Pub Date : 2024-04-09DOI: 10.4102/sajpsychiatry.v30i0.2207
Carrie Brooke-Sumner, Bongwekazi Rapiya, Bronwyn Myers, Inge Petersen, Charlotte Hanlon, Julie Repper, L. Asher
Background: People with severe mental health conditions, such as schizophrenia, and their family caregivers are underserved in low- and middle-income countries where structured psychosocial support in the community is often lacking. This can present challenges to recovery and for coping with additional strains, such as a pandemic.Aim: This study explored the experiences and coping strategies of people with lived experience of a severe mental health condition, and family caregivers, in South Africa during the initial stages of the coronavirus disease 2019 (COVID-19) pandemic.Setting: This qualitative study was conducted in the Nelson Mandela Bay District, Eastern Cape, South Africa, in the most restrictive period of the COVID-19 lockdown.Methods: Telephonic qualitative interviews were conducted with people with lived experience (n = 14) and caregivers (n = 15). Audio recordings were transcribed and translated to English from isiXhosa. Thematic analysis was conducted with NVivo 12.Results: Participants described negative impacts including increased material hardship, intensified social isolation and heightened anxiety, particularly among caregivers who had multiple caregiving responsibilities. Coping strategies included finding ways to not only get support from others but also give support, engaging in productive activities and taking care of physical health. The main limitation was inclusion only of people with access to a telephone.Conclusion: Support needs for people with severe mental health conditions and their families should include opportunities for social interaction and sharing coping strategies as well as bolstering financial security.Contribution: These findings indicate that current support for this vulnerable group is inadequate, and resource allocation for implementation of additional community-based, recovery-focused services for families must be prioritised.
{"title":"COVID-19 experience of people with severe mental health conditions and families in South Africa","authors":"Carrie Brooke-Sumner, Bongwekazi Rapiya, Bronwyn Myers, Inge Petersen, Charlotte Hanlon, Julie Repper, L. Asher","doi":"10.4102/sajpsychiatry.v30i0.2207","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v30i0.2207","url":null,"abstract":"Background: People with severe mental health conditions, such as schizophrenia, and their family caregivers are underserved in low- and middle-income countries where structured psychosocial support in the community is often lacking. This can present challenges to recovery and for coping with additional strains, such as a pandemic.Aim: This study explored the experiences and coping strategies of people with lived experience of a severe mental health condition, and family caregivers, in South Africa during the initial stages of the coronavirus disease 2019 (COVID-19) pandemic.Setting: This qualitative study was conducted in the Nelson Mandela Bay District, Eastern Cape, South Africa, in the most restrictive period of the COVID-19 lockdown.Methods: Telephonic qualitative interviews were conducted with people with lived experience (n = 14) and caregivers (n = 15). Audio recordings were transcribed and translated to English from isiXhosa. Thematic analysis was conducted with NVivo 12.Results: Participants described negative impacts including increased material hardship, intensified social isolation and heightened anxiety, particularly among caregivers who had multiple caregiving responsibilities. Coping strategies included finding ways to not only get support from others but also give support, engaging in productive activities and taking care of physical health. The main limitation was inclusion only of people with access to a telephone.Conclusion: Support needs for people with severe mental health conditions and their families should include opportunities for social interaction and sharing coping strategies as well as bolstering financial security.Contribution: These findings indicate that current support for this vulnerable group is inadequate, and resource allocation for implementation of additional community-based, recovery-focused services for families must be prioritised.","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140725927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-08DOI: 10.4102/sajpsychiatry.v30i0.2225
Saajidah Khan, I. Ntatamala, R. Baatjies, S. Adams
