The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa最新文献

{"title":"Prevalence and correlates of psychological distress amongst healthcare workers during the COVID-19 pandemic: An online survey.","authors":"Olamiji A Badru,&nbsp;Kehinde O Oloko,&nbsp;Abdulwasiu O Hassan,&nbsp;Oyindamola B Yusuf,&nbsp;Umar A Abdur-Razaq,&nbsp;Saheed Yakub","doi":"10.4102/sajpsychiatry.v27i0.1617","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v27i0.1617","url":null,"abstract":"<p><strong>Background: </strong>Understanding the mental health needs of healthcare workers during coronavirus disease 2019 (COVID-19) pandemic with a view of mitigating its impact on occupational functioning is vital.</p><p><strong>Aim: </strong>To determine the prevalence and correlates of psychological distress amongst healthcare workers.</p><p><strong>Setting: </strong>The study was carried out in Nigeria during COVID-19 pandemic.</p><p><strong>Methods: </strong>A cross-sectional quantitative study using a convenience sample was conducted amongst healthcare workers. The survey comprised of two Google formatted self-report questionnaires, a 12-item General Health Questionnaire and a questionnaire containing socio-demographic, work related and knowledge of COVID-19 variables. Questionnaires were distributed via closed professional WhatsApp platforms. Data were analysed using descriptive statistics, chi-square test and logistic regression.</p><p><strong>Results: </strong>There were 313 respondents and prevalence of psychological distress was 47.0%. Females were almost twice as likely to have psychological distress as males (OR = 1.92, 95% CI: 1.21-3.04, <i>p</i> = 0.006). Healthcare workers who had no contact with COVID-19 positive patients had an 87% reduced risk of psychological distress (OR = 0.13, 95%CI: 0.23-0.25, <i>p</i> = 0.018) compared with those who had contact with COVID-19 positive patients. Healthcare workers with poor knowledge of COVID-19 had a 44% reduced risk of psychological distress compared with those with good knowledge (OR = 0.56, 95% CI: 0.34-0.93, <i>p</i> = 0.025).</p><p><strong>Conclusion: </strong>Findings revealed that healthcare workers in Nigeria reported psychological distress during COVID-19 pandemic. Greater risk was amongst females and those who had contact with COVID-19 positive patients whilst poor knowledge was protective.</p>","PeriodicalId":520815,"journal":{"name":"The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa","volume":" ","pages":"1617"},"PeriodicalIF":1.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8335756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39313525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The profile of suspected criminal offenders referred for psychiatric evaluation on an outpatient basis at Ngwelezana Hospital.","authors":"Sithembisile Mngadi,&nbsp;Andrew Tomita,&nbsp;Vusi Khanyile,&nbsp;Bonginkosi Chiliza","doi":"10.4102/sajpsychiatry.v27i0.1722","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v27i0.1722","url":null,"abstract":"<p><strong>Background: </strong>Some suspected criminal offenders in South Africa are required to undergo forensic psychiatry assessments before or during the trial, which can be delayed as a result of the shortage of psychiatrists and inpatient forensic psychiatry beds. In KwaZulu-Natal (KZN) province, only one hospital (Fort Napier Hospital [FNH]) is designated for the 30-day inpatient forensic psychiatry assessments and there is a long waiting list for suspected criminal offenders awaiting assessment. There is a need to find ways of alleviating the backlog in the waiting list, with the use of outpatient forensic assessments being a possible adjunctive method.</p><p><strong>Aim: </strong>To determine the demographic, clinical and forensic profile of suspected criminal offenders referred for outpatient preliminary assessment to Ngwelezana Hospital, and identify the profile of those who most likely require referral to FNH for a 30-day inpatient assessment.</p><p><strong>Setting: </strong>The study was conducted at Ngwelezana Tertiary Hospital, in KZN, South Africa.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of 207 suspected criminal offenders referred for outpatient forensic assessment from January 2009 to June 2015.</p><p><strong>Results: </strong>The majority of the participants were males (94.2%), with a diagnosis of substance use disorder (28.2%), intellectual disability (23.4%) or psychotic disorders (21.8%). Forty three per cent were charged with sexual crimes and 10.7% with murder. Fifty seven per cent were recommended for referral to FNH for a 30-day inpatient forensic assessment, whilst 43% were not recommended for referral. Those recommended for inpatient assessment were significantly more likely to have a lower level of education (<i>p</i> = 0.02), to be on a disability grant (<i>p</i> < 0.01), and to have been diagnosed with intellectual disability (<i>p</i> < 0.01), than those not recommended for referral.