South African Journal of Psychiatry

Corrigendum: A call for SASOP to review their position on the care of ‘transgender and non-binary youth’

2026-10-16T12:10:05+00:00

No abstract

Corrigendum: Locally relevant, ethically urgent: Defending SASOP’s stance on transgender and non-binary youth

2026-10-16T12:27:07+00:00

No abstract

Locally relevant, ethically urgent: Defending SASOP’s stance on transgender and non-binary youth

2026-02-16T17:04:20+00:00

No abstract.

FDNHSA’s response to KL Dunkle et al.’s ‘Upholding clinical integrity and South African relevance: A defence of the SASOP position statement on the care of transgender and non-binary youth’

2026-02-16T22:17:06+00:00

No abstract.

Psychiatry and artificial intelligence: A need for informed engagement

2026-10-14T11:45:48+00:00

No abstract

Self-reported mental health effects of unemployment on young people in Mdantsane, South Africa: A qualitative study

2026-02-16T17:21:08+00:00

Background: South Africa has been experiencing a persistently high unemployment rate among young people. This high youth unemployment is a stressor to young people, which may culminate in mental health issues.

Aim: The study aimed to describe the self-reported mental health effects of unemployment among young people in Mdantsane township, Eastern Cape province.

Setting: The study was conducted in Mdantsane township, at the Lingomso Youth Centre in the Eastern Cape province, South Africa.

Methods: A descriptive qualitative approach was used. Participants were recruited purposively until data saturation. Data were collected through individual face-to-face interviews. Thematic analysis was conducted using a six-step approach.

Results: The sample comprised 19 young people aged between 19 years and 29 years, and most were men. Two themes emerged: theme one was negative effects, which were characterised by substance use, feelings of worthlessness, stress and anxiety, masking of personality, and social isolation; theme two was that social support buffered the potential adverse effects of unemployment, and this was supported by interdependent role relationships that protected individuals from the effects of unemployment.

Conclusion: There is a need to recognise mental health issues emanating from unemployment, like social isolation, to enable comprehensive, appropriate interventions for young people.

Contribution: This study contributes to understanding mental health issues experienced by unemployed young people. Findings can be used to develop targeted interventions in a large township, such as Mdantsane, in South Africa.

Management and co-morbidities in children and adolescents with attention deficit hyperactivity disorder diagnosis: A clinical audit in the Eastern Cape province, South Africa

2026-02-16T17:28:51+00:00

Background: Attention deficit hyperactivity disorder (ADHD) is a common childhood disorder, with a prevalence rate of 5% – 8%. Clinical practice guidelines have been developed internationally to standardise the care and management of patients with ADHD.

Aim: To assess compliance with clinical guidelines on the management of children with ADHD in two hospitals in the Eastern Cape province using the National Institute for Health and Care Excellence (NICE) guidelines as the gold standard.

Setting: Paediatric departments of two hospitals in the Buffalo City Municipality, Eastern Cape province, South Africa.

Methods: A clinical audit was conducted on children and adolescents diagnosed with ADHD attending neurodevelopmental clinics (NDCs). Patient folders were reviewed between June 2021 and December 2021, and data were collected using a 16-point audit tool based on the NICE guidelines for ADHD.

Results: A total of 111 patient folders met the inclusion criteria. Of the 16 audit standards, 8 demonstrated over 80% compliance, while 2 achieved fair compliance (50% – 79%). Significant gaps were identified in the 6 standards with poor compliance (<50%). Co-morbidities were highly prevalent, with 83% of patients presenting with at least one co-existing condition.

Conclusion: The audit demonstrated overall good clinical compliance with the NICE guidelines for ADHD management, but it also exposed gaps in psycho-social interventions, caregiver support and the availability of structured support groups.

Contribution: This study highlights service gaps in resource-limited settings and is expected to further inform government policy planning in developing auxiliary services and multidisciplinary support for children with ADHD and their families in such settings.

Vulnerability to anxiety and depression symptoms co-occurring among adult patients at family medicine clinics in Najran University Hospital, Saudi Arabia

2026-02-16T17:25:45+00:00

Background: Depression and anxiety are pervasive mental health concerns worldwide that pose significant challenges to individuals and societies.

Aim: The aim of the study is to investigate the prevalence of co-occurring depression symptoms and anxiety among adult patients receiving care

Setting: Primary clinics within the Family and Community Medicine Department, in Najran University Hospital, Saudi Arabia

Methods: A cross-sectional study was conducted in February 2024, recruiting 300 adult patients across seven primary care clinics serving diverse populations. Data were collected using a comprehensive questionnaire that included socio-demographics, medical history, and screening for anxiety and depression symptoms. Multivariate regression analysis was employed.

Results: Most participants were aged 21–30 years (33.0%), predominantly female (64.0%), and Saudi (68.7%). Chronic diseases affected 26.4%, and 31.6% had a past medical history. Depression symptoms were reported by 21.7%, while 14% had anxiety, and 10.7% experienced both. Multivariate regression analysis revealed that stress, psychiatric conditions, herbal medication use, and sleep problems were independent risk factors for co-occurring symptoms.

Conclusion: Co-occurring anxiety and depression symptoms were prevalent in the study population.

Contribution: The findings advocate for comprehensive mental health strategies that priorities the early detection of co-occurring depression and anxiety, by considering factors essential for improving patient outcomes.

Prevalence and predictors of high-dose antipsychotic therapy among adult psychiatric inpatients in Baghdad, Iraq

2026-02-16T22:19:06+00:00

Background: Current evidence-based guidelines recommend the use of antipsychotic monotherapy at the lowest effective dose. Nonetheless, high-dose antipsychotics and antipsychotic polypharmacy appear to be common in clinical practice, often deviating from established recommendations.

Aim: This study aimed to estimate the prevalence and factors associated with high-dose antipsychotic prescribing among adult psychiatric inpatients.

Setting: The study was conducted at Ibn Rushd Psychiatric Teaching Hospital in Baghdad, Iraq.

Methods: The medical records of inpatients admitted from 24 April 2023 to 12 September 2023, were retrospectively analysed to extract routinely collected patient-level data and medication details; dosing appropriateness was based on that stated in the British National Formulary.

Results: Of the 225 eligible patients, 51.1% were male, aged 18–82 years (mean = 33.9). Altogether, 48.6% of patients received antipsychotic polypharmacy, and 35.6% were prescribed high-dose antipsychotics. No significant associations were found between high-dose antipsychotic prescribing and patients’ characteristics, including age, sex, length of hospital stay, and number of admissions. Predictors of high-dose antipsychotics were polypharmacy (adjusted odd ratio [AOR]:12.61; 95% confidence interval [CI]: 1.78, 89.50), first-generation antipsychotics (AOR: 7.049; 95% CI 1.33, 37.44), quetiapine (AOR: 5.66; 95% CI 1.16, 27.53), procyclidine (AOR: 0.17; 95% CI 0.05, 0.55), and antidepressants (AOR: 0.19; 95% CI 0.05, 0.76).

Conclusion: Approximately one in three patients received regular high-dose antipsychotic therapy, which contradicts optimal clinical practice and risks patient safety. Targeted educational interventions are warranted to enhance guideline adherence and promote safe and appropriate use of antipsychotics.

Contribution: This is the first study to assess the magnitude and factors associated with highdose antipsychotic prescription in Iraq.

Substance abuse in first-episode psychosis at Chris Hani Baragwanath Hospital

2026-02-16T17:01:20+00:00

Background: In South Africa, the use of substances is associated with serious health challenges, exacerbated by limited health resources. Substance use is often associated with first-episode psychosis (FEP). Prevention and treatment protocols can be established by understanding the socio-demographic and clinical characteristics of patients with FEP.

Aim: To determine the prevalence, patterns, socio-demographic and clinical factors associated with substance use in patients with FEP at Chris Hani Baragwanath Academic Hospital.

Setting: The study was conducted at Chris Hani Baragwanath Academic Hospital, a tertiary healthcare facility in Soweto, South Africa.

Methods: The study was a retrospective chart review analysis of clinical records of 200 patients presenting with FEP. The data were then statistically analysed, and patients with and without substance use in FEP were compared.

Results: The prevalence of substance use was 73.6%. Most patients were male and between 21 years old and 30 years old (37.0%). Substance-induced psychotic disorder was the most common diagnosis. Cannabis (THC) (46.0%) was the most commonly used substance. Substance use was associated with aggression (45.0%), and only 34.0% of substance users were referred to social services.

