South African Journal of Psychiatry最新文献

{"title":"South African mental healthcare providers' views about exercise for people with mental illness.","authors":"Belinda S Marais","doi":"10.4102/sajpsychiatry.v30i0.2227","DOIUrl":"10.4102/sajpsychiatry.v30i0.2227","url":null,"abstract":"<p><strong>Background: </strong>People living with mental illness (PWMI) have significantly reduced life expectancy compared to the general population, yet mental healthcare providers (MHCPs) do not regularly prescribe exercise, despite its proven health benefits.</p><p><strong>Aim: </strong>This study aimed to evaluate South African MHCPs' views regarding exercise for PWMI.</p><p><strong>Setting: </strong>A cross-sectional descriptive study conducted across five public sector specialised psychiatric units in Gauteng.</p><p><strong>Methods: </strong>Mental healthcare providers were surveyed using the Exercise in Mental Illness Questionnaire - Health Professionals Version.</p><p><strong>Results: </strong>Most participants were nurses (49.1%) and doctors (26.2%) and reported no prior formal training in exercise prescription (79.4%). The vast majority (up to 89.7%) agreed regarding the physical benefits of exercise, particularly cardiometabolic benefits. The most common barriers, as perceived by MHCPs, to exercise participation for PWMI were: stigma (56.5%) and medication side effects (56.5%). The majority (76.2%) reported prescribing exercise for PWMI at least 'occasionally'. The method most frequently used was personal discussion (77.3%) and aerobic exercise was most frequently recommended (81.0%). Specific instructions regarding physical activity recommendations however were often not provided. Regarding MHCPs personal exercise habits, only a third (34%) met physical activity guidelines. Most MHCPs (92.1%) indicated an interest in further training regarding exercise for PWMI.</p><p><strong>Conclusion: </strong>Mental healthcare providers were supportive of exercise for PWMI. Strategies to address the stigma around mental illness and medication side-effects, to improve training regarding exercise prescription, as well as the exercise habits of MHCPs themselves, and collaboration with exercise professionals and organisations are recommended.</p><p><strong>Contribution: </strong>This study provides insight into the views of South African MHCPs regarding exercise for PWMI.</p>","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11079334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lived experience narrative: My journey with schizophrenia.","authors":"","doi":"10.4102/sajpsychiatry.v30i0.2259","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v30i0.2259","url":null,"abstract":"","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11079424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introducing the 'Lived Experience' section of the <i>South African Journal of Psychiatry</i>.","authors":"Laila Asmal, Mehita Iqani","doi":"10.4102/sajpsychiatry.v30i0.2268","DOIUrl":"10.4102/sajpsychiatry.v30i0.2268","url":null,"abstract":"","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11079359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicidal behaviour among patients with congestive cardiac failure in a Nigerian teaching hospital","authors":"Tomilola O. Shofu-Akanji, Bolanle Ola, D. Adegbaju, A. Ajibare, Adefemi A. Adeoye, Ismail O. Adesina","doi":"10.4102/sajpsychiatry.v30i0.2204","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v30i0.2204","url":null,"abstract":"Background: Suicidal behaviour is an established psychiatric complication of congestive cardiac failure (CCF), contributing significantly to morbidity and death by suicide. The magnitude and risk factors for suicidal behaviour among patients with CCF are yet to be unpacked, especially in developing nations such as Nigeria.Aim: To determine the prevalence of suicidal behaviour and the risk factors associated with suicidal behaviour, among patients with CCF in Nigeria.Setting: Cardiology outpatient clinic of Lagos State University Teaching Hospital, Lagos, Nigeria.Methods: A cross-sectional study was conducted among 98 randomly selected patients with a diagnosis of CCF. Participants were assessed with a socio-demographic and clinical factors questionnaire and Beck Scale of Suicidal Ideation. Chi-square test, t-test and logistic regression were used to analyse data.Results: The prevalence of suicidal ideation and suicidal attempt among patients with CCF was 52% and 1%, respectively. No socio-demographic factor was significantly associated with suicidal ideation. Clinical factors associated with suicidal ideation were age at diagnosis (p = 0.042), aetiology of CCF (p = 0.001) and severity of CCF (p = 0.032). Only the severity of CCF (odds ratio [OR] = 20.557, p = 0.014) predicted suicidal ideation among patients with CCF.Conclusion: Suicidal behaviour constitutes a huge burden among the outpatient CCF population. The identification of clinical risk factors for suicidal ideation (age at diagnosis, aetiology and severity of CCF) further illuminates a pathway to mortality among patients with CCF.Contribution: The findings lend a voice to the need for screening for suicidal behaviour, suicide prevention programmes, surveillance systems and government policies that support mental health for patients with CCF.","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140667097","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}

