Journal articles 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>

Depression is a common psychiatric disorder and can be costly, having a significant impact on the individual and employers. The South African Depression and Anxiety Group (SADAG) in partnership with HEXOR, with the support of Lundbeck, undertook research into depression in the workplace, because South African information is not available on this topic. It provides insight into the prevalence of depression within the workplace in South Africa, as well as the impact of depression on the employees and employers in terms of sick leave and levels of productivity, especially when the symptoms include cognitive impairment. It is apparent that stigma plays a pivotal role in the reasons for non-disclosure to employers. It further highlights the magnitude of awareness, early detection and the provision of a holistic support system within the work environment, free from bias, to ensure that optimum benefit can be achieved for both employer and employee.

In South Africa, it has been established that a high number and growing proportion of children are growing up without fathers in their lives. Research suggests that some children who grow up without their biological fathers seek to know them during adolescence. Some discover them whilst others never do. This paper aimed to investigate experiences of young women who discover their fathers during adolescence. We undertook a qualitative study in the Mpumalanga Province of South Africa to understand experiences of children who grow up with absent fathers. We conducted face-to-face, gender-matched interviews with young women aged 15 to 26. Five case studies are presented here. We used Topical structural analysis to examine the narratives. Findings reveal that mother or someone else from the maternal family was instrumental in the disclosure of the father’s identity. Four topics that cover the resultant experiences in relation to the father were; a weak or no relationship formed, a positive relationship was formed, the child was disinterested or the mother barred regular visits to the father. This study concludes that the maternal family context, reasons for father absence, how the disclosure happened influence experiences that follow discovering one’s father. Forming a positive relationship with the father depended on the child and father’s common interest.

The prevalence of HIV/AIDS has reached alarming proportions in South Africa. Although it is strongly associated with depressive moods, there are very few published studies on its treatment in patients with HIV/AIDS. This article reviews the prevalence, treatment and potential effects of depressive disorders on immunity and adherence to antiretroviral therapy (ART).The studied prevalence of depressive disorders in HIV-positive patients varies widely, ranging from 0% to 47.8%. However, these patients have nearly twice the likelihood of having had a recent episode of major depressive disorder compared with HIV-negative individuals.<p>Currently available antidepressant medications are equally effective in treating HIV/AIDS patients and the general population. Furthermore, intervention studies have shown that psychotherapy reduces depressive symptoms and is well tolerated. Interpersonal psychotherapy is more successful than supportive psychotherapy in lessening depression, and patients experience improved functioning physically and emotionally.</p><p>Untreated depression may be associated with reduced adherence to ART, immunosuppression, and more rapid HIV illness progression. In South Africa, HIV/AIDS patients may be at greater risk for psychiatric disorder given the potentially stressful living conditions including high rates of unemployment and poverty, poor and unstable housing, inadequate social services, and high rates of crime and domestic violence. A lack of data on depression in South Africa underscores the need for further research.</p>

Purpose: Violence against children increases in adolescence, but there is a research and practice gap in research-supported child abuse prevention for the adolescent years. A pilot program for low-resource settings was developed in collaboration with nongovernmental organizations, government, and academics in South Africa, using research-supported principles. Method: This study used a pre-post design to test initial effects of a 10-session parenting program with 60 participants (30 caregiver–adolescent dyads) in high-poverty rural South Africa. Areas requiring further testing and adaptation were also identified. Results: Pre-post findings show medium to large program effects in reducing child abuse and adolescent problem behavior, as well as large effects in improvements of positive parenting, and perceived parent and adolescent social support. Discussion: There is potential to reduce child abuse, improve parenting, and reduce adolescent problem behavior in rural South Africa through parenting programs. Further development, testing and longer term follow-up are required to ascertain potential for scale-up.

Depression is prevalent among people living with HIV in South Africa and interferes with adherence to antiretroviral therapy. This study evaluated a nurse-delivered, cognitive behavioral therapy intervention for adherence and depression among antiretroviral therapy users with depression in South Africa ( n = 14). Primary outcomes were depression, antiretroviral therapy adherence, feasibility, and acceptability. Findings support robust improvements in mood through a 3-month follow up. Antiretroviral therapy adherence was maintained during the intervention period. Participant retention supports acceptability; however, modest provider fidelity despite intensive supervision warrants additional attention to feasibility. Future effectiveness research is needed to evaluate this nurse-delivered cognitive behavioral therapy intervention for adherence and depression in this context.

AbstractA considerable body of evidence suggests that early caregiving may affect the short-term functioning and longer term development of the hypothalamic–pituitary–adrenocortical axis. Despite this, most research to date has been cross-sectional in nature or restricted to relatively short-term longitudinal follow-ups. More important, there is a paucity of research on the role of caregiving in low- and middle-income countries, where the protective effects of high-quality care in buffering the child's developing stress regulation systems may be crucial. In this paper, we report findings from a longitudinal study (N = 232) conducted in an impoverished periurban settlement in Cape Town, South Africa. We measured caregiving sensitivity and security of attachment in infancy and followed children up at age 13 years, when we conducted assessments of hypothalamus–pituitary–adrenocortical axis reactivity, as indexed by salivary cortisol during the Trier Social Stress Test. The findings indicated that insecure attachment was predictive of reduced cortisol responses to social stress, particularly in boys, and that attachment status moderated the impact of contextual adversity on stress responses: secure children in highly adverse circumstances did not show the blunted cortisol response shown by their insecure counterparts. Some evidence was found that sensitivity of care in infancy was also associated with cortisol reactivity, but in this case, insensitivity was associated with heightened cortisol reactivity, and only for girls. The discussion focuses on the potentially important role of caregiving in the long-term calibration of the stress system and the need to better understand the social and biological mechanisms shaping the stress response across development in low- and middle-income countries.

South Africa represents one of the most rapidly aging countries in sub-Saharan Africa with a rising burden of age-related psychological morbidities. Despite having one of the highest human development scores in the region, the country faces serious poverty and food insecurity related challenges. Previous studies have shown a positive association between food insecurity and poor mental health among the adult population, however there is no systematic evidence on this association among the elderly population in an African setting. In the present study, we aimed to address this research gap by analyzing cross-sectional data (n = 931) on the over-50 population (>50 years) from the SAGE (Study on global AGEing and adult health) Well-Being of Older People Study (WOPS) of the World Health Organization, conducted between 2010 and 2013. The outcome variable was perceived depression and the explanatory variables included several sociodemographic factors including self-reported food insecurity. The independent associations between the outcome and explanatory variables were measured using multivariable regression analysis. Results showed that close to a quarter of the population (22.6%, 95% CI = 21.4, 24.7) reported having depression in the last 12 months, with the percentage being markedly higher among women (71.4%). In the multivariable regression analysis, self-reported food insecurity was found to be the strongest predictor of depression among both sexes. For instance, severe food insecurity increased the odds of depression by 4.805 [3.325, 7.911] times among men and by 4.115 [2.030, 8.341] times among women. Based on the present findings, it is suggested that national food security programs focus on promoting food security among the elderly population in an effort to improve their mental health status. Nonetheless, the data were cross-sectional and the associations can’t imply causality.

Based on the outcome of a previous qualitative study in the same setting it was hypothesized that assessing the prevalence and severity of helplessness and depression, and the quality of social support among people with tuberculosis (TB) may provide indicators of how to provide interventions to enhance their quality of life. Building on the results of previous research it was found that among people with TB who were attending a public health clinic in the Cape Metropole area of South Africa the psychosocial factors that had a negative influence on adherence to the Directly Observed Short Course program were feelings of helplessness (10.9% of the group in the study), depression (64.3%), and inadequate social support. The majority of participants received the most social support from their close relatives. These findings indicate that the assessment and treatment programs at this health site should also be focused on screening for depression and providing necessary interventions where appropriate. Ultimately, these interventions should reduce the burden of TB as an infectious disease.

Black South Africans are disproportionately affected by HIV compared with White counterparts. In their unique social context, South African families affected by HIV are vulnerable to adverse psychosocial effects. U.S.-based and emerging South African research suggests mothers living with HIV may experience compromised parenting. In the United States, mother-child relationship quality has been associated with internalizing (anxiety, depression) and externalizing (delinquency, acting out) child behaviors. This study adds to South African research with emphasis on the role of the mother-child relationship among HIV-affected South Africans from multiple communities. Structural equation modeling examined relationships between maternal health and child adjustment, operating through mother-child relationship. The best-fitting model suggested maternal health influences youth externalizing behaviors through the mother-child relationship, but that maternal health is directly related to child internalizing problems. Findings support and extend previous results. Further research would benefit from investigating ways the unique South African context influences these variables and their interactions.