Conclusion: Substance use is a modifiable risk factor in the presentation of psychotic disorders. Integrated models of care, addressing both mental health and substance use and targeting early intervention, are essential to improve patient outcomes.

Contribution: In this study, the focus was on the interrelationship between substance use and psychosis. It emphasised the need for integrated strategies for the treatment of mental health and substance use. It provides a crucial insight into the socio-demographic and clinical predictors of substance use in patients with FEP, which can inform clinical practice and intervention strategies.

Clinical and psychological changes associated with music listening in haemodialysis patients: A prospective study

2026-02-16T17:32:06+00:00

Background: Chronic kidney disease (CKD) is a progressive condition associated with high morbidity and mortality. Haemodialysis (HD) patients experience significant psychological and physiological stress. Non-pharmacological interventions such as music listening sessions can alleviate anxiety and depression without drug-related side effects.

Aim: This study was conducted to evaluate the effects of music therapy on psychological well-being and selected biochemical parameters in HD patients.

Setting: This study was conducted with 49 HD patients at the Dialysis Unit of Harran University Faculty of Medicine between May and July 2025.

Methods: All patients underwent a 4-week music listening programme (12 sessions, each session consisting of 30 min of traditional music). Psychological status was assessed before and after the intervention using the Beck Anxiety and Depression Inventories. Biochemical parameters and dialysis efficiency indicators were also recorded. Data were analysed using the Wilcoxon Signed-Rank Test.

Results: Significant decreases were observed in anxiety and depression scores (p < 0.001). Biochemical analyses showed significant changes in sodium (p < 0.001), calcium (p = 0.002), glucose (p = 0.024) and albumin (p < 0.001) levels. No significant changes were observed in dialysis efficiency indicators.

Conclusion: Music listening sessions administered during HD sessions improved patients’ psychological state and affected selected biochemical parameters. This is a safe, cost-effective, complementary intervention that may increase comfort and potentially improve physiological outcomes.

Contribution: This study highlights the potential of music listening sessions as an adjunct to conventional treatments in HD care.

Socio-economic and psychological factors contributing to drug use among females in Khyber Pakhtunkhwa, Pakistan: A mixed-methods approach

2026-02-16T16:53:33+00:00

Background: Women in Khyber Pakhtunkhwa face several barriers, including poverty, cultural stigma, intense social pressure and a lack of accessible services, which prevent them from addressing drug use and mental health issues.

Aim: The study aimed to explore the impact of socio-economic and psychological factors on substance use among women aged 25–34.

Setting: This study was conducted at community centres and private schools across several cities in Khyber Pakhtunkhwa, Pakistan, including Peshawar, Charsadda, Nowshera, Swabi and Mardan.

Methods: A mixed-methods approach was employed, combining quantitative surveys from 120 participants to analyse drug use patterns and qualitative interviews with 20 participants to investigate personal and social challenges through in-depth interviews.

Results: Quantitative data indicated that unemployment, financial hardship and low education significantly predicted drug use, whereas moderate depression, anxiety and stress exacerbated it. Perceived stigma serves as a protective role in this study. Qualitative findings highlight themes such as socioeconomic challenges, mental health issues, cultural pressures and barriers to treatment that exacerbate these problems.

Conclusion: This study highlights the importance of rehabilitation centres and community counselling services tailored to women’s specific needs, along with legislative measures to address gaps in support and resources for women facing drug use issues.

Contribution: This study contributes to the understanding of the complex relationships between mental health, socioeconomic status and cultural factors influencing drug use among women and aims to inform public health policy and strategy.

Clinical audit of psychotropic medication use at a South African intellectual disability hospital

2026-02-16T17:18:00+00:00

Background: Individuals with intellectual disability (ID) are often prescribed psychotropic medications at disproportionately high rates, particularly for managing psychiatric symptoms or behaviours that challenge (BTC). International guidelines emphasise cautious, evidence-based use and the prioritisation of non-pharmacological interventions.

Aim: This audit evaluated prescribing practices at a specialist psychiatric hospital in South Africa to determine the extent of alignment with internationally recommended standards for psychotropic use in individuals with ID.

Setting: Outpatient department (OPD) of an advanced psychiatric care institution in Cape Town.

Methods: A retrospective folder and prescription review was conducted for 103 patients with ID who were newly referred between January 2018 and August 2019. Prescribing decisions at the first visit and 6-month follow-up were assessed against guidance from the World Psychiatric Association (WPA) and National Institute for Health and Care Excellence (NICE).

Results: Psychotropic medications were prescribed to 88% of patients. Antipsychotics were the most frequently used agents, comprising over half of all prescriptions, often for BTC in the absence of a psychotic disorder. While certain elements of guideline-based care were evident – such as use of low effective doses – gaps were noted in documentation of rationale, review scheduling, side-effect monitoring and consistent use of behavioural strategies. These areas highlight opportunities for strengthening practice.

Conclusion: This audit emphasises the complexity of psychotropic prescribing for individuals with ID and the need for structured, multidisciplinary approaches to ensure safe and appropriate medication use.

Contribution: Embedding standard protocols and regular reviews into clinical workflows may support better adherence to international best-practice standards.

Gambling and its associated factors among students of the University of Ilorin, Nigeria

2026-02-16T16:47:57+00:00

Background: Studies have revealed a global surge in gambling and gambling disorders, particularly among young adults, including university students. This disturbing trend poses significant risks not only to individual’s mental well-being but also to the wider community.

Aim: The objectives of the study were to determine the prevalence of gambling, gambling disorder and the associated socio-demographic factors among undergraduate students of University of Ilorin.

Setting: The study was conducted at the University of Ilorin, a federal government owned tertiary educational institution located in Kwara State, North-Central Nigeria.

Methods: A pro forma questionnaire was used to obtain socio-demographic information about the students. Respondents who had gambled in their lifetime proceeded to complete the self-administered South Oaks Gambling Screen (SOGS). Score of at least 1 out of 20 on the SOGS indicated gambling disorder, having met the criteria for either problem gambling (score 1-4) or pathological gambling (score ≥ 5).

Results: Responses of 2044 of the respondents were analysed. Their mean age was 21.74 ± 2.64 years, and male respondents accounted for 54.5%. A total of 409 (20%) of respondents had ever gambled in their lifetime, with sports betting been the most gambled activity. About 14.9% of the respondents had gambling disorders (10.5% problem gambling; 4.4% pathological gambling). Male gender, positive family history of mental illness, a lack of adequate financial support and staying off-campus were significantly associated with presence of gambling disorders. Logistic regression revealed that only positive family history of mental illness was predictive of gambling disorder (OR = 6.987, 95% CI [2.119–23.038], p = 0.001).

Conclusion: This study revealed that three-quarters of respondents with a lifetime history of gambling developed gambling disorder.

Contribution: This implies that a significant proportion of individuals who initially engage in social gambling may have a propensity to develop gambling disorder overtime.

Validation and improvement of the mental health literacy scale to assess undergraduate nursing students in South Africa

2026-02-16T16:58:06+00:00

Background: Mental Health Literacy (MHL) refers to knowledge, skills and attitudes related to mental health and is often measured by the revised Mental Health Literacy Scale (MHLS). This scale has been validated on a group of primary healthcare (PHC) workers in Zambia and South Africa, but its usefulness for a group of nursing students has not been investigated until now.

Aim: To investigate the psychometric properties of the revised scale for a group of undergraduate nursing students at a South African university, while also assessing the level of MHL in the group under investigation.

Setting: Nursing students (N = 121) studying for their Bachelor of Nursing degree at a South African public university.

Methods: A quantitative, cross-sectional survey was conducted between July 2023 and August 2023, using a purposive sampling technique. A socio-demographic data form and a revised version of the MHLS were used to collect data online. Descriptive statistics, Cronbach’s alpha, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to analyse the data.

Results: The EFA and CFA seemed to confirm a new 5-factor structure, including only 17 items. This structure holds similar factors to the MHL subscales. The reliability of most of the new factors was good, with two factors that need further intervention. This version of the MHLS proposed satisfactory levels of MHL for this group.

Conclusion: This study proposes a shortened, 5-factor structure version of the MHLS to be used to assess nursing students.

Contribution: The revised 5-factor structure measure can potentially identify gaps in the MHL of students, and this can inform appropriate interventions to address the MHL needs in South Africa generally.

