African Journal of Psychiatry - Volume 12, Issue 1, 2009
Volume 12, Issue 1, 2009
Author Oye GurejeSource: African Journal of Psychiatry 12 (2009)More Less
Source: African Journal of Psychiatry 12, pp 1 –3 (2009)More Less
The personal and social impact of mental illness is huge. Although there is now good evidence for what works in delivering effective treatment in response to this burden, very few Low and Middle Income (LAMI) countries are delivering such services. This dichotomy was outlined in a series of papers in the Lancet journal in 2007, which explored the state of global mental health services. The Movement for Global Mental Health is a response to the call for action by the series' authors. It was launched on World Health Day in October 2008.
Source: African Journal of Psychiatry 12, pp 5 –7 (2009)More Less
In two recent editorials published - in the African Journal of Psychiatry - on the high school samurai sword slaying in Krugersdorp last year, Szabo and Potterton made some clear-headed comments about the events that do (or don't) drive a teenager to commit a school rampage shooting, spree slashing, or other sort of violent, dramatic crime in a public venue. Both highlight the fact that South African society is not new to violence; we are after all, considered one of the most violent societies in the world. Violent crimes, including homicides and family murders, are part of our daily lives. However this incident, possibly because of its bizarre execution, has captured the country's attention.
Source: African Journal of Psychiatry 12 (2009)More Less
Eighth newsletter of the African Association for Child and Adolescent Mental Health (AACAMH) : AACAMH newsletterSource: African Journal of Psychiatry 12, pp 16 –20 (2009)More Less
Message from our Chairperson
Child and adolescent mental health in Africa : a collective voice to reject the neglect
Leadership course for young psychiatrists
Tragedy strikes child and adolescent psychiatry in the eastern Mediteranean region
Good news for child and adolescent mental health in Ethiopia
African Journal of Psychiatry
Board of International Affairs Pan-African Division Quarterly newsletter - African International Division, Royal College of Psychiatrists : newsletterSource: African Journal of Psychiatry 12, pp 23 –26 (2009)More Less
"A welcome from the editor"
10th Annual Meeting for the International Society of Addiction Medicine (ISAM)
Mental health in Nigeria - the way forward
Samaritans in Kenya - free services for people with suicidal behaviour / symptoms in Kenya
Signing of memorandum of understanding on colaboration between RCPsych and WACP on the 23rd June 2008 : the International Conference on Philosophy and Psychiatry
Source: African Journal of Psychiatry 12, pp 29 –30 (2009)More Less
This Action Plan has been produced by the WPA Planning Committee, and reviewed and approved by the WPA Executive Committee. It contains the WPA institutional goals for the triennium 2008-2011 and a list of actions by which these goals will be pursued. The plan takes advantage of the experience acquired by the WPA during the past trienniums, and is going to be implemented with the active involvement of all the components of the Association.
The 5 / 95 Gap on the dissemination of mental health research : the World Psychiatric Association (WPA) task force report on project with editors of low and middle income (LAMI) countries : World Psychiatric Association reportSource: African Journal of Psychiatry 12, pp 33 –39 (2009)More Less
The World Psychiatric Association (WPA) Task Force and a small group previously convened by the WPA publications committee initiated three activities between 2006-2008 that aimed to respond to the need for greater support for psychiatry journals in LAMI countries. In a joint venture with participants from the Global Mental Health Movement the Task Force editors from LAMI countries in Africa, Asia, Eastern Europe and Latin America were contacted to identify potential journals to target for indexation (Medline and ISI). The committee analyzed the editors' applications on the following criteria: a) geographical representativeness; b) affiliation to a professional mental health society; c) regular publication of at least 4 issues per year over the past few years; d) comprehensive national and international editorial boards; e) publication of original articles, or at least abstracts, in English; f) some level of current indexation; g) evidence of a good balance between original and review articles in publications; and h) a friendly access website. The committee received 26 applications (11 from Latin America, 7 from Central Europe, 4 from Asia and 4 from Africa), and selected 8 journals, 2 from each geographical area, on the basis of the overall scores obtained for the items mentioned, to participate in an editors meeting held in Prague in September 2008. The aims of the committee are twofold: a) to concentrate support for those selected journals; and b) to assist all LAMI mental health editors in improving the quality of their journals and fulfilling the requirements for full indexation. This report summarizes the procedures conducted by the committee, the assessment of the current non-indexed journals, and offers suggestions for further action.
Author G.C. VersterSource: African Journal of Psychiatry 12, pp 42 –46 (2009)More Less
The pineal gland has long been implicated in psychiatric disorders, but only after the discovery of melatonin has the physiology behind these theories been better researched and understood, especially its role in chronobiology. The role of melatonin in sleep is well known and the interrelatedness with mood and other disorders is also receiving increasing attention. Circadian rhythm disorders are also common, and often cause psychiatric symptoms, resulting in impairment in daily functioning. Together with other factors, melatonin has an integral role in the pathogenesis and treatment of these conditions. The role of melatonin in various neurological disorders is also of interest and warrants further investigation. Changes in melatonin levels related to ageing have important clinical implications and should be considered in sleep and cognitive disorders in the aged.
