27 research outputs found

    First episode schizophrenia

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    Schizophrenia is a chronic psychiatric condition. Patients with schizophrenia present clinically with psychotic, negative and cognitive symptoms, which can become evident late in adolescence or in early adulthood. The peak age for presentation is 20 years in males and 25 years in females. This chronic condition follows a relapsing remitting course, and eventually results in a chronic state of residual symptoms and functional impairment.Keywords: hallucinations, psychiatric condition, psychotic, schizophrenia, social withdrawa

    First episode schizophrenia

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    Schizophrenia is a chronic psychiatric condition. Patients with schizophrenia present clinically with psychotic, negative and cognitive symptoms, which can become evident late in adolescence or in early adulthood. The peak age for presentation is 20 years in males and 25 years in females. This chronic condition follows a relapsing remitting course, and eventually results in a chronic state of residual symptoms and functional impairment.http://www.tandfonline.com/ojfpam201

    Dealing with schizophrenia in general practice

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    Schizophrenia is a psychiatric illness of unknown aetiology, and impairs cognition and social and occupational functioning. It is challenging in terms of the disability it causes, the unclear nature of what causes it, the complexity of diagnosis and treatment limitations. General practitioners can play a role in various phases of the illness, from early intervention to chronic care, in liaison with the psychiatrist.http://www.safpj.co.z

    Profile of mortality of patients admitted to Weskoppies Psychiatric Hospital in South Africa over a 5-year period (2001-2005)

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    Objective: Mortality in the psychiatric population, both from natural and unnatural causes, is higher than in the general population and this is despite an improvement in the delivery of care and treatment of mental illness in recent years. The study was conducted to determine a profile of mortality and standardized mortality rates within our psychiatric hospital. Method: A retrospective clinical case audit was conducted of deaths that occurred at Weskoppies Hospital between 1st January 2001 and 31st December 2005. Direct standardised mortality rates were calculated (gender specific adjusted for age according to the South African population). Results: A total of 164 deaths were observed during this period. The gender-specific all cause mortality rates, standardised to the South African population, were 0.0177 (95% CI 0.0141, 0.0213) and 0.0163 (95% CI 0.0121, 0.0206) for males and females respectively. The all cause mortality rates for the South African male and female population were 0.0188 and 0.0170 respectively (not significantly different as it falls within the 95% confidence interval of the standardised rates). The predominant natural cause of mortality was infection. Ten of the deaths were due to unnatural causes, of these 7 were suicides. The mortality ratio for unnatural causes was 0.47. Conclusion: Mortality studies are important tools for determining quality of health care provisions to patients. Studies of this nature assist in making recommendations for optimal clinical practice and aid in developing preventative measures.Key words: Psychiatric; In-patient; Mortality; Mortality rati

    Combined experimental and computational investigations of rhodium-catalysed C-H functionalisation of pyrazoles with alkenes

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    Detailed experimental and computational studies have been carried out on the oxidative coupling of the alkenes C(2)H(3)Y (Y=CO(2)Me (a), Ph (b), C(O)Me (c)) with 3-aryl-5-R-pyrazoles (R=Me (1 a), Ph (1 b), CF(3) (1 c)) using a [Rh(MeCN)(3)Cp*][PF(6)](2)/Cu(OAc)(2)⋅H(2)O catalyst system. In the reaction of methyl acrylate with 1 a, up to five products (2 aa–6 aa) were formed, including the trans monovinyl product, either complexed within a novel Cu(I) dimer (2 aa) or as the free species (3 aa), and a divinyl species (6 aa); both 3 aa and 6 aa underwent cyclisation by an aza-Michael reaction to give fused heterocycles 4 aa and 5 aa, respectively. With styrene, only trans mono- and divinylation products were observed, whereas with methyl vinyl ketone, a stronger Michael acceptor, only cyclised oxidative coupling products were formed. Density functional theory calculations were performed to characterise the different migratory insertion and β-H transfer steps implicated in the reactions of 1 a with methyl acrylate and styrene. The calculations showed a clear kinetic preference for 2,1-insertion and the formation of trans vinyl products, consistent with the experimental results

    A descriptive study of biological and psychosocial factors associated with body mass index for age, in adolescents attending an outpatient department at Weskoppies Psychiatric Hospital

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    OBJECTIVE : To describe biological and psychosocial factors associated with body mass index (BMI) for age in adolescents attending an outpatient department at Weskoppies Psychiatric Hospital. METHODS : A total of 50 adolescents participated in a convenience sampling research study. BMIs were calculated using their weights and heights to distinguish different weight categories based on the 2007 World Health Organization (WHO) growth charts. Based on their BMIs, participants were categorised as underweight, normal body weight, overweight and obese. The association between the BMIs of the biological parents and their adolescent children was investigated using the Fisher’s exact test. The data collection included adolescents’ demographic information, psychiatric diagnosis, psychiatric medication, nutritional intake, eating habits and the intensity of physical activity such as sports, leisure and sedentary behaviour. SETTING : The study was conducted at Weskoppies Psychiatric Hospital’s adolescents outpatient department. RESULTS : Of the participants, 72% were males. Forty-eight per cent of all the adolescents had a normal BMI, mostly of black African descent. When comparing the adolescents’ BMI with that of their biological mothers, 50% of those who were obese also had mothers who were mostly obese (53.8%). The Fisher’s exact test indicated a statistically significant association between the BMI categories of mothers and those of their adolescent children (Fisher’s exact test, p = 0.032). Despite the above association, no significant association could be found regarding their nutritional intake and eating habits. Also, no significant association was found between the adolescents’ BMIs and the use of psychotropic medication, as compared with other previous studies. Furthermore, no association could be found between adolescents’ BMI categories and the level of intensity of physical activity such as sports and leisure activities or sedentary behaviours. CONCLUSION : This study supports previous findings that a significant association exists between maternal and childhood obesity. The association between BMI and psychotropic medication, nutritional intake and eating habits, and level of physical activity could not be confirmed in our study. The study results were limited by the small sample size and the convenience sampling method. Although this was only a descriptive study, it highlighted the complexity of biological and psychosocial factors involved in weight gain. Further studies are needed to explore the interplay of physical and environmental risk factors for childhood obesity, as well as to ensure early identification and education of patients and their families to prevent development of obesity.http://www.sajpsychiatry.orgam2017PsychiatryStatistic

