Masters Degrees (Psychiatry)

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Now showing 1 - 5 of 23
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    The impact of perinatal trauma and HIV exposure on maternal mental health and infant social-emotional development in Khayelitsha, South Africa.
    (Stellenbosch : Stellenbosch University, 2023-12) Motingoe, Kediemetse; Lachman, Anusha; Laughton, Barbara; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Psychiatry.
    ENGLISH SUMMARY: There is limited knowledge on the impact of HIV and trauma exposure on maternal mental health and infant social-emotional development. This study investigated pregnant women living with HIV, with either late or early initiation of antiretroviral therapy, and those not living with HIV and their infants. These mother-child dyads were followed up for 12 months postnatally. Maternal trauma levels, infant social withdrawal and symbolic play were evaluated using the Harvard Trauma Scale, Alarm distress baby scale, and the Belsky tests, respectively. This study showed low rates of PTSD compared to previous studies in this setting, with HIV status not showing significant differences in trauma exposure. There was insignificant impact of maternal HIV and trauma causing infant withdrawal and poor symbolic play. Larger, longer-term studies are necessary for further exploration.
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    Experiences of Xhosa women providing kangaroo mother care in a tertiary hospital in the Western Cape, South Africa
    (Stellenbosch : Stellenbosch University, 2023-12) Mpongwana-Ncetani, Sibongile; Lachman, Anusha; Roomaney, Rizwana; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Psychiatry.
    ENGLISH SUMMARY: Kangaroo mother care (KMC) has been recognized as one of the interventions to improve preterm birth outcomes by the World Health Organization. KMC requires high user engagement and consists of continuous skin‐to‐skin contact between the mother and infant and exclusive breastfeeding. We conducted a qualitative study of Xhosa women (n=10) practicing KMC in a tertiary hospital in the Western Cape, South Africa. All interviews were conducted in IsiXhosa, audio recorded, and transcribed. The transcribed data were analysed using thematic analysis. Four themes emerged: (1) KMC, a beneficial but foreign concept; (2) distress in the KMC ward; due to factors like poor milk supply, uncomfortable nursing positions and sleep deprivation; (3) themissing umbilical cord: experiences ofmothers in theKMC ward reflecting on respect for cultural and traditional practices but having limited knowledge of its significance themselves; and (4) the KMC village: interpersonal relations in the ward that oscillates between staff and fellow patient mothers. Our study showed that cultural practices still pose a challenge to fully accepting KMC. We suggest more studies on cultural sensitivity to encourage acceptance of interventions that affect culturally diverse groups.
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    Psychotropic medication prescribing patterns during pregnancy in two South African Maternal Mental Health clinics
    (Stellenbosch : Stellenbosch University, 2023-12) Farmer, Catherine; Niehaus, Daniel Jan Hendrik; Koen, Liezl; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Psychiatry.
    ENGLISH SUMMARY: Background: There is a significant burden of mental illness during pregnancy and the safety of medication use in pregnancy is an ongoing focus of research. There is potential risk for the developing fetus and the mother from the increased risk for psychiatric illness and medication effects. Psychotropic polypharmacy during pregnancy is common, but not well- researched and there is a paucity of data on the use of psychotropic medication during pregnancy in South African women suffering from a mental illness. Aim: To determine the psychotropic medication prescription patterns in pregnant patients attending one of two maternal mental health clinics in Cape Town in terms of: the general classes of medication prescribed, the frequency and duration of psychotropic use, medication exposure according to pregnancy trimester and the prevalence of polypharmacy use. Methods: Pregnant women attending two maternal mental health clinics were studied from presentation to six weeks postpartum. Demographic data, psychiatric history, medical comorbid illnesses, pregnancy related data and medication prescription was collected and tabulated at treatment-as-usual visits. Polypharmacy prevalence was determined by using the definition of the use of two or more psychotropic medication prescriptions for a period of at least ninety days. Results: Data was collected on 303 pregnancies and the majority of pregnant women (51.8%) were diagnosed with major depressive disorder. Anti-depressant medication was the most commonly prescribed medication class (64.3%). A third of participants received prescriptions in all three trimesters. Polypharmacy criteria was met in 18.8% of the sample population. Conclusion: Prescribing psychotropic drugs in pregnancy is challenging because of the need to weigh up the potential risks of drug- related effects on the mother and child against those of discontinuing treatment. Our data contributes to raising awareness and aids medical professionals with regards to the rational use of psychotropic medication in pregnant women.