</p><p><strong>Conclusion: </strong>Identifying the characteristics of suspected criminal offenders who are most likely to be recommended for referral to FNH will potentially reduce the number of unnecessary referrals.</p>","PeriodicalId":520815,"journal":{"name":"The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa","volume":" ","pages":"1722"},"PeriodicalIF":1.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8335753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39313526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Theoretical understanding of contextual motivations for sustained adolescent marijuana use in South Africa.","authors":"Emmanuel Manu,&nbsp;Mbuyiselo Douglas,&nbsp;Mohlomi J Ntsaba","doi":"10.4102/sajpsychiatry.v27i0.1615","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v27i0.1615","url":null,"abstract":"<p><strong>Background: </strong>Although various reasons for adolescent marijuana use have extensively been explored, contextual factors that sustain the practice in settings where the plant is illegally cultivated, especially in South Africa, remain a grey area.</p><p><strong>Aim: </strong>We aimed to explore the contextual factors of sustained adolescent marijuana use in two illicit marijuana-growing settings of the Ingquza Hill Local Municipality of South Africa, based on the differential opportunity theory (DOT) and subcultural theory (SCT).</p><p><strong>Setting: </strong>The study was conducted in two illicit marijuana-growing communities in the Ingquza Hill Local Municipality of the Eastern Cape Province of South Africa.</p><p><strong>Methods: </strong>Exploratory qualitative research, using focus group discussions approach, was conducted amongst 37 participants, four focus groups and in two communities in the Ingquza Hill Municipality of the Eastern Cape Province of South Africa. Purposive and snowball sampling techniques were used to select the communities and participants, respectively. The data were analysed using a thematic content analysis approach and presented under various themes.</p><p><strong>Results: </strong>Nine themes, grouped under two broad factors, DOT influences (availability and affordability of marijuana, idleness and means of dealing with personal problems) and SCT influences (peer conformity, the pleasure derived from marijuana smoking, manipulation of appetite, health reasons, for higher cognitive function and addiction), emerged from the analysis.</p><p><strong>Conclusion: </strong>As marijuana has been identified to be a gateway drug for the use of other illicit drugs, its sustained usage amongst adolescents poses a health challenge to the user, community and the country's healthcare system at large. Hence, there is the need to intensify adolescent marijuana use prevention campaigns in illicit marijuana-growing contexts of South Africa, focussing on the differential opportunities and subcultural inclinations that promote the behaviour in those contexts.</p>","PeriodicalId":520815,"journal":{"name":"The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa","volume":" ","pages":"1615"},"PeriodicalIF":1.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8335752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39313524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the clinical utility of the severity dependence scale for benzodiazepine use disorder.","authors":"Karishma Lowton,&nbsp;Gaveeta Chiba","doi":"10.4102/sajpsychiatry.v27i0.1571","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v27i0.1571","url":null,"abstract":"<p><strong>Background: </strong>Benzodiazepines are often used as a part of mental health pharmacological management; however, often when prescribed for extended periods, they increase the risk of benzodiazepine use disorder (BUD). Clinical interviews are at the centre of diagnosing this disorder. However, in addition to clinical assessment a simple, validated questionnaire conducted by any healthcare professional may aid in screening for BUD and referral for further management.</p><p><strong>Aim: </strong>To compare the accuracy of the severity dependence scale (SDS) as a screening tool for BUD against the standard clinical interviews using the Diagnostic and Statistical Manual of Mental Disorders, edition 5, (DSM 5) checklist amongst benzodiazepine users with primary psychiatric disorders.</p><p><strong>Setting: </strong>Outpatient psychiatric clinic in South Rand Hospital, Johannesburg, South Africa.</p><p><strong>Methods: </strong>A cross-sectional study was conducted, once informed consent was attained, looking at demographic and clinical profiles of benzodiazepine users. Clinical interviews were conducted in 81 patients who completed the SDS. In comparing the results of the SDS and clinical interview outcomes, chi-square tests were used to determine an association between categorical variables. A receiver-operating characteristic (ROC) curve was generated in determining the cut-off score in the SDS with the highest sensitivity and specificity.