Version Of General Health Questionnaire Research Articles

Association between Physical Activity, General Health and Burden of Dementia Caregivers

Most caregivers do not engage in physical activity programs despite evidence that physical exercise improves general health and relieves symptoms of depression, anxiety and stress. The aim of the study is a) to investigate the amount of physical activity of caregivers in everyday life, b) to examine the reasons of limited participation in physical activities and c) to find out if limited participation in physical activity affects their general health. Fifty three (n=53) caregivers (59.04±12.76 yrs) were recruited by a Dementia Day Care Center. A caregiver questionnaire was designed to obtain information on basic demographics, living habits and current care details (hours of care, etc). The Greek version of PASE questionnaire was used to measure the amount of physical activity undertaken by caregivers. Caregiver burden was assessed via the Greek version of the validated Zarit burden interview and general health was investigated via the Greek version of General Health Questionnaire (GHQ-28). All data were analyzed by using SPSS, version 22. The majority of caregivers are daughters or wives. The current sample had a PASE mean score of 168.0±87.46. Differences in PASE score were found between occupational status (F=6.210, p=0.001) and living arrangements (F=3.882, p=0.05). No differences were found in PASE score between different levels of burden (F=1.058, p=0.376). PASE score was not related to GHQ28 scores. High correlations were found between ZBI and GHQ28 total (r=0.71, p=0.001) and ZBI and GHQ28 four subscales (somatic: r=0.62, p=0.001, anxiety-insomnia: r=0.66, p=0.001, social dysfunction: r=0.54, p=0.002, severe depression: r=0.44, p=0.003). ZBI was also correlated with years of care (r=0.38, p=0.004) and hours of care/day (r=0.40, p=0.003). The most frequent barriers to physical activity cited by caregivers were their living arrangements and their occupational status. In addition, burden was not cited as a significant barrier.

The predictive value of personality traits for psychological problems (stress, anxiety and depression): Results from a large population based study

The current study aimed to determine the prognostic values of personality traits for common psychological problems in a large sample of Iranian adult.In a large sample of healthy people (n = 4763) who lived in Isfahan province; the NEO-FFI was used to assess the personality traits; depression and anxiety were assessed using the “Hospital Anxiety and Depression Scale (HADS)” also stress was measured through Persian validated version of General Health Questionnaire (GHQ-12). Receiver Operating Characteristics Curve (ROC) analysis was used as main statistical method for data analysis.ROC analysis showed neuroticism was the best predictor for all psychological problems with highest area under the curve (AUC) (95% confidence interval) for stress, 0.837 (0.837–0.851), anxiety 0.861 (0.847–0.876) and depression 0.833 (0.820–0.846) (p < .001) and the corresponding cut-off points (sensitivity, specificity), were 21.5 (77%, 66%), 22.5 (81%, 77%) and 20.5 (77%, 74%), respectively .Other personality traits were significant protective factors for being affected with psychological problems (p < .001). Similar findings were observed separately in women and men.The present study showed that the neuroticism is significant risk factor for being affected with three psychological problems while other traits are significant protective factors. Personality traits are useful indices for screening psychological problems and an effective pathway toward prevention in general population.

Sustained Benefit of a Psycho-educational Training Program for Dementia Caregivers in Taiwan

Summary Background Informal caregivers for dementia are vulnerable to psychological distress. Researches have shown the inconsistent results in the efficacy of various psychosocial interventions for burden of informal caregivers for patients with dementia. The aim of this study was to provide further understanding for the relative efficacy of psychosocial interventions in lessening the burden of caregivers. Methods This research was a prospective, longitudinal, one-group pretest–posttest design to measure the effectiveness of 32-h psycho-educational training program for family caregivers in Taiwan. The Chinese version Zarit Burden Interview (ZBI), the 12-item version of General Health Questionnaire (GHQ-12), and Medical Outcome Study 36-item Short-Form Health Survey (SF-36) were assessed at pre-intervention, 3-month post-intervention, 6-month post-intervention, and 9-month post-intervention. Pre–post comparisons were made using general estimate equations (GEE) to confirm the longitudinal effects of the intervention for caregivers. Results A total of 53 caregiver–patient dyads met the study criteria, of whom 34 (64.2%) dyads completed total assessments. There were significant improvements of the overall effects on ZBI (p Conclusion The caregivers for dementia patients may have sustained benefit of reducing burden, decreasing psychological morbidity and enhancing psychological wellbeing after the intensive psycho-educational training programs' intervention.

