African Journal of Psychiatry - Volume 12, Issue 2, 2009
Volume 12, Issue 2, 2009
Author Christopher P. SzaboSource: African Journal of Psychiatry 12, pp 93 –95 (2009)More Less
On the 10th March 2009 a letter was sent to myself as Editor-in-Chief of this Journal from Sheldon Kotzin; a letter from the National Library of Medicine in Bethesda, Maryland, United States of America. The letter informed me that the African Journal of Psychiatry had been selected for inclusion in the MEDLINE database. A milestone in the life of any biomedical journal.
Author Detlef ProzeskySource: African Journal of Psychiatry 12, pp 103 –107 (2009)More Less
Each profession has unique elements. It has its own scope of practice and service, its own body of knowledge and skills, its own way of regulating itself. One way of classifying the professions is according to the primary focus of their practice - whether it is the material world (such as engineers, architects and laboratory scientists) or whether it is people, human beings (such as teachers, lawyers, social workers, ministers of religion and, of course, health care professions). The people centred professions serve their fellow humans in different ways. They provide help with tasks which oil the wheels of society (such as educating the new generation, drawing up legal contracts, or even keeping people healthy).
Board of International Affairs Pan-African Division Quarterly newsletter : African International Division, Royal College of Psychiatrists : quarterly newsletterSource: African Journal of Psychiatry 12, pp 109 –113 (2009)More Less
"A welcome from the editor"
5th Anniversary Lecture for Professor Lambo - by dr. Bola Ola
Post graduate training in psychiatry : Department of Psychiatry, University of Zambia (UOZ) - prof. David M. Ndetei
Stakeholders' Meeting on Mental Health
Training the trainers workshop
Source: African Journal of Psychiatry 12, pp 115 –128 (2009)More Less
Objective: To review the clinical features and current knowledge on the treatment of psychiatric symptoms and disorders in patients with human immunodeficiency virus (HIV) infection.
Method: We searched the PubMed database combining HIV / AIDS with different keywords for psychiatric diagnoses and symptoms (e.g. depression, mania, anxiety, psychosis, dementia, substance abuse) and for psychopharmacological treatment. The years covered by these searches included 1980 to 2008.
Results: Patients with HIV infection are at an increased risk of psychiatric illness. Major depressive disorder and subsyndromal depressive symptoms, as well as anxiety disorder and substance abuse are more prevalent among HIV infected individuals than among the general population. HIV-associated neurocognitive disorders (HAND) are common among HIV patients, and HIV-associated dementia (HAD) is a serious condition during the acquired immune deficiency syndrome (AIDS) stage of HIV disease. Secondary mania and psychosis might be the first clinical symptom of HIV dementia. The introduction of highly active anti-retroviral therapy (HAART) has resulted in significant decreases in morbidity and mortality for HIV infected patients. HAART has also decreased the incidence of HAD, but does not give complete protection from this condition. The utility of psychotropic medications in HIV patients has not been studied sufficiently as a basis for guidelines, and more controlled trials are needed.
Conclusion: Psychiatric illness is common in HIV infected individuals, and underlines the importance for screening not only for cognitive impairment but also for co morbid mental disease in HIV-positive patients. Further studies of the neuropsychiatric complications during HIV disease and the use of psychotropics under these circumstances are clearly needed. A better understanding of the pathogenesis of HAD is essential to identify additional therapeutic strategies for prevention and treatment of this neurodegenerative disease. Studies are also needed for optimizing effective utilization of antiretrovirals into the CNS. Mania and psychosis secondary to HAD may be used as an indicator to initiate HAART, irrespective of CD4 count. Further research on the utility of HAART in the treatment of such acute neuropsychiatric symptoms associated with HIV infection should be initiated.
South Africans in flux : exploring the mental health impact of migration on family life : review articleAuthor M. Marchetti-MercerSource: African Journal of Psychiatry 12, pp 129 –134 (2009)More Less
In the context of post-apartheid South Africa mental health professionals are increasingly faced with the complexities linked to people leaving the country, those left behind and those returning. In an attempt to illustrate the mental health challenges linked to the South African migration phenomenon, this article will firstly explore the global phenomenon of migration and some of the theoretical approaches used to understand it. The psychological impact of immigration on individuals and their families will also be explored. In conclusion the author will propose some possible preventative measures which may be of use to mental health professionals.
Source: African Journal of Psychiatry 12, pp 135 –143 (2009)More Less
The Brain Fag Syndrome (BFS) is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as a culture bound syndrome. BFS is a tetrad of somatic complaints; cognitive impairments; sleep related complaints; and other somatic impairments. Prince first described this psychiatric illness associated with study among African students in 1960. There have been questions relating to the nosological status of the syndrome as to whether : BFS is an objective or subjective phenomenon; it is one phenomenon or a variant of other known disorders; it is a mental illness? These three questions pose challenges to the culture bound / depressive or anxiety equivalent approach to the condition. The scope of this paper is the scope of BFS history from its first reference in the psychological medicine to the most contemporary descriptions in transcultural psychiatry. The conceptual history of BFS is divided into four major perspectives : Traditional medicine, Psychoanalysis, Biopsychological and Transcultural psychiatry. This helps to outline some of the key issues, helps to clarify its nosological status, its present status and helps to set the stage for the future progress. From its conceptual history, BFS as a phenomenon, with its distinct presentations, is subjectively real and is best classified with the framework of psychiatry, psychology and or sociology. The existence of BFS is evidenced by case as well as epidemiological reports of the condition in different locations. However, its course, response to treatment and outcome deserve more attention than has been given.
