Descriptive Profile of Sex and Psychiatric Diagnosis among Rural and Peri-Urban Clinic Attenders in South Africa (original) (raw)
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The South African Society of Psychiatrists (SASOP) and
2012
position statements Contents 1. SESIG aims and objectives 2. Background Position Statement 1 on national mental health policy 3. Proceedings of the SESIG strategic workshop and identified key issues Position Statement 2 on psychiatry and mental health 3.1 Infrastructure and resources Position Statement 3 on infrastructure and resources 3.2 Standard treatment guidelines (STGs) and essential drug lists (EDLs) Position Statement 4 on STGs and EDLs 3.3 Mental health and psychiatric disorders in context of the global burden of disease, including HIV/AIDS and substance-related problems 3.3.1 HIV/AIDS and neuropsychiatry Position Statement 5(a) on HIV/AIDS in children Position Statement 5(b) on HIV/AIDS in adults 3.3.2 Substance abuse and addiction Position Statement 6 on substance abuse and addiction 3.4 Community-centred psychiatry and referral levels Position Statement 7 on community psychiatry and referrals 3.5 Recovery framework Position Statement 8 on recovery and integration 3.6 Culture, mental health and psychiatry position statements
Women's mental health in South Africa
South African Health Review , 2006
Mental health is a neglected topic, and that of women’s mental health even more so, with the latter receiving little attention within the South African public health sector. This chapter provides a selective, focused overview of women’s mental health issues requiring public sector attention in South Africa. It reports global and South African prevalence rates and burden of disease estimates for common mental disorders in women, focusing on depressive and anxiety disorders. Several key factors which impact on the mental health status of South African women are discussed, namely gender disadvantage, poverty, gender violence, HIV/AIDS and peripartum depression. Policy and programme implications of women’s mental health issues are noted, and recommendations for effecting a comprehensive, multi-sectoral approach to improving the mental health status of women are outlined.
Psychiatric disorder in a South African general hospital
General Hospital Psychiatry, 1997
The aim was to elicit the individual and comparative prevalence of psychiatric disorder in medical, surgical, and gynecological wards in a South African hospital comprising a predominantly Third World patient population. Results indicated that 21%, 95% coltfidence interval (16;26) of the total sample of 230 patients had a DSM-111-R psychiatric disorder. Fifty-six percent had a diagnosis of substance dependence and 33% were found to have depressive disorders. Comparative analysis between disciplines indicated that the highest prevalence was in surgical wards. There was a statistically signifcant difference between the sexes. The variables associated with the presence of a psychiatric disorder and implications for better recognition and treatment are discussed.
Experssion of schizophrenia in black Xhosa-speaking and white English-speaking South Africans
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
To investigate whether schizophrenia manifests itself differently in Xhosa-speaking South Africans, compared with English-speaking white South Africans. A comparative study of the presentation of schizophrenia in two groups of patients. A sample of 63 patients (43 Xhosa-speaking and 20 English-speaking) admitted to a large psychiatric hospital for the first time with a diagnosis of schizophrenia. The Present State Examination (PSE) was used to confirm the clinical diagnosis of schizophrenia. The Relatives' Rating of Symptoms and Social Behaviour (KAS-R) was used to obtain information on the behavioural and emotional expression of schizophrenia. A significantly higher prevalence of aggressive and disruptive behaviour was reported by relatives of Xhosa-speaking patients with schizophrenia of recent onset compared with English-speaking patients. The PSE elicited significantly more delusions of persecution, sexual and fantastic delusions, self-neglect and irritability in the Xhosa-s...
Social Psychiatry and Psychiatric Epidemiology
Purpose There is considerable variation in epidemiology and clinical course of psychotic disorders across social and geographical contexts. To date, very little data are available from low-and middle-income countries. In sub-Saharan Africa, most people with psychoses remain undetected and untreated, partly due to lack of formal health care services. This study in rural South Africa aimed to investigate if it is possible to identify individuals with recent-onset psychosis in collaboration with traditional health practitioners (THPs). Methods We developed a strategy to engage with THPs. Fifty THPs agreed to collaborate and were asked to refer helpseeking clients with recent-onset psychosis to the study. At referral, the THPs rated probability of psychosis ("maybe disturbed" or "disturbed"). A two-step diagnostic procedure was conducted, including the self-report Community Assessment of Psychic Experiences (CAPE) as screening instrument, and a semi-structured interview using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Accuracy of THP referrals, and test characteristics of the THP rating and the CAPE were calculated. Results 149 help-seeking clients were referred by THPs, of which 44 (29.5%) received a SCAN DSM-IV diagnosis of psychotic disorder. The positive predictive value of a THP "disturbed" rating was 53.8%. Test characteristics of the CAPE were poor. Conclusion THPs were open to identifying and referring individuals with possible psychosis. They recognized "being disturbed" as a condition for which collaboration with formal psychiatric services might be beneficial. By contrast, the CAPE performed poorly as a screening instrument. Collaboration with THPs is a promising approach to improve detection of individuals with recent-onset psychosis in rural South Africa.
Abstract This paper reports on an epidemiological study of common mental health and substance abuse problems in a historically disadvantaged urban and rural community in South Africa. In the rural Limpopo Province of South Africa, and in a peri-urban township near Cape Town, self-report instruments were used in two random population samples and among respondents at primary care and traditional healer settings, to assess common mental health problems, substance abuse problems and associated problems in social functioning. A high prevalence of mental health and substance abuse problems was observed in both communities, with highest rates in the peri-urban township. Even higher prevalences were found among respondents at primary health care or traditional healers. The study shows that mental health and substance abuse problems constitute a considerable burden of disease among disadvantaged communities in South Africa. The study further underscores the integral role of traditional healers in the mental health care system.
Clinical correlates of first episode early onset psychosis in KwaZulu-Natal, South Africa
Journal of child and adolescent mental health, 2015
The study of first episode early onset psychosis can yield many clues to understanding the early development of psychosis and guide interventions to decrease psychosis risk and improve outcome. The aim of the study was to investigate the socio-demographic profile and clinical correlates in early onset psychosis. Forty-five adolescents with first episode early onset psychosis were assessed by a clinical interview, socio-demographic questionnaire, the Positive and Negative Syndrome Scale (PANSS), Symptom Onset in Schizophrenia (SOS) score, the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (WHO ASSIST) questionnaire for substance misuse and a urine cannabis level. The mean age of the respondents was 15.9 years (SD 1.8, range 10-18 years). Thirty-one (69%) were male. There was a poor recognition of the prodromal period in 22 (49%) patients and caregivers. The mean duration of untreated psychosis (DUP) was 27.2 weeks (SD 56.7). There was a negative c...