Academic literature on the topic 'Depression in adolescence - Research - South Africa'

Abstract Introduction As a leading global disease risk factor, cigarette smoking has declined in some developed countries, but its health consequences are not well established in sub-Saharan Africa. This is particularly evident in South Africa, where few investigations have quantified the dually neglected challenges of cigarette smoking and depression, despite decades of research from developed countries. We investigated the association between cigarette smoking and incident depression, with the hypothesis that adolescents are particularly vulnerable. Methods Panel data from the South African National Income Dynamics Study, a nationally representative sample of households at follow-up periods (years 2008–2015), were used. Our incident cohort consists of 14 118 adult participants who were depression free at baseline. The generalized estimating equation models were fitted to assess the association between current cigarette smoking and incident depression. Results Current cigarette smoking among individuals aged at least 15 was significantly associated with incidents of depression among men (adjusted relative risk [aRR] = 1.16, 95% CI = 1.01 to 1.34), but not women. When the analyses were restricted to a sample population of older adolescents (ages 15–19), current cigarettes smoking was significantly associated with incident depression in both men (aRR = 1.84, 95% CI = 1.18 to 2.88) and women (aRR = 2.47, 95% CI = 1.15 to 5.29). Conclusion The results suggest an important relationship between cigarette smoking and incident depression, particularly among older adolescents, who are developmentally vulnerable and socioeconomically disadvantaged to experiencing depression. There is a considerable need to implement and prioritize culturally and developmentally appropriate prevention and cessation measures to reduce cigarette smoking and depression directed at adolescent populations. Implications There has been little population level research into the role of smoking on depression in sub-Saharan Africa, a region classified as a tobacco epidemic in the making. Our results have major implications for the often neglected crosscutting issues of tobacco control (Sustainable Development Goal 3.9) and mental health (Sustainable Development Goal 3.4). They indicate the role of smoking on depression, with the association being particularly pronounced among adolescent who are developmentally vulnerable and socioeconomically disadvantaged, and emphasize the need to implement and prioritize prevention and cessation measures directed at this population.

Background. Maternal depression is a major public health concern as it affects both mothers and their children. Antenatal depression, which is often underdiagnosed, has been associated with preterm labour, low birth weight, and intrauterine growth restriction. Research has demonstrated that postpartum depression is associated with mother-infant bonding impairment, child abuse, child neglect, maternal substance abuse, and self-harm. Globally, the prevalence of depression in pregnant and postpartum adolescents varies. This paper reports on the findings of the prevalence of depression and its associated risk factors among pregnant and postpartum adolescents in KwaZulu-Natal, South Africa. Methods. Data were generated by means of a descriptive cross-sectional study that was conducted between June and November 2017 utilizing a sample of 326 adolescent females accessing maternal health services in a medium-sized rural peripheral district hospital in Ugu, Southern KwaZulu-Natal. The Edinburgh Postnatal Depression Scale questionnaire was used to screen participating pregnant and postnatal adolescents for depression. A cut-off score of ≥13 was used to identify pregnant and postnatal adolescents with symptoms of depression. The data were analysed using R software. Results. The prevalence of depression among the pregnant participants was 15.9% (21/132), whereas it was 8.8% (17/194) among the postpartum participants. Antenatal depression was associated with physical violence (adjusted odds ratio (aOR) 6.47, 95% CI 1.36-30.53, p=0.01) and verbal abuse (adjusted odds ratio (aOR) 4.8, 95% CI 1.5-15.16, p=0.006). The pregnant participants who indicated they received a lot of support from their partners were 0.93% less likely to have depression. Postnatal depression was associated with physical violence (adjusted odds ratio (aOR) 7.32, 95% CI 1.66-29.44, p=0.005), verbal abuse (adjusted odds ratio (aOR) 4.3, 95% CI 1.03-15.79, p=0.03), and intimate partner violence (adjusted odds ratio (aOR) 9.58, 95% CI 1.58-48.82, p=0.008). Conclusion. The prevalence of antenatal depression was higher than postpartum depression in the study sample. In light of the findings, maternal healthcare professionals are cautioned to consider the mental health of pregnant and postpartum adolescents who seek their services at health facilities.

SETTING: Treatment tolerability among adolescents diagnosed with multidrug-resistant tuberculosis (MDR-TB) is underexplored. We present qualitative study data from adolescents participating in an observational cohort in the Western Cape, South Africa.OBJECTIVE: To elicit adolescent experiences of MDR-TB diagnosis and treatment with qualitative body-mapping activities and discussions.DESIGN: Adolescents in an observational MDR-TB cohort received routine toxicity and audiology screenings from clinicians. We enrolled eight participants (age 10–16 years) to participate in additional body-mapping activities and in-depth interviews. A thematic deductive analysis was conducted. We present a comparison of the clinical assessments and qualitative discussions.RESULTS: Adolescent participants reported few adverse effects on standard toxicity and audiology reports. Only nausea and vomiting were reported in >10% of cases, all of which were grade 1 (causing no/minimal interference) adverse effects (AEs). However, when comparing toxicity reports with qualitative body-mapping activities and interviews, we found previously unreported AEs (neurosensory alteration, neuromuscular weakness, pain); underestimated severity of AEs (nausea, itching); and missed psychosocial symptoms (signs of depression).CONCLUSION: Adolescents receiving treatment for MDR-TB experienced treatment-related AEs that were not reported during routine clinical assessments. Psychosocial experiences of adolescents are not taken into account. More research is needed to understand the experiences of this vulnerable group. We recommend that drug safety monitoring be adapted to include more creative and patient-driven reporting mechanisms for vulnerable groups, including children

The Revised Children’s Manifest Anxiety Scale (RCMAS) is regularly used with South African children, although its performance in this context has yet to be empirically evaluated. This study assessed the basic psychometric properties of the RCMAS using data collected in a large study examining the mental health of children and adolescents living in poor urban communities around Cape Town. Reliability of the full-scale was good, and the predicted relationships between anxiety, depression, PTSD, delinquency, age, sex, and somaticism scores offered evidence of construct validity. However, the reliabilities for the physiological, worry/oversensitivity, and concentration subscales were low, and confirmatory factor analysis revealed the hypothesized three-factor model did not adequately fit the data. Exploratory analyses suggested a four-factor solution consisting of social evaluation, worry, affective responses, and physiological symptoms/sleep disturbance factors. Further confirmatory research examining this four-factor structure is needed. Given the continued use of the RCMAS in South Africa, these findings provide an important first step in establishing its reliability and validity for use with South African youth; however, scores obtained on the three subscales should be interpreted with caution and further detailed psychometric evaluation of the RCMAS in South African samples is clearly required.

With an increasing number of studies showing a rise in adolescent suicidal behaviour and a wealth of literature concerning adolescent coping strategies, this study examined both these issues within a South African context. The interplay between social, political, and economic factors in South Africa, with its history of apartheid, must impact upon the lives of adolescents living in this country and play a role in stress, depression, and feelings of hopelessness, helplessness, and possible suicidal ideation. The objectives of the study were to determine the coping strategies exhibited by a South African sample of adolescents, the relationship between these coping strategies and suicidal ideation, and to investigate whether gender had any influence on this relationship. This study therefore aimed to get a better understanding of the relationship between the variables: suicidal ideation, coping strategy, and gender. Such research is important in learning to understand how adolescents cope, in order for caregivers and professionals in the field to be able to identify potential suicide ideators through their behaviours and coping strategies. A sample of 161 adolescents in grade eleven completed a demographic questionnaire, the Positive and Negative Suicidal Ideation Scale (PANSI), and The Coping Across Situations Questionnaire (CASQ). The findings indicated the majority of the sample (51 %) had a positive outlook on life, feeling optimistic about the future most or a good part of the time. Further results showed that males and females followed the same pattern of coping by scoring highest on the functional coping strategies and lowest on the dysfunctional one. There was a significant difference between males and females on each coping strategy, with females scoring higher than males in each case. Correlation studies indicated a positive significant relationship between active coping (functional coping strategy) and positive suicidal ideation scores (positive outlook on life) and between withdrawal (dysfunctional coping strategy) and negative suicidal ideation scores (negative outlook on life). Results for each gender differed, with the female sub-sample revealing significant correlations between functional coping strategies and positive suicidal ideation scores, while the only significant correlation found within the male sub-sample was between the dysfunctional coping strategy and negative suicidal ideation scores.

