Publications by authors named "Musa Ramli"

19 Publications

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Prevention and control of COVID-19 in pastoral community through One Health Approach.

One Health 2020 Dec 13;11:100181. Epub 2020 Oct 13.

Department of Professional Nursing Studies, Kulliyah of Nursing, IIUM, Malaysia.

The vast majority of its population being a pastoralist community, the Somali region in Ethiopia shares the longest border with its neighboring east African countries. These communities face a high risk for transmission of imported COVID-19 cases and remain vulnerable due to lack of access to health delivery and low utilisation of services. Valuable lessons from other countries, has placed the One Health Approach as an appropriate, feasible and applicable preventive and control measure for COVID-19. This paper discusses the epidemiological and social susceptibility of pastoral communities in the transmission of COVID-19 and the introduction of One Health Approach as an effective inter-disciplinary response and management.
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http://dx.doi.org/10.1016/j.onehlt.2020.100181DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7552999PMC
December 2020

Cross-cultural translation and validation of the Malay version of the Swanson, Nolan, and Pelham Parent Rating Scale of attention deficit hyperactivity disorders symptoms among Malaysian probands: A preliminary study.

Asia Pac Psychiatry 2020 Aug 19:e12414. Epub 2020 Aug 19.

Department of Optometry & Visual Science, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia (IIUM), Kuantan Campus, Kuantan, Malaysia.

The aim of this study is to evaluate the psychometric properties of the Malay version of the Swanson, Nolan, and Pelham Parent Rating Scale of attention deficit hyperactivity disorders (ADHD) symptoms (M-SNAP-IV). For this purpose, the SNAP-IV scale was translated into the Malay language and was pilot-tested on 91 parents of children aged 8 to 11 years (ADHD [n = 36] and non-ADHD children [n = 55]). The findings depicted that the M-SNAP-IV has excellent content validity, internal consistency, and test-retest reliability. The M-SNAP-IV is a valid and reliable screening tool to detect ADHD symptoms in children and has the advantages to assess the specific presentation of ADHD.
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http://dx.doi.org/10.1111/appy.12414DOI Listing
August 2020

Anxiety and Depression Among Women Living with HIV: Prevalence and Correlations.

Clin Pract Epidemiol Ment Health 2020 21;16:59-66. Epub 2020 Jul 21.

Department of Professional Nursing Studies, Kulliyah of Nursing, IIUM, Kuantan, Malaysia.

Introduction: It has been found that HIV positive women are becoming increasingly affected by various illnesses, including Common Mental Disorders (CMDs) such as depression. Such comorbidity escalates the disease progression to the severe stage and commonly hinders treatment adherence. This study determined the prevalence of anxiety and depression amidst women living with HIV.

Methods: Based on a cross-sectional and facility-based study, 357 HIV positive women were recruited using the systematic sampling technique from two public hospitals in Jijiga town, Ethiopia. The Hospital Anxiety and Depression Scale (HADS) was administered for screening, and followed by a pre-tested questionnaire that comprised of Perceived Social Support and HIV stigma.

Results: The results revealed that the prevalence of both anxiety and depression amidst HIV positive women was 28.9% and 32.5%, respectively. In the multivariate analysis, it was discovered that lack of formal education, being divorced, unemployed, and earning a monthly income less than 1400 ETB (37.5 USD) were significantly associated with depression. Women with symptomatic HIV clinical stage III (AOR =2.06, 95% C.I (0.75-5.61), with CD4 cell count below 250 (AOR = 1.14, 95% C.I (0.57-2.28), and with co-infections (AOR= 1.04, 95% C.I (0.40-2.71) also suffered from depression.

Conclusion: The study outcomes show that the prevalence of depression in women with HIV was 32.5%, but they were more likely to be depressed if they were illiterate, divorced, unemployed or had a financial burden. In addition, HIV positive women with less CD4 cell count and in the final clinical stage or suffered from a co-infection were also associated with depressive symptoms. This signifies the public health implications of psychological and cognitive morbidities of the illness among these women with chronic illnesses. Hence, future mental health interventions and HIV care should be integrated with substantial emphasis given to vulnerable groups, including HIV positive women.
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http://dx.doi.org/10.2174/1745017902016010059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7372730PMC
July 2020

Depression and HIV Disease Progression: A Mini-Review.

