South African Journal of Psychiatry - Volume 18, Issue 3, 2012
Volume 18, Issue 3, 2012
Author Werdie Van StadenSource: South African Journal of Psychiatry 18, pp 70 –71 (2012)More Less
This issue of the South African Journal of Psychiatry celebrates the 60th anniversary of the South African Society of Psychiatrists (SASOP) and its 17th national congress. It reflects on the past of psychiatry, ponders on what psychiatry has become, and looks ahead, particularly in South Africa. Doing so says something of the identity of psychiatry in South Africa, which is crucially about people - our people.
Author Ian WestmoreSource: South African Journal of Psychiatry 18, pp 72 –74 (2012)More Less
I became involved with the South African Society of Psychiatrists (SASOP) on the national front in 2002, when I happened to be the chair of the Free State subgroup and was appointed as the convener of the 2004 congress. In the decade that has passed, and as my involvement with SASOP has grown, I have been witness to the evolution of our Society to where it finds itself in 2012 - proudly celebrating 60 years of psychiatry in South Africa.
Significant historical changes in private practice psychiatry during the past two decades : editorialAuthor Franco ColinSource: South African Journal of Psychiatry 18 (2012)More Less
Author David SwinglerSource: South African Journal of Psychiatry 18, pp 76 –77 (2012)More Less
'Are patients any better off now compared with the Eighties?' I was lamenting to a junior specialist colleague that, 26 years down the line in psychiatry, I could not honestly answer 'yes'. We have a profusion of papers, a plethora of brain images, and an abundance of new knowledge (soon to be followed by rafts of new diagnoses, I fear), but that's of little succour to those bedevilled by schizophrenia. Haloperidol has been swapped for olanzapine; overweight vasculopaths now out-shadow the rigid and tremulous, and 1 in 3 remain psychotic, whatever we prescribe.
Author Lynn GillisSource: South African Journal of Psychiatry 18, pp 78 –82 (2012)More Less
The history of psychiatry in South Africa stretches back to the first settlement by Europeans in the Cape of Good Hope in 1652. Its development falls into 3 phases with some overlaps. The first was a period of expediency and restraint during the early stages of the occupation of the Cape by the Dutch East India Company; the second, which could be called the psychiatric hospital era, was under the control of the British from the earlier part of the 19th century towards the beginning of the 20th century; and the third, broadly speaking, is the modern period since then. This article traces major developments over these 5 centuries to the present time, when psychiatry has become a highly evolved modern medical discipline.
Source: South African Journal of Psychiatry 18, pp 84 –88 (2012)More Less
Objectives. Anxiety disorders are the most common childhood psychiatric disorders. Previous research suggests that South African rates may be high. Our study examined the prevalence and severity of anxiety and depression among Grade 11 and 12 learners attending schools in central Bloemfontein. Learners' perceptions of the important stressors as well as the most relevant coping strategies were investigated.
Methods. A cross-sectional study was conducted by using self-assessment rating scales and questionnaires. The Hospital Anxiety and Depression Scale (HADS) was used to screen for anxiety and depressive symptoms. Participants were provided with an additional list of possible stressors and coping skills, from which they identified those applicable to themselves. All students enrolled in Grades 11 and 12 at the selected schools during August 2009 were eligible for inclusion.
Results. Five hundred and fifteen learners participated in the study, of whom 32.0% presented with moderate or severe anxiety and 5.3% with moderate or severe depressive symptoms. Mild symptoms were reported by an additional 29.0% on the anxiety subscale and 14% on the depression subscale of the HADS. Academic workload was reported as the main source of stress (81.4%).
Conclusions. Although the study had limitations in terms of methods and size, resulting in undetermined validity, it indicated potentially higher prevalence rates for anxiety and depression than in previous South African studies and worldwide prevalence rates for adolescents. Pupils were generally hesitant to seek help from formal assistance structures provided by the schools, and preferred discussing problems with parents or friends.
An overview of the State Employed Special Interest Group (SESIG) of the South African Society of Psychiatrists (SASOP) from 2000 - 2012Author Bernard Janse van RensburgSource: South African Journal of Psychiatry 18, pp 90 –94 (2012)More Less
Introduction. The State Employed Special Interest Group (SESIG) of the South African Society of Psychiatrists (SASOP) was established in Durban during the national congress in September 2000. Issues of concern at the time included: suboptimal physical conditions in state hospitals and clinics; stalling of the essential drug list (EDL) review process; and understaffing and difficulties in recruiting and retaining mental health medical personnel in the state sector. During the past 2 years, attention was given to liaising with the South African Medical Association (SAMA) as a medical labour organisation; standards for psychiatric inpatient structures, services and care; and scheduling a national SESIG strategic workshop.