List of abstacts and authors:1. Integrating the art and science of psychiatryEugene Allers2. Chronic pain as a predictor of outcome in an inpatient Psychiatric populationEugene Allers and Gerhard Grundling3. Recent advances in social phobiaChrister Allgulander4. Clinical management of patients with anxiety disordersChrister Allgulander5. Do elephants suffer from Schizophrenia? (Or do the Schizophrenias represent a disorder of self consciousness?) A Southern African perspectiveSean Exner Baumann6. Long term maintenance treatment of Bipolar Disorder: Preventing relapseCharles L. Bowden7. Predictors of response to treatments for Bipolar DisorderCharles L. Bowden8. Aids/HIV knowledge and high risk behaviour: A Geo-graphical comparison in a schizophrenia populationP Buckley, S van Vuuren, L Koen, J E Muller, C Seller, H Lategan, D J H Niehaus9. Does Marijuana make you go mad?David J Castle10. Understanding and management of Treatment Resistant SchizophreniaDavid J Castle11. Workshop on research and publishingDavid J Castle12. From victim to victor: Without a self-help bookBeatrix Jacqueline Coetzee13. The evaluation of the Gender Dysphoric patientFranco Colin14. Dissociation: A South African modelA M Dikobe, C K Mataboge, L M Motlana, B F Sokudela, C Kruger15. Designated smoking rooms...and other "Secret sins" of psychiatry: Tobacco cessation approaches in the severely mentally illCharl Els16. Dual diagnosis: Implications for treatment and prognosisCharl Els17. Body weight, glucose metabolism and the new generation antipsychoticsRobin Emsley18. Neurological abnormalities in first episode Schizophrenia: Temporal stability and clinical and outcome correlatesRobin Emsley, H Jadri Turner, Piet P Oosthuizen, Jonathan Carr19. Mythology of depressive illnesses among AfricansSenathi Fisha20. Substance use and High school dropoutAlan J. Flisher, Lorraine Townsend, Perpetual Chikobvu, Carl Lombard, Gary King21. Psychosis and Psychotic disordersA E Gangat 22. Vulnerability of individuals in a family system to develop a psychiatric disorderGerhard Grundling and Eugene Allers23. What does it Uberhaupt mean to "Integrate"?Jürgen Harms24. Research issues in South African child and adolescent psychiatryS M Hawkridge25. New religious movements and psychiatry: The Good NewsV H Hitzeroth26. The pregnant heroin addict: Integrating theory and practice in the development and provision of a service for this client groupV H Hitzeroth, L Kramer27. Autism spectrum disorderErick Hollander28. Recent advances and management in treatment resistanceEric Hollander29. Bipolar mixed statesM. Leigh Janet30. Profile of acute psychiatric inpatients tested for HIV - Helen Jospeh Hospital, JohannesburgA B R Janse van Rensburg31. ADHD - Using the art of film-making as an education mediumShabeer Ahmed Jeeva32. Treatment of adult ADHD co-morbiditiesShabeer Ahmed Jeeva33. Needs and services at ward one, Valkenberg HospitalDr J. A. Joska, Prof. A.J. Flisher34. Unanswered questions in the adequate treatment of depressionModerator: Dr Andre F JoubertExpert: Prof. Tony Hale35. Unanswered questions in treatment resistant depressionModerator: Dr Andre F JoubertExpert: Prof. Sidney Kennedy36. Are mentally ill people dangerous?Sen Z Kaliski37. The child custody circusSean Z. Kaliski38. The appropriatenes of certification of patients to psychiatric hospitalsV. N. Khanyile39. HIV/Aids Psychosocial responses and ethical dilemmasFred Kigozi40. Sex and PsychiatryB Levinson41. Violence and abuse in psychiatric in-patient institutions: A South African perspectiveMarilyn Lucas, John Weinkoove, Dean Stevenson42. Public health sector expenditure for mental health - A baseline study for South AfricaE N Madela-Mntla43. HIV in South Africa: Depression and CD4 countM Y H Moosa, F Y Jeenah44. Clinical strategies in dealing with treatment resistant schizophreniaPiet Oosthuizen, Dana Niehaus, Liezl Koen45. Buprenorphine/Naloxone maintenance in office practice: 18 months and 170 patients after the American releaseTed Parran Jr, Chris Adelman46. Integration of Pharmacotherapy for Opioid dependence into general psychiatric practice: Naltrexone, Methadone and Buprenorphine/ NaloxoneTed Parran47. Our African understanding of individulalism and communitarianismWillie Pienaar48. Healthy ageing and the prevention of DementiaFelix Potocnik, Susan van Rensburg, Christianne Bouwens49. Indigenous plants and methods used by traditional African healers for treatinf psychiatric patients in the Soutpansberg Area (Research was done in 1998)Ramovha Muvhango Rachel50. Symptom pattern & associated psychiatric disorders in subjects with possible & confirmed 22Q11 deletional syndromeJ.L. Roos, H.W. Pretorius, M. Karayiorgou51. Duration of antidepressant treatment: How long is long enough? How long is too longSteven P Roose52. A comparison study of early non-psychotic deviant behaviour in the first ten years of life, in Afrikaner patients with Schizophrenia, Schizo-affective disorder and Bipolar disorderMartin Scholtz, Melissa Janse van Rensburg, J. Louw Roos53. Treatment, treatment issues, and prevention of PTSD in women: An updateSoraya Seedat54. Fron neural networks to clinical practiceM Spitzer55. Opening keynote presentation: The art and science of PsychiatryM Spitzer56. The future of Pharmacotherapy for anxiety disordersDan J. Stein57. Neuropsychological deficits pre and post Electro Convulsive Therapy (ECT) thrice a week: A report of four casesUgash Subramaney, Yusuf Moosa58. Prevalence of and risk factors for Tradive Dyskinesia in a Xhosa population in the Eastern CapeDave Singler, Betty D. Patterson, Sandi Willows59. Eating disorders: Addictive disorders?Christopher Paul Szabo60. Ethical challenges and dilemmas of research in third world countriesGodfrey B. Tangwa61. The interface between Neurology and Psychiatry with specific focus on Somatoform dissociative disordersMichael Trimble62. Prevalence and correlates of depression and anxiety in doctors and teachersH Van der Bijl, P Oosthuizen63. Ingrid Jonker: A psychological analysisL. M. van der Merwe64. The strange world we live in, and the nature of the human subjectVasi van Deventer65. Art in psychiatry: Appendix or brain stem?C W van Staden66. Medical students on what "Soft skills" are about before and after curriculum reformC W van Staden, P M Joubert, A-M Bergh, G E Pickworth, W J Schurink, R R du Preez, J L Roos, C Kruger, S V Grey, B G Lindeque67. Attention deficit hyperactivity disorder (ADHD) - Medical management. Methylphenidate (Ritalin) or Atomoxetine (Strattera)Andre Venter68. A comprehensive guide to the treatment of adults with ADHDW J C Verbeeck69. Treatment of Insomnia: Stasis of the Art?G C Verster70. Are prisoners vulnerable research participants?Merryll Vorster71. Psychiatric disorders in the gymMerryl Vorster72. Ciprales: Effects on anxiety symptoms in Major Depressive DisorderBruce Lydiard

List of abstracts and authors:1. Comparative benefits of Atypical antipsychoticsDiana P Morrison2. Evidence-based management of depression in SchizophreniaAndre F Joubert3. Second generation Antipsychotics: An African updateDave Swingler4. The drug management of patients with HIV/Aids in the Mental Health Care setting: A therapeutic challengeDenise White5. New developments in the treatment of Bipolar depressionJospeh R Calabrese6. Dual action antidepressants: Faster onset, more remission, better value?Roger M Pinder7. Antisocial personality disorder: A reviewDonald W Black8. The South African study of stress and health: An overviewDavid R Williams9. Ugliness is in the eye of the beholder: Psychiatric apsects of body image disturbanceDavid Castle10. Over diagnosed or under recognized? Treating ADHDDora Wynchank11. The contagious effects of trauma and their impact on human service organisationsKerry Gibson12. Temporal lobe epilepsy in adolescence - 'Understanding the narrative'Helen Clark13. The effectiveness of treatment programs for Methaqualone (Mandrax) dependenceGreg McCarthy, Nandi Siegfried, Bronwyn Myers14. Community influence on alcohol and marijuanaAlan J Flisher, Robyn Mallett, Gary King, Neo Morojele, Martie Muller, Carl Lombard15. Psychiatric presentations of medical illnessSebastian Akalula16. Imaging of brain function using SpectJames Warwick17. Selected neuropsychological test performances and SSRI usageTheophilus Lazarus18. Comparative effectiveness and safety of antipsychotic treatments for outpatient SchizophreniaFrans Korb, Adel Sadak, Aly Akram, Sunar Birsoz, Abderrahmane Belaid19. Evidence-based mental healthcare - What do you know, think, feel?Nandi Siegfried, George Swingler, Soraya Seedat, Martie Muller, Rachel Churchill, Dan Stein20. Competitions Act - Anti-competitive health care practicesZ Nthakwana21. Unique approach to mental wellness by medical SchemesPetro Kempen22. What happens to my medical aid contribution?Eugene Allers23. Financial issues in a modern private practiceMike Edwards24. Transcranial magnetic stimulation: Uses in brain function research and medical interventionAlan St Clair Gibson25. The Neurochemistry of dreams: Implications for PsychiatryMark Solms26. Tenascin-R expression in the Central Nervvous system of lower vertebratesRuth Jarvis, N-. Hsu, P. Pesheva and D.M. Lang25. Localisation of the Nogo-A receptor in Neronal Lipid raftsEdward Nyatia, D.M. Lang26. Characterising an animal model for early life trauma using time dependent sensitisationJoachim D.K. Uys, Willie M.U. Daniels, Dan J. Stein27. Tolmetin affords protection against Quinoclinic acid induced Neurotoxixity in Rat brainAmichand Dairam, S Daya28. Acetaminophen and aspirin inhibit superoxide anion generation and Lipid Peroxidation, and protect against 1-Methyl-4Phenyl Pyridinim-induced Dopaminergic Neurotoxicity in ratsH. Maharaj, D.S. Maharaj, K. S. Saravanan, K.P. Mohanakumar, S. Daya29. Can exercise provide Neuroprotection in a rat model for Parkinson's disease?M Mabandla, L Kellaway, A St Clair Gibson, M Lambert, V Russell30. Treatment of rapid cycling Bipolar disorderJoseph R. Calabrese31. Depression as a Neurodegenerative Disorder: The need for achieving remissionRoger M Pinder32. Side-effects induced by modern antidepressants- Overview and managementFranco Colin33. The Placebo response in antidepressant clinical trialsRobin Emsley34. Impulse control disorders: An overviewDonald W. Black35. Post traumatic stress disorder: The Wits trauma clinic experienceUgash Subramaney36. Post traumatic stress disorder among recently diagnosed patients with HIV in South AfricaSoraya Seedat, Bo Olley, D J Stein37. Improving outcome in SchizophreniaDiana P Morrison38. Reviewing post Graduate trainingCliff W Allwood39. Ethics in HIV ResearchKeimanthro Moodley40. Improving and maintaining ethical standrads in Psychiatric researchTuviah Zabow=============================================================Posters: Neurosciences section (Presenting author only)1. Blunted Acth response correlates with altered Neurotransmitter function in maternally separatedratsW M U Daniels2. A mechanism for zinc toxicity in Neuroblastoma cellsW M U Daniels3. The effects of Hypericum Perforatum, Quercetin, and Fluoxetine on receptor densities in the Rat BrainL Heiderman4. Trichotillomania and obsessive-compulsive disorder: Clinical and genetic comparisons within a South African populationS M J Hemmings5. Expression of Nogo-A in the amphibian central nervous systemN. J. Hsu6. Biochemical model for inflammation of the brain: The role of iron, transferring and toxiferring in Lipid PeroxidationS J Van Rensburg7. Improvement in Alzheimer's disease patients with antioxidant supplementation over 15 monthsS J Van Rensburg8. The Placebo effect - Is it all in the mind?S J Van Rensburg9. Very low serum iron concentrations in elderly patients with active CarcinomaS J van Rensburg10. Melatonin affords protection against Rotenone-induced NeurotoxicityR John11. Effect of enriched environment on Ca uptake via NMDA receptors into barrel cortex slices of spontaneously HypertensiveratsM Lehohla12. Effects of Methylpenidate in a rat model for Attention Deficit Hyperactivity DisorderG. L. S. Lelaka13. 6-Hydroxymelatonin converts Fe (III) to Fe(II) and reduces iron-induced Lipid PeroxidationD S Maharaj14. Metrofinate Potentiates Quinolinic Acid and Potassium Cyanide induced NeurotoxicityA Ramsunder15. The effect of chronic Intra-Amylgdala CRF injections on rat behaviour and HPA-Axis functionL Richter16. Effect of Glutamate in the Prefrontal Cortex of a rat model for Attention-Deficit Hyperactivity DisorderV Russell17. An investigation into the relationship between Corticosterone and Neuron Cell deathP J Van Vuuren=============================================================41. Blunted Acth response correlates with altered Neurotransmitter function in maternally separated RatsW M U Daniels, C Y Pietersen, M E Carstens, D J Stein42. A mechanism for Zinc Toxicity in NeuroBlastoma CellsW M U Daniels, J Hendricks, R Salie, S J Van Rensburg43. The effects of Hypericum Perforatum, Quercetin and Fluoxetine on receptor densities in the rat brainL Heideman and S Daya44. Trichotillomania and obsessive-compulsive disorder: Clinical and genetic comparisons withn a South African populationS M J Hemmings, C J Kinnear, C Lochner, H Moolman-Smook, D J H Niehaus, V Corfield, D J Stein45. Expression of Nogo-A in the amphibian central nervous systemN. J. Hsu, R Jarvis, D. M. Lang46. Biochemical model for inflammation of the brain: The role of iron, transferring and Toxiferring in Lipid PeroxidationS J Van Rensburg, R T Erasmus, J M van Zyl, D Hon, W M U Daniels, F C V Potocnik, M J Kotze, N J De Villiers, P R Hurly47. Improvement in Alzheimer's Disease patients with antioxidant supplementation over 15 monthsS J van Rensburg, F C V Potocnik, J M Van Zyl, B J Van der Walt, D Hon, A Roos, E Rienhardt, R T Erasmus48. The Placebo effect - Is it all in the mind?S J van Rensburg, R A Emsley, C M Smuts, M Kidd, S Van der Merwe, C C Myburgh, P Oosthuizen, H Bleeker49. Very low serum Iron concentrations in elderly patients with active CarcinomaS J van Rensburg, R Erasmus, D Hon, C Bouwens50. Melatonin affords protection against Rotenone-induced NeurotoxicityR John, S Daya51. Effect of enriched environment on Ca uptake via NMDA Receptors into barrel Cortex slices of spontaneously Hypertensive ratsM Lehohla, V Russell, L Kellaway52. Effects of Methylpenidate in a rat model for Attention-Deficit Hyperactivity DisorderG. L. S. Lelaka, V. A. Russel, L. A. Kellaway53. 6-Hydroxymelatonin converts Fe (III) to Fe (II) and reduces iron-induced Lipid PeroxidationD S Maharaj, S Daya54. Metrofinate Potentiates Quinolinic Acid and Potassium Cyanide induced NeurotoxicityA Ramsunder, S Daya55. The effect of chronic Intra-Amygdala CRF injections on rat behaviour and HPA-Axis functionL Richter, W Daniels, D J Stein56. Effect of Glutamate in the Prefrontal Cortex of a rat model for Attention-Deficit Hyperactivity DisorderV Russell, M Lehohla, L Kellaway57. An investigation into the relationship between Corticosterone and Neuron cell deathP J Van Vuuren, J Hendricks, W M U Daniels=============================================================Posters: Psychiatry Section1. Descriptive study of Tardive Dyskinesia in a South African Xhosa populationS Brink2. Alcohol drinking problems at three urban High Schools in UmtataO Alonso Betancourt3. Childhood and adolescent sexual abuse - Demographic, traumatic and clinical signpostsP D Carey4. Inositol in the treatment of Obsessive Compulsive DisorderP D Carey5. A review of factors associated with Suicidal behaviour in children and adolescents admitted to Tygerberg HospitalT Du Plessis6. Psychological and physical outcomes fo elective abortion; Local Anaesthesia vs Intravenous SedationT Ericksen7. Mental health literacy of Human Resource Practitioners in South AfricaC J Hugo8. The importance of a specialized clinic for the care of patients with first episodes of psychosisN Keyter9. Self-report vs Urinary drug screening in Schizophrenia: A pilot studyL Koen10. The effect of aggression on the use of Psychotropics in Schizophrenia: A naturalistic studyH Lategan11. Factor analysis of obsessive-compulsive spectrum disorders in patients with obssessive-compulsive disorder: Clinical and Genetic correlatesC Lochner12. Experiences in obsessive-compulsive Disorder and Trichotillomania: Role of childhood traumaC Lochner13. Delusional systems in Xhosa Schizophrenia SibpairsJ E Muller14. OCD Heteogeneity reflected by lack of Genealogically determined founder effectD J H Niehaus15. The efficacy and tolerbaility of low-dose vs standard dose Haloperidol in first episode Psychosis. A randomised, double-blind studyP P Oosthuizen16. Treatment with low-dose Haloperidol does not protect against Tardive DyskinesiaP P Oosthuizen17. Do healthcare funders discriminate against members on the grounds of mental illness?O Scholtz18. Treatment strategies in patients with Clozaopine-resistant Schizophrenia at Stikland Hospital: A critical evaluation of one optionA Schulte19. Early coadministration of Clonazepam with Paroxetine for generalized social anxiety disorderS Seedat20. Trauma exposure and post-traumatic stress symptoms in adolescents: A schools' survey in Cape Town (South Africa) and Nairobi (Kenya)S Seedat21. The QTC effects of Thioridazine when used as a second line Anti-psychotic ( at Stikland Hospital)C Seller22. Brain imaging and substance related disordersD J Stein23. Gender differences in trauma exposure & post traumatic stress disorder in a clinic sampleS Suliman24. Assessing the prevalence of anxiety and depressive symptoms among clinica at Tygerbeg Academic Hospital and controlsH Van der Bijl25. Pharmacological challenge with a serotonin ID Agonist in alcohol dependenceB Vythilingum26. The treatment of ADHD in adultsW Verbeeck=============================================================58. Descriptive study of Tardive Dyskinesia in a South African Xhosa populationS Brink, D J H Niehaus, L Koen, J E Muller59. Alcohol drinking problems at three Urban High Schools in UmtataO Alonso Betancourt, M Morales Herrera60. Childhood and adolescent sexual abuse - Demographic, traumatic and clinical signpostsP D Carey, J Walker, S Seedat, D J Stein61. Inositol in the treatment of obsessive compulsive DisorderP D Carey, S Seedat, D J Stein62. A review of factors associated with suicidal behaviour in children and adolescents admitted to Tygerberg HospitalT Du Plessis, S M Hawkridge, F H Theron, S A Du Plessis63. Psychological and physical outcomes of elective abortion: Local anaestheisa vs Intravenous sedationT Ericksen, S Seedat, P Labuschagne, D J Stein64. Mental health literacy of Human resource practitioners in South AfricaC J Hugo, H D Vos, D J Stein65. The importance of a specialized clinic for the care of patients with first episodes of psychosisN Keyter, P P Oosthuizen, R A Emsley, H J Turner66. Self-reort vs urinary drug screening in Schizophrenia: A pilot studyL Koen, D J H Niehaus, J E Muller, C Seller, N Keyter67. The effect of aggression on the use of Psychotropics in Schizophrenia: A naturalistic studyH Lategan, L Koen, D J H Niehaus68. Factor analysis of obsessive-compulsive spectrum disorders in patients with obsessive-compulsive Disorder: Clinical and genetic correlatesC Lochner, D J H Niehaus, S M J Hemmings, C J Kinnear, V A Corfield, J C Moolman-Smook, D J Stein69. Experiences in obsessive-compulsive disorder and Trichotillomania: Role of childhood traumaC Lochner, S Seedat, P D Carey, D J Stein70. Delusional systems in Xhosa Schizophrenia SibpairsJ E Muller, D J H Niehaus, L Koen, C Seller, N Keyter, C Laurent, R A Emsley71. OCD Heteogeneity reflected by lack of Genealogically determined founder effectD J H Niehaus, L Endeman, I Bosman, S Hemmings, C Lochner, L Koen, H Moolman-Smook, V A Corfield, D J Stein72. The efficacy and tolerability of low-dose vs standard dose Haloperidol in first episode Psychosis. A randomised, double-blind studyP P Oosthuizen, R A Emsley, H J Turner, N Keyter73. Treatment with low-dose Haloperidol does not protect against Tardive DyskinesiaP P Oosthuizen, R A Emsley, H J Turner, N Keyter74. Do healthcare funders discriminate against members on the grounds of mental illness?O Scholtz, P P Oosthuizen, C Hugo, B Richards75. Treatment strategies in patients with Clozapine resistant Schizophrenia at Stikland Hospital: A critical evaluation of one optionA Schulte, D J H Niehaus, L Koen, J E Muller, P P Oosthuizen, R A Emsley76. Early coadministration of Clonazepam with Paroxetine for generalised Social Anxiety DisorderS Seedat, M B Stein77. Trauma exposure and post-traumatic stress symptoms in adolescents: A schools' survey in Cape Town (South Africa) and Nairobi (Kenya)S Seedat, C Nyamap, F Njenga, B Vythilingum, D J Stein78. The QTC effects of Thioridazine when used as a second line Antipsychotic (at Stikland Hospital)C Seller, P P Oosthuizen79. Brain imaging and substance related disordersD J Stein80. Gender differences in trauma exposure & post traumatic stress disorder in a clinic sampleS Suliman, S Seedat, F Gxama, J Walker, W Rossouw81. Assessing the prevalence of anxiety and depressive symptoms among clinicians at Tygerberg Academic Hospital and controlsH Van der Bijl, P P Oosthuizen82. Pharmacological challenge with a Serotonin ID agonist in alcohol dependenceB Vythilingum, C Wessels, S Maritz, W P Pienaar, D J Stein83. The treatment of ADHD in adultsW Verbeeck

