Attention deficit/hyperactivity disorder (ADHD) frequently co-occurs with language disorders including reading disabilities (RD) and language impairment (LI). Results from recent genetic studies have implicated Cadherin 13 (CDH13) and Contactin Associated Protein-like 2 (CNTNAP2) as ADHD and LI candidate genes, respectively. Studies have also indicated genomic regions of overlap between ADHD and reading disability (RD), suggesting a shared genetic etiology for both disorders. In the present study, we conducted a family based association analysis to investigate whether CDH13 and CNTNAP2 genes are associated with ADHD, RD and language ability in ADHD and RD samples. Although we found several trends for associations between CDH13, CNTNAP2 and ADHD and language measures, none would remain significant following corrections for multiple tests. However, the study represents the first time CDH13 and CNTNAP2 have been studied for a relationship with language in ADHD/RD samples. Further studies employing larger sample sizes are necessary to confirm our findings.

It has been suggested that a unique feature of some mental health nurses' work is exposure through their role as therapists to clients' descriptions of, and reactions to, trauma, and that these experiences may actually indirectly cause distress and traumatization to the nurse. This proposed phenomenon has been termed "secondary traumatic stress" and is the focus of the current study. Aim: The aim of this study was to explore secondary traumatic stress experienced by nurses working in mental health services in Rwanda. Methods: The research was conducted in Ndera Psychiatric Hospital. The questionnaire consisted of items of the Trauma Attachment Belief Scale (T ABS), demographic characteristics of participants, personal trauma history, work related aspects and support systems. A convenient sampling of 50 nurses who provide a mental health care to trauma survivors and mentally ill patients in the Ndera Psychiatric Hospital was adopted. Results: Results of the study indicate that there is belief disruption in the respondents. The mean scores of most of the respondents were high in all areas of cognitive believe. Of the respondents, 98% (n=49) had T -score of 80 for other-safety which was extremely high. The nurses identified the psychiatric nurses and a psychiatrist as their main support systems in dealing with secondary traumatic stress and generally believed in the usefulness of supervision. Conclusion: In summary, this study expanded on knowledge into the effects of secondary traumatization, particularly with concern to mental health clinicians, a population often ignored. This study was considered to be a contribution to trauma literature as it provides much needed empirical evidence. / Thesis (M.Cur.)-University of KwaZulu-Natal, Durban, 2008.

The purpose of this qualitative study was to explore how psychiatric nurses working with psychiatric clients in the EThekwini District understand the spiritual dimension of holistic psychiatric nursing practice. Descriptive phenomenology informed the study design, data collection and analysis. Integrating spiritual and psychiatric care is an important contemporary issue for psychiatric nursing if the profession is to continue to define itself as a holistic and client-centered activity and to provide socially responsive care (Greasley et al 2001; Mohr, 2006). Local data about how nurses understand and practice spirituality in their working encounters with clients would be an important first step in enhancing holistic, patient-centered psychiatric nursing care in the South African context. Purposeful sampling was used to select the seven psychiatric nurses working in psychiatric settings in the EThekwini District. These participants were selected from the advanced psychiatric nursing classes of the School of Nursing of the University of KwaZulu-Natal for 2008/2009 and 2009/2010. Data were collected through in-depth interviews lasting for 45minutes to lhour and were audio-taped and later transcribed to facilitate easy analysis. The Colaizzi Method of data analysis and representation was utilized. The following four themes emerged during the analysis of the data. Each theme had between three and twenty one associated significant statements. Theme 1 revolved around the higher power of spirituality, religion and their relationship. The participants conceptualized spirituality in a variety of ways, linking spirituality to religion and to cultural values, daily moral and interpersonal experiences with self and others that provide direction and meaning in life. Spirituality was conceived of as "the glue that brings people together" and as a primary source of meaning making in daily life that provides people, nurses and patients with a sense of belonging and of joy, hope, and comfort in both difficult and happy times. The second theme "Central to but forgotten in psychiatric nursing practice" concurs with the literature view that spirituality and psychiatric nursing care are related, although spirituality is often forgotten in psychiatric nursing practice. Participants linked spirituality specifically to Maslow's Hierarchy of needs. The third theme entitled "Psychiatric nursing for the spirit: Enabling and limiting factors identifies a number of factors which influence how psychiatric nurses engage with this dimension of holistic psychiatric nursing practice. This theme focuses on factors which influence psychiatric nurses in providing spiritual care for their patients. Enabling factors include psychiatric' nurses own spiritual orientation and knowledge about spiritual care enables them to provide spiritual care whereas limiting factors include the lack of spiritual education and spiritual knowledge in providing this care. The final theme highlights what these nurses see as important for developing their ability to provide spiritual assistance and includes education in method of spiritual assessment and intervention as the basis for providing holistic psychiatric nursing practice. A number of recommendations for psychiatric nursing practice, education, research and policy-making based on the data from the study were made to relevant stakeholders. If accepted and implemented will go a long way in augmenting psychiatric nursing intervention to be holistic wherein psychiatric nursing care will include not only the biological, psychological and social care but also the spiritual care. / Thesis (MN)-University of KwaZulu-Natal, Durban, 2010.