Background: Burnout, resulting from chronic workplace stress that has been unsuccessfully managed, has previously been documented in doctors. The coronavirus disease 2019 (COVID-19) pandemic has increased occupational challenges faced by doctors, potentiating their risk for burnout.Aim: This study aimed to determine the prevalence and determinants of burnout among medical doctors during the COVID-19 pandemic.Setting: Three public sector hospitals in Gqeberha, South Africa.Methods: A cross-sectional study of 260 voluntary participants was conducted. Participants completed self-administered electronic questionnaires. Logistic regression analysis was performed to explore the determinants of burnout.Results: The prevalence of burnout in this study was 78%. Burnout was significantly associated with being a medical intern or community-service medical officer (adjusted odd ratio [AOR] = 6.72, 1.71–26.40), being in the lowest income band (AOR = 10.78, 2.55–45.49), and using alcohol to manage work-related stress (AOR = 3.01, 1.12–8.04). Job-related factors associated with burnout were experiencing high conflict at work (AOR = 5.04, 1.92–13.20) and high role ambiguity and role conflict (AOR = 4.49, 1.98–10.18). Low support at work (AOR = 9.99, 3.66–27.23), medium job satisfaction (AOR = 5.38, 2.65–10.93) and medium support at work (AOR = 3.39, 1.71–6.73) were positively associated with burnout. Participants with medium (AOR = 0.28, 0.10–0.80) and high levels of resilience (AOR = 0.08, 0.03–0.25) were protected against burnout. Coronavirus disease 2019-related factors were not significantly associated with burnout.Conclusion: The burnout prevalence among South African medical doctors at public hospitals during the COVID-19 pandemic was high and strongly associated with job stress factors.Contribution: Given the increased prevalence of burnout among doctors and the strong associations with job stress factors, mitigation of burnout requires targeted organisational interventions.
{"title":"Prevalence and determinants of burnout among South African doctors during the COVID-19 pandemic","authors":"Saajidah Khan, I. Ntatamala, R. Baatjies, S. Adams","doi":"10.4102/sajpsychiatry.v30i0.2225","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v30i0.2225","url":null,"abstract":"Background: Burnout, resulting from chronic workplace stress that has been unsuccessfully managed, has previously been documented in doctors. The coronavirus disease 2019 (COVID-19) pandemic has increased occupational challenges faced by doctors, potentiating their risk for burnout.Aim: This study aimed to determine the prevalence and determinants of burnout among medical doctors during the COVID-19 pandemic.Setting: Three public sector hospitals in Gqeberha, South Africa.Methods: A cross-sectional study of 260 voluntary participants was conducted. Participants completed self-administered electronic questionnaires. Logistic regression analysis was performed to explore the determinants of burnout.Results: The prevalence of burnout in this study was 78%. Burnout was significantly associated with being a medical intern or community-service medical officer (adjusted odd ratio [AOR] = 6.72, 1.71–26.40), being in the lowest income band (AOR = 10.78, 2.55–45.49), and using alcohol to manage work-related stress (AOR = 3.01, 1.12–8.04). Job-related factors associated with burnout were experiencing high conflict at work (AOR = 5.04, 1.92–13.20) and high role ambiguity and role conflict (AOR = 4.49, 1.98–10.18). Low support at work (AOR = 9.99, 3.66–27.23), medium job satisfaction (AOR = 5.38, 2.65–10.93) and medium support at work (AOR = 3.39, 1.71–6.73) were positively associated with burnout. Participants with medium (AOR = 0.28, 0.10–0.80) and high levels of resilience (AOR = 0.08, 0.03–0.25) were protected against burnout. Coronavirus disease 2019-related factors were not significantly associated with burnout.Conclusion: The burnout prevalence among South African medical doctors at public hospitals during the COVID-19 pandemic was high and strongly associated with job stress factors.Contribution: Given the increased prevalence of burnout among doctors and the strong associations with job stress factors, mitigation of burnout requires targeted organisational interventions.","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140730807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-04DOI: 10.4102/sajpsychiatry.v30i0.2187
Renata Schoeman, Antoinette L. Miric, M. Talatala, C. Grobler
No abstract available.
