South African Journal of Psychiatry最新文献

Background: Body shaming, a pervasive issue, has severe psychological and societal repercussions, particularly for early adolescents. This study addresses the gap in understanding body shaming in smaller urban settings such as Jember City, often overlooked in favour of larger metropolitan areas.

Aim: The study aimed to investigate the psychological effects, trigger factors and potential preventive measures of body shaming among junior high school students in Jember City.

Setting: The study was conducted in junior high schools in Jember City, East Java, Indonesia.

Methods: An observational, cross-sectional design with both quantitative and qualitative approaches was used. Data were collected through self-administered questionnaires and in-depth interviews. The quantitative analysis was performed using the Spearman's rank test.

Results: The study included 320 adolescents aged between 12 and 15 years. Of these, 6.3% were 12 years old, 31.2% were 13, 31.6% were 14, and 30.9% were 15. Additionally, 56.2% of the participants were female. The majority (95%) identified as Muslim, and 72.8% had parents with bachelor's degrees. Parental occupations ranged from private business to civil service. In terms of body mass index, 34.7% were classified as very thin, 18.1% as thin, 40.9% as normal, and 3.1% as fat or obese. Body shaming was widespread, with 73.1% criticized for their clothing, 59.9% for their speech, and 66.7% compared to others. The main sources of body shaming were family, peers, media, and personal insecurities. There was also a significant correlation between body shaming and stress (ρ = 0.404, p < 0.01).

Conclusion: Body shaming affects mental health, particularly among adolescents. It stems from societal norms and media perpetuation.

Contribution: This study provides insights into body shaming in smaller urban settings, highlighting the need for targeted prevention efforts to mitigate its effects and promote healthier self-esteem and body image.

Background: Adolescents living with HIV (ALWHIV) are more vulnerable to developing depressive symptoms. Despite this knowledge, the screening for depression is not routinely integrated into HIV treatment programmes.

Aim: The study aimed to determine the prevalence of depressive symptoms among ALWHIV.

Setting: The study was carried out in the primary healthcare clinics and an antiretroviral clinic situated in a district hospital, West Rand District, Johannesburg.

Methods: This was a cross-sectional study of 125 ALWHIV. The modified Patient Health Questionnaire for Adolescents (PHQ-A) was used to screen for depressive symptoms with a score of ≥ 5 deemed significant. A distress protocol was used for immediate psychological intervention.

Results: The prevalence of depressive symptoms was 44.8% and the majority of ALWHIV reported mild-moderate symptoms (36.8%). Overall, 25.6% of adolescents had suicidal behaviours. Those with psychosocial difficulties and those who reported a previous suicide attempt were 3.6 (adjusted odds ratio [aOR] 3.59, 95% confidence interval [CI]:1.17-11.03) and 6.9 (aOR 6.93, 95% CI:1.39-34.55) times likely to develop depressive symptoms, respectively.

Conclusion: A high prevalence of depressive symptoms was found in ALWHIV. Psychosocial difficulties and previous suicide attempts were predictive factors for depressive symptoms. This highlights the unmet need for the integration of mental health screening and overall mental health services into adolescent HIV programmes.

Contribution: This study emphasises an urgent need for routine mental health screening and prompt psychosocial support in ALWHIV.

Background: The global disease burden attributable to mental and neurological disorders has been increasing over the years. World Health Organization (WHO) recommends the integration of mental health services into existing primary healthcare framework as one strategy for dealing with the burden. Understanding the attitudes of nurses towards people with mental illness is important for a successful integration and management outcome of patients.

Aim: This study aimed to determine primary healthcare nurses' attitudes towards people with mental illness.

Setting: The study was conducted at Greater Lobatse health district, one of the primary healthcare districts in Botswana.

Methods: A cross-sectional study was conducted among 202 nurses working in the greater Lobatse health district from 01 May 2023 to 30 November 2023. Convenience sampling was used. Data were collected using a structured self-administered questionnaire.

Results: The prevalence of negative attitudes was 51.5%. The mean age (standard deviation [s.d.]) of respondents was 33.4 (8.0) years. Being a non-specialised nurse (B= -0.184; p = 0.014), having a personal history of mental illness (B = -0.215; p = 0.002), and having poor knowledge about mental illness (B = -0.149; p = 0.032) were associated with negative attitudes.

Conclusion: More than half of the respondents have negative attitudes towards people with mental illness. This justifies the need for training and educational programmes and anti-stigma campaigns among primary healthcare nurses to mitigate negative attitudes.