BackgroundPrevious review studies have not systematically mapped the existing body of knowledge on adolescent sexual and reproductive health (ASRH) in sub-Saharan Africa (SSA). Our scoping review addresses this gap by examining how the body of research on ASRH in SSA has evolved over the past decade, and its present profile, in terms of trends in volume, geographic and substantive focus, and Africa-led inquiry.MethodsWe used a three-step search strategy to identify English and French peer-reviewed publications and relevant grey literature on ASRH in SSA published between January 2010 and December 2019. Two reviewers screened the titles, abstracts and full texts of publications for eligibility and inclusion.ResultsA total of 1302 articles were published over the period, rising from 91 in 2010 to 183 in 2015. However, the bulk of the studies (63.9%) focused on six (South Africa, Kenya, Nigeria, Tanzania, Uganda and Ethiopia) of the 46 SSA countries. Ten countries had no ASRH papers, while five others each had only one publication. While issues like HIV (17.2%), sexual behaviours (17.4%) and access to sexual and reproductive health services (13.0%) received substantial attention, only a few studies focused on early adolescence (10–14 years), programme interventions, scaling up of interventions and policy evaluation. Just over half of publications had authors with African institutional affiliations as first authors (51.1%) or last author (53.0%). Sixteen per cent of papers did not include any authors from institutions in Africa.ConclusionsOur review demonstrated that research on ASRH is limited in focus and is unevenly distributed across SSA countries. The identified gaps can guide future research and funding to advance ASRH policies and programmes. It is also vital for stakeholders in the research enterprise, including researchers, donors, ethical review boards, and journal editors and reviewers, to implement measures that foster national investigators’ inclusion.

Research conducted over the past 20 years has linked exposure to violence to posttraumatic stress disorder (PTSD) in children both in the United States and South Africa, but very little research has investigated PTSD as a mediating variable between exposure to violence and other problems. The purpose of the current research was to determine if PTSD acts as a mediating variable between exposure to violence and depression, and exposure to violence and aggressive and violent behavior at school among a sample of 247 South African children. Regression analysis suggested that PTSD mediated the effects of exposure to violence on depression, whereas the effect of exposure to violence on aggression and violent behavior was only direct. The findings are discussed in terms of their implications for intervention and treatment.

The scarcity of mental health resources in low- and middle-income countries requires the identification of effective interventions that can be taken to scale in a cost-efficient manner. Yet the evidence base for treatment of common mental disorders in low- and middle-income countries remains limited. As one of the better resourced countries on the African continent, South Africa could potentially play a leading role in developing an African evidence base for mental health care. This study sought to describe and evaluate the South African evidence base for treating common mental disorders. A systematic review of randomised controlled trials for depression, substance use, and anxiety in the adult South African population from 2000 to mid-2015 was conducted. Eligible studies were assessed for their consistency with recommendations for mental health interventions in low- and middle-income countries and for methodological and reporting rigour. A total of 16 RCTs satisfied the inclusion criteria, of which 8 targeted depression, 6 targeted substance use, and 2 targeted anxiety symptoms. There has been a strong trend towards alignment with prevailing recommendations for delivery of mental health interventions in resource-scarce regions. While there are some promising findings with regard to effectiveness of specific interventions, replication, costing, and dissemination studies are still required and there is still an urgent need for treatment studies for anxiety disorders, which are the most common class of common mental disorder in South Africa. The review also indicates that research design and reporting practices in South African mental health intervention research could be enhanced and recommendations towards this are suggested.

SummaryEarly sexual debut is of major concern because it is a correlate for health and economic shocks experienced in adulthood. In South Africa, this concern has provided impetus for research directed at the HIV and AIDS epidemic, teenage pregnancy and the effect of adolescent sexual behaviour on persistence in school. Of interest to the present study is high school completion, which is a well-established empirical barometer of adult socioeconomic opportunities. Using data from the five waves of the Cape Area Panel Study (CAPS), this paper examines the association between sexual behaviours initiated in pre- and early adolescence and high school completion rates. The CAPS study is a longitudinal survey that was designed to investigate young people’s (aged 14–22 years) educational attainment and sexual behaviours in Cape Town, South Africa. The sample was constituted from 3213 individuals who had initiated sex during their teenage years and the analysis was undertaken when the youngest cohort was aged 21, an age at which they should have completed high school if they were on time. Logistic regression models were fitted separately for males and females. Overall, the results reveal that early sexual debut is correlated with long-term negative educational outcomes. Individuals who experience early sexual debut are less likely to complete high school than their counterparts who make their sexual debut later on in life. This effect is worse for Africans, who also disproportionately have an earlier sexual debut than other race groups. Apart from race however, the findings also reinforce the effect of other demographic factors on high school completion, namely, place of residence and family socioeconomic status as measured by parental education and household income. Hence, early sexual debut adds another layer of inequality and worsens the plight of Africans, females, those living in rural areas and those who come from low-income families.

Recent research has shown that the prevalence of stroke incidents and the number of survivors in developing countries surpass those from developed countries. This study aimed to enumerate the prevalence of post-stroke psychiatric and cognitive symptoms among stroke survivors from West and South Asia and Africa through a systematic review and meta-analysis. Data from each country was systematically acquired from five major databases (PsycINFO, Web of Science, Scopus, PubMed/Medline, and Google Scholar (for any missing articles and grey literature)). Meta-analytic techniques were then used to estimate the prevalence of various post-stoke psychiatric and cognitive symptoms. A total of 36 articles were accrued from 11 countries, of which 25 were evaluated as part of the meta-analysis. The pooled prevalence of post-stroke depression as per the Hospital Anxiety and Depression Scale (HADS), Hamilton Depression Rating Scale, Patient Health Questionnaire, Schedules for Clinical Assessment in Neuropsychiatry (SCAN), Geriatric Depression Scale, and the Montgomery–Asberg Depression Rating Scale ranged from 28.00 to 50.24%. Pooled prevalence of post-stroke anxiety based on the HADS and SCAN was 44.19% and 10.96%, respectively. The pooled prevalence of post-stroke cognitive impairment as per the Mini-Mental Status Examination was 16.76%. This present review has suggested that both psychiatric and cognitive symptoms are common among stroke survivors. Concerted efforts are needed to institute robust studies using culturally sensitive measures to contemplate mechanisms that address the unmet needs of this vulnerable population.

AbstractGrowth in early life is associated with various individual health outcomes in adulthood, but limited research has been done on associations with a more comprehensive measure of health. Combining information from multiple biological systems, allostatic load (AL) provides such a quantitative measure of overall physiological health. We used longitudinal data from the Birth to Twenty Plus cohort in South Africa to calculate an AL score at age 22 years and examined associations with birth weight and linear growth and weight gain from age 0 to 2 years and 2 to 5 years, as attenuated by trajectories of body mass index and pubertal development in later childhood and adolescence. Differences in total AL score between males and females were small, though levels of individual biological factors contributing to AL differed by sex. Increased weight gain from age 2 to 5 years among males was associated with an increased risk of high AL, but no other early-life measures were associated with AL. Increased adiposity through childhood and adolescence in females was associated with higher AL in early adulthood. These results illustrate that patterns of early-life growth are not consistently associated with higher AL. While more research is needed to link AL in young adulthood to later health outcomes, these results also suggest increased adiposity during childhood and adolescence represents a potential early sign of later physiological risk.