Clin Pract Epidemiol Ment Health 2019 31;15:153-159. Epub 2019 Dec 31.

Department Basic Medical Sciences, Kulliyah of Nursing, IIUM, Malaysia.

Background: Depression is the most common mental disorder and a leading cause of disability, which commonly presents unexplained psychological and physical symptoms. Depression and HIV/AIDS are commonly comorbid. This review provides an insight into the effect of depression on disease progression among people living with HIV.

Methods: A search for relevant articles was conducted using a database like MEDLINE, Scopus, PsycINFO and CINAHL. Peer-reviewed English journals published between 2015 and 2019 were included in the review.

Results: A total of eight studies conducted in different settings were included in the review. This review has found that psychosocial, neurohormonal and virologic factors associated with depression affect HIV disease progression. Yet, the chronicity of depression, absence of the hormones that have a buffer effect on depression and lack of examination if depression is a predictor, or an outcome of disease progression, were some of the gaps that require further investigation.

Conclusion: Considerably, more research is needed to better understand the effect of mental disorder, especially depression, on HIV disease progression to AIDS and future interventions should, therefore, concentrate on the integration of mental health screening in HIV clinical setup.
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http://dx.doi.org/10.2174/1745017901915010153DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7040472PMC
December 2019

Editorial.

Curr Drug Targets 2019 ;20(2):145

Department of Psychiatry International Islamic University Kuantan, Pahang, Malaysia.

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http://dx.doi.org/10.2174/138945012002181203145147DOI Listing
March 2020

The Therapeutic and Psychosocial Interaction in Enhancing Drug Targets.

Curr Drug Targets 2018 ;19(12):1351

Faculty of Medicine, University of Malaya 50603 Kuala Lumpur, Malaysia.

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http://dx.doi.org/10.2174/138945011912180723102630DOI Listing
December 2019

Editorial: Advances in Psychopharmacological Treatment.

Curr Drug Targets 2018 ;19(8):855

Department of Psychiatry, International Islamic University, Kuantan, Pahang, Malaysia.

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http://dx.doi.org/10.2174/138945011908180518113546DOI Listing
October 2019

DASS21: A Useful Tool in the Psychological Profile Evaluation of Dialysis Patients.

Am J Med Sci 2018 04 1;355(4):322-330. Epub 2017 Dec 1.

Biostatistics Department, Clinical Research Centre, Kuala Lumpur, Malaysia.

Background: The effect of dialysis treatment is complex, with both clinical and socio-psychological effects. In this study, we aimed to assess the psychological status of this growing population of end-stage renal disease.

Methods: Using the Short Form of Depression, Anxiety and Stress Scale (DASS21) questionnaire, we aimed (1) to measure the psychological states of hemodialysis (HD) or peritoneal dialysis (PD) subjects from 15 sites, (2) to compare DASS21 scores between HD and PD, and (3) to identify the associated demographic and medical factors of better psychological states.

Results: A total of 1,332 were eligible for analysis. Stress (48%) recorded the highest negative emotional states, followed by depression (37%) and anxiety (20%). By multivariate analysis, normal body mass index weight status, religion and absence of coronary artery disease were associated with lower score for depression, anxiety and stress, respectively. Tertiary education was associated with the lowest score in depression and anxiety, whereas HD had a lower score in stress than PD. A younger age was associated with worse DASS21 score of anxiety and stress.

Conclusions: Obesity, religion and coronary artery disease were significantly associated with all 3 symptoms of depression, anxiety and stress. Older age has a protective effect on anxiety and stress. Further study is needed to evaluate the relationship between these significant factors and each psychological state.
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http://dx.doi.org/10.1016/j.amjms.2017.11.015DOI Listing
April 2018

Relationship between levels of thyroid stimulating hormone, age, and gender, with symptoms of depression among patients with thyroid disorders as measured by the Depression Anxiety Stress Scale 21 (DASS-21).

