bluuebunny/crossref_metadata_2025 huggingface dataset:
An investigation into onshore captive insurance companies
Authors: Le Roux ME , Mostert FJ
Published: June 2017

Insurance provided by captive insurers is one of various forms of risk financing.  The nature and main types of captive insurance companies are discussed.  This is followed by the results of an empirical study that focused on South African onshore captive insurance companies.  The objectives in establishing and operating a captive insurer, the factors which determine the decision of the parent company to establish and operate a captive insurer and the future and usefulness of insurance provided by captive insurers are some of the aspects that are addressed.
The primary demand for oilseeds in South Africa: An error correction linear approximated and almost ideal demand system (ECM-LA/AIDS)
Authors: Van Schalkwyk HP , Van Schalkwyk HD , Alemu ZG , Taljaard PR , Obi A
Published: June 2017

The paper presents the results of a study that estimated the demand relations for primary oilseeds in South Africa.  The Error Correction version of Linear Approximated Almost Ideal Demand System (LA/AIDS)(ECM-LA/AIDS) were estimated.  Time series data for the period 1971-2002 were analysed.  Prior tests stablished weak searability between four oilseeds (sunflower seed, soybeans, groundnuts and cotton seed), indicating that these oilseeds should be modelled together.  The results suggest that the demand for oilseeds is negatively influenced by own price, which is consistent with economic theory, while positive long-term expenditure elasticities suggest that some oilseeds, notably sunflower seed and cotton seed, are luxury commodities in South Africa.
Mental health service policy, implementation and research in South Africa - are we making progress?
Authors: Thom Rita
Published: June 2017

NO ABSTRACT AVAILIBLE
Antidepressants and suicide in children and adolescents: a storm in a teacup?
Authors: Seedat Soraya
Published: June 2017

NO ABSTACT AVAILIBLE
A proud contribution
Authors: Colin Franco
Published: June 2017

NO ABSTRACT AVAILIBLE
Attention-deficit/hyperactivity disorder - co-morbidity and differential diagnosis
Authors: Shokane M J , Rataemane L U Z , Rataemane S T
Published: June 2017

NO ABSTRACT AVAILIBLE
Use of the Judicial Section 9 Certification in the Free State
Authors: Meyer S J , Slabber M , Van Rensburg P HJJ , Nel M
Published: June 2017

A direct referral system for referring persons who perpetrate a crime while suffering from a mental illness has evolved between the office of the Director of Public Prosecution (DPP) in the Free State, and the Free State Psychiatric Complex (FSPC) over the years. The efficiency and impact of this direct referral system have never been quantified. This study found that this alternative system is uncomplicated, functions quite effectively with a minimum of inappropriate referrals, and contributes greatly towards decreasing the workload of the judicial as well as the psychiatric system.
QT-prolonging drugs - should they ever be used?
Authors: Okreglicki A
Published: June 2017

NO ABSTRACT AVAILIBLE
Interview
Authors: Spencer Jones Jonathan
Published: June 2017

No abstract available.
Marriage and mental health
Authors: Smith Mike Ewart
Published: June 2017

NO ABSTRACT AVAILIBLE
Facts and Values in Psychiatric Practice: the theme of the 2006 national psychiatry congress
Authors: Van Staden C W
Published: June 2017

NO ABSTRACT AVAILIBLE
ECG changes in patients on chronic psychotropic medication
Authors: Moosa M Y H , Jeenah F Y , Mouton C
Published: June 2017

Objectives. To determine the ECG changes in a group of outpatients on chronic psychotropic medication, and the association, if any, with factors such as gender, age, co- morbid illness and the use of concomitant medication.

Methods. Study subjects included patients 18 years and older attending the outpatient departments of Chris Hani Baragwanath and Johannesburg hospitals. The subjects’ demographic and clinical characteristics were obtained and a resting ECG was recorded.

Results. Eighty patients were included in the study. The mean age of the subjects was 45.4 (standard deviation (SD) =18.2) years, with a minimum age of 18 and a maximum of 86 years. Fifty-four subjects (67.5%) had evidence of some ECG abnormalities. There was no significant difference between the occurrence of ECG abnormalities and the different age groups (p > 0.05), gender (p > 0.05), and different race groups (p > 0.05). Sixty-one subjects (76.3%) had no co-morbid medical illness and were on psychotropic medication only; of these patients 43 (70.5%) had abnormal ECG tracings (p > 0.05). The ECG abnormalities recorded included abnormal rate (28.8%), abnormal ST segment (20.5%), abnormal QRS complex (17.8%), abnormal T wave (15.4%), prolonged or borderline corrected QT interval (8.2%), irregular rhythm (5.5%) and prolonged PR interval (2.7%). There was a significant positive correlation between the corrected QT interval and age (r = 0.43, p < 0.05) and between corrected QT interval and female gender (r = 0.31, p < 0.05). There was no correlation between corrected QT interval and treatment of a co-morbid illness (r = 0.13, p > 0.05).