无摘要。
{"title":"The SASOP/PsychMg guidelines for psychiatric independent medical examinations","authors":"Renata Schoeman, Antoinette L. Miric, M. Talatala, C. Grobler","doi":"10.4102/sajpsychiatry.v30i0.2187","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v30i0.2187","url":null,"abstract":"No abstract available.","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140742407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-31DOI: 10.4102/sajpsychiatry.v30i0.2157
L. Robertson, Jade C. Bouwer
Background: South African legislation advocates for equitable access to mental healthcare services integrated into general healthcare settings. Mental, neurological, and substance use (MNS) disorders are often comorbid. Pharmacoepidemiology provides indirect evidence of service provision for conditions amenable to medicine treatment.Aim: The study aims to evaluate medicine procurement for MNS disorders at different service levels in the health system.Setting: The Public health sector, Gauteng province formed the setting for the study.Method: A secondary analysis of the Gauteng pharmaceutical database was conducted using Anatomic Therapeutic Chemical (ATC) and defined daily dose (DDD) methodology. Anatomic Therapeutic Chemical classes of medicines for MNS disorders were included. Defined daily doses and costs were calculated per 1000 population served by each facility and service level. Statistical comparisons were made using chi-square testing.Results: General healthcare settings accounted for 90% (R118 638 248) and specialised hospitals for 10% (R13 685 032) of expenditure on medicines for MNS disorders, procuring 94% (n = 49 442 474) and 6% (n = 3 311 528) of DDDs, respectively. Although district clinics procured 60% of DDDs, they procured the least per 1000 population served, whereas district hospitals procured the most. For almost all ATC classes, procurement differed significantly between municipalities at every service level and between specialised hospitals.Conclusion: In Gauteng province, most medicines for MNS disorders are procured by general healthcare services, but access to care may not be equitable. While population coverage at district clinics appears low, district hospitals may experience the greatest care burden. Research regarding quality of care at each service level is recommended.Contribution: This study provides insight into service provision for MNS disorders.
{"title":"Mental health services in Gauteng, South Africa: A proxy evaluation using pharmaceutical data","authors":"L. Robertson, Jade C. Bouwer","doi":"10.4102/sajpsychiatry.v30i0.2157","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v30i0.2157","url":null,"abstract":"Background: South African legislation advocates for equitable access to mental healthcare services integrated into general healthcare settings. Mental, neurological, and substance use (MNS) disorders are often comorbid. Pharmacoepidemiology provides indirect evidence of service provision for conditions amenable to medicine treatment.Aim: The study aims to evaluate medicine procurement for MNS disorders at different service levels in the health system.Setting: The Public health sector, Gauteng province formed the setting for the study.Method: A secondary analysis of the Gauteng pharmaceutical database was conducted using Anatomic Therapeutic Chemical (ATC) and defined daily dose (DDD) methodology. Anatomic Therapeutic Chemical classes of medicines for MNS disorders were included. Defined daily doses and costs were calculated per 1000 population served by each facility and service level. Statistical comparisons were made using chi-square testing.Results: General healthcare settings accounted for 90% (R118 638 248) and specialised hospitals for 10% (R13 685 032) of expenditure on medicines for MNS disorders, procuring 94% (n = 49 442 474) and 6% (n = 3 311 528) of DDDs, respectively. Although district clinics procured 60% of DDDs, they procured the least per 1000 population served, whereas district hospitals procured the most. For almost all ATC classes, procurement differed significantly between municipalities at every service level and between specialised hospitals.Conclusion: In Gauteng province, most medicines for MNS disorders are procured by general healthcare services, but access to care may not be equitable. While population coverage at district clinics appears low, district hospitals may experience the greatest care burden. Research regarding quality of care at each service level is recommended.Contribution: This study provides insight into service provision for MNS disorders.","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140359281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-30DOI: 10.4102/sajpsychiatry.v30i0.2222
M. Nagdee, Lillian Artz, U. Subramaney, Charles Young, Amanda Pieterse, Julia Pettitt
