Stroke ranks second in the list of major causes of disability and death in the world. Stroke is the sudden onset of focal or generalized abnormalities of brain function caused solely by vascular causes that are associated with cerebral blood flow and last for more than 24 hours. Stroke can also be diagnosed if symptoms persist for more than 24 hours, but with a confirmation of neuroimaging studies, the ischemic area has been clearly located and documented, symptoms disappeared after thrombolytic therapy, or the patient died within 1 day of symptoms onset. Often, patients with stroke experience emotional and behavioral disorders. Their frequency varies depending on factors such as the patient's age, gender, socio-economic status, post-stroke disability, and cognitive changes that play a crucial role in patients’ well-being and can significantly affect the recovery process. This article describes common psychiatric presentations in patients in a post-stroke period. Some available evidence-based data on the treatment of these conditions and identified possible risk factors that influence their development are presented.

Child schizophrenia is a mental disorder that affects brain structures, emotional and cognitive functions. The disorder is characterized by psychotic symptoms: disorder of thinking, inadequate emotional reactions, disorganized behavior, deterioration of social functioning and loss of will. Schizophrenia in children is one of the most common mental illnesses affecting up to 1% of all children. For a long time, the term "child schizophrenia" was used to refer to various disorders that had similarities with each other. Children were referred to schizophrenics if they had borderline symptoms. Child schizophrenia develops gradually; sudden onset it is not common. Schizophrenic child requires help from multidisciplinary team members including child and adolescent psychiatrist and all possible levels of psychotherapy and psychological interventions. This article discusses classification, clinical presentation, all possible treatment and rehabilitation of children with schizophrenia.

Attention deficit hyperactivity disorder (ADHD) is described as the most common neurobehavioral condition of childhood. Symptoms include difficulty concentrating, hyperactivity and poorly controlled impulsivity. ADHD always manifests in childhood, children with the syndrome rush around the room, switch their attention from one to the other, cannot calm down and take lessons or reading. ADHD may persist into adulthood causing disruptions to both professional and personal life. The pharmacotherapy of ADHD is cost-effective, but treatment should be individual. Main outlines of clinical practice guide on management of ADHD of Academy of Medicine and Ministry of Health of Singapore are discussed in this article. Some focus on diagnostic process and associated with ADHD problems is emphasized. It can be invaluable example for the specialists engaged in the treatment of the children with this psychiatric disorder.

Induced Delusional Disorder or Shared Psychosis is a rare psychotic syndrome which involves transference of a delusional belief and or abnormal behaviour from one individual to another or others who has/ have been in close association with the primary affected person. This is a case study of a married couple with five children who had been living on a ten hector plot on a settlement scheme in a district of the Northern Province of Zambia. The wife strongly believed herself to be a prophetess and prophesied that the world would soon come to an end. Over several months she influenced her husband into this belief and together including children started praying and fasting on the isolated farming plot to an extent that children were not allowed to attend school and either couple was not seen at a local market or at the grinding mill. The last born son of about one and half years apparently had developed a fever during this period of isolation. The child was not taken to the health center in the belief that the "Spirit" they had would heal him. The child died five days after the onset of the fever. The death was not reported to authorities in the belief that the body would be resurrected. Relatives and neighbours found the body in a decomposed state two weeks later after forcing their way into the house in which the couple had barricaded itself with the children. Both husband and wife were charged with Murder in a High Court contrary to Section 200 of the Penal Code Chapter 87 the Laws of Zambia. Both husband and wife were admitted at a Forensic Facility for Medical Examinations in terms of Section 17 of the Criminal Procedure Code Chapter 88 of the Laws of Zambia. To the best of our knowledge this is the first documented case of Induced Delusional Disorder from Zambia.

