Mental Health Matters is published five times a year with the objective of bringing information and support to South Africa’s GP’s in their role as first line care givers and identifiers of mental health issues.

July/Aug 2017  I CURRENT EDITION  I VOLUME 4  I NO. 4

I had the pleasure of being invited to South Africa to present at the SADAG & Discovery Mental Health Press Summit in June 2017 – not only to share my knowledge and experience of mental healthcare from around the world, but also to learn what’s being done to address the evident mental health treatment gaps in the country. It reinforced the notion that we need hope, now more than ever.

G Ivbijaro

In the first two articles in this series on Anxiety in Childhood, I looked at the crisis of the increasing incidence of anxiety in children in our country, in terms of the importance of recognising its presence in our individual children, as well as understanding it, both at an individual and societal level within the contexts of its predisposing causes. In this third article, entitled “Anxiety in Childhood – Now Let Us Help The Children”, I will, firstly, suggest how we should be seeking to relieve the distress of the individual anxious children we see (Part 1).

H Clark

Suicide in Youth
Suicide is the leading cause of death in adolescence and young adults and this
trend appears to be increasing according to many sources. For example in 2004 suicide was the third leading cause of death among youths and young adults aged 10–24 years in the United States, accounting for 4,599 deaths. The SASH (South African Stress and Health Study) conducted between January 2002 and June 2004
including 4185 South African adults indicated the lifetime prevalence rates of suicidal ideation, suicide plans and suicide attempts to be 9.1%, 3.8% and 2.9% respectively.
F Korb

Hormonal changes at puberty, during menstrual cycles, pregnancy and menopause have an impact on neuronal brain excitability and thus influence seizure frequency in the female with Epilepsy.

DS Magazi

Daniel was awarded a national prize for his results in electronic engineering in his third year of studies. He came from a high achieving family: His older sister graduated as a clinical psychologist, his older brother started and ran a successful business, and his fraternal twin brother was rapidly climbing the corporate ladder after he‘d graduated from his economic and management studies.

LM Eskell Blokland

Major depressive disorder is a lifelong and chronic disorder, with an average of 4 lifetime episodes lasting 20 weeks each. Individuals who have suffered a major depressive episode also have an 80% chance to experience repeated episodes, suggesting the need for both effective treatment and appropriate relapse prevention is critical. Considering the serious impact that depressive
symptoms can have on an individual in all spheres of life, the relapse of depression should be of critical concern to every mental healthcare worker.

G Eccles

Increased associations have been reported between AD(H)D and SDB (Sedky, Bennett & Cavalho 2014). Both conditions have a negative impact on a person’s ability to learn. Because the symptoms are so similar, it often takes a more holistic approach and a multidisciplinary team to solve the conundrum. The following case study illustrates the effectiveness of a multidisciplinary team.

Multi-disciplinary team: S Reddy, C Keevy,
K Green, C Van Wyk, K Rosen, J Fox,
C Venter, A Pillay, G Marsay

1. HOW SHOULD A GP MANAGE WOMEN WITH BIPOLAR DISORDER WHO ARE
PREGNANT OR WANT TO FALL PREGNANT?
For many women, their GP is the first person they turn to for family planning advice. GP’s often have a long-term relationship with patients and are actively involved in managing women’s bipolar disorder. GP’s need to be aware of how they counsel women on bipolar medication. Advocating against pregnancy may raise ethical dilemmas. GP’s should promote contraception until such time as
the patient is stable and a pregnancy can be well planned. When the pregnancy
is unplanned, medication should not be stopped abruptly as this increases the
risk of relapse. If however, the woman is on Valproate, it should be tapered
down over a week and substituted for another medication along with folate
supplementation. Referral or discussion with a psychiatrist is recommended.

C Marsay

However, there are very few correctly trained cognitive behavioural psychologists in this country, therefore a lack of availability for the majority of panic sufferers. The family practitioner is quite frequently the first and only person a patient interacts with around the panic, so this article contains strategies for day to day coping with the panic. (The “daily coping with panic” tips below are all ones that would be elaborated on in CBT with a qualified psychologist.)

C Linde

Obsessive-compulsive disorder (OCD) is a prevalent and disabling neuropsychiatric disorder, and leads to impairment and distress in a number of life-domains (work/ school, relationships and family life). OCD is characterized by persistent, intrusive thoughts or images (obsessions), causing significant anxiety and, in an attempt to neutralise these, repetitive, timeconsuming behaviours are performed according to rigid rules (compulsions).

C Lochner, DJ Stein, L Taljaard

Substance abuse – including alcohol, illegal narcotics and prescription medication is an ever-growing problem worldwide. The International Labour Organisation (ILO) have conducted studies to investigate the effects of Substance Abuse in the work place:

A Sweidan, T Kuret

I’m dying. And so are you. The reality of being alive is that it is a transient state. One that is finite and that will ultimately end. This reality is however, one that we avoid discussing and perhaps, even acknowledging. Because we are so reluctant to talk about death, we are also very unlikely to plan for it, or to express our treatment wishes to our loved ones in the event that we become unwell. A survey in Australia revealed that 82 % of Australians think that talking to your family about your end of life wishes is important. Yet only 27 % have ever done so.

L Moodley

Picture this: I’m an only child who has grown up in an emotionally supportive and financially stable family. My parents have been married for 30 years and
I’ve never seen them argue. I had a normal, happy childhood accompanied by some really good friends. I excelled in all my school endeavours and nothing traumatic
had ever happened in my life. Sounds pretty ideal, right?

L Michas

Zane Wilson Founder SADAG

  • Neil Amoore,
  • Psychologist, Johannesburg
  • Kevin Bolon,
  • Psychologist, Johannesburg
  • Dr Jan Chabalala,
  • Psychiatrist, Johannesburg
  • Dr Lori Eddy,
  • Psychologist, Johannesburg
  • Lee-Ann Hartman,
  • Psychologist, Johannesburg
  • Dr Frans Korb,
  • Psychiatrist/Psychologist, Johannesburg
  • Professor Crick Lund,
  • Psychiatrist, Cape Town
  • Dr Rykie Liebenberg,
  • Psychiatrist, Johannesburg
  • Dr Colinda Linde,
  • Psychologist, Johannesburg
  • Zamo Mbele,
  • Psychologist, Johannesburg
  • Nkini Phasha,
  • SADAG Director, Johannesburg
  • David Rosenstein,
  • Psychologist, Cape Town
  • Professor Dan Stein,
  • Psychiatrist, Cape Town
  • Professor Bernard van Rensburg,
  • Johannesburg
  • Dr Sheldon Zilesnick,
  • Psychiatrist, Johannesburg
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