Background: Women charged with violent offences may be referred by courts for forensic psychiatric assessment to determine whether mental disorder or intellectual disability impacts their fitness to stand trial and/or criminal responsibility. The profile of these women is a poorly researched area in South Africa.Aim: This study examined the socio-demographic, offence-related, and clinical profile of South African women charged with violent offences referred for forensic assessment.Setting: Fort England Hospital (FEH), a forensic psychiatric institution in the Eastern Cape.Methods: The clinical records of 173 women referred by courts for forensic psychiatric evaluation over a 24-year period (1993–2017) to FEH were systematically reviewed.Results: Most women were single, black mothers with dependent children, who were unemployed and socio-economically impoverished. Many had backgrounds of pre-offence mental illness, alcohol use and alleged abuse. The majority were first-time offenders whose victims were known to them. Most child victims were biological children killed by their mothers. Likely primary motives for violence were related to psychopathology in half of cases, and interpersonal conflict in a third. Forensic assessment most frequently confirmed psychotic disorders and dual diagnoses. Half the cases were fit to stand trial and under half were criminally responsible.Conclusion: Violent female offending occurs within a gendered context, with high rates of prior trauma, alcohol use and psychosocial distress in perpetrators. An emphasis on gender-sensitive psychosocial interventions is required.Contribution: This study highlights the nature and context of violent offending by women referred for forensic psychiatric assessment in South Africa.
{"title":"The gendered context of women charged with violent offences in the forensic psychiatric setting","authors":"M. Nagdee, Lillian Artz, U. Subramaney, Charles Young, Amanda Pieterse, Julia Pettitt","doi":"10.4102/sajpsychiatry.v30i0.2222","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v30i0.2222","url":null,"abstract":"Background: Women charged with violent offences may be referred by courts for forensic psychiatric assessment to determine whether mental disorder or intellectual disability impacts their fitness to stand trial and/or criminal responsibility. The profile of these women is a poorly researched area in South Africa.Aim: This study examined the socio-demographic, offence-related, and clinical profile of South African women charged with violent offences referred for forensic assessment.Setting: Fort England Hospital (FEH), a forensic psychiatric institution in the Eastern Cape.Methods: The clinical records of 173 women referred by courts for forensic psychiatric evaluation over a 24-year period (1993–2017) to FEH were systematically reviewed.Results: Most women were single, black mothers with dependent children, who were unemployed and socio-economically impoverished. Many had backgrounds of pre-offence mental illness, alcohol use and alleged abuse. The majority were first-time offenders whose victims were known to them. Most child victims were biological children killed by their mothers. Likely primary motives for violence were related to psychopathology in half of cases, and interpersonal conflict in a third. Forensic assessment most frequently confirmed psychotic disorders and dual diagnoses. Half the cases were fit to stand trial and under half were criminally responsible.Conclusion: Violent female offending occurs within a gendered context, with high rates of prior trauma, alcohol use and psychosocial distress in perpetrators. An emphasis on gender-sensitive psychosocial interventions is required.Contribution: This study highlights the nature and context of violent offending by women referred for forensic psychiatric assessment in South Africa.","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140364314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-29DOI: 10.4102/sajpsychiatry.v30i0.2144
Olindah Silaule, Fasloen Adams, Nokuthula G. Nkosi
Background: Informal caregivers are an essential health resource in the care of persons with severe mental disorders, particularly in South Africa where access to mental healthcare services is limited.Aim: The study aimed to explore and describe the coping strategies used by informal caregivers and the specific health impacts they face in the context of severe mental disorders in South Africa.Setting: The study was conducted in Bushbuckridge municipality situated in the northeastern parts of Mpumalanga province, South Africa.Methods: A descriptive qualitative methodology was used to conduct semi-structured interviews with 12 purposefully selected participants. Audio-recorded interviews were translated, transcribed and analysed inductively on NVivo12 using reflexive thematic analysis.Results: The themes identified were caregivers’ experience of consequences of caregiving and caregivers’ experience of coping with their caregiving role. Participants experienced negative consequences on their emotional, mental and physical health. The participants use internal and external resources to cope with the challenges they face, and many highlighted using emotion-focused coping strategies.Conclusion: The findings revealed an urgent need to develop support strategies to strengthen informal caregivers’ coping and promote good health particularly in rural South Africa where informal caregivers play a crucial role in the management of severe mental disorders.Contribution: The finding demands that policymakers and healthcare providers prioritise the health and well-being of the informal caregivers. There should be policies targeted specifically at developing and implementing caregiver-orientated healthcare services.