The Effect of Early Skin-to-skin Contact on the Mental Health of Mothers in Traumatic Childbirths

Background: Providing and sustaining the mental health of mothers who have experienced a traumatic childbirth have significant impact on the health of the mother, family and society. This study aimed to evaluate the effect of early skin-to-skin contact in the first hour of birth on the mental health of mothers with traumatic childbirth. Methods: This randomized clinical trial was conducted in 2015 on 82 mothers who, based on Diagnostic and Statistical Manual of Mental Disorders (DSM-V-TR) criteria, had experienced a traumatic childbirth. After randomly assigning mothers into groups, the intervention group received early skin-to-skin contact in the first hour after birth, and the control group received the routine procedures. The mental health as an outcome of this study was evaluated using the Persian version of General Health Questionnaire (GHQ-28). Results: The results showed that the mean score of mental health of mothers in the intervention and control groups was significantly different (P < 0.001) and with the passage of time, the mental health status in the intervention group appeared better than that of the control group (P < 0.001). Conclusions: Early skin contact in the first hour of birth not only in normal deliveries but also in traumatic births can have an important and effective role in improving the mental health of the mother

Children with neurodevelopmental disorders: The burden and psychological effects on caregivers in Lagos, Nigeria

Background: Children with neurodevelopmental disorders (CNDs) are a group requiring more attention as their care is often challenging, particularly for parents with primary caregiving roles in resource-restricted settings. This study had set out to investigate the burden and psychological distress among caregivers of children with neurodevelopmental delays. Materials and Methods: A total of 68 caregivers were recruited during the 2013 annual autism health program organized by the College of Medicine, University of Lagos in collaboration with Guaranty Trust Bank, Nigeria and Blazing Trails, USA. Of these caregivers, 60 respondents (caregivers and children) were included in the final analyses due to poorly completed questionnaires. The Zarit Caregivers Burden Scale (ZCBS) and General Health Questionnaire version 12 (GHQ-12) were administered to elicit caregivers' experience with respect to burden and psychological distress, respectively. Results: Of the 60 participants included in the final analyses, the majority constituted parents (96.3%) with mothers accounting for 71.7%; 28 (46.7%) participants were government workers and 3 (5%) were full-time housewives. The mean age of CNDs was 6.8 (±3.2) years, and 33 (55.0%) were males. Delivery by cesarian section was reported in 19 (31.8%). The common presenting complaints by caregivers were inability to walk (32.7%), repetitive behavior (25.5%), difficulty with verbal communication (10.9%), nonsocialization (9.1%), seizures (9.1%), and hyperactivity (3.6%). Problems were noticed at ≤ 1 year in 46.7% while they were noticed after 2 years in more than half the children, and a little above one-eighth (14%) had siblings with similar problems. On the ZCBS, nine (15.0%) caregivers reported a significant burden. In addition, 23 (38.3%) caregivers had psychological distress. Caregivers' burden was significantly related to the report of psychological distress in caregivers (P < 0.001) and there was a trend toward the presence of psychological distress in almost all caregivers with children experiencing seizures. Conclusions: The findings in this study underscore the need for counseling and psychosocial support for caregivers of CNDs. Further research on the emotional experience of caregivers is also warranted.

AIDS-related stigma and mental disorders among people living with HIV: a cross-sectional study in Cambodia.

