First-episode psychosis and substance use in Nelson Mandela Bay: Findings from an acute mental health unit

Thungana, Yanga; Zingela, Zukiswa; Wyk, Stephan van

doi:10.4102/sajpsychiatry.v25i0.1372

Cited by 12 publications

(19 citation statements)

References 38 publications

(54 reference statements)

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“…In South Africa, variable prevalence rates of SUD amongst psychiatric inpatients have been found. 10,14,29,30,31 Our results are similar to the 62% prevalence of a current SUD found amongst acute psychiatric patients in the Western Cape, 29 and to the 72% prevalence found amongst a sample of Gauteng state patients. 14 Using the ASSIST questionnaire in a study at a regional psychiatric hospital in KwaZulu-Natal, South Africa, 22 patients were reported to have a similar 54% recent alcohol use and 43% recent cannabis use.…”

Section: Discussionsupporting

confidence: 84%

“…However, the prevalence in our sample was less than the 81.2% found amongst patients admitted with first episode psychosis in the Eastern Cape. 30 Substance use disorder has been shown to be more common with first episode psychosis than with subsequent episodes. 32 Index psychiatric presentations were not frequent amongst those with SUD in our sample; however, if the 60 participants with an index psychiatric presentation were considered separately, then 75% ( n = 45) had a SUD, bringing the prevalence rate closer to that found in the Eastern Cape study.…”

Section: Discussionmentioning

confidence: 99%

“… 32 Index psychiatric presentations were not frequent amongst those with SUD in our sample; however, if the 60 participants with an index psychiatric presentation were considered separately, then 75% ( n = 45) had a SUD, bringing the prevalence rate closer to that found in the Eastern Cape study. 30 …”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence and clinical correlates of substance use amongst acute psychiatric inpatients in Gauteng, South Africa

Anic

Robertson

2020

South African Journal of Psychiatry

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Background Mental disorders and substance use disorders (SUD) commonly occur together, impacting healthcare outcomes. The diagnosis of substance use is often inadequate when comorbidity is present. It is vital to understand the prevalence of substance use amongst psychiatric patients to inform both clinical practice and service development in South Africa. Aim To ascertain the prevalence and clinical correlates of SUD amongst acute psychiatric inpatients. Setting The setting for this study was Helen Joseph Hospital acute psychiatric ward. Methods A cross-sectional study was conducted whereby consecutively admitted patients were invited to participate in a structured clinical interview utilising the alcohol use disorders identification test (AUDIT) and drug use disorders identification test (DUDIT) questionnaires. Statistical comparisons were made between those with and without SUD. Results Of 150 participants, 100 (67%) were identified with a SUD. Those with SUD were younger ( p = 0.0010), more often male ( p = 0.012), less likely to have a disability grant ( p = 0.015) and more likely to be brought to hospital by police, ambulance or self than by a family member ( p = 0.025). Almost half of people with bipolar disorder (47.3%) and schizophrenia (41.4%) had comorbid SUD. Twenty-three (15%) participants identified with SUD on questionnaire had been missed clinically. Only two participants were referred for inpatient substance rehabilitation on discharge. Conclusion Substance use disorders are highly prevalent amongst psychiatric inpatients. The AUDIT and DUDIT are potentially useful screening tools in routine clinical practice. Greater collaboration between psychiatric and substance rehabilitation services is recommended.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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Prevalence and clinical correlates of substance use amongst acute psychiatric inpatients in Gauteng, South Africa

Anic

Robertson

2020

South African Journal of Psychiatry

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“…Amphetamines (tik, speed), cocaine (coke, crack, rock), and opiates each had a prevalence of use of 0.3% [8]. Authors [27] Thungana et al (2019) reported a prevalence of 81.9% among individuals admitted with first-episode psychosis (FEP) in the Nelson Mandela Bay of Eastern Cape Province. Findings of Thungana et al (2019) are limited to people with FEP and do not reflect the broader categories of mental illnesses managed at the province's health facilities.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Demographic Correlates of Substance Use among Adults with Mental Illness in Eastern Cape, South Africa: A Cross-Sectional Study

