Abstract
BackgroundThe 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.AimTo describe patients admitted to the acute adult admissions unit at Lentegeur Hospital.SettingLentegeur Psychiatric Hospital is situated in Mitchells Plain, Cape Town, and serves about 1 million people from nearby urban and rural areas.MethodsThis 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.ResultsThe 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.ConclusionSubstance use and a history of violence contributed to admissions in this population.
Highlights
The Western Cape province has the highest documented lifetime prevalence of common mental disorders in South Africa.[1]
A study conducted at Stikland Psychiatric Hospital, located in Cape Town, suggested that patients with a comorbid substance-use disorder, especially those using cannabis and methamphetamine, were significantly more likely to have violence contributing to their admission.[5]
Psychosis was the predominant symptom on referral, with more than 90% of cases presenting with psychotic symptoms
Summary
The Western Cape province has the highest documented lifetime prevalence of common mental disorders in South Africa.[1] Lentegeur Psychiatric Hospital (LGH) is the largest of four specialist mental health hospitals in the Western Cape and serves a population of approximately 1 million people.[2] The catchment area of the hospital includes two urban townships, Mitchells Plain and Khayelitsha; both of which are characterised by high levels of crime and substance use, and poor socio-economic status.[3,4] Recent data confirm that Mitchells Plain and Khayelitsha have one of the highest rates of contact crimes in the province (SAPS).[5]. Methamphetamines (35%) and cannabis (22%) are the most commonly abused substances in the Western Cape.[6] A study conducted at Stikland Psychiatric Hospital, located in Cape Town, suggested that patients with a comorbid substance-use disorder, especially those using cannabis and methamphetamine, were significantly more likely to have violence contributing to their admission.[5] This previous study showed that violence and substance abuse were associated with poorer patient outcomes. Equitable and effective distribution of current resources, there is a need to determine the profile of patients requiring psychiatric admission
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