Enferm Clin 2018 Feb;28 Suppl 1:180-183

Kulliyyah of Medicine, International Islamic University Malaysia. Kuantan Campus, Pahang, Malaysia.

Objective: The aim of this study was to investigate the correlation between levels of depression symptoms and age, thyroid-stimulating hormone levels, and stressful life events of the participants.

Method: Patients above 18 years old, with any thyroid disorders, and without psychiatric disorders were included in this study. All participants completed the Depression Anxiety Stress Scale 21 (DASS-21). The depression symptom score was calculated and interpreted as follows: less than 9: no depression; between 10 and 13: mild depression; between 14 and 20: moderate depression; between 21 and 27: severe depression, and more than 28: extremely severe depression.

Results: The total number of participants in this study was 199. There was no correlation between age, thyroid stimulating hormone, and the DASS score. There was also no significant difference in the DASS-21 score between genders. However, there was a positive correlation between depression symptoms and stressful life events (r=0.201, n=199, p < 0.05).

Conclusions: These findings would suggest that increased depression symptom scores correlate with increased stressful life events. A larger study should be undertaken to confirm these findings.
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http://dx.doi.org/10.1016/S1130-8621(18)30063-9DOI Listing
February 2018

Construct and criterion validity of the Malaysia version of Lower Extremity Functional Scale (LEFS).

Asia Pac J Sports Med Arthrosc Rehabil Technol 2017 Oct 4;10:8-11. Epub 2017 Oct 4.

Department of Orthopedic & Rehabilitation, Kulliyyah of Medicine, International Islamic University Malaysia, Jalan Hospital, 25150 Kuantan, Pahang, Malaysia.

Objective: The objective of this study is to translate the Lower Extremity Functional Scale (LEFS) into the Malay language and to validate the resulting version.

Methods: A two-stage observational study was conducted. The LEFS was initially cross-culturally adapted to Malay language through double forward and backward translation. The finalized version of Malay LEFS (M-LEFS) was subsequently validated for both construct validity and criterion validity. Participants (n = 208) with normal lower limb condition and various lower limb conditions completed the M-LEFS.

Results: Reliability of M-LEFS revealed excellent Cronbach's alpha value of 0.98. Construct validity, evaluated using exploratory factor analysis, exhibited good factor loadings (>0.6) of all 20 items. Interestingly, we extracted 2 components which was not reported elsewhere. With a cut-off point of 60, the sensitivity of the scale was 99% and the specificity was 81%.

Conclusions: The M-LEFS had very good psychometric properties among the studied population. Further studies are needed to enhance these preliminary outcomes in Malaysia.
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http://dx.doi.org/10.1016/j.asmart.2017.09.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5780294PMC
October 2017

Depression, anxiety and stress among patients with dialysis and the association with quality of life.

Asian J Psychiatr 2015 Dec 22;18:49-52. Epub 2015 Oct 22.

Ampang Puteri Hospital, Kuala Lumpur, Malaysia.

Studies addressing the nature of relationship between psychological symptoms and quality of life among dialysis patients in Malaysia are scarce. Hence, this study is intended to investigate the association between psychological symptoms such as depression, anxiety and stress on the quality of life in dialysis patients. A cross sectional multicentre study was conducted from May to October 2012 at 15 centres that provide haemodialysis and/or peritoneal dialysis. Apart from socio-demographic profile data collection, WHOQOL-BREF and DASS21 questionnaires were administered to study subjects. All three psychological symptoms had significant impact on quality of life domains of physical health, psychological health, social impact, perceived environment and overall quality of life. These findings suggest that subjects with symptoms of depression, anxiety and stress had poorer quality of life than those without, highlighting the negative impact of psychological symptoms.
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http://dx.doi.org/10.1016/j.ajp.2015.10.004DOI Listing
December 2015

Disrupted-in-Schizophrenia-1 SNPs and Susceptibility to Schizophrenia: Evidence from Malaysia.

Psychiatry Investig 2015 Jan 12;12(1):103-11. Epub 2015 Jan 12.

Faculty of Medicine, University of Sultan Zainal Abidin, Terengganu, Malaysia.