<p><strong>List of abstracts and authors:</strong></p><p><strong>1. Bipolar disorder not otherwise specified -overdiagnosed or underdiagnosed?</strong></p><p>E Allers</p><p><strong>2. The prognosis of major depression untreated and treated: Does the data reflect the true picture of the prognosis of this very common disorder?</strong></p><p>E Allers</p><p><strong>3. Can we prolong our patients' life expectancy? Providing a better quality of life for patients with severe mental illness</strong></p><p>O A Betencourt</p><p><strong>4. The scope of ECT practice in South Africa</strong></p><p>J Benson-Martin, P Milligan</p><p><strong>5. Biomarkers for schizophrenia: Can we evolve like cancer therapeutics?</strong></p><p>P Buckley<strong></strong></p><p><strong>6. Relapse in schizophrenis: Major challenges in prediction and prevention</strong></p><p>P Buckley</p><p><strong>7. Informed consent in biological treatments: The right to know the duty to inform</strong></p><p><strong></strong>I Chetty</p><p><strong>8. Effectiveness of a long-acting injectable antipsychotic plus an assertive monitoring programme in first-episode schizophrenia</strong></p><p><strong></strong>B Chiliza, L Asmal, O Esan, A Ojagbemi, O Gureje, R Emsley</p><p><strong>9. Name, shame, fame</strong></p><p>P Cilliers</p><p><strong>10. Can we manage the increasing incidence of violent raging children? We have to!</strong></p><p>H Clark</p><p><strong>11. Serotonin, depression and antidepressant action</strong></p><p>P Cowen</p><p><strong>12. Prevalence and correlates of comorbid psychiatris illness in patients with heroin use disorder admitted to Stikland Opioid Detoxification Unit</strong></p><p>L Dannatt, K J Cloete, M Kidd, L Weich</p><p><strong>13. Investigating the association between diabetes mellitus, depression and psychological distress in a cohort of South African teachers</strong></p><p>A K Domingo, S Seedat, T M Esterhuizen, C Laurence, J Volmink, L Asmal</p><p><strong>14. Neuropeptide S -emerging evidence for a role in anxiety</strong></p><p>K Domschke</p><p><strong>15. Pathogenetics of anxiety</strong></p><p>K Domschke</p><p><strong>16. The effects of HIV on the fronto-striatal system</strong></p><p>S du Plessis, M Vink, J Joska, E Koutsilieri, C Scheller, B Spottiswoode, D Stein, R Emsley</p><p><strong>17. Effects of acute antipsychotic treatment on brain morphology in schizophrenia</strong></p><p>R Emsley, L Asmal, B Chiliza, S du Plessis, J Carr, A Goosen, M Kidd, M Vink, R Kahn</p><p><strong>18. Development of a genetic database resource for monitoring of breast cancer patients at risk of physical and psychological complications</strong></p><p>K Grant, F J Cronje, K Botha, J P Apffelstaedt, M J Kotze</p><p><strong>19. Unipolar mania reconsidered: Evidence from a South African study</strong></p><p><strong></strong>C Grobler</p><p><strong>20. Antipsychotic-induced movement disorders: Occurence and management</strong></p><p>P Haddad</p><p><strong>21. The place of observational studies in assessing the effectiveness of long-acting injectable antipsychotics</strong></p><p>P Haddad</p><p><strong>22. Molecular mechanisms of d-cycloserine in fear extinction: Insights from RNS sequencing</strong></p><p>S Hemmings, S Malan-Muller, L Fairbairn, M Jalali, E J Oakeley, J Gamieldien, M Kidd, S Seedat</p><p><strong>23. Schizophrenia: The role of inflammation</strong></p><p>DC Henderson</p><p><strong>24. Addictions: Emergent trends and innovations</strong></p><p>V Hitzeroth</p><p><strong>25. The socio-cultural-religious context of biological psychiatric practice</strong></p><p>B Janse van Rensburg</p><p><strong>26. Biochemical markers for identifying risk factors for disability progression in multiple sclerosis</strong></p><p><strong></strong>S Janse van Rensburg, M J Kotze, F J Cronje, W Davis, K Moremi, M Jalali Sefid Dashti, J Gamieldien, D Geiger, M Rensburg, R van Toorn, M J de Klerk, G M Hon, T Matsha, S Hassan, R T Erasmus</p><p><strong>27. Alcohol-induced psychotic disorder: Brain perfusion and psychopathology - before and after antipsychotic treatment</strong></p><p>G Jordaan, J M Warwick, D G Nel, R Hewlett, R Emsley</p><p><strong>28.'Pump and dump': Harm reduction strategies for breastfeeding while using substances</strong></p><p>L Kramer</p><p><strong>29. Adolescent neuropsychiatry - an emerging field in South African adolescent psychiatric services</strong></p><p>A Lachman</p><p><strong>30. Recovery versus remission, or what it means to be healthy for a psychiatric patient?</strong></p><p>B Latecki</p><p><strong>31. Holistic methods utilised to normalise behaviours in youth diagnosed with neuro-biochemical disorders</strong></p><p>P Macqueen</p><p><strong>32. Candidate genes and novel polymorphisms for anxiety disorder in a South African cohort</strong></p><p>N McGregor, J Dimatelis, S M J Hemmings, C J Kinnear, D Stein, V Russel, C Lochner</p><p><strong>33. Higher visual functioning</strong></p><p>A Moodley</p><p><strong>34. The effects of prenatal methylmercury exposure on trace element and antioxidant levels in rat offspring following 6-hydroxydopamine-induced neuronal insult</strong></p><p>Z M Moosa, W M U Daniels, M V Mabandla</p><p><strong>35. Paediatric neuropsychiatric movement disorders</strong></p><p>L Mubaiwa</p><p><strong>36. The South African national female offenders study</strong></p><p>M Nagdee, L Artz, C de Clercq, P de Wet, H Erlacher, S Kaliski, C Kotze, L Kowalski, J Naidoo, S Naidoo, J Pretorius, M Roffey, F Sokudela, U Subramaney</p><p><strong>37. Neurobiological consequences of child abuse</strong></p><p>C Nemeroff</p><p><strong>38. What do Stellenbosch Unviversity medical students think about psychiatry - and why should we care?</strong></p><p>G Nortje, S Suliman, K Seed, G Lydall, S Seedat</p><p><strong>39. Neurological soft skins in Nigerian Africans with first episode schizophrenia: Factor structure and clinical correlates</strong></p><p><strong></strong>A Ojagbemi, O Esan, O Gureje, R Emsley</p><p><strong>40. Should psychiatric patients know their MTHFR status?</strong></p><p>E Peter</p><p><strong>41. Clinical and functional outcome of treatment refractory first-episode schizophrenia</strong></p><p>L Phahladira, R Emsley, L Asmal, B Chiliza</p><p><strong>42. Bioethics by case discussion</strong></p><p>W Pienaar</p><p><strong>43. Reviewing our social contract pertaining to psychiatric research in children, research in developing countries and distributive justice in pharmacy</strong></p><p>W Pienaar</p><p><strong>44. The performance of the MMSE in a heterogenous elderly South African population</strong></p><p>S Ramlall, J Chipps, A I Bhigjee, B J Pillay</p><p><strong>45. Biological basis addiction (alocohol and drug addiction)</strong></p><p>S Rataemane</p><p><strong>46. Volumetric brain changes in prenatal methamphetamine-exposed children compared with healthy unexposed controls</strong></p><p><strong></strong>A Roos, K Donald, G Jones, D J Stein</p><p><strong>47. Single voxel proton magnetic resonance spectroscopy of the amygdala in social anxiety disorder in the context of early developmental trauma</strong></p><p>D Rosenstein, A Hess, S Seedat, E Meintjies</p><p><strong>48. Discussion of HDAC inhibitors, with specific reference to supliride and its use during breastfeeding</strong></p><p>J Roux</p><p><strong>49. Prevalence and clinical correlates of police contact prior to a first diagnosis of schizophrenia</strong></p><p>C Schumann, L Asmal, K Cloete, B Chiliza, R Emsley</p><p><strong>50. Are dreams meaningless?</strong></p><p>M Solms</p><p><strong>51. The conscious id</strong></p><p>M Solms<strong></strong></p><p><strong>52. Depression and resilience in HIV-infected women with early life stress: Does trauma play a mediating role?</strong></p><p>G Spies, S Seedat</p><p><strong>53. State of affairs analysis for forensic psychiatry in SA</strong></p><p>U Subramaney</p><p><strong>54. Escitalopram in the prevention of post-traumatic stress disorder: A pilot randomised controlled trial</strong></p><p>S Suliman, S Seedat, J Pingo, T Sutherland, J Zohar, D J Stein</p><p><strong>55. Epigenetic consequences of adverse early social experiences in primates</strong></p><p>S Suomi</p><p><strong>56. Risk, resilience, and gene x environment interactions in primates</strong></p><p>S Suomi</p><p><strong>57. Biological aspects of anorexia nervosa</strong></p><p>C Szabo</p><p><strong>58. Agents used and profiles of non-fatal suicidal behaviour in East London</strong></p><p>H Uys</p><p><strong>59. The contributions of G-protein coupled receptor signalling to opioid dependence</strong></p><p>J van Tonder</p><p><strong>60. Emerging trend and innovation in PTSD and OCD</strong></p><p>J Zohar</p><p><strong>61. Making the SASOP treatment guidelines operational</strong></p><p>E Allers</p><p><strong>Poster Presentations</strong></p><p><strong>62. Neuropsychological deficits in social anxiety disorder in the context of early developmental trauma</strong></p><p><strong></strong>S Bakelaar, D Rosenstein, S Seedat</p><p><strong>63.Social anxiety disorder in patients with or without early childhood trauma: Relationship to behavioral inhibition and activation and quality of life</strong></p><p><strong></strong>S Bakelaar, C Bruijnen, A Sambeth, S Seedat</p><p><strong>64. Exploring altered affective processing in obssessive compulsive disorder symptom subtypes</strong></p><p>E Breet, J Ipser, D Stein, C Lochner<strong><br /></strong></p><p><strong>65. To investigate the bias toward recognising the facial expression of disgust in obsessive compulsive disorder as well as the effect of escitalopram</strong></p><p>E Breet, J Ipser, D Stein, C Lochner</p><p><strong>66. A fatal-case of nevirapine-induced Stevens-Johnson's syndrome in HIV mania</strong></p><p>A Bronkhorst, Z Zingela, W M Qwesha, B P Magigaba<strong></strong></p><p><strong>67. Association of the COMT G472A (met/met) genotype with lower disability in people diagnosed with multiple sclerosis</strong></p><p>W Davis, S J van Rensburg, L Fisher, F J Cronje, D Geiger, M J Kotze</p><p><strong>68. Homocycsteine levels are associated with the fat mass and obesity associated gene FTO(intron 1 T&gt;A) polymorphism in MS patients</strong></p><p>W Davis, S J Van Rensburg, M J Kotze, L Fisher, M Jalali, F J Cronje, K Moremi, J Gamieldien, D Geiger, M Rensburg, R van Toorn, M J de Klerk, G M Hon, T Matsha, S Hassan, R T Erasmus</p><p><strong>69. Analysis of the COMT 472 G&gt;A (rs4680) polymorphism in relation to environmental influences as contributing factors in patients with schizophrenia</strong></p><p>D de Klerk, S J van Rensburg, R A Emsley, D Geiger, M Rensburg, R T Erasmus, M J Kotze</p><p><strong>70. Dietary folate intake, homocysteine levels and MTHFR mutation detection in South African patients with depression: Test development for clinical application </strong></p><p>D Delport, N vand der Merwe, R Schoeman, M J Kotze</p><p><strong>71. The use ofexome sequencing for antipsychotic pharmacogenomic applications in South African schizophrenia patients</strong></p><p>B Drogmoller, D Niehaus, G Wright, B Chiliza, L Asmal, R Emsley, L Warnich</p><p><strong>72. The effects of HIV on the ventral-striatal reward system</strong></p><p>S du Plessis, M Vink, J Joska, E Koutsilieri, C Scheller, B Spottiswoode, D Stein, R Emsley</p><p><strong>73. Xenomelia relates to asymmetrical insular activity: A case study of fMRI</strong></p><p>S du Plessis, M Vink, L Asmal</p><p><strong>74. Maternal mental helath: A prospective naturalistic study of the outcome of pregancy in women with major psychiatric disorders in an African country</strong></p><p>E du Toit, L Koen, D Niehaus, B Vythilingum, E Jordaan, J Leppanen</p><p><strong>75. Prefrontal cortical thinning and subcortical volume decrease in HIV-positive children with encephalopathy</strong></p><p>J P Fouche, B Spottiswoode, K Donald, D Stein, J Hoare</p><p><strong>76. H-magnetic resonance spectroscopy metabolites in schizophrenia</strong></p><p>F Howells, J Hsieh, H Temmingh, D J Stein</p><p><strong>77. Hypothesis for the development of persistent methamphetamine-induced psychosis</strong></p><p><strong></strong> J Hsieh, D J Stein, F M Howells</p><p><strong>78. Culture, religion, spirituality and psychiatric practice: The SASOP Spirituality and Psychiatry Special Interest Group Action Plan for 2012-2014</strong></p><p>B Janse van Rensburg</p><p><strong>79. Cocaine reduces the efficiency of dopamine uptake in a rodent model of attention-deficit/hyperactivity disorder: An <em>in vivo</em> electrochemical study</strong></p><p><strong></strong>L Kellaway, J S Womersley, D J Stein, G A Gerhardt, V A Russell</p><p><strong>80. Kleine-Levin syndrome: Case in an adolescent psychiatric unit</strong></p><p>A Lachman</p><p><strong>81. Increased inflammatory stress specific clinical, lifestyle and therapeutic variables in patients receiving treatment for stress, anxiety or depressive symptoms</strong></p><p>H Luckhoff, M Kotze, S Janse van Rensburg, D Geiger</p><p><strong>82. Catatonia: An eight-case series report</strong></p><p>M Mabenge, Z Zingela, S van Wyk</p><p><strong>83. Relationship between anxiety sensitivity and childhood trauma in a random sample of adolescents from secondary schools in Cape Town</strong></p><p>L Martin, M Viljoen, S Seedat</p><p><strong>84. 'Making ethics real'. An overview of an ethics course presented by Fraser Health Ethics Services, BC, Canada</strong></p><p>JJ McCallaghan</p><p><strong>85. Clozapine discontinuation rates in a public healthcare setting</strong></p><p>M Moolman, W Esterhuysen, R Joubert, J C Lamprecht, M S Lubbe</p><p><strong>86. Retrospective review of clozapine monitoring in a publica sector psychiatric hospital and associated clinics</strong></p><p>M Moolman, W Esterhuysen, R Joubert, J C Lamprecht, M S Lubbe</p><p><strong>87. Association of an iron-related TMPRSS6 genetic variant c.2007 C&gt;7 (rs855791) with functional iron deficiency and its effect on multiple sclerosis risk in the South African population</strong></p><p>K Moremi, S J van Rensburg, L R Fisher, W Davis, F J Cronje, M Jalali Sefid Dashti, J Gamieldien, D Geiger, M Rensburg, R van Toorn, M J de Klerk, G M Hon, T Matsha, S Hassan, R T Erasmus, M Kidd, M J Kotze</p><p><strong>88. Identifying molecular mechanisms of apormophine-induced addictive behaviours</strong></p><p>Z Ndlazi, W Daniels, M Mabandla</p><p><strong>89. Effects of lifestyle factors and biochemistry on the major neck blood vessels in patients with mutiple sclerosis</strong></p><p>M Nelson, S J van Rensburg, M J Kotze, F Isaacs, S Hassan</p><p><strong>90. Nicotine protects against dopamine neurodegenration and improves motor deficits in a Parkinsonian rat model</strong></p><p>N Ngema, P Ngema, M Mabandla, W Daniels</p><p><strong>91. Cognition: Probing anatomical substrates</strong></p><p>H Nowbath</p><p><strong>92. Chronic exposure to light reverses the effects of maternal separation on the rat prefrontal cortex</strong></p><p>V Russel, J Dimatelis</p><p><strong>93. Evaluating a new drug to combat Alzheimer's disease</strong></p><p>S Sibiya, W M U Daniels, M V Mabandla</p><p><strong>94. Structural brain changes in HIV-infected women with and without childhood trauma</strong></p><p>G Spies, F Ahmed, C Fennema-Notestine, S Archibald, S Seedat</p><p><strong>95. Nicotine-stimulated release of hippocampal norepinephrine is reduced in an animal model of attention-deficit/ hyperactivity disorder: the spontaneously hypertensive rat</strong></p><p>T Sterley</p><p><strong>96. Brain-derive neurotrophic factor (BDNF) protein levels in anxiety disorders: Systematic review and meta-regression analysis</strong></p><p>S Suliman, S M J Hemmings, S Seedat</p><p><strong>97. A 12-month retrospective audit of the demographic and clinical profile of mental healthcare users admitted to a district level hospital in the Western Cape, South Africa</strong></p><p>E Thomas, K J Cloete, M Kidd, H Lategan</p><p><strong>98. Magnesium recurarization: A comparison between reversal of neuromuscular block with sugammadex v. neostigmine/ glycopyrrolate in an <em>in vivo</em> rat model</strong></p><p><strong></strong>M van den Berg, M F M James, L A Kellaway</p><p><strong>99. Identification of breast cancer patients at increased risk of 'chemobrain': Case study and review of the literature</strong></p><p>N van der Merwe, R Pienaar, S J van Rensburg, J Bezuidenhout, M J Kotze</p><p><strong>100. The protective role of HAART and NAZA in HIV Tat protein-induced hippocampal cell death</strong></p><p>S Zulu, W M U Daniels, M V Mabandla</p>

