South African Journal of Psychiatry最新文献

Background: Anxiety is a common psychological response among caregivers of children with severe illnesses, yet limited research has explored its prevalence and associated factors in guardians of children with severe malaria in Malawi. Understanding the severity of anxiety and its correlates is crucial for supporting caregiver mental health and improving paediatric outcomes.

Aim: This study aimed to determine the prevalence and severity of anxiety, and identify social, demographic and clinical factors associated with anxiety among guardians of children admitted with severe malaria.

Setting: The study setting was the Peadiatric ward of Thyolo District Hospital in Malawi.

Methods: A cross-sectional study was conducted involving 187 guardians of children diagnosed with severe malaria. Data were collected using a structured questionnaire incorporating socio-demographic and clinical information, alongside the Generalised Anxiety Disorder 7-item (GAD-7) scale. Descriptive statistics, Chi-square tests and logistic regression were used to analyse the data.

Results: Mild anxiety was the most common (79.7%) among participants, followed by moderate (10.7%) and minimal (9.6%), with no cases of severe anxiety. Significant socio-demographic factors associated with higher anxiety included age (p < 0.001), guardian type (p < 0.001), education level (p < 0.001), area of residence (p < 0.001) and source of income (p < 0.001). Clinically, longer hospital stays (p < 0.001) and repeated admissions (p < 0.001) were significantly associated with increased anxiety severity.

Conclusion: Anxiety is prevalent among guardians of children with severe malaria, with several socio-demographic and clinical factors contributing to its severity. The findings highlight the importance of integrating psychological support services into paediatric care settings.

Contribution: This study underscores the need for routine anxiety screening, mental health support and context-specific interventions targeting caregivers of hospitalised children with severe illnesses in low-resource settings.

Background: Insomnia disorder is a modifiable risk factor for maternal and offspring psychopathology, yet it remains overlooked in low-resource settings like Malawi, where maternal mental health services are underprioritised.

Aim: To assess the prevalence and associated psychiatric factors for insomnia disorder among pregnant women at Kamuzu Central Hospital (KCH).

Setting: Antenatal care unit (ANC) at KCH, Lilongwe.

Methods: A cross-sectional design was employed. Systematic random sampling was used to select 110 pregnant women. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate insomnia. Descriptive and logistic regression established the association between socio-demographic, obstetric, sleep arrangement and biometric factors and sleep quality.

Results: The prevalence of insomnia disorder was found to be 79.1% (mean PSQI = 8.77 ± 3.79), indicating significant sleep disturbances. Logistic regression revealed a significant association with gestation, participants in the second trimester (adjusted odds ratio [AOR] = 5.21, 95% confidence interval [CI]: 1.49-18.26, p = 0.010) being at higher risk and increased odds among married women (odds ratio [OR] = 0.14, 95% CI: 0.13-0.48, p = 0.038) and those sharing bed (OR = 5.28, 95% CI: 1.14-24.55, p = 0.034) at higher risk of poor sleep quality.

Conclusion: Poor sleep quality is common among pregnant women in Malawi, with trimester-specific and psychosocial predictors elevating psychiatric risks.

Contribution: Integration of sleep screening and perinatal mental health interventions into antenatal care is urgently needed in the second trimester to mitigate adverse maternal and offspring outcomes.

Background: Parents with a history of alcohol consumption contribute to their children's drinking behaviour.

Aim: This study aimed to investigate the influence of parents' history of alcohol use on their children's drinking habits.

Setting: The study was conducted at a contact learning university in South Africa.

Methods: A cross-sectional quantitative study with 350 undergraduate university students was conducted.