Objective: Even though the role of the DICS1 gene as a risk factor for schizophrenia is still unclear, there is substantial evidence from functional and cell biology studies that supports the connection of the gene with schizophrenia. The studies associating the DISC1 gene with schizophrenia in Asian populations are limited to East-Asian populations. Our study examined several DISC1 markers of schizophrenia that were identified in the Caucasian and East-Asian populations in Malaysia and assessed the role of rs2509382, which is located at 11q14.3, the mutual translocation region of the famous DISC1 translocation [t (1; 11) (p42.1; q14.3)].

Methods: We genotyped eleven single-neucleotide polymorphism (SNPs) within or related to DISC1 (rs821597, rs821616, rs4658971, rs1538979, rs843979, rs2812385, rs1407599, rs4658890, and rs2509382) using the PCR-RFLP methods.

Results: In all, there were 575 participants (225 schizophrenic patients and 350 healthy controls) of either Malay or Chinese ethnicity. The case-control analyses found two SNPs that were associated with schizophrenia [rs4658971 (p=0.030; OR=1.43 (1.35-1.99) and rs1538979-(p=0.036; OR=1.35 (1.02-1.80)] and rs2509382-susceptibility among the males schizophrenics [p=0.0082; OR=2.16 (1.22-3.81)]. This is similar to the meta-analysis findings for the Caucasian populations.

Conclusion: The study supports the notion that the DISC1 gene is a marker of schizophrenia susceptibility and that rs2509382 in the mutual DISC1 translocation region is a susceptibility marker for schizophrenia among males in Malaysia. However, the finding of the study is limited due to possible genetic stratification and the small sample size.
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http://dx.doi.org/10.4306/pi.2015.12.1.103DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310907PMC
January 2015

Quality of life in dialysis: A Malaysian perspective.

Hemodial Int 2014 Apr 8;18(2):495-506. Epub 2013 Nov 8.

Biostatistics Department, Clinical Research Centre, Kuala Lumpur, Malaysia.

There is a growing interest to use quality of life as one of the dialysis outcome measurement. Based on the Malaysian National Renal Registry data on 15 participating sites, 1569 adult subjects who were alive at December 31, 2012, aged 18 years old and above were screened. Demographic and medical data of 1332 eligible subjects were collected during the administration of the short form of World Health Organization Quality of Life questionnaire (WHOQOL-BREF) in Malay, English, and Chinese language, respectively. The primary objective is to evaluate the quality of life among dialysis patients using WHOQOL-BREF. The secondary objective is to examine significant factors that affect quality of life score. Mean (SD) transformed quality of life scores were 56.2 (15.8), 59.8 (16.8), 58.2 (18.5), 59.5 (14.6), 61.0 (18.5) for (1) physical, (2) psychological, (3) social relations, (4) environment domains, and (5) combined overall quality of life and general health, respectively. Peritoneal dialysis group scored significantly higher than hemodialysis group in the mean combined overall quality of life and general health score (63.0 vs. 60.0, P < 0.001). Independent factors that were associated significantly with quality of life score in different domains include gender, body mass index, religion, education, marital status, occupation, income, mode of dialysis, hemoglobin, diabetes mellitus, coronary heart disease, cerebral vascular accident and leg amputation. Subjects on peritoneal dialysis modality achieved higher combined overall quality of life and general health score than those on hemodialysis. Religion and cerebral vascular accident were significantly associated with all domains and combined overall quality of life and general health.
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http://dx.doi.org/10.1111/hdi.12108DOI Listing
April 2014

Knowledge and attitude on sex among medical students of a Malaysian university: a comparison study.

Asia Pac Psychiatry 2013 Apr;5 Suppl 1:103-9

Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

Introduction: The objective of this study was to determine the relationship between clinical/socio-demographic factors with knowledge and attitude on sex among medical students of the National University of Malaysia (UKM).

Methods: A cross-sectional study assessing 452 students using a self-administered questionnaire of knowledge and attitude was performed and had a response rate of 80%.

