South African Journal of Psychiatry - Volume 13, Issue 2, 2007
Volume 13, Issue 2, 2007
Source: South African Journal of Psychiatry 13, pp 38 –39 (2007)More Less
Individuals with depression are generally less healthy than those with a major chronic disease, according to data collected by the World Health Organization (WHO) in its World Health Survey on health and health-related outcomes and their determinants in adults aged 18 years and older and presented in the organisation's World Health Statistics 2007.
Source: South African Journal of Psychiatry 13, pp 40 –45 (2007)More Less
Patients with psychiatric illnesses show a greater degree of non-adherence than those with physical disorders. Adherence to treatment may be assessed using biological measurements, clinician ratings, patient self-report, pill count, caregiver reports and side-effects of medication. Reasons cited for non-adherence include factors related to the treatment, patient-related factors, health care, and socio-economic circumstances. It is important not to make prejudicial predictions of non-adherence based on these factors, or the use non-adherence as an excuse to blame the patient for an unfavourable outcome. Rather, non-adherence should be seen not only as the patient's inability to follow treatment recommendations but also as the health system's failure to provide adequate care and to meet the patient's needs.
Anxiety, depression, health attitudes and coping strategies in doctors and teachers in a Cape Town setting : articleSource: South African Journal of Psychiatry 13, pp 46 –51 (2007)More Less
Objective. To investigate two professional groups (doctors and teachers) with regard to symptoms of anxiety and depression as a measure of psychological distress, as well as perceptions regarding job satisfaction, workload and adequacy of remuneration. To assess health care behaviour as evidenced by substance use, psychotropic medication use, self-prescribing habits (in doctors), help seeking behaviour as well as negative coping strategies as indicated by the intention to emigrate and / or leave the profession.
Design. Data were collected from randomly distributed questionnaires which included a validated objective screening instrument, the Hospital Anxiety and Depression Scale (HADS).
Subjects and setting. Questionnaires were distributed among 260 physicians at Tygerberg Academic Hospital and 200 teachers from five different schools in the northern suburbs of metropolitan Cape Town.
Results. We found high levels of job dissatisfaction and symptoms of anxiety and depression in both groups, with teachers more affected than doctors. A large proportion of respondents with clinically significant levels of anxiety and depression remain untreated. Many respondents displayed a passive attitude with regard to seeking help. A significant proportion of doctors self-prescribed antidepressant and benzodiazepine medications. Only a small minority of doctors had a general practitioner whom they would consult when ill. Twenty-nine per cent of doctors indicated their intention to emigrate and 40% of teachers were planning to leave their profession.
Conclusion. Our results suggest that doctors and teachers in South Africa are two professional groups at high risk for developing serious mental health problems, with low levels of recognition and intervention at present.
Source: South African Journal of Psychiatry 13, pp 52 –55 (2007)More Less
Objectives. Critical aspects in the management of attempted-suicide patients have been identified in the literature. The aim of this study was to determine which of these aspects were included in the management of patients who attempted suicide in a rural district of KwaZulu-Natal.
Design. Descriptive study.
Setting. The two hospitals in a rural district of KwaZulu-Natal.
Subjects. Attempted-suicide patients admitted to the above two hospitals between 1 June 2001 and 31 March 2002.
Outcome measures. Patients were interviewed regarding how they were managed and were followed up until 3 months after the attempted suicide.
Results. Medicine was given to 41% of participants on admission and 64% were counselled by a doctor. A nosuicide contract was entered into in 42% of counselled cases. Family therapy, social worker involvement and psychiatric referral were very low and there was no involvement of friends, teachers or priests.
Conclusion. Management of patients who attempted suicide in this district is inadequate as there are no proper policy guidelines. It is important that health caregivers be trained in psychiatry.
Source: South African Journal of Psychiatry 13, pp 56 –58 (2007)More Less
A relatively small number of persons with mental illness become involved in criminal acts that can be related to their mental disorder. Crimes are mainly property-related, and less often against persons (i.e. less violent crimes). The mental state of the defendant is usually brought to the attention of the criminal court through the bizarre nature of the crime, a known history of psychiatric treatment, or unusual behaviour by the accused following arrest.
Source: South African Journal of Psychiatry 13, pp 60 –63 (2007)More Less
Background. Some studies have suggested that breastfeeding may be protective against the development of schizophrenia. Such a theory supports the neurodevelopmental hypothesis of schizophrenia.
Objective. To determine whether there were differences in breastfeeding patterns between patients with schizophrenia and controls.
Method. Fifty subjects with schizophrenia and 50 age- and gender-matched controls were included in the study. All subjects and their mothers were interviewed using a structured questionnaire to determine the extent of breastfeeding in infancy and age of onset of psychosis.
Results. There was a significant difference in the duration of breastfeeding in patients versus controls (p < 0.05).
Conclusion. Breastfeeding seems to be protective against the development of schizophrenia. This supports the neurodevelopmental hypothesis of this disorder and may be indicative of the role of essential fatty acids in normal brain development and the prevention of schizophrenia.