Conclusion. The use of psychotropic drugs is associated with ECG changes in ordinary doses. However, this study serves to strengthen previous evidence that, although common, most of these changes are of a benign nature.
Dissociation - a preliminary contextual model
Authors: Krüger C , Sokudela B F , Mataboge L M , Dikobe A M
Published: June 2017

Background. The Diagnostic and Statistical Manual of Mental Disorders (DSM) system has certain limitations when applied to two South African examples of dissociation, because it is descriptive (non-explanatory) and focuses on intrapsychic (non-communal) processes. Even the existing Western explanatory models of dissociation fail to accommodate fully the communal aspects of dissociation in our South African context.

Objectives and methods. The aim was to explore an expanded perspective on dissociation that does not limit it to an intrapsychic phenomenon, but that accounts for the interrelatedness of individuals within their social context. Auto-ethnography was used. In this article a collective, socially orientated, contextual hermeneutic was applied to two local examples of dissociation. Three existing Western models were expanded along multicontextual, collective lines, for them to be more useful in the pluralistic South African context.

Results. This preliminary contextual model of dissociation includes a person’s interpersonal, socio-cultural, and spiritual contexts, in addition to the intrapsychic context. Dissociation is considered to be a normal information-processing tool that maintains balanced, coherent selves-in-society, i.e. individuals connected to each other. In the South African context dissociation appears mostly as a normal phenomenon and seldom as a sign of mental illness. Dissociation is pivotal for the normal construction of individual and communal identities in the face of conflicting sets of information from various contexts. Dissociation may help individuals or communities to survive in a world of conflicting messages, where conflict is often interpersonal/cultural/societal in nature, rather than primarily intrapsychic.

Conclusions. This model should be developed and evaluated further. Such evaluation would require suitable new local terminology.
Treatment adherence
Authors: Moosa M Y H , Jeenah F Y , Kazadi N
Published: June 2017

Patients with psychiatric illnesses show a greater degree of non-adherence than those with physical disorders. Adherence to treatment may be assessed using biological measurements, clinician ratings, patient self-report, pill count, caregiver reports and side-effects of medication. Reasons cited for non-adherence include factors related to the treatment, patient-related factors, health care, and socio-economic circumstances. It is important not to make prejudicial predictions of non-adherence based on these factors, or the use non-adherence as an excuse to blame the patient for an unfavourable outcome. Rather, non-adherence should be seen not only as the patient’s inability to follow treatment recommendations but also as the health system's failure to provide adequate care and to meet the patient’s needs.
Psychiatric uses of topiramate: What is the current evidence?
Authors: Joubert Pierre M
Published: June 2017

Topiramate enhances gamma-amino-butyric acid effects, has anti- glutaminergic effects, and is a state-dependent sodium channel blocker. 1 It is registered as an adjunctive treatment for epilepsy but is not registered for psychiatric indications. Nevertheless, it may be useful beyond its initial indication, considering the promising literature on which I report below. However, much more research evidence is needed to establish sufficient scientific justification for prescribing it routinely for psychiatric purposes.
HIV/AIDS and psychiatry: Towards the establishment of a pilot programme for detection and treatment of common mental disorders in people living with HIV/AIDS in Cape Town
Authors: Joska John A , Stein Dan J , Flisher Alan J
Published: June 2017

n/a
Attack on psychoanalysis
Authors: Lakie Bruce Richard , Kaliski Professor Sean
Published: June 2017

Critique of the editor's attack on psychoanalysis in the editorial MY BRAIN MADE ME DO IT, SAJP March 2009, Vol. 15, No 1
Stigmatising attitudes towards the mentally ill: A survey in a Nigerian university teaching hospital
Authors: Ukpong Dominic Ignatius , Abasiubong Festus
Published: June 2017

Background. The burden of mental illness is particularly severe for people living in low-income countries. Negative attitudes towards the mentally ill, stigma experiences and discrimination constitute part of this disease burden.

Objective. The aim of this study was to investigate knowledge of possible causes of mental illness and attitudes towards the mentally ill in a Nigerian university teaching hospital population.

Method. A cross-sectional descriptive study of a convenience sample of 208 participants from the University of Uyo Teaching Hospital, Uyo, Nigeria, using the Community Attitudes towards the Mentally Ill (CAMI) scale. Information was also obtained on beliefs about possible causes of mental illness.

Results. The respondents held strongly negative views about the mentally ill, mostly being authoritarian and restrictive in their attitudes and placing emphasis on custodial care. Even though the respondents appeared to be knowledgeable about the possible role of psychosocial and genetic factors in the causation of mental illness, 52.0% of them believed that witches could be responsible, 44.2% thought mental illness could be due to possession by demons, and close to one-third (30%) felt that it could be a consequence of divine punishment.

Conclusions. Stigma and discrimination against the mentally ill are widespread even in a population that is expected to be enlightened. The widespread belief in supernatural causation is likely to add to the difficulties of designing an effective anti-stigma psycho-educational programme. There is a need in Nigeria to develop strategies to change stigma attached to mental illness at both institutional and community levels.
Cannabis publication analysis using density-equalising mapping and research output benchmarking
Authors: Vogelzang B H , Scutaru C , Mache S , Vitzthum K , Kuzma B , Mutawakel K , Groneberg D A , Quarcoo D
Published: June 2017

Background. Cannabis has been a topic of political and medical controversy in many countries over the past century. Although many publications on this topic are available, there is currently no comprehensive evaluation of global research activities in the field.

