South African Psychiatry Review - Volume 9, Issue 3, 2006
Volume 9, Issue 3, 2006
Source: South African Psychiatry Review 9, pp 121 –125 (2006)More Less
It would probably be safe to say that any psychiatrist in South Africa could deliver a lecture, without too much preparation, presenting their own view of the "state of our psychiatric nation". To consider psychiatry in South Africa in terms of the status quo, or more bravely in terms of the future, one has to take an integrated, multi-faceted view. There is no doubt that in this editorial as many issues as will be raised, there will be as many not raised.
Source: South African Psychiatry Review 9 (2006)More Less
At the previous South African Society of Psychiatrists (SASOP) conference, held in the Drakensburg in September 2004, a series of discussions between the then Sanofi-Synthelabo CNS product manager Althea Fordyce and the Journal took place. The discussions centered on how Sanofi Synthelabo might contribute to South African psychiatry. These discussions were initiated by Prof. David Castle (University of Melbourne), who was one of the international guest speakers at that conference, and culminated in the decision to fund an educational grant using South African Psychiatry Review as the vehicle. The aim was to promote research endeavor.
Adaptive plasticity during stress and depression and the role of glutamate-nitric oxide pathways : review articleAuthor B.H. HarveySource: South African Psychiatry Review 9, pp 132 –139 (2006)More Less
Anxiety and mood disorders are amongst the most prevalent and disabling of all the psychiatric disorders. Under-diagnosis and current treatments that are often less than adequately effective, contributes to an enormous personal and economic cost to the patient, family and health-care organizations. Although distinctly separate disorders at neuropathological and phenomenological levels, brain-imaging studies in posttraumatic stress disorder (PTSD) and depression have emphasized that both illnesses may induce damaging effects on regions of the brain involved in regulating the response to stress. While controversy prevails as to whether these changes represent an adaptive process or are indeed pathological, they are associated with marked changes in memory and other cognitive functions. In depression, a history of prior episodes is correlated with a higher risk of relapse, while poor compliance with antidepressants not only predicts later relapse, it may result in a more rapid shrinkage of the abovementioned brain regions, possibly providing a basis for relapse and treatment resistance. Similarly, even with the introduction of effective medications for PTSD, many patients remain treatment-resistant. Stress in various guises may alter synaptic connectivity in the brain by bolstering glutamatergic excitotoxic mechanisms. Understanding these mechanisms may assist in developing more effective treatment strategies. This paper will review pre-clinical and clinical evidence supporting a role for the glutamatenitric oxide pathway as a putative mediator of the neuropathological changes evident in depression and stress-related disorders, particularly PTSD, and its potential as a novel target for psychotropic activity.
The medical management of attention-deficit / hyperactivity disorder : spoilt for choice? : review articleAuthor A. VenterSource: South African Psychiatry Review 9, pp 143 –151 (2006)More Less
This paper focuses specifically on the medical management of attention-deficit / hyperactivity disorder (ADHD) and the options currently available in South Africa. References are made to current thinking on the etiology of this disorder and the pharmacological principles involved in its treatment. This review will not try to address all aspects of ADHD but highlight the range of medical management options, their advantages or disadvantages, their clinical application and give some personal perspectives about the practicalities within the clinical setting. Although the treatment of co-morbidities are not systematically discussed in this paper, reference are made to specific co-morbidities where relevant.
Publication bias - a reason for the decreased research output in developing countries : original articleAuthor D. SinghSource: South African Psychiatry Review 9, pp 153 –155 (2006)More Less
Objective : The low level of mental health research from low and middle-income countries, as measured by the relative lack of publications in high impact journals is an inaccurate reflection of research being conducted in these countries. The number of manuscripts submitted for publication is a more accurate measure of the research activities. The study aimed to quantify the number of manuscripts submitted and accepted for publication in high impact psychiatric journals.
Method : Editors of 8 psychiatric journals were requested information on the number of manuscripts submitted, the country of origin and the number of manuscripts accepted for publication from April to September 2005.
Results : 5, 2 % of all manuscripts submitted for publications were from low and middle income countries. The overall acceptance rate of manuscripts was 16, 6 % but the acceptance rate for low and middle-income countries was 4, 8 %. Manuscripts from high-income countries had a 5, 8 times greater odds (2, 5 - 4, 9) of being accepted for publication than an article from a low and middle-income country.