Attention deficit/hyperactivity disorder (ADHD) frequently co-occurs with language disorders including reading disabilities (RD) and language impairment (LI). Results from recent genetic studies have implicated Cadherin 13 (CDH13) and Contactin Associated Protein-like 2 (CNTNAP2) as ADHD and LI candidate genes, respectively. Studies have also indicated genomic regions of overlap between ADHD and reading disability (RD), suggesting a shared genetic etiology for both disorders. In the present study, we conducted a family based association analysis to investigate whether CDH13 and CNTNAP2 genes are associated with ADHD, RD and language ability in ADHD and RD samples. Although we found several trends for associations between CDH13, CNTNAP2 and ADHD and language measures, none would remain significant following corrections for multiple tests. However, the study represents the first time CDH13 and CNTNAP2 have been studied for a relationship with language in ADHD/RD samples. Further studies employing larger sample sizes are necessary to confirm our findings.

Attention deficit/hyperactivity disorder (ADHD) frequently co-occurs with language disorders including reading disabilities (RD) and language impairment (LI). Results from recent genetic studies have implicated Cadherin 13 (CDH13) and Contactin Associated Protein-like 2 (CNTNAP2) as ADHD and LI candidate genes, respectively. Studies have also indicated genomic regions of overlap between ADHD and reading disability (RD), suggesting a shared genetic etiology for both disorders. In the present study, we conducted a family based association analysis to investigate whether CDH13 and CNTNAP2 genes are associated with ADHD, RD and language ability in ADHD and RD samples. Although we found several trends for associations between CDH13, CNTNAP2 and ADHD and language measures, none would remain significant following corrections for multiple tests. However, the study represents the first time CDH13 and CNTNAP2 have been studied for a relationship with language in ADHD/RD samples. Further studies employing larger sample sizes are necessary to confirm our findings.

This thesis explores the experiences of a group of women in Aotearoa/New Zealand who have been diagnosed with a psychiatric illness, with the aim of gaining some understanding about how they negotiate issues around diagnosis, recovery and resilience-development and employment. A qualitative methodology was used to encourage the women to relate their vocational and life experiences. Fifteen women, whose ages ranged from 17 to their late 60s, with a range of psychiatric diagnoses, were interviewed across ten months. One woman identified as having Māori ancestry and several identified as lesbian. Each interview, which was semi-structured, was transcribed and then verified by the women, and all data were analysed using thematic content analysis and symbolic interactionist and discourse/narrative analyses. Salient issues provided a focus for later interviews and generated theory. The thesis is organised according to major themes that were generated from the data: ‘Getting unwell and getting help,’ ‘Getting well’ and ‘Getting back to work.’ Within these broad themes, key ideas emerged around the women’s views on the difference between ‘madness’ and ‘mental illness’, the biological basis for mental distress, the impact of labelling, the importance of having a ‘literacy’ around psychiatric illness that helps foster agency, the importance of workplace accommodations and mentors in vocational settings, and the process of renegotiating vocational identity when one has a psychiatric illness. Data analysis revealed how participants make ‘sense’ of their psychiatric ill health and recovery/resilience-development experiences, create a vocational self-concept and view themselves as social beings in the current socio-political and cultural context of being New Zealanders. The women’s narratives exhibited negligible explicit gender role identification and the present research uncovered very little explicit data relevant to lesbian and bisexual women’s lives, apart from data on sexual identity disclosure. Rather the women spoke as members of a group that accepted Western diagnoses and used various strategies to reclaim what had been lost and grow new social and vocational roles. The thesis, therefore, provides a platform for understanding the experiences of women living with psychiatric illness in Aotearoa/New Zealand. It provides new information on service-users’ views of medical models of psychiatric illness and the efficacy of their alliances with mental health professionals. It also provides evidence of the needs women have for gaining and maintaining employment after diagnosis with psychiatric illness.

