Antidepressant discontinuation syndrome (ADDS) is often an under-recognised cause of multiple unpleasant symptoms upon stopping antidepressant. It requires a high index of suspicion to not miss this elusive diagnosis. This case will look at a common scenario of a nursing home resident forgetting to refill his antidepressant prescription which lead to the above syndrome. This will lead to discussion on how to treat this syndrome and subsequently allow the patient to carry on their daily life.

Introduction: The use of assessment tools to measure postnatal mental illness is essential in healthcare settings. However, variations in the types of tools and their reliability in a particular population lead to under-recognition of mental health status in postnatal mothers. The aim of this review is to evaluate the most recent 10 year of research on the validity and reliability of postnatal mental illness assessment tools. Methods: A literature search of studies from online databases PubMed, Scopus, and Science Direct was conducted. Results: A total of 59 studies were selected for this review. Several studies utilised multiple assessment tools, and a total of 96 assessment tools were identified and classified into six domains: postnatal blues, postnatal stress, postnatal anxiety, postnatal depression, postnatal psychosis, and postnatal psychological disorder. In this review, EPDS was the most common tool used to identify postnatal depression and anxiety while DASS 21 was the most common tool used to identify postnatal psychological disorder. There is a wide range in preponderance of evidence for the reliability of each assessment tool and there were inconsistencies in assessing the validity of the assessment tools. Conclusion: This review provides information regarding some of the main assessment tools currently available to measure postnatal mental illnesses. There were no standardised tools that were used in a particular setting. The results may differ in different population because there are differences in not only languages and dialects, but also cultural and racial backgrounds, which greatly influences their perception and interpretation of postnatal mental illness.

During the COVID-19 pandemic, medical and nursing students are faced with various challenges such as the need to attend online classes and juggling clinical postings under the new norm. This study aimed to assess the association between depression, anxiety, and behavioural changes among medical and nursing students during the COVID-19 pandemic. An online self-administered questionnaire was distributed between March 2021 and July 2021 to 292 undergraduates medical and nursing students in a higher education institute on the East Coast of Malaysia. The questionnaires consisted of four parts: sociodemographic data, the Generalised Anxiety Disorder-7, the Patient Health Questionnaire-9, and questions related to behaviours during the COVID-19 pandemic. This study found that 23.6% and 33.6% of the students experienced anxiety and depression respectively, possibly caused by the COVID-19 pandemic. Anxiety was associated with a high level of behavioural changes during the pandemic with a total of 87% of the students showing behavioural changes. Therapeutic interventions such as online counselling and consultation should be implemented by the university to reduce the prevalence of depression and anxiety resulting from the COVID-19 pandemic among medical and nursing students.

The prevalence of mental health problems among antenatal women has escalated during the COVID-19 pandemic compared to the pre-pandemic period. Physical activity palys role to reduce depression and anxiety, which required to be studied further. This study aimed to assess the association between physical activity with depression and anxiety among antenatal women during the COVID-19 pandemic. This cross-sectional study applied convenience sampling to recruit 544 antenatal women from March to June 2021. Questionnaires including the Edinburgh postnatal depression scale (EPDS), state-trait anxiety inventory (STAI), and pregnancy physical activity questionnaire (PPAQ) were distributed via social media to determine the prevalence of depression, anxiety, and physical activity level. Data were analysed using descriptive statistics, chi-square, mann-whitney, and kruskal wallis tests. Out of 544 antenatal women, 24.1% of them had depressive symptoms and 82.4% had anxiety. Only 12.1% of the women were sufficiently active during the pandemic. There was no association between physical activity, depression, and anxiety. The high prevalence of depression and anxiety during the COVID-19 pandemic among Malaysian antenatal women underscores the urgent need for addressing this public health burden. Interventions to alleviate the symptoms should include strategies beyond physical activity, for example, a mobile application or telephone-delivered social support that is made easily accessible throughout the pandemic.

The global outbreak of the COVID-19 pandemic has had a profound impact on societies worldwide. The implementation of a nationwide lockdown as a measure to control the spread of disease has resulted in economic instability, which has had a significant impact on the livelihood of the general population, particularly vulnerable groups such as transgender women or trans women. The primary objective of this study was to explore the economic impact of the COVID-19 pandemicon Malay transgender women within the context of the lockdown measures implemented in Malaysia. This study employed in-depth interviews, using a semi-structured interview protocol, to gather data from a sample of eleven localMalay trans women residing in southern Malaysia. By identifying and describing emergent patterns across data through the search for implicit and explicit themes pertinent to the study's objectives, thematic analysis was utilised. This study identified seven prominent themes: (1) job struggle and loss of income; (2)forced to use saving to survive; (3) food insecurity due to severe financial constraint; (4) impact on accommodation; (5) financial burden to support others; (6) reliance on aid and (7) reluctance in getting financial aid due to presumed stigma and discrimination. This study provides evidence that the implementation of lockdown measures during the COVID-19 pandemic had a significantimpact on the economic well-being of Malay transgender women in Malaysia. Further research is needed to explore the post-pandemic status of individuals, with a special focus on their health and psychosocial well-being.