Source: African Journal of Psychiatry 12, pp 47 –51 (2009)More Less
Objective : Stroke is an important neurological problem and a leading cause of death in clinical practice. Among survivors, over half have significant disabilities; and / or psychiatric complications most especially Post-stroke depression (PSD). The study aimed to establish prevalence and risk factors for post stroke depression. Method : A prospective study carried out among selected stroke survivors in Lagos University Teaching Hospital (LUTH). Subjects included those who satisfied the WHO definition of stroke. The necessary socio-demographic data was obtained from each subject; the Depression Anxiety Stress Scale-21 (DASS-21) and Modified Motor Assessment Scale (MMAS) were administered. Risk factors of PSD studied were gender, laterality of stroke, post stroke functional impairment and post stroke duration before clinical presentation. Results : A total of 51 stroke survivors were studied, made up of 31 (60.8%) males and 20 (39.2%) females. The mean age was 52.5±5.9 years; and age range of 40-64 years. From assessment with the depression subscale of DASS-21, 38 (74.5%) of the subjects were normal and the rest 13 (25.5%) had depression. Risk factors found to be statistically significant for PSD in the study included : gender (X2 = 10.3 at p = 0.001*) and stroke laterality (X2 = 6.1 at p = 0.013*). However, there were no statistically significant differences for mean post-stroke duration before clinical presentation and PSD ("t" = 3.5 and p = 0.073); and post-stroke disability as shown by mean MMAS scores and PSD ("t" = 7.6 and p = 0.084). Conclusion : Depression was found to be an important complication among stroke survivors in our study. Important risk factors found for PSD included gender and laterality. The findings emphasized a need for appropriate health facilities and for stroke survivors to present early for treatment to attenuate stroke complications.
Problem drinking among patients attending primary healthcare units in Kampala, Uganda : original articleSource: African Journal of Psychiatry 12, pp 52 –58 (2009)More Less
Objective : Previous studies have shown that a large a number of primary health care patients have alcohol related problems and very few are detected and treated. Few studies have been done in developing countries on this topic. This study sought to determine the prevalence and detection of alcohol related problems in a Primary Health Care setting (PHC). in Kampala Uganda. Method : 768 consecutive PHC patients in two PHC centers in Kampala, Uganda, were screened in a two stage procedure. After being asked if they drink alcohol they were interviewed by means of the CAGE questionnaire and a quantity / frequency questionnaire. Those who scored positive on the CAGE were further diagnosed for alcohol dependence using the DSM-IV diagnostic criteria. Results : Of all patients, 17.4% scored above cut-off on the CAGE, 28.5% had a high risk drinking pattern and 9.5% had alcohol dependence. Among drinkers, drinking beyond safe limit was more common among men. Males and those aged between 35 to 44 years, were more likely to be CAGE positive and to be diagnosed with alcohol dependence. Only 27 out of 366 drinkers were asked about alcohol by the PHC professional. Males and high risk drinkers were more likely to be asked. Conclusion : Prevalence of alcohol problems was high and detection rate of alcohol related problems was low in this Ugandan setting. Training of PHC professionals in diagnosing and treating alcohol related problems is required.
Author N.C. AghukwaSource: African Journal of Psychiatry 12, pp 59 –63 (2009)More Less
Objective : Teachers as role models stand in a unique position in the formation of their pupils' set values about mental health issues. The aim of this study therefore was to determine the attitude of teachers to mental illness. Method : The questionnaire for the study was a drafted modified self-administered one, distributed among a randomly selected sample of teachers in the area of study. Results : A significant number of teachers would not want to interact with former mentally ill persons in close social situations and many of them felt such people were unpredictable. Most of the respondents would not want former mentally ill persons holding sensitive jobs. More years of teaching was associated with not perceiving the former mentally ill person as being unpredictable. Teachers' highest educational qualification significantly related to their attitude towards former mentally ill persons. More teachers with Master's Degree than those with N.C.E qualification would not mind employing former mentally ill persons as gardeners, likewise not perceiving them as unpredictable or dangerous to other people in their surroundings. Results of the study showed that the majority of the teachers expressed negative attitudes in close social situations and job entrustments towards former mentally ill persons. Conclusion : Mental health educational programmes geared towards a change in teachers' preconceptions about mental illness and with opportunities for positive interactions with mentally ill persons might be effective in changing their negative attitude towards former mentally ill persons.
