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Biomedical subjects

M Dhadphale

Publications and source records attributed to M Dhadphale.

At least 19 recordsLinked to original sources
PubMed1997

A comparison of older longstay psychiatric and learning disability inpatients using the Health of the Nation Outcome Scales.

OBJECTIVE: With increasing longevity, the number of elderly patients with psychiatric or learning disabilities is likely to increase. The degree of overlap of symptoms and needs of these two groups of patients, which may allow for their care within the same service, was examined. DESIGN: Twenty-six longstay, elderly (> 65 years) psychiatric patients resident in psychogeriatric wards of a psychiatric hospital were compared with 23 longstay, elderly patients and 40 longstay patients aged 50-65 years, both resident in the wards of a specialist hospital for learning disabilities. The instrument used was the Health of the Nation Outcome Scales (HoNOS). RESULT: On the HoNOS, the elderly psychiatric patients scored significantly higher for problems with mood, relationships and occupation/activities. There were no significant differences for any of the scales rated between the 50-65 and > 65 years old patients with learning disabilities. CONCLUSION: The similarities between the three groups of patients would suggest that for some patients the same services may be utilized. This could reduce the cost of the care in the community and entail more economical use of the facilities and staff. The HoNOS proved to be a concise and simple instrument, which could become a useful tool in monitoring the outcome of healthcare in longstay patients.

Aged↗
PubMed1991

The pathways to psychiatric care: a cross-cultural study.

This paper describes the referral pathways taken by 1554 patients newly referred to the mental health services in 11 countries, and documents factors associated with delays in referral. The pathways in centres relatively well provided with psychiatric staff were dominated by general practitioners and to a lesser extent hospital doctors: the relatively less well resourced centres showed a variety of pathways with native healers often playing an important part. Delays were remarkably short in all centres regardless of psychiatric resources, but in some centres we found longer delays on pathways involving native healers. Somatic problems were a common presentation in all centres, and in some centres there was a tendency for patients presenting with somatic problems to have longer delays than those with symptoms of depression or anxiety. The implications of these findings are discussed in the context of an ongoing programme of WHO research activities aimed at improving the quality of mental illness care available in community settings.

Adult↗
PubMed1990

Family study of Kenyan children with school refusal.

The problem of school non-attendance is an increasing one in our setting and yet its cause has not been established. This paper presents data of work done through interviews with parents and observations of the home environments of the sample cases in attempt to establish factors associated with school non-attendance. After the initial interviews, the children were seen periodically for follow-ups, usually at two to three monthly intervals for at least one year, by the team which consisted of a consultant psychiatrist, a clinical psychologist, a paediatric registrar and a psychiatric social worker. Out of the ten cases sampled for the study, nine were of school phobia and one of conduct disorder (truancy). Generally, family characteristics significantly associated with school non-attendance in this study were neuroticism in parents, unstable family relationships occasioned by marital discord, parental expectations of high academic performance by the child and, to some extent, poverty. The common management approaches used were family therapy, counselling and anti-depressant pharmacotherapy.

Adolescent↗
PubMed1989

Prevalence and presentation of depressive illness in a primary health care setting in Kenya.

Using a two-stage screening procedure, ICD-9 diagnostic criteria, and the Hamilton Rating Scale for Depression, the authors diagnosed depressive disorders in 81 (9.2%) of 881 patients in a primary care setting in Kenya. All depressed patients had somatic symptoms, and all of the 27 depressed patients assessed with the Hamilton scale scored higher than 2 on the work and activities item. These findings contradict the earlier reports that Africans do not admit to being depressed. Nearly one-third of the depressed patients were moderately or severely ill and would have benefited from psychiatric assessment and treatment.

Ambulatory Care↗
PubMed1987

Treatment compliance among psychiatric outpatients in Kenya.

One hundred psychiatric outpatients discharged from mental hospital in Kenya were studied to estimate the treatment compliance after 3 months. The relatives and patients were interviewed separately to assess treatment adherence; 55 percent of them had defaulted in their treatment. Various factors were responsible for failure of compliance which included amongst many: unavailability of drugs which appears to be a common factor in Third World countries. Suggestions for better compliance included easily available injectable depot preparations or simple generic psychotropic drugs.

Adolescent↗
PubMed1987

Prevalence of khat chewers among primary health clinic attenders in Kenya.

In a rural district hospital in Kenya, the authors screened 100 randomly selected outpatients for khat (miraa) chewing. A surprisingly high number of them admitted chewing khat leaves. The implications of this finding and the controversy about whether or not khat is a harmful drug are discussed.

Adolescent↗
PubMed1986

Severe self-mutilation among Kenyan psychotics.

Four case reports are presented of psychotic patients seen in clinical practice in Nairobi over a period of one year, who inflicted serious bodily harm to themselves during that period. Possible psychopathological basis for this self-damage is briefly considered. A review of the literature reveals paucity of similar reports from Africa and the third world. Reasons for this paucity are hard to come by.

Adolescent↗
PubMed1985

Family hysteria in a Kenyan setting.

A case study of hysterical fits affecting five children in the same family in rural Kenya is presented. The only girl in the study was the last to succumb, probably reflecting her modeling upon her mother. The psychopathology of the family is discussed. Conjoint family therapy led to rapid and dramatic recovery.

Adolescent↗