What patients with bipolar disorder and major depressive disorder perceive as adverse life events precipitating a current major depressive episode

BACKGROUND : Adverse life events (ALEs) as precipitants of a major depressive episode (MDE) have been the subject of many studies. These studies indicate an increase in ALEs in the 6 months preceding an MDE. OBJECTIVES : The study examined what participants, suffering from major depressive disorder (MDD) or bipolar disorder (BD), perceived as the precipitating ALE of a current MDE. The severity and categories of ALEs were compared between these two patient groups. METHODS : Consenting, adult inpatients were sourced from Weskoppies Hospital, Steve Biko Academic Hospital, Tshwane District Hospital, Denmar Psychiatric Hospital and Vista Clinic in the Pretoria area. A semi-structured questionnaire was used to obtain demographic data and the diagnosis. Information regarding the course of the disorder, including the number of previous MDEs and the age at which the first MDE occurred, was also obtained. The perceived precipitating ALE was detailed for each participant. A severity value referred to as a Life Change Unit Score (LCU score), based on the Recent Life Changes Questionnaire (RLCQ) by Miller and Rahe, was then assigned to each participant’s perceived precipitant. RESULTS : Of the 64 participants, 12.7 % were experiencing a first MDE. In those participants who had experienced prior episodes the average number (standard deviation (SD)) of previous episodes was 3.86 (2.46). The mean approximate age (SD) at first onset of an MDE was 24.81 (10.9) years. The BD group had significantly more previous MDEs than the MDD group. Although the average LCU scores were higher in the BD group than the MDD group this did not reach statistical significance. Therefore, this study could not find a difference in the severity of the perceived precipitants between the BD group and MDD group. However, when the LCU scores were analysed within subcategories of the RLCQ, it was found that participants with BD perceived significantly more problems associated with the workplace as precipitants of a current MDE than individuals with MDD. CONCLUSION : Most participants could link an ALE to the onset of a current MDE. The study did not find a differential response to ALEs between patients with BD and MDD. The severity of the social precipitants did not differ significantly between the two groups. The notion of a ‘kindling effect’ could not be supported by the outcome of this study. Because some study participants experienced ALEs not accounted for by the RLCQ, a more comprehensive assessment instrument may be more appropriate for similar studies.http://www.sajp.org.za/index.php/sajphb201

Patients’ opinions about referral from a tertiary specialist psychiatric hospital to primary healthcare

BACKGROUND : Referral of patients from tertiary specialist psychiatric hospitals to primary healthcare settings is a worldwide goal. This is of particular importance in South Africa with its considerable burden of mental disorders and limited resources. However, patients are often reluctant to be referred and studies have shown that patients may prefer a dedicated psychiatric service over an integrated primary healthcare service. AIM : This study explored the opinions of patients receiving care at a tertiary psychiatric hospital’s outpatient department (OPD) about referral to a primary healthcare clinic (PHCC). SETTING : The study was conducted at Weskoppies Psychiatric Hospital OPD. METHODS : This was a qualitative study based on grounded theory. Participants were recruited through purposive-theoretical sampling. Data were collected by means of individual interviews and mini-essays. RESULTS : From the 80 participants, 18 had individual interviews and 62 wrote mini-essays. Thirty-nine participants had previously attended a PHCC, while 41 had not. Perceived advantages of referral to PHCCs included: close proximity to participants’ homes, resulting in saving on travelling time and transport costs, as well as the convenience of receiving psychiatric and other medical treatment at the same healthcare facility. Perceived disadvantages of PHCCs included: unavailability of treatment; lack of doctor-based care; lack of specialised care; loss of established relationships with hospital healthcare workers; mistreatment by PHCC nursing staff; longer waiting times; more stigmatisation. CONCLUSION : The perceived disadvantages of referral from a tertiary psychiatric hospital to a PHCC outweighed the perceived advantages. Nonetheless, participants expressed willingness for such a referral if their concerns were addressed.https://sajp.org.zaPsychiatr

A comparison between the Mini-Mental State Examination and the Montreal Cognitive Assessment Test in schizophrenia