There is limited evidence on the acceptability, feasibility and cost-effectiveness of task-sharing interventions to narrow the treatment gap for mental disorders in sub-Saharan Africa. The purpose of this article is to describe the rationale, aims and methods of the Africa Focus on Intervention Research for Mental health (AFFIRM) collaborative research hub. AFFIRM is investigating strategies for narrowing the treatment gap for mental disorders in sub-Saharan Africa in four areas. First, it is assessing the feasibility, acceptability and cost-effectiveness of task-sharing interventions by conducting randomised controlled trials in Ethiopia and South Africa. The AFFIRM Task-sharing for the Care of Severe mental disorders (TaSCS) trial in Ethiopia aims to determine the acceptability, affordability, effectiveness and sustainability of mental health care for people with severe mental disorder delivered by trained and supervised non-specialist, primary health care workers compared with an existing psychiatric nurse-led service. The AFFIRM trial in South Africa aims to determine the cost-effectiveness of a task-sharing counselling intervention for maternal depression, delivered by non-specialist community health workers, and to examine factors influencing the implementation of the intervention and future scale up. Second, AFFIRM is building individual and institutional capacity for intervention research in sub-Saharan Africa by providing fellowship and mentorship programmes for candidates in Ethiopia, Ghana, Malawi, Uganda and Zimbabwe. Each year five Fellowships are awarded (one to each country) to attend the MPhil in Public Mental Health, a joint postgraduate programme at the University of Cape Town and Stellenbosch University. AFFIRM also offers short courses in intervention research, and supports PhD students attached to the trials in Ethiopia and South Africa. Third, AFFIRM is collaborating with other regional National Institute of Mental Health funded hubs in Latin America, sub-Saharan Africa and south Asia, by designing and executing shared research projects related to task-sharing and narrowing the treatment gap. Finally, it is establishing a network of collaboration between researchers, non-governmental organisations and government agencies that facilitates the translation of research knowledge into policy and practice. This article describes the developmental process of this multi-site approach, and provides a narrative of challenges and opportunities that have arisen during the early phases. Crucial to the long-term sustainability of this work is the nurturing and sustaining of partnerships between African mental health researchers, policy makers, practitioners and international collaborators.