BackgroundAIDS-related stigma and mental disorders are the most common conditions in people living with HIV (PLHIV). We therefore conducted this study to examine the association of AIDS-related stigma and discrimination with mental disorders among PLHIV in Cambodia.MethodsA two-stage cluster sampling method was used to select 1,003 adult PLHIV from six provinces. The People Living with HIV Stigma Index was used to measure stigma and discrimination, and a short version of general health questionnaire (GHQ-12) was used to measure mental disorders. Multivariate logistic regression analysis was conducted.ResultsThe reported experiences of discrimination in communities in the past 12 months ranged from 0.8% for reports of being denied health services to 42.3% for being aware of being gossiped about. Internal stigma was also common ranging from 2.8% for avoiding going to a local clinic and/or hospital to 59.6% for deciding not to have (more) children. The proportions of PLHIV who reported fear of stigma and discrimination ranged from 13.9% for fear of being physically assaulted to 34.5% for fear of being gossiped about. The mean score of GHQ-12 was 3.2 (SD = 2.4). After controlling for several potential confounders, higher levels of mental disorders (GHQ-12≥ 4) remained significantly associated with higher levels of experiences of stigma and discrimination in family and communities (AOR = 1.9, 95% CI = 1.4–2.6), higher levels of internal stigma (AOR = 1.7, 95% CI = 1.2–2.3), and higher levels of fear of stigma and discrimination in family and communities (AOR = 1.5, 95% CI = 1.1–2.2).ConclusionsAIDS-related stigma and discrimination among PLHIV in Cambodia are common and may have potential impacts on their mental health conditions. These findings indicate a need for community-based interventions to reduce stigma and discrimination in the general public and to help PLHIV to cope with this situation.

Psychosocial Factors Associated with Erectile Dysfunction in the Niger Delta Region of Nigeria

Introduction: Erectile dysfunction (ED) is a major psychosocial problem resulting in profound distress in men. Objectives: The objectives of this study were to determine the prevalence as well as psychosocial factors associated with erectile dysfunction in the Niger Delta Region of Nigeria. Method: A cross-sectional study involving 400 respondents attending the general outpatient clinic of University Of Uyo Teaching Hospital (UUTH) between January and March 2009 were randomly assessed for ED as well as psychosocial factors associated with it, using abridged version of international index of erectile function (IIEF-5) and the twelve-item version of general health questionnaire (GHQ-12). Results: The prevalence of erectile dysfunction in this study was 41.5%, the prevalence was higher among respondents aged 50 and 70 years of age (38.3%). Respondents who reside in the rural areas had higher prevalence of ED (22.0%) compared to those in the urban areas (19.5%). Respondents with ED scored high on GHQ-12 indicating significant psychopathology. Thirty seven (9.2%) respondents believed ED can be caused by stress, excessive thinking or hard work; 7.3% believed that ED can be caused by demonic attack, stepping on charms or sexual infidelity; 12.2% believed that ED can result from such medical conditions as hypertension, diabetes mellitus; 19.5% thought that ED can be treated with orthodox medicine while 22.0% believed that ED can be treated using a combination of orthodox and spiritual care; 15.0% respondents believed that ED can result in reduced work ability, income, social life and sex; while 12.5% respondents believed that ED can result in permanent incapacitation for the sufferer. Conclusion: Findings from this study show that ED affects men both physically and psychosocially.Health care providers must realize and be sensitive to the fact that sexuality is an essential part of our lives.

Factorial Validity and Reliability of the Tamil Version of Multidimensional Scale of Perceived Social Support Among a Group of Participants in University Malaya Medical Centre, Malaysia

Background and Objectives:This study was done to validate the Tamil version of Multidimensional Scale of Perceived Social Support (MSPSS-TV) among a group of Indian participants in University Malaya.Materials and Methods:Ninety-four people who took part in this study were given MSPSS-TV, Medical Outcome Study (MOS) social support survey, Malay version of Beck Depression Inventory (BDI), Malay version of General Health Questionnaire (GHQ), and English version of MSPSS. After a week, these participants were again required to complete the MSPSS-TV, but with the item sequences shuffled.Results:Internal consistency of this scale was excellent (Cronbach's alpha = 0.924), and both test-retest reliability (0.71) and parallel form reliability (0.92) were high (Spearman's rho, P<0.01). MSPSS-TV was negatively correlated with GHQ and BDI.Interpretation and Conclusions:The MSPSS-TV demonstrated sound psychometric properties in gauging the social support among a group of participants. It could therefore be used as a simple screening tool among the young educated Malaysians.

