Impact of completing a psychosocial rehabilitation programme on inpatient service utilisation in South Africa.

Background: Deinstitutionalisation refers to the process of transferring most of the psychiatric care provision from inpatient state-run institutions to community-based care. However, it has proven difficult to implement and failed to reach its desired targets. New Beginnings (NB) is a transitional care facility that facilitates the transition from in- to outpatient care.

Descriptive outcomes for a cohort of high-frequency psychiatric service users in the Western Cape, South Africa after 10 years.

Background: Assertive community treatment (ACT) is an intervention implemented to manage the effects of deinstitutionalisation. South African studies have reported decreased admissions at 12 and 36 months when a modified ACT intervention is compared with standard care. However, costs associated with the intervention have raised the question of its feasibility in developing countries.

Characteristics of inpatients in dialectical behaviour therapy modified for a resource-limited setting.

Background: Emotional dysregulation in psychiatric disorders contributes to morbidity, mortality and healthcare costs. Dialectical behaviour therapy (DBT) is effective in addressing this, but is complex and costly to implement. Recent literature indicates that DBT can be modified for use in resource-limited settings, but little is known about its implementation in African settings.

Evaluation of an undergraduate psychiatric clinical rotation: Exploring student perceptions.

Background: Globally, the appropriate transformation of medical training is critical to ensure the graduation of competent physicians who can address the growing health needs.

Aim: 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.

Setting: 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.

Factors Affecting Specialist Psychiatry Training in South Africa: Are Psychiatry Residents Satisfied with Their Training?

Objective: The authors investigated South African psychiatry residents' satisfaction with their training, physical, and mental health to inform the development of a strategy to improve the quality and experiences of training.

Method: A cross-sectional online survey was undertaken to assess the factors affecting residents' satisfaction with their current training program. The authors conducted a comparative analysis of residents across the training institutions in South Africa.

Clozapine-Associated Leukopenia and Agranulocytosis in Western Cape, South Africa: A 3-Year Retrospective Cohort Study.

Background: Clozapine may cause life-threatening hematological side effects (HSEs). Hematological side effect incidence data from Sub-Saharan Africa are lacking. Furthermore, clozapine reduces cellular immunity, and it is unknown whether clozapine is a risk factor for tuberculosis or whether HIV is a risk factor for developing HSEs.

Digit ratio as an endophenotype in a schizophrenia population.

Background: Schizophrenia is a debilitating mental health condition affecting the lives of many South Africans. The origins of the heterogeneity in the presentation of the illness remain uncertain.

Aim: This cross-sectional study performed a retrospective data analysis to determine the usefulness of digit ratio as an endophenotype in a South African schizophrenia population.

The clinical and demographic profile of women living with HIV admitted to the acute unit at Stikland Psychiatric Hospital.

Background: There is a paucity of research on the clinical profile of women living with human immunodeficiency virus (HIV) (WLWH) admitted with acute mental health illness. Existing studies are small and did not look at factors that could have an impact on medication adherence. As a first step to inform service delivery for this vulnerable population, a thorough understanding of the composition and needs of these patients should be identified.

Demographic and clinical profile of patients utilising a transitional care intervention in the Western Cape, South Africa.

Background: The World Health Organization's action plan for 2020 has identified the need for service-based data to motivate for more appropriate community-based services. To date, there is no published data from step-up or step-down facilities in South Africa.

Aim: To describe the demographic and clinical profile of all patients admitted to New Beginnings between 01 January 2011 and 31 December 2015.

Burnout and job satisfaction of nursing staff in a South African acute mental health setting.

Background: Psychiatric nurses constitute a fundamental part of the mental health care system in South Africa. However, high levels of burnout and job dissatisfaction among nursing staff have been associated with reduced empathy and quality of care, and poor service delivery. Stikland Psychiatric Hospital is a state psychiatric hospital situated in Belville and provides all levels of psychiatric care to a large part of the Cape metro region.

Erratum: The validation of the visual screening tool for anxiety disorders and depression in hypertension and/or diabetes.

No abstract available.

A clinical profile of inpatient admissions to the psychogeriatric unit at Stikland Hospital.

Background: Globally, the number of older people is rising. As a consequence of greater longevity, an increased burden on both medical and mental health care is expected. As a first step towards developing strategies to provide quality mental health care for this growing population, practitioners need to have a thorough understanding of the composition and needs of these patients.

The impact of a psychiatry clinical rotation on the attitude of South African final year medical students towards mental illness.

