Scielo RSS <![CDATA[South African Journal of Psychiatry ]]> http://www.scielo.org.za/rss.php?pid=2078-678620220001&lang=pt vol. 28 num. 1 lang. pt <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>Coulrophobia: An investigation of clinical features</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100001&lng=pt&nrm=iso&tlng=pt BACKGROUND: Coulrophobia refers to fear or disgust elicited by clowns, or images of clowns, and may be accompanied by significant distress. The medical literature on sociodemographic and clinical features of coulrophobia is, however, sparse AIM: This study aimed to investigate coulrophobia sociodemographic and clinical features in an online support group. SETTING: A self-administered questionnaire was distributed to an online support group for coulrophobia. METHODS: Members of the online coulrophobia support group received a link to a self-administered questionnaire. The questionnaire focused on sociodemographic and clinical features, including fear-related and disgust-related symptoms, and included DSM-5 diagnostic criteria for specific phobia. RESULTS: Of the 95 survey respondents, 79 were female respondents (mean age: 39.8 ± 12.6 years), with the mean age of onset 9 ± 6.1 years. Coulrophobia symptoms were associated with significant psychological distress and with impaired social functioning. About 7.4% of respondents reported severe anxiety with panic attacks. Comorbid disorders included major depressive disorder (9.5%), obsessive-compulsive disorder (5.3%) and panic disorder (3.2%). Individuals with fear-related symptoms were more likely to fulfil DSM-5 criteria for specific phobia. CONCLUSION: Coulrophobia is a phenomenon that warrants clinical attention, given its association with significant comorbidity, psychological distress and impaired functioning. Several sociodemographic and clinical features are consistent with a diagnosis of specific phobia, although future work employing clinician-administered diagnostic tools is needed to consolidate and extend the findings here. <![CDATA[<b>Mental health distress during the COVID-19 pandemic in Nigeria: Need for psychological intervention</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100002&lng=pt&nrm=iso&tlng=pt BACKGROUND: The world began to realise the impact of the coronavirus disease 2019 (COVID-19) in January 2020, and since then the number of people infected has exceeded 1 million globally. In less than 1 month following the first reported case in Nigeria, over 180 people had tested positive to the disease. Studies have shown that such rapidly spreading infectious diseases have the potential to create widespread fear, apprehension, panic and anxiety amongst the general public. AIM: This study aimed at evaluating the impact of information dissemination and public mental healthcare needs during the COVID-19 pandemic in Nigeria. It also hopes to determine if there is an unmet need for telepsychiatry in Nigeria. SETTING: Community-based study covering the North, South and West of Nigeria. METHODS: This was a descriptive cross-sectional study using an on-line survey form via the snowballing sampling method. RESULTS: Social media was identified as the main source of information concerning COVID-19, and half of the respondents opined that information dissemination was inadequate. Psychological distress was present in 90.5% of the participants and 61.8% admitted that this distress was worsened by fake news and myths concerning COVID-19. However, 53.8% of the participants were willing to access mental healthcare services, with telepsychiatry being the preferred choice. CONCLUSION: There is a need to implement a national public mental health service during this emergency. Telepsychiatry has numerous advantages in this context and maybe an opportunity to roll out a novel means of delivering mental healthcare. <![CDATA[<b>From ideation to attempt: A study of suicidality and its correlates amongst patients with schizophrenia in a resource-poor country</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100003&lng=pt&nrm=iso&tlng=pt BACKGROUND: There is increasing evidence that patients with schizophrenia have high tendency to commit suicide. However, such an act is usually preceded by suicidal behaviours (or suicidality) such as suicidal ideations, suicidal intent, suicidal plans and suicidal attempt. If any of this suicidal behaviour spectrum is missed, then suicide results. In spite of the relevance of such behaviours in the management and prognosis of schizophrenia, there is a paucity of research on the patterns and correlates of suicidal behaviours amongst this population group in sub-Saharan Africa. AIM: This study assessed the prevalence and pattern of suicidality and its relationship with certain sociodemographic and clinical variables. SETTING: The study was conducted at the outpatient psychiatric clinic of the Lagos University Teaching Hospital, Idi-Araba, Lagos State. METHODS: Suicidal behaviours were assessed amongst 160 randomly selected patients with schizophrenia over a six-month period. The prevalence, pattern and correlates of suicidal behaviour amongst them were also assessed. Data were collated and processed with the eighteenth version of Statistical Package for Social Sciences (SPSS 18). RESULTS: About 43.1% of the participants exhibited suicidal behaviour. Of these, 5.8% exhibited suicidal plans whilst 75.4% attempted suicide. In terms of severity, one tenth (10%) of those who expressed suicidal behaviour exhibited severe suicidal tendencies. Participants who earned lesser income were more likely to exhibit suicidal behaviour. The same pattern was observed for medication adherence viz a viz suicidal behaviour. CONCLUSIONS: The study brings to the fore the tendency of patients with schizophrenia to commit suicide, hence the need to screen for suicidal behaviour before suicide eventually occurs. <![CDATA[<b>Profile of suicide within the northern part of Ghana: A decade under review</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100004&lng=pt&nrm=iso&tlng=pt BACKGROUND: Several reports show that suicide is the second and third leading cause of untimely death in young people below the age of 30. Little, however, is known about the profile and trend of suicide in this country due to lack of systematic studies and a lack of national statistics on suicide. This study seeks to examine the profile and pattern of suicide cases recorded within northern Ghana for the past decade. AIM: This study aimed to report the prevalence of suicide as an independent cause of death; the choice of suicide method and the alleged reasons for suicide within the northern part of Ghana. SETTING: Retrospective review of coroners' reports within the northern part of Ghana. METHOD: In this descriptive study, 309 completed suicides as archived by the office of the coroner were examined. The coroners' reports of 309 individuals, whose deaths received a suicide verdict or an open verdict in which the cause of death was likely to be suicide from 2008 to 2017, were examined. Student's t-test was used to ascertain significant age differences between the genders involved. RESULTS: Amongst the 309 decedents examined, approximately, 61% were male, with ages ranging from 5 to 81 years. Hanging and poisoning were the most commonly used methods to complete suicide accounting for 124 (40.1%) and 102 (33.0%) deaths, respectively. Regarding the reasons for completed suicide, 78 (25.2%) were because of unknown reasons and 66 (21.4%) were because of social stigma. There was a notable decline in the prevalence of suicide from 2014 to 2017 compared with the years from 2010 to 2013 CONCLUSION: Suicide was highest in the 30-39 year age group with hanging and poisoning being the most common method employed. Stigmatisation and psychosocial problems arising