African Journal of Psychiatry最新文献

Neurosurgical interventions date back to ancient civilization, 5100 BC through a practice known as trephination. Due to past abuse and ethical considerations, neurosurgical interventions in psychiatry remain a controversial issue. This article aims to review the different surgical techniques and their current application in the treatment of psychiatric disorders. The U.S Food and Drug Administration (FDA) gave its approval for vagal nerve stimulation (VNS) for the management of treatment-resistant depression in 2005 and deep brain stimulation (DBS) for refractory obsessive-compulsive disorders (OCD) in 2009. These invasive but non destructive techniques represent the future of neurosurgery for mental disorder.

Objective: This paper reports on overarching strategies which supported the establishment and sustainability of 9 mental health self-help organisations in seven African countries.

Method: Eleven key informants were identified through snowballing and interviewed regarding their experience in the organisations. Thematic analysis of the interview data and other documentary evidence was guided by a coding scheme derived using a framework analysis approach to defining, categorising, mapping and interpreting textual data.

Results: Sustainability strategies include: commitment to members' advocating for their rights and rebuilding their lives within their communities; independent decision-making, user-led membership and leadership; financial self sufficiency, alliances with donor organisations, non-governmental organisations (NGOs), disabled people's organisations (DPOs) and ministries which support self-determination and promote control over agenda-setting and responsiveness to members' needs. Organisations' work include advocacy to destigmatise mental disorders and promote the protection of users rights, activities to improve access to health care and to income generation and social support, participation in legislative and policy reform, and capacity building of members.

Conclusion: Self-help organisations can provide crucial support to users' recovery in resource-poor settings in Africa. Support of Ministries, NGOs, DPOs, development agencies and professionals can assist to build organisations' capacity for sustainable support to members' recovery.

Objective: There is a paucity of literature on consultation-liaison psychiatry, in northern Nigeria. This study aimed to determine both the pattern of psychiatric referrals, and the attitudes of doctors toward the treatment of mental disorders in a teaching hospital, in northeast Nigeria.

Method: In this cross-sectional survey, we used a modified version of the self-rated Kumar 12-item questionnaire and a basic socio-demographic questionnaire to assess a non-random convenient sample of 100 postgraduate resident doctors (with a response rate of 70%) from the University of Maiduguri Teaching Hospital (UMTH). We subjected the data obtained to descriptive statistical analysis, using EPI info (2003), to report averages.

Results: A relatively low percentage (57.1%) of doctors acknowledged treating patients with mental disorders in their practice, with a higher proportion acknowledging referral (75%). Nearly one in five (17.6%) of the respondents were unaware that patients with functional illness could have psychological disorders. We found more awareness for psychotherapy (44.1%) than other non-pharmacological treatment interventions, while 10.3% were ignorant of non-pharmacological forms of treatment for psychological problems.

Conclusion: Although this is a preliminary report, the research reported here demonstrated that doctors in the teaching hospital concerned recognized the need for psychiatric consultation and referral. It is difficult to draw further conclusions because of the limitations of this study.

Objective: The study aimed to investigate the types of mental illnesses treated by traditional healers, and their methods of identifying and treating mental illnesses in their patients.

Method: In urban informal settlements of Kibera, Kangemi and Kawangware in Nairobi, Kenya, we used opportunistic sampling until the required number of traditional healers was reached, trying as much as possible to represent the different communities of Kenya. Focus group discussions were held with traditional healers in each site and later an in-depth interview was conducted with each traditional healer. An in-depth interview with each patient of the traditional healer was conducted and thereafter the MINIPLUS was administered to check the mental illness diagnoses arrived at or missed by the traditional healers. Quantitative analysis was performed using SPSS while focus group discussions and in-depth interviews were analysed for emerging themes.

Results: Traditional healers are consulted for mental disorders by members of the community. They are able to recognize some mental disorders, particularly those relating to psychosis. However, they are limited especially for common mental disorders.

Conclusion: There is a need to educate healers on how to recognize different types of mental disorders and make referrals when patients are not responding to their treatments.

Objective: Public attitudes toward mental illness in two widely disparate cultures, Canada and Cameroon, were compared using an experimental version of a survey instrument, the Public Opinion Survey of Human Attributes-Mental Illness or POSHA-MI(e).

Method: 120 respondents rated POSHA-MI(e) items relating to mental illness on 1-9 equal appearing interval scales: 30 in English and 30 in French in both Cameroon and Canada. Additionally, 30 matched, monolingual English, American respondents were included as a comparison group.

Result: In Canada (and in the USA), attitudes were generally more positive and less socially stigmatizing toward mental illness than in Cameroon. Differences between countries were much larger than differences between language groups.

Conclusion: Consistent with other research, beliefs and reactions of the public regarding mental illness reflect stigma, especially in Cameroon. Cultural influences on these public attitudes are more likely important than language influences. Results of this field test of the POSHA-MI(e), documenting differences in public attitudes toward mental illness in two divergent cultures, support its further development.