This study aimed to assess the prevalence and factors associated with bullying victimization from a nationwide school-based survey among 27 458 students aged 13 to 17 years. The overall prevalence of having been bullied in the past 30 days was 16.2%; this decreased with age. Multivariate logistic regression analysis revealed that factors most strongly associated with bullying victimization were exposure to physical attacks (adjusted odds ratio [aOR] = 2.46, 95% confidence interval [CI] = 2.17-2.79), illicit drug use (aOR = 2.44, 95% CI = 1.78-3.34), involvement in physical fights (aOR = 1.97, 95% CI = 1.74-2.23), being younger than 14 years (aOR =1.95, 95% CI = 1.59-2.38), and having ever attempted suicide (aOR = 1.83, 95% CI = 1.51-2.21). Other significantly associated factors include loneliness, truancy, making suicidal plans, and symptoms of depression, anxiety, and stress. Exposure to bullying victimization can result in negative lifelong sequelae and important associated factors should be considered in planning effective school-based anti-bullying interventions.

Aim: Elder abuse is a significant public health problem. This study aims to estimate its prev-alence and associated factors, using representative national Malaysian data.Methods: A nationwide population-based survey involving 3977 community-dwelling olderpersons aged ≥60 years was conducted via face-to-face interview, of whom 3466 older personswere eligible for screening using a locally validated tool. Elder abuse was defined as any oneoccurrence of neglect, financial, psychological, physical or sexual abuse perpetrated by some-one in a position of trust that was experienced in the past 12 months.Results: About 9.0% of older persons in Malaysia have experienced elder abuse in the past12 months, with neglect being the commonest type experienced (7.5%; 95% confidenceinterval [CI]: 5.54, 10.07). There is no significant difference by age group and geographicallocation. Males (adjusted odds ratio [aOR] 1.7; 95% CI: 1.06, 2.60), poorer social support(aOR 5.0; 95% CI: 2.25, 11.22), dependency in activities of daily living (aOR 2.1; 95% CI:1.23, 3.44) and a previous history of abuse (aOR 10.1; 95% CI: 4.50, 22.86) show higher oddsof experiencing elder abuse. Almost 5% of abused older persons reported experiencing multi-ple types of abuse. Reporting is low at 19.3% with none reporting to healthcare personnel.Conclusions: The prevalence of elder abuse in this study is lower than global estimates, butsimilar to local studies. Preventive measures and programs are crucial to overcoming elderabuse and need to be carried out at multiple levels – the individual, community, healthcareand other stakeholders.

Introduction: An estimated 13% of women in the postnatal period suffer from postnatal depression (PND) worldwide. In addition to underprivileged women, women who are exposed to violence are at higher risk of PND. This study aimed to investigate the relationship between intimate partner violence (IPV) and PND in Malaysia. Methods: This survey was conducted as a nationwide cross-sectional study using a cluster sampling design. Probable PND was assessed using a self-administered Edinburgh Postnatal Depression Scale (EPDS). Demographic profiles and IPV were assessed using a locally validated WHO Multicountry Study on Women’s Health and Life Events Questionnaire that was administered in a face-to-face interview. An EPDS total score of 12 or more and/or a positive tendency to self-harm were used to define PND. Results: Out of 6669 women, 5727 respondents were successfully interviewed with a response rate of 85.9%. The prevalence of probable PND was 4.4% (95% CI 2.9 to 6.7). The overall prevalence of IPV was 4.9% (95% CI 3.8 to 6.4). Among the women in this group, 3.7% (95% CI 2.7 to 5.0), 2.6% (95% CI 1.9 to 3.5) and 1.2% (95% CI 0.9 to 1.7) experienced emotional, physical and sexual violence, respectively. Logistic regression analysis revealed that women who were exposed to IPV were at 2.3 times the risk for probable PND, with an adjusted OR (aOR) of 2.34 (95% CI 1.12 to 4.87). Other factors for PND were reported emotional violence (aOR 3.79, 95% CI 1.93 to 7.45), unplanned pregnancy (aOR 3.32, 95% CI 2.35 to 4.69), lack of family support during confinement (aOR 1.79, 95% CI 1.12 to 2.87), partner’s use of alcohol (aOR 1.59, 95% CI 1.07 to 2.35) or being from a household with a low income (aOR 2.99; 95% CI 1.63 to 5.49). Conclusions: Exposure to IPV was significantly associated with probable PND. Healthcare personnel should be trained to detect and manage both problems. An appropriate referral system and support should be made available.