Results: The majority of respondents were Malays (56%), females (57.5%), lived in urban areas (66.4%), had a median family income of RM3000 and perceived themselves as moderately religious (60%). The overall score on knowledge about sex was 21.7 of 35 (a higher score indicates better knowledge about sex). It was noted that 73.2% of students felt that they did not receive adequate training in medical school to deal with patients' sexuality and sexual problems, while 51.5% felt uncomfortable talking to patients about these issues. Students in the clinical year were more knowledgeable than those in pre-clinical years (22.67 versus 20.71, P < 0.001). No significant differences were found in terms of their backgrounds, such as being from urban or rural areas (P = 0.349) and between genders (P = 0.286). Only 54.9% of students had a satisfactory level of knowledge on sex (>22 marks [median score]).

Discussion: The students' attitude on sex was considered conservative as the majority of them disagreed on premarital sex, masturbation, abortion, homosexuality and oral sex. Gender and religiosity have a large influence on attitudes on controversial sexual issues, whereas clinical status plays a small role. Knowledge on sex among UKM medical students is inadequate and their attitudes on sex are considered conservative. Integration of sexual medicine and health modules in the medical curriculum is crucial for students to more effectively address patients' sexual problems and promote non-judgmental attitudes towards patients.
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http://dx.doi.org/10.1111/appy.12053DOI Listing
April 2013

Relationship of psychological symptoms, antipsychotics and social data with psychosocial function in schizophrenia patients in Malaysia.

Asia Pac Psychiatry 2015 Mar 21;7(1):45-53. Epub 2013 May 21.

Department of Basic Medical Sciences, Faculty of Medicine, International Islamic University Malaysia, Kuantan, Malaysia.

Introduction: The present study investigated the relationship between psychological symptoms and psychosocial function and the role of relevant sociodemographic data and antipsychotic use in the prediction of psychosocial function among multiracial schizophrenia outpatients in Malaysia.

Methods: A total of 223 participants were recruited in this cross-sectional study conducted from December 2010 to April 2011. Psychological symptoms were assessed using the Positive and Negative Syndrome Scale whilst the psychosocial function was assessed using the Personal and Social Performance scale. Sociodemographic and treatment variables were gathered through interview or review of the medical records.

Results: All dimensions of psychosocial functions were inversely correlated with Positive and Negative Syndrome Scale sub-domains. Only the disorganization sub-domain significantly predicts all dimensions of psychosocial function. For social data, body mass index and employment status were significant predictors of all dimensions of psychosocial functions. Typical antipsychotics significantly predict social function negatively as compared to sulpiride (β = -0.152, P = 0.028).

Discussion: We found that the relationship between psychological symptoms and psychosocial functions were relatively consistent with the findings from the Caucasian population. Additionally, disorganization was the only significant predictor of all dimensions of psychosocial functions. This further emphasized the importance of cognition in psychosocial function. The roles of sulpiride, body mass index and employment status as predictors of psychosocial function were also discussed.
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http://dx.doi.org/10.1111/appy.12089DOI Listing
March 2015

A preliminary study of the psychological differences in infertile couples and their relation to the coping styles.

Compr Psychiatry 2014 Jan 19;55 Suppl 1:S65-9. Epub 2013 Feb 19.

Department of Psychiatry, Kulliyyah of Medicine, International Islamic University Malaysia, Bandar Indera Mahkota, 25200 Kuantan, Pahang Malaysia. Electronic address:

Background: Studies from Western countries have observed that couples undergoing infertility treatment suffer various physical and psychological difficulties at a higher frequency than the comparable general population. These relate to treatment challenges and other psychosocial stressors, often influenced by coping style, personality factors and available support systems. There is paucity of studies in non-Western populations.

Objective: The aim of this pilot investigation was to evaluate characteristics and gender differences in perceived psychological difficulties reported by infertile Malaysian couples. In particular, depression, anxiety and stress, along with correlated coping styles, were examined between spouses.

Methods: Demographic information, including age, ethnicity and duration and causes of infertility, were collected from participants treated within a fertility clinic. The Depression, Anxiety and Stress Scale (DASS) and Coping Inventory for Stressful Situation (CISS) were completed to measure psychological distress and coping styles.