Results: The independent samples t-test results revealed that students who had parents with a history of alcohol use (M = 4.20, standard deviation [s.d.] = 2.95) scored significantly higher on hazardous alcohol use compared to their counterparts whose parents did not have a history of alcohol use (M = 2.47, s.d. = 2.70). The results also showed that students who had parents with a history of alcohol use (M = 5.78, s.d. = 4.48) scored significantly higher on harmful alcohol use compared to students with parents who did not have a history of alcohol use (M = 2.98, s.d. = 3.66). Moreover, students who had parents with a history of alcohol use (M = 4.42, s.d. = 3.20) scored significantly higher on alcohol dependence symptoms than those whose parents did not have a history of alcohol use (M = 1.95, s.d. = 2.61).

Conclusion: Parents with a history of alcohol use influence their children's drinking habits. The observed drinking habits can affect children's health and interrupt their university studies.

Contribution: Investing in university alcohol prevention programmes could reduce the surge of alcohol abuse among students and promote healthy drinking habits.

Background: There is a strong link between chronic pain and neurocognitive impairment. The co-occurrence of the two disorders often leads to a poor quality of life and significant disability.

Aim: To determine the prevalence of neurocognitive impairments in adults with chronic pain.

Setting: The study was conducted at a tertiary hospital in Pietermaritzburg, KwaZulu-Natal.

Methods: This cross-sectional study was conducted at a pain clinic within a tertiary hospital in Pietermaritzburg, KwaZulu-Natal. Participants were required to be clinic attendees, proficient in English, and have a minimum of a Grade 7 education. Exclusion criteria included neurological disorders, significant language barriers, or ineligible age. Recruitment used purposive sampling with informed consent. Data were collected using socio-demographic and clinical questionnaires, namely, the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and the Physical Self-Maintenance Scale (PSMS). The primary outcome was the prevalence of neurocognitive impairment; secondary outcomes examined associations with demographic and clinical factors using both descriptive and inferential statistics.

Results: A total of 105 participants (59 females and 46 males) were enrolled in the study. The mean age of the participants was 55.1 ± 6.75 years. A total of 73.3% (n = 77) of participants screened positive for neurocognitive impairment on MoCA and 55.2% on MMSE.

Conclusion: Chronic pain is associated with impairments in neurocognitive performance, particularly in short-term memory and executive functioning.

Contribution: A significant correlation was found between lower education levels and neurocognitive impairment (p = 0.02 for MoCA, p = 0.04 for MMSE).

Background: Diagnosing and treating vitamin B₁₂ deficiency in psychiatric populations is important, but the justification for routine screening in patients without risk factors or physical findings remains uncertain, especially in resource-limited settings.

Aim: This study aimed to assess the clinical utility and cost-effectiveness of routine vitamin B₁₂ screening in adult psychiatric inpatients.

Setting: The study was conducted at Townhill Hospital, a tertiary psychiatric facility in South Africa.

Methods: A retrospective chart review was performed for the period 01 July 2021 to 31 December 2022. Data collected included demographics, clinical diagnoses, medications, risk factors for deficiency, vitamin B₁₂ test results, associated costs, and clinical responses to abnormal findings.

Results: Of 366 patients (168 male, 198 female; mean age 35.95 ± 13.44 years), the mean serum vitamin B₁₂ level was 423.86 mmol/L (SD ± 233.37), with a median of 359 mmol/L. Vitamin B₁₂ deficiency was identified in eight patients (2.2%). The cost per deficient patient was R5780.73. Statistically significant associations were found between low B₁₂ levels and pregnancy, vegetarian diet, abdominal surgery, and metformin use (p < 0.05). Only half of the deficient patients received replacement therapy.

Conclusion: Routine vitamin B₁₂ screening in the absence of physical findings or known risk factors is not clinically or economically justified. Targeted screening should be considered to optimise resource use and patient outcomes.

Contribution: In resource-constrained environments, prioritising high-yield interventions is essential to improving care efficiency.

Background: Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) and affective disorders often coexist, leading to suboptimal health outcomes. Poor management of this comorbidity can result in decreased medication adherence, increased hospitalisations and diminished quality of life.

