Browsing by Author "Schoeman, Renata"
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- ItemAdult attention-deficit hyperactivity disorder : why should we pay attention(AOSIS Publishing, 2017) Schoeman, Renata; Albertyn, Ruth; De Klerk, ManieBackground: Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, with a chronic, costly and debilitating course if untreated. Limited access to diagnosis and treatment for adults with ADHD contributes to the cost of the disorder and the burden of disease. Aim: This study aims to identify the barriers to care for adults with ADHD. Methods: A qualitative analysis of semi-structured interviews with 10 key opinion leaders in the field of adult ADHD in SA was conducted to obtain narratives regarding frustrations experienced when treating adults with ADHD and needs of patients regarding management of ADHD. Qualitative content analysis was completed using Atlas.ti (version 7). Results: Four key themes which emerged from the interviews were ‘lack of recognition of the disorder’, ‘lack of access to diagnosis’, ‘lack of access to treatment’ and ‘a life of perpetual failure’. Core to these themes are the lack of knowledge amongst health care professionals, funders, and society at large. Conclusion: Our findings expand on previous research regarding the need to increase the knowledge base on adult ADHD. A collaborative stakeholder approach is needed to provide research and training for improved diagnosis and treatment for adults with ADHD in the South African context.
- ItemCorrigendum to "Summary of the 1st Schizophrenia International Research Society Conference oral sessions, Venice, Italy, June 21-25, 2008: The rapporteur reports". [Schizophrenia Research 105 (2008) 289-383] (DOI:10.1016/j.schres.2008.08.015)(2009) Abubaker, R.; Alaerts, M.; Allman, A-A.; Barnett, J.; Belujon, P.; Bittner, R. A.; Burne, T. H. J.; Cahn, W.; Chance, S.; Cherkerzian, S.; DeSouza, R.; Di Forti, M.; Du Bois, T.; Fatjo-Vilas, M.; Green, M.; Halperin, D.; John, J. P.; Kemp, A.; Koelkebeck, K.; Lee, J.; Lodge, D. J.; Michalopoulou, P.; Mompremier, L.; Nelson, B.; Perala, J.; Rotarska-Jagiela, A.; Schoeman, Renata; Thakkar, K. N.; Valuri, G.; Varambally, S.; Zai, C.; DeLisi, L. E.[No abstract available]
- ItemA prospective study of cognitive deficits in first episode psychosis, and the response thereof to treatment with Flupenthixol Decanoate(Stellenbosch : University of Stellenbosch, 2011-03) Schoeman, Renata; Oosthuizen, P. P.; University of Stellenbosch. Faculty of Health Sciences. Dept. of Psychiatry.ENGLISH ABSTRACT: Contemporary research has confirmed the presence of cognitive deficits as a core feature of schizophrenia that has a definite and adverse impact on functional outcome. Cognitive functioning can be improved by psychopharmacological intervention, with evidence supporting the superiority of second generation antipsychotics over their first generation predecessors. Despite evidence that cognitive impairment contributes to medication non-adherence and that depot antipsychotics are able to enhance treatment compliance whilst decreasing relapse rates, depot preparations remain less frequently prescribed than their oral counterparts, especially in patients with first episode psychosis (FEP). The aims of this study were primarily to investigate cognitive deficits in patients with FEP, and to then describe the response of these impairments to treatment with a very low dose flupenthixol decanoate. This was a prospective, non-randomized, single arm, open-label, longitudinal study of 58 participants with FEP treated according to a fixed protocol over a period of 12 months. There was a wash-out phase of up to seven days during which all psychotropic medications were discontinued. There was an initial treatment period of one week with oral flupenthixol 1mg/day, after which flupenthixol decanoate was initiated at 10mg intramuscular depot injection every fortnight. Dose increases, in cases of poor or inadequate response, were allowed at 6-weekly intervals and in increments of 10mg per injection, up to a maximum of 30mg per fortnight. The principal findings of the study were as follows: The majority of participants were markedly ill, with significant cognitive impairment at baseline. There was a discrepancy between subjectively reported, and objectively measured, cognitive impairment. The majority of the participants responded to, and achieved remission, on a very low dose of flupenthixol decanoate (22.48 ± 0.47mg/month). The majority of symptomatic and cognitive improvement occurred between baseline and three months, with response leveling out at six months. Social cognition did not improve significantly over time, whereas functional outcome and quality of life did improve with treatment. Flupenthixol decanoate was well tolerated and side-effects were of a mild and transient nature. This study reconfirms that the majority of individuals with FEP experience significant cognitive impairment at baseline. It also suggests that these impairments can be successfully treated with a very low dose of flupenthixol decanoate. The use of depot flupenthixol decanoate ensures sustained treatment delivery, thereby decreasing the risk for relapse. This holds the promise of improved long-term functional outcome for those suffering with psychotic illness.