{"title":"Health effects of caregiving and coping with severe mental disorders: A caregivers’ experience","authors":"Olindah Silaule, Fasloen Adams, Nokuthula G. Nkosi","doi":"10.4102/sajpsychiatry.v30i0.2144","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v30i0.2144","url":null,"abstract":"Background: Informal caregivers are an essential health resource in the care of persons with severe mental disorders, particularly in South Africa where access to mental healthcare services is limited.Aim: The study aimed to explore and describe the coping strategies used by informal caregivers and the specific health impacts they face in the context of severe mental disorders in South Africa.Setting: The study was conducted in Bushbuckridge municipality situated in the northeastern parts of Mpumalanga province, South Africa.Methods: A descriptive qualitative methodology was used to conduct semi-structured interviews with 12 purposefully selected participants. Audio-recorded interviews were translated, transcribed and analysed inductively on NVivo12 using reflexive thematic analysis.Results: The themes identified were caregivers’ experience of consequences of caregiving and caregivers’ experience of coping with their caregiving role. Participants experienced negative consequences on their emotional, mental and physical health. The participants use internal and external resources to cope with the challenges they face, and many highlighted using emotion-focused coping strategies.Conclusion: The findings revealed an urgent need to develop support strategies to strengthen informal caregivers’ coping and promote good health particularly in rural South Africa where informal caregivers play a crucial role in the management of severe mental disorders.Contribution: The finding demands that policymakers and healthcare providers prioritise the health and well-being of the informal caregivers. There should be policies targeted specifically at developing and implementing caregiver-orientated healthcare services.","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140366876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-28DOI: 10.4102/sajpsychiatry.v30i0.2209
Muthumuni Nemavhola, T. Melapi, Danie Hoffman, Ora Gerber-Schutte
Background: Globally, crime is highly masculinised and research into female criminality is scarce. In South Africa, no research specifically investigating the characteristics of female observandi referred for non-violent crimes has been published.Aims: The study aimed to describe the socio-demographic, clinical, and forensic correlates in women referred to Sterkfontein Hospital for forensic psychiatric observation following a non-violent criminal charge between 2010 and 2019. It also sought to establish the relationship between the correlates and fitness to stand trial and criminal responsibility, as well as the relationship between the socio-demographic characteristics and the different non-violent criminal charges.Setting: Sterkfontein Hospital.Methods: A retrospective record review of all cases referred to Sterkfontein Hospital for a single observation over 10 years was conducted.Results: Sixty-five cases were included in the study. Most observandi referred for non-violent crimes were found to be single (84.6%), unemployed (67.7%), reported abuse (55.4%), and had a high prevalence of mental illness (90.8%). Non-adherence to treatment was identified in 59.1% and substance use was identified in 72.2% of the study sample. The most common charge was theft (64.6%). The majority of the sample was found fit and responsible (57%). Bipolar (21%) and Primary Psychotic Disorders (35.7%) were associated with statistically significant outcomes of trial incompetence (p = 0.005) and lack of responsibility (p = 0.028).Conclusion: It is recommended that prospective studies are conducted which include comparisons with male counterparts and females referred for violent crimes.Contribution: The study identified correlates that should be included in the standard of care in forensic assessments of female observandi.