Demographic factors, social problems and material amenities as predictors of psychological distress: a cross-sectional study in Karachi, Pakistan

Previous research has shown high prevalence rates for stress and psychiatric morbidity in rural areas of Pakistan, but prevalence findings from urban areas vary widely (between 18 and 70%). Many of these studies have focused on special populations and may not be representative of the general population in urban settings. The purpose of the present study was to ascertain prevalence and predictors of psychological distress in a representative sample of community dwelling adults from mid-low to low-income urban areas of Karachi, Pakistan. A cross-sectional survey was undertaken utilizing probability-based sampling from five mid-low to low-income communities of Karachi. Measures included the twelve-item Urdu version of general health questionnaire (GHQ-12), a demographic questionnaire, and questions about financial, health-related and family problems and about access to services and material amenities owned. Seventeen per cent of respondents (N = 1,188) were positive for psychological distress. More females were distressed than males and migrant groups had higher prevalence of distress as compared with natives of the city. Although other studies have shown low education or income to be associated with emotional distress and non-psychotic psychiatric morbidity, our study suggested that having limited income or education may make one more vulnerable to social problems that in turn may be associated with greater distress. An access to services and material amenities had a small but significant association with decreased distress. The overall national prevalence rates may not reveal the influence of gender, region (rural v. urban) and migration on psychological distress. Further research is needed to address mental health of migrant groups in urban centers of Pakistan.

The role of social support in the relationship between mental health and posttraumatic stress disorder amongst orthopaedic patients

Some life-event experiences such as injuries in car accidents, gun shots and the like, can be life changing and traumatic. The article investigated the relationship between mental health and posttraumatic stress disorder (PTSD) symptoms after orthopaedic trauma, and attempted to understand whether social support moderates the relationship between mental health and PTSD. A cross-sectional research model was used. Two hundred participants were selected using simple randomisation within a hospital complex in Gauteng, South Africa. The sample consisted of 110 men and 90 women (x̄=37.8 years, s.d.=12.9 years). Data were collected using the Revised Civilian Mississippi Scale for PTSD, the Multidimensional Scale of Perceived Social Support (MSPSS), and the General Health Questionnaire version 28. The findings of the study indicated that there is a statistically significant relationship between mental health and PTSD after orthopaedic trauma, and a positive correlation between poor mental health and PTSD (r=0.52, n=200, p<0.05). However, perceived social support did not moderate mental health or PTSD, indicating that perceived social support did not significantly influence mental health or PTSD, (MSPSS B=0.07, p=0.66). Those with high scores on social support had a lower regression coefficient (B=0.19) for mental health and PTSD than those who reported low social support (B=0.26). There is a significant relationship between mental health and PTSD of orthopaedic patients, and social support did not moderate the relationship between mental health and PTSD.

Psychological and gynecological morbidity in women presenting with vaginal discharge in Pakistan

Gynecological morbidity has been reported to be associated with psychological distress among women. However, no formal research has been conducted in Pakistan on psychological and gynecological morbidity in women presenting with vaginal discharge. This study aimed (1) to examine whether women presenting with a primary complaint of vaginal discharge are more likely to have a Common Mental Disorder compared with those not presenting with vaginal discharge and (2) to examine whether gender disadvantage is associated with vaginal discharge. Psychological morbidity was examined in women (n=377) presenting at gynecological clinics with and without a primary complaint of vaginal discharge. Gynecological and Psychological morbidity were assessed using Urdu version of General Health Questionnaire (GHQ-28) and the National Family Health Survey Interview. Women presenting with a primary complaint of vaginal discharge were significantly more likely to have a common mental disorder than women presenting with other gyn...

The impact of IVF/ICSI on parental well-being and anxiety 1 year after childbirth

More couples are delaying childbirth resulting in an increase of age-related subfertility in women. Subfertility and assisted reproductive technology (ART) treatments may affect couples' psychological well-being. The aim of the present study was to investigate whether factors related to IVF/ICSI affect anxiety and mental health in couples 1 year after childbirth. In this cohort study, we included couples with a singleton pregnancy following IVF/ICSI treatment (n=113) and subfertile couples who naturally conceived (NC; n=83). Parental trait anxiety (Dutch version of the Spielberger State-Trait Anxiety Inventory) and mental health (Dutch version of General Health Questionnaire) were assessed 1 year after childbirth. The influence of fertility-related factors was analyzed with logistic regression analyses. One hundred and ninety-six couples participated, 93% of those eligible. Trait anxiety and mental health were similar in IVF/ICSI and NC groups. However, NC fathers had more often mental health scores in the clinical range (21%) than fathers in the IVF/ICSI group (9%). The risk of having a trait anxiety or mental health score in the clinical range was reduced by the presence of one of the following factors: for females a higher number of IVF/ICSI treatment cycles, and a maternal cause of subfertility, for males having been treated by IVF/ICSI and a longer time to pregnancy. The present study indicates (i) that IVF/ICSI treatment is not associated with an increase in clinically relevant Spielberger State-Trait Anxiety Inventory and General Health Questionnaire scores in parents 1 year after childbirth and (ii) a higher number of IVF/ICSI treatment cycles and a longer time to pregnancy were associated with less trait anxiety and better mental health. A limitation of the study is the absence of mental health and trait anxiety data at baseline.

