Risk factors for female and male homicidal strangulation in Johannesburg, South Africa

Background. There is a paucity of research on homicidal strangulation by gender.Objectives. A sex-disaggregated and comparative research approach was used to investigate individual-level risk factors for female and male homicidal strangulation in Johannesburg, South Africa (2001 - 2010).Methods. Data were drawn from the National Injury Mortality Surveillance System. Logistic regressions were used to examine associations between each of the independent variables and homicidal strangulation in females and males relative to all other female and male homicides, respectively.Results. The risk of fatal strangulation was high for both females and males aged ≥60 years, but markedly high only for male children and adolescents. Temporal risk for females was undifferentiated for day of the week, and the risk for males was high during weekdays. Females were more likely to be strangled in public places, and males in private locations.Conclusions. The study underlines the importance of disaggregating homicide by external cause and gender.

9Th Injury Prevention and Safety Promotion Conference, Melbourne, Australia

No Abstract

Post traumatic stress disorder: undiagnosed cases in a tertiary inpatient setting

Objective: Post traumatic stress disorder (PTSD) is a common, debilitating anxiety disorder characterized by emotional and physical symptoms that may occur after exposure to a severely traumatic event. Since it occurs commonly as a comorbid diagnosis with other mood- and anxiety disorders, we postulated that this disorder may be under- diagnosed in therapeutic wards where anxiety and mood disorders are treated. The study thus sought to determine the prevalence of undiagnosed PTSD in an inpatient population, and to compare the demographic details and comorbid diagnoses of subjects with and without PTSD. Method: The Clinician-administered PTSD Scale for DSM-IV (CAPS) was administered to 40 subjects who were inpatients in a therapeutic ward of a large psychiatric hospital and who had never had a diagnosis of PTSD before. Results:16 (40%) subjects met the DSM-IV criteria for PTSD. We did not find significant clinical differentiating factors between subjects with and without PTSD; however subjects with PTSD were more likely to use cannabis. Conclusions: PTSD remains undiagnosed in many patients admitted to therapeutic units. Keywords: Stress Disorders, Post-Traumatic; Diagnosis; Inpatients;African Journal of Psychiatry Vol. 11 (2) 2008 pp. 119-12

Urban and rural differences in child injury deaths in South Africa: A one-year review

Injury, a major cause of morbidity and mortality for children worldwide, is concentrated in low- to middle-income countries (LMICs). Despite the growing rate of childhood injury in LMICs, effective prevention and control remain inadequate owing to the lack of comprehensive epidemiological information on the external causes and magnitude of this problem. This population based study examined whether the incidence and the pattern of fatal injuries among children differ in rural and urban areas of South Africa. The National Injury Mortality Surveillance System (NIMSS) was used to select cases for the period of 2007. Age and gender-specific incidence rates for rural and urban children were computed for specific injury types. Following a cross-sectional method, we analysed all deaths among children below 15 years of age in Gauteng (urban) and Mpumalanga (rural) who died in 2007. For the year 2007, NIMSS recorded a total of 612 injury deaths among children in Mpumalanga (rural) and another 1 400 injury deaths among children in Gauteng (urban). Equally high overall injury death rates were found among children from Gauteng (31.7/100 000) and Mpumalanga (29.2/100 000). The study also revealed several differences with respect to the primary external causes of child injury-related deaths across the two provinces. In particular, passenger related motor vehicle deaths were more evident among children in rural areas than in urban areas, while other unintentional (non-transport-related) deaths – specifically those associated with burns – were more common among urban children than among rural children.Such differences may arise because of the many environmental and infrastructure-related differences that exist between rural and urban areas. Therefore, prevention and intervention efforts in South Africa should focus on the risk factors that are unique to urban and rural children respectively.Keywords: childhood, urban, rural, death

Community Engagement: International Day of the Older Person 2009

No Abstract

Psychopatholgy, fundamental assumptions and CD-4 T lymphocyte counts in HIV-positive patients

Objective:  Key words: Fundamental Assumptions; HIV; PsychopathologyWe investigated whether psychopathology in HIV-positive patients was associated with more negative fundamental assumptions than in healthy controls. In addition, we explored whether psychopathology and negative fundamental assumptions in HIV-positive patients were associated with lower CD4 T-lymphocyte counts. Method: Self-rating questionnaires to assess depressive symptoms, posttraumatic stress symptoms, alcohol abuse, general psychopathology and fundamental assumptions, were completed by 123 HIV-positive patients and 84 uninfected clinic attendees at three primary health care clinics in the Western Cape, South Africa. CD4 T-lymphocyte counts were obtained from chart records. Results: HIV-positive patients reported more depressive and posttraumatic symptoms than uninfected individuals. However when controlling for socio-economic status, the number of traumatic events experienced and other potential confounds, no differences remained. Fundamental assumptions (FA) were mainly positive in both HIV-positive patients and controls and no correlations were found between fundamental assumptions, psychiatric symptoms and CD4 levels. However, in infected patients FA and psychopathology were negatively associated with all participants scoring in the positive range of the FA scale. Conclusion: The positive scores on the FA scale indicate that positive assumptions are related to less psychopathology. Longitudinal studies investigating the association between the valence of fundamental assumptions and HIV morbidity are needed