Tindimwebwa

Ajayi

Adeniyi

2021

IJERPH

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This study reports on the prevalence and demographic correlates of substance use among individuals with mental illness in the Eastern Cape, South Africa. This cross-sectional study was conducted in the Outpatient Clinic of a large hospital in the Eastern Cape, South Africa. A pre-validated tool on alcohol and psychoactive drug use was administered to 390 individuals with mental illness. Multivariable logistic regression models were fitted to explore the demographic correlates of alcohol and psychoactive drug use. Of the total participants (N = 390), 64.4% and 33.3% reported lifetime (ever used) and past-year use of alcohol, respectively, but the prevalence of risky alcohol use was 18.5%. After adjusting for relevant covariates, only male sex, younger age, and rural residence remained significantly associated with risky alcohol use. The prevalence of ever-use and past-year use of psychoactive substances was 39.7% and 17.4%, respectively. The most common substance ever used was cannabis (37.4%). Male sex, younger age, owning a business, and being unemployed were significantly associated with higher odds of lifetime and past-year use of psychoactive substances. Findings highlight the need for dedicated infrastructure and staff training in the management of these dual diagnoses in the region.

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“…The same argument made for integrated addictions treatment has given the high rates of substance abuse in our setting, not just amongst patients with psychotic disorders but the general population as well. 41 , 42 Further research is therefore needed to validate the low levels of evidence (opinion) for these interventions in low resource settings. This study however may form a basis for the development of SEIS for psychotic disorders in the region.…”

Section: Discussionmentioning

confidence: 99%

Quality of individual and group level interventions for first-episode psychosis at the tertiary psychiatric hospital in Uganda

Mwesiga

Nakasujja

Nankaba

et al. 2021

South African Journal of Psychiatry

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Background: Individual and group level interventions have the largest effect on outcomes in patients with the first episode of psychosis. The quality of these individual and group level interventions provided to first-episode psychosis patients in Uganda is unclear. Aim: To determine the quality of the individual and group level interventions provided to first episode psychosis patients in Uganda Setting: The study was performed at the only tertiary psychiatric hospital in Uganda. Methods: A retrospective chart review of recently discharged adult in-patients with the first episode of psychosis was performed. The proportion of participants who received different essential components for individual and group level interventions were calculated. From the different proportions, the quality of the services across the individual and group interventions was determined using the first-episode psychosis services fidelity scale (FEPS-FS). The FEPS-FS assigns a grade of 1-5 on a Likert scale depending on the proportion of patients who received the different components of the intervention. Twelve essential components across the individual and group interventions were assessed and their quality quantified. Results:The final sample included 156 first-episode psychosis patients. The median age was 27 years (inter-quartile range ) and 55% of the participants were female. All 12 essential components had poor quality with the range of scores on the FEPS-FS between one and three. Only one essential component assessed (use of single antipsychotics) had moderate quality. Conclusion:Amongst current services at the Butabika National Referral Mental Hospital in Uganda, the essential components for individual and group level interventions for psychotic disorders are of poor quality. Further studies are required on how the quality of these interventions can be improved.

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First-episode psychosis and substance use in Nelson Mandela Bay: Findings from an acute mental health unit

Cited by 12 publications

References 38 publications

Prevalence and clinical correlates of substance use amongst acute psychiatric inpatients in Gauteng, South Africa

Prevalence and clinical correlates of substance use amongst acute psychiatric inpatients in Gauteng, South Africa

Prevalence and Demographic Correlates of Substance Use among Adults with Mental Illness in Eastern Cape, South Africa: A Cross-Sectional Study

Quality of individual and group level interventions for first-episode psychosis at the tertiary psychiatric hospital in Uganda

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