[Lennox-Gastaut syndrome--course and treatment].

Background: Lennox-Gastaut syndrome (LGS) is a severe epileptic encephalopathy, which starts in childhood with various seizure types. The children develop cognitive impairment and a typical EEG pattern. The aim of this article is to describe the clinical presentation of LGS, with particular emphasis on the course in adulthood.

Meeting the millennium development goals in Sub-saharan Africa: what about mental health?

Mental health is a crucial public health and development issue in sub-Saharan Africa (SSA), a region where little progress has been made towards achieving the Millennium Development Goals (MDGs). In this paper we argue that not only will limited progress in achieving these targets have a significant impact on mental health, but it will be impossible to achieve some of these aspirations in the absence of addressing mental health concerns. We consider the strong relationship of mental health with dimensions of human development represented in the MDGs, including reducing poverty, achieving universal primary education, decreasing child mortality rates, improving maternal health, HIV, environmental factors and improving the lives of those living in informal settlements.

'Mental health is everybody's business': roles for an intersectoral approach in South Africa.

Intersectoral action is increasingly recognized as necessary to address the social determinants of mental health. This study aims to assess South Africa's progress in intersectoral collaboration for mental health, and provide recommendations for intersectoral collaboration, to generate lessons for other low- and middle-income countries. We conducted a survey of the existing mental health system in South Africa using the World Health Organization Assessment Instrument for Mental Health Systems.

Common understandings of women's mental illness in Ghana: results from a qualitative study.

Despite the high rates of depression and anxiety disorders amongst women, the mental health of women is a neglected area, particularly in Africa. This study sought to explore what key stakeholders perceive as the main causes of mental illness in women in Ghana. Using qualitative methods, 81 semi-structured interviews and seven focus group discussions were conducted with 120 key stakeholders drawn from 5 of the 10 regions in Ghana.

Viewing Uganda's mental health system through a human rights lens.

There has been increased global concern about the human rights violations experienced by people with mental disorders. The aim of this study was to analyse Uganda's mental health care system through a human rights lens. A survey of the existing mental health system in Uganda was conducted using the WHO Assessment Instrument for Mental Health Systems.

Mental health care user participation in mental health policy development and implementation in South Africa.

This paper describes current support for mental health care user participation in policy development and implementation in South Africa and suggests strategies for improving participation. The World Health Organization (WHO) Mental Health Policy Checklist and WHO Mental Health Legislation Checklist were completed. Between August 2006 and August 2009 96 semi-structured interviews with national, regional and district stakeholders were conducted.

Human resource challenges facing Zambia's mental health care system and possible solutions: results from a combined quantitative and qualitative study.

Human resources for mental health care in low- and middle-income countries are inadequate to meet the growing public health burden of neuropsychiatric disorders. Information on actual numbers is scarce, however. The aim of this study was to analyse the key human resource constraints and challenges facing Zambia's mental health care system, and the possible solutions.

Test-retest reliability of the Xhosa version of the Diagnostic Interview Schedule for Children.

Background: The Diagnostic Interview Schedule for Children (DISC-IV) is a widely used structured psychiatric diagnostic instrument for children that is designed to be administered by non-clinicians. Although reliability data on several versions of the DISC are available, none have assessed the Xhosa version for use in the South African context. The objective of this study was to examine the test-retest reliability of the Xhosa version of the DISC-IV.

Increasing the priority of mental health in Africa: findings from qualitative research in Ghana, South Africa, Uganda and Zambia.

Despite the high prevalence of mental illness, mental health remains a low priority in Africa. There has been no investigation of the views of stakeholders in Africa on why this is and what can be done. This paper reports a comparison of the views of stakeholders in Ghana, South Africa, Uganda and Zambia, focusing on the priority given to mental health by the government at the national and regional/province levels.

Efficacy and tolerability of long-term treatment with vagus nerve stimulation in adolescents and adults with refractory epilepsy and learning disabilities.

