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Journal article

Symptoms of depression and anxiety among a sample of South African patients living with HIV

Authors:
KAGEE Ashraf, MARTIN Lindi
Journal article citation:
AIDS Care, 22(2), February 2010, pp.159-165.
Publisher:
Taylor and Francis

Little systematic epidemiological research has been conducted on the extent of psychiatric disorders among South African patients in general, and among patients living with HIV in particular – yet disorders such as depression and anxiety appear to be common with patients suffering from HIV. This study reports on a survey conducted among 85 patients receiving treatment at three HIV clinics in the Western Cape. Participants completed the Hopkins Symptom Checklist and the Beck Depression Inventory - both self-report instruments designed to measure mood disorder. The mean score of the sample on the Hopkins Symptom Checklist was 47.54, which was significantly different from the commonly used cut-off-point of 44 for clinically significant distress; 52.9% of the sample scored in the elevated range on this measure. On the Beck Depression Inventory, 37.6% of the sample fell in or above the normal range for depression. The results suggest that a considerable number of the sample may experience psychiatric difficulty, for which they may not be receiving treatment.

Journal article

An exploratory investigation of co-occurring substance-related and psychiatric disorders

Authors:
FABRICIUS V., LANGA M., WILSON K.
Journal article citation:
Journal of Substance Use, 13(2), April 2008, pp.99-114.
Publisher:
Informa Healthcare

This exploratory, quantitative study investigated the prevalence rate of patients with co-occurring substance-related and psychiatric disorders (CODs) at a private rehabilitation centre in Johannesburg, South Africa. Details of the case histories of the clients were collected, coded and analysed using Statistical Analysis System (SAS). The results indicated that 57.1% of 419 clients had one or more co-occurring psychiatric disorder, along with a substance-related disorder. Of the 239 with a COD, 155 had a mood disorder, 40 had an anxiety disorder, 39 had ADHD, 35 had an eating disorder, eight had a conduct disorder and five had schizophrenia. Statistically significant relationships were found for ADHD with cannabis-related disorders and polysubstance dependence; anxiety-related disorders with alcohol-related disorders; and mood disorders with cocaine-related disorders, possibly substance-induced disorders and substance-induced disorders. These results showed that a large group of patients admitted at the centre had one or more COD and this made the treatment more complex. The results of this study suggest the need to develop specialized treatment programmes for patients with CODs.

Journal article

Exploring mental health adjustment of children post sexual assault in South Africa

Authors:
MATHEWS Shanaaz, ABRAHAMS Naeemah, JEWKES Rachel
Journal article citation:
Journal of Child Sexual Abuse, 22(6), 2013, pp.639-657.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

Large numbers of children are affected by child sexual abuse in South Africa. This study aimed to assess psychological adjustment of children post sexual assault. In-depth, semistructured interviews were conducted with caretakers, and structured interviews using mental health assessment screening tools were given to children at three intervals over a five-month period after presentation at a sexual assault centre. Almost half of the children met clinical criteria for anxiety, and two-thirds met criteria for full symptom post-traumatic stress disorder two to four weeks post disclosure. With standard care, the authors observed some recovery; 43.3% of children still met full symptom post-traumatic stress disorder nearly six months postdisclosure. Our findings indicate that current practice in South Africa does not promote adequate recovery for children. (Publisher abstract)

Journal article

Psychological distress among persons living with HIV, hypertension, and diabetes

Author:
KAGEE Ashraf
Journal article citation:
AIDS Care, 22(12), December 2010, pp.1517-1521.
Publisher:
Taylor and Francis

It has been assumed that receipt of a diagnosis of HIV is a uniquely distressing event, more so than with any other illness. This article examines the extent to which sub-clinical psychological distress among South Africans living with HIV is any different from patients living with other chronic diseases, namely hypertension and diabetes. The study compared the mean scores on the Hopkins Symptom Checklist, a measure of emotional distress, of 85 patients with HIV/AIDS, 85 patients with hypertension, 25 with diabetes, and 14 patients with both hypertension and diabetes. The differences among the 4 groups were non-significant, suggesting that living with HIV/AIDS may be no more emotionally distressing than other common chronic illnesses. It is speculated that these findings may be accounted for in terms of the high prevalence of HIV in South Africa, the recent availability of antiretroviral treatment resulting in HIV being seen as a chronic illness rather than a death sentence, and the base rate of mental health problems among the South African population.

Journal article

Social determinants of psychological distress in a nationally-representative sample of South African adults

Authors:
MYER Landon, et al
Journal article citation:
Social Science and Medicine, 66(8), April 2008, pp.1828-1840.
Publisher:
Elsevier

There is substantial evidence from developed countries that lower socioeconomic status (SES) is associated with increased occurrence of mental illness, and growing interest in the role of social support and social capital in mental health. However, there are few data on social determinants of mental health from low- and middle-income nations. We examined the association between psychological distress and SES, social support and bonding social capital in a nationally-representative sample of South African adults. As part of a national survey of mental health, a probability sample of 4351 individuals was interviewed between 2002 and 2004. Non-specific psychological distress was measured using the Kessler K-10 scale. SES was assessed from an aggregate of household income, individual educational and employment status, and household material and financial resources. Social support, bonding social capital and traumatic life events were measured using multi-item scales. The mean age in the sample was 37 years and 76% of participants were black African. Measures of SES and social capital were inversely associated (p < 0.001). Both recent and traumatic life events were more common among individuals with low levels of SES and social support. After adjusting for participant demographic characteristics and life events, high levels of psychological distress were most common among individuals with lower levels of SES and social capital. There was no independent association between levels of social support and psychological distress. The occurrence of recent life events appeared to partially mediate the association between SES and psychological distress (p = 0.035) but not the association involving social capital (p = 0.40). These data demonstrate persistent associations between levels of SES, social capital and psychological distress in South Africa. The increased frequency of recent life events appears to only partially explain higher levels of psychological distress among individuals of lower SES. Additional research is required to understand the temporality of this association as well as mechanisms through which SES and social capital influence mental health in low- and middle-income settings where high levels of poverty and trauma may contribute to excess burden of mental illness.

