A profile of adult acute admissions to Lentegeur Psychiatric Hospital, South Africa

Abstract

Background: The Western Cape province has the highest documented lifetime prevalence of common mental disorders in South Africa. To ensure the efficient, equitable and effective distribution of current resources, there is a need to determine the profile of patients requiring psychiatric admission.Aim: To describe patients admitted to the acute adult admissions unit at Lentegeur Hospital.Setting: Lentegeur Psychiatric Hospital is situated in Mitchells Plain, Cape Town, and serves about 1 million people from nearby urban and rural areas.Methods: This retrospective study involved an audit of all patients (18–60 years of age) admitted between 01 January 2016 and 30 June 2016. The clinical records of 573 adult patients were examined.Results: The median age of the cohort was 29 years. Most patients (63%) were educated to the secondary level. Only 12% of the patients were employed, and 37% received disability grants. More than 90% of the patients presented with psychotic symptoms. Of these, 28% presented with a first-episode of psychosis. Of all patients, 20% were referred with manic symptoms and 7% with depressive symptoms. Many patients (62%) used substances concurrently in the period leading up to admission. Significantly more males (73%) used substances compared to females (38%). Cannabis was the most widely used substance (51%), followed by methamphetamine (36%). Recent violent behaviour contributed to 37% of the current admissions. A total of 70 patients (13%) tested positive for human immunodeficiency virus (HIV), and 49 (9%) tested positive for syphilis.Conclusion: Substance use and a history of violence contributed to admissions in this population.

The clinical and demographic profile of women living with HIV admitted to the acute unit at Stikland Psychiatric Hospital

“…40 Franken et al found a similar unemployment rate of 89% amongst female patients admitted to another acute psychiatric unit in the Western Cape. 34 Only 3 of our 55 patients (5.5%) had a history of interpersonal violence documented in their folders, which is low given that it has been reported that one in three South African women experience physical interpersonal violence at some point in their current relationship. 41 Most of the female patients in this study were involuntary patients under the Mental Health Care Act and may have felt too anxious or vulnerable to disclose their history.…”

“…40 Franken et al found a similar unemployment rate of 89% amongst female patients admitted to another acute psychiatric unit in the Western Cape. 34 …”

“… 46 Franken et al also found a relatively high prevalence of syphilis (12.5%) amongst female patients with acute mental illnesses. 34 Patients with severe mental illness are known to engage in high-risk behaviours that put them at risk for contracting sexually transmitted diseases like syphilis. 8 Syphilis and HIV are known to increase the acquisition and affect the clinical course of one another.…”

“…5,6,7 A recent study conducted at Lentegeur Hospital in the Western Cape reported that 28% of female acute psychiatric inpatients were living with HIV. 34 One possible explanation for the difference between Stikland and Lentegeur could be that the area (Khayelitsha) that was reported to have the most HIV-related deaths in the Cape Metro region is covered by Lentegeur. 35 The mean age of the cohort was 30.7 years, which is slightly higher than the median age of 27.6 years for women in South Africa.…”

An assessment of voting knowledge and related decisions amongst hospitalised mental healthcare users in South Africa

“…This pattern of education is not consistent with previous research in hospitalised MHCUs in South Africa, where it was noted that 63% of acute male admissions in Lentegeur Psychiatric Hospital in the Western Cape Province were educated to a secondary level. 16 When controlling for differences in level of education, there was no significant association with MCAT-V scores and group (MHCU vs. controls), suggesting that education level influenced total scores on the MCAT-V rather than membership of the group (MHCU vs. control). No previous associations have been reported between CAT-V scores and level of education.…”