Clinical characteristics and premorbid variables in childhood-onset schizophrenia : a descriptive study of twelve cases from a schizophrenia founder population : original articleSource: African Journal of Psychiatry 12, pp 144 –148 (2009)More Less
Objective: To analyze clinical and demographic data of childhood-onset (12 years and younger) schizophrenia patients collected for a genetic study in schizophrenia, undertaken nationally in South Africa, using multiple parameters.
Method: Patients with an onset of schizophrenia at 12 years or younger, were included. From the Diagnostic Interview for Genetic Studies (DIGS), patients' information and summary report data was tabulated and analyzed. Specific subgroups were further compared. This sub-population of 12 subjects was further compared with a group of the adult sample.
Results: Of the 12 patients recruited, prominent results were: male to female ratio of 1:1; all had insidious onset of psychosis; a third had all 3 multidimensional impairment (MDI) symptoms; all patients that received ADHD treatment had ADHD treatment failure; two thirds had milestone delay; 58% had birth complications; a third were predominantly bottle fed; 42% had family history of schizophrenia; a third had family history of other major psychiatric conditions; all patients had at least one non-psychotic deviant behaviour (NPDB); no patient used cannabis; all delusions were paranoid; 92% had school achievement difficulty and a third had treatment resistance. Gender comparison included: earlier onset of psychosis in females; all females had aggression versus a third of males; more females had school achievement difficulty than males; males had more treatment resistance. Patients with MDI, compared to the sample average had:earlier onset of non-psychotic deviant behaviour; lower school drop-out rate; less social difficulty and no treatment resistance.
Conclusion: The results compare well to previous research on this topic. The new concepts introduced by the present study require further investigation.
Source: African Journal of Psychiatry 12, pp 149 –156 (2009)More Less
Objective: The Yoruba are an ethnic group in southern Nigeria. It is said that their world view centers around a continuous battle between forces of good and evil. Adverse events such as illness are due to the malevolence of enemies, using metaphysical means. Remedy often involves corrective metaphysical intervention, either exclusively or in addition to other methods, such as 'western Medicine'. This 'rule' is said to fit mental illness more than any other type of illness, although there is a lack of empirical data on the subject. This study is aimed at identifying elements of a Yoruba world view, and factors relevant to the perception and treatment of psychotic illness.
Method: 500 Yorubas in Lagos were randomly sampled (with a questionnaire), and 100 'home video' films were analyzed. Data were analyzed for : elements of world view; elements that pertain to illness in general; elements that pertain to psychotic illness; how such illness is to be treated.
Results: The world view has a significant influence on perception of psychotic illness.
Conclusion: It is necessary to understand a people's world view in order to understand (and influence) attitudes towards psychotic illness in themselves and other people.
Author A.B.R. Janse van RensburgSource: African Journal of Psychiatry 12, pp 157 –165 (2009)More Less
Objective: Traditional health practice was recently mainstreamed in South Africa by the promulgation of the Traditional Health Practitioners Act, No. 35 of 2004. Due to the extent of integration of mental health in the legal definition of traditional health practice, promulgation of this Act also has significant implications for mental health care delivery. This paper explored the documented interface of traditional health practice with mental health care in South Africa over the past almost 50 years.
Method: A preliminary overview of health literature was done on formal mental health care and traditional alternatives in South Africa since the 1950's. Important themes were identified as first step in a qualitative approach to identify concepts.
Results: The search yielded 143 references, between 1958 and 2004, from articles, case reports, scientific letter, theses and chapters in books. A cross section of 56 references was selected for inclusion in this review of the material.
Conclusion: The documentation on the interface between the two parallel systems contribute to establish a context against which the promulgation of the legislation to formally integrate and regulate African traditional health practice in South Africa can be considered. South African policy makers may now have ensured that a multi-faceted, multi-cultural and multi-cosmological context for health and mental health care delivery has come to pass. To health administrators, though, the inclusion of traditional healers into the formal public health system and mental health may still prove to be too costly to implement.
Author Franco P. VisserSource: African Journal of Psychiatry 12 (2009)More Less
Joe's flashbacks introduce the viewer at first to his childhood in the 70's and his developing friendship with Boots and the fun times that the two of them had together. Both Joe and Boots lived by the sea in a small village in England where everyone knew each others' business.
Source: African Journal of Psychiatry 12 (2009)More Less
Early response or nonresponse of schizophrenia symptoms to antipsychotic medication is a predictor of long-term outcome : product newsSource: African Journal of Psychiatry 12 (2009)More Less
After prescribing antipsychotic medication, many clinicians will wait 4 to 8 weeks before deciding whether to maintain the current treatment or to change it if the patient displays a suboptimal clinical response. However, a recent meta-analysis of randomised clinical trials (RCTs) has demonstrated that this delay is unnecessary, because the greatest reduction of symptoms occurs during the first 2 weeks of therapy. Furthermore, post hoc analyses of RCTs have shown that nonresponse in the first 2 weeks after treatment initiation is a reliable predictor of subsequent nonresponse in patients with schizophrenia.