The association between psychopathology and substance use: adolescent and young adult substance users in inpatient treatment in Cape Town, South Africa.

Introduction: Evidence suggests that comorbid psychopathology can negatively affect treatment outcomes in substance users. In South Africa, limited information exists regarding the prevalence, nature and role of psychiatric comorbidity in substance users. This study examined psychiatric comorbidity and its association with specific substance use, and young adult substance users in treatment for substance use.

The association between substance use and common mental disorders in young adults: results from the South African Stress and Health (SASH) Survey.

Introduction: Although substance use is commonly associated with mental disorders, limited data on this association are available from low and middle income countries such as South Africa. The aims of the study were i) to determine patterns of substance use in young adults, ii) to identify trends of common psychiatric disorders in relation to use of specific substances, and iii) to determine whether specific psychiatric disorders were associated with use of specific substances in the South African population.

Methods: Data were drawn from the South African Stress and Health (SASH) study, a nationally-representative, cross-sectional survey of South African households that forms part of a World Health Organisation (WHO) World Mental Health (WMH) initiative to standardise information on the global burden of mental illness and its correlates.

Peer education training for sexual health and well-being in public high schools in South Africa: Is it enough to change peer educators themselves?

Objective: To evaluate the effects of a high school peer educator training programme on the sexual behaviour and related psychosocial outcomes of peer educators.

Method: A total of 728 students from 15 randomly selected public high schools in the Western Cape, South Africa, with a peer education programme and 15 matched comparison schools were recruited, comprising 295 students in the intervention group and 433 students in the comparison arms of the study respectively. Age of sexual debut, use of condom at last sex and psychosocial outcomes such as decision making, goal orientation, critical thinking and self-esteem were measured at baseline and follow-up 18 months later.

The relationship between substance use and delinquency among high-school students in Cape Town, South Africa.

Research has shown a positive relationship between substance use and delinquent-type behaviours among adolescents. The aim of this study is to explore the temporal relationships between these outcomes through secondary data analysis of a longitudinal study of high-school students' risk behaviours. Two regression models were compared and gender, socioeconomic status and repeating a grade were found to be consistent predictors of delinquent-type behaviour.

Predicting referral practices of traditional healers of their patients with a mental illness: an application of the Theory of Planned Behaviour.

Objective: Although many studies indicate that traditional healers are willing to collaborate with Western practitioners in South Africa, none focus specifically on mental health care, and none use a theory of health behaviour to explain their findings. The present study applies the Theory of Planned Behaviour (TPB) to predict traditional healer referral practices of patients with a mental illness.

Method: One hundred traditional healers were first interviewed to assess the TPB variables and were contacted again 5 months later to measure self-reported behaviour.

Adolescent alcohol use in rural South African high schools.

Objective: To examine psychosocial correlates of lifetime alcohol use among adolescents in rural South African high schools.

Method: Questionnaires were administered to 1600 students from 20 randomly selected high schools in the Mankweng district within Limpopo province. Self-report data on alcohol use, demographic, environmental and psychosocial variables were collected.

Child and adolescent mental health in South Africa.

Mental health problems in childhood and adolescence pose a major threat to public health. Epidemiological studies in high, middle and low income countries indicate that approximately one in five children and adolescents suffer from a mental disorder. In many instances these persist into adulthood.

Mental illness and lost income among adult South Africans.

Purpose: Little is known regarding the links between mental disorder and lost income in low- and middle-income countries. The purpose of this study was to investigate the association between mental disorder and lost income in the first nationally representative psychiatric epidemiology survey in South Africa.

Methods: A probability sample of South African adults was administered the World Health Organization Composite International Diagnostic Interview schedule to assess the presence of mental disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders, version IV.

'I think it's about experiencing, like, life': a qualitative exploration of contemporary adolescent intimate relationships in South Africa.

