Building our identity of psychiatry in the past, present and future South Africa

No abstract available

Examining fallacies in diagnostic reasoning

No abstracthttp://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2753hb201

Patients’ voices from music therapy at a South African psychiatric hospital

BACKGROUND: In the Life Esidimeni tragedy, crucial voices of mental healthcare users and practitioners were silenced, captured in the Ombud’s report as a ‘failure to listen’. Working against this kind of failure, various therapeutic interventions listen deliberately and uncover the voice of the patient, that is, what matters from his or her subjective perspective in his or her particular circumstances. Amongst these interventions, music therapy provides for this sensitive listening by expanding the scope and means of expression from the verbal to the musical. AIM: This article reports on a qualitative exploration of patients’ lived experiences both during and after their course of individual music therapy, expressed both verbally and in the language of active music-making. Setting: A tertiary public psychiatric hospital in South Africa. METHODS: Audio-video recordings of 131 music therapy sessions and 15 post-therapy interviews were analysed thematically. From three sets of themes accounting for patients’ verbal contents, musical participation and verbal post-therapy reflections, 11 salient voices were identified. RESULTS: The 11 voices that emerged were (1) the voice of struggle, (2) the voice of disturbance, (3) the voice that feels, (4) the voice of isolation, (5) the powerless voice, (6) the voice that desires, (7) the voice of flow and connection, (8) the reflecting voice, (9) the symbolic voice, (10) the resilient voice and (11) the voice of liberation. CONCLUSION: Although mental health practitioners may recognise these voices from their clinical experience, space and opportunity for hearing the voice of each patient should be generated deliberately.http://www.sajp.org.zadm2022MusicPsychiatr

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

Validity and reliability of the Vigour Assessment Scale in avolitional schizophrenia outpatients

A few items of existing schizophrenia scales measure avolition, but no research has been reported on vigour in schizophrenia, including whether avolition would be more or less the inverse of vigour. Such research requires a valid and reliable measure of vigour. In the absence of this, this study developed and examined the validity and the reliability of the Vigour Assessment Scale (VAS) among 242 avolitional schizophrenia outpatients in relation to measures of workplace vigour, behavioral inhibition and activation, procrastination, fatigue, anxiety, depressive features, and active involvement in personal growth. Convergent validity was found in moderate to strong correlations (r = 0.5 to 0.714) between the VAS and measures approximate to vigour. Discriminant validity was found in lower and/or inverse correlations with depression (r = -0.423), anxiety (r = -0.279), behaviour inhibition (r = -0.045), procrastination (r = -0.656), and fatigue (r = -0.684). Internal consistency was good with Cronbach's alpha coefficients above 0.8, and strong correlations for split-half (r = 0.71) and test-retest (r = 0.77) reliability. The standard error of measurement was seven on a scale of 145 points. An exploratory factor analysis yielded a 27-item version with a six-factor structure accounting for 61.9% of the cumulative variance. These results suggest that the VAS is a valid and reliable instrument in avolitional schizophrenia outpatients, suitable for use in further research on vigour and when vigour is pursued therapeutically or in efficacy studies. Subject to further validation, the VAS may be used in other clinical populations (e.g., in depression) and healthy populations where vigour may be pursued as a desirable attribute.Appendix A. Interview and Observation Guide on Avolition.https://www.elsevier.com/locate/schreshj2022PsychiatryStatistic

Validity and reliability of the Vigour Assessment Scale in avolitional schizophrenia outpatients

https://drive.google.com/file/d/1WWqq_h8SgS3FDFWAyyHAMKbB3lf2qoZE/view?usp=sharinghttps://drive.google.com/drive/folders/16nq6QiwhGx2EUpkta8SjX1N1ezDIqA4B?usp=sharinghttps://drive.google.com/drive/folders/1CUGyP5jEb32IKCrS3GI9_Ii6kSBgqjMV?usp=sharin

International Perspectives in Values-Based Mental Health Practice

This open access book offers essential information on values-based practice (VBP): the clinical skills involved, teamwork and person-centered care, links between values and evidence, and the importance of partnerships in shared decision-making. Different cultures have different values; for example, partnership in decision-making looks very different, from the highly individualized perspective of European and North American cultures to the collective and family-oriented perspectives common in South East Asia. In turn, African cultures offer yet another perspective, one that falls between these two extremes (called batho pele). The book will benefit everyone concerned with the practical challenges of delivering mental health services. Accordingly, all contributions are developed on the basis of case vignettes, and cover a range of situations in which values underlie tensions or uncertainties regarding how to proceed in clinical practice. Examples include the patient’s autonomy and best interest, the physician’s commitment to establishing high standards of clinical governance, clinical versus community best interest, institutional versus clinical interests, patients insisting on medically unsound but legal treatments etc. Thus far, VBP publications have mainly dealt with clinical scenarios involving individual values (of clinicians and patients). Our objective with this book is to develop a model of VBP that is culturally much broader in scope. As such, it offers a vital resource for mental health stakeholders in an increasingly inter-connected world. It also offers opportunities for cross-learning in values-based practice between cultures with very different clinical care traditions

International Perspectives in Values-Based Mental Health Practice

This open access book offers essential information on values-based practice (VBP): the clinical skills involved, teamwork and person-centered care, links between values and evidence, and the importance of partnerships in shared decision-making. Different cultures have different values; for example, partnership in decision-making looks very different, from the highly individualized perspective of European and North American cultures to the collective and family-oriented perspectives common in South East Asia. In turn, African cultures offer yet another perspective, one that falls between these two extremes (called batho pele). The book will benefit everyone concerned with the practical challenges of delivering mental health services. Accordingly, all contributions are developed on the basis of case vignettes, and cover a range of situations in which values underlie tensions or uncertainties regarding how to proceed in clinical practice. Examples include the patient’s autonomy and best interest, the physician’s commitment to establishing high standards of clinical governance, clinical versus community best interest, institutional versus clinical interests, patients insisting on medically unsound but legal treatments etc. Thus far, VBP publications have mainly dealt with clinical scenarios involving individual values (of clinicians and patients). Our objective with this book is to develop a model of VBP that is culturally much broader in scope. As such, it offers a vital resource for mental health stakeholders in an increasingly inter-connected world. It also offers opportunities for cross-learning in values-based practice between cultures with very different clinical care traditions

Conceptual work to advance psychiatric and neuroscientific sophistication: a report by the WPA Section on Philosophy and Humanities in Psychiatry

No abstract available.https://onlinelibrary.wiley.com/journal/20515545hj2020Psychiatr