<p><strong>Objectives.</strong> Anxiety disorders are the most common childhood psychiatric disorders. Previous research suggests that South African rates may be high. Our study examined the prevalence and severity of anxiety and depression among Grade 11 and 12 learners attending schools in central Bloemfontein. Learners’ perception of the important stressors as well as the most relevant coping strategies were investigated.<strong></strong></p><p><strong> Methods.</strong> A cross-sectional study was conducted by using self-assessment rating scales and questionnaires. The Hospital Anxiety and Depression Scale (HADS) was used to screen for anxiety and depressive symptoms. Participants were provided with an additional list of possible stressors and coping skills, from which they identified those applicable to themselves. All students enrolled in Grades 11 and 12 at the selected schools during August 2009 were eligible for inclusion.</p><p><strong>Results.</strong> Five hundred and fifteen learners participated in the study, of whom 32.0% presented with moderate or severe anxiety and 5.3% with moderate or severe depressive symptoms. Mild symptoms were reported by an additional 29.0% on the anxiety subscale and 14% on the depression subscale of the HADS. Academic workload was reported as the main source of stress (81.4%).</p><p><strong>Conclusions.</strong> Although the study has limitations in terms of methodology and size, resulting in undetermined validity, it indicates possible higher prevalence rates for anxiety and depression than in previous South African studies and worldwide prevalence rates for adolescents. Pupils were generally hesitant to seek help from formal assistance structures provided by the schools, and preferred discussing problems with parents or friends.</p>

