Medicare-reimbursed psychiatric consultations before and after telehealth expansion in Australia: a time series study.

Objective Telepsychiatry consultations grew rapidly with increased total consultations and reduced face-to-face consultations following the pandemic-triggered expansion of Medicare Benefits Schedule (MBS) telehealth items. It was unclear how much telehealth expansion independently impacted overall and face-to-face consultation trends after accounting for lockdown severity. Methods We extracted monthly MBS Item Reports for psychiatric consultations (January 2012-December 2023).

Deprescribing antidepressants for depression - what is the evidence for and against?

Objective: Recent guidelines suggest that the overall quantity and duration of antidepressant prescriptions should be reduced. In this paper, we comment on the evidence both for and against this view.

Methods: We critically review the arguments proposed by proponents of antidepressant deprescribing in the context of the evidence-base for the treatment of depression.

Comparing the trends of MBS telepsychiatry and consultant physician telehealth services from 2017 to 2022: A retrospective study.

Objective: The Medicare Benefit Schedule (MBS) telehealth items were expanded in March 2020 during the COVID-19 pandemic. We measured the use of MBS telepsychiatry items compared to consultant physician telehealth items within the context of these item changes, to understand differences in telepsychiatry and physician telehealth utilisation.

Methods: Monthly counts of face-to-face and telehealth (videoconferencing and telephone) MBS items for psychiatrists and physicians from January 2017 to December 2022 were compiled from Services Australia MBS Item Reports.

Telepsychiatry in Australia: A Scoping Review.

Telepsychiatry formed part of the Australian mental health response to COVID-19, but relevant reviews pre- and post-pandemic are sparse. This scoping review aimed to map the literature on telepsychiatry in Australia and identify key research priorities. We searched databases (Medline, PubMed, PsycINFO, Scopus, Web of Science, EBSCO Psychology & Behavioral Sciences Collection, Proquest databases, and Cochrane Central Register of Controlled Trials) and reference lists from January 1990 to December 2022.

Comparison of the out-of-pocket costs of Medicare-funded telepsychiatry and face-to-face consultations: A descriptive study.

Objective: Telepsychiatry items in the Australian Medicare Benefits Schedule (MBS) were expanded following the COVID-19 pandemic. However, their out-of-pocket costs have not been examined. We describe and compare patient out-of-pocket payments for face-to-face and telepsychiatry (videoconferencing and telephone) MBS items for outpatient psychiatric services to understand the differential out-of-pocket cost burden for patients across these modalities.

"It kinda helped us to be there": students' perspectives on the use of virtual patient software in psychiatry posting.

Background: At the Faculty of Medicine of the National University of Malaysia, a virtual patient software program, DxR Clinician, was utilised for the teaching of neurocognitive disorder topics during the psychiatry posting of undergraduate medical students in a modified team-based learning (TBL) module. This study aimed to explore medical students' learning experiences with virtual patient.

Methods: Ten students who previously underwent the learning module were recruited through purposive sampling.

Practical psychiatry: On therapeutic equipoise - Principles of a balanced approach to psychiatric treatments.

Objective: There are many burgeoning treatments, and a large range of therapeutic options for 21 century psychiatry. This paper briefly comments upon considerations for balancing treatment to suit the patient, their illness, and their milieu.

Conclusions: Therapeutic equipoise, for psychiatric care, is an aspiration rather than a position easily achieved.

Practical psychiatry: Providing temporary psychiatric cover.

Objective: Psychiatric cover for healthcare staffing shortfalls is increasingly common post-pandemic. We aim to provide comprehensive practical advice on providing temporary inpatient or outpatient cover as a psychiatrist, based on the authors' clinical experience and the existing research literature.

Conclusions: There is limited peer-reviewed advice available on providing safe and effective temporary psychiatric consultant cover for patient care.

Psychometric properties of the Malay-version beck anxiety inventory among adolescent students in Malaysia.

Background: The Beck Anxiety Inventory (BAI) is a common tool for screening anxiety symptoms. In Malaysia, the Malay-version 21-item BAI has been previously validated in the Malaysian adult population. However, information regarding its reliability and validity among adolescents below 18 years old is still lacking.

Case report: Bipolar disorder in 48,XXYY syndrome.

48,XXYY syndrome is a rare condition. The presentations of impulsive and aggressive behavior have been reported in several case reports among patients with 48,XXYY syndrome. The management of the psychological impact and neuropsychiatric sequela of this condition is a significant issue faced by families, carers, and healthcare professionals.

Perception of Current Educational Environment, Clinical Competency, and Depression among Malaysian Medical Students in Clinical Clerkship: A Cross-Sectional Study.

The COVID-19 pandemic has altered the educational environment of medical students in clinical clerkship, with potential impacts on clinical competency and reported increased prevalence of depression. This study aimed to determine the relationship between the perception of the educational environment, self-perceived clinical competency, and depression among them. Subjects ( = 196) at the National University of Malaysia participated through convenience sampling in an online survey including sociodemographic data, COVID-19-related stressors, Dundee Ready Education Environment Measure (DREEM), self-perceived clinical competency, and Patient Health Questionnaire (PHQ-9).

Case report: Effectiveness of brexpiprazole and esketamine/ketamine combination: A novel therapeutic strategy in five cases of treatment-resistant depression.

A significant proportion of patients with treatment-resistant depression do not attain functional recovery despite administration of multiple steps of pharmacotherapeutic strategies. This highlights the elusiveness of meeting unmet needs in existing pharmacotherapies for treatment-resistant depression. There is accumulating evidence that antidepressant agents involving the glutamatergic system such as brexpiprazole and esketamine/ketamine have more rapid onset of action and potentially improved effectiveness as an augmentation therapy in treatment-resistant depression.