The long-term effects of vagus nerve stimulation (VNS) on seizure frequency were studied in 50 patients with epilepsy and learning disabilities. Mean observation time was 4.6 years.

Mental illness--stigma and discrimination in Zambia.

Objective: The aim of this qualitative study was to explore the presence, causes and means of addressing individual and systemic stigma and discrimination against people with mental illness in Zambia. This is to facilitate the development of tailor-made antistigma initiatives that are culturally sensitive for Zambia and other low-income African countries. This is the first in-depth study on mental illness stigma in Zambia.

Isoproterenol stimulates 5'-AMP-activated protein kinase and fatty acid oxidation in neonatal hearts.

Isoproterenol increases phosphorylation of LKB, 5'-AMP-activated protein kinase (AMPK), and acetyl-CoA carboxylase (ACC), enzymes involved in regulating fatty acid oxidation. However, inotropic stimulation selectively increases glucose oxidation in adult hearts. In the neonatal heart, fatty acid oxidation becomes a major energy source, while glucose oxidation remains low.

Integrating mental health into primary health care in Zambia: a care provider's perspective.

Background: Despite the 1991 reforms of the health system in Zambia, mental health is still given low priority. This is evident from the fragmented manner in which mental health services are provided in the country and the limited budget allocations, with mental health services receiving 0.4% of the total health budget.

Poverty and common mental disorders in low and middle income countries: A systematic review.

In spite of high levels of poverty in low and middle income countries (LMIC), and the high burden posed by common mental disorders (CMD), it is only in the last two decades that research has emerged that empirically addresses the relationship between poverty and CMD in these countries. We conducted a systematic review of the epidemiological literature in LMIC, with the aim of examining this relationship. Of 115 studies that were reviewed, most reported positive associations between a range of poverty indicators and CMD.

A situational analysis of child and adolescent mental health services in Ghana, Uganda, South Africa and Zambia.

Objective: Approximately one in five children and adolescents (CA) suffer from mental disorders. This paper reports on the findings of a situational analysis of CA mental health policy and services in Ghana, Uganda, South Africa and Zambia. The findings are part of a 5 year study, the Mental Health and Poverty Project, which aims to provide new knowledge regarding multi-sectoral approaches to breaking the cycle of poverty and mental ill-health in Africa.

Mental health stigma: what is being done to raise awareness and reduce stigma in South Africa?

Objective: Stigma plays a major role in the persistent suffering, disability and economic loss associated with mental illnesses. There is an urgent need to find effective strategies to increase awareness about mental illnesses and reduce stigma and discrimination. This study surveys the existing anti-stigma programmes in South Africa.

Scaling up community-based services and improving quality of care in the state psychiatric hospitals: the way forward for Ghana.

Objective: This paper aims to explore the options available for developing community-based care and improving the quality of care in psychiatric hospitals in Ghana.

Method: Semi-structured interviews (SSIs) and focus group discussions (FGDs) were conducted: with a cross-section of stakeholders including health professionals, researchers, policy makers, politicians, users and carers. The SSIs and FGDs were recorded digitally and transcribed verbatim.

A situation analysis of mental health services and legislation in Ghana: challenges for transformation.

Objective: To conduct a situation analysis of the status of mental health care in Ghana and to propose options for scaling up the provision of mental health care.

Method: A survey of the existing mental health system in Ghana was conducted using the WHO Assessment Instrument for Mental Health Systems. Documentary analysis was undertaken of mental health legislation, utilizing the WHO Legislation checklists.

Pathways to inpatient mental health care among people with schizophrenia spectrum disorders in South Africa.

Objective: This study examined service utilization patterns and pathways to specialist mental health services among individuals with schizophrenia spectrum disorders in the Western Cape, South Africa, an area that has undergone deinstitutionalization since the mid-1990s.

Methods: Individuals who were consecutively admitted to any of the three psychiatric hospitals in the Western Cape from February 2007 to January 2008 were interviewed. Data on demographic characteristics, psychiatric history, service utilization, and pathways to care were gathered from service users, their relatives or associates, and hospital files.