Objective. This study was conducted in order to provide a quantitative and qualitative analysis of the worldwide research output on cannabis.

Methods. In a quantitative approach, items concerning cannabis published between 1900 and 2008 were retrieved from the ISI Web of Science databases developed by the Thompson Institute of Scientific Information and analysed using scientometric methods. In a second step, research fields of growing interest were identified.

Results. We found that publications on this topic increased during the late 1960s, as well as during the period 1990 - 2008. We noted that South Africa was one of the countries with a high research output, having published numerous articles on cannabis. A comparison of cannabis with other drugs (e.g. alcohol, tobacco, cocaine and heroin) showed that in relation to the proportion of respective drug users, cocaine and heroin are overly represented in terms of research output. When analysing the main subjects of the publications, psychiatry was prominent, especially with regard to research on psychosis.

Conclusion. There is increasing interest in research on cannabis. The research only partially reflects the drug’s importance with regard to number of users.
Religious beliefs, coping skills and responsibility to family as factors protecting against deliberate self-harm
Authors: Kannan K , Pillai S K , Gill J S , Hui K O , Swami V
Published: June 2017

Background. Deliberate self-harm (DSH) ranges from behaviours aiming to communicate distress or relieve tension, but where suicide is not intended, to actual suicide. Not all individuals are prone to DSH, which suggests that there are factors that protect against it. Identifying these could play an important role in the management and prevention of DSH.

Objectives. This study examined whether religious beliefs, coping skills and responsibility to family serve as factors protecting against DSH in Kota Kinabalu, Sabah, Malaysia.

Method. A cross-sectional comparative study assessed DSH patients consecutively admitted or directly referred to Queen Elizabeth General Hospital and Hospital Mesra Bukit Padang during the period December 2006 - April 2007. DSH patients (N=42) were matched with controls (N=42) for gender, age, religion, race, occupation and marital status. The DSH and control groups were compared using psychosocial tests that assess coping skills, religious beliefs and responsibility to family.

Results. There were significant differences in religious beliefs (p=0.01) and responsibility to family (p=0.03) between the DSH patients and the control group. There were also significant differences in coping skills, DSH patients tending to use emotion-orientated coping (p=0.01) as opposed to task- and avoidance-orientated coping.

Conclusion. Consistent with international studies, coping skills (i.e. task-orientated skills), religious beliefs and responsibility to family were more evident in patients who did not attempt DSH than in those who did. These findings imply that treating DSH should not start only at the point of contact. Protective factors such as religious beliefs, responsibility to family and coping strategies can be inculcated from a very young age. However, caution is required in generalising the results owing to limitations of the study. Further extensive research on religious and psychotherapeutic interventions and prospective studies on protective factors will be helpful.
The use of Clozapine in Adolescents: A Case Report
Authors: Hashim Aili Hanim , Pillai Subash Kumar , Nordin Amer Siddiq Amer , Kaur Manveen
Published: June 2017

This is a report about a child diagnosed with childhood-onset schizophrenia and subsequently treated with clozapine. Clozapine is often used as the last line of treatment for patients with schizophrenia even in the pediatric population. This report highlights the usefulness and challenges of using clozapine in children with schizophrenia.
Prevalence of Attention-Deficit/Hyperactivity Disorder (ADHD) symptomatology and psychiatric comorbidity among adolescents diagnosed with ADHD in childhood
Authors: Walker Stephen , Venter André , Van der Walt Adriana , Esterhuysen KGF
Published: June 2017

Objectives: Given the paucity of research on adolescent ADHD, this study aimed to establish the prevalence of DSM-IV ADHD in a cohort of South African adolescents who had been diagnosed with the disorder in childhood. It also aimed to establish the prevalence of psychiatric comorbidities and adjustment difficulties in this sample.

Method: Data regarding age of diagnosis, current ADHD status, current ADHD-related pharmacological management, current psychopathology and current adjustment were gathered from 64 adolescents and their guardians via self-report questionnaire. Descriptive statistics were calculated with regard to current ADHD status, comorbid psychopathology and adjustment difficulties, as well as current ADHD-related medication.

Results: According to parent reports, 59.38% of the sample met DSM-IV criteria for ADHD Inattentive subtype, while 37.50% met the criteria for ADHD Hyperactive/Impulsive subtype. Approximately sixty-four percent (64.06%) of the adolescents were still using stimulant medication. Based on the adolescent self-report, 43.75% of the sample reported clinically significant symptoms of psychopathology or maladjustment. Furthermore, 39.28% of the adolescents met the diagnostic criteria for at least one psychiatric comorbidity.

Conclusion: ADHD did persist into adolescence in the current sample. A significant psychopathological and maladjustment load appears evident amongst adolescents previously diagnosed with ADHD despite continuous pharmacological management of the condition.
Brunel mood scale: South African norm study
Authors: Van Wijk Charles H
Published: June 2017

Objective: The Brunel Mood Scale (BRUMS) has proved useful to assess mood states in a range of clinical settings. Its local utility is restricted by the lack of normative data from South Africa. This paper presents preliminary normative data for the use of the BRUMS in the South African health care setting.