</p><p><strong>Results: </strong>This study indicated that a cutoff score of greater than or equal to six of the SDS showed 86% sensitivity and 90.3% specificity compared to a diagnosis of BUD made with clinical interview. The only categorical variables of marginal significance (<i>p</i>~0.06) in comparison to a BUD diagnosis were with benzodiazepine type (oxazepam) and longer duration of use (greater than 24 months).</p><p><strong>Conclusion: </strong>This study identified the SDS as a useful screening tool for BUD with a high sensitivity and specificity compared to interview outcomes. Statistically, correlates were identified between duration and type of benzodiazepine prescribed and BUD suggesting emphasis on these factors when prescribing benzodiazepines.</p>","PeriodicalId":520815,"journal":{"name":"The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa","volume":" ","pages":"1571"},"PeriodicalIF":1.0,"publicationDate":"2021-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8335755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39313522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menstrual psychosis - From myth to reality: A case report of periodic psychotic symptoms associated with the menstrual cycle.","authors":"Waddah M Alalmaei Asiri","doi":"10.4102/sajpsychiatry.v27i0.1650","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v27i0.1650","url":null,"abstract":"Menstrual psychosis is characterised by the acute onset of psychotic, mood or behavioural symptoms during certain stages of the menstrual cycle. By definition, these symptoms exhibit in a relapsing-and-remitting pattern in concordance with the menstrual cycle.1 Menstrual psychosis is not considered a ‘specific disease entity’ in the current standard classification of mental health disorders. However, the temporal relationship between the onset and remission of the symptoms of menstrual psychosis to specific stages of the menstrual cycles has prompted many experts to regard menstrual psychosis as a unique disorder.2 In his monograph ‘Psychosis Menstrualis’, Krafft-Ebing first described and classified menstrual psychosis in 1878.3 Many case reports have been published and enriched the scientific literature about this disorder.4,5,6","PeriodicalId":520815,"journal":{"name":"The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa","volume":" ","pages":"1650"},"PeriodicalIF":1.0,"publicationDate":"2021-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8252155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39159221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of premorbid adjustment with type and timing of childhood trauma in first-episode schizophrenia spectrum disorders.","authors":"Anna M Smit,&nbsp;Sanja Kilian,&nbsp;Robin A Emsley,&nbsp;Hilmar K Luckhoff,&nbsp;Leslie Swartz,&nbsp;Soraya Seedat,&nbsp;Laila Asmal","doi":"10.4102/sajpsychiatry.v27i0.1639","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v27i0.1639","url":null,"abstract":"<p><strong>Background: </strong>Childhood trauma may contribute to poorer premorbid social and academic adjustment which may be a risk factor for schizophrenia.</p><p><strong>Aim: </strong>We explored the relationship between premorbid adjustment and childhood trauma, timing of childhood trauma's moderating role as well as the association of clinical and treatment-related confounders with premorbid adjustment.</p><p><strong>Setting: </strong>We conducted a secondary analysis in 111 patients with first-episode schizophrenia (FES) disorders that formed part of two parent studies, EONKCS study (<i>n</i> =73) and the Shared Roots study (<i>n</i> =38).</p><p><strong>Methods: </strong>Type of childhood trauma was assessed with the Childhood Trauma Questionnaire, short-form and premorbid adjustment using the Premorbid Adjustment Scale. Timing of childhood trauma was assessed using the Life Events Checklist and life events timeline. Linear regression analyses were used to assess the moderating effect of timing of childhood trauma. Clinical and treatment-related confounders were entered into sequential hierarchical regression models to identify independent predictors of premorbid adjustment across key life stages.</p><p><strong>Results: </strong>Childhood physical neglect was associated with poorer premorbid academic functioning during childhood and early adolescence, and poorer premorbid social functioning during early and late adolescence. By hierarchical regression modelling (<i>r</i> ² = 0.13), higher physical neglect subscale scores (<i>p</i> = 0.011) independently predicted poorer premorbid social adjustment during early adolescence. Timing of childhood trauma did not moderate the relationship between childhood trauma and premorbid functioning.</p><p><strong>Conclusion: </strong>In patients with FES, childhood physical neglect may contribute to poorer premorbid social functioning during early adolescence. This may provide us with an opportunity to identify and treat at-risk individuals earlier.