South African Journal of Psychiatry - Volume 16, Issue 2, 2010
Volume 16, Issue 2, 2010
Schizophrenia-Window-of-Hope.com : development of a psycho-educational Internet resource for the South African settingSource: South African Journal of Psychiatry 16, pp 34 –38 (2010)More Less
Psycho-educational programmes for families of persons with schizophrenia have been shown to reduce relapse rates, subsequently reducing the burden on the family as well as health care systems. Although various South African helplines and psycho-educational websites exist, none of these focused specifically on schizophrenia. The South African Depression and Anxiety Group (SADAG) was approached for assistance to enable us to develop a piggy-back schizophrenia service on their already established helpline. A multidisciplinary mental health team compiled a manual for use by SADAG helpline operators, but owing to the huge amount of information it was realised that the resource would be more efficient if both a helpline and an Internet resource could be created. The website (www.schizophrenia-window-of-hope. com) was then developed with the help of an IT professional. This site represents the first attempt to create an Internet-based schizophrenia-specific educational resource for the South African setting. The next step will be to obtain formal feedback from helpline and website users in order to inform the ongoing development of the site.
Source: South African Journal of Psychiatry 16, pp 40 –49 (2010)More Less
Background. The aim of the study was to explore the epidemiology of drug abuse treatment in South Africa.
Methods. Treatment demand statistics were analysed from South African National Council on Alcoholism and Drug Dependence and the South African Community Epidemiology Network on Drug Use records, and a rapid situation assessment was conducted. Twenty-one key informant interviews were conducted in all 9 provinces among provincial substance abuse co-ordinators, and one manager per treatment centre from a sample of treatment centres. Three focus groups were conducted and 46 self-administered questionnaires were distributed among inpatients at 2 selected treatment centres in Free State and North West provinces. Qualitative data were analysed using grounded theory, and quantitative data analysed using SPSS.
Results. Treatment records show that the most frequent substance of abuse was alcohol (51%), followed by cannabis (21%), crack/cocaine (9.6%), heroin/opiates (7.9%), methamphetamine (Tik) (4.5%), prescription/over-the-counter drugs (2.0%), and cannabis/mandrax (1.7%). More substance abusers were male, of lower education, white or black, than were female, more highly educated, coloured and Indian/Asian. Key informant interviews showed that females are the 'hidden' substance abusers and tend not to be identified in research statistics and at treatment centres. Poverty, unemployment, lack of recreational facilities, being surrounded by substance abusers, and long work shifts were also mentioned as factors contributing to substance abuse. The age of initiation of substance abuse using non-drugs such as glue was 9 years old, alcohol 10 - 12 years old, dagga 11 - 12 years old, poly-drug use (alcohol, tobacco and dagga) 14 years old, and harder drugs such as cocaine and heroin at 16 - 17 years old, as reported by key informants. Family care and support, improved socio-economic conditions and increased law enforcement would help to discourage substance abuse.
Conclusion. Prevention interventions and policies in South Africa should focus on reducing substance abuse by targeting the 'at risk populations' identified in this study.
Source: South African Journal of Psychiatry 16, pp 50 –55 (2010)More Less
Background. Behavioural problems among schoolchildren can pose a burden on families and society.
Objective. To determine the prevalence and pattern of behavioural problems among children living in Uyo, a town in South-South Nigeria.
Methods. A cross-sectional study was carried out among 572 pupils from six primary schools selected randomly from private and government schools in Uyo. Pupils with a normal IQ were selected using a systematic sampling method. The Rutter behavioural scale for teachers (B2) was completed by their teachers, and that for parents (A2) was completed by the parents. Student's t-test was used to compare pairs of means, frequencies were compared using the chi-square test, and p<0.05 was taken as significant.
Results. According to the teachers' scale 132 pupils (23.1%) had scores within the range indicating behavioural problems, compared with 103 pupils (18.0%) on the parents' scale. This was statistically significant (X2=19.8, p=0.001). Pupils in government and private schools had mean scores of 7.4 (standard deviation (SD) 6.41) and 5.12 (SD 6.26) and 7.29 (SD 5.84) and 6.96 (SD 5.76), respectively. Behavioural problems were more common among children in government schools and among those in the lower socio-economic class. Boys had significantly higher mean scores than girls, and both scales showed more boys to be disturbed. Antisocial behaviour was commonest among boys and older children.
Conclusion. There is a high prevalence of behavioural problems among primary school children in Uyo, with a predominance of antisocial behaviour. The government needs to provide appropriate services to deal with this state of affairs.
Stigmatising attitudes towards the mentally ill : a survey in a Nigerian university teaching hospitalSource: South African Journal of Psychiatry 16, pp 56 –60 (2010)More Less
Background. The burden of mental illness is particularly severe for people living in low-income countries. Negative attitudes towards the mentally ill, stigma experiences and discrimination constitute part of this disease burden.
Objective. The aim of this study was to investigate knowledge of possible causes of mental illness and attitudes towards the mentally ill in a Nigerian university teaching hospital population.
Method. A cross-sectional descriptive study of a convenience sample of 208 participants from the University of Uyo Teaching Hospital, Uyo, Nigeria, using the Community Attitudes towards the Mentally Ill (CAMI) scale. Information was also obtained on beliefs about possible causes of mental illness.
Results. The respondents held strongly negative views about the mentally ill, mostly being authoritarian and restrictive in their attitudes and placing emphasis on custodial care. Even though the respondents appeared to be knowledgeable about the possible role of psychosocial and genetic factors in the causation of mental illness, 52.0% of them believed that witches could be responsible, 44.2% thought mental illness could be due to possession by demons, and close to one-third (30%) felt that it could be a consequence of divine punishment.
Conclusions. Stigma and discrimination against the mentally ill are widespread even in a population that is expected to be enlightened. The widespread belief in supernatural causation is likely to add to the difficulties of designing an effective antistigma psycho-educational programme. There is a need in Nigeria to develop strategies to change stigma attached to mental illness at both institutional and community levels.
Source: South African Journal of Psychiatry 16, pp 61 –64 (2010)More Less
Objectives. Depression is associated with diabetes mellitus and affects treatment goals negatively. We aimed to determine the prevalence of depression and identify its socio-demographic or clinical correlates among patients with diabetes mellitus attending an out-patient clinic in Nigeria.
Methods. Two hundred consecutively recruited diabetes patients (index group) were compared with a similar number of apparently healthy controls in a cross-sectional survey. In both groups, in addition to obtaining socio-demographic details, depression was diagnosed using the Schedule for the Clinical Assessment in Neuropsychiatry (SCAN), while the Beck Depression Inventory (BDI) was used to assess depression symptom severity.
Results. Sixty (30%) diabetes patients met a SCAN diagnosis for clinical depression, compared with 19 (9.5%) in the control group. Having a smaller income and more children were significantly correlated with higher depression symptoms on the BDI.
Conclusion. Depression is highly co-morbid with diabetes mellitus. The care of individuals with diabetes mellitus should include the screening and possible treatment for depression in order to achieve and sustain treatment goals.