South African Journal of Psychiatry - Volume 14, Issue 1, 2008
Volume 14, Issue 1, 2008
Source: South African Journal of Psychiatry 14, pp 2 –3 (2008)More Less
Poor access to mental health care for people infected and affected by HIV combined with poor access to HIV prevention, care and treatment for people with mental health needs were key themes discussed at a World Federation for Mental Health (WFMH) expert forum convened in Cape Town, South Africa, in January.
Providing psychiatric services in general medical settings in South Africa : mental health-friendly services in mental health-friendly hospitals : editorialSource: South African Journal of Psychiatry 14, pp 4 –6 (2008)More Less
Neuropsychiatric disorders rank high on the list of the most disabling medical disorders in both the developed and developing worlds. Significant comorbidity also exists between neuropsychiatric disorders and general medical disorders; this is key in the South African context where HIV / AIDS and substance use disorders are highly prevalent. It has therefore become essential to provide mental health services in a range of settings, including those that focus on the delivery of general medical services. Furthermore, the Mental Health Care Act 17 of 2002 underlines the importance of providing integrated, accessible mental health care in the local community.
Ageing and mental health resources for older persons in the African region of the World Health OrganizationSource: South African Journal of Psychiatry 14, pp 8 –12 (2008)More Less
Africa is a region where a demographic transitionfrom high child mortality and low life expectancy, to lowchild mortality and high life expectancy is only just beginning.Nevertheless, some countries already have a growing numberof persons over the age of 60 - a number that is likely toincrease rapidly. As a consequence, the number of olderpersons with mental disorders is likely to increase. To betterunderstand the organisation of care for older persons, dataare being collected to reduce the imbalance between 'diseaseinformation' and 'resource information' - information thataddresses older persons' needs in terms of mental health care.This review presents some results from the continent. Mentalhealth problems among older adults are still not a public healthpriority in Africa, but careful examination of each countrynevertheless reveals certain specificities, such as divergent lifeexpectancy and different values regarding ageing. The authorspresent some recommendations for the development of carefor old persons with mental disorders, based on the generalrecommendations made by the World Health Organization(WHO) in the World Health Report 2001 (WHR 2001), andby the WHO and the World Psychiatric Association (WPA) insome consensus statements on psychiatry of the elderly.
Source: South African Journal of Psychiatry 14, pp 14 –19 (2008)More Less
Interest in the subject of first-episode psychosis has increased considerably in the last two decades. At present, a number of centres around the world focus on early identification and intervention in people with psychotic disorders. Researchers have focused particularly on people who are possibly experiencing the prodromal phase of the illness in the hope that, by instituting appropriate early intervention, the outcome of schizophrenia will be improved. Patients with first-episode psychosis present with different symptom domains that should be taken into account when planning treatment. Most patients initially respond to treatment; however, there is a high rate of relapse within a few years. It is therefore important that we continue to seek improved relapse prevention strategies. There has also been a resurgence of interest in psychosocial risk factors for the development of schizophrenia in the recent literature. We review the literature on first-episode psychosis and highlight the significant findings.
The profile analysis of attempted-suicide patients referred to Pelonomi Hospital for psychological evaluation and treatment from 1 May 2005 to 30 April 2006Source: South African Journal of Psychiatry 14, pp 20 –25 (2008)More Less
Background. Suicide is an increasing phenomenon worldwide. A suicide occurs every 40 seconds, and there is 1 attempt every 1 to 3 seconds. By 2020, these figures may have doubled. No accurate statistics regarding the occurrence of attempted suicide (or non-fatal suicidal behaviour) in South Africa exist, because there has been no systematic data collection.
Aim. The aim of the study was to determine the profile of patients who had attempted suicide and were referred to Pelonomi Hospital, Bloemfontein, for psychological evaluation and treatment during the period 1 May 2005 to 30 April 2006.
Method. A descriptive, retrospective study was conducted. The study population comprised 258 attempted-suicide patients referred to Pelonomi Hospital for psychological evaluation and treatment. A data form was compiled to transfer the relevant information from patients' clinical files.
Results. The majority of patients were female (68.9%). The median age was 22 years. The most common method used in suicide attempts was drug overdose (66%) - mostly antidepressants (19.7%)) and analgesics (8.2%). More females than males overdosed on drugs (p=0.0103). The main precipitating factors included problematic relationships (55.4%), financial problems (22.9%), psychiatric problems (22.1%), arguments (19.8%), abuse (emotional, sexual, physical - 18.2%), low self-esteem / worthlessness / hopelessness / humiliation (16.7%), and recent life changes (13.2%).
Conclusion. The aim of the study was to determine the profile of patients who had attempted suicide. Possible factors associated with suicide attempts in our sample were identified and summarised in the form of a screening checklist. The value of the checklist is that it can be used as a screening method to identify possible suicide risk in patients.
Source: South African Journal of Psychiatry 14, pp 27 –31 (2008)More Less
Introduction. Following the suicide of a 4th-year medical student, questions were raised as to whether medical students are more vulnerable to depression and suicide than their counterparts studying other courses at the University of Pretoria. A literature search revealed that medical students and doctors run a higher risk for suicide than other students and professions.
Method. A questionnaire was devised and distributed to medical students and a control group of other students, asking about feelings of despair / hopelessness, suicide ideation and previous attempts, knowledge regarding support structures provided by the university, and willingness to use these structures.
Results. Both groups of students responded similarly to all questions. Frequency of diagnosed psychiatric illness, use of medication, and suicidal thoughts and attempts did not differ significantly. Both groups of students were unaware of support services offered by the university, and both were unwilling to utilise such services. The students seemed to have high rates of depression in comparison with prevalence data from other countries.
Conclusion. Attempts to improve support for medical students should address students' awareness of available support structures and their willingness to utilise them.
Primary Health Care Psychiatry : A Practical Guide for Southern Africa, Sean Exner Baumann : book reviewAuthor J.L. RoosSource: South African Journal of Psychiatry 14 (2008)More Less