUSION: An educational video within the local setting should involve the usage of a short emotionally driven video, highlighting illness- and treatment-related content, and addressing the preference and concerns of women within the religious and cultural context. The use of edutainment as an educational tool is replicable and has a high outreach even to those who are illiterate. The findings can be used in the tailored development of an educational video on postnatal depression which will benefit local women by creating awareness and encouraging early help-seeking.

Objectives: To explore the relevance and adaptability of the Optimal Health Program for mental and primary healthcare providers in Malaysia. Methods: Evaluate stakeholder engagement and training programme for psychiatrists, family medicine specialists, public health specialists, physicians, clinical psychologists, counsellors, and representatives from a patient support group. Evaluate the programme for applicability, as well as participant’s knowledge and confidence in using key components. Results: The training was very well received in terms of content, training materials and facilitation style. Development of culturally specific materials will be needed. Improvement in the self-rating measurement for knowledge and confidence in using key Optimal Health Program components was reported at the completion of the 2-day training. Conclusions: The Optimal Health Program has potential as a comprehensive socio-culturally responsive self-management programme that is relevant within mental health services and adaptable for task-sharing of mental health care in Malaysia.

Major depressive disorder (MDD) is a common but complex illness that is frequently presented in the primary care setting. Managing this disorder in primary care can be difficult, and many patients are underdiagnosed and/or undertreated. The Malaysian Clinical Practice Guidelines (CPG) on the Management of Major Depressive Disorder (MDD) (2nd ed.), published in 2019, covers screening, diagnosis, treatment and referral (which frequently pose a challenge in the primary care setting) while minimising variation in clinical practice.