South African Journal of Psychiatry - Volume 12, Issue 1, 2006
Volume 12, Issue 1, 2006
Source: South African Journal of Psychiatry 12 (2006)More Less
Extracted from text ... Volume 12 No. 1 March 2006 - SAJP news news news news news news news news news SASOP supports same-sex marriages On 1 December 2005, the Constitutional Court made a judgement legalising same-sex marriages. This includes the right to adopt children for gay and lesbian couples. The only restriction recognised by the Court was that marriage officers could refuse to marry homosexual couples if it was against their conscience. While the ruling political party, opposition party and many churches responded favourably to the ruling, population surveys have documented that most South Africans are uncomfortable with homosexuality. Traditional leaders, such as ..
Source: South African Journal of Psychiatry 12, pp 4 –8 (2006)More Less
Extracted from text ... editorial Volume 12 No. 1 March 2006 - SAJP Serious mental illness and HIV / AIDS A previous editorial1 emphasised the need for leadership from all sectors of society in tackling the HIV / AIDS epidemic. This certainly does not exclude a critical role for mental health practitioners. There is growing global recognition of the interrelationship between mental health and HIV / AIDS and in developing countries, where the impacts of the pandemic are by far the greatest, we need increased efforts to better understand these interactions and to intervene effectively. In this editorial we look specifically at relationships between ..
Author J.L. RoosSource: South African Journal of Psychiatry 12, pp 10 –12 (2006)More Less
Extracted from text ... 10 editorial Volume 12 No. 1 March 2006 - SAJP Pitfalls in the care of the very sick psychotic patient In the state psychiatric sector consultants are often faced with management of the very sick psychotic patient. There are guidelines to managing treatment resistance in schizophrenia, which may follow the following path.1 If a treatment effect (30 - 40% improvement of positive symptoms on standardised rating scales after a month or two of treatment) is not observed, most clinicians switch to a second-generation antipsychotic drug. When switching from either conventional antipsychotics to a second-generation antipsychotic or from one second-generation antipsychotic ..
Author Soraya SeedatSource: South African Journal of Psychiatry 12, pp 13 –16 (2006)More Less
Extracted from text ... 13 editorial Volume 12 No. 1 March 2006 - SAJP War and post-traumatic stress disorder War, like terrorism, instills fear and threat at both an individual and a societal level. Soldiers of war and military peacekeeping forces are not only at risk for being maimed but also for witnessing, or suffering from, the aftermath of violence. While many soldiers function well under trying circumstances and remain asymptomatic, a significant number fall victim to a host of post-traumatic sequelae, of varying persistence and severity.1 In 1952, following several accounts of combat stress reactions that occurred during World War II and the ..
Amisulpride as adjunct to clozapine in treatment-resistant schizophrenia and schizoaffective disorder : an open-label pilot studySource: South African Journal of Psychiatry 12, pp 17 –20 (2006)More Less
<I>Background.</I> Although clozapine is the treatment of choice for treatment-resistant schizophrenia, many patients remain symptomatic despite adequate treatment with this medication. One suggested strategy to improve efficacy has been the addition of a potent D<SUB>2</SUB> blocker such as amisulpride to treatment with clozapine. <BR><I>Methods.</I> In this study, 20 subjects who were treatment-resistant to conventional antipsychotics and who were still symptomatic despite adequate treatment with clozapine received amisulpride as adjunctive treatment. After baseline assessment all subjects were titrated to amisulpride 400 mg per day and then reassessed after 8 weeks by a blinded rater. <BR><I>Results.</I> Analysis showed statistically significant improvements in PANSS (Positive and Negative Symptom Scale) total score (<I>t</I> = 3.49, df = 18, <I>p</I> = 0.003), PANSS negative subscale score (<I>t</I> = 3.22, df = 18, <I>p</I> = 0.005), and PANSS depression factor score (<I>t</I> = 3.89, df = 19, <I>p</I> = 0.001). <BR><I>Discussion.</I> This study suggests that addition of the second generation antipsychotic amisulpride to a stable treatment regimen with clozapine may offer additional benefits in terms of negative and depressive symptoms.
