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.
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