Browsing by Subject "Schizophrenia"

Now showing 1 - 7 of 7
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    DSM-5: a collection of psychiatrist views on the changes, controversies, and future directions
    (BioMed Central Ltd, 2013) Nemeroff, Charles; Weinberger, Daniel; Rutter, Michael; MacMillan, Harriet; Bryant, Richard; Wessely, Simon; Stein, Dan; Pariante, Carmine; Seemuller, Florian; Berk, Michael; Malhi, Gin; Preisig, Martin; Brune, Martin; Lysaker, Paul
    The recent release of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association has led to much debate. For this forum article, we asked BMC Medicine Editorial Board members who are experts in the field of psychiatry to discuss their personal views on how the changes in DSM-5 might affect clinical practice in their specific areas of psychiatric medicine. This article discusses the influence the DSM-5 may have on the diagnosis and treatment of autism, trauma-related and stressor-related disorders, obsessive-compulsive and related disorders, mood disorders (including major depression and bipolar disorders), and schizophrenia spectrum disorders.
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    Family Histories of Mental Illness and Violence in State Patients
    (2021) Vogts, Elizabeth; Roffey, M; Kaliski, Sean; Ramesar, S
    Background: It is known that both severe mental illness and violence have genetic components. Multiple genes play a role in the cause of violent behaviour. Violence is one of the leading causes of death for young people in South Africa and yet little is known about its prevalence in state patients and their family members. Aim: This study aimed to investigate the prevalence of violence and mental illness in the families of state patients, to what extend these coincide and to compare schizophrenia and mood psychosis in that context. Setting: The study included 60 state patients' folders, all of whom were diagnosed with a psychotic disorder, in accordance with DSM5 criteria. The subjects were divided into two groups: those who have committed violence and those who have not committed violence. Method: Patients' folders were selected by purposive sampling. These folders were then reviewed by the researcher and a questionnaire was completed. Results: Violent patients had more first-generation relatives with violent convictions (68.2%), compared to 36.4% of non-violent patients. Only 3.3% of non-violent patients witnessed domestic violence, whereas 13.3% of violent patients witnessed domestic violence. A significantly higher proportion of patients with bipolar disorder had been convicted of physical assault (p=0.035). 17.6% of violent schizophrenia patients had a family history of violence and mental illness, compared to 18.2% of violent patients with mood psychoses which is not statistically significant. Conclusion: It was found that violence runs in families and that mental illness and violence was prevalent in the described group. Of further concern was that more violent patients witnessed domestic violence compared to non-violent patients, emphasising the idea that the cause of violence is multifactorial (genetic, environmental), and that identification of not only high-risk patients but also high-risk families need to be implemented.
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    Results of an investigation into a group of patients presenting the symptoms of schizophrenia
    (1953) Freed, Louis Franklin
    An investigation of the problem of schizophrenia necessitates in the first instance recourse to the following procedures: (I) A definition of the problem and a description of the symptomatology upon which the diagnosis of the disorder is based; (II) An elucidation of the methodological approach to the problem; and (III) A statment in regard to the sources of the clinical material which the investigator has utilised for the purpose of his research. These procedures are treated of in some detail in the ensuing sections.