from chronic illness and economic hardship were significant triggers of suicide amongst the suicide decedents in the northern part of Ghana. <![CDATA[<b>Mental illness and HIV amongst female inmates in Durban, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100005&lng=pt&nrm=iso&tlng=pt BACKGROUND: There is limited data regarding the prevalence of mental illness and human immunodeficiency virus (HIV) amongst female inmates in South Africa. Rehabilitation programmes can only be formulated once the needs of this population have been identified. AIM: This study aimed to measure the prevalence of mental illnesses, borderline and antisocial personality disorders and HIV amongst female inmates. SETTING: The study was based at a correctional centre in Durban, KwaZulu-Natal, South Africa. METHODS: This study forms part of a larger two-phased, mixed methods, sequential, explanatory design study. In phase one, 126 female inmates were interviewed using a clinical questionnaire and the Structured Clinical Interview for Diagnostics and Statistical Manual (DSM)-5 diagnoses - Research Version. RESULTS: The following lifetime prevalence rates were found: depressive disorder 70.6%, alcohol use disorder 48.4%, post-traumatic stress disorder (PTSD) 46.8%, borderline personality disorder 33.3%, substance use disorder 31.7%, antisocial personality disorder 15.1% and psychotic disorder 4.8%. The prevalence of current adult attention-deficit and hyperactivity disorder was 9.5%. A total of 39% of the participants admitted to past suicide attempts, whilst 64.3% reported past suicidal ideation and 36.5% had a current episode of a psychiatric disorder. A total of 64.3% of the participants were living with HIV. Although 90.4% had a lifetime psychiatric disorder, only 16.7% were previously diagnosed with a mental illness. The majority of inmates with lifetime disorders had psychiatric comorbidities. CONCLUSION: The high prevalence of mental illness and HIV amongst female inmates, and the fact that most with mental illness remain undiagnosed, is concerning. Improved screening, identification and treatment of mental illnesses in this population is needed to ensure optimal mental health outcomes and decreased recidivism. <![CDATA[<b>Characteristics of inpatients in dialectical behaviour therapy modified for a resource-limited setting</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100006&lng=pt&nrm=iso&tlng=pt 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. AIM: To describe the demographic and clinical characteristics of participants in a modified DBT-ST (skills training) programme at a South African psychiatric hospital. SETTING: The study was conducted at Stikland Hospital, a public psychiatric hospital in the Western Cape province, South Africa. METHODS: A retrospective, cross-sectional chart review of patients included in a modified inpatient DBT-ST programme between 30 June 2014 and 30 June 2019 was conducted. Descriptive analyses were performed on the data both as a complete set and after division into several subgroups. RESULTS: We included 349 records. Two-thirds of the patients completed the programme. Major depressive disorder, borderline personality disorder and substance use disorder were the most prevalent diagnoses. Most patients had psychiatric comorbidities. A total of 90.61% (n = 309) of the patients were exposed to at least one traumatic event and three-quarters (n = 261) had attempted suicide at least once before. CONCLUSIONS: The demographics of our sample did not differ markedly from the international literature. Rather, what stood out was that modified DBT-ST could be a choice in resource-limited settings for a diagnostically heterogeneous group that displayed significant clinical complexity and high levels of emotional dysregulation. Our findings might suggest that the intervention was well tolerated and possibly most appropriately delivered at the first admission, although further research is required. <![CDATA[<b>Working memory and set-shifting in school-aged children classified as having attention-deficit hyperactivity disorder</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100007&lng=pt&nrm=iso&tlng=pt BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is a common psychiatric disorder reported in both children and adults; it is often associated with a variety of executive functioning deficits. AIM: This study investigated the extent to which working memory and set-shifting are impaired in school children with and without ADHD. SETTING: This included primary schools in Lepelle-Nkumpi Municipality in Limpopo province, South Africa. METHODS: A total of 216 children (108 screened positive for ADHD and 108 matched controls without ADHD symptoms), aged between 6 and 15 years, participated in the study. The performance of the two groups was compared on tests of working memory (Forward and Backward Digit Span subtests of the Wechsler Intelligence Scale for Children - Fourth Edition) and set-shifting (Trail Making Test Part B). The scores were analysed as a function of gender and age. RESULTS: The group with possible ADHD performed worse than the neurotypical control group on tasks of working memory and set-shifting. The results did not indicate that gender affected performance. However, the younger age group performed worse than the older children CONCLUSION: Children classified as ADHD showed significantly more impairments in working memory and set-shifting than neurotypical controls. Neither test showed any significant difference between male and female performance, whilst age was shown to affect performance on both tests. Early identification and treatment of children with attention-deficit hyperactivity disorder are crucial to their well-being. <![CDATA[<b>Are female bipolar patients of reproductive age aware of the teratogenic risk of sodium valproate? A qualitative study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100008&lng=pt&nrm=iso&tlng=pt BACKGROUND: Sodium valproate is considered the most teratogenic of all anticonvulsant drugs. Internationally, new regulations require women to sign risk assessment forms if initiated on it. AIM: This study aimed to explore patients' awareness of the teratogenic risk of sodium valproate. SETTING: Weskoppies Psychiatric Hospital, Tshwane, Gauteng. METHODS: We conducted a qualitative study comprising 23 semi-structured interviews with female bipolar patients of reproductive age at a tertiary psychiatric hospital in South Africa. RESULTS: Patient psychoeducation and self-education is improving as many patients were aware of the risk of teratogenicity of sodium valproate either by being educated or by searching online after developing an interest. Our study identified the need for female patients to be educated about contraceptive use when starting on sodium valproate to avoid pregnancy. CONCLUSION: Our study shows that patients are becoming more aware of the teratogenic risk of sodium valproate. This suggests that consultations focusing on the issues of conception and the use of sodium valproate in women of childbearing potential has improved. <![CDATA[<b>Neuropsychiatric symptoms in a patient with Cushing's syndrome</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100009&lng=pt&nrm=iso&tlng=pt Cushing's syndrome (CS) may present with different neurological and/or psychiatric symptoms including anxiety, depression, cognitive impairment and psychosis. Psychosis is a rare clinical manifestation, with literature limited to case reports. We report a case of a 52-year-old woman with psychosis secondary to CS who was mis-diagnosed as schizophrenia-like psychosis. This case highlights the importance of considering CS as a differential when ruling out medical causes in patients with either new or persistent mental health disturbances. <![CDATA[<b>End-of-life