<p><strong>List of abstracts and authors:</strong></p><p><strong>1. Antipsychotics in anxiety disorders</strong></p><p>Christer Allgulander</p><p><strong>2. Anxiety in somatic disorders</strong></p><p>Christer Allgulander</p><p><strong>3. Community rehabilitation of the schizophrenic patient</strong></p><p>Orlando Alonso Betancourt, Maricela Morales Herrera</p><p><strong>4. Dual diagnosis: A theory-driven multidisciplinary approach for integrative care</strong></p><p>David Blackbeard</p><p><strong>5. The emotional language of the gut - when 'psyche' meets 'soma'</strong></p><p>Helen Clark</p><p><strong>6. The Psychotherapy of bipolar disorder</strong></p><p>Franco Colin</p><p><strong>7. The Psychotherapy of bipolar disorder</strong></p><p>Franco Colin</p><p><strong>8. Developing and adopting mental health policies and plans in Africa: Lessons from South Africa, Uganda and Zambia</strong></p><p>Sara Cooper, Sharon Kleintjes, Cynthia Isaacs, Fred Kigozi, Sheila Ndyanabangi, Augustus Kapungwe, John Mayeya, Michelle Funk, Natalie Drew, Crick Lund</p><p><strong>9. The importance of relapse prevention in schizophrenia</strong></p><p>Robin Emsley</p><p><strong>10. Mental Health care act: Fact or fiction?</strong></p><p>Helmut Erlacher, M Nagdee</p><p><strong>11. Does a dedicated 72-hour observation facility in a district hospital reduce the need for involuntary admissions to a psychiatric hospital?</strong></p><p>Lennart Eriksson</p><p><strong>12. The incidence and risk factors for dementia in the Ibadan study of ageing</strong></p><p>Oye Gureje, Lola Kola, Adesola Ogunniyi, Taiwo Abiona</p><p><strong>13. Is depression a disease of inflammation?</strong></p><p><strong></strong>Angelos Halaris</p><p><strong>14. Paediatric bipolar disorder: More heat than light?</strong></p><p>Sue Hawkridge</p><p><strong>15. EBM: Anova Conundrum</strong></p><p>Elizabeth L (Hoepie) Howell</p><p><strong>16. Tracking the legal status of a cohort of inpatients on discharge from a 72-hour assessment unit</strong></p><p>Bernard Janse van Rensburg</p><p><strong>17. Dual diagnosis units in psychiatric facilities: Opportunities and challenges</strong></p><p>Yasmien Jeenah</p><p><strong>18. Alcohol-induced psychotic disorder: A comparative study on the clinical characteristics of patients with alcohol dependence and schizophrenia</strong></p><p>Gerhard Jordaan, D G Nel, R Hewlett, R Emsley</p><p><strong>19. Anxiety disorders: the first evidence for a role in preventive psychiatry</strong></p><p>Andre F Joubert</p><p><strong>20. The end of risk assessment and the beginning of start</strong></p><p>Sean Kaliski</p><p><strong>21. Psychiatric disorders abd psychosocial correlates of high HIV risk sexual behaviour in war-effected Eatern Uganda</strong></p><p>E Kinyada, H A Weiss, M Mungherera, P Onyango Mangen, E Ngabirano, R Kajungu, J Kagugube, W Muhwezi, J Muron, V Patel</p><p><strong>22. One year of Forensic Psychiatric assessment in the Northern Cape: A comparison with an established assessment service in the Eastern Cape</strong></p><p>N K Kirimi, C Visser</p><p><strong>23. Mental Health service user priorities for service delivery in South Africa</strong></p><p>Sharon Kleintjes, Crick Lund, Leslie Swartz, Alan Flisher and MHaPP Research Programme Consortium</p><p><strong>24. The nature and extent of over-the-counter and prescription drug abuse in cape town</strong></p><p>Liezl Kramer</p><p><strong>25. Physical health issues in long-term psychiatric inpatients: An audit of nursing statistics and clinical files at Weskoppies Hospital</strong></p><p>Christa Kruger</p><p><strong>26. Suicide risk in Schizophrenia - 20 Years later, a cohort study</strong></p><p>Gian Lippi, Ean Smit, Joyce Jordaan, Louw Roos</p><p><strong>27.Developing mental health information systems in South Africa: Lessons from pilot projects in Northern Cape and KwaZulu-Natal</strong></p><p>Crick Lund, S Skeen, N Mapena, C Isaacs, T Mirozev and the Mental Health and Poverty Research Programme Consortium Institution</p><p><strong>28. Mental health aspects of South African emigration</strong></p><p>Maria Marchetti-Mercer</p><p><strong>29. What services SADAG can offer your patients</strong></p><p>Elizabeth Matare</p><p><strong>30. Culture and language in psychiatry</strong></p><p>Dan Mkize</p><p><strong>31. Latest psychotic episode</strong></p><p>Povl Munk-Jorgensen</p><p><strong>32. The Forensic profile of female offenders</strong></p><p>Mo Nagdee, Helmut Fletcher</p><p><strong>33. The intra-personal emotional impact of practising psychiatry</strong></p><p>Margaret Nair</p><p><strong>34. Highly sensitive persons (HSPs) and implications for treatment</strong></p><p>Margaret Nair</p><p><strong>35. Task shifting in mental health - The Kenyan experience</strong></p><p>David M Ndetei</p><p><strong>36. Bridging the gap between traditional healers and mental health in todya's modern psychiatry</strong></p><p>David M Ndetei</p><p><strong>37. Integrating to achieve modern psychiatry</strong></p><p>David M Ndetei</p><p><strong>38. Non-medical prescribing: Outcomes from a pharmacist-led post-traumatic stress disorder clinic</strong></p><p>A Parkinson</p><p><strong>39. Is there a causal relationship between alcohol and HIV? Implications for policy, practice and future research</strong></p><p>Charles Parry</p><p><strong>40. Global mental health - A new global health discipline comes of age</strong></p><p>Vikram Patel</p><p><strong>41. Integrating mental health into primary health care: Lessons from pilot District demonstration sites in Uganda and South Africa</strong></p><p>Inge Petersen, Arvin Bhana, K Baillie and MhaPP Research Programme Consortium</p><p><strong>42. Personality disorders -The orphan child in axis I - Axis II Dichotomy</strong></p><p><strong></strong>Willie Pienaar</p><p><strong>43. Case Studies in Psychiatric Ethics</strong></p><p>Willie Pienaar</p><p><strong>44. Coronary artery disease and depression: Insights into pathogenesis and clinical implications</strong></p><p>Janus Pretorius</p><p><strong>45. Impact of the Mental Health Care Act No. 17 of 2002 on designated hospitals in KwaZulu-Natal: Triumphs and trials</strong></p><p>Suvira Ramlall, Jennifer Chipps</p><p><strong>46. Biological basis of addication</strong></p><p>Solomon Rataemane</p><p><strong>47. Genetics of Schizophrenia</strong></p><p>Louw Roos</p><p><strong>48. Management of delirium - Recent advances</strong></p><p>Shaquir Salduker</p><p><strong>49. Social neuroscience: Brain research on social issues</strong></p><p>Manfred Spitzer</p><p><strong>50. Experiments on the unconscious</strong></p><p>Manfred Spitzer</p><p><strong>51. The Psychology and neuroscience of music</strong></p><p>Manfred Spitzer</p><p><strong>52. Mental disorders in DSM-V</strong></p><p>Dan Stein</p><p><strong>53. Personality, trauma exposure, PTSD and depression in a cohort of SA Metro policemen: A longitudinal study</strong></p><p>Ugashvaree Subramaney</p><p><strong>54. Eating disorders: An African perspective</strong></p><p>Christopher Szabo</p><p><strong>55. An evaluation of the WHO African Regional strategy for mental health 2001-2010</strong></p><p>Thandi van Heyningen, M Majavu, C Lund</p><p><strong>56. A unitary model for the motor origin of bipolar mood disorders and schizophrenia</strong></p><p>Jacques J M van Hoof</p><p><strong>57. The origin of mentalisation and the treatment of personality disorders</strong></p><p>Jacques J M Hoof</p><p><strong>58. How to account practically for 'The Cause' in psychiatric diagnostic classification</strong></p><p>C W (Werdie) van Staden</p><p><strong>POSTER PRESENTATIONS</strong></p><p><strong>59. Problem drinking and physical and sexual abuse at WSU Faculty of Health Sciences, Mthatha, 2009</strong></p><p>Orlando Alonso Betancourt, Maricela Morales Herrera, E, N Kwizera, J L Bernal Munoz</p><p><strong>60. Prevalence of alcohol drinking problems and other substances at WSU Faculty of Health Sciences, Mthatha, 2009</strong></p><p>Orlando Alonso Betancourt, Maricela Morales Herrera, E, N Kwizera, J L Bernal Munoz</p><p><strong>61. Lessons learnt from a modified assertive community-based treatment programme in a developing country</strong></p><p>Ulla Botha, Liezl Koen, John Joska, Linda Hering, Piet Ooosthuizen</p><p><strong>62. Perceptions of psychologists regarding the use of religion and spirituality in therapy</strong></p><p>Ottilia Brown, Diane Elkonin</p><p><strong>63. Resilience in families where a member is living with schizophreni</strong></p><p>Ottilia Brown, Jason Haddad, Greg Howcroft</p><p><strong>64. Fusion and grandiosity - The mastersonian approach to the narcissistic disorder of the self</strong></p><p>William Griffiths, D Macklin, Loray Daws</p><p><strong>65. Not being allowed to exist - The mastersonian approach to the Schizoid disorder of the self</strong></p><p>William Griffiths, D Macklin, Loray Daws</p><p><strong>66. Risky drug-injecting behaviours in Cape Town and the need for a needle exchange programme</strong></p><p>Volker Hitzeroth</p><p><strong>67. Neuroleptic malignant syndrome in adolescents in the Western Cape: A case series</strong></p><p>Terri Henderson</p><p><strong>68. Experience and view of local academic psychiatrists on the role of spirituality in South African specialist psychiatry, compared with a qualitative analysis of the medical literature</strong></p><p>Bernard Janse van Rensburg</p><p><strong>69. The role of defined spirituality in local specialist psychiatric practice and training: A model and operational guidelines for South African clinical care scenarios</strong></p><p>Bernard Janse van Rensburg</p><p><strong>70. Handedness in schizophrenia and schizoaffective disorder in an Afrikaner founder population</strong></p><p>Marinda Joubert, J L Roos, J Jordaan</p><p><strong>71. A role for structural equation modelling in subtyping schizophrenia in an African population</strong></p><p>Liezl Koen, Dana Niehaus, Esme Jordaan, Robin Emsley</p><p><strong>72. Caregivers of disabled elderly persons in Nigeria</strong></p><p>Lola Kola, Oye Gureje, Adesola Ogunniyi, Dapo Olley</p><p><strong>73. HIV Seropositivity in recently admitted and long-term psychiatric inpatients: Prevalence and diagnostic profile</strong></p><p>Christina Kruger, M P Henning, L Fletcher</p><p><strong>74. Syphilis seropisitivity in recently admitted longterm psychiatry inpatients: Prevalence and diagnostic profile</strong></p><p>Christina Kruger, M P Henning, L Fletcher</p><p><strong>75. 'The Great Suppression'</strong></p><p>Sarah Lamont, Joel Shapiro, Thandi Groves, Lindsey Bowes</p><p><strong>76. Not being allowed to grow up - The Mastersonian approach to the borderline personality</strong></p><p>Daleen Macklin, W Griffiths</p><p><strong>77. Exploring the internal confirguration of the cycloid personality: A Rorschach comprehensive system study</strong></p><p>Daleen Macklin, Loray Daws, M Aronstam</p><p><strong>78. A survey to determine the level of HIV related knowledge among adult psychiatric patients admitted to Weskoppies Hospital</strong></p><p><strong></strong> T G Magagula, M M Mamabolo, C Kruger, L Fletcher</p><p><strong>79. A survey of risk behaviour for contracting HIV among adult psychiatric patients admitted to Weskoppies Hospital</strong></p><p>M M Mamabolo, T G Magagula, C Kruger, L Fletcher</p><p><strong>80. A retrospective review of state sector outpatients (Tara Hospital) prescribed Olanzapine: Adherence to metabolic and cardiovascular screening and monitoring guidelines</strong></p><p>Carina Marsay, C P Szabo</p><p><strong>81. Reported rapes at a hospital rape centre: Demographic and clinical profiles</strong></p><p>Lindi Martin, Kees Lammers, Donavan Andrews, Soraya Seedat</p><p><strong>82. Exit examination in Final-Year medical students: Measurement validity of oral examinations in psychiatry</strong></p><p>Mpogisheng Mashile, D J H Niehaus, L Koen, E Jordaan</p><p><strong>83. Trends of suicide in the Transkei region of South Africa</strong></p><p>Banwari Meel</p><p><strong>84. Functional neuro-imaging in survivors of torture</strong></p><p>Thriya Ramasar, U Subramaney, M D T H W Vangu, N S Perumal</p><p><strong>85. Newly diagnosed HIV+ in South Africa: Do men and women enroll in care?</strong></p><p>Dinesh Singh, S Hoffman, E A Kelvin, K Blanchard, N Lince, J E Mantell, G Ramjee, T M Exner</p><p><strong>86. Diagnostic utitlity of the International HIC Dementia scale for Asymptomatic HIV-Associated neurocognitive impairment and HIV-Associated neurocognitive disorder in South Africa</strong></p><p>Dinesh Singh, K Goodkin, D J Hardy, E Lopez, G Morales</p><p><strong>87. The Psychological sequelae of first trimester termination of pregnancy (TOP): The impact of resilience</strong></p><p>Ugashvaree Subramaney</p><p><strong>88. Drugs and other therapies under investigation for PTSD: An international database</strong></p><p>Sharain Suliman, Soraya Seedat</p><p><strong>89. Frequency and correlates of HIV Testing in patients with severe mental illness</strong></p><p>Hendrik Temmingh, Leanne Parasram, John Joska, Tania Timmermans, Pete Milligan, Helen van der Plas, Henk Temmingh</p><p><strong>90. A proposed mental health service and personnel organogram for the Elizabeth Donkin psychiatric Hospital</strong></p><p>Stephan van Wyk, Zukiswa Zingela</p><p><strong>91. A brief report on the current state of mental health care services in the Eastern Cape</strong></p><p>Stephan van Wyk, Zukiswa Zingela, Kiran Sukeri, Heloise Uys, Mo Nagdee, Maricela Morales, Helmut Erlacher, Orlando Alonso</p><p><strong>92. An integrated mental health care service model for the Nelson Mandela Bay Metro</strong></p><p>Stephan van Wyk, Zukiswa Zingela, Kiran Sukeri</p><p><strong>93. Traditional and alternative healers: Prevalence of use in psychiatric patients</strong></p><p>Zukiswa Zingela, S van Wyk, W Esterhuysen, E Carr, L Gaauche</p>

