Publications by authors named "Christopher P Szabo"

Psychiatry is an under-resourced discipline, specifically in terms of personnel, not least of all in developing world settings. The capacity for training specialists does not seem to meet the requirements of an increasing disease burden. Notwithstanding the status quo, countries in such settings continue to train and graduate specialists.

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Mental health law in South Africa has been dominated in recent times by the Mental Health Care Act 2002. This paper provides selective insights into specific aspects of that Act and highlights its impact on clinical practice within a broad clinical setting and in so doing suggests areas for review and revision.

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Background: Mental health leadership is a critical component of patient access to care. More specifically, the ability of mental health professionals to articulate the needs of patients, formulate strategies and engage meaningfully at the appropriate level in pursuit of resources. This is not a skill set routinely taught to mental health professionals.

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Background: Community mental health services (CMHS) are a central objective of the National Mental Health Policy Framework and Strategic Plan. Three core components are described: residential facilities, day care and outpatient services. Primary mental health care with specialist support is required according to an intervention pyramid.

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Objective: To describe clinical presentation and service requirements for those under six years of age referred to a specialised child and adolescent psychiatry unit.

Method: This study used a retrospective review of preschoolers, six years and younger, assessed at a child, family and adolescent psychiatric unit (January 2006 to 31 December 2010). Data analysis established predominant diagnoses (prevalence percentages) and correlations and associations (diagnoses and a range of clinical variables - Fischer's exact test and chi-square test).

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A growing body of research indicates that a bidirectional response to a stressor may occur in maltreated children and may be associated with later life psychopathology. However, few studies have investigated stress reactivity in children when they first present to a sexual abuse clinic. Thus, in order to evaluate whether HPA axis dysregulation would be evident at first presentation to a sexual abuse clinic in young girls (n = 26), between the ages of 6-12 years old, blood samples were obtained immediately following examination at a forensic sexual abuse clinic and from the matched control group of children (n = 14; 10.

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Objective: Elsewhere, curricula for undergraduate and postgraduate psychiatry have been extended to include the role of spirituality. It has also become important to establish how, within accepted professional boundaries, spirituality should be incorporated appropriately into the current model for South African practice and training. The objectives included exploring, analyzing, and describing the views and experience of local academic psychiatrists on this topic.

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The current bio-psycho-social approach in South African psychiatry refers to Engel's extended model of health care. It forms the basis of the existing collaboration between medicine, nursing, psychology, occupational therapy and social work. Psychiatry also has to bridge the multi-cultural, multi-religious and spiritual diverse reality of everyday practice.

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This case report highlights the dilemma faced by staff with regard to the timing of surgery on a child with a disorder of sex development living in a large, lower socio-economic class, South African, urban township. In this community, children with disorders of sex development can sometimes become an object of interest and ridicule or are thought to be bewitched. Many parents of children with such disorders find it difficult to protect their offspring from the marginalization and rejection that is the consequence of such curiosity and transparency.

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Background: Eating disorders have traditionally been associated with the white community in South Africa. The emergence of eating disorders among blacks in the mid 1990's appeared to signal a demographic shift. Subsequent data suggested that eating disorders would increase in prevalence amongst black South Africans.

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This study was undertaken as part of an exploration of the potential risk for future eating disorders in the black female population of South Africa. Previous research has documented eating attitudes suggesting that such a risk exists in urban populations. A translated version of the Eating Attitudes Test (EAT-26) was applied in a Zulu speaking, rural population (n=361).

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Eating disorders were first described in black females in South Africa in 1995. A subsequent community based study of eating attitudes amongst adolescent females in an urban setting suggested that there would be increasing numbers of sufferers from within the black community. The current study sought to extend these findings using a larger, more representative urban sample.

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