Method: Participants (N=2200), ranging from 18 to 59 years, employed in the public sector, and were recruited during routine occupational health surveillance, completed the 24-item self-report BRUMS. They came from all South African race and language groups, and from all nine provinces.

Results: Significant differences were found between the scores of women and men, and their results are reported separately. Due to the language dependant nature of the BRUMS, results are also reported separately for respondents with English as first language, and those who have other South African languages as mother tongue. Norm tables with T-scores are presented for the full sample, and per gender X language groups.

Conclusion: This study presents normative data for a sample of educated and employed South Africans from various backgrounds. Its brevity, and provisionally language friendly nature makes it a useful measure for screening psychological distress in the SA clinical health care context.
Detecting child psychiatric disorders during routine clinic work: A pre-interventional study of primary care physicians in Ilorin, Nigeria
Authors: Abiodun O A , Tunde-Ayinmode M F , Ayinmode B A , Adegunloye O A
Published: June 2017

Back-ground Primary care physicians (PCP) are accessible health care provider for most patients and are gatekeepers to specialist care. The extent to which they can identify children with mental health problems need to be explored.

Objective: To explore the extent to which primary care physicians can identify children with mental health problems. Study setting The study was carried out at the Paediatric Clinic of the department of Family Medicine, University of Ilorin teaching Hospital, Ilorin, Nigeria.

Method: A 2 staged study in which 350 children aged 7-14 years were screened with child behaviour questionnaire (Rutter Scale A2). A stratified sub-sample of 157 (all high scorers and about 30% of low scorers) were further interviewed with children version of Schedule for Affective Disorders and Schizophrenia (K-SADS) by the psychiatrists. They were also evaluated by primary care physicians for the presence of mental health problems.

Results: Out of the 157 children interviewed in the second stage, primary care doctors identified 12 children as having mental health problems. K-SADS identified 40 as cases, this includes 8 of the 12 identified by primary care doctors; that is, they identified 8 cases. They were poor in discriminating between cases and non- cases (P=0.012). Poor school attendance (P=0.001), frequent hospital visit (P=0.009) and long standing illness (P=0.039) were associated with case-ness.

Conclusion: This study suggests that primary care physicians had difficulties in identifying mental health problems in the children. Interventions such as guideline protocols, primary care physician education and educational programmes to increase mental health literacy, may be effective in improving detection by primary care physicians.
Self-concept in overweight adolescents
Authors: Vuk Pisk Sandra , Mihanovic Mate , Silic Ante , Bogovic Anamarija , Vidovic Vesna
Published: June 2017

Background and objective. Adolescence is considered a critical stage of life, and one during which body image and self-concept are of particular importance for peer acceptance and approval. Body weight may impact on satisfaction or dissatisfaction in adolescent girls’ self-concept. The aim of this research was to determine the association between obesity and self-concept among adolescent girls.

Methods. The study sample consisted of 40 overweight (BMI 25 - 30) 18-year-old girls in their last year of high school. A further 40 girls of the same age with a BMI of 18 - 25 formed a control group. The Offer Self-Image Questionnaire for Adolescents (OSIQ) was used to evaluate their self-concept. Descriptive statistical methods used in analysing the data included calculation of the median and standard deviation of variables, and t-tests were used to compare group differences, with p<0.05 taken as the level of significance.

Results. Statistically significant differences between two groups were found in two components of the OSIQ, sexual attitudes (p=0.044) and psychopathology (p=0.020), but no differences were found in other components such as impulse control, emotional tone, body and self-image, social relations, morals, family relations, mastery of the external world, vocational educational goals and superior adjustment.

Conclusion. Our results suggest that overweight adolescent girls are less adjusted with regard to their sexual attitudes and present with more psychopathology as measured by the OSIQ compared with their peers of average weight.
Sociodemographic and health correlates of sleep problems and duration in older adults in South Africa
Authors: Peltzer K
Published: June 2017

Objective. To investigate sleeping problems, sleep duration and associated factors in a national probability sample of older South Africans who participated in the Study of Global Ageing and Adult Health (SAGE) in 2008.

 Methods. In 2008 I conducted a national population-based cross-sectional study with a sample of 3 840 South African individuals aged ≥50 years. A questionnaire was used to survey sociodemographic characteristics and health variables, and anthropometric and blood pressure measurements were recorded.

 Results. Of the participants, 9.1% reported having a sleeping problem at the time of the study. The average number of self-reported hours of sleep was 8.6 (SD ±2.1), with 11.6%, 45.1%, 20.0%, and 23.5% reporting ≤6, 7 - 8, 9, and ≥10 h, respectively. In multivariable analysis, depression, cognitive impairment, lack of social cohesion, and moderate or severe activity limitations were associated with having a current sleeping problem. In terms of sociodemographic and health variables, a short sleep duration was associated with: white, Indian/Asian or coloured ethnicity; daily tobacco use; and moderate and severe activity limitations. In participants aged 60 - 79 years, lower wealth, hypertension, risky drinking and lower health-related quality of life were associated with a long sleeping duration.