{"title":"Social, forensic, and clinical correlates in female observandi referred for non-violent crimes","authors":"Muthumuni Nemavhola, T. Melapi, Danie Hoffman, Ora Gerber-Schutte","doi":"10.4102/sajpsychiatry.v30i0.2209","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v30i0.2209","url":null,"abstract":"Background: Globally, crime is highly masculinised and research into female criminality is scarce. In South Africa, no research specifically investigating the characteristics of female observandi referred for non-violent crimes has been published.Aims: The study aimed to describe the socio-demographic, clinical, and forensic correlates in women referred to Sterkfontein Hospital for forensic psychiatric observation following a non-violent criminal charge between 2010 and 2019. It also sought to establish the relationship between the correlates and fitness to stand trial and criminal responsibility, as well as the relationship between the socio-demographic characteristics and the different non-violent criminal charges.Setting: Sterkfontein Hospital.Methods: A retrospective record review of all cases referred to Sterkfontein Hospital for a single observation over 10 years was conducted.Results: Sixty-five cases were included in the study. Most observandi referred for non-violent crimes were found to be single (84.6%), unemployed (67.7%), reported abuse (55.4%), and had a high prevalence of mental illness (90.8%). Non-adherence to treatment was identified in 59.1% and substance use was identified in 72.2% of the study sample. The most common charge was theft (64.6%). The majority of the sample was found fit and responsible (57%). Bipolar (21%) and Primary Psychotic Disorders (35.7%) were associated with statistically significant outcomes of trial incompetence (p = 0.005) and lack of responsibility (p = 0.028).Conclusion: It is recommended that prospective studies are conducted which include comparisons with male counterparts and females referred for violent crimes.Contribution: The study identified correlates that should be included in the standard of care in forensic assessments of female observandi.","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140372311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.4102/sajpsychiatry.v30i0.2158
Phumla S. Gasa, Andrew Tomita, Vidette M Juby, Saaeda Paruk
Background: Sodium valproate (valproate) that is used both as an anti-epileptic and a mood stabiliser is teratogenic in pregnancy. A Dear Health Care Professional Letter (DHCPL) issued in December 2015 recommended the avoidance of sodium valproate prescription in women of childbearing age (WOCBA) and pregnant women.Aim: This study aimed to describe the prescription pattern of valproate in female mental healthcare users (MHCUs).Setting: Regional hospital psychiatry department in King Dinizulu Hospital Complex, Durban, KwaZulu-Natal.Methods: This was a descriptive, retrospective chart review of female in- and out-patient aged 12–55 years who were receiving a valproate prescription for mental illness between 01 January 2018 and 31 December 2020.Results: Of the 158 females who received valproate during the study period, 15 (9.5%) had it tapered off while 143 (90.5%) were continued. Only 19% of all the patients had documented counselling regarding valproate, 19 (12%) had documented contraceptive use, and six (3.8%) continued its use at any point during pregnancy. The most frequently prescribed dose range was 800 mg – 1499 mg/day (n = 111, 70.7%) and the most common psychiatric indication was a psychotic disorder.Conclusion: This study showed that prescription of valproate in female MHCUs still occurs in practice in a referral centre in South Africa despite the guidelines outlining management of those of reproductive age on valproate. The prescription pattern and monitoring of valproate were poorly documented in relation to the guideline.Contribution: This study highlights the lack of adherence to recommendations regarding the prescription of valproate in WOCBA and the need for improved documentation of the indications, consent and counselling.