Source: African Journal of Psychiatry 12, pp 64 –70 (2009)More Less
Objective : To determine the prevalence of pain and its psychological and physical effects on cancer patients. Method : We interviewed 210 consecutively admitted cancer patients in the University College Hospital, Ibadan between May 2006 and November, 2006 using the socio-demographic / clinical questionnaire with a section designed to measure psychological and physical symptoms. The screening modules of the depression and anxiety sections of the Structured Clinical Interview for DSM-IV diagnosis was used to screen for depression and anxiety. Results : There were 63 (30%) males and 147 (70%) females. Sixty-eight (32.4%) subjects had breast cancer, 59 (28.1%) had cervical cancer, 40 (19.0%) had colon / rectal cancer while the remaining 43 (20.5%) had prostate cancer. The prevalence of pain was found to be 73.8%. Presence of pain was significantly associated with depressive and anxiety symptoms, suicidal ideation, poor sleep, impaired concentration, lack of opportunity for leisure, dissatisfaction with health, poor overall quality of life, poor ability to get around and the need for extreme amount of medical treatment to function in the daily life. Conclusion : Pain is common among cancer patients and is associated with significant psychological and physical impairment. Therefore pain should be adequately assessed and managed.
Relationship between job burnout and work performance in a sample of Iranian mental health staff : original articleSource: African Journal of Psychiatry 12, pp 71 –74 (2009)More Less
Objective : Job and workplace characteristics, particularly among mental health workers, have been identified as "stressors". In this study, the objective was to assess the relationship between work performance and job burnout amongst staff at a psychiatric hospital. Method : The respondents comprised 100 mental health professionals from Raazy Psychiatric Center, Tehran, Iran; including nurses, co-nurses, psychologists, social workers, and occupational therapists. Instruments used were the Job Burnout Inventory, standardized for an Iranian population; and a 10-item questionnaire about job performance. Results : The study showed that 45.6% of the sample had job burnout at a high level ; 42.5% of subjects had emotional exhaustion at a high level and 65.5% had experienced depersonalization at a high level; however, only 21% experienced feelings of failure in individual achievement at a high level. There was a significant correlation between job burnout and inability for job performance. Conclusion : The findings are of concern and show the need to take cognizance of the existence of job burnout amongst mental health professionals and to consider strategies for dealing with the problem.
Mechanisms used to face difficulties encountered following surgical treatment for breast cancer : scientific letterSource: African Journal of Psychiatry 12, pp 75 –76 (2009)More Less
Qualitative studies report factors that may affect the quality of life (QoL) of patients after breast cancer treatment. These range from lack of information provided by healthcare professions, in relation to complications, which include lymphedema and inflammatory processes, to emotional problems including shock, fear, revulsion, frustration, a negative body image, anxiety and depression.
Brideshead Revisited, film directed by Julian Jarrold, produced by Robert Bernstein, Douglas Rae and Kevin Loader, screenplay by Andrew Davies and Jeremy Brock : movie reviewAuthor Franco P. VisserSource: African Journal of Psychiatry 12, pp 79 –80 (2009)More Less
'Be careful what you wish for, because your wish might just come true...' a dear friend once told me. How true those words are when having seen Brideshead Revisited, the film adaptation of the book with the same title written by Evelyn Waugh in 1945. Set in prewar England the film tells the story of Charles Ryder (played by Matthew Goode), a first year student reading history at Hertford College, Oxford University and his 'entry' into the strange and turmoil filled world of the Marchmain peerage with their magnificent country seat, Brideshead.
Effectiveness of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder : product newsSource: African Journal of Psychiatry 12 (2009)More Less
The second-generation (atypical) antipsychotic drugs were introduced over a decade ago. Although they were intended to have greater efficacy and better tolerability (eg induction of motor side-effects) than the first-generation antipsychotics, their clinical effectiveness is still debated. In previous studies treatment response has been defined by the use of scales that measure the extent of psychopathology, and efficacy has been measured according to narrowly-defined criteria. A study was thus needed with the aim of measuring effectiveness which is a combination of efficacy and tolerability. Early-stage schizophrenia might also well respond differently to antipsychotic drugs. The EUFEST study then undertook with a pragmatic open randomized-controlled trial design to compare the effectiveness of second-generation antipsychotic drugs, with that of a low dose of haloperidol in first-episode schizophrenia. Funding was provided by AstraZeneca, Pfizer and Sanofi-Aventis.
Alleviation of painful physical symptoms in depressed patients will increase remission : product newsSource: African Journal of Psychiatry 12 (2009)More Less
Depression is a chronic disease consisting of emotional / psychological and painful symptoms. Emotional symptoms have been shown to respond to currently available antidepressants; however, painful symptoms may not be as responsive. It was hypothesised that resolution of both psychological and painful symptoms of depression would predict a higher percentage of patients achieving remission.
Author Vikram PatelSource: African Journal of Psychiatry 12 (2009)More Less
This is the fourth monthly summary of the activities of the Movement, sent to members who signed up to receive these updates. As of January 31st, the Movement now has nearly 500 members; four more institutions signed up in January (the Institute of Psychiatry, UK; the Mon Foundation, India; PHC, Netherlands; and Manas, India ) taking the total of partner institutions to 46. We still have some way to go to reach our target of 1000 members and 100 institutions by the time of the Global Mental Health Summit! Please keep the momentum going by encouraging your colleagues and institutions to join up. We have seen a few new submissions, for example 3 new human rights stories. The site also has a new submission portal for news or articles on advocacy related activities.