Masters Degrees (Psychiatry)

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Browsing Masters Degrees (Psychiatry) by Subject "Dissertation (M.Med. (Psychiatry))--University of the Free State, 2021"

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    A comparative cost analysis of functional neurological disorder with other neurological disorders in patients admitted at Universitas Academic Hospital Neurology Ward
    (University of the Free State, 2021-05) Christopher, Leonriche Leonard Christo; Pretorius, P. J.; Moodley, A.
    Background: There is a lack of published data about functional neurological disorder and related costs incurred on the health care system in South Africa. Aim: To compare the health care costs of functional neurological disorder (FND) to those of other neurological conditions admitted in an inpatient setting. Setting: Universitas Tertiary Academic Hospital, Neurology Department, Free State, South Africa. Method: Secondary data was collected from Meditech for the period of 1 January 2018 until 31 December 2019. All neurology patient records were reviewed to ensure that patients with FND admitted during the study period were correctly identified. A descriptive data analysis was performed with means and standard deviations calculated for all patients included in the analysis. Categorical variables were summarised by frequencies and percentages. P-values were reported as a measure of significance for the main outcome variable, namely cost. Results: A total of 530 patients were admitted during the study period. Every 12th patient with a diagnosis other than FND were chosen as the comparator group. Of the 58 patients included in the study, 29/58 (50%) had a diagnosis of FND and 29/58 (50%) were admitted for other neurological disorders. A median age of 28 years IQR (19-36) was reported for the patients diagnosed with FND and 34 years IQR (25-45) for admissions with comparable neurological diagnoses. Both groups had similar gender representations with 11/29 (37.9%) being male, and 18/29 (62.1%) females. The median length of stay was significantly shorter (p value 0.007) for patients diagnosed with FND. Patients with FND most commonly (41.4%) presented with paraplegia. The average cost for the FND patients was significantly less (p value 0.008) than other neurological disorders. The majority (72.4%) of patients admitted for FND was from a low-income category. Conclusion: Patients admitted at the neurology ward with FND incurred lower costs and had fewer medical comorbidities than patients diagnosed with other neurological disorders.
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    Prevalence of mood symptoms in patients with cannabis use admitted to the acute wards at Free State psychiatry complex with schizophrenia spectrum and related disorders
    (University of the Free State, 2021-02) Pooe, M. T.; Van Niekerk, J. S. S.
    Background: Cannabis is the most commonly used drug among psychotic patients. Literature shows that the frequency and intensity of cannabis use, is a risk-factor for the development of schizophrenia-related psychosis. However, evidence for causality of mood disorders remain conflicting. Aim: The purpose of this study was to compare the prevalence and severity of mood symptoms in patients with schizophrenia spectrum and related disorders with comorbid cannabis use and those that does not use cannabis. Setting: This study was conducted in patients with schizophrenia spectrum and related disorders admitted at the acute wards at the Free State Psychiatric complex. Methods: A prospective study was conducted among 30 non- cannabis users and 40 cannabis users. The Young Mania Rating Scale (YMRS) and Hamilton Depression (HAM-D) rating scale for depression was administered within three days of admission and repeated after 7-14 days. Results: Among cannabis users, symptoms compatible with mania like symptoms was significantly more prevalent shortly after admission with (p<0.01). However, this difference declined to non-significance after 7 – 14 days with no clinical separation between the groups. Conclusion: Seventy-five percent of schizophrenia spectrum and related disorders patients that used cannabis, scored ≥18 on the YMRS shortly after admission. Mania like symptoms were of mild-moderate severity. The study indicated a possible association between cannabis use and higher scores on the YMRS rating scale during the early phase of treatment. A causal link between mood symptoms and cannabis use could not be established and confounding factors were not excluded.