Masters Degrees (Psychiatry)

Permanent URI for this collection

https://scholar.sun.ac.za/handle/10019.1/499

Browse

Browsing Masters Degrees (Psychiatry) by browse.metadata.advisor "Koen, Liezl"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Long-term outcomes of an assertive community treatment (ACT) intervention : a 10-year follow-up
    (Stellenbosch : Stellenbosch University, 2022-12) Coetzee, Danell; Botha, Ulla; Koen, Liezl; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Psychiatry.
    ENGLISH SUMMARY: Background: Assertive community treatment (ACT) is an intervention implemented in many countries to manage the effects of deinstitutionalization, with studies in South Africa demonstrating decreased admissions at 12 and 36-month follow-up for patients receiving modified ACT compared to standard care. Whilst shown to be effective, costs associated with the intervention has raised the question of its feasibility in developing countries. Aim: This study aimed to describe the demographic and clinical outcomes of a group of patients included in an ACT interventional study, 10 years after inclusion. Methods: This is a retrospective description of the 10-year outcomes of a group of 55 highfrequency psychiatric users (HFUs) included in the first ACT intervention in South Africa. The group either received follow-up with a modified ACT program or at a community care centre. Demographics, admissions, social functioning and adverse events were outcomes reviewed. Results: Nine patients remained in ACT for the full 10 years, 16 were never included and 30 patients spent some time in ACT. Five participants died, 2 were admitted to long-term wards and 12 were never re-admitted. The group had an overall low level of education, a mean age of 43 years and most were single (82%). The mean number of admissions were 3.73 and the mean number of admission days was 261.11. Conclusions: This was the first study looking at the long-term outcomes of a group of HFUs in an under-resourced setting receiving a modified ACT intervention. Correlation with the poor psychosocial outcomes often associated with schizophrenia were found in this group, but overall, the study findings suggest increased stabilization, service utilization and quality of life for patients exposed to ACT at some stage in their treatment.
  • Thumbnail Image
    Item
    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.