Psychiatric disorders and general medical conditions: implications for the clinician

Patients with severe mental illness have higher than expected prevalence rates of co-morbid general medical conditions, particularly metabolic and cardiovascular disease. They are also at increased risk of contracting HIV. Conversely, these and other medical disorders also increase the risk of developing mental disorders. Mental illness and general medical conditions have mutually adverse effects on long-term outcome. This interaction of diseases contributes significantly to the excess morbidity in and higher than expected standard mortality ratios for patients with mental illness. As medical practice becomes more specialized and arguably compartmentalized it may increasingly fail to integrate health care for patients with severe mental illness. In this paper we discuss the high co-morbidity of mental illness with other medical disorders as well some of the potential mechanisms involved. We furthermore argue that the bidirectional relationship between mental and medical disorders should be considered in the planning of treatment for either group of disorders. The central role of the psychiatrist in co-ordinating and integrating the health care of patients with severe mental illness is emphasized.African Journal of Psychiatry Vol. 11 (1) 2008: pp. 18-2

Quantum information processing using strongly-dipolar coupled nuclear spins

Dipolar coupled homonuclear spins present challenging, yet useful systems for quantum information processing. In such systems, eigenbasis of the system Hamiltonian is the appropriate computational basis and coherent control can be achieved by specially designed strongly modulating pulses. In this letter we describe the first experimental implementation of the quantum algorithm for numerical gradient estimation on the eigenbasis of a four spin system.Comment: 5 pages, 5 figures, Accepted in PR

Health care discrimination against the mentally ill - A comparison of private health insurance benefits for major depressive disorder and ischaemic heart disease in South Africa

CITATION: Oosthuizen, P. et al. 2004. Health care discrimination against the mentally ill - A comparison of private health insurance benefits for major depressive disorder and ischaemic heart disease in South Africa. South African Medical Journal, 94(10):821-823.The original publication is available at http://www.samj.org.za[No abstract available]Publisher’s versio

Features and development of Coot

Coot is a molecular-graphics program designed to assist in the building of protein and other macromolecular models. The current state of development and available features are presented

Fidelity enhancement by logical qubit encoding

We demonstrate coherent control of two logical qubits encoded in a decoherence free subspace (DFS) of four dipolar-coupled protons in an NMR quantum information processor. A pseudo-pure fiducial state is created in the DFS, and a unitary logical qubit entangling operator evolves the system to a logical Bell state. The four-spin molecule is partially aligned by a liquid crystal solvent, which introduces strong dipolar couplings among the spins. Although the system Hamiltonian is never fully specified, we demonstrate high fidelity control over the logical degrees of freedom. In fact, the DFS encoding leads to higher fidelity control than is available in the full four-spin Hilbert space.Comment: 10 pages, 2 figure

Health care discrimination against the mentally ill - A comparison of private health insurance benefits for major depressive disorder and ischaemic heart disease in South Africa

CITATION: Oosthuizen, P. et al. 2004. Health care discrimination against the mentally ill - A comparison of private health insurance benefits for major depressive disorder and ischaemic heart disease in South Africa. South African Medical Journal, 94(10):821-823.The original publication is available at http://www.samj.org.za[No abstract available]Publisher’s versio

Digitally supported CBT to reduce paranoia and improve reasoning for people with schizophrenia-spectrum psychosis: the SlowMo RCT

