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Papers by Ravivarma Rao Panirselvam
Suicide by Self-Immolation, 2021
This book contains transcript from the live webinar "Clinical Updates in COVID-19" orga... more This book contains transcript from the live webinar "Clinical Updates in COVID-19" organized by Institute for Clinical Research, NIH Malaysia on 28th May 2020. There are four presentations in this webinar focusing on mental health and forensic medicine in COVID-19. High Risk Autopsy by Dr Ahmad Hafizam, National Institute Forensic Medicine, Hospital Kuala Lumpur Befrienders Experience in Community during Movement Control Order (MCO) and Conditional Movement Control Order (CMCO) by Esther Teo Siam Cheng, National Council of Befrienders Malaysia (NCOBM) COVID-19 Pandemic, The Mental Health Demons: How to Overpower The Challenges Ahead by Dr.Ahmad Rostam bin Md Zin, Hospital Sultanah Bahiyah Alor Setar CATCH-22: Psychological _____ on Healthcare Workers by Dr. Ravivarma Rao Panirselvam, Hospital Miri.
The Malaysian Journal of Psychiatry, 2017
Introduction: Children and adolescents requiring mental health services are increasing. This pape... more Introduction: Children and adolescents requiring mental health services are increasing. This paper is a registry of new clients in the Child and Adolescent Mental Health (CAMH) outpatient clinic of Hospital Sultan Abdul Halim (HSAH), Sungai Petani, Kedah, Malaysia from January 2014 to December 2014. Objectives: We aimed to determine the trends of different types of mental disorders in first contact clients at an outpatient CAMH clinic in HSAH. Thereafter, we sought to compare the differences in demographics with types of illness and treatments modalities. Method: We reviewed electronic case records retrospectively for the study period from January 2014 to December 2014 and universal sampling was done. Results: During the study period, there were 160 new cases. The highest number of patients were from the primary school age group with a mean age of 9.98 years. The highest incidence was Attention Deficit Hyperactivity Disorder (23.8%), followed by Autism Spectrum Disorder (17.5%) and ...
Average retention after a didactic lecture is around 5% of the content. Active learning like di... more Average retention after a didactic lecture is around 5% of the content. Active learning like discussion forums and teaching others make the retention rate to surpass 70%. Peer-Assisted Learning (PAL) is an effective method that makes active learning interesting and productive. However, drawbacks like minimal focus, bad structuring of content materials, poor time management, and other channels of distraction can limit the effectiveness of the
The Malaysian Journal of Psychiatry, 2019
According to the World Health Organisation (WHO), nearly 800 000 people lose their lives each yea... more According to the World Health Organisation (WHO), nearly 800 000 people lose their lives each year to suicide (1]. This translates to one loss of life every 40 seconds. For each loss of life, approximately 20 others attempt suicide [1]. The prevalence of suicide in Malaysia is reported to be 6 to 8 per 100,000 population in a systematic review conducted by Armitage and team (2015) [2] while the Ministry of Health’s National Suicide Registry Malaysia (NSRM) [3] reported a much lower, likely under-reported figure of 1.18 per 100 000 population. Although the NRSM is currently inactive after 2010 due to funding issues, the prevalence of suicide-related symptoms as reflected in the National Health Morbidity Survey (NHMS) reports are concerning. In 2011, the NHMS reported that there were 1.7% who had suicidal ideation, 0.9% with suicide plans and 0.5% who had attempted suicide [4]. In the more recent 2017 NHMS report, nearly 7% of Malaysian adolescents were found to have attempted suicide...
Frontiers in Psychology, 2021
Media guidelines on safe suicide-related reporting are within the suicide prevention armamentariu... more Media guidelines on safe suicide-related reporting are within the suicide prevention armamentarium. However, implementation issues beleaguer real-world practice. This study evaluated the perspectives of the Malaysian media community, persons with lived experience of suicidal behavior (PLE), and mental health professionals (MHP) on suicide-related reporting in terms of the impact, strategies, challenges, and the implementation of guidelines on safe reporting. Three focus group discussions of purposively sampled Malaysian media practitioners (n = 8), PLE (n = 6), and MHP (n = 7) were audio-recorded, transcribed, coded and thematically analyzed. Inclusion criteria were: English fluency, no clinical depression or suicidal ideation (current), no recent previous suicide attempts or suicide bereavement. Three major themes emerged: (1) Unsafe Reporting; (2) Impact; and (3) Safe Reporting. Most described current reporting as unsafe by being potentially triggering to media users and may contr...