Depression among adolescents has been recognized as a major public health issue. The objective of this study was to determine the prevalence and correlates of depression among school-going adolescents in Malaysia. Data from the Malaysia Global School-based Health Survey (GSHS) 2012 were analyzed with additional data from the validated DASS21 (Depression, Anxiety, and Stress) questionnaire. The study revealed that 17.7% of respondents had depressive symptoms. Multivariate analysis further showed that feeling lonely (adjusted odds ratio [aOR] = 2.99; 95% CI = 2.57-3.47), Indian ethnicity (aOR = 2.00; 95% CI = 1.63-2.44), using drugs (aOR = 1.85; 95% CI = 1.21-2.82), and being bullied (aOR = 1.79; 95% CI = 1.60-1.99) were significantly associated with depressive symptoms. Lack of parental supervision, alcohol use, and tobacco use were also significant risk factors. Addressing depressive symptoms among adolescents may have implications for managing their risks of being bullied and substance use. This study also highlights the need to further investigate depressive symptoms among adolescents of Indian ethnicity.

Intimate partner violence (IPV) is an important gender-based, social, and public health problem that affects women worldwide, including women who are pregnant or have recently given birth. Studies have shown that violence against women often increases during pregnancy and the postpartum period. This study aims to examine lifetime and past-year prevalence of IPVamong postpartum women in Malaysia, and to determine the socio-demographic as well as husband’s/partner’s behavioral factors associated with IPV exposure. This is a nationwide, cross-sectional and clinic-based study involving a total of 5727 women at 6 to 16 weeks postpartum, who attended randomly selected government health clinics between July to November 2016. Face-to-face interviews were conducted by trained female enumerators based on a pre-validated structured questionnaire, using mobile devices as data collection tools. Chi squared tests and multivariable logistic regressions were used to investigate selected factors associated with IPVexposure. The lifetime and past-year prevalence of any form of IPV among postpartum women were 4.94% (95% CI [3.81,6.39]) and 2.42% (95% CI [1.74,3.35]) respectively, with the highest prevalence being emotional violence, followed by physical and sexual violence. Multivariable analysis showed that husband’s/partner’s behaviors, such as frequent alcohol use, drug use, fighting habits and control ling behaviour were significantly associated with both lifetime and past-year IPV (all p < 0.001 for past-year IPV). These findings suggest that prevention and intervention strategies for IPV should consider the prevention of substance use and reducing controlling behaviors by husband/partner, as well as raising awareness to build healthy relationships through education.

We assessed the current situation of physical abuse among adolescents at home in Malaysia. A total of 27 497 school-going adolescents answered a self-administered questionnaire during the Malaysian National Health and Morbidity Survey 2017. A complex sampling analysis was applied to identify factors associated with physical abuse among adolescents using multivariate logistic regression analysis. The prevalence of physical abuse at home among students was 11.8%. Our result shows that adolescents aged 13 years had significantly higher odds of such abuse, with odds decreasing as the adolescents age. Girls and adolescents from Indian ethnicity (minority ethnic group) had higher odds of such abuse. Other associated factors were mental health problems, substance abuse, and problems at school. Physical abuse among adolescents at home should be countered with appropriate measures.

Serious injury due to motor vehicle accidents (MVAs) significantly contributes to the adolescents’ health status. The objective of this study was to estimate the prevalence of nonfatal injury due to MVAs and its associated factors among Malaysian school-going adolescents. Nationally representative samples were selected via 2-stage stratified cluster sampling. Data was collected using a validated self-administered questionnaire. Logistic regression analysis was conducted to examine the associations between the variables. A total of 1088 out of 27 497 adolescents reported that they had sustained serious injury due to MVAs with a prevalence of 4.1% (95% confidence interval [CI] = 3.7-4.5). Serious injury due to MVAs among adolescents was positively associated with being current cigarette smokers (adjusted odds ratio [aOR] = 2.5; 95% CI = 2.2-2.9), followed by Malay ethnicity (aOR = 2.4; 95% CI = 1.9-3.0), current drug users (aOR = 2.3; 95% CI = 1.9-3.0), boys (aOR = 2.1; 95% CI = 1.8-2.4), Indian ethnicity (aOR = 1.8; 95% CI = 1.2-2.5), and those who were in upper secondary school (aOR = 1.3; 95% CI = 1.2-1.5). Targeted intervention and curbing substance use among boys may reduce the morbidities from MVAs and its resulting complications.

Adolescence is the time of greatest risk for the first onset of suicidal behaviors. This study aimed to identify the risk and protective factors associated with suicidal ideation among Malaysian adolescents. Data from the 2012 Malaysia Global School-based Student Health Survey, a nationwide study using a 2-stage cluster sampling design, were analyzed. The survey used a self-administered validated bilingual questionnaire and the Depression Anxiety and Stress Scale. The prevalence of suicidal ideation was 7.9%. Analysis revealed that suicidal ideation was positively associated with depression, anxiety, stress, substance use, being bullied, and being abused at home, either physically or verbally. In addition, suicidal ideation was significantly higher among females and among the Indians and Chinese. Having close friends and married parents were strongly protective against suicidal ideation. Understanding the risk and protective factors is important in providing comprehensive management for suicidal ideation.