<p><strong>1. How can we maintain a sustainable private practice in the current political and economic climate?</strong></p><p>Eugene Allers</p><p><strong>2. SASOP Clinical guidelines, protocols and algorithms: Development of treatment guidelines for bipolar mood disorder and major depression</strong></p><p> Eugene Allers, Margaret Nair, Gerhard Grobler</p><p><strong>3. The revolving door phenomenon in psychiatry: Comparing low-frequency and high-frequency users of psychiatric inpatient services in a developing country</strong></p><p>U A Botha, P Oosthuien, L Koen, J A Joska, J Parker, N Horn</p><p><strong>4. Neurophysiology of emotion and senses - The interface between psyche and soma</strong></p><p>Eugene Allers</p><p><strong>5. Suicide prevention: From and beyond the psychiatrist's hands</strong></p><p>O Alonso Betanourt, M Morales Herrera</p><p><strong>6. Treatment of first-episod psychosis: Efficacy and toleabilty of a long-acting typical antipsychotic </strong></p><p>B Chiliza, R Schoeman, R Emsey, P Oosthuizen, L KOen, D Niehaus, S Hawkridge</p><p><strong>7. Treatment of attention deficit hyperactivity disorder in the young child</strong></p><p>Helen Clark</p><p><strong>8. Holistic/ Alternative treatment in psychiatry: The value of indigenous knowledge systems in cllaboration with moral, ethical and religious approaches in the military services</strong></p><p>J Dill</p><p><strong>9. Treating Schizophrenia: Have we got it wrong?</strong></p><p>Robin Emsley</p><p><strong>10.Terminal questions in the elderly</strong></p><p>Mike Ewart Smith</p><p><strong>11. Mental Health Policy development and implementation in Ghana, South Africa, Uganda and Zambia</strong></p><p>Alan J Flisher, Crick Lund, Michelle Frank, Arvin Bhana, Victor Doku, Natalie Drew, Fred N Kigozi, Martin Knapp, Mayeh Omar, Inge Petersen, Andrew Green andthe MHaPP Research Programme Consortium</p><p><strong>12. What indicators should be used to monitor progress in scaling uo services for people with mental disorders?</strong></p><p>Lancet Global Mental Health Group (Alan J Flisher, Dan Chisholm, Crick Lund, Vikram Patel, Shokhar Saxena, Graham Thornicroft, Mark Tomlinson)</p><p><strong>13. Does unipolar mania merit research in South Africa? A look at the literature</strong></p><p>Christoffel Grobler</p><p><strong>14. Revisiting the Cartesian duality of mind and body</strong></p><p>Oye Gureje</p><p><strong>15. Child and adolescent psychopharmacology: Current trends and complexities</strong></p><p>S M Hawkridge</p><p><strong>16. Integrating mental illness, suicide and religion</strong></p><p>Volker Hitzeroth</p><p><strong>17. Cost of acute inpatient mental health care in a 72-hour assessment uniy</strong></p><p>A B R Janse van Rensburg, W Jassat</p><p><strong>18. Management of Schizophrenia according to South African standard treatment guidelines</strong></p><p>A B R Janse van Rensburg</p><p><strong>19. Structural brain imaging in the clinical management of psychiatric illness</strong></p><p>F Y Jeenah</p><p><strong>20. ADHD: Change in symptoms from child to adulthood</strong></p><p>S A Jeeva, A Turgay</p><p><strong>21. HIV-Positive psychiatric patients in antiretrovirals</strong></p><p>G Jonsson, F Y Jeenah, M Y H Moosa</p><p><strong>22. A one year review of patients admitted to tertiary HIV/Neuropsychiatry beds in the Western Cape</strong></p><p>John Joska, Paul Carey, Ian Lewis, Paul Magni, Don Wilson, Dan J Stein</p><p><strong>23. Star'd - Critical review and treatment implications</strong></p><p>Andre Joubert</p><p><strong>24. Options for treatment-resistent depression: Lessons from Star'd; an interactive session</strong></p><p>Andre Joubert</p><p><strong>25. My brain made me do it: How Neuroscience may change the insanity defence</strong></p><p>Sean Kaliski</p><p><strong>26. Child andadolescent mental health services in four African countries</strong></p><p>Sharon Kleintjies, Alan Flisher, Victoruia Campbell-Hall, Arvin Bhana, Phillippa Bird, Victor Doku, Natalie, Drew, Michelle Funk, Andrew Green, Fred Kigozi, Crick Lund, Angela Ofori-Atta, Mayeh Omar, Inge Petersen, Mental Health and Poverty Research Programme Consortium</p><p><strong>27. Individualistic theories of risk behaviour</strong></p><p>Liezl Kramer, Volker Hitzeroth</p><p><strong>28. Development and implementation of mental health poliy and law in South Africa: What is the impact of stigma?</strong></p><p>Ritsuko Kakuma, Sharon Kleintjes, Crick Lund, Alan J Flisher, Paula Goering, MHaPP Research Programme Consortium</p><p><strong>29. Factors contributing to community reintegration of long-term mental health crae users of Weskoppies Hospital</strong></p><p>Carri Lewis, Christa Kruger</p><p><strong>30. Mental health and poverty: A systematic review of the research in low- and middle-income countries</strong></p><p>Crick Lund, Allison Breen, Allan J Flisher, Ritsuko Kakuma, Leslie Swartz, John Joska, Joanne Corrigall, Vikram Patel, MHaPP Research Programe Consortium</p><p><strong>31. The cost of scaling up mental health care in low- and middle-income countries</strong></p><p>Crick Lund, Dan Chishlom, Shekhar Saxena</p><p><strong>32. 'Tikking'Clock: The impact of a methamphetamine epidemic at a psychiatric hospital in the Western Cape</strong></p><p>P Milligan, J S Parker</p><p><strong>33. Durban youth healh-sk behaviour: Prevalence f Violence-related behaviour</strong></p><p>D L Mkize</p><p><strong>34. Profile of morality of patients amitted Weskoppies Psychiatric Hospital in Sout frican over a 5-Year period (2001-2005)</strong></p><p>N M Moola, N Khamker, J L Roos, P Rheeder</p><p><strong>35. One flew over Psychiatry nest</strong></p><p>Leverne Mountany</p><p><strong>36. The ethical relationship betwe psychiatrists and the pharmaceutical indutry</strong></p><p>Margaret G Nair</p><p><strong>37. Developing the frameor of a postgraduate da programme in mental health</strong></p><p>R J Nichol, B de Klerk, M M Nel, G van Zyl, J Hay</p><p><strong>38. An unfolding story: The experience with HIV-ve patients at a Psychiatric Hospital</strong></p><p>J S Parker, P Milligan</p><p><strong>39. Task shifting: A practical strategy for scalingup mental health care in developing countries</strong></p><p>Vikram Patel</p><p><strong>40. Ethics: Informed consent and competency in the elderly</strong></p><p>Willie Pienaar</p><p><strong>41. Confronting ommonmoral dilemmas. Celebrating uncertainty, while in search patient good</strong></p><p>Willie Pienaar</p><p><strong>42. Moral dilemmas in the treatment and repatriation of patients with psychtorders while visiting our country</strong></p><p>Duncan Ian Rodseth</p><p><strong>43. Geriatrics workshop (Psegal symposium): Medico-legal issuess in geriatric psyhiatry</strong></p><p>Felix Potocnik</p><p><strong>44. Brain stimulation techniques - update on recent research</strong></p><p>P J Pretorius</p><p><strong>45. Holistic/Alternative treatments in psychiatry</strong></p><p>T Rangaka, J Dill</p><p><strong>46. Cognitive behaviour therapy and other brief interventions for management of substances</strong></p><p>Solomon Rataemane</p><p><strong>47. A Transtheoretical view of change</strong></p><p>Nathan P Rogerson</p><p><strong>48. Profile of security breaches in longerm mental health care users at Weskoppies Hospital over a 6-month period</strong></p><p>Deleyn Rema, Lindiwe Mthethwa, Christa Kruger</p><p><strong>49. Management of psychogenic and chronic pain - A novel approach</strong></p><p>M S Salduker</p><p><strong>50. Childhood ADHD and bipolar mood disorders: Differences and similarities</strong></p><p>L Scribante</p><p><strong>51. The choice of antipsychotic in HIV-infected patients and psychopharmacocal responses to antipsychotic medication</strong></p><p>Dinesh Singh, Karl Goodkin</p><p><strong>52. Pearls in clinical neuroscience: A teaching column in CNS Spectrums</strong></p><p><strong></strong>Dan J Stein</p><p><strong>53. Urinary Cortisol secretion and traumatics in a cohort of SA Metro policemen A longitudinal study</strong></p><p>Ugash Subramaney</p><p><strong>54. Canabis use in Psychiatric inpatients</strong></p><p><strong></strong>M Talatala, G M Nair, D L Mkize</p><p><strong>55. Pathways to care and treatmt in first and multi-episodepsychosis: Findings fm a developing country</strong></p><p>H S Teh, P P Oosthuizen</p><p><strong>56. Mental disorders in HIV-infected indivat various HIV Treatment sites in South Africa</strong></p><p>Rita Thom</p><p><strong>57. Attendanc ile of long-term mental health care users at ocupational therapy group sessions at Weskoppies Hospital</strong></p><p>Ronel van der Westhuizen, Christa Kruger</p><p><strong>58. Epidemiological patterns of extra-medical drug use in South Africa: Results from the South African stress and health study</strong></p><p>Margaretha S van Heerden, Anna Grimsrud, David Williams, Dan Stein</p><p><strong>59. Persocentred diagnosis: Where d ps and mental disorders fit in the International classificaton of diseases (ICD)?</strong></p><p>Werdie van Staden</p><p><strong>60. What every psychiatrist needs to know about scans</strong></p><p>Herman van Vuuren</p><p><strong>61. Psychiatric morbidity in health care workers withle drug-resistant erulosis (MDR-TB) A case series</strong></p><p>Urvashi Vasant, Dinesh Singh</p><p><strong>62. Association between uetrine artery pulsatility index and antenatal maternal psychological stress</strong></p><p>Bavanisha Vythilingum, Lut Geerts, Annerine Roos, Sheila Faure, Dan J Stein</p><p><strong>63. Approaching the dual diagnosis dilemma</strong></p><p>Lize Weich</p><p><strong>64. Women's mental health: Onset of mood disturbance in midlife - Fact or fiction</strong></p><p>Denise White</p><p><strong>65. Failing or faking: Isses in the fiagnosis and treatment of adult ADHD</strong></p><p>Dora Wynchank</p>