Insomnia among vocational college students in China: Status and influencing factors

2026-02-17T21:12:48+00:00

Background: Sleep-related problems, particularly insomnia and sleep disturbances, have become increasingly prevalent. However, few studies have specifically explored these issues among vocational college students.

Aim: To investigate the prevalence and influencing factors of insomnia and its relationship with sleep disturbances in Chinese vocational college students.

Setting: Two vocational colleges in Ganzhou, Jiangxi Province, China.

Methods: A cross-sectional survey was conducted in April 2025 using cluster sampling. A total of 1,993 students completed the Athens Insomnia Scale (AIS), the Espie Sleep Disturbance Questionnaire (SDQ) and a self-designed questionnaire.

Results: In all, 48.02% of students reported insomnia symptoms in the past month. Higher insomnia severity was significantly associated with three SDQ dimensions: sleep restlessness/ agitation (t = 7.466, p < 0.001), mental overactivity (t = 9.670, p < 0.001) and preoccupation with insomnia consequences (t = 9.509, p < 0.001). Other significant factors included being female (t = −3.582, p < 0.001), being a freshman (t = −5.782, p < 0.001), dissatisfaction with their academic major (t = −4.731, p < 0.001), alcohol use (t = 2.654, p = 0.007) and engaging in fewer than 7 h per week of extracurricular study or reading (t = −2.328, p = 0.020).

Conclusion: Insomnia in vocational college students is influenced by multiple factors and is strongly linked to sleep disturbances.

Contribution: This study provides empirical evidence on insomnia in this population and offers insights to guide targeted interventions in higher education settings.

South African mental health workers’ knowledge and attitudes to trans and gender-diverse people

2026-02-17T21:22:38+00:00

Background: Transgender and gender-diverse (TGD) individuals experience higher rates of mental illness compared to cisgender populations. Accessing appropriate care remains challenging because of discrimination and a lack of provider knowledge. There is limited evidence exploring mental health worker views in a local setting.

Aim: This study aimed to explore knowledge and attitudes of South African mental health workers in specialised psychiatric settings towards TGD people.

Setting: This study was conducted at two specialist tertiary psychiatric hospitals in Johannesburg.

Methods: A cross-sectional descriptive study utilising the Transgender Knowledge, Attitudes, and Beliefs (T-KAB) scale was conducted among 150 mental health workers. Information on socio-demographic features, professional characteristics, and work experience was collected and analysed in relation to T-KAB scores.

Results: Participants demonstrated moderately favourable attitudes with a mean T-KAB score of 2.81/4.00. Professional category significantly influenced attitudes, with psychologists followed by medical doctors scoring the highest, and nurses and social workers scoring lowest. Age, sexual orientation, and religious affiliation were significantly associated with T-KAB scores, while years of practice, previous training in TGD-related care, and prior exposure to TGD patients showed no associations.

Conclusion: Mental health professionals in South African psychiatric hospitals hold moderately positive attitudes towards TGD individuals, with significant variations across professional categories. Prior training and clinical exposure were not associated with attitudes.

Contribution: This study provides one of the first assessments of mental health worker attitudes towards TGD individuals in an African setting. Nurses constitute the majority of the workforce and demonstrate less favourable attitudes, which has implications for approaches to improve transgender-affirming mental healthcare in this setting.

Unmet needs of young adults following first-episode psychosis in KwaZulu-Natal, South Africa: Baseline findings from a pilot randomised controlled trial of basic income support

2026-03-10T21:00:40+00:00

Background: People with psychosis have multiple and complex needs. The first episode of psychosis (FEP), as a distinct health challenge that occurs frequently during adolescence or early adult years, is a serious threat because of high levels of poverty among the youth in South Africa.

Aim: This study quantifies the needs among unemployed FEP adults aged 18–29 years in South Africa for potential early intervention targeting.

Setting: The study was conducted at government psychiatric facilities in Msunduzi Municipality, KwaZulu-Natal province, South Africa.

Methods: As part of a pilot randomised controlled trial of an unconditional cash transfer (UCT) intervention, also known as basic income support (BIS), 60 FEP participants were enrolled, and we assessed their needs using the Camberwell Assessment of Needs, the Household Food Insecurity Access Scale and the Water Insecurity Experience Scale. Descriptive cross-sectional analyses were summarised for various domains of needs.

Results: Most participants were black people (n = 58, 96.7%), male (n = 47, 78.3%), with a median age of 23 years (interquartile range [IQR] = 20.0–25.5), with half being diagnosed with schizophrenia (n = 30, 50%). The most significant severe unmet need was the inability to access government benefits to which one is entitled. Despite the limited availability of mental health services in South Africa, the majority reported that their need for managing psychotic symptoms was met or partially met.

Conclusion: The needs of youth must go beyond the temporary management of psychotic symptoms.

Contribution: This study highlights the unmet needs of young adults with FEP in resourceconstrained environments and underscores the need for integrated interventions.

Lithium prescription patterns for bipolar disorder at a psychiatric hospital in KwaZulu-Natal

2026-03-10T21:18:26+00:00

Background: Lithium is regarded as the gold standard in the treatment of bipolar disorder (BD) globally and is accordingly recommended as first-line treatment for BD in the South African public sector guidelines. However, there is a downward trend in the use of lithium internationally, with a paucity of research regarding lithium use in South Africa.

Aim: This study aimed to investigate the prescription of lithium for outpatients with BD.

Setting: Townhill Hospital, a tertiary pyschiatric hospital in Pietermaritzburg, KwaZulu-Natal.

Methods: A retrospective review of the clinical records of outpatients aged 18 and above who were treated for BD was conducted from 01 August 2022 to 31 July 2024.

Results: Of the 206 records that were reviewed, there were 137 (66.5%) females and 69 (33.5%) males with a median age of 37 years (interquartile range 30.0, 50.0). Only 13 (6.3%) of patients were taking lithium, all in combination with other medications. Most patients were prescribed oral antipsychotics (72.8%; n = 150) and anticonvulsant mood stabilisers (72.8%; n = 150), followed by antidepressants (55.8%; n = 115), alone or in combination with other psychotropics.

Conclusion: The low prescription of lithium for BD in this study is concerning, despite the long-standing evidence for lithium’s efficacy and effectiveness in the literature. This highlights the need to remind clinicians about the South African BD guidelines.

Contribution: The results of this study expand the existing literature on lithium prescribing patterns in BD internationally by contributing data on the prescription of lithium for BD in Africa.

Prevalence of burnout and contributing factors among physicians in Burundi: A cross-sectional study

2026-03-10T21:28:36+00:00

Background: Burnout negatively impacts interpersonal skills, job performance, career satisfaction and psychological health and is marked by physical and emotional exhaustion from prolonged exposure to emotionally demanding work. Despite its known consequences, research on physician burnout prevalence and burden in Burundi remains limited.

Aim: This study aimed to assess the prevalence and investigate the contributing factors of burnout among physicians in Burundi.

Setting: Public and private sector hospitals in Burundi.

Methods: We conducted this cross-sectional analytical study in Burundi from 25 February 2025 to 25 April 2025, recruiting 435 hospital-based physicians with a minimum of 1 year of experience. Data on socio-demographics and burnout contributors were collected via a structured questionnaire, with burnout prevalence assessed using the Oldenburg Burnout Inventory (OLBI). SPSS was used for analysis. Multinomial logistic regression was used to investigate the association with burnout.

Results: Among 435 physicians, burnout was high at 66.2%, with over half disengaged and most exhausted. Burnout was linked to heavy workloads, long hours, limited patient time, poor work-life balance, financial strain and difficult workplace dynamics, especially among younger, less experienced doctors.

Conclusion: High prevalence rates of physician burnout have been observed in Burundi, driven by work-related and socio-demographic factors. Addressing the problem of burnout is crucial for sustainable healthcare, patient safety, physician well-being and overall healthcare system performance.

Contribution: This study provides the first national-level evidence of physician burnout prevalence and contributing factors in Burundi, establishing a crucial foundation for targeted organisational interventions and developments.

Prevalence of depressive symptoms among teachers in the Tshwane Metropolitan Municipality, South Africa

2026-03-10T21:13:54+00:00

Background: Depression is a significant contributor to the overall burden of mental disorders. The workplace has been identified as a notable source of depression, which includes the school environment. Mental disorders among teachers, especially if undiagnosed and untreated, contribute to compromised teaching and learning outcomes.