Results: Depression, anxiety and stress-related difficulties were reported at significantly higher frequency by wives than husbands (p<0.05). There were no significant differences in coping styles between wives and husbands. However, emotional-oriented coping style was associated with significantly higher levels of depression, anxiety and stress (p<0.05) within the overall sample with odds ratios of 2.5, 3.0 and 1.5, respectively.

Conclusion: The study confirms that, as with Western subjects, Malaysian infertile couples demonstrate the vulnerability to psychological distress that occurs more frequently among wives than husbands. As anticipated, emotional coping style was associated with greater distress in both genders.
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http://dx.doi.org/10.1016/j.comppsych.2013.01.001DOI Listing
January 2014

Post tsunami psychological impact among survivors in Aceh and West Sumatra, Indonesia.

Compr Psychiatry 2014 Jan 12;55 Suppl 1:S13-6. Epub 2013 Jan 12.

Kulliyah of Medicine, International Islamic University of Malaysia, Kuantan, Pahang, Malaysia.

Objective: In 2004, the province of Aceh, Indonesia was rocked by tsunami and in September 2009, West Sumatra, Indonesia was hit by an earthquake. The aim of this study was to determine the long-term psychological impact on the residents inhabiting these regions and to identify factors associated with it.

Methods: A cross-sectional study was conducted among the residents. The Depression, Anxiety and Stress Scale (DASS) was used to measure their psychological well-being.

Results: Out of 200 respondents, 1 in 5 (19%) was found to suffer from a high level of depression, 1 in 2 (51%) had anxiety and 1 in 5 (22%) experienced stress. Factors found to be significantly associated with depression, anxiety and stress were female, young age, unemployed, and single (p<0.05).

Conclusion: The psychological impact following the tsunami persisted in the population after many years post-disaster. It is recommended that the psychological profile of the population be evaluated for the vulnerable group following any natural disaster.
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http://dx.doi.org/10.1016/j.comppsych.2012.12.002DOI Listing
January 2014

Two-year outcomes of methadone maintenance therapy at a clinic in Malaysia.

Asia Pac J Public Health 2012 Sep 13;24(5):826-32. Epub 2011 Apr 13.

Department of Psychiatry, Kulliyyah of Medicine, International Islamic University Malaysia, Bandar Indera Mahkota, Kuantan, Pahang, Malaysia

Background: The commencement of methadone maintenance therapy (MMT) in 2005 represents a quantum leap in the management of heroin dependence in Malaysia.

Objective: To examine the 2-year outcomes of this modality in the treatment of heroin dependence with respect to the quality of life (QOL), heroin abstinence, and rate of employment among heroin dependants attending the Tengku Ampuan Afzan Hospital (HTAA) MMT clinic.

Method: This was an experimental study in which the second QOL assessment was conducted 2 years after treatment initiation.

Results: A total of 172 patients enrolled at the point of entry to the MMT program. The authors examined 107 patients who remained in the program 2 years later (62.6% retention rate). A paired t test demonstrated significant improvements in all 4 domains of QOL (physical, psychological, social relationships, and environment; P < .001). The most marked improvement was noted in the psychological domain.

Conclusion: The MMT program at HTAA is effective in improving the QOL among heroin dependants.
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http://dx.doi.org/10.1177/1010539511404396DOI Listing
September 2012

Dissociative episode secondary to hypoglycemic state in anorexia nervosa: a case report.

Int J Eat Disord 2009 Apr;42(3):290-2

Department of Psychiatry, Kulliyyah of Medicine, International Islamic University, Bandar Indera Mahkota, 25200, Kuantan, Pahang Malaysia.

Objective: Hypoglycemic attack had been reported as one of the medical complications in anorexia nervosa.

Method: We present a 25-year-old man who was diagnosed earlier with anorexia nervosa, presented with an episode of dissociative state during which he was caught for shoplifting.

Results: In the history, he had a few episodes of fainting spells, which are most possibly due to hypoglycemia. There was no evidence to suggest any misdeeds to support that the stealing was intentional.

Discussion: Hypoglycemic attack may be common in anorexia nervosa, but this is a rare case with medico-legal implication.
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http://dx.doi.org/10.1002/eat.20596DOI Listing
April 2009