Intimate or dating relationships play an important role in young people's psychosocial development and well-being. Yet, we know relatively little about how teenagers conceptualise and experience them. Research knowledge about young people's intimate relationships is largely gleaned from studies whose primary focus has been on adolescent sexuality and violence.

Community influences on adolescents' use of home-brewed alcohol in rural South Africa.

Background: Alcohol represents a major public health challenge in South Africa, however little is known about the correlates of alcohol use among rural adolescents. This article examines community influences on adolescents' use of home-brewed alcohol in a rural region of South Africa.

Method: A total of 1600 high school adolescents between 11 and 16 years of age participated in this study.

The theory of planned behaviour as a framework for predicting sexual risk behaviour in sub-Saharan African youth: A critical review.

Amongst the psychological theories that have been used to help understand why people have unprotected sex, the Theory of Planned Behaviour (TPB: Ajzen 1991) has earned a prominent position. This article is a critical review of 11 peer-reviewed studies conducted in sub-Saharan Africa during 2001 to 2009, which used the TPB as a model of predicting sexual risk behaviour in young people. All the studies revealed the predictive ability of the TPB in urban, rural, and traditional African settings, with R (2) coefficients ranging between 0.

Effects of the SATZ teacher-led school HIV prevention programmes on adolescent sexual behaviour: cluster randomised controlled trials in three sub-Saharan African sites.

In this study, the effects on young adolescent sexual risk behaviour of teacher-led school HIV prevention programmes were examined in two sites in South Africa (Cape Town and Mankweng) and one site in Tanzania (Dar es Salaam). In Cape Town, Dar es Salaam and Mankweng, 26, 24 and 30 schools, respectively, were randomly allocated to intervention or comparison groups. Primary outcomes were delayed sexual debut and condom use among adolescents aged 12-14 years (grade 8 in South Africa and grades 5 and 6 in Tanzania).

Multi-level influence of school norms on tobacco use in South Africa: an ecometric consideration of group differences.

Objectives: Tobacco use has been found to be related to contextual-environmental characteristics. This study focuses on the influence of contextual norms on adolescent smoking behavior with consideration of racial differences.

Methods: Data for this study were derived from the South African Community Epidemiology Network on Drug Use survey.

Methamphetamine use and sexual risk behaviour in Cape Town, South Africa: a review of data from 8 studies conducted between 2004 and 2007.

Objective: Community studies and studies of admissions to drug treatment centers indicate a dramatic increase in the prevalence of methamphetamine use in Cape Town since 2003. There has also been a substantial increase over this time period in the prevalence of HIV infection among women attending public antenatal clinics in the Western Cape province. This study aimed to review research conducted in Cape Town on the link between methamphetamine use and sexual risk behaviour.

Reliability of self report questionnaires for epidemiological investigations of adolescent mental health in Cape Town, South Africa.

Objective: This study aimed to assess the reliability of a number of self report questionnaires for epidemiological investigations of adolescents' mental health in Cape Town, South Africa. The scales used were: the Short Mood and Feelings Questionnaire (SMFQ), Zung Self-rating Anxiety Scale (SAS), Self-esteem Questionnaire (SEQ), Harvard Trauma Questionnaire (HTQ) and Multi-Dimensional Scale of Perceived Social Support (MSPSS).

Method: The self-report questionnaire (available in Afrikaans, English and isiXhosa) was administered to 237 grade 8 students (14-15 years) on 2 occasions in metropolitan Cape Town high schools.

Can peer education make a difference? Evaluation of a South African adolescent peer education program to promote sexual and reproductive health.

Peer education is popular both with governments and with young people. The purpose of this quasi-experimental study was to evaluate the effectiveness of a government-led peer education program on the self-reported sexual health behavior and related psychosocial outcomes of adolescent students in public high schools in the Western Cape of South Africa. Grade 10 students (n = 3934), at 30 public high schools (15 intervention, 15 comparison) were recruited to the study.

Sexual health, HIV risk, and retention in an adolescent HIV-prevention trial preparatory cohort.