{"title":"The valproate prescription pattern for female mental healthcare users of reproductive age","authors":"Phumla S. Gasa, Andrew Tomita, Vidette M Juby, Saaeda Paruk","doi":"10.4102/sajpsychiatry.v30i0.2158","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v30i0.2158","url":null,"abstract":"Background: Sodium valproate (valproate) that is used both as an anti-epileptic and a mood stabiliser is teratogenic in pregnancy. A Dear Health Care Professional Letter (DHCPL) issued in December 2015 recommended the avoidance of sodium valproate prescription in women of childbearing age (WOCBA) and pregnant women.Aim: This study aimed to describe the prescription pattern of valproate in female mental healthcare users (MHCUs).Setting: Regional hospital psychiatry department in King Dinizulu Hospital Complex, Durban, KwaZulu-Natal.Methods: This was a descriptive, retrospective chart review of female in- and out-patient aged 12–55 years who were receiving a valproate prescription for mental illness between 01 January 2018 and 31 December 2020.Results: Of the 158 females who received valproate during the study period, 15 (9.5%) had it tapered off while 143 (90.5%) were continued. Only 19% of all the patients had documented counselling regarding valproate, 19 (12%) had documented contraceptive use, and six (3.8%) continued its use at any point during pregnancy. The most frequently prescribed dose range was 800 mg – 1499 mg/day (n = 111, 70.7%) and the most common psychiatric indication was a psychotic disorder.Conclusion: This study showed that prescription of valproate in female MHCUs still occurs in practice in a referral centre in South Africa despite the guidelines outlining management of those of reproductive age on valproate. The prescription pattern and monitoring of valproate were poorly documented in relation to the guideline.Contribution: This study highlights the lack of adherence to recommendations regarding the prescription of valproate in WOCBA and the need for improved documentation of the indications, consent and counselling.","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140378328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-21DOI: 10.4102/sajpsychiatry.v30i0.2115
J. Onu, T. Onyeka
Background: Mental healthcare workforce shortage in Nigeria poses a major obstacle to mental health services scale-up. Digital psychiatry may provide a veritable platform to bridge treatment gaps.Aim: To provide an overview of quantity and range of peer-reviewed publications on digital psychiatry in Nigeria.Setting: A comprehensive literature search encompassed all original, peer-reviewed research articles on digital psychiatry in Nigeria. PubMed, Google Scholar, and a direct exploration of relevant journal article reference lists were utilised. Inclusion criteria covered peer-reviewed original articles conducted in Nigeria between January 2013 and January 2023, regardless of quality. Exclusions comprised case reports, reviews, dissertations, and abstracts.Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines were adhered to, while methodological framework of Arksey and O’Malley was used to describe the review.Results: Fourteen studies meeting inclusion criteria exhibited two primary research areas: implementation and intervention. Most studies focused on intervention strategies, showcasing efficacy of digital devices in enhancing outcomes in depression and clinic appointments. Implementation studies indicated favorable acceptance by both clients and healthcare practitioners.Conclusion: Digital technology seems acceptable to Nigerian patients and clinicians. Policies to operationalise provision of digital healthcare services will have positive impact in addressing unmet mental health needs. Finally, the quality of the evidence from majority of studies has to be enhanced, and additional studies are required to uncover gaps in some regions of the country.Contribution: This research demonstrates that, despite some drawbacks, digital methods of providing mental healthcare are practical in Nigeria.