    First episode schizophrenia

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    Schizophrenia is a chronic psychiatric condition. Patients with schizophrenia present clinically with psychotic, negative and cognitive symptoms, which can become evident late in adolescence or in early adulthood. The peak age for presentation is 20 years in males and 25 years in females. This chronic condition follows a relapsing remitting course, and eventually results in a chronic state of residual symptoms and functional impairment

    Ambiphilic C-H activation routes to heterocycles

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    This thesis describes investigations of Cp*Rh- and (p-Cy)Ru-catalysed C-H functionalisation reactions of various substrates with alkynes and alkenes for the formation of several heterocycles and carbocycles. Mechanistic studies and DFT calculations are also presented. Chapter One includes a discussion of different mechanisms of C-H activation namely oxidative addition, σ-bond metathesis, 1,2-addition, electrophilic activation and AMLA/CMD. The applications of these different mechanisms of C-H activation in catalysis are also discussed with a particular emphasis on the use of AMLA/CMD in direct arylation reactions. Chapter Two gives an overview of stoichiometric and catalytic studies of AMLA C-H activation and subsequent reactivity with alkynes at Ir, Rh, and Ru. The results of Cp*Rh- and some (p-Cy)Ru-catalysed reactions of C-phenylpyrazoles with alkynes are presented. N-H and C-H activation occurs, leading to heterocycles. Mechanistic studies and DFT calculations show that C-H activation is reversible and rate limiting in the cases examined. Chapter Three is similar to Chapter Two but focusses on reactions with alkenes. The Cp*Rh-catalysed reactions of C-phenylpyrazoles with alkenes lead to mono or divinyl products which may undergo further aza-Michael cyclisations if the alkene is a good Michael acceptor. Mechanistic studies and DFT calculations are also discussed. Chapter Four deals with Cp*Rh-catalysed coupling reactions of other directing groups, including imidazole, imidazoline, pyrazolidinone, hydrazine, carboxylic acid and oxime with alkynes. Again, there is discussion on the different factors affecting product selectivity. Chapter Five gives a summary of all the conclusions on the work presented in this thesis. Throughout the thesis, all new compounds are characterised spectroscopically and several compounds have been characterised by X-ray crystallography

    Psychiatric sequelae and mental health aftercare experiences in women who had a life-threatening complication in pregnancy and those with uncomplicated pregnancies : an explorative-descriptive study

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    Introduction Studies in the literature indicate that women are vulnerable to develop psychiatric conditions during the perinatal period. Mental health is a neglected topic and that of women’s mental health to a greater extent, with limited attention paid to these women in the South African public health sector. Furthermore, maternal mortality persists as a major public health problem in developing countries, despite global initiatives and strategies aimed at improving maternal health and decreasing mortality. An improvement in maternal health can ensue if together with a decrease in the number of maternal deaths, a reduction in the complications during pregnancy and the postpartum period occurs. Recognition and treatment of severe complications are important as they can have an adverse effect on women’s health not only from a biological but a psychosocial perspective too. The study set out to determine whether women who experience severe life-threatening stressors during pregnancy are more vulnerable to develop psychiatric complications and what are their lived experiences after discharge from hospital? Methods A mixed-method study conducted at two hospitals in Pretoria, South Africa consisted of two arms, a qualitative and a quantitative arm executed in a parallel convergent manner. Data collection occurred concurrently and merging of the data occurred at the level of interpretation. Two groups of participants namely women who experienced life-threatening complications and those with uneventful pregnancies were selected and interviewed at fourtime intervals namely, shortly after delivery, at six weeks, three months and six months postpartum. The quantitative arm consisted of completion of Level 1, symptom appropriate Level 2 cross-cutting symptoms measures and a WHO Disability Assessment. The qualitative arm consisted of in-depth semi-structured interviews of sixteen participants who were purposefully sampled to obtain maximum variation and richness of information. Results A total of eighty-nine women participated in the study. (Forty-six of whom were women with life-threatening complications and forty-three were women with uneventful pregnancies.) Women with life-threatening complications were more vulnerable to develop psychiatric sequelae and presented with a greater variation in their levels of functioning as compared to women with uneventful pregnancies. Psychiatric sequelae included major depressive disorder, anxiety disorders, somatic symptoms, and cognitive impairments; sleep disturbances, anger, psychotic disorders and substance abuse. Common themes identified from the lived experiences included amongst others, feelings of inadequacy, guilt, loss and disappointment, fear of rejection, abandonment, and infidelity and feelings of anger. Conclusion Women in the present study were not only susceptible to risk that predisposed them to develop postpartum psychiatric complications, but also experienced life-threatening complications. These women displayed resilience in that they were able to adapt despite experiencing severe stressors and adversity. The women displayed acceptance, a will to survive and cope as well as strong belief and unwavering faith in God.Thesis (PhD)--University of Pretoria, 2018.School of Health Systems and Public Health (SHSPH)PhDUnrestricte
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