Source: South African Journal of Psychiatry 12, pp 21 –24 (2006)More Less
Extracted from text ... articles 21 Volume 12 No. 1 March 2006 - SAJP Clozapine-induced intestinal obstruction - a critical examination of four cases C Seller, MB ChB, MMed (Psych) L Koen, MB ChB, MMed (Psych) D J H Niehaus, MB ChB, MMed (Psych), DMed Ngaphakathi Workgroup, Department of Psychiatry, Stellenbosch University Clozapine is an atypical antipsychotic drug indicated for the management of severely ill patients with schizophrenia who fail to respond adequately to standard antipsychotic treatment. It has demonstrated superior efficacy in treating both the positive and negative symptoms in treatment-refractory cases.1 It also has the added benefit of causing minimal extrapyramidal ..
Author Karien BothaSource: South African Journal of Psychiatry 12, pp 25 –32 (2006)More Less
Extracted from text ... 25 articles Volume 12 No. 1 March 2006 - SAJP As an inevitable end to life, death is one of the most denied experiences all of us will go through. As young people, we tend to think of ourselves as invincible.1 By the age of 65, over half of all women and over 10% of all men have been widowed at least once. Among those who survive 85 years or more, 81.3% of women and 40.5% of men are widowed.2 Grief is defined as the expression of our reaction to loss. Mourning involves the process of reorientating ourselves in ..
Source: South African Journal of Psychiatry 12, pp 33 –37 (2006)More Less
<I>Objectives.</I> The study involved Nigerian soldiers engaged in peacekeeping missions in Liberia and Yugoslavia. Using case illustrations, the study sought to describe patterns of homicidal violence among soldiers from the same country or soldiers from allied forces, and to suggest possible reasons for the attacks. <BR><I>Design and setting.</I> Nigeria was actively involved in peacekeeping missions in Liberia between 1990 and 1996. During this period, intentional homicidal attacks occurred among the Nigerian military personnel. Posthomicidal interviews conducted among the perpetrators were combined with evidence obtained at military courts to produce the case studies. <BR><I>Subjects.</I> Six Nigerian military personnel who attacked other Nigerians or soldiers from allied forces, with homicidal intent. <BR><I>Results.</I> Possible predisposing and precipitating factors for these attacks were highlighted. The possibility of recognising these factors before embarking on overseas missions was discussed, so that preventive measures could be instituted as far as possible. Finally, medico-legal implications of homicide in the military were discussed. <BR><I>Conclusions.</I> A certain degree of pre-combat selection is essential to exclude soldiers with definite severe psychopathology. A clearly defined length of duty in the mission areas and adequate communication with home could reduce maladjustment. Health personnel deployed to mission areas should be very conversant with mental health issues so that early recognition of psychological maladjustment is possible.
Post-traumatic stress disorder, survivor guilt and substance use - a study of hospitalized Nigerian army veteransSource: South African Journal of Psychiatry 12, pp 37 –40 (2006)More Less
<I>Objectives.</I> To investigate the prevalence of post-traumatic stress disorder (PTSD) and survivor guilt in a sample of hospitalised soldiers evacuated from the Liberian and Sierra-Leonean wars in which Nigerians were involved as peace keepers. The relationships between PTSD, survivor guilt and substance use were also investigated. <BR><I>Design.</I> A socio-demographic data questionnaire, the PTSD checklist and a validated World Health Organization substance use survey instrument were used to obtain data from the subjects. <BR><I>Setting.</I> The study took place at the 68 Nigerian Army Reference Hospital, Lagos, Nigeria, which was the base hospital for all casualties from the Liberian and Sierra- Leonean operations. <BR><I>Subjects.</I> All hospitalised patients from the military operations during a 4-year period (1990 - 1994) who were physically capable of being assessed were included in the study. <BR><I>Results.</I> The prevalence rate for PTSD was found to be 22% and survivor guilt was found in 38% of the responders. PTSD was significantly associated with long duration of stay in the mission area, current alcohol use, lifetime use of an alcohol / gunpowder mixture, and lifetime cannabis use. Survivor guilt was significantly associated with avoidance of trauma-related stimuli but not duration of combat exposure. <BR><I>Conclusions.</I> Although the sample studied was specific, PTSD might be quite common and probably undetected among Nigerian military personnel engaged in battle in Liberia and Sierra-Leone. Detection of such persons through deliberate screening in military community studies should help to alleviate the symptoms since good intervention methods are now available. Primary prevention efforts with regard to alcohol and cannabis use should help to reduce the incidence of PTSD.