Contribution: This study provides insight into primary healthcare nurses' attitudes towards people with mental illness.

[This corrects the article DOI: 10.4102/sajpsychiatry.v30i0.2260.].

Background: Disruptive mood dysregulation disorder (DMDD) is characterised by severe emotion regulation difficulties, particularly anger and irritability, in children. Despite the impact of attachment on emotional and behavioural regulation, the link between attachment style and DMDD is under-researched.

Aim: This study investigated whether attachment style and parasympathetic regulation differentiate the response profiles to frustrating conditions between children diagnosed with DMDD and controls.

Setting: Participants were assessed at schools in Johannesburg, Gauteng, South Africa.

Methods: Thirty participants were divided into two matched groups (n _DMDD = 15; n _Control = 15) and assessed. Respiratory sinus arrhythmia (RSA) and heart period were measured during an Affective Posner Task, inducing frustration. Attachment style was assessed using the Attachment Style Classification Questionnaire for children. Parents of children with DMDD completed a social interaction problems questionnaire.

Results: The DMDD group showed a higher prevalence of avoidant attachment style (p = 0.013) compared to controls. Both groups displayed adaptive vagal withdrawal and recovery during the task (p = 0.005; p = 0.021). Controls had significantly higher heart period throughout the assessment (game 1: p = 0.006; game 2: p = 0.013; game 3: p = 0.007). In the DMDD group, lower vagal tone during frustration correlated with more social interaction problems (p = 0.049).

Conclusion: The study demonstrates a potential link between attachment style and altered physiological state in children with DMDD.

Contribution: The findings provide insight into possible atypical vagal regulation of the heart and avoidant attachment styles in DMDD, highlighting potential therapeutic and intervention targets.

Background: Coronavirus disease 2019 (COVID-19) has impacted on a range of physical, mental and societal health indices. Increased levels of psychological stress are often reported following pandemics.

Aim: To describe and compare the presentations of mental health care users pre- and post-initiation of the lockdown, with an emphasis on demographic profiles and final diagnoses.

Setting: The study was conducted as a retrospective record review over the predetermined period at a large public hospital in Johannesburg and included all mental health care users requiring psychiatry consultation during the study period.

Methods: Clinical records were traced via the emergency department registration desk, and information pertaining to demographics, presenting complaints, date of presentation and diagnosis was extracted.

Results: A significant increase was seen in patients with psychotic disorders from pre-COVID-19 to post-COVID-19. There was a reduction in presentations of mood disorders and substance-related disorders. Patients presenting in the post-COVID-19 time period were significantly younger than in the pre-COVID-19 time period.

Conclusion: Pandemics result in notable negative mental health sequelae. Policies aimed at mitigating the spread of infective agents should be implemented with consideration of the burden of psychological distress following the pandemic.

Contribution: This study provides insights into clinical and demographic variables in a mental health care population serviced at a government hospital pre- and post-COVID-19 lockdown regulations.

Background: The coronavirus disease 2019 (COVID-19) pandemic has placed the psychological functioning of mental healthcare practitioners under severe strain. Coping methods may affect mental health outcomes.

Aim: The study examined the relationship between depression, anxiety, stress, and coping styles utilised by mental healthcare practitioners during the COVID-19 pandemic.

Setting: Three private and one public mental healthcare facility in Bloemfontein, South Africa.

Methods: Respondents completed the Depression, Anxiety and Stress Scale (DASS-21) and Brief Coping Orientation to Problems Experienced (Brief-COPE) inventories. An ordinal regression model was used to assess the relationship between coping styles, anxiety and depression.

Results: A total of 212 practitioners were included in the analysis. According to DASS-21 measures, approximately 41% and 28% of respondents had moderate to severe depressive and anxiety symptoms, respectively, with the highest prevalence among younger female respondents and nurses. The association between stress severity, anxiety and depression was significant. Avoidant coping methods and two approach coping strategies (planning and acceptance) were associated with depression and anxiety. Anxiety was linked to an increased likelihood of transitioning to higher avoidant categories, while participants with depression were less likely to move to higher avoidant or approach categories.

Conclusion: Mental healthcare practitioners, especially nurses, experienced significant COVID-19-related psychological distress during the pandemic. Avoidant coping mechanisms may increase the risk of poor mental health outcomes.