The purpose of this study was to examine the relative risk of psychiatric disorders occurring in patients diagnosed with neurological disorders. This study separately computed the relative risk ratios for identified psychiatric disorder (i.e., anxiety, mood disorders, somatization, schizophrenia, alcohol abuse, and antisocial personality disorder) on seven of the more common neurological disorders (i.e., brain tumor, closed head injury, stroke, dementia, multiple sclerosis, cerebral palsy, and Parkinson's disease). The six psychiatric disorders were chosen based on the epidemiological catchment area (ECA) research (Robins & Reigier 1991) and provided the control group of psychiatric disorders in the general population by which comparisons were made to the neurological care setting. The neurological disorders were included based on the frequency of referrals to a neuropsychological practice. Further, this study provided an overall relative risk ratio of psychiatric disorders for all seven neurological disorders considered together.Participants in this study included a sample of 367 consecutive referrals to a neurology practice in the Midwest. All of the 376 subjects were diagnosed with a neurological disorder. Two hundred forty-six of the subjects were diagnosed with a neurological disorder and no psychiatric disorder. One hundred twenty-one of the subjects were diagnosed with both a neurological and a psychiatric disorder. The MMPI2 was used in the assessment and diagnosis of psychiatric disorders. The control group, represented by the ECA study, was composed of 19,640 participants.Relative risk estimates were made using cross products ratio. Significance of the risk ratio was tested using Chi-square Continuity Correction values. Power analysis was conducted using Fisher's Exact Test.The results of the analysis suggested that patients with neurological disorders are more likely to present with psychiatric disorders compared to the general population. The overall relative risk for this study revealed that patients were 1.669 times more likely to have a comorbid psychiatric disorder following the diagnosis of a neurological disorder. Additionally, three individual disorders had relative risk ratios suggesting an increase in psychiatric disorders above the risk in the general population. These three conditions included stroke (RR = 3.038), dementia (RR = 2.762), and multiple sclerosis (RR = 3.617). / Department of Educational Psychology

Introduction: Anxiety and depression are common among patients enrolled in psychiatric outpatient care. Ear Acupuncture is an alternative form of treatment that has been shown to relieve anxiety and depression in previous studies. Aim: To evaluate ear acupuncture as a group treatment for depression and anxiety Method: A psychiatric outpatient clinic has been offering group treatments with ear acupuncture for anxiety and depression for 5 weeks. Participants of the study have answered self-rating scales Montgomery Åsberg Depression Rating Scale, Beck Anxiety Inventory and Sheehan Disability scale before and after the treatment period. Material was collected in the period 2008-2012 and has been analyzed in SPSS. Results: Data from 31 patients were included in the study. The results from the study showed a significant difference, between the measurements before and after treatment, with a reduction of the average values in the three different scales. Summary: From this study, it is difficult to draw any conclusions about the effect of ear acupuncture. More studies in this area is needed to be able to draw any conclusions. Keywords: Acupuncture, anxiety, auricular acupuncture, depression, psychiatric. / Introduktion: Ångest och depression är vanligt förekommande bland patienter inskrivna i psykiatrisk öppenvård. Öronakupunktur är en alternativ behandlingsform som visat sig lindra ångest och depression enligt flera tidigare utförda studier. Syfte: Utvärdering av öronakupunktur som gruppbehandling vid ångest och depression Metod: En psykiatrisk öppenvårdsmottagning har erbjudit gruppbehandlingar med öronakupunktur mot ångest och depression under 5 veckor. Deltagarna har svarat på självskattningsskalorna Montgomery Åsberg Depression Rating Scale, Beck Anxiety Inventory och Sheehans funktionskala före respektive efter behandlingsperioden. Material är insamlat mellan 2008-2012, vilket har analyserats med hjälp av SPSS. Resultat: Data från 31 patienter inkluderades i studien. Efter behandling visades en signifikant skillnad med en sänkning av medelvärdena i de tre olika skalorna. Slutsats: Utifrån denna studie är det svårt att dra några slutsatser angående öronakupunkturens effekt. Mer studier inom området är önskvärt. Nyckelord: Acupuncture, anxiety, auricular acupuncture, depression, psychiatric.

Mental illnesses are very common. Those who are affected experience significant disadvantages that are evident in terms of poorer health outcomes, higher rates of premature death and enduring disability, socioeconomic disadvantage and poor quality of life. People with mental illness are significant users of health services, having frequent and lengthy hospitalisations and requiring extensive medication therapy. Polypharmacy is common amongst those with psychiatric illnesses, and the drugs that are used are often of low therapeutic index and with considerable potential to cause significant medication-related problems. This thesis explores the prevalence, nature and impact of medication-related problems that affect people with serious psychiatric illnesses, and examines the ways in which specialist pharmacy practitioners can assist with strategies to address these.

Mental illnesses are very common. Those who are affected experience significant disadvantages that are evident in terms of poorer health outcomes, higher rates of premature death and enduring disability, socioeconomic disadvantage and poor quality of life. People with mental illness are significant users of health services, having frequent and lengthy hospitalisations and requiring extensive medication therapy. Polypharmacy is common amongst those with psychiatric illnesses, and the drugs that are used are often of low therapeutic index and with considerable potential to cause significant medication-related problems. This thesis explores the prevalence, nature and impact of medication-related problems that affect people with serious psychiatric illnesses, and examines the ways in which specialist pharmacy practitioners can assist with strategies to address these.