exudates and Somatoform-Disorders

Understanding the sociocultural dimension of a patient's health beliefs is critical to a successful clinical encounter. Malaysia with its multi-ethnic population of Malay, Chinese and Indian still uses many forms of traditional health care in spite of a remarkably modern rural health service.. The objective of this paper is discuss traditional health care in the context of some of the cultural aspects of health beliefs, perceptions and practices in the different ethnic groups of the author's rural family practices. This helps to promote communication and cooperation between doctors and patients, improves clinical diagnosis and management, avoids cultural blind spots and unnecessary medical testing and leads to better adherence to treatment by patients.. Includes traditional practices of 'hot and cold', notions of Yin-Yang and Ayurveda, cultural healing, alternative medicine, cultural perception of body structures and cultural practices in the context of women's health. Modern and traditional medical systems are potentially complementary rather than antagonistic. Ethnic and cultural considerations can be integrated further into the modern health delivery system to improve care and health outcomes.

Topics: Adult; Attitude of Health Personnel; Australasia; Child; Complementary Therapies; Culture; Family Practice; Female; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Medicine, Traditional; Rural Health Services; Somatoform Disorders; Terminal Care; Women's Health

Somatisation disorder (SD) has been reported as common in all ethnic groups, but the estimates of its prevalence have varied and the evidence for its associated factors has been inconsistent.. This study seeks to determine the prevalence of SD and its associated factors in multiethnic primary care clinic attenders.. This cross-sectional study was on clinic attenders aged 18 years and above at three urban primary care clinics in Malaysia. The operational definition of SD was based on ICD-10 criteria for SD for research, frequent attendance, and excluded moderate to severe anxiety and depression. The instruments used were the ICD-10 symptom list, the Hospital Anxiety and Depression Scale, a semi-structured questionnaire, and SF-36.. We recruited 1,763 patients (response rate 63.8%). The mean age of respondents was 44.7 ± 15.8 years, 807 (45.8%) were male; there were 35.3% Malay, 30.1% Chinese and 34.6% Indian. SD prevalence was 3.7%; the prevalence in Malay was 5.8%, Indian 3.0% and Chinese 2.1%. Significant associations were found between SD prevalence and ethnicity, family history of alcoholism, blue-collar workers and the physical component summary (PCS) score of SF-36. Multivariate analysis showed that SD predictors were Malay ethnicity (OR 2.7, 95% CI 1.6, 4.6), blue-collar worker (OR 2.0, 95% CI 1.2, 3.5) and impaired PCS score of SF-36 (OR 0.92, 95% CI 0.90, 0.95).. The prevalence of SD was relatively uncommon with the stringent operational criteria used. SD preponderance in blue-collar workers may be attributable to secondary gain from getting sickness certificates and being paid for time off work.

Topics: Adult; Age Factors; Chi-Square Distribution; China; Cross-Cultural Comparison; Cross-Sectional Studies; Cultural Characteristics; Female; Humans; India; Malaysia; Male; Middle Aged; Prevalence; Primary Health Care; Sex Factors; Socioeconomic Factors; Somatoform Disorders; Statistics, Nonparametric

Standard psychiatric criteria for depression developed in the United States and United Kingdom are increasingly used worldwide to establish the prevalence of clinical disorders and to help develop services. However, these approaches are rarely sensitive to local and cultural expressions of symptoms or beliefs about treatment. Mismatch between diagnostic criteria and local understanding may result in underreporting of depression and underutilization of services. Little such research has been conducted in Malaysia, despite the acknowledged high rate of depression and low access to services. This study examines depression in Moslem Malay women living in Johor Bahru, Southern Peninsular Malaysia, to explore depression symptoms using the Structured Clinical Interview for DSM-IV. The 61 women interviewed were selected on the basis of high General Health Questionnaire scores from a large questionnaire survey of 1,002 mothers. The illustrative analysis looks at descriptions of depressed mood, self-depreciation and suicidal ideation, as well as attitudes toward service use. The women gave full and open descriptions of their emotional symptoms, easily recognizable by standard symptom categories, although somatic symptoms were commonly included, and the spiritual context to understanding depression was also prevalent. However, few women had knowledge about treatment or sought medical services, although some sought help from local spiritual healers. Attending to such views of depression can help develop services in Malaysia.