Contribution: This study added data on the mental health effects of COVID-19 on mental healthcare practitioners, as well as psychological methods used to cope during the pandemic.

Background: Adverse childhood experiences (ACEs), substance use, depressive symptoms, and HIV outcomes in people living with HIV (PLWHIV) have not been comprehensively investigated within a single study.

Aim: The aim of this study was to investigate the prevalence and association of ACEs, substance use, depressive symptoms and human immunodeficiency virus (HIV) outcomes in PLWHIV accessing HIV care during the coronavirus disease 2019 (COVID-19) pandemic.

Setting: District hospital HIV clinic in South Africa.

Methods: A total of 196 PLWHIV completed a socio-demographic and clinical questionnaire; an adapted World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test; WHO ACEs International Questionnaire, and Patient Health Questionnaire.

Results: The most common ACEs were having one or no parent, parental separation or divorce (n = 131, 66.8%), exposure to collective (n = 57, 29.1%) and community violence (n = 55, 28.1%), with 40.3% (n = 79) experiencing ≥ 3 ACEs. The most commonly used substances were alcohol (n = 34, 17.3%), tobacco (n = 33, 16.8%), and cannabis (n =13, 6.6%). The prevalence of depressive symptoms was 19.4% (n = 38). Linear regression analyses indicated greater alcohol (adj β = 2.84, p < 0.01), tobacco (adj β = 3.64, p < 0.01) and cannabis use risk scores (adj β = 2.39, p < 0.01) were associated with ≥ 3 ACEs. Logistic regression indicated depressive risk (adjusted odds ratio [OR] = 9.39, 95% confidence interval [CI] 4.78-23.51) was associated with ≥ 3 ACEs.

Conclusion: A high prevalence of ACEs, substance use and depressive symptoms exists among PLWHIV, along with an association between cumulative ACEs and both substance use and depressive symptoms.

Contribution: Enhanced screening and management services are recommended to address this triple burden in PLWHIV.

Background: Bipolar disorder (BD) is a chronic, disabling mental illness that may require recurrent hospitalisation. The length of hospital stay (LOS) for BD patients is variable, and literature suggests that this is because of clinical and socio-demographic factors.

Aim: To determine the average LOS for patients admitted for BD at a hospital and its relation to clinical and socio-demographic factors.

Setting: A public tertiary hospital in South Africa.

Methods: Clinical and socio-demographic data were obtained from a retrospective record review of patient admissions at a hospital over 1 year. Length of hospital stay, defined as the duration between admission and discharge date, and other variables were retrieved.

Results: A total of 215 patients were admitted during the study period. The mean LOS was 30 days. The mean age of the patients was 35.9 years (standard deviation [s.d.] = 12.4, range 18-72 years). There were similar numbers of males and females admitted. Significantly more patients were not married (p < 0.001), unemployed (p < 0.001), and had a history of substance use (p < 0.001). Employed patients were 2.5 times more likely to have a short stay than those unemployed (p = 0.03). There was a statistically significant association between the number of comorbidities and LOS.

Conclusion: The study findings align with the literature's results. The median length of stay was 25 days and was impacted by socio-demographic but not clinical factors.

Contribution: The study provided insight into the impact of variable factors in LOS for BD patients.

Background: Depression is reported as one of the most common mental disorders. Research on Indian men's understandings of depression is limited.

Aim: The authors aimed to explore South African Indian men's understanding of depression in a community, and how this guides help-seeking behaviour.

Setting: Community dwelling participants in Gauteng, South Africa.

Methods: An exploratory qualitative design was employed and a purposive sampling method was used to recruit participants. Semi-structured interviews were conducted with seven Indian adult men and analysed using thematic analysis.

Results: The findings of this study yielded a total of six themes. These included understanding of depression, depression is taboo, diverging gender role expectations and depression, help-seeking behaviour, barriers to help-seeking, and mental health community support.

Conclusion: The findings suggest a lack of understanding and awareness of depression among participants and discussions around mental illness being regarded as taboo. Gender roles and societal expectations were considered as one of the contributors to depression onset. Coping and help-seeking behaviour included adaptive and maladaptive coping mechanisms with professional psychological help being least prioritised. Self-stigmatisation and fear of discrimination were highlighted as barriers to help-seeking behaviours.

Contribution: This study contributed to the limited body of knowledge on understanding of depression among Indian men in South Africa and highlighted the importance of mental health awareness campaigns and professional help-seeking behaviour.