care in South Africa: Important legal developments</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100010&lng=pt&nrm=iso&tlng=pt Cushing's syndrome (CS) may present with different neurological and/or psychiatric symptoms including anxiety, depression, cognitive impairment and psychosis. Psychosis is a rare clinical manifestation, with literature limited to case reports. We report a case of a 52-year-old woman with psychosis secondary to CS who was mis-diagnosed as schizophrenia-like psychosis. This case highlights the importance of considering CS as a differential when ruling out medical causes in patients with either new or persistent mental health disturbances. <![CDATA[<b>Prioritising maternal mental health and infant neurodevelopment research in Africa - A call for action amidst the backdrop of the COVID-19 pandemic</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100011&lng=pt&nrm=iso&tlng=pt Cushing's syndrome (CS) may present with different neurological and/or psychiatric symptoms including anxiety, depression, cognitive impairment and psychosis. Psychosis is a rare clinical manifestation, with literature limited to case reports. We report a case of a 52-year-old woman with psychosis secondary to CS who was mis-diagnosed as schizophrenia-like psychosis. This case highlights the importance of considering CS as a differential when ruling out medical causes in patients with either new or persistent mental health disturbances. <![CDATA[<b>A population-based survey of autistic traits in Kenyan adolescents and young adults</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100012&lng=pt&nrm=iso&tlng=pt BACKGROUND: To date, there have been no large-scale population studies of autistic traits (AUT) conducted in AfricaAIM: The study aimed to estimate the prevalence and characteristics of autism spectrum disorders in a large sample of Kenyan adolescents and young adultsSETTING: Tertiary academic institutions (87%) and directly from the community (13%METHODS: Our study surveyed 8918 youths (aged 15-25 years) using the autism spectrum quotient (AQ). Based on AQ scores, we derived groups with low (L-AUT), borderline (B-AUT), and high (H-AUT) autistic traits. Relationships of AUT with demographic factors, psychosis, affectivity and stress were investigatedRESULTS: Internal consistency of the AQ in the population was excellent (Cronbach's α = 0.91). Across all participants, 0.63% were estimated as having H-AUT, while 14.9% had B-AUT. Amongst community youth, prevalence of H-AUT was 0.98%. Compared to those with low and borderline traits, H-AUT participants were more likely to be males, to have lower personal and parental educational attainment, and to be of a lower socioeconomic status. The H-AUT group also had higher psychotic and affective symptoms as well as higher psychosocial stress than other groupsCONCLUSION: The prevalence of H-AUT amongst Kenyan youth is comparable to Autism spectrum disorder (ASD) rates in many countries. Autistic traits in Kenya are associated with worse social and clinical profiles. Further research on autism across Africa is needed to investigate cross-cultural heterogeneity of this disorder, and to guide healthcare policy <![CDATA[<b>Promotive factors associated with internalising symptoms amongst college students during the COVID-19 lockdown in Enugu metropolis, Nigeria</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100013&lng=pt&nrm=iso&tlng=pt BACKGROUND: The outbreak of the coronavirus disease 2019 (COVID-19) pandemic has caused a high burden of psychological distress amongst adolescentsAIM: This study aimed to evaluate associations of personal strengths including resilience and social support with internalising symptoms amongst college students during the lockdown in the wake of the COVID-19 pandemicSETTING: The study population included students from senior and junior college classes in public schools in Enugu metropolis, NigeriaMETHOD: A school-based cross-sectional study design was employed for the study. A two-stage sampling technique was used to select 496 students (mean age = 16.5, s.d. = 1.9 years; 52.2% female) in six out of 33 public colleges in Enugu metropolis, Nigeria during the lockdown period occasioned by the COVID-19 pandemic. Validated questionnaires assessing anxiety, depression, resilience and social support were used to collect informationRESULTS: Most of the students reported depressive symptoms, whilst just over a third of the sample reported anxiety or both depressive and anxiety symptoms. Chi-square and logistic regression analyses revealed that being male and reporting higher levels of social support and the ability to bounce back from stress were associated with less anxiety. Being younger and reporting a moderate level of support were associated with more depressive symptoms, whilst the ability to bounce back was associated with fewer depressive symptomsCONCLUSIONS: Good social support and the ability to bounce back from stress were linked to lower levels of anxiety and depressive symptoms amongst college adolescents during the lockdown in the wake of the COVID-19 pandemic despite high prevalence rates <![CDATA[<b>Correlates and cascade of HIV care in patients with psychiatric disorders in the Eastern Cape province, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100014&lng=pt&nrm=iso&tlng=pt BACKGROUND: The cascade of human immunodeficiency virus (HIV) care in patients with psychiatric disorders is poorly understoodAIM: This study determined the prevalence of HIV and described its cascade of care among patients with psychiatric disorders in the Eastern Cape province, South Africa. The study also examined the correlates of HIV comorbidity with psychiatric disorders in the cohortMETHODS: In this cross-sectional study, a total of 368 individuals attending the Psychiatric Outpatients' Department of Cecilia Makiwane Hospital in Eastern Cape were interviewed with a structured questionnaire. Relevant items on demographics and clinical information were extracted from the medical records. Virologic suppression was defined as viral load < 1000 RNA copies/mLRESULTS: The HIV prevalence after the intervention was 18.8% and a significant proportion of participants already knew their status (n = 320; 87.0%). Linkage to care and antiretroviral therapy initiation occurred in 61 participants, of those diagnosed with HIV (88.4%), with 84.1% being eligible for viral load monitoring (n = 58) and 53.4% having achieved virologic suppression. Being female (AOR = 5.48; 95% CI 2.61-11.51) and black (adjusted odds ratio [AOR] = 3.85; 95% confidence interval [CI] 1.06-14.03) were independent predictors of HIV comorbidity in individuals living with psychiatric disordersCONCLUSION: This study found a moderately high prevalence (close to 19%) of HIV in individuals with psychiatric disorders, with a significant correlation with being female and being black people. This study also found a significant gap in the linkage to antiretroviral therapy (ART) initiation and a low rate of virologic suppression of 53.4%. Clinicians, therefore, should monitor and provide interventions for patients with concomitant HIV infection along this cascade of care <![CDATA[<b>The significance of sleep quality in euthymic bipolar patients from Nigeria</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100015&lng=pt&nrm=iso&tlng=pt BACKGROUND: Bipolar disorder is highly under-researched in Africa. Existing studies show that racial/ethnic disparities exist for sleep quality. Poor sleep quality in bipolar disorder causes significant morbidity and mortality even during periods of euthymiaAIM: This study aimed to assess sleep quality and its correlates amongst euthymic patients with bipolar I disorder from NigeriaSETTING: The study was carried out in a teaching hospital, and state hospital, in Ibadan, NigeriaMETHOD: This cross-sectional study was conducted amongst 76 euthymic bipolar patients aged between 18 and 60 years, meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria for bipolar disorder. Euthymia was defined as having a score of ≤ 5 on the Young Mania Rating Scale and < 8 on the Hamilton Depression Rating Scale. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQIRESULTS: A total of 37 (48.7%) participants had poor quality sleep. Sleep quality was associated with marital status (p = 0.013) and suicide plan (p = 0.047). Participants with good sleep quality had higher total sleep duration, lower time to fall asleep (sleep latency), better subjective quality of sleep, were less likely to use sleep medications and had less daytime dysfunction than participants with poor sleep quality. All p-values were < 0.05. Subjective quality of sleep, ongoing use of sleep medication, daytime dysfunction were independently associated with poor sleep qualityCONCLUSION: Poor sleep quality frequently persists during euthymic periods in patients with bipolar disorder. The correlates identified can be targeted for intervention during treatment <![CDATA[<b>Influence of first- and second-generation antipsychotics on anthropometric parameters of male psychiatric patients</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100016&lng=pt&nrm=iso&tlng=pt BACKGROUND: The use of antipsychotic medication, particularly second generation antipsychotics (SGAs) is a major risk factor for cardiovascular disease in people with severe mental illness (SMI). Few studies have compared body measures of people with SMI taking first generation antipsychotics (FGAs) to those taking SGAsAIM: We compare body measures between long-term male inpatients using either FGAs or SGAsSETTING: The study was conducted at Weskoppies Psychiatric Hospital, in Pretoria, GautengMETHODS: A total of 30 patients were selected from a list of male inpatients and were included in our study. Each participant had the following anthropometric measures done and these were compared between the two groups: Waist circumference (WC), body mass index (BMI), waist to hip ratio (WHR), waist to height ratio (WHtR) and hip circumference (HC). Hospital records were used to record demographic variables, diagnosis, comorbid disease and psychotropic medication for each participantRESULTS: Participants in the FGA and SGA groups had similar body measures, resulting in similar BMI, WHR and WHtR. Participants had a mean HC of 100.5 cm, 95% confidence interval (CI) (97.68, 103.22). BMI ranged from 21.87 kg/m² to 37.65 kg/m², with an overall mean of 28.5 kg/m², 95% CI (26.69, 30.22). Participants had a mean WHtR of 0.59, 95% CI (0.56, 0.61). Participants had a mean WC of 100.6 cm and 95% CI (96.26, 104.87), and the mean WHR of both groups was 1.0CONCLUSION: Participants using FGAs and SGAs had similar body measures, and these indicated that this sample of male inpatients with SMI is at high risk for CVD <![CDATA[<b>Prevalence of depressive symptoms in patients with rheumatoid arthritis at a regional hospital in KwaZulu-Natal, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100017&lng=pt&nrm=iso&tlng=pt BACKGROUND: Depression affects 14.8% - 38.8% of patients with rheumatoid arthritis (RA) in developed countries. The prevalence and risk factors for depression in patients with RA in sub-Saharan Africa is not well establishedAIM: To determine the prevalence of depressive symptoms in patients with RASETTING: Public sector regional hospital in South AfricaMETHODS: A cross-sectional descriptive study was undertaken with 110 adult RA patients. A structured socio-demographic and clinical questionnaire, the modified health assessment questionnaire (mHAQ), the simplified disease activity index (SDAI) for RA, the patient health questionnaire (PHQ-9), and the Household Food Insecurity Access scale (HFIAS) for nutritional status, were used. Correlates of depressive symptomatology in participants with RA were identified using t-tests and regression analysesRESULTS: Most of the participants were women (90.9%), 67% had moderate to severe RA disease on the SDAI score, 92.7% reported functional disability (HAQ score of ≥ 1), and 87.2% reported mild to severe depressive symptoms. Unemployment (p < 0.01), severe food insecurity (p < 0.01) and functional disability (p = 0.02), were significantly associated with the depressive symptoms, but not with disease activity (p = 0.8) or inflammatory markers (p = 0.63). Unemployment (adjusted β = −5.07, p < 0.01) and severe food insecurity (adjusted β = −4.47, p < 0.01) were significantly associated with depressive symptoms, based on the adjusted regression modelCONCLUSION: As RA effects functional status, with the impact of the resulting unemployment and food insecurity being associated with depression, affected people should be screened for depression and managed using a multidisciplinary approach, especially considering the role of social determinants in RA patients with depression <![CDATA[<b>Common mental disorders amongst frontline healthcare workers during the COVID-19 pandemic in Ethiopia: A cross-sectional study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100018&lng=pt&nrm=iso&tlng=pt BACKGROUND: A novel coronavirus had a profound physiological and psychological burden with regards to contracting the disease or uncertainties in the care of infected patients. Especially, at risk are frontline healthcare workers who are participating in the care of such patientsAIM: This study investigated the burden of mental health problems amongst the frontline health workers during the coronavirus disease 2019 (COVID-19) pandemic in EthiopiaSETTING: East Hararghe Zone of Oromia Region and Harari Regional State, EthiopiaMETHODS: A cross-sectional study was conducted in three selected hospitals of COVID-19 treatment centers. Simple random sampling was used to select a sample of 423 participants from each hospital. The self-Reporting Questionnaire (SRQ-20) was used to assess the presence of common mental disorders. Binary and multivariable logistic regressions were fitted to identify factors associated with common mental disorders. Statistical significance was declared at a p-value less than 0.05RESULTS: The prevalence of common mental disorders amongst frontline healthcare workers was 22.6%. Being female, married, having had direct contact with COVID-19 patients, working in COVID-19 treatment centers and ICU, having any symptoms of COVID-19, current three-month use of any substances, and poor social support were found to be strong predictors of common mental disorders in frontline health workers during COVID-19 pandemic in EthiopiaCONCLUSION: The considerable proportions of frontline health care workers have common mental health problems. Strategies need to address COVID-19 related mental health problems, and integrate psychosocial intervention to support the frontline health workers is paramount <![CDATA[<b>The effect of structured psychoeducation on caregiver burden in carers of patients with schizophrenia in Nigeria: A 12-week follow-up investigation</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100019&lng=pt&nrm=iso&tlng=pt BACKGROUND: Despite robust evidence of the huge burden of caregiving amongst caregivers of patients with schizophrenia, there is a paucity of data in Africa on the interventions to address this enormous burden of caregivingAIM: This study aimed to determine the effect of structured psychoeducation intervention on the burden of caregiving in comparison with 'care as usual' in a Nigerian Psychiatric HospitalSETTING: This study was done at the out-patient and in-patient units of the Federal Neuropsychiatric Hospital, Enugu, NigeriaMETHODS: Caregivers of inpatients who fulfilled the International Classification of