Topics: Adult; Antidepressive Agents; Asian People; Cross-Cultural Comparison; Depressive Disorder, Major; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Interview, Psychological; Islam; Malaysia; Mental Health Services; Mothers; Patient Acceptance of Health Care; Religion and Psychology; Social Values; Somatoform Disorders; Spiritual Therapies; Spirituality; Suicidal Ideation

Topics: Culture; Humans; Malaysia; Review Literature as Topic; Somatoform Disorders; United Kingdom

A large literature argues for the Chinese--whether in mainland China or elsewhere--being highly likely to express depression somatically, leading to predictable detection and diagnostic difficulties. If true, detection might be assisted if a set of somatic proxies of depression were identified, and this was the principal initial objective in mounting this study.. We studied two sets of depressed outpatients, one of Malaysian Chinese and the other of Australian Caucasians, matched by age and sex. We identified the prime symptom nominated by them when they first sought assistance, and required them to complete an inventory of both somatic and cognitive symptoms, and rank the three items they judged as most capturing their distress.. The Chinese were distinctly more likely to nominate a somatic symptom as their presenting complaint (60% vs 13%), while the Australian subjects were more likely to nominate depressed mood, cognitive and anxiety items. Responses to the inventory established that the Chinese did score somewhat higher on a somatic set of items, but differed far more distinctly in being less likely to affirm cognitive items of depression, resulting in significantly lower total inventory scores. Variation across the contrast samples in acknowledging the presence of symptoms did not relate simply to the prevalences of those symptoms.. Our failure to identify a culture-specific somatic factor as a proxy of depression, together with establishing a high rate of somatic and related items (e. g. insomnia) in both samples, may largely reflect the phenomenon of 'corporization', whereby depressed patients irrespective of culture are more likely to experience and report in response to a 'somatosensory amplification' influence.

Topics: Adult; Aged; Australia; China; Cross-Cultural Comparison; Depression; Factor Analysis, Statistical; Female; Humans; Malaysia; Male; Middle Aged; Prevalence; Risk Factors; Somatoform Disorders

This study aimed to look at the link between childhood recurrent abdominal pain (RAP) and the presence of recent life-events in an urban community in Malaysia. School children aged from 9 to 15 years in the city of Petaling Jaya were randomly selected to fill in a questionnaire and to be interviewed. The prevalence of RAP among 1488 school children studied was 9.6% (95% confidence interval (CI), 8.18-11.25). Higher prevalences of RAP were found in children who had experienced the following life-events in the previous year: loss of a family member through death (P<.001), hospitalisation of a family member (P<.001), the child's own hospitalisation (P=.001), change of address (P<.001), change in occupation of an immediate family member (P<.001), failure in a major school examination (P<.001), bullying at school (P=.001). Following logistic regression analysis, five life-events remain significant: hospitalisation of a family member (P=.038), the child's own hospitalisation (P=.034), change in occupation of an immediate family member (P=.049), examination failure (P=.001) and bullying at school (P=.028). This study strongly suggests that recent stressful life-events are important risk-factors for RAP.

Topics: Abdominal Pain; Adolescent; Child; Female; Humans; Life Change Events; Malaysia; Male; Recurrence; Risk Factors; Somatoform Disorders; Urban Population

A case of Koro is described in a Malaysian Chinese man in the setting of martial dysharmony and sexual rejection. A distinction is suggested between the epidemic form of Koro and the Koro symptom occurring sporadically. Existence of the sporadic Koro syndrome is discussed and a unified classificatory system is proposed.

Topics: Adult; Anxiety, Castration; Conflict, Psychological; Cultural Characteristics; Erectile Dysfunction; Humans; Malaysia; Male; Marriage; Rejection, Psychology; Somatoform Disorders; Stress, Psychological

Topics: Anxiety; Child; Female; Humans; Malaysia; Male; Mass Behavior; Schools; Somatoform Disorders