Aim: The purpose of this study was to determine the prevalence of depressive symptoms among teachers in the Tshwane Municipality, South Africa.

Setting: Tshwane Municipality, South Africa.

Methods: The Patient Health Questionnaire was used to screen depressive symptoms; a quantitative questionnaire was used to collect socio-demographic data; and Stata 14 was used to analyse the data.

Results: Most of the participants (n = 299, 75.13%) were female and married (n = 223, 56.03%), with a mean age of 39.5 years (standard deviation [SD] 12.4). The prevalence of depressive symptoms was 50.25% (n = 200). Being married, teaching Grade 12 and not seeking professional mental help within the previous 6 months were associated with the presence of depressive symptoms (p ≤ 0.05).

Conclusion: The findings of this study indicate a high prevalence of depressive symptoms among teachers in the Tshwane Municipality, highlighting depression as a significant mental health concern within the school environment.

Contribution: This study confirmed the high prevalence of depressive symptoms among both primary and high school teachers and across the three districts of the Tshwane Municipality.

Prevalence of depression and association with qualityof-life among oncology patients at Princess Marina Hospital, Botswana: A cross-sectional study

2026-04-15T08:49:37+00:00

Background: Depression significantly impacts cancer patients globally, complicating treatment outcomes by negatively affecting quality-of-life (QOL), self-care and treatment adherence. However, little is known about the prevalence of depression and its effects on QOL among cancer patients in Botswana.
Aim: This study aimed to assess the prevalence of depression and its relationship with QOL among cancer patients at Princess Marina Hospital’s oncology unit.
Setting: Patients seen at the oncology unit of Princess Marina Hospital, Botswana’s largest tertiary referral hospital.
Methods: A cross-sectional study was conducted from February 2023 to August 2024. The sample size was 302. Socio-demographic data were collected using a researcher-designed questionnaire. Depression was assessed using the PHQ-9, with a score of 9 or higher indicating depression, and QOL was measured using the WHOQOL-BREF.
Results: The prevalence of depression was 35.8% (95% confidence interval [CI]: 30.3%, 41.5%). Patients with depression had a higher mean pain score (6 vs. 4, p < 0.001) and poorer QOL across all domains: physical health (40.9 vs. 59.7, p < 0.001), psychological health (52.3 vs. 69.3, p < 0.001), social relationships (49.0 vs. 68.3, p < 0.001) and environmental health (48.1 vs. 58.8, p < 0.001). A new diagnosis of cancer was associated with an increased risk of depression (p = 0.03).
Conclusion: The prevalence of depression among cancer patients is high in Botswana, and it is associated with poorer QOL, highlighting a significant public health concern.
Contribution: Treatment of depression in this group of patients, along with pain management, may be crucial in improving their QOL.

Assessment of burnout and the associated risks in intensive care unit nursing staff at Chris Hani Baragwanath Academic Hospital in Gauteng, South Africa

2026-04-15T08:32:42+00:00

Background: Burnout significantly impacts well-being and job performance. High burnout rates in healthcare providers affect patient care, job satisfaction, and staff retention. This is of particular concern in an intensive care unit (ICU). The first step in addressing burnout is to determine the extent of the problem.
Aim: This study explores burnout prevalence and risk factors among ICU nurses at an academic hospital in Gauteng, South Africa.
Setting: The study was conducted at Chris Hani Baragwanath Academic Hospital, Soweto, Gauteng province, South Africa.
Methods: A cross-sectional study design was employed in which a demographic questionnaire and the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS [MP]) were used.
Results: The study of 141 ICU nurses found that 51.1% exhibited burnout, characterised by high exhaustion and low personal accomplishment levels on the MBI-HSS (MP) (95% confidence interval 42.8% – 59.3%). Socio-demographic factors had minimal impact, but nurse category significantly influenced exhaustion levels (χ² = 11.74, df = 4, p = 0.019), with professional and auxiliary nurses reporting higher exhaustion than staff nurses.
Conclusion: A moderate portion of the ICU nurses studied experience burnout, driven primarily by the demanding nature of the profession, while most socio-demographic factors show little impact.
Contribution: This study highlighted the rate of burnout among ICU nursing staff at an academic hospital, indicating the necessity of individual and institutional interventions to address this issue.

Clinical and socio-demographic characteristics associated with perinatal depression and human immunodeficiency virus

2026-04-15T09:47:34+00:00

Background: Perinatal depression is highly prevalent in South Africa. Human immunodeficiency virus (HIV), a known risk factor for depression, affects a large proportion of South African women of reproductive age. Few studies have compared depressive symptoms and associated risk factors in HIV-positive and HIV-negative pregnant and postpartum women, despite both conditions being linked to adverse maternal and child outcomes.
Aim: To compare socio-demographic and clinical characteristics of HIV-positive and HIV-negative women in the perinatal period attending a maternal mental health clinic.
Setting: The maternal mental health clinic at Chris Hani Baragwanath Academic Hospital in Soweto, Johannesburg.
Methods: A retrospective record review was conducted on 190 patients (HIV-positive: n = 40; HIV-negative: n = 150) seen at the clinic between January 2024 and April 2025. Data were extracted from the clinic’s REDCap database and analysed.
Results: The prevalence of significant depressive symptoms (Edinburgh Postnatal Depression Scale [EPDS] score > 13) was 43.2% (n = 82), regardless of HIV status. High rates of unplanned pregnancies (78.1%, n = 145), substance use in pregnancy (19.5%, n = 37), and intimate
partner violence (15.1%, n = 28) were observed regardless of HIV status. Poor social support was significantly more prevalent among HIV-positive women (p = 0.042).
Conclusion: Perinatal depressive symptoms were highly prevalent. Human immunodeficiency virus-positive women were more likely to report poor social support, a key risk factor for depressive symptoms. The findings of this study underscore the need for targeted psychosocial interventions.
Contribution: This study encourages further research to explore risk factors associated with perinatal depression, especially in HIV-positive women.

Examining the length of hospital stay and associated factors in adult patients with schizophrenia

2026-10-14T11:53:50+00:00

Background: Inpatient care is a key driver of mental healthcare costs in South Africa (SA). Schizophrenia is a common psychiatric diagnosis amongst hospitalised patients in the public sector of SA. Determining the length of stay (LOS) and associated factors in patients with schizophrenia could assist in effective utilisation of the mental healthcare budget.
Aim: To determine the LOS and any associated socio-demographic and clinical factors in patients with schizophrenia.
Setting: A psychiatric unit in a central public hospital, Chris Hani Baragwanath Academic Hospital (CHBAH) and a specialised psychiatric hospital, Tara H Moross (TARA) in Gauteng, SA.
Methods: A quantitative retrospective review of the records of patients with schizophrenia admitted to CHBAH and discharged from CHBAH and TARA hospital over the study period was conducted. Information on the LOS, socio-demographic and clinical factors was collected upon discharge.
Results: The median LOS for the 132 patients with schizophrenia was 42 days, with a mean of 55 days. In bivariate analysis, statistically significant factors associated with LOS were living arrangements ( p = 0.036), number of previous admissions (first admission) ( p = 0.009) and being on clozapine ( p < 0.001). However, in regression analyses, only living alone remained statistically significant and associated with a shorter LOS ( p = 0.004).
Conclusion: Prolonged LOS indicates ongoing reliance on inpatient care due to service level constraints, including poorly resourced community psychiatric services and individual contextual factors. Both socio-demographic and clinical factors influenced LOS. Associated factors such as living alone and early clozapine initiation provide targets from which to start addressing modifiable contributors that may reduce LOS.
Contribution: This study contributes to the limited data on the LOS for patients with schizophrenia in SA.