Introduction: Healthcare practitioners involved in the maternity care provision should be equipped with adequate knowledge and skills in the screening of postnatal mental illness. The promotion of a screening tool for this purpose can enhance these skills among the healthcare providers. In Malaysia, there is a lack of fundamental knowledge among healthcare practitioners regarding postnatal mental illness and their perceptions are not fully understood, thus hindering the development of relevant screening tools. This study aimed to explore the views of Malaysian healthcare practitioners on the indicators and potential mechanisms for the screening of postnatal mental illness. Method: This qualitative study was conducted using semi-structured interviews involving 28 healthcare practitioners at maternal and child health clinics, psychiatric departments, and obstetrics and gynaecology departments across 18 maternal and child health clinics and six government hospitals in the states of Pahang, Terengganu, Perak, Negeri Sembilan, and Kuala Lumpur. The data were analysed using framework analysis. Results: The healthcare practitioners’ views on postnatal mental illness were reflected in three themes, namely perceived causes of postnatal mental illness, indicators of postnatal mental illness, as well as screening and intervention mechanisms for postnatal mental illness. According to the respondents, the existing screening tools available within the clinical practice were less sensitive in assessing postnatal mental illness. Conclusion: The introduction of a relevant screening tool in addressing the common symptoms of postnatal mental illness can improve its the detection among Malaysian women.

Introduction: Orang Asli (OA) in Malaysia is considered vulnerable to social, economic and legal abuse. The increase in prevalence of Non-Communicable Diseases (NCDs) among OA was reported due to their lifestyle changes. Our study aimed to determine the level of knowledge on NCDs among OA community and its’ association with demographic factors. Methods: A cross-sectional study by face-to-face interview was conducted among consented adult OA in Jelebu, Negeri Sembilan using a validated questionnaire. Their knowledge on risk factors, complications and treatment of cardiovascular diseases, diabetes mellitus, and chronic obstructive pulmonary diseases was asked. Respective thresholds and ranges for poor, moderate and good categories were set as 0-15, 15–21 and 21- 28. Mann-Whitney and Kruskal-Wallis test was used to test the association between the demographic profile and knowledge score since the data was not normally distributed. Results: A total of 325 respondents with mean age 39.94 (±13.196) ranged from 18 to 83-year-old participated in this study. Majority were females (71.1%) with primary education (39.1%) and mean household income of RM 615.47 (± 446.79). Their mean knowledge score was 12.82 (±9.671). Majority of them had poor knowledge (51.7%). The respondents with higher education background had significantly better knowledge score compared to lower education background (p <0.001). Conclusion: Study shows that the level of knowledge on NCDs among OA is low and associated with level of education. Effective health intervention programs among OA can be one of the strategic methods to increase their knowledge on NCDs and eventually their health.

Introductions: One of the mental health disorders that have an impact on physical health is called somatization disorder. Somatization is characterized by the appearance of complaints of pain in body parts that occur repeatedly. Anxiety, various physical complaints, and an increasing number of symptoms accompany symptoms of somatization disorder. The most common physical complaint is heartburn. Case: This case report discusses the case of a 36-year-old woman who complained of heartburn by visiting various doctors, but no medical results showed any abnormalities. Purpose: This case report aims to provide a literature review of heartburn symptoms due to somatization. Discussion: The Relationship between Heartburn Levels and Somatoform Disorders Psychosocial stressors are related to psychological factors that influence medical conditions that cause prominent psychological and somatic disorders. Psychological disorders and vice versa can cause physical disturbances. The patient's bodily medical condition can cause psychological disorders. Patients with severe acute pain will experience anxiety, fear, and sleep disturbances. This is due to the patient's discomfort with his condition, where he suffers from the pain he experiences and cannot move. With increasing duration and intensity of pain, the patient may experience a depressive disorder, and then the patient will be frustrated and irritable towards those around him and himself. Conclusion: The high pain intensity in the patient will cause sensitivity and increase his concern for his physical, lowering the threshold for detecting physical sensations or expressing distress and pain.

The lockdowns or ‘movement control order’ especially during the first wave of the COVID-19 pandemic had impacted all walks of life in Malaysia, including the transgender community. This study aimed to explore the psychosocial impact of lockdown regulation during the first wave of COVID-19 pandemic on Malay trans women or Mak Nyah in a southern state in Malaysia. This is a qualitative study with semi-structured, in-depth interviews and thematic analysis. 11 local Malay trans women aged 33 to 50, participated using purposive snowball sampling, starting with a local outreach worker. Six salient, interrelated themes were identified, namely: (1) Fear of the pandemic; (2) The psychological impact of lockdown; (3) The social impact of lockdown; (4) Family as a main concern during lockdown; (5) Transgender community as a source of support; and (6) Concerns about own health. Although the lockdown had considerable psychosocial impact, the close relationship among the local trans women community has alleviated some of the hardship. The COVID-19 pandemic and lockdown imposed psychosocial challenges impacting Malay trans women in a southern state in Malaysia. Being in a local transgender network provided invaluable moral support, relieved loneliness and offered some solutions for financial burden during the lockdown.