HIV/AIDS has presented humanity with various challenges, one of which is the manner in which it has affected family structure and patterns. Parental illness and eventual death due to the HIV/AIDS pandemic is escalating. One of the major challenges of HIV/AIDS in southern Africa is the increase in the number of orphaned and vulnerable children. As a result new family forms are emerging such as the "skip-generation" family in which children or adolescent siblings head the family. It is anticipated that HIV/AIDS in South Africa will progressively increase the number of such families. During this time of profound family change, the family as an institution has remained remarkably resilient. The present study utilised the Family Resilience Framework and the Resiliency Model of Family Stress, Adjustment and Adaptation to explore and describe the resilience of HIV/AIDS’ adolescent headed families. A qualitative, exploratory-descriptive research design, which was assessed against Guba’s (1985) model of trustworthiness, was employed and the participants were sampled using non-probability purposive sampling. The Masizakhe Community Project volunteers (an AIDS Community Project in Kwazakhele, Port Elizabeth receiving support from the iThemba AIDS Foundation) assisted in identifying participants according to the predetermined inclusion criteria. The sample consisted of four female, adolescent heads of HIV/AIDS’ affected households, who volunteered at the Masizakhe Community Project and resided in Kwazakhele. The data that was collected via audio-recorded semi structured interviews were transcribed verbatim and subjected to Interpretive Phenomenological Analysis. Family resilience factors that emerged included intrafamilial strengths (family cohesion, organisation, hardiness, and adaptability); social support resources (especially from the community project, friends, and community members); family appraisal processes; and problem solving and coping strategies. Extended family support was partial and largely financial. The findings from this study provided insights into the resilience of adolescent-headed families; provided guidance for the development of intervention programmes to assist these families; and affirmed the existing strengths of the families. Furthermore, it has contributed to the research and literature on family resilience and formed the foundation for future research projects.

Thesis (PhD)--Stellenbosch University, 2012.
Includes bibliography
ENGLISH ABSTRACT: Background/Aims: Obesity has increased rapidly in South African children and adolescents with significant variability observed among racial groups. Genes that regulate appetite have been studied in different populations worldwide, but their role in obesity among South African adolescents is unknown. The present study aimed at investigating the role of these genes, and their combined effect with physical activity in the development of obesity among South African adolescents. Methods: A total of 1564 South African school learners of Caucasian (n= 146), Mixed Ancestry (n= 872) and Black African (n= 537) ethnic groups were recruited for a research project that aimed to elucidate diabetes and the metabolic syndrome in children and adolescents attending schools in periurban areas of the Western Cape. The present case-control study included 227 obese-overweight (115 Black Africans and 112 Mixed Ancestry), and 204 normal weight (94 Black Africans and 110 Mixed Ancestry) adolescents learners. The learners were genotyped for nine polymorphisms (LEP: 19G>A, Lys36Arg, Val94Met; LEPR: Lys109Arg; Gln223Arg, Lys656Asn; CART: c.160-33G>A, c.499delA, and c.517A>G; GHRL: Leu72Met; and MC3R: Thr6Lys, Val81Ile) using allele-specific restriction enzyme analysis and automated sequencing. Genotype and haplotype associations with anthropometric variables such as body mass index (BMI), waist, hip, and mid-upper-arm circumferences (WC, HC, MUAC), and metabolic traits (fasting blood glucose, high density lipoproteincholesterol, total cholesterol), and blood pressure were further conducted. Furthermore, the type and frequency of physical activity was assessed by means of structured questionnaires; and its effect on obesity-related variables investigated in learners that were genotyped for the MC3R Thr6Lys and Val81Ile polymorphisms. Results: In a stepwise backward logistic regression analysis (containing age, gender, and LEP, LEPR, CART and GHRL polymorphisms), CART c.517A>G was independently significantly associated with obesity (OR= 5.98; 95%CI= 2.02, 21.27). CART c.517G carriers had higher MUAC (b coefficient= 1.88; 95%CI= 0.31, 3.44) while the LEPR 109Arg allele was significantly associated with decreased BMI (b coefficient = -2.36; 95%CI= -4.24, -0.47), WC (b coefficient = -5.66; 95%CI= -9.89, -1.44) and MUAC (b coefficient = -1.61; 95%CI= -3.00, -0.22); after adjusting for age, gender, and ethnicity. The haplotype containing the three LEP polymorphisms (A-A-A compared to the reference G-A-G haplotype) increased BMI (p= 0.0155), MUAC (p= 0.0146), and HC (p= 0.0128). The minor alleles of the MC3R polymorphisms decreased BMI, HC, WC, MUAC and TC; whilst only the Thr6Lys was associated with systolic and diastolic blood pressure (p= 0.0047 and 0.0027, respectively) in Mixed Ancestry learners. Doing house chores was associated with lower total cholesterol, independently and in the presence of the 81Ile allele (b coefficient = -0.355; 95%CI= 0.148, 0.561). Conclusion: To our knowledge, this is the first study that reports CART c.517A>G polymorphism as a risk factor for obesity in adolescents. Furthermore, the present study demonstrated that the MC3R polymorphisms had a positive effect on total cholesterol, which was further enhanced in physically active individuals. Similar to other studies, LEPR Lys109Arg and LEP polymorphisms were associated with variations in obesity-related variables among Black African and Mixed Ancestry South African learners.
AFRIKAANSE OPSOMMING: Agtergrond/Doelwitte: Vetsug het drasties toegeneem in Suid-Afrikaanse kinders en adelossente met ‘n beduidende variasie opgemerk tussen verskillende rassegroepe. Gene verantwoordelik vir regulering van eetlus is reeds wêreldwyd in verskillende bevolkingsgroepe bestudeer, maar hul rol in oorgewig Suid-Afrikaanse adolessente is onbekend. Die huidige studie was daarop gerig om ondersoek in te stel na die rol van hierdie gene en hul gekombineerde effek met fisiese aktiwiteit in die ontwikkeling van vetsug onder Suid-Afrikaanse adolessente. Metodes: ‘n Totaal van 1564 Suid-Afrikaanse leerders van Kaukasiese Afkoms (n=146), Gemengde Afkoms (n=872) en Swart Afkoms (n= 537) was gewerf in die navorsingsprojek wat ten doel gehad het om kinders en adolosente met diabetes en die metaboliese sindroom te identifiseer wat skole bygewoon het in semi-voorstedelike gebiede van die Wes-Kaap. Die huidige gevalle studie het 227 vetsugtige-oorgewig (115 Swart Afkoms en 110 Gemengde Afkoms) en 204 normale gewig (94 Swart Afkoms en 110 Gemengde Afkoms) leerders ingesluit. Die leerders was gegenotipeer vir nege polimorfismes (LEP: 19G>A, Lys36Arg, Val94Met; LEPR: Lys109Arg; Gln223Arg, Lys656Asn; CART: c.160-33G>A, c.499delA, and c.517A>G; GHRL: Leu72Met; and MC3R: Thr6Lys, Val81Ile) met die gebruik van alleel-spesifieke restriksie ensiem analises en geoutomatiseerde DNA volgorde bepalings tegnieke. Genotipiese en haplotipiese assosiasies met antropometriese veranderlikes soos liggaamsmassa indeks (BMI), middel-, heup- en mid-boarm omtrek (WC, HC, MUAC), metaboliese tendense (vastende bloed glukose, hoë-digtheid lipoproteïen-cholesterol, totale cholesterol) en bloeddruk was ook uitgevoer. Die tipe en frekwensie fisiese aktiwiteit was geassesseer deur middel van gestruktureerde vraelyste; en die uitwerking daarvan op vetsugverwante veranderlikes ondersoek in leerders wat vir die MC3R Thr6Lys en Val81Ile polimorfismes gegenotipeer was. Resultate: Statistiese ontleding (‘‘stepwise backward logistic regression analysis”), wat ouderdom, geslag en polimorfismes (LEP, LEPR, CART GHRL) ingesluit het, het getoon dat CART c.517A>G betekenisvol onafhanklik geassosiasieer was met vetsug (OR= 5.98; 95% CI= 2.02, 21.27). CART c.517G draers het ‘n hoër MUAC waarde gehad (b koeffisient = 1.88; 95%CI= 0.31, 3.44), terwyl die LEPR 109Arg alleel betekenisvol geassosieer was met verlaagde BMI ((b koeffisient = -2.36; 95%CI= -4.24, -0.47), WC (b koeffisient = -5.66; 95%CI= -9.89, -1.44) en MUAC (b koeffisient = -1.61; 95%CI= -3.00, -0.22) na die aanpassing van ouderdom, geslag en etnisiteit. Die haplotipe met die drie LEP polimorfismes (A-A-A teenoor die G-A-G verwysingshaplotipe) het die BMI (p= 0.0155), MUAC (p= 0.0146) en HC (p= 0.0128) verhoog. Die mindere allele van die MC3R polimorfismes het die BMI, HC, WC, MUAC en TC verlaag; terwyl slegs die Thr6Lys polymorfisme met sistolies en diastolies bloeddruk (p= 0.0047 en p= 0.0027, onderskeidelik) geassosieer was in Gemengde Afkoms leerders. Die verrigting van algemene huistake was geassosieer met laer totale kolesterol vlakke, onafhanklik en in die teenwoordigheid van die 81lle alleel (b koeffisient= -0.355; 95%CI= 0.148, 0.561). Gevolgtrekking: Na ons wete is hierdie die eerste studie wat die CART c.517A>G polimorfisme as ‘n risikofaktor vir vetsug in adolessente aantoon. Die huidige studie toon ook dat die MC3R polimorfisme ‘n positiewe effek op totale kolesterol gehad het, wat ook verder versterk was in fisiese aktiewe individue. Soortgelyk aan ander studies, was die LEPR Lys109Arg en LEP polimorfismes geassosieer met variasies in vetsug-verwante veranderlikes onder Suid-Afrikaanse Swart en Gemengde Afkoms leerders.
This research was supported by a grant from the University Research Fund of the Cape Peninsula University of Technology, Harry Crossley, University of Stellenbosch, Faculty of Health Sciences, Medical Research Council, and the National Health Laboratory Services, South Africa.

Thesis (MEdPsych (Educational Psychology))--Stellenbosch University, 2008.
A depressive mood disorder has been for the past decade the mood disorder with the highest prevalence in the general population. Independent studies done in South Africa indicated a prevalence of depression between 13% to 53%. These results do not concur with official published statistics indicating a prevalence of depression in 16% of the general population over a lifetime. Depression is probably under diagnosed by general practitioners and only a small proportion of adolescents with depression are recognised and even less receive any support for their depression. The aim of this study was to explore the following: the prevalence of symptoms of depression in grade 10 learners in schools in Stellenbosch, gender differences regarding the prevalence of depression symptoms in grade 10 learners, the prevalence of specific symptoms of depression and to explore similarities between symptoms of depression and the adolescent developmental phase. The study was conducted by means of the Beck Depression Inventory. The survey was conducted with 201 grade 10 learners with the necessary permission. The results regarding the prevalence of depression symptoms and gender differences regarding the prevalence of depression correlate with international statistics. This study found that more respondents indicated one or more symptom of depression at the given time than indicated by the literature. It was also found that some adolescent developmental tasks are similar to some symptoms of depression. Further research in South Africa regarding the prevalence of symptoms of depression was recommended.