BACKGROUND : Cognitive impairment is a core feature of schizophrenia that also has strong prognostic significance. In most clinical settings comprehensive neuropsychological testing to detect cognitive impairment in schizophrenia patients is not readily available, but because cognitive deficits in schizophrenia are clinically important it would be useful to detect or at least screen for them in a clinical setting. Unfortunately there are no validated, brief screening instruments for the detection of cognitive impairment in schizophrenia. Nevertheless, the Montreal Cognitive Assessment Test (MoCA) and the Mini-Mental State Examination (MMSE) show promise in this regard. The objective of this study was to compare the results of the MMSE and MoCA in a group of outpatient schizophrenia sufferers to contribute to research into the instruments’ potential usefulness as screening tools for cognitive impairment in schizophrenia. METHOD : The Afrikaans versions of the MMSE and MoCA were administered to Afrikaansspeaking adult outpatients. Participants had at least seven years of formal education and had been in partial or full remission for at least 3 months. The MMSE and MoCA scores for each participant were matched and compared using the non-parametric Wilcoxon matched pairs test. RESULTS : The sample consisted of 30 Afrikaans-speaking outpatients with schizophrenia. The mean MMSE score was 27.17 ± 2.64, and the mean MoCA score was 22.53 ± 3.91. There was a statistically significant difference between participants’ performance on the MMSE and MoCA tests (p = 0.000008). CONCLUSION : Compared to the MMSE, the MoCA may be a more useful instrument to detect cognitive impairment in patients with schizophrenia. Further studies are required.http://www.sajpsychiatry.orgam2016Psychiatr

Behaviour that underpins non-pathological criminal incapacity and automatism : toward clarity for psychiatric testimony

Psychiatric expert testimony is challenging in cases of violence when the accused person submits a defence that he or shewas so overwhelmed by emotions triggered by an upsetting event that his or her violent behaviourwas an uncontrollable consequence of the emotions. This defence is usually presented in terms of an automatismparticularly not attributed to a mental disorder. Clouding testimony in these cases is the various definitions of both automatism and mental disorder—definitions by which the jurisprudential distinction is made between a sane and an insane automatism, or pathological and non-pathological incapacity (NPCI). To avert testimony that is tainted from the very beginning by the lack of agreed definitions, this article proposes that psychiatrists focus in their assessment and testimony on particularly the behaviour as being distinct fromthe jurisprudential concernswhether that behaviour constitutes an automatism andwhether it is (not) attributed to a mental disorder. This focus on the behaviour affords clarity by which the properties of the behaviour may be examined theoretically and clinically in terms of behaviour therapy, specifying accordingly its antecedents, consequences, topography, intensity, latency, duration, frequency, and quality. So informed, the behaviour that underpins NPCI and automatism is described here as emotionally triggered involuntary violent behaviour about which testimony may be given distinct from whether the behaviour is (not) causally attributed to a mental disorder, and from jurisprudential concerns with accountability.A postgraduate bursary by the University of Pretoriahttp://www.journals.elsevier.com/international-journal-of-law-and-psychiatryam2017Psychiatr

Community mental health literacy in Tshwane region 1 : a quantitative study

BACKGROUND: Although mental health literacy is a major determining factor of mental health outcomes and functional capacity of individuals, there is dearth of research on the issue in South Africa. AIM: To assess the literacy of three mental disorders, namely major depressive disorder (MDD), schizophrenia and generalised anxiety disorder (GAD) and to compare the resultant assumed literacy level between urban and townships participants. SETTING: Five clinics of region 1 in Tshwane, South Africa. METHOD: A cross-sectional descriptive study was performed between November 2019 and January 2020. A total of 385 questionnaires were distributed equally in all five clinics. By means of questions about three fictive cases with clinical pictures indicative of MDD, schizophrenia and GAD the following were assessed: recognising a mental disorder, identifying the cause and knowledge about what would help best. RESULTS: The majority of participants (67.3%) recognised the clinical picture indicative of schizophrenia as a mental disorder, almost half of the participants (49.9%) recognised the clinical picture indicative of MDD as a mental disorder, whilst just more than one third (36.3%) of participants recognised the clinical picture GAD as a mental disorder. Concerning the causes for the clinical pictures, most participants indicated that stress was the cause for MDD and GAD (77.4% and 68.1%, respectively), whilst indicating that biological or psychological (59.5%) causes are relevant to the clinical picture indicative of schizophrenia symptoms. Fewer participants indicated supernatural causes for any of the clinical case (MDD: 2.6%; schizophrenia 15.3%; GAD 4.2%). Most participants chose professional help as the best option for all three cases (MDD 81.3%, schizophrenia 82.2%, GAD 66.1%). The indicators for health literacy in this study show that urban participants had better knowledge than township participants across all questions about the cases. CONCLUSION: Overall, the study indicated a variable knowledge regarding the three mental disorders in region 1 of Tshwane and variable literacy levels in townships compared with urban settings. The results indicate that awareness campaigns should focus on the deficient areas.http://www.sajp.org.zadm2022PsychiatryStatistic

Influence of first- and second-generation antipsychotics on anthropometric parameters of male psychiatric patients

