A profile of adult acute admissions to Lentegeur Psychiatric Hospital, South Africa

Introduction: The Western Cape Province has the highest documented lifetime prevalence of common mental disorders in South Africa. To ensure the efficient, equitable and effective distribution of current resources, there is a need to determine the profile of patients seeking psychiatric treatment. Aim: The aim of this study was to describe patients admitted to the Acute Adult Admissions Unit at Lentegeur Hospital (LGH) which is situated in Mitchells Plain, Cape Town. Methods: This retrospective study involved an audit of all patients (18–60 years of age) admitted between 01 January 2016 and 30 June 2016. Results: A total of 573 adult psychiatric patients were profiled. The median age of the cohort was 29 years. The majority of patients (63%) were educated to the secondary level. Only 12% of patients were employed and 37% received disability grants. More than 90% of cases presented with psychotic symptoms. Of these, 28% presented with first episode psychosis. Of all patients, 20% were referred with manic symptoms and 7% with depressive symptoms. Many patients (62%) used substances in the period leading up to admission. Significantly more males (73%) used substances compared to females. Cannabis was the most widely used substance (51%), followed by methamphetamine (36%). Violence was a contributing factor to 37% of admissions. A total of 70 patients (13%) tested positive for HIV, while 49 (9%) tested positive for syphilis. Conclusion: We found the average patient requiring admission to be a young urban male who would likely have a secondary level (grades 8–12) education, but be unemployed. This patient would also likely be a user of illicit substances, would present psychotic and would likely display violent behaviour prior to referral. Substance use and a propensity for violence were identified as significant factors that influence the likelihood of admission. We invite planners in the Department of Health, as well as other stakeholders, to take heed of this burgeoning crisis and to implement specific strategies for addressing these problems before the effectiveness of mental health services as a whole is further undermined

Do disinhibited eaters pay increased attention to food cues?

The Three Factors Eating Questionnaire's measure of disinhibited eating is a robust predictor of long-term weight gain. This experiment explored if disinhibited eaters display attentional bias to food cues. Participants (N = 45) completed a visual dot probe task which measured responses to food (energy dense and low energy foods) and neutral cues. Picture pairs were displayed either for a 100 ms or 2000 ms duration. All participants displayed attentional bias for energy dense food items. Indices of attentional bias were largest in disinhibited eaters. Attentional bias in disinhibited eaters appeared to be underpinned by facilitated attention

Eating behaviour associated with differences in conflict adaptation for food pictures

Objective: The goal conflict model of eating (Stroebe, Mensink, Aarts, Schut, & Kruglanski, 2008) proposes differences in eating behaviour result from peoples’ experience of holding conflicting goals of eating enjoyment and weight maintenance. However, little is understood about the relationship between eating behaviour and the cognitive processes involved in conflict. This study aims to investigate associations between eating behaviour traits and cognitive conflict processes, specifically the application of cognitive control when processing distracting food pictures. Method: A flanker task using food and non-food pictures was used to examine individual differences in conflict adaptation. Participants responded to target pictures whilst ignoring distracting flanking pictures. Individual differences in eating behaviour traits, attention towards target pictures, and ability to apply cognitive control through adaptation to conflicting picture trials were analysed. Results: Increased levels of external and emotional eating were related to slower responses to food pictures indicating food target avoidance. All participants showed greater distraction by food compared to non-food pictures. Of particular significance, increased levels of emotional eating were associated with greater conflict adaptation for conflicting food pictures only. Conclusion: Emotional eaters demonstrate greater application of cognitive control for conflicting food pictures as part of a food avoidance strategy. This could represent an attempt to inhibit their eating enjoyment goal in order for their weight maintenance goal to dominate

Risk-taking and impulsivity; the role of mood states and interoception

Objectives: The consequences of impulsive decisions and actions represent a major source of concern to the health and well-being of individuals and society. It is, therefore, crucial to understand the factors which contribute to impulsive behaviors. Here, we examined how personality traits of behavioral tendencies, interoceptive sensibility as well as transient mood states predict behavioral performance on impulsivity and risk-taking tasks. Method: 574 (121 males; age 18-45) individuals completed self-report personality measures of impulsivity, reward sensitivity, punishment avoidance as well as interoceptive sensibility, undertook a mood assessment and performed a set of cognitive tasks: delay discounting (temporal impulsivity), probability discounting (risk-taking), and reflection impulsivity task. Data were interrogated using principal component analysis, correlations and regression analyses to test mutual relationships between personality traits, interoceptive sensibility, mood state and impulsive behaviors. Results: We observed a clear separation of measures used, both trait and behavioral. Namely, sensation-seeking, reward sensitivity and probability discounting reflected risk-taking. These were separate from measures associated with impulsivity, both trait (negative and positive urgency, premeditation, perseverance) and behavioral (delayed discounting and reflection impulsivity). This separation was further highlighted by their relationship with the current emotional state: positive affect was associated with increased risk-taking tendencies and risky decision-making, while negative emotions were related to heightened impulsivity measures. Interoceptive sensibility was only associated with negative emotions component. Conclusions: Our findings support the proposal that risk-taking and impulsivity represent distinct constructs that are differentially affected by current mood states. This novel insight enhances our understanding of impulsive behaviors

Computational Bacterial Genome-Wide Analysis of Phylogenetic Profiles Reveals Potential Virulence Genes of Streptococcus agalactiae

The phylogenetic profile of a gene is a reflection of its evolutionary history and can be defined as the differential presence or absence of a gene in a set of reference genomes. It has been employed to facilitate the prediction of gene functions. However, the hypothesis that the application of this concept can also facilitate the discovery of bacterial virulence factors has not been fully examined. In this paper, we test this hypothesis and report a computational pipeline designed to identify previously unknown bacterial virulence genes using group B streptococcus (GBS) as an example. Phylogenetic profiles of all GBS genes across 467 bacterial reference genomes were determined by candidate-against-all BLAST searches,which were then used to identify candidate virulence genes by machine learning models. Evaluation experiments with known GBS virulence genes suggested good functional and model consistency in cross-validation analyses (areas under ROC curve, 0.80 and 0.98 respectively). Inspection of the top-10 genes in each of the 15 virulence functional groups revealed at least 15 (of 119) homologous genes implicated in virulence in other human pathogens but previously unrecognized as potential virulence genes in GBS. Among these highly-ranked genes, many encode hypothetical proteins with possible roles in GBS virulence. Thus, our approach has led to the identification of a set of genes potentially affecting the virulence potential of GBS, which are potential candidates for further in vitro and in vivo investigations. This computational pipeline can also be extended to in silico analysis of virulence determinants of other bacterial pathogens