http://hdl.handle.net/10386/173 2013-05-21T22:05:38Z 2013-05-21T22:05:38Z Pillay, Nivendhiren http://hdl.handle.net/10386/461 2012-08-14T08:49:00Z 2010-01-01T00:00:00Z

Title: Psychiatric consultation-liaison at Dr George Mukhari Hospital in Ga-Rankuwa between January- December 2009 Authors: Pillay, Nivendhiren Abstract: The aim of the study was to establish a profile of psychiatric illnesses that are encountered during consultation-liaison (C-L) psychiatry and to describe interventions undertaken. The objective was to identify referral patterns, establish the referral rate, and to profile the diagnoses & describe the actions taken by the consulting doctor. This was a retrospective cross-sectional descriptive study conducted on all inpatients that were referred to psychiatry from other disciplines in the hospital for the 12 month period January to December 2009. The study was conducted at Dr George Mukhari Hospital, which is a tertiary psychiatric unit which caters for mental health care users in the Garankuwa , Soshanguve and Mabopane region. The study found that the referral rate to psychiatric C-L services was lower than at other institutions. Amongst the referred patients, there was a high incidence of organic brain syndrome diagnoses, but a low rate of depression. The study proposed further investigation into the reasons behind the low rate of referral and low rate of depression, so as to improve C-L service delivery in the hospital. Description: Thesis (M Med (Psychiatry))--University of Limpopo (Medunsa Campus), 2010.

2010-01-01T00:00:00Z Sepeng, Goitsemang Gomolemo http://hdl.handle.net/10386/455 2012-09-08T22:01:41Z 2010-01-01T00:00:00Z

Title: The Diagnostic outcomes of electroencephalogram performed on adult psychiatric patients at Dr George Mukhari Hospital, Ga-Rankuwa " over a period of January 2006 to December 2008 Authors: Sepeng, Goitsemang Gomolemo Abstract: The yield of EEG amongst psychiatric patients has been reported to be low and the value of EEG in the practice of psychiatry is questionable.EEG is used as part of a diagnostic work up for patients with psychiatric disorders .Often the reason given for its use is to exclude epilepsy as a cause of psychiatric symptoms. Epilepsy is primarily a clinical diagnosis, but the EEG may provide strong support by the findings of inter – ictal Epileptogenic discharge METHOD: All the adult EEGs requested at Dr George Mukhari psychiatric hospital, over a 36 month period ,were reviewed to describe the outcome of the requested EEG reports .The study is a simple retrospective analysis of 111 consecutive EEG requested to the department of Neurology at DGMH from psychiatric unit at DGMH. Subjects were both inpatients and outpatients .All the EEG was reported by a qualified Neurologist. Data were extracted from the EEG request form and the patients’ clinical files, which reported on the clinical reason for the EEG test, nature of psychiatric diagnosis of patients, the psychiatric treatment received prior to the EEG test and the nature of the EEG results RESULTS There were 111 EEG reports analysed, and 69 EEG reports for males and 42 EEG reports for females. The reason for EEG request was dominated mainly by exclusion of epilepsy. Majority of the patients were diagnosed with a psychotic disorder , followed second by a mood disorder , all of which was attributed to GMC (epilepsy).About 62.73% of patients were on a combination of treatment of antipsychotic drug and anticonvulsants, whilst 34.55% were on antipsychotic monotherapy prior to the EEG test. Further analysis of the requested EEG form was carried out in whom the test was to determine whether or not the patients were suffering from epilepsy.EEG abnormalities were identified amongst 24% of the patients. About 11,7% of patients presented with non specific EEG results .Out of a total number of 111 patients whom an EEG test was requested and epilepsy was highly suspected from clinical presentation, only 14 patients (12.6%),presented with epileptiform discharge on their EEG results. However majority of the patients (76%) demonstrated normal EEG pattern, which doesn’t exclude a diagnosis of epilepsy. CONCLUSION The yield of EEG in psychiatry is low. To diagnose epilepsy as a cause of psychiatric presentation, clinicians should continue to rely on the clinical history of attacks and not the EEG .In the practice of psychiatry it is not recommended to routinely order an EEG to exclude a diagnosis of epilepsy, more so to confirm a psychiatric diagnosis.The presence of a psychiatric symptoms in patients who presents with epilepsy, is rarely associated with meaningful EEG changes Description: Thesis (M Med (Psychiatry))--University of Limpopo (Medunsa Campus), 2010.

