A survey of the prevalence of diabetes type 2 amongst schizophrenics in a chronic care treatment facility.

OBJECTIVE: The determination of the prevalence of type 2 diabetes in a group of patients suffering from schizophrenia who have been hospitalized in a chronic care facility and to consider the role of factors which may contribute to the increased risk of developing diabetes. METHOD: The hospital files of patients suffering from diabetes type 2 were reviewed and assessments were made in terms of age, gender and body mass index (BMI) duration of stay and co-existing medical conditions. Fasting blood glucose estimations were done on all schizophrenic patients not receiving treatment for diabetes. Medications of patients were recorded. A protocol was prepared and approval to conduct the study was obtained from the hospital authorities. RESULTS: Of 494 schizophrenic patients 19 (3.85%) were found to suffer from diabetes. 68% of patients in the diabetic group were found to be overweight in terms of BMI rating. Only one patient had a medical condition. Proportionately the number of women was relatively high. CONCLUSION: The prevalence if diabetes type 2 in a group of chronically ill hospitalised patients with schizophrenia is significantly lower than in outpatient populations. Residing in a facility long term may serve as a protective factor. The exclusion of psychological stressors such as isolation, poverty and abandonment may account for the finding.

The distinction of malingering and mental illness in black forensic cases.

The ability of twenty items to separate malingering from mental illness is tested. The items were obtained from the literature and clinical experience. The study used an experimental, cross-sectional design which compared fifty malingering African patients and a control group of fifty African State Presidents' Detainees. The chi-square test and the Fisher's exact test were used to assess statistical significance. The effectiveness of these items was assessed by calculating their sensitivity, specificity, false positives and negatives and positive and negative predictive values. Seventeen items showed statistical significance. Eleven items had high positive predictive values mostly above 90% with four items scoring 100%. These diagnosed malingering effectively. Another six items had high negative predictive values mainly above 90%. These diagnosed mental illness directly and excluded malingering effectively. The study proved that seventeen items can scientifically and effectively separate mental illness from malingering.

A study of referrals of black children to a general hospital psychiatric outpatient clinic.

Five hundred and seventy-seven children who attended a child psychiatric out-patient clinic during 1987 were evaluated. Their clinical and demographic characteristics are described and management discussed. High on the list of presenting complaints were poor school performance and behavioural problems. Factors considered as influencing referrals are socio-economic, political, lack of school psychological services and facilities for the management of the intellectually handicapped. The most common diagnoses were mental retardation (39.5%) and epilepsy (16.2%).

Stereotyped movement disorder of rocking.

Despite the relatively common occurrence of rocking behavior in children, the literature contains little information on the diagnosis, management, and treatment of this condition. The authors report a case of body rocking in an 8-year-old girl, for which they discuss possible etiological factors and therapeutic strategy.