Criminalization of suicide attempts is an archaic barrier to suicide prevention. Globally, clinic... more Criminalization of suicide attempts is an archaic barrier to suicide prevention. Globally, clinical profiles of prosecuted suicide attempters are an under-researched area. This retrospective study aims to describe the clinical profiles of individuals who were charged for attempted suicide and subsequently sent for criminal responsibility and fitness to plead evaluation in a forensic psychiatric unit in Malaysia from January 1, 2008, to December 31, 2019. We identified 22 cases who were mostly adult males (90.9%). Seventy-three percent have a psychiatric disorder. Mood disorders were more prevalent (32%) followed by psychotic disorders and substance use disorders. For most of these individuals, this was the first contact with any form of mental health services and 41% defaulted their treatment before arrest. This sample illustrates a vulnerable group who has been disengaged with mental healthcare. Future research is warranted to further investigate mechanisms that are effective in ad...
The parity of esteem remains as a global mental health challenge. The divide is greater in the de... more The parity of esteem remains as a global mental health challenge. The divide is greater in the developing world where physical health of individuals with mental health conditions often takes a backseat. This article explores the extent of the problem and feasible solutions both in global and regional perspectives of Bintulu; a low resource centre in Sarawak, Malaysia. Starting from the self which focuses on empowering mental health providers in becoming cognizant of monitoring physical health in service users. The discussion then delves on the overarching role of mental health teams in supporting allied services including primary health care teams and caregivers. Finally the need to improve healthcare systems in becoming more comprehensive and inclusive to service users is analysed. In conclusion practical evidence based solutions necessitate in achieving parity of esteem.
Systemic lupus erythematosus (SLE) is a debilitating and chronic autoimmune disease which strikes... more Systemic lupus erythematosus (SLE) is a debilitating and chronic autoimmune disease which strikes insidiously. The disease currently has a prevalence of 43/ 100 000 individuals in Malaysia. The presentation of the disease is varied resulting in delay in diagnosis and onset of complications prior to management. The disease commonly presents as joint pain and cutaneous manifestations. Neuropsychiatric presentation accounts for 24% of symptoms during onset of illness. This case report highlights that we encountered a patient who presented with neuropsychiatric manifestations, whereby the patient was managed for the psychiatric symptoms prior to the organic diagnosis being made.
Introduction: Children and adolescents requiring mental health services are increasing. This pape... more Introduction: Children and adolescents requiring mental health services are increasing. This paper is a registry of new clients in the Child and Adolescent Mental Health (CAMH) outpatient clinic of Hospital Sultan Abdul Halim (HSAH), Sungai Petani, Kedah, Malaysia from January 2014 to December 2014. Objectives: We aimed to determine the trends of different types of mental disorders in first contact clients at an outpatient CAMH clinic in HSAH. Thereafter, we sought to compare the differences in demographics with types of illness and treatments modalities. Method: We reviewed electronic case records retrospectively for the study period from January 2014 to December 2014 and universal sampling was done. Results: During the study period, there were 160 new cases. The highest number of patients were from the primary school age group with a mean age of 9.98 years. The highest incidence was Attention Deficit Hyperactivity Disorder (23.8%), followed by Autism Spectrum Disorder (17.5%) and others at 15.6%. Out of those sampled, 61% were treated pharmacologically and 39% were receiving non-pharmacological treatment. Conclusions: There is a need to enhance and expand services to enable the client and family to obtain the necessary intervention. With improved screening and empowerment of the family, better outcomes could be achieved for the client.
As a mental health community we are proud to mark World Health Day, 7th April 2017, which this ye... more As a mental health community we are proud to mark World Health Day, 7th April 2017, which this year has a theme of depression and suicide. This is the first time that there has been mental health theme on World Health Day since 2001. We commemorate this day with stories of depression from over 30 countries around the world. We know that depression is one of the most disabling conditions in global health – currently the third most disabling condition globally and predicted to be the leading and most disabling condition throughout the world by 2030. Depression is universal, taking no account of class, religion, or ethnic group. It spares neither the rich, nor the poor. It is the silent illness causing untold misery. It leads to effects on whole families, children's health and wellbeing. In terms of mental health interventions, if there is just one thing we can do, it should be to diagnose and treat depression. Treatment of depression is cost-effective and cheap, with a huge dividend in well-being for the affected and their families. In these stories we see a range of views of depression, but the same themes come up again and again – barriers to treatment, stigma, missed diagnosis and opportunities to pick up depression are universal in low-, middle- and high-income countries. The countries have been selected through our professional and personal connections and don’t represent any agenda. The views expressed belong to the individual authors.