2010-01-01T00:00:00Z Ballyram, Theona http://hdl.handle.net/10386/454 2012-09-08T22:01:40Z 2010-01-01T00:00:00Z

Title: Prevalence and predictors of new episodes in patients with bipolar 1 disorder at Dr George Mukhari Hospital over a one year period (June 2007-June 2008) Authors: Ballyram, Theona Abstract: Background: Bipolar disorder is a lifelong illness typically presenting with frequent relapses and/or recurrences. Bipolar disorder carries a high morbidity and mortality and can cause significant functional impairment. In understanding the relapsing course of the illness, chronicity may be reduced by preventing or delaying the occurrence of new episodes. Objectives: The objectives of this study were to establish the prevalence of new episodes in patients with bipolar I disorder and to determine predictors of new episodes. Methods: This was a retrospective, descriptive study based on the review of medical records of patients with bipolar I disorder seen at Dr. George Mukhari Hospital – psychiatry unit between the period of 1 June 2007 to 1 June 2008. Data concerning sociodemographic parameters of the patients and psychiatric information was collected using a data collection sheet. Results: Data was extracted and analysed from a total of 143 patient records. Ninety (63%) experienced new episodes and fifty-three patients (37%) did not have any new episodes. Seventy-nine patients (55%) had one or more manic episodes (mean=0.64) and nineteen (13.38 %) had one or more depressive episodes. (Mean=0.14). The maximum number of new episodes was 2 and the mean was 0.78. The most recent episode was manic in seventy-six patients (84%). The mean number of hospital admissions was 0.88. Of the patients that had new episodes, the age ranged from 18 to more than 55 years, the vast majority were black (94%) and of Christian faith (97%). More than half were female (58%) and single (49%), with 1-2 children (48%). The majority achieved high school education (60%), and were unemployed (70%). Only 47% were receiving a disability grant. New episodes were more prevalent in patients who experienced a younger age of onset of illness (41% in the 18-24 year age group) and who were ill for more than ten years (43%). Less than half had a positive family history of mental illness (43%), 39% had a history of substance use, the most common substance being alcohol (54%), and 39% suffered from one or more comorbid medical illnesses. 78% of the patients who had new episodes were on antipsychotics, 93% were on mood stabilisers, and 69% were on a xii combination of mood stabilisers and antipsychotics. The only factor that was significantly predictive of new episodes was poor compliance. Conclusion: There is a high prevalence of relapse in patients with bipolar I disorder, particularly to the manic pole. Compliance with medication remains a serious problem and is associated with the occurrence of new episodes. Improved treatments should include biopsychosocial strategies, identification of risk factors for relapse/recurrence and early and consistent intervention. Description: Thesis (M Med (Psychiatry))University of Limpopo (Medunsa Campus), 2010.

2010-01-01T00:00:00Z Modisane, L. N. http://hdl.handle.net/10386/442 2012-07-13T07:15:16Z 2010-01-01T00:00:00Z

Title: Relationship between cannabis use and psychiatric disorders in patients admitted at Dr George Mukhari Hospital Psychiatric Unit Authors: Modisane, L. N. Abstract: BACKGROUND Cannabis is the commonly used illicit drug of choice in South Africa and throughout the world. The majority of individuals who use cannabis do not report adverse reactions to it, however a minority of heavy users will develop problems. A substantial number of patients admitted at our psychiatry unit seem to be using cannabis. AIMS The aim of the study was to assess the relationship between cannabis use in psychiatric disorders in patients admitted in George Mukhari Hospital Psychiatry Unit, to determine the pattern of cannabis use, to identify the common psychiatric disorders in patients using cannabis, to determine the socio-economic factors that may lead to cannabis use. METHODS A total of 75 participants admitted at Doctor George Mukhari hospital and diagnosed with psychiatric disorders according to the diagnostic and statistical manual of mental disorders fourth edition text revised were interviewed using a structured questionnaire and had urine specimens collected for analysis. Out of 75 participants a control group of 34 participants who tested negative for urinary cannabinoids were interviewed. The participants had signed a written informed consent in their language of preference. The study had been approved by the Research Ethics and Publications Committee of the University of Limpopo (Medunsa Campus).Data was analysed with the help of the statistician and reported on graphs, pie-charts and tables. RESULTS 16(39%) of participants who tested positive were diagnosed with schizophrenia, 7 (17%) of those who tested positive were diagnosed with cannabis induced psychotic disorder, 5(12%) of those tested positive were diagnosed with psychosis due to GMC (HIV) and 6(15%) were diagnosed with psychosis due GMC (epilepsy). 8(24%) of those who tested negative were diagnosed with schizophrenia, 15(44%) of those tested negative were diagnosed with cannabis induced psychotic disorder, 2(6%) were diagnosed with psychosis due to GMC (HIV) and to 2(6%) of those who tested negative were diagnosed with psychosis due to GMC (epilepsy). Majority 24 (32%) smoked cannabis using pipes 4-5 times, 19 (25%) used zols 4-5 times, 12(16%) used pipes 2-3 times, 11(14%) used 1 zol in the 30 days prior to the interview. Most of the participants were of low socio-economic status and had started using cannabis early in their lives. CONCLUSION Cannabis use is related to a number of psychiatric disorders in patients admitted at Dr George Mukhari Hospital. Schizophrenia, cannabis induced psychotic disorder, psychosis due to GMC (HIV), psychosis due to epilepsy were the commonest identified disorders. Description: Thesis (M Med (Psychiatry))--University of Limpopo, 2010.

2010-01-01T00:00:00Z