M.A.
In the face of economic hardship, social, political and cultural change, matriculants in South Africa are confronted with increased pressure when exploring and deciding on their career paths. This task in itself is complex and is expected to culminate in a career decision upon leaving school, even when subject to these and other extrinsic limitations over which the individual has no control. For example, the serious lack of career guidance programs in the large majority of our schools (Mathabe & Temane, 1993). Regardless, school pupils in South Africa are expected to make their preliminary choice in Standard 7 when they choose their matric subjects. Three years later they are expected to leave school with a career decision. These same individuals are also struggling to meet the challenges of adolescence and are searching for an identity they can call their own. It is surmised that those pupils who have not yet made a career decision are more likely to experience feelings of depression than those with definite career plans. This study regarding the relationship between depressive symptomatology and career choice, had the following objectives: A comprehensive literature review focusing on depression, depressive symptomatology, the aetiology of depression, theory and research with reference to the adolescent in particular. A further literature review focusing on various theories of career choice and research with particular reference to career indecision. A quantitative and qualitative investigation of career choice and depressive symptomatology in matriculants in South Africa. The initial part of the study focuses on the theoretical review of depressive symptomatology and career choice, to firstly define the concepts as operationalised in this study and secondly to explore the theory and research to date with reference to the factors contributing to and maintaining feelings of depression and career indecision in adolescents. The researcher reviews and discusses phenominological differences and similarities between the adult and adolescent experience of depression, with particular reference to depressive symptomatology, the approach used in this research. Career choice is also defined and discussed with reference to the developmental stage of adolescence. Various theoretical approaches with regard to depression and career choice are reviewed and discussed. Identity development, and the related concepts of self esteem and self efficacy are discussed, as well as the role of cultural factors, with reference to both depressive symptomatology and career indecision Matriculants from four different regions in Gauteng took part in the study. The sample comprised pupils from both genders and various population groups. Each pupil filled in a questionnaire developed by the researcher, the Beck Depression Inventory (BDI) and the Career Decision Scale (CDS). The data collected from the self developed questionnaire provided insight into various factors of career choice such as realistic goals and dream goals, perceived restrictions and elements of self esteem. This data was described and interpreted in a qualitative analysis and from such the researcher inferred predominant themes and concepts with suggested avenues for further research. The quantitative data collected from the results of the BDI and CDS were statistically described and analyzed. From this data the statistically significant findings were presented and discussed with reference to theory and research. The researcher found that depressive symptomatology and career indecision are significantly related with the incidence of feelings of depression being related to career indecision and career indecision possibly giving rise to symptoms of depression. The study can be criticized for not including a measure of self esteem, a factor closely related to depressive symptomatology and career choice. A further criticism is that the most highly represented cultural groups were the English and Zulu speaking pupils, future studies should include pupils from all cultural groups. The qualitative analysis is subject to an interpretative bias, which may be subjective and influenced by the researcher's own views. The recommendations that were made as a result of this study are as follows: More research is needed into career choice and the incidence of depressive symptomatology with coenizance of levels of self esteem, a more representative sample and perceptions as regards career choice and limitations to certain vocations. The implied direction of the relation between career indecision and depressive symptomatology requires in depth research to further investigate the findings of this research. If career indecision does indeed give rise to feelings of depression, then programs that are being developed and those that are already in place should take cognizance of these results and include preventative measures in any future programs. The implied higher incidence of depressive symptomatology and career indecision in the black population requires further investigation and if the findings in this study are further supported, preventative action is desperately needed. Fifty percent of the pupils show signs of moderate to severe depression. Further research is needed to reaffirm these results and, if substantiated, urgent preventative measures should be taken.

Thesis (Ph.D.)--University of the Witwatersrand, Faculty of Health Sciences, 2012.
Background: the subject of the mental health of young people in Sub-Saharan Africa has received very little research attention. Despite the fact that many in this region face ubiquitous material deprivation, childhood adversity, violence, AIDS and orphanhood which could result in distress, there is very little scientific understanding of the precursors of psychological distress. Understanding and intervening in young people is important as psychological distress is believed to precede one of the most common health problems facing young people, that is, risky sexual behaviours. This thesis aims to document and describe the prevalence of depressive symptoms in a sample of young people, develop an explanatory model for factors associated with depressive symptoms and distress, and explore links with risky sexual behaviours. Method: This thesis is based on two studies that were both conducted in the Eastern Cape Province of South Africa. Study 1 was an analysis of cross-sectional and longitudinal data collected amongst young people aged 15 to 26 who were enrolled in a cluster randomised controlled trial evaluating an HIV prevention intervention. The study sample was drawn from volunteers who normally resided in villages and townships in and around the area within 1.5 hours drive radius of Mthatha. Volunteers were mostly recruited through schools. In each of the seventy study sites, approximately twenty males and twenty females were included resulting in the enrolment of 2,801 volunteer participants. Quantitative data were collected by a fieldworker-administered questionnaire in 2003/4 and 2004/5, and analysed separately for men and women, using STATA IC 11.0. A crosssectional analysis of 2003/4 data was undertaken to investigate factors associated with depressive symptoms. Presence of depressive symptoms was established through a self report measure - the Centre for Epidemiological Studies on Depression Scale. Participants who scored above a cut-off point of 16 were considered to have depressive symptoms. Results for factors associated with the presence of depressive symptoms are presented in Paper I. The association between baseline depressive symptoms and sexual risk taking at baseline (2003/4) and twelve months later (2004/5) was explored. Here, participants with depressive symptoms were treated as an exposed group and were compared to those who scored below 16 on the symptom checklist within the same cohort. These results are presented in Paper II. In Study 2, phenomenological experiences of distress were explored. In-depth face-toface, one-on-one interviews with forty young people were conducted in isiXhosa between 2007 and 2008. Participants for Study 2 were recruited in Butterworth from the townships. The sampling approach was a non-random, non-probability approach, with participants who self-selected and volunteered on the basis of their interest in the research topic. The sample came from a town that was included in Study 1 and generally shared similar socio economic conditions, cultural experiences, and history as the other community sites that participated in Study 1. Criteria for inclusion into the study included having no known clinical diagnosis of a mental health problem. Participants were aged 16 to 26 years. Each interview took about forty five minutes to an hour. Data were analysed using the constant comparison approach and following recommendations for qualitative phenomenological studies. Findings from this study are presented in two papers. Paper III of this thesis presents a conceptual model based on discussions of perceived sources of distress by participants. Paper IV discusses the role of undisclosed paternal identity in causing distress. Findings: In Study 1, the prevalence of self-reported depressive symptoms was 21% among women and 14% among men. Child abuse and neglect (aOR 1.34 95% CI 1.116, 1.55), substance use (aOR 1.98 95% CI 1.17, 3.35), perceptions of less cohesion in the community (aOR 1.2395% CI 1.07, 1.40), intimate partner violence victimisation (aOR 2.2195% CI 1.16, 3.00) and sexual violence before the age of eighteen (aOR1.45 95% CI 1.02, 2.02) were associated with depressive symptoms in women. For men, factors associated with depressive symptoms were child abuse and neglect (aOR 1.61 95% CI 1.38, 1.88), having lost a mother (aOR 2.24 95% CI 1.25, 4.00), alcohol abuse (aOR 1.63 CI 1.13, 2.35), having been forced by a woman to have sex (aOR 2.36 95% CI 1.47, 3.80) and conflict in the current sexual relationship (aOR 1.07 95% CI 1.01, 1.12). Findings on the associations between depressive symptoms and risky sexual behaviours show that women with depressive symptoms at baseline were more likely to have dated a man five years or older than them in their lifetime (aOR 1.37 95% CI 1.03-1.83), had transactional sex (aOR 2.60 95% CI 1.37-4.92) and experienced intimate partner violence (IPV) at baseline (aOR 2.56 95% CI 1.89-3.46). Women with depressive symptoms were more likely to have experienced IPV a year later (aOR 1.67 95% CI 1.18-2.36) after adjusting for baseline IPV experiences. At baseline, in men, an association between depressive symptoms and perpetration of intimate partner violence (aOR 1.50 95% CI 0.98-2.28) and rape was evident (aOR 1.81 95% CI 1.14-2.87). Men who had depressive symptoms were also less likely to report correct condom use at last sex, at both baseline and twelve months later (aOR 0.50 95% CI 0.32-0.78 and aOR 0.60 95% CI 0.40-0.89). Study 2 showed that family-based adversity, most notably perceptions of mother’s distress, conflict over financial resources, undisclosed paternal identity and parental substance abuse caused distress in young people. A culture of silence in families on issues considered pertinent by participants, such as paternal identity appeared to intensify distress. From this study, sexual relationship problems, including intimate partner violence, an unacknowledged pregnancy, and violent transactional sexual relationship themes dominated women’s narratives of distress. In their narratives, men described violence and sexual risk taking as expressions of anger directed towards women. They described using substances and sexual philandering as ways to express distress, and as coping mechanisms, although they in turn became sources of distress. xiv Discussion, conclusions and recommendations: This research reports a high prevalence of depressive symptoms among young people in South Africa and supports international patterns of a higher prevalence in women than men. Findings presented in this thesis have important implications as they show that structural factors that cause different forms of disempowerment are implicated in some of the psychological distress experienced by young people. For instance, gender power inequity, violence, cultural expectations of respect from youth and women, compounded by financial dependence on relatives were sources of vulnerability especially in the face of maternal orphanhood. When ones mother was perceived to be under distress and honest and effective communication within families was lacking this caused distress. Depressive symptoms were associated with risky sexual behaviours commonly found among rural young people such as intimate partner violence, boys’ sexual victimisation by women, relationship conflict and involvement in transactional sex. Though HIV prevalence among young men is lower than in women in South Africa, consistent failure to use a condom at last intercourse among men with depressive symptoms may ultimately increase risk for HIV infection. Hence, sexual health youth-friendly clinics should be aware of the links between depressive symptoms and sexual expression. The strength of this thesis is in the mixed method approach to exploring psychological distress through qualitative and quantitative data. The quantitative study used a large sample and had a prospective component, which enabled the impact of depressive symptoms on sexual risk-taking to be studied in temporal sequence. This is valuable and unusual in a dataset. However, it has a volunteer sample and its findings cannot necessarily be generalised to all young South Africans. Nevertheless, there is no reason to expect the associations described to significantly differ from those that would be found in a non-volunteer sample. Qualitative research is inherently non-generalising, but the methodology used here enables a depth of understanding an exposure of nuance that is not attainable through quantitative methods. Prevention of depressive symptoms among young people in South Africa should start with interventions to reduce exposure to childhood adversity. Some of this distress could be reduced if relationship violence was prevented for women, pregnancies acknowledged and disputes resolved on time by the putative fathers. This research suggests that a reduction in young people’s depressive symptoms could have positive benefits for reduction of HIV risk taking behaviours.

M.A.
Hubley (1990) notes that Acquired Immunodeficiency Syndrome (AIDS) is a relatively recently recognized disease. It is caused by infection with the Human Immunodeficiency Virus (HIV), which attacks selected cells in the immune system and produces defects in functioning. These defects may not be apparent for years. They lead, however, to a severe suppression of the immune system's ability to resist harmful organisms. This leaves the body open to an invasion by various infections, which are therefore called opportunistic diseases, and to the development of unusual cancers. The virus also tends to reach certain brain cells. This leads to so-called neuropsychiatric abnormalities or psychological disturbances caused by physical damage to nerve cells. Many of those infected with HIV may not even be aware that they carry and can spread the virus. Combating it is a major challenge to biomedical scientists and health-care providers. HIV infection and AIDS occur among the most pressing public policy and public health problems world-wide. Since the first HIV/AIDS cases have been reported in 1981, through mid-1993, more than 600 cases were reported in South Africa. This is only the tip of the iceberg of HIV/AIDS infection as it was estimated that between 2 and 2.5 million South Africans had been infected with the virus through the early 1990s but not yet developed the clinical symptoms. In terms of the historical data from previous surveys (ie. the results of the 1996 survey) in South Africa confirmed the trend of a growing HIV/AIDS epidemic. HIV infection has increased in all provinces, but Kwa-Zulu Natal and Mpumalanga had the highest HIV prevalence rates of 18,23% compared to 1994's '14,35% and 16-18%, compared to 12-16% respectively (see table 1).. Of particular concern are the pregnant women in South Africa under twenty years where a prevalence of 12,78% has been found. Thirty per cent of babies born to HIV positive women in South Africa are infected. Of the 3638 births in VVitbank — a rather small town in Mpumalanga-.Province — in 1996, 219 of the women were tested HIV positive (Masiphile Vol. 1: 1997).