Background: Sex work is a high-risk occupation for mental health problems as sex workers are vulnerable to high rates of violence, sexual coercion, stigma and HIV. Aim: To determine the prevalence of depressive and anxiety symptoms and substance use in sex workers.Method: A crosssectional questionnaire survey of all men and women attending the Sisonke health initiative, a non-profit non-governmental organisation (NGO), for sex workers was conducted over three months. A socio-demographic questionnaire, the Self Reporting Questionnaire (SRQ 20), the Patient Health Questionnaire (PHQ 9) and the WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST V3.0) were administered. Results: A total of 155 participants were surveyed. The prevalence of anxiety and depressive symptoms on the SRQ 20 and PHQ 9 total scores were 78.4% and 80.9% respectively. Some 40% of sex workers reported suicidal ideation in the year preceding the study. High rates of violence (n = 112, 72%) and childhood abuse (n = 107, 69%) were reported. The prevalence of HIV was 76.1%. The lifetime prevalence of substance use for nicotine (87.8%), alcohol (87.8%) and cannabis (87.7%) was high. Despite the high prevalence of psychiatric symptoms reported, only 15 (9.7%) participants were receiving psychiatric treatment at the time of the survey. Conclusions: The high prevalence of anxiety, depression, suicidal ideation, substance use and co-morbid HIV infection reported by sex workers and the significant treatment gap suggests an urgent need to provide an integrated health service that targets physical and mental health in sex workers. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2016.1272247

172 Background: In the USA, use of patient-reported outcome (PRO) instruments for monitoring treatment toxicity has been associated with improved patient quality of life (QoL) and clinical outcomes. No similar PRO tools exist for the African cancer patients. We aimed to validate the Patient Reported Symptoms – South Africa (PRS-SA) survey, a novel PRO tool designed to measure subjective stress and symptoms in South African (SA) cancer patients receiving chemotherapy. Methods: We enrolled patients receiving chemotherapy at the oncology clinic at Charlotte Maxeke Hospital, Johannesburg. At 3 separate visits, participants completed the PRS-SA survey, which allowed reporting of stress on a numerical ranking scale (range 0-10) and severity of 11 common chemotherapy-related symptoms (i.e., pain, fatigue, fever, dyspnea, cough, mucositis, nausea, vomiting, diarrhea, constipation, and neuropathy) using lay language descriptions corresponding to Common Terminology Criteria for Adverse Events grades. They simultaneously completed the EORTC Core Quality of Life Questionnaire (QLQ-C30), the Global Impression of Change (GIC) questionnaire, and the Hospital Anxiety and Depression Scale (HADS). All instruments were offered in English and isiZulu. We constructed a receiver operator characteristics (ROC) curve for stress scale values and a total HADS score ≥15, representing clinical depression/anxiety. We evaluated construct validity for each symptom item by comparing symptom severity to the simultaneous QLQ-C30 summary score (Pearson correlation tests) and ECOG performance status (PS) (Mann-Whitney U tests). We assessed symptom item responsiveness by comparing change in severity across visits to change in QLQ-C30 summary score and comparing standardized mean symptom scores in those reporting negative, no, or positive change on the GIC using a Jockheere-Terpstra trend test. Results: Overall, 196 participants completed instruments at visit 1, 173 at visit 2, and 150 at visit 3. Area under the ROC curve for stress score was 0.76, and a score of 4 had 82% sensitivity and 55% specificity for clinical depression/anxiety. All symptom items showed construct validity by association with QLQ-C30 score (all p-values < 0.0001), and all but mucositis showed validity by association with ECOG PS (highest p = 0.03). All but cough showed responsiveness to change in QLQ-C30 score (highest p = 0.045), and the standardized mean in symptom scores demonstrated a trend across negative, neutral, and positive GIC scores (p = 0.03). Conclusions: In SA cancer patients, the PRS-SA’s stress scale behaves similarly to the distress thermometer in other populations, and the symptom items demonstrated construct validity and responsiveness. Further research should address implementation of the PRS-SA in the clinical setting for monitoring cancer treatment-related toxicity and its impact of patients’ QoL and outcomes.

Abstract Investigations of extreme rainfall events in the southern African region are limited by the paucity of the observational network. Furthermore, the lack of full radar coverage for South Africa makes quantitative precipitation estimation difficult. Therefore, numerical modeling represents the most effective method for improving the understanding of the mechanisms that contribute to extreme rainfall events in this region with the caveat that accurate validation of model simulations is hampered by the limited observations in the region. This paper describes an intense cutoff low event over South Africa that led to record rainfall and flash flooding along the south coast of the country and adjoining hinterland. Analyses from the Global Forecast System model showed that the cutoff aloft was accompanied by a strong low-level jet (LLJ) impinging onto the south coast where rainfall was heaviest, and that lapse rates were steep in the lower troposphere. Simulations of the event were carried out using a numerical model [i.e., the fifth-generation Pennsylvania State University–National Center for Atmospheric Research Mesoscale Model (MM5)], which showed that severe convection occurred over the ocean on the right-hand side of the LLJ, and at its leading edge where it impinged on the coastal topography. This topography was also very important in providing additional forcing for the ascent of moist air. A factor separation technique was used to show that surface heat fluxes from the warm sea surface temperature (SST) of the Agulhas Current were important in enhancing low-level cyclogenesis, and that topography was important in maintaining the position of the low-level coastal depression, which led to favorable conditions for rainfall remaining in the same area for an extended period of time. It is suggested that improved representation of the tight topographic and SST gradients of the southern African region in NWP models or postprocessing systems would help to provide more accurate forecasts of the amount and location of heavy precipitation during cutoff low events where surface forcing is important.

This study examined the level of maternal depressive symptoms and ways of coping among mothers with preterm infants as compared with those of 50 mothers with full-term babies. It was conducted in a hospital in Pretoria, South Africa, using the Edinburgh Postnatal Depression Scale (EPDS; Cox, Holden, & Sagovsky, 1987) and the Ways of Coping Questionnaire (Folkman & Lazarus, 1988). No significant difference was found in the level of depression between the two groups. The overall level of depression found with both combined groups, was 2–3 times higher than those suggested in the literature. A positive correlation was found between the “Seeking Social Support” coping strategy and higher levels of depression among mothers of preterm infants. A positive correlation was also found among mothers of full-term infants who used the “Accepting Responsibility” coping strategy and higher levels of depression. The high number of mothers in this study identified as suffering from a depressive illness of varying severity raises concern. A clear need for professional help among this population is emphasized. Future research in this area is needed in order to better understand and effectively address this problem.

Background: The number of people who suffer and die from Cardiovascular Disease (CVD) is increasing at an alarming rate in low-and middle-income countries. Objective: The objective of the study was to screen communities using the non-laboratory INTERHEART Risk Score tool (NLIRS) to determine their level of risk for developing CVD. Methods: A community-based quantitative study was conducted in the Capricorn District of Limpopo Province. A total of 3315 participants were screened by 63 community health workers (CHWs) using the NLIRS tool. The tool covers the following items which are allocated different scores: Gender:male ≥55 years or female ≥65years=2; being a smoker or having stopped ≤12 months ago = 2; smoking1-5 cigarettes =2; 6-10=4; 11-15=6;16-20 a day and ≥20=11; indirect smoking last 12 months =2; having diabetes=6 and high blood pressure=5; parental history of heart attack=4; having stress and depression=3 each; consumption of salty and fried food, no vegetables or fruits each scored a 1; eating meat twice a day =2; being inactive =2; waist-to-hip ratio ≥.874-0.963=2 and ≥0.964=4. The scores were added and those who scored 0-9 were classified to be at low risk, 10-15 moderate and 16-48 at high risk. Results: On average 58% and 33% were found to be at low and moderate risk, respectively for developing CVD and 9% at high risk. The majority consumed salty, fried foods and meat and were inactive. Being hypertensive constituted 67% of being at high risk of developing CVD. Conclusion: Envisaged intervention will focus on preventive strategies for risk factors such as diet, exercise and hypertension. More males should be recruited to participate in future research to determine if the same results will be obtained.