Assessment of serum inflammatory cytokines in first-episode psychosis: Cross-sectional study

2026-10-15T11:18:35+00:00

Background: Chronic low-grade systemic inflammation is implicated in the pathophysiology of schizophrenia, particularly in its early stages. Pro-inflammatory and anti-inflammatory cytokines have been implicated, particularly interleukin (IL) 6, 8 and 10.
Aim: To investigate the association between serum inflammatory cytokines (IL-6, IL-8 and IL-10) and first-episode psychosis (FEP).
Setting: The study was at five clinical sites in KwaZulu-Natal, South Africa.
Methods: This study was an observational, cross-sectional sub-analysis of data derived from a larger longitudinal cohort study of individuals with FEP. In this analysis, we included HIV-negative participants who were 18 years to 45 years old and had less than 6 weeks of antipsychotic exposure. Measures included socio-demographics (age, sex), body mass index (BMI), psychiatric diagnosis (Mini International Neuropsychiatric Interview, MINI), psychosis severity (Positive and Negative Syndrome Scale, PANSS), depressive symptoms (Patient Health Questionnaire-9, PHQ-9), substance use (WHO Alcohol, Smoking and Substance Involvement Screening Test, WHO-ASSIST), childhood trauma (Childhood Trauma Questionnaire, CTQ), and serum cytokines (Multiplex ELISA).
Results: The sample comprised 58 participants, predominantly men (83%), with high rates of lifetime alcohol use (88%) and at least one type of childhood trauma (66%). There was a statistically significantly higher cytokine expression with current alcohol use: IL-6 (p = 0.04), IL-8 (p = 0.01) and IL-10 (p = 0.03). There was also a statistically significant association between lifetime alcohol and tobacco use and elevated IL-10 (p = 0.00 and p = 0.04, respectively). There was no statistically significant association between PANSS, PHQ-9, CTQ, BMI or cannabis and interleukins.
Conclusion: The study concludes that there is some evidence of immunological dysfunction at baseline in treatment-naïve persons diagnosed with FEP.
Contribution: This study contributes novel data on inflammatory cytokine profiles in individuals with FEP in a South African context, an under-represented population in psychoneuro-immunology research.

Clinical utility and psychometric validity of the International Adjustment Disorder Questionnaire in a sample of South African working adults

2026-10-15T11:32:37+00:00

Background: Adjustment disorder (AjD) is a significant yet often underdiagnosed condition in workplace mental health. The International Adjustment Disorder Questionnaire (IADQ) has shown promise as a screening tool, but its clinical utility within South African (SA) occupational settings remains unexplored.
Aim: To assess the psychometric validity and clinical utility of the IADQ in an educated SA workplace population.
Setting: The research was conducted across various occupational sectors in South Africa.
Methods: A cross-sectional survey included the IADQ alongside validated measures of depression, anxiety, post-traumatic stress disorder and psychological resilience. Confirmatory factor analysis assessed structural validity, while performance of the IADQ
algorithm was evaluated against clinical interviews. A grey zone approach was considered to refine screening thresholds.
Results: Adjustment disorder point prevalence was 4.3% in this sample. Confirmatory factor analysis supported the two-factor model of AjD symptoms, with measurement invariance observed across gender and language groups. The IADQ algorithm demonstrated good diagnostic accuracy for screening purposes, with sensitivity and specificity values exceeding 0.95. Psychological resilience was associated with lower odds of AjD.
Conclusion: The IADQ demonstrated good psychometric properties and clinical utility for comparable workplace mental health screening. The grey zone approach may offer a practical framework for graduated triage in resource-limited settings.
Contribution: Our study supported the global applicability of the two-factor AjD symptom model, provided updated AjD prevalence rates for a SA workplace sample, and considered a refined screening method for use in occupational mental health services.

South African mental health workers’ knowledge and attitudes to trans and gender-diverse people

2026-03-10T21:10:41+00:00

Aim: This study aimed to explore knowledge and attitudes of South African mental health workers in specialised psychiatric settings towards TGD people.

Setting: This study was conducted at two specialist tertiary psychiatric hospitals in Johannesburg.

Insomnia among vocational college students in China: Status and influencing factors

2026-03-10T21:22:38+00:00

Aim: To investigate the prevalence and influencing factors of insomnia and its relationship with sleep disturbances in Chinese vocational college students.

Setting: Two vocational colleges in Ganzhou, Jiangxi Province, China.

Conclusion: Insomnia in vocational college students is influenced by multiple factors and is strongly linked to sleep disturbances.

Contribution: This study provides empirical evidence on insomnia in this population and offers insights to guide targeted interventions in higher education settings.

Motivational interviewing for substance use among adults in low- and middle-income countries: A systematic review

2026-06-09T19:33:17+00:00

Background: Harmful substance use (HSU) poses a significant global health challenge, impacting social, economic, and healthcare systems. Lowand middle-income countries (LMICs) are particularly burdened as a result of limited infrastructure for managing substance-related issues. While evidence-based brief interventions like motivational interviewing (MI) are widely used in high-income countries, research on their effectiveness in LMICs is limited.

Aim: This systematic review aims to evaluate studies employing MI as part of interventions for adults with HSU in LMIC settings.

Setting: This review focused on studies within lowand middle-income countries which include settings characterised by constrained mental health resources, high treatment gaps for substance use disorders (SUDs), and diverse service delivery contexts.

Methods: Following Cochrane and PRISMA guidelines, we searched PubMed, EBSCOhost, Web of Science, Cochrane Library, clinicaltrials.gov and GSK Clinical Study Register for publications from 2010 to 2022. A narrative analysis was conducted, and the Joanna Briggs Institute Critical Appraisal Tools assessed study quality.

Results: Out of 518 publications, 11 studies from five countries met our inclusion criteria. Most were randomised controlled trials, with some using qualitative or mixed methods. The interventions targeted alcohol, opioids, and other drugs. Different strategies were used, including MI-blended with other interventions (such as cognitive-behavioural therapy, behavioural activation, and imaginal desensitisation) or using MI-informed approaches.

Conclusion: Overall, MI-informed interventions were shown to improve substance use outcomes in six of the 11 studies, with a significant reduction in substance use. However, further high-quality research with larger samples and rigorous designs is needed to strengthen the evidence base and address potential sources of bias.

Co-producing adult attention-deficit/hyperactivity disorder (ADHD) care in South Africa: A patientcentred framework for agency, trust, satisfaction and continuity

2026-06-09T19:35:36+00:00

Background: Despite advances in diagnostics and pharmacological interventions, adults with attention-deficit/hyperactivity disorder (ADHD) experience poor mental health outcomes in South Africa. Patient involvement in psychiatric care remains inconsistent, and co-production has yet to be explored for improved continuity, adherence, and satisfaction.

Aim: This study explored how adults with ADHD perceive their involvement in psychiatric care to inform co-production practices for clinicians.

Setting: Participants were recruited via the South African Society of Psychiatrists (SASOP) ADHD Special Interest Group (SIG).

Methods: This qualitative study explored how adults with ADHD perceive their involvement in psychiatric care. Thirteen adults formally diagnosed with ADHD were purposively sampled. Semi-structured interviews, guided by the SERVPERF model, were conducted online and analysed thematically using ATLAS.ti (version 24.2.1 [32295]; ATLAS.ti Scientific Software Development GmbH, Berlin, Germany).

Results: The proposed patient-centred care framework is based on four identified themes: (1) patient agency enhances engagement when decision-making is shared and treatment options are clearly explained; (2) trust in provider expertise and empathy influence adherence and comfort with treatment plans; (3) satisfaction increases with personalised, responsive care, particularly during medication adjustments and follow-up; and (4) continuity of care and timely access foster sustained engagement, while inconsistent communication leads to frustration and dropout. Together, these dynamics form a relational framework for the co-production of care.

Conclusion: Patient involvement in ADHD care is relational and influenced by trust, effective communication, and continuity of care. Where co-production was present, patients experienced improved outcomes. Contribution: This study emphasises integrating co-production into psychiatric practice through structured involvement strategies, improved continuity, and relational training for healthcare providers.

A profile of psychotropic medication in bipolar patients of reproductive age

2026-06-09T19:37:34+00:00

Background: Bipolar disorder (BD) is associated with unfavourable reproductive health outcomes. Evidence-based treatment guidelines advocate for reproductive safe prescribing, including family planning, avoidance of teratogenic medication and documentation of risk acknowledgement. However, there is poor adherence to the prescribed guidelines in clinical practice.

Aim: To describe the range of psychotropic medications prescribed to women of reproductive age (WRA) with BD at a tertiary psychiatric unit.

Setting: Helen Joseph Hospital, Johannesburg, South Africa.

Methods: A retrospective record review of females aged 18–49 years treated for BD between January 2016 and December 2023 was conducted. A convenience sample of 141 files was reviewed. Data were collected from the latest clinical notes and prescription charts.