Background: Stigmatising attitudes of health care professionals towards mental illness can impede treatment provided for psychiatric patients. Many studies have reported undergraduate training to be a critical period for changing the attitudes of medical students, and one particularly valuable intervention strategy involves time spent in a clinical psychiatric rotation. In South Africa, medical students are exposed to a clinical rotation in psychiatry but there is no evidence to show whether this has an effect on attitudes toward mental illness.

The development of the visual screening tool for anxiety disorders and depression: Addressing barriers to screening for depression and anxiety disorders in hypertension and/or diabetes.

 There is a lack of screening tools for common mental disorders that can be applied across cultures, languages and levels of education in people with diabetes and hypertension. Aim: To develop a visual screening tool for depression and anxiety disorders that is applicable across cultures and levels of education. Setting: Participants were purposively recruited from two not-for-profit organisations and two public health facilities - a maternal mental health unit and a primary health care centre.

An Attempt to Stem the Tide: Exploring the Effect of a 90-Day Transitional Care Intervention on Readmissions to an Acute Male Psychiatric Unit in South Africa.

Introduction: Pressure on inpatient beds often results in premature discharges, which may precipitate early readmission. This has prompted an increased interest in transitional care interventions to bridge the gap between in- and outpatient care to reduce such readmissions. Our study aimed to assess the effect of a Transitional Care Service (TCS) on readmission rates in a high pressure inpatient service which utilizes a premature discharge policy to address bed pressures.

The effect of an occupational therapy mental health day treatment centre on the use of inpatient services in the Western Cape, South Africa.

The aim of this study was to determine whether attendance at an occupational therapy-led day treatment centre for mental health care users affects the use of inpatient services in South Africa. A retrospective pre-test/post-test quasi-experimental study design was used to compare admissions and days spent in hospital during the 24 months before and after attendance at the centre, using the hospital's electronic records. Total population sampling yielded data for 44 mental health care users who made first contact with the service between July 2009 and June 2010.

Risk factors for unplanned pregnancy in women with mental illness living in a developing country.

Pregnant women in general are at an increased risk of experiencing symptoms of mental illness, and those living in a developing country are even more vulnerable. Research points towards a causal relationship between unplanned pregnancy and perinatal mental illness and suggests that pregnancy planning can aid in reducing the negative impact of mental illness on a woman, her unborn baby, and the rest of the family. In this quantitative, descriptive study, we investigated both socio-demographic factors and variables relating to mental illness itself that may place women at an increased risk of experiencing unplanned pregnancy.

Facial affect recognition and exit examination performance in medical students: a prospective exploratory study.

Background: Facial affect recognition (FAR) abilities underpin emotional intelligence (EI). The latter is suggested to predict academic success and to be important for clinician-patient interaction. It is therefore of interest to investigate the possible association between FAR and academic performance in undergraduate medical students.

Religious Delusions in a Xhosa Schizophrenia Population.

Here, we assessed for the first time the frequency of religious delusions and the effect of treatment on religiosity and the phenomena of religious delusions in a Xhosa schizophrenia population. Religious delusions were present in 42 (70%) participants, and treatment significantly reduced religiosity (p = 0.02) as well as mean scores for certain phenomena associated with the delusions including changes in both thinking (p = 0.

The rise of assertive community interventions in South Africa: a randomized control trial assessing the impact of a modified assertive intervention on readmission rates; a three year follow-up.

Background: Many countries have over the last few years incorporated mental health assertive interventions in an attempt to address the repercussions of deinstitutionalization. Recent publications have failed to duplicate the positive outcomes reported initially which has cast doubt on the future of these interventions. We previously reported on 29 patients from a developing country who completed 12 months in an assertive intervention which was a modified version of the international assertive community treatment model.

Characterization of the genetic variation present in CYP3A4 in three South African populations.

The CYP3A4 enzyme is the most abundant human cytochrome P450 (CYP) and is regarded as the most important enzyme involved in drug metabolism. Inter-individual and inter-population variability in gene expression and enzyme activity are thought to be influenced, in part, by genetic variation. Although Southern African individuals have been shown to exhibit the highest levels of genetic diversity, they have been under-represented in pharmacogenetic research to date.

Comparison of treatment response in second-episode versus first-episode schizophrenia.

This study investigated whether illness progression and treatment refractoriness emerge after relapse in schizophrenia. We compared outcomes in a cohort treated with a standardized protocol for the first and second episodes of illness. The sample comprised 31 participants who (1) had successfully completed a 2-year open-label treatment phase with risperidone long-acting injection (RLAI) for a first episode of schizophrenia; (2) underwent an intermittent treatment extension phase up to 3 years or until recurrence, and (3) entered a further 2-year treatment phase with RLAI for a recurrence episode.