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A cross-sectional descriptive study of clinical features and course of illness in a South African population with bipolar disorderGrobler, Christoffel 06 May 2013 (has links)
There is generally a lack of studies examining prevalence and phenomenology of bipolar disorder in Africa. In literature, a unipolar manic course of illness in particular is reported to be rare. The purpose of this study was to investigate and describe the course of illness and clinical features in a cross-section of patients diagnosed with bipolar disorder attending public hospitals in Limpopo Province, South Africa and to determine the rate of a unipolar manic course in this sample of patients. This was a descriptive, cross-sectional study of patients presenting with a history of mania between October 2009 and April 2010, to three hospitals in Limpopo Province. A purposeful sample of 103 patients was recruited and interviewed using the Affective Disorders Evaluation. This study confirms that a unipolar manic course is indeed much more common than rates suggested in present day literature with57% of the study sample only ever experiencing manic episodes. The study also confirms the debilitating nature of bipolar disorder with more than two-thirds being unemployed in spite of a quarter of the study subjects having a tertiary education. The high rates of attempted suicide, history of violence and history of drug abuse all furthermore points to the devastating effects bipolar disorder has on individuals and their families. Treatment choice appeared to be a combination of a mood-stabilising agent in combination with an anti-psychotic. It was found that two-thirds of study subjects had consulted with faith- or traditional healers. Significant gender differences appeared in that females were more likely to suffer from comorbid anxiety disorders, have a history of sexual trauma, and be HIV positive whilst men were more likely to have a forensic- and substance-abuse history, experience hallucinations and receive clozapine. Patients presenting with a unipolar manic course of illness, as described in this thesis, may contribute to the search for an etiologically homogeneous sub-group which presents unique phenotype for genetic research and the search for genetic markers in mental illness. A unipolar manic course therefore needs to be considered as a specifier in diagnostic systems in order to heighten the awareness of such a course of illness in bipolar disorder, with a view to future research. / Thesis (MD)--University of Pretoria, 2012. / Psychiatry / unrestricted
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'n Maatskaplikewerkondersoek na gesinspatrone wat 'n kind met 'n serebrale gestremdheid en Bipolêre versteuring in optimale funksionering beperk (Afrikaans)Kotze, Susanna Johanna 05 September 2003 (has links)
The purpose of this research was to determine family patterns which limit the optimal functioning of the child in middle childhood with Bipolar Disorder and Cerebral Palsy. To achieve this goal a thorough literature study was performed with regard to the child with Bipolar Disorder and Cerebral Palsy. The nature, causes and state of these two conditions in the family were investigated. Cresswell's combined model of research namely the "dominant-less-dominant" model of investigation was used. The less dominant part of the research was quantitative where the "Hudson scale: Index of Parental Attitudes" was used. This is a standardised questionnaire that aims to measure the attitudes of parents. The qualitative part of the research produced more information regarding the above-mentioned aspects. Unstructured interviews with the family, as well as the multi-disciplinary team currently involved with the family were conducted. The "One shot case study" was used to determine the significance of negative family patterns. This is an in-depth study of a single unit and required that the researcher become part of the family and family activities for a specific period of time. From this specific family, patterns were identified which limit the child with Bipolar Disorder and Cerebral Palsy to optimal functioning. From the results it was clear that significant family patterns exist in this family which limit the child. The research question could therefore be answered and certain themes could be identified. With regard to dimensions of family functioning, significant patterns around affection, behaviour control, value transmission, structure, communication and external systems were identified which limit the child to optimal functioning. Through this the researcher comes to the conclusion that family functioning has a significant influence on the optimal functioning of the child with an affective disorder and disability. With these results in mind, it is important that families are guided in the handling of children with affective disorders and disabilities, so that these children too, can reach optimal functioning. / Thesis (MSD (Play Therapy))--University of Pretoria, 2004. / Social Work and Criminology / unrestricted
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An exploration of ego impairment in Bipolar Mood Disorder using the Ego Impairment Index-2Simpson, Jenny Lee 16 August 2011 (has links)
The study was exploratory in nature, with 62 adult participants participating in this research. The aim of the study was to determine the level of ego impairment, if any, among a group of patients diagnosed with Bipolar Disorder. The data obtained from this sample was subjected to the Rorschach-based Ego Impairment Index-2 (EII-2). An in-depth analysis of the composite variables of this index was performed, allowing a comprehensive grasp of the implications of ego impairment in everyday functioning. The study was conducted in order to ascertain the nature of the psychological dynamics at play amongst this population group. The value of using the EII-2 is seen in its ability to establish various strengths and weaknesses in areas of ego functioning that are a core component of the personality, rather than behavioural manifestations that are sporadic and subject to change. Thus the results will reflect traits that are enduring and fundamental when considering the personality. In addition, the areas of psychological functioning that were determined were linked to the current conceptualisation of Bipolar Disorder, which, at present, is primarily conceived of as a biological disorder. The results of the EII-2 yielded from this sample indicated an overall moderate ego impairment falling within the moderate range, indicating that for this population, an impairment of ego was evident. Particularly, the domains of reality testing, cognitive functioning and object relatedness seemed to be most impaired. / Dissertation (MA)--University of Pretoria, 2010. / Psychology / Unrestricted
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