Diseases (ICD-10) criteria for diagnosis of schizophrenia were recruited for the study. The caregivers were then allocated into two groups (Group A received structured psychoeducation intervention in addition to 'care as usual' whilst group B received only 'care as usual'). After the baseline assessment, the caregivers were followed up every 4 weeks for a period of 12 weeks. At each interval of follow-up, caregivers were assessed for caregivers' burden using the Zarit Burden Interview (ZBI). Repeated measures analysis of variance (mixed type) was used to determine the effects of the interventions on caregivers' burden in the two arms of the study across the intervals of follow-upRESULTS: The attrition rate at week 12 was 10.7%; leaving 130 for the assessment of outcome variable at the end of follow-up. Structured psychoeducation intervention was significantly better than 'care as usual' in ameliorating caregivers' burden [F (1, 123) = 21.75, p < 0.001, Partial Eta Squared = 0.39CONCLUSION: These findings seem to suggest that caregivers who received structured psychoeducation intervention experienced a greater reduction in caregiver burden than those who received 'care as usual'. Whilst the study addressed short-term effect, the findings of this study are in accord with other studies that have supported the impression that psychoeducational family-based intervention is useful with regard to caregiver burden <![CDATA[<b>The prevalence and correlates of anxiety and depression amongst essential workers during the COVID-19 lockdown in Ekiti State, Nigeria</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100020&lng=pt&nrm=iso&tlng=pt BACKGROUND: Essential workers are imperative in the fight against the coronavirus disease (COVID-19) pandemicAIM: To assess the prevalence and factors associated with anxiety and depression among essential workers during the COVID-19 pandemic and lockdownSETTING: This study was set in Ekiti State, NigeriaMETHOD: This was a cross-sectional study involving essential workers in Ekiti State Nigeria, during the COVID-19 pandemic and lockdown. A total of 588 essential workers were sampled. Online socio-demographic variables and the Hospital Anxiety and Depression Scale, a 14 item self-reported questionnaire were usedRESULTS: The prevalence of anxiety and depression among the respondents was 93.4% (CI = 91.2-95.2) and 64.3% (CI = 60.4-68.4) respectively. Among the health workers, the prevalence of anxiety and depression were 96.5% (CI =94.8-98.1) and 66.5% (CI = 60.5-69.8) respectively while the prevalence of anxiety and depressive symptoms among non- health workers were 84.6% (CI = 78.7-90.1) and 61.5% (CI = 54.2-69.4) respectively. The odds ratio (OR) of depressive symptoms was increased among, respondents who were not satisfied with the support they received from the government during the pandemic (AOR = 2.071, CI = 1.350-2.213), respondents that were 35 years and younger (AOR = 1.512, CI = 1.033-2.213) and reduced amongst Christians (AOR = 0.501, CI = 0.286-0.879). The odd of anxiety was increased among health workers compared to non-health workers (AOR = 3.700, CI = 1.744-7.851) and the odds of anxiety was reduced among respondents with previous history of mental illness (AOR = 0.215, CI = 0.049-0.943CONCLUSION: Anxiety and depressive symptoms were common mental illness among essential workers working during the COVID-19 lockdown, therefore their mental health should be adequately considered to sustain the fight against the virus <![CDATA[<b>Exploring burnout among psychiatric trainees at a South African university</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100021&lng=pt&nrm=iso&tlng=pt BACKGROUND: The mental health of doctors is increasingly topical, internationally and locally. Of importance is the phenomenon of burnout, a far-reaching repercussion of chronic work-related stress. Psychiatrists are more vulnerable to stress, burnout and suicide in comparison with other medical specialities. There is a void in published research relating to South African psychiatric traineesAIM: The study aimed to investigate burnout and associated factors among psychiatric registrars at a South African universitySETTING: Department of Psychiatry at the University of the WitwatersrandMETHODS: This was a cross-sectional study via an anonymous self-administered questionnaire. The questionnaire comprised three sections: demographics; the Maslach Burnout Inventory Human Services Survey (MBI-HSS) and questions relating to contributing factors, protective factors and consequences of burnout. The MBI-HSS is recognised as the leading measure of burnout, consisting of three subscales: emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PARESULTS: The questionnaire was completed by 33 out of 55 psychiatric registrars (60.0% response rate). Data from 31 registrars were used in the analyses, as two registrars did not provide informed consent. Among participants, EE was the most commonly affected, followed by DP and lastly PA. The majority (67.8% or n = 21) had scores in the high category for any one of the three subscales (EE/DP/PA). Significant factors associated with burnout included poor work and non-professional life balance (p = 0.017), utilising annual leave days for work-related tasks (p < 0.001), irregular holidays (p = 0.003) and financial debt (p = 0.026). A possible protective factor was an amicable relationship with fellow psychiatric registrarsCONCLUSION: There is evidence of some degree of burnout in more than two-thirds of participants. Associated factors lie largely at an organisational level, and while optimising individual resilience is important, systemic support plays a key role <![CDATA[<b>Prevalence of depressive symptoms and quality of life among patients with diabetes mellitus with and without HIV infection: A South African study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100022&lng=pt&nrm=iso&tlng=pt BACKGROUND: Diabetes mellitus (DM) and human immunodeficiency virus (HIV) infection are both associated with increased risk of mood disorders and poorer quality of life (QOL). This association has not been explored in patients living with comorbid DM and HIVAIM: To describe the prevalence of depressive symptoms and impact on the QOL in patients with DM living with and without HIV attending a public sector hospital in South AfricaSETTING: A medical outpatient clinic at a state regional hospitalMETHODS: A cross-sectional questionnaire pilot survey was conducted amongst 101 patients with DM attending a specialist medical outpatient service. The assessment was conducted using a structured socio-demographic and clinical questionnaire, the patient health questionnaire 9 (PHQ-9) for depressive symptoms and the World Health Organization QOL scale. The HIV status was confirmed from the clinical records. The correlates of depressive symptomatology in the participants with DM living with and without HIV were identified using t-testsRESULTS: The prevalence of depressive symptoms in the participants with DM was 36%. Moderate to severe depression was associated with female gender (p = 0.03) and low educational level (p = 0.02) but not with HIV comorbidity or clinical characteristics of DM. The QOL was influenced by moderate to severe depressive symptoms (QOL in physical p < 0.218 and environmental p < 0.001 domains), but not HIV status (p = 0.218CONCLUSION: A substantial proportion of people with DM reported depressive symptoms, which is slightly higher than the average reported in other out-patient studies. The association of depression with poor QOL highlights the need for integrated mental health access in medical outpatient services. The lack of association between comorbid HIV status and DM with depression or QOL needs to be further explored <![CDATA[<b>The prevalence of depression