 Conclusion. This study robustly characterised the prevalence of sleeping problems and specific associated risk factors in a large sample in South Africa. This can help to direct future healthcare efforts.
Effectiveness of psycho-education on depression, hopelessness, suicidality, anxiety and substance use among basic diploma students at Kenya Medical Training College
Authors: Muriungi Susan Kagwiria , Ndetei David Musyimi
Published: June 2017

Objective. To determine the effectiveness of psycho-education on symptom severity in depression, hopelessness, suicidality, anxiety and risk of substance abuse among para-medical students at Kenya Medical Training College (KMTC).

Methodology. A clinical trial drew experimental (N=1 181) and control (N=1 926) groups from different KMTC campuses. Self-administered questionnaires were used to collect data: the researcher-designed social demographic questionnaire was used at baseline only, while Beck’s Depression Inventory, Beck’s Hopelessness Scale, Beck’s Suicide Ideation Scale, Beck’s Anxiety Inventory and World Health Organization alcohol, smoking and substance involvement screening test (ASSIST) (for drug abuse) were used for baseline, mid-point and end-point assessments at 3-month intervals. The experimental group received a total of 16 hours of structured psycho-education. All study participants gave informed consent.

Results. Overall, there was no significant reduction in symptom severity between the experimental and control groups at 3 months (p>0.05) but there was a significant difference at 6 months (p<0.05).

 Conclusion. Psycho-education was effective in reducing the severity of symptoms of depression, hopelessness, suicidality, anxiety and risk of substance abuse at 6 months. 
Recollected experiences of first hospitalisation for acute psychosis among persons diagnosed with schizophrenia in South Africa
Authors: Zubi Y , Connolly P
Published: June 2017

First-time admission to a psychiatric hospital for acute psychosis has been reported to be extremely traumatic, and this has not been adequately researched in the South African context. This study approached persons diagnosed with schizophrenia and explores their recollected, subjective experiences of their first admission to a South African psychiatric hospital ward for acute psychosis. Semi-structured individual interviews were conducted with seven participants diagnosed with schizophrenia. These were analysed using thematic content analysis. While some participants had positive experiences, the majority reported frightening, distressing, emotionally painful or traumatic experiences during their first hospitalisation. The first hospital admission was also described as having serious long-term implications for the person’s wellbeing, particularly as the diagnosis of schizophrenia made them feel isolated and stigmatised, which further hinders them from recovering from their symptoms and reintegrating into society. This study therefore draws attention to aspects of the process of first admission to psychiatric wards in South Africa, which may benefit from proactive intervention and closer research attention.
The South African Society of Psychiatrists (SASOP) Treatment Guidlelines for Psychiatric Disorders
Authors: Emsley R , Flisher A J , Grobler G , Seedat S , Szabo C P
Published: June 2017

The South African Society of Psychiatrists (SASOP) Treatment Guidelines for Psychiatric Disorders have been developed in order to address the local need for guidelines in our unique clinical setting.
Generalised anxiety disorder
Authors: Stein D J
Published: June 2017

Generalised anxiety disorder (GAD) is a common disorder with

a lifetime prevalence of 6.1% and a 1-year prevalence of 2.9% in

one large study.

[

1]

It occurs most commonly in the 45 - 55-year

age group with women twice as likely as men to have GAD.

[

1]
Reasons for parasuicide among patients admitted to Tshilidzini Hospital, Limpopo Province: A qualitative study
Authors: Obida M , Clark Christopher , Govender Indiran
Published: June 2017

Background. Suicide and suicide attempts are commonly encountered in primary healthcare. To manage them competently and in a non-judgmental manner, health workers require an in-depth understanding of this problem.
Objective. To determine the reasons for suicide attempts among patients admitted at Tshilidzini Hospital. 

Method. A descriptive qualitative study used an unstructured in-depth interview for data collection, with 10 purposively selected participants. The data were analysed thematically.

Results. The participants gave the following reasons for their suicidal acts: poverty, unemployment and its associated financial difficulties; domestic violence; interpersonal conflicts; HIV/AIDS-related problems; maternal death; depression; hallucinations; and accusations of witchcraft. These factors interacted, producing feelings of hopelessness, worthlessness and lack of meaning in life, thereby driving the individual to resort to desperate measures. The choice of method for each suicide attempt was influenced by availability, knowledge, experience and the seriousness of intent to die.

Conclusion. This study supports the idea that a suicidal act is a complex phenomenon arising in an distinctive way in each individual, based on the interplay of various factors.
Profile of rape victims referred by the court to the Free State Psychiatric Complex, 2003 - 2009
Authors: Calitz F J W , De Ridder Loube , Gericke Nandi , Pretorius Anmarie , Smit Jaco , Joubert Gina
Published: June 2017

Background. The psychological evaluation of rape victims to determine their competency to testify in court and whether they are capable of consenting to sexual intercourse is challenging, especially when the rape victim is mentally retarded.

Objective. To describe the profile of mentally retarded rape victims referred to the Free State Psychiatric Complex (FSPC) in Bloemfontein from 2003 to 2009.

Methods. A descriptive retrospective study was conducted. The study consisted of 137 rape victims referred by the court to the FSPC for psychological evaluation from 2003 to 2009. Patient files were used to obtain information.