Aim: To determine the predictors and correlates of depression and suicidality among children and adolescents living with HIV and AIDS in Maiduguri, Nigeria.

Setting: This study was conducted at the antiretroviral therapy (ART) clinic of the University of Maiduguri Teaching Hospital, Nigeria.

Methods: A cross-sectional study was conducted to recruit 160 children and adolescents with HIV and AIDS who are attending ART clinics. Participants were selected using a systematic random sampling approach. The Schedule for Affective Disorders and Schizophrenia for School-Aged Children Present and Lifetime Version (K-SADS-PL), which is both a screening and diagnostic instrument, was administered to identify those with depression and suicidality.

Results: Suicidality and depression rates were found to be 30.6% and 45.0%, respectively. Frequent hospital admissions and medication non-adherence were significantly associated with both depression and suicidality.

Conclusion: This study highlights the significant mental health burden among children and adolescents living with HIV and AIDS. The association between frequent hospitalisations, medication non-adherence and emotional disorders emphasises the need for integrated mental health services within HIV and AIDS care.

Contribution: This study offers insightful information about the mental health situation of children and adolescents living with HIV and AIDS (CALWHA), contributing to a deeper understanding of their unique needs and informing the development of targeted interventions.

Background: Internalising disorder, which is characterised by anxiety and depression, is a mental health disorder observed among in-school adolescents in Nigeria, with consequent school dropout, substance use and suicide.

Aim: This study examined the effects of adverse childhood experiences (ACEs) and personality traits on internalising disorder among in-school adolescents in Lagos State, Nigeria.

Setting: The study was conducted among in-school adolescents attending secondary schools in Lagos State, Nigeria.

Methods: A cross-sectional design and multistage sampling techniques were used to select 357 participants (138 males = 38.7%; 219 females = 61.3%) from five high schools in Lagos State, who responded to the ACEs Questionnaire, Personality Inventory and Revised Children's Anxiety and Depression Scale.

Results: The prevalence of ACEs is 23.8% mild, 33.1% moderate, 13.4% severe experiences being higher on internalising disorder, and 29.7% with no experience. Sixteen per cent of children were clinically significant on internalising behaviour, with 19.3% significant on anxiety and 9% on depression. Adverse childhood experiences significantly predicted internalising disorder; likewise, conscientiousness, neuroticism, and openness to experience consistently and significantly predicted internalising disorder. Adverse childhood experiences and personality traits contributed a significant variance of 16% in anxiety, 26% in depression and a combined 20% to the total variance in internalising disorder.

Conclusion: The study encourages practical, tailored interventions that address ACEs and foster positive personality traits to mitigate against internalising disorder.

Contribution: The study underscores the importance of personality traits in the outcomes of children and adolescents exposed to ACEs in Nigeria.

Background: The rigorous demands associated with caring for critically ill patients place intensive care unit (ICU) nurses at a heightened risk for mental health issues.

Aim: This study investigated the individual and combined benefits of two distinct intervention strategies, resilience training and yoga training, on enhancing the mental health of ICU nurses.

Setting: Hospitals located in Bitlis Province, Turkey.

Methods: A sample of 84 participants was chosen and randomly and equally allocated to resilience, yoga, resilience+yoga or the control group. Resilience or yoga training comprised eight sessions, each lasting 45 min. Participants in the combined group completed both resilience and yoga training. Data analysis was conducted using an analysis of variance test.

Results: Engagement in either resilience or yoga training alone led to a significant decrease in depression, anxiety and stress levels (p < 0.05). Finally, the resilience + yoga training had additive benefits and resulted in a significantly greater reduction in depression, anxiety and stress levels compared to the individual resilience or yoga training (p < 0.05).

Conclusion: Intensive care unit nurses should engage in both resilience and yoga training to reap the associated physical and psychological benefits.

Contribution: This study sheds light on the value of the resilience and yoga combination for the mental health of ICU nurses.