Factor structure and reliability of the 30-item Sinhala version of General Health Questionnaire (GHQ)

ObjectiveTo determine the factor structure and the reliability of the Sinhala version of the General Health Questionnaire-30 (GHQ-30). MethodsThis was a descriptive study including 368 patients with in the age range of 18–75 years, attending the Out Patient Department (OPD) of Colombo North Teaching Hospital, Ragama, Sri Lanka during the period between June 2009 and September 2010. Sinhala version of GHQ-30 was given to be completed by the participants. Each item of the GHQ was rated on a four-point scale (0-1-2-3). Factor analyses were performed by applying Generalized Least Squares method using oblimin rotation. The internal consistency was assessed by calculating Cronbach's α coefficient. ResultsMedian age of the study population was 32.5 years (Inter quartile range [IQR]=21 years) and the median GHQ score was 9 (IQR 7). GHQ-30 produced a five factor solution which accounted for 51.6% of the total variance (TV). Factor I (Depression) accounted for 38% of TV, Factor II (Loss of confidence) 5%, Factor III (Insomnia) 4%, Factor IV (Social dysfunction) 2.7% and Factor V (Anxiety) 2%. The Cronbach's alpha coefficients of GHQ-30 was 0.94 indicating satisfactory internal consistency. ConclusionsGHQ-30 comprises five factors/subscales and it displayed adequate reliability for assessment of psychiatric disorders among Sinhala speaking primary care attendees in Sri Lanka.

Burden and psychological effects : caregiver experiences in a psychiatric outpatient unit in Lagos, Nigeria

Worldwide, research into experiences of care givers are gradually increasing and their central role in community care is being acknowledged. Caregivers experience a multidimensional range of problems, often associated with their caregiving role. It becomes important to identify these areas of burden and provide necessary support. The study sought to determine the prevalence of psychological distress and experience of burden of care among the caregivers of mentally ill patients. A cross sectional descriptive study. Eligible consecutive subjects were recruited to the study over a 6 month period. Fifty three caregiver relatives of patients diagnosed with a psychiatric illness were assessed using the General Health questionnaire version 12, an Adapted Burden of Care (BOC) Schedule and a Sociodemographic questionnaire. The caregivers were 51% male and 49% female. Most were above 35years in age (66.1%). They were either parents (38.8%), siblings (18.4%), uncle/aunt (14.3%), first cousin (12.2%) or other extended relatives (16.3%). Almost half of the relatives had psychological distress (43.8%) and most of which (63%) had more burden. The mean score on the BOC among the caregivers was 41 (±18.68SD), with scores ranging from 0.00-89.00, and 45.3% of relatives experiencing more than average burden of care. There is a significant level of burden and psychological distress experienced by caregivers in this study location. It is recommended that effectively planned interventions are targeted at alleviating this burden and at improving the ability of caregivers to cope, within the Nigerian mental health service delivery system.

Psychiatric morbidity in hypertensives attending a cardiology outpatient clinic in West Africa

To determine kinds of psychiatric morbidity among a sample of stable hypertensive outpatients in a teaching hospital. A cross-sectional study of 260 enrolled outpatients. Psychiatric morbidity was assessed using a 2-stage evaluation method with the General Health Questionnaire Version 12 (GHQ-12) and Structured Clinical Interview for DSM-IV (SCID) to assess for psychiatric diagnosis. 28 (10.8%) of the 260 patients endorsed some psychological distress, with a mean GHQ-12 score of ≥ 2. At the second stage, 16.1% (N=13 of 81) interviewed had one or more psychiatric disorder on the SCID. The commonest psychiatric diagnosis made were mood disorders, with current major depressive disorder occurring at a rate of 6.2%. Other disorders found were past major depressive episode (2.5%), organic mood syndrome (3.7%), and somatoform disorder (3.7%). The relationship between hypertension and mood disorders should inform a higher index of suspicion among physicians and general practitioners in order to give patients appropriate treatments or referrals where necessary. It is recommended that collaboration with mental health service providers be encouraged.

