South African Journal of Psychiatry - Volume 10, Issue 3, 2004
Volume 10, Issue 3, 2004
Author Soraya SeedatSource: South African Journal of Psychiatry 10, pp 52 –54 (2004)More Less
Extracted from text ... Paediatric psychopharmacology has entered a new and exciting era, with a substantial increase in the number of randomised controlled trials in paediatric mood and anxiety disorders. Although not a child and adolescent psychiatrist, I have followed the recent controversies and negative press surrounding antidepressants and self-harming behaviours in youth with keen interest, particularly given the manner in which regulatory authorities have taken stock of the available evidence to answer the deceptively simple question: 'Are antidepressants associated with increased suicidality?' Why is this an issue now? The idea of SSRI (selective serotonin reuptake inhibitor)- associated suicidality first came to light ..
Author Franco ColinSource: South African Journal of Psychiatry 10 (2004)More Less
Extracted from text ... 56 opinion In the August 2004 issue of Medical Chronicle, the Dean of the Faculty of Health Sciences at the University of Pretoria, Professor Thanyani Mariba, is described as 'passionate about academic medicine - and about being a role model to South Africa's future doctors'. He is quoted as saying: 'However I never went into medicine to make money. What message would I have been sending had I gone into private practice? That only patients who could afford my fees were deserving of my care? In effect I would have been telling the patients who couldn't afford to pay, ..
Source: South African Journal of Psychiatry 10, pp 58 –66 (2004)More Less
<I>Background.</I> The introduction of a new generation of atypical antipsychotic agents has raised difficult economic and ethical questions, particularly in lower-income countries. The reported tolerability and efficacy advantages of the atypical antipsychotics over their conventional predecessors have to be weighed against their higher acquisition costs. Pharmaco-economic studies conducted in Western countries consistently report cost advantages or cost neutrality for these new agents. However, considerable differences in health care service provision make it difficult to generalise these findings to South Africa. <br><I>Method.</I> We compared the direct costs (private and public sector) of treating schizophrenia with an atypical antipsychotic quetiapine, and with a conventional antipsychotic haloperidol, by adapting a decision-analytic pharmaco-economic model for South African circumstances. The sample comprised patients partially responsive to antipsychotics, who had participated in a multinational randomised controlled trial comparing the efficacy and safety of quetiapine versus haloperidol. <br><I>Results</I>. The estimated total direct cost for the treatment with quetiapine in South Africa was slightly less than for haloperidol for various models in both the private and the public sectors. <br><I>Conclusions</I>. Significant differences in health care provision make pharmaco-economic studies conducted in other countries invalid for South African circumstances. Previously quetiapine treatment did not result in direct cost savings in South Africa. However, the recently introduced legislation to establish single exit prices for medications has resulted in the cost of quetiapine treatment declining by 36.7% and that of haloperidol by 13%. This has translated into an overall direct cost saving for quetiapine in both the private and public sector models. This, together with additional indirect advantages of the atypical antipsychotics such as improved quality of life and better social and vocational functioning, argues strongly from both an economic and ethical perspective for the use of atypical antipsychotics in treating schizophrenia in South Africa.
Source: South African Journal of Psychiatry 10, pp 67 –72 (2004)More Less
Extracted from text ... 67 articles M J Shokane, MB ChB, MMed (Psych) L U Z Rataemane, MPhil, MSoc (Psychol) S T Rataemane, MB ChB, FFPsych, Dip Child Psych (UK) Department of Psychiatry, University of the Free State, Bloemfontein Attention-deficit/hyperactivity disorder (ADHD) is a chronic and disabling condition in children. It is among the most prevalent, chronic health conditions affecting school-aged children. Children with ADHD may experience significant functional problems, such as school difficulties, academic underachievement, and troublesome interpersonal relationships with family and peers.1, 2 Parents and teachers may diagnose a child's school problems as being ADHD-related, when in fact the difficulties are ..
Source: South African Journal of Psychiatry 10, pp 73 –92 (2004)More Less
Extracted from text ... 73 abstracts INTEGRATING THE ART AND SCIENCE OF PSYCHIATRY Eugene Allers Private Practice The history of Psychiatry is presented regarding the development from a dualistic approach to the present systems and constructivist approaches. This is integrated in the psychotherapeutic techniques and principles of modern psychiatry. The history of the development of biological treatments and the paradigms of the various periods in the development of treatments in Psychiatry is explored. The biological neurotransmitter systems and the developments of the latest discoveries in the neurotransmitter system are discussed as a system interfaced with the present psychological theories. The Psycho-Social interventions are ..
Author Jose SegalSource: South African Journal of Psychiatry 10, pp 93 –95 (2004)More Less
Extracted from text ... 93 letter To the Editor: The aim of this article1 was stated as 'to give a general overview of the use of ECT and an updated overview of newer research in this field. It also gives practical guidelines for administering ECT.' Unfortunately many of the articles quoted in this review have been overtaken by more up-to-date publications, especially in previously controversial areas, as will be discussed below. The following in particular warrant further discussion. 1. Bilateral (BL) versus unilateral (UL) ECT Prinsloo and Pretorius quote a paper by Sackeim et al. 2 published in 1993, in which the response ..
Author Liezl KoenSource: South African Journal of Psychiatry 10, pp 95 –96 (2004)More Less
Extracted from text ... 95 book reviews Objective structural clinical examinations in psychiatry OSCEs in Psychiatry. Ed. by Albert Michael. Pp. 210. Illustrated. Elsevier Science Limited. 2004. ISBN 0-443-07297-3. Objective structured clinical examinations (OSCEs), using real or simulated patients, were developed with a view to improve what some regard as unreliable traditional examination methods by standardising variability in both patients and candidate assessment. As such they are a fairly new phenomenon in the field of psychiatry and have only recently replaced the so-called 'long case' in the UK Royal College of Psychiatrists Part 1 examinations. The aim of this volume is therefore ..
Origins of Phobias and Anxiety Disorders : Why More Women Than Men, Michelle G. Kraske : book reviewAuthor S. SeedatSource: South African Journal of Psychiatry 10 (2004)More Less
Extracted from text ... Origins of Phobias and Anxiety Disorders: Why More Women Than Men Origins of Phobias and Anxiety Disorders: Why More Women Than Men. Michelle G Kraske. Pp. 304. Oxford: Elsevier Ltd. 2003. ISBN 0-08-044032-0. Anxiety disorders, as we know, are common to both youth and adult populations. This book provides intriguing insights, primarily from a developmental perspective, into the basis of pathological fear and anxiety and explores the question of why a greater risk for anxiety and anxiety disorders exists in women. Anxiety disorders often precede and predict other disorders (e.g. major depression), suggesting that they may, in fact, represent ..