Previous pandemics have demonstrated short and long-term impacts on healthcare workers’ mental health, causing knock-on effects on patient care and professional functioning. Indeed, the present COVID-19 pandemic has created unprecedented disruption in social interactions and working conditions. Malaysia has been under the Recovery Movement Control Order since June 2020; however, with the upsurge of cases, healthcare workers face pressure not only from working in resource-deprived settings but also from the increasing patient load. The primary objective of the present study was to examine the cross-sectional relationship of COVID-19 fear and stress to psychological distress (operationalized as anxiety and depression) in healthcare workers. The present sample included 286 frontline healthcare workers from three hospitals in Selangor, Malaysia. Self-administered questionnaires containing sociodemographic and occupational items, the Malay versions of the Coronavirus Stress Measure scale, the Fear of Coronavirus-19 scale, the Generalized Anxiety Disorder-7, and the Patient Health Questionnaire-9 were distributed via online platforms. Hierarchical multiple regression findings suggest that age, shift work, and COVID-19 stress consistently predicted anxiety and depression among frontline healthcare workers after adjusting for sociodemographic and occupational variables. The present findings suggest that frontline healthcare workers are not only inoculated against COVID-19 itself but also against the psychological sequelae of the pandemic.

Background: Over the years, cognitive-behavioural therapy (CBT) has gained momentum because of its robust evidence in the treatment of several disorders. However, there is an issue of religious and cultural appropriateness as CBT principles are based on Western conceptualization. This single‐case study (N = 1) implements a culturally and religiously adapted CBT on ...

The present study examined the relations between clinical characteristics and cognitive deficits in adult patients with major depressive disorder (MDD) from a local outpatient psychiatric clinic in Malaysia. The present sample included 110 participants aged 20–60 years old. Participants were invited to provide their information on sociodemographic variables (age, gender, and educational level) and clinical characteristics (age at onset of depression and duration of illness) and to complete a series of cognitive performance measures including the Trail Making Tests A (psychomotor speed) and B (executive function), the Digit Symbol Substitution Test (attention), and the Auditory Verbal Learning Test (immediate free recall, acquisition phase, and delayed recall). The Mini International Neuropsychiatric Interview Version 6.0 was used to confirm the diagnosis of MDD and the Montgomery–Åsberg Depression Rating Scale was used to assess illness severity. At the bivariate level, relations of age and educational level to all cognitive deficit domains were significant. At the multivariate level, only educational level and illness severity consistently and significantly predicted all cognitive deficits domains. Therapeutic modalities should be individualised whilst considering the impacts of cognitive deficits in an attempt to prevent further deterioration in psychosocial functioning of MDD patients.

Background: Cotard’s syndrome (CS) is a neuropsychiatric condition marked by nihilistic delusional(s). Due to its rarity, misdiagnosis of the syndrome often occurs. The current case study is of a Malaysian woman who was misdiagnosed for several years by professionals due to the presence of hypochondriac symptoms before receiving the correct diagnosis. Case presentation: In this case presentation, we describe the case of L, a 42-year-old Malaysian lady who was first misdiagnosed with depression. The diagnosis of schizophrenia and CS was confirmed after thorough clinical examination, diagnostic investigations, and deliberation at a departmental forum. The patient improved after receiving electroconvulsive therapy (ECT) along with antipsychotic medications. Conclusions: This case study highlights the importance of early recognition of CS by professionals as it can save time for both parties when setting up a treatment plan. Essentially, early recognition of CS in schizophrenia is paramount in the process of rapid stabilization through ECT and promotion of patient recovery.

The COVID-19 pandemic has become the greatest challenge of the new millennium. Most healthcare workers (HCWs) experienced unprecedented levels of workload since the pandemic. This study aims to identify the prevalence and factors of depression, anxiety and stress among HCWs in Malaysian healthcare facilities in the midst of the pandemic due to the SARs-CoV-2. An emergency response programme on mental health was conducted from June to September 2020. A standardized data collection form was distributed among the HCWs in the government hospital in Klang Valley. The form contained basic demographic information and the self-reported Malay version of the Depression, Anxiety and Stress scale (BM DASS-21). Of the1,300 staff who attended the Mental Health and Psychosocial Support in Covid-19 (MHPSS COVID-19) programme, 996 staff (21.6% male, 78.4% female) completed the online survey (response rate: 76.6%). Result showed that staff aged above 40 years old were almost two times more likely to have anxiety (AOR = 1.632; 95% CI = 1.141–2.334, p:0.007) and depression (AOR = 1.637; 95% CI = 1.1.06–2.423, p:0.014) as compared to staff who were less than 40 years old. Those who had direct involvement with COVID-19 patients were likely to suffer stress (AOR = 0.596; 95% CI = 0.418–0.849, p:0.004), anxiety (AOR = 0.706; 95% Ci = 0.503–0.990, p:0.044) and depression (AOR = 0.630; 95% Ci = 0.427–0.928, p:0.019). HCWs with stress (AOR = 0.638; 95% CI of 0.476–0.856, p = 0.003), anxiety (AOR = 0.720; 95% CI 0.542–0.958, p = 0.024) and depression (AOR = 0.657; 95% CI 0.480–0.901, p = 0.009) showed less confidence to treat critically ill patients and need psychological help during outbreak. This study showed the importance of psychosocial support to reduce psychological distress among HCWs when working or coping during the COVID-19 pandemic or outbreak.

Acute disseminated encephalomyelitis (ADEM) is an autoimmune inflammatory demyelinating disease of the central nervous system (CNS) involving the spinal cord and white matter of the brain, usually affecting children and young adults after vaccination or an infection. Neuropsychiatric manifestations are common but are less frequently reported in literature. This case details a young man with no previous comorbidities, who presented with a range of neuropsychiatric manifestations including blank stares, catatonic-like symptoms, selective mutism, irritability, aggression, and visual hallucination. Magnetic resonance imaging showed focal abnormal signal intensity at the splenium of the corpus callosum, notably mildly hypointense on T1W, hyperintense on T2W/FLAIR with restricted diffusion on ADC/DWI. Minimal patchy enhancement was noted postcontrast. Subtle T2/FLAIR hyperintensities were also seen involving the right medial thalamus. He was diagnosed with monophasic ADEM and initiated on intravenous methylprednisolone 1 g daily; however, he developed potential steroid-induced psychosis and was subsequently changed to orodispersible olanzapine and intravenous immunoglobulin (IVIG) 0.4 g/kg/h for 5 days to which he responded satisfactorily. This case report highlights the importance of treating ADEM with steroids and immunoglobulins as it can result in high psychiatric and physical morbidity and mortality if untreated early.