Conclusion : Both the quantity and quality of research from low and middle-income countries must be improved. Interventions to improve the quality of research must be directed towards capacity development, increasing international collaborations, mentoring of researchers and establishing formal psychiatric epidemiology training programs to equip researchers with skills to produce papers that meet the publication criteria of reviewers. Studies must become more innovative and include the changing paradigm in epidemiological research. Manuscripts that describe innovative studies have a greater chance of being published.
The prevalence of mental disorders among children, adolescents and adults in the Western Cape, South Africa : original articleSource: South African Psychiatry Review 9, pp 157 –160 (2006)More Less
Objective : To provide estimates of the prevalence of selected mental disorders in the Western Cape, based on the consensus achieved by a working group established for this purpose.
Method : An expert working group was established to provide technical expertise for the project. Potential risk factors likely to influence local prevalence rates were identified. Annual prevalence rates for adults and for children and adolescents were derived by consensus, informed by a systematic literature review. Prevalence rates were derived for individual disorders and adjusted for comorbidity.
Results : The overall prevalence was 25.0% for adults and 17.0% for children and adolescents.
Conclusion : Prevalence rates of child, adolescent and adult mental disorders were derived in a short period of time and with the use of minimal resources. Although of unknown validity, they are useful for policy development and for planning service utilisation estimates, resource costing and targets for service development for local mental health needs. This in the absence of an existing methodologically sound national prevalence study. We recommend that policy and programme developers draw on the expertise of local academics and clinicians to promote research-informed planning and policy development in the public sector.
Source: South African Psychiatry Review 9, pp 163 –168 (2006)More Less
This paper aims to review the phenomenology of vampirism and the various forms of its expression including its presentation in the psychopathology of psychotic disorders. We will explore in detail the case of an African vampire in a psychiatric clinical setting. Vampirism does not have roots in traditional African culture or folklore and thus this case is worth examining due to the unusual nature of the patient's clinical presentation. After a review of the literature, both lay and professional, a clinical case will be described. The discussion will suggest a biopsychosocial and contemporary psychoanalytic understanding of vampirism, and more specifically, of this patient. We also propose an additional type of vampirism be considered for inclusion in the classification of clinical vampirism.
Exploring the association between low bone density and depression : a worthy pursuit for the South African context? : letter to the editorSource: South African Psychiatry Review 9, pp 171 –172 (2006)More Less
Osteoporosis claims a place in the World Health Organization's list of the world's ten most serious diseases, but in spite of this, the disease is not afforded adequate attention in South Africa. According to Bateman most South African medical aids have removed osteoporosis from their list of prescribed minimum benefits, resulting in even fewer people being able to access preventative medicine for this silent disease. The epidemiology of osteoporosis is cause for alarm.
Author J. WeinkoveSource: South African Psychiatry Review 9, pp 175 –176 (2006)More Less
Andrews et al (2001) in a large epidemiological study in Australia found high rates of mental illness but low rates of service utilisation. Although not systematically investigated in South Africa, there is no reason to believe this country is any different. In South Africa staff shortages have given the impression of service over utilization.
Author Franco P. VisserSource: South African Psychiatry Review 9 (2006)More Less
The mere mention of the word 'highjack' elicits a variety of feelings, reactions and comments from people. The concept and its occurrence has become so familiar to South Africans that hardly a conversation goes by without someone having had some kind of experience with it, or with any kind of violent crime for that matter. With dread I decided to review the film "Tsotsi" for the Journal (SAPR).
Leadership and professional skills for young psychiatrists : the Addis Ababa experience : personal viewAuthor Anersha PillaySource: South African Psychiatry Review 9 (2006)More Less
Three young South African psychiatrists, rapt with excitement and anticipation, boarded a Saturday afternoon flight to traverse the continent. Their destination was Addis Ababa, the seat of the African Union. For the three this would be their first visit to Ethiopia; their first venture into the rest of Africa and its rich history. In February 2006, I along with many other young psychiatrists from around Africa received an invitation to apply for selection for a course on leadership and professional skills for young psychiatrists.
Source: South African Psychiatry Review 9, pp 190 –192 (2006)More Less
Attention Deficit Hyperactivity Disorder (ADHD) is a condition that presents in children in the early school years. These children find it difficult to concentrate, focus on a specific task or control their behaviour. Between 3 and 5% of children have ADHD with a male to female ratio of 4:1.