South African Journal of Psychiatry - Volume 15, Issue 2, 2009
Volume 15, Issue 2, 2009
Author L. ScribanteSource: South African Journal of Psychiatry 15, pp 29 –32 (2009)More Less
Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent and widely studied disorders of childhood. On searching the literature, thousands of articles are found on all aspects of this disorder, including its diagnosis, co-morbidities, longitudinal course and management.
Bipolar mood disorder (BMD) has traditionally been seen as an adult disorder and has only been described in children since the last decade of the 20th century. In the past 10 years, the number of children being diagnosed with BMD has more than doubled, with more than 100 000 children in the USA receiving treatment for BMD in 2001 in spite of the uncertainties that still surround its diagnosis in children.
Source: South African Journal of Psychiatry 15, pp 33 –36 (2009)More Less
Objectives. This study examined the quality of referrals to secondary-level outpatient psychiatric services rendered by the Department of Psychiatry, University of the Free State. Referral letters were evaluated according to specific quality criteria. Aspects that would enable secondary-level doctors to make informed decisions in terms of further management and need for special investigations were specifically considered.
Design. A descriptive study design was used, and convenience sampling included all referrals to the unit over a 6-month period (June - November 2007). All referral letters were screened according to a checklist designed for this study.
Setting. The study was undertaken at the Psychiatry Outpatient Department of the Pelonomi Provincial Hospital in Bloemfontein, which functions as a secondary-level referral centre for mental health in the southern Free State.
Outcome measures. Descriptive statistics (percentages, means and standard deviations) were used to summarise results.
Results. Two hundred and sixty-three referral letters were included in the study. Less than 20% of the referral letters included information on previous psychiatric consultations, current psychotropic medication, the outcome of physical examinations, and results of special investigations. Only 17 (6%) referral letters indicated a preliminary diagnosis according to an officially recognised classification system.
Conclusion. There was conclusive evidence that the quality of referrals to the Psychiatry Department was generally inadequate. A need for more effective referral strategies was identified.
Source: South African Journal of Psychiatry 15, pp 37 –42 (2009)More Less
Objective. To determine compliance with Section 40 (1-3) of the Mental Health Care Act (MHCA) No 17 of 2002, viz. handing over custody by the South African Police Service (SAPS) of suspected mentally ill patients to medical services at Chris Hani Baragwanath Hospital (CHBH).
Methods. The study was a retrospective record review of patients who were 18 years and older, referred by SAPS to CHBH. In accordance with Section 40 of the MHCA, a MHCA form 22 is completed when suspected mentally ill patients are handed over by SAPS to the medical services. MHCA forms 22 that were completed during the period July 2007 to December 2007 were obtained from hospital records and analysed to determine the compliance of SAPS and medical practitioners in completing them.
Results. During the study period, 708 of the 718 patients handed over by SAPS to the Emergency Department of CHBH were entered on MHCA forms 22. SAPS officials had correctly completed 86% of the forms, whereas the medical practitioners had only correctly completed 9.9% of the forms. Of the 718 patients handed over by SAPS, 319 (44%) were discharged for outpatient care.
Conclusion. The findings of this study suggest that not all parties fully comply with Section 40 of the Mental Health Care Act No 17 of 2002. We suggest that the situation can be improved by training of all parties; amendments to the MHCA form 22; partnership between mental health care practitioners and members of SAPS; and combining resources towards implementing a crisis intervention model similar to that in other countries.
Source: South African Journal of Psychiatry 15, pp 43 –47 (2009)More Less
Background. Caring for patients with schizophrenia places an enormous burden on the caregivers. The magnitude of this problem remains largely unknown in sub-Saharan Africa.
Objective. The objective of this study was to determine the nature of the burden reported by caregiving relatives of patients with schizophrenia.
Materials and method. A total of 129 primary caregivers of patients with schizophrenia attending the outpatient clinic of Katsina State Psychiatric Hospital were interviewed, using a socio-demographic data collection sheet and the Zarith Burden Interview (ZBI).
Results. The mean age of the respondents was 45.1±8.9 years. Most of the caregivers were female. A high level of burden was found in 47.3% of respondents. The level of burden experienced was significantly associated with place of residence and family size.
Conclusion. Schizophrenia is associated with a high level of caregiver burden. Efforts should be made to alleviate this burden for better outcomes in both patients and caregivers.
Source: South African Journal of Psychiatry 15, pp 48 –52 (2009)More Less
Given the high incidence of cervical cancer in South Africa and the distress it causes, we aimed to determine the extent of anxiety in patients undergoing colposcopy at Chris Hani Baragwanath (CHB) Hospital, Johannesburg.
Method. A descriptive and cross-sectional study design was applied on a convenient sample of patients from the waiting area of the colposcopy clinic at CHB Hospital. Females attending a first colposcopy appointment were invited to participate by completing the State-Trait Anxiety Inventory (STAI) after written informed consent had been obtained.
Results. Among a total of 31 women, the mean STAI score for state anxiety was 46.77 (SD=12.92) and the mean STAI score for trait anxiety was 46.81 (SD=9.50); 51.6% of the patients had a STAI state anxiety score of >50, while 41.9% of the patients had a STAI trait anxiety score >50. There was no significant association between either elevated STAI state or trait anxiety scores and age group (χ2=1.77; p=0.18 and χ2=0.001; p=0.98, respectively); marital status (χ2=0.301; p=0.58 and χ2=0.834; p=0.36); level of education (χ2=0.444; p=0.51 and χ2=2.40; p=0.12); employment status (χ2=1.78; p=0.18 and χ2=0.001; p=0.98); monthly income (χ2=1.15; p=0.28 and χ2=0.03; p=0.86) or using stimulants (χ2=0.416; p=0.52 and χ2=0.394; p=0.53). There was a significant negative correlation between age and STAI state anxiety scores (r2=0.004; p=0.017) and a positive correlation between age and STAI trait anxiety scores (r2=0.004; p=0.019).
Conclusion. This study reported significantly elevated trait anxiety scores relating to colposcopy and emphasises the need to identify the anxiety and institute a plan to ameliorate it with information booklets, leaflets, video colposcopy and educational counselling.