and its associated factors among patients with diabetes mellitus attending a tertiary clinic in Gaborone, Botswana</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100023&lng=pt&nrm=iso&tlng=pt BACKGROUND: Depression is one of the commonest co-existing medical conditions among patients with diabetes mellitus (DM). A bidirectional relationship between depression and DM exists, complicating glycaemic control leading to an increase in diabetic complications. There is a dearth of information regarding the prevalence of depression and associated factors among patients with DM in BotswanaAIM: This study aimed to determine the prevalence of depression and associated factors among patients with DM. The study also assessed the association between depression and glycaemic controlSETTING: A tertiary diabetic referral clinic in Gaborone, BotswanaMETHOD: A sample of 260 randomly selected patients with DM was recruited in this cross-sectional study. Socio-demographic and clinical characteristics of the patients were collected using a case report form. Depression was evaluated using the Patient Health Questionnaire (PHQ)-9 scale. Multivariate regression analysis was used to determine factors significantly associated with depressionRESULTS: The mean age (standard deviation [s.d.]) of study participants was 58.4 (11.8) years, and the majority, 160/260 (61.5%), were females. The prevalence of depression was 30.4% and significantly associated with female sex (adjusted odds ratio [AOR] = 5.529, p-value = 0.004), three or more diabetes-related hospitalisations (AOR = 3.886, p-value = 0.049) and inversely associated with systolic blood pressure (SBP) ≥ 140 mmHg (AOR = 0.11, p-value = 0.001CONCLUSION: Depression is a common problem among patients with DM in our setting. Routine screening of depression in diabetic patients to enable early detection and treatment is recommended <![CDATA[<b>Evaluating the efficacy of an online depression screening tool in South Africa: A pilot study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100024&lng=pt&nrm=iso&tlng=pt BACKGROUND: A global increase of 16% in depression rates from 1990 to 2019 highlights the alarming situation in relation to increase in depression. Research has indicated that this rate is likely to increase as a result of the coronavirus disease 2019 (COVID-19) pandemic. In South Africa, the depression life-time prevalence rate is 9.47%. However, the lack of access to mental healthcare services leads to people not receiving much needed information and care. The growing accessibility to the Internet for South Africans offers a solution for the screening and access to self-help information for depression. The Center for Epidemiologic Studies Depression Scale (CESD)-R was adapted for online usage and a website, mddsa.co.za, was piloted in this regardAIM: This study reports on the efficacy of the online adapted CESD-R for use in South Africa by reporting on the reliability and criterion validity as well as the user friendliness of the website and the appropriateness of the instant feedback providedSETTING: The study was conducted in South Africa during COVID lockdown level 1 and 2METHODS: This study followed a quantitative, cross-sectional research design. A convenience sample of 21 individuals, above the age of 18, with a depression diagnosis and 86 individuals with no mental health diagnosis participated in the study. Participants accessed the screening instrument online at the websiteRESULTS: Internal consistency reliability coefficients exceeded 0.80. T-test and sensitivity and specificity results attested to the accuracy of the tool. All items contributed well to the instrument, including the items that were culturally specific to South Africa. Feedback from participants indicated that the tool was easily comprehensible, the website was user friendly and the instant feedback provided was appropriateCONCLUSION: The online adapted CESD-R evidenced excellent reliability and criterion validity and was able to accurately screen for depression amongst South Africans. The website and the tool have the potential to be utilised to increase access to a screening instrument for individuals who display symptoms of depression and to enhance the opportunity for individuals to practise self-help <![CDATA[<b>Second victims of obstetric care - Support for healthcare professionals in KwaZulu-Natal, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100025&lng=pt&nrm=iso&tlng=pt BACKGROUND: A global increase of 16% in depression rates from 1990 to 2019 highlights the alarming situation in relation to increase in depression. Research has indicated that this rate is likely to increase as a result of the coronavirus disease 2019 (COVID-19) pandemic. In South Africa, the depression life-time prevalence rate is 9.47%. However, the lack of access to mental healthcare services leads to people not receiving much needed information and care. The growing accessibility to the Internet for South Africans offers a solution for the screening and access to self-help information for depression. The Center for Epidemiologic Studies Depression Scale (CESD)-R was adapted for online usage and a website, mddsa.co.za, was piloted in this regardAIM: This study reports on the efficacy of the online adapted CESD-R for use in South Africa by reporting on the reliability and criterion validity as well as the user friendliness of the website and the appropriateness of the instant feedback providedSETTING: The study was conducted in South Africa during COVID lockdown level 1 and 2METHODS: This study followed a quantitative, cross-sectional research design. A convenience sample of 21 individuals, above the age of 18, with a depression diagnosis and 86 individuals with no mental health diagnosis participated in the study. Participants accessed the screening instrument online at the websiteRESULTS: Internal consistency reliability coefficients exceeded 0.80. T-test and sensitivity and specificity results attested to the accuracy of the tool. All items contributed well to the instrument, including the items that were culturally specific to South Africa. Feedback from participants indicated that the tool was easily comprehensible, the website was user friendly and the instant feedback provided was appropriateCONCLUSION: The online adapted CESD-R evidenced excellent reliability and criterion validity and was able to accurately screen for depression amongst South Africans. The website and the tool have the potential to be utilised to increase access to a screening instrument for individuals who display symptoms of depression and to enhance the opportunity for individuals to practise self-help <![CDATA[<b>Developing a healthcare worker psychological preparedness support programme for the COVID-19 outbreak</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100026&lng=pt&nrm=iso&tlng=pt BACKGROUND: The coronavirus disease 2019 (COVID-19) outbreak caused worldwide disruptions to healthcare systems. The emerging evidence indicates that mental health problems have consequently become an occupational hazard in frontline healthcare workers. AIM: We aimed to develop a psychological preparedness training (PPT) programme to support frontline health workers in three resource-limited hospitals in South Africa dealing with the COVID-19 outbreak and to evaluate its effectiveness using an audit tool. We established a theoretical framework and goals for a psychological preparedness programme to support healthcare workers at the study sites. SETTING: Data were collected at the Dora Nginza Hospital, Nelson Mandela Academic Hospital and Elizabeth Donkin Hospital. METHODS: We employed an observational, descriptive, and cross-sectional design. A group psychological intervention was developed and implemented at the three sites in South Africa, from