Background: Evidence suggests that South African traditional healers (THs) treat various mental complaints. However, there is little literature on Swati THs’ accounts on this subject. The current study therefore, sought to address this gap. Methods: Data was gathered using qualitative research methods, namely semi-structured interviews with 10 purposely sampled Swati THs practicing in the Kanyamazane peri-urban township (Mpumalanga Province, South Africa). Data was thematically analysed. Results: Results showed that THs treat seven psychological aliments, viz. adjustment disorders, depression, mental illness due to ancestral calling, mental illness due to bewitchment, mental illness due to breaking of taboos, psychotic disturbance and substance induced mental illness. Generally, an integrated treatment protocol was utilised by THs to treat and manage these disorders. Most of these procedures are acceptable from either folkloric or scientific viewpoint, and have demonstrat- ed certain level of efficacy in treating mental illness. Conclusion: Taken together, the evidence presented indicates that Swati THs use different traditional methods to manage various mental complaints. In doing so, they carry a large share of the community caseload for mental health, whilst admit- ting patients in their homes for extended periods of time, and also referring some (patients) for additional care within the Western health sector. Keywords: Mental illness; Mpumalanga; Swati; traditional healers; treatment methods; psychological ailments.

This research sought to investigate the role of social networks in coping and adjustment to spousal bereavement. A total of 198 Xhosa-speaking participants, drawn from the rural areas of the Eastern Cape Province, South Africa, took part in the study. Quantitative data analyses revealed significant correlations between perceived social support on Social Support Appraisals scale and the anxiety scores on the Beck Depression Inventory-Second Edition and the problem-solving coping strategy scale on the Coping Strategy Indicator. Regression analyses revealed that depression contributed to increased social support appraisals, while anxiety was a significant negative predictor of the participants' experience of perceived social support. The authors highlight the need for bereavement intervention programs in the rural areas to be geared toward psycho-educating the conjugally bereaved individuals, within the socio-cultural framework, to continuously evaluate their support structures and strengthen ties with social networks that render support, instrumental assistance, and advice in times of need.

Background: Depression in the geriatric population has been identified as a significant problem in view of the associated negative outcomes regarding poor functioning, increased perception of poor health and increased utilisation of medical services. Significantly associated with increased morbidity and mortality, depression has been found to be an independent cause of disability as well as adding to disability due to primary physical illnesses. Early identification and treatment of depression reduces medical costs and lessens caregiver burden. Epidemiological data and prevalence rates of geriatric depression in Africa are limited, although such data are vital to mobilise and plan government mental health initiatives aimed at screening and early intervention. Objective: To determine the prevalence of depression and associated clinical and socio-demographic factors amongst older adult patients attending a primary health care clinic in the Ethekwini District in Kwa-Zulu Natal, South Africa. Methods: The 15-item Geriatric Depression Scale and a socio-demographic questionnaire were administered in English to 255 geriatric outpatients, randomly selected, at a local community clinic in Durban. Data analysis: Data were analysed using SPSS version 23®. Descriptive statistics were used to summarise the sample demographics and response rate and non-parametric statistics were used to test for associations and differences. Results: A Cronbach’s alpha for the GDS was calculated (p = 0.793). Some 40% of participants screened positive for depression. Female gender, widowhood and a negative subjective health status rating were significantly associated with depression and marriage appeared to be protective (p < 0.001). Participants with a poor subjective health rating were 21 times more likely to be depressed and widowhood conferred an almost fourfold increased risk of being depressed, with widows at greater risk than widowers. No association between depression and specific medical conditions was identified. Conclusion: There is a high rate of undetected depression among the elderly attending a local primary health care clinic with widowhood and poor subjective health being strong predictors of mood disorders. The findings warrant replication in bigger samples. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2016.1272250

Background: The postnatal period represents a time of risk for the emergence of Postnatal Depression (PND), a common maternal mental health problem affecting the well-being of the mother, the newborn and the entire family. Previously, it was postulated that African women were not affected by PND, due to traditional rituals and other cultural factors. However, the assumption has been refuted because of the existence of empirical evidence of PND in Africa and beyond, particularly among women living in socio-economic disadvantaged regions. Despite the growing magnitude of PND reported in South Africa, the country continues to focus more on reducing maternal and infant mortality and promoting infant physical health with limited efforts made to address PND among postpartum women. Objective: To screen for PND and determine the associated risk factors among postpartum women in selected community health centres situated in the Nkangala District, South Africa. Methods: The study was cross-sectional in design and applied a quantitative approach. Random sampling was used to select the three community health centres in the Nkangala District. A sample of 228 women who had delivered a live infant within 12 weeks of the time of data collection was selected using purposive sampling from the three community health centres. Trained research assistants administered a questionnaire to obtain information on demography and obstetric history, while the Edinburgh Postnatal Depression Scale (EDPS) was used to screen for postnatal depression. An EDPS score of 13+ confirmed the probability of PND. Data was analysed using STATA 14. Results: The mean age of women was 28±7 years. The majority of women were single (61%), living in large households (77%), and living in households with a monthly income of less than $291.10 (63%). Most women had normal (i.e., vaginal) delivery (83%) and reported unplanned pregnancies (65%). The probability of developing PND among women was 22%. The odds of developing PND were 3.17 times more likely in women with babies aged six weeks and above (AOR=3.17, CI; 1.39 - 7.23) and 4.50 times more likely in women living in households with an income of less than $115.55 (AOR=4.50, CI; 1.03 - 19.74). Partner/husband violence increased the odds of developing PND (AOR = 6.89, CI; 1.49 - 31.93), as well as a stressful life event (AOR= 3.73, CI: 1.52 - 9.17). Having partner/husband support (AOR=0.10, CI: 0.03 - 0.37) and receiving social support (AOR=0.28, CI: 0.09 - 0.93) reduced the risk of developing PND. A chi-square test showed significant associations between the EDPS scores and partner/husband support, partner/husband having another sexual partner, receiving social support, having a person who offers social support, partner/husband violence, and stressful life events. Conclusion: The probability of PND was high among postpartum women in the Nkangala District of the Mpumalanga Province, South Africa. The key determinants for the probability of PND were the age of a baby, household income, partner/husband violence, partner/husband support and receiving social support. Routine screening to identify women who are at risk of PND should be integrated into postnatal care settings for immediate intervention to protect the mother and her baby from different forms of morbidity.

Background: Following the 2014 Ebola virus disease (EVD) outbreak in West Africa, the UK Department for International Development funded South London and Maudsley National Health Service (NHS) to develop a psychological intervention that ex-Ebola Treatment Centre (ETC) staff could be trained to deliver to their peers to improve mental health in Sierra Leone. Aim: The two key aims were to assess the feasibility of training a national team to deliver a cognitive behavioural therapy (CBT)–based group intervention, and to evaluate the effectiveness of the overall intervention within this population. Methods: UK clinicians travelled to Sierra Leone to train a small team of ex-ETC staff in a three-phased CBT-based intervention. Standardised clinical measures, as well as bespoke measures, were applied with participants through the intervention to assess changes in mental health symptomology, and the effectiveness of the intervention. Results: The results found improvements across all factors of mental health in the bespoke measure from phase 1 to phase 3. Additionally, the majority of standardised clinical measures showed improvements between phase 2 and the start of phase 3, and pre- and post-phase 3. Conclusion: Overall, the findings suggest that it is possible to train staff from ETCs to deliver effective CBT interventions to peers. The implications of these results are discussed, including suggestions for future research and clinical intervention implementation within this population. The limitations of this research are also addressed.

Although there has been extensive research on the phenomenon of stress, there is still a lack of assessment tools, especially in the South African context, that have strong theoretical underpinnings, tapping into both internal depletion of resources and the excessive external demands from the environment in the measurement of stress. The aim of this study was to validate the Setswana version of the original 30-item long form of the Stress Overload Scale as well as the 10-item short form (Stress Overload Scale–Short Form), both evaluating experienced personal vulnerability and external event load. A sample of N = 376 adults living in a rural community in the Northern Cape Province of South Africa were randomly selected to partake in the study. Emerging model fit indices of confirmatory factor analysis testing the hypothesized two-factor structure of the original Stress Overload Scale were not convincingly good. However, we found a remarkable improvement in model fit indices in the case of the Stress Overload Scale–Short Form. Concurrent validity was shown for the Stress Overload Scale–Short Form in significant correlations with depression and emotional well-being. We conclude that the Setswana version of the Stress Overload Scale–Short Form is a psychometrically sound instrument for measuring stress in the present context; however, further validation of the original Stress Overload Scale in diverse samples is necessary to provide stronger support for the hypothesized two-factor structure.