Results: A combination of mood stabilisers (MS) and atypical antipsychotics was predominantly prescribed (81.6 %). Of the MS, valproate use was most common (50.6 %), followed by lithium (29.3 %). Risperidone was the most prescribed antipsychotic (39.0 %), followed by olanzapine (24.7 %) and quetiapine (20.5 %). Antidepressants were combined with MS or antipsychotics in 10.6 % of cases. Documented contraception counselling (5 %) and contraception use (9.2 %) were low. None of the records had documented risk acknowledgement for valproate use (100 %).

Conclusion: Prescribing guidelines for teratogenic MS were not consistently followed. Therefore, WRA diagnosed with BD may be at an increased risk of teratogenic drug exposure in pregnancy. Contribution: This study highlights the need for improved documentation of medication risk discussions, family planning and informed consent at every visit.

UKuvala umkhokha ‘ending the curse’: Unpacking the healing practice steps followed by traditional healers in KwaZulu-Natal when working with rape survivors

2026-08-12T08:29:04+00:00

Background: South Africa is considered as the epicentre of rape. Despite the establishment of hospital-based post-rape centres, uptake remains limited. Within the context of medical pluralism, many individuals utilise both biomedical and traditional healing systems, which
are often perceived as culturally congruent and accessible. This study explored post-rape care services provided by traditional health practitioners (THPs) when survivors seek care outside the formal healthcare system.
Aim: The study aimed to demystify traditional healing methods used in post-rape care by describing treatment approaches and formulations.
Setting: The study was conducted in KwaZulu-Natal, South Africa, which is a province with high rates of gender-based violence and rape.
Methods: A qualitative descriptive design was used. Fifteen THPs, including faith healers, diviners, and herbalists, participated in one-on-one interviews conducted in isiZulu and translated into English. Data were analysed using thematic analysis and the healthworlds
framework.
Results: Findings indicated that rape was often understood as spiritual contamination affecting both survivors and their bloodline. Healing practices therefore focused on addressing this perceived spiritual transgression.
Conclusion: The results of this study highlight the importance of culture and spirituality in shaping understandings of rape, treatment formulation, and holistic post-rape care.
Contribution: The study demonstrates the significance of traditional healing methods in providing holistic post-rape care.

Depression and anxiety symptoms and their association with quality of life in patients with colorectal cancer: A cross-sectional study

2026-08-12T08:24:23+00:00

Background: Colorectal cancer is one of the most common types of cancer worldwide, including in Indonesia, and has a significant impact on patients’ quality of life. In addition to the physical burden it causes, colorectal cancer patients often experience psychological
disorders such as depression and anxiety, which worsen their quality of life.

Aim: Although many studies have assessed the physical impact of cancer, the relationship between psychological disorders and quality of life still requires further attention.

Setting: This study was conducted at H. Adam Malik General Hospital in Medan, Sumatra.

Methods: This study used a correlative analytical design with a cross-sectional approach, involving 300 colorectal cancer patients. Data were collected using the Patient Health Questionnaire-9 (PHQ-9), Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A) and World Health Organization Quality of Life-Brief (WHOQOL-BREF) questionnaires to evaluate depression syndrome, anxiety levels and quality of life. Spearman’s test, logistic regression and linear regression model were used in this study.

Results: The results of the study show that 41% of patients experienced severe depression, while 58% of patients experienced severe anxiety. There was a strong negative correlation between symptoms of depression (PHQ-9) and anxiety (HADS-A) and quality of life
(WHOQOL-BREF), with a p-value < 0.001 for both. Clinical factors such as stage IV and metastasis, as well as socioeconomic status such as employment and education, were also found to have a significant association.

Conclusion: Psychological disorders, particularly depression and anxiety, significantly affect the quality of life of colorectal cancer patients. Psychological interventions, such as cognitive behavioural therapy (CBT), are essential to reduce symptoms of depression and anxiety and improve patients’ quality of life.

Contribution: Strong social support has also been shown to play an important role in improving patients’ psychological well-being and treatment outcomes.

Exploring caregivers’ experiences when seeking mental health care services for their children with autism spectrum disorder: A qualitative study from South Africa

2026-08-12T10:20:11+00:00

Background: The increasing prevalence of autism spectrum disorder (ASD) highlights the importance of understanding caregivers’ experiences in accessing mental healthcare for their children, particularly given the demanding nature of supporting children with ASD in
resource-constrained settings.
Aim: This study aimed to explore the experiences of caregivers of children with ASD when accessing mental healthcare services in South Africa.
Setting: This qualitative study was conducted at the Child and Adolescent Psychiatric Unit at Weskoppies Hospital, a tertiary-level hospital in Pretoria West, Gauteng province, South Africa.
Methods: This qualitative case study purposively sampled 15 caregivers of children with ASD at a tertiary psychiatric facility in South Africa. Data were gathered through in-depth interviews and analysed using a Grounded Theory-informed thematic analysis approach.
Results: Five main themes emerged: (1) challenges in accessing mental health care services, (2) delays in screening and early diagnosis, (3) limited ongoing education and knowledgesharing, (4) the need for emotional support and counselling, and (5) facilitating referrals to
specialised schools and allied health care services.
Conclusion: The study identified significant barriers to mental health service utilisation, underscoring the urgent need for improved service accessibility, caregiver support and increased public awareness.
Contribution: The findings advocate for strengthened mental healthcare access and targeted caregiver support for families of children with ASD in South Africa.

Investigation of serum lactate dehydrogenase levels in generalised anxiety disorder

2026-08-12T09:35:24+00:00

Background: Lactate dehydrogenase (LDH) plays a crucial role in glucose metabolism by catalysing the conversion of pyruvate to lactate and facilitating lactate utilisation. Given LDH’s central role in energy metabolism, it may serve as a promising biomarker for anxiety disorders.

Aim: This study aimed to compare serum LDH levels between patients with generalised anxiety disorder (GAD) and healthy controls (HC) and to examine the associations between LDH levels and clinical features.

Setting: Bursa City Hospital: A tertiary hospital in Bursa, Turkey.

Methods: This study included 113 participants with GAD and 90 HC. Group comparisons were conducted using an independent samples t-test. Correlations between LDH levels and clinical variables were assessed using the Pearson rank correlation coefficient. To control for
the impacts of possible confounding factors on LDH levels, an analysis of covariance (ANCOVA) was conducted.

Results: Serum LDH levels were significantly lower in the GAD compared to the HC (157.7 ± 18.7 vs. 173.2 ± 23.3; p: <0.001, t: −5.249, d Cohen: 0.733). The ANCOVA analysis revealed that there was a statistically significant difference in adjusted LDH levels between
the control and GAD groups (p < 0.001; mean difference: −15.607; 95% confidence interval [CI]: −21.180 to −9.975). Additionally, LDH levels were negatively and significantly correlated with HAM-A scores (r = −0.218, p = 0.021) and psychic subscale scores (r = −0.250, p = 0.008).

Conclusion: These findings support the hypothesis that LDH may represent a potential biomarker and therapeutic target in the clinical management of anxiety.

Contribution: This study is the first to report significantly reduced LDH levels in individuals with GAD, highlighting a potential link between altered lactate metabolism and anxiety pathogenesis.

AWARE: Anaesthesia trainee wellbeing at respective educational institutions: A national prospective study of burnout, depressive symptoms and occupational stress

2026-08-12T09:42:16+00:00

Background: Anaesthesia trainees are at increased risk of burnout and depression – with occupational stress recognised as a trigger for both. Previous South African single-site studies have assessed these outcomes separately, but not within the same study.
Aim: This study aimed to describe a composite mental well-being profile of South African anaesthesia trainees, focusing on burnout, depression screening, occupational stress and associated risk factors.
Setting: The study was conducted among South African anaesthesia trainees from nine university-affiliated public teaching hospitals.
Methods: Participants were recruited via convenience sampling through engagement with study representatives. Burnout, depression screening and occupational stress were measured using the abridged Maslach Burnout Inventory-Human Services Survey for Medical
Personnel, the Harvard Department of Psychiatry National Depression Screening Day Scale and the Effort–Reward Imbalance questionnaire. The response rate was 37%.
Results: Of the 194 trainees, 54 (28%) met burnout criteria, 88 (45%) screened positive for depression and 144 (74%) demonstrated chronic occupational stress. Forty-one (21%) trainees simultaneously met criteria for all three study outcomes, representing a
distinctly vulnerable subcohort. Risk factors included: previous and/or current treatment for psychiatric illness, registrars in their second year of training and self-prescribing anxiolytics and antidepressants.
Conclusion: Burnout rates in this population closely approximate international estimates; however, both depressive symptoms and occupational stress prevalence exceed international figures.
Contribution: This first-of-its-kind study provided a composite insight into the mental well-being profile of South African anaesthesia trainees, identifying a bigger cohort at risk of burnout and/or depression in the near future.