{"title":"Factors associated with long hospitalisation for psychotic disorder patients in an acute ward: Tertiary care hospital","authors":"Tshepiso I. Paliweni-Zwane, Lucas N. Modisane, G. Grobler","doi":"10.4102/sajpsychiatry.v30i0.2049","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v30i0.2049","url":null,"abstract":"Background: The average length of stay is often used to indicate health system efficiency; shorter stays are associated with reduced costs. In South Africa, mental healthcare expenditure is spent on inpatient care.Aim: To identify factors associated with a long stay in an acute psychiatric unit.Setting: A tertiary hospital.Methods: A case-control study review of inpatients diagnosed with psychotic symptoms was used. Sample was divided into two groups, length of stay (LOS) (LOS greater than 21 days, LOS less than 14 days). Total of 82 patients were divided into short stay group (SSG, n = 23) and long stay group (LSG) (n = 59). A comparison of demographic, clinical and system variables was conducted.Results: In demographics, LSG had fewer men compared to SSG (78.3%) and differed statistically from LSG with p = 0.05. Long stay groups were older in comparison to SSG with a p = 0.02. Illicit substance use in LSG was 44.1% and statistically less than SSG (73.91%; p = 0.02). A high proportion of LSG had medical or surgical and psychiatric comorbidities (67.8%) compared to SSG (43.5%) (p = 0.04). A total of 95% patients in SSG had family support.Conclusion: Longer stay was found to be associated with older females with primary psychotic disorders. Comorbidities with less availability of family support were associated with younger males presenting with psychotic symptoms that may be related to illicit substances that respond to rapid stabilisation.Contribution: Active surveillance of medical comorbidities amongst older female patients is necessary for early liaison services to reduce their length of stay.","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140667603","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}

{"title":"Nurses’ practice of metabolic monitoring for patients on antipsychotics in Lesotho","authors":"Relebohile P. Matete, L. Rathobei","doi":"10.4102/sajpsychiatry.v30i0.2219","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v30i0.2219","url":null,"abstract":"Background: Severe mental illness is associated with higher physical health morbidities and reduced life expectancy, with an estimated 14.3% of global deaths attributed to mental disorders. Antipsychotic medications (APs) used in treatment contribute to physical health issues, including metabolic and cardiovascular effects.Aim: The aim of this study was to assess nurses’ practices regarding metabolic monitoring for patients prescribed antipsychotic medications at Mohlomi Hospital in Lesotho.Setting: The study was conducted at Mohlomi Hospital, the primary psychiatric facility in Lesotho.Methods: Using a cross-sectional design, 44 nurses from Mohlomi Hospital participated in the study. A structured questionnaire assessed nurses’ metabolic monitoring practices.Results: Most of the respondents were female (n = 30, 75%), and minority were male (n = 10, 25%). The academic qualifications of respondents were distributed as follows: 40% (16) held a nursing assistant certificate and 22.5% (9) held an advanced nursing diploma, among others. The average age of all respondents was 39.05 (s.d. 8.9), with an average of 8 years of experience in psychiatry (s.d. 7.6). The overall rate of nurses’ practices of metabolic monitoring for patients taking antipsychotic medications showed variability, with a mean score of 2.83 (s.d. 0.524). However, only 20% performed ECG tests, 22.5% measured blood pressure, 27.5% tested for glucose abnormalities and 17.5% conducted lipid profile testing.Conclusion: Results revealed a significant gap in the practice of metabolic monitoring among nurses with various aspects of metabolic monitoring, not being adequately monitored.Contribution: The study’s findings shall inform policy and guidelines for monitoring patients on antipsychotic medications while guiding future research.","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140674981","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}

{"title":"Schizophrenia and schizoaffective disorder: Length of stay and associated factors","authors":"Ladawa Y. Goga, B. Marais","doi":"10.4102/sajpsychiatry.v30i0.2237","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v30i0.2237","url":null,"abstract":"Background: Patients with schizophrenia and schizoaffective disorder often require longer admissions.Aim: To explore length of stay (LOS) and associated factors of patients with schizophrenia and schizoaffective disorder, admitted to a public sector specialised psychiatric hospital, over a 4-year period.Setting: The study was conducted at Tara Hospital in Johannesburg.Methods: A retrospective record review of 367 adult schizophrenia and schizoaffective disorder patients admitted between 01 January 2015 and 31 December 2018. Average LOS was calculated and the proportion of short-stay ( 30 days), medium-stay (31–90 days) and long-stay ( 90 days) admissions determined. Sociodemographic, clinical and admission outcome data were collected and analysed from a randomly selected subset of patients in each LOS category.Results: Mean LOS was 128 days (median 87, interquartile range [IQR] 49–164, range 0–755 days). A significantly greater proportion had long-stay admissions (p 0.001). Male gender (p = 0.018), being unmarried (p = 0.006), treatment resistant (p 0.001) and on clozapine (p = 0.009) were factors found to have a significant association with long-stay admissions. Rates of unemployment ( 80%), comorbid substance use disorders ( 40%), medical illnesses ( 40%), antipsychotic polypharmacy ( 40%) and readmissions ( 80%) were high. Most ( 80%) were discharged.Conclusion: Long-stay admissions were frequently required for patients with schizophrenia and schizoaffective disorder admitted to Tara Hospital.Contribution: This study highlights factors associated with long-stay admissions in patients with schizophrenia and schizoaffective disorder. More research is needed into whether increased access to community-based services, such as residential and daycare facilities, outpatient substance rehabilitation programmes and dual diagnosis clinics, could translate into shorter admissions, less frequent relapses and improved outcomes in this population.","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140673054","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}