Results. The majority of individuals (n=129; 94.2%) in the cohort were female. The mean age of the participants was 19 years (range 3 - 52). The number of victims evaluated increased from four in 2003 to 36 in 2009. Most participants were diagnosed with moderate (67.2%), followed by severe (18.3%) and mild (14.6%) mental retardation. Only two of the victims were able to give legal consent to sexual intercourse. Only one participant was able to testify in a court of law. A noteworthy finding was that in only 25 (18.2%) cases, a clinical psychologist was subpoenaed to testify in court.

Conclusion. The vast majority of mentally retarded rape victims in our cohort, regardless of their level of intellectual functioning, were not able to testify in court and were not able to give informed consent to sexual intercourse.
A cross-sectional study of factors affecting seasonality in bipolar disorder
Authors: Mittal Pankaj Kumar , Mehta Shubham , Solanki Ram Kumar , Swami Mukesh Kumar , Meena Parth Singh
Published: June 2017

Background. Researchers have evinced interest in the effect of seasonal variations on mood and behavioural patterns in affective disorders. 

Objective. To study seasonality in bipolar disorder (BD) patients and also the factors affecting this seasonality. 

Method. Forty-nine patients with BD in euthymic phase were recruited and analysed using the Seasonal Pattern Assessment Questionnaire and Morningness-Eveningness Questionnaire. 

Results. Most of the patients were morning types but chronotype had no influence on seasonality. Age of patient and number of episodes were the most important factors affecting seasonality in BD. 

Conclusion. Seasonality and its influencing factors must be considered while managing bipolar disorder.
Undiagnosed metabolic syndrome and other adverse effects among clozapine users of Xhosa descent
Authors: Faasen N , Niehaus Dana J H , Koen L , Jordaan E
Published: June 2017

Background. Clozapine use is known to be associated with significant side-effects, including prolongation of the QT-interval, agranulocytosis and metabolic syndrome. However, few data exist on the prevalence of clozapine side-effects in patients of Xhosa descent. 

Objective. To gather data from Xhosa patients with schizophrenia to establish the prevalence of clozapine side-effects in this population. 

Methods. Twenty-nine Xhosa patients with schizophrenia (as per the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)) who had been receiving clozapine treatment for >1 year on an outpatient basis were selected for inclusion. All patients were participating in a genetics study in the Cape Metropolitan area. The participants were evaluated for the presence of side-effects (tests including an electrocardiogram, white blood cell count (WCC) and fasting blood glucose). 

Results. The prevalence of metabolic syndrome was 44.8% (95% confidence interval (CI) 26.7 - 62.9) and of undiagnosed diabetes mellitus 13.8% (95% CI 1.24 - 26.34). There was a significant association between metabolic syndrome and body mass index (BMI) (p<0.01). The mean (SD) WCC was 7.8 × 109/L (2.8), with 3.4% of the subjects having a WCC <3.5 × 109/L. Sedation (82.8%; 95% CI 69.0 - 96.5), hypersalivation (79.3%; 95% CI 64.6 - 94.1) and constipation (44.8%; 95% CI 26.7 - 62.9) were common. The mean QT-interval was 373.8 (35.9) ms and 10% had a corrected QT-interval >440 ms. There was an association between the duration of clozapine treatment and QT-interval (with Bazett’s correction).  

Conclusion. The high prevalence of metabolic syndrome and undiagnosed diabetes mellitus in this sample points to a need to monitor glucose levels and BMI on a regular basis. A larger study should be done to accurately quantify the differences in prevalence of side-effects between population groups.
Lessons from the past: Historical perspectives of mental health in the Eastern Cape
Authors: Sukeri Kiran , Alonso-Betancourt Orlando , Emsley Robin
Published: June 2017

The development of mental health services in the Eastern Cape Province is inextricably entwined in South Africa’s colonial history and the racist policy of apartheid. Prior to the development of mental hospitals, mental health services were provided through a network of public and mission hospitals. This paper explores the development of early hospital and mental health services in the Eastern Cape from the time of the Cape Colony to the dissolution of apartheid in 1994, and highlights the influence of colonialism, race and legislation in the development of mental health services in this province. The objective is to provide a background of mental health services in order to identify the historical factors that have had an impact on the current shortcomings in the provision of public sector mental health services in the province. This information will assist in the future planning and development of a new service for the province without the stigma of the past. This research indicates that one lesson from the past should be the equitable distribution of resources for the provision of care for all that inhabit this province, as enshrined in South Africa’s constitution.

 
SASOP Congress 2014
Authors: Nye Ingrid
Published: June 2017

No abstract available.
Integrating spirituality in the approach to psychiatric practice
Authors: Janse van Rensburg Albert B R
Published: June 2017

[Editorial]
Extent of alcohol use and mental health (depressive and post- traumatic stress disorder symptoms) in undergraduate university students from 26 low-, middle- and high-income countries
Authors: Peltzer Karl , Pengpid S
Published: June 2017

Objective. To estimate if there is a non-linear association between varying levels of alcohol use and poor mental health (depressive and post-traumatic stress disorder (PTSD) symptoms) in university students from low-, middle- and high-income countries. 