- ItemRemoving mental health barriers to education : a community project(AOSIS, 2018) Schoeman, Renata; Enright, Jena; James, Anelet; Vermeulen, Cornelia; De Beer, NicIntroduction: Attention-deficit hyperactivity disorder (ADHD) is the most common psychiatric disorder in children – affecting 2% to 16% of the school-age population (National Resource Centre on AD/HD, 2013). However, in South Africa, data on prevalence rates, access to care and treatment for ADHD are limited and research is lacking. Many children- especially those in underprivileged communities- suffering from ADHD remain undiagnosed, or if diagnosed, do not receive optimal treatment. The Goldilocks and The Bear Foundation provides screening for ADHD and other mental health disorders to learners at school level. We will be presenting the statistics compiled for the first year of operation (July 2017 – June 2018). Methods: In the schools visited, children are referred to the Foundation by the School Based Support. Collateral information is obtained from educators and parents, and parental consent secured before any child is evaluated. Trained nurses do the basic physical screening and behavioural observations for each child. All information is collated and controlled by a trained psychiatrist or psychologist, who determine the possible diagnosis and refer accordingly (either to the community clinic, school doctor, optometrists, audiologists, educational psychologist or occupational psychologist). A detailed database was built capturing all the aforementioned information. Results: We have visited 18 schools (N = 12 447), of which 13 schools participated (N = 8780). A total of 543 children (6.2%) from the school population were screened. The ratio of boys to girls was 2:1, with an age range of 5–14 years. Of the children included in the current analysis (to be updated at the end of the study period), 2.7% were diagnosed with ADHD and 0.67% with depression and/or anxiety. Further detail will be provided with regard to risk factors and comorbid conditions and problem areas. Conclusion: Although mental health clinics exist in the public sector, children with ADHD often never reach this point of diagnosis and treatment because of a lack of awareness and knowledge in their communities. Improved outcomes are possible to achieve if patients suffering from ADHD are diagnosed as such and receive multi-modal intervention – which would include psychopharmacological interventions, behavioural interventions and support.
- ItemThe South African Society of Psychiatrists/Psychiatry Management Group management guidelines for adult attention-deficit/hyperactivity disorder(AOSIS Publishing, 2017) Schoeman, Renata; Liebenberg, RykieDisclaimer: These guidelines do not aim to provide a comprehensive review of all the pertinent literature comprising the evidence base and, as such, should be utilised in conjunction with other guidelines as well as the responsibility of practitioners to maintain a high level of personal knowledge and expertise. Despite the known efficacy of treatment and the substantial costs of untreated attention-deficit/hyperactivity disorder (ADHD), access to healthcare and treatment is not a given for many patients in South Africa (SA). In SA, there is poor identification and treatment of common mental disorders at primary healthcare level and limited access to specialist resources with a service delivery and treatment gap of up to 75%. Medication options are also often limited in emerging markets and in SA psychiatrists, and patients do not have access to the medication armamentarium available in established markets. Furthermore, the majority of South Africans currently utilise the public healthcare sector and may not have access to treatment options referred to in these guidelines. These guidelines should therefore not be seen as a policy document. The process: The South African Society of Psychiatrists’ Special Interest Group (SIG) for adult ADHD was launched on 25 September 2015, with doctors Rykie Liebenberg and Renata Schoeman as convenor and co-convenor, respectively. The overall objective of the ADHD SIG is to improve the basket of care available to patients with ADHD. This is only possible through a combined and concerted effort of individuals with a special interest in and passion for ADHD to improve knowledge about and funding for the care of individuals with the disorder. One of the specific aims of the ADHD SIG was to develop South African guidelines for the diagnosis and treatment of adult ADHD specifically and update guidelines for the treatment of child, adolescent and adult ADHD. Dr Schoeman has recently completed her MBA at the University of Stellenbosch Business School with a thesis entitled ‘A funding model proposal for private health insurance for adult attention-deficit/hyperactivity disorder in the South African context’. This is first South African study exploring the situation with regard to the prevalence and treatment of adult ADHD. Dr Schoeman was tasked by the SIG with the drafting of guidelines. Dr Liebenberg provided valuable input. The guidelines were then circulated to the SIG members, as well as the Chair of the Public Sector SIG, for written feedback and evidence- based suggestions which were then incorporated into the guidelines. The final guidelines were circulated for written approval by the SIG members, followed by formal approval at a SIG meeting held on 14 August 2016, after which it was submitted to the South African Society of Psychiatrists (SASOP) and Psychiatry Management Group (PsychMG) boards for recommendation and ratification.
- ItemSummary of the 1st Schizophrenia International Research Society Conference oral sessions, Venice, Italy, June 21-25, 2008: The rapporteur reports(2011-05-15) Abubaker, R.; Alaerts, M.; Allman, A-A.; Barnett, J.; Belujon, P.; Bittner, R. A.; Burne, T. H. J.; Cahn, W.; Chance, S.; Cherkerzian, S.; DeSouza, R.; Di Forti, M.; Du Bois, T.; Fatjo-Vilas, M.; Green, M.; Halpern, D.; John, J. P.; Kemp, A.; Koelkebeck, K.; Lee, J.; Lodge, D. J.; Michalopoulou, P.; Mompremier, L.; Nelson, B.; Perala, J.; Rotarska-Jagiela, A.; Schoeman, Renata; Thakkar, K. N.; Valuri, G.; Varambally, S.; Zai, C.; DeLisi, L. E.The Schizophrenia International Research Society held its first scientific conference in Venice, Italy, June 21 to 25th, 2008. A wide range of controversial topics were presented in overlapping and plenary oral sessions. These included new genetic studies, controversies about early detection of schizophrenia and the prodrome, treatment issues, clinical characteristics, cognition, neuropathology and neurophysiology, other etiological considerations, substance abuse co-morbidity, and animal models for investigating disease etiology and for use as targets in drug studies. Young investigators in the field were awarded travel grants to participate in the congress and one of their roles was to summarize the oral sessions and subsequent discussions. The reports that follow are the culmination of this work produced by 30 young investigators who attended the congress. It is hoped that these summaries will be useful synopses of what actually occurred at the congress for those who did not attend each session or were unable to be present. The abstracts of all presentations, as submitted by the authors a few months prior, were previously published as supplement 2 to volume 102/1-3, June 2008. © 2008.