BACKGROUND: The use of antipsychotic medication, particularly second generation antipsychotics (SGAs) is a major risk factor for cardiovascular disease in people with severe mental illness (SMI). Few studies have compared body measures of people with SMI taking first generation antipsychotics (FGAs) to those taking SGAs. AIM: We compare body measures between long-term male inpatients using either FGAs or SGAs. SETTING: The study was conducted at Weskoppies Psychiatric Hospital, in Pretoria, Gauteng. METHODS: A total of 30 patients were selected from a list of male inpatients and were included in our study. Each participant had the following anthropometric measures done and these were compared between the two groups: Waist circumference (WC), body mass index (BMI), waist to hip ratio (WHR), waist to height ratio (WHtR) and hip circumference (HC). Hospital records were used to record demographic variables, diagnosis, comorbid disease and psychotropic medication for each participant. RESULTS: Participants in the FGA and SGA groups had similar body measures, resulting in similar BMI, WHR and WHtR. Participants had a mean HC of 100.5 cm, 95% confidence interval (CI) (97.68, 103.22). BMI ranged from 21.87 kg/m² to 37.65 kg/m², with an overall mean of 28.5 kg/m², 95% CI (26.69, 30.22). Participants had a mean WHtR of 0.59, 95% CI (0.56, 0.61). Participants had a mean WC of 100.6 cm and 95% CI (96.26, 104.87), and the mean WHR of both groups was 1.0. CONCLUSION: Participants using FGAs and SGAs had similar body measures, and these indicated that this sample of male inpatients with SMI is at high risk for CVD.http://www.sajp.org.zadm2022Psychiatr

Étude d'une souche Marocaine du virus de la Peste Porcine (Association du virus pestique et d’un virus agent d’une Pneumonie à virus du Porc).

Girard H. C., Mackowiak Czesław, Goret Pierre, Joubert L., Lucam François, Poulet M.-J. Étude d’une souche Marocaine du virus de la peste porcine. In: Bulletin de l'Académie Vétérinaire de France tome 106 n°10, 1953. pp. 555-568

Metasurface-enhanced Light Detection and Ranging Technology

Deploying advanced imaging solutions to robotic and autonomous systems by mimicking human vision requires simultaneous acquisition of multiple fields of views, named the peripheral and fovea regions. Low-resolution peripheral field provides coarse scene exploration to direct the eye to focus to a highly resolved fovea region for sharp imaging. Among 3D computer vision techniques, Light Detection and Ranging (LiDAR) is currently considered at the industrial level for robotic vision. LiDAR is an imaging technique that monitors pulses of light at optical frequencies to sense the space and to recover three-dimensional ranging information. Notwithstanding the efforts on LiDAR integration and optimization, commercially available devices have slow frame rate and low image resolution, notably limited by the performance of mechanical or slow solid-state deflection systems. Metasurfaces (MS) are versatile optical components that can distribute the optical power in desired regions of space. Here, we report on an advanced LiDAR technology that uses ultrafast low FoV deflectors cascaded with large area metasurfaces to achieve large FoV and simultaneous peripheral and central imaging zones. This technology achieves MHz frame rate for 2D imaging, and up to KHz for 3D imaging, with extremely large FoV (up to 150{\deg}deg. on both vertical and horizontal scanning axes). The use of this disruptive LiDAR technology with advanced learning algorithms offers perspectives to improve further the perception capabilities and decision-making process of autonomous vehicles and robotic systems.Comment: 25pages, 18 figures. Including supplementary material

Metasurface-enhanced light detection and ranging technology

: Deploying advanced imaging solutions to robotic and autonomous systems by mimicking human vision requires simultaneous acquisition of multiple fields of views, named the peripheral and fovea regions. Among 3D computer vision techniques, LiDAR is currently considered at the industrial level for robotic vision. Notwithstanding the efforts on LiDAR integration and optimization, commercially available devices have slow frame rate and low resolution, notably limited by the performance of mechanical or solid-state deflection systems. Metasurfaces are versatile optical components that can distribute the optical power in desired regions of space. Here, we report on an advanced LiDAR technology that leverages from ultrafast low FoV deflectors cascaded with large area metasurfaces to achieve large FoV (150°) and high framerate (kHz) which can provide simultaneous peripheral and central imaging zones. The use of our disruptive LiDAR technology with advanced learning algorithms offers perspectives to improve perception and decision-making process of ADAS and robotic systems

Avant projet d'un post-accélérateur de 500 MeV/A à GANIL : CSS3

La communauté des physiciens utilisateurs du GANIL a commencé en 1989 à réfléchir aux domaines de recherche que pourraient ouvrir l'existence à GANIL de faisceau d'ions à 500 MeV/nucléon dont les qualités optiques et les intensités seraient équivalentes à celles attendues après l’achèvement de l'Opération d'Augmentation d'Intensité (phases 1 et 2)