</p>","PeriodicalId":520815,"journal":{"name":"The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa","volume":" ","pages":"1639"},"PeriodicalIF":1.0,"publicationDate":"2021-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8252179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39159222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and determinants of tobacco use amongst South African adults with mental illness in the Eastern Cape.","authors":"Linda K Tindimwebwa,&nbsp;Anthony I Ajayi,&nbsp;Oladele V Adeniyi","doi":"10.4102/sajpsychiatry.v27i0.1637","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v27i0.1637","url":null,"abstract":"<p><strong>Background: </strong>Given the physical and mental health consequences of tobacco use amongst individuals with mental illness, it was imperative to assess the burden of tobacco use in this population.</p><p><strong>Aim: </strong>This study examined the patterns and factors associated with tobacco use in individuals attending the outpatient unit.</p><p><strong>Setting: </strong>Cecilia Makiwane Hospital Mental Health Department in Eastern Cape province, South Africa.</p><p><strong>Methods: </strong>Lifetime (ever use) use and current use of any tobacco products were examined in a cross-sectional study of 390 individuals between March and June 2020. A logistic regression was fitted to determine the correlates of lifetime and current use of any tobacco products.</p><p><strong>Results: </strong>The rates of ever use and current use of tobacco products were 59.4% and 44.6%, respectively. Of the participants interviewed, lifetime tobacco use was more prevalent amongst individuals with schizophrenia (67.9%) and cannabis-induced disorders (97.3%) and lower in those with major depressive disorders (36.1%) and bipolar and related disorders (43.5%). Men were six times more likely to have ever used or currently use tobacco products in comparison to women. Also, those who had a salaried job or owned a business were over three times more likely to have ever used or currently use tobacco products compared with those receiving government social grants.</p><p><strong>Conclusions: </strong>The prevalence of tobacco use in this study was significantly higher than the general population in the Eastern Cape. Therefore, smoking prevention and cessation interventions targeted at the general population should target this often neglected sub-population in the region.</p>","PeriodicalId":520815,"journal":{"name":"The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa","volume":" ","pages":"1637"},"PeriodicalIF":1.0,"publicationDate":"2021-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8252167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39159220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of an undergraduate psychiatric clinical rotation: Exploring student perceptions.","authors":"Inge M Smit,&nbsp;Mariette Volschenk,&nbsp;Liezl Koen","doi":"10.4102/sajpsychiatry.v27i0.1583","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v27i0.1583","url":null,"abstract":"<p><strong>Background: </strong>Globally, the appropriate transformation of medical training is critical to ensure the graduation of competent physicians who can address the growing health needs.</p><p><strong>Aim: </strong>To explore medical students' perceptions of their learning experience during the undergraduate psychiatry late clinical rotation (PLCR) at Stellenbosch University (SU) and to use the findings to make possible recommendations regarding curriculum renewal.</p><p><strong>Setting: </strong>In recognition of this, the Department of Psychiatry at the Faculty of Medicine and Health Sciences of SU is reviewing its current teaching and learning practices.</p><p><strong>Methods: </strong>Data were collected from two focus groups.</p><p><strong>Results: </strong>Three main themes emerged: 'learning in the clinical context', 'gaining knowledge' and 'generational needs'. Whilst several suggestions were made for potential improvement, the participants still endorsed that the PLCR does provide them with a good learning experience in psychiatry.</p><p><strong>Conclusions: </strong>Considering that these perceptions are from a group of millennials, the insights arising from the 'generational needs' theme were especially valuable. To bridge the generational gap and develop a curriculum that will not only meet the standards expected by educators but also achieve acceptance from learners, future research with a specific focus on clinical teachers' perceptions is needed.</p>","PeriodicalId":520815,"journal":{"name":"The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa","volume":" ","pages":"1583"},"PeriodicalIF":1.0,"publicationDate":"2021-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39043195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"My sibling's mental illness: An interpretative phenomenological analysis of experiences of having an adult sibling with a mental illness in semi-rural South Africa.","authors":"Lisa Saville Young,&nbsp;Raylene Flannigan","doi":"10.4102/sajpsychiatry.v27i0.1585","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v27i0.1585","url":null,"abstract":"<p><strong>Background: </strong>When there is a lack of resources in the community to support deinstitutionalisation, the siblings of an individual with a mental illness are the ones who are the most affected and vulnerable. Nevertheless, sibling care work is still largely unacknowledged in the mental health sector in low- and middle-income countries.