Desktop Analysis and Qualitative Investigation of Programmes and Initiatives for the Prevention of and Response to Gender Based Violence at South African Universities with Medical Campuses

Gender-based violence (GBV) is pervasive at South African higher education institutions (HEIs). Based on a media statement (dated 6 October 2016) by the Department of Higher Education and Training, GBV programmes at HEIs need to be evidence-informed, responsive, contextually relevant, inclusive and person-centred. The present article aims to explore the nature of GBV programmes currently implemented at HEIs in South Africa. A rapid review of the literature, supported by qualitative interviews with representatives of South African HEIs with medical campuses, was conducted. Findings indicate that there is an urgent need to clearly define GBV and to mention it explicitly in policy documents. In addition, research evidence on the effectiveness of prevention and response interventions at HEIs in South Africa is lacking. Challenges highlighted by the HEIs that were surveyed include the lack of trust by staff and students in the response and action plans of the response/task teams at HEIs, uncertainty with regards to the roles of relevant stakeholders and sectors when reporting incidents, as well as insufficient information about what GBV is. This study is intended to provide a baseline for further research evaluating current GBV programmes on medical campuses at HEIs, and highlights the need for an evidence-informed framework of the key ingredients for effective GBV response and prevention programmes

Prevalence and clinical characteristics of obsessive-compulsive disorder and obsessive compulsive symptoms in Afrikaner schizophrenia and schizoaffective disorder patients

Objective: There is evidence of variation in the prevalence of co-morbid obsessive-compulsive disorder in schizophrenia amongst ethnic groups. This study evaluated the lifetime prevalence and clinical characteristics of obsessive-compulsive disorder (OCD)/ obsessive-compulsive symptoms (OCS) in Afrikaner schizophrenic and schizoaffective disorder patients. Method: An ongoing genetic study of schizophrenia is currently being conducted on the Afrikaner founder population. In this cohort of 400 subjects from the original genetic study, we identified 53 subjects with schizophrenia or schizoaffective disorder and co-morbid OCD/OCS (study group). They were matched for gender and age of onset of illness with 59 subjects who do not have OCD/OCS (control group). The diagnostic instrument used in this cohort is the Diagnostic Interview for Genetic Studies (DIGS) version 2, which has been translated into Afrikaans. In addition to the DIGS, information for the relevant clinical characteristics reported in this study was also drawn from a detailed narrative chronological summary report and clinical files. A checklist was completed. Results: The prevalence of co-morbid OCD/OCS amongst 400 subjects with schizophrenia or schizoaffective disorder was 13.2% [n=53] of which 40 were male and 13 female patients. The prevalence of OCD was 10.7% and OCS was 2.5%. Contamination obsessions [n=17] were the most common type of obsession reported, followed by religious obsessions [n=8]. The most prevalent compulsions were repetitive rituals [n=32] followed by checking behaviour [n=22]. Onset of psychotic symptoms was found to be insidious in 86.8% of the study group compared to 24.6% of the control group (

Childhood trauma in adults with social anxiety disorder and panic disorder: a cross-national study

Objectives: The influence of childhood trauma as a specific environmental factor on the development of adult psychopathology is far from being elucidated. As part of a collaborative project between research groups from South Africa (SA) and Sweden focusing on genetic and environmental factors contributing to anxiety disorders, this study specifically investigated rates of childhood trauma in South African and Swedish patients respectively, and whether, in the sample as a whole, different traumatic experiences in childhood are predictive of social anxiety (SAD) or panic disorder (PD) in adulthood. Method: Participants with SAD or PD (85 from SA, 135 from Sweden) completed the Childhood Trauma Questionnaire (CTQ). Logistic regression was performed with data from the two countries separately, and from the sample as a whole, with primary diagnoses as dependent variables, gender, age, and country as covariates, and the CTQ subscale totals as independent variables. The study also investigated the internal consistency (Cronbach alpha) of the CTQ subscales. Results: SA patients showed higher levels of childhood trauma than Swedish patients. When data from both countries were combined, SAD patients reported higher rates of childhood emotional abuse compared to those with PD. Moreover, emotional abuse in childhood was found to play a predictive role in SAD/PD in adulthood in the Swedish and the combined samples, and the same trend was found in the SA sample. The psychometric qualities of the CTQ subscales were adequate, with the exception of the physical neglect subscale. Conclusion: Our findings suggest that anxiety disorder patients may differ across countries in terms of childhood trauma. Certain forms of childhood abuse may contribute specific vulnerability to different types of psychopathology. Longitudinal studies should focus on the potential sequential development of SAD/PD among individuals with childhood emotional abuse.Keywords: Childhood trauma; Social anxiety disorder; Panic disorder; Cross-nationa