{"title":"Nigeria mental health law: Challenges and implications for mental health services","authors":"G. O. Ozota, Ruth N. Sabastine, Franklin C. Uduji, Vanessa C. Okonkwo","doi":"10.4102/sajpsychiatry.v30i0.2134","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v30i0.2134","url":null,"abstract":"Background: The Nigerian mental health law titled the Lunacy Act of 1958 has been under scrutiny for violating the human rights of people with mental illness. The call to reform the obsolete Lunacy Act has garnered attention from the government, as the law has been unamended for over 60 years.Aim: This study presents the challenges and implications of the new mental health law to the mental health services of Nigeria.Methods: ScienceDirect, PubMed, and Google Scholar were used to find pertinent material. The implications and difficulties facing the new mental health law examined from the literature were discussed. Recommendations were made following an exploratory search for literature on mental health legislation in Nigeria.Results: The new Law in Section 5(6) saw the introduction of mental health services in primary and secondary healthcare. It also addresses critical issues such as non-discrimination, fundamental human rights, standards of treatment, access to information, confidentiality and autonomy, and the employment rights of persons with mental health and substance abuse-related disorders. The Law failed to include mental health services in the country’s health insurance system.Conclusion: There is a need for legislation to meet people’s mental health needs and encourage them to seek treatments, such as regulations that protect against discrimination and harsh treatment of people with mental illness.Contribution: Nigerian mental health services would benefit from the new mental health law if the key issues raised in this review are addressed.","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140684748","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}

{"title":"Demographic and mental health profile of youth in a gender service: An African case series","authors":"Simon D. Pickstone-Taylor, E. L. Davids, Graham N. De Bever, Petrus J. De Vries","doi":"10.4102/sajpsychiatry.v30i0.2160","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v30i0.2160","url":null,"abstract":"Background: Despite a massive global increase in research on gender-diverse youth, there have been no studies in Africa on gender-diverse children and adolescents presenting to health services.Aim: This study aimed to present the first African findings of the demographic and mental health profile of youth who have presented at a gender service in South Africa.Setting: A specialist mental health outpatient service, consisting of psychiatry, psychology and nursing input, for gender-diverse child and adolescent patients in the Western Cape.Methods: All consenting youth seen at a gender service, consisting of psychiatry, psychology and nursing input, in state and by the same clinician in private practice between January 2012 and May 2019 were participants of a retrospective, sequential case series study. Data of interest, including gender identity and sexuality, mental health history and social information, were extracted from the psychiatry files of participants.Results: Thirty-nine participants were part of the registry and qualified for the study: 72% self-identified as white, 15% as coloured and 13% as black African. The rate of co-occurring psychopathology was high (64%) and included high rates of autism, particularly in trans males (26%), suicidal ideation in 31% and a history of suicide attempt(s) in 10%.Conclusions: This first study describing gender-diverse youth seeking support relating to their gender identity in Africa showed they had remarkable similarities to those studied internationally.Contribution: Establishing that transgender youth of all major racial groups in the province with similar demographic profiles to other parts of the world are presenting to services in South Africa and in need of mental health support and interventions.","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140693863","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}

{"title":"Comparing the medication costs of treating patients with schizophrenia who use cannabis with those who do not","authors":"Nikhil Nowbath, Nada Abdelatif, Gian Lippi","doi":"10.4102/sajpsychiatry.v30i0.2211","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v30i0.2211","url":null,"abstract":"Background: Cannabis use is more prevalent among people with schizophrenia than in the general population. This usage detrimentally impacts disease prognosis, contributing to escalated admissions, heightened severity of psychotic symptoms, and reduced medication response. The recent decriminalisation of cannabis in South Africa may lead to an upsurge in usage, consequently intensifying the strain on mental healthcare services.Aim: This study aimed to compare the medication costs of patients with schizophrenia depending on cannabis use.Setting: Weskoppies Hospital, Pretoria, South Africa, 2018–2019.Methods: Data pertaining to medication expenses during the 2018–2019 period were acquired from the hospital pharmacy. Data were collected from 114 patient records to form two equal cohorts: one exposed to cannabis and the other non-exposed, as indicated by urine drug screens or admission of cannabis use. Medications prescribed from admission to time of being ready for discharge were recorded and corresponding costs were calculated.Results: Patients who were exposed to cannabis had higher medication costs (R 516.47) than patients who were non-exposed (R 328.69) (p = 0.0519), over the whole admission period.Conclusion: Cannabis exposure escalates the financial burden of treating schizophrenia at Weskoppies Hospital. This might be attributed to failure of cost-effective, first-line medications prompting the prescription of costlier, second-line alternatives or higher prescribed dosages.Contribution: This study contributes to findings that it is more expensive to treat patients with schizophrenia who have relapsed, if they are using cannabis. This finding has future cost implications when budgeting for pharmacotherapeutic treatment.","PeriodicalId":51156,"journal":{"name":"South African Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140700884","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}