South African Psychiatry Review - Volume 7, Issue 3, 2004
Volume 7, Issue 3, 2004
Author Anthony FeinsteinSource: South African Psychiatry Review 7 (2004)More Less
Extracted from text ... GUEST EDITORIAL 7:1 South African Psychiatry Review - August 2004 1 War, journalists and psychological health terminology, some of these findings will be applicable to themselves as well.4 For example, higher levels of dopamine courtesy of lower monoamine oxidase inhibitor levels has been linked to risk taking. This biochemical profile is found more often in young males who have eschewed marriage or a commitment to a long term relationship. In the war journalist study, almost 80 percent of the sample were male, the average age was less than 40 years and most were single or divorced, a profile fundamentally ..
Depression may be associated with hippocampal volume changes and HPA axis dysfunction : is treatment to remission the answer? : review articleAuthor Roger M. PinderSource: South African Psychiatry Review 7, pp 5 –9 (2004)More Less
Under-treatment of depression is common practice and carries substantial risks of relapse and recurrence while increasing morbidity and mortality in co-morbid medical illnesses. It may also lead to or exacerbate structural brain changes in depression, most particularly in the hippocampus, with an accompanying decline in cognitive functioning. Treatment to full remission of symptoms and maintaining patients in remission is therefore essential. Although all current antidepressants seem to provide comparable efficacy in preventing relapse, some of the newer dual action antidepressants can induce a faster response and produce greater degrees of remission. However, remission rates are low even with the best treatments. There remains a need for treatments that will act quickly to reverse not only the symptoms of depression but also the accompanying brain abnormalities.
Source: South African Psychiatry Review 7, pp 11 –17 (2004)More Less
Dissociation can be defined as the failure to integrate experience. Dissociation is a common symptom of a spectrum of severe psychopathologies, from reactive attachment disorder of infants to dissociative identity disorders, psychotic experiences, borderline personality disorders and post-traumatic stress disorders of adults. The incidence of abuse in the childhood histories of adults with dissociative disorders is extremely high. The adaptational value of dissociation is that it allows survival in catastrophic events. The disadvantage is that when dissociation occurs frequently, the development of neural networks is impaired. Especially disadvantageous are problems which develop with a) higher circuit control over lower circuits, b) primitive parasympathetic regulation by the dorsal motor nucleus, c) memory, d) left hemisphere, e) integration of bodily sensations, f) sense of self, and g) affect and motivation. These aspects are discussed in more detail. The clinician's primary function is as an affect regulator and therapy should focus on integration.
Lithium - an update on the mechanisms of action. Part two : neural effects and neuroanatomical substrate : review articleAuthor Jose SegalSource: South African Psychiatry Review 7, pp 18 –24 (2004)More Less
Lithium has been clinically utilized for about 50 years. It is only in the last several years however that there has been a rapid growth in our understanding of its biochemical effects. It is now clear that lithium has a complicated multitude of diverse effects in the human nervous system. This new data is helping us understand the neurobiology of bipolar disorder. The focus of this review will be to distil this new knowledge.This, the second of a two part review will focus principally on neural effects and neuroanatomical substrates.
The intercontinental schizophrenia outpatient health outcomes (IC-SOHO) study : baseline clinical and functional characteristics and antipsychotic use patterns in the North Africa and Middle Eastern (AMEA) region : original articleSource: South African Psychiatry Review 7, pp 27 –34 (2004)More Less
<I>Objective:</I> To describe the baseline findings of the Intercontinental Schizophrenia Outpatient Health Outcomes (IC-SOHO) study in the North Africa and Middle Eastern sub-region (AMEA-SOHO) <br><I>Method:</I> The IC-SOHO study is an ongoing prospective, three-year, non-interventional observational study of schizophrenia treatment, clinical characteristics and mental health services utilization in two North African and two Middle Eastern countries. The study population consists of non-hospitalised patients who had initiated treatment with or changed to a new antipsychotic. <br><I>Results:</I> The baseline findings of the IC-SOHO study (AMEA Subset) appear to reflect clinical practice in Turkey, Saudi Arabia, Egypt and Algeria (N=1, 398). Overall, the patients were moderately to markedly ill and either overweight (46%) or obese (8%) when they entered the study. Functionally, the majority of patients were not involved in social activities, could not care for themselves and were unemployed. Substance and alcohol dependency/abuse was not a problem in this study population. At baseline the majority of patients were treated with typical antipsychotics (oral and depot); and anticholinergics were the most commonly prescribed concomitant medication. Sexual side effects were most frequently reported among the surveyed adverse events. Overall compliance/adherence to medication was good. <br><I>Conclusion:</I> The baseline IC-SOHO data highlighted various clinical and functional characteristics and antipsychotic use patterns in a group of outpatients with schizophrenia in a naturalistic setting. Once completed, the IC-SOHO study will add further to this knowledge base.
Lecture notes on behavioural sciences and psychiatry for medical students in east and central Africa : letter to the editorAuthor David M. NdeteiSource: South African Psychiatry Review 7, pp 36 –37 (2004)More Less
Extracted from text ... LETTERS TO THE EDITOR 7:36-38 South African Psychiatry Review - August 2004 36 Lecture notes on behavioural sciences and psychiatry for medical students in east and central Africa 3. The above information will be relayed to me. On receiving those details I will link up lecturers from every department of psychiatry with those from other departments in other medical schools interested in the same topics. Those with the same interest will then work together to perfect the lecture notes so that they would be easily acceptable across the region. Each group will decide on the order of authorship of ..
Source: South African Psychiatry Review 7, pp 37 –38 (2004)More Less
Extracted from text ... South African Psychiatry Review - August 2004 37 Duration of hospitalization in an acute psychiatric unit Making more efficient use of existing funding and cutting the cost of in-patient care in South Africa has stimulated a lot of debate about the factors influencing the length of hospitalisation. Studies have indicated that whilst a long hospital stay (>7 days) does not decrease subsequent hospitalisation, improve social adjustment or diminish psychopathology1, 2, short stay (< 7 days) after the initial evaluation is cited as one of the reasons for failure of community care3, 4 and the emergence of "revolving door" and ..
Board is concerned about administration of psychological tests : media statement by the Health Professions Council of South Africa (HPCSA)Author Phephela MakgokeSource: South African Psychiatry Review 7 (2004)More Less
Extracted from text ... 7:39 South African Psychiatry Review - August 2004 39 MEDIA STATEMENT BY THE HEALTH PROFESSIONS COUNCIL OF SOUTH AFRICA (HPCSA) Board is concerned about administration of psychological tests The Executive Committee of the Professional Board for Psychology at its Strategic Planning Workshop in June 2004 formulated the following mission statement: " to strive to provide protection for the public and guidance to the profession, based on transparency, integrity and consultation and to be cognisant of both our unique South African context and international perspectives, through formulating and regulating standards for professional education, training and best practices". It also set ..
Source: South African Psychiatry Review 7 (2004)More Less
Extracted from text ... South African Psychiatry Review - August 2004 40 Fast facts about social phobia Social Phobia affects an estimated one in ten people. It affects people of all races and social classes. It is estimated that fewer than 25% of people with Social Phobia receive adequate treatment. The onset of Social Phobia is typically during adolescence, but it may occur in childhood, prior to the age of ten. Approximately 40% of social phobias appear before the age of ten, and 95% before the age of twenty. Social Phobia is characterised by an underlying fear of scrutiny ..