Contextualizing migration and mental health in the post-COVID era

Background: The population of migrants all over the world is progressively rising. The major reasons for migration include the desire for self-actualization, moving to a place with more opportunities, tourism, and education, and escaping hardship and political unrest in the home country. In recent times climate change, insecurity, and economic hardship are top of the list. The global economy has suffered a major blow from the multiple waves of the lingering COVID-19 pandemic. To lessen the scourge of inflation and to restore economic stability, several countries are being forced to liberalize their immigration policies and therefore immigrants are welcomed in these nations. This review attempts to investigate how migration in the post-pandemic era affects migrants' mental health. Main Text: Migration and the COVID-19 epidemic both have beneficial and durable effects on the mental health of migrants and immigration laws have a direct impact on several health-related issues. Mental health disorders may develop at any point from the pre-migration phase to the post-migration settlement in the host nations. Factors such as host community, racism, marginalization, political climate, poor support, loss of social status, language barriers, undocumented status, climate change, mode of dressing in the host country, and several others may lead to mental health disorders among migrants. Unfortunately, there is limited access to care, and the services provided may not be culturally sensitive. Conclusion: Despite the benefits gotten from migration like financial benefits and economic development of the native country and the left behind family members, migration has enormous psychological complications which have to be attended to. Access to specialists who are trained to provide culturally sensitive interventions and implement outreach programs to introduce the services to the migrants' community should be encouraged.

Deuil et infection à COVID-19 : à propos d'un cas dans un centre de crise de Yaoundé

Le personnel soignant en première ligne dans la riposte contre l'infection à COVID-19 et les familles des défunts au COVID-19 vivent pour certains des troubles anxieux, des burn-outs et des troubles dépressifs caractérisés, suite à la perte soit d'un patient soit un proche. Ces troubles sont relevés dans la littérature mondiale. Le sujet africain vit dans un environnement culturel plus communautaire qu'individualiste. Il peut donc souffrir davantage lorsqu'il est privé de ses commémorations culturelles au cours de la mise en terre des morts, dans un contexte de mesures barrières physiques et communautaires des gouvernements. Notre cas clinique se propose de montrer une autre affection « psychiatrique » étiquetée de deuil pathologique, qui pourrait se développer dans notre continent, contrairement à d'autres dans les mois avenir. Nous montrerons ainsi l'intérêt de l'accompagnement psychologique à long terme dans les centres de crise

Anxiety disorders: Psychiatric comorbidities and psychosocial stressors among adult outpatients

Background: Anxiety disorders are the most prevalent class of lifetime mental disorders according to South African research. However, little is known about the prevalence of factors that might complicate treatment among adults in a psychiatric outpatient setting. Aim: To explore the psychiatric comorbidities and psychosocial stressors among a population of adults treated for anxiety disorders at the outpatient unit of a tertiary psychiatric facility in Bloemfontein. Methods: In this retrospective cross-sectional study, clinical files of all mental healthcare users receiving treatment were reviewed to identify those with a current or previous diagnosis of one or more of the following anxiety disorders: generalised anxiety disorder (GAD), panic disorder, social anxiety disorder (SAD) and agoraphobia. Results: Of the 650 available records, 103 (15.8%) included at least one anxiety disorder. Of those, 65.1% had GAD, 34.0% had panic disorder and 29.1% had SAD. Agoraphobia was diagnosed in 14.6% of patients almost exclusively as comorbid with panic disorder. Additional psychiatric disorders were present for 98.1% of patients and 36.9% had multiple anxiety disorders. The patients had a history of relational problems (64.1%), educational and occupational stressors (55.3%), abuse and neglect (28.2%), other problems related to the social environment (24.3%) and self-harm (23.3%). Conclusion: Clinical practice should take the high rates of comorbidity into account and the importance of integrated substance-related interventions in mental healthcare settings is clear. Diagnostic practices regarding agoraphobia without panic, and the comorbidity of anxiety and personality disorders should receive further attention. Clinicians should be aware of the potential impact of the frequently reported psychosocial stressors

Early-onset psychosis in an adolescent with DiGeorge syndrome: a case report

DiGeorge syndrome (DGS) was first described in 1829 by Dr Angelo DiGeorge. DGS is a cluster of symptoms because of a defect in the development of the pharyngeal pouch. Evidence from cytogenetic studies has linked the pathogenesis of DGS with a deletion of a gene located in chromosome 22-band 22q11. In most affected individuals, the deletion is de novo; however, inheritance has been reported in 10% ­ 25% of patients. DGS commonly presents with a classical triad of conotruncal cardiac anomalies, hypoplastic thymus and hypocalcaemia. DGS may be of focus to a psychiatrist as it is associated with cognitive deficits, high rates of schizophrenia and anxiety disorders. Patients may also present to mental health care workers with learning disabilities, developmental delay and behavioural disorders such as attention-deficit or hyperactivity disorder. Mental health workers therefore play an invaluable role in the diagnosis and timely treatment of the disorder. In a resource-limited area such as Botswana, with scarce mental health professionals, paediatricians and neurologists, DGS may be frequently misdiagnosed with consequent inappropriate interventions that may increase morbidity. Herein, we present a case to raise awareness and demonstrate one of the varied ways the syndrome may present. Themultifaceted nature of DGS presentation underscores the need for a multidisciplinary approach to treatment