The relationship between childhood traumatic life experiences and social anxiety disorders

2026-08-12T09:58:32+00:00

Background: Childhood traumatic experiences are known to have profound and lasting effects on mental health; however, there are limited data on the relationship between types of childhood trauma and social anxiety in non-clinical populations.
Aim: This study aimed to explore the associations between types of childhood trauma and social anxiety symptoms in non-clinical young adults.
Setting: The study was conducted at the Faculty of Health Sciences of a university in Istanbul, Turkey.
Methods: This cross-sectional study included 486 university students. Sample size was determined via G*Power analysis to ensure statistical power. Participants completed the Liebowitz Social Anxiety Scale (LSAS) and the Childhood Trauma Questionnaire (CTQ) to
assess childhood trauma types and social anxiety symptoms. Data were analysed using stepwise multiple regression.
Results: The mean age of the participants was 21.8 ± 4.0 years, and 81% were female, with emotional abuse and neglect scoring highest in both genders. The sample’s LSAS total mean score was 63.87 ± 11.68. When the subscales were compared by gender, females had
significantly higher mean fear and avoidance scores than males (p < 0.05). The results show that childhood abuse and neglect were significant predictors of social anxiety and explained 23% of the social anxiety variance.
Conclusion: Childhood abuse and neglect are clearly associated with social anxiety symptoms. Interventions and treatments for individuals with social anxiety should incorporate a detailed assessment of childhood trauma history, with a particular focus on
emotional abuse and neglect.
Contribution: This study contributes to the literature by clarifying the associations between specific types of childhood trauma and social anxiety symptoms in a non-clinical young adult population.

Mental health practitioners’ experiences providing mental healthcare services to students in a higher education institution: A qualitative study

2026-08-12T10:07:52+00:00

Background: Mental healthcare service provision is challenging and becomes more complex
when users are students. Students are more vulnerable to experiencing mental health
challenges. Therefore, higher education institutions (HEIs) must offer effective mental
healthcare services to meet the mental health needs of students.
Aim: To understand the experiences of mental health practitioners (MHPs) who work for a
HEI providing mental healthcare services.
Setting: The study was conducted in South Africa within the context of higher education.
Methods: A qualitative, exploratory, descriptive and contextual research design, incorporating
the Appreciative Inquiry 5D Model, was used. This method allowed for the exploration and
description of the experiences of MHPs working in a higher education setting who are tasked
with providing mental healthcare services to students.
Results: Five themes emerged from the analysis of data: (1) mental healthcare services are
viewed as a source of holistic support, (2) mental healthcare provision is experienced as
fulfilling and challenging, (3) mental healthcare services should be student-centred and
engaging, (4) services should be available, accessible and responsive to address students’
needs, (5) mental healthcare services should integrate monitoring and evaluation strategies.
Conclusion: Resource challenges and the rising demand for mental healthcare services by
students remain an enormous burden on the already-burdened healthcare system. Higher
education institutions must commit to funding these services, and then MHPs will be able to
provide effective mental healthcare services to the students.
Contribution: Strategies to guide the facilitation of students’ mental health were developed.

The occurrence of postpartum post-traumatic stress disorder among women in Johannesburg metropolitan clinics

2026-09-18T16:52:53+00:00

Background: Childbirth has been associated with post-traumatic stress disorder (PTSD) in women, affecting mother–child bonding, foetal growth, cognitive development and marital relationships. However, there is a dearth of literature on postpartum PTSD in Africa.

Aim: The study aimed to investigate the occurrence of postpartum PTSD among women.

Setting: The study was conducted within Johannesburg metropolitan clinics.

Methods: The study included 88 women attending postnatal clinics in the metropolitan area. A questionnaire was used to collect data on their characteristics, obstetric and neonatal factors and perceived social support. The City Birth Trauma Scale was used to screen for postpartum PTSD symptoms. Data were analysed using R software with a significance level of 0.05.

Results: Almost half of the participants (48.9%) perceived their most recent childbirth as a traumatic event. One participant (1.1%; 95% CI: 0.0003–0.06) endorsed all symptoms required to diagnose PTSD. Endorsing childbirth as a traumatic event was significantly associated with reporting intrusion and/or re-experiencing symptoms (OR = 3.7) and avoidance symptoms (OR = 3.3). There was no association between the mode of childbirth and PTSD symptom scores. There is no association between the presence or absence of neonatal complications and PTSD symptom scores.

Conclusion: Although the occurrence was relatively low, our findings highlight the importance of routine screening and early intervention in maternal health services.

Contribution: There is need for further research to inform culturally relevant prevention and treatment strategies.

The impact of a brief psychoeducational intervention on hospital security personnel’s attitudes towards aggression and violence management at Cecilia Makiwane Hospital

2026-09-18T16:50:42+00:00

Background: Aggression and violence remain persistent challenges in healthcare settings, particularly in psychiatric and emergency units. Security personnel serve as frontline responders but frequently lack structured training in de-escalation techniques, increasing the risk of harm.

Aim: This study aimed to assess and improve security personnel’s attitudes towards the causes and management of aggression through a structured de-escalation training programme.

Setting: The study was conducted at Cecilia Makiwane Hospital, a regional academic facility in the Eastern Cape province of South Africa, housing the only public-sector mental health unit in Buffalo City Municipality.

Methods: A quasi-experimental single-group pre-test–post-test design was used. Security personnel completed an interactive educational programme incorporating discussions, roleplay, and scenario-based exercises. The Management of Aggression and Violence Attitude Scale (MAVAS) was administered before and after the intervention. Data were analysed using paired-samples t-tests and multiple regression at a 5% significance level.

Results: Baseline MAVAS domain scores indicated moderate agreement with all four domains. Following the intervention, significant improvements were observed across all MAVAS domains (p ≤ 0.01), reflecting more positive attitudes towards aggression management. Female participants showed greater changes in environmental and interpersonal causes of aggression (B = −0.259, p = 0.003), while longer work experience predicted increased recognition of patient-related causes. Job rank and age were not significant predictors.

Conclusion: Structured de-escalation training effectively improved security personnel’s attitudes towards managing aggression and violence in a hospital setting.

Contribution: This study provides empirical evidence that context-specific de-escalation training for security personnel may support workplace safety and strengthen multidisciplinary collaboration in the South African setting.

Profile of male acute admissions at a state psychiatric hospital in the Western Cape, South Africa

2026-09-18T16:58:05+00:00

Background: Inpatient psychiatric services in South Africa are faced with challenges such as high demand for beds, rapid discharges, limited community services upon discharge and high readmission rates.

Aim: To provide a profile of the demographic and clinical characteristics of the mental health users of inpatient male acute psychiatric services.

Setting: The male acute unit at Stikland Hospital.

Methods: A retrospective folder review of all patients discharged (n = 693) from the male acute psychiatric unit at Stikland Hospital between 01 February 2022 and 31 January 2023, and followed up for 1 year post-discharge.

Results: Most of the admissions were young males (29 [23–35] years), single (89%) and unemployed (80.8%), with no secondary-level education (65.4%). Thirty per cent of admissions were admitted directly to the unit, and most patients presented with a diagnosis of schizophrenia (42.1%). Almost half (47.8%) of all admissions were patients previously admitted to Stikland Hospital, and more than one quarter (27.6%) were readmitted within 1 year following discharge. Most admissions had a short length of stay (36 [27–53] days) and were crisis-discharged (63.5%). The use of long-acting injectables (LAI) was highly prevalent (73.4%).

Conclusion: Current inpatient psychiatric services are functioning as crisis intervention units. The study provides a foundation for developing context-specific, tailored strategies to be integrated into the discharge planning processes within the existing healthcare system.

Contribution: Current system-related factors, such as bed shortages, lead to short length-of-stays (LOS) and crisis discharges, which likely contribute to a higher rate of readmissions.