Case Report: Cotard's Syndrome in Anti-N-methyl D-aspartate (NMDA) Receptor (Anti-NMDAR) Encephalitis.

Cotard's syndrome is uncommon psychopathology among patients with psychotic illnesses. Limited cases had been reported regarding the occurrence of this syndrome in anti-NMDAR encephalitis which itself is a relatively new disease that often presents with florid psychotic symptoms. This poses difficulties in differentiating it from a primary psychiatric illness.

Psychosocial Determinants of Marital Satisfaction Among Gynecologic Cancer Survivors in Malaysia.

Marital issues among gynecologic cancer survivors are common but complex. This study aimed to investigate the relationship between sociodemographic and clinical factors, including sexual dysfunction and marital satisfaction among Malaysian gynecologic cancer survivors. A cross-sectional survey of married women with gynecologic cancers was conducted at a Malaysian university hospital.

Implementation of brief dialectical behavior therapy skills training among borderline personality disorder patients in Malaysia: feasibility, acceptability, and preliminary outcomes.

Aim/background: Even though dialectical behavior therapy (DBT) has received substantial empirical support in treating patients with borderline personality disorder (BPD), fewer studies have evaluated whether a brief DBT skills group may be effective in improving clinical outcomes in this population. Further, less is known regarding the feasibility and outcomes of DBT beyond Euro-American contexts. This paper describes outcomes from a pilot study examining the feasibility, acceptability, and clinical outcomes following completion of a shortened, 14-week DBT skills group in a sample of Muslim-majority BPD patients in Malaysia.

Depression, anxiety, and the COVID-19 pandemic: Severity of symptoms and associated factors among university students after the end of the movement lockdown.

Background And Aims: This online cross-sectional study investigated the severity of depressive, anxiety, and stress symptoms among university students and determined the association between various factors and the levels of depressive and anxiety symptoms in response to the coronavirus disease 2019 (COVID-19) pandemic after the movement control order (MCO) was lifted.

Methods: A total of 316 participants were administered a self-report questionnaire that collected data on sociodemographic attributes, personal characteristics, COVID-19-related stressors, religious coping, and clinical characteristics. In addition, the Multidimensional Scale of Perceived Social Support (MSPSS) and the 21-item Depression, Anxiety and Stress Scale (DASS-21) were administered.

Quality of Life and Its Predictive Factors Among Healthcare Workers After the End of a Movement Lockdown: The Salient Roles of COVID-19 Stressors, Psychological Experience, and Social Support.

Although healthcare workers play a crucial role in helping curb the hazardous health impact of coronavirus disease 2019 (COVID-19), their lives and major functioning have been greatly affected by the pandemic. This study examined the effects of the COVID-19 pandemic on the quality of life (QoL) of Malaysian healthcare workers and its predictive factors. An online sample of 389 university-based healthcare workers completed questionnaires on demographics, clinical features, COVID-19-related stressors, psychological experiences, and perceived social support after the movement lockdown was lifted.

A case series of super-refractory status epilepticus successfully treated with electroconvulsive therapy.

Super-refractory status epilepticus (SRSE) is a neurocritical emergency, associated with significant morbidity and mortality. The precise pathophysiology is still not completely understood. The likelihood of spontaneous seizure termination reduces with time, and it is of paramount importance to abort status in order to prevent permanent long-term neurological sequelae and death.

Mental Health Status of University Healthcare Workers during the COVID-19 Pandemic: A Post-Movement Lockdown Assessment.

This study investigated the prevalence and severity of depression, anxiety, and stress and determined the association between various factors, social support, and depression, anxiety, and stress among university healthcare workers in Malaysia after the government lifted the movement control order (MCO) put in place to curb the coronavirus disease 2019 (COVID-19) pandemic. This online, cross-sectional survey recruited 399 participants from two university hospitals, and they were administered a self-reported questionnaire on demographic, personal, and clinical characteristics, as well as COVID-19-related stressors and coping. In addition, they completed the Multidimensional Scale of Perceived Social Support (MSPSS) to measure perceived social support, as well as the 21-item Depression, Anxiety, and Stress Scale (DASS-21) to assess depression, anxiety, and stress.

Burnout, Mental Health, and Quality of Life Among Employees of a Malaysian Hospital: A Cross-sectional Study.

Burnout and mental health issues are common among healthcare workers. Burnout and mental ill-health may also adversely affect quality of life (QOL). This study aimed to determine the prevalence of burnout, mental ill-health, and QOL among employees of Hospital Bentong in Pahang state, Malaysia.

How Much Do We Know about the Biopsychosocial Predictors of Glycaemic Control? Age and Clinical Factors Predict Glycaemic Control, but Psychological Factors Do Not.

Objective: Diabetes mellitus is one of the most common noncommunicable diseases in Malaysia. It is associated with significant complications and a high cost of treatment, especially when glycaemic control is poor. Despite its negative impact on health, data is still lacking on the possible biopsychosocial predictors of poor glycaemic control among the diabetic population.

Depression, anxiety, and associated factors in patients with diabetes: evidence from the anxiety, depression, and personality traits in diabetes mellitus (ADAPT-DM) study.

Background: Depression and anxiety are common psychiatric complications affecting patients with diabetes mellitus. However, data on the prevalence of depression, anxiety, and associated factors among Malaysian diabetic patients is scarce. The Anxiety, Depression, and Personality Traits in Diabetes Mellitus (ADAPT-DM) study aimed to determine the prevalence of depression and anxiety, and their associated factors in the Malaysian diabetic population.