Background In March 2020, South Africa implemented strict nonpharmaceutical interventions (NPIs) to contain the spread of COVID-19. Over the subsequent 5 months, NPI policies were eased in stages according to a national strategy. COVID-19 spread throughout the country heterogeneously; the disease reached rural areas by July and case numbers peaked from July to August. A second COVID-19 wave began in late 2020. Data on the impact of NPI policies on social and economic well-being and access to health care are limited. Objective We aimed to determine how rural residents in three South African provinces changed their behaviors during the first COVID-19 epidemic wave. Methods The South African Population Research Infrastructure Network nodes in the Mpumalanga (Agincourt), KwaZulu-Natal, (Africa Health Research Institute) and Limpopo (Dikgale-Mamabolo-Mothiba) provinces conducted up to 14 rounds of longitudinal telephone surveys among randomly sampled households from rural and periurban surveillance populations every 2-3 weeks. Interviews included questions on the following topics: COVID-19–related knowledge and behaviors, the health and economic impacts of NPIs, and mental health. We analyzed how responses varied based on NPI stringency and household sociodemographics. Results In total, 5120 households completed 23,095 interviews between April and December 2020. Respondents’ self-reported satisfaction with their COVID-19–related knowledge and face mask use rapidly rose to 85% and 95%, respectively, by August. As selected NPIs were eased, the amount of travel increased, economic losses were reduced, and the prevalence of anxiety and depression symptoms fell. When the number of COVID-19 cases spiked at one node in July, the amount of travel dropped rapidly and the rate of missed daily medications doubled. Households where more adults received government-funded old-age pensions reported concerns about economic matters and medication access less often. Conclusions South Africans complied with stringent, COVID-19–related NPIs despite the threat of substantial social, economic, and health repercussions. Government-supported social welfare programs appeared to buffer interruptions in income and health care access during local outbreaks. Epidemic control policies must be balanced against the broader well-being of people in resource-limited settings and designed with parallel support systems when such policies threaten peoples’ income and access to basic services.

IntroductionDepression and alcohol use disorders are international public health priorities for which there is a substantial treatment gap. Brief mental health interventions delivered by lay health workers in primary care services may reduce this gap. There is limited economic evidence assessing the cost-effectiveness of such interventions in low-income and middle-income countries. This paper describes the proposed economic evaluation of a health systems intervention testing the effectiveness, cost-effectiveness and cost-utility of two task-sharing approaches to integrating services for common mental disorders with HIV and diabetes primary care services.Methods and analysisThis evaluation will be conducted as part of a three-armed cluster randomised controlled trial of clinical effectiveness. Trial clinical outcome measures will include primary outcomes for risk of depression and alcohol use, and secondary outcomes for risk of chronic disease (HIV and diabetes) treatment failure. The cost-effectiveness analysis will evaluate cost per unit change in Alcohol Use Disorder Identification Test and Centre for Epidemiological Studies scale on Depression scores as well as cost per unit change in HIV RNA viral load and haemoglobin A1c, producing results of provider and patient cost per patient year for each study arm and chronic disease. The cost utility analyses will provide results of cost per quality-adjusted life year gained. Additional analyses relevant for implementation including budget impact analyses will be conducted to inform the development of a business case for scaling up the country’s investment in mental health services.Ethics and disseminationThe Western Cape Department of Health (WCDoH) (WC2016_RP6_9), the South African Medical Research Council (EC 004-2/2015), the University of Cape Town (089/2015) and Oxford University (OxTREC 2–17) provided ethical approval for this study. Results dissemination will include policy briefs, social media, peer-reviewed papers, a policy dialogue workshop and press briefings.Trial registration numberPACTR201610001825405.

Burnout is considered an occupational health concern. The burnout–depression overlap is an important area of research as the foundations of burnout and its diagnostic value have come under increasing scrutiny, calling for burnout to not be classified as an independent disorder but rather as a subtype of depression. Furthermore, as burnout is defined as a work-specific syndrome, workplace factors have been argued to be the major indicators of burnout. Recent research however, calls this into question. This study seeks to establish the overlap between burnout and depressive symptoms and to determine if burnout is in fact a multi-domain phenomenon. A cross-sectional research design was used, a convenience sample of educators from the Gauteng province of South Africa was collected ( N = 399). Confirmatory factor analysis was applied in a structural equation modelling framework. Discriminant validity analysis was conducted by investigating the average variance extracted and the shared variance between constructs. Finally, relative weight analysis was conducted to ascertain the unique contribution explained by the work-specific and general life domain factors. Results showed that burnout could be distinguished from depressive symptoms. Job demands, depressive symptoms, and satisfaction with life all explained significant amounts of variance in the burnout construct. Relative weight analysis revealed that emotional load and depressive symptoms explained equal amounts of variance in burnout, but that the aggregated work-specific factors explained the most variance in burnout. This study indicates that burnout is a multi-domain phenomenon and not isolated to the domain of work. Further research is needed in this regard.

Civilian war trauma and torture rank among the most traumatic life experiences; exposure to such experiences is pervasive in nations experiencing both internal and external conflict. This has led to a high volume of refugees resettling throughout the world with mental health needs that primary care physicians may not be screening for and prepared to effectively address. In this article, we review the literature on demographics, predictors, mental health outcomes of torture, and integrated care for the mental health needs of refugees. We searched PubMed and PSYCINFO databases for original research articles on refugees and mental health published in the English language between 2010 and present. Nine percent of 720 adults in conflict areas in Nepal, with predominance of literate married males, met the threshold for Post-Traumatic Stress Disorder (PTSD), 27.5% for depression, and 22.9% for anxiety. While, PTSD rate has been documented as high as 88.3% among torture survivors from Middle East (ME), Central Africa (CA), South Asia (SA), Southeast Europe (SE). Depression was recorded as high as 94.7% among 131 African torture survivors and anxiety as high as 91% among 55 South African torture survivors. Torture severity, post-migration difficulties, and wait time to receive clinical services were significantly associated with higher rate of mental health symptoms. Mental health screening is not a standard component of initial physical exams for refugees, yet these individuals have had high trauma exposure that should inform clinical care. Integrated care models are lacking but would greatly benefit this community to prevent progression to greater severity of mental health symptoms.

AbstractObjectiveThe aim of the present systematic review was to investigate the evidence on the association between food literacy and adolescents’ dietary intake.DesignThe review included searches of six databases with no restriction on the year of publication or language.SettingThe studies eligible for review were from five countries/regions: USA (n 6), Europe (n 4), Australia (n 1), Middle East (n 1) and South Africa (n 1).SubjectsAdolescents aged 10 to 19 years.ResultsThirteen studies were eligible for inclusion. None of the studies investigated all aspects of food literacy. Eight studies reported a positive association between food literacy and adolescents’ dietary intake. For example, adolescents with greater food knowledge and frequent food preparation behaviours were shown to have healthier dietary practices. Three studies found a mixed association of food literacy and adolescents’ dietary intake. For example, adolescents who frequently helped to prepare dinner had healthier dietary intake, but food shopping tasks were associated with less healthy food choices. Two studies found no association between measures of food literacy and adolescents’ dietary intake.ConclusionsFood literacy may play a role in shaping adolescents’ dietary intake. More rigorous research methods are required to effectively assess the causality between food literacy and adolescents’ dietary intake in order to confirm the extent of the relationship. Evidence recommends public health practitioners and policy makers consider new public health strategies that focus on increasing understanding of food literacy in adolescence.

Grief does not only affect human emotions but also impacts their physical health. Understanding physical grief of people can bring to bear the grip of its daunting nature, a situation where routines become challenging. A qualitative explorative descriptive research method was used. A purposive sample of 18 ward supervisors and 39 ward midwives was used to ascertain the physical effects of maternal deaths on these caregivers in the Ashanti Region of Ghana. Data were collected through semistructured and focus group discussions. Data analysis was done parallel with data collection till saturation was reached. Ethics was obtained from the University of the Western Cape, South Africa, and Ghana Health Service. The findings indicated that generally, as a result of grieving over the deaths of their patients, midwives experienced physical health sufferings. Therefore, reported depression is expressed as insomnia, appetite loss, exhaustion, and social isolation. There is the need to reduce the physical effects of patients’ death on caregivers in Ghana and therefore, the study recommends that all hospitals in Ghana utilize employee assistance programmes, a workplace intervention programme designed for such purposes.

Abstract Kwanza basin, located on the west coast of Africa and the east side of the South Atlantic Ocean, has the potential for deep-water oil and gas exploration. Previous studies have shown that the pre-salt system within the area has high potential for oil and gas storage. However, due to the shielding effect of the evaporating salt rock during the Aptian period, the quality of seismic reflection profiles of the pre-salt layers is poor. This means that the pre-salt sequences, the main fault, the scale and distribution pattern of the rift are not clear. To clarify the pre-salt regional structure pattern and further guide pre-salt exploration, we carried out a series of analyses and target processing of seismic and gravity data. Further, combining other available geological and lithology data as well as a tectonic model, we put forward a new understanding of the pre-salt structure of Kwanza basin. The research shows that the Kwanza basin can be divided into three uplift belts below the salt layer, which are distributed in the NW–SE trending direction. The three key profiles illustrate the distribution of uplift and depression in detail. The explained structural highs distributed in the outer Kwanza basin may be related to oil and gas reservoir. This study could provide the geophysical basis for the re-interpretation of the pre-salt seismic sequence, the strategic selection of pre-salt oil and gas and the next exploration deployment.