</p><p><strong>Aim: </strong>This article describes and interprets the lived experiences of 'black' isiXhosa-speaking individuals having a sibling with a mental illness, to shed light on how mental health professionals might support and sustain the involvement of individuals in the treatment and care of their sibling.</p><p><strong>Setting: </strong>The study was conducted in a semi-rural town in the Eastern Cape of South Africa.</p><p><strong>Methods: </strong>The study employed a qualitative research design using interpretative phenomenological analysis as the research method. Semi-structured interviews were conducted and analysed.</p><p><strong>Results: </strong>The findings present interview extracts which give voice to participants' experiences of financial burden, social burden and stigma, and of engaging with psychiatric treatment while providing care for their mentally ill sibling. Findings also highlight the positive aspects of caring for a sibling with a mental illness.</p><p><strong>Conclusion: </strong>This study specifically highlights the gendered nature of care work and siblings' increased understanding of mental illness by virtue of their relationship with their brother or sister, thereby possibly pointing to sibling relationships as valuable relational resources for challenging stigma. The study findings suggest that calls for greater cooperation between healing belief systems should include dialogue with western religious belief systems alongside traditional healing belief systems.</p>","PeriodicalId":520815,"journal":{"name":"The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa","volume":" ","pages":"1585"},"PeriodicalIF":1.0,"publicationDate":"2021-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39043196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical use of neuro-imaging in psychiatric patients at the Charlotte Maxeke Johannesburg Academic Hospital.","authors":"Bokang L Letlotlo,&nbsp;Lavinia D Lumu,&nbsp;Mahomed Y H Moosa,&nbsp;Fatima Y Jeenah","doi":"10.4102/sajpsychiatry.v27i0.1614","DOIUrl":"https://doi.org/10.4102/sajpsychiatry.v27i0.1614","url":null,"abstract":"<p><strong>Background: </strong>Neuro-imaging is relatively new in psychiatry. Although the actual role of neuro-imaging in psychiatry remains unclear, it is used to strengthen clinical evidence in making psychiatric diagnoses.</p><p><strong>Aim: </strong>To analyse the records of inpatients referred for neuro-imaging (computerised tomography [CT] and/or magnetic resonance imaging [MRI] scans) to determine the proportion of abnormal neuro-imaging results and, if any, factors associated with abnormal neuro-imaging results.</p><p><strong>Setting: </strong>This study was conducted at the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) situated in Johannesburg, South Africa.</p><p><strong>Methods: </strong>This was a quantitative retrospective record review. All adult psychiatric inpatients who had undergone a CT and/or MRI scan during 01 January 2014 to 31 December 2015 were included. Out-patients or patients admitted in the medical wards were excluded from the study. All neuro-imaging referrals were identified from hospital records and their demographics, scan characteristics and diagnoses were subsequently captured.</p><p><strong>Results: </strong>A total of 1040 patients were admitted to the CMJAH psychiatric unit, of which 213 (20.5%) underwent neuro-imaging tests. Of the 213 scans performed, 74 were abnormal, representing a yield of 34.7%. The most common reported pathology was atrophy (<i>n</i> = 22, 29.7%). There was no statistically significant association between age group (<i>χ</i> ² = 3.9, <i>p</i> = 0.8), gender (<i>χ</i> ² = 1.3; <i>p</i> = 0.5), psychiatric diagnoses and abnormal scans. However, there were trends towards an association with comorbid HIV infection (<i>χ</i> ² = 3.476, <i>p</i> = 0.062) and comorbid substance abuse (<i>χ</i> ² = 2.286, <i>p</i> = 0.091).</p><p><strong>Conclusion: </strong>This study supports the need for clear clinical indications to justify the cost-effective use of neuro-imaging in psychiatry. This study's high yield of abnormal CT scans, although similar to other studies, advocates that HIV positive testing and the presence of focal neurological signs will improve the yield further.</p>","PeriodicalId":520815,"journal":{"name":"The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa","volume":" ","pages":"1614"},"PeriodicalIF":1.0,"publicationDate":"2021-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39043199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}