3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Prevalence and patterns of substance use amongst psychiatric inpatients at Helen Joseph Hospital(2018) Anic, AniBackground: Mental Disorders and Substance Use Disorders (SUD) commonly occur together, termed dual diagnosis, this is associated with poorer functioning, higher suicidality rates, hospitilisation, greater risk for crime and high health risk behavior. Methods: Cross-sectional study with a sample size of 150 participants, gathered over 4 months. Data was collected with a structured clinical interview, and inpatient hospital records. Alcohol and drug misuse was screened for using the AUDIT and DUDIT respectively. A descriptive analysis was then made, prevalence of substance misuse was determined, and comparisons were made between those with and without substance misuse. Results: The study group was predominantly young, single, african, unemployed men. The leading presenting symptoms were psychosis, aggression and mania, requiring mostly involuntary admissions, with a mean of 14 days hospital stay. Twothirds of the participants were classified as substance misusers, these were significantly younger men, more often brought to hospital by the police or ambulance, and showed higher rates of substance use and substance-induced disorders. Conclusion: This highlights the benefit of using screening tools for diagnosing substance use, and the need for improved management of those with a dual diagnosis.Item The attitudes of doctors in South Africa teaching hospitals towards mental illness and psychiatry(2016) Jury, Kerry-Leigh CeciliaIntroduction. Mental illnesses are highly prevalent worldwide. The majority of mentally ill individuals are reintegrated into society where they often encounter stigma and discrimination. Stigmatisation by the community is a well-known and highly researched phenomenon. However, fewer studies have investigated the attitudes of medical doctors towards mental illness and as yet no such study has been done in South Africa. On reviewing the literature it is evident that negative attitudes also exist towards psychiatry as a profession, however to date there is limited data available on this topic. The aim of this study was to determine the attitudes of a group of psychiatric and non-psychiatric doctors towards people with mental illness and towards psychiatry as a profession. Methods. This was a cross-sectional study in the form of a self-administered questionnaire, which was distributed to medical doctors at five teaching hospitals in Gauteng, South Africa. All qualified doctors working at the selected institutions were eligible to participate in the study, regardless of their level of experience or specialist field. The questionnaire investigated their attitudes towards three mental illnesses namely; depression, schizophrenia and borderline personality disorder, and towards psychiatry as a profession. A convenience sampling method was used and two different questionnaires were distributed, one to the psychiatric and the other to the non-psychiatric doctor group. Results. A total of 531 doctors (16.4% psychiatric & 83.6% non-psychiatric) completed the questionnaire. Overall, the doctors’ attitudes were more negative towards persons with schizophrenia and borderline personality disorder than towards those with depression. For all three of the mental illnesses in question more than 50% of the doctors felt that persons would improve with treatment, however less than one third felt that they would ever recover fully. The non psychiatric doctors’ attitudes were more negative towards persons with schizophrenia and depression than the psychiatric doctors, with significantly more non-psychiatrists agreeing that such persons are unpredictable, dangerous and hard to talk to. More than 70% of the psychiatric group felt that non-psychiatric doctors considered psychiatrists to know less than other doctors and psychiatry to be an unimportant specialty. However, less than 11% of the non-psychiatric doctors actually held these negative views. Conclusion. Overall, the doctors in this inquiry did hold negative attitudes towards mental illness. However, the psychiatric doctor group were noted in a number of instances to be significantly more positive in their attitudes towards mental illness than their non-psychiatric colleagues. In addition, a large proportion of the psychiatric doctor group had encountered stigma towards their profession, but it was clear that they have incorrect perceptions with regards to the extent of the non-psychiatric doctors’ negative attitudes towards them and their profession.Item A retrospective review of substance use disorders amongst psychiatric inpatients at Chris Hani Baragwanath academic Hospital.(2014-04-23) Motala, Zaahir Ahmad E.Objective: Anecdotal evidence suggests that substance use is a significant problem among psychiatric patients admitted to Chris Hani Baragwanath Academic Hospital. The purpose of this study was to investigate the prevalence of substance use, the type of substance used and the socio-demographic and clinical factors associated with substance use among a group of psychiatric inpatients. Method: This study was a retrospective record review of all patients admitted to the psychiatric wards at Chris Hani Baragwanath Academic Hospital between the periods of July and December 2008. Results: Substance use was 4.8 (95% CI:2.7-8.4) times more likely among male subjects (p<0.001), 4.1 times (95%CI: 1.8-9.3) more likely in subjects aged 18-30 years compared to older patients (p=0.001), 3 times (95% CI: 1.2-7.4) more likely in subjects who were single (p=0.001), 1.9 (95% CI:1.4-2.7) times more likely in subjects who did not have children (p<0.001), and 1.5 (95% CI:1.2-2.1) times more likely in subjects with a psychotic disorder (p=0.004) compared to those with a mood disorder. Mood and psychotic disorders were compared and only the past psychiatric history was found to be significantly associated with psychotic disorders. Conclusion: Male gender was found to be significantly associated with substance use. Alcohol and cannabis were the most common substances used and polysubstance use also was a common occurrence. These findings have implications for preventative measures, psychiatric practice and specialized care for dual diagnosis patients.