Browsing by Author "Cloete K.J."

Now showing 1 - 3 of 3
  • No Thumbnail Available
    Item
    Changes in regional brain volumes in social anxiety disorder following 12 weeks of treatment with escitalopram
    (2010) Cassimjee N.; Fouche J.-P.; Burnett M.; Lochner C.; Warwick, James M.; Dupont P.; Stein D.J.; Cloete K.J.; Carey P.D.
    It has been suggested that antidepressants, including the selective serotonin reuptake inhibitors have neurotrophic effects. Nevertheless, the impact of treatment with a selective serotonin re-uptake inhibitor on regional brain volumes in social anxiety disorder has not been studied. 11 subjects with social anxiety disorder completed magnetic resonance imaging both before and after 12-weeks of treatment with 20 mg/day escitalopram. No increases in structural grey matter were found, but there were decreases in bilateral superior temporal cortex, vermis and the left cerebellum volumes following 12 weeks of treatment with escitalopram. These preliminary findings require replication to determine their reliability, and extension to determine whether or not they are disorder specific. © 2010 Springer Science+Business Media, LLC..
  • No Thumbnail Available
    Item
    Diagnostic outcome of patients referred to psychiatry with medically unexplained symptoms: A retrospective study
    (2011) Govender R.C.; Oosthuizen P.; Cloete K.J.
    Objective: Medically unexplained symptoms (MUS) are commonly encountered in medical practice. In psychiatry, they are classified mostly as Somatoform Disorders and are often associated with anxiety and depression. The literature suggests that, in some cases, MUS may be ascribed to Somatoform Disorders when, fact, they are "organic" syndromes that are misdiagnosed. In developing countries, with fewer resources, MUS may be more difficult to assess. Method: We undertook a retrospective chart review to examine the demographics, referral pathway, management and diagnostic outcome of subjects (n = 50) referred to psychiatry with MUS over an 18 month period. Results: Subjects with MUS accounted for only 4.5% of the total number of files reviewed. In only 38% of cases did the final diagnosis in psychiatry concur with the referral diagnosis. In 28% of cases a new "organic" diagnosis was made and in 72% of cases a new psychiatric diagnosis was made. Subjects who were diagnosed with "organic" illness were seen fewer times prior to referral to psychiatry and were significantly older than other subjects. Conclusion: In developing countries like SA, a significant number of patients with MUS may have underlying "organic" illness, and most may have psychiatric disorders. Patients with MUS, especially older patients, should be more extensively investigated. Psychiatric referral of these patients is very appropriate.
  • No Thumbnail Available
    Item
    The clinical utility and cost effectiveness of routine thyroid screening in adult psychiatric patients presenting at Stikland hospital, cape town, South Africa
    (2012) Lachman A.; Cloete K.J.; Kidd M.; Schoeman R.
    Objective, The use of thyroid tests to assess psychiatric patients remains debatable. Therefore, this study was conducted to examine the utility and cost effectiveness of the current protocol used in thyroid testing in adult psychiatric patients presenting at Stikland Hospital, Cape Town, South Africa. Method, This was a retrospective chart review conducted at Stikland Hospital between 1 January 2000 and 31 December 2005. The following data was recorded, demographic variables, clinical diagnoses at admission and discharge, number of days from admission to a thyroid test request, the reason for thyroid screening, number of thyroid tests, their yield and costs involved, as well as the action taken following an abnormal thyroid test result. Results, The mean age of patients (n = 1080, n = 364 male, n = 716 female) was 42.8 years (SD ±16.6). Pre-existing thyroid disease was documented in 70 (6%) of patients. Normal Thyroid Stimulating Hormone (TSH) test results significantly (p = 0.0001) increased, whilst abnormal TSH test results significantly (p = 0.0001) decreased from baseline to follow-up. Except for gender, the outcome of TSH screening was independent of demographic and clinical diagnoses. Only 16% of TSH tests yielded clinically significant results. Conclusion, The findings of this study do not support the early, routine screening for thyroid dysfunction in psychiatric patients at this facility. It is possible that thyroid screening may present with transient abnormalities of no particular clinical significance, and would therefore not be a cost effective practice.