The effects of insomnia and internet addiction on depression in Hong Kong Chinese adolescents: an exploratory cross-sectional analysis

The negative association of insomnia and internet addiction with mental health is widely documented in the literature, yet little is known about their inter-relationships. The primary aim of this study was to examine the inter-relationships between insomnia, internet addiction and depression. A total of 719 Chinese adolescents in Hong Kong participated in this school-based cross-sectional study. Participants completed the Chinese version of the Pittsburgh Sleep Quality Index (PSQI), the Chinese Internet Addiction Scale (CIAS), the 12-item version of General Health Questionnaire (GHQ-12) and questions assessing internet use pattern and sociodemographic characteristics. The classification of internet addiction and insomnia was based on the CIAS cutoff global score >63 and PSQI cutoff global score >5, respectively. Multiple regression analyses tested the effects of insomnia and internet addiction on depression. Among students with internet addiction (17.2%), 51.7% were also identified as insomniacs. Internet addicts scored significantly poorer on all PSQI components, except sleep duration, than their non-addicted counterparts. After adjustment for gender and internet use time, both internet addiction (β=0.05; Sobel test Z=6.50, P<0.001) and insomnia (β=0.59; Sobel test Z=4.49, P<0.001) demonstrated a significant association with depression. Overall, there is high comorbidity between internet addiction and insomnia. Both insomnia and internet addiction emerged as significant explanatory factors, but they exerted differential effects on depression. Future research should be directed at determining the causal relationship between internet addiction and insomnia, and its underlying mechanism with depression.

Predictive factors for psychiatric morbidity among women with infertility attending a gynaecology clinic in Nigeria

To determine the psychosocial and clinical factors that are associated with psychiatric morbidity among women with infertility attending a Nigerian gynaecology clinic. Over a four month period, 320 respondents (160 in the study group and 160 in the control group) were interviewed using a proforma (designed by the authors) and a screening instrument, General Health Questionnaire version 30 (GHQ-30). All probable cases with a score of 5 or more on GHQ-30 were interviewed using the Present State Examination (PSE). Psychiatric diagnosis was made in accordance with the diagnostic criteria of the 10th edition of the International Classification of Diseases (ICD-10). The infertility rate among the study group was found to be 25.8% with primary and secondary infertility rates constituting 21.9% and 78.1% respectively. The prevalence of psychiatric morbidity among women with infertility (48.8%) was significantly more than that in the control group (11.2%) (chi(2) = 51.80, p < 0.0001). Lack of support from husband (chi(2) = 15.31, p < 0.001), lack of support from husband's relatives (chi(2) = 39.60, p < 0.0001), discrimination (chi(2) = 69.91, p < 0.0001) and history of induced abortion (chi(2) = 30.40, p < 0.0001) were found to be significantly associated with psychiatric morbidity among patients with infertility when compared with the fertile control population. There was no significant difference in the rate of psychiatric morbidity between women with primary infertility and those with secondary infertility (chi(2) = 0.03; p = 0.87). Psychiatric morbidity is significantly more common among patients with infertility as compared with those without. There was a significant association between psychiatric morbidity and absence of support from husband and his relations, presence of discrimination, and a history of induced abortion. We suggest more public enlightenment on the need for moral/psychosocial support to women with infertility. In addition, more efforts should be made towards early screening and identification of cases of psychiatric morbidity among patients with infertility.