mid-April 2020 over 20 weeks. We collected data using an audit tool to measure healthcare workers' perceptions of the outbreak before and after the intervention. We analysed the data to test for a statistically significant difference between the pre-intervention and post-intervention audit tools. RESULTS: We supported 761 healthcare workers during the 20 weeks of the programme. Statistical analysis showed a significant positive change from pre- to post-intervention measures in perceptions of health worker about the outbreak, their anxiety associated with the outbreak, their ability to control reactions to stress and the perception of their ability to support others. Feedback comments indicated that the programme was beneficial for the majority of those who attended. CONCLUSION: Health workers who attended the programme reported improvement in stress levels and in perceptions about their ability to cope with the outbreak, as well as in their perceptions of being able to support others. <![CDATA[<b>Job satisfaction, personality traits, and its impact on motivation among mental health workers</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100027&lng=pt&nrm=iso&tlng=pt BACKGROUND: Working in a resource setting that caters to people's poor mental health is associated with increased vulnerability to physical, psychological, and social stressors that make motivation to work a difficult goal to attain. One way of viewing physical and social stressors in the workplace is to evaluate job satisfaction which has both intrinsic and extrinsic components. The personality of workers is a component of psychological wellbeing and this determines the way events and situations are perceived. Thus, the achievement of the mission and vision of an organisation will be dependent on the level of motivation of the employees which will be influenced by their predominant personality traits and the level of satisfaction at work. AIM: My study aimed to sought to highlight the relationship between motivation, job satisfaction and personality dimensions. SETTING: The Neuropsychiatric Hospital, Aro, Abeokuta, Ogun State, Nigeria. METHODS: Our study involved a cross-sectional study of staff showing the relationship between motivation, job satisfaction and personality traits among mental health workers. A total of 146 participants using systematic proportional sampling were analysed with a response rate of 67.3%. A Socio-demographic Questionnaire, Minnesota Satisfaction Questionnaire (Short Version), Big Five Inventory and the Multidimensional Work-Motivation Scale were administered to the participants. In the analysis, linear correlation and linear regression were used to determine the relationship between continuous variables (Normality was determined using kurtosis and skewness) while t-test was used to determine the relationship between categorical independent variables and continuous dependent variables RESULTS: The level of significance was set at < 0.05 while higher scores using the Multidimensional Work-Motivation Scale represented motivated participants and vis-a-vis. The socio-demographic variable was explored using descriptive statistics; the relationship between personality, job satisfaction and motivation were explored using t-test. Most of the participants were married (80.8%), female (60.3%), with at least tertiary education (63%) and with an occupational status of class I (76%). The mean age of the participants was 40.29 ± 8.27 with a mean length of service of 13.63 ± 8.49. The most dominant personality traits were agreeableness (97.3%) and conscientiousness (97.3%), and the least was neuroticism (55.5). High agreeableness (0.01), high conscientiousness (0.03), and high openness (0.01) were significant and positively correlated with motivation. The relationship between motivation and gender (t = 4.26; p ≤ 0.001) and occupational status were statistically significant (t = -3.59; p ≤ 0.001). CONCLUSION: To proffer a solution to poor motivation in the workplace, human resource department should give more focus to individuals with high scores in agreeableness, conscientiousness, and openness. This is because it appears that they are more likely to be motivated at work and likely to move the organisation to a greater height. Besides, those with high neurotic scores who have already been employed will require some form of psychological remodelling (therapy), so they can contribute meaningfully to the institution. <![CDATA[<b>Community mental health literacy in Tshwane region 1: A quantitative study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100028&lng=pt&nrm=iso&tlng=pt BACKGROUND: Although mental health literacy is a major determining factor of mental health outcomes and functional capacity of individuals, there is dearth of research on the issue in South Africa AIM: To assess the literacy of three mental disorders, namely major depressive disorder (MDD), schizophrenia and generalised anxiety disorder (GAD) and to compare the resultant assumed literacy level between urban and townships participants SETTING: Five clinics of region 1 in Tshwane, South Africa METHOD: A cross-sectional descriptive study was performed between November 2019 and January 2020. A total of 385 questionnaires were distributed equally in all five clinics. By means of questions about three fictive cases with clinical pictures indicative of MDD, schizophrenia and GAD the following were assessed: recognising a mental disorder, identifying the cause and knowledge about what would help best RESULTS: The majority of participants (67.3%) recognised the clinical picture indicative of schizophrenia as a mental disorder, almost half of the participants (49.9%) recognised the clinical picture indicative of MDD as a mental disorder, whilst just more than one third (36.3%) of participants recognised the clinical picture GAD as a mental disorder. Concerning the causes for the clinical pictures, most participants indicated that stress was the cause for MDD and GAD (77.4% and 68.1%, respectively), whilst indicating that biological or psychological (59.5%) causes are relevant to the clinical picture indicative of schizophrenia symptoms. Fewer participants indicated supernatural causes for any of the clinical case (MDD: 2.6%; schizophrenia 15.3%; GAD 4.2%). Most participants chose professional help as the best option for all three cases (MDD 81.3%, schizophrenia 82.2%, GAD 66.1%). The indicators for health literacy in this study show that urban participants had better knowledge than township participants across all questions about the cases CONCLUSION: Overall, the study indicated a variable knowledge regarding the three mental disorders in region 1 of Tshwane and variable literacy levels in townships compared with urban settings. The results indicate that awareness campaigns should focus on the deficient areas <![CDATA[<b>Feasibility and acceptability of a mental health stigma intervention for low-income South African caregivers: A qualitative investigation</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100029&lng=pt&nrm=iso&tlng=pt BACKGROUND: Common mental health illnesses such as depression and anxiety disorders are increasing globally. There remain significant gaps in health services provision and support for mental illness linked to stigma in developing countries. AIM: Our study aimed to assess the feasibility and acceptability of a mental health intervention for caregivers of mental health service users. SETTING: Low-income South African communities. METHOD: Our study qualitatively assessed the feasibility of an anti-stigma mental health intervention for family caregivers in low-income settings. The intervention was structured into five sessions delivered over three days. Caregivers attended all the sessions at a centralised community venue. Semi-structured