Journal article

Lifetime prevalence of psychiatric disorders in South Africa

Authors:
STEIN Dan, et al
Journal article citation:
British Journal of Psychiatry, 192(2), February 2008, pp.112-117.
Publisher:
Royal College of Psychiatrists

Data on the lifetime prevalence of psychiatric disorders in South Africa are of interest, not only for the purposes of developing evidence-based mental health policy, but also in view of South Africa's particular historical and demographic circumstances. A nationally representative household survey was conducted between 2002 and 2004 using the World Health Organization Composite International Diagnostic Interview (CIDI) to generate diagnoses. The data-set analysed included 4351 adult South Africans of all ethnic groups. Lifetime prevalence of DSM–IV/CIDI disorders was determined for anxiety disorders (15.8%), mood disorders (9.8%), substance use disorders (13.4%) and any disorder (30.3%). Lifetime prevalence of substance use disorders differed significantly across ethnic groups. Median age at onset was earlier for substance use disorders (21 years) than for anxiety disorders (32 years) or mood disorders (37 years).In comparison with data from other countries, South Africa has a particularly high lifetime prevalence of substance use disorders. These disorders have an early age at onset, providing an important target for the planning of local mental health services.

Journal article

Factors associated with prevalence of mental disorder in people living with HIV/AIDS in South Africa

Authors:
FREEMAN M., et al
Journal article citation:
AIDS Care, 19(10), November 2007, pp.1201-1209.
Publisher:
Taylor and Francis

The study examines the association between the presence of mental disorder and a range of independent variables. A sample of 900 HIV-positive individuals was administered the Composite International Diagnostic Interview to determine the presence of selected mental disorders. A structured interview assessed support received and factors that may contribute to mental disorder. Overall prevalence of mental disorder was 43.7% - though higher in Stage 3 (49.7%) and in Stage 4 (68%) of the disease. Eighteen percent of respondents were receiving antiretroviral treatment. Having had pre- and post-test counselling was not related to mental disorder; nor were the number of sessions, the professional status of the counsellor and perceived helpfulness of counselling. Being in an HIV support group was related to presence of a mental disorder, although the frequency of attendance was not. Although most of those who disclosed their HIV status found the experience helpful there was a significant positive association between presence of a mental disorder and having disclosed HIV-positive status. Although being a member of an association for people with HIV/AIDS and being religious was perceived as helpful, neither was statistically associated with the presence of mental disorder. Discrimination by community and family and isolation were related to mental disorder. Death of a significant other due to AIDS was related to mental disorder. The findings suggest a strong need for provision of psychiatric care as part of AIDS care as well as strengthening of support services.

Journal article

Family disorganisation and mental health in a South African mining community

Authors:
CHENGA C., CRONJE F.
Journal article citation:
Social Work Maatskaplike Werk, 43(2), June 2007, pp.139-161.

Most of the communities around South African mines are synonymous with poor family structures by virtue of the nature of the mining environment. This article discusses the impact of family disorganisation on mental health. The article is based on qualitative research undertaken in mining communities around a platinum mine in the North-West Province in South Africa. Data collection methods included mainly focus groups and interviews. Some of the main factors identified that contribute to family disorganisation were: migrant labour, poverty and unemployment, HIV/AIDS and infrastructure (eg services, recreation facilities and housing). The authors argue that reducing the social risk factors there will be a probability of improvement in family disorganisation and mental health.

Journal article

Mental health problems in women attending district-level services in South Africa

Authors:
PILLAY Anthony, KRIEL Anita J.
Journal article citation:
Social Science and Medicine, 63(3), August 2006, pp.587-592.
Publisher:
Elsevier

Various sociodemographic and clinical variables pertaining to women using district-level clinical psychology services in Pietermaritzburg, South Africa were examined. During the year 2004, a total of 422 women accessed this service. Over one-third had relationship problems, 21% depression, and 14% suicidal behaviour. Nearly half the women reported significant financial problems. Of the 174 married (or cohabiting) women, 94.8% experienced relationship problems, 56.9% reported substance-abusing partners, and 48.3% reported violent partners, and 51.1% perceived their partners as disengaged while 37% viewed them as oppressive. Clinician estimates revealed notably low self-esteem in 65% of the women.The authors conclude that mental health services and training programmes need to become more cognisant of gender issues to develop gender-sensitive interventions.

Journal article

The appropriateness and necessity of short term therapy in the context of the employee assistance programme

Author:
TAUTE Florinda
Journal article citation:
Social Work Maatskaplike Werk, 40(1), March 2004, pp.15-24.

Discusses critically the concept of short-term therapy within the EAP context, focusing on its appropriateness and necessity. The role of homework during short-term therapy for the employee as a client in EAP is highlighted. Definitions of short term therapy are provided for a better understanding of this work. The types of problems that can be addressed by short-term therapy in the workplace will be discussed.

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