Attitudes of final-year medical students towards psychiatry as a specialisation at a university in South Africa

2026-10-15T11:43:29+00:00

Background: Despite mental illness being a major burden in South Africa, there is a shortage of psychiatrists compared to global rates. By understanding final-year medical students’ attitudes towards psychiatry, new recruitment strategies can be implemented to overcome this hurdle.
Aim: This study aimed to assess final-year medical students’ attitudes toward psychiatry and to identify demographic and experiential factors that influence the intention to specialise in psychiatry.
Setting: The University of the Witwatersrand.
Methods: A cross-sectional, quantitative survey was conducted among final-year medical students between July 2024 and October 2024 using the Mental Illness: Clinicians’ Attitudes (MICA-2) Scale.
Results: Among 171 students, the overall mean MICA-2 score was 40.43 (standard deviation = 8.16), indicating moderately positive attitudes. Females demonstrated significantly more favourable attitudes (mean = 39.35) than males (mean = 43.08, p = 0.022). Older students (> 33 years, n = 8, 4.7%) had slightly more positive attitudes than younger age groups, but these findings were not significant (p = 0.268). Exposure to a psychiatry clinical rotation did not positively influence students’ attitudes (p = 0.257), and personal fulfilment and work-life balance were the predominant deciding factors with regard to specialisation choice.
Conclusion: There is no significant stigmatisation towards psychiatry across all cohorts. The study instead reflects differing levels of positive attitudes towards psychiatry. However, this did not translate to students pursuing psychiatry as a specialty, as they feel it does not offer personal fulfilment and work-life balance.
Contribution: Future strategies must focus on work-life balance and personal fulfilment when attempting to increase the recruitment rate into psychiatry.

Catatonia knowledge in medical practitioners from low-resource settings

2026-10-15T11:51:07+00:00

Background: Catatonia is a neuropsychiatric emergency that requires rapid intervention to prevent complications. It is unclear whether African medical practitioners have the requisite knowledge to identify and manage catatonia.
Aim: To examine knowledge of catatonia among medical practitioners across partnering institutions of the African Catatonia Registry (ACR), a multi-country resource for research in Africa.
Setting: The study was conducted among medical practitioners across the ACR partnering institutions.
Methods: The study was a descriptive, cross-sectional online survey comprising 63 questions to examine knowledge of catatonia. Responses were scored with a positive mark if correct and a negative mark if wrong, then standardised and dichotomised to indicate low or sufficient knowledge.
Results: Out of 321 participants, nearly half (46.7%) were psychiatrists, and 50.8% had sufficient knowledge of catatonia. Multivariate analysis showed that knowledge varied by sub-domain, country, specialty and prior experience with catatonia. Specialisation in
psychiatry was significantly associated with sufficient knowledge of classification (adjusted risk ratio [aRR] 2.15 [95% confidence intervals {CI}: 1.35–3.43]), diagnostic symptoms (aRR = 3.30 [95% CI: 1.62–6.69]), screening (aRR = 4.72 [95% CI: 2.25–9.91]) and rating scales (aRR = 3.34 [95% CI: 1.32–8.46]). Prior experience with catatonia was also associated with sufficient knowledge across these areas (all p ≤ 0.05).
Conclusion: While knowledge of catatonia and its diagnostic criteria is sufficient among practitioners, knowledge of its symptoms, treatment and complication management remains low.
Contribution: The study highlights the need for the ACR to promote improvements in the identification and management of catatonia to achieve better patient outcomes.

Prevalence and determinants of readmission at a tertiary psychiatric hospital in Zanzibar

2026-10-15T12:01:35+00:00

Background: Psychiatric readmission is a global concern, leading to poorer clinical outcomes and higher healthcare costs. In Tanzania, where mental health services operate within a resource-constrained health system, repeated psychiatric admissions may place additional pressure on already limited services. However, local evidence on psychiatric readmission remains limited.
Aim: To determine the prevalence of psychiatric readmission and its determinants among psychiatric patients admitted to a tertiary psychiatric hospital in Unguja, Zanzibar.
Setting: A tertiary psychiatric referral hospital in Unguja, Zanzibar, serving patients across Unguja and Pemba islands.
Methods: A cross-sectional study was conducted among psychiatric patients 18 years and older admitted between June 2024 and August 2024. Data were collected through interviewer-administered questionnaires. Modified Poisson regression with robust error variance was used to identify factors associated with psychiatric readmission.
Results: A total of 311 patients (mean age 36, standard deviation [s.d.] = 11 years; females 52.4%; schizophrenia 32.5%) were enrolled. The prevalence of psychiatric readmission within 3 months was 58.5% (n = 182). Readmission was associated with age group 30–39 years (adjusted prevalence ratio [APR] = 1.47; 95% confidence interval [CI]: 1.16–1.84, p-value [ p] = 0.001), schizophrenia (APR = 1.23; CI: 1.00–1.50, p = 0.041), bipolar disorders (APR = 1.69; CI: 1.26–2.26, p < 0.001), higher education (APR = 1.61; CI: 1.16–2.22, p = 0.010), history of physical abuse (APR = 1.49; CI: 1.16–2.22, p < 0.001), and being prescribed both oral and injectable medications (APR = 1.46; CI: 1.37–2.20, p < 0.001).
Conclusion: There is a high psychiatric readmission rate in Zanzibar. Interventions should focus on high-risk groups, particularly middle-aged individuals and those requiring combination treatment to break the cycle of readmission and promote long-term mental health recovery.
Contribution: This study provides evidence on psychiatric readmission in Zanzibar and identifies high-risk groups requiring targeted post-discharge intervention in low-resource psychiatric settings.

A case report: Neuropsychiatric presentation of atypical rasmussen’s encephalitis

2026-09-18T16:48:22+00:00

Introduction: Rasmussen’s encephalitis (RE) is a rare, progressive inflammatory neurological disorder characterized by treatment-resistant epilepsy, progressive hemiplegia, and cognitive decline. Although its pathogenesis remains incompletely understood, immune-mediated mechanisms are thought to play a central role. RE predominantly affects children, with only approximately 10% of cases occurring in adults. Diagnosis relies on the combination of clinical features, serial neuroimaging, and electroencephalographic findings. Early recognition is essential, as treatment options are limited and outcomes are improved with timely intervention. Atypical adult-onset presentations are particularly uncommon and may present significant diagnostic challenges.

Patient presentation: We report a case that presented with atypical, adult-onset RE with major neurocognitive disorder.

Management and outcome: The patient’s diagnosis was made with neuroimaging 10 years following seizure onset. Findings indicated moderate generalised atrophy, with asymmetric involvement of the left cerebral hemisphere. Interventions required a multidisciplinary team, and pharmacological management included sodium valproate and lamotrigine for seizure control, as well as quetiapine and fluoxetine for behavioural disturbances. The patient’s prognosis remains poor because of generalised brain atrophy limiting treatment options.

Conclusion: There is a need to raise awareness of RE to assist with early detection and treatment. Late diagnosis may have contributed to the patient’s poor prognosis. Contribution: Despite the need for further research, early neuroimaging of patients with new adult-onset seizures may help decrease morbidity associated with RE.

A case report: Neuroimaging in an atypical presentation of Parkinson’s disease

2026-04-15T08:16:14+00:00

Introduction: Parkinson’s disease (PD) is the second leading neurodegenerative disorder in the world. The diagnosis of idiopathic Parkinson’s disease (IPD) is mainly through clinical presentation of motor and non-motor symptoms. Motor symptoms include tremor,
bradykinesia and rigidity. Atypical parkinsonism may pose a challenge in diagnosing IPD. Functional neuroimaging can assist in diagnosing IPD and in differentiating it from atypical parkinsonism due to other neurodegenerative aetiologies.
Patient presentation: We present a case report of a patient with atypical parkinsonism and mild neurocognitive disorder.
Management and outcome: Neuroimaging revealed IPD, distinguishing it from other causes of neurocognitive disorders. The patient received multidisciplinary team (MDT) input and appropriate medication, including a fixed combination of carbidopa and levodopa,
rivastigmine, venlafaxine and quetiapine with improvement of his symptomatology.

Conclusion: Neuroimaging assisted in establishing the diagnosis and guiding treatment.

Contribution: Although evidence and studies are needed for definitive use in clinical practice, there is supportive evidence to suggest the diagnostic utility of these modalities in parkinsonian syndromes.

Life beyond diagnosis: My journey of hope

2026-08-12T09:15:27+00:00

No Abstract