{"title":"Digital psychiatry in Nigeria: A scoping review","authors":"J. Onu, T. Onyeka","doi":"10.4102/sajpsychiatry.v30i0.2115","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v30i0.2115","url":null,"abstract":"Background: Mental healthcare workforce shortage in Nigeria poses a major obstacle to mental health services scale-up. Digital psychiatry may provide a veritable platform to bridge treatment gaps.Aim: To provide an overview of quantity and range of peer-reviewed publications on digital psychiatry in Nigeria.Setting: A comprehensive literature search encompassed all original, peer-reviewed research articles on digital psychiatry in Nigeria. PubMed, Google Scholar, and a direct exploration of relevant journal article reference lists were utilised. Inclusion criteria covered peer-reviewed original articles conducted in Nigeria between January 2013 and January 2023, regardless of quality. Exclusions comprised case reports, reviews, dissertations, and abstracts.Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines were adhered to, while methodological framework of Arksey and O’Malley was used to describe the review.Results: Fourteen studies meeting inclusion criteria exhibited two primary research areas: implementation and intervention. Most studies focused on intervention strategies, showcasing efficacy of digital devices in enhancing outcomes in depression and clinic appointments. Implementation studies indicated favorable acceptance by both clients and healthcare practitioners.Conclusion: Digital technology seems acceptable to Nigerian patients and clinicians. Policies to operationalise provision of digital healthcare services will have positive impact in addressing unmet mental health needs. Finally, the quality of the evidence from majority of studies has to be enhanced, and additional studies are required to uncover gaps in some regions of the country.Contribution: This research demonstrates that, despite some drawbacks, digital methods of providing mental healthcare are practical in Nigeria.","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140220764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.4102/sajpsychiatry.v30i0.2190
U. Subramaney, Nasiha Minty, Chad M. Himlok, Damilola Adetiba, Hamza Ahmed, Elouise Barnard, Yolanda R. Mahachi, Koketso Selekana, Jenna R. Smith, Samantha Iyaloo
Background: Trauma experiences, particularly in childhood, have been associated with criminality and mental illness. There is a paucity of research into the crime of murder, trauma and mental illness.Aim: This research study focused on state patients charged with murder and sought to determine associations with prior trauma experiences, and specific types of traumas (sexual, physical and emotional).Setting: The study was conducted at a forensic psychiatric hospital in Johannesburg, South Africa.Methods: The records of state patients admitted over a 21-year period on a charge of murder were reviewed and analysed with respect to sociodemographic variables, clinical profiles, trauma experience and victim characteristics.Results: Experience of trauma in this population, with a much higher number of males compared with females, was lower than previous studies. Neurocognitive disorder was significantly associated with physical trauma. Physical trauma was found to have a significantly negative association with psychotic disorders, compared with other mental disorders.Conclusion: Although trauma is common in psychiatric patients, the study’s findings are lower than previous studies. Noting the male bias in state patients that commit murder, greater sample sizes are needed to adequately address issues of specific types of traumas, the development of mental illness and murder.Contribution: Exploring and managing prior trauma in state patients who commit murder is important while considering rehabilitation efforts, such that reintegration into the community and non-recidivism are encouraged.
{"title":"Prior trauma experiences among state patients charged with murder: A retrospective records review","authors":"U. Subramaney, Nasiha Minty, Chad M. Himlok, Damilola Adetiba, Hamza Ahmed, Elouise Barnard, Yolanda R. Mahachi, Koketso Selekana, Jenna R. Smith, Samantha Iyaloo","doi":"10.4102/sajpsychiatry.v30i0.2190","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v30i0.2190","url":null,"abstract":"Background: Trauma experiences, particularly in childhood, have been associated with criminality and mental illness. There is a paucity of research into the crime of murder, trauma and mental illness.Aim: This research study focused on state patients charged with murder and sought to determine associations with prior trauma experiences, and specific types of traumas (sexual, physical and emotional).Setting: The study was conducted at a forensic psychiatric hospital in Johannesburg, South Africa.Methods: The records of state patients admitted over a 21-year period on a charge of murder were reviewed and analysed with respect to sociodemographic variables, clinical profiles, trauma experience and victim characteristics.Results: Experience of trauma in this population, with a much higher number of males compared with females, was lower than previous studies. Neurocognitive disorder was significantly associated with physical trauma. Physical trauma was found to have a significantly negative association with psychotic disorders, compared with other mental disorders.Conclusion: Although trauma is common in psychiatric patients, the study’s findings are lower than previous studies. Noting the male bias in state patients that commit murder, greater sample sizes are needed to adequately address issues of specific types of traumas, the development of mental illness and murder.Contribution: Exploring and managing prior trauma in state patients who commit murder is important while considering rehabilitation efforts, such that reintegration into the community and non-recidivism are encouraged.","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140083819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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