Average retention after a didactic lecture is around 5% of the content. Active learning like di... more Average retention after a didactic lecture is around 5% of the content. Active learning like discussion forums and teaching others make the retention rate to surpass 70%. Peer-Assisted Learning (PAL) is an effective method that makes active learning interesting and productive. However, drawbacks like minimal focus, bad structuring of content materials, poor time management, and other channels of distraction can limit the effectiveness of the
Suicide by Self-Immolation, 2021
This book contains transcript from the live webinar "Clinical Updates in COVID-19" orga... more This book contains transcript from the live webinar "Clinical Updates in COVID-19" organized by Institute for Clinical Research, NIH Malaysia on 28th May 2020. There are four presentations in this webinar focusing on mental health and forensic medicine in COVID-19. High Risk Autopsy by Dr Ahmad Hafizam, National Institute Forensic Medicine, Hospital Kuala Lumpur Befrienders Experience in Community during Movement Control Order (MCO) and Conditional Movement Control Order (CMCO) by Esther Teo Siam Cheng, National Council of Befrienders Malaysia (NCOBM) COVID-19 Pandemic, The Mental Health Demons: How to Overpower The Challenges Ahead by Dr.Ahmad Rostam bin Md Zin, Hospital Sultanah Bahiyah Alor Setar CATCH-22: Psychological _____ on Healthcare Workers by Dr. Ravivarma Rao Panirselvam, Hospital Miri.
The Malaysian Journal of Psychiatry, 2017
Introduction: Children and adolescents requiring mental health services are increasing. This pape... more Introduction: Children and adolescents requiring mental health services are increasing. This paper is a registry of new clients in the Child and Adolescent Mental Health (CAMH) outpatient clinic of Hospital Sultan Abdul Halim (HSAH), Sungai Petani, Kedah, Malaysia from January 2014 to December 2014. Objectives: We aimed to determine the trends of different types of mental disorders in first contact clients at an outpatient CAMH clinic in HSAH. Thereafter, we sought to compare the differences in demographics with types of illness and treatments modalities. Method: We reviewed electronic case records retrospectively for the study period from January 2014 to December 2014 and universal sampling was done. Results: During the study period, there were 160 new cases. The highest number of patients were from the primary school age group with a mean age of 9.98 years. The highest incidence was Attention Deficit Hyperactivity Disorder (23.8%), followed by Autism Spectrum Disorder (17.5%) and ...
Average retention after a didactic lecture is around 5% of the content. Active learning like di... more Average retention after a didactic lecture is around 5% of the content. Active learning like discussion forums and teaching others make the retention rate to surpass 70%. Peer-Assisted Learning (PAL) is an effective method that makes active learning interesting and productive. However, drawbacks like minimal focus, bad structuring of content materials, poor time management, and other channels of distraction can limit the effectiveness of the
The Malaysian Journal of Psychiatry, 2019
According to the World Health Organisation (WHO), nearly 800 000 people lose their lives each yea... more According to the World Health Organisation (WHO), nearly 800 000 people lose their lives each year to suicide (1]. This translates to one loss of life every 40 seconds. For each loss of life, approximately 20 others attempt suicide [1]. The prevalence of suicide in Malaysia is reported to be 6 to 8 per 100,000 population in a systematic review conducted by Armitage and team (2015) [2] while the Ministry of Health’s National Suicide Registry Malaysia (NSRM) [3] reported a much lower, likely under-reported figure of 1.18 per 100 000 population. Although the NRSM is currently inactive after 2010 due to funding issues, the prevalence of suicide-related symptoms as reflected in the National Health Morbidity Survey (NHMS) reports are concerning. In 2011, the NHMS reported that there were 1.7% who had suicidal ideation, 0.9% with suicide plans and 0.5% who had attempted suicide [4]. In the more recent 2017 NHMS report, nearly 7% of Malaysian adolescents were found to have attempted suicide...
Frontiers in Psychology, 2021
Media guidelines on safe suicide-related reporting are within the suicide prevention armamentariu... more Media guidelines on safe suicide-related reporting are within the suicide prevention armamentarium. However, implementation issues beleaguer real-world practice. This study evaluated the perspectives of the Malaysian media community, persons with lived experience of suicidal behavior (PLE), and mental health professionals (MHP) on suicide-related reporting in terms of the impact, strategies, challenges, and the implementation of guidelines on safe reporting. Three focus group discussions of purposively sampled Malaysian media practitioners (n = 8), PLE (n = 6), and MHP (n = 7) were audio-recorded, transcribed, coded and thematically analyzed. Inclusion criteria were: English fluency, no clinical depression or suicidal ideation (current), no recent previous suicide attempts or suicide bereavement. Three major themes emerged: (1) Unsafe Reporting; (2) Impact; and (3) Safe Reporting. Most described current reporting as unsafe by being potentially triggering to media users and may contr...