Sexual Maturation and Psychiatric Morbidity among Persons with Sickle Cell Anaemia in a Nigerian Teaching Hospital

Sickle Cell Anaemia (SCA), an inherited HbSS disease, is common in Nigeria with attendant high morbidity and mortality most especially in the setting of poor health care services. Impaired physical and sexual development is one of the prominent complications of SCA; and with attendant secondary psychiatric sequelae. A cross-sectional study was carried out at the haematology clinic of Lagos University Teaching Hospital (LUTH), among adolescent attendees (10-19 years) with SCA. Age and sex-matched controls were recruited from Action Health Incorporated (AHI), an NGO to promote adolescent health advocacy. The haemoglobin genotypes SS for subjects and AA for controls were confirmed with gel electrophoresis. Each subject and control was physically examined for the assessment of external genitalia (sexual) maturation using Tanner Staging Method, and were also evaluated with General Health Questionnaire-version 12 (GHQ-12). In all, 136 adolescents with SCA and of equal sex distribution and equal number of controls were studied, with mean ages of 14.3 +/- 2.8 and 13.5 +/- 2.6 years, respectively. On GHQ assessment, 113 (83%) subjects and 25 (18.4%) controls had GHQ scores of 5, indicating probable presence of psychopathology. For both males and females, the subjects significantly lagged behind the controls in different areas of sexual maturation, with corresponding significant higher GHQ scores among the subjects. For example, in sexual maturation rate (SMR) stage 1 of pubic hair development, the mean ages for male subjects and controls were 11.9 +/- 1.5 and 10.7 +/- 0.9 years, respectively, with significant "t" of 5.06 at p < 0.03*; for females: 13.0 +/- 2.6 and 10.4 +/- 0.6 years for subjects and controls respectively with significant "t" of 4.36 at p < 0.04*. The corresponding GHQ scores were for subjects: < 5 for 6 and > or = 5 for 20 of the subjects respectively; and for controls, the GHQ scores were < 5 for 9 and nil of controls for > or = 5 score. The difference in GHQ scores for subjects and controls in this stage 1 pubic hair maturation was significant with chi2 = 16.15, df = 1, p = 0.00. It is concluded that SCA subjects had significantly delayed sexual maturation and increased risk of psychiatric morbidity when compared to controls. The need for genetic counseling to reduce the prevalence of SCA was emphasized.

Validation of the Malay version of the Multidimensional Scale of Perceived Social Support (MSPSS-M) among a group of medical students in Faculty of Medicine, University Malaya

Objective The aim of this study was to validate the Malay version of the Multidimensional Scale of Perceived Social Support (MSPSS-M) among a group of medical students in Faculty of Medicine, University Malaya. Methods 237 students participated in the study. They were given the Malay version of MSPSS, medical outcome study (MOS) social support survey, Malay version of General Health Questionnaire (GHQ), Malay version of Beck Depression Inventory (BDI) and English version of MSPSS. A week later, these students were again given the Malay version of MSPSS. Results The instrument displayed good internal consistency (Cronbach's alpha = 0.89), parallel form reliability (0.94) and test–retest reliability (0.77) (Spearman's rho, p < 0.01). The negative correlation of the total and subscales of the instrument with the Malay version of GHQ and BDI confirmed its validity. Extraction method of the 12 items MSPSS using principle axis factoring with direct oblimin rotation converged into three factors of perceived social support (Family, Friends and Significant Others) with reliability coefficients of 0.88, 0.82 and 0.94, respectively. Conclusion The Malay version of the MSPSS demonstrated good psychometric properties in measuring social support among a group of medical students from Faculty of Medicine, University Malaya and it could be used as a simple instrument on young educated Malaysian adolescents.

Effects of care giving environment on caregiver burden stress of family engaged in in-home medical care

The purpose of the study was to clarify the effects of care environment on health status of caregivers engaged in at-home medical care for their family member. Twenty-eight female caregivers were surveyed three times, i. e. one week, one month, and two months after discharge of the family member, using a questionnaire containing the Japanese version of General Health Questionnaire 12 (GHQ12) and Zarit Caregiver Burden Interview (J-ZBI). Concentrations of salivary cortisol were also measured in 28 caregivers. At one week and one month after discharge, concentrations of salivary cortisol and GHQ12 and J-ZBI scores in 28 subjects were higher as compared with previous reports in the literature. Levels of salivary cortisol significantly decreased during the period from one month to two months after discharge (p<0.05), whereas GHQ12 and J-ZBI scores did not change significantly, suggesting that their stress were physiologically decreased although psychologically they were still in high stress status. Decrease in salivary cortisol was observed greatly in the caregivers with social support and/or at lower burden of care giving. Also, scores of GHQ-12 and J-ZBI remained higher in subjects without social support or at higher burden of care giving during the study period ; GHQ-12 reflected psychological aspects of care giving stress, whereas J-ZBI were related to physical factors of care environment.