An investigation into the prevalence and causative factors of adolescent depression in the greater Johannesburg area was undertaken. Present-day South African socio-economic pressures together with the normal demands and difficulties of adolescence, led to an investigation into which factors were having a bearing on adolescent depression and whether more male than female adolescents were depressed. A literature study was done and major factors, which could potentially influence the development of depression, were identified. The results of the empirical investigation indicated that negative family relations and negative peer relations play a significant role in the development of adolescent depression. Other identified factors did not appear to have a statistically significant bearing on adolescent depression. No significant statistical difference was found between the prevalence or severity of male and female adolescent depression. Educational implications of the findings are discussed and guidelines are given to teachers and parents.
Teacher Education
M.Ed. (Guidance and Counselling)

M.A.
"Stroke is one of the leading causes of death and disability in all races in South Africa" (Fritz & Penn, 1992, p 1). It has devastating effects, and may impact on every aspect of the person's functioning. Research shows that depression is common after stroke, becoming more of a problem with time, and having a greater effect on quality of life than the actual disability (Lezak, 1995). Despite such evidence psychologists have played a very limited role in the rehabilitation of this group. Those with communication problems especially have been excluded from research and therapy, which usually require competence with language to be successful. This study attempts to find an alternative method of research and therapy in order to include this group. Following the model of learned helplessness (Seligman, in, Bleiberg, 1986), it was proposed that the unavoidable, inescapable effects of stroke lead to feelings of helplessness, which are also impossible to escape, and the person soon looses the motivation to attempt to control the situation. This then leads to depression. A method of therapy which breaks this cycle, and allows for the person to experience how their actions do have an effect on their lives is needed. In addition to this, an alternative means of self expression for those with communication difficulties needs to be provided. Art therapy was found to address the problems presented by this group (Dailey, 1984). It has proved useful with other populations that have not been able to benefit from traditional psychotherapy. It becomes an alternative means of self expression for those whose communication ability is compromised. It is accessible to most people, as it only requires the ability to make marks on paper. A theme centred, art therapy approach was therefore chosen for the study. The aims of the study were; to create a therapeutic milieu which allowed for self expression, specifically the expression of emotions, which included all the participants; to investigate the effects of introducing an opportunity for self expression on self concept and group process; and to look at the themes which emerge from the art. The participants were members of a pre-existing support group for stroke survivors. A quasiexperimental design was used. The Draw a Person Test, was administered pre and post intervention. Additional information was gathered using the Beck's Depression Inventory and a demographic questionnaire. This study uses a qualitative method, which includes information regarding the researcher's experience, and is interpreted from the researcher's perspective. It was found that art therapy had a positive effect on self concept. It influenced group process, as participants who were previously marginalised became more central. Numerous themes emerged, some which were specific to individuals, but others that were of relevance to the group as a whole. It proved rewarding for the researcher, both as a therapist and in terms of her relationship with her father who is a stroke survivor with aphasia. Art therapy therefore seems to be a useful tool to be used with this group that has traditionally been excluded from therapy and research. It is suggested that further research would be useful, and suggestions regarding future research are discussed.

D.Litt. et Phil.
Although rapid progress was made in the past decade in the development of short term treatment approaches, relatively little attention was given to the treatment of Dysthymic Depression as a separate disorder. It is therefore important that medical doctors and other health professionals recognize this disorder as a separate disorder from Major Depression and adjust their treatment of this disorder accordingly (Keller, 1994). Although Dysthymia is seen as 'n low grade disorder and not as severe as Major Depression, this disorder also has a hampering effect on the quality of the individual's life. It affects relationships with meaningful others, mental and physical well - being as well as productivity (Keller, 1994; Klerman & Weissman, 1992). With the hampering effect on the individual's life, Dysthymic Depression is also costly and is a substantial burden for the family and the community. According to Rupp (1995) appropriate treatment of individuals with affective disorders will be costeffective. , The prevalence of depression in primary care make this disorder an ideal target for treatment-(Robinson, 1995). In this regard, Robinson (1995) mentions that treatment for these disorders is less intensse and'more short term that specialized treatments. In the past few years there have been a.shift from long term treatment strategies to short term structured handbook orientated treatment programs for disorders like depression. Pantalon, Lubetkin & Fishman (1995) emphasize the need for objective and •knowledgeable guides for the treatment of mental disorders. According to these researchers selfhelp books and guides are effective together with cognitive behavioral therapy. The aim of this study was therefore the development of a short term cost effective handbook orientated treatment program for Dysthymic Depression as well as the effectiveness of the treatment program. Antoher aspect of this treatment program that makes it unique, is the exercise component that is incorporated into the program with the cognitive behavioral approach. A group of 23 Dysthymic patients have been evaluated to establish the degree of depression, personality pathology that is present and the course of the therapeutic intervention. This group , received treatment over a period of 8 weeks. A second group of 22 patients served as a control group. The control group received medication and other therapy. The results of this study indicate that not only 'did the intensity of the depression lift, but certain indexes of psychopathology were also reduced. The indexes of psychopathology that indicated an reduction, were the Avoidant, Self-defeating, Schizotypal, Borderline, Anxiety, Somatoform, Dysthymic as well as Major Depression disorders. The effectiveness of the therapy sessions were also monitored over the , period of 8 weeks and indicated a reduction in certain negative factors, namely: Aggression, Anxiety, Fatigue, Sadness and Skepticism. While these factors indicated a reduction in prevalence the following factors indicated an increase in preValence over the 8 therapy sessions: . Surgency, Elation, Concentration, Social Affect, Egotism and Vigor. Although the test sample were relatively small, it is accepted that it was representative of the universum of the Gauteng region where this sample was taken from. From the results obtained from this study it seems that - this handbook orientated treatment program was not only effective for Dysthymic Depression, but also for certain indexes of psychopathology over the 8-week therapy sessions. From the analysis of the components of the therapy sessions, is clear that the model of the Dysthymic individuals showed an improvement with the handbook orientated treatment program.

Adolescent girls and young women (AGYW) in sub-Saharan Africa are at very high risk of HIV infection. 6% of adolescent AGYW ages 15-19 are infected with HIV, increasing to over 17% by age 20-24. Adolescents matter and yet we have limited, rigorous information on what matters for adolescents living in developing countries and how we can best help them transition safely to adulthood. This chapter uses longitudinal data on a cohort of over 2,000 adolescent girls in rural South Africa who have been followed over 8 years as they transition from adolescence into early adulthood to examine how the timing and occurrence of multiple, non-repeatable social and behavioral determinants shape the risk of HIV acquisition over the adolescent life course. The analysis uses multiple event process survival mixture modeling to examine how key exposures such as childhood sexual abuse, depression, household shocks, poverty, parental loss, early pregnancy, school leaving and gender based violence shape HIV risk during adolescence. This is a unique opportunity to examine key behavioral and social life events in combination and longitudinally among young women in rural Africa, providing unique insights into when best to intervene and on what.

Adolescence is a time of rapid change in the lifecycle, with significant shifts in physical, cognitive and psychological competencies, and major changes in social roles and expectations. However, our collective understanding of the patterning of these changes and the types of support young people require to reach their full human capabilities is still limited. Given that multiple Sustainable Development Goals rest on investments in adolescents (from goals on eliminating harmful traditional practices including child marriage and female genital mutilation to ensuring quality secondary, tertiary and technical and vocational education), investing in a more robust evidence base and improved measurement is critical. The Gender and Adolescence: Global Evidence (GAGE) research programme is a key initiative aimed at contributing to this evidence and measurement lacuna. This article discusses the design and methodological choices of the GAGE study, which is the largest longitudinal research initiative focused on adolescents (10-19 years) in the Global South, following 18,000 adolescent girls and boys in developmental and humanitarian contexts in sub-Saharan Africa, MENA and South Asia. It includes a discussion in line with the 2030 Sustainable Development commitment to leave no one behind of the programme’s purposeful sampling of advantaged adolescents.

While the physical health of women and children is emphasized in international policy guidelines, the mental dimensions of their health are often ignored, especially in developing countries. However, recent and strong evidence suggests that the mental and physical health of mothers and children is inextricably linked, and the one cannot be possible without the other (Prince et al. 2007). This chapter reviews the evidence and suggests directions for policy and research in this area. Depression is the fourth leading cause of disease burden and the largest cause of nonfatal burden, accounting for almost 12% of all total years lived with disability worldwide. Depression around childbirth is common, affecting approximately 10–15% of all mothers in Western societies (O’Hara and Swain 1996). Epidemiological studies from the developing world have reported increasingly high rates of postnatal depression in diverse cultures across the developing world. An early pioneering study by Cox (1979) in a semirural Ugandan tribe found rates of 10% based on the ICD-8 criteria. Two decades later, a community study by Cooper et al. (1999) in a periurban settlement in South Africa, found rates of 34.7%, an increase of over threefold. Hospital-based studies have found rates of 23% in Goa, India (Patel et al. 2002), 22% in eastern Turkey (Inandi 2002) and 15.8% in Dubai, United Arab Emirates (Goubash and Abou-Saleh 1997). A rural-community study in Rawalpindi, Pakistan, reported over 25% women suffering from depression in the antenatal period and 28% in the postnatal period (Rahman et al. 2007). Over half these women were found to be still depressed a year later (Rahman and Creed 2007). A recent meta-analysis shows that the rates in low- and middle-income countries (LAMIC) are higher than high income countries, ranging from 18–25% (Fisher et al. 2012). Risk factors identified include previous psychiatric problems, life events in the previous year, poor marital relationship, lack of social support, and economic deprivation. Female infant gender was found to be an important determinant of postnatal depression in India, but not in South Africa. Importantly, postnatal depression was found to be associated with high degrees of chronicity, disability and disturbances of mother–infant relationship.

ABSTRACT This paper focuses on the tectonic evolution of the North African petroleum basins as the controlling factors on the major basins’ formation, evolution and the hydrocarbon accumulation, analyzing the petroleum enrichment conditions and proposing hydrocarbon accumulation mode. The analysis concludes that the distribution of North Africa Basins is in regular east-west direction, clear depression associates with highland structure. The basins becomes gradually older from the west to the east, corresponding to the Western Paleozoic basin, the Middle part Paleozoic and Mesozoic superimposed basin and the Eastern Mesozoic-Cenozoic rift basin. Petroleum in the Middle-West basins is mainly controlled by western Hercynian tectonic movement with obvious NE – SW distribution character, while petroleum in the East basins controlled by the Alpine tectonic movement, showing NW-SE distribution. Experienced a number of north-south direction reversals, the Paleozoic basin developed in the South and the Mesozoic-Cenozoic superimposed basin overlaying the Paleozoic Basin located in the North. The basins have two different accumulation models, which are younger source rocks associated with the older reservoirs and the older source rocks with the younger reservoirs.