qualitative interviews were held separately with caregivers (n = 10) and their service users (n = 9) eight weeks post-intervention. Interviews were translated verbatim from local languages to English prior to framework analysis RESULTS: Post-intervention, service users reported improved family relations and understanding of mental illness among family members. The intervention was reported as acceptable and helpful by caregivers as it increased knowledge, fostering better relationships with service users. Group discussions were noted as a critical driver of intervention success. Widespread mental health stigma within communities remained a key concern for caregivers and service users. CONCLUSION: With the government's drive for deinstitutionalisation, the need to integrate anti-stigma interventions within community mental health services is vital, as is the need for population-wide anti-stigma interventions to support the integration of mental health service users within communities. <![CDATA[<b>Depression and quality of life among pregnant women in first and third trimesters in Abeokuta: A comparative study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100030&lng=pt&nrm=iso&tlng=pt BACKGROUND: Pregnancy is a dynamic time during which a woman's emotional state may undergo extensive change. There have been conflicting views about the magnitude of emotional turmoil that occurs during pregnancy. Some investigators suggest that pregnancy is a time of particularly good psychological adjustment; others have reported high levels of psychological challenge. AIM: Our study aimed to compare the prevalence and correlates of depression in the first and third trimesters of pregnancy and to determine the relationship between quality of life and depressive disorder SETTING: The antenatal clinic of the State Hospital, Ijaiye.. METHOD: A descriptive, comparative study of depressive disorder and the quality of life between first- and third-trimester pregnant women (confirmed through a pregnancy test and an abdominopelvic ultrasound. RESULT: For each trimester, 285 participants were recruited. The prevalence of depression among the pregnant women who participated in the study was 7.2%. In the first trimester of pregnancy, the prevalence of depression was 30 (10.5%), while it was 11 (3.9%) in the third trimester of pregnancy. Collectively, the relationship between depression and QoL was significant in the overall domain, satisfaction with general health domain (t = 2.27; p = 0.03), psychological domain (t = 2.74; p = 0.010, and environmental domain (t = 4.57; p ≤ 0.01 CONCLUSION: Our study also highlights the need to pay closer attention to the psychological well-being and quality of life of all pregnant women and not just on their physical health and the baby's well-being. <![CDATA[<b>Cyberbullying perpetration and victimisation amongst adolescent psychiatric patients at Lentegeur Hospital, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100031&lng=pt&nrm=iso&tlng=pt BACKGROUND: Cyberbullying is a type of harassment that is perpetrated or experienced by a person or groups of persons via the use of electronic devices, and it frequently occurs amongst young people. Research has shown that cyberbullying is associated with psychiatric comorbidity, which could indicate a need for screening adolescents who present for mental health services. AIM: This study aimed to determine the prevalence of cyberbullying amongst adolescents. The secondary aim was to determine the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 psychiatric diagnoses associated with cyberbullying. SETTING: Lentegeur Hospital Child and Adolescent Mental Health Service in the Western Cape, South Africa. METHODS: This cross-sectional study included a convenience sample of 97 participants (sampled from both inpatient and outpatient services) between the ages of 13 years and 18 years. Adolescent assent and parental consent were obtained. Demographic and clinical data were collected from patient folders, and the Revised Cyber Bullying Inventory II was used to assess cyberbullying behaviours. RESULTS: The overall prevalence rate of some form of cyberbullying in this sample was 56.7%, of which 6.2% were cyberbullies, 20.6% were cyber-victims and 29.9% were cyberbullies and cyber-victims. Female participants were more likely to be involved in cyberbullying than males. The most prevalent primary psychiatric diagnoses in adolescents involved in cyberbullying included major depressive disorder (72.4%), schizophrenia (57.1%) and attention deficit hyperactivity disorder (22%). There was no significant association between cyberbullying and any psychiatric diagnoses. CONCLUSION: The high prevalence rate of adolescents involved in cyberbullying suggests that this behaviour is a cause for concern in the South African population. More screening and treatment programmes should be implemented to address this issue. <![CDATA[<b>Differences in alcohol and cannabis use amongst substance use disorder patients with and without comorbid attention-deficit/hyperactivity disorder</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100032&lng=pt&nrm=iso&tlng=pt BACKGROUND: Substance use disorders (SUDs) continue to be a public health problem. Attention-deficit/hyperactivity disorder (ADHD) is seen as a risk factor for SUD. Prevalence of alcohol and cannabis use amongst adults with SUD and comorbid ADHD impacts both disorders cognitively and behaviourally. AIM: Our study aimed to compare alcohol and cannabis use between treatment-seeking SUD patients with ADHD and SUD patients without ADHD symptomatology. SETTING: Various rehabilitation centres, including the South African National Council on Alcoholism and Drug Dependence (SANCA) Centres, and Private and Provincial Government Substance Abuse Treatment Centres. METHODS: A cross-sectional study of adults on drug rehabilitation was conducted. Data on socio-demographic information and alcohol and cannabis use from 185 post-detox inpatients were collected. Diagnoses were based on DSM-IV criteria. Attention-deficit/hyperactivity disorder diagnosis was confirmed by the Diagnostic-Interview for ADHD in Adults (DIVA 2.0). SUD+ADHD (n = 52) and SUD-ADHD (n = 128) groups were compared on alcohol and cannabis use as a function of gender. RESULTS: No significant differences in the use of alcohol between the SUD+ADHD and SUD-ADHD groups were found. However, the SUD+ADHD group showed increased cannabis consumption. Especially, the SUD+ADHD females showed an earlier age of onset of cannabis use than the SUD-ADHD females and revealed that they use cannabis for a longer period compared with the SUD-ADHD females and SUD+ADHD and SUD-ADHD males. CONCLUSION: The results revealed the relationship between ADHD and cannabis use, especially amongst females with ADHD and reinforce the need to consider ADHD in cannabis use SUD in clinical interventions. <![CDATA[<b>Case study: New onset of neuropsychiatric symptoms following switching to a dolutegravir regimen</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2078-67862022000100033&lng=pt&nrm=iso&tlng=pt Although reports of neuropsychiatric side effects have been reported with efavirenz, these have been limited in comparison with regard to the now recommended dolutegravir regimens. We present a patient with new onset neuropsychiatric manifestations secondary to dolutegravir that resulted in significant physical injuries. The patient was initiated on risperidone for symptomatic control which was subsequently weaned and discontinued following reverting to an original efavirenz antiretroviral regimen, with resolution of neuropsychiatric symptoms. Neuropsychiatric side effects are increasingly noted with dolutegravir, and these should be monitored for on initiation and switching of treatment regimens.