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    The mental health of caregivers of children with atopic dermatitis at Tygerberg hospital
    (Stellenbosch : Stellenbosch University, 2023-12) Suresh, Shwetha; Lachman, Anusha; Kannenberg, Suretha; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Psychiatry.
    ENGLISH SUMMARY: Background: Atopic dermatitis (AD) is a chronic and often debilitating illness for children but also has a significant effect on caregiver quality of life (QOL) and mental health. Aim: To explore the relationship between AD in children on the QOL and the mental health of their caregivers. Methods: We conducted a cross-sectional study of patients and their caregivers attending the Dermatology Clinic at Tygerberg Hospital in Cape Town, South Africa. Participants were recruited between February 2021 and August 2021. Results: Most of the children in this study experienced mild AD symptoms. Almost 90% of the children had an identifiable trigger, with the most common triggers being an environmental temperature change (66.7%) and stress (57.4%). We noted a weak but significant correlation between QOL and AD severity (rs = 0.395, p = 0.003) and a strong positive correlation between the caregivers’ QOL and their mental health (rs = 0.650, p < 0.001). Conclusions: The use of uncomplicated and rapid screening tools for caregiver mental health and QOL should be implemented when treating patients with AD. Understanding the burden and allowing room for mitigation of these modifiable factors will play a large role in ensuring a better therapeutic outcome for those children with a chronic illness like AD.
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    Intimate partner violence and its association with substance use disorder : a qualitative study
    (Stellenbosch : Stellenbosch University, 2023-12) Ferreira, Luzette; Roos, Annerine; Lochner, Christine; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Psychiatry.
    ENGLISH SUMMARY: Intimate partner violence (IPV) is a serious public health and social problem affecting a large proportion of women in both developed and developing countries. South Africa has one of the highest prevalence rates of IPV compared to other countries, with significant negative effects on the well-being and mental health of the victims. IPV has been significantly associated with substance use disorder (SUD) and victims of IPV are significantly more prone to abuse multiple substances. There is a lack of rich narrative information within a South African context with regards to women’s experiences of IPV and SUD. My aim was to qualitatively investigate the experiences and challenges of women present with both SUD and IPV. Twelve participants with ages ranging between 18 and 43, in an inpatient unit offering rehabilitation services, were interviewed using a semi-structured interview and several questionnaires to assess type, severity and history of IPV and SUD; to identify risk factors such as mental health symptoms and childhood abuse. After transcription of audiotaped interviews, thematic analysis was used to derive from participants’ narratives three primary themes: i) Substance abuse and relationship development, ii) The relationship became abusive, and iii) Becoming sober and leaving the relationship. Under each primary theme, four subthemes were identified. A history of abuse and mental health problems contributed to increased vulnerability in these participants. Mental health consequences of IPV were mostly undiagnosed and participants identified symptoms of depression, anxiety, and trauma. IPV often went untreated as the primary treatment was for SUD. These findings describe the complexity of IPV and SUD in women within treatment centres as well as the escalation and severity of these two problems when they occur simultaneously. This study adds to the limited literature on South African women’s daily experiences of living with both IPV and SUD. Participants’ narratives provide valuable information that provide a foundation for future investigations among larger populations of women with IPV and SUD; to determine their unique experiences, difficulties and needs for targeted treatment.