Methods. A quantitative retrospective review of the demographic and occupational profile of SESIG's members, as captured by the SASOP database of current and potential members, was performed. The investigation included a review of the policies and processes by which strategic activities, priorities and measures for progress were identified within the different areas of SESIG's mandate.
Results. In 2007, 38% (144) of the potential total number of state-employed psychiatrists (380) were paid-up SESIG members; and 53% (202) of the potential total number (378) in 2011. The Eastern Cape, Free State and Northern Gauteng subgroups had the biggest percentage of members per region in 2007, which changed in 2011 to Northern Gauteng, Western Cape and Eastern Cape. In 2011, 40% of the total membership comprised psychiatric registrars. Presentations and discussions at the first national strategic meeting of state-employed psychiatrists in 2012 covered: the scope of state sector practice; pertinent policies for state practice; planning per region; teaching and research; accepted principles for care; and strategic mobilisation (details in the supplement of this issue of the South African Journal of Psychiatry).
Conclusion. Eleven position statements were formulated to guide SASOP/SESIG activities during 2012 - 2014, relative to: national mental health policy; psychiatry and mental health; infrastructure and human resources; standard treatment guidelines and EDL; HIV in children and adults; substance abuse and addiction; community psychiatry and referral levels; recovery and re-integration; culture, mental health and psychiatry; the specialty status of South African psychiatry; and forensic psychiatry.
Help-seeking by substance dependants presenting to healthcare professionals in the Free State ProvinceSource: South African Journal of Psychiatry 18, pp 96 –102 (2012)More Less
Introduction. Current data regarding treatment needs in South Africa for substance dependence are based on admissions to specialised treatment centres. The data therefore do not include patients presenting to independent healthcare workers and state hospitals.
Aim. The aim of this study was to investigate help-seeking behaviour for substance dependence disorders from the perspective of healthcare professionals at various levels of the referral chain in the Free State Province.
Design. A descriptive study was performed.
Setting. Treatment environments in the Free State Province accessible to substance-dependent persons served as the study setting.
Participants. General practitioners, private psychiatrists, prescribing healthcare professionals at state hospitals and treatment centres, and non-prescribing therapists responsible for the management of substance-dependent persons, were considered for participation.
Measurements. A questionnaire was used to determine the level of help-seeking experienced by the participants regarding various classes of psycho-active substances.
Findings. The presentation of alcohol, cannabis, opioid, benzodiazepine, ecstasy, cocaine and inhalant dependency at general practitioners, private psychiatrists, treatment centres and non-prescribing therapists was compared. Different patterns of help-seeking for substance dependence from the various professional groups were detected. Regarding alcohol dependence, 40.3% of private general medical practitioners reported being confronted with alcohol dependence at least once per month, compared with 100% of treatment centre representatives and private psychiatrists, 70.6% of state hospitals and 53.8% of non-prescribers. State hospitals reported the highest frequency for contact with cases of cannabis dependence, compared with the other professional groups, while psychiatrists reported the highest contact with cases involving benzodiazepine, cocaine and ecstasy. Therapists reported a higher level of contact with inhalant dependence, while this group virtually never presented at general practitioners and private psychiatrists.
Conclusion. Help-seeking data can be used in conjunction with other data, such as treatment demand data, to inform and adapt policies and practice. Variations in the manifestation of help-seeking behaviour at various groups may be important pointers to conditions that influence help-seeking, and should therefore be investigated further.
17th Biennial National SASOP Congress
'Pride, prejudice and promise - from origins to outcomes', 7 - 11 September 2012, Muldersdrift, Johannesburg : abstractsSource: South African Journal of Psychiatry 18, pp 104 –132 (2012)More Less
The South African Society of Psychiatrists (SASOP) and SASOP State Employed Special Interest Group (SESIG) Position Statements on Psychiatric Care in the Public Sector : position statementsSource: South African Journal of Psychiatry 18, pp 133 –148 (2012)More Less