South African Journal of Psychiatry
Published by the South African Medical Association Health and Medical Publishing Group on behalf of the South African Society of Psychiatrists. The journal provides a vehicle for the publication of news, editorials, and original articles in the field of psychiatry, with emphasis on the conditions prevalent in South and southern Africa.
|Coverage||Vol 8 Issue 3 2002 - current|
ISI Social Science
Conjoint moderate or high-risk alcohol and tobacco use among male out-patients in Thailand : original research
Objective: To better understand conjoint alcohol and tobacco use among male hospital out-patients, the purposes of this study were: (1) to assess the prevalence of conjoint use and (2) to determine the factors associated with the conjoint alcohol use and tobacco use.
Methods: In a cross-sectional survey, consecutive male out-patients from four district hospitals in Nakhon Pathom province in Thailand were assessed with the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Hospital Anxiety and Depression Scale (HADS), self-reported chronic conditions and health-seeking behaviour. The sample included 2208 study participants, with a mean age of 36.2 years (SD = 11.7) and an age range of 18-60 years.
Results: Overall, 34.5% of the male hospital out-patients were conjoint moderate or high-risk alcohol and tobacco users, and 31.1% were moderate or high-risk alcohol or tobacco users. In multivariate analysis, younger age, having primary or less education, being separated, divorced or widowed, not having diabetes and not being obese were associated with conjoint moderate or high-risk alcohol and tobacco use.
Conclusion: High prevalence and several risk factors of conjoint alcohol and tobacco use were found among hospital male out-patients. The findings of this study call for dual-intervention approaches for both alcohol and tobacco.
Methylphenidate use and poly-substance use among undergraduate students attending a South African university : original research
Background: Methylphenidate hydrochloride (MPH) is used in the treatment of attention deficit hyperactivity disorder (ADHD). The non-medical use of MPH by learners and students has been reported by numerous studies from abroad. The practice stems from beliefs about the benefits of MPH in achieving academic success. Little is known about the use of MPH in South African student populations.
Objectives: The study set out to determine (1) the extent and dynamics associated with MPH use and (2) poly-substance use among undergraduate students attending a South African university.
Methods: 818 students took part in a written, group-administered survey. Data analysis resulted in descriptive results regarding MPH use and tests of association identified differences in MPH and poly-substance use among respondents.
Results: One in six respondents (17.2%) has used MPH in the past, although only 2.9% have been diagnosed with ADHD. Nearly a third (31.7%) of users obtained MPH products illegally. The majority (69.1%) used MPH only during periods of academic stress. A significant association ( p < 0.001) was found between MPH use and the frequency of using alcohol, tobacco, cannabis, hard drugs (e.g. cocaine) and prescription medication.
Conclusion: MPH use among students appears similar to experiences abroad, especially in the absence of clinical diagnosis for ADHD. Institutions of higher education should inform parents and students about the health risks associated with the illicit use of MPH. Prescribers and dispensers of MPH products should pay close attention to practices of stockpiling medication and poly-substance use among students who use MPH.
Spirituality, depression and quality of life in medical students in KwaZulu-Natal : original research
Background: The majority of studies on spirituality demonstrate its positive association with mental health. Despite the increasing number of studies, there remains a dearth of studies emanating from African countries looking at the relationship between mental illness, quality of life and measures of spirituality. The present study evaluates the role of spirituality in relation to current depression and quality of life in medical students, who are known to be at high risk for depression.
Objectives: The aim of this study was to determine the prevalence of moderate and severe depressive symptoms in this population and explore potential correlations between spirituality,depression and quality of life.
Methods: 230 medical students were surveyed at the University of KwaZulu-Natal Medical School, using the Zung Self-Rating Depression Scale (Zung SDS), Spiritual Involvement and Beliefs Scale (SIBS), WHO Quality of Life Scale (WHOQOL) and a demographic data sheet.
Results: There was a high prevalence of depressive symptoms in the medical students, with a significant proportion (15.6%) showing evidence of severe depressive symptoms (indicating likely depressive illness). Those with a history of mental illness or of having attended traditional, complementary or alternate medical practitioners showed higher levels of depression. Lower spirituality was associated with non-adherence to a major religion and a history of mental illness. Quality of life was better in second and fifth year students and poorer in those with a history of mental illness.
Conclusion: Medical students' experiences of depression (most probably due to stress) and its relationship with spirituality and quality of life merit further investigation with a view to establishing policy guidelines for dealing with this issue.
Depression is a common psychiatric disorder and can be costly, having a significant impact on the individual and employers. The South African Depression and Anxiety Group (SADAG) in partnership with HEXOR, with the support of Lundbeck, undertook research into depression in the workplace, because South African information is not available on this topic. It provides insight into the prevalence of depression within the workplace in South Africa, as well as the impact of depression on the employees and employers in terms of sick leave and levels of productivity, especially when the symptoms include cognitive impairment. It is apparent that stigma plays a pivotal role in the reasons for non-disclosure to employers. It further highlights the magnitude of awareness, early detection and the provision of a holistic support system within the work environment, free from bias, to ensure that optimum benefit can be achieved for both employer and employee.
Assessing the usefulness of electroencephalography in psychiatry : outcome of referrals at a psychiatric hospital : scientific letter
This retrospective study was conducted at Sterkfontein psychiatric hospital in Gauteng. The objectives included investigating reasons for referral to conduct an electroencephalography (EEG) and to determine whether EEG findings have impact on clinical management. Source data included EEG reports over an 18-month period and clinical records. The total sample was 85 adult inpatients (53 males; 32 females). Seizure disorder exclusion was the main reason for EEG referral (69.0%). Seventy-four (87.0%) records were normal, 7 (8.2%) were abnormal, 2 (2.4%) were inconclusive and 2 (2.4%) EEG reports were unavailable. There was no statistically significant correlation between abnormal EEG results and demographic variables, symptoms,admission diagnosis and medications. EEG recording demonstrated a low yield of abnormal results. In this study, EEG results did not appear to influence the treating psychiatrists regarding management, but this could be as a result of the small sample size. As interactions between psychiatric conditions and epilepsy are important and well established, negative EEGs are indeed useful and it is recommended that clinicians should carefully consider which patients should be referred for EEGs.
Depressive symptoms and marital adjustment among primary care patients with erectile dysfunction in Umuahia, Nigeria : original research
Objectives: The aim of this study was to investigate the relationship between erectile dysfunction (ED), marital adjustment and depression.
Methods: The survey was conducted among primary care patients at Federal Medical Centre, Umuahia. Subjects were 678 married, male primary care patients; aged 20-70 years (mean age = 45 years). ED was assessed by International Index of Erectile Function 5 (IIEF-5) score, the presence of clinically significant depressive symptoms was assessed with the 5-item version of the Center for Epidemiological Studies Depression Scale (CES-D), and marital adjustment was assessed with the Revised Dyadic Adjustment Scale (RDAS).
Results: The prevalence of probable depression by CES-D and ED by IIEF-5 score was 20.9% and 26.0%, respectively. Marital distress was rampant (62.0%) among subjects with ED (p < 0.05, X2 = 196.58). Erectile dysfunction was associated with marital adjustment (p < 0.05). Partial correlation revealed that depression affects both ED and marital adjustment, and is closely related to both variables.
Conclusion: Partner involvement and screening for depression should be emphasised in the care of patients with ED.