Background: Reasoning may play a causal role in paranoid delusions in psychosis. SlowMo, a new digitally supported cognitive–behavioural therapy, targets reasoning to reduce paranoia. Objectives: To examine the effectiveness of SlowMo therapy in reducing paranoia and in improving reasoning, quality of life and well-being, and to examine its mechanisms of action, moderators of effects and acceptability. Design: A parallel-arm, assessor-blind, randomised controlled trial comparing SlowMo plus treatment as usual with treatment as usual alone. An online independent system randomised eligible participants (1 : 1) using randomly varying permuted blocks, stratified by site and paranoia severity. Setting: Community mental health services in three NHS mental health trusts in England, plus patient identification centres. Participants: A total of 362 participants with schizophrenia-spectrum psychosis. Eligibility criteria comprised distressing and persistent (≥ 3 months) paranoia. Interventions: Eight face-to-face SlowMo sessions over 12 weeks plus treatment as usual, or treatment as usual alone (control group). Main outcome measures: The primary outcome measure was paranoia measured by the Green Paranoid Thoughts Scale and its revised version, together with observer-rated measures of persecutory delusions (The Psychotic Symptom Rating Scales delusion scale and delusion items from the Scale for the Assessment of Positive Symptoms). The secondary outcome measures were reasoning (measures of belief flexibility, jumping to conclusions, and fast and slow thinking), well-being, quality of life, schemas, service use and worry. Results: A total of 362 participants were recruited between 1 May 2017 and 14 May 2019: 181 in the SlowMo intervention group and 181 in the treatment-as-usual (control) group. One control participant subsequently withdrew. In total, 325 (90%) participants provided primary Green Paranoid Thoughts Scale outcome data at 12 weeks (SlowMo, n = 162; treatment as usual, n = 163). A total of 145 (80%) participants in the SlowMo group completed all eight therapy sessions. SlowMo was superior to treatment as usual in reducing paranoia on all three measures used: Green Paranoid Thoughts Scale total at 12 weeks (Cohen’s d = 0.30, 95% confidence interval 0.09 to 0.51; p = 0.005) and 24 weeks (Cohen’s d = 0.20, 95% confidence interval –0.02 to 0.40; p = 0.063); Psychotic Symptom Rating Scales delusions at 12 weeks (Cohen’s d = 0.47, 95% confidence interval 0.17 to 0.78; p = 0.002) and 24 weeks (Cohen’s d = 0.50, 95% confidence interval 0.20 to 0.80; p = 0.001); and Scale for the Assessment of Positive Symptoms persecutory delusions at 12 weeks (Cohen’s d = 0.43, 95% confidence interval 0.03 to 0.84; p = 0.035) and 24 weeks (Cohen’s d = 0.54, 95% confidence interval 0.14 to 0.94; p = 0.009). Reasoning (belief flexibility, possibility of being mistaken and Fast and Slow Thinking Questionnaire measure) improved, but jumping to conclusions did not improve. Worry, quality of life, well-being and self-concept also improved, improving most strongly at 24 weeks. Baseline characteristics did not moderate treatment effects. Changes in belief flexibility and worry mediated changes in paranoia. Peer researcher-led qualitative interviews confirmed positive experiences of the therapy and technology. Nineteen participants in the SlowMo group and 21 participants in the treatment-as-usual group reported 54 adverse events (51 serious events, no deaths). Limitations: The trial included treatment as usual as the comparator and, thus, the trial design did not control for the effects of time with a therapist. Conclusions To the best of our knowledge, this is the largest trial of a psychological therapy for paranoia in people with psychosis and the first trial using a brief targeted digitally supported therapy. High rates of therapy uptake demonstrated acceptability. It was effective for paranoia, comparable to longer therapy, and equally effective for people with different levels of negative symptoms and working memory. Mediators were improvements in belief flexibility and worry. Our results suggest that targeting reasoning helps paranoia. Future work: Further examination of SlowMo mechanisms of action and implementation

Thermodynamic aspects of materials' hardness: prediction of novel superhard high-pressure phases

In the present work we have proposed the method that allows one to easily estimate hardness and bulk modulus of known or hypothetical solid phases from the data on Gibbs energy of atomization of the elements and corresponding covalent radii. It has been shown that hardness and bulk moduli of compounds strongly correlate with their thermodynamic and structural properties. The proposed method may be used for a large number of compounds with various types of chemical bonding and structures; moreover, the temperature dependence of hardness may be calculated, that has been performed for diamond and cubic boron nitride. The correctness of this approach has been shown for the recently synthesized superhard diamond-like BC5. It has been predicted that the hypothetical forms of B2O3, diamond-like boron, BCx and COx, which could be synthesized at high pressures and temperatures, should have extreme hardness