Methods. Using anonymous questionnaires, data were collected from 19 238 undergraduate university students (mean age 20.8; standard deviation (SD) 2.8) from 27 universities in 26 countries across Asia, Africa and the Americas. Alcohol use was assessed in terms of number of drinks in the past 2 weeks and number of drinks per episode, and measures of depression and PTSD symptoms were administered. 

Results. The proportion of students with elevated depression scores was 12.3%, 16.9%, and 11.5% for non-drinkers, moderate drinkers, and heavy drinkers, respectively, while the proportion of students with high PTSD symptoms was 20.6%, 20.4% and 23.1% for non-drinkers, moderate drinkers, and heavy drinkers, respectively. Logistic regression found that non-drinkers and heavy drinkers had a lower odds than moderate drinkers to have severe depression, after adjusting for sociodemographic variables, social support and subjective health status. Further, heavy, more frequent drinkers and more frequent binge drinkers had a higher odds to have elevated PTSD symptoms than moderate and non-drinkers, after adjusting for sociodemographic variables, social support and subjective health status. 

Conclusion. The results suggest a reverse U-shaped association between recent alcohol use volume and frequency and depressive symptoms (unlike that previously identified), and a J-shaped association between binge drinking frequency and depressive symptoms and alcohol use and PTSD symptoms.
The prevalence of body dysmorphic disorder among South African university students
Authors: Dlagnikova Antonia , Van Niekerk Rudolph Leon
Published: June 2017

Background. The prevalence of body dysmorphic disorder (BDD) among South African students is explored in this article. BDD is regarded as an obsessive-compulsive-related disorder characterised by a preoccupation with one or more perceived defects or flaws in physical appearance and expressed in repetitive behaviours or mental acts as a response to the appearance concerns, causing clinically significant distress or impairment in functioning. 

Objectives. To determine the prevalence of BDD among undergraduate students (N=395) at an inner-city university. 

Methods. Proportionate stratified random cluster sampling was used to select the sample. The students completed a demographics survey and the Body Image Disturbance Questionnaire. 

Results and conclusion. An overall prevalence rate of 5.1% was found in this study, which is similar to prevalence rates reported in existing literature among student populations. No clinically significant differences in the severity of the BDD were found on the demographic variables of gender, race or sexual orientation. However, students differed significantly in their experience of the severity of the disorder in terms of age, in that students over the age of 21 reported higher severity levels than students under the age of 21. Although the prevalence of the disorder compares with that in other countries, its severity seems to increase with age among South African students.
Towards an Afrocentric approach to psychiatry
Authors: Mkize D L
Published: June 2017

NO ABSTRACT AVAILIBLE
Challenges to the current provision of mental health services and development of psychiatry in Africa
Authors: Kigozi Fred
Published: June 2017

NO ABSTRACT AVAILIBLE
Neuropsychological evidence for subjective memory complaints in the neurologically well individual
Authors: Lucas M D
Published: June 2017

Background. Subjective memory and concentration difficulties are frequently expressed in modern society and, if sufficiently worrying, may elicit a medical consultation for elucidation. When a clear explanation cannot be given, a neuro- psychological assessment may be a useful tool.Method. The present naturalistic study recruited 20 patients who reported cognitive difficulties for which a medical expla- nation could not be found. Each subject underwent a clinical interview and neuropsychological assessment in order to iden- tify the nature and severity of the problem, and to identify a possible cause of these complaints.Results. Several possible explanations were documented but mood disturbance was considered the most likely reason for the identified cognitive difficulties.Limitations. This was a naturalistic study with a specific sample, and consequently generalisability may be reduced.Conclusion. Even in episodes of mild depression cognitive dif- ficulties occur that may be presented to neurologists rather than psychiatrists. In such instances the patient is at risk of not receiv- ing the appropriate treatment for his or her mood disorder .
South African psychiatrists and the Aversion Project
Authors: Kaplan Robert M
Published: June 2017

NO ABSTRACT AVAILIBLE
Glacier evolution in high-mountain Asia under stratospheric sulfate aerosol injection geoengineering
Authors: Zhao Liyun , Yang Yi , Cheng Wei , Ji Duoying , Moore John C.
Published: June 2017

Abstract. Geoengineering by stratospheric sulfate aerosol injection may help preserve mountain glaciers by reducing summer temperatures. We examine this hypothesis for the glaciers in high-mountain Asia using a glacier mass balance model driven by climate simulations from the Geoengineering Model Intercomparison Project (GeoMIP). The G3 and G4 schemes specify use of stratospheric sulfate aerosols to reduce the radiative forcing under the Representative Concentration Pathway (RCP) 4.5 scenario for the 50 years between 2020 and 2069, and for a further 20 years after termination of geoengineering. We estimate and compare glacier volume loss for every glacier in the region using a glacier model based on surface mass balance parameterization under climate projections from three Earth system models under G3, five models under G4, and six models under RCP4.5 and RCP8.5. The ensemble projections suggest that glacier shrinkage over the period 2010–2069 is equivalent to sea-level rise of 9.0 ± 1.6 mm (G3), 9.8 ± 4.3 mm (G4), 15.5 ± 2.3 mm (RCP4.5), and 18.5 ± 1.7 mm (RCP8.5). Although G3 keeps the average temperature from increasing in the geoengineering period, G3 only slows glacier shrinkage by about 50 % relative to losses from RCP8.5. Approximately 72 % of glaciated area remains at 2069 under G3, as compared with about 30 % for RCP8.5. The widely reported reduction in mean precipitation expected for solar geoengineering is unlikely to be as important as the temperature-driven shift from solid to liquid precipitation for forcing Himalayan glacier change. The termination of geoengineering at 2069 under G3 leads to temperature rise of about 1.3 °C over the period 2070–2089 relative to the period 2050-2069 and corresponding increase in annual mean glacier volume loss rate from 0.17 to 1.1 % yr−1, which is higher than the 0.66 % yr−1 under RCP8.5 during 2070–2089.
CITRATE 1.0: Phytoplankton continuous trait-distribution model with one-dimensional physical transport applied to the Northwest Pacific
Authors: Chen Bingzhang , Smith S. Lan
Published: June 2017