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    Subjective wellbeing in a sample of South African, Xhosa people with schizophrenia
    (2018) Boshe, Judith; Stein, Dan; Campbell, Megan
    Subjective well-being when on neuroleptic treatment (SWBN), has been established as a good predictor of adherence, early response and prognosis in patients with schizophrenia(1, 2). The 20-item subjective well-being under neuroleptic treatment scale (SWN-K 20) is a self-rating scale that has been validated to measure SWBN(3). However, the SWN-K20 has not been previously used in a Low- and Middle-income country (LMIC). Aims and Objectives: This study explored the psychometric properties of SWN-K20 in a sample of Xhosa speaking African patients with schizophrenia, and investigated factors associated with SWBN in this population. Methods: As a part of a large genetic study, 244 study participants with a confirmed diagnosis of schizophrenia completed the translated SWN-K 20 scale. Internal consistency analysis was performed, and convergent analysis and exploratory analysis were conducted using Principal Component Analysis (PCA).Varimax rotation method was selected as we did not assume any correlation of the factors(4). Linear regression methods were used to determine predictors of SWBN in the sample population. Results: The PCA extracted 4 components which cumulatively explained 52.21% of the total variance. The internal consistency of the SWN-K 20 was 0.86 and those of the sub-scales ranged between 0.47 and 0.59. The total scores of the SWN-K 20 demonstrated moderate correlation r= 0.44 with GAF scores. The sub-scale scores had lower correlations ranging between r=.41 and r=.30 with the GAF scores. The total scores on SWN-K20 scale were used to explore factors influencing SWBN. There was a significant correlation between overall subjective well-being score with higher education level, increased illness severity and GAF scores. Discussion and Conclusion: The isiXhosa version of the SWN-20 scale can be used for clinical and research purposes in LMICs but predictors of SWBN in this population differed from those previously established in (high income countries) HICs. The individual sub-scales of the SWN-K20 were less reliable when translated into isiXhosa and hence the subs-scales were not a meaningful measure of specific domains of wellbeing . These findings merit evaluation to determine whether cultural and linguistic specific sub-cales might provide further insight and recommendations for use in South African context. Predictors of SWBN in this LMICs population were not comparable to those in HICs setting(5, 6). Older patients with lower baseline level of education, poor global functioning and less severe symptoms were noted to have lower SWBN and hence at risk of poor compliance. This information could provide guidance for clinicians, researchers and interventions that aim at improving compliance and the treatment experiences of this patient group.
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    Systematic review of feasibility and acceptability of psychosocial interventions for schizophrenia in low and middle income countries
    (2015-02-12) Brooke-Sumner, Carrie; Petersen, Inge; Asher, Laura; Mall, Sumaya; Egbe, Catherine O; Lund, Crick
    Abstract Background In low and middle income countries there is evidence to suggest effectiveness of community-based psychosocial interventions for schizophrenia. Many psychosocial interventions have however been conceptualized in high income countries and assessing their feasibility and acceptability in low and middle income countries is pertinent and the objective of this review. Methods Six databases were searched using search terms (i) “Schizophrenia”; (ii) “Low and middle income or developing countries” and (iii) “Psychosocial interventions”. Abstracts identified were extracted to an EndNote Database. Two authors independently reviewed abstracts according to defined inclusion and exclusion criteria. Full papers were accessed of studies meeting these criteria, or for which more information was needed to include or exclude them. Data were extracted from included studies using a predesigned data extraction form. Qualitative synthesis of qualitative and quantitative data was conducted. Results 14 037 abstracts were identified through searches. 196 full articles were reviewed with 17 articles meeting the inclusion criteria. Little data emerged on feasibility. Barriers to feasibility were noted including low education levels of participants, unavailability of caregivers, and logistical issues such as difficulty in follow up of participants. Evidence of acceptability was noted in high participation rates and levels of satisfaction with interventions. Conclusions While there is preliminary evidence to suggest acceptability of community-based psychosocial interventions for schizophrenia in low and middle income countries, evidence for overall feasibility is currently lacking. Well-designed intervention studies incorporating specific measures of acceptability and feasibility are needed.
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    The content of delusions in a sample of South African Xhosa people with schizophrenia
    (BioMed Central, 2017-01-24) Campbell, Megan M; Sibeko, Goodman; Mall, Sumaya; Baldinger, Adam; Nagdee, Mohamed; Susser, Ezra; Stein, Dan J
    Background: Although the relationship between cultural beliefs and schizophrenia has received some attention, relatively little work has emerged from African contexts. In this study we draw from a sample of South African Xhosa people with schizophrenia, exploring their cultural beliefs and explanations of illness. The purpose of the article is to examine the relationship between this cultural context and the content of delusions. Methods: A sample comprising 200 Xhosa people with schizophrenia participating in a South African schizophrenia genomics study were interviewed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Participant delusions were thematically analyzed for recurring themes. Results: The majority of participants (n = 125 72.5%) believed that others had bewitched them in order to bring about their mental illness, because they were in some way jealous of the participant. This explanation aligns well with the understanding of jealousy-induced witchcraft in Southern African communities and highlights the important role that culture plays in their content of delusions. Conclusions: Improved knowledge of these explanatory frameworks highlights the potential value of culturally sensitive assessment tools and stigma interventions in patient recovery. Furthermore such qualitative analyses contribute towards discussion about aspects of delusional thought that may be more universally stable, and those that may be more culturally variable.