Introduction: Studies in mental health care for low-resource settings indicate that providing services at the primary care level would significantly improve the provision utilization of mental health services. Challenges related to inadequate funding were noted as significant barriers to service provision, with the contribution of low knowledge of mental health conditions and stigma in the community. Objective: This study aimed to assess and explore health-seeking behaviors and their associated factor at Chainama Hills College Hospital (CHCH), Lusaka, Zambia. The study was conducted at CHCH on clients and/or their caregivers receiving and accessing in- and outpatient (OPD) alcohol and drug detoxification and rehabilitation services at CHCH. 79 participants took part in the study taking into consideration all ethical issues. Methodology: Data was collected using the structured questionnaire administered to 79 participants and primary caregivers. Qualitative data was collected using in-depth interviews captured using the digital recorder. The quantitative data were analyzed using SPSS software and the digitally recorded responses for qualitative data were transcribed and analyzed using thematic analysis. Results: Factors influencing health-seeking behavior were related to health systems, socio-cultural, socioeconomic, and individual factors. The main system issues were related to the availability and attitudes of staff and the shortage of supplies and medicines. Conclusion: The engagement of community health workers and increasing efforts to sensitize the community about mental health would prove beneficial. Strengthening the community health systems for mental health could improve access and increase the utilization of services.

Introduction: Patients using antipsychotic drugs are more likely than the general population to suffer glucose metabolism dysfunctions. Patients who take antipsychotic drugs, particularly second-generation antipsychotics, are four times more likely to develop overweight, obesity, and diabetes type 2. Failing to recognize these metabolic issues puts an individual at risk of developing cardio-metabolic and others disorders that potentially worsen psychiatric problems. For controlling and enhancing potential psychiatric treatment outcomes, early diagnosis and treatment of glucose metabolism dysfunction are crucial. Objective: To optimize the early diagnosis of glucose metabolism impairments in patients with psychiatric disorders treated with antipsychotic medications. Methodology: This is a descriptive cross-sectional study that was conducted at the outpatient psychiatric clinic of the University Teaching Hospital (Lusaka, Zambia). A systematic sampling method was applied to all patients who were receiving antipsychotic drugs. All participants were checked for their weight, height, Body Mass Index (BMI), waist circumference, random, and fasting blood glucose levels respectively. The results were analyzed by using SPSS software (version 20), while Fisher’s exact test was used to determine the relationship between categorical variables. Results: The proportion of individuals with impaired fasting blood glucose levels found in this study was 11.1% and that of individuals with diabetes was 10.0% respectively which is higher compared to the general population. Patients who were receiving second-generation antipsychotics showed a slightly higher proportion of impaired fasting blood glucose levels compared to those on conventional antipsychotic medications. Conclusion: The glucose metabolism deficit in patients with psychotic disorders was found to be high. Patients of both sexes had an equal chance of developing the problem, though females had a higher proportion as compared to males, and it is not time-dependent. Older patients showed a higher proportion of impaired fasting blood glucose levels compared to younger ones. It is recommended that basic screening measures of glucose metabolism parameters that are simple and cost-effective, like checking weight, BMI, waist circumferences, and regular checking of blood glucose levels, be routine practice in all psychiatric settings before starting antipsychotic medications.

Folie à deux, Shared Psychosis or Induced Delusional Disorder is a rare psychotic syndrome which involves transference of a delusional belief and or abnormal behaviour from one individual to another or others who has/ have been in close association with the primary affected person. This is a case study of a married couple with five children from the Northern Province of Zambia. The wife strongly believed herself to be a prophetess and prophesied that the world would soon come to an end. She influenced her husband into this belief and together including children started praying and fasting on the isolated farming plot to an extent that children were not allowed to attend school and either couple was not seen at a local market or elsewhere. The last born son of about one and half years apparently had developed a fever during this period of isolation. The child died five days after the onset of the fever. The death was not reported to authorities in the belief that the body would be resurrected. Relatives and neighbours found the body in a decomposed state two weeks later after forcing their way into the house in which the couple had barricaded itself with the children. Both husband and wife were charged with Murder in a High Court contrary to Section 200 of the Penal Code Chapter 87 the Laws of Zambia. To the best of our knowledge this is the first documented case of Folie à deux from Zambia.

Parkinson's disease (PD) is a progressive neurological disorder characterized by a large number of motor and nonmotor features that can impact on function to a variable degree. The syndrome of parkinsonism is recognized, which can become apparent with akinetic rigid disorders in other brain injuries and medication-induced parkinsonism. Genetic mutations or variants, neuroimaging abnormalities and other tests are potential biomarkers that may improve diagnosis and allow the identification of persons at risk. This literature review describes pathogenesis and clinical characteristics of PD with emphasis on modern treatment and possibilities of dopamine agonists, especially pramipexole. During pramipexole treatment of the patients with the early and late stages of PD, we can observe the reduction of expression of cognitive and affective (mood) disorders, the improvement of the quality of life and social functioning.