Criminalization of suicide attempts is an archaic barrier to suicide prevention. Globally, clinic... more Criminalization of suicide attempts is an archaic barrier to suicide prevention. Globally, clinical profiles of prosecuted suicide attempters are an under-researched area. This retrospective study aims to describe the clinical profiles of individuals who were charged for attempted suicide and subsequently sent for criminal responsibility and fitness to plead evaluation in a forensic psychiatric unit in Malaysia from January 1, 2008, to December 31, 2019. We identified 22 cases who were mostly adult males (90.9%). Seventy-three percent have a psychiatric disorder. Mood disorders were more prevalent (32%) followed by psychotic disorders and substance use disorders. For most of these individuals, this was the first contact with any form of mental health services and 41% defaulted their treatment before arrest. This sample illustrates a vulnerable group who has been disengaged with mental healthcare. Future research is warranted to further investigate mechanisms that are effective in ad...
The parity of esteem remains as a global mental health challenge. The divide is greater in the de... more The parity of esteem remains as a global mental health challenge. The divide is greater in the developing world where physical health of individuals with mental health conditions often takes a backseat. This article explores the extent of the problem and feasible solutions both in global and regional perspectives of Bintulu; a low resource centre in Sarawak, Malaysia. Starting from the self which focuses on empowering mental health providers in becoming cognizant of monitoring physical health in service users. The discussion then delves on the overarching role of mental health teams in supporting allied services including primary health care teams and caregivers. Finally the need to improve healthcare systems in becoming more comprehensive and inclusive to service users is analysed. In conclusion practical evidence based solutions necessitate in achieving parity of esteem.
Systemic lupus erythematosus (SLE) is a debilitating and chronic autoimmune disease which strikes... more Systemic lupus erythematosus (SLE) is a debilitating and chronic autoimmune disease which strikes insidiously. The disease currently has a prevalence of 43/ 100 000 individuals in Malaysia. The presentation of the disease is varied resulting in delay in diagnosis and onset of complications prior to management. The disease commonly presents as joint pain and cutaneous manifestations. Neuropsychiatric presentation accounts for 24% of symptoms during onset of illness. This case report highlights that we encountered a patient who presented with neuropsychiatric manifestations, whereby the patient was managed for the psychiatric symptoms prior to the organic diagnosis being made.
Introduction: Children and adolescents requiring mental health services are increasing. This pape... more Introduction: Children and adolescents requiring mental health services are increasing. This paper is a registry of new clients in the Child and Adolescent Mental Health (CAMH) outpatient clinic of Hospital Sultan Abdul Halim (HSAH), Sungai Petani, Kedah, Malaysia from January 2014 to December 2014. Objectives: We aimed to determine the trends of different types of mental disorders in first contact clients at an outpatient CAMH clinic in HSAH. Thereafter, we sought to compare the differences in demographics with types of illness and treatments modalities. Method: We reviewed electronic case records retrospectively for the study period from January 2014 to December 2014 and universal sampling was done. Results: During the study period, there were 160 new cases. The highest number of patients were from the primary school age group with a mean age of 9.98 years. The highest incidence was Attention Deficit Hyperactivity Disorder (23.8%), followed by Autism Spectrum Disorder (17.5%) and others at 15.6%. Out of those sampled, 61% were treated pharmacologically and 39% were receiving non-pharmacological treatment. Conclusions: There is a need to enhance and expand services to enable the client and family to obtain the necessary intervention. With improved screening and empowerment of the family, better outcomes could be achieved for the client.
As a mental health community we are proud to mark World Health Day, 7th April 2017, which this ye... more As a mental health community we are proud to mark World Health Day, 7th April 2017, which this year has a theme of depression and suicide. This is the first time that there has been mental health theme on World Health Day since 2001. We commemorate this day with stories of depression from over 30 countries around the world. We know that depression is one of the most disabling conditions in global health – currently the third most disabling condition globally and predicted to be the leading and most disabling condition throughout the world by 2030. Depression is universal, taking no account of class, religion, or ethnic group. It spares neither the rich, nor the poor. It is the silent illness causing untold misery. It leads to effects on whole families, children's health and wellbeing. In terms of mental health interventions, if there is just one thing we can do, it should be to diagnose and treat depression. Treatment of depression is cost-effective and cheap, with a huge dividend in well-being for the affected and their families. In these stories we see a range of views of depression, but the same themes come up again and again – barriers to treatment, stigma, missed diagnosis and opportunities to pick up depression are universal in low-, middle- and high-income countries. The countries have been selected through our professional and personal connections and don’t represent any agenda. The views expressed belong to the individual authors.
Average retention after a didactic lecture is around 5% of the content. Active learning like di... more Average retention after a didactic lecture is around 5% of the content. Active learning like discussion forums and teaching others make the retention rate to surpass 70%. Peer-Assisted Learning (PAL) is an effective method that makes active learning interesting and productive. However, drawbacks like minimal focus, bad structuring of content materials, poor time management, and other channels of distraction can limit the effectiveness of the