South African Psychiatry Review - Volume 6, Issue 3, 2003
Volume 6, Issue 3, 2003
Source: South African Psychiatry Review 6, pp 6 –11 (2003)More Less
Leptin, a protein, is secreted mainly by adipocytes. It is important in the regulation of food intake and energy balance. It also has metabolic and neuroendocrine functions. Numerous studies have exploited the relationship between leptin levels and various psychatric conditions and treatments. To date, no conclusive relationship has been established although there may be a greater role for leptin than is currently understood.
Source: South African Psychiatry Review 6, pp 12 –17 (2003)More Less
<i><b>Objectives</i></b> : To estimate the effects of clothiapine, a dibenzothiazepine neuroleptic, for the management of acute psychosis. <i><b>Methods</i></b> : Six databases were searched, reference lists were inspected and relevant industry and authors contacted. Randomised clinical trials involving clothiapine for acute psychosis were identified and relevant data extracted. <i><b>Results</i></b> : Five relevant trials were found comparing clothiapine with antipsychotics or lorazepam. We found no evidence to support or refute the use of clothiapine in the psychiatric emergency (no significant improvement compared with other antipsychotics RR 0.82, 95% CI 0.2 to 3.1, heterogeneous p=0.09, N=83; no difference in mental state change when clothiapine was compared to lorazepam WMD -3.36 95%CI -8.09 to 1.37, N=60). Clothiapine may result in less need for antiparkinsonian treatment than zuclopenthixol acetate (RR 0.43, 95%CI 0.02 to 0.98, N=38). <i><b>Conclusions</i></b> : Wide confidence intervals prevent any firm conclusions, but clothiapine could be effective and cheap for rapid tranquillisation.
HIV / AIDS and mental illness : ethical and medico-legal issues for psychiatric services : research articleAuthor Rita G.M. ThomSource: South African Psychiatry Review 6, pp 18 –22 (2003)More Less
<i><b>Objectives</i></b> : To investigate and address some of the ethical and medico-legal issues associated with the HIV / AIDS epidemic in South Africa and the management of people with mental illness. <i><b>Design</i></b> : Qualitative / exploratory / Participatory process. <i><b>Setting</i></b> : The Gauteng Health Department. <i><b>Subjects</i></b> : Key stakeholders. <i><b>Outcome measures</i></b> : Areas of consensus / concern. <i><b>Results</i></b> : Policy guidelines for the province have been written. They include guidelines on HIV testing and treatment and the practice of universal precautions as well as for education programmes for patients and staff, especially with regard to patient sexuality. Confidentiality is considered to be critical, and specific guidelines are suggested regarding when confidentiality may be breached. Special attention is paid to the management of patient exposure to HIV infection through assaults and injuries while in hospital. The issues related to managing children and youth in specialized psychiatric hospitals are highlighted. Many of the difficult issues relate to the degree of capacity of a mentally ill person to give informed consent, as well as the serious implications of a diagnosis of HIV infection. <i><b>Conclusions</i></b> : This work highlights the complexity of the issues involved in the care of mentally ill people who are exposed to HIV infection. It is hoped that the guidelines will help to raise awareness of these issues and guide clinicians and hospital managers in difficult situations.
Source: South African Psychiatry Review 6, pp 24 –27 (2003)More Less
<i><b>Objectives</b></i> : To correlate geomagnetic storm activity with suicide rates. <i><b>Design</i></b> : A retrospective analysis over a 13 year period, Janaury 1980 to December 1992. <i><b>Setting</i></b> : Hermanus Magnetic Observatory (data on geomagnetic storm activity), South African Central Statistical Services (data on suicide rates). <i><b>Subjects</i></b> : Nil. <i><b>Outcome measures</i></b> : Geomagnetic storm activity and suicide rates. <i><b>Results</i></b> : A significant correlation (r= 0, 6964 ; p< 0, 01) was found between the mean total of suicides and the mean average of storm activity during the same period. This correlation was true of both male (r= 0, 6301 ; p< 0, 025) and female (r= 0, 7544 ; p< 0, 005) suicides. <i><b>Conclusions</i></b> : Geomagnetic storm activity is correlated with suicide, and confirms previous research suggesting an impact of ambient magnetic field activity on behaviour.