Sceletium tortuosum (L.) N.E.Br. (Mesembryanthemaceae), commonly known as kanna or kougoed, is an effective indigenous medicinal plant in South Africa, specifically to the native San and Khoikhoi tribes. Today, the plant has gained strong global attraction and reputation due to its capabilities to promote a sense of well-being by relieving stress with calming effects. Historically, the plant was used by native San hunter-gatherers and Khoi people to quench their thirst, fight fatigue and for healing, social, and spiritual purposes. Various studies have revealed that extracts of the plant have numerous biological properties and isolated alkaloids of Sceletium tortuosum are currently being used as dietary supplements for medicinal purposes and food. Furthermore, current research has focused on the commercialization of the plant because of its treatment in clinical anxiety and depression, psychological and psychiatric disorders, improving mood, promoting relaxation and happiness. In addition, several studies have focused on the isolation and characterization of various beneficial bioactive compounds including alkaloids from the Sceletium tortuosum plant. Sceletium was reviewed more than a decade ago and new evidence has been published since 2008, substantiating an update on this South African botanical asset. Thus, this review provides an extensive overview of the biological and pharmaceutical properties of Sceletium tortuosum as well as the bioactive compounds with an emphasis on antimicrobial, anti-inflammatory, anti-oxidant, antidepressant, anxiolytic, and other significant biological effects. There is a need to critically evaluate the bioactivities and responsible bioactive compounds, which might assist in reinforcing and confirming the significant role of kanna in the promotion of healthy well-being in these stressful times.

<p><strong>Objectives.</strong> Part I of this research paper presented a needs and gap analysis for the management of schizophrenia, bipolar mood disorder and major depression for the Eastern Cape Province, South Africa. It identified deficits and inequitable distribution of human resources and beds in the province. In this article, Part II, the authors propose a plan for public sector mental health services to address the human resource needs in the poorer eastern regions of the province. The plan focuses on human resource training and development. </p><p><strong>Methods.</strong> Evidence-based data on staff development in mental health from low-middle income countries were utilised to develop strategies to increase staff capacity to address unmet need. A financing model with a poverty index was developed to sustain a needs-based plan. Databases searched included Pubmed, Medline, Google and Google Scholar. The key words used included: mental health, mental health training, mental health resources, mental health in low-middle-income countries, mental health policy and plans, mental health needs- based planning, primary healthcare, primary mental healthcare, mental health financing. In addition the websites of the World Health Organization and the World Psychiatric Association were searched for similar resources.</p><p><strong>Conclusions.</strong> It is feasible, with careful attention to planning and implementation of evidence-based tools, to improve public mental health service delivery in this province. Sustained political will and professional commitment will ensure successful delivery of mental health services in a resource-limited province.</p>

Purpose Cyberbullying occurs when a minor is tormented, threatened, harassed, humiliated, embarrassed or otherwise targeted by another child. Given that cyberbullying entails defamation or spreading false information or portfolios about someone, it is regarded as a violation of the ethical code of information use. The purpose of the study was to explore the perceptions, experiences and challenges of post-high school youth with regards to cyberbullying. This is a quantitative study that used a survey approach to gather data using a self-administered questionnaire, which was distributed to 60 youth from the KwaZulu-Natal computer literacy community engagement project. The findings attest that youth recognise that cyberbullying might have detrimental effects on victims, such as alcohol and drugs abuse, low self-esteem, high level of absenteeism, poor grades and depression and suicidal thoughts. There is a low percentage of victims and perpetrators of cyberbullying in rural contexts in South Africa. It is hoped that findings may will a positive impact in the rural communities and enable the youth to interact with the modern technologies and handle them in an ethical manner. The study recommends that parents need to take cognisance of the probable possible dangers of the various technologies so that they could be instrumental in educating their children about children cyberbullying. Further, the schools and the Department of Education can play a fundamental role in educating children about cyberbullying and cyber ethics. Design/methodology/approach This survey was conducted to explore youth perceptions and experiences, as well as violations, of ethics through cyberbullying as experienced by the rural community at Mbazwana in the North Coast of KwaZulu-Natal. Convenience sampling was used, because although the questionnaire was distributed to all 60 participants in the project, not all of them completed the instrument, as participation was voluntary. Only 43 were completed, which is equal to 72 per cent response rate. The validity of the data collection instrument used was enhanced by the fact that questions were derived from the main objective of the study. Some themes of the instrument were self-designed and others were adapted from a similar study by Dehue et al. (2008), who looked at cyberbullying experiences of youth. The instrument was tried out in a pilot study in grade 12 classes in two high schools at Mbazwana in a bid to find out whether the learners would understand the questionnaire. Post-high school learners were considered to be at a similar level as the grade 12 learners polled. The pilot study proved its own importance: students who filled in the questionnaire indicated that they were not familiar with some terms and the researchers had to simplify the language to make it more understandable. Findings A large portion of the youth studied (45 per cent) indicated that they used their smartphones to access the internet, 25 per cent identified libraries as their source of access to the internet and 13 per cent reported accessing the internet from community laboratories (usually found in Department of Education centres). In total, 13 per cent of respondents reported accessing the internet from friends’ computers. Last, the smallest proportion at 4 per cent reported having internet access via their home desktop computers. The South African Mobile Report (2014) reveals that a great majority of South Africans access the internet via their own smartphones. These findings might indicate that many people nowadays do indeed have internet access in their regions. Research limitations/implications The results of this study indicate that not all households own a desktop computer, as some people rely on community laboratories and others rely on friends who own desktop or laptop computers. Practical implications The study results reveal that most students who did the computer literacy course consider themselves at an “intermediate” level. It was noted that cellphones/smartphones play a significant role in gaining access to the internet and to social networking applications in rural communities. The social media applications most visited by youth in this study were shown to be Facebook and WhatsApp. Only a relatively low percentage of the respondents in this study in a rural context in South Africa reported being either victims or perpetrators of cyberbullying. Social implications Social media give people ample opportunities to interact and socialise with other people in global context. Only a relatively low percentage of the respondents in this study in a rural context in South Africa reported being either victims or perpetrators of cyberbullying. It is hoped that insights gained from these findings may have a positive effect in the rural communities if awareness programmes are put in place to enable the youth to interact with the modern technologies and handle them in an ethical manner. Originality/value The contribution to the world of knowledge is that this study gives a clear indication of experiences and perceptions of cyberbullying in rural areas in South Africa. This will inform other scholars who want to engage in similar studies in different contexts that can be compared with the results of this study. It is notable that one cannot predict one’s own knowledge of a certain aspect of a community until one has fully engaged in research. Prior to this study, the researchers did not know whether the rural community youth participated in cyberbullying.

Amputation affects the patient physically, psychologically, socially, economically, and spiritually. The highest number of prevalent traumatic amputations was in East Asia and South Asia followed by Western Europe, North Africa, and the Middle East, high-income North America and Eastern Europe. Similarly in Nigeria, amputation has devastating effects on individuals, and on the economy. A number of researchers have invested time and energy in reducing the challenges but it appear that the number of depression and other effects are increasing daily. Therefore, the research aimed at assessing the psychological well-being, social support and coping strategies of patients with amputation. The study adopted a quantitative descriptive cross-sectional designed to investigate the psychological well-being of amputees. Total enumeration was adopted for the research. A validated questionnaire was used with a Cronbach’s alpha internal consistency ranging from 0.81 to 0.81. Data were collected and analyzed using IBM SPSS version 23 to generate summaries of descriptive statistics and inferential statistics. Results showed that the age ranged of the participants were from 25-34 years. The characterization of the degree of Psychological well-being of patients shows that majority of the respondents are of high level of disappointment, discouragement, dissatisfaction and despondent about their present conditions and life. Similarly, the first regression result indicate that there is a significant relationship between the psychological well-being and coping strategies which affects the duration of the amputees attending the clinics with [R2 = .721, R2 adj = .558, F(27, 46) = 4.411, p < .001], therefore this hypothesis was accepted. Also, the second hypothesis indicated that there is a significantly relationship among the psychological well-being, social support and coping strategies of amputees attending clinic with [R2 = .909, R2 adj = .805, F(39, 34) = 8.748, p < .001]. Therefore, this hypothesis was accepted. The study concluded that complexity of psychological well-being, social and coping strategies in the lives of human being and their inter relationships were well exposed and their relationships were evaluated. Future research should be conducted on a larger sample, using a mixed-method approach to uncover a large diversity of coping efforts used, by individuals who had a lower limb amputation.