Childhood trauma in adults with social anxiety disorder and panic disorder: a cross-national study

Objectives: The influence of childhood trauma as a specific environmental factor on the development of adult psychopathology is far from being elucidated. As part of a collaborative project between research groups from South Africa (SA) and Sweden focusing on genetic and environmental factors contributing to anxiety disorders; this study specifically investigated rates of childhood trauma in South African and Swedish patients respectively; and whether; in the sample as a whole; different traumatic experiences in childhood are predictive of social anxiety (SAD) or panic disorder (PD) in adulthood. Method: Participants with SAD or PD (85 from SA; 135 from Sweden) completed the Childhood Trauma Questionnaire (CTQ). Logistic regression was performed with data from the two countries separately; and from the sample as a whole; with primary diagnoses as dependent variables; gender; age; and country as covariates; and the CTQ subscale totals as independent variables. The study also investigated the internal consistency (Cronbach alpha) of the CTQ subscales. Results: SA patients showed higher levels of childhood trauma than Swedish patients. When data from both countries were combined; SAD patients reported higher rates of childhood emotional abuse compared to those with PD. Moreover; emotional abuse in childhood was found to play a predictive role in SAD/PD in adulthood in the Swedish and the combined samples; and the same trend was found in the SA sample. The psychometric qualities of the CTQ subscales were adequate; with the exception of the physical neglect subscale. Conclusion: Our findings suggest that anxiety disorder patients may differ across countries in terms of childhood trauma. Certain forms of childhood abuse may contribute specific vulnerability to different types of psychopathology. Longitudinal studies should focus on the potential sequential development of SAD/PD among individuals with childhood emotional abuse

Post traumatic stress disorder: undiagnosed cases in a tertiary inpatient setting

Objective : Post traumatic stress disorder (PTSD) is a common; debilitating anxiety disorder characterized by emotional and physical symptoms that may occur after exposure to a severely traumatic event. Since it occurs commonly as a comorbid diagnosis with other mood- and anxiety disorders; we postulated that this disorder may be under-diagnosed in therapeutic wards where anxiety and mood disorders are treated. The study thus sought to determine the prevalence of undiagnosed PTSD in an inpatient population; and to compare the demographic details and comorbid diagnoses of subjects with and without PTSD. Method : The Clinician-administered PTSD Scale for DSM-IV (CAPS) was administered to 40 subjects who were inpatients in a therapeutic ward of a large psychiatric hospital and who had never had a diagnosis of PTSD before. Results :16 (40) subjects met the DSM-IV criteria for PTSD. We did not find significant clinical differentiating factors between subjects with and without PTSD; however subjects with PTSD were more likely to use cannabis. Conclusions : PTSD remains undiagnosed in many patients admitted to therapeutic units

Les urgences psychiatriques au Mali. Etude epidemio-clinique dans le Service de Psychiatrie de l'hopital du Point-G a Bamako

Cette etude longitudinale ayant ete conduit sur 7 mois; allant du 01/09/2004 au 31/03/2005 dans le service de psychiatrie de l'hopital du Point G. L'objectif general etait d'etudier les urgences psychiatriques. Le sexe ratio etait de 2;92 en faveur des hommes 35;6des patients se situaient entre 25-34 ans. L'agressivite (28;2) et l'agitation (12;8) etaient les motifs de prise en charge les plus evoques. Les moments feconds de schizophrenie (30;2); la Bouffee delirante (17;4) ; la depression (09;4) et confusion mentale (8;7) etaient les pathologies les plus frequentes. Plus de la moitie de nos patients (51;7);sont arrives aux heures de garde

Obsessive compulsive disorder: report of six cases

Obsessive compulsive disorder (OCD) refers to interlping and interative thoughts; ideas; images; fantasies; impulses and actions accompanied by feelings of distress and declarations of resistance. It is assumed that OCD is rare among black Africans. This paper reports six cases from Uganda. The report indicates that OCD exists among black Africans and that those affected experience considerable amounts of emotional; social and occupational distress. It is suggested that OCD should be taught adequately to medical students to enable future general -duty medical officers to recognise and manage it appropriately. The names that appear in the text are pseudonyms