South African Journal of Psychiatry - Volume 10, Issue 1, 2004
Volume 10, Issue 1, 2004
Source: South African Journal of Psychiatry 10, pp 8 –13 (2004)More Less
This article is a summary of a document prepared by a task team appointed by the Superintendent-General, Head: Department of Health, KwaZulu-Natal. The terms of reference of the task team were to scrutinise all available documents on mental health in the province and to come up with a new document entitled 'Strategic and Implementation Plan for Delivery of Mental Health Services in KwaZulu-Natal', with operational plans and time frames, and to make specific recommendations with regard to community mental health services and forensic psychiatry. <br>The documents used to prepare the new document were: A Framework for the Delivery of Mental Health Services by Institutions in KwaZulu-Natal; Mental Health Services Planning Report; Strategic Policy Document for Mental Health Services in KwaZulu-Natal; Community Mental Health Services at Indlovu Region, KwaZulu-Natal; KwaZulu-Natal Health Care Act 2000; Mental Health Act 2002; World Health Report on Mental Health 2001; and Mental Health and Substance Abuse Report. <br>The article is divided into nine sections, namely organisational structure; education, training and research; mental health service provision; highly specialised services; community mental health services; forensic mental health services; mental health and the private sector; pharmaceutical services; and summary of recommendations.
Author Pieter Van der BijlSource: South African Journal of Psychiatry 10, pp 13 –16 (2004)More Less
<I>Background.</I> Drug abuse is as relevant today as ever. Management of such cases on a primary health care level may be challenging, particularly when laboratory facilities are unavailable. Furthermore, substance abuse and its sequelae place a significant burden on the already overstretched primary health care resources in the country, as well as on other services and society in general. <br><I>Objectives.</I> The current study surveyed the trends in demand for laboratory determination of amphetamines, opiates, methaqualone, cannabis, cocaine and ethanol for the period 1991 - 2002, in the Western Cape. The survey was conducted by extracting the relevant data from the records of the Pharmacology/Toxicology Laboratory of the University of Stellenbosch and Tygerberg Academic Hospital. This facility processes the largest number of specimens by a single laboratory in the Western Cape. <br><I>Results.</I> From the data obtained a seasonal pattern emerged for all substances except ethanol, with a trough appearing in early winter. Demand for ethanol analysis was fairly constant throughout the year, with a peak in the last quarter. Ethanol level was the most frequently requested analysis between 1991 and 1997. This concurs with its status as the main substance of abuse in South Africa and the rest of the world. There was an increased demand for analysis of amphetamines, opiates, methaqualone, cannabis and cocaine between 1991 and 2002. Generally dominating, next to ethanol, were requests for cannabis and methaqualone analysis. Interesting to note was the increase in demand for opiate analysis, following the trend observed in certain other regions of the world. <br><I>Conclusion.</I> The analysis trends observed in this study demonstrate global patterns of drug abuse emerging in the Western Cape. The medical and social effects of drug abuse impose a grave responsibility on policymakers to ensure that adequate funding is available for analytical laboratories. Only in such a way can these patients be correctly diagnosed and treated.
Factor analysis of the Children's Behaviour Questionnaire in a Nigerian paediatric primary care populationSource: South African Journal of Psychiatry 10, pp 17 –20 (2004)More Less
<I>Objective.</I> This paper examines the factor structure of the Yoruba translation of the Children's Behaviour Questionnaire for Completion by Parents (CBQ) administered in a Nigerian paediatric primary care population. <br><I>Design.</I> A cross-sectional questionnaire survey. <br><I>Subjects.</I> Four hundred and seventy-eight children aged 7 - 14 years who attended a primary care clinic in Ibadan, Nigeria, over a 3-month period. <br><I>Methods.</I> Parents' ratings of the children were obtained using the Yoruba translation of the CBQ. The factor structure of this instrument was examined using principal component analysis with varimax rotation. Only factors with eigenvalues of greater than 1 were examined further. <br><I>Results.</I> The first seven dimensions were readily conceptualised. These factors are conduct problem, hyperactivity, emotional problem, irritability, problems with elimination, a somatic complaint and a school problem dimension. <br><I>Conclusion.</I> These factors are similar to what has been observed in other studies involving populations of children with psychopathology, with the exception of the somatic complaint and school problem dimension. The emergence of these two factors, which are quite different from what has been observed in other studies, may demonstrate differences that reflect the influence of language, culture and the peculiarities of a primary care setting. On the other hand the similarity of most of the factors to those found in previous studies confirms the broad similarities in the behaviour of children across different cultures.
Source: South African Journal of Psychiatry 10, pp 21 –24 (2004)More Less
<I>Background.</I> Although there is growing literature on the psychological responses to and the psychopathology associated with HIV / AIDS, few investigations have focused on the role of gender. This study compared psychiatric morbidity, coping responses, and disability in male and female outpatients recently diagnosed with HIV / AIDS. <br><I>Method.</I> One hundred and forty-nine patients (44 male, 105 female) with HIV / AIDS (mean + standard deviation (SD) months since diagnosis 5.8 + 4.1) attending an infectious diseases clinic at Tygerberg Hospital, Cape Town, were evaluated. Subjects were assessed using the MINI International Neuropsychiatric Interview (MINI), the Carver Brief COPE, and the Sheehan Disability Scale. In addition, negative life events and risk behaviours were evaluated. <br><I>Results.</I> Fifty-six per cent of patients were diagnosed with a psychiatric disorder, most commonly major depression (34.9%), dysthymic disorder (21.5%), post-traumatic stress disorder (14.8%), and alcohol dependence (10.1%). There were no significant gender differences in the prevalence of mood disorders in the sample. Men, however, were more likely than women to meet diagnostic criteria for alcohol abuse or dependence, and to engage in certain risky sexual behaviours. Women were more likely to suffer from post-traumatic stress disorder, and to use coping strategies of planning and religion to deal with the illness. There were no significant gender differences in disability. <br><I>Conclusion.</I> Psychiatric disorders are common in recently diagnosed HIV / AIDS patients in South Africa. Clinicians should be aware of the high prevalence of mood disorders in both men and women, and of gender-different responses such as increased alcohol and substance use and more risky sexual behaviour in men.