Purpose: Although adolescents are at high risk for human immunodeficiency virus (HIV) infection, they have not been, included in HIV vaccine trials.

Methods: In preparation for enrollment in HIV vaccine trials, 100 HIV-negative adolescents aged 14-17 years from Cape Town were recruited into a cohort. HIV, syphilis, pregnancy testing, and sexual risk questionnaires were conducted at varying intervals for a year.

The association between students' perceptions of a caring teacher and sexual initiation. A study among South African high school students.

This paper has the following aims: (i) to explore the extent to which students who received an intervention involving HIV/AIDS and sexuality perceived that their teacher cared for their health and well-being, (ii) to investigate the characteristics of students who reported to have caring teachers and (iii) to document the association between students' perceptions of care and reported onset of sexual activity. Data were obtained from the second follow-up survey of a prospective study carried out among high school students in South Africa (Cape Town and Mankweng). We analyzed data from 3483 students who met the inclusion criteria.

Treated prevalence of and mental health services received by children and adolescents in 42 low-and-middle-income countries.

Background: Little is known about the treated prevalence and services received by children and adolescents in low- and middle-income countries (LAMICs). The purpose of this study is to describe the characteristics and capacity of mental health services for children and adolescents in 42 LAMICs.

Methods: The World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS), a 155-indicator instrument developed to assess key components of mental health service systems, was used to describe mental health services in 13 low, 24 lower-middle, and 5 upper-middle-income countries.

Impact of HealthWise South Africa on polydrug use and high-risk sexual behavior.

This study was designed to evaluate the efficacy of the HealthWise South Africa HIV and substance abuse prevention program at impacting adolescents' polydrug use and sexual risk behaviors. HealthWise is a school-based intervention designed to promote social-emotional skills, increase knowledge and refusal skills relevant to substance use and sexual behaviors, and encourage healthy free time activities. Four intervention schools in one township near Cape Town, South Africa were matched to five comparison schools (N = 4040).

The neurobiology of HIV dementia: implications for practice in South Africa.

In this review, the neuropathogenesis of HIV dementia (HIV-D) is discussed in the context of the local epidemic. HIV-D continues to be prevalent in the era of highly active anti-retroviral therapy. HIV neuro-invasion into the central nervous system may result in the development of separate HIV genotypes in an individual through compartmentalisation.

An assessment of mental health policy in Ghana, South Africa, Uganda and Zambia.

Background: Approximately half of the countries in the African Region had a mental health policy by 2005, but little is known about quality of mental health policies in Africa and globally. This paper reports the results of an assessment of the mental health policies of Ghana, South Africa, Uganda and Zambia.

Methods: The WHO Mental Health Policy Checklist was used to evaluate the most current mental health policy in each country.

A task shifting approach to primary mental health care for adults in South Africa: human resource requirements and costs for rural settings.

BACKGROUND A recent situational analysis suggests that post-apartheid South Africa has made some gains with respect to the decentralization and integration of mental health into primary health care. However, service gaps within and between provinces remain, with rural areas particularly underserved. Aim This study aims to calculate and cost a hypothetical human resource mix required to populate a framework for district adult mental health services.

Stakeholder's perceptions of help-seeking behaviour among people with mental health problems in Uganda.

Introduction: Mental health facilities in Uganda remain underutilized, despite efforts to decentralize the services. One of the possible explanations for this is the help-seeking behaviours of people with mental health problems. Unfortunately little is known about the factors that influence the help-seeking behaviours.

Association between psychopathology and substance use among school-going adolescents in Cape Town, South Africa.

Limited information exists regarding the association between psychopathology and specific substance use in young people both globally and locally. We examined the association between psychopathology and substance use in high school students to determine the nature of the associations and the role of demographic factors in these associations. Grade 8 (N=480) and Grade 11 (N=459) students from 39 high schools in Cape Town, South Africa, completed a self-administered questionnaire.