Abstract. Diversity plays critical roles in ecosystem functioning, but it remains unclear how best to model phytoplankton diversity in order to better understand those roles and reproduce consistently observed patterns in the ocean. In contrast to the typical approach of resolving distinct species or functional groups, we present a ContInuous TRAiT-basEd phytoplankton model (CITRATE) that focuses on macroscopic properties such as total biomass, mean trait values, and trait variance. This phytoplankton component is embedded within a Nitrogen-Phytoplankton-Zooplankton-Detritus-Iron model that itself is coupled with a simplified one-dimensional ocean model. Size is used as the master trait for phytoplankton. CITRATE also incorporates trait diffusion for sustaining diversity, as well as simple representations of physiological acclimation, i.e. flexible chlorophyll-to-carbon and nitrogen-to-carbon ratios. We implemented CITRATE 1.0 at two contrasting stations in the Northwest Pacific where several years of observational data are available. The model is driven by physics forcing including vertical eddy diffusivity imported from three-dimensional ocean circulation models. One common set of model parameters for the two stations was optimized using the Delayed Rejection Adaptive Metropolis-Hasting Monte Carlo (DRAM) algorithm. The model faithfully reproduced most of the observational patterns and gave robust predictions on phytoplankton mean size and size diversity. With proper physical forcing, CITRATE 1.0 can be applied to any oceanic station where either nitrogen or iron limits phytoplankton growth.
Exploration of virtual catchments approach for runoff predictions of ungauged catchments
Authors: Zhang Jun , Han Dawei , Song Yang , Dai Qiang
Published: June 2017

Abstract. We explore unit hydrograph (UH) properties influenced by catchment geomorphology that could be used in ungauged catchments. Unlike using gauged catchments, a robust approach with virtual catchments was adopted in deriving UH equations. Over 2000 virtual catchments were created from the baseline model of the Brue catchment, UK. A distributed model, SHETRAN, was used to generate runoff in these catchments. Using virtual catchments is feasible to control catchment geomorphologies, which could not be done with the real catchments due to their vast heterogeneity. Catchment characteristics of average slope, drainage length and a new index of catchment shape were examined of their influence on UH properties. The agreement of the results with the hydrological principles is a useful validation of the approach (e.g., the increasing slope led to quick response to peak (Tp) and high peak volume (Qp) of UH, whereas the drainage length presented an opposite trend). Catchment shape was shown to have a significant effect on UH properties. Compared with the widely used empirical equation from the U.K. Institute of Hydrology, the drawn conclusion recommends more indicators to be included to derive more comprehensive equations: apart from catchment geomorphologic properties, storm patterns including storm intensity and temporal distribution are also influential on the UH shape. The indicators in this study were limited to generate a sophisticated equation for use. However, these results can be considered as a testing case to gain more understanding in hydrologic processes for ungauged catchments with the help of the virtual catchment approach.
Estimating extreme river discharges in Europe through a Bayesian network
Authors: Paprotny Dominik , Morales-Nápoles Oswaldo
Published: June 2017

Abstract. Large-scale hydrological modelling of flood hazards requires adequate extreme discharge data. In practise, models based on physics are applied alongside those utilizing only statistical analysis. The former require enormous computational power, while the latter are mostly limited in accuracy and spatial coverage. In this paper we introduce an alternate, statistical approach based on Bayesian networks (BNs), a graphical model for dependent random variables. We use a non-parametric BN to describe the joint distribution of extreme discharges in European rivers and variables representing the geographical characteristics of their catchments. Annual maxima of daily discharges from more than 1800 river gauges (stations with catchment areas ranging from 1.4 to 807 000 km2) were collected, together with information on terrain, land use and local climate. The (conditional) correlations between the variables are modelled through copulas, with the dependency structure defined in the network. The results show that using this method, mean annual maxima and return periods of discharges could be estimated with an accuracy similar to existing studies using physical models for Europe and better than a comparable global statistical model. Performance of the model varies slightly between regions of Europe, but is consistent between different time periods, and remains the same in a split-sample validation. Though discharge prediction under climate change is not the main scope of this paper, the BN was applied to a large domain covering all sizes of rivers in the continent both for present and future climate, as an example. Results show substantial variation in the influence of climate change on river discharges